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Saturday, March 31, 2012

Oh Happy Day!

Today has been excellent!  My friend and I walked ~5 miles today in roughly 1.5 hours!  My knees were just a little tender afterward and my legs "feel" the walk this evening.  That's good, right?  We even set another date!  Next Saturday we're going to venture across the river and check out a different walking trail/path in KY.

Picked up my Turkish daughter for lunch.  Took her to Manna Mediterranean Grill, our favorite place to dine together.  I got the vegetarian platter complete with falafels, stuffed grape leaves, hummus and baba ganoush.  (Didn't even eat the pita that came with it.)

Afterward, we came back to our house.  She played some Xbox with the boys while I did some things around the house.  Then we spent the next 3 hours sitting on the back deck talking and drinking coffee.  It was a GREAT way to enjoy the weather God's been giving us!

And to top off the day, I got a letter in the mail today that said:

Dear Deedra:
We reviewed your request to cover Laparoscopy, surgical, gastric restrictive procedure with gastric bypass and Roux-en-Y gastroenterostomy for you.  Based on the information submitted and your benefit plan, we determined that the health care service is eligible for coverage.
...more stuff that really has no importance to me (ha!)...
Insurance Company 

Why yes, folks, I have the insurance company's approval!!!!!

OH HAPPY DAY!  Happy day, indeed!!!!
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Thursday, March 29, 2012

It's The Little Things

It's the little things that are making me smile.  First, this evening I made a "date" with a wonderful friend of mine.  We're meeting Saturday morning at 9am for a walk!  That's right...a walk!  Not lunch, not coffee...a walk!  It makes me smile that we get to spend time together - it's been way too long - but I love the fact that we're going walking!

CME handed me the debit card a few minutes ago and said, "order that protein stuff you wanted."  So I order this: Unjury Protein Starter Kit.  Seems silly, but I'm super-excited about that!  Wasn't too happy that the shipping was almost 1/3 the price of the product, but still excited that the first order is placed!

Tomorrow, I get to see some of my very favorite people!  Yes, we're having lunch, but we all eat lunch anyway.  I know the restaurant and I already know what I'm having; a yummy spinach salad.  Yay for planning, right?

Also, I was a bit concerned that I'd not done so well lately.  I've not journaled like I need to the past couple of weeks, but I have made conscious decisions like smaller portions, no snacking, etc.  (I know!  I know!!!)  So this morning, I reluctantly pulled out the Wii (the most accurate "scale" I own).  Although I do get a little annoyed when she tells me, "Step On" quickly followed by "Ooh!", the scale went down 2.4# from last Thursday!  I'm so glad no one was awake to see me do a silly little victory dance!!

So yeah...this week is good (even if I've still not heard from the insurance company!)  The little things are BIG things to me!
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Wednesday, March 28, 2012

Change of Seasons

We've had a very mild winter here in Southern Indiana.  It's the end of March and we've had more days in the upper 70s than we have anything else.  Spring has officially sprung (and so has the grass).  That means that I need to get all my spring/summer clothes out of that space-saver Space Bag and put away the old winter clothes.  

Put away?  Well, not really.  I will never wear these clothes again.  My winter season of size 26-28 (3x) clothes will be a thing of the past by the time I'll need them again.  Still, I'm hesitant to take them to Goodwill just yet.  I want to be brave and just do it.  But there's that little bit of hesitation in my mind saying, "You've not heard back from the insurance company... you've not had surgery yet...you better wait."  So I think for now I'm going to get them out of my closet (probably this weekend) and put them "away" - if only temporarily.

I'd be lying if I didn't tell you that I am excited to be able to wear cute clothes some day.  To be able to shop in any store I want and buy/wear trendy clothes - not something frumpy and designed for someone twice my age.  I'm looking forward to silly little things like being able to own at least one set of cute matching bra and panties!  Something I've NEVER been able to do.  Ever.  (Sorry if that's TMI.)  I'm looking forward to the day when I drop off the clothes at Goodwill...knowing that I'll never be this size again. 

I'm looking forward to the change of seasons.
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14


I need some feedback from anyone who has had gastric bypass surgery.  (Or even if you've not had the surgery, but use these products.)  Which protein supplements did you like best?  Which did you like the least?  What's the best bang for your money?  Protein consumption is a huge factor in weight loss...especially in drastic weight loss.  Protein protects the muscles in the body - specifically the heart!  (I'm even willing to say forget about the hair...it's all about the heart!)  So I don't want just "any" protein supplement.  I want ones that are made for gastric bypass patients - those that are complete protein.

I was able to try three different protein powder drinks at my nutritional class on Monday and I can say that two of them were very tasty.  The third didn't taste bad, but the smell wasn't too appealing even though it was "unflavored".  Obviously these supplements will be the most expensive part of the food plan, but in the long run I think it's worth it.  I think *I* am worth it.

The first supplement I tried was 3 (tiny) scoops Beneprotein powder in 8 oz. sugar free pink lemonade.  This one didn't taste bad necessarily...it was a "little" grainy, but you could smell the vitamins.  (18g protein)

The second drink I tried was 1 scoop Chocolate Splendor Unjury powder mixed with 1c. light vanilla Silk soy milk.  This one was good!  It was rich and thick and not even a remote hint of that vitamin smell.  (20g protein)

The third drink supplied was 1 scoop Nectar Cappuccino flavored powder with 1 c light vanilla Silk soy milk.  Seriously people, this could replace my coffee!  It wasn't quite as smooth as the Unjury, but it was definitely drinkable. (30g protein)

The main thing that I need to look for when searching out the protein supplements is to make sure that Whey or Soy Isolate is the first ingredient.  Then of course I need to look at calories and sugar content.  There are a lot of good websites with information...but I really want to hear from people who are on this type of program and who have first-hand experiences with the different protein supplements.  Any feedback is appreciated!

One question I need to remember to ask RD - can I count the protein drinks as part of my liquid intake???
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

It Could Be Overwhelming

I just looked at the little weight tracker at the top of my page.  Really looked at it.  Here are the two things I saw just now.

  • I have 132 pounds to lose to get to the goal weight I chose.
  • The rainbow is a reminder from God. 

Satan tells me this is impossible.
God tells me anything is possible with Him.  (Luke 18:27)
Satan tells me I can't do it.  
God tells me I can do all things. (Phil 4:3)
Satan tells me it's not worth it.  
God tells me it will be worth it.  (Rom 8:28)
Satan tells me I can't manage this.  
God tells me He will supply all my needs.  (Phil 4:19)

It could be overwhelming, but I'm going to choose to focus on the rainbow and God's faithfulness.

"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Monday, March 26, 2012

Hurry Up and Wait

That's the stage I feel like I'm in right now...hurry up and wait.  

Last week, bariatric center called me because the insurance company needed more information from my PCP.  I called my PCP immediately, only to get placed into their voice mail box.  I left the message as to why I was calling...and then I waited.  And waited.  And waited.  Nearly 5 hours later, I called again only to be directed straight back to the voice mail box.  I was not feeling very patient at that moment, so I decided not to leave a second message.  When the PCP office finally called me back, I explained what I was told bariatric center needed so they could submit it to the insurance company.  I was greeted with a whole bunch of questions about did they need labs, did they want notes, etc.  I told the nurse that I didn't really know I was just relaying the message.  She proceeds to say, "well, why don't you just have bariatric center call me then?"  Knowing how long it took me to get a return call, I was not fond of that idea at all.  So, as politely as I could, I said, "How about I conference you in?"  (A perk of working in an office-environment - I know when and how to begin a conference call!)  I could sense the irritability on the line - though to be honest, I'm not really sure if it was mine or the PCP's office that was the most irritated. So a quick phone call later, the nurses chatting among themselves and they come to an understanding of what's needed.  Almost 24 hours later, bariatric center finally got what they had requested and got it sent in to the insurance company.

Today on the way to my nutrition class, I decided to call the insurance company myself.  I'm really feeling like I'm ready.  Ready to get this done.  Ready to start the next phase, yet things beyond my control are slowing this down.  Yes, I know it's all in God's timing - and this just may be my weakness showing through.  But the answer I got from the insurance company annoyed me..."yes, bariatric center sent us what we requested.  It's all still in review."  I am so thankful for insurance.  I really am.  I'm also so very annoyed that they never ever seem to be in a hurry to make a decision.  I've done what was required (from both the medical side of it as well as the requirements the insurance company told bariatric center needed to be done) so why does it take so long?!  Really???  

So I'm hurrying up...and waiting.  Continuing to do what I need to do...and waiting.  I need patience, Lord!  Or at least the grace to show patience to others even when I'm not feeling so patient!
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Saturday, March 24, 2012

My Responsibility

"The food you eat is your responsibility" - a gentle reminder in the education manual that I am still accountable for how this program will work for me.

What's a sample menu look like?  Glad you asked.  Each phase reminds me of another phase of my life.  We can all look back and say "during that time, I was...or I did..."  That's the same way I'm looking at this part.  God has graciously gotten me through some rough phases of life and it is nothing for Him to guide me through these phases as well.


Phase 1:  Clear Liquids.  First meals after surgery.  Foods to include: water or ice chips, low fat clear broth, sugar free jello, sugar free popsicles, 100% juice diluted with 1/2 water, sugar free beverages like Crystal Light or Sugar Free Kool-aid.  Start slowly - limited to 2 oz per hour.  Do not use straws. take small 'pea sized' bites.  Do not be surprised if it is difficult to take a total of 2 ounces in 1 hour.  It's normal to feel bloated, gurgly and bubbly in your stomach.

Phase 2:  Strained Full Liquids.  These foods will be started on day 3 of the hospital stay.  Strained creamed soups, diluted fruit juice, low fat/low sugar yogurt, low sugar pudding, skim or 1% milk (or lactose free/soy milk) any of the stuff from Phase 1.  Meals should last 30 minutes.  Sip additional beverages.  You will not be able to drink all the allowed fluids.  This is okay.  Stop when you feel full.  Wait and start sipping again.

Phase 3:  Modified Full Liquids.  Days 4-14.  For the first time since surgery, you will need to stop drinking fluids 30 minutes before and after your meal.  Foods allowed:  You may add protein powder to foods. Low fat cottage cheese, very soft scrambled egg or egg substitute, soft cooked egg - avoid crispy or rubbery consistency, ricotta cheese, thin baby food rice cereal/oatmeal, cream of rice/wheat, grits, thinned oatmeal (avoid dry and lumpy oats), thinned mashed potatoes, vegetable juice, no sugar added applesauce, 2nd step baby food fruit plus all foods in Phases 1 & 2.  Sample menu:  Breakfast - 1 soft cooked egg; Mid-morning snack - 4 oz protein smoothie; Lunch - 1 oz grits plus protein powder, 1 oz applesauce with protein powder; Mid-afternoon snack - 4 oz. protein smoothie; Dinner - 1 oz low fat/sugar free yogurt mixed with 1 oz baby strained fruit and protein powder; Evening snack - 4 oz. protein smoothie.  Total protein: 67g

Phase 4: Pureed.  Weeks 2-4.  To protect the new stomach, the food should be blended or pureed to applesauce consistency prior to eating.  Foods to include (all foods in Phases 1-3): canned, water packed meat - chicken, tuna, lean ham or salmon, 2nd foods baby meats (no thank you!), homemade pureed meats (avoid beef), canned sweet potatoes and canned pumpkin, green beans, carrots, beets, squash, spinach, asparagus, zucchini, mushrooms, avocado - all cooked until very tender and pureed.  Be sure to strain to remove any strings or hulls.  Pureed (canned in own juice or fresh) peaches, pears, fruit cocktail, strawberries, cantaloupe, honeydew, watermelon, kiwi, papaya, mango.  Sample menu:  Breakfast - 2 soft scrambled eggs, 1 oz oatmeal with protein powder; Mid-morning snack - 4 oz protein smoothie; Lunch - 2 oz cottage cheese, 1 oz green beans; Mid-afternoon snack - 4 oz protein smoothie; Dinner - 2 oz canned tuna with fat free mayo, 1 oz pureed cantaloupe; Evening snack - 4 oz protein smoothie.  Cool added bonus is that they also included "Everything you need to know to make blended (aka pureed) food".  So I'm not going at this blind.  Total protein: 79g

Phase 5:  Medium Soft Diet.  Weeks 5-7.  Foods to include (all foods in Phases 1-4): baked seafood, moist baked ham, boneless skinless chicken breast (cooked soft), 90% or leaner ground turkey, low fat cheese, 1T low-fat peanut butter, low fat refried beans, thin sliced or shaved lean lunch meets, beans and legumes (avoiding hulls), baked potato (no skin), unsweetened dry cereal, saltine crackers, low-fat pretzels or rice cakes, thin tortilla , wrap or pita bread, cooked corn, peas, broccoli, cauliflower, peppers, onions, tomatoes, eggplant, cabbage (veggies cooked until soft), banana pineapple, cherries, blueberries, raspberries, blackberries, mandarin oranges.  Sample menu:  Breakfast - 2 oz low fat cheese, 1 oz cantaloupe; Mid-morning snack - 4 oz protein smoothie; Lunch - 2 oz turkey breast, 1 oz stewed tomatoes with protein powder; Mid-afternoon snack - 1T low fat peanut butter, 2 saltine squares; Dinner - 1 oz baked salmon, 1 oz asparagus, 1 oz baked potato; Evening snack - 4 oz protein smoothie.  Total protein: 72g

I find it interesting that they broke "phase 6" into 4 sections...to me it would be phases 6, 7, 8 and 9.  But whatever...  

Phase 6:  Modified Regular.  Months 2-5.  ~3 oz per meal.  Remember to eat slowly and chew thoroughly.  Add only one new food each day to help determine tolerance.  All the foods in Phases 1-5 plus add moist, soft cooked pork chop or loin, moist veal along with pasta and cooked rice (must be very moist).  Sample menu:  Breakfast - 2 oz hard boiled egg plus 1 oz grits with protein powder; Mid-morning snack - 4 oz protein smoothie; Lunch - 3 oz deli turkey meat with 1 tsp low fat mayo; Mid-afternoon snack - 4 oz protein smoothie; Dinner - 2 oz moist boneless skinless chicken breast, 1/2 oz mashed potatoes with protein powder, 1/2 oz cooked spinach; Evening snack - 1/2 rice cake and 1T low fat peanut butter.  Total protein: 85g
Months 6-7.  New foods added ~4 oz per meal.  Add: 1/2 c air popped popcorn, celery, lettuce and raw veggies, prunes, raisins, apricots, oranges, tangerines, nectarines, plums and raw apples.  Sample menu:  Breakfast - 3 oz soy sausage link and 1 oz of strawberries; Mid-morning snack- 4 oz protein smoothie; Lunch - 2 oz low fat chicken salad, 1 oz red leaf lettuce; Mid-afternoon snack - 4 oz protein smoothie; Dinner - 3 oz lean ham, 1/2 oz brown rice, 1/2 oz green beans; (no evening snack).  Total protein: 81g
Months 8-9.  You may increase the amount of food at each meal to five to six ounces per meal.  Remember to stop eating when you first feel full.  Sample menu: Breakfast - 3 oz Canadian bacon, 3 oz of oatmeal with protein powder; Mid-morning snack - (none); Lunch - 3 oz low fat cottage cheese 3 oz sliced tomato; Mid-afternoon snack - 2 oz cantaloupe; Dinner - 4 oz tuna steak, 1 oz baked potato (no skin), 2 oz chopped lettuce; Evening snack - 4 oz protein smoothie.  Total protein: 75g.
Months 10-12.  You may increase the amount of food you eat to six to eight ounces per meal.  Remember to stop eating when you first feel full.  Sample menu: Breakfast - 3 oz scrambled eggs (or eggbeaters), 2 oz chopped veggies to add to eggs and 2 oz low fat cheese to add to eggs.  Mid-morning snack - 4 oz protein smoothie; Lunch - 3 oz chicken breast, 3 oz tossed salad with low fat dressing; Mid-afternoon snack - (none); Dinner - 3 oz baked pork chop, 2 oz applesauce, 2 oz steamed broccoli; Evening snack - (none).  Total protein: 76g

Obviously there will be substitutions and I've been provided with quick reference guide to foods that will help me figure out all of that.  I'll need to PLAN.  It's one of the key parts that I've been hearing about.  Plan your meals, don't try to do it impromptu.  I'm not the best at planning.  I'm really really not.  I'm definitely going to have to be better at that going forward.  Plus, I'll need to make sure that I am getting the proper amount of water.  It's essential.  

Bariatric Center has also provided some "how tos" for cooking soft lean meat, tips on eating out and so on.  They've been good to include reminders like, learn to stop eating when you first sense fullness; eat slowly (each meal should take 30 minutes!); measure your food; change your snacking behavior (from high-calorie, high fat foods with minimal nutritional value to protein rich snack); make an eating schedule to eat no sooner than every 3-4 hours between a meal or snack; avoid foods high in sugar and/or fat; limit caffeine and carbonated beverages; no bread until after at least 6 months if not a year; seek recipes that soft cook meats; chew all foods to a puree consistency; plan your meals in advance; be prepared for food intolerances; find other things to replace "habits" of eating; take vitamins as recommended; over the counter medicines should be sugar free; record your foods; go to the support groups!

The following may slow my weight loss:  drinking liquids that contain sugar; eating high calorie foods; eating to overfull; skipping meals; eating while watching TV, driving or reading; eating snacks that are not following the dietary guidelines; not exercising; not monitoring food intake.  

Lack of exercise, poorly balanced meals, constant grazing and snacking are the basic causes of not losing or maintaining weight loss. (And what has gotten me to the point of needing this surgery anyway!)  Bariatric Center wants you to be one of the 97% that looses and keeps off the weight for many years.  Begin today to learn new lifestyle changes on the journey.

The food I eat is my responsibility.
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Possible Complications

There are some people who really worry about the risks and potential complications from gastric bypass surgery.  I'm not trying to be all pollyanna about it, but I am truly not concerned.  I know that there are risks involved, but I also trust God to ease the anxiousness that could make me re-think this whole thing.  Bariatric Center has listed these as complications that could occur:

Stomal Stenosis:  This occurs when the opening between the stomach and the intestine become tighter, or constricted.  Symptoms include: a) vomiting after eating or drinking, worsening with time (may occur 2-3 months after surgery) b) feeling that food is "sticking" and your stomach is not opening c) unable to tolerate foods that were formerly tolerated after surgery. (This is an obvious "Contact Bariatric Center if you feel you have developed stomal stenosis.)

Constipation:  It's not uncommon after bariatric surgery for bowel movements to be less frequent and smaller because of eating less food.  Though constipation is not common, it can happen.  To help with this, be sure to get plenty of fluids and exercise regularly.  As you progress, the stomach will have more space for higher fiber foods to alleviate constipation.

Nausea:  Eating too fast, drinking with meals, not chewing food thoroughly, filling overfull and taking large bites generally causes nausea and possible vomiting.  Take 30 minutes to eat every meal.  (I'm wondering what it will be like to take 30 minutes to drink 2T of broth!)  Use a baby spoon to remind yourself to take pea size bites.  Stop eating just before first signs of fullness.

Gas and Bloating:  Swallowing a lot of air can contribute to gas.  Bubbles in carbonated beverages can swell in our stomach causing pressure to your staple line.  You will find that some foods cause gas - learn to avoid foods that do not agree with you.  Lactose, the sugar in milk, might not be tolerated immediately after surgery - but may subside after a few weeks.  Lactose free milk or soy milk can be used in place of milk.  Dairy products such as yogurt, ricotta cheese, and cottage cheese have low lactose content and are usually well tolerated.

Hair Loss:  (yes I put a big star by this one...silly, I know)  Your compliance to the post surgery diet and vitamin supplementation will affect the amount of hair loss sustained.  Some will experience hair loss from the stress of surgery.  When you consume less protein than your body needs, your body will make those proteins considered essential for existence.  Hair is not considered essential.  (WHAT?!?!)

Ulcers:  Some ulcers are caused by long-term use of non-steroidal anti-inflammatory agents (NSAIDs) like aspirin and ibuprofen.  NSAIDs interfere with the stomach's ability to protect itself from acidic stomach juices.  Avoid aspirin and related products.  After surgery, use Tylenol instead and be sure to stay on all prescribed medications.

Dumping Syndrome:  Dumping can cause side effects of nausea, cramps, diarrhea, rapid heartbeat and weakness.  As foods high in sugars pass through the digestive tract, water rushes to your intestines from the surrounding tissues to dilute the sugar concentration.  This stimulates the muscles to contract sending foods quickly through the intestines.  Avoid dumping syndrome by limiting sugars in foods - even "hidden sugars".  (I've got a whole page dedicated to finding the hidden sugars - words like dextrose, glucose, maltose, lactose, (bunch of "ose" words) as well as sugar alcohols like sorbitol, xylitol, mannitol which are often found in foods labeled "sugar free" like sugar free candy.  Because they are not completely digested, food companies don't have to report hem on the food label as grams of sugar.  So a food can list 0 grams of sugar and still contain large amounts of sugar alcohols that can cause dumping syndrome.  Almost seems deceptive, doesn't it?)

Bad Breath:  After surgery, some patients experience bad breath.  Sip on water throughout the day and include proper dental hygiene in your daily routine.

Food Intolerance:  Food tolerance varies after gastric bypass surgery.  Bread and beef products can ball up and not pass through the digestive tract after surgery.  Avoid doughy or sandwich bread until 6 months to a year after surgery, and even then try toast first.  After about 2 months, lean ground beef is recommended in soups, chili, spaghetti sauce.  Tough or dry cuts of any meat should be avoided.  After 6 months to a year, tender lean cuts of red meat cooked soft may be tolerated.  Any dry tough foods that lump together or that cannot be finely chewed may not work well.  If a food is recommended in the "Education Manual" but you do not feel comfortable trying it yet - don't try it.  But by about 3 months after surgery, strive to start eating a variety of foods.

Those are the listed complications though the only one I would consider a true "complication" would be the stomal stenosis.  The others seem to be more of an inconvenience - yes, even the hair loss.  
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Tuesday, March 20, 2012

Harder than I thought

Baby food is for babies!  For infants before their taste buds develop!  Textures, blandness, smells - not for an adult who likes savory flavors!!  Sure the fruits would be fine if that's what I needed.  But noOOOooOOoO.  I need meats with protein.  I'm not sure if I'll eat baby food after the surgery during whatever phase it is that I need to eat it.  I'm going to need to find something else!  Back to the manual to see what other alternatives I have.

This is going to be harder than I originally thought.
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Monday, March 19, 2012

Hey Grandpa! What's for Supper?

Yes, I'm sure I just dated myself with that old HeeHaw reference, but it just seems so fitting for this post.

This question has been asked a lot "Hey Deedra!  What's for supper?" aka "What will you be able to eat after surgery?"  I thought I'd go ahead and write an entry on the nutrition section of my "Education Manual".  The section is large, so I'll probably break it down into multiple posts over the next several days.

I was almost intimidated by the realization that I will be tested by the surgeon on the information RD will provide me at the nutrition class.  Really?  An actual test?  But then I thought, that's actually a really good idea.  It means that they want to make certain that I am truly understanding this is no walk in the park.  I've got to be prepared!  So prepared that I'm even going to have to bring in a full day's menu on stage III and a full day's menu on stage IV to make sure I can do this.  

There are actually six phases that progressively add foods back to my diet after surgery.  My first 3 meals in the hospital will be clear liquids (1-2 ounces) plus 2 ounces of fluids per hour.  I then progress to strained full liquids (1-2 ounces), modified full liquids (1-2 ounces), pureed (1-3 ounces), modified soft (1-3 ounces), and modified regular (1-3 ounces) between months 2-5.  At approximately 6-7 months, I should increase the volume to about 4 ounces, and then around month eight, I'll be on regular foods - but not more than 5-6 ounces per meal and by a year post-op, I should have increased to between 7-8 ounces per meal.  Each stage also has a set number grams protein needed which is anywhere between 50 - 90 grams depending on which stage I'm in.  Looks like the optimal protein at a year post-op is 75 grams.  (Please remember that this is not recommended for anyone who has not had bariatric surgery and those not being monitored by an MD and RD!)

The Q&A section questions that stood out to me:

  • How much can I eat after surgery?  The normal stomach is approximately 40 ounces (football size).  The surgery limits stomach size to 1-2 ounces (egg size).  - This is a visual that I needed.  Wow!  What a drastic difference.
  • Can it be healthy to eat so few calories per day? (a common question I've had asked of me already... "aren't you just starving yourself?") Your health is of primary concern to our weight loss team.  You will work with the RD to ensure you are getting proper nutrition through the carefully planned diet.  Vitamin supplements are also important for your health.
  • Can I ever lose too much weight? (ha!) Your weight will level off after 12-18 months as the new pouch increases in size.  You will find the weight that is right for your body.  After surgery, lack of exercise, poor food choices, constant grazing and snacking are the main causes of not maintaining weight loss!!!

How do you measure ounces by volume not weight?  That was my question...and here's the answer:
1 ounce = 2 tablespoons = 1/3 cup = 30 cc
2 ounces = 4 tablespoons = 1/4 cup = 60 cc
3 ounces = 6 tablespoons = 1/4 cup + 2 tablespoons = 90 cc
4 ounces = 8 tablespoons = 1/2 cup = 120 cc
8 ounces = 1 cup = 240 cc


What vitamins will I be taking after the surgery (for life)?
- 2 chewable multivitamins each day (taken at separate times)
- 1500 mg daily Calcium plus Vitamin D (not taken with multivitamins)
- 500 mcg per day Vitamin B12
- An antacid will also be prescribed as a preventative method to keep the stomach pouch from developing ulcers.

 - If needed, I'll be on iron supplements - I'm hoping it's not needed!  
Reminder:  all over the counter medication like cold/cough syrups should be sugar and alcohol free.

Some of the key points to the Nutrition 101 section:(I've abbreviated most of this)

  • Protein: The body uses protein for growth, maintenance and for muscles and major organs.  It's essential for healing after surgery.  Protein is needed to maintain muscle mass, healthy skin and hair.  Eat high-quality protein every day.  Eat protein before you eat any other food group.
  • Carbohydrate:  Carbohydrate foods, especially complex carbohydrates, are a good source of energy and provide vitamins and minerals and are needed for normal body functioning.  Carbs are starches, grain foods and sugars.  After surgery, you will experience dumping syndrome if you consume high sugar foods.  Choose foods that are around 10 grams of sugar per serving.
  • Fat:  (info on good fats vs bad fats...then) Fat may be difficult to digest after surgery. Too much fat delays emptying of the stomach and may cause stomach acid to back up on to the esophagus.  It may also cause gas, stomach discomfort and nausea.  Look for foods with no more than 3 grams of fat per 100 calories (no more than 30%).
  • Vitamins (see above):  Vitamins and minerals are necessary for various body functions - over 30 vitamins and nutrients are required by our bodies.  Essential vitamins are also found in lots of vegetables and fruits as well.  Eating a variety of foods that contain a variety of vitamins and minerals is essential.
  • Water:  adequate fluid intake after surgery is necessary for important body function.  You must sip fluids throughout the day to avoid dehydration.  Water can help prevent/ease constipation (TMI for some of you).  As the body gets too little water, it siphons what it needs from internal sources (colon is one source used).  Avoid using straws - when you drink with a straw you will swallow air with each drink.  This can cause uncomfortable "air bubble" and gas pain after surgery.  If you drink too fast or take too large a gulp, it can cause nausea, vomiting and premature stretching (of the stomach).

So how can I start preparing for some of these changes?
I've already started by adding a multivitamin per day to the routine.  It's also suggest to try the pureed foods now so its not new to me after surgery. So in an attempt to not be totally shocked when I may be an emotional mess anyway, I've already bought a few jars of baby food to "test" drive.  Plus I was given a "suggested" supply list to purchase prior to surgery so I can focus on recovery not grocery shopping and running errands after ward.  Shopping list:

  • Baby spoon (will help me to remember to eat small pea-sized bites)
  • Sipper cup (small sips...no gulps)
  • Blender/food processor (got a Ninja already!  woot!)
  • Ice cube trays (to puree some food ahead of time and freeze into individual servings and store in baggies - each ice cube is about 1 ounce)
  • Ziplock bags
  • Adult liquid Tylenol (stomach won't digest pills well for a while)
  • Vitamins
  • Protein powder
I've got a few of those items already and will gradually pick up a few more.  I've got to look a bit further into the pureed stage to see what I want to try ahead of time and freeze (if it's worthy of freezing!) for later.  

I am thankful for bariatric center's approach to all of this.  I really do feel like I'm being prepared ahead of time and not just going into it blind.  Still lots of learning and work to do to get ready, but I'm excited that the day is drawing closer!

And for those of us who are old enough to remember Grandpa Jones...

"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Sunday, March 18, 2012

I got an "A"

I was tested this evening.  Baskin-Robbins' Peanut Butter 'n Chocolate ice cream was calling CME's name.  Since I had to pick up our oldest from church...and since I was out...

Please don't take that as if CME was testing me.  He was not.  I made the decision to go.  I made the decision to walk into those 31-derful flavors.  I made the decision to pick up the ice cream for CME and a scoop for each of the boys.  I made the [conscious] decision NOT to indulge in my own scoop(s)!  THAT is huge for me.  Really.  I loooooove ice cream.  But I made the decision because I asked myself two things:  1) Am I hungry?  [answer was no] and 2) Can I walk into an ice cream store and not get some for me?

I was tested.  And I got an A!
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14


I don't recall exactly when it was, I just remember it was either this past fall or winter when God awakened me to "John 15:5".  It was drilled into my head as I slept..."read John 15:5"... "don't forget to check out John 15:5"..."when you wake, get your Bible and read John 15:5".  I fully 100% believe that God wanted me to read John 15:5.  It was the ONLY thing in my dream that I remembered.  So when I awoke, I grabbed my phone (it was closer than my Bible) and checked out my Bible app but couldn't remember the verse!  I went first to John 5:15.  Nope...that couldn't be it.  It didn't make any sense whatsoever.  So I switched the numbers around and immediately knew this was the verse God was speaking to me.
I am the vine; you are the branches.  If a man remains in me and I in him, he will bear much fruit; apart from me you can do nothing.
I clung to that verse when I began thinking about having gastric bypass surgery.  I thought of it often - remembering that i need to remain in Christ Jesus to be successful in this journey.  Since I've begun the process, I've thought about it occasionally, but I've not really clung to it like before.  I'm not sure why, but I haven't.  

The verse was part of our message at church today too.  Pastor K pointed out that Jesus intends for us to remain in Him.  We have a choice whether or not to pray, to be in the Word of God, to be righteous, to worship.  I have a choice to remain in Him through this process.  I've said it before, but if I do not allow Him to be in control of this part of my life, I will not succeed.  Apart from Him, I can do nothing.

Today I was awakened...again.
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Another New Page - UPDATED

I've added another page - one to log pictures of my food intake.  CME's idea.  You can click on the link at top to get to a place to click the link to the pics...I'm sure you'll figure it out!  :)
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

The "F" Word


It's a mean word and according to a recent CNN article that CME sent to me, it's the new "ugly" on the playground.  I don't know how new it really is; I remember being called fat in elementary school - odd thing is that I wasn't fat back then,  I just wasn't skinny.

The article mentions that children as young as 3...THREE...are already concerned with weight and body appearance.  (I wasn't too far off when I mentioned in my last post that how we see ourselves starts at a VERY young age!)

Regardless, the "F" word is as offensive to me as any other 'f' word that might come from someone's mouth - especially if it's targeted at children!  PARENTS!!!  PLEASE teach your children how hurtful words can be and how to be a good friend to others - even those whose body types and skin color are different from their own.

Click here for the article:
Fat is the new ugly on the playground

"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Wednesday, March 14, 2012

Behavior Modification...Part Deux

"You've done everything we've asked..."  Those were the words of MD today.  And that was the deciding factor for him to give the thumbs-up to the insurance company.  3.8# down this visit.  Blood pressure was an all-time low of 98/60 and my pulse was 68.  I was totally shocked considering what feels like overwhelming stress on the work side coupled with over-commitment of my schedule.  I can only attribute it to the peace of Jesus that He's given me.  I have no other way to explain it.

I met with the RD and the RN today too.  The RN did a blood draw to check my Vitamin D levels and the RD and I discussed a few more things on the nutrition side of it all.  I have a full hour-long nutrition "class" with her on 3/26, where we'll go over a LOT more of the post-op eating phases.  I like RD.  She's not afraid to say, "I tried it that way and it was disgusting.  This is what I think is better."  I understand that everyone's tastes are different, but it's good to know that she's tried the recipes and protein supplements.  She also provided me with some more information - one was about the importance of water and the second was about fiber (should look for a minimum of 3-5 grams of fiber per serving).  I was actually surprised to see avocados on the list of high fiber foods; not because of the fiber part (though I didn't know that either) but because I was always told to avoid avocados because of the fat content.  RD said that while they are high in fat, it's a good fat and the fiber content is a good balance.  (My paraphrasing, but that's how I understood it.)

I attended the second Behavior Modification (group) class today.  Our topic this time was "Eating Patterns".  We all introduced ourselves, advised where were were in the process, what we've already done to make those small sustainable changes and what we're still struggling with.  This gave me the opportunity to share the fact that CME and I just recently purchased smaller plates to use to help with portion control.  The response I got to that was amazing - affirmation from the LCSW and a lot of "that's a great idea!" or "I wrote that one down".  This was also a good glimpse for me as to what the support groups are like through bariatric center.  It's one of the things they really stress - to share with others; ideas, challenges, successes.  We are all on the same journey, though our paths and lives may be so incredibly different.  My struggle - snacks laying around the work place.  I wish I could call in sick anytime we have a food day at work.  Ok, I know that I'll not feel that way forever, but it really is a danger zone for me.

Some staggering statistics were shared in the class:

  • In the US, conservative estimates indicate that after puberty, 5-10 million girls and women and 1 million boys and men are struggling with eating disorders including anorexia, bulimia and binge eating disorder.
  • In a national survey 55% of women and 41% of men reported being dissatisfied with their weight.
  • In addition, up to 80% of American women are dissatisfied with their appearance.
We stopped to discuss that point.  80% of American women are dissatisfied with our appearance.  Eighty percent.  That's mind-boggling to me.  We were asked why we think that is.  I think that there are a ton of contributing factors.  I think that it starts at a very VERY young age when adults say things like, "You look so pretty!  You look like a princess!  You are adorable.  Look how cute you are!"  I've been guilty of doing just that.  I'll see a little girl and instead of complimenting her on good character, I compliment her on appearance.  Why do we do that when we should be recognizing her/him as a fearfully and wonderfully made child of God with awesome character traits.  "You are are so kind!  You are so well behaved!  You are a very generous caring person.  Look how much you love your brother!" and so on and so on.  

In addition, we are so prone to believing what the world says is beautiful.  The ultra-thin Hollywood movie star; the girl with the perfectly straight bright white teeth; the blonde (or brunette, or redhead...) that caught the attention of our [date, significant other, spouse, etc].  We have been trained, even if by accident, to compare ourselves with others.  When we don't think we live up to those expectations, how else would we feel but dissatisfied with our appearance?  That is where I have been time and time again.  But as God is taking me through this time in my life, I now see myself as God sees me...as his perfectly and wonderfully made child.

By the way, the one man in our class today said that he disagrees with the 55/41 ratio.  He said more than ever, men are starting to be more aware of their appearance and weight and the dissatisfaction is just as high as it is with women.  Is it?  Really?  (Asking because I don't know...)

Eating patterns are established as children.  We've all heard (and probably spoken these words before - or something darn near it) "Eat your dinner... there are starving kids in Africa."  or "You can have dessert if you eat all your food."  I can't say that we ever were forced to "clean our plate" at meal time, but I don't really recall being taught healthy eating habits.  We were blessed as a family and we not only had the necessities in our cabinets/fridge but we had snacks and sodas (or pops or cokes - depending on where you're from!) and had free reign to them whenever we wanted.  Portion control or serving size were not phrases I ever heard. And then Grandmama ALWAYS fixed us snacks after school, before bedtime at her house, etc.  I'm in no way trying to blame my obesity on my family...please do not read it that way.  What I'm saying is that we really didn't learn healthy habits.  I am solely responsible for the mess I've made out of my body.  I've been an adult MUCH longer than I was a child.  I have had plenty of time to correct bad habits, but haven't.

We talked a lot about binge eating (as well as some other disorders).  And though I can say that I don't medically fall into a binge eating profile, I have had my episodes of binge eating over the years.  If I really sat down and wrote about the days where that has happened, I know it would shock people.  Not only the quantity of food, but the variety and the weird things that I'd make to eat.  

Okay...so if I'm going to be transparent here, maybe I should give you a glimpse of what that would look like in past.  -deep breath-  I'd come home from work (because I don't binge in front of people...I might be judged if I did that!) and fix supper for the boys and myself.  CME would be at work.  (remember the trigger situations?  yeah, this is one of them)  The boys would go to bed at 8:00pm.  At 8:15 (enough time for them to at least be drowsy if not already asleep) I'd start:

  • bowl of cereal with milk
  • hmmm...second bowl of cereal and milk
  • peanut butter and jelly... by the spoonfuls
  • still feeling snacky...maybe should have something "healthy"... like fruit (name your fruit)
  • wow...I've had a lot of sweet stuff...maybe some crackers/pretzels/chips
  • t.h.i.r.s.t.y.  Diet Coke, please and thank you
  • salty isn't satisfying me... 
  • oooh!  I'll make icing.  (yes make it)  butter, powdered sugar, milk, vanilla.  
  • I don't care that I don't have anything to ice...i'll just eat it with a spoon.
  • Sooo sweet...maybe a few more bites of crackers to get the sweetness out...followed by another Diet Coke.
  • As I work on drinking that last soda, GUILT begins to set in.  How could I eat all that?  WHY would I eat all that?  I think I'm going to be sick - literally (though I have never thrown up from one of these nights).
  • tomorrow I will have nothing but water.
And at 10:30 when the guilt is overwhelming and I'm not too far out for a blood sugar crash, I'll head to bed.

Ugly, huh?  Truth, though.

So what I've been challenged to do is prepare a list of alternate activities for those days when I feel like a binge is the way I'm headed.  I may even post it on my refrigerator as a reminder to "Go read your book" before I start on that totally destructive path.  It's another small sustainable change that I can do!

At this point, I'm waiting to hear from the insurance company so we can work on a concrete date for the surgery.  I feel like this is going to be the longest part of it all...the wait.  However, I know that if God has given me the courage to move forward, He will give me the patience get through the next few weeks.  
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

Tuesday, March 13, 2012

The boring but good to know stuff

Section 2

Frequently Asked Questions
I like that there is an FAQ section in the manual.  There are 46 questions and answers about the whole process.  I'm not going to list all those out, but it is a very extensive list.  Ones that stood out to me are:

  • Why do you get an EGD (that scope thingy I had done last month)?  Many morbidly obese patients have reflux and ulcer disease which is not diagnosed and may need treatment prior to surgery.  Furthermore, once the stomach is divided, evaluating the stomach will be difficult and if abnormalities are found at the time of the EGD, treatment can take place before the gastric pouch is divided.  This does not prevent things from happening in the future.  Note that stomach cancer is not associated with gastric bypass.
  • How is the stomach divided? A stapler is used to divide the stomach. The two parts of the stomach will be separated completely.  (Why does the scene from the movie Office Space come to my mind?  You know, the one where Milton is explaining why he kept his Swingline stapler after the company switched to the Boston staplers?)
  • How much intestine is bypassed?  The "roux" (or bypass) limb will vary from 75-150 cm, but most likely it will be closer to the 150 cm length.
  • What size is the stomach pouch?  Approximately 30ml or 1 ounce; the size of an egg.  (That's pretty small - see diagram below.)
  • Do you cut the acid producing nerves to the stomach?  No.  Some surgeons prefer to cut these vagus nerves to minimize ulcers but this is not the standard of care.  You will still have acid in your digestive tract to break down the food.
  • When can I drink water and other liquids?  After your UGI (upper GI x-ray) on postoperative day 1 is cleared you can drink.  Your bariatric diet will begin at this time.  Your nurse will let you know when to start drinking and help you keep records of how much was consumed.
  • How do people die from gastric bypass surgery?  Most patients die from either leaks resulting in peritonitis or from clots in their legs traveling to the lungs (pulmonary embolism).  The risks will be discussed with you in detail prior to your surgery.  (This is actually a concern that my youngest son had about me having surgery.  Keep him in your prayers as he's not really sure about the whole thing.)
  • Why do you not remove the other part of the stomach that is divided?  It continues to secrete important juices for digestion and removal of this organ has been associated with more postoperative complications.
  • What about the extra skin after I have lost all that weight?  After 18-24 months, most patients will plateau with respect to their weight loss/gain and referral to a plastic surgeon will be an option for excision of extra skin.
  • What are some common side effects after surgery?  Nausea, vomiting, hernia at incision site, infection at incision site, general fatigue and constipation are often seen after surgery, but all resolve or can be fixed without much trouble.
  • Is rapid weight loss dangerous?  Yes.  Usually this danger is because the patients don't consume the essential nutrients during this time period.  The bariatric center will be working with you on a regular basis to prevent this from happening.  Essentially this danger is eliminated if you follow the recommendations of the nutritionist/dietitians. 
  • Can I drink coffee and soft drinks after surgery?  Caffeinated drinks dehydrate your body and should not replace other fluid supplement such as juice or water.  Carbonated beverages can cause painful gas and potentially unwanted pressure on the staple lines.  Leaks could happen from this.  Soft drinks that are "flat" are more acceptable once you are eating your lifetime diet. (Forget that!  Flat soft drinks are icky!)
  • What is dumping syndrome?  When you eat pure or refined sugars (high caloric foods), these immediately enter the small bowel causing fluid to rush in to the intestine as part of digestion.  This action is associated with flushing, sweating, rapid heart beats, abdominal pain, and diarrhea. The degree of dumping depends on the amount and type of food.  It usually subsides in 30 minutes.  Try to learn what food causes these symptoms such that they are avoided in the future.

Discharge Instructions
The postoperative phase of gastric bypass can be very demanding of your mental and physical endurance.  What details do I need to remember after surgery?

Surgery performed / wound care - standard post-op wound care instructions.  Keep it dry; don't take the steri-strips off until advised by the doctor; notify the doctor if there is bleeding from the suture line, the skin starts to separate, pus or cloudy fluid is seeping from the incision, the incision or abdomen become increasingly painful and medication is not controlling the discomfort, fever >101, inability to urinate or pass stool/gas.

Activity - laparoscopic surgery: May resume any and all activities when comfortable; may return to work in 1-3 weeks if no problems arise; WALK as much as tolerated; expect your endurance to be low initially, but will improve; no driving until cleared by surgeon.

Medication - do not take aspirin, or aspirin containing medicine (ugh! Excedrin  is usually the only thing that works for my headaches!); Immodium AD to help with post-op diarrhea as needed; Gas-X can be beneficial; Fiber supplements with Metamucil or Fibercon are recommended once you are are on the pureed diet; some pills will be rather large and difficult to digest.  Crush if possible. Some medications dosages may even need to be altered to accommodate for the altered digestive tract.  You will need to take an antacid medication (chewable Pepcid or stronger) for approximately 6 months after surgery to lesson the chance of marginal ulcer formation.

Diet - At time of discharge, you have been advanced to Phase III or full liquids.  You'll maintain this regimen until your first postoperative visit by the dietitian and then should advance to a pureed diet. (More on the phases in a different post.)  Remember to drink 48-64 oz of fluid per day - sipping but not with a straw.  Straws can lead to swallowing of excess air.

General Concerns - any of these should prompt you to call your doctor: sudden shortness of breath or tightness in our chest not relieved by resting; uncontrolled nausea with vomiting; increased abdominal pain or new chest pain; persistent hiccups; leg pain or swelling.

Again, this is just a little of the information in this section.  For me it's the "boring" but good to know" stuff.  It also helps me to feel even more informed about the procedure.  It's good not to enter into a major event being ignorant of the details.  

My next appointment is tomorrow and I feel like I'm right on target where they want me to be.  If so, that means MD should give the thumbs-up to the insurance company and we'll work on getting a concrete date set!  It's hard to believe how quickly this process is going.  I first stepped foot into bariatric center in September 2011.  The time has flown by!  I'm anxious to see where I am in another 6 months!

"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

So much information...How do I remember it all?

I've read through my "education manual" now.  There. is. so. much. information. SOOOOO much!  I'm feeling a little overwhelmed by it all, and to be perfectly honest a little bit intimidated by it.

That may seem silly to some of you, but there is just so much to take in and so much to remember.  I know the manual is there for my reference, but I want to "know" it.  I want to be able to not really have to think about it - because when I stop to think about it, I realize that the surgery is really only a tool.  Another tool to help me lose weight.  Tools have failed me in past.  Tools have broken.  Tools have gotten lost in the shuffle of life.  So yes, it's a bit scary and a bit intimidating.  That being said, I'm still excited.  I'm still encouraged by how God is giving me the strength and courage to face the surgery.  I'm looking forward to my appointment on Wednesday to see if MD is ready to recommend the surgery to the insurance company!!

Thoughts on all I've read...

I want to be careful not to post too much information here.  I don't want anyone to think that they can (or should) try to follow certain "eating" plans without being under supervision of a physician.  Our bodies are intricate machines...designed by God to function as He planned.  We should really be very careful in how we treat it.  Years of abusing our bodies really takes its toll.  So make sure before you start repairing the damage you've done to consult a physician or health professional.

So... what's in the manual?  Glad you asked!  I'm going to highlight things that stuck out to me as I went through the manual.  To keep this entry from getting WAY too long (it's long enough as it is!), I'm going to tackle one section of the manual per post.

Section 1
Two Weeks Prior to Surgery
  • Begin walking.  (Common theme throughout this section.)
  • Reduce caffeine by 1/2 - it stimulates the appetite.
  • Drink six 8-ounce glasses of water per day.
  • Take chewable multivitamins.  (started this already)
  • Take calcium twice per day.  (going to ask about this one)
  • Start eating 3 meals per day.  Do not worry about the calories, just work on the habit for now.  (I do okay with this...most days.)
  • Avoid binge eating or having the "Last Supper"  (hahahaha!  I've had a lot of "lasts suppers" over the course of my weight loss journeys... the "what is the one thing that I want to eat before I can never eat again" meal!)

Ten Days Before Surgery
  • Choose protein-rich foods.
  • Start eliminating sweets and carbs.
  • Reduce by another half or eliminate completely the caffeine I drink.

One Week Before Surgery
  • Stock the pantry with foods for the first few weeks after surgery.  Be sure to have a variety of "Free Foods", the foods allowed on Phase II, Phase III, and Phase IV.  Remember I will only be eating small quantities...don't buy these in bulk!
  • Read the nutrition information in the manual again.
  • Make sure to take all vitamins daily.

Day Before Surgery
  • Relax!!!  (great advice...you try relaxing before surgery!)
  • Ask your doctor for medication to help you sleep the night before surgery.
  • Read your education manual.  (again?!)
  • Write in your weight-loss journal.
  • Call a friend who is supportive of your decision.
  • Reread your commitment statement and the reasons you chose to have surgery.
  • Starting at 6am the day prior to surgery, begin clear liquids only - NO CAFFEINE (caps added for my benefit!): Beef or chicken broth; jell-o; Sprite or 7-up, crystal light, clear juices.
  • Walk as much as possible.
  • No nail polish.  (No problem)
  • Medications - list of what not to take and what's ok to take
  • Shower with CHG soap (night before and morning of surgery) - given specific instructions on how to shower, how long to shower, how long to rinse, etc.  (What?!  I hope CVS has it!) 

Day of Surgery
  • Arrive two hours before scheduled surgery.
  • Meet with the anesthesiologist.  (I'm sure CME will make reference to him/her about how I breathe funny when trying to come out from under anesthesia.)
  • The operation time can vary - but in some case it can be up to 2-3 hours  (Glad I'll be out of it during that time!) and approximately an hour in recovery.
  • I'll be given Heparin or Lovenox right before surgery to lesson my chance of forming blood clots.

Hospital Stay
  • Length of stay is 2-4 days (including day of surgery)
  • Must take comfortable slippers because I'll be up and out of bed walking quickly.  I'm not sure if my sock-monkey slippers will be "safe" to walk in right after surgery.  I may need new slippers.
  • Walking after surgery is EXPECTED.  If you do not agree to walk, then you will not have the surgery. 
  • Why is walking after surgery important?  It helps prevent blood clots, improves healing, relives post-op indigestion and gas, promotes deep breathing, decreases the chance of developing pneumonia, helps control pain and improves emotional outlook.
  • Bring my education manual with me to the hospital!

  • The size of the incision(s) varies and depends on whether surgery is open or laparoscopic.  (I'm hoping for the 5-6 smaller [1cm] incisions over the incision from the bottom of my breastbone to my above my navel!)

  • Each person's pain tolerance is different (my words), expect some level of pain in the first couple of days after surgery.  Usually mild to moderate abdominal soreness but not severe abdominal pain.
  • IV pain meds will be given and I'll be taught how to use it effectively to control the pain.
  • I may experience nausea and indigestion but I can let the nurse know so she can give me the appropriate medications.
  • I'll have pain meds to take when I am released.  (I hope to not have to take those - I really dislike taking medication...for anything.)

  • I will begin with clear liquids for 24 hours before surgery and resume with clear liquids for three meals after surgery.
  • I will progress to "full liquids" on day four.
  • I will be monitored closely while in the hospital to make sure I am getting adequate nutrition.
  • My RD will visit me.  :)
  • I may struggle to get in all the liquids required the first few days after surgery.  IT'S NORMAL.
  • I will not be able to drink and eat at the same time.  My stomach will not have enough room and it will make me vomit.  (Ewww!  I hate vomiting!)

Drains, Catheters, Tubes and Other Devices
I'll save you the graphic details - you can thank me later.

How to Prepare
  • Walking is the single most important activity you can do to improve your health and prevent blood clots after surgery!  (this is really a good thing to remember even if you're not having surgery!  W.A.L.K.)
  • Start walking now.
  • Walking improves circulation and lung function and develops a habit of exercise.  (Note to self - tackle the exercise topic soon!)

Range of Emotions
  • The first few days/weeks may be very difficult emotionally.
  • My hormones may be disrupted after surgery (watch out world!)
  • Sadness - because I have lost a "friend" (food)
  • Anger - that I can't change my mind and go back to my old life.
  • Hurt - life and people do not magically change once I lose weight.
  • Resentment - of others who can eat like I would like to...but can't.
  • Fear - of others noticing me more...or of regaining weight.
  • Vulnerable - having to face old hurts that have been hidden beneath the layers of fat and are now exposed.  (I put an * next to this one.)
  • Happiness - with myself, life, others
  • Joy - at experiencing what I have wanted so badly
  • Pride - in myself and what I've accomplished (side note - please pray that I never become prideful, but continue to focus on God's work in my that allowed me to accomplish these goals!)
  • Relief - from the medical conditions I lived with.  
  • Freedom - to move, to breath, to live life to the fullest!!

Facts to Remember About My Digestive System
Again, I'll save you a lot of the details...here are the most important in my mind:
  • Nausea may be frequent int he first few weeks after surgery.  There are medications to help!
  • My new stomach pouch will only hold a maximum of 2-3 ounces at one time right after surgery.
  • STOP EATING WHEN YOU FEEL FULL.  If you over eat, you will vomit.
  • You must eat three meals per day in order for my pouch to stretch normally.  
  • I will be taking Vitamin B12 for the rest of my life.  (Much better than taking medications for heart disease, diabetes, etc!)
  • I should carry some form of identification on me that will inform healthcare workers of my altered digestive system - in case of emergency.  (I'll ask my paramedic hubby what he thinks would be good for this part!)

So there is a glimpse of the first section of my manual.  I'll end this post with one other sentence that caught my attention and a word of good advice regardless of where you are in your own journey:

Your weight won't defeat you, but your negative thoughts will.
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14