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Reflections on my two year journey post RNY surgery.

1.  It has not been an easy ride.  I still have to watch what I eat or I find myself grazing all day on carby junky items.  I still have a hard time getting my 80 grams of protein in unless I make an effort.  

2.  I still have hunger.  Especially during hormonal shifts in the month.  A week before my cycle, I find I am so voraciously hungry I could eat the paint off the walls.  I am nice to myself and eat things that will do the least amount of damage.

3.  I still have to remind myself to eat slowly and take human bites.  If I don't, I end up clogged up and with the foamies.  I have to run to the bathroom and regurgitate.  Yes, it has become more rare, but it still happens to me from time to time.

4.  I have overeaten to the point of giving myself stomach cramps exactly twice.

Having some constipation issues early on post-op, and not seeing the scale move too much, I decided to focus on eating correctly and writing it all down so I can track calories, fat, protein, carbs, and fiber.  I decided that I would wait until the 6 week visit to see what the weight loss is.  Here is what I do know:  all time high weight from nutritionist's scale Dec 2011 was 307.  My surgeon's office records my high weight as 299.  My two week pre-op weight from surgeon's office was 281.  He seemed pleased.  My scale at home agrees with the surgeon's office scale, and morning of surgery I weighed 276.  Interestingly enough, I was not officially weighed in the hospital before surgery, but rather they asked my weight.  Then my two-week post-op weight in surgeon's office was 266.  Nice.  Since then, constipation and not enough movement of any kind and the last time I stepped on the scale it said 263.  Depressing to not be losing that much.  Next week I have my 6 week post-op visit and I sure hope that I am not a complete failure.  I have Miralaxed myself each morning, supplemented with stool softeners and add Benefiber to my water in the evening.  I have been regular for the past few days.  I also have joined a gym and it finally opened this week.  Brand new rubber smell is nice :)  I did two workouts. just treadmilling at 3.0 mph for an hour Wednesday and Thursday, so I hope this helps my numbers next week.  Seriously, I do not want to get yelled at by the surgeon.  When he removed my drain tube, I misunderstood him when he asked how often I cleared the line and said once (thought he meant how often I changed the bandage) and he blew his stack.  I had to explain that I misunderstood and said two-three times a day.  So, I can only imagine what he would do if I go in there without any serious weight loss.  Ugh.  Some of my clothing is hanging on me--have to put a bunch of shirts in the donate pile, along with a ton of pants.   I am fitting into some of my smaller clothing, going from tight size 24s, to fitting into 22s and some 20s.  I can still wear some 24 size pants that are a bit loose and baggy, but some just have to go.  Like most, I am losing top down, but I think that my problem area, which is my giant stomach, will be the last to go.  I have never needed a belt for my pants, but even with the giant stomach, I think I will have to buy one pretty soon.  So I must be losing something.  Calorie wise, I am averaging around 800-1100 a day.  I am hungry.  Thought that would not be the case so soon, but perhaps it is acid related. I have started taking my twice daily 20 mg pepcid and that might help.  Either way, I am going to have to watch it and keep my exercising going.  So, fingers crossed that my 6 week post op will be ok.

I looked into having WLS back in 2005.  Went to the seminar and did what was asked, but I was turned down.   So this past July 2011,  I decided to give it a go again.  My insurance has changed and my age and weight are higher.  In fact, for the past five years, I have medical records showing me over 300 pounds.  Crazy.  So, after the seminar, I went about trying to do all the steps.  I saw my PCP after five years.  Luckily, she was not too mad at me.  In those five years, I did see my Gyno and did go to urgent care twice, so thankfully I have five years of medical records that have my high weight recorded.  My PCP, Dr. Bader, was very much in favor of me having gastric bypass and when I asked her about putting me on a medically supervised diet as part of the process of getting approved, she referred me to the wellness center that is part of the office and would be included in the medical records she signs off on.  Fabulous.  Then I had my concult wth my surgeon, Dr. Eric Schlesinger, and got a checklist of tests to complete:  bloodwork, chest x-ray, EKG, sleep study, psych consult, dietitician consult. So I set about getting all those done.  Finally, in February, I asked Dr. Bader to write the physician's letter of medical necessity, which she did, and I submtted it to the WLS office.  And heard nothing.  So, I followed up and called the patient advocate and finally got on the phone with her. She said the only thing left for me to submit was the five years of medical records...which was nutty because that is the very first thing I accomplished. She said she would go though the large file of records I submitted and would send it all in to the insurance company, BCBSAZ, for approval and get back to me.  And a week later, she actually did.  I nearly dropped the phone when I got the call mid March.  I was still on spring break. She said that she just got off the phone with my insurance company and my gastric bypass was approved and the surgery schedulers will be calling to set up the pre-op appointment and the actual surgery date.  Needless to say, I opted for sooner rather than later.  I have 125 sick days, so I can afford to take a few weeks off work to recover.  My pre-op appointment was last Wednesday, March 28th.  That went very well,  Got all the final blood work, chest xray, breathing test and urine specimin done,  Then took a nutritional class to go over the post op diet.  And in a week, April 9th, I am having my surgery..  This is not for the faint of heart, to be sure.  I will have a drain tube coming out of the incision for two weeks and if I do what they say, I will have it removed in my post op two week appointment.  At that meeting, I will find out if I can go back to work sooner (I am hoping to be back to close out the year at my school.) So glad things are gong quickly finally, so that I don't have time to ruminate and dwell.  Already put in my paperwork for my leave.  Told my mother and sister, and close friends and certain coworkers. This should be interesting.  I am butterflies in the stomach nervous, but super excited at the same time.

Right now, I am on the pre-op two week protein and liquid diet.  When I had my appointment, the surgeon was pleased that I had already lost 18 pounds since I last saw him.  With this pre-op diet, I should lose a little more.  I am not saying it is easy, but it is going to help with surgery and get me used to what I wiill be eating post-op, so it can be bad.  Eyes on the prize.  Big picture.  It will all be worth the trouble. I am certain of it.