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Wednesday, February 8, 2012

Another Day...Another Appointment

Today is better.  For the most part, at least.  (Warning - long post ahead)

I saw the MD, RD and had my first Behavioral Modification class today.  As I admitted in my last post, I hadn't journaled my food intake all week.  The scales reflected it. I gained 1.7 pounds.  CME (hubby) mentioned that it was "normal" and more than likely I was dehydrated last week because of the bug.  I guess.  Still...

MD was nice, but almost stern about it.  He again stressed the importance of the education portion of the program.  He said something like, "Don't let this happen again.  Just get your head back in the game.  You can lose weight with just the information in the meetings, but the surgery will not be successful unless you use what you're learning."  He's right, of course.    And though it may seem silly, I'm glad I wasn't totally let off the hook about it. I cannot will not fall back into the same patterns as before.  

His nurse left me with some exercise Do's and Don'ts and at home exercises to do.  Though I chuckled reading about "Toothbrush Tush Push", "Towel Toner" and "Upside Down Toe Touches", I may try at least the towel toner one tomorrow. 

My time with RD was quick.  She gave me some more information on reading labels and definitions of the "claims" and requirements to those claims made on food labels - fat free vs. low fat vs. less fat vs. saturated fat free; high, rich in, or excellent source; etc.  It's actually kind of interesting to read.  She said that there are times it's better to not get the "light" version, but rather just eat a smaller amount of the full version.  Calories may not vary as much as you may think.  She did recommend that no more than 30% of your total calories should come from fat.  She also said to be sure to keep sugars to less than 10g/serving to help reduce the risk of dumping syndrome.

The "class" was a group of 4 patients, all in different stages of the pre-op process.  We got the opportunity to share where we are in the process and discuss responses to what we are learning.  This session was on "Stress".  Ironic?  Coincidence?  (I don't believe in coincidences, by the way.)  The first part was "Promoting Healthy Living."  We had to rate how we/our body reacts to stress by rating 0-2 in certain areas.  The list and my answers are below:

Reactions to Stress
0 = never; 1 = sometimes; 2 = always

Record your physical responses to stress:
Headache - 1
Change in Appetite - 1
Fatigue - 2
Interrupted Sleep - 1
Indigestion - 0
Lower back pain - 0

Record your psychological responses to stress:
Sadness or depression - 1
Difficulty concentrating - 1
Feeling inadequate - 1
Feeling emotionally drained - 2
Forgetful - 0

My behavior responses to stress:
Decreased productivity - 1
Increased irritability and anger - 1
Eating or smoking or drinking - 1

Causes of Stress
0 = not a source of stress; 1 = stressful; 2 = very stressful

I have too many demands - 1
I don't like my present job - 1 (only because of what's going on right now)
Communication with my poss and co-workers - 0

I worry about my safety - 0
I'm bothered by all the noise - 0
I don't like daily traffic - 0

Life Events
I've been divorced in the lats year or lost a loved one - 0
I moved within the last year - 0
Adult children/grandchildren/other family moved in - 0

Triggers for Stress
My family responsibilities are overwhelming - 1 (though I wish there was a .5)
I don't have enough fun or free time - 1
My appearance concerns me - 2

I'm concerned with my weight - 2
I'm concerned about my general health - 2
I'm concerned about my level of physical fitness - 2

I'm concerned about job security - 2 
My salary is too low to meet monthly bills - 1 (due to current situation)
I made a large purchase (house, car, tuition) - 0

We also learned some symptoms of stress.  These are the ones I recognized in my life at some point:  clearing throat (CME makes fun of me for doing this when I'm on the phone - especially if I may not like how the conversation is going or if I have to say something difficult), backache, emotional instability, nightmares, constipation (sorry TMI, I'm sure), foot tapping, irritability, negative thoughts, crying, fatigue, headache, overeating, inability to concentrate, insomnia and depression.  Yep - all of those have had a place in my life at some point.  We talked through these and how stress affects the body and methods of coping with stress (what it looks like to learn to relax, practice acceptance, etc.)  One sentence really stuck out to me:  Acceptance does not mean we are giving our approval, it meas we accept "what is" so we know what to do to take care of ourselves and what boundaries we need to set. It went on to talk about setting healthy boundaries and what that may look like.  I like this too:

Guard your personal freedoms - the freedom to choose your friends, the freedom to love, the freedom to feel what you feel, the freedom to think and believe as you choose, the freedom to structure your time as you deem appropriate, and the freedom to set your life's goals.  

We ended the class with a self esteem overview.  I wrote down when LCSW said, "Self esteem is a choice - not chance."  I'm not sure why at this point I found that note-worthy, but I hope when I look back on this whole thing it will be crystal clear to me then.  There is a lot of good information in this packet that I still need to read, but a few things that caught my eye were:
"Bariatric surgery provides the tool to help lose weight and to make bodies healthier.  However there is no surgical procedure to make minds healthier."
"Who we are is God's gift to us...What we become is our gift to God."
"Seek solitude. Schedule regular periods of quiet time for yourself.  PRAY, reflect, meditate. "
Our last task of the day was to complete a worksheet to help improve our self-esteem.
"Your self esteem is closely connected to what you recognize as your talents, capabilities, strengths, the positive qualities about yourself.
We then had to list as many characteristics as we could about ourselves in:  Performance at Work, Relationships, Personal Appearance and Performance with Daily tasks.  Though I came up with some decent ones for Performance at Work and Relationships, I struggled with finding even one "positive" for Personal Appearance and Performance of Daily Tasks.  Each one of us had to choose two of the four topics and read our lists.  Interestingly enough, we all chose performance at work and relationships.  LCSW said, "It's so funny but almost everyone chooses to share "Performance at Work" and "Relationships" as their two categories.  So many overweight people try to compensate for their weight by being excellent employees, excellent wives, mothers, and friends.  It's just so hard to be excellent all the time!  It's stressful!"

LCSW then asked this question:  Do you take as good care of yourself as you do your job and relationships (others)?  Now that's a question!  I've never thought of it that way.  The obvious answer at this point is "No, but I'm working on it!"

Tomorrow I will have my upper endoscopy and then come home to sleep off the sedatives.  Is it bad to say I'm hoping for it to be some of the best sleep I've had in weeks?!?  Even if it's bad, that's what I'm saying!  Bring on the sleep!  
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

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