New Clothes, Old Clothes, Belts and Suspenders

Today I wore one of my smallest t-shirts (which now fits me perfectly) and my largest pair of jeans.  I had to wear the latter with suspenders and resembled a clown a bit.  I can easily hold my fists on their respective hips within the pants.  It's a fun feeling, even though belts and suspenders are frustrating when I want to dress for the office.  I've got some important meetings and business trips later this month, and I know that I should get some new clothes that fit well, but I'm hesitant because I don't know what will fit me then.  I guess I'm going shopping the weekend before!

Despite the impression that I may have given over the years, I like clothes and have a sense of style.  I also don't want my clothing to be too tight or show what I would prefer to hide, which, when added to comfort, doesn't give me a lot of options.  There's also the matter of self-confidence.  When I don't feel good about myself, I not only dress with less care, but I look worse wearing it.  Between a great new job and the surgery's effects, I'm feeling better about myself.  It's not a cure-all for every neurosis, bad mood, or day in the dumps, but the days are so much more positive when I'm moving forward.

I'm still just beginning the journey, and my attitudes about my weight will vacillate along the way - people of all sizes feel fat and disgusting at times.  I also know that the build underneath all of this will never be a size 6 or particularly dainty - that would be unhealthy and disproportionate.  However, this surgery also won't take me to my ideal weight and won't make me fit and toned - for that I will need to exercise.

In the warm summer months, and even now in the autumn, I've enjoyed my walks along the harbor and around the neighborhoods where I live and work.  As the New England winter approaches and my endurance (hopefully) increases, I will need an indoor solution.  This has me thinking about a gym, so I've started investigating.  I love to swim, but also want to learn more about other type of exercise, including weight training.  The YMCA is a more affordable option than many gyms around here, and there is a location along my route home, as well as one within moderate walking-distance from my home.  The one closer to work even has a pool!  That's almost unheard-of downtown.

The one near work has more group exercise classes that interest me, as well, and longer hours, so that will probably be the one that I join. It will be nice to know, on the other hand, that the location nearer to home is about a 15-minute walk away (at least, according to Google).  This is probably a bad month to start, schedule-wise, but procrastinating won't do me any favors.  If nothing else, I will try to walk to the neighborhood Y at least once before my next post.  If you have any other ideas for fitness, that don't require me to purchase any equipment, let me know!

One Month After

Friday was exactly a month after my surgery, making today a month after I was released from the hospital.  To "celebrate" the former, I had a bunch of appointments at the Weight Center.  The nutrition group kicked off the morning, and I was glad to see many more faces around the table and hear experiences spanning the first three months after surgery.  We learned more about the reasons for the prescribed diet, how our bodies now operate, and more.  One of the things that really stuck out to me is that fat is lighter than fluid and muscle - it just takes up more space.

I also weighed in again and got some perspective on my progress.  As of Friday, I'm down 52 pounds from my peak (since they have been tracking me anyway), over 34 of which have been since my final pre-op appointment.  Last week, I was a bit disappointed with my loss since the previous visit, and while my daily average had increased this time, I still didn't know what to expect.  The conversations with the staff at the Weight Center reassured me: I'm losing at a rate 2 to 8 times as fast as most people do with a basic change to diet and exercise (depends on who you get the rate from - some say 1 or 2 pounds per week, others a half pound per week).  *phew*

I'm still just adding fruits and vegetables to my protein intake.  Once I can handle a certain amount of those things, I'm allowed to add in starches - but do I want to?  Starches/carbohydrates are fuel, and my body will try to burn those first, rather than the fat.  I'm supposed to be gearing up for a somewhat-normal diet, and eventually I will need that external fuel again.  At this point, it's not worth thinking about, since I'm still having trouble eating much.  I had an omelet at a restaurant today and the waitress didn't think I had eaten any of it when I requested a box!

Today was my second experience dining out, the first being Tuesday night when I had a cup of chili.  It's certainly an adventure, but so far it has worked out well.  I'm now that annoying person who asks about the ingredients and food prep before saying all of the things that I want left off or out.  Hahaha...  :)  As far as I'm concerned, doing so politely is definitely worth the opportunities to dine with friends!

With regard to exercise, I did more walking this past week than I had the previous two.  On work days, I've added events to my Outlook calendar for walks, meals, supplements, when to start drinking, etc.  The weekends are still amorphous, so I'm working to make them more regulated.  As far as walks, I didn't do too badly on Saturday, and today went really well.  Steady progress and a positive outlook, one month into my new life.

Comparisons and Boundaries

I had a group nutrition meeting on Monday, where I weighed in, then chatted with a nutritionist and a woman whose surgery had been the day before mine.  It seemed that our stories couldn't have been more different.  She was down 2 clothing sizes, eating out at restaurants, and enjoying a variety of foods. I was only down 2 pounds in 5 day and had only been consuming dairy and eggs from home.  She still wasn't working, but I had been working from home.  She was smaller than me in height and starting weight. She appeared to feel on top of the world, and it was nice to see her joy.

I, on the other hand, was frustrated.  Why weren't the pounds falling off of me the way they were for her?  I wasn't even venturing as far into solid foods as she was. Maybe she was exercising more. Maybe she was able to eat more mindfully, since she hadn't returned to work yet. Maybe her body is just different from mine.  They warned me that everyone is different, but mostly in the context of what foods they could handle.

All I can really know about her experience is what she said in that meeting, but I know what my life is like.  I split the work week between home and the office.  It should probably be easier to step away to take a walk or sit down elsewhere to focus on a meal, but it hasn't been. I have a tendency to sleep in and then get absorbed in my work.  At the office I got sucked into meetings and conversations - usually bunched up in the middle of the day.  I didn't set boundaries to protect what my body needs.

My meals at home were a mix. There were a couple of times when it was nothing but the food, my stomach and I.  I chewed each tiny bite to a pulp, set down my fork, and checked to see how I felt.  More often, I was working at the computer or reading.  I took some risks with my food that enforced the restrictions of my new diet.  Apparently there was table sugar in that pre-made chicken salad...

While, in some ways, I'm approaching eating the same way, it is fundamentally different.  I am not really hungry.  If I just stuck to stage 2, I would probably be fine: protein from milk and other nutrients from my supplements.  Mentally, I want other foods, but I'm just not enjoying them after the first bite.  The rules around my fluids intake make meals a little complicated for me.  I find thinking about the schedules, amounts, and sensations to be a distraction.  I just want to go about my life - if I could drink everything I needed over the course of the day, I would. Drinking is the only part that I really want to do, but the rules make it a headache.

I don't really have a tidy wrap-up this time.  There's lots to think about and explore further: what I can handle, where I need to create boundaries, what works for me.  My next meetings at the Weight Center are in about another week (a month from the date of my surgery), and hopefully I will have figured out some of these things before then.  If nothing else, maybe I will have more specific questions for the professionals while I'm there.


PS) I've made an update to the Phase 3 description, but there will be more as I make more changes to my diet.

Being "With It"

I noticed today that I'm one month away from my 30th birthday.  The age isn't scary and I've earned each year, but there are things I want to be different (and there always will be).  I naively expected that I would have my career figured out and be an elegant, "with it" woman by the age of 30.  My life would be filled with friends, interesting hobbies, travel, order, style, learning opportunities (perhaps a graduate degree), and maybe a romantic relationship.

Part of that vision was getting my weight down.  I've been overweight to some extent for 22 years, and while I know that the surgery alone will not get me to my "ideal" weight, I now have a powerful tool and access to experts in this area.  Now that the first big step has been taken, it's up to me to take the many little steps that will be part of  the rest of my life.  I saw a quote from a post-op patient the other day on Facebook - "They gave you "the tool" now you got to play by the rule!!!!".  It's true.  For anything and anyone, if you want it, you have to work towards it each day - a language, a relationship, fitness, etc.

Some of my goals are in pretty good shape; I have many wonderful friends, have visited some incredible places, and have kept educating myself through books, magazines, podcasts, and more.  I've also made some big decisions that have brought me closer to becoming the woman that I want to be: moving to Boston, making a career change and this surgery.  Each of these steps brings me a little closer and they are shaping my character in the process.  What's the point of being "with it" if you are boring or a jerk?

At the end of the day, an age is not a deadline - it's just a marker along the road.  I can look back on the years I've completed, celebrate the achievements and remember the lessons.  Even the past 12 months have brought more change that I would have expected.  It's also an opportunity to look forward to the future and make some plans, but with the knowledge that there are things beyond my control.  As long as I enjoy my life, learn, remain open to change, and love those around me, I'd say that's pretty "with it".

Solid Food and Easing Back Into My Life

Yesterday, Wednesday, I had my first post-op appointment with my surgeon.  She was pleased with my healing and progress.  I also got her to explain that the stomach, liver and pancreas are still attached because they still produce fluids that help the body absorb nutrients.  I've posted a video of how my innards are now arranged in the "The Surgery" tab at the top.  Don't worry, it's a cartoon - no blood or sharp objects.

I also had a group nutrition meeting where they handed us the next diet phase: introducing solids.  There are a lot of rules in this new phase and I'm still reviewing the material to figure it out, but I will post what I understand in a tab above, like the ones for previous stages.  I'll update it as I understand more and make a mini-post announcing the updates.

Today I had some sort of solid at each meal.  I made an omelet (that's probably the best description) with egg whites and low-fat cheese, eating about 2/3 of it for breakfast.  At lunch I had cottage cheese, and I finished the day with some milk and the rest of my omelet.  I had string cheese for dinner last night.  It's been hard trying to get all of my clear liquids today, and oversleeping definitely didn't help.

Unless you are familiar with post-op life, you probably wouldn't believe how long it takes to eat now.  All of my bites are supposed to be no bigger than the nail on my pinky finger.  They have to be nice and moist, and then I have to chew them to a pulp.  Basically, my food prep and mouth have to do all of the things that my stomach used to do.  The Binder says that it should take about 10 minutes per ounce.  The Binder is the resource provided by the Weight Center with details of the diet stages, descriptions of common problems, tips, contact information, and more.  I'm supposed to bring it to every appointment.

During my visit, I also had a weigh-in.  My last weigh-in at the Weight Center was August 12, 12 days before my surgery. Since then, I've lost a little over 25 pounds - almost a pound for each of the 27 days.  It's kind of exciting, but I know this is just the start.

While my mother was here, we read a book together called " Women Food and God" by Genene Roth.  It got a bit new age-y at points, but there were some really good points about emotional eating and healthy practices.  The main thrusts were that we need to listen to our bodies' signals of hunger and fullness, notice how different foods make us feel, take time to observe how foods actually taste and feel, etc. I was reminded of it during the nutrition visit yesterday, because they talked about eating mindfully: breathing and putting down the fork/spoon/whatever between bites, seeing how the stomach feels, and stopping when it feels like another bite would make you feel too full.

This is good advice in general, but especially relevant to gastric bypass patients as they start eating again - don't force yourself to eat more if you can't handle it.  I need to hear it in particular, since I feel like I have to get all of my protein - no matter what!  I do the same with my walks and my schedule.  I push myself, which can be good, but I can't do it at the expense of my body and recovery.  It feels almost like I'm learning how to live all over again.

Since my mother left, I've been adjusting to my new life in stages.  Remembering when to have meals, taking walks on my own, starting to work from home this week, getting back on public transit, etc. I'm supposed to return to the office next week, which entails a 50 minute commute each way, mostly by train.  I took two trips into the city yesterday, which exhausted me, so I will need to build up my transit stamina.

Finally, I've been trying to figure out how to enjoy meals with friends.  Many have felt uncomfortable eating around me since my pre-surgery diet started.  Yesterday's visit was good news for that: I will have real food in front of me, and it will take me so long to eat that they won't feel like I'm starving.  I think a chili party is in my future - after I get used to working at the office again!

The First Week

It's been about a week since I met my mother at the airport on the eve of my surgery.  I've been out of the hospital for four days.  In that time, I've been easing back into normal life.  Right after surgery, they had me take three 5-minute walks in my wing of the hospital.  Since checking out, I have expanded those walks to about 15 minutes in the neighborhood.

Up until my release, I got my fluids, nourishment, and sometimes my medications, through an IV. From Monday (8/23) through Thursday (8/26), I was on the Stage I diet - clear liquids.  For me, this mostly consisted of water, although I did have a little bit of tomato juice the last evening.  Since then I've been on the Stage II diet - at least 3 cups of clear and "full" liquids, each.  I'll add a tab about each diet stage as I progress.

I started out taking pills every four hours: one for the itching and 3 for the pain.  I've gradually reduced the pain pills down to one, although I'm feeling a little more pain than usual with the most recent reduction.   When I start getting more and more tired, I usually reduce the dosage.  As it is, I still sleep about 9 or 10 hours at night and nap for over an hour in the afternoons.

As the title of this blog indicates, my stomach can only hold one ounce right now.    Whether it's water, soup, jello, or whatever, I have to go slowly, since the stomach will only hold so much.  I have to take breaks while I eat and often feel tightness and fullness throughout my mini-meals.  It's important for me to eat minimum of each type of liquid to prevent dehydration and loss of muscle mass.  Without enough protein, the body starts breaking down muscles to get amino acids.  That's the last thing I need, so I continue with my long, slow meals.

It has really helped to have my mother with me during this time.  In addition to comfort, care, and company, we get along well.  She goes on the walks with me, prepares my meals, and helps me keep track of time so that I take my medications and meals regularly.  We've also been reading and discussing a book about overeating with each other, as well as watching movies at night.  Having her here has made the process smoother and more enjoyable.

I will try to post at least weekly, but feel free to subscribe for updates.  I'm excited about this journey and look forward to sharing it with you.