Video and Safe Words - not as dirty as it sounds

"Hello, fans and friends and odds and ends!  And now, for you gals and guys, a few words to the wise.  You Jims and Sals are my best pals..."

I will award 10 bonus sparkly unicorn points for anyone who knows where that quote is from...

I think it's relatively safe to say that I have completely lost my mind.  This liquid diet might be the end of me.

I have established a safe word at work.  First of all, my team rocks and has been nothing but supportive and helpful through this process.  So I want to put that out into the universe first - awesome amazing set of humans in my corner.

However.

We are event planners.  Food is a seriously major part of our day and lives.  Lunch is also typically a conversation that can last up to an hour.  Deciding where to go.  What we're in the mood for.  What we had yesterday.  What we're doing for dinner.  So what should we do now?  How much did we eat for breakfast?  Are we hungover...

SO MUCH FOOD TALKY TALKY!!

My safe word is ASPARAGUS.

So today, when they started talking about "what are you doing for lunch?"  "Hmm... I don't know, I think I want pizza.  But I've been eating like crap lately.  Where are you going?"  "I don't know.  I had soup yesterday"

LADIES!  ASPARAGUS!  TAKE IT OUTSIDE.

And because they are such wonderful, amazing, awesome humans, they listen to me.

I just had an asparagus moment over a vendor sending us two packs...

TWO

PACKS

... of Oreos because, I don't know, the universe enjoys laughing at me.

Anyway, it has helped me keep from thinking about all of the things I can't have right now if I can get my team to stop chatty-cathying about everything to eat under the sun.

Other than completely losing my mind I'm doing pretty well.  I am still struggling with getting my water in, but I'm all over those protein shakes.  Dr. Wayne told me yesterday that he felt like I had lost some weight.  My boss says that she thinks I'm more energetic.  I think it's anxiety but who knows.  I'm on a no-carb diet, TONS of protein.  So maybe I have lost some weight.  I'm holding off weighing myself until surgery day.  My clothes aren't fitting me any different so if I've lost anything I don't think it's substantial.

Diet today:
5 protein shakes
some water - I just... I don't even know
Coffee, skim milk, 2 truvia packets


And here, my gals and guys, is my video!  It's my second one, but it's the first I'm linking to in the blog.  So basically I'm going back and forth between the blog and the video.  I think both will be helpful.  So... here we go!

Enjoy!

Aaaaarrrrgh YouTube Videos! ... And surgery costs

Pre-Op Day 8

So... I haven't posted in a few days because I'm trying so freaking hard to do YouTube videos and they aren't uploading!!

So if anybody has any answers for why I can edit my video on the YouTube app (iphone 6s), and can upload, but then the "processing" just sits at 0% that would be... just so freaking wonderful.


So anyway.

I'm 8 days pre-op which means I'm 6 days...



6!!!!!!!!!!!!!!!

DAYS!!!!!!!!!!!!!!!!

from my surgery.  I feel ok.  I'm still sucking at my diet, but I promise I'm trying!  In case my stupid videos never load and I can never link to them, I've given up on the terrible Shakeology shakes.

because I just can't even.  I have found muscle milk.  I'm supposed to have 5 muscle milks per day, which is a lot of protein to drink.  And I'm also not getting in my water (100oz).

BUT!

Today is a new day.  I'm trying the regular muscle milk that is 230 calories, 1.5g saturated fat, 11g carbs and 25g protein.  So still within my dietary limits BUT I only have to drink 3 of them.  So I'm taking it.  I'm set on getting in at least 75oz of water today.  I'll let you know how that goes.

Basically, I'm doing well.  Every time I think about my surgery coming up in just 6 days I get a little dizzy.  It's just so fast, which I know most WLS people don't want to hear.  I know most have to wait months or a year or more for their surgeries and I really feel for that type of frustration.  In a way, I've been waiting for this for 15 years.  In another way, I've been waiting about 15 days.  So crazy.



THIS JUST IN:

A big deal, whether it should be or not, when considering barriatric surgery of any kind is cost.  I believe that you should be willing to have the surgery regardless of cost if this is really the right step for you.  I might be full of it.  But any responsible adult, even if they are willing to take the financial plunge, has to think about what it will cost at least a little bit.

No matter how hard I looked, I couldn't get a good idea of what exactly I would have to pay out of pocket.  Because health insurance is such a labyrinth anyway, each person's experience and out of pocket cost will be different.  Which makes it difficult to know if you are really comfortable with the financial risks involved.

I went in assuming that my cost would be between $2000 and $5000 out of pocket.  That seemed reasonable to me, and was a risk I was comfortable paying.  I am fortunate, and was able to consider asking my family for some financial support to make this happen.  Not everyone has that option.  You'll have to weigh your options carefully.

The financial advisor for NYU just called me to give me the information about my out of pocket costs.  My heart started racing, I was definitely nervous.  I pulled out my pad and pen to write down, what I expected to be, a daunting number.

"$673.72".

Uh.  Whut?

I'LL TAKE IT!

$673.72 is all that I will have to pay out of pocket, thanks to having a really good health care program through my office, and having already covered most of my out of pocket requirements due to weight loss attempts with another doctor.

That being said, both the nutritional assessment and the psych assessment cost $250 each.  Plus the cost of doctors visits is about $300 more.  So all-in my cost for this surgery is about $1500.  But I will pay that any day if this is the answer I've been searching for!



Oh and PS - my YouTube video just uploaded.  TALK ABOUT A GOOD NEWS DAY!!

Today's Diet:

3 Muscle milk
75oz water (fingers crossed...)

Endoscopy

Pre-op day 4

Since I opted for VSG (vertical sleeve gastrectomy) I was required to have an endoscopy to confirm that everything was healthy and that my stomach would heal after surgery.

Now, this is not something I've ever had to do before. The last time I was under anesthesia was in 2001 and came out of it crying for no reason. Not something I was super stoked to try again. But then I started thinking about the mechanics of the procedure (a flexible tube is inserted through your mouth down to your stomach. The tube has a camera on the end to look at your esophagus and stomach).

Uh. One question, professor...

If there's a tube down my throat, how the crap do I breathe?

So I did what anyone would do and I turned to the Internet - the place good medical advice goes to die (current blog and most I watched/read excluded of course...). The Mayo Clinic described the procedure pretty well. However, it said that I would be sedated, a numbing spray would be used to numb my mouth and throat during the procedure, and that the doctor would still ask me to do things like swallow to assist the tube going down my throat. Needless to say, I was nervous. And not at all better informed about my breathing question.

So at 6:00 this morning I got into an uber and traveled the 58 blocks to the endoscopy center. It sounds far... It took 12 minutes.

I walked in and checked in. Before I was able to sign in I had to confirm that neither I, nor anyone I had spent time with over the last 24 months, had been to Africa or the Middle East. Then I had to sign in, and give them the forms I had filled out prior to arrival.

Here's the thing on that - you don't know what you don't know. When I made the appointment, I really didn't know what I was signing up for. Most doctors require a consult before performing the endoscopy... I found one willing to move forward without the consult given my time constraints. I was told to bring my photo ID and my insurance card. That's it.  Fast forward 2 days and I have a voicemail from a lovely nurse talking about forms and prescriptions and escorts... It was all foreign to me. So I called back and said...

"Uh. Whut?"

She explained that I needed to go to their website and download, print, fill out and bring in 23 pages of forms and reading material on the procedure. These were basically the forms you typically fill out at a doctors office (insurance, patient bill of rights, authorizations, etc.). I would also need to have someone willing to sign me out and take responsibility for my safety after the procedure. Also, no eating after midnight the night before which would be no problem since I'm on an all liquid diet...

Um. Confession time. I've cheated HARD on the pre-op diet.  I knew exactly what I was doing. I knew it was wrong. I did not care. I did it anyway. I understand the purpose, the importance, the consequences of not following, the diet. I couldn't do it. 2 weeks is a very long time. And the shakes are so gross. Tomorrow I'm going to try some other shake options and get my (life, self, diet... Whichever noun you'd like to use) back on track. I've also been bad about getting in all, or even most of the water. But it's go time now.

Back to the endoscopy - I did fast before hand, nothing to eat after about 8:30pm the night before so I was in the clear. I convinced my friend Tassie to take responsibility for me after the procedure. I arrived on time. I turned in all my paperwork. The nurse called me back, confirmed any allergies, pregnancy, medications, medical history, etc. and took my blood pressure.  Then I asked about the breathing. The nurse confirmed that I would be completely under anesthesia, so I wouldn't feel anything at all. And the tube is tiny enough to breathe while its down my throat, so no worries there.

Then I changed. I was able to keep my bra and pants/underwear on. I had paper booties to put on my feet instead of shoes. I got 2 papery gowns to put on (one like a jacket, one like a smock) so I was completely covered. I took a urine pregnancy test (I never heard the results but I'm assuming I'm in the clear. I mean. Unless it's the second coming of Christ or something...). 

Then I was taken back to the room. I had some very lovely ladies working with the Doctor that made me feel completely comfortable. They reconfirmed the no-eating, whether I had anything loose in my mouth (dentures, caps, etc.) what my allergies are, things like that. I had sticky electrodes stuck to my arms and chest, a monitor on my finger, and an IV for the anesthesia. The put an oxygen tube up to my nose. They requested I lay on my left side and put a cushion at my back to support me through the procedure. And I had a hard plastic piece with a round hole inserted into my mouth with a band around my head to hold it in place. It sounds uncomfortable - I was awake with it in my mouth for like 6 seconds and it was fine.

My doctor was a lovely old man wearing a classy version of a Hawaiian shirt. He looked a little like Larry David. He was positive, upbeat, and had great energy - all things important to me going into a procedure where I will have zero control.

As she started the anesthesia she told me to breathe deeply. I remember consciously taking maybe 4 or 5 deep breaths (max) and then things went fuzzy.

About 20 minutes later I woke up in the recovery room. I was very interested in the cleaning lady's braid and how she got it to look so nice. Any time the nurse removed the monitor on my finger, the machine would beep and I'd say "oops... I'm dead", to which she'd laugh at and say "no no, you're fine". After about 15 minutes in recovery the doctor came to speak to me. He said that everything looked great and good to go for surgery. He mentioned that I had some inflammation from acid reflux, and he prescribed something to heal it up (which I'll pick up tomorrow). I was given several copies of the report (which include pictures of my insides... Eww...) and was told that the report would also be sent to my surgeon's office.

I changed, and met Tassie in the waiting room. She signed me out, and we got in a cab.

Note to self: DO NOT TAKE A CAB HOME FROM SURGERY.

This was one of the worst cabbies I've ever had in the 6.5 years I've lived in New York City, and I would hate to have that kind of terrible luck after having abdominal surgery. 

I was pretty groggy when I got home, and I'm lucky enough that my boss is understanding and flexible. I decided to sleep off the rest of the anesthesia and work from home for the rest of the day. I slept from 9:30am until 1:30pm.

I got up and made myself some broth and drank some water. I answered some emails but generally took it easy for the day. 

All in all, it was one of the easiest procedures that I had to deal with. I feel good now, no soreness in my throat, no more grogginess.  My doctor said he took samples, not sure what of but I don't feel any tenderness in my stomach. So pretty good!

Tomorrow is admission testing. I'm telling you what, we are getting close!

Today's Diet:

30oz water

2 cups broth with mushrooms

6 pieces sashimi ... Oh leave me alone at least in owning it! I skipped the rice, didn't I?!

*Sidenote* I was thinking about attempting my first video today but, trust me, nobody would have been interested in seeing what I have going on. But, maybe soon I'll start vlogging...

Protein Shake Purgatory

Day Two Pre-Op

Pre-op is something I'm taking very seriously.  I'm making sure I have everything in order and on my Ps and Qs (what does that even mean?).

I scheduled my endoscopy for this Friday morning at 6:30am.

Ya'll.

I am not a morning person. But, it must be done, and so at 6am on this Friday I will be climbing into an uber and making my way to my appointment.  This is required to make sure there's nothing wrong with my stomach, and that it should heal properly after surgery.  So MUY MUY IMPORTANTE but also MUY MUY INCONVENIENT.  And big shout-out to Tassie for being willing to take responsibility for me when I leave the appointment after being under anesthesia.  That should be a real treat for her.

However, without having actually had the endoscopy, the worst part of this whole pre-op dealy has got to be the protein shakes.  I am on a 2 week long liquid diet before the operation.  This is to shrink my liver so that it's easier to get to my stomach during surgery.

I understand the concept.

But I hate it.

They have a bunch of options that you can choose from which is great.  However, I have a TON of left-over Shakeology from another failed dieting attempt.  So I thought I'd just use that.

I can deal with the Strawberry and the Vanilla.

I canNOT deal with the Chocolate.  It's like... mud-covered expired chocolate on spinach.  It's so bad.  It's like poison.  It's like death. It's like sludge.  It's like the stuff that gunks up the valves in your car.
And the worst part??  IT LOOKS DELICIOUS!  It looks like a thick, delicious dark chocolate milkshake.  You WANT to drink it!  And then you do and it's like swallowing the crypt keeper himself.





I broke down and had some goldfish crackers last night...

I love Gold Fishes cuz they're so delicious.... Gone Gold Fishin'...

And then I felt guilty.  But 2 weeks is a really long time and really overwhelming! I think that's the gist of my emotions at this point in time.  I'm just... overwhelmed.  In every way.  I booked the surgery faster than I expected.  And then I had to go on this liquid diet sooner than expected.  And I have to go have weird things done (endoscopy) really soon.  And in like 12 days, 80% of my stomach will be GONE.

That's a lot to wrap one's mind around.  

I woke up today with a pretty serious headache, and already constipated (sorry, this is gonna get really real, really fast... all in the name of responsible reporting!).  So I think tonight I'm going to have to make some broth with veggies in it to get some fiber.  Also, I'm trying to focus on getting more water.  I want to say yesterday I got something like 30 ounces of plain water.  I'm really bad at getting in my water, but am committed to improving because:

1) high protein diets dehydrate you, so you need more water than normal

2) It will be essential to keeping my skin tight as possible post-surgery

3) mama needs to poop on a fairly regular basis (<-- the Real)

However - I feel like all I do is drink.  I might just float away.... And I miss wine already.  Also, I have been watching as many YouTube videos as I can get my eyes on to try to prepare myself for everything that is about to happen to me.  

Listen up Clusie and MellieMay.  You ladies talking about cheating on your pre-op diets is ruining my life!  Just kidding.  But for real, I can only have a couple of veggies and everything else is liquid and it's awful.  The temptation of cheating (like I did with the goldfish last night) is real.  So i'm going to do my best and stick to this diet to make sure everything goes as smoothly as I can possibly control... but ya'll bitches are killin my vibe right now!  (PS thanks for all of the great tips and help, love you, mean it...)

                     

I've also developed a little bit of an eye twitch which lets me know I'm a bit stressed out...  

Today's Diet:

One (GIANT) cup of coffee with skim milk and 2 packets of truvia

40 Oz. of water

2 Strawberry Shakeology with 4oz water and 4oz almond milk

1 Vanilla Shakeology with 4oz water and 4oz skim milk
2 cups chicken broth and two cups mushrooms
2 ham and cheese wrap-ups... whoopsies....

The Decision

"Would you... consider... bariatric surgery?"

Uh...

Um...

No?

Wait... I don't know...

Maybe?

*gulp*

Like... SURGERY, surgery?

Am I... big enough for that?

I, much like most people that struggle with their weight, feel like I've done EEEVVVVEEERRRRYYYYTTTTHHHIINNNNGGGGGGG to try to lose weight.  

Weight watchers?

Medifast?

HCG?

Nutritionist?

Diet and Exercise?

Personal Trainers?

And all of this started when I was maybe 12 years old?  I always felt big.  When I look back at pictures from high school, I don't think I look big at all, but I was bigger than the other girls and that's all that mattered.  So I started dieting early in life.  My weight was always on my mind.  I went to Weight Watchers for the first time when I was 15.  And it has never. freaking. ended.

I was mildly successful using several of these tactics.  Weight watchers helped me lose 40, then gain back all of it.  Then I lost 18, then I gained back all and more.  Most recently I gained 10 pounds over a 3 month attempt (screw you, Jennifer Hudson.)  (No I like you, I'm sorry.  Just... WHAT DID I DO WRONG?!).

I had an awesome trainer that got me nice and tight and fit and lookin good... but I didn't lose an ounce by working out.  I lost everything while I was doing HCG.  I lost 60 pounds.

60

POUNDS!!!!

And then I gained - like... 90 back.

I had a nutritionist put me on an all egg diet for 2 weeks.  

1) don't do this.  Cholesterol is not to be messed with.  

2) I lost like, 3 pounds  because do you know how nasty it is to eat eggs all day every day?  Gross.

I've subscribed to the EAT LESS YOU'LL LOSE WEIGHT mantra.  I've subscribed to the YOU CAN'T LOSE WEIGHT IF YOU'RE HUNGRY ALL THE TIME mantra.  I've subscribed to the 6 SMALL MEALS A DAY matra.

And cue - I've now destroyed my metabolism.  I'm burning like, 800 calories a day when the average person burns like 1500 a day.  Just.  Humaning.  Just living and breathing.  Not even working out.  Just for sitting in a chair and breathing, they burn almost double what I now burn.  

Fair?

No.

But it's the reality I am now faced with.

At my highest, I currently weigh 272 pounds.  

I can't even believe that's real.  Like.  Seriously.  

Something I should mention - I don't carry my weight the way most people my weight carry it.  I consider myself lucky that I carry it in my hips and boobs, but also just kind of all over.  Don't get me wrong - I look big.  I am big.  I am a big girl.  But I wear between a size 14 and a size 16.  I can shop at stores that sell "average" sized clothing (I just can't bring myself to say normal sized because... ugh... what does that even MEAN?!).

So before I decided to have this surgery, I obviously had a loooooot of trouble losing weight.  I convinced myself that I had a thyroid issue.  What else could it possibly be?!  I've done EVERYTHING.  

So I made an appointment with a Gastroenterologist and had her do a bunch of tests.  

Yeah, apparently I'm the most healthy human on the planet.

All of my labs came back normal.  Not just normal, but they each hit directly in the center of the range that they should have been in for my demographic.  So... not my thyroid... 

I tried Victoza for 6 weeks.  I lost zero pounds. 

So that's when the opening conversation happened with my doctor...

"Would you... consider... bariatric surgery?"

So I did some research.  I attended the seminar at NYU to learn about the options - Lap Band, Gastric Bypass, Vertical Gastric Sleeve.

I had myself completely convinced that I should be doing the Lap Band.  My Gastroenterologist said she thought I needed something more drastic.  But what did she know?!  I wanted the least invasive, easiest to recover from, most impermanent option around.  

And then this weird thing happened.  The more I researched, the more I read, the more people I heard from, the more I changed my mind.  For starters...

"Let's talk about which would fit best into your life"

Wait.  What?

Which would fit best into MY life?  I get a say?  I'm not trying to conform to the solution for weigh loss?  We're trying to consider my human component?  

There is a LOT of guilt and shame associated with being overweight.  You may not even realize how much you feel.  I didn't.  But there's a lot of pressure to make yourself conform.  And when you don't - when the weight loss program doesn't work, or you gain weight back, or you start having to shop at the big girl stores, or whatever - you feel bad.  You feel ashamed that you couldn't do it.  Because when thin people need to lose a couple pounds to look good in that bikini for the summer, they try for like 2 weeks and they're good to go.  You try for two weeks and it's like "WHAT?!  I GAINED 3 pounds?!  How?!"  And you know all of that "water weight" "eat less salt" "muscle weighs more than fat" crap does NOT resonate at a time like that.  

So the idea that I was making a decision that would both help me lose weight, but that was meant to work with me as the person that I am was... liberating!  Freeing! Shocking!  Emotional! Cray-cray!

A little (more) background on me - I'm an event planner.  I travel.  I eat.  I drink.  All for my job.  I'm paid to do these things.  Which adds to the struggle of losing weight.  Because nothing says "I'm not eating right" like 10 days straight on airport/hotel/restaurant food paid for by the company...

So I discovered that the lap band had some draw-backs for people like me.

1) the band can tighten due to air pressure when you fly

2) Just because something digests without issue today, does not mean that it will work as well next week... or tomorrow...

3) "band sick" is real, and could have me running to the bathroom a lot because something isn't staying down.

Basically, the band wasn't going to work with my LIFESTYLE (it's crazy how crazy of a concept that is to me, but... I digress).

I decided on the VGS pretty quickly after that.  It was between the bypass and the sleeve, but the sleeve is less invasive, but still would change the hormones and way that I digest food.  it would limit my portion sizes (a huge plus for me, as I tend to eat pretty healthy, just too much for my sad little metabolism).  But I can eat most normal foods, which works for my job.  I just... won't be able to eat very much of them.  Which I am just fine with!

So... the process of setting up surgery.  After attending the seminar in June/July, I left with a lot of information, and a long list of things I needed to compile before meeting with the surgeon for the first time.  I made my first (and I think only... so far...) mistake by not booking with the surgeon while I worked on compiling everything.  It can take a month or more to get an appointment - they are very busy and important.  So by August I had all of my past medical records compiled, but then had to wait until September to meet with the surgeon.

My first trip to the surgeon went quickly.  I spoke to a nurse about my process to that point, and what I was thinking.  He basically told me that I would be a good candidate for any of the procedures because I am young (awww... blushing... I'm 31.  I'm not that young.) and healthy (meaning I don't have any blood pressure, diabetes, etc. issues due to the weight and I'm not on any medication.)  Then I met with the surgeon. 

I love her.

I told her all about my struggle with my weight and weight loss.  I told her about my lifestyle.  She agreed that surgery was a good option for me.  But she didn't know which she wanted to recommend.  So she asked me to come back in a month.  I very much appreciated that she wasn't in a rush.  That she wanted to take the time to think this through and decide what was best for me (again, a foreign concept.)

Then I met with her surgical coordinator.  She gave me a whole list of things i needed to compile for her:

• Blood work-up from my panel done at the Gastroenterologist's office
• Letter of recommendation from my PCP
• A few more notes from my medically supervised weigh loss attempts*
• Psych Evaluation
• Nutritional Evaluation

*For my insurance, I was required to prove 7 consecutive months of medically supervised weigh loss attempts.  I had, like, 2 years worth.  So I was covered.  Insurance companies and practices differ, so just make sure you follow whatever they need.  I had a relatively easy time getting everything together because I basically had everything done already.  Unfortunately, some have a harder time, or have to go through 7 months of the medically supervised weigh loss attempt before they can schedule surgery.  Just make sure you are asking questions and staying on top of what you need.

So I took the next month.  I did some more research.  I got all of the above together. And I came back.

Ya'll.

I did NOT see this happening so fast.  

I went in expecting to talk to the surgeon about my decision.  Figure out next steps.  HOPEFULLY schedule surgery before the end of the year.

Ya'll...

YA'LL.

I told her what I was thinking.  She agreed.  She sent me to the surgical coordinator to give her the rest of the stuff that I had compiled.  And do you know what that lovely surgical coordinator said to me?

"Ok, so let's get this on the calendar.  How does.... November 3rd look to you?  I have the 3rd or the 5th."

 

(My face)

That was a full 18 days from Friday.  18 days?!?!?!

So I said ok, let's do it.  I need to get a pre-op authorization from my PCP and an agency within the hospital.  I need to have an endoscopy to make sure my stomach is healthy enough to heal from the surgery.  And that's like... it.

Oh wait. 

No.  

That's not it.

Today I start a 2 week liquid only diet - and no, I can't have booze.  Which is like... my favorite thing.

So I can still have coffee (thank. God.)  I need to drink 5 or 6 protein shakes a day (less than 35 grams of fat per day, around 1000 calories per day, and at least 50 grams of protein per day).  I can eat some vegetables and chicken broth (hellooooo dinner!  ugh.)

This is so the liver is less fatty for the surgery and makes the stomach easier to see, get to... whatever it is they need during surgery.  

So I think this brings us current.  My plans is to use this blog to track my thoughts, experiences, feelings, things I learn along the way... etc.

I'll also post before and after pictures.  

Like this!

Here's my starting picture...

It's me!

This picture makes me sad.  Because I think I look cute, and I think if I saw me on the street I would think I looked cute.  But I also think I would think "that poor girl... I bet she just wants to lose weight so bad".  I could be projecting.  So this will be the picture I use to compare to pictures as I progress.

Ok.  Here we go!