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About this blog

A week by week journal describing my journey through Gastric Sleeve surgery, beginning with my experiences with the pre-op diet, and hopefully ending with me at my goal weight!

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85% of My Stomach is Missing! (Part two)

So, post-op day one for me could be summed up with one word: Nausea. Starting around 10pm the night of surgery, I began feeling like I was going to vomit, and unfortunately it never really went away... despite receiving the anti-nausea medication (Zofran) every four hours. That whole night, and into the morning was sort of a nightmare for multiple reasons. First and foremost was the nausea, it would hit me in waves, and I would sit straight up in bed, holding my "puke bucket" under my chin, even though I knew there was nothing in my stomach to throw up. And then I would spit, burp, spit, burp, for about 10 minutes before the wave passed. Then I would put my bed back into the recline position, and fall back asleep until the next wave hit me... Secondary to giving that whole long night a nightmarish quality was the fact that when I was between waves of nausea, and able to sleep, I would inevitably be woken up for something. Literally every hour, for the entire night, I was woken up for something or other. Now, if you've read my other entries, you may be aware that I am a nurse, and I work nights. And let me tell you, I make it my mission when working a night shift to let my patients get as much sleep as possible. Not the case here. In her defense, my night nurse was brand new. If I'd been feeling better, I may have tried to teach her a little bit about grouping activities together. For instance, if I had medications scheduled at 12am, and 1am, it's perfectly acceptable to give both at 12:30! Vital signs due at 4am? Why not come in and do them when phlebotomy comes in to draw blood at 3am? That was just a little irritating for me. I was woken at midnight for vital signs and IV fluids, at that time, I asked if I was getting my heparin shot, and she said "No, that's due at 1am." So at 1:30am, she was back for that. At 3am, phlebotomy. At 4am, vital signs. At 5am more nausea meds. At 6am, she came and took my foley catheter out. And then at 7am, day shift comes in, so they all came in to say good morning! Aaargh! So post-op day 2 has already started off on a sort of bad leg. My surgeon did come in and talked to me at about 7:30, and at that time, I begged him for something stronger for nausea. He agreed, and went out to order me some Phenergan. Now in this instance, it was probably good that I'm a nurse, so I know how things work. Otherwise I probably would have sat there and expected the medication to be given to me in the next 10 or 15 minutes. But no. When the doctor says he's going to order a medication, there is a process that it has to go through. He types the order into a computer. The order goes to pharmacy. The pharmacist looks at the order, and verifies that the medication, dose, frequency, and route of administration are appropriate, and also that it won't interact negatively with any of the other medications the patient is receiving. If they have a question regarding any of those things, they don't call the doctor. They call the nurse. Then the nurse calls the doctor, clarifies the order, and calls the pharmacy back. Then, and only then does the medication get verified by the pharmacy so that the nurse is allowed to administer it. Needless to say, it was nearly two hours before I received the Phenergan. In the meantime, I had stopped using my pain button at 3am, aware that the dilaudid my very well be contributing to my nausea. So my pain was back in full force too. Regardless of that, I knew I had to walk, so I got myself out of bed, walked to the bathroom, and peed on my own for the first time. I also emptied my drain, which was alarmingly full, compared to yesterday. Then I brushed my teeth, and sat in the chair. That was how my husband found me when he came in to visit. Shortly after he arrived, they gave me my Phenergan, which does have the side effect of making you sleepy. So when they came to get me for my leak test, I was literally falling asleep while sitting up in the chair. But I wanted that leak test done, so I could get some oral pain medication, since I was refusing to use the Dilaudid anymore. So we went down to Radiology for that. Let me tell you, that test was by far the worst part of the entire experience for me. Everyone in radiology was super-nice, but the stuff they have you drink tastes like lemon dish soap (if your parents ever washed your mouth out with soap, you know the taste). They have you take small sips of it while standing in front of an x-ray machine, and a radiologist watches it flow through your esophagus, into your stomach, and into your small intestine. But you have to drink enough that they can see all that, and be sure none is leaking out, and also that there is no obstruction in your small intestine. I never would have been able to do it if I hadn't gotten the Phenergan prior to going. Even with it, I had to hold a puke basin in front of me, and dry heave into it every few sips. But, finally the radiologist said I had drank enough, and she hadn't seen any leaks, so I was allowed to drink water when I got back upstairs! The rest of the day was a blur, because I was so tired from the phenergan, and then the subsequent oral pain medication (Lortab). I did walk in the hallway with my hubby after I got back from radiology, then I was told to start sipping water, approximately 2 ounces per hour. I managed to do that when I was awake, but the problem was I kept falling asleep. But I probably managed to drink a good 20 ounces of water that day. And later in the night, I noticed that my left hand where I had my IV was getting really puffy. So I when I saw that my IV bag was empty, I stopped it, and didn't tell my nurse. When she came in, I showed her my hand, and told her I didn't want anymore fluids by IV, and promised I would drink enough. Since it was scheduled to come out in the morning anyway, she said that was okay. The nausea went away almost completely after the phenergan, although I did get a small wave of it each time I took the Lortab, it was nothing compared to prior, so I never took any more nausea medication after that. And that pretty much sums up post-op day 1 for me. I really, really slept that night, fortunately had a different night nurse who definitely is of the same philosophy as me, and lets her patient sleep, which I greatly appreciated. Woke up at 7am feeling like a brand new person! Post-op Day 2 was also discharge day, so with that in mind, I got right up at 7, brushed my teeth and my hair (which I hadn't done since I'd been there). I got a morning "breakfast" tray consisting of orange SF jello, broth of some sort, plain decaf tea, and a Crystal Light lemonade. I ate the Jello, but have had bad experiences in the past with plain tea causing nausea, so didn't go there. And lukewarm broth just wasn't appealing. I saved the Crystal light for later. I got lots of visits from all kinds of new people that day. The bariatric coordinator, Sandy came in and told me she was going to be there later to answer all of my questions, so I started trying to think some up. But I didn't have a pen to write anything down. Then another nurse navigator named Robert came in, and told me he was going to make my follow up appointment for me, which I thought was sort of overkill, since I am perfectly capable of dialing a phone. But I know it's his job and everything, so I told hime when my husband got there and we could look at his schedule, I'd call him. At this point, I realized everything was kind of stuck on my hubby coming to get me, and he'd spent the night with a friend in Miami the night before, which was at least an hour away. Knowing that this friend has a tendency to keep late hours, and party, I decided to call and find out an ETA. When I got ahold of him at 10am, he was just eating breakfast. I told him to hurry it up, since I thought they were preparing to kick me out. But in reality, I still had my drain in, and was still wearing a hospital gown. So I may have been lying a little to get him in gear. But shortly after, my nurse did come in, and said it was time to pull the drain. Now this drain is something I've mentioned in passing, but haven't really described yet. If you're easily grossed out, skip the next paragraph. It's called a JP drain, and it's like the little bulb shaped suction thingies that they use to clear out baby's nostrils, except attached to a long hose that goes inside of you (gross, I know). It's attached to your skin with a couple of sutures, and fluid collects in it. When I was first out of surgery, there wasn't much fluid, but it was all bloody. Now on day 2, it was full of more serous fluid, kind of yellow tinged. It had drained about 400-500ml of fluid out of my abdomen since I'd left surgery, so it's probably a useful thing to have, but I was sure psyched to get rid of it. So the nurse snipped off the sutures using sterile scissors, which hurt a little. Then she just pulled on the thing, and it was absolutely the most bizarre feeling I've ever experienced. It didn't hurt at all, but it was an extremely strange sensation of something moving inside of my abdomen. Maybe if you've ever been pregnant and felt the baby move, it might compare to that, but I haven't, so I had nothing to compare it to. It was just weird. But anyway, with the drain out, I thought maybe I could take a shower. Nope... that would require a doctor's order. Okay, I played along, and just washed up as best I could in the sink, and changed into my loosest shorts and t-shirt that I had brought with me. Around that time, my surgeon came back in with the Bariatric coordinator, Sandy, and told me he was ready to discharge me. I guess this is when I was supposed to ask the questions that I had come up with, but I didn't know that, and I hadn't written them down anyway, so I kind of blanked. So he just told me what meds he was going to send me home on (Vicodin and pepcid) and then said he would go write it up, and see me in his office in a few weeks. In retrospect, I would have liked to ask when I can start exercising, and when I can go swimming. But I am a smart girl, I can figure stuff out on my own. Finally, around noontime, my husband showed up, and probably not a moment too soon either, because they were definitely ready to be rid of me. Almost as soon as he walked into the room the discharge nurse came in behind him, and handed me my paperwork. She definitely wasn't answering any questions. So I signed, hopped in the provided wheelchair, and was wheeled out to my hubby's car in record time. Hospital stay over! I am completely without medical supervision until my follow up appointment on the 21st! I guess I'll end this entry here, and talk about being at home, and starting purees in a later post. Goodnight!

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butterfyeffect

 

Halfway to Goal! (and some ramblings about BMI)

Well, here I am again. Almost three months post-op, and just over halfway to my personal goal of 140 pounds. My surgeon said that 160 would be a very achievable goal for me, but I'm going to try and push it to 140, which would put me at a "normal" BMI of 24, something I have never achieved in my adult life... or my life period, really, since I've been overweight since I was eight or nine years old. Actually, my stretch goal is 135, since I will likely put a few pounds back on after the first year or so, at least that's what I understand from reading what some of the long-term sleeved folks have to say on the maintenance forums.   Speaking of BMI, I now have to write about how annoying I find the whole thing. The person who "invented" the BMI scale never meant for it to be used how it is today. It was meant as a very quick way for healthcare professionals to estimate about what a person's healthy body weight should be, based on their height. It was never meant to be used as the only way for them to determine what a healthy weight should be for everyone, since people are different, we come in many different shapes and sizes! The classic example, of course is the body builder who falls into the obese category on the scale, yet has like 3% body fat. But then there are also those who fall into the "healthy" category, but who have no muscle tone whatsoever, and are in fact very unhealthy! Since I'm a nurse, I literally see this every day. I also see some very healthy people who happen to have higher BMI's. And yet I am supposed to mark "Obesity" as part of the health history for every patient I see with a BMI of over 25. (I don't do this, by the way.)   Okay, off my soapbox, and on to what I am doing to make sure that I fall into that category of a healthy person with a healthy BMI... I have to admit that since shortly after my surgery, I have been very lazy about doing cardio. This is bad, since my surgeon has emphasized to me that exercise is the one thing that separates his very successful patients from his moderately successful patients (apparently he does not have any unsuccessful patients).   For the first two weeks after surgery, I walked about two or three miles every day. But then, I didn't really have anything else to do. I wasn't working, I couldn't eat anything, I couldn't go in my pool. So I walked. Then I went on vacation, and didn't do anything active the whole time. And then I was back to work, but cleared for lifting. So I got back into my weight-lifting workouts, which I had always been pretty consistent with before surgery. I do them with my husband so it's fun, it only takes about 20-25 minutes, and I really see the results, which I like. I have never actually seen any results from doing cardio, I just did it because I knew I had to. But with weight lifting, I can feel my muscles getting bigger, and see them looking more toned. Now that they've slimmed down a bit, I actually think I have very nice legs!   About a month ago however, my husband started bugging me about running. In the twelve and a half years we have known each other, he has never done any cardio consistently (and never really had to, since he's one of these people who can eat like a horse, and not gain an ounce). But I was always telling him that he should, since he is starting to get some old-man problems, like high blood pressure, and high cholesterol, despite being at a healthy weight (ahem, see my rant above). So I really wanted to encourage him, but I hate running! Or so I thought I did.   I had tried to do the whole couch to 5k thing before my surgery, to help me get a jump on the weight loss, but had only made it through week two before I stopped. I just ran out of energy during my two week pre-op diet. And I really had no interest in going back to it, since it was really hard to do before my surgery. And it's Summer in Florida! Ninety degrees, and one hundred percent humidity everyday does not make for a pleasant run! But finally, after about two weeks of him bugging me about it I downloaded the C25K app again, and we headed out on our first run together... And guess what? It was kind of fun! Turns out going running when you weigh in the 180's is a completely different animal from running when you weigh in the 230's. Who knew?   We now go running at sunset on our nights off, mostly on the golf course that's about a half-mile from our house. It's a gorgeous time of day, with the sun setting in the west, and the palm trees swaying in the breeze. Today we were treated to Mother Nature's firework show off to the east of us, with huge, puffy white cumulus clouds and awesome forks of lightning making them glow (miles away, very safe). The sand paths on the golf course are easier on the joints than sidewalks, and our run takes us over a bridge that we always see turtles hanging out under. It has become something that I truly look forward to doing three times a week, and after eleven years of marriage, my husband and I have discovered something new that we like to do together. We are already planning on running a 5k road race in December. Like many other bariatric surgery patients have before me, I feel like I've finally found my inner athlete!

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85% of My Stomach is Missing! (Part one)

Well, here I am. Back from the hospital after a 2 night stay, with 85% of my stomach missing. I'll try and describe what it was like day by day...   Day 1 (Surgery Day): Let me preface this by saying that I did not sleep a wink the night before surgery. Not. A. Wink. So, upon arriving to the hospital for my 7am appointment, I had already been awake for 24+ hours. So that probably added to the dream-like quality that everything had to it that day. But still, that's the only way I could possibly describe everything that happened that day. It was surreal. Since I couldn't sleep, I decided that my husband shouldn't either, so I got him up at 4:30, and we set out from our hotel for the hospital at 5:30, even though it was only a 30 minute drive, and we didn't have to be there until 7am. At this point, I was convinced that I was probably going to die on the operating table, so I was giving my husband instructions, such as "My wedding ring is in the change pocket of my purse. I'll want to be buried with it on." Stuff like that. I'm sure he was amused by it all, but looking back, I can't believe I did that to my husband! (who already has some anxiety issues BTW) So we arrived at the hospital super-early, and I tried, yet again to catch a 15 minute nap in the car. When it became apparent that even that wasn't going to happen, we went into the hospital to register at 6:30. They brought me back pretty quickly, but left my hubby in the waiting room. They weighed me (219.4) and brought me into a room with a stretcher in it, and told me to change into the gown and socks that were on the stretcher. Now, I don't know if they just see that someone is having bariatric surgery, and automatically put the XXL gown on the stretcher, or what, but that gown was huge. You could have put three of me in it. The socks were also ridiculous, they could have fit on my feet over a pair of winter boots! But I did as I was told, and proceeded to spend the next hour and a half trying not to flash everyone in the pre-op area... Then a nurse came in, took my vital signs, and did an admission questionnaire and had me sign paperwork. Then three separate anesthesiologists came in and talked to me, looked in my mouth, and asked me several of the same questions the nurse had just asked. Then another nurse put an IV in my left hand. Then, finally they allowed my husband to come back in. We sat there and talked for awhile, and then my surgeon came in... now I know many of us bariatric surgery patients have had multiple appointments with their surgeon prior to the actual surgery day, but for me that was not the case. I'd only met Dr. Shillingford once for about 5 minutes, in January. But meeting him for the second time on surgery day, I was again reassured by his confident demeanor, and his relaxed bedside manner. Plus it helped that every other medical staff person I'd met so far that day had referred to him as an excellent surgeon. Once he arrived, that really seemed to get the ball rolling. Just about 10 minutes later, they were giving my pre-op "cocktail" (I asked, it was Versed). Then we rolled into the OR. I remember them asking me to scootch from the stretcher I was on, to the operating table, which I was able to do, and then....nothing. Next thing I knew, I was lying on a different stretcher, in a different room, with a different gown on and someone was taking an oxygen mask off of me, and putting me on a nasal cannula (the little prong things that go in your nose). I was in a lot of pain, which I guess they anticipated, because someone handed me a little button, and said I could push it as much as I wanted for pain medication. Now, being a nurse, I know there is a lockout period, so you can't overdose yourself, so I must have asked that. They said it was set to dispense medication every 8 minutes. There was a blood pressure cuff on my right arm that kept squeezing every few minutes, so I decided to push the button every-other time the BP cuff went off. After three or four pushes, the pain had faded into the background, but by then I was becoming nauseated. Like clockwork, they asked me if I wanted medication for nausea. Yes, please! Once I had those nausea medications in, I was feeling pretty good. Good enough in fact, that when they got me up to my room, I was able to stand up and waddle over to my new bed almost all by myself... At this point, I was hooked up to two IV's, I had a foley catheter in, and I didn't know it yet, but there was a drain hanging off of the right side of my abdomen. But the only thing that was sore (and still is) was the incision on the left side of my abdomen. I later found out that's where my stomach was taken out. The rest of that day went by in a little bit of a blur. I wasn't allowed any water, or anything else by mouth, but they did give me some swabs, and some ice chips, which were a godsend. I remember going for a walk, up and down the hallway with my hubby later in the evening, but other than that, I pretty much slept in between being asked, like 10 times, by 10 different people if I was diabetic, and/or did I need to have a CPAP machine (no, and no). And that was pretty much Day 1. And since I'm pretty wiped out, I think I'll save Days 2 and 3 for another post...

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butterfyeffect

 

Almost Two Weeks Post-Op and Facing Some Challenges

Hi there! It's been over a week since I've last posted, and I've spent that time transitioning from liquids, to pureed food, and am now eating soft solids... but it hasn't been without it's trials...   The first three days home from the hospital, my surgeon's plan calls for a pureed diet. For me, this consisted of mostly Greek yogurt, protein drinks, and some delicious pureed mushroom soup that my husband made for me. I'm sorry, but the idea of pureeing meat or fish or something just turned me off, so I didn't go there, but I feel like for those few days, I actually was doing well at getting in my protein in. Managed to get about 50 grams most days. And I have never had an issue getting my fluids in. I always get 50-64 ounces of straight fluid, not including my protein shakes.   No, my big issue those first few days was with swallowing my pills. I was still having a fair amount of pain, so I was taking the Vicodin my surgeon prescribed probably twice a day, plus trying to take all of my vitamins, and the Pepcid. No matter what time I tried to take them, or what I took them with, I would inevitably get something "stuck" and end up "sliming" until I eventually vomited. More times than not, the pill itself stayed down and just water came out.... weird. This is a huge change from the pre-op me, who could swallow all 6 of my vitamins at once, and not flinch. Needless to say, I've stopped taking my vitamins in pill form, instead I got some calcium chews, and some Biotin chews (I'm very worried about losing hair), and I found these cool things at Costco that are like a Crystal Light powder that you put in your water, but they are chock-full of vitamins! I drink two of them a day in my water. So the only thing I'm still a little worried about is my Iron, but I just can't tolerate plain Iron pills, it makes me nauseous... and I've been doing enough vomiting lately without adding in anything that may upset my little tummy more!   So on Post-op day 4, my surgeon's plan called for me to start trying some soft foods. On the list of soft foods allowed was soft baked fish. So my husband decided to cook dinner for us on Sunday, and made me a beautiful, tiny piece of tilapia, which he served over some soft polenta. It looked and smelled so delicious that I dug right in, and ate more than half of it without any regard to how my tiny tummy was handling it! With about one bite of food left on the plate, I realized what I had done, and knew I was in trouble. I spent the next two hours running into the bathroom. Every time I thought I was through, more would come out! It was awful, but not unexpected. I knew what I had done, and vowed to eat more slowly next time. Well, the next time turned out to be the following night, when I made what sounded like a wonderful recipe for a Ricotta cheese bake. But, yet again, it smelled and looked so good, I ate about half of the 1/4 cup portion that I had served myself way too fast, then got sick again...   So, long story short, I am becoming a professional vomiter. I keep a pillow next to the sink to splint my incisions while I puke out whatever it is that I took one too many bites of. It's gotten better over the past day or two, as I've kind of learned to take one bite of something, and then wait about ten minutes to see how it will sit. If it seems to be settling well, I'll eat another two bites. But three bites of any soft or pureed texture food seems to be my limit.   I've also become more severely lactose intolerant than I ever was pre-operatively. During my two week protein shake diet, I was able to enjoy at least one of the Premier chocolate shakes per day, as long as I took a lactaid pill with it. And I never had any issues with yogurt. Not the case post-operatively... I've sworn off of the Premier shakes entirely (too bad, because they pack 30 grams of protein in each one!), and as of yesterday, decided that the yogurt wasn't working either. So there went two big sources of protein. Between the vomiting, and the lactose intolerance, I've been really struggling to hit the protein goals set by my surgeon. I'm probably averaging about 40 grams/day, with a goal of 60 grams.   So with all this talk about what's not working, this probably sounds like a pretty discouraging post. So let's talk about what is working! Foods that I can eat in small amounts with no issues: Eggs, refried beans, powdered protein shakes made with almond milk, and bananas. Sounds like a pretty short list, but here's the thing: I'm never hungry. Like, never. If I wasn't worried about my hair falling out, I would happily just drink my vitamin water all day and not eat at all. Once in awhile I get a craving for something, like yesterday I kept thinking about bagels, but it's never accompanied by actual hunger. It's just a craving, and it passes.   Pain-wise, I haven't taken a Vicodin in three days, and prior to that I was only taking them at bedtime, and taking Tylenol during the day. Now I don't take either. I get an occasional twinge of pain under the incision on my left side (where they took the stomach out), but it goes away in a few seconds. As far as my surgical incisions go, all of my steri-strips (the little tape like things over my incisions) have fallen off, and I have to say, they look good! Three of them are completely healed over, and the last two just have tiny scabs on them. I've been putting vitamin E on them.   And now... the big scale question. I have lost (drumroll please) 24 pounds since I started the pre-op diet, with 11 of those pounds having come off since surgery. So that's 11 pounds in less than two weeks, 24 pounds in less than a month. I am pretty pleased with that. And, hey, I just realized that 24 pounds is more than 10% of my starting weight, which is something I never managed to accomplish in months of sitting through meetings at Weight Watchers!   The pictures below were taken yesterday. I decided after looking at someone else's before and after pictures to wear the same clothes in all of my progress pictures... I can really see a difference in how the shorts fit around my butt and thighs. My husband can't get over how much thinner my face is already. So overall, very pleased, despite all of the challenges!   I have my first follow-up appointment coming up this Wednesday, and then I go out of town for 10 days, so I'll have some info to put in another update pretty soon!

butterfyeffect

butterfyeffect

 

Things I learned while traveling with my sleeve

Well, it's been a few weeks since I've posted, due to me being out of town, and then adjusting back to work... but here I am, almost 6 weeks since my surgery, and feeling way more normal than I did last time I posted. Not to say that I am not still having challenges, but I'm definitely well on my way to recovery.   About three weeks ago, my husband Dan and I headed up north to visit relatives. For this we flew. Now I have to give kudos to those of you who were sleeved (or banded, or had RNY) in Mexico, and flew home a few days after surgery, because my flight north was not a fun experience. My tiny tummy definitely did not like the changes in altitude. So, first lesson of my trip: Sit in an aisle seat on the plane. I did, in fact have an aisle seat, but even so, I still got to use my barf-bag on a plane for the first time ever! I never threw up, but I was doing a ton of spitting up into it, just praying for the fasten seat belts light to go out so I could run into the bathroom and upchuck my protein shake. Of course by the time that we were free to move about the cabin, I felt way better, and never actually had to vomit. Still, not my finest moment.   So, after a three hour flight, we arrived at my in-law's home where, while my husband's immediate family knew that I had just had surgery, his visiting cousins didn't. That made for some weird mealtimes... I actually sat in a separate room from everyone else during dinner, claiming it was too crowded in the main room. Fortunately, Dan's cousins are vegans, so they really weren't eating the same foods as the rest of us, so maybe didn't notice that neither was I...   I was on soft foods at this point, and had told my mother in-law that I could eat eggs... so she made me a quiche. Yeah, I threw that up into her hedge. It was a super-awkward time for me. Basically at this point, I hadn't really kept anything other than protein shakes down in days, so I was pretty much destined to vomit up almost anything else that I ate. Yet at the same time, I don't want to offend anyone, since they were going out of their way to make foods that I'd be able to eat. So, yeah, I took a lot of long walks around in Dan's parent's back yard, and in the woods behind my brother in-law's house while I was there.   Next, Dan, myself, and my in-laws made the four hour road trip to where my parents live. Second lesson I learned on my trip: Riding in the back seat of a car may cause motion sickness. Now, I'm not going to say that my in-laws are not good drivers... but riding in the back of their van for four hours was torture for me. I have literally never gotten carsick in my entire life, but there I was, fighting off waves of nausea. I again, had only had a protein shake in the morning before we left, and spent almost the entire trip spitting up into a water bottle. Finally, about 3 hours in, Dan asked me if it would help if we cracked a window. After about 10 minutes of fumbling around in the front seat to figure out how to turn off the child-protective locks on the windows, my window was opened about two inches. Those two inches felt like freedom to me. They felt like life pouring back into my lungs. I spent the rest of the trip with my nose stuck out the window like a dog... but I got there in one piece, and perhaps more importantly, with my protein shake still in my stomach!   So, we arrived in New York just in time for my mother's Memorial Day picnic. I think I've mentioned before that my family likes to eat. Here, it was a little different because everyone at the picnic knew that I'd had this surgery. Just nobody cared. Although my mom has had weight loss surgery, and knows what a soft diet looks like, I was presented with grilled chicken, pasta salad, watermelon, chips, buffalo chicken dip, and chocolate chip cookies. I ate about four bites of grilled chicken. I tried to wet it with BBQ sauce. I threw it up in my mother's bathroom. When I got back to the table, my mom said "Is your stomach empty now?" I lied and said no, just to not give her the satisfaction. I then ate about two bites of the pasta salad, which thankfully did stay down. When we left her house for my dad's, where we were staying, my mother presented me with a plastic baggy with three hard boiled eggs in it. "I thought you could eat these." "Uh, yeah. Why didn't you give them to me before I barfed up your chicken." (That's what I wanted to say. I didn't though.)   Now, while I preferred staying at my Dad's house because the bed is comfier, and I love his dog, this presented it's own challenges, in that he does not cook. Not unless you count hot dogs or toast. He literally eats out seven days a week. And he lives at least a half hour from anywhere. So we spent a lot of time in the car. Here's my next lesson for when you're traveling with your sleeve: Full tummy and riding in a car do not mix. The first day I spent with my dad, I literally threw up everything that I attempted to eat. Threw up my protein shake at the restaurant where he, Dan, and the in-laws were eating breakfast. Threw up the quiche that I ordered for lunch (in a super-fancy hotel, I might add). Threw up the two bites of a chicken dumpling I tried to eat for dinner in my dad's truck!   It did get better after Dan's parents went home to Massachusetts, and we picked up our rental car. Next Lesson: If you must ride in a car, better to be the driver. Not always a perfect solution, but it did cut back on the throwing up in the car episodes.   The problems that I had for the rest of the trip were mainly just from me trying to be accommodating to everyone else, instead of the other way around. So, my final lesson is this: If you can, try and eat what you know you can tolerate, and on your own schedule, not everyone else's. Not always easy to do, especially when you're a guest in someone else's home, but when I look back on the ten days that I spent traveling, I know I would have been a lot more comfortable if I'd just said "You know what, I need fifteen or twenty minutes to just sit here and digest before we can go anywhere." more often.

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Getting Back to (A New) Normal

Well, I just re-read my last few posts, and can't help but be proud of how far I've come. I will be 10 weeks out from surgery on Tuesday, and feel pretty much normal. But a new normal, where I'm not hungry all of the time, and when I am, I get full really quickly on a small amount of food. Sometimes I even almost forget that I had surgery. But then I look at the scale, which is down more than 40 pounds, and I realize that I never would have been able to do that if I hadn't had some help. Because my old normal was scary bad, and I never want to go back to it.   My old normal was that I would wake up in the morning with a growling stomach. I would usually think about what I was going to eat before I had even gotten out of bed. Before I finished breakfast, I was already planning what I would have for lunch, and before lunch was over, I would already be thinking about dinner. And the last thing I would usually do before bed would be to eat a late-night snack. Like a half a package of Oreos kind of snack. My entire day literally revolved around food. Not healthy.   My new normal is that I get up in the morning, and I'm usually thirsty. I'm getting the proper amount of fluids - at least 64 ounces per day, but I think compared with the amounts that I used to drink, it's still not that much. And it's summer in Florida... So, yeah, I'm usually pretty dry when I wake up. I still can't gulp down a glass of water like I used to. But I can guzzle it pretty well. So, I usually get up and drink a glass or two of water or Crystal Light before I even think about eating. And even then, it's usually because my husband says he's hungry that I actually go to the trouble of eating some food.   And when I do eat, it's usually about a half-cup of something. I can get in more if it's something like soup. But in general I don't eat that much soup anymore, because I'm trying to be proactive about eating more solid-type foods. So far, I can stomach most things if I eat them slowly enough. That continues to be a challenge for me. I am usually mindful of what I'm doing, it's a challenge more often just because of the time required in order to eat at the proper pace... I'll be trying to eat dinner before leaving for work, for instance. Or on a half-hour lunch break at work. That's when I run into trouble. I'm better off just keeping my food at my work station, and taking a bite here or there. Most night nurses don't take breaks anyway, so no one really finds that to be weird.   As far as what I eat, I do find that the softer textures still go best. Grilled chicken or fish can still be a problem. I do better if it's served with some kind of sauce. Better still if it's cooked in the sauce though. For instance, we're having chicken tikka masala that was done in the slow cooker for dinner tonight. Perfect food for my tiny tummy. I've just in the past week started experimenting with fresh vegetables a little. Just a bite or two of lettuce, tomato. So far so good. Also just this week I've eaten pasta twice, and had no issues with it. And last night, I ate my first piece of un-toasted bread. Just a small one, but it went quite well, I thought. None of the "stuck" feeling that I've heard others complain about.   What still isn't working, and I am so very sad about it, is spicy foods. Just can't seem to tolerate them. I ate a few bites of Buffalo chicken at work the other night. I'd just been craving the Buffalo sauce. It stayed down, but I got the sliming sensation, and it burned in my chest for a long time. I have always loved spicy foods, so I'm really hoping that this reaction goes away at some point. Other than that, though I am incredibly happy with my new normal.

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Nice to meet you!

Hi there! My name is Kourtney, I am 34 years old, and I have been overweight for as long as I can remember. I think the first time I recall knowing how much I weighed, I was in the fourth grade, and I weighed 90 pounds. I remember even then, seeing that all of the other girls in my class weighed just 60 or 70 pounds, and wondering why I was so different... I won't go into all of the reasons why I was overweight at such a young age, let's just chalk it up to genetics, poor eating habits, and little-to-no parental encouragement to pursue athletic activities. I went on my first diet when I was 10 years old, and have continued to diet sporadically for the past 24 years. When I was 14, I took up running, and managed to keep my weight pretty steady in the 150's throughout high school... still heavier than many of my classmates, and I considered myself "fat" then, but looking back... What I wouldn't give to weigh 150! In college, I continued to exercise and managed to stay fairly stable with my weight in the 160's. But I started to notice that if I slacked off on the exercise for even a couple of weeks, I would definitely gain a few pounds, and quickly. But I could always rely on losing them pretty easily by hitting the gym. But then, starting in my mid-twenties, exercise no longer worked. I still continued to be fairly active, but started not seeing any results on the scale, and then started actually seeing it move in the opposite direction of what I wanted! Incredibly discouraging. So I turned back to dieting, trying everything from Weight Watchers, to Atkins, to Medifast, to Paleo. Everything worked at the beginning, I would feel great, losing 10, or even 15 pounds in the first month or two. And then inevitably, the weight loss would slow, I would become discouraged, and slowly lose interest. "What is the point?" I would ask. Little by little, I would start cheating, stop counting points, stop measuring portion sizes. And before I knew it, I would weigh more than I had started out at... sound familiar? Then in 2010 my Mother, who had also been obese for as long as I could remember, had Gastric Bypass surgery. For her, it seemed like a "no-brainer". Only in her 60's, she was an insulin-dependent diabetic, wore a CPAP to sleep at night, and could barely walk a hundred yards without experiencing chest pains. I remember encouraging her to look into the surgery at the time, because I knew that if she didn't do something I would likely be losing her in the next 10 years. Never, though did I imagine that I would be contemplating a similar surgery in the next few years! I just needed to keep exercising, and find the right diet! But then, wow! What a change I saw in my mother. She went from being the sedentary, obese woman I had known all of my life, to being an active, energetic size-10 woman who does water aerobics, rides a bike, and walks for fun! My mom at her heaviest, and a more recent photo (She made me blur her face) I started to look at weight loss surgery differently. Instead seeing it as some sort of of the last ditch measure to help manage diabetes, sleep apnea, and heart disease in my aging mother, I began to see that it could be a tool for someone younger. Someone who had struggled with their weight all of their life. Someone like me. Why wait until I am older, and sicker to consider it as an option? Why not do it now, and not struggle for the next thirty years like my mom did? So I made one last effort at diet and exercise, this past December. I lasted less than a week, and then fell ill with the flu. For me, that was a sign... So I did my research, found a surgeon three hours away that does the Vertical Sleeve for a very reasonable cash price, made an appointment with him on January 29th, and am scheduled for my sleeve in just over two weeks. I plan on journaling my experience here for anyone else who may be struggling with the decision, to give a real, first hand account my day-by-day struggles and successes. Looking forward to writing my next entry, by then I'll be almost a week into my two-week liquid diet. Now I'm headed out for a run!! Me at a "happier weight" and at my heaviest

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Week One of Pre-op Diet almost done...

Well, it's been about a week since I voluntarily started my pre-op diet a little early. I was supposed to have started it on Tuesday, but since I have been through carb withdrawal before, and know how miserable I can be, I chose to go start it on Friday, and do the "carb flu" on days when I was working, rather than on my days off. Strange logic, I know but in my mind I'd be busier at work and have less time to think about food. My initial plan was to just start drinking only protein shakes on Friday night when I got to work. (I'm an ER nurse. I work nights. Get used to me referring to things that happened in the late afternoon as "morning" and for things that happened in the early morning to be referred to as "last night") Anyway, that worked well until one of my co-workers decided to make a Chipotle run... then I altered my plan to just start low carbing for the weekend. Still drinking one or two protein shakes a day, and having one lean and green meal. Did that through Monday night at work, got home Tuesday morning with the best of intentions to have just liquid protein shakes from then on. So far, I'm ashamed to say that hasn't been happening. I am not cheating in large amounts, or with bad foods. I'd have to say all in all my calories have not been over 700 any day since Tuesday. And my carbs have easily stayed below 40. But I just have absolutely no appetite for the shakes. I can drink one Premier Protein (160 calories, 30g protein, 2g net carbs) in my 12 hours at work, and then I'm just not be able to face another one. But a few soy nuts? Sure, I'll eat those. I can chew them. So, a brief snapshot of my diet so far this week: Tuesday: -1 Isopure Chocolate Splendor Shake made with Almond Milk (160 calories, 21g protein, 11g carbs) -1 Premier Protein Chocolate Shake -1 bag of roasted peanuts (240 calories, 9g protein, 4g net carbs) -1 serving Isopure Chicken Soup (100 calories, 21g protein, 2g carbs) Wednesday -1 Isopure Chocolate Shake -2 hardboiled eggs (180 calories, 0 carbs, 18g protein) -1 serving Isopure Chicken Soup -2oz of cheddar cheese cubes (220 calories, 16g protein, 2g carbs) Thursday -1 Isopure Chocolate Shake -1 serving Isopure Protein'd Cheese Sauce over 1/2 cup steamed broccoli and cauliflower (190 calories, 21g protein, 11g carbs) 1 serving Isopure Vanilla mixed into 1/2 cup plain greek yogurt (165 calories, 32g protein, 8g carbs) Friday -1 serving Isopure Chicken soup -1 slice of cheese pizza (250 calories, 10g protein, 25g carbs) -1 Premier Protein Shake -1/8 cup of soy nuts (65 calories, 6g protein, 1g carbs)   So, as you can see, not stellar. But on the plus side, I've lost over nine pounds in seven days, and I am literally never hungry, at least not for protein shakes. But if you put a slice of pizza in front of me, I'll eat it (as evidenced by Friday's log). But here's the strange thing that I've noticed. The pizza didn't taste that good. The sauce tasted weirdly acidic, and the crust tasted like cardboard. This was from a pizza place that we've ordered from at work multiple times, so I know what it used to taste like, and it just tasted... different. And then this morning, I went with my husband through the McDonald's drive thru. Now honestly, I don't like McDonald's. I think the last time I ate there was in December, and that was only because it was Sunday, and the Chik-fil-a was closed. But his fries smelled good, so remembering the pizza last night, I tried one. It tasted like salt and grease. Not at all appealing. Unfortunately, both the pizza and the fries still smelled good... so the cravings are still there. But if I keep telling myself that the taste isn't the same, I think I can talk myself out of some trigger foods. One of the negatives of the pre-op diet (aside from the obvious, that it's a diet ): I have literally no stamina for exercise. I've attempted to go for a run just once since this all started, and I got about halfway through what I usually do, and started feeling like my legs were made of lead. I took the stairs up to the 5th floor of the parking garage when I got out of work last night. Same thing; lead legs. So my cardio has decreased to basically walking the dog, although for some reason, I can tolerate my usual strength-training workouts with no problem. So I don't know what I'm going to do for exercise after my surgery. I guess walking is all that's advised for the first few weeks anyway. But that's been sort of bothering me anyway, because my surgeon said that his patients who have the most success are the ones who exercise the most... but how can I exercise if I have no stamina? I guess as I get lighter, I'll need less stamina to move my body. Other negatives? A slight headache that doesn't go away (this may be from giving up my one diet coke a day). A sticky feeling in my mouth that only goes away with constantly drinking water. That's about it. It's only two weeks of my life, as I keep reminding myself. I will keep plugging away at it, and hopefully get a little better at it by next week. Only 9 more days to go! My "Before Pre-op diet" photos

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Love-Hate

New Progress Pics!!   Well, here I am. Back to post what's going on with me at a little over four months post-op. At this point, I sort of have a love-hate relationship with my sleeve.   I love my sleeve when people make comments to me such as yesterday, when one of my co-workers said to me: "Kourtney, you are going to blow away, you're getting so skinny!" I'm really not that skinny; I weighed 174.2 at my last weigh-in. But it was still nice to hear, and put a smile on my face. I have finally gotten to the point where people are really starting to notice the weight loss, which is interesting, because I've probably only lost 8-10 pounds since my last post, but literally only one person at work had commented on my weight loss at that time. Now it's like the flood gates have opened... One person commented that I've lost the weight so fast, to which I was able to accurately answer: "No, actually I haven't, just nobody noticed for a really long time!" But it must seem like it, because just in the last two weeks, I have probably had five or six people ask me if I had lost weight, how much, and how.   This is where I have been fibbing. I kept my surgery a secret at work. I was working as a contractor, so had the luxury of just taking a month off between contracts with no explanation. So that's what I did. I took the month of May off, and didn't tell anyone what I was doing. Partly because I didn't want to go through the hassle of having to get cleared to come back to work by the Employee Health department due to the lifting restriction. But also partly because I work with someone who is very open about having had Gastric Bypass surgery, and people are not-so-nice about it behind her back, and even make comments to her like "Should you be eating that?" I didn't want that. So I've been telling people that I've lost 30 pounds (I've actually lost closer to 60). I've been telling them that I've been focusing on eating smaller portions, increasing protein, and that I've started running. All true. But at the same time I feel a little ashamed for lying.   Worse still, I saw a friend a couple of weeks ago that I haven't seen since I moved to Florida. She was, of course wowed by my weight loss. And she is someone who has also struggled with her weight, someone who I vowed that I would tell about it when the time came. But then I chickened out! What's wrong with me??? I've actually thought about emailing her and telling her the truth, because the guilt is getting to me. So I sort of hate that my sleeve has made me into a liar.   On the other hand, I love my sleeve when I get to go shopping in my closet! I love pulling out all of the clothes that haven't fit me in years, and wearing them! It's like getting brand new clothes. I also have a new obsession with Poshmark. It's a virtual consignment store. I've been selling all of my old size 16's that don't fit me anymore, and I've been buying size 10's. They don't quite fit yet, but they're close.   Diet-wise there are still things I can't eat. Grilled fish, for example. I tried again the other night, and it just does not stay down. I ate it with some red-curry noodles (because tuna-noodle casserole had stayed down beautifully, so I thought there may be something to the fish-sauce-noodle combo) and then was really uncomfortable for about 30 minutes before it finally came back up. Interestingly, I tried the rice noodles the next day with chicken (because my husband had heated them up, and they smelled so good) and they came up again. So it very well may have been the very glutenous noodles. But I'm playing it safe, and avoiding all fish (except tuna-noodle casserole). So I hate that my sleeve has taken away some things that I used to really enjoy. But at the same time, I love that it has given me the control to just have a little bit of the things that I can tolerate, and that I still love. Self control is something I was severely lacking pre-sleeve, so I'm thrilled to have it. Overall, getting my sleeve is still the best $10,000 dollars I have ever spent.

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