Good Right Now, Where I Am

Shifting Paradigms and New Math Revisited


Although my actual Surg-I-Versary is not until June 6, I had my official 1-year checkup today at the surgeon's office, meeting with the exercise physiologist and the dietician.  As of today, I have lost 78% of my excess body weight and my body mass index is down a staggering 22.2%.  At the 1-year point the desired percentage of excess weight loss is 66%, so I am 12% ahead of that.  The overachiever in me is delighted!  According to my scale, I have lost 127 pounds total, 100 of that since surgery.  My blood pressure today was 94/62.  The exercise physiologist took it and asked me if this is about where it tends to run now, and I assured him that it is.  Part of The New Normal.

Results from my 14-vial blood draw last week were mixed, but mostly good.  My iron is improved but still a little low, so I am still on extra iron, for now.  Protein is also a little low, but just by .1%, so I am not worried about that.  It will be an ongoing process to make sure my protein intake is adequate.  Vitamin K is low this time, so the dietician has added a vitamin K supplement to my routine.  No biggie.

The liver enzymes that my family doctor found to be elevated a few months ago at my annual physical are still elevated.  So I am being referred to a gastroenterologist to check into that more thoroughly.  While I am not thrilled with this development, I am also not really worried about it.  I'm not having any pain or symptoms, so I am hoping this will turn out to be no biggie as well.  I'll update here when I have seen Dr. Gut-Check (nickname for the GI doctor) and have something more concrete to report.  I feel fine so I'm not going to be freaking out about it just yet.

My appointment and discussions today, especially with the dietician, were great indicators of progress made and a wake-up call about where I really am in this whole process.  I am basically at an acceptable weight and BMI, right where I am.  I thought I had a lot more weight to lose, but the dietician told me I am at a good place now, and if I lose more than 10 more pounds, I need to come see her for closer monitoring and ADDING calories to my daily intake.

Excuse me, I could not possibly have heard that correctly.  I am good right now, where I am?  Really?

I am having some trouble absorbing this, because in my whole life, I have never been good right now, where I am.  Never.  When I was in 6th grade, 5 feet, 1 inch tall and wearing a junior size 11 jeans and a 34-B bra, I was "too fat."  At least, that's what I was always hearing.  Looking back as an adult, I can realize that I was just fine at that size, and the Fatophobes in my life saying I was fat were lying.  I was just an early bloomer.  If I had been told just once by the right people that I looked good at that weight and size, I might have been able to stay there.  But I wasn't.  I was "too fat", and my life from then on became a struggle with ballooning weight and size, diets, shame and never measuring up because of my measurements.

I grew up in a world of extremes and judgments.  There were fat people and skinny people.  Skinny people were better than fat people.  And I was fat people.

I still feel fat, to be honest.  I see loose skin and wiggly-jiggly stuff on my body.  I don't have a textbook tummy or firm, flat abs.  But I am less large than I used to be, and now that the number of pounds I need to lose is minimal, I can start working on toning my body and investigating skin removal on my abdomen, if my insurance will cover that.  Making the transition in my mind from "freakin'-HUGE" to "Good-right-now-where-I-am" will be a big paradigm shift for me.

After my appointment I stopped to pick up my new vitamin K supplements and, on a lark, did a little shopping.  I thought I was in the mood to look for shoes, but nothing in the shoe store appealed to me.  Turns out there was something else I was meant to do.  I found my way into a department store and, out of curiosity, I picked up an armful of different jeans in several sizes to try on.

Today, after being told that I am good right now, where I am, I zipped myself into a pair of size 12 Levi's.  I did a happy dance in the dressing room, cried a little and then texted my cousin Judy to share the news with her.  She understands my issues with weight/size/self-image in a way few other people do, and she rejoiced with me on this milestone.  I can't ever remember wearing a 12 in jeans.  I remember going from an 11 junior size straight into 14's and up...and up.   I realize it's just a number on a label, but it still feels like a victory somehow.

New math for me indeed.

The Scales Of Justice

Tallying up the totals from vacation


The Diva has survived her first post-surgery vacation without doing too much damage to her program!  In fact, I am pleased to report that when I got on my scale this morning, I somehow actually managed to lose about half a pound while we were gone.  It's not much, but considering the variation in routine and the fact that I did not have my trusty scale with me on the trip, I am counting a half pound lost over vacation as a big victory!

There are other tallies to be added up, and a big one will get done tomorrow.  I am going in to get my big 1-year labs drawn at the weight loss center tomorrow, and while I am hopeful that everything turns out well, I am also a little nervous.  I'll go and do that right before I head to the hospice for my Monday afternoon at the front desk.  I won't be donating a pint of blood, but I will get several vials drawn to check nutrients, protein, iron and various other levels to make sure I am getting what I need from both supplements and food sources. I am especially hoping that my iron is better, maybe even in the normal range by now.  If you're a praying person and you read this between now and in the morning, a small prayer for good blood work for me would be more than welcome!

My actual appointment for the 1-year checkup is next week, when we will discuss my progress, my percentage of excess weight lost to date and the results of my big blood draw that happens tomorrow.  (They need about a week to process those results.)  And there might be a photo-op.  I know that right before surgery they took a "before" picture, so the 1-year checkup might involve an "after" one.  Which is fine.  While we were on vacation, I did something that The Hubs said took guts---I posted a waist-up swimsuit picture to my Facebook timeline.  The photo I posted is not pristinely clear, and there is a piece of wall art behind me that makes me look like I have spikes growing out the side of my head.  But it gives a good representation of the progress made since the weight loss journey began, both in the actual change in size and in the fact that I was willing to post a picture like that in the first place!  It's not indecent or anything, and there's not a foot of cleavage showing.

The Girls, however, are still very much present and accounted for.  Once the losing process is done and the maintenance phase is underway, there may be some body work ahead for me, depending on what my insurance will cover.  Years ago, when a co-worker's wife had weight loss surgery, insurance covered her tummy-tuck procedure after she had achieved goal weight.  That is something I would consider.  And there might still be room (and insurance coverage) for The Girls to have their own reconstruction/reduction.  While there has been significant breast loss as I have shrunk, The Girls are still large...and heavy.

Lots of things are sagging and bagging.  I have wing flaps on the backs of my arms and sagging thigh skin that exercise won't really address because it is skin and not muscle.  There is wrinkly-crinkly stuff under my chin and on my neck now that bugs me.  But, these things are just vanity and nothing that I will pursue surgical correction for.  Tummy reconstruction is somewhat different because there are literally pounds of skin in that area, just hanging there.  Not to be graphic, but folds of skin hanging like that can trap moisture and harbor infections if a patient is not careful, which is why loose belly skin becomes a real health issue, and why, I suspect, insurance often covers a tummy-tuck.

But I am getting ahead of myself.  Goal weight is close, but I'm not there yet.  Once I get there, then we'll start considering what else might need to be done for the sake of my health and well-being.  For now, let's get me through the next couple of weeks, the big blood draw and the 1-year checkup.  

Worth It

Things you can't put a price on...


Today is our last day of vacation.  Tomorrow we will be back on the road home. The last day of a vacation always makes me a little sad.  As I write this, I am sitting in Palm Coast Coffee, one of my favorite places on the planet, having just enjoyed half of a scone with The Hubs.  Only half of a scone because that was enough to fill me up!  Life is very different in many ways since surgery.

Yesterday we got out and did a little shopping and sightseeing.  One of the things I wanted to do on this trip was to climb the St. Simons Lighthouse, and we did that yesterday.  It's probably not that big a deal to most people, but accomplishing the climb meant a lot to me.  The lighthouse has 129 steps to the top, a narrow spiral staircase with landings about every 20 steps and a window at each landing for viewing the island and taking pictures.  The top viewing deck is 360 degrees of beautiful views of both the island and the ocean.  The afternoon was sunny and warm, and the climb didn't take long at all.  Going down the steps was actually a little more challenging because of how narrow the staircase is, and how twisty.  The Hubs uses a FitBit, and it told him that the lighthouse was equivalent to 7 flights of stairs!

St. Simons Island is a cool little community.  There are always people outside walking their dogs, walking their kids in strollers, riding bikes and being friendly to everyone else.  It's a very dog-friendly place, and Palm Coast is as well.  As I write this there are 2 families outside on the porch/patio with their dogs in tow.  Lots of places down here offer dog-friendly dining options with decks, patios and porches where humans can bring their four-legged children.  The lifestyle here just seems more relaxed.  Of course, I am on vacation, so the relaxed side of life here is what I see.  When we win that Powerball jackpot, we'll have a cottage down here, and some other houses in some other places!  It's nice to dream.

The last time we visited here, my dreams were about being smaller and healthier, feeling better and hurting less.  Those dreams have begun to come true since weight loss surgery.  While there has been plenty of laziness on this trip, even the laziness has felt different somehow.  Simple things like walking the dog have been more enjoyable.  While I may have possibly been able to climb the lighthouse before, it would have been exhausting and painful, and much slower to do.

I have a couple of friends who are planning their own weight loss procedures for this summer.  These women inspire me with their choice to reclaim health, strength and vitality for themselves.  I pray for their process as they prepare for surgery, undergo their procedures and recoveries, and begin the journey into The New Normal.  I don't lie to anyone and say that it's an easy process, because it is anything but easy.  There are costs, substantial ones, financial and otherwise.

It is not easy.  It is not cheap, either.  It is sometimes a struggle, and I'm still in that first-year honeymoon period.  Big changes have to happen.  A friend at work asked me about the mental/psychological part of the equation, and I said that before I could change my body, I had to change my mind.  And that is going to be a lifelong process.

It's not easy.

But it's worth it.

Give Us This Day Our Daily Meds

Special considerations for the weight loss patient


I have been dreaming a lot while we have been on vacation, with vivid, stressful nightmares the first couple of nights.  One of my dreams was that The Hubs and I were in New York City, lost somewhere up there, and among all the other things that were wrong with that scenario, I had not packed my vitamins and supplements, and there was no place where I could just dash in and buy them.  Not having my meds was the worst part of the dream by far because serious health problems can result if I don't stick to my regimen, and I was paranoid about getting complications from not having my supplements.

Prior to surgery I didn't take much medication on a regular basis, especially considering my age and my weight at that time.  No meds for diabetes, heart disease, high cholesterol or hypertension, because I had been spared those conditions.  I took medicine as needed for headaches and allergy symptoms, and on a daily basis, my birth control pill and an acid blocker because of reflux due to a hiatal hernia. ( The Hubs has more medications because of his diabetes, but he always takes care of packing his own bag.  Lots more information than you needed, I realize.) Anyway...this being my first big post-surgery trip, I was a little paranoid I would forget something I needed to pack.

My daily meds now consist of the pills I took before, PLUS:

8 huge bariatric multi-vitamin pills (although I don't take them all at the same time);

The acid blocker, which I will take for the rest of my life because, even though my surgeon repaired my hiatal hernia, I also have about 70-80% less stomach than I did before, and what's left needs to be protected from acid and possible ulcers, which could become a major problem if they develop;

A probiotic that I also get from the weight loss center because it is specially formulated for bariatric patients (I have compared it to the ones available at retail and mine are both more complete and way less expensive);

2 iron supplement pills which are also bariatric-patient-specific.

I need to take such an overabundance of supplements in part because I don't absorb nutrients, calories or fats the way someone with an unaltered digestive tract does.  This malabsorption is a big reason that my kind of surgery has a good success rate; it is also why I have to be extra-careful about getting the nutrients I need by gulping so many pills every day.  And because my supplements are specifically designed for weight loss patients, I can't just stop at the local neighborhood pharmacy and find what I need there.

So my paranoia in my dream was echoing my paranoia in real life, nervousness about forgetting something I needed to pack and getting sick or breaking a bone from lack of vitamins.  It happens to patients who don't stick to their plan more often than we hear about, and the dieticians at the weight loss center have preached the importance of supplements so well that I am a true believer.  I had surgery to improve my health and strength, after all.  Why would I risk my health and strength now by not taking my supplements?  I won't.  I am too aware of all that could go wrong if I don't stick to the plan.

I am a true believer.  I AM a true believer!  Can I get an Amen?

A Different World

And a beautiful day in the neighborhood

This vacation is special for a lot of reasons.  First of all, it's just been a long time since The Hubs and I have had a break of any kind.  Secondly, this is the first trip to St. Simons that we've stayed someplace a second time.  We are in the house we stayed in on our last trip here, right before my (and The Hubs's) weight loss journey began in earnest.  While the house is the same, some things have changed.  The wood floors have been painted white, which opens up the space and looks cheerful, as does the new yellow paint color on the walls in the living/dining/kitchen area.  I am writing this on a big new sofa that sits where a futon used to be.  

Some other things have changed as well.  The cheval mirror in the bedroom doesn't bother me as much as it did the last time we were here!  Am I completely pleased with what I see in there?  No, of course not.  But it gives me a good view of how my body has changed.  As I've mentioned before, I don't have a full-length mirror at home.  (I should get one, I know.)  

The Hubs and I took a quick dip in the pool this afternoon, then sat in the sunshine for a while to dry off.  The water was just a touch chilly for us today, but I'm hoping it will get warmer this week and we can spend more time in the pool.  Morning and evening temperatures have been wonderful for good walks with the dog, and all of us are enjoying that...except for the early morning when the bed is warm and the dog is insistent that he wants to go out NOW!  The Hubs has been getting up for the first walks, which I appreciate.  Anyway, for this afternoon's pool visit I wore the swimsuit my cousin Judy had sent home with me in February, and I am grateful to have it.  It's cute and, dare I say, it's flattering.  It is also a little looser than when I first tried it on.  So even though my weight loss has been a little slower the last few months, I have made measurable progress.  After we came in from outside, I pulled on some shorts and took the dog for a walk, in my swimsuit top, and I wasn't mortified to be seen like that.  That kind of progress is beyond measure!  

I meant to pack my digital tell-me-every-sin-I-ever-committed scale for the trip, but I forgot it.  There is an old-school scale where we're staying, but it can only be a very general reference for this week.  I will admit that I am freaking out a little not having my own scale, but even my own scale would have little variances because of weather conditions here and different elevation above sea level.  I have found that, for me, weighing every day is a good strategy to keep myself accountable and on the straight-and-narrow.  The fact that I view my scale not as a nemesis but rather as an ally in my process is a huge paradigm shift for me.  But Mr. Old-School scale will serve the purpose for this week, and as long as my number doesn't go up, I'll be happy.  It might not be such a big deal except that my one-year checkup at the surgeon's office is the week after we get back. So I need to be sensible this week and pick my treats carefully.  

That said, I did indulge in a small bowl of Kooky Poofs yesterday.  They were delicious and a small bowl satisfied me.  Mostly I am trying to stick to my plan pretty closely.  The extra walks with the dog are good for me, and I am enjoying the outdoors, fresh, salty coastal air and sea breezes.  I am enjoying the relaxation and down time.  I am enjoying the chance to read all I want, nap and then read some more.

Life is pretty sweet at this moment, and I am so grateful for the opportunity to enjoy everything in a different way now.  Walking the dog the last time we were here was such a chore, because of how my body felt and the effort it took to do it.  Now I am enjoying it so much...with the exception of the first walk of the day when the bed is warm and I don't want to leave it just yet.  For all the miracles that have come from weight loss surgery, it can't change every single thing.  Getting smaller will never make me a morning person!  

  

Eleven Months Since Surgery

The New Normal and traveling


It has been a slow month for weight loss.  I am down a total of 124 pounds to date.  I've been doing some more scrounging through closets and drawers in recent weeks looking for old things that I can wear again.  I have a meeting coming up with my music fraternity students and since it's one in which we will recognize graduating seniors and install next year's officers, we dress in white.  So I went looking to see what I have that will work, and I was pleased to find several options for the occasion.  I just need to decide which one to wear.

I also started packing for our upcoming vacation.  I am notorious for over-packing and I always have been.  It's hard to predict the weather and I'm always afraid I'll need something and not have it.  I know I have too many clothes in my bag already, and I'll probably unpack and repack at least once between now and when we leave.  I am not much of a shorts-wearing girl, and the only ones I have are way too big, but I'm taking them anyway.  They have drawstrings so I can cinch the waists in and make them work.  I'm not buying new shorts until my weight is settled where it needs to be.

Packing my "health and beauty" bag will be different this trip, and from now on, because I have so many vitamins and supplements I need to take with me.  This is our first trip since my surgery so I'll be super-vigilant about making sure I've packed all the extra bottles, bars and pouches.  Just another part of The New Normal.

St. Simons Island is such a relaxing vacation spot, and over the years we've discovered a favorite little cafe there called Palm Coast Coffee.  We originally went there because it's an Internet cafe and we wanted to check e-mail and whatnot.  We also discovered that it has great food and wonderful regional atmosphere, with local artists' paintings on the walls and available for purchase.  Our last trip, on our way out of town, we stopped there for scones to take with us on the road, (something of a leaving-the-island tradition) and I asked if they had t-shirts with their logo on them.  I bought one in the largest size they had, knowing that, right then, it would not fit me...but knowing that eventually it would, once I had my surgery.

It fits me now and I've packed it to take with me, along with the fabulous Kissy Shirt that is way too big.  But I will never part with it, and I'll certainly never take a vacation without it.  A big part of The New Normal is figuring out what I am willing to let go of and what I am adamant about keeping.  And clothes are only a part of that process.  I am having to learn what attitudes and self-perceptions are still valid, as well as the ones that aren't accurate any longer.  I am no longer always the biggest person in the room, for example, but I still usually feel like I am, because I was for such a long time.  I am, in fact, getting really close to being of "average size", something I have not been in decades, and even when I was, I still felt fat because I was always hearing that I was fat.  I don't think I've ever felt average-sized, or more pointedly, normal.  In the words of a favorite author of mine, Patsy Clairmont, "Normal is just a setting on your dryer!"

The New Normal isn't about what I look like.  It's the way I live my life now in order to get and stay healthy and strong.  It's eating a new way, working activity into my routine and valuing myself enough to make the changes I need to make.  What I look like is just a by-product of The New Normal.