Post-Endo Synopsis

Lost 14 lbs since the last time I saw him. Not pleased at so little, but hey, at least it's LOSING and not gaining.

Blood pressure still needs to come down, remained pretty constant around 130/80 (on average), despite losing close to 25% of my overall body weight. But then again? My coffee consumption has (easily) doubled or even tripled since my surgery. Everyone's got a vice, mine is coffee. I'm trying not to be hard on myself, because some folks end up becoming alcoholics post-op, because they can't comfort themselves with food, and liquids are easier to get in, plus post-op it doesn't take much booze to affect you. So, I won't be too hard on myself about the coffee. Plus, it's got magical laxative effects. I could make an argument I drink it for medicinal purposes.

Not sure if my uric acid levels dropped as a result of the post-op dietary changes (unlikely, as seafood and cheese are still being consumed regularly), or if it's from exogenous sources such as the cherry extract capsules I've been taking for the last month. Whatever it is, it seems to be working. Just wish my joints would stop hurting.

Everything seemed to be within normal parameters except for my good cholesterol, but I suspect as I lose more weight (and hopefully when the joint pain gets addressed), I'll become more mobile, and those levels will change. But let's face it. I'm a sloth.

Thinking seriously of putting together a spreadsheet, so I can compare in 3 month intervals, starting the year before my surgery right up to current date, the progress I've made, lab results-wise.

The new-to-me-gyno will be GonzoGyno hereforward. When I saw the endo on Monday he asked about the ultrasound results, of which I hadn't received, even after being terrorized by being handed that pamphlet for Novasure without discussion. I refuse to call GonzoGyno's office. Endo's office got the results for me. 2.5 cm fibroid (tho I didn't get the location of it), and my endometrial stripe is perfect. So I was terrorized for absolutely nothing.

One thing I think SOME doctors neglect to realize is the economics involved in being a patient, and fail to realize that while these assholes treat their patients like a dollar sign or a number rather than treating them with dignity and compassion (subtext: "Do no harm"), they also, by extension fail to realize that the patient, much like any CONSUMER when displeased with the quality (or lack thereof) of services rendered is free to take their business elsewhere.

Life is too short for me to suffer fools. Hence, I'll be taking my endo's recommendation. Granted it means yet another health care provider of mine is in NYC, but it's only 35 minutes away via train; it's not as if it's JUPITER.

Return: December.
Meds get shifted around/changed. June starts our "100 Day Project."

Horrendous Cramps

Finally broke down and slurped some liquid children's motrin (after I ate). Hopefully that little bit is enough to soften the sharp pain. Really don't want to rely on my Lortab...there are times I actually want to stay awake.

Friday's Noms

Mammy and Pappy

Well, at least two tests came back clean!

Day 2 of 7

Day two of no communication from the new-to-me gyno re: results of ultrasound.

Note to self: do a preliminary call to see if the recommended gyno in NYC is taking new patients and if he takes my insurance.

Also: 1 p.m. head to former gyno's office to pick up medical records, because the dolts can't figure out what to do.

24 Days

Yikes. Normally I'm 28-35 days, onset day to onset day.

Today took me by surprised: 24 days onset day to onset day. WTF?

Also: OF COURSE. I *HAD* TO BE WEARING KHAKIS TODAY.

Protip: Dear NYC metro area menstruators, do NOT use Duane Reade ultra thins. While the pad itself is what you'd expect, the adhesive DOES NOT ADHERE. Dear Duane Reade Corporate/Dear MEN in Duane Reade Corporate: Next to absorption, ADHESION is the second most important thing a woman looks for in an ADHESIVE menstrual pad.

Month-long Plateau

That is all.

Preliminary Result

Technician said I have a 2 cm fibroid, and did not notice any other abnormality. She also gave me some feedback that, YES VIRGINIA, this doctor isn't "chatty," and would more likely comment/compliment me on my necklace (WHICH SHE MOST CERTAINLY, FUCKING *DID*) than she would make small talk to find out if I was even interested in having kids or not.

So hurry up and wait until this antisocial twunt calls me back to let me know the full results of the ultrasounding of my snapper.

Who has time to be trifled like this?

Future Recourse

My endocrinologist made a recommendation for a gynecologic oncologist, should I need to seek out a second opinion. And even if I don't require a second opinion (assuming all is clear on my ultrasound and any biopsy and any other diagnostics to be run to determine what is going on with my baby basket), I might still seek out this doctor for a consultation and see if he can be my primary gyno.

I loathe pussyfooting around with a good majority of the medical professionals found in the 'burbs. Who has the time and energy to be trifled with? And if going to Columbia for my gastric bypass, and going to Mt. Sinai for a gynecological consult makes me a snob, then so be it. At least I'm a snob who is alive and well, and has a reasonable quality of life.

It's like that line of dialogue from Shawshank Redemeption, "Either get busy living, or get busy dying." Therein is the rub. Dying a slow death due to negligence (either by me or by an inept doctor) is not an acceptable state of being for me.

Three more days until my ultrasound... well, TWO more and "a wake up."

Ultrasound

Turns out 9/12 is a hot hot day in our office to be out, as two of the remaining secretaries will also be out that day for doctor appointments.

Works out better for me that I rescheduled my ultrasound for this coming Saturday. At least it's two extra days I don't have to be waiting for this diagnostic.

Already sent out an email to my endocrinologist telling him what's going on. Hopefully he'll be able to navigate things, medically, for me; and hopefully he'll provide me with a recommendation for a gynecologist who specializes in this type of thing.

Perhaps I'm a glutton for punishment.

Today is my ten year wedding anniversary, and the "pragmatic me" scheduled a gyno appt, much in the way of how I scheduled blood work for my birthday last month.

I'm finally going to address the excessive pain and excessive mess of my periods. Tomorrow is a mamo. 9/12 is the ultrasound to get an idea of what’s cookin’ in my uterus (i.e. fibroids, cysts, endometriosis? the mind reels, honestly).

Depending on the outcome, I may end up having to go in for a procedure which not only could potentially decrease my ability to get pregnant, but make it even more dangerous (more dangerous than just being 43 with a blood clotting disorder, that is) to get pregnant.

I spent 10 years with the ex, wasting prime baby making years on him, with that marriage imploding the very year we were to start working at starting a family. Yet, there he is, divorced from #2, and with a son who has the very name I picked out for the son we never had.

And here I am 43, rickety, broken down, some days unable or unwilling to take care of myself, and kind of feeling numb, not really sad, that the notion of DECIDING to have a kid was not something I’d have a part in.

My reality I have to come to accept, eventually is, that for me, I never had the luxury of making that decision. Either other people or circumstances stood in my way (poverty in the first marriage; and now post-op gastric bypass here), and here I am at the tail end of that aftermath, with husband #2, who is okay with the idea of adoption if we choose to do so, and I just feel numb.

Time is standing still, somewhat. I can look backwards in time, and look to the present, but left to live in the here and now, and not look forward. Beyond me there is nothingness.

I’m undecided how I feel about this. I love my life. I love my vacations and my husband and my home. I would have loved to have had a kid of my own, and yet, always held back on letting that desire drive me in life. To me my gender never equated to my destiny.

I wasn’t sad when I first started typing this. And now…I selfishly wish my dad were alive today, so I could bury my face in his chest, and we both could cry about this together.

Adipose Apron

Yeah. Mine is now deflated to a large degree, and the skin now stays put if I pinch it. Yes. It stays pinched. Wild stuff. Husband declared I've got ball skin on my belly.

Gone Fishin'

Kinda.

Emotionally and physically taxed, exhausted, spent. Light headed. Legs have a rubber bandy type feeling in the joints. Going into a downward spiral. Going inward. Hibernating. The juices have run clear. The meat has fallen off the bone. I'm done. For now. Just done. Have to work on building my energy back up. Been taxed for over a month, and this is the consequence. Radio silence until... whenever.

Breakfast of Champions

Goin' For Bloods

Getting some lab work done on Friday. Need to avoid my vitamin supplements for 48 hours for an accurate read.

Feeling very drained today.

But on an upnote, nothing says Happy Birthday like going in for lab work! Good stuff!

Tuesday's "In My Pouch"

After Tuesday's trip to see the surgeon for my six month
post-op visit, I was on a never-ending, rainy day
odyssey to stores "not open yet" or closed
for the day.
Pictured above: Grilled beef satay which was
consumed after having a cup of tom kha gai,
at Long Grain (aka Lemongrass Grill) nr. the
92nd Ave subway station.

Not pictured: Bevvy of items procured at
Murray's Sturgeon (aka "The Sturgeon King").

So if you like rhyming or aliteration:
After the surgeon, I went to get sturgeon. :)

6 Month Visit w/Surgeon

No news is good news.

No vitamin deficiencies.
No pain or problems related to incision sites.
No gastric distress.
No limitations on the variety of food I eat.

Nurse practitioner appeared impressed with my progress and my state of being, as well as the strategies I use to get thru my day.

All in all a good visit. Next visit: February.

So, after the surgeon, I treated myself with a trip to the sturgeon, or specifically, Murray's Sturgeon (aka "Murray the Sturgeon King" by locals). Well worth the trip. The smoked whitefish salad is so good, I get weepy thinking about it. :)

Waxing Bartholian...

TMI

Bartholin's cysts hurt like a mofo.

That is all.

Another Small Victory

I put on a size 18 skirt this a.m., only to have to make another wardrobe choice, given the fact that even ZIPPED UP, the skirt slipped off my hips with ease.

While this makes me happy at my progress, I am somewhat annoyed now that I'll have to get some things altered if I want to wear them this summer. :)

FIRST WORLD PROBLEM!

My Left Foot

Yep. I've got gout. Had it for a while. Flare ups come and go, and are quite agonizing. I was hoping that the surgery would help my uric acid levels. So far, six months out, and no change.

Going to have to wait until I see my endocrinologist (in two months) before anything is done pharmaceutically speaking, for it. I'm starting myself on tart cherry extract, and hoping it'll help.

I get my bloods done a month from now, so a month should be a good indicator of whether it's working or not. Thinking good thoughts.

The pain isn't isolated to the metatarsal-phalangeal joint (left foot), but also higher up on the instep, where I also am suffering (Dx'd by my podiatrist) post-traumatic osteo-arthritis at the site of a fracture I sustained 35 years ago, which happens to have burrs/spurs at the fracture site (never healed smooth).

Between the gout and the fracture issue, it's a perfect storm of pain in my foot.

Note to self:
5/27/11
Uric acid level: 7.2

Let's see what August's figures will be.

Breaky Noms!

Total thus far: 65#

Made a small batch of these last night.
Essentially they are eggs baked in mushroom caps, with a little pecorino
and prosciutto, and minced scallion.
Calories 130-140 approx.
Protein 11-12 gm, approx.

Recipe:

6 large button type mushrooms, destemmed
6 large eggs
Pecorino cheese (1/2 tsp per mushroom cap)
Prosciutto (1/2 oz per mushroom cap)
Scallion minced (a few pinches per cap)

Procedure:
Preheat oven to 350 (thereabouts, I really don't remember!)

In standard size muffin pan, spritz with Pam or other aerosol type oil spray. Place mushroom cap, top side down, in muffin pan. Spritz that, too. Sprinkle a little black pepper on it if you're so inclined.

Sprinkle mushroom cap w/1/2 tsp. Pecorino cheese (Yeah, yeah, you can use parmesan or even grated swiss; but I wanted pecorino). Crack egg into it. Sprinkle w/scallion, and layer prosciutto over the top.

Bake for 30 minutes (thereabouts) until the egg is set.

Enjoy.

Relating Entirely Too Much To Fat Bastard

Blessed are you, Flying Spaghetti Monster, Noodle of the Universe,
Please.
I beseech thee.
*DO NOT* Vaginatize my neck if/when I lose the next 60#.
~Raaaaaaaaaa-men!!!

Vending Machine Temptation

Now in workplace vending machine: Not as lethal as you'd think.

90 calories for less than an ounce of brownie. Meh?!

Taste-wise it's "good enough."

Worth noting: Negligible nutritional value. Not "nutritionally compact." Net carbs: 13. Meh. Protein: 1 gm. Kinda disappointing. Tho it IS low in fat. However, I can see a use for this on knit nights when we go to Paneras and there's NOT ONE TREAT I can reasonably enjoy. So into the knitting bag this goes (and I'll check at Sam's to see if they carry these, so I don't have to pay vending machine mark up for this stuff).

Four bites and it's gone. It's about as much of a brownie as White Castle sliders are a "burger." It's more "brownie-esque." But fuck. It's chocolate, and I can jam it into my food hole after I drink some tea in a social setting.

A Fistful of Hair

Nails are healthy. Then why is hair shedding by the fistful daily?

See also: The fistfuls of vitamin supplements I take daily (including but not limited to: calcium citrate, biotin, alpha lipoic acid, extra magnesium, B12, D3, iron, omega-3, flax seed oil, evening primrose oil, extra vitamin C, and when I have it on hand, spirulina.)

For What It's Worth

My gastroenterologist (not to be confused with my bariatric surgeon), has given me the okay to commence aspirin therapy.

It's a calculated risk.

I do a lot of air travel. I worry about getting a clot in my legs from long flights, of which I'm at a higher risk for due to having Factor Five Leiden Mutation. Never had a clot or stroke, so why push my luck? Additionally, aspirin therapy is good for cardiac health. And let's not forget about the whole anti-inflammatory thing!

I'm actually thrilled to be taking my baby aspirin every day, and make sure I stagger time between other medications; I don't take it with coffee or vitamins; and if I'm taking the chewable, I make sure I do so on a full pouch.

Being pouch responsible.

Calculated risks... isn't that what life is all about?

Today's Supplements

Perhaps one of these days I should post an itemized list of which vitamins and their corresponding dose, which I ingest daily.

Perhaps.

Newsflash: I'm feeling bold. As I approach my five month surgiversary, I feel somewhat confident about dropping my daily stool softener from 2 capsules a day down to 1.

Note: Yep. Those gel caps are pretty big. Bigger than an M&M (the size the surgeon told me not to exceed with tablets). I find the gel caps go down without incident, plus I suspect they dissolve pretty quickly given I take them with hot tea or hot coffee.

A Few Pics!

How my day normally starts... a fistful of supplements, stool softeners, and a hot cup of tea!

Tho on vacation last week (cruise from Seattle to Alaska and British Columbia),
I neglected to show off two things consumed
(tho not in ENTIRETY!) on vacation:

(Gotta love buffets, I can load up, then just pick at it!)

Perhaps in the future, I should snap a before and after pic, so you'll see I don't eat it all. Perhaps. But then again, I'm inherently lazy. Act surprised if/when it happens.
In no particular order...

The pineapple chicken dish the hubby had at Mae Phim Thai, Seattle.
(I had two bites!)

The nommy Yum Talay I had at Mae Phim.
After I had a bowl of tom kha gai, I only
had enough room for four bites of the Yum.
Broke my heart. It was delicious!
I want to move to Seattle JUST to eat
at Mae Phim every week.

For the record: WITHOUT A DOUBT
THE BEST THAI WE HAVE EVER HAD!!

And lastly,
The only photo worthy meal on the cruise itself.
Had this in one of the dining rooms.
Lobster tail w/tilapia, with steamed veggies.
For once, "Nouvelle Cuisine" sized
portions don't annoy me anymore. :)

End notes:
Cruise line: NCL
Ship: Pearl
5th Cruise we've been on; 2nd cruise w/NCL

58# Lost

Nothing else going on here! Other than I was in Seattle, Alaska and British Columbia, only to come home and be out of commission for about five days with "teh respiratory ebolaz."

Mood: Lungular.

I believe I've been abducted by aliens.

Perhaps!

I got to bed almost by 3 a.m., so you'd think I'd be a bit "out of it" all things considered.

For the first time in hmmm, almost three years (it'll be 3 years in July-August), I woke up, and got out of bed before 8 a.m. (actually by 7:45, which is UNHEARD OF for me). Had a leisurely cup of coffee, packed up my lunch bag, and even managed to shampoo today and got the husband off to the train station pretty damned close to "on time."

Productive. Alert. A little ranty and rambling, but, I think I'm doing LIGHT YEARS better than I was on "the junk." I even *GASP!* stayed on my exercise bike about 40 minutes last night. WHO THE HELL AM I? :)

146.5 hours since my last dose of Effexor, and so far so good. Still cold turkey.

Epilogue to Last Night's Rant

Found the missing container in question.

It was in the freezer.

120 Hours Sans Effexor

Please don't preach to me. I went off it cold turkey, and so far I haven't looked back.

So right about now, I'm shall we say, EDGY. I can't stand being touched, and there's no reasoning with me at the moment. Work tomorrow is going to be a true joy. NOT!

I need to get to some specialist, which one? I haven't a clue at the moment, to get a handle on defining, with certainty, WHAT EXACTLY DO I HAVE (bipolar? who knows), because psychotherapy, I do not believe is helping me. And medication isn't helping me at all. Each have run their course, and I have hit the proverbial wall.

I have all this good stuff happening in other aspects of my life as it pertains to my weight loss: the weight loss itself, improved health (allegedly), and this one's more for others (I think I'm cure as is), but folks tell me it makes me more attractive. WHATEVER. I just want to get the fuck off medications.

My reproductive endocrinologist had alluded to me that he might put me back on metformin for my PCOS (my A1C and fasting glucose are (and have been) within normal parameters for a while). This distresses me. Every pill I pop, I worry about what it's doing to my liver.

Oh, I'm rambling. Get used to it.

I got tired of being a zombie. A foggy-headed zombie. I had zero focus (hence my inability to follow a relatively simple crocheted sock pattern, frogging the toe FOUR FUCKING TIMES). Paranoid, fatigued, even more depressed than I was to begin with, mysterious intense aches and pains, unable to take my tramadol for my arthritis since it would interfere with my effexor (contraindicated: SEIZURES allegedly will result). Additionally, I got tired of waking up thinking to myself, "Fuck, I didn't die in my sleep" and be genuinely disappointed! No one seems to give a shit about this. Got tired of the lethargy. Got tired of fighting with the husband in the a.m. Got tired of constantly making him late due to my lethargy and my befuddled disorganization in the morning. And the bottom line is. Let me lose my job, not him.

So there you have it. In a lot of aspects of my life the effexor was simply not helping. It helped to a point (i.e. got my grief stricken crying jags to taper off--dad passed in 2008, and I didn't stop crying until roughly 2009 when I switched off my Celexa to Effexor), but, so too, did Zoloft and Celexa in the 1990s; and Celexa and Lexapro from 1998-2008. Hell, I even went on the anti-seizure medication Topamax, because my endocrinologist* said it could help my migraines and have a magical effect on my weight. Nothing magical happened. The first week or so, I was fine, and just didn't give a shit about anything. Then the second and third weeks I titrated up, and things got a bit hairy. Very (inwardly) hostile and paranoid. That's no way to live.

*Endo recommended it; however, I did go to a neurologist who was the one who examined me and prescribed the Rx.

Ultimately, I'd like to get off every medication I currently am on. None of it is worth a god damn, imho. I'm tired of "robbing Peter to pay Paul" and trading off one or two sets of symptoms for an equally loathesome set of side effects.

*Popping 50 mcg of melatonin*
*Continuing with tonight's prattle*

Ever see the movie Airplane! ? Remember the scene where Lloyd Bridges' character does that bit about, "I picked the wrong week to give up.... (fill in the blank: cigarettes, cocaine, sniffing glue)" ? Well that's a fair assessment of how I feel right this moment. I'm about one day away from the Gates of Almighty Hell opening up and flowing out my uterus, we're going on vacay sometime very soonish, and yeah, I picked the wrong week to get my fucking fat ass off Effexor. BRILLIANT! JUST BRILLIANT!!!

*Now for tonight's scheduled downward spiral.*

So anyway, the thing which precipitated me prattling all this off here? Oh yes, I'm packing my lunch for tomorrow. I'm a bit obsessive about my lunch bag and bento box and all my little accoutrements/amenities to make my lunchtime BEARABLE, and to ensure that I remain in the habit of packing healthy lunches to remain "compliant" in my post-op lifestyle change.

Well, I'm totally undone. So undone I had to "self-medicate" with a sugar free pudding and a hot cup of tea to "regroup."

I have a box. One of those Fit and Fresh lunch box systems, where there's a larger box, which is large enough to put stuff in the bottom (like a sammy), then there's an ice pack insert, then there's two smaller self contained boxes to sit atop, and a lid to keep it all together. I am a creature of motherfucking habit. I eat. I clean the box. I put it back in my bag. It's a no brainer. Unless, I didn't clean it, in which case, the self contained insert boxes went thru the dish washer.

I looked in the dishwasher.
I looked in the cupboard.
I looked in my project bag for my crochet.
I tore apart the fridge.
I looked in the basket where I keep all my smaller bento box items when not in use.
I looked IN my lunch bag.

This particularly sized insert box is now missing. Which pisses me off to no end. Seriously. My household has only two people in it. Where the fuck could this thing have gone?* I'm furious on a lot of levels.

*We're now suspecting it fell off the counter and into the plastics recycling bag, which, of course, as fate would have it, was taken out to the dumpster DAYS AGO. BRILLIANT! FUCKING BRILLIANT!!!

Some folks may think I might be frivolous about some things, or even possibly come off as I don't know, perhaps well-to-do? I don't know. But I don't mind spending some cash for quality things (i.e. good work horse clothing which will wear like iron for YEARS, good shoes which don't hurt my feet, good natural fiber yarn to crochet with, and lastly, good food); however, it sticks up my ass sideways (WITH BURRS ON IT!!!) when I have to continually replace items because I cannot find the shit I am looking for. It's this very phenomenon which causes me to have:

10 Hair brushes
Dozens of hair clips and pony tail holders (apparently the husband had been tossing my pony tail holders in the trash when he'd find them, and not know what they were)
3 pairs of flip flops
10 umbrellas
COUNTLESS totes and shopping bags
More looseleaf tea I could shake a stick at.

I worry that when I finally do die, and folks are going thru my possessions, they're going to think I'm OCD or something, or a hoarder, when the reality is, I live with Felix Unger, who insists on putting shit away in such a manner where I cannot find MOTHERFUCKING JACK SHIT when I need it.

Note to those who will go thru my possessions, post-mortem: The only thing you will find that is eccentric which was intentional, will be a box of hair. January 2012, I will be collecting my hair I shed, so I can document how much I lose on average, annually. Just because I'm curious. Afterwards? I don't have a plan for it. Perhaps a needle felting project. I don't know.

And mind you, those are just things that I can think of off the top of my head which I *KNOW* I have replaced. I absolutely LOATHE having to make unnecessary purchases.

SO yes. I go to Amazon, ISO replacement cups for my Fit and Fresh lunch box system thingy. Can't find them, but find some 2 cup capacity thing marketed for kids, which isn't what I need. SO I go to the Fit and Fresh website, thinking the manufacturer surely has the option to buy replacement "parts." Well, apparently, Fit and Fresh defines "replacement parts" as the ice pack inserts, because with ONE exception, every replacement part on their replacement parts page are... you guessed it... ICE PACKS.

So, if you're still with me here, and didn't bail out in paragraph oh... I don't know... TWO? The only option I have now to get ONE REPLACEMENT ONE CUP CAPACITY CONTAINER is to buy an entire lunch box system, which I don't need.

Oh this reminds me of my 32 oz capacity Assam pot by Bodum. The plunger broke. They don't sell replacement plungers. WTF. So They sent me a replacement pot. Lovely, right? Well the fucking pot they sent me wasn't the 32 oz pot, it was a "tea for one" individual pot. I didn't even bother sending it back to get the correct pot, because that's too much fucking effort invested already... when all I needed was a fucking replacement plunger.

Perhaps I've said too much.
Perhaps I've lost my audience with this rant.

Fuck ya's. I'm going to bed.

My Tracker So Far

Four Month Surgiversary

Not much to report! Or is there? You be the judge.

50 lbs lost thus far. AND HOLDING. Currently in a plateau.

The impaction issue seems to be abating somewhat. Turns out edamame was the key to unlock that problem, tho I am still taking 2 Dulcolax daily until I feel confident that the impaction issue has passed (excuse the pun) entirely. Nearly 4 weeks since the last impaction episode.

33 Hours since my last dose of Effexor. I've decided to go cold turkey off the junk. I felt like I hit a brick wall as far as it being effective for me, and if anything, I felt paranoid, depressed to the point of barely functioning, and felt *DULL*.

Something had to give, as it were, and I just can't function anymore. If this means that the crying jags come back in full force, so be it. Because I know if the crying jags come back in full force, that also means my productivity and creativity will be back in full force, too. I thought I would be headachey and irritable without the Effexor. But so far, so good.

Once I actually start to feel better and BELIEVE I FEEL BETTER, then I might be able to muster up the strength and "give a fuck" to make other necessary changes in my life (such as quit my fucking miserable job).

My weight loss has brought good things: the loss of the weight, increased good health, improving my appearance (so superficial to even mention it), as well as increased stamina for walking and endurance. It's even brought my husband and I closer together, as he's a willing and capable participant in my new lifestyle. Funny thing is, he's 135-145 lbs. The man doesn't NEED to lose weight, and ... well, he's losing weight vicariously through my weight loss surgery.

So many good things happening, and yet my depression has gotten the better of me, to the point where I barely have the energy or motivation to get out of bed in the a.m., with my major daily accomplishment being: Getting up. Getting washed. Getting dressed. Dragging my ass to work. Only to come to work, be miserable, foggy-headed, unfocused, miserable, unproductive, miserable, alienated, strung out, miserable... are you sensing a theme here?

So I'm hoping getting off the junk will help at least clear the fog out, make me more productive, and give me some modicum of a sense that I've accomplished more than being a bump on a log with a pulse. Besides, I've got shit I need to do at work (i.e. WORK!!!), which, sadly, I've been great at masquerading and appearing productive and busy, but not really accomplishing anything. I'm so distracted and alienated at work, coupled up with my depression and fog from the medication, that I can't stay on track to finish anything. So this is another level of dread I have about the work place, above and beyond the lack of professionalism (to the point of it being a hostile work environment, IMHO).

Once I clear my head, I need to tackle this problem head on. The resume has been dusted off and emailed out, and I've put out feelers to some folks to keep their eyes open for anything that they think might be suitable for someone with my particular talents.

I also hope to get more active. But this will necessitate two things: 1. The motivation factor (see paragraph devoted to me getting off Effexor); and 2. Getting a handle on my pain (can't take Tramadol if I'm on my effexor, which leaves me few options to help with my pain, since NSAIDs are verbotten post-op). But every once in a while (subtext: every other day or so) the husband is successful in getting me to get on the recumbent bike, and I pedal for about a half hour.

This weekend, he introduced me to Tamilee Webb, and got me to do her 10 minute arms on Saturday and Sunday. I wouldn't mind doing THAT every day! I felt good and tender after (days after, not immediately after doing it), and thought to myself I could manage exercise in 10 minute increments. I mean, I'm not THAT lazy that I can't manage it. So pain notwithstanding, I hope to get addicted to Tamilee Webb like my husband is.

Also worth mentioning, I got my first bag of Caramel calcium chews from Bariatric Advantage, and they are very tasty! I don't do chewables for all my calcium needs. For me, I like to have something sweet with a hot cup of tea and I take my chewy chews then. It's a nice change of pace from my other supplements I use.

Impaction Chronicles: A Soliloquy For My Ass

To prune or not to prune

that is the question:

Whether 'tis nobler in the mind to suffer

The slings and arrows of outrageous impaction,

Or to take arms against a sea of TP,

And by opposing end them? To flush, to poop

No more; and by a poop to say we end

The fart-ache, and the thousand farty after shocks

No fresh air to: 'tis a flatulation

Devoutly to be wished. To flush, to poop;

To poop, perchance to dream – ay, there's the rub:

For in that flush of poop what dreams may come,

When we have extruded out the mighty coil,

Must give us pause – there's the respect

That makes calamity of no poop, strife.

For who would bear down the whips and scorns of time,

The impactor's wrong, the proud man's epic continence,

The pangs of despised assblood, the log's delay,

The insolence of orifice, ASS! it burns,

That patient merit of the unworthy takes,

When he himself might his quietus make

With a bare bottom? Who would flatus bear,

To grunt and sweat under a weary strife,

But that the dread of something after death,

The undiscovered country from whose bourn

No turtlehead returns, puzzles the will,

And makes us rather bear down ills we have

And fly to other stalls we know not of?

Thus manual-disimpaction doth make cowards of us all,

And thus the native hue of resolution

Is sicklied o'er with the pale cast of thought,

And enterprises of great pitch and moment,

With this regard their currents turn awry,

And lose the name of impaction. Soft stool now,

The fair Orifice! Nymph, in thy nether regions

Be all my sins remembered.

*FLUSH!*

(C) 4/25/11 "Maven"

Poo in Review

Held hostage today in the handicapped restroom.

Had to manually disimpact to free myself from my captor's clutches.

Note to self: get disposable rubber gloves and keep in desk at work.

PS: Also get stool softener, and stop living in denial that you need it.

2 Days W/out Movement

So yes, another poo related post. I want to illustrate the divergent differences between my pre-op and post-op poo procedures.

Pre-Op:

I get the urge.
Go to bathroom.
Sit down.
Evacuate the soft-serve.
Leave bathroom within 5 minutes.

Post-Op:

I get the urge.
Go to bathroom.
Sit down.
Bear down hard.
Take a breather.
Rub knees.
Bear down a bit more.
Take a breather.
Give self a pep talk.
Press pressure point on hand which is supposed to magically release the Krakken.
Bear down some more.
Do toilet yoga, bending and contorting this way and that, hoping to leverage the fecal leviathan out.
Take a breather.
Pinch a few times.
Take a few deep breaths.
Wipe.
Thank the universe.
Leave bathroom.
Estimated time held hostage by my feces: Half hour (+/-).

Today: 248.5

Things I'm Tolerating Thus Far (5 Weeks Out)

All meats & fish (except for whole cuts of meat; haven't tried steaks yet);
Grapes (w/skins)
Apples (w/out skins)
Bread
Butter
Crackers
Almonds

Eggs, however, sit in my pouch like a lead ball.

The Poop Report

This is my last Poop Report until such time it changes:

It's not a fluke. I REPEAT. It's not a fluke. It's a trend. I'm regular again. Maven: 1; Impaction: 0.

Here endeth the Poop Report.
#itonlytookfiveweeks

Open Letter to My Colon

Open Letter to My Bung:

Wait a cotton pickin’ minute. Srsly.

A BM yesterday? A BM today? Doesn’t take much to please me these days. Pls don’t lead me on and let me down tomorrow. I’d rather cut off a pinky toe (with polish!) rather than go one more week of unpreditable, paining, straining ahem “activity.”

Colo-rectally yours,
Maven
________________

Today was the 5 week post-op visit w/the surgeon. All went well. Only a miserable .5# lost since the 3 week visit. He told me not to get hung up on it, and that plateaus happen. Next visit: April 19th.

Lunch Today

Nutritional content of this serving suggestion
Cals: 171.35/Protein: 10.95/Carbs: 10.813

My home made chicken liver pate stuffed in a mushroom cap, multigrain crackers, sugar free gerkins and 1/2 a hard boiled egg w/Old Bay seasoning on it.

NOM.

Desperate Times Call for Desperate Measures

Dear Colon,

It's not me, it's you. Something's gotta give, and by "something," I really mean YOU, and by "give," I mean a regularly occurring bowel movement which involves neither strain nor pain, and doesn't leave me wondering if I need to go to the ER.

It was fun while it lasted, (FOUR WHOLE WEEKS)but really, your behavior is just "asking" for it.

Yours in firey rectal revenge,
Me.

Things I'm Tolerating Thus Far (3 Weeks Out)

Omlettes/eggs
Meatballs
Peanuts
Turkey Jerky
Cheddar Cheese (regular, not low-fat)
Dim Sum
Clam Chowder
Bread (w/butter)
Coffee
Sushi
Seaweed salad
Steamed, chilled shrimp
Grilled chicken on a stick
Salad greens

Three Week Post-Op Follow Up

Alrighty, I've been a bit remiss about posting how my three-week (which really should have been my two-week) follow-up with the surgeon went.

For starters, it's a huge-o-la PITA to get to his office. My choices aren't great: MetroNorth to (East) 125th, then either find a cab or a cross town bus to (West) 125th to take the #1 all the way up to 168th. But really? I don't feel *safe* at East 125th. So I took the most convoluted route, because my other option would have been to drive into NYC, and well, that's just something I. DO. NOT. DO. (or at least something I do not do AT THE MOMENT) So the route was MetroNorth to Grand Central, passing 125th en route, Grand Central to Times Square via Shuttle, #1 all the way back up town to 168th, passing 125th a second time, then walk to 165th for the appointment. I was exhausted before I even got there.

Considering my "impaction" issues I've been having lately, I grabbed the smallest cup of coffee I could from a street vendor, thinking it would help loosen things up a bit so I could purge more before my weigh in. But no such luck.

First up, they made an appointment for me with "their" nutritionist. I have to say I am glad I went with my first impression ("Blink" really made my life a lot easier by going with my gut instinct instead of thinking too long or hard about things). Her personality (such as it is) is dry, I did not come out of the appointment with any further information than I already had (or anything else that MY nutritionist did not provide on Tuesday), suggested I take in Benefiber 3x a day, and then admonished me for being "non-compliant" when I said I was already integrating soft foods into my diet, a few days before being officially transitioned. WTF.

Then I met with the surgeon and a "fellow" (who assisted with my procedure), who is in training to learn how to do bariatric surgery. The consultation went very well. I'm healing nicely. The time with the doctors was very positive and uplifting.

Talk ranged from concerns about my arthritis (and yes, I can take children's liquid motrin now if the pain gets THAT BAD, provided I take a prilosec first), my impaction, my energy levels, and yes, I came clean on the fact that I was already integrating food into my daily intake. Surgeon seemed actually jazzed about this, and didn't blink or react negatively when I said I was eating things like peanuts or turkey jerky. If anything, he seemed pleased that the things I was eating were protein intensive.

The surgeon progressed me to where I can take my medications uncrushed (yay), provided they are no bigger than the diameter of a pencil eraser. So another benchmark for me. Great!

The overall vibe of the meeting was good, supportive, friendly, "light," and the surgeon obliged and removed the last two steri-strips which I was afraid to just yank off. Suture sites have all but healed up at this point.

Had lunch at Nice Matin. Appt w/the surgeon was great, and I was invigorated, and felt I owed it to myself to celebrate. So I treated myself to "brunch." Had their veggie/sausage frittata and coffee. Sipped coffee until right before my meal arrived. Then I took my time, sitting in the sunny window, people watching then reading my book. Sitting there with my "Jackie O" styled sunglasses, trying to get into a "South of France" mindset (afterall, I *have* visited NICE, FRANCE in 2008). Envisioned myself a french woman, and took small bites, savoring my food. And I'd say maybe I ate 1/3 of that frittata, maybe 1/4. But it's not like I had a scale on hand. I eyeballed it. I also had some of the soft part of a piece of multigrain bread (and YES I put butter on it). Took my time. Eventually had the waiter pack it up for home, then asked for a container of the soup du jour for home. Continued to sit there long enough until I could sip a little more of my coffee. Really enjoyed this.

Also, while there, I found out about the "Stinky Cheese Festival" which is coming up. I hope to go back to Nice Matin for lunch. I've already picked out what I want to eat: "Limberger Steak Hache." I can't wait. I can get maybe 3 meals out of that burger. This new lifestyle of mine is really appealing to my sense of thrift. Rather than snarfing down one meal and not be satisfied, now I'm eating considerably less, enjoying it more, and have enough leftovers for 2-3 meals. WIN WIN WIN.

Oh? And FWIW? I ate four mini-meals from that frittata I ordered. I have to say that this really appeals to my thrifty nature!

After lunch, I yarn shopped, and went to the drug store, and ran some smaller errands, all the while I could feel my custom orthodic shift in my boot, causing a sore spot on my heel (left foot is smaller than the right). Going to have to get some moleskin to snug it up in the boot.

So I continued the subway route in reverse, and while on the Times Square shuttle back to Grand Central, the car was full of high school kids, acting very ghetto and foolish. At first words were said back and forth (the most ridiculous and low class was a girl saying "Suck my dick" and dropping the F-bomb repeatedly), which then progressed to a shoving match between the two groups of teens. Mind you, I'm sitting dead center between the two groups. At first I thought it was just horseplay, but once out onto the platform fisticuffs broke out, with the two groups of teens totally unaware that the rest of the world was trying to get the hell out of their way.

Lunch!

2 oz steamed shrimp w/old bay

1 oz wakame seaweed salad

The Poop Report

Rather than go into the particulars of today's *ahem* movement, I've decided it best to share what I call "hai-poos," which is to say, haiku about POO.

*AHEM*

Oh puckered o-ring
Bearing down, extrude! extrude!
Won’t you stop throbbing?

Throb, throb, throb, throb, throb
Flames, shooting out my ass, still
Still throb, 9 to 6.

A total standstill
My G.I. tract a dead end
Did I eat concrete?

Strong Firey Krakken!
I once knew your name very well!
My ass has grown mute.

DEMON DOWN BELOW!
Breach birth’d anal alien
Tear me limb from limb.

Such a cosmic joke
Anal. Hellfire. Damnation.
Won’t sit right for days.

On every third day
I have to birth a demon
It holds me hostage.

Note To New Readers

If you haven't dug thru my archives, here's a tidbit of what I've been dealing with in regards to my PCOS. My testimonial is about five years old at this point, but gives insight into how I eventually decided on my WLS.

Day 15 Out

Woke up exceedingly dizzy. The room spun HIGH SPEED, round and round. Had equal amount of nausea but no vomitting. A bit shaky and scared. Husband still went off to work, leaving me by myself.

Sat for a while watching t.v. w/a bowl in my lap just in case I hurl, then went to bed around 10 a.m. until almost 4 p.m. Feel a bit better, tho not 100%. Called surgeon's office to talk to NP, no call back.

I've put myself on clears until I feel a bit better. Even my shake seems off putting.

Not hungry so much as I am parched, and concerned.

"The Easy Way Out"

Some folks out there, I'm sure, think of WLS as something folks slink off to do... the easy way to dump off weight.

To me, there's nothing easy about it. Sure, it's great that the surgery (for now) seems to have curtailed my ravenous appetite; however, there's nothing easy about those times during the day when I take in my purees. One ounce, one slurp, and pretty much it's gone. There's no savoring. These are called "mini meals," but to be honest, if the total volume of your "meal" is less than that of a shot glass? That's no meal. What it is, is the dietary equivalent of Chinese Water Torture, slowly killing your will, one drop at a time.

Two Glib & Fatuous Sayings I Do Not Need To Hear or Read

Two glib and fatuous things NOT to say to me (now or ever):

"Nothing tastes as good as THIN FEELS?" Well, ya wanna know what? Nothing tastes as good as a rib eye, roasted to perfection, served with its own juices.

“Pre-op you were living to eat, and now you’re EATING TO LIVE.” This, too is bullshit, because slurping down one ounce at a time (every other hour) is neither eating, nor is it living.

Pls. STFU, then FOADIAF. Oktxbai.

Pre-op/Post-op

A glimpse of my pantry, as it appeared, "pre-op."

Here's a picture of it now, post-op.
If I think about this too long, it'll depress me.

My Intake Schedule

ETA: This schedule has been modified very slightly since

the time I typed it into an excel spreadsheet, but this

is pretty much the format I am following the first month.

In Summation: The First Week (TMI)

1/19/11: 275
1/21/11: 280
1/22/10: "Onset day" (That dirty bitch, Flo!)
1/25/11: 261

One thing I don't think I was given adequate warning for was something as simple/basic as a daily bowel movement. I never thought to ask my surgeon exactly what to expect (really there are so many more pressing details to focus upon), and now that I'm in "the thick of it" it's affecting my daily living. And I guess will continue to do so until me and my body establish and re-define exactly what is "normal" for us.

• Day 5: Had 2 doses of milk of magnesia with zero effect.
• Day 6: Husband administered *shudder* an enema, which elicited lackluster (imho), and I might add, it also broke down what little "mystery" was left in our marriage.
• Day 7: I spiked my protein shake with 2.5 tsps of flax seed oil to help counteract the constipation; Zero poo activity. (Tho, I will be boosting this to the full 1 T. dose on the bottle for my next shake that is mixed up.)
• Day 8: (Today) Evacuation completed, no other intervention, tho it was "time consuming" and bordering-on-painful to do so. Pre-op, if I had the urge to go, I had to heed it immediately or suffer the consequences (I always suspected I had a "touch" of IBS; but really? It could have been the metformin--note: I'm not on my metformin for my PCOS, and probably won't resume until after 5 weeks, when I follow up with my endocrinologist, so that's a factor here too.).

Here endeth this week's Poop Report.

Day Five

I’m on liquids and purees at the moment. Will be for a month. I’m risking it right now, as I’m drinking my first bit of coffee in all this while, hoping it’ll help with my headache (as well as my constipation).

I’ve had a horrible headache that (believe it or not) the hydrocodone isn’t even helping. Additionally, I came home just in time to have my period. Between the headache, the period pains (mine get worse each month), and my neck/shoulder/back spasms, I’m in quite a bit of discomfort.

Oh, and I have a horrible rash on my buttocks, which I've scratched RAW. It's an unrelenting itch.

Today, I take off my bandages covering the sutures. The adhesive is now irritating me. Oh and I have a bad rash on my bum!

I’m a wreck, eh? :)

Operation was a success. Surgeon did not even order up a leak test to see if the pouch leaks. He’s that confident that it was great. Also, I stayed in the hospital an additional day, and was on purees before I left, so if I had any problems, they would have taken care of it before releasing me.

I am just wishing this first post-op month to go FAST. :)

Three Days Later...

I'm home.

Ow. Ow. Ow.

The surgeon removed the gall bladder and repaired my hiatal hernia in addition to doing the gastric bypass.

I'm alternating between feeling sucker punched in the gut, and feeling like the cross county bus hit me and dragged me for a few stops. The thing that surprises me is how winded I feel, and how it hurts to take a deep breath. I wasn't expecting this. Not complaining, just making note of it.

Also fun and newsworthy: Came home just in time for my period to start. Some folks told me this would happen "because of the stress of the surgery," but to be honest, I believe it's just happening because my last onset day was 12/25, so I'm "due."

Headachey. And throat now is feeling horrible. Time for some hot tea and more relaxation.

Oh And For What It's Worth?

Looks like after all the struggling and whining, I may have lost about 7 lbs in the two weeks I've been on a modified fast.

Starving... for seven measley pounds.

::SEETHES::

T-Minus 16.5 hours (Thereabouts)

About 12 noon tomorrow is when they slice 'n dice me.

EFFEXOR DON'T FAIL ME NOW!

Packing list thus far (and this is being modest):

Back Brace
Bathrobe
Book, magazine and/or portable crochet project to fight boredom
Boroleum (ointment for nose)
Carmex/Chap Stick
Chlorox wipes (hey, I found a travel pack)
CPAP
Cell phone
Day Planner
Identification
Inventory of medications and supplements
Lipstick (Hey, trying to make a silk purse out of the sow's ear that my hospital stay will be)
Little can of lysol (because let's face it, hospitals are filthy, skeevy places)
Menstrual supplies (just in case I gush post-op)
Moisturizer
Moisturizing mouth spray
Pajamas
Slippers & socks
Thermacare heat wraps
Toiletries
Underpants
Water bottle/Crystal lite packets
Wet Wipes

Last Minute Nesting & Errands

Headed out today for a dental cleaning (and then later, a pedicure & manicure) pre-op, figuring I couldn't do so for at least a month post-op due to the blood thinners. Chiropractor. Grocery. Dry cleaners. Supermarket for things we didn't get at Whole Foods on Thursday night. Japanese market for some stuff. Then off to BB&B for a microwavable rice cooker (one of the best inventions ever). Came home and promptly put up dinner for the husband. Otherwise been vegetating a bit here.

But one good tidbit I managed to get from my dental hygenist was that folks who are on a high protein diet or who use high protein shakes should really use electric toothbrushes, as the proteins fuse to the teeth, thus causing a rapid accumulation of plaque/tartar/calculus/whatever. Useful information! Once I go back to work, I should make a point of brushing after my morning shakes.

Color on toes: Linkin Park After Dark by Opi.

Mood: Resigned, yet relaxed. There will be plenty of time for me to have a HOLY SHIT breakdown before the 19th.

Not sure how much more prepared I should get. Bought more broth, Jello, and some Gatorade. So far this has been a lot of $$$; but fortunately for me insurance covers the procedure, so I guess things could be far more expensive.

Last things to work on:

Overtime report for work (going to compile and format it, then email it to a coworker to print out);
Pack bag;
Phone-in appt w/therapist on Tues;
Drop off paperwork at office on Tues;
Drop off/pick up laundry tomorrow;
Sit and knit with some friends tomorrow;
Clean CPAP, mask and hose to make hospital ready.

Today's Craving

Seaweed salad
Icy cold scallop w/roe sack & connective tissue attached

Intense Cravings I've Had This Week

In no particular order:

Pork shumai dimsum dumplings
Deviled Eggs
Macaroni salad
BBQ Ribs

Something To Be Considered Down The Line

Note to self: Donate professional wear to: Dress For Success.

Avert Your Eyes. Whining Ahead.

Last night, I opted not to have my third shake, nor my yogurt, nor my fruit as is allowed in this "modified" fast I'm on to shrink my bloated liver, to avoid problems or injury during my surgery next week.

I was just so depressed and disgusted, I brushed my teeth and went to bed. Woke up with a headache and an aggressive mood swing, rendering me into a fit of tears. I stood in the bathroom after my shower, sobbing, putting my forehead on the wall, sobbing uncontrollably, and wishing it were my father's chest rather than the wall, as that was how he'd comfort me, standing, in a hug, letting me sob into his chest.

Great way to start the day, get out of the house and interact with people, starting the day wanting to be dead.

So, I was so hungry this a.m., I had my only solid meal at breakfast, which I know will come back and bite me in the ass, as it's already 3:24 p.m., and I"m drinking my second shake, knowing I only have one more to get me thru the day. Yogurt and fruit are still on my list, and I think 2 cups of veggies. But I'm just sick of food. Sick of worrying about it. And sicker still... of the shakes.

Sure, yay me. I'm doing something proactive, going in for the surgery to try to reverse some of this shit I'm going thru physically. But there is a little part of me that acknowledges how very twisted it is, for me to go thru what amounts to "surgical anorexia" and who-knows-how this will affect me and make me a food freak.

I have no real will to live and am doing so out of habit, and out of pure cowardice, not to mention my intense fear of failure, which is preventing me from acting on my sorrow, because knowing me, I'd fuck it up, and when I wake from the coma, I'd be attached to a dialysis machine for the rest of my life, thus ensuring I never go anywhere interesting ever again.

So yeah. I'm bleak. Whatever. I'm so depressed I should just puke, if it weren't for the fact that would make me bitchier, more hungry, and make me get a headache that Tylenol won't even be able to remedy.

I just want to curl into a ball and die.

Mood: Surly with a soupÇon of "I'll rip your throat out."

Ridin' Out The Storm

Day 1 of my fast was Thursday (two days ago). I made the fatal mistake of not eating everything I was entitled to, and rather, had a large salad w/extra chicken as my "meal" of the day. All went well on Day 1, or so I thought, until I woke up yesterday a.m.

I woke up with a headache so fierce, and it hadn't even blossomed into full force at that point. At 8 a.m., I called in sick, and went back to bed until 1. The rest of the afternoon consisted of me attempting to eat or drink or take my medications, and promptly vomit, cry, break out into a cold sweat, and then lay down for a nap. Repeat about 3X thru the day. I spent the greater portion of the day in the fetal position in agony, hoping for the sweet release that only death can bring.

As much as I *thought* I wsan't eating all that many carbs or refined foods, apparently I have been consuming them.

Luckily, I had some Rx cough syrup with some "special stuff" in it, which I promptly swigged down in the hopes of breaking the headache of doom. By about 9 p.m., I had calmed down enough to take in SOME sustenance.

Honestly, I hope this was the worst of the pre-op stuff. Eleven more days until surgery. Honestly I don't know how some folks can eat right up until the surgery and not have this interim period with the fasting. It gets you in a habit with the shakes and supplements.

As miserable as I've been the last two days, I can see the benefit of it.

But still secretly, or not so secretly, I"m open to any change: whether the surgery is a success, or if I die on the table under anesthesia. It's all good.

Pre-Op Nesting Continues:

Lovonox and Prevacid have been purchased.

Pre-op modified fast started at 9:30 this a.m. By 10:15 I was counting down the moments until lunch (decided to have my solid meal at lunch rather than dinner).

Every joint in my body is hurting. Extra strength tylenol is not cutting it. Can't wait until this weekend when I see my podiatrist, so I can start Celebrex ASAP.

We Have Now Achieved "Pre-Op" Status

Went to NYC to have the pre-op testing and admissions done.

So stressed out, from both, the transit getting there as well as the "holy shit, this is really really going to happen," I had explosive diarrhea AND a migraine which just refused to quit.

Took, what I believe is officially the last advil and excedrin I'm going to have for a good long while. Going to the internist sometime maybe this weekend to see about getting some Rx medication for my headaches to have "just in case," as I cannot take NSAIDs for 2 weeks prior to surgery and I'll no doubt be strongly told not to take them post-op due to concerns of ulcerations.

Weight was taken as the official start weight: 277.2. There. I said it.

Starting tomorrow, I will be on the pre-op modified fast until surgery, which is scheduled for 1/19/11. Don't have a time yet.

Did so much walking yesterday, didn't know it at the time, but hells bells, my shins hurt. Yanno that spot between the two bones of your shin? RIGHT THERE. THROBBING PAIN.

Still think it's pretty sad that I'd rather undergo surgery than be at the office. But there ya go... that's my reality.

Nothing Noteworthy, Really

12/25 Got period.
12/30 ENT follow up.
12/31 Abdominal ultrasound.

Call tomorrow to see if sleep center can cram me in and get me titrated prior to surgery.

Omnicef? Lovonox?

WTF.

I feel like it's burning a hole in my stomach after only one day's dosage (2x).

Takin' it for my sinus infection. That and Flonase. I think my body is finally revolting against all the chemicals I've been putting in it.

Dropped off my Lovonox Rx to be filled for my post-op use. Been informed by my pharmacist and again by a friend, of "how expensive" this Rx is. I'm hoping my insurance covers a lot of the cost.

ENT Results

Went to an ENT specialist yesterday due to my hearing problems, balance, chronic cough, sleep issues, and follow up for sleep study.

He ran every single test he's got. Turns out I've had a sinus infection for a long time. Rx antibiotics and a nose spray to help with that.

Tested me for allergies, to rule out environmental issues. Turns out I'm allergic to feathers. Fortunately for me, my pillows and comforters are all polyfill.

Hearing is normal. Balance is normal.

Go back in 2 weeks to follow up and see if the antibiotics help.

No need for follow up sleep study. Not yet.

Still tired of waking up feeling like crap.

Don't know if sleep issues are related to the apnea, or my weight. Only time will tell.

WLS Chronicles: This Shit Is a Full Time Job

2/3/11 First appt w/Nutritionist
TBA Two week follow up appt w/Surgeon
1/19/11 Date of Surgery
1/15/11 10 a.m. Dentist appt
1/15/11 10:45/11 a.m. Chiropractor Appt
1/8/11 9:15 Podiatrist appt
1/6/11 Start pre-op diet
1/4/11 10:30 Pre-op testing (blood, ekg, meet w/anesthesiologist)
1/4/11 4:30 Therapist appt
12/31/10 Abdominal U/S (gallstones)
12/21/10 Chiropractor appt
12/20/10 Fill Rx for Lovonox (for post-op)
12/18/10 12 noon, ENT appt
12/18/10 10:30 a.m., appt w/Internist
12/16/10 6:45 p.m., Chiropractic appt

Calls I've made thus far today:

Surgical supply co., for supplies for CPAP;
Sleep Ctr., to fwd sleep study to surgeon;
Podiatrist to shift appt to Saturday;
Anesthesiology group to ensure anesthesiologist for surgery is "in network";
RN for insurance who is my case manager re: surgical date

Emails I've made thus far:
Endocrinologist to advise re: surgical date.

Forms filled out today:
New patient forms for ENT specialist.

Possible appt to be made:
Sleep Ctr for possible follow-up sleep study to titrate/adjust settings on CPAP;
Imaging Ctr for abdominal ultrasound re: Gall stones.

Things purchased today:
More protein powder (mocha flavor)
Liquid vitamins: calcium, D3, Geritol w/iron, propolis
Kalhua flavored syrup

OY!

Trip to the Pharmacy

Went to Duane Reade and dropped off six (6) prescriptions. Good times. I'm a wreck.

They filled my Mobic & Effexor immediately. Popped a Mobic during lunch. Start the Effexor tomorrow a.m.

Here's hoping I start feeling even REMOTELY better-ish. Soon.

Funny thing is, the package insert for the Effexor warns me to be on the look out for:

thoughts about suicide or dying;
new or worse depression;
new or worse anxiety;
feeling very agitated or restless;
panic attacks;
trouble sleeping;
new or worse irritability;
acting aggressive, being angry or violent.

Shit.

That pretty much sums me up where I am at RIGHT NOW.

Makes me laugh.

Not in a "ha ha" kinda makes me laugh; but in a WTF is wrong with me, nervous, twitchy, half-giggle.

Better living through chemistry, bitches.

It's Not a Tooomah

Dx: Post traumatic osteoarthritis (same site on the foot where I suffered a fracture of my instep 36 years earlier).

Rx: Mobic.

Bye bye Gyno

The nuts and the bolts. Two appointments in quick succession. One on a Friday (the final appointment with my gyno, who hereforward will be referred to as ByeByeBye-no), and one on a Monday with my ReproEndoGuy.

I had cultivated a 10 year patient-doctor relationship with my ByeByeBye-no. For the first few years, despite my age and my PCOS diagnosis, he reassured me that when I was ready to try to get pregnant, they could do "ovarian drilling" to perforate my leathery ovaries. Ten years @ 2 appts per year = 20 appointments total. During the last four appointments (2 years), each appointment pretty much rendered me to the brink (if not outright) tears. 

Despite the fact that I have sought out an EXPERT reproductive endocrinologist, my ByeByeBye-no started to manifest signs that he knew what was better for me. Not sure how. He didn't do much beyond growing increasingly less polite or less professional, and in the final two years, almost bordering on hostile with me and my unique constellation of health issues ranging from PCOS to Factor Five Leiden Mutation, to Syndrome X, to depression and anxiety, to ... well, you name it. Always appending each appointment with a reminder that I should do something about my weight, even going so far as to suggest outright that I should consider weight loss surgery.

At the end of what would become my second-to-last appointment with him, I asked him flat out, yet rhetorically, "Why is it, by the time my exams are done, I am either in tears or on the brink of it?" No real response given by him. You'd think after what was nearing 10 years of being a patient, would have elicited SOME response.

So, during what would be the final appointment, there I sat in the paper gown, as he started in with the fat shaming questions:

Him: Have you tested your glucose daily?
Me: Why would I do that?
Him: For your obvious diabetes.
Me: I don't have diabetes. I have PCOS.
Him: So why are you not checking your glucose?
Me: Because my ENDOCRINOLOGIST hasn't indicated I should.

Things just went downhill from there. The exam was done, and we were wrapping things up:

Me: Well, all that will be a moot point next month.
Him: What's next month?
Me: I'm going in for gastric bypass.
Him: Well that won't fix your underlying issue.
Me: (taking the bait) WHAT ISSUE?
Him: Your OBVIOUS OVER EATING.

It was at that very moment that solidified my resolve that the doctor I once knew no longer KNEW ME or even remotely cared to know me as a person or as a patient. And there I was, obviously acting on and taking his advice, advice he had given me for YEARS, and rather than say,"Great! Good luck!" he had to slam me for something which clearly is not my issue.

So, on Monday, I go to my ReproEndoGuy. 
I adore my ReproEndoGuy, and I think you will, too, after reading this.

So I regale him of the ByeByeBye-no's dialogue from Friday's appointment. And when I got to the point in the story where I said, "and I took the bait and asked... WHAT ISSUE?" ReproEndoGuy said, "What did he say? What did he say?" And when I got to the point where he said the blurb about my obvious overeating, ReproEndoGuy turned to me and said, "What a fucking asshole! Anyone who knows you, knows you OVER SLEEP, not over eat!" I hugged my ReproEndoGuy for TOTALLY GETTING AND SUPPORTING ME. 

It would be another six months before I had to make the move (to a new Gyno) official, and the first Gyno I went to afterwards was not a good fit (and luckily I knew this RIGHT UP FRONT and did not have to waste a decade of my life cultivating a rapport with a doctor who turned out to be an asshole--no no no. She proved herself to be an asshole right up front. But in the three years since discontinuing seeing ByeByeBye-no? Yeah. Not one fucking regret. 

Not every fat woman is fat for obvious reasons.
Not every woman going to a gyno is looking for a baby farmer. This guy clearly was a baby farmer, and not necessarily focused on WOMEN's health.

Tomorrow: Podiatrist
Next Tuesday: Pre-op consultation w/bariatric guy; then visit w/psychotherapist.

Eventually will reschedule appt w/pulmonologist, and will need to schedule appt w/ENT specialist... also interested in getting a sleep study re-done, to make adjustments on CPAP.

This is my life. A never ending stream of doctor appointments.

Note

Pre-op consulation: December 14th.

Date fast approaching.

WLS Chronicles: Blaring Lack of a Support System

Here's an actual email exchange between me and the husband today in regards to my pre-op consultation in December, which I had hoped he'd accompany me to (obviously, read from the bottom up--yes, I am TOO lazy to restructure this in ascending order):
___________

3.
From Me to Him:
Dunno how long the appt IS; however, who knows how long I'll have to wait before seeing him. We could go for the appt, then lunch, then the shrink and go home, if you want...

And uh... what do you want me to do about the appts? THERE ARE A LOT. And I have a finite amount of time that I can take off to handle everything. If I take multiple days, it then cuts into either my sick time I have banked for the surgery/recovery, or it'll cut into my vacation time.

You don't have to go if you don't want to. I won't force you to do anything you don't want to do. Just keep in mind, I'm only in NY because of YOU, and YOU are all I've got as far as a support system. Either you're a part of this, or you're not. But this is my life. And I'm not going to beg you to love me enough to support me. Either you do, or you don't.

Lunchtime.

Peace out.
_______________
2.
From Him to Me:
ayayayayay!

cant get a reprieve that day either!hate these all day appts thingy.

how long is Dr. appt?
_______________
1.
From Me to Him:
Subject: Reminder: Dec 14th

10:30 Dr. [redacted] appt
4 p.m. Therapist

Wanna schedule a reservation someplace we haven't been together? Or shall I pick
a place?

It's Approved.

Insurance approved me for the surgery.

12/14 is the date I meet w/the surgeon for the pre-op consult.

I'm hoping to schedule surgery on 1/14 or 1/15, so as not to fuck up my holidays with this.

Where I"m at.

For starters, I don't give a shit that I ended the title of this post with a preposition. Fuck grammar in its ear.

Second:

Friday, I:

Went to get my blood work done (because so many things are wrong with me);
Went to the gyno where I was reminded of how many things are wrong with me, as well as giving me his 2 cents (unasked) regarding my pursuit of WLS, thus undermining this very difficult decision which took a long time for me to accept and an opinion which is bolstered by two of the very best, top doctors in NYC who are treating me (mercinary, IMHO, given that I'm there, vulnerable and in a flimsy paper gown that barely covers what it needs to cover.) Note to self: Find a new gyno;
Went to my internist to get my antidepressant Rx adjusted (only to realize after I got home that the Rx is the wrong Rx and the same dosage I'm at currently;
And finally, the last thing I did was a phone-in session with my therapist (too emotionally spent after the first three appointments to make the trek into NYC just for this appointment).

Took a nice longish nap afterwards. Just spent.

At this point, I don't even know if all my paperwork has been submitted to the insurance for approval yet, as I have to continually check, double check, and even triple, quadruple, and quintuple check if the surgeon's office has received all my documentation.

At this point, I just want to die. I don't even want to go in for the surgery. I just want to curl up in a fucking ball and die.

Work sucks syphilitic, leper testes. I'm a half step away from crocheting a voo doo doll and asking a friend to cast a spell, or teach me how to do such a thing. And my personal life is so chock full of ennui and meh, I cannot even stand it. I'm so full of rage and pissedoffedness that there are so many things going on in my life, none of which I have any control.

Roughly Two More Months To Go (For Insurance Approval)

Nothing new to report, other than a whole lotta "hurry up and wait." Oh, and a gout flare up. Good times.

Haven't lost much weight from month to month for my pre-approval monthly weigh-ins with my internist. Next weigh-in: July 31.

I go for my three month visit w/the ReproEndoGuy tomorrow. Not sure what any of the tests will show. Forgot and took a Claritin right before they drew blood. Not sure if that will skew things. Don't much care anymore.

Already started "nesting" a bit for post-op. I got two jugs of protein powder, a shaker jar, some vitamins, a pill crusher and some liquid Tylenol (tho I know this shit doesn't work on me, my aches, nor my migraines).

I just wish it were over with by now.

Still tired.
Still depressed.
Still achey.
Still bored out of my mind with job, with life, with everything.

To date it's been 9 months since I last saw my immediate family. I keep making plans and then flake. I think I might just surprise them rather than give them a head's up. At this point, I'd just assume have them think I'm an unreliable flake or uninterested in seeing them, rather than whine about what's going on with me.

I still don't know what the point of all this (life, existence, etc) IS.

Checkin' In

Currently at (almost beyond) the halfway point in documenting whatever "progress" on my "diet" in order to submit to get insurance to approve my weight loss surgery. Go for my fourth weigh in on Saturday. Two more to go after that. Brings me to August. Then submit for approval. Then after that, I suppose, there'll be a flurry of appointments with a cardiologist, a blood doctor, a pulmonologist, and who knows who else.

Received two jugs of Nectar brand protein powders and a bottle of liquid extra strength Tylenol in the mail yesterday. Starting to "nest" and prepare for what I hope to be the logical conclusion of all this planning. Buying things piecemeal so I won't get hit with sticker shock if I were to buy all my supplies all in one shot. Flavors purchased: (1) Fuzzy Navel; (1) Ice Tea (which I plan on mixing WITH brewed, ice tea (don't lecture me about caffeine; I'm not willing to endure the unpleasantness of the surgery and post-op in an un-caffeinated state.)

Still waiting for my Torrone "Marshmallow" flavored syrup, and B12 spray to arrive. Can't wait to try them.

Next on my list: propolis, calcium, and liquid vitamin supplements and an ice cream maker. I'm envisioning a lot of green tea flavored or mint chocolate flavored high protein "ice cream" post op.

I'm not optimistic. I'm a hybrid: stoic, fatalist, pragmatist. I don't like that this at all. But know I have no other choice. It's this and hope to reverse my health, adding a couple more GOOD QUALITY years to my life; or do nothing, and continue on the slippery slope to spending my "golden years" house bound, miserable, and with considerable health issues, not unlike my mother.

Went to lab yesterday for bloodwork. Not too many tubes this time. ONLY ten. Go on Monday to drop off my 24 hour "collection" jug. Gah.

Next appt w/the ReproEndoGuy: 7/15.

It's a wash

I was sleeping too much before Celexa, due to my depression and crying jags. Now I'm sleeping too much because of the Celexa. But at least the crying jags have cut down in frequency.

Five more months of documenting my "diet and exercise..." before submitting to insurance to see if they'll approve me for weight loss surgery.

Hurry up and wait.

In the meantime, I'm still dealing with my grief. Seventeen months since dad passed. I'm in shock still. Refuse to believe it. Miss him tremendously. Even though I've got siblings, and my mother is still alive, I feel like my entire sense of family is gone. Orphaned. And I've got the over-riding sensation that everything about existence is random and without meaning.

3/10/10

Went for my first official weigh-in to start the documentation my insurance co., requires prior to approving me for surgery.

Also marks two weeks since I started Celexa. I'm a zombie, but at least I'm not crying every day like I have for the last 17 months. EVERY DAY.

Altered States

I finally broke down and decided to get back on an anti-depressant. Between my physical garbage going on and my depression, persistent state of being blue on top of still grieving for my dad, there's not much else I can handle to be honest.

A week ago I had an appt w/my internist to discuss five different things. I know I've got problems when there's so many I have to write them down on a 3x5 card to ensure I mention all of them.

I knew instinctively the office visit was going to be an *ahem* "issue," when I showed up and they had me fill out all my forms (as if I were a new patient; including every last Rx I'm currently on), and doing so on an electronic pad with an electronic stylus. ONE MOTHERFUCKING LETTER AT A TIME.

Nearly 10 minutes later, I finished, the doctor isn't in yet, and I'm there on my lunch hour. FML.

So I wait another 10-15 minutes only to be told the doctor I scheduled the appointment with won't be in until 2 p.m. (the appointment was scheduled for 1:15). I WAS EFFING LIVID. "What kind of operation are you running here? Why would someone schedule an appointment KNOWING FULL WELL the doctor won't be in for another 45 minutes? I'm here on my lunch hour. How unprofessional! Someone should have given a call so I could reschedule and not waste my lunch hour waiting!"

This of course was made worse by the fact that it took me getting emotional and yelling for them to suggest I see Dr. G., of whom I have also seen (as he did my endoscopy in 2008). Now why the fuck did they make me wait a half hour before even suggesting this?

So they usher me into an exam room, and the whomever-she-is came in to take my pressure and temp. Of course I'm furious. She then asks me, "Are you on any medications?" I immediately crossed my arms over my chest and said, "Yessssss!" "What are they?" I then lost my shit and started yelling, "Didn't I JUST fill out all that information on that useless form? Isn't all this shit in my chart? This whole thing was a mistake coming here. I have problems every time I schedule an appointment." She got huffy, I don't care. I hope I made her cry. Lord knows I was on the verge of it myself, and no one was giving a shit.

So the doctor comes in and immediately is on the defense because the walls are paper thin and everyone in the office could hear me yelling. And no, I don't regret it, and neither am I embarrassed by it.

I told him why I was there:

1. To get back on anti-depressants (no shit!);
2. To get seasickness patch Rx;
3. To get something to treat this sinus infection I now have;
4. To discuss getting on track with appointments to document everything to get insurance to qualify me for bariatric surgery.

I could swear there was a fifth item on that list, but it escapes me now.

So he started to disarm me by asking me about the cruise we're taking (hence the seasickness patches), and as I was telling him point by point, I was on the verge of laughing and crying at the same time. A sense of relief and just reflecting on how unnecessary all that stress was. How it all could have been avoided had anyone given a shit and not just been in paper-pushing drone mode at the front desk.

Turns out, he went to medical school with my surgeon. And realizing this, I then realized how fortuitous it was that I was seeing Dr. G., that he knew "my guy," and that he's the best, giving me one more reason to think I picked the "right guy" to do the surgery.

My eyes are dilated from the Celexa now, and I need a nap, and I still have 8 hours of work ahead of me.

Hoping no one harshes my mellow.

My Day Off

Off for President's Day. Thank goodness. Woke up with a head full of goo, which now makes me wonder and worry if I can take Mucinex D (or any other 12 hour time release cold remedy) post-op?

I Hate Know-it-Alls

To the dumb shit on the "Have your innards been rearranged" group on Ravelry: No, dumbshit, acesulfame K is NOT the same thing as aspartame. I hate your disingenuous replies to everyone. Not every post demands your reply.

The Initial Consult

I’m now plunged a bit further into a slump given that all this time with my researching the gastric bypass I had been whining about “only 4 ounces” being the capacity of my stomach pouch post-op, only to find out today from the nutritionist that my post-op pouch will ONLY BE ONE EFFING OUNCE CAPACITY.

Let that marinate for a bit.

One ounce roughly equates to 5 teaspoons. How the hell can you even quench your thirst 5 teaspoons at a time? I’d sooner give up food than to give up drinking; and SHIT! If you’re ingesting it 5 teaspoons at a clip, that’s probably at a slower rate than you’re perspiring or urinating it away.

I’m devastated by this. Shocked actually.

The actual meeting with the surgeon went well enough and he’s not as folks had described (some said he wasn’t really warm and fuzzy). He seemed interested in my case, we talked over each other at points, and I think I let him know that I have been doing my homework on the topic and it’s not a decision I’ve made casually.

Additionally he discussed another procedure called a banded bypass, and he took out some of the polypropylene banding material, and my husband laughed when I said, “Wait a minute… is that knitted?” He would have given me the sample to take home, but it was the only piece he had on hand.

In all the YouTube Vlogs I've seen thus far on the topic of WLS, I have yet to see one where someone shows in REAL TIME how long it takes to drink their shake or how long it takes to drink water of any varying unit of measurement. Too many folks I guess armed with good intentions (or egoism, too) are putting themselves in front of a camera and you can tell how uncomfortable they are or how shy they are because they're not really talking loud enough for you to hear them, and some just have too much whining about whatever it is. I'm trying thru process of elimination to find someone's "journey" which is more of a balance of experience PLUS expectation.

Will go to my PCP to follow up with him, and well... start the HURRY UP AND WAIT process. It'll be agony.

Perhaps I'm a bit OCD

I don't do anything without doing as much research and meditation on the topic beforehand. Why bother attempting anything if I'm going to fail? Not researching or meditating upon something, to me, is a formula for failure.

This could explain the condition of my den, which is always in some level of disarray. The room just is lacking the necessary organizing tools for me to get everything the way I need, so why bother?

Both my den could be a metaphor for my life and my health; and my life and my health are a metaphor for my den, as both are in chaos.

And I suppose the same could be said about my health or life in general. Only as it pertains to my health, no matter how little I eat, it has the inverse reaction, that of agitating a hungry lion. When I eat very little, my hunger just grows beyond where I can manage it. So why bother attempting to do anything to change it, when it so clearly has a life force of its own?

Bottom line is and always has been, I am tired of attempting to slay this beast by myself, with my bare hands. I'm 41 and I am tired. Physically and emotionally. I don't have it in me to fight this fight anymore, and I am surrendering to it. I'm acknowledging my shortcomings and limitations. I just can't do this anymore.

From middle school until present day, I've tried all manner of things to fight this beast: Cambridge Diet, Ayds Diet Chews, Dexatrim (back in the day when it had "the good stuff" in it). Then along came anorexia and bulemia and obsessive exercise, and for a while, I thought the monster was dead. It was merely in hibernation, to awaken a few years later with a mighty vengeance, hand-in-hand with Satan's handmaiden, PCOS.

At some point in the late 1980s, I was involved with someone who had "feeder" tendencies, who fattened me up gladly with the most delicious tortellini Alfredo and Caesar salads ever crafted by a human. That entire relationship was a haze of Parmesan cheese flavored infatuation and drowsiness, allowing the sedentary lifestyle take root.

The late 1990s saw me thru three car accidents, one of which I suffered "soft tissue damage," no broken bones, but exacerbated a congenital defect in my spine (diminished disc space, "hip dysplasia," etc.,) and gave me a herniation in my neck. Everyday is spent in pain to one degree or another. Some days just getting up out of my chair at work to walk a few feet is too painful for words. Gone are the days of high impact aerobics and running mile upon mile.

Then along came Slim Fast and Weight Watchers, both with marginal result. Two years of Atkins helped me lose close to 30-40 lbs, but fears of gout and just an overall disgust of eating such a protein intensive diet got to me. I am an omnivore! Slowly, nearly every Atkins-lost pound found its way back home.

Then Xenical and the "sudden onset liquified indignity." Then topamax, with its promised to not only help my migraines but also dump off a shit-ton of weight. Migraines were kept in check, not one pound of weight came off, and in the end it made me more depressed and hostile and paranoid.

I can't take amphetamines to help me lose weight due to my blood pressure, though high it is being managed with medication.

I recognize that if I lose a lot of weight, it'll ease my joint pain and lead to the very real possibility of being more active than I am.

At the moment, I'm viewing surgery as "surgically induced anorexia" and "surgically mutilating" my stomach into submission. I can do this. I can "comply." I just don't want to think about or be ruled by food and my connections associated with it anymore.