A new approach to Christmastime...

Everyone knows that Christmastime is fraught with caloric dangers: treats from the neighbors, goodies at family get-togethers, etc., etc. I've taken different approaches from year to year, ranging from, "I'm going to just enjoy myself and not worry about it," to "I'm not going to eat any sugar at all." Neither of those approaches worked very well. If I told myself I wasn't going to eat any treats, then I felt deprived, like I was missing out. If I threw caution to the wind, well then, the consequences of that are pretty obvious. The problem is that "Christmas" is not a one day event. There are temptations spread out over several weeks, starting with Thanksgiving and ending sometime after all the New Year's goodies are either eaten or thrown out.

As you can see, I was never very good at moderation. I tend(ed?) to be an all-or-nothing person. That's why this year was amazingly, and refreshingly, different. If the neighbors brought treats, I had a couple of bites and I was done. Christmas Eve family dinner? A couple bites of cheesecake and a miniscule nibble of fudge. Done. I simply didn't want any more. I didn't feel deprived, and I didn't overdo it. Do you have any idea how amazing this is to me?

For the first time in memory, I lost weight during the Christmas season. My stall has broken and I am down a couple more pounds, making a total of 31 lbs. lost to date.

I have had a couple of "firsts" in the past week or so. I had my first "emotional" wrestle with food post-surgery. It's a bit strange, but I'll share anyway. We were serving up dinner, which happened to be one of my favorites, and as I dished up the plates and put this little tiny serving on my plate I felt cheated, almost like it wasn't "fair." I know it sounds crazy, but this really upset me. I had a hard time putting words on my feelings, until I was talking about it with my sister and sister-in-law. My SIL was the one who identified the "fairness" issue. It's kind of like serving up a piece of cake to your two children, and you give one child a big piece and the other child a little tiny sliver. Naturally, child number two is going to say, "Hey! Wait a minute! That's not fair!" That is what I felt like, even though I know--logically--that I simply can't eat a normal-sized portion. I think that my "fairness" issue shows up in many areas of my life--for better or worse. Like most traits, it can have both positive and negative implications. However, by being aware of it, we can mitigate the negative.

My other "first" was being very sick on something I ate. Other than the fried foods, which I mentioned in an earlier post (made me feel generally "yucky" and uncomfortable), I've been able to tolerate everything I tried. Until Christmas dinner last night. I made a pork roast with cranberry chutney, garlic mashed potatoes, and creamed green beans. I'm not really sure what was the culprit, but I suspect the pork roast. I am supposed to be on mushy foods still, but I didn't want to eat only potatoes, so I thought I would just chew the roast really well. I only had a few bites before I started feeling really awful. I excused myself from the table and went into my room to lie down for a bit. The pain in my stomach was just horrible! Finally, I threw up my "dinner." I had no idea such a tiny stomach could retch so powerfully! It still took a couple hours to feel semi-normal again. Lesson learned--no more non-pureed meat until I'm ready for that! I'm not sure when "ready" will be, since I'm now too nervous to even try for quite awhile! Sorry to share such an unpleasant event, but I never promised a glossy view of what's going on. This blog is about the whole journey, not just the feel-good moments.

Moving on to happier outcomes. The other "first" I experienced this last week was my first "eating in public where nearly everyone knows I had surgery". I've been out to eat since surgery, but that was no big deal. However, the ward party had me very nervous. I almost didn't go because I was so worried about what people might be thinking. "Why is she eating so little?" "Should she be eating that?" "Did you hear about Cassi?" Blah, blah, blah. In the end, of course, it was nothing to worry about. I had some ham and scalloped potatoes, and I put a roll on my plate even though I had no intention of eating it. I just felt silly with two little tiny portions of ham and potatoes on my plate! Unfortunately, there were no cooked vegetables, just salad (which I cannot eat yet). We sat down by our neighbors and I ate s-l-o-w-l-y and I don't think anyone even noticed! Oh, and I had one bite of Alden's brownie. It wasn't all that great. Sometimes it amazes me how we worry about what people are thinking, and in the end it turns out to be nothing at all. Silly, silly! It was a lovely party and I was glad that I went.

Oddly, someone that I hardly know (we recently changed ward boundaries) came up to me and said, "I heard you had that stomach cutting thing; how's that going for you?" That was weird. Turns out, though, that his wife has been wanting to do it, so he just wanted to talk about it. I'm not sure how he found out. I only told a few people in the ward, but that's about all it takes for it to become public knowledge! Besides he's new in our bishopric, so maybe he heard about it through that grapevine. Anyway, I told him I was soooooo glad I had done it, that the risks need to be considered along with the benefits, along with alternatives (such as Weight Watchers, regular exercise, etc.). But that, for me, it was definitely the right decision.

People do need to realize that WLS is not instead of diet and exercise. It is a tool to work along with diet and exercise. It will not push you out the door to go exercise. It will not stop you from filling up on empty carbs/calories. If anything, you have to be particularly conscientious about the nutritional quality of what you eat. It is not, I repeat NOT, the easy way out. What it is, is a very successful route from point A to point B. The 5-year success rate for gastric bypass is about 80-85%. The 5-year success rate for traditional dieting is about 3-5%. That doesn't mean that WLS is guaranteed to be successful, nor does it mean that traditional dieting won't be successful. I think it means that success hinges on making lasting, permanent changes. If you can do that without surgery, awesome! I couldn't. Or at least I hadn't yet been able to. Maybe I could have eventually. But in the meantime, the sands of my life were quickly slipping through the hourglass, and I was not going to lose anymore time wishing, wanting, waiting. I decided to let the odds work in my favor, and chose the surgery. And so far, I've been very glad that I did (and very chagrined that it took me so long to make the decision!)

Merry Christmas, everyone!

Four weeks post surgery...

Well, it happened. I hit a stall last week. On the surface, I was prepared for this. I was told that it often hits at 3-6 weeks as the body goes into a "starvation" mode and starts hanging on to fat as tenaciously as a bulldog. However, I still don't like it. In fact, I've been bummed about not losing this week (actually, I gained 1/2 a pound).

That having been said (and, yes, it felt better to whine for half a second), I know that it's in my hands to move out of this stage and start losing again. So, here are the things I need to do:

1) eat more protein (I haven't been getting in the requisite 70 grams since I stopped drinking the protein shakes--which I quit drinking because I got bored of them. Bored, schmored! I need to get over it and do what I'm supposed to! Nobody said it was all fun and games!)

2) drink more water (I never have been good about getting in the 64 oz. of fluids everyday. I need to sip, sip, sip all day long! This one is a real struggle for me! I knew beforehand that it would be one of my biggest post-op challenges--and it has been.)

3) up my exercise (I've been good about the "daily" part, now I need to bump up the intensity)

4) stop weighing daily, switch to weekly (I don't know if I can do this one, to be honest)

Okay, so three out of four is pretty good, yes? I will check back in next week to report--not necessarily on my weight loss, but on how well I kept those three commitments.

BTW, total weight loss to date is exactly 27 lbs. Not too shabby! I'm going to do what it takes to move out of this stall and keep on moving towards my goal!

Foodwise, I am definitely liking this new "mushy" stage and can now it just about anything that is soft (or crispy, like a cracker). I still can't have raw fruits and vegetables, though. Many people develop food intolerances post-surgery, but I've done fairy well. The only thing I cannot tolerate is fried foods. I tried popcorn chicken and chicken strips, thinking I could chew the chicken really well. Uh, no. Both times I felt sick to my stomach--not nausea, just really icky. It felt like I'd just eaten 20 lb bricks of lead. Both times were when I was out and about and I didn't have anything to eat with me. Lesson learned--always have something stashed in my purse!

I decided not to post one month pictures, because you really can't see much difference yet. I can certainly feel it, though! My clothes are getting loser, my feet are MUCH less puffy and swollen, and my energy level gets better all the time. Last week I went to Jana's choir concert and slipped easily into the auditorium seat, which used to be a tight fit! That was a nice "wow" moment! The changes I'm noticing are much more subtle, but still very meaningful. What's exciting to me is that this is just the beginning!

Two week follow-up...

Welp, it's been two weeks since surgery. (Actually, it's been two weeks and two days, but I forgot to post on Monday.) I have had an incredibly smooth recovery! My energy level is great (as long as I don't overdo it--see below), and my incisions are all completely closed and nearly 100% healed. I haven't missed a single day of exercise since the surgery--a commitment I intend to keep for the rest of my life. Some days have been "lighter" than others, but I'm determined to do something every single day. I've started doing "band" work for my upper body. But now the surgeon has cleared me for moderate exercise, so I think I'm going to start using the exercise ball as well.

From what I hear, most people have a hard time getting in enough protein at this stage because they can't stand the protein powders, but I found a brand that I liked, so I haven't had a hard time with that. I started searching for protein powders several weeks before surgery because I'm quite particular about not using artificial sweeteners. I finally found a whey protein at Whole Foods that is sweetened with stevia (an herb that is naturally sweet and very good for you). It comes in vanilla and chocolate, and I add various flavoring oils (eggnog, butterscotch, strawberry, peppermint, etc.) to get variety.

At my two week visit I was given the go-ahead to move to the next stage of pureed foods. Yeah! You have no idea how boring liquids can get! Towards the end I was getting pretty desperate and putting about two tablespoons of whatever we had for dinner into the blender with 8 oz. of chicken broth,which I then put through the strainer. That gave me a whole new world of options! I will admit that a cheated a couple of times and had some (well-chewed) crackers. I tolerated those very well, which was why I went ahead asked the doctor if I could move on the pureed/mushies. So far I've added cottage cheese (mmmm!) and saltine crackers with pumpkin spice cream cheese. I've even had stir-fry veggies, which I steamed a little longer in the microwave to get them to the soft stage. After two weeks of liquids, that felt like gourmet cuisine! It's so nice to feel like I can eat almost-normal foods. This new stage will last a few more weeks, then regular foods can be added in carefully. Some people develop food intolerances post-surgery, especially to dairy, eggs, and certain meats (different ones for different people). So far I've been fine with dairy. I've only tried eggs, chicken, and ham one time each; they were each fine so far.

One thing that is new is my sense of fullness. Obviously, I get full on much less food, that's a given. What is new is the physical feeling when I'm full. It's very different from before. It's quite impossible to describe, but it happens quickly, and usually AFTER I've finished eating. If I eat until I am full, then it is TOO LATE. About 5-10 minutes later I begin to feel over-full, and it is NOT a comfortable feeling! It has only happened three times, but it's definitely something I would rather avoid! So, I've learned to be very careful about measuring my food and eating only that. On that note, here's a word of advice for everyone who wants better control over their eating: measure portions and use smaller plates/dishes. I now use a salad plate as a dinner plate, and I bought several glass ramekins (custard cups) to use as bowls. I usually eat with a baby spoon and fork as well. It's amazing how quickly these have become habit. At first such tiny bites felt so silly, but now it feels very normal.

Also at my two week follow-up, I was cleared for driving. Yeah! Freedom! I celebrated by spending the rest of the day shopping. That was not so smart. Alden even warned me, "Don't overdo it and spend hours shopping around!" I told him not to worry, I was just looking for a few decorations for the tree and some cool weather clothes for Josh. Well, you probably know how that ended up. I felt like I'd been through the wringer by the end of the day! And then I came home, made dinner, started decorating the tree with the family. I've never been so exhausted! I dropped into bed and slept like a log! Oh, that was my first night back in my bed. I've been sleeping in a recliner (thanks, Mom) since I came home from the hospital because it hurt to stretch flat and/or turn around in bed. Ahhh..it felt SO good to be back in my nice comfy bed!

The only struggle I've been having in getting in enough fluids. The goal is 64 oz or more (that's for everyone, not just bariatric patients). And getting enough water/fluids is absolutely critical for weight loss. I typically have been getting about 40-50 oz. The last couple of days I have gotten 64+ oz, so hopefully I'm on the right track. For me, the trick is to remember to sip ALL the time. I can't guzzle water anymore (weep!) so I have to remind myself constantly to get in those little sips. Again, it's just a matter of learning a new habit. Very do-able.

I'll post pictures on my one month update. Oh, I've lost 15 lbs. in the two weeks since surgery, and 25 lbs. since my highest pre-op weight.

Later!

Cassi

I'm home and doing great!

I came home yesterday afternoon, and I'm doing very well. I had along wait for surgery. It was originally scheduled for 2:30, one of the surgeries before me went long, so my new time was 3:00. Then the doc came in and told me that he had an important meeting over at another hospital at 4:00 and that he would do me at 4:30. That didn't sound realistic, and sure enough it wasn't. I was wheeled in for surgery at 5:00. But at least they didn't postpone it to another day! I'll tell you, I was one thirsty girl, since I had been NPO since midnight. They had a hard time finding a vein for the IV, of course, but other than that, it was smooth sailing.

Recovery has been just fine. Pain is manageable, although getting into and out of bed is still a beast. Anything that involves the core/tummy muscles is mighty uncomfortable! That will pass, though,so I'm just keeping it all in perspective. I'm just SO glad to be home now and relaxing in my own environment.

It still amazes me how little I can eat! I had a hard time just finishing what the hospital brought (photo below) which looked hilarious on a plate, and yet I sometimes couldn't eat it all. I'm also relearning how to drink water! I used to love to guzzle aglass of water. Now I have to remind myself to take small sips, and to do it CONSTANTLY! No wonder I hear about people struggling to get all their water in!

I am walking, walking, walking! I was told that this would be an important factor in a quick recovery and decreasing gas pains, and I am taking that very seriously. In the hospital, I started walking immediately after surgery, although that was very painful because the pain medication administration machine was NOT working (dead battery!). I got up and walked almost every two hours, except when I was sleeping. Initially it was just to the end of the hall and back, but each time I went a little further so that by the end I was walking the full floor five times around. I'm still continuing the walking at home, and I intend to make this a daily habit. I think the commitment do exercise every single day is almost as important as the exercise itself.

My diet for the first three weeks is full liquids (which can include yogurt and cream of wheat thinned out a bit). The next five weeks is pureed/mashed foods, baby-food consistency. This gives your insides a full two months of "easy" foods so that the stomach/intestines can heal completely. We had Thanksgiving over at Mikki's today. I was feeling quite good, although towards the end I was getting pretty tired and sore. It was kind of silly eating my 1/4 c. of turkey broth while everyone else was eating Thanksgiving, but again, I couldn't have eaten a drop more. I was tempted to have a teeny tiny bite of mashed potatoes--they are soft and smooth, after all, but I was a good girl and stuck to my doctor's orders. I didn't go through all of this to"cheat" here and there. No way! I can't wait to watch the progress unfold!

This is the official "before" picture, taken the night before surgery.

I wasn't the least bit nervous on the day of surgery. I was SO ready for this!

My first meal: apple juice and jello!

Tomorrow's the day!

Wow! It's really here! It feels rather surreal, even as I make all the final preparations:

bag packed--check
meals brought in (family and church)--check
meals in freezer for next two weeks--check
someone to pick up ds after school--check
hibiclens/antiseptic showers--check
bowel prep (ughh!)--check

I feel like a pilot doing a pre-flight check-down. Actually, it's a nice analogy 'cause I am ready to FLY! After tomorrow, my life will be forever changed. I'll still be the same person, but with a tool to make my dreams come true.

Oh yeah! Here I come!

$43.11 of Mortification

I bought a new pair of shoes today. That hardly seems like blog-worthy news, but it is. They were athletic shoes. Now, to most of you, that seems even less blog-worthy. Maybe some Bandalinos or Guccis, sure, but tennies? The truth is, I haven't bought tennis shoes in years. It is simply too much of an ordeal. My feet are not exactly normal-sized. The tennis shoes I bought today were a size 9.5 wide. I almost died! Not that there's anything wrong with being a size 9.5. The problem is that I'm NOT a 9.5! Standing on the foot measuring thingy, I'm a size 6. Seriously! But does my foot actually FIT in a size 6? Uh, no. Maybe my big toe would, but it's a little hard to walk that way. :-)

Even more embarrassing than the size was the fact that it was so awkward to put on my socks and shoes. Tying them was quite a feat of body contortion. Eventually the sales girl (tiny, of course) said, "Here, let me get that for you." And she tied my shoe for me. Could I please just crawl under a rock?

Here's something I've noticed. Since deciding to do this surgery, my weight/size issues have come to a painful awareness. I used to think that I didn't worry much about what other people may or may not be thinking. Now I realize that that was just a sham, a survival mechanism. I had to adopt a shell of "I don't care what people are thinking" just so I could get on with doing what I needed to do. For example, when I went back to school nine years ago, I did not fit in. And I mean that quite literally. I did not fit in the desks. Yet, I was determined to go back to school and get my degree. So, I started "scouting out" the rooms ahead of time. I made sure there was a chair in the room that was not attached to a desk. Then when I went to class, I got there early so that I could "set up" by sitting in the regular chair and turning one of the desks around backwards to use as a writing surface. I did this for four years. Dang, I can sure be determined sometimes! However, I think that creating a facade of "I don't care" has its downsides.

So, back to my tennis shoes. Or, more accurately, my walking shoes (tennis will come later). I survived the ordeal and I am now the proud owner of a pair of New Balance shoes. Post surgery, lots of walking is important--even from the very first day they get you up and walking the halls. Initially, this is because they expand the abdomen with CO2 gas in order to do the surgery laproscopically, which can result in nasty gas pains. The best way to work the gas out is walk, walk, walk. After that, though, walking continues to be important for getting in non-strenuous exercise in the first six weeks post-op. As you know, walking is hard for me; I get severe pain in my back after about 10 minutes. So, I will do what I can and push it a little, but not so much that I can't continue the next day.

After my shoe purchase, I went to our gym and met with a personal trainer. I want to do this right, and I am very committed to the exercise portion of losing weight. Surgery doesn't "fix" that part of the equation! We did an overall assessment to get my "starting point", which is not too impressive. But it sure will be exciting to see it improve! So, here are my stats:

Chronological Age: 42 (Body age=52)
Weight: 352 lbs (initial goal=299)
Max VO2: 14.7, very poor (initial goal: 30.0, fair=29.45-32.30)
Bicep Strength: 52 lbs, average (initial goal: 60 lbs, good=56-72 lbs)
Flexibility: 10", poor (initial goal: 12.0", fair=11.1-12.8")
Body Fat: 43.1%, obese (initial goal: 35%, overweight=30.1-35.0%)

I will keep these updated as I go along through my metamorphosis. I think these numbers are much more telling than the numbers on the scale!

Three more days!

It's for real now!

It's one thing to think about it and initiate the process, but when you find out you're approved, it can be a little bit mind-blowing. It's exciting and frightening all at the same time. You know the saying, "Be careful what you ask for--you just might get it!" That's how I feel right now.

So, it really is official. Insurance has approved it and the hospital called today to schedule all the pre-op tests (blood draws, abdominal ultrasound, EKG, sprirometer, etc., etc.). My surgery date is November 19th--right before Thanksgiving! Too bad it couldn't be right after :-(

Oh well, I'm just thankful that it all managed to work out! There were a few hiccups along the way. Well, just one big one, really. Insurance coverage. I'm still not sure how it's going to sort out for coverage after November, but I'm covered for the surgery. So, I'm moving forward. Thank you for all your prayers and fasting! I am so blessed to have such wonderful support!

Top 10 Reasons for Morphing...

10. I want to be able to paint my own toenails.





9. I want to wear cute shoes, not Z-coils!







8. I want to go to restaurants and theatres and not wonder if I will fit in the seats.





7. I want to fly without a seatbelt extender, and I want to climb the Great Wall of China, not just take pictures of it.







6. I want to work in my yard and garden without aching for days afterward.






5. I want to have the energy to work full-time and still have plenty of energy left at the end of the day for family and volunteering.





4. I want to be off my medications, especially diabetes and pain meds.





3. I want to be able to buy clothes that fit my tastes, not my size.





2. I want to bike, hike, swim, and play with my kids and husband.







1. I want to be around to see my children have children. And for their children to have children.

The game begins...

Where to begin? I was small when I was born (6 lbs, 6 oz) and that was the last time I remember being small. Okay, I don't really remember that. Which means, I cannot remember a time--ever--that I didn't feel overweight. Which is not to say I was always obese. My younger sister was naturally skinny, and I was naturally somewhat chubby. In my mind, compared to her, I was fat. I look back at my childhood pictures and say, "Wait a minute! I wasn't as fat as I thought I was!"

Fast-forward forty years, and I am exactly what I always thought I was. Fat. Very fat. If there were a category for super super morbidly obese, I'd be in it. The weight began creeping on during my high school years. I weighed 140 lbs as a freshman (age 14) and I thought I needed to lose 50 lbs. Granted, I'm short, but still, I wasn't as fat as I thought I was (that seems to be a theme). By my early twenties I was around 240-260. I lost 80 lbs at one point, just before I met/married my husband. But after baby #1, I was right back up to 260. After baby #2 (seven years later) I was up to 320. After about 10 years of rigorous dieting and vigorous eating (cuz you know they go hand-in-hand!) I found myself over the 350 mark. 358 to be exact.

The last 15 years have been a gradual climb of 100 lbs. It was so slow you'd almost not notice. And when you're already fat, it seems to all just "blend in". However, when I see myself in photographs, I now have the opposite reaction than I did as a child. It always surprises me to see how large I really am. Apparently, my sense of "what size I am" is rather warped. That is something I will have to deal with on my way down. I'm sure other things will come up as well. I am 100% convinced that extreme obesity has as many emotional connections as it does physical.So, after years of resisting the idea of weight loss surgery (thought I was giving up, wanted to do it on my own, didn't want to take the easy way out, etc.), I have finally learned that a) it's okay to ask for and/or accept help, b) it's NOT the easy way--but it's almost always the SURE way, and c) I'm pretty darn stubborn. Now I'm going to take that stubbornness, which we shall reclassify as determination, and put it to good use.

The game has begun...