Tomorrow, Tomorrow, There's Always Tomorrow...

So tomorrow is the big day!  I’m finally here and having the surgery.  My stepmom asked me if I was nervous about it during church today and I told her I wasn’t.  I feel that I’m well prepared for this and I don’t mind being cut open.  The anesthesia bothers me more than anything.  I know how dangerous anesthesia can be because I worked in a veterinary hospital full-time for two summers.  You can literally die from it if it isn’t done correctly.  This is also why anesthesiologist have such a long residency and high mal-practice fees.  Also, the only time that I’ve had full anesthesia was when I was six and had my tonsils and adenoids removed.  It made me really sick.

I seem to recover really well from any procedure that I have.  I ate Thai food the night that I had my wisdom teeth out and had very little pain with that.  I drove the day after as well.  When I had my tonsils and adenoids removed, I just slept a lot.  My mom called the doctor and asked what was wrong.  He said that it was a good thing since a lot of kids are crying in pain.  I have also removed my own stitches twice (the only two times that I’ve had stitches).  The most painful injuries and the ones that took the longest to recover from were torn ligaments.  Pulled muscles are painful too, but that’s what Valium is for.  I’m also planning on driving myself to the hospital tomorrow because I don’t want to ride in my mom’s smoky car and I’m hoping that I will be able to drive myself home Tuesday.  That one is doubtful because I will be on pain medication then.

I feel like I’ve been on a gerbil wheel the last couple of weeks.  I’ve been trying to do so much since I don’t know how I will feel after surgery.  I’ve been interviewing for tons of nanny jobs since I lost my main nanny family and preparing for nursing school as well.  I’ve had a lot of Statistics homework, projects, and tests as well.  There has been a lot of shopping for the house and I’m tying to clean now so I won’t have to do it after tomorrow.

I’m not allowed to wear nailpolish during surgery.  I think this is because of the oxygen monitor that they put on your finger.  So, I’ve been painting my nails dark colors with lots of glitter.  I know that it is one day without nailpolish, but so be it.

I’ve cheated some more on the liver shrinking diet.  I had some Thai food.  Boy was it good!  I also had some cheese sticks, which were also good, but nowhere near as good as the Thai food.  I have also probably been over using the spray on salad dressing and I’ve been adding shredded cheese to my salads.  To make up for these things, I’ve cut out a few protein shakes, fruit and yogurt.  It helps with the over all calorie count.  So I didn’t ace this diet, but I don’t think that I failed either.  If I look at all of my cheats and all of the days that I stayed within limits, I would give myself a C, maybe a C-.  At least that is a passing grade, right?

Because I will come home from the hospital with a drain, something to catch the fluid coming out of the drain, and a fanny pack full of pain medicine, I’m wondering what clothes I will be able to wear and how to conceal it all.  I’m not ready to tell people what’s going on just yet, so I’m hoping it isn’t all too noticeable.

I went to a support group meeting this week for pre-surgery and post-surgery patients.  It was great to see people that were in the same situation that I’m in and others that had successfully lost weight.  Each of the post-surgery patients stood up and introduced themselves, told which type of surgery they had had, the date of the surgery, and how much weight they had lost.  We clapped for each patient.  It was truly incredible the amount of weight that some of the people had lost and it made me teary-eyed.  It gave me the feeling again that this is a good decision and that I can be successful.

I went to a football game with my mom yesterday, and on the way there, we argued.  She didn’t completely understand what the dietary restrictions are post-surgery.  I told her that I can eat whatever I want in moderation, including sugary food as long as I’m not one of the few sleeve gastrectomy patients that gets dumping syndrome.  She didn’t know that.  I told her that it is important to have balanced meals (like we should all be eating) with a lot of protein though.  The protein is important because you want your body to eat the fat and not the lean tissue because it is basically going into starvation mode post-surgery.

We also argued because I told her that I would be bringing my kiddie plates and silverware to Thanksgiving and Christmas dinners.  She said that I would ruin the décor of the beautiful table – or something close to that.  (Of course my Martha Stewart mother thinks of this first.)  She said that I would also be drawing attention to myself.  I told her I would be drawing attention to myself no matter what I did because I can only eat half a cup of food at a time.  If I put half a cup of food on a regular sized plate, it looks like nothing and my family would ask why I wasn’t eating as much.  If I used a saucer or appetizer plate, then it’s the question of why I was using a smaller plate.  So I told her, why not go with what I’m comfortable with.  Plus, kiddie stuff comes in fun colors.  I told her I had to do what was right for me and what would make me most successful.  I will still be only a couple of weeks out from surgery at Thanksgiving and Christmas and this whole eating thing will be new to me.  Maybe next year I will be able to eat on regular sized plates.  She also wondered about me telling my other family members and what they would think.  I told her that it would eventually come out and when they see me eating a really small portion they will ask questions.  Why not put it all out on the table up front and be like “Look, I had this surgery and this is all I can eat, got it?”  At that point, it’s too late to turn back, so they’ll just have to deal with it.  Bite me.

My mom is worried about my family judging me and she said that she is trying to protect me.  I told her that I don’t need protection and that actually the family members that she is worried about judging me are probably the ones that will support me the most since they have always said that I was pretty, but needed to lose weight.  Also, one of my cousins asked my mom a while back ago if I qualified for bariatric surgery.  At the time I didn’t, but I think that they will understand me now.  (Let’s hope so at least.)

My mom and I have also argued about clothes.  She has always been a yo-yo dieter and she threw out all of her heavy clothes.  She gained a bunch of weight back and now wears my clothes.  I told her that I would go shopping in her closet when I started losing weight and that she could have my old clothes.  She likes the idea of having my old clothes, so that she has something to wear (of course), but doesn’t like the idea of me wearing her clothes.  She claims that she will fit back into them.  Whatever.  I will believe it when I see it.  I really doubt that it will be happening anytime soon.

I have a list of things that I want to get done tonight and I’m feeling pretty energetic right now.  I doubt that I would be able to sleep tonight anyway since I’m so excited and nervous for tomorrow.  I’m counting on the anesthesia to give me a nice nighty-night. 

I only took a week off officially of work and I’m hoping that’s all that I need.  At the support group meeting, there was a woman there that had just had the surgery the week before and she was still able to attend the meeting.  This made me hopeful.  She said that she wasn’t in a lot of pain either.  She also happened to be in my pre-surgery information class as well, which was nice to see a face that I recognized.  Some people looked at me like I was crazy when I told them that I wanted to go back to work in a week.  It’s just that I need to pay for things and make money.  I can’t afford to be out of work for more than a week (literally).  With my track record, I should be fine though.

At the support group meeting it was nice to hear that other pre-surgery patients hadn’t told everyone that they were having the surgery.  It is so comforting when you can relate to someone.  There was one patient who was going to be a third generation bariatric patient and she was telling me how much weight her grandmother and mother had lost in such a short amount of time and it was incredible.

There was also a very funny woman at the meeting that said she thought that her husband should have the surgery because he had poor eating habits and ate unhealthy food.  She said that she had threatened to cook him only bacon for a month and push him on over into the grave.  Someone said that they hoped that she had life insurance on him and she said, “Don’t worry I do!” and we all started cracking up laughing.

Well, there are a lot of things that I want to accomplish before I attempt to sleep/rest.  The next update will be post-surgery!

The Last Supper and Cheating Hell

For those of you who know me well, I’m sure that you’re not surprised to learn that my last meal was carbs – all carbs.  I ate three different types of mac and cheese.  Two were instant and one was Velveeta.  (I can’t remember which one, but one of the instant ones was horrible.)  It was a glorious experience.  I even threw in a honey bun in there.  I haven’t had one of those in ages.  I guess some may have guessed that Thai food would be my last meal, which would have been a close second, except that I had had it twice recently.

I am now going through the hell diet as I call it.  It didn’t help that the first few days of it I had major PMS and was craving anything.  Literally, I would have eaten a rock if my teeth could have handled it.  My mother claims that it can’t be that bad and I scream at her that she has no idea.  She said that she is going to go on my liquid diet post surgery to make me feel better.  I told her it would have been better if she was on my diet with me now since I physically can eat regular foods and it is hard to resist them.  It would be dangerous post-surgery to eat regular food and I won’t have the sensation of hunger any more either.

I call it the anorexic diet, but really it is meant to shrink my liver.  It can shrink my liver by up to 40%.  It is important to shrink the liver before surgery so that it is safe to lift it up to get to the stomach.  To understand the anatomy of it, here is a diagram (the white part is the liver, which sits over top of the stomach):   

The diet is about 800-900 calories a day.  This is far fewer calories than I’m used to.  What is really hard is that two out of the three daily meals are meal replacement shakes, so you don’t feel like you’re actually eating.  Other things that I eat are low calorie vegetables (spinach, tomatoes and green beans), 4 ounces of lean meat (chicken), two pieces of whole grain low calorie bread with fiber, one small piece of fruit (a super small apple or a clementine) and one 100-calorie yogurt.  I make a salad at night, which is actually really good and tasty.  If I could have that for lunch as well, then this whole thing wouldn’t be so bad and I wouldn’t feel like I was starving.

I have big time cheated on the diet twice.  I ate a cheese steak in substitute for a protein shake – not exactly and equal trade.  I had Doritos with the cheese steak too.  They were stale, but I didn’t care because I was so desperate for food that I was going to eat anything.  I also had stress eating and ate flavor rice (oh my gosh, the carbs were fabulous).  I have done small cheats too like over eating vegetables and fruit (yes, there is an actual limit on how many you can have) and adding some shredded Parmesan cheese and spray salad dressing to my salads as well.  I ate a few bites of pasta at one of the family’s houses where I babysit.  I feel proud of all the things that I have resisted on snacking on though, so there is some progress.

I have already planned to cheat again (not quite sure when though) with a big Thai meal.  I feel like I’m having some kind of affair because I have to hide the evidence from my mom so that she doesn’t get mad at me.  I’m also disappointed in some ways in myself, but it is difficult to stick to such a strict diet when my stomach is the same size, but I’m eating way less than I’m used too.  I feel that it will be easier to eat less when my stomach is smaller size and can hold less in it.  It also feels good to chew and I don’t get to do that very often throughout the day.  Thinking of chewing makes me dread the two week liquid diet, but I know that if I eat solid foods too early, I could literally kill myself, so I will definitely tough it out.

Something that I have found that helps with the hunger is Crystal Light.  That stuff is my crack at the moment.  The fact that I can have different flavors is fantastic and some even have caffeine in them!  They are low calorie too, so they don’t add much to my total daily calorie intake.  It is also nice to have a change from plain water since I’m not drinking Diet Coke/Coke Zero anymore.

I have been really good and haven’t had any carbonated beverages since starting the diet.  I don’t miss the flavors that much right now either.  I purposely over drank them prior to the diet starting so that I could get a taste aversion to them and wouldn’t crave them.  Not having the caffeine was the hardest part though.  I don’t drink coffee (just the smell of it makes me nauseous) and you’re not supposed to have caffeine on the diet/post-surgery due to the small risk that it could cause dehydration.  Carbonated drinks are out after surgery because of the air expanding in the small stomach.

Sometimes I wonder about my decision with the surgery and how I will really have to change my eating habits after.  Being on this diet has helped me eat healthier and I’m using my kiddie spoons to eat my yogurt.  I’m also trying to chew/eat/drink slower, enjoy the flavor of the food, and overall take my time eating.  I will have to eat and drink very slowly after surgery, so I’m trying to practice now and get in the habit of doing it.

I’ve tried a few different meal replacement shakes and there are only a few that I like.  They all have a lot of protein in them, so they can taste like chalk sometimes.  I tried my mom’s brand of choice in strawberry cream and it was disgusting and painful to drink.  I couldn’t drink it and ended up wasting it.  The mint chocolate wasn’t terrible, but was still hard to put down.  She claims that she actually likes them.  I’m bagging the Myloplex and sticking with Carnation Instant Breakfast and Ensure.  Carnation Instant Breakfast is actually really good, but I get tired of having the same flavor since it only comes in one flavor (chocolate).  The Ensure comes in two flavors, but I’m only going to buy the vanilla since I get chocolate in the Carnation.  Ensure isn’t terrible, but it isn’t great either.

Now that my period has started and my PMS has subsided, I am a lot less irritable and hungry.  This has helped a lot.  I snapped on my mom a couple of times (although she had it coming since she instigated some things that she knew would irritate me).  I keep pulling the death card on her – “I could die you know from surgery?” 

On the death note, I have signed a living will or as it is called an advanced medical directive (doesn’t sound as scary in those terms).  Basically, I told them to keep me alive at all costs.  I told my mom that as well.  Even if the doctors say I’m brain dead, I promised her that I would come back.  I’m a fighter and I’m not going down.  She said that even if I were a vegetable that she wouldn’t pull the cord on me.  She said she would take care of me.  I disagreed with that and told her to hire a nurse because I didn’t want her wiping my ass and sponge bathing me.  She laughed, but I was dead serious.  I told her that I wouldn’t be doing the same for her, so I don’t want her doing it for me.

I was also at high stress levels because I had a math project due (which thank God, I finally finished), math homework and a test (still working on those), and the burden of not knowing how I’m going to pay for nursing school starting in January.  I’m also worried about making enough money to finish paying back my dad and paying basic bills since I have lost my regular nanny family.  I have been interviewing for jobs and hoping to get several small ones that will add up to the hours I need each week to make enough money.  Then there is the beginning of the Christmas musical rehearsals at church too.  I was supposed to go to Lynchburg this weekend for a Christian women’s retreat and volunteer there.  Sarah Palin was going to be a guest speaker (regardless of your political views, it would be really cool to see a former vice presidential candidate in person).  I was also going to catch up with my cousin, his wife, and their baby, Thomas, who live in the area, but I stayed home to finish my math project, homework, and test.  (School comes first!)  I think this was all a blessing in disguise because I needed some time to relax as well.  I have a midterm next week in Statistics as well and I need to make an equation sheet and study for that too.  I was trying to pack too much into this weekend.  Basically, I have a lot on my mind/plate and as surgery gets closer I get a little bit more nervous/anxious.

Side note: I got into Bon Secours Memorial College of Nursing!  Yeah!  This was a huge burden off my shoulders since I didn't get in the first time that I applied and you can only apply to the school twice.  I think that this too was God's plan because if I had started nursing school full-time this semester, then I wouldn't be able to have the surgery this fall and probably would have had to wait until next summer.  In the end, everything works out and God has a plan for us all.

There are times when I question my decision to have bariatric surgery and others when I’m sure this is the right thing for me.  I also question my motives as well.  At times I think this is mostly a health conscious decision when at other times I think this is a purely cosmetic/self-esteem decision.  I also think that I’m doing this partly to make other people happy by being thinner and doing it to piss others off because they don’t want me to do it.  It’s all very complex and a lot of emotions and thoughts are swirling through my head.  I can’t wait until it is over and done and it can’t be taken back.  Also, at that time, I will be able to tell more people because they can’t try to convince me not to do it or tell me that they don’t support my decision because it will be too late.

What helps motivate me that this is the right choice is by watching larger people in everyday life.  I think to myself that I don’t want to gain any more weight and that I don’t want to live my life like this anymore.  I see the struggles that they face doing everyday tasks and it pains me because I’m not far from that point.  I also think about what kind of medical conditions that they may have that are associated with their weight.  I also think back to vanity and buying cute clothes, wearing a beautiful wedding dress one day (hopefully), and having babies.

I was watching a program on TV while the kids were napping and it was about supper skinny people and supper large people.  Watching that made me think to myself that bariatric surgery may not be for everyone, but it can be helpful.  Again, I had the thoughts of what I didn’t want my life to be like and what I didn’t want to become.

My health insurance company has assigned me a registered nurse to talk to and a dietitian.  Studies have shown that people are more successful with weight loss surgery if they have a support team.  I will take all the support that I can get.  I guess Aetna figures if they are paying for 90% of my surgery, then it better work.  I also have the support of Dominion Surgical Associates and their team members, the dietitians at St. Mary’s Hospital, and the support groups at the hospital as well.  This all helps in my decisions and choices and will hopefully make me successful post-surgery.  Bariatric surgery is not a cure, it is a tool and used correctly, it can help you lose weight.

I've sent my grandfather a big packet that I made on the surgery and what it entails, hoping that he will come through on his promise to help pay for it.  I'm hoping that by reading about the procedure, he will see that this is a good thing.  I also sent him a lot of information about Bon Secours Memorial College of Nursing since he said he would help pay for that as well.  I hope that it all works out financially so that it will be another burden lifted off my shoulders.

So here’s to a little more than a week to go until the big day and to my new tummy that will look something like this: