Midway through the third week

I'm not doing very well keeping up with this blog.  I want some sort of documentation of my process, so I need to get better.

I had a bad day yesterday when I weighed in and had somehow gained two pounds.  Why the face?  I'm assuming it was water retention, because I can't possibly gain weight when I'm eating 600 calories a day.  So that sucked.  I'm going to let a few days go by and weigh myself again Wednesday to make sure the number is going in the right direction.

I'm eating soft solid food now.  I can easily tell the difference in restriction as opposed to liquids and purees.  I can't take much more than a few small bites before I start to feel full.  Little Sleevie Wonder is definitely doing his job.  I can't eat a whole scrambled egg.  I, and sorry if this starts to get gross, couldn't finish two shrimp.  I almost did, but I ended up spitting out the last bite instead of swallowing it.  I'm terrified of the slimies.

I've learned that I can't have liquids near me when I eat, otherwise I'll mindlessly take a drink.  Yeah, learned that one the hard way.  Ouch.  Watching the clock to make sure I stop drinking half an hour before eating can be annoying, but I understand why I have to do it, and now I've experienced the consequences of drinking while eating.  I don't plan to do it again.

I still haven't felt any real hunger, though I did experience some head hunger over the weekend.  It was nothing a good fanfic couldn't cure.  Thankfully it hasn't come back since.  I think it was in response to being able to eat regular food for the first time.  My foody brain was all, "Mmmmm... food!  We should eat more.  Yum!"  And my stomach was all, "Yeah, you go ahead and try that.  I bet I can change your mind."  Then my Edwardy brain was all, "Hey!  Clipped Wings and Inked Armor just updated!"  Then I read and by the time I finished the chapter is was time for a protein shake and all was well.

Speaking of, it is time for a protein shake now.

Change in tastes

I was warned before surgery that I shouldn't stock up on any protein shake brand or flavor just because I liked it before surgery.  Now I understand why.  I've found one powder flavor and two brands of ready to drink shakes that I can't drink now, all of which I tried and liked well enough when I was on the pre-op diet.

And it's not that I just don't like them.  Well, the Atkins shakes were more along the lines of just not liking them, but the other two were absolutely disgusting to me.  Seriously.  I gagged just at the smell of the Unjury powder, and the Muscle Milk tasted like smoke.  So nasty.

For the most part I've been OK with the samples of Nectar, although the tropical punch flavor I tried this morning didn't work for me at all.

Tonight I'm going to try tomato soup.  Real, actual tomato soup.  I've been a little nervous about incorporating actual food, but it's time.  I'm not getting enough calories on protein powders and broth, plus I need to see how my banana reacts to other liquids before I move on to the next phase.  I'm hoping I haven't suddenly stopped like tomato soup. 

Besides the wasted protein drinks, my only other complaint right now is cabin fever.  I want to do something, but I was advised to stay close to the couch for the first week.  I understand why.  With the combination of recovering from surgery and living on about 300 calories (if that) a day, I get tired really quickly.  Just a walk to the mailbox and back left me lightheaded.  Which is why I'm going to try tomato soup tonight.  Even 100 extra calories would be helpful.

Pre-op diet

As I was researching VSG (vertical sleeve gastrectomy), I saw many different versions of the pre-op liver shrinking diet.  The majority of them were some version of an all-liquid or mostly liquid diet.  Protein shakes and sugar free jello, two meals of protein shakes and one meal of lean protein and vegetables, some lasted two weeks, some up to four weeks, some allowed only clear liquids for the final three days before surgery.

Mine came with only one restriction:  no more than 40g of carbs a day.  It hasn't been difficult at all to stick to it.  In fact, the only thing that has been difficult is to get in as many calories as I should.

The scale went insane, and I lost nine pounds in the first five days.  Crazy!  Right around then was when I started to have a hard time getting enough calories, and for about a week, the scale didn't move much-- just a fraction of a pound here and there.

Over the weekend I got my 1200 calories each day, and I'm happy to say I was down another 2.4 pounds this morning.  Yay!  That's 13.6 pounds I've lost since I started this almost two weeks ago.  That is insane for two weeks.  Yeah, I know a lot of it is water, but it's fun to see anyway.  Too bad I can't trust  myself to stick with this for the long haul without the help of a teeny stomach.  I could save $20,000 (actually, with all the pre-screenings and PCP visits and prescriptions, there's another $2000 added to that).  Unfortunately, my problem is less losing weight than it is keeping it off.

I don't know what sparked the scale to move again.  I hate to believe it was getting the calories in, because after surgery it's going to be quite some time before I'll be able to get that many calories in one day.  For the first couple of days it'll be almost no calories.  Once I work up to full liquids, which should start around the third day after surgery, I'll be lucky to get 500 calories in.  I'll only be able to drink/eat around 1/3 of a cup at a time, and I'm sure I'll have to work up to that.

Whatever.  I should stop worrying about that.  This surgery is a proven weight loss method.  I might post more later about my fears there.

Nutritional Assessment

Well, I don't actually know what type of assessment the nutritionist made, but I think I passed.  She mentioned that she would be seeing me a lot in the future, so I'm assuming it's a go. 

The time was pretty evenly split between her asking about my eating habits and letting me know how I will eat after the surgery.  She did a lot of probing to find out if I'm a binge eater.  I am not.  I'm more of a grazer.  That actually ended up being a good thing.  The sleeve surgery doesn't work well for bingers, because they can end up over-stuffing and getting sick or even popping staples if they go too overboard. 

Overall it was both comfortable and horrifying.  We sat at a round table and just talked about eating habits, expectations, willingness to work for it, things like that.  She introduced me to how I would eat after the surgery, what was most important in my post-op diet (protein!), products that will help me to get in all the protein I need, approximate meal size... things like that.  That was the comfortable part.

The horrifying part was weighing and measuring me.  Bleh.  I weighed myself before going, and I've been doing weekly weigh-ins for the past couple of months, so the number wasn't a surprise to me.  I just didn't love sharing that number with someone.  But she is the one who will be tracking my progress after surgery, so she had to know.  Still.  Horrifying.

Surprisingly, when I asked if I should be doing any special diet right now, she said no.  I'll eventually go on a low carb diet for two weeks before my surgery, which is standard to shrink the liver, but before then it was almost like, "Live it up while you can!"  Not really.  She did mention that if I lose weight before the surgery, it makes it easier for the surgeon, but there was no calorie or fat counting program she recommended.

All in all, it was fairly interesting.  I didn't say anything stupid or fall or break the scale, so yay!

Trials of organization

Last night I got the brilliant idea that I needed a binder to keep all my weight loss surgery (WLS from here on out) information organized.  I've got things for the nutrition portion, psych, exercise, surgeon, pre-op, and post-op.  Too much to keep organized without a binder.  I also realized that I needed a printer so I could print stuff to put in my binder.

I was out bright and early to make my way to Staples.  Fun!  I found an inexpensive all-in-one printer/copier/scanner, which was more than I really needed, but there's no such thing as just a printer anymore, at least not at Staples.  I also bought some regular and three-hole paper, binder clips, paper clips. a notebook, pens, post-its, manila folders, and binder tabs/separators.  It really was a joy.  I like shopping for stuff like that.

I started setting up the printer right away when I got home.  I first had to clear off a spot for it on my desk, which was no simple task, but it wasn't that bad.  I got the printer set up with no major issues, and all that was left was installing the software on my laptop.  That should be the easiest part.  It was not.

For some stupid reason (eventually I realized that stupid reason's name is Vista), it wouldn't read the CD.  I kept trying and trying, but nothing.  This made me unhappy.  I started to lose it.  Words were shouted.  "Motherfuckingcocksuckingbastardsonofabitchpieceofshit!  FUCKING WORK ALREADY!"  Then came the tears.  "All I want out of life is to put a binder together to keep my information organized, but NOOOOOOOOOO.  I can't even get the damned CD to work.  Why can't one thing ever go right for me?"  Yes, I realize I was a bit melodramatic.  It was a moment.  Not a proud moment, mind you, but a moment.

I finally took a few deep breaths and visited the website of the printer's maker.  Good choice.  They had the info there on what I needed to do to get it to work with Vista, and I had to download the drivers from the site. Things were looking up.

Then I tried to print something.  *sigh*  It wasn't the end of the world or anything, but the three-hole paper doesn't work properly in this printer.  If I put it in the wrong way, it prints just fine, but the holes are on the wrong side.  When I put it in so the holes are on the correct side, it jams.  Or at least it claims to be jammed.  What really happens is that the paper is shoved through without printing, but it says it's jammed.  Grrrr.

I found that I can go into print setup and have it rotate 180 degrees when it prints, which isn't such a big deal, but why the heck can't it just take the paper so the holes are on the correct side in the first place?  Sheesh!

The good news is that I now have my different forms and other info printed, and I'm ready to put it all in The Binder, which is exciting.

That's my story for today.  Tomorrow I visit the nutritionist.

Drumroll

It's been awhile, I know, but I've made my decision.  Before I get to my decision, here's what I've been up to.  There's not a big story or anything.  I've just been researching the surgery options as well as the facilities in the area and the different costs.  The cost didn't vary much from place to place.  $20,000 is the norm.  The couple of places that were a few thousand dollars less didn't have as much follow-up built into the pricing, so I would end up paying in the end anyway.  So, after a lot of online research and a few seminars for different facilities, here's what I've come up with.

I'm getting the vertical sleeve gastrectomy.  Factors that went into my decision include rate of complications, side effects, and necessary follow-up.  The lap band is the least invasive procedure with the lowest probability of complications during or immediately after the surgery, but I've read too many horror stories of longer term complications, with the band slipping or eroding, needing adjustments, fills... not for me.  The gastric bypass has the quickest weight loss, because it's both restrictive and malabsorptive (the sleeve and lap band are restrictive only), but there's a hospital stay involved, and side effects that you don't really consider until you do your research.  You need to take more supplements because you don't absorb most of the nutrients you take in, and there's a higher likelihood of things like hair loss.  Again, not for me.  I think the sleeve gastrectomy is the best option.  It's not without risks, complications, or side effects, but nothing is.  I had to choose what's best for me.

I've also decided where I'm getting it done.  I chose the facility and surgeon based on several factors, including complication statistics, satisfaction of other patients, the out-patient option, and the follow-up included in the cost.  I have my first consultation with the surgeon on Oct. 1st.  Before then I have nutritional and psych evals.  That oughta be interesting, particularly the psych one.  I wonder what types of questions they'll ask.  I guess I'll find out soon enough. 

It's all starting to feel real to me now, and it's exciting.  I never thought I could get excited over something like this, but it's increasingly feeling like the only option.  I've been eating right and exercising pretty regularly for the past month and a half, and I've lost 14 pounds, but that doesn't seem like enough, and my downfall is always impatience.  The surgery will help me to lose the weight faster and keep me from saying "fuck it" and eating a bag of Funyons.

So that's where I am.  I need to talk to my friend about the financing, and he needs to have some questions answered about liability, and I think that's the only thing that could hold this up.  Other than that, the ball is rolling and I'm looking forward to finding the new me.

24 Hours Later

I still haven't made up my mind.  I guess I shouldn't get too impatient with myself.  This is a life-altering decision.  I don't have to make it in a day.

I believe that if I do go through with it, I'll get the sleeve.  Of course, after consulting with the surgeon, that may change, but that's what I'm leaning towards.  I'm definitely at least going to the first clinic to get some more information.  I'm about 75-25 in favor of surgery right now.  It's scary, it'll change many things about my life, but what the hell am I clinging to, anyway?  Barring unforseen complications, the good will far outweigh the bad. 

Next step:  fill out an online medical history thingy that they need before they set me up for my first appointment.

Weight Loss Surgery Seminar

Well, it wasn't what I expected, though it makes sense that it was what it was.  The seminar was put on by a specific hospital, so of course it was all about why I should choose them to do my surgery.  There was a brief explanation of the most common types of weight loss surgery, but for the most part it was "here's why we're the best."

Actually, at first it was "here's why surgery is a good option."  And they did their job very well, totally selling me on the concept.  Very early on the surgeon made his argument for why choosing the surgical route isn't failure, so either he read my entry from earlier today, or I'm not the only one who feels that way.  His presentation made sense to me, his statistics showing why it's the only proven way to go made sense to me, hell he even did a pretty good job at convincing me he's the best man for the job.  If he's as good a surgeon as he is a salesman, I would be in very good hands. 

What this didn't do is help me to decide which procedure would be best for me, which is what I was hoping would happen.  In fact, he said they generally go with whatever your gut instinct is on what you want, though of course if you ask he'll give his opinion on what he thinks is best.

It did help me to rule out the lap band, which is funny, because that seemed to be what they were pushing most.  It's the least  invasive, which is certainly a bonus, but it requires the most follow-up.  You have to keep going in for adjustments.  It's also the slowest in terms of weight loss.  Typically it takes 2-3 years to lose what you would in about a year with the gastric bypass or the sleeve. 

I'm glad I went, but I'm not closer to a decision now than I was yesterday.  Ugh.

What to do?

After an open and honest talk with my friend the other night, I've decided to consider weight loss surgery.  I'm going to a seminar this evening to get information on the different options to see which one, if any, is right for me.

This is a huge step, as I've always been hung up on losing weight on my own.  There's a part of me that feels like I've failed (there's that word again) if I get surgery.  Other people do it without surgery, why shouldn't I be able to do it, too?  But I've been trying, off and on, for ten years now, and yes, I've lost some weight in there, but I've always gained it back and then some.  I'm failing anyway, so I may as well fail in a different way that gives me a better chance at succeeding, right?  And isn't the statistic that something like 90% of people who lose weight by dieting gain it all back within five years?  Wouldn't the life change that comes with surgery make it more likely for me too keep it off?  It almost seems like the obvious choice.

If only it were that simple.  There's more to this decision for me.  I have no health insurance, nor do I have the cash lying around to pay outright for the surgery as well as the tests, checkups, et cetera that go with it.  What I do have, however, is a friend-- the same friend who convinced me that I should at the very least consider the surgery option-- who has offered to loan me the money to pay for it.  Beyond that, he offered to go to consultations with me and help me out however he can.  And he's enthusiastic and encouraging.  I know, right?  How fucking lucky am I to have a friend who is willing and able to help me this way?  There's another whole post about this somewhere along the line.

That being said, I honestly don't know if I can do it.  I checked out the the estimated cost of the different surgeries without insurance to cover any of the costs, and it's $18,000-$35,000.  Holy shit.  It makes me almost barf just thinking about borrowing that much, no matter how many times I'm told that the money isn't an issue. 

So.  Tonight I see my options and at least start thinking about whether surgery is the right option for me.  If I decide that it is, then I move on to the next step- deciding whether I can go through with borrowing the money for it.

Who I am

I know it's a totally cliché thing to say, but I'm at a crossroads.  Or a fork in the road.  Something like that.  I've hit my low by hitting my high.  I've never been heavier than I am right now.  That's a lie.  I was heavier a month ago when I decided I needed to do something.  But things are all relative, and relative to my weight?  I'm not much lighter than I was a month ago.  Every little bit counts and all that bullshit, but I'm not completely satisfied with my trajectory.

Sure, I've made some changes.  I'm eating better, moving a little bit more.  I don't know that it's enough.  The moving part is difficult.  My back aches, my knees fucking kill (Dear Fitness DVD Experts, Fat people can't do lunges without terrorizing their knees.) and I have the endurance of a chicken in flight.  I want to do more, but at the moment, there are too many things that I can't do.

I want.  I want to be thinner, I want to be healthier, I want to be successful.  You gotta want it!  That's what they say, right?  Hmph.  I agree with the sentiment, but it's an incomplete thought.  Wanting it is a start, but I've wanted it for the past 10+ years, yet here I am.  You have to put in effort.  Have I done that in the past?  Eh.  Sometimes.  But not nearly enough or I wouldn't be at the bottom of this canyon, struggling to climb up with very little to grasp.

How did I get down here, anyway?  It's simple, really.  I'm an avoider.  Before a month ago, I hadn't really looked at myself in years.  I am a master at selected sight.  I can look at my face in the mirror and see only the parts rather than the whole.  I can look in a full-length mirror and only see my eyes.  If I don't look at the rest, it doesn't exist.  If I don't wear jeans, I don't have to know what size I need.  If I don't step on a scale, I don't have to know how much I weigh.  If I don't lose the weight, I don't have to find out if I would still be living the same unenviable life in a different body.

That's the crux of it.  Abject fear of failure with a heaping side of inferiority complex and almost no self-esteem.  If I don't try, I can't suffer the humiliation of failure.  And so the irony, of course, is that my fear of failure has caused me to become a failure.  37 years old, overweight, unemployed, alone.  Not completely alone.  I have great friends and a wonderful family.  But until yesterday when I gained custody of a cat in my friends' divorce, I didn't even come home to a plant.

Whatever.

So here I am, steering my way toward the right path, but with a precarious grasp on the wheel.  Is it enough?  What if I hit a pothole?  Fall down?  Encounter too steep a hill?  Will I fail again?  Will I be able to pick myself up if I do?  What about this fork I've reached?  Will I choose the right prong?

I have a decision to make.  I'm not good at making decisions.  At all.  I couldn't even make a decision on what was the better night to go out last weekend, how the fuck can I decide on something so crucial?  What if I choose wrong?  Ugh.  I am a mental case.  I need to do more thinking, some research.  Then I really need to make a decision.

Right now, I choose to go to sleep.