Tuesday, November 24, 2009

91 pounds

I've lost 91 pounds. I've put a bunch of my clothes in a large garbage bag to take to Goodwill or Salvation Army. I've bought new clothes and new shoes. I've swum in the Caribbean Sea in a new bathing suit. I look better. Physically, I feel better. I can do more: walk farther, climb steps without discomfort, enjoy exercise.

I no longer feel as if food has some kind of hold over me. I can only eat so much. There are consequences to "just one more" bite: pain in my chest, vomiting over a period of a couple of hours. It's no fun.

This month, for pretty much the first time, I am beginning to feel depression set in. It's that apathy, that lack of spark, that desire to do nothing. I expected my life to change. I'll admit it. I expected all the things I dreamed of to come true. I expected to feel exultant and proud. I just feel something like deflation. As if the pounds going away took some part of me with them.

I try not to dwell on people looking differently at me. I actually prefer when someone asks me about the surgery, or asks if I've lost weight. The silence and wide eyes make me feel slightly furtive, like I've pulled a fast one. Most people seem to be treating me the same way, acting as if nothing has changed. This makes me feel weird. Again, I prefer people to voice their impressions, ask their questions. The silence is disconcerting.

At my 3-month appointment, the nurse who runs the group classes said depression medication is possibly the only exception to the post-surgery rule. That is, in most cases, bariatric patients take less medication after losing weight: Diabetes abates, blood pressure goes down, sleep apnea is silenced. No need for pain meds when your knees/back/ankles, etc. no longer hurt. Nurse Natalie said the malabsorption feature of the surgery may undermine the work of the depression medication. Great.

I dislike my job more, rather than less. Somewhere in my mind I figured that since losing weight would make me happier with myself, maybe I'd be happier with my situation. I would be okay with my job. I would go ahead and buy a house. Instead, escape is my constant and most fervent wish. How can I get out of here? How can I pack a few bags and just hit the road. I would love to drive and drive, stop in a hotel when I'm tired. Get up and do it again the next day. I'd take pictures. I'd see sights. I'd visit old friends from coast to coast. When I got to the coast, I'd get on a plane or a boat or a ship and keep going.

I cleaned out what was left of my pension from a former job and paid off half of my debts. If I could get rid of my debt, I would quit my job and go find what's out there.

So, I've lost 91 pounds. Seventy-one to go.

Friday, September 4, 2009

It's been a while..

But here I am, minus 54 pounds since March. About 110 pounds to go. I've been fighting a cough for about 10 days, and it's now on the wane. It's been tough to get my 65 grams of proteins in as I've tired of protein drinks. At my doctor's appointment yesterday, though, I was reminded that not getting enough protein can cause my hair to fall out. Luckily, now that I can eat more foods, there are more options. Smoothies with protein powder on high on my list to try.

As you may recall, I lost 24 pounds between March and surgery at the end of July. So, since surgery I've lost 30 pounds. My main preoccupation lately has been figuring out which foods agree with me and which do not. Eggs have not been a success, whether scrambled or hard-boiled. When foods don't go down well, there's a heaviness or sometimes a bit of pain in the area of my new stomach pouch. Sometimes it can trigger vomiting. This happened when I first ate tilapia. I realized that I had to slow down my eating pace. That seems to do the trick. I will try eggs again, eating slower. Each meal is supposed to take at least 30 minutes to complete, which can be a challenge when you only have about half of cup of food to finish! Still, it's a must for painless eating, so I am getting used to it.

Otherwise, I've been enjoying tuna, tilapia, even tofu! Baked potatoes are great, of course, but not very valuable in terms of the nutrients I need. Whole wheat toast, whole grain wheat thins, Yoplait fat-free yogurt. I had lentil soup at a restaurant that went down pretty smooth.

Here are some recipes that I came up with and am enjoying:

HOLLY'S BAKED TILAPIA -- 3 ounces have 22 grams of protein!

Saute about 1 tsp of minced or chopped garlic in 1/4 cup white wine, 1 tsp extra virgin olive oil, 1 tsp lemon juice for about 3-4 minutes

Place 2 tilapia filets in a baking dish (spray with Pam beforehand). Preheat oven to 400 degrees

Pour saute mixture over filets. Add a dash of black pepper to filets.

Mix 1/4 cup bread crumbs with 1 tbsp parmesan cheese. Spread over filets evenly.

Place filets in the oven and bake for 12 minutes. Turn off heat and let filets stay in over for a few more minutes. Remove from oven.



Depending on your preference, use firm or extra firm tofu.

Chop tofu into in small blocks.

Prepare marinating mixture: 1 cup beef or chicken broth, 1 tsp curry powder, a dash of black pepper, 1 tsp olive oil, 1 tsp minced or chopped garlic. Toss in tofu blocks. Marinate in fridge for about 2 hours.

Remove tofu and marinate from fridge. Place blocks on a baking sheet sprayed with Pam.

Bake for 12-15 minutes.

Eat! Serve with toast or anything you want!


For best results, use solid white albacore in water!

Mix tuna with lite Miracle Whip, to taste.

Add Mrs. Dash lemon pepper seasoning and dill to taste. Toss in a dash of black pepper.

If you like, stir in a tsp of relish and/or finely minced onion.

Eat! Great on wheat thins ;)

August 10, 2009

No More Naps?

Before my surgery, I built my days around naps. Since I work evenings and get home at about 11 p.m. and get to bed around 1 a.m., I would get up around 9 or 10 a.m. and start my day. Not that I got much accomplished. Breakfast was coffee and a muffin or bagel (although after I started planning for surgery I cut out muffins and cut that bagel in half). I would watch the news, Will & Grace reruns, and HGTV while I answered emails and did work on my laptop. Sometimes I would do an errand or two, always keeping my eyes on the time so that I could be sure to fit in lunch AND a two-hour nap.

Granted, this recovery period is pretty much stress-free, and no work. So, I may get back into the napping habit once I get back to work next week. I suspect there will be some days when I'll want a nap and others when I won't. We'll see.

Back to the muffin... It's not the only thing I gave up starting back in March. Just cutting out certain items and replacing them with more healthful foods helped me lose 13 lbs by June. I also stopped grazing at work, on whatever the students or my colleagues would bring in -- stuff like cookies, chips, pretzels, etc.

Fast food & other restaurant food had to go. My faves were the burgers and spicy chicken sandwich at Wendy's with fries, Culver's fish and chips and concrete (custardy ice cream with chunks of peanut butter cups), Big Mac, General Tso's chicken, shrimp fried rice, cheese cake, avocados, nachos, pizza -- you get the idea! I started cooking more, avoiding carbs as much as I could stand. If I did eat out, I would pick up a Greek Salad with chicken from Panera or a Chipotle salad (no rice, of course). Ice cream and other fatty deserts I replaced with Edy's fruit bars (lime and lemonade are my favorites) and the mango smoothie at Panera. Also Yoplait yogurt. Looking back, it wasn't that hard to do. Of course, I slipped up from time to time -- mainly after work, when I would get hungry on my way home around 11 p.m., having eaten dinner at work about four hours earlier. I worry about this still. Will my dinner at work keep me full until bedtime?

Today I went walked at the park, just about 15 minutes -- not much, but a start. I definitely got my heart rate up, but did not really sweat much as it was cool, overcast and breezy. I sat for a while afterward and let the delicious breeze flow over me, listening to kids playing and a fountain splashing. I reflected on how good it feels to be DOING something about my weight, rather than sitting around THINKING I should be doing something about my weight.

August 10, 2009

Today was my first day completely alone since my surgery on July 27. My mother stayed with me through yesterday, and my brother came to visit a couple of times. He's a doctor, so it's been good to have him around for some of my appointments.

I cried last night, that's how much I missed my mother. I am 40 years old! We talked on the phone and she promised to check in with me today. This morning I got up and got out the door (after a Slim Fast and my first round of vitamins), picked up a coffee at Starbucks (I can't stand the smell of coffee in my own apartment) and listened to This American Life on NPR sitting in the park. Then, I hit the road and drove around my area. There are some very scenic towns and countryside, so I took photos (tramping around was good exercise) and nipped in and out of antique stores. I drank a delicious iced tea at a little general store/cafe, then came back to town to do some shopping at Target.

As I drove around, I found tears streaming down my cheeks from time to time. It was a sense of profound relief, gratitude, and accomplishment. I did it. These are the times when I truly believe there is a good, that's how profound the feelings were. I know I'm just at the beginning of the rest of my life, but now I feel there's something to look forward to. I was so tired of feeling like the elephant in the room -- literally! No one said anything (my family avoided the subject after many years of trying to get me to lose weight), but "it" was always there.

On another note, I don't know how other surgeons do it, but the team I am working with seems extremely thorough. They don't beat around the bush when it comes to the dire things that could happen if you don't properly follow the post-surgery diet progression, take your vitamins, and otherwise decide to do your own thing.

Friday, August 7, 2009

Feeling better & different

I am beginning to feel less like a walking, talking side of a house. Thursday (my fortieth birthday), I had my first post-surgery appointment and was happy to say goodbye to the drainage tube and mini football. I felt a strange, cringe-worthy sensation as the nurse sort of yanked it all out of my side. The hole left behind was immediately covered with gauze and tape, and that was it.

Also at this appointment I learned I had lost 12 pounds since my previous weigh-in on July 23. Twelve pounds in about two weeks. Crazy. So, to date: Lost 13 pounds from March to June, 11 pounds from June to late July (liquid pre-surgery diet), 12 pounds after surgery.

My watch slides around on my wrist. My bras fit more comfortably. Clothes are looser. No swollen ankles (not that I've been on my feet as much as usual).

In the week immediately after surgery, I had started taking my vitamins and other medication -- rather half-heartedly, I admit. After neatly organizing them in a brightly colored plastic case (a different color for each day of the week), I sort of lost hope. Somehow, seeing them all in one place made me wonder how I would ever get them all down. My post-surgery appointment reminded me how vital these are to my health. For the rest of my life.

6 multivitamin capsules a day
1 chewable iron tablet
4 chewable Calcium citrates (they taste and have the consistency of Starburst candy, never one of my favorites)
1 Pepcid (to prevent acid from eroding the lining and sutures of my newly small tummy)
Twice a week I have to put a small B12 pill under my tongue until it dissolves

Oh, and I have to exercise, plus make sure to get 65 grams of protein (Slim Fast), and 64 ounces of clear liquids. I admit, thinking about all of this gets me down sometimes. It all seems daunting. But, I just have to put one foot in front of the other and keep going. The alternative is unacceptable.

Next Thursday, I'll begin eating real food (half a cup per meal)! My menu choices are "cream of" soups (blended to get out any chunks), mashed potatoes, sugar free pudding, and scrambled egg! By the time I go to a conference I'm attending at the end of the month I'll be enjoying shaved deli meats, cheese, and toast. All these mundane foods sound sublime to me now.

I do think about food quite a lot, mostly at night when I am trying to fall asleep -- even though I am not hungry. This must the psychological part kicking in: the comfort and routine of a hot meal and eating until I'm stuffed (and then having desert).

Monday, August 3, 2009

Those three days circled in red...

...Are past now. I'm sitting at home trying to not think about the five openings I have in my body, less than inch-long incisions now stapled shut. Plus on my left side, upper under my breast is a hole with plastic tube coming out of it. This tube attached on the outside of my body to a small plastic container that's sort of shaped like a football. This thing collects drainage from the stuff that's going on inside my body, post-surgery.

I can shower, which I do daily -- very carefully. I lie around alot, as sitting straight up is uncomfortable. There are a lot of vitamins to take, there's a lot of fluid to imbibe, dressings to be changed, etc.

My mother is here with me. She mostly watches TV and reads as I try to do as much as possible for myself. Still, it's good to have her around. I would hate to be alone at this time.

After a few days post-surgery, I began to experience the first glimmerings of hunger, but they are easily sated with clear juices, broth, water, and jello (although I don't really like the jello). My new favorite snack is Crystal Light Frozen pops. Actually something I can crunch on AND counts as a liquid!

On Thursday, my birthday, I go to my first doctor's appointment post surgery. At this time I hope to have the tube and little football removed, and learn when I can start nibbling on such delicacies as scrambled eggs and mashed potatoes!

Friday, July 24, 2009

Getting Closer

The only things in my refrigerator are old condiments and protein drinks. I have cans of broth on my counter ready to heat when hunger strikes.

Surgery Monday. I did most of my pre-op stuff yesterday: Got weighed and blood pressure checked. BP is good and I lost another 11 pounds! Most likely due to the protein & liquid regimen. That makes a net loss of about 25 pounds since March (I gained a few pounds early in the process).

Met my surgeon Dr. Roger de la Torre, seems like a nice guy. Signed a blood transfusion (just in case) consent form. Then I went to University Hospital where I had blood drawn (including pregnancy test), my first-ever EKG, and then a couple of chest x-rays. This stuff seems to be in aid of making sure I am fit for the actual procedure. Then I pre-registered, which means all I have to do Monday morning is get a couple of wrist bands and talk the the anesthesiologist. About what, I am not sure.

I did better than expected making it through my time at work these past two weeks on the protein & liquids. This week promised to be extra challenging because I had to work a few more hours each day to fill in the gaps left by three other managers who happened to be out this week. Actually, it turned out to be a good thing because I was not sitting around thinking about food or how hungry I was. I took cans of broth and Slim Fast with me to work. Easy Peasy.

By the way, I have to give props to Slim Fast Low Carb Chocolate & Vanilla . They taste pretty good, and one can provides 20% of the protein intake required in pre-surgery. I also like the Muscle Milk Lite mocha latte. The EAS AdvantEdge Carb Control in chocolate and vanilla are fine. The only clear protein drink I've tried is Isopure, in iced tea and apple melon. Pretty decent.

After surgery, there's a week of clear fluids, so I will have to stock up on the Isopure and pick up something called New Whey. Plus broth. O, glorious broth! The deep rich smell and food-like taste are elixirs. Especially the chicken broth from Campbell.

This week I came across pictures of another old boyfriend on Facebook. He looks great. He was partying with three other people and a buttload of Moet ( to judge by the empty bottles on the table). At age 38, he is living his life very much as he did at 19 & 20, when we were together. Was that a bit of existential fatigue I saw in his eyes? Probably wishful thinking on my part.

Still, those pictures reminded me that I allowed relationships with boys and men to weigh me down. I gave these males far too much credit for being better than me. For knowing best. For having good intentions, underneath it all. These disasters entered my very flesh and I fed the sense of failure with self-disgust and actual food. Talk about baggage. My thirties are almost gone now, and I wasted the personal side of my life wallowing in fat. It was a sort of emotional hibernation, with brief forays into romance and other danger zones, like losing control of my finances. Food was my reward for suffering so much. This is what I told myself.

Sunday, July 19, 2009

Feeling Better, Optimistic

It was a strange first week. Cranky, euphoric, tired, weak, discouraged, purposeful. These were just some of the emotions I experienced on my protein/liquid diet.

I found that by eating a "meat salad" (greens and some kind of meat, chicken) in the evening I can manage to get through the day. I don't know how this will affect the liver shrinkage, but I imagine that compared to what I was eating before my liver is a lot better off.

Tomorrow marks one week before the surgery. I meet the the surgeon for the first time on Thursday and then talk to the anesthesiologist.

I feel so ready to fly! I want to soar and be great. I've been hiding my light (and now I really do feel I have light) for too long.

Confession: part of what is motivating me lately is a pronounced "that'll show 'em" attitude. There are people (friends, relatives) who probably think I've thrown in the towel as far as my weight goes, that I've decided not to care about myself enough to be healthy. There are men who may have liked my personality, even become attracted to me, but decided they couldn't date a fat woman. Hah! Just you wait! "That'll show 'em." It's almost like revenge. Not the purest of attitudes, but there it is.

Wednesday, July 15, 2009

Feeling Furtive

Last night I felt like a drug addict jones-ing for a fix. I made it through the entire day on the fluids, then -- ravenous at about 8 pm -- heated up some remaining pasta sauce and drank it like soup. Then after 10 pm, I got dressed (I'd already put on my pajamas) and drove to Wendy's and bought a taco salad. It comes with iceberg lettuce, a cup of chili, a few sprinklings of cheese and slivers of a nacho-like garnishment. Also, a creamy salad dressing. It was the most delicious thing ever. I don't feel very guilty, just worried about the condition of my liver and whether I am undermining the surgery.

I am finding it hard to fall asleep, whether for a nap or at bedtime. My body is weak and I'm tired but my mind is wide-awake and active with all kinds of thoughts, worries, doubts, etc. Oh, and I am having my period. So, I'm miserable.

This afternoon, I was checking Facebook and had to do a double-take when I saw a face from the past as a suggested friend. It was a guy I was engaged to in my twenties. We had known each other in high school and then gotten reacquainted. He called things off about three months before the wedding, which devastated me. I was looking great, too. One of the many failed relationships which confirmed to me that attractiveness was not much use, if --in addition to being smart, fun, friendly, affectionate, caring, and generous -- I couldn't make a relationship work. Especially since HE had pursued me in the first place.

I began to gain weight steadily after that breakup. One of the hardest things to deal with was not knowing WHY. His explanations were meager and unsatisfying: "I am not ready to be responsible for another person" was the gist of what he told me. What I assumed were things like: I was not attractive enough, I was not smart enough, I was not enough-enough.

Now to see him smiling back at me from the computer -- looking happy, handsome, and a tad bit pleased with himself -- hits me hard. His life has been great, I assume. He made the right decision to cut himself loose from me. My life has been a series of mistakes and bad judgment calls. He knew what he was doing.

Have I mentioned that I'm miserable?

Tuesday, July 14, 2009

Women & Food

Women talk about food a lot. My students (20-somethings) always seem to be talking about what they are going to be eating next and reflecting on what their previous meals were like. Today I went to the UPS Store to express-mail something and the all-female staff was discussing getting Subway for lunch. It was just past 11:30 a.m.

My sister-in-law Emily and I have discussed this phenomenon. It seems even skinny women think and talk about food. Perhaps even more feverishly than women who struggle to maintain their weight. Perhaps skinny women (like my young students) have more to lose (or gain!) by gaining weight. I used to be one of those skinny gals. Of course I thought I was overweight; par for the course these days, right? I remember the terrible sense of failure and self-loathing when a pair of pants suddenly seemed a wee bit tight. The awful punch-in-the-gut sensation upon hearing a family member or friend I hadn't seen in a while say: "Girl, you've put on some weight!"

Here is a list of the diets and weight loss cycles I have put myself through:

Age 17 -- sensible three meals, no desert, no soda, few carbs (felt I only needed to lose a few pounds)
College -- The breakfast-only diet, with aerobics in the evenings (lost probably about 15 pounds or so) ALSO, the cookie diet, surviving on the oatmeal cookies my roommates mother made. A couple of those in the morning and that was it. (Lost probably about 5 pounds or so).
Early 20's -- Jenny Craig. Lost 40 pounds. Kept it off for about a year. Jenny Craig again about two years later when I was engaged and getting ready for my wedding. Again lost about 40 pounds. Gradually gained weight through my mid-twenties as depression set in. Weight from size 10 to 12, 14, 16.
Late 20's -- sensible three meals (Lean Cuisine and yogurt for lunch, for example) and walking 30-40 minutes each day. Don't know how much weight I lost, but friends and co-workers noticed the change. This lasted maybe six weeks. Soon after...
Also Late 20's Weight Watchers -- lost maybe 20 pounds but fell off the wagon when my meetings (in a beautiful old mansion by the lake) moved to a generic Weight Watchers Center and my leader changed. Size 16 to 18.
Mid-30's -- Weight Watchers again. Great meeting, great leaders. Lost 45 pounds, back to size 16. Yay! This lasted until just after I got married about a year later. Tough period emotionally. Up to size 20.
Late 30's -- Slim Fast, only lasted a week. Hated it. ALSO, Nutrisystem. Again about a week. Hated it.

Now at age 39... I weigh about 320 pounds, that's size 22-24. Most of my shoes are extra-wide and have to be ordered from catalogs.

I need to lose about 160 pounds, according to the needs of my body (height, age, etc.) This will put me at about a size 14. People always tell me my appearance doesn't match my actual weight, so perhaps I will look like a size 12? Ha ha!

About the protein/liquid regime. Yesterday was tough. I made it through the entire day, but when I tried to fall asleep about midnight the hunger set in big time. I lost control and ate an Amy's Kitchen Organic Breakfast Burrito and a cinnamon raisin bagel with nothing on it. These are the last edible things in my apartment aside from the protein drinks and cans of broth. I had three cans of broth yesterday -- 2 Campbell's chicken, which were pretty delicious and comforting, and one Swanson's beef which was bland.

The clinic I am working with requires this regime for two weeks (!) before surgery. It's supposed to shrink the liver to allow the surgeon better access to the stomach. I can't help but wonder, if I eat at least one high protein meal/low carb/low fat a day will that sink my surgery? I am afraid to ask the clinic in case they decide I am not fit for the procedure, willpower-wise.

Monday, July 13, 2009

No food, just fluids -- 2 hours in

Day one of the two-week pre-surgery liquid diet. I have to ingest at least 100 grams of protein a day, plus 64 ounces of clear fluids. The ingesting part is not too bad, it’s the hunger and desire to chew on something later today that I am afraid of.

I veer between apprehension and excitement. This is the start of the new me, or the improved me – I hope.

So here are some of the reasons I am doing this… Things I need to remember as I hit the rough patches in this process (in no particular order):

Feel better about myself
Be able to buy fashionable clothes & look good in them
Fit comfortably into airplane seats and not need a seatbelt extension
Have more energy
Look attractive to men
Have sex
Not feel scared about seeing people who knew me when I was skinny
Set a good example for my niece and nephews
Allow my family not to worry about my health and well-being
Be healthier

Now I know what it feels like for smokers and drug addicts to try to kick their habits: It feels like a minute by minute fight to tolerate hunger accept the fact that there will be no food for a very long time. Just yucky protein drinks, water and broth.

Thursday, July 9, 2009

Waiting and Worrying

It's the waiting that's getting me now. There are three July dates circled on the calendars in my apartment and at work:

July 13, 2009
Begin protein supplement & liquids regimen.

July 23, 2009
Visit with surgeon and anesthesiologist about procedure

July 27

At the moment I am almost most worried about surviving the two weeks without solid food than I am about the surgery. Will I feel weak all the time? Will I be able to concentrate? Will I have cravings?

The purpose of this two weeks of fluids (most of my diet will consist of protein shakes, broth, and jello) is to reduce the size of my liver so the surgeon can have easier, safer access to my stomach.

My procedure is the gastric bypass, otherwise known as the Roux-en-Y. Here's what WebMD has to say about it.

I need to lose about half of my current weight, and I decided that the gastric bypass would be the best way to achieve this. The other option was the Lap Band, which is not permanent and less invasive, but generally does not lead to the major weight loss I need.

The only people I've told about this are members of my family and one long-time friend who also has had the surgery. In explaining to my bosses why I need to be off work for two to three weeks, I simply said I have to have surgery. I didn't go into specifics and they cannot ask, so that's that.

Before I even got to this point I had to keep monthly appointments at the bariatric clinic. This was an insurance company requirement. I suppose they hope you change your mind so they won't have to shell out the dough for the procedure! These sessions consisted of: a weigh-in and blood pressure check, short meeting with a doctor, and a class with fellow prospective patients. In the class we learned a lot about how much our lifestyles will have to change after surgery and also did some written exercises to evaluate our motives for surgery and self-esteem. I also had to keep logs of my food intact (concentrating especially on protein) and exercise. I actually lost thirteen pounds during this time! And, I really learned a lot, so it was definitely worth it.

And there's more... The insurance company also required a "psych evaluation," so I went to one of the doctors recommended by the clinic and answered questions about how long I'd been overweight, why I wanted to have the surgery, whether I had family support, etc. Toward the end of the hour I unexpectedly started crying. I was thinking about the younger me, the one who hated to be looked and leered at, the one who had been hurt in relationships, the one who already felt overweight (even though I was quite normal), the one who told herself it was better to be insulated from pain, better to be alone that part of the frenetic relationship/jealousy/beauty/competition scene. Better to feel very little than to open oneself up to the slings and arrows of outrageous fortune.

I hope this blog will help me through the process of drastic weight loss. Perhaps it will also help others.

Until next time....