Monday, December 26, 2011

It Was A Dark And Stormy Night...

Monday 12-26-11
No, really, it was!

The Sunday night after Thanksgiving was my overnight sleep study.  I arrived at the hospital at 8 pm, right on time to begin the paperwork and preparations for the evening.  It was pouring buckets of rain and, in typical fashion, the closest parking places were still a lengthy walk away from the hospital entrance.  So I wagged myself, my overnight bag and a not-quite-large-enough umbrella from parking lot to hospital door without getting too soaked.

After filling out some forms and getting acquainted with Renee, my sleep tech, together we began the rather involved process of getting me prepped for the night.  Electrodes and wires were attached to my temples, jaws (to detect if I grind my teeth in my sleep), ankles (to monitor feet and leg movements), and various spots on my scalp to measure my brain activity and the various levels of my sleep.  I also wore a pulse oxymeter on my fingertip to measure my oxygen levels during the night.  Then the whole bundle of wires got hooked up to a monitor at my bedside.

The room itself was pretty spartan, although not uncomfortable.  There was a television which I never turned on, but for people whose bedtime routine includes TV it is good to have it there.  I brought my Bible because reading it is my bedtime routine; I've done it for years, reading through the Bible annually, mostly at bedtime (and occasionally on my lunch hour).  I can't really say how much Bible reading has improved the quality of my sleep, but it has certainly improved the quality of my life over the years.

I don't know how most people perceive their sleep study experiences, but it seemed to take me a long time to get to sleep that night.  When I went in to discuss the findings of my study, the doctor told me that it had indeed taken me over an hour to get to sleep that night.  (There was no clock in my room so I had to estimate how long it took me to fall alseep and how much sleep I thought I had gotten on the questionnaire I filled out the next morning.)  Considering I was hooked up to a lot of wires, it was not as uncomfortable as I had thought it would be.  I am a side sleeper and I know that I wake up momentarily every time I turn over, I have as long as I can remember.  My sleep felt fitful to me, and the findings confirmed that it had been.  I only experienced 2 brief periods of REM sleep, and during both periods my oxygen level dropped to about 82%.  My diagnosis is mild sleep apnea and there is a CPAP unit in my future (continuous positive airway pressure) to make sure that my breathing and oxygen stay at a healthy level while I sleep.

Sleep apnea is common among obese people and can be a life-threatening condition.  Most people are unaware thay they suffer from sleep apnea, which varies from mild to severe, in which cases patients actually stop breathing multiple times per night.  Once other causes are ruled out, sleep apnea can also often be resolved with weight loss, surgical or otherwise.  While I continue medically supervised weight loss prior to surgery, and as I get adjusted to my CPAP, I am hopeful that my sleep quality will be better and I may feel much more rested and energetic.  If it makes the kind of difference my doctor thinks it will, I may feel better than I have in years.  That is definitely worth a dark and stormy night spent at the hospital!

Thursday, December 22, 2011

Untitled Drug-Addled Blog Project

Thursday 12-22-11
Diva Got Run Over By The "Itis"


I have spent the last week and a half sick.  Hard core, fever-running, croupy-coughing, sore-throating, cold-sweating, crazy-dreaming SICK.  It began with bronchitis, for which I went to the doctor, although because of scheduling, I could not see my regular doctor.  I had to see another doctor in the office.  Not a mistake I will repeat if I can avoid it.  Dr. "P-is-for-Precious" started by telling me, "I just HATE antibiotics", and then elaborated that every time he sees a red bump come up on his skin, he thinks it's MRSA.  Oh, dear Lord.  So even with the cough and fever I brought with me to the office, he only grudgingly agreed to prescribe me a Z-Pak, which was clearly insufficient for my infection.  He also prescribed an inhaler, which gave me a really bad reaction, keeping me up pacing my floor all night with heart palpitations and fits of tears for no reason.  Horrific.

In all fairness, my escalating illness was partly my own fault.  Last weekend my choral group joined with our city's symphony orchestra for a series of annual holiday concerts, four concerts in 3 days in full concert garb under hot stage lights packed onto risers in very close proximity with a hundred other singers breathing each other's air.  These concerts are physically taxing under the best of circumstances, and since I was sick to begin with they were doubly so.  By the end of the 3rd show on Saturday night, I was barely standing, and I did not make the final performance on Sunday.  I could feel myself fevering during each of the shows, and I could also feel myself becoming more dehydrated with every phrase I sang.  I spent all of Sunday in bed, getting up only for bathroom breaks, drinks and medicine.  By this point, the bronchitis/infection had moved into my sinuses and my ears.  When I get sick like this I almost feel like I'm going to die...then I wish I'd just go ahead and DIE already. 

Monday was orientation for the CPE program.  My sweet Hubs asked, "Do you think you'll be able to make it through orientation?"  I thought, how could I ask God to bring me this far and then say I'm too sick to show up?  So, I showed up, and I did get through the day...with many prayers, mine and those of other people.  Orientation was an all-day affair, including a 2-hour walking tour of the hospital where I'll be serving, and the tour included more fever and dehydration.  Tuesday was a little calmer a day, an appointment to get my car serviced, followed by breakfast, then a consult and weigh-in at my surgeon's office, then another break before going to my sleep center for the results of the sleep study I had last month.  So I had breaks and time to rest, eat something and drink water. 

Wednesday, yesterday, Hallelujah!  I was able to see my regular doctor and get REAL medicine!  Thank You, Lord, for a family doctor who knows me, who will prescribe strong antibiotics when necessary, and who knows what sick looks like when I bring it in with me.  I received an injection of Rocephin ( strong broad-spectrum antibiotic) in the office, and prescriptions for Augmentin, (another strong broad-spectrum antibiotic) prednisone for imflammation of the infected areas, and a cough liquid that will help with the coughing and also help me to sleep.

At my weigh-in and consult on Tuesday I had lost another 6 pounds (a pleasant surprise) and according to the printout, it was all fat loss.  Yippee!  So that is a total of 15 pounds and 3 BMI points down.  My next appointment and weigh-in are January 24, so I will have a little time after Christmas and New Year's to recover if I have any holiday mishaps with food. 

So far, being sick has killed my appetite so the temptations have been minimal.  Being sick, however, has also gotten me wondering how I will deal with illnesses like this once I am post-surgery.  My body may respond differently to medicines, and my stomach pouch may not be able to take horse pill-sized antibiotics.  At next month's support group meeting I'll be sure to ask about these concerns so I can be prepared for whatever could happen if I get The "Itis" after surgery.      

Tuesday, December 13, 2011

Lead Me Not Into Temptation...I Can Find It All By Myself

Tuesday 12-13-11
Yes, I stole another country song title for my blog


It may be the most wonderful time of the year, but for people with food issues, it is fraught with peril.  The Holidays, that sugar-glazed, rum-soaked, cider-and-cookies-and-chocolate-whipped frenzy between Thanksgiving and New Year's Day poses multiple hazards for us, the fatties-trying-to-be-former-fatties of the world.  This year for me, pre-surgery, it is simply a matter of avoiding the seasonal onslaught of sweets and goodies because I need to lose pounds before my surgery.  Simple enough, right?  Next year it will be a whole different set of issues.

Next year at this time, Lord willing and knock wood, I will have undergone my surgery and started losing weight in substantial quantities.  I will need to avoid the food gauntlet for the weight-gain reasons, of course.  But I will also have fear to motivate me...fear of dumping, clumping and getting really sick. 

Dumping syndrome is what happens when a weight-loss surgery patient eats too much of something too sweet or too fatty in too quick a time, resulting in quick and violent cramps, diarrhea and an overall feeling that the stomach pouch and intestines are rebelling against the substance placed inside them.  Clumping can happen when the patient consumes too much of something without enough liquid in it to allow it to ease its way into the stomach pouch, resulting in a feeling that the food is trapped, or clumped, at the stomach opening.  This has been described to me as an incredibly painful and frightening experience.  No thanks, I would prefer to pass on anything painful or frightening.

Even though next year's holidays should find me in the last stage of the post-operative stages of diet and I should have no limitations (i.e. I should be well past the liquid-puree-soft food stages and back to "normal" foods) my holiday dining will never be the same.  Seeing that sentence in writing, it looks sad and nostalgic, and in some ways, it feels a little bit sad.  I have to remember that the things I am giving up are nothing compared with the healthier me I am giving them up for.  I cannot let The Ghost of Christmas Goodies Past derail me from my goals.  The Ghost of Good Health Yet to Come reminds me that this process is not about deprivation, but about salvation...saving my health, my joints, my heart and lungs, and my future. 

Monday, December 5, 2011

"He must increase, but I must decrease." John 3:30

Monday 12-5-11
Yes, Virginia, this IS from the Bible...


Today an e-mail came to me that I have been hoping for months would come.  I had gathered a group of friends in the summer to pray with The Hubs and me about a course I was thinking of applying for.  After  completing some fairly arduous essay questions for the application, sending my materials in for consideration and ultimately being asked to come in for the interview, I am now pleased and grateful to say that I have been accepted for an extended unit of CPE (Clinical Pastoral Education) at my local university's hospital.  Clinical Pastoral Education is, among other things, a course of study that most chaplains pursue at some point in their educations.  I will state here that I don't know if chaplaincy is in my future or not; this unit of CPE will answer a lot of questions for me and help me to determine if God is leading me in that direction.  If not, I will still definitely learn a great deal, and what I learn will make me a better caregiver for the hospice families and patients I serve and for the college students I work with, and a better communicator with everyone in my life. 

I feel like it is no coincidence that this has all coalesced at the same time as my weight-loss surgery journey.  God leads us where He does, when He does, for a reason.  And I believe that His timing is always significant.  I know that the above verse from John's gospel did not apply specifically to weight loss...but in my case, it certainly can.

Over the next 5 and 1/2 months I will be continuing my medically-supervised weight loss and doing CPE at the same time, and I am thinking that each effort is going to enhance the other one, by giving me very specific goals to work for, and by helping me to distinguish self-care from self-denial.  The occasional hunger pangs and growling stomach that have come with my new way of eating and drinking sometimes feel very much like self-denial, especially on cranky, self-pitying days...but I realize that they are actually a part of me finally taking care of myself.

Likewise, this unit of CPE will require a great deal of time, energy and soul-searching.  I consider myself to be pretty transparent most of the time, but if I tell the truth, I have to admit that even I have masks that I hide behind sometimes.  In my CPE group, those masks will have to come off.  I will have to show myself as I am.  I know that unmasking myself will feel like another form of self-denial.  I also know that in taking off the masks I will actually be caring for myself in a new sense, by allowing myself to be known in a new way by new people.  While not a strictly "therapeutic" setting, CPE is a small group situation in which deep issues are discussed with honesty and frankness, balanced with respect for ourselves and our groupmates.  It will be intensely personal.  This will stretch me, I suspect, far beyond my comfort zone at times.  And this stretching will be good for me, even if it hurts a little.  Like physical stretching does for the body, CPE will challenge me to stretch my horizons and perceptions, making my heart and mind both stronger and more supple.

I am looking forward to watching how all of this unfolds.  God is so good and He has blessed me so greatly.  I have a Hubs who loves me after all these years and a core of supportive friends who encourage me unconditionally.  It's going to be very cool seeing how I can grow and shrink at the same time!





 

Saturday, December 3, 2011

Constant (Cursed!) Cravings

Saturday 12-3-11
Caffeine, Calories and Carbonation


Thanksgiving kicked my butt a little, and led up to a week that kicked it some more.  Nothing earth-shakingly bad happened, there has just been a lot going on.  I fell off the healthy wagon a bit over Thanksgiving weekend and I was disappointed in myself because of that.  And I think it ended up showing on the scale at my first official weigh-in at the surgeon's office because my loss was a little less than I had hoped.  Still, I was down 9 pounds, so at least I moved in the right direction.

I'll backtrack a little.  Thanksgiving Day I worked my usual 7 am to 6 pm shift at my job, where most of us brought in some kind of food to share.  Some of the food was healthy and wonderful, and some of the food was unhealthy... and even more wonderful!  At least, it tasted wonderful.  My sweet tooth got the better of me and I indulged in some tasty treats (although not with the reckless abandon of years past), followed by some guilt.  And the leftovers lingered on into the weekend, but by Saturday I was back to eating my new normal way. 

The Sunday night after Thanksgiving I spent the night at the hospital for my sleep study.  It was not all that uncomfortable physically, but even on vacation I never sleep well the first night in a strange bed, so my sleep seemed fitful to me.  I was happy not to be awakened 2 hours in to hook me up to a CPAP, which I was told might happen if it became obvious that sleep apnea was a problem for me.  I may still have it, but at least not a severe enough case to warrant a split-night sleep study.  I go in to discuss the findings in a couple of weeks. 

The Sunday night study was not at the ideal time because I had an interview the following morning for a class I had applied for and I was concerned about not being at my best for this important meeting.  (More on that will follow in a future post.)  At any rate, I came home from the hospital in pouring rain with something like Crisco globbed in my hair and itchy residue from the tape that had attached the leads and electrodes to my skin and scalp.  Fortunately and by the grace of God, I was able to wash all the glop out of my hair and ended up with a great hair day for my interview, and The Humility Pimple that had threatened over the weekend vanished as well!  (Probably more will follow on The Humility Pimple in a future post, too.)

Wednesday I went in for my weigh-in, followed by a consult with the dietician.  Talking with her opened my eyes to some things I had been wondering about.  In the little over a month since my first visit with the surgeon, I was able, with some difficulty, to begin eating from (and trying to stick to) the recommended foods list, to start paying closer attention to portions, labels and calories, to begin drinking the recommended 64 ounces daily of non-caloric liquids, and to get myself off of caffeine completely.  The caffeine withdrawal was not easy for me.  I weaned off gradually for about 2 weeks and then quit caffeine altogether, and my head ached every day for at least a portion of the day, until actually just a few days ago.  They have not all been migraine-caliber headaches, mostly just persistent, nagging, relentless ones, the kind that make me cranky and irritable.  My Hubs has endured less-than-charming company from me the last few weeks.  Eliminating caffeine may not be the culprit in all the headaches, but it definitely played a role in some of them.  

Seems like I am dealing with a lot of C's, although not the fun kind associated with diamonds.  Caffeine is conquered, calories will be ongoing, and I won't even try to tackle carbonation until after the holidays are over.  I may need a few bubbles to get me through the stress of Christmas cheer and the foods that accompany it. 

I was curious as to why I won't be able to have carbonated drinks after surgery.  The dietician told me about a lady she had recently seen who had undergone weight-loss surgery a few years ago and lost most of her excess weight, then started gradually to gain some of it back.  She explained that she was still eating properly, controlling portions, eating healthy foods and drinking non-caloric drinks.  Then the dietician noticed that the patient had a diet soda in her tote bag and asked if she drank many carbonated drinks.  When the lady said she had resumed drinking the bubbles, the dietician explained that the bubbles in sodas expand the stomach pouch, stretching it out so that it gradually needs more food to fill it up.  I never even thought about that, but it makes perfect sense. 

So after the holidays, one of my New Year's resolutions will be to cut out the bubbles.  At least my carbonated drinks of choice for decades have not contained sugar, which is a blessing.  Still, I have loved my diet yellow bubbles, diet ginger ale and diet root beer.  Saying goodbye to these old friends will be a struggle, but I hope not as much of a headache as giving up caffeine was.



 

Tuesday, November 22, 2011

Give Us This Day

Tuesday 11-22-11
Our daily bread...or at least the memories of it

Thanksgiving is bringing with it some mixed feelings and anxiety this year, for obvious reasons since I am doing the whole medically supervised weight loss.  It is, for many people, and historically for my family, the biggest food holiday of the year.  Compounding my nervousness is the fact that my brother is the only person in my family who knows that I am preparing for weight loss surgery, and he most likely won't be with us.  So my holiday will be spent working my normal shift at my job and then rushing to the family gathering place for Thanksgiving supper.

Thank God for The Hubs!  He will be with me to help me deal with any strangeness that could possibly ensue if anyone notices my altered eating and drinking habits.  I am encouraged by the fact that I had lunch with a friend today and never touched the rolls that immediately landed on our table.  (They materialized out of nowhere, as though Scotty from Star Trek just beamed them over!)  Of course, the friend I was with today knows all about my weight loss process and completely supports me.  But still, it was an accomplishment for me not even to touch the bread. 

I am a Southern Diva to the core, and we Southern girls love us some bread.  The scents, textures and rich flavors of the many kinds of breads we adore are the stuff fat girl dreams are made of.  (Forgive me if the following descriptions and recollections border on the pornographic, I may not be able to help myself.)  Some of my sweetest, albeit most carb-laden, memories are surrounded by the wafting aroma of bread...and some sad memories as well.

Mama mixed a few simple ingredients into a cast iron skillet and made a miracle every day at lunchtime for my Granny.  Some corn meal, a splash of buttermilk, a little blob of bacon grease and some water, stirred with love and baked in a tiny little skillet turned into the best cornbread I have ever tasted in my life.  No one else's "bread" (as Granny always called it) ever tasted as good, and I certainly never mastered this art form.  I need to get the bread skillet from Dad's house before it gets gone.

Mamaw would make biscuits to eat with supper when Dad would take us to her and Papaw's house, usually on Sunday nights.  There would always be a little dab of dough left over, too small to make another biscuit from but too big to waste. Mamaw, with her mischievous sense of humor, would fashion this remnant into a snake, sometimes with cinnamon sprinkled on top.

My Aunt Ruby made biscuits every day, from scratch, for over 4 decades, and when I was a kid/young adult, there were always leftover breakfast biscuits on her stove, slightly blackened on the bottom from the pan she baked them in and at least 2 inches tall at their golden-brown tops. Her husband, one of my 2 Uncle Johns, showed me how delicious those biscuits were with maple syrup on them along with the butter.

Holiday meals with my Mom and Pop-in-Law were usually crowded, hectic and filled with all kinds of delicious treats, including Mom-in-Law's homemade pies.  They were legendary in our family.  She could put together an incredible, nutritious and festive meal for a lot of people with efficiency and grace...and she was notorious for burning the rolls!  Not crackly-crunch burned, just a little more toasty than she would have liked. 

Mama died in the wee hours of the morning on December 8, 1997.  We had spent what seemed like endless weeks there at the hospital with her as she declined, rallied and declined again.  That last long day that I spent with her was grey and dreary, and the atmosphere inside the four walls of her room felt as chilly as the winter day outside.  After she died and I left the hospital for the last time, I made the long walk once more  from her room out to the parking garage, a walk I had made so many times I could almost count the ceiling tiles from one end of the trek to the other.  Emerging into the cold night air, my awareness of everything around me seemed heightened, and my nostrils were filled with the warm, buttery aroma of bread being made at the bakery down the street.

So many of my memories involve food, and bread in particular.  It isn't even the bread I miss so much (although I do miss it) as much as the hands who sifted and mixed, kneaded and rolled, and the hearts who baked love into every bite of warm, nourishing, sustaining bread I enjoyed growing up.  I am thankful to God for all the bakers who fed me, not just my body, but my soul.

Sunday, November 20, 2011

This One's For The Girls (This AIN'T the Martina McBride song)

Sunday 11-20-11
Boobies busting out all over...

In my last post I talked a lot about The Girls, and how they have influenced my life since their arrival.  My breasts developed early and, like a houseplant that has found a favorite window, they grew, and grew, and...I don't think they ever completely stopped.  As my body size has increased, my breasts have increased as well.  When I have dieted and exercised to shrink, however, I have successfully lost inches around my rib cage and back, but The Girls have always held their ground.  My chest must be some prime real estate because The Girls ain't budging!

I have toyed for over 20 years with the idea of getting breast reduction surgery, but something always held me back from going ahead with it.  I feel sure this is another part of God's plans and His timing, because now I am at a point where I am ready for weight loss surgery.  I am so big now all over, it's time to just shrink everything.  With the kind of weight the surgeon tells me I can expect to lose, some breast loss is all but inevitable.  And I am fine with that.

Some education about breasts and their confinement:  First of all, bra cup sizes don't stop at the letter D, or even at more than one or 2 D's.  There is a whole alphabet of cup sizes beyond D, they just don't stock them in stores.  Even the bras at so-called "plus-size" retailers never worked for me because the cups were just not big enough.  My "cups runneth over."  And believe me, I write this with nothing but humility (bordering on humiliation). 

Secondly, for girls with Big Girls, we often need to find either an online source for bras that will accommodate us, or better yet, a custom fitter within a decent distance of where we live.  I am blessed to live in a city where a custom fitter has operated a little shop out of her house for decades.  Here busty ladies can find bras that will work for us, fitted with both expertise and compassion for our situation.  I call her my Lingerie Lady, and I have referred countless other girls to her over the years for fittings.  Nothing much is worse than trying to pour, stuff or force The Girls into a space too small to house them, in a style or fabric intended for much smaller breasts.  Big Girls need substantial undergarments for daily wear, and comfort is not to be had in some filmy, flimsy, next-to-nothing bra, period.  Back, neck and shoulder strain and pain are sure to follow.  Some gals can wear lingerie; when you're built like I am, it's more like armor! 

Some medical history about The Girls is in order as well, especially since I mentioned that they've been contentious ever since they were installed.  I had my first scare with a breast lump at age 12.  It was incredibly painful and, even with the miniscule likelihood of a malignancy at that age, I and my Mama were both pretty freaked-out about it.  After seeing my lifelong (male) pediatrician, I was referred to a surgeon, a man with no bedside manner and cold hands.  Fortunately he was also knowledgeable and preferred to take a wait-and-see approach to my lump, which he said was most likely a clogged milk duct, and while it was painful, it was harmless and would likely resolve on its own, which it did.

In the years that followed I was diagnosed with fibrocystic breasts, which makes sense because they've been lumpy for as long as I can remember.  I had a lump come up about a year after the Hubs and I got married, and at age 23, I underwent my first mammogram.  That lump (as well as the mammogram) also turned out to be harmless, thank God.  The years that followed brought several other lumps, many mammograms and a few breast ultrasounds and/or spot compressions when something suspicious showed up.  Most women have yearly mammograms starting at age 40, but because of my history of lumps and the sheer size of my breasts, I began having annual mammograms at age 35, which my insurance always covered.  There has never been any cancer, for which I again thank God, and knock wood! 

I will stress here the vital importance of monthly self-exams for all women of every breast size, because all of us women need to know how Our Girls feel normally.  That way if something out of the norm pops up, we can be aware of it and get it checked.  We have to be our own best advocate when it comes to our health.  This public service announcement is proudly sponsored my My Girls, for the health and benefit of Your Girls.

Saturday, November 19, 2011

Fitting In

Saturday 11-19-11
Why the world is not designed for me

My whole life I've been battling with various things that don't fit me.  For example, despite how big I have allowed my body to become, I have really small bones underneath it all.  Really, petitely, ridiculously small.  I have an old ring of my Mama's that I wear on my right thumb that is a size 7.  On my THUMB.  As big as I am, you'd think my hands and fingers would be sized on a scale to match.  But no.  And since most rings on display in jewelry store windows are usually a size 7, anytime I have bought a ring or had one purchased in a store for me, it has always had to be sized down.  While my wedding dress definitely does not fit me anymore, my wedding band still does.

Then there were the years when it was nearly impossible to find the shoes I wanted because of my size 5 feet.  Really.  I remember the Easter that I bought a navy blue silk dress with a white collar.  I loved that dress and I wanted navy and white spectator pumps to wear with it.  The Hubs and I searched for weeks all over the Florida panhandle to find the shoes I wanted because, while the stores that year had plenty of navy and white spectator pumps, there was a distinct shortage of them in the size 5 medium I needed.  I think we finally found the "perfect shoes" in Panama City.  I am fortunate to have a Hubs who will trek hither and yon on quests such as The Great Spectator Pump Hunt of 1989.

I am also left-handed, so lots of things people use every day are not designed for me.  Kitchen knives often have blades with edges made for use by the right hand, as do scissors.  My schools only had right-hander desks, so I sat in them.  I didn't even know left-hander desks existed until high school and by then I had gotten used to the other ones.  I grew up adapting to these little inconveniences without much trouble.  To this day, I cannot use a pair of left-handed scissors because I had to use right-handed ones for so long I got used to them.  Ditto for computer mouses (mice?) because they are always placed on the right.  I am unable to "mouse" left-handed.  I wear my watch on my left wrist like all the right-handers in my life did because I was surrounded by them and that is how they wore their watches.  Putting it on my other arm feels weird to me.

The biggest issues I have had with things not designed to fit me, though, have been because of The Girls.  You know...hooters, knockers, ta-ta's, melons, jugs, boobies, sweater cows, man pillows.  The names for women's breasts are limited only by one's imagination and/or lack of good taste.  Mine have been large and contentious ever since they were installed!  And the warranty on my breasts has not been good, either.

In the sixth grade at age 11, I was 5 feet, 1 inch tall, weighing 109 pounds and wearing a 34-B bra.  Looking at photographs of myself back then, I realize that I was just plain STACKED.  At the time, though, all I felt was huge and fat.  I was taller than most of my classmates, and the arrival of The Girls just made me stick out (pardon the pun) all the more, at a time when all I wanted was just to fit in.  Girls my age who had been all through grade school with me started acting differently toward me, and boys I'd known since first grade became mouthy, lewd and sometimes even grabby.  I was freakin' 11!  Junior high was pretty much the same story, although I think that my having a steady boyfriend in the ninth grade encouraged other boys to keep their hands and comments to themselves.

My family didn't seem to know what to make of The Girls, either.  Before the growth spurt of both height and boobs, I'd had a couple of pudgy years, and I think my father (the Fatophobe) had already decided that I was just going to be another fat member of my mother's family, because as I asserted before, obesity does not come from his side.  When I got a little taller and The Girls came to live with me, Dad had nothing to say about my appearance.  It's sad because his approval meant more to me than anyone else's...probably because I never felt like I had earned it.  I have always wondered, if he had just told me that I was pretty and looked good at that size, might I have been able, or encouraged, to stay there?  I'll never know because he never did. 

The Girls came around the same time that my period, my migraines, and my own thoughts about things started to erupt.  I have always joked that my scintillating best-selling memoirs would be called "Breasts and Opinions".  (If I saw a book with that title on a shelf, I'd sure pick it up!  Wouldn't you?  Just don't steal my title and use it for your own.  Thanks.)  In truth, the arrival of Breasts and Opinions began what I have come to think of as The Great Divide with my Dad.  I think he just had no clue what to do with me, or how to relate to me anymore.  As I got older and my breasts, and the rest of me, got bigger, his distance and disapproval seemed to increase. 

He's not a bad person, but he has definite ideas about how people are supposed to look and behave.  Fat people are not presentable, and we are never just fat.  We are generally fat and something else...fat and lazy, fat and sloppy, fat and undisciplined, fat and pathetic, fat and selfish.  But I never heard him allude in any way to the fact that someone could be fat and wounded, which is how I believe many of us get fat to begin with.  I feel pretty sure that my own wounds contributed to my own problem, the "need to feed".

As I try to sort out the tangle of emotional and physical issues that have gotten me here, I know that The Girls will get more blog time.  And that is only fitting.  After all, when addressing The Girls, the blog entry should naturally be a Two-Parter!  (Yeah, I know.  Groan.)

          

Monday, November 14, 2011

Supplies and Demands

Monday 11-14-11
Why we need to replenish ourselves...

For a tired, fat girl, I have a lot going on in my life.  Granted, I do have my crash-time when I am not working at my job, but I also have some "extracurricular activities" that I am involved in.  Those things are a time and energy commitment, but they are worth it because they give me so much more than they take from me.

For example, Monday is my volunteer-at-the-hospice day, followed by my go-get-my-scream-on-at-music-practice day.  Sometimes the day flies by, and sometimes it seems to crawl.  But the interesting thing about my Marathon Mondays is that, while the activities take a lot of energy out of me, they never leave me feeling depleted.  Tired, for sure, but not depleted.  There is a big difference between the two.

For a long time, I let the musical part of me get pushed aside by schedules, a perceived lack of time and energy, the typical excuses one makes for letting things go.  A couple of years ago I auditioned for my musical group again after an 11-year absence, with considerable trepidation.  I was afraid that I had let my voice go for so long that it had left me, a "use it or lose it" scenario.  The gracious gentleman who heard my audition apparently thought I had something left to offer and I was accepted, even welcomed, back into my chorus.  It's strange, I didn't realize my soul was starving until I began to feed it again. 

This afternoon at the hospice, things were pretty slow, we had a number of empty beds and I made my rounds and patient visits with time left over.  So I spent my last half hour or so singing unaccompanied in the hospice chapel.  It's not a huge room, but the acoustics in there are glorious and it's become a favorite space for me to sing in. 

When I am working or singing at the hospice, I never feel like I am being judged because of my appearance.  I feel appreciated and respected and loved, even though I usually deal with a different set of patients and families every week when I go there.  As much as my time with both the hospice and my chorus on Mondays demands of me, it supplies even more.  And I have found that THAT is a huge secret to feeling worthwhile, productive and balanced.

I need to adjust to putting the supplies-and-demands principle into practice regarding my food intake as well.  I can no longer equate food with comfort.  Food is the fuel that my body runs on in order to accomplish what I need to get accomplished every day.  Good quality fuel will give me better results and more efficient operation, just like with my car.  And I need to remember not to over-fill my fuel tank, to continue the metaphor.  If I supply too much and demand too little...well, we see where that practice has gotten me.  So to nutshell it:  Food = Fuel. 

Comfort = ?

So much of what we have to face daily just drains us dry.  For some people, it's family problems, while for others it is work-related stress.  Some of us deal with addictions, our own or a loved one's, or both.  Financial straits, health crises, divorce, death and taxes...it's never-ending!  We HAVE TO find things that can replenish the inner resources that daily life drains out of us.  I read a quote somewhere:  "Life is a cup to be filled, not drained." 

Comfort = Surrounding myself with people, activities and things that fill me and feed my soul, and to jettison (as much as possible) the people, activities and things that drain me and make me feel empty.  When I manage to do that, I feel better and I am better able to give my best self to the world.  Getting thinner and healthier will just make that whole process easier.   

Friday, November 11, 2011

Living By The Numbers

Friday, 11-11-11
So THIS is that "new math..."

When I was a kid in grade school, I kept hearing grown-ups talking about "that new math" they were teaching us in school.  I still don't know what the difference was supposed to be between old math and new; I was never much good at any kind of math so it was kind of a moot point for me anyway.  I can manage enough basic mathematical calculation to get me through life in relative safety and without bouncing checks.

Now that I have begun the weight loss journey in earnest, it seems as though everything is about numbers!  Quel horreur!   Body mass index, blood pressure, fasting blood glucose, metabolic rate, serum cholesterol, and, of course, the number on the scale, all seem to take on added significance now.  Then, of course, I am also treading into the new territory of carbs, protein grams, how many pretzels exactly are IN one ounce...If I allowed it to, the irony of all these numbers could throw me into a dimension of pissed-off heretofore unexperienced by humankind!  Because as I previously asserted, I have never been good with numbers.

For some reason, though, I've been blessed with more good numbers than bad ones, thank God.  My cholesterol, blood pressure and metabolic rate are all good, and my blood glucose is decent, surprisingly so for a person my age and size.  The bad numbers are my weight and BMI, and we are working on those.  At least I don't have so many other factors going against me in this process, and I am really grateful for that. 

One thing I am confident of is this:  I am not a number, not one on a scale, or a BMI measurement or a jean size.  Those things are only a description of who I am, and not even a description of the best parts of me.  I am by no means a wonderful person.  I am flawed, cantankerous, blunt, cranky and usually in some kind of hot water for something I said before I could stop it.  I am also compassionate, empathetic, big-hearted, loyal, a good listener, an excellent keeper of confidences and secrets, and I hope, the kind of friend that my friends appreciate having.  I am "more than just the sum of my parts".  The numbers are only a tool to help me find my better self...the healthier one who has more energy to fuel my compassionate, big-hearted, loyal, secret-keeping self the rest of the way through my life and the lives of those around me. 

By the way, 2 1/2 weeks in, I am 8 1/2 pounds down.  That's a pretty decent number, as numbers go!  I may just be getting the hang of this new math.

Sunday, November 6, 2011

It Ain't Over Till the Fat Lady Shrinks

Sunday 11-6-11
Why clothes aren't the only things that need to fit properly

I was invited to sing at my friend's church this morning, so I went there and participated in their All Saints' Sunday, singing 4 songs as part of their worship service and remembrance of their departed saints from the past year.  As I have gotten older (and larger) I've noticed things happening to my voice, particularly in the last few years when I've been singing more often in public.  Some of the changes have been positive, a slightly richer, more mature sound and timbre in my voice that was not always there.  Some of the changes, not so much. 

As singers we have to recognize that our bodies are our instruments, and my instrument is showing some signs of mistreatment, both outwardly as I have ballooned to my current size, and more subtly as my breathing has become more compromised.  My lungs and my diaphragm are being crowded into inefficiency by the fat in my abdomen. 

A few facts about the human voice: Changes in both male and female voices occur several times after the primary one that happens at the onset of puberty.  The changes happen in the areas of range (number of notes that can be sung, either growing or shrinking with maturity), tone color or timbre, (brightness or darkness in the tone), loudness or softness that can be achieved, and even the place where the voice "breaks" from full voice into head voice.  (I am a voice geek so please forgive the tutorial, it serves a purpose here!)  So as a singer ages, different pieces and types of music become appropriate...or become uncomfortable.  The things that "fit" the voice change as the voice itself changes.  My college voice professor always said that a piece of music should fit me like a custom-made wedding gown.  Today I was asked to sing a piece of music that I dearly love, and have sung very successfully and joyfully in the past.  It doesn't fit me as well now as it used to, and while I can attribute that partly to my age, I also have to be honest with myself and admit that it is also largely due to my weight and size that I cannot phrase properly or with the kind of energy or stamina that I once enjoyed.  My fatness, belly fat in particular, is impairing my ability to sing.

In 2004, Wagnerian opera diva Deborah Voigt, after years of battling with her weight, finally chose to undergo weight-loss surgery.  She had been dismissed from a London production of Strauss's opera, Ariadne auf Naxos, a signature role for her, because instead of the usual period costumes, this production required her to wear a "little black dress", which did not fit her.  Instead of altering the dress, the producers hired a different soprano to fill the title role...and the dress.  The incident became a controversy, and Voigt admitted being angry about the dismissal.  (Do a Google search on it, it's really interesting.)  She did not have surgery to get "skinny"; she did it to help her to sing better and enjoy a better quality of life.  At her largest, she was beautiful and glamourous; now she is just radiantly, drop-dead gorgeous, and singing with less effort and more joy.  She inspires me in countless ways, especially now that I have also chosen to pursue surgery in an effort to get healthier.

I am no opera singer.  That is not the path that my life led me down.  God had other plans for me and for my voice.  For years I made a living using my voice in the radio world, a profession I loved and will always miss (unless, of course, God takes me back there!)  Even though it has not turned out to be my profession, singing has been the one thing in my life that has been there since the beginning.  Mama always said that when I was born I "came out singing!"   But the voice, and indeed the body, that God gave me are resources that I frankly have not treated with the respect they deserve.  I have let myself go.  I am thankful that God is in the business of second chances, for both my soul and my body. 

Like Ms. Voigt, I am looking forward to being a fat lady who shrinks! 

Friday, November 4, 2011

Get Thee Behind Me, Ghrelin!

Friday 11-4-11
Why it's not all in my head...some of it is in my stomach.

Until late August, I had never heard the word "Ghrelin".  Sounded a little like Gremlin and reminded me of that little station wagon from the 1970's.  My first exposure to ghrelin was at in informational seminar given by my weight loss surgeon.  I learned that there is a part of the stomach that releases a "hunger hormone" and that hormone is called ghrelin.

Since the seminar, and especially since we decided to go ahead and get the weight-loss surgery process in motion, I've been doing research on my own on a number of the topics of recent interest to me, and reading about ghrelin has proven to be especially enlightening.  In one article I read that in studies, laboratory mice exposed to chronic, prolonged stress experienced increased levels of ghrelin and consistently chose higher calorie, higher fat foods. 

So, if I can put this together...stress in my head can trigger a hunger hormone released by my stomach?  This explains a lot.  It is not an excuse, I realize.  But it does seem to make sense if my history is any indication. 

I am not an uninformed woman, yet my surprise at some of the things I am learning, well, surprises me.  I've always known that we human beings are "fearfully and wonderfully made", God's intricate and complex design of interconnected physical, psychological and emotional systems.  It is impossible to impair one part without the others being affected. 

My journey toward healthier living needs to prepare me for surgery as well as for life after surgery.  Even if the part of my stomach that releases the hunger hormone is removed surgically, eventually my appetite will return in some form or other.  By the time I start to really feel hungry again, my goal is to crave different kinds of foods and, more importantly, to have the tools I need to deal with the stressors in my life that have contributed to my getting to this point. 

Right now I'm still in the phase of having to allow myself to feel some hunger pangs and discomfort, either ignoring or disagreeing with both head and stomach when they want to eat something that is not healthy.  That's OK.  I know this phase, while difficult,won't last forever. 

Wednesday, November 2, 2011

"D" Is For "Deficient"

Wednesday 11-2-11
What am I really lacking?

It looks like I will be receiving a lot of phone calls and paperwork to fill out in the weeks to come, courtesy of the team of specialists being called upon to consult on my various health concerns.  This afternoon the surgeon's office called with my lab results from the blood they drew last week.  It was a shock to learn that I have a vitamin D deficiency, and a fairly substantial one.  They are recommending that I come in for an injection, which I have scheduled for next week.  As much cereal as I consume (always with skim milk, thank you very much) a vitamin D deficiency comes as a surprise.  I am doing some research on my own to see if my medication for acid reflux has anything to do with this.  So, I lack some vitamin D.

When I came home from work, I found that a large manila envelope came in the mail from the sleep center where I will soon be spending a night to determine if I have sleep apnea.  I'm betting that I have it just from the answers to the questions on the first page of the NINE pages of forms I need to fill out for them.  As I have mentioned in a previous post, I snore like a lumberjack, or so I have been told.  And my energy is not what it should be.  So, apparently, I am also lacking some sleep.  Well, Duh.

It makes me think about what I've been lacking in my life that has brought me to this place of pursuing surgical intervention for my lifelong weight problem.  I have always been an emotional, or stress, eater.  Seeing it in print like this, it looks like I eat emotions and stress...which, kind of, is what I've been doing all along.  Of course, I've been eating my stress and my emotions with large side orders of ice cream and pizza.  The yummy foods make the emotions go down easier.  And the emotions I've eaten have always been prompted by some shortcoming or inadequacy of mine, some failure...some deficiency. 

"Those 5 A's on your report card are really good, but what's the B for?"

"You won the contest, that's nice.  Did they give you any money for it?"

"You have such a pretty face..."

"You're lazy and trifling."

"Can't you be more like (fill in the blank)?"

For most of my life I have felt like I didn't quite measure up to the standards of the people who mattered most to me.  This blog is not meant to be an airing of all my dirty laundry, but I have to reconcile myself to the fact that I have lived the stereotype of the fat girl stuffing her sorrows down with food.  It's why I'm here. 

It's sad to be overfed and starving at the same time, but this is what emotional eating really does.  Ice cream and pizza can never feed the parts of me that are truly hungry.  My value as a person does not come from how I look or what I do or any of the other exterior packaging.  It has taken me 47 years to realize that my value comes from being a beloved, forgiven, understood child of God.  There is nothing I can do to make Him stop loving me.

Would I like to have unconditional love from other people in my life?  Of course.  Has eating my emotions gotten me anywhere closer to gaining their approval and love?  No.  Will getting healthy and shrinking maybe get them to finally love me and embrace me for who I am?  It doesn't really matter anymore, because I'm not doing it for them.  And the truth is, if someone can't appreciate me fat, then they probably won't appreciate me any other way, either.

Sunday, October 30, 2011

To Sleep, Perchance to Knock It Off With The Dreams Already!

Sunday 10-30-11
Why sleep is good...

Yesterday was not a good day at work.  It was stressful and, as I have already mentioned, my work is stressful even on a good day when nothing goes wrong.  Yesterday things went wrong, and my stress level, as usual, skyrocketed.  I've always joked that I could work on a daisy farm and still have too much stress, I manufacture it internally, like a hormone or something.

This is, of course, not a great outlook for a Christian to have.  It's always been a struggle, and God knows that.  Everyone struggles with something.  I happen to struggle with stress/anxiety/depression.  Some of these issues run in my family.  This is not an excuse, but it does serve as a kind of explanation.  God and I are dealing with it.

My dad is a worrier and always has been, although he is very good at denying that fact.  As I've grown older and learned more about myself and where I come from, I've realized that I inherited quite an interesting and mixed-up bag of traits from both sides of my family.  I am a musician (a singer, and yes, singers are also musicians, although not always instrumentalists, which is what most civilians assume the word "musician" means) and the musical genes come from both sides of the family, abilities for which I am supremely grateful.

Dad gave me a colorful assortment of genetic gifts.  I can spell pretty much anything.  I can pick things up with my toes.  I can always tell how big a container will be needed to store leftover foods.  Musically, I inherited Dad's sharp ear and ability to improvise, although not as well as he can. 

I also got some of Dad's health patterns, although I must be very clear that the obesity does NOT come from his side.  He would be adamant that I make that plain.  (He's got Fatophobia.)  During my lifetime I have seen my father suffer with both migraine headaches and allergy problems, both of which I inherited, and, like him, I have seen the patterns in my own headaches and allergies change around the same age that he experienced similar changes in his own.  It has been helpful to be able to ask him when I have experienced changes in the frequency or intensity of headache, or if a symptom changes a little, I can ask whether he experienced it as well.  For example, I never used to have olfactory (smell) issues with migraines until my 40s.  After asking Dad, I learned that he often used to get a strong scent of chlorine with his headaches.  I will place a disclaimer here:  I have been having various kinds of headaches for so long I am confident that I would know when one requires medical attention. 

Perhaps the most interesting thing I inherited from Dad is the tendency toward strange and vivid dreams, often with recurring themes, and often with very strong recall.  I consider this a mixed blessing, because sometimes the dreams are wonderful and lifelike, resulting in profound peace that lasts far into my waking life.  Other times the dreams, especially the recurring ones, are sad, depressing, stressful and jarring enough to wake me from my slumber in sweats, tears and complete disorientation.

The only reason this is relevant is because my weight loss doctor has referred me for a sleep study to determine whether I have sleep apnea.  Overweight people often do have sleep apnea without realizing it.  Combine my weight with the fact that I snore like a lumberjack AND I've been tired since college (OK, that is only half-joking) and sleep apnea may indeed be another issue that weight loss will address.  I've never done any research to see if apnea and dreaming are related, but I'm sure I will soon.  I'm not sure how I would feel about my dreams, or my recall of them, going away completely.  But the sad, stressful dreams I could definitely do without. 

So, yesterday just sucked.  But last night, I slept decently and with minimal dreaming.  My husband thinks that I could write a pretty interesting blog describing my dreams.  We came up with a name for it while we were on vacation.  It would be "Dream Goulash".  That's pretty much what my dream assortment is like on any given night, a big ol' mixed-up pot of whatever my mind puts together out of its leftovers.  As I continue learning to eat differently, some of my dream-triggering foods will be drastically reduced, if not eliminated altogether.  And I don't care what science says, weird/spicy/hot foods can trigger weird dreams.  I am my own evidence in this regard!  I don't know if getting rid of the foods will get rid of the dreams, but I am not holding my breath on it.  I've got WAY more stuff besides food to make my dreams crazy. 

Wednesday, October 26, 2011

We'll always have oatmeal...

Wednesday, 10-26-11
Back to Work

Some days it just seems like I need a "mental health holiday".  Today was like that.  Yesterday my self-esteem took a bit of a beating at the surgeon's office, coming face-to-face as I did with the hard truth of just how far I have let myself go.  So today was day 1 of the preparations-in-earnest for the new, improved, shrinking me. 

My work is stressful on a good day when nothing unexpected happens.  Today in my work e-mail was a message from my boss summoning me and several members of my team into a meeting to rehash a problem that occurred nearly a month ago.  I was already in a foul mood because I was hungry!  Oatmeal saved the day, and my sanity. 

I know that as I withdraw from unhealthy foods and drinks, and learn a new eating pattern, I will have moments of moodiness, sadness, annoyance or outright anger.  I need to radically decrease, if not entirely eliminate, caffeine and carbonation from my drinking.  The last time I gave up caffeine, I was in college.  I gave it up for Lent, and my college choir toured during spring break, which also fell during Lent.  Touring with my choir was a joy every year, and we all gave up our spring break willingly in order to do the tour.  But the schedule, singing a full concert at least once a day, traveling by bus in close quarters over hundreds of miles, sometimes enduring extremes in climate, sleeping in a different town every night and eating plate after plate of good old Baptist hospitality, all took its toll on us.  It was grueling...wonderful, but grueling.  Giving up caffeine during this time made me a much more cranky Diva than I would have been anyway.  I am imagining that I will be more cranky this time because I don't have youth on my side!

As a lifelong migraine sufferer, I also know that caffeine withdrawal can trigger THUNDERING headaches.  That prospect does not bring me joy, either.  I'll have to do the caffeine part gradually, while I deal with some unaccustomed hunger pangs during this time as well.  My list of "good for the Diva" foods will be a constant companion for a while until I'm used to making healthy choices for myself.  My list, and a packet of oatmeal.   

Tuesday, October 25, 2011

Here we go...

Tuesday 10-25-11
The First Surgeon Visit

Today my husband and I went for the initial consultation with the surgeon who will (Lord willing, knock wood) be doing my weight-loss surgery sometime next year.  I am leaving the date open because at this point, I have applied for a class and, once I find out if I have been accepted into the program, I will be more able to narrow down a date for surgery.  More on that endeavor will come in future entries here.

I'm not entirely sure why I felt the need to do this, but that may make itself clearer over time.  I suppose it's just a desire to document what is happening, and will be happening in the months and, probably years, to come as I commit to the weight-loss surgery journey.  I never thought I would find myself here, considering surgery to "fix a problem" I've dealt with for my entire life.  The tipping point for me came last spring when I injured my ankle and found myself in such pain that I could not have worked out even if I wanted to...not that working out during the last year had really helped anyway.  I have reached critical mass, period. 

I am 47 years old, and the common-sense things that I have done in the past to lose weight just don't work anymore.  It is likely a perfect storm of age, hormones, sleep issues and all sorts of other indignities that come with being a woman "of a certain age".  My weight loss history has been spotty at best, with several substantial losses over my lifetime, none of them permanent.  Obviously.  It seems like I have been fat forever, although I can look back at old photographs of myself and see that there were times when I looked fine.  It's been difficult to perceive myself with any accuracy or perspective.  I have always felt fat, partly because I have always been hearing that I am fat, even when I really wasn't so much fat as just...pleasingly plump with really big boobs.  That's the past, though.  Now I am what Mama would have called "Gobby Fat"...still with really big boobs.  They will get their own entry (or entries!) here as well. 

Now, I am looking at the ultimate goal of surgery, with lots appointments between now and then, with a dietician, exercise physiologist, psychologist, my primary care doctor AND a sleep study.  I am blessed to have a lot of things in my favor for this process.  I do not have diabetes, heart disease or hypertension, which is really surprising for someone my age and size.  And I know that God has allowed me to "dodge the bullet" with regard to those comorbidities.  I'll talk about God a lot here, so if you read this and have a problem with that, you might as well either "Get to likin' it" or find another blog! 

The things about me that will always be the same are:

I am a blunt, plainspoken Southern Diva, with big boobs and a big heart underneath them;
I am a woman, wife, musician, daughter/sister/cousin/aunt/niece/friend, volunteer and child of God; 
I will always have curves no matter how much I shrink;
I am a big believer that God allows everything for a purpose, and that His timing is always significant. 

So, until next time, I am
The Incredible Shrinking DIva