4/16/2010

I had my sleeve done on 9/15/09 and suffered with unrelenting anxiety post surgery. Prior to surgery I was never clinically depressed only took anxiety medication once for an acute bout w/anxiety during a doctor supervised WL regimen that required me to take handfuls of vitamins and phentermine. I lost 76 lbs but put it all back on and then some about 5 years later.

After having the sleeve surgery I was so full of anxiety that I needed to get help. I was on the phone and on these message boards crying out for help. My PCP was very supportive and met with me often. Straight away she convinced me that it was OK to take an anti-anxiety medication while healing and that it might help me to get in the much needed nutrition. I tried xanax for about 2 weeks and although it helped me to feel better-- relaxed enough to get in bits of nutrition...when it wore off my anxiety grew even higher. My medication was changed to Klonopin .5mg and with such a low dose it was long lasting and helpful. I started therapy with the psychologist who has a practice and also works with my surgeon. I still had trouble eating even drinking, I'd a aversion, even repulsion towards food. My PCP had recorded one of my symptoms after WLS as "anorexia". I went to 2 psychiatrists, tried 2 anti-depressants, Welbutrin and Zoloft--both trials didn't last more than 5 days--I literally couldn't eat anything, they only increased my repulsion and anxiety. The second psychiatrist was better-I started at a low dose of an SNRI Serotonin Norepinephrine Reuptake Inhibitor (since the SSRI"s increased my anxiety and aversion to food). The name of the drug is Remeron (generic version-Mirtazapine), 30mgs taken daily at night before bed...Bingo! It worked. I found out about Remeron through this message board...(if you go back and read through my early posts you may find it.) A couple of people on this message board mentioned Remeron but didn't like it because of the side effect of an increase in appetite. When I saw that I figured it could be helpful to me since I had no appetite and fear of eating. My psychiatrist confirmed this for me and started me at a low dose of 15 mg for the first week then upped the dose to 30...I had no weird side effects, just a little groggy at first in the morning. What did happen was that finally I wanted to eat. I desired foods, (not everything) but it was so much better. I was able to eat and had to remember to eat slowly and chew well. Fast forward to this week and I've stopped taking the Remeron, (I do not want to be dependant on any medication indefinately). I notice a minor decrease in my appetite but I am able to eat enough to keep myself healthy. It's been 8 days since I stopped and I am alright so far. I still take a .5 dose of Klonopin as needed for anxiety--that usually amounts to 1 a day whenever the anxiety gets too high.

During this whole process of adjustment, I've I gotten myself in a 12 step support group called Overeaters Anonymous. The imposed weight loss compelled me to see I had issues with food and eating that had to be addressed so like a tortoise without its shell, I'm ready to deal with some underlying issues that created my compulsive eating habits etc. For me, I need to fix the inside as well as the outside in order to function well with the dramatic changes from this surgery. I'm 7 months out, 5'7", 158 lbs (25 lbs to goal) and wearing a size 10-12. It honestly feels good to have so much weight off but I still am not at peace with the forced changes in my eating capacity. I pray that will soon come.

4/18/2010

A big part of my anxiety is generated from discomfort in eating. I have lost most of my excess weight and it does feel healthier to not feel that heaviness on my body, although I am just now noticing that in some places I still have pain (like my right hip), which I had thought might be due to all the belly,hip, and rear-end fat I was carrying. There is a definite improvement in my knees, feet, and general mobility.

On the down side, I feel I am more vulnerable and must guard myself against any outside illness/infection etc. I'm uncomfortably cautious of what I eat for fear of any food born illness-UGH. I just feel like I can't afford to be sick since my consumption for nutrition is now limited and stomach so small. I'm yet uneasy about the way food feels much of the time when eating. With the exception of soft stuff, I still have to stand often (helps the food move down) and/or stop and wait 10 minutes or so before resuming even a 3 or 4 oz portion of some denser protein like meats and sometimes even fish. This is something that causes me anxiety. I just get scared and wonder if there could be something wrong--Seven months out and I still don't drink plain (even the best filtered/alkaline), water. Water weighs too heavy on my sleeve so I drink Vitamin Water and dilute it with good water--I don't know why but it works.

To sum it up I think I am happy that I went ahead with this surgery. I hope that in the final analysis I will truly be healthier and feel peace in that. For now there is always that nagging doubt and "what if" feeling and with every unusual sensation I worry.:cursing: