Knee Surgery Tomorrow Morning

Apr 08, 2008

Tomorrow I have arthroscopic surgery on my right knee to clean out some torn meniscus and some bone spurs.  While I'm under anesthesia, my surgeon will give me a cortison injection in the left knee, which has also been bothering me.  The pain in my knees has been hindering me a lot lately from walking as much as I was, and so I am looking forward to getting past this and being able to move much better!

It feels kind of weird to think of going under the knife again tomorrow, just 6 months after my RNY.  In some ways I was more prepared mentally for my RNY and it's a much bigger deal than what I'm doing tomorrow.  I chalk it up to all the other things going on in my life now.....

Ah well, I'm going to drink my last drink of water before my surgery tomorrow and head for some sweet, sweet sleep.


Sugar-Free Candy? Insight

Apr 03, 2008

I bought a box of sugar-free candy at Easter time and occasionally have one or two pieces.  It's okay -- not great though :).  I found it calling my name again last night and had two pieces.  This morning I threw out the rest of the box because I just don't want it around calling my name anymore.

I do keep sugar-free red licorice around because it's much lower in calories and is an occasional sweet, chewy treat.  However, I know that if I start feeling its pull too much I will not keep that in the house either.

This is the first time ever that I have been so aware of the power of some foods over my psyche -- and more importantly, have the "calm ability" to move them out of my presence without the anxiety or even sense of deprivation and mourning I used to feel.  I guess this means I'm starting to change on the inside too!

I've Broken Into the 2teen's!

Apr 03, 2008

Today I broke into the 2-teens!  Passed the 220s finally.  It took awhile and it seems whenever I travel it takes a few days for the weight loss to kick in again.  But here I am at 219.2 and closer than ever to breaking into OnEdErLaNd!  Hallelujah!  I am so, so grateful for my RNY.


A Resounding CLICK!

Mar 31, 2008

On my recent flights to New York and back, I reveled in the fact that I no longer have to use seatbelt extensions, and that the armrest goes down easily with room to spare.

I loved the CLICK that the seatbelt makes, the couple of inches of strap 'left over" and the fact that I forgot to unbuckle my seatbelt when I got up to get off the plane (it buckled so easily around me I didn't feel it)!

Strange the little things I notice about losing weight and the joy they give me.  Well, maybe not so little.

Feelings, Whoa-Whoa-Whoa Feelings

Mar 31, 2008

Just feel like blogging on some of my feelings tonight:

SAD because my father is nearing the end of his life.
WEARY because the last few days have been emotionally draining.
HOPEFUL because my weight-loss continues.
WORRIED...sometimes I am worried that I will fail, that I won't reach goal, or that if I do, I will regain.
ANXIOUS...to get my knees fixed and move on to more excercises that I love.
BORED...I probably need a new hobby or outlet.
JOYFUL...there is still an undercurrent of joy.
GRATEFUL....for all the many blessings in my life

Don't Buy This!

Mar 31, 2008

Note to self:

Don't buy sugar-free cookies!

They really call my name and it's too tempting to eat more than 1 serving.

Musts for Maintenance Success

Mar 29, 2008

From Wendy Fou's post:

The following is a list of things I think are real MUSTS for RNY post-ops who want to:
a) lose all the weight they want/need to lose
b) maintain that loss FOREVER.

Argue with me if you want to OR add to the list if you want to.  I'm just compiling information and putting it out there because I agree with it.  

Tips for Successful Weight LOSS and MAINTAINANCE for post-op RNYers

 1. Attend all your follow-up appointments with your surgeon.

            Your relationship with your RNY surgeon should be a life-long relationship.  Follow-up is not just for lab work-ups and/or to pad your surgeon’s pocket. 

             Research has shown that patients who continue long-term follow-up care with their surgeon maintain substantially more of their weight loss than those that do not.  Differences in maintained weight loss become evident around 3 – 4 years.  In addition, research has shown that an increase in the frequency of support group attendance has been shown to increase weight loss.  See below:

 

 

 

 

 

Post-ops Attending Every Scheduled Post-op Appointment (even 3 - 4 years out)

 

 

 

Post-ops Attending Only the 1st Year's Post-op Appointments Before Being Lost to Follow-up

 

 

 

Post-ops Attending Who Were Lost to Follow-up During 1st Post-op Year

 

 

 

Excess Weight Loss at 1 Year Post-op

 

 

 

70%

 

 

 

65%

 

 

 

not stated

 

 

 

Excess Weight Loss at 3 - 4 Years Post-op

 

 

 

74%

 

 

 

61%

 

 

 

56%

 

 

 

Source:             http://www.soard.org/article/S1550-7289(07)00570-9/abstract

                         http://www.soard.org/medline/record/MDLN.9819086

 2. Attend support group meetings regularly.

            Regular attendance to monthly support group meetings produces MULTIPLE benefits: emotional support, practical advice/tips, continuing education and fellowship.  But it also produces physical benefits as well. 

 Research has shown that regular attendance (>5 per year) to support group meetings has been linked to increased weight loss after RNY.  The difference in weight lost between post-ops attending or not attending support group meetings is seen after the initial 6 months post-op.  See below:

 

Post-op Time:

 

 

 

Excess Weight Loss for RNYers attending support group meetings regularly

 

 

 

Excess Weight Loss for RNYers NOT attending support group meetings regularly

 

 

 

2 weeks

 

 

 

10.5%

 

 

 

11.3%

 

 

 

6 weeks

 

 

 

21.4%

 

 

 

21.8%

 

 

 

3 months

 

 

 

30.9%

 

 

 

31.8%

 

 

 

6 months

 

 

 

45.4%

 

 

 

41.3%

 

 

 

9 months

 

 

 

53.6%

 

 

 

45.2%

 

 

 

12 months

 

 

 

55.5%

 

 

 

47.1%

 

 

 

Source:             http://www.soard.org/article/S1550-7289(07)00087-1/abstract

 3.  Exercise regularly.

             Regular exercise has many mental, emotional and physical benefits.  Not surprisingly, it is imperative to incorporate exercise into your life to increase your chances of getting to goal and staying there. 

 In fact, research has shown that 75% of patients who incorporate exercise into their life GET to their goal and STAY THERE.  Research also shows that the majority of patients who regain are consuming too high-calorie foods and beverages and don’t exercise enough. 

 Source:             OH Magazine March-April 2008

                         http://www.mayoclinic.com/health/gastric-bypass-diet/WT00007

 4.  Measure your meals (by volume).  Do not just eat until you are “full”. 

             It is unreasonable to expect an individual who has overeaten, in most cases, for years to 1) identify a proper portion size for a “normal” person, much less a new post-op portion size

 2) know what “full” feels like, especially as a new post-op.

            Research has shown that post-ops who measure their meals have a much higher success rate than those that eat until “full”.  If you are eating until you feel "full", you have eaten enough food to fill your pouch to capacity.  The problem with this is that, over time, it will take more and more to give you that "full" feeling.  This will lead to regain long-term and inadequate short-term weight loss in some cases.

 Source:             OH Magazine January-February 2008

5.  Do not eat and drink at the same time.  
            There is a reason that - despite VASTLY different post-op directions given to RNY patients regarding diet allowances, etc - 99.9% of surgeons agree that post-ops should not eat and drink at the same time.  Drinking with your meals can cause a wide range of issues, some directly affecting your health and weight loss chances.
            Drinking with your meals can:
a) lead to dumping, even in individuals not prone to dumping since the food is washed out of the pouch sooner than it should be
b) lead to malnutrition since a pouch that contains liquid in addition to solids can hold LESS solids (therefore less nutrient rich foods)
c) lead to inadequate satisfaction following a meal (since the food is almost immediately "washed out", leaving the pouch empty of protein rich foods that are most satisfying
d) stretch the stoma (since food needs time to slowly leave the pouch - it does not need to be pushed through the stoma by ingesting liquids too soon after meal).

6. Do not drink carbonated beverages.  (I will update this post to continue this when I have the time, but my hubby is wanting to use the computer now.)

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Goodbye to My Father

Mar 29, 2008

I am sitting at my father's dining room table in upstate New York.  I came to visit and to say goodbye from my father, who is dying with brain cancer.

It is clear Dad hung on to wait until we flew in from our various out of state homes.  We all arrived Wednesday night and had good visits with him on Thursday and Friday.  He has had many friends visiting with him as well.  He is enormously respected in the community and has amazing, decades-long deep friendships.  

At any rate, today when we went to visit him at the hospital, it was clear that he is starting to let go and is ready to die.  In fact, he asked that we not visit him long today, and wanted to say final goodbyes.  We are not leaving until tomorrow, and we were a little taken aback, but want to honor his wishes.

Later this afternoon, one of his closest friends stopped by the house after seeing my father at the hospital.  His friend, Lou, washed my father's face with a cool washcloth and my father told him he does not want us to see him suffering as he dies.  The pain is intensifying and he is becoming disoriented.  Another close friend is standing vigil, reading to him, letting him sleep as he desires, and just being with him.  

I feel I could be with him now but will respect his wishes that we not be around to see him as he dies.  It's hard to sit "here" knowing he's "there"; I'm full of life and he's losing his.  But you will love his final words:

I love you so much.  I can handle this, I'm ready to go now.  I'm ready spiritually, and that's the most important thing.  I will wait for you on the other side, I will be waiting for you in heaven.

Oh Dad, I love you.

It's Official: I Weigh Less Than My DH!

Mar 22, 2008

I've reached a goal that I have longed for for many years.  I can't remember when the last time was that I weighed less than my husband, but now I do!  I feel a deep sense of joy and accomplishment.  My husband is 6 feet tall, strong and stocky.  It just never seemed right to me, at 5'5", to be bigger than he!


Knees and Sleeps

Mar 20, 2008

This week I am working on knees and sleeps.

First the sleeps.  Having lost 126 pounds, I am curious re whether my CPAP should be adjusted, or if I need another sleep study.  I met with my sleep disorders doc and he asked me if I'm having any discomfort or problems with my CPAP.  I'm not -- so he asked me to drop by the card from the CPAP so he can download the info re my compliance, etc. (I'm extremely compliant though :) ).  He wants to see me again in 40 pounds and said once I reach goal he wants to do another sleep study.

Now for the knees!  My right knee has been "unstable" since an injury a couple of years ago.  Recently it has become more so and frequently twists unexpectedly, with a loud click and sharp pain.  I had a twisting episode last week while in Minneapolis on business, then did a lot of walking around town.  I favored that knee a little with the result that now my other knee hurts!

I met with an orthopedic surgeon on Tuesday and he thinks it's all about my knee caps, and likely I won't need surgery, just some PT.  To be sure there's not something else going on though, he wants me to have an MRI done -- which I have scheduled for tomorrow.  Then he'll review the results with me on a follow-up visit and devise a treatment plan.

Taking care of stuff, I am :)

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