Friday, July 22, 2016

One Last Look Ahead



Well, this is it.

After 5 months and 90 blog posts, this is the last post I will make before the day of my surgery (July 25, 3 days from today.)

On Monday, at 7:30 AM (MST), I will get taken back to pre-op, and within a couple of hours, my whole life will change. Again. After 80% of my stomach is removed, I will get moved out to the general population of the hospital for a couple of days. There, I will sleep or shuffle slowly back and forth around the hallways, hauling my IV rack around behind me. Until, on Wednesday, they send me home, where I will collapse into a real bed for about a week or so.

Where am I getting this vision of the future from? I just watched Lor go through it, about 5 weeks ago. It took her three weeks to really get her feet back under her, and I know darn well she is tougher than I am. I am resigned to some quality bed time post-surgery.

I will continue to keep everyone informed as usual - my next blog post will be from the hospital, either immediately pre- or post-surgery. Let's go with "pre". Lord only knows what I would say if I wrote something immediately after surgery. Anesthesia can do some strange stuff to the mind.

How do I feel about it? A mixture of dread and relief. Dread because I hate hospitals sooo much. Relief because I will at least be done with waiting. Lor even informs me that I will be done with feeling like I am constantly starving, so there is that to look forward to. 

Curiously, I am not afraid of the procedure itself. We have picked some amazingly competent surgeons in a world-class organization focused exclusively on bariatric surgery. After some of the horror stories we have heard and read about these procedures being performed by less experienced doctors, we are so glad that ABQ Health Partners Bariatrics was available to us.

I am, admittedly, kinda worried about the "5 shanks and a boot knife" results, but 5 weeks out Lor is already rocking and rolling with pretty much full use of her core muscles, so I suppose I have real evidence in front of me that it isn't as bad as it looked. 'Cause boy, did it look bad.

Mainly, I am ready to get home on Wednesday, so I can lie around and binge-watch all the shows I have been stacking on Netflix, and go through my old DVD collection. 

I will keep everyone in the loop as things progress. Only 72 hours to go.

Ready For That Tasty Hospital Food,

- Hawkwind

Thursday, July 21, 2016

Fear of Failure at the Finish Line

Photo Credit: schiiiinken via Compfight cc

After another grueling 8 hours across the desert (including 4 different multiple-mile construction zones) we have returned home. Arizona is safely behind us, and we will not return until the average temperature drops 20 degrees.

At least.

An interesting (and discouraging) shift took place while we were there, though. Throughout the process of switching to a low-carb diet, I have rarely actually been hungry. Even the first 6 days of the liquid diet didn't make me hungry - just cranky and stupid. Oh, I have had cravings, of course. But real, live hunger? That had not been an issue. 

Until our first day in Tucson. 

Since our arrival there 5 days ago I have been ravenous. I have never been closer to breaking diet protocol than I am right now. I am so ready to throw it all away so I can go have a waffle. Topped with blueberries and whipped cream. With 6 fried eggs, and maybe 12 pieces of sausage. And a cheeseburger for dessert. That kind of hunger. My stomach has literally hurt constantly for 5 days straight.

This is not only discouraging, it is frightening as well. I am afraid of "falling off the wagon" and eating so much that I regain enough to disqualify myself for surgery. (Not sure how I would regain 53 pounds in 4 days, but who said fear is rational?) I fear sneaking out behind Lor's back to go binge somewhere and then lying about it when I return home - you know, addict behavior. I am even afraid to be in proximity to pretty much any "real" food right now. When Lor threw away half a boiled egg last night that she couldn't finish, I almost cried.

The real fear, though, is what happens after surgery? I know that removing the greater curvature of the stomach takes with it the majority of the ability to produce ghrelin - the hormone responsible for hunger. But I can't wrap my head around how that will feel right now. My biggest fear is that I am going to come out of surgery and feel exactly the way I feel right now - that my whole life post-surgery is going to be a constant, gnawing hunger that I am fighting off 100% of the time. I know myself well enough to know that I won't succeed in that case. And then all this, including having the majority of one of my major organs removed, will have been for nothing.

Lor keeps trying to encourage me, pointing out the fact that I have been taking in only 600 calories (plus or minus) a day while expending more than 3000 a day in moving activities every day that I have felt this way. I am difficult to encourage. I just know that I have 4 days left until surgery, and I don't want to fall flat on my face, here within sight of the finish line. 

87 hours until I cease eating entirely for surgery prep (at 10 pm on Sunday). Wish me luck in keeping the faith until then.

Dying For A Quarter Pounder,

- Hawkwind

Tuesday, July 19, 2016

In the Land of the Hot, Hot Heat



Day 3 in Tucson. Out in the deserts around us there are the skeletal remains of pre-surgical bariatric patients, caught for eternity in the act of reaching for a protein shake or Powerade Zero forever just out of their reach.

But, seriously, it is freakin' hot out here. So hot that yesterday I ignored all the warning signs and pushed a little too hard through the antique stores and thrift shops with Lor and our recently relocated friend, and had my very first heat-triggered seizure. Just to make things perfect, this occurred in a claustrophobic thrift shop where I was surrounded by floor-to-ceiling shelves covered in glassware, china teapots, and ancient porcelain dolls.

Ever tried to keep your balance during a seizure when surrounded by hundreds of old breakables? I don't recommend it.

Luckily, Lor got me outside before I racked up any damages, and we called off the expedition. I went back to our friend's apartment and took a cold shower to drop my core body temperature, then went to sleep for an hour or so. I got out of it with nothing more than a small bite on the inside of my cheek, and what will probably be a lifelong phobia of tightly packed thrift stores.

But, seriously, this is what happens from hauling myself out into the desert on a protein-shake-only diet, then working myself into the ground, then exposing myself for hours to what passes for normal July weather here in Arizona. A "normal" person would have passed out, maybe. Since I already suffer from epilepsy, my brain just took the shortcut of having a seizure. I knew darn well that this was a potential outcome.

I just didn't plan for the whole antique store part.

I can't stress enough - if you are planning on going through this process, do not follow my example. Protect yourself while you are operating on such a low caloric level. Stay hydrated. Do not expose yourself to extremely high, brain-frying heat.

And you might want to skip antiquing, too. Just to be safe.

24 Hours Until I Can Get Out Of This Heat (And Six Days Until Surgery),

- Hawkwind

Monday, July 18, 2016

400 miles and 50 pounds

Photo Credit: Snap Man via Compfight cc

During the final 2 weeks before gastric surgery, you are supposed to be gentle with yourself. Your liquid diet leaves you operating under a pretty severe caloric restriction, having to be careful to maintain your 60 grams of protein (to avoid malnutrition) and 64 ounces of water a day (to avoid dehydration) to make sure you do not damage yourself while undergoing the crash weight-loss that will reduce the size of your liver, giving your surgeon more room to operate. Caution is key.

So, in the name of caution, we have now driven 450 miles to engage in 3 days worth of household moving for a friend of ours. Not just to anywhere - to Tucson, Arizona, where it is so hot that you can literally fry an egg on a manhole cover. (Look it up - it is on YouTube.) 

Today is actually not that bad, so far. A rainstorm showed up last night and brought the previously miserable heat down to a tolerable temperature. And, as a reward for my interstate moving efforts, I had a surprise waiting for me this morning.

Today, I am finally down 50 pounds.

I had actually not expected to hit this marker until next week sometime, after I leave the hospital. (7 days to go!) But, it turns out driving and then moving heavy objects around are fairly significant calorie burners. Who knew? Accordingly, I have arrived at the half-century mark a full week earlier than I expected.

I want to be able to minimize it, and blow it off as no great accomplishment, but that isn't really how I feel about it. It is a major accomplishment, and an excellent start on where I eventually want to wind up. This is not part of a post-surgical honeymoon period. Getting this far required work, and sacrifice, and a whole lot of discomfort, It is the hardest thing I have done since I developed Epilepsy, and it is probably right up there in my personal list of "hardest things ever done." I am proud that I have made it this far - it encourages me to believe that I will be able to maintain this focus and discipline after my surgery and for the rest of my life. After all, after next Monday I will have the tool of the Sleeve to assist me.

I know that many of you that follow the blog have questions about your own weight loss. But the fact is simple - if I can do this, anyone can. There is no reason for anyone to remain shackled to obesity - whether by making lifestyle changes, or by the more extreme measure of going through surgery to support those changes. You, too, can do this.

The household is waking up around me, so it is time to get back to moving heavy objects. I hope the heat does not descend today like yesterday - it was like working in an oven.

Praying For Rain,

- Hawkwind 

Friday, July 15, 2016

The Day I Threw Down With the Founder


One of the primary sources for support and information for those of us going through bariatric surgery is the World Wide Web. We can find medical info, tips and recipes, "journey" blogs like Misdirected and The World According To Eggface, and good old fashioned "support" sites.

Early on in our process, a friend introduced us to a closed Facebook group for bariatric surgery support. The support group (who I will not name, you'll see why shortly) was an outreach arm of a company that manufactures, among other things, protein shakes.

The group was a bit disconcerting, to say the least. The atmosphere was very similar to attending a group of religious fundamentalists. Here, though, the "devil" was carbohydrates, and the holy writ was something like "Drink our protein shakes every day, lest ye experience regain."

I tried, I really did. I spent months on this group, looking at recipes, investigating nutritional advice, reading about other people's experiences with bariatric surgery. But I was perpetually taken aback when the group leaders would brutally slam members whenever they would mention the forbidden word: carbohydrates.

The primary enemy, as this group's moderators see it, is anyone teaching that Everything In Moderation (EIM, as they called it) was a reasonable diet after surgical recovery. Nope, they very mention of adding white rice, or a potato, or pasta to a post-surgical diet was enough to send them into full-on frenzy: "EIM is a ticket to failure! Any carb ingestion will ultimately doom you to a regain, and ruin your diet! Carbohydrates are what caused your obesity!" (All paraphrased, but you get the point.)

Oddly, one of the primary products this group was promoting was a program to re-start weight loss after a regain, centered around purchasing their protein shakes.

For months I had remained silent. But this morning, a member of the group posted a copy of her Phase 3 diet - you know, the diet handed to her by her surgical team. But, after all the anti-carb info she had received from this support group, she was a little uncomfortable with the carbs included in this diet. 

This is what fearmongering gains you, you see. Lor just finished this transitional diet, on her way back to normal foods. It includes several soft foods that would not be considered low-carb friendly. Things like applesauce, mashed potatoes and the like. Things that are retraining the recovering stomach into digesting food, and not pure liquid. This poor woman was worried that the minuscule amounts of "unhealthy" carbs in her recovery diet would somehow damage her attempt to lose weight via bariatric surgery. 

Was this woman encouraged, that this was a temporary phase, intended by her doctors and nutritionists to ease her through a two week period?

Nope. A group moderator instantly jumped in with the following:

Moderator: "I wouldn't touch those foods with a 10-foot pole!!! Here are some awesome choices!!!" 

The "awesome choices", of course, included a recommendation for the company's protein shakes.

This was just too much for me. Where was the advice to "follow your surgical team's instructions."? What, exactly, was the basis for the expertise that allowed this moderator to direct this questioner to an alternate source of nutrition, rather than the one dictated by her surgical team? I removed the muzzle I have been wearing for several months, and replied:

Me: "Every time I start to get comfortable with the ***** group, something like this happens: ***** directly contradicting advice from a patient's medical team, all in the name of selling more protein shakes. I am fully aware that ***** is in business to sell shakes. But the number of times I have seen this kind of ***** activity makes me very uncomfortable. The fact that someone represents themselves as ***** on this group does NOT supersede advice from your surgical team, folks.

Asterisks represent redacted names and identities, not expletives.

Within 10 minutes, the Founder of the group had appeared. Her initial post told me that I was "missing the message" if I thought the group was doing this to sell shakes. This was not surgical advice - this was nutritional advice - advice that was being used by surgeons across the country because it worked! Hundreds of people were regaining weight because they weren't obeying the advice found in this group!

All in all, it was a very "How dare you?" kind of post.

Why no quotes here? Because within 20 minutes of her very angry post, she edited it to a much more friendly tone. But, as far as I was concerned, the damage was done here. Any site that is directly opposing medical advice, and then responding quickly, defensively, and angrily when called on it, is probably not a source I need for assistance with my weight loss. I replied to that effect, then left the group.

It's too bad, really. Some of the recipes were great.

Back In Search Of Sane Bariatric Surgery Support,

- Hawkwind

Thursday, July 14, 2016

Pre-op Prep



Day 4 of the liquid diet. I grow crankier and dumber by the minute, it seems. The weird thing is, I don't feel particularly upset at any given moment. But, whenever I am interacted with, my responses all seem to come out of the "annoyed" section of my vocabulary. Lor has been very tolerant, and has not cut my head off and buried me in the backyard.

Yet.

In the midst of this not-so-great emotional adjustment, I got to travel across town for my pre-operative appointment yesterday. This was a new experience for me - during Lor's pre-op appointment I was in a nutritional appointment, so I missed the whole thing. I imagined tons of highly technical information that I was going to completely misunderstand due to my current brain fog.

Luckily, the appointment was nothing more than a re-hash of all the experiences we just went through with Lor's surgery. On the day of the surgery, I will consult with the anesthesiologist and my surgeon. They will roll me back to a surgical suite and inject me with something that will put me to sleep. They will then inflate my abdomen like a beach ball so the surgeon has lots of room to work in. They will punch a hole in me to correct my hiatal hernia, then punch 5 more holes in me to perform to the removal of the "greater curvature of my stomach." I will then be returned to the hospital room to recover for 48 hours.

I was struck by how much the pre-surgical briefing minimizes the actual trauma they will be inflicting on you. True, they will not be slicing me open like a dissected frog in biology class. But they will still be leaving me with the equivalent of 5 shank wounds and a puncture from a belt knife. I have read many testimonials of people who say they were back at work immediately after their surgeries. Quite frankly, I don't understand how. Lor is only now getting back to where she can bend or flex at the abdomen comfortably, and she is 4 weeks out from her surgery as of yesterday.

Speaking of 4 weeks out, Lor got to have her 4-week post op appointment yesterday while I was having my pre-op appointment. (That is how closely we scheduled these surgeries.) She has been returned to the land of Those Who Can Eat Real Food. Her visit to Trader Joe's yesterday was a lot like a child being taken to a candy store. I have never seen someone so excited about the prospect of eating salmon, bananas, and kale chips.

After my 6 weeks without real food, I am sure I will have a whole different perspective on that too.

Ready To Have My Brain Turned Back On,

- Hawkwind

Tuesday, July 12, 2016

The Lights Are On, But No One Is Home



So, the first 24 hours of the liquid diet phase is over. I consumed 3 protein shakes, 2 sugar-free popsicles, 1 greek yogurt and 80+ ounces of water - while only occasionally staring longingly into the refrigerator at things I could chew. I got a little cranky towards the end of the day, but I suppose this is to be expected on a day where you only ingest 725 calories all day. (I did manage 93 grams of protein, so yay Muscle Milk shakes!)

But the really weird part occurred right around 3:30 yesterday afternoon. We were sitting in the office of a title company, working on scheduling the closing on our home, when I very distinctly felt my brain shut off. It is hard to describe it otherwise - one moment I was looking over the paperwork, the next I was unable to focus on anything, reading the same line over and over. I am real familiar with this condition - this is how postictal state feels: that is, the period of time after a seizure. But there had been no seizure to accompany it.

I struggled through the next half an hour - forgetting my email address, filling out paperwork incorrectly, trying to remember how to sign my name, for goodness sake. I smiled a lot to make up for it, and we exited the office.

I mentioned it to Lor cautiously, fearing this might be some weird interaction between the severe caloric restriction and my epilepsy. She just nodded her head. "Yeah, that's what happens when you are on the liquid diet. You come down with brain fog."

Wait...she felt like this for 4 weeks?

Yes, it turns out that, for Lor at least, the 4 weeks of liquid diet were accompanied by serious mental confusion and inability to focus. She spent the whole first week like this, recovered for week 2, and then the surgery tipped her right back over the edge into "brain fog". She is only now really getting her mental legs back under her. 

If everyone feels like this while they are going through this process, no wonder they are in a bad mood! Being unable to think straight for a month would drive anyone crazy. We were told to expect fatigue, not mental confusion, during this process - which makes me wonder how many people are just going to bed rather than trying to think.

For maybe the first time in my life, I can be grateful for my experience with epilepsy. I have over a decade of experience in getting through life with my brain functioning at "a sub-optimal level" (as a neurologist would put it.) But it is a very strange sensation - normally I just sort of sit quietly somewhere while post-ictal and wait for the lights to turn back on. Here I am having to push through, not expecting to get back to normal...until August sometime.

Thank goodness I am a writer and am used to sitting around and staring at a blank page, waiting for the next idea to arrive. Can't imagine how this would work if I was an airline pilot. Or a brain surgeon.

1 Hour & 30 Minutes - Longest Time To Write A Blog Post Ever,

- Hawkwind