Nutritional Homework!

So, I kind of had the mentality to read back through some of the paperwork from my nutritional information sessions, and re-setup my account on My Fitness Pal.  It's incredibly helpful, if you haven't already been to it or used it. The only thing I can't figure out at the moment is if there is a way to just set the numbers yourself, instead of them being generated from the information you enter. The reason I bring it up is that there are certain numbers I'm looking to "hit" now, pre-surgery, and afterward. So here's a quick breakdown:

• Protein - 70-90 grams
• Carbohydrates - < 200 grams
• Fats - < 60 grams
• Vitamins & Minerals - oodles & oodles
• Water - 8 cups/64 oz.

So, I am hoping to track that. I *believe* I'm supposed to shoot for 1500 calories total? But I can't remember exactly, and it will take considerably more rifling through my binder of info. Anyway, I am needing to settle myself into that, post haste. I am already taking a good amount of vitamins and supplements - a regular multivitamin, a calcium supplement and a fiber supplement. I've also picked up a biotin supplement, but I'm going to start taking that a bit closer to "go time". Supposedly it's pretty common to have hair loss as a side effect, though most likely months after surgery... Most likely just protein deficiency, but many people on the gastricsleeve.com forums say that even with the requisite daily intake, they still had hair loss. So! Just another supplement to pop in there.

Anyhoo, time to start buckling down while I'm waiting for all this cardiology stuff to sort itself out, and deal with the weight gain from the IUD insertion.

Continued frustrations!!! Plus some more intimate details..

So, I haven't been able to get ahold of my primary care physician's office to get the referral I need to go to the cardiologist for that final clearance. Still. Their phones have been out since Wednesday (if not earlier). I called the main hospital they are affiliated with, and then was transferred to a general referral line, so hopefully that will work? If not, I've asked Dave to go out and shake 'em down. Since I am at work during their business hours, and can't give them what for myself. I'm hoping they won't give him grief whenever I finally reach the point where it's time to "release the hounds," since I'm 99% sure he's my emergency contact, but from HIPAA laws they might not consider that enough. Meh. And it's not like they can call me to say "is this ok to give to him?" ....ARGH.

On another note, Dave and I have been having some difficulties in the bedroom lately, and though I thought they were not my fault at first, their persistence is really giving me cause for concern. Is it something I've done? The way I look? For awhile (xyz months ago), we would be getting down to it, and I would suddenly have a realization that I was horrified and disgusted by the way I looked (seeing myself from a omniscient perspective). Naturally, I would go cold and often start crying, and just "turn off." I haven't been feeling that way lately, but I'm really starting to get concerned that there's something wrong with me. It's even more bothersome because Dave and I haven't had much time together lately to talk about it, since we've both been working opposite hours. So in the meantime, I am just trying to not think about it, and not connect it to my size.

A week hiatus, for what?

So, I haven't posted in about a week because...nothing's happened, other than more frustrations. After I made the appointment for the cardiologist, I immediately called my primary care doctor to get the referral I needed. Well, surprise, don't have anything yet and haven't heard from their office whatsoever, even though I emphasized that I wanted a call back whether I needed to pick it up or have it mailed or anything. Even to confirm the details and verify that I still wanted it.

Well, yesterday my doctor's office was having phone problems, so I had no way to find out about my referral. I called a second time and was transferred (magically?) to a woman who said that the phones weren't working in the office, and that I should call back tomorrow (aka, today). Called back today...phones still not working. Seriously, isn't that..um..unacceptable?! I mean, my thing isn't an emergency situation (i.e. life and death), but still - there must be people who are having urgent issues. For example, what if you needed a refill on a prescription that you were about to run out of, and the pharmacy you use didn't have it? Then what? Tough noogies is what. >:(

Anyway, cancelled and rescheduled cardiologist for two weeks from now more or less.

In other news, I made an appointment to start seeing a therapist again next week. I am hoping I will not be going every single week, which is what I was doing before. It's just too much of a regular hassle for me.. I have been having a good amount of emotional difficulties lately, possibly a side effect of "renewing" my Mirena approximately a month ago, but who knows. We adjusted my medications when I went to the psychiatrist, so I think that's helping me be less manic than I was starting to be. But I am definitely depressed, and my social anxiety keeps rising and rising. I definitely could do without that, and with money being excruciatingly tight, I've been kind of using it as an excuse to not involve myself with other people.

On a more positive note, I have officially been donut-free for a month! Not sweets/cookies, but at least not a single donut. And that is a serious accomplishment for me. So, that's a bit of yay.

Crafty?

Just curious - how much should I be posting crafty stuff? I will probably post a good deal more with recuperationy time, but in the meantime, should I be posting anything?

So, more information about several things...

First, let me give an update on the financial frustration from my last post. I am not able to make use of the sick bank whatsoever - they won't even give me an application. They will not even give me a piece of paper to try and plead my case. No no, you pay us oodles of money all year long and never use us for anything, but when you want something, you can kindly bugger off.

*twitch*

Needless to say that got me really hot under the collar. So now I'm doing an "extended sick leave request" - which is calculated (and approved?) based on the average sick leave you had available for the past 3 years as of 12/31. So, in short, I probably will get 1 day, if I'm lucky. I'm going to need probably a minimum of 10 days, and probably more like 15 days, of leave time... I will be lucky if I can even get a 7 I think. I am looking into applying for FMLA (Family & Medical Leave Act) to cover the extended time off, and further appointments/weakness/complications (god forbid), so we'll see how that goes. Unfortunately, FMLA does not equal pay - you still have to use your leave time. Also, if I am "out-of-pay" for a whole pay period, I have to pay for my whole health insurance myself. (Lovely!!!)

Ok, second thing. I had my second EKG on April 1st, after my primary care doctor refused to do one at her office and do just a side-by-side comparison. Then their office never sent it to my surgeon's office, so I had to get the copy I finegled and fax it over, which I did on either this past Monday or Tuesday. I was/am eager to get this part squared away so I can schedule my next appointment with my surgeon, so we can keep on truckin'.

So I heard back from the nurse finally, after she had had a chance to review the EKG paperwork. A good EKG isn't enough - I still need to get cardiac clearance. Know what that means? Another doctor's appointment! (Hooray.....) So I am scheduled to go to the cardiologist for a full appointment next week. Nevermind that a cardiologist signed off on my EKG. :T

In other news, I have been cutting back very well on my soda and caffeine, but I have been CRAVING sweets (mainly chocolate) like you would not believe. It's so difficult. :'( Just eating the Viactiv chocolate chews at night isn't cutting it. Soooo, I don't know if the cravings are escalating because of the no soda and/or caffeine? Or what. Also have been getting some significant caffeine withdrawal headaches, so that sucks too. But, meh - that too will pass.

Frustration!

So, I just called my union to discuss taking advantage of their sick leave bank donation.

Sick leave bank: if you are a member of my union, you may elect to donate some of your sick leave time to the "sick bank", where other employees in the union can request it for time off when they have run out of leave time. When "open enrollment" for that was taking place, I circled "no" - I never have any time to donate, so how would I even be able to participate? (One of the stipulations is that you have to donate a day in order to participate.) I never have any sick leave time because I am always going to doctor's appointments! Aren't these kind of people the ones who need it most?

Anyway.

I just got off the phone with the union. Because I did not select to enroll, I can't take advantage of it. I asked if I could appeal, and I was redirected to leave a voicemail with a supervisor (I guess). I know there is an application and a review panel that goes over it, but I don't even know if I will be eligible to even fill out the damn application.

This complicates matters extremely. While I think I have a good reason for requesting it, and needing it, I don't know if they will see it that way. The donation of sick time has always been very confusing. I did not know that you can participate if you can't donate - I thought that was one of the stipulations. And maybe I'm wrong? Maybe you can't participate. I tried to relay my confusion in the message as well....

If I cannot make use of the sick bank, then I will not be able to do my surgery, unless I win the lottery. I will have to postpone it indefinitely... It will take me over a year to accrue that much leave time, and that's with combining all types I get (sick, vacation, personal). In that year, I could lose a lot of weight, with a 50/50 chance of actually keeping it off. In that time, my BMI would drop and I would not be eligible for the surgery anyway.

ARGH.

I do not have enough money (or any money) saved up to pay for all my bills for the 3-4 week recuperation period after the surgery. Bills for rent, utilities, cell phone, internet, credit cards, student loans, insurance, credit monitoring, medications, doctor appointments, food, gas, etc........... It's a long ass laundry list for someone who can barely keep afloat as it is. And to have to pay all that, and no salary? It's not possible.

So, I don't know what I'm going to do. Hopefully I will hear back from this union rep on Monday, and see what my options are from there.

Post-Appointment

So, I had my third appointment today. So far these are the appointments I've had, though some are more loosely termed as appointments...

1. Information Session
2. Appointment with Financials, Surgeon, and the Dietitian
3. Appointment with Dietitian (group appointment setting, with one other person)
4. Appointment with Dietitian (w/Dave)

My next appointment will be with the Surgeon, in a month's time, whereupon we will start submitting everything to the insurance company for authorization.

The appointment today (technically #4, if you count the info session as an appt) went well - more info on specifically the diet in the days preceding the surgery, then what I can and can't eat in the weeks/months following the surgery. There's a specific days, weeks, months, etc. breakdown. Most importantly, I can drink caffeine sooner than I thought. But still no carbonation for 6 months.... and pretty much no starches (breads, rice, pasta, etc.). Thankfully, Dave was there to absorb the information directly... so hopefully that will help him to realize what page I'm on, and get him more and more involved. Also, he will probably be going to all the upcoming appointments as well.

That's all for now - possibly more later.

Pre-Appointment Anxiety

I have an appointment in an hour, and I am feeling incredibly anxious, to the point of almost having a panic attack (and I will be taking some Ativan shortly). This is, in theory, the last appointment before my surgery will be scheduled. I will give updates after, but I am just...terrified. Dave is meeting me there, which I wasn't originally planning on, but changed my mind yesterday when the anxiety really started to kick in.

I think I'm meeting with the dietitian and others today, but it may just be her... We'll see. I'll keep you posted! (By the way, this is my 3rd appointment, and I am on the 3-month track.)

Fat Foot (aka early lymphedema)

So, one of the problems that is sorta linked to obesity (but really just exacerbated by it) is my fat foot. My right foot is constantly swollen - specifically on the top of my foot and my toes. After going to my primary care physician, then a podiatrist, then a pulmonary specialist/surgeon...the result was you probably have early lymphedema, but we're not actually going to test for it because the test is very painful, and the course of treatment would be the same.

1. Lymphedema is a fluid retention caused by poor circulation. (I'm not doctor, but this is what I gather from what I've been told and/or the internet.)

2. The test for lymphedema is sticking needles between the webbing of each of your toes.

3. The course of treatment is to wear compression stockings, and/or lose weight. Weight loss will ameliorate the symptoms.

So, in addition to all of this, when visiting the podiatrist to try and figure this crap out, it was discovered that I have arthritis in one toe. Yep, that's right. The second toe on my right foot...my fat foot. Because of this, and the pressure of the swelling, walking for long periods of time, or being on my feet all day, can hurt a lot faster than if I was sedentary. Not really conducive to losing weight. (It hampers it, but doesn't eliminate it - there are always ways to work around that.) Some of the swelling in that toe specifically (it looks the worst of all of those little piggies) is related to the arthritis.... But unfortunately the rest of my foot can't truly be affected by that.

In addition, I've had this for 7 years now.

Even with losing weight and gaining weight and losing weight (sound familiar?), there has been no significant reduction in its obnoxiousness. For the most part it is just unsightly - one puffy foot sticking out of a heel, the other fine and dandy. But, like I said, it can be uncomfortable and painful with some regularity.

The reason I bring this up is that it's one of the things that I hope will get better with the surgery. And it's on my mind because it's hurting right now, lol~

My other chief obesity-related complaint is asthma, but that's for another day and another post, which will most likely be twice as long.

First juicing and smoothie!

This past weekend, I did my first run with making a smoothie and juicer. (I've probably made smoothies before, but not in a healthful way.)

My smoothie was this:

• 1 cup strawberries
• 1 cup raspberries
• 1/2 cup pineapple juice
• 1 cup low-fat natural yogurt (I used vanilla)
• 3-5 ice cubes

(recipe courtesy of Juicer Recipes Pro: http://juicerrecipespro.com/smoothies/low-fat-smoothie-recipes.html)

My juice was this:

• 1/2 large pineapple, peeled, cored, and cut into cubes
• 1 cup strawberries
• 1 pear
• 30 mint leaves

(recipe courtesy of Williams-Sonoma: http://blog.williams-sonoma.com/30-days-of-juicing/)

Dave made the smoothie, and I made the juice. We only ended up making one substitution - instead of fresh raspberries, we used frozen. Neither are cheap, but I already had frozen raspberries.

While I would like to juice a meal every day, I need to do it the night before. Making the juice with the pineapple, while delicious and filling, was very time consuming. (Mainly because of cutting up the pineapple.) So I definitely wasn't going to be doing it this morning, when I barely was able to drag myself out of bed.

That being said, Dave is very supportive in more ways than one: he was willing to test out a slightly weirder smoothie, made with peanut butter and strawberries (to resemble a PB&J). He is willing to clean all the parts of everything. I think he was surprised with how filling both the smoothie and the juice were - as am I - so much so that it was easy to see how that could fill a whole meal. Hopefully this optimistic attitude will stay with me through the juicing as I start to go greener with kale, spinach, etc.

Gastricsleeve.com Blogs

I haven't really done much posting yet on gastricsleeve.com, but I hope to start doing so. I have mostly been reading and been inspired that way. But here's a blog post I stumbled across that I thought was really meaningful - that discusses the significant other's role and part to play in this journey.

http://www.gastricsleeve.com/forum/blogs/bluiz77/12088-it-is-not-just-about-us.html

#1 My husband is scared he may lose me do to complications
#2 It is not just a huge change for me physically but also one that may take my husband a while to get use to, he was use to me being heavy for a long time.
#3 He may be mourning food in a different way because we are no longer going out to eat together and that was something we would do to have alone time from the kids. (farther out this won't be a problem) he is probably missing this 
#4 He is probably intimadated by the looks I am getting from other men not realizing that it really pisses me off because a month a go they would not even glance my way
#5 He will need reassurance in our relationship just as much as I will (I do question what if he is not attracted to me when I am thin, or have loose skin I will want reassurance that he is happy with me for who I am)

Some very strong and very true words - truly an eye opener indeed. I will have to start being more mindful of Dave's part in this all, and pray that his patience and support will hold out.

Diet & Exercise

So, let me start off with the exercise part. And by start, I mean... I haven't been doing any. The only exercise I've been getting really is going up the three flights of stairs to my apartment. I bought a groupon for some fitness classes at Silhouettes in Rosedale, MD, but have only gone for one class. (They also have equipment I can do a circuit on, but I haven't gone back for that either.) I bought a dvd called Burlesque Beat that just arrived in the mail yesterday, so I am hoping I will try that out this evening or sometime this weekend. (I love burlesque shows and have always been very interested in doing burlesque, but definitely don't have the body and/or moves to do it. Even with plus-size burlesquers, I am still too big. Meh.) I need to get on track with that - that is the hardest part for me, of all of this.

As for diet - that's actually much better news. I have been taking a good amount of vitamins and supplements: I received some I had ordered as well yesterday. So currently I am taking a Centrum Multivitamin (chewable), VitaFusion Fiber Well fiber gummies, Viactiv calcium supplements (chocolate chews! They smell awful in the container, but taste pretty decent). I also ordered Biotin, so I will probably start taking that as soon as I find out a surgery date.

In addition, I have more than halved my consumption of soda, caffeine, and chocolate! Before, I used to have quite a high intake of soda - I could polish off a 2-liter in the course of a day with nary a blink of an eye. Now, I have 1-2 glasses in the evening with dinner, caffeine-free diet cola. For caffeine, I have 1-2 cups of Earl Grey Tea in the morning. I have Earl Grey green at home that I hope I can start drinking and placebo-effect myself into feeling caffeinated. However, I have a lot of sleeping problems (feeling sleepy throughout the day, falling asleep while driving, etc), so I think kicking caffeine completely will be an incredible challenge. Lastly, chocolate/sweets. I am hoping with the Viactiv calcium supplements, I will get a small amount that way. I may take them in the evening when I take my other evening medication, so that way it can be my requisite "after-dinner sweet". However, I am still having some chocolate and sweets after dinner. After lunch, I have been chewing gum (mint), to kind of cleanse my palate. I always complained of wanting something sweet to balance out the savory of a meal, and the gum helps a lot to curb that craving.

Two days ago, the juicer I bought arrived in the mail, so that's the new exciting thing. Dave is going to be going along with me on this, at least partially. We are going to start out juicing one meal a day, most likely breakfast (since it will be the easiest to get through). Though I know juicing is not recommended after the gastric sleeve procedure, since the calories just go through without making you full, I think if I do it in moderation, it will be a good way to bulk up on those vitamins and minerals to keep me strong even if I'm half-starving my body. I am hoping to hit up the cheap produce market tomorrow (if it's open) to pick up some stuff, so we'll see how that goes! Exciting things all the time I guess.

Newspaper Article: "Weight Loss is Never Easy"

My mother sent me an article from her local newspaper, the Courier Post (South Jersey). The headline read, "'Weight loss is never easy': Bariatric surgery is a tool to shed pounds, but requires long-term lifestyle changes." You can read the article in its entirety here: http://www.courierpostonline.com/apps/pbcs.dll/article?AID=2013304010010.

I am glad she found it, and hoped she and my father read it. They have been worried about the procedure, and doubtful of my commitment and forethought. However, with reading this article, it emphasizes a lot of the things I've told them with all truth and earnestness. One of the most startling statistics (if true), to me, is: "Fewer than 5 percent of morbidly obese people can lose excess weight and keep it off without weight loss surgery." If my parents read this, I wonder if it hits home for them as well. My father was/is? morbidly obese, and last year went on the Nutri-System diet and lost around 70 lbs I believe. However, he is steadily gaining it back. I worry about his health because he has high blood pressure and high cholesterol. I know with the weight loss he was able to drop some of those numbers. However, I don't know if they have gone away completely. Part of the reason he went on the diet was because his younger brother, also overweight, had a heart attack, and was found to have 90% blockages in his arteries. My dad decided to make a drastic dietary change to lose weight and save his life. While some of the things he learned in the diet have stuck, many of his old habits have returned and he is gaining weight. I don't know if he would go under the knife, considering he is turning 60 this year, but he would have my unconditional support and love if he did.

I'm planning on bringing this newspaper clipping with me when I go to my next appointment, if it's something the office might want to share with people at their office, or people who want additional resources after the information session.

Appointment Follow-Up

Welp, everything worked out in the end for me to get my second EKG today. Also, it came back normal! So my heart is going to be fine for surgery. Another appointment next week, another appointment for my psychologist, and then another appointment with my gynecologist a few weeks after that. So I put in all my leave slips (requests for time off) today, hoping I've got all of them knocked out. But I'm sure that will change in time.