Dusting off the cobwebs

That creaking noise? It’s the sound of me walking up the stairs to this rickety old blog.

I just  have one small update to share: I have a broken boob.

Looking back, it’s hard to believe that it was almost a year ago that I started consultations for the brachioplasty/mastopexy/augmentation. But it has been that long, and I had surgery a full six months ago. Unbelievable!

One boob is great. The other feels like it’s made of cement and aches all the time. Naked, I look ridiculously lop-sided and weird. Thankfully it’s disguised in clothing.

So I saw my surgeon yesterday and after some pharmaceutical attempts didn’t work, I’m going back in for surgery so that he can fix my capsular contracture. While I’m under, he’s going to revise my left arm as well.

I can’t believe I’m having to do this again, but whatever. Last time was horrible. I’m hoping this is a quick little fixer-upper.

December 10th. The very moment I finish teaching my last class of the semester.

And now I’m backing down these rickety old stairs again. See ya when I see ya!

NOTE TO SELF

I don’t know how I got in the habit of posting once a MONTH, but I did, and that’s where it is. I think it’s because my life isn’t 100% weight related right now. And I’m busy. And there’s facebook to keep up with.

But every now and then I’m drawn into thoughts/feelings that aren’t entirely appropriate for public (i.e. facebook) consumption, and these are them:

• Seriously, I’m a moron and I do not learn my lesson. If I eat eleventy million servings of baked lays, I will enter a crazy-scary episode of what might be reactive hypoglycemia / the shakes / duuuhhh-ville. I will type things like “note to selfs” plural and not even notice. Apparently, one of my multiple personalities can’t spell. And then everything is funny. I notice phrases on TV like “she’s floppy like a duck” and can’t stop laughing. And you tell me carbs are not like DRUGS???

Actually, that’s only one bullet point. See? See what happens to me?

I never learn!

18 months

Today marks 18 months since my RNY. Somehow in my mind, I imagined weighing 155 on this day. I’m at 165, and that’s fine. That’s 20 pounds over “normal,” and that too is fine. It’s all good. It will come off or it won’t. And that’s fine.

But let’s be honest about why those twenty extra pounds are still here–food. End of story!

So a rundown of life as of now. Three major things:

• I got a fabulous new bike! My Trek 7.2 was awesome, but she didn’t quite cut the mustard for rides upwards of 50 miles. It was time for a road bike. Behold the Trek 4.7 WSD! There is one word to describe her: smooth.

• I’m having some anxiety about the upcoming Fall semester. I passed my first-year review in the PhD program, but this year is going to be ridiculously difficult. Not only will I finish my full-time coursework, but I’ll also have to teach for my fellowship funding. That’s no problem, except that I already work full-time. It pans out like this: take 3 classes, teach 2 classes, teach 2 classes as part of my regular job, plus all the other duties of my regular job. That’s a heck of a lot. So much, in fact, that my counselor said I should take a leave of absence from work. And that she’d be willing to write a letter stating that its “medically necessary” for my mental health. I’m not sure I’d go that far, but she’s the expert. I’ll talk with my boss in 2 weeks to work out my fall schedule. I’m hoping to cut down to about 20 hours per week, and make up the rest with vacation time. Fortunately, I have enough saved up to account for the fall semester at part-time. We’ll see!
• As far as post-surgical healing, I’m doing great! I don’t look very different from the pictures I posted, except that my abdomen is a much less swollen. Everything feels good!

And that just about covers everything in my world. Where on earth did summer go?!

Long time no see!

Well hello there! Yes, I’ve been gone for a while. No, you probably don’t care. Yes, that means I’m going to do a bulleted list of updates. Weee!

• I’m currently typing on my new Macbook Pro, which I looooove. My Dell crashed a few weeks back, and with it went ALL of my pictures of our honeymoon, house being built, old house, family vacations, etc. And then there was also the documents from the first year of PhD coursework. But hey, you live and learn. Yes, I got an external hard drive this time. And an iphone. I’m wired, baby!
• I went to the Emergency Room last week. Something got stuck during lunch Tuesday, hurt like a mutha, and I finally went in Wednesday late morning. I threw up over and over again (apparently, my pouch is HUGE!) and it eventually went away. God, it was horrid.
• I’m working VBS  this week. I have NINE two year-olds in my class, and they’re adorable and exhausting!
• My weight is a mess. My scale needs batteries and I’m too scared to get on it anyway. I’m way past the danger zone, and I need need need to get my ass in gear. Seriously, my behavior scares me. I’ve been on two bikes rides in the past two weeks (25 miles and 40 miles), but that’s it. No gym time. I feel like  my belly is distended from here to China. I feel massive and lethargic and crappy. I know how to fix it: back to basics.
• My healing has progressed a ton in the last week. The last hole in my arm incisions closed up. Now it’s just a matter of treating the scars so they fade! I’m so thankful the surgery was uneventful even if recovery was rough.

That’s about it without getting into super-ridiculous minutia. Life is good and getting better!

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Nutrition Check-in

I mentioned all the areas I need to assess, and now that I’ve got vitamins squared away for the time being*, I’m trying to figure out what in the heck to do about food.

Why do I feel so lost about what I am eating versus what I “should be” eating?

Why do I feel like there’s no plan?

Well, I’m almost a year and a half out, I can eat ANYTHING (and I do mean anything), and there’s a whole world of food out there to be had. It was a lot easier when I had a list of “approved” foods for the stage I was in and I was too afraid to veer off the list. Things aren’t so simple now. I’ve got to actually figure out how to eat a healthy, balanced diet and friends–this is new territory for me.

Because let’s be honest. The post-surgical diet is no way to live long-term. 1/4 cup here, 1/4 cup there, all protein-all the time isn’t normal. Yes, our bodies obviously can survive. But now that I can eat more (a LOT more, sadly), I’d like to make sure that MORE FOOD = MORE NUTRITION. Like vitamins, minerals, antioxidants, all that jazz. Not just more simple carbs.

Because while I say I can eat anything, let me be clear: anything except simple carbs compounded one after the other. Like rice followed by banana = carb coma following by sweats followed by fainting. Or, in other works, hypoglycemia. Not on my wellness plan.

But when I think about well-balanced eating, I always come back to the food pyramid and I have no idea what to do with that. What’s a protein bar? 1 protein, 1 carb, huh? Why is a potato a grain and not a vegetable? Why is low-fat sour cream a fat and not a dairy? WTF??

Melting Mama posted this info today, and it has been pretty helpful because it’s  food pyramid guideline tailored for post-op bariatric patients. Here are the links:

• Overall guidelines
• Proteins (Meat & Dairy)
• Fruits / Vegetables / Hydration
• Grains/Starches
• Fats

So here’s my action plan. I’m going to:

1. Use these guidelines to meal plan June 1-5
2. I’ll also food journal on livestrong to try and get calorie equivalents, but this is less important than balance
3. Once I have a week of journaling, I’m going to send it to my University’s dietician (who I met with last week) for her review. She thinks I’m already eating pretty close to the food pyramid, so this will just be for some feedback and additional ideas.

And I have to admit, I’m going to amend some of the rules as listed on the plans. I’m currently drinking probably 30 oz per day of caffeinated beverages (*hangs head in shame*) so I’ll need to cut back more slowly. Going to 6oz cold turkey might very well kill me.

In other news, I’m going in for my 1-month follow-up with Dr. Hartog Tuesday. I’m nervous about it because I’m not so thrilled with how my arms are shaping up, and I worry that he’ll be like “oh well, they look good to me, thanks and goodbye” when what I’d really like is “yes, I see what you mean, and I can fix it!” We’ll see what happens.

I know you need before/afters, and I’m working on it. I’m going to try and get Lee to take some this afternoon, and I’ll upload tomorrow. I’ll probably make it a password-protected post since I don’t want any creeps checking it out.

* Apparently, I have no stoma and can easily swallow ginormous horse-pills. The B-50 complex pills are huge, but they go down without a fight. No wonder I never feel full!

Vitamin Update

It was time to re-stock on vitamins anyway, and with all the focus on vitamins yesterday I did some price comparisons again. I’ll be trying some capsules for the first time since surgery, so we’ll see how that goes! Here are the products I decided on.

From www.bariatriceating.com:

• Celebrate brand Iron + C tablets. I was using the Bariatric Advantage brand chewable iron, but the Celebrate product has the same nutrition for less money. Plus the chewables were super-sweet and had a tendency to go mushy before I could finish the bottle. That’s partially my fault since I’m sure you’re not supposed to store them in a steamy bathroom medicine cabinet, but hey–I take them at night before I brush my teeth! I’m hoping the tablets hold up better.
• Celebrate brand Dry Vitamin D capsules. They’re only 1000 IU of D3, but I’m getting D in all my calcium citrate supplements as well. Kim had recommended this sublingual D3 which looks awesome, but it’s $7.80 for 60 1000 IU tablets whereas Celebrate is $7.99 for 90 1000 IU tablets, so I’ll try Celebrate first.
• Solgar B-50 Complex. I’m sure I could pick up a comparable B-complex at the grocery store, but every time I look at them the capsules look ginormous! I don’t know if these are any smaller, but I figured that if they’re marketed directly to RNY post-ops, it’s probably doable!

As for my other vitamins, I’ll be switching to store-brands since there doesn’t seem to be any difference between bariatric formulas and others.

• I’ll finish this chewable multi-vitamin with extra E, D, A, and K and then switch to something like Centrum Silver complete, Flintstone’s complete, or whatever.
• I love these Bariatric Advantage calcium citrate lozenges. I’ll probably keep buying these even though they’re expensive because they’re just yummy! I’m going to keep taking two of these every day as I have been, and I’m adding 2-3 citrical petites since I’ve been unknowingly skimping on calcium.

So that’s it for now. I’ll probably need to re-order in August so I’m stocked for the fall semester, and I’ll re-evaluate then.

Vitamin Craziness

Ask 20 bariatric patients about their supplementation, and you’ll get 20 different answers. For some people, Flintstones vitamins are all it takes. For others, it’s a $40 pill every 5 minutes all day long. Everyone swears their labs are great, everyone is alive and kickin’, so who knows.

My inclination is to follow what some of my favorite post-ops from the boards are doing. People like MelissaF and PamT seem to have their stuff together. They sound like they’ve done the research, compared costs, figured it out. Even still, their regiments are different, so who’s to say?

I took a survey of vitamin schedules on the OH boards. I asked on both the RNY board and the WLS graduates board. Because the answers varied so much, I went back to the ASBS for their recommendations. I’ve read this report before, but it’s nice to get a refresher every now and then.

The report reminds me of things I know, but often forget. Like the fact that vitamin and mineral levels affect “appretite, hunger, nutrient absorption, metabolic rate, fat and sugar metabolism, thyroid and adrenal function, energy storage, glucose homeostasis, neural activities” and so on. Thus, one reason to avoid junk food is calories and weight gain. The more important reason to avoid junk food, though, is because it keeps me from eating something else, something nutritious, something that helps maintain countless bodily functions. I need to re-learn that every now and then!

Table 5 of the report shows all of the vitamins and the names of the specific blood tests that can help determine whether levels are okay. I plan on taking this with me next time I see my primary doctor!

So based on the ASBS research, post-op proximal RNYs need the following supplementation:

• A high-potency vitamin containing 100% of daily value for at least 2/3 of nutrients. And we’re to take TWO of these to get 200% recommended daily value. Should have 18mg iron, 400 units folic acid, and should contain selenium and zinc. Complete children’s formulas should be okay. Take with food. Each brand should be evaluated for absorption and bioavailability. Progress to whole tablet/capsule as tolerated.
• 1000 units of sublingual B12 daily
• 1500-2000 units of calcium citrate plus D3 daily split into 500-600 mg doses. Also eat calcium-rich food, for a total of 1700 or more units of calcium daily.
• Additional iron (18-27mg) for a total of 50-100mg elemental iron daily. C may enhance absorbtion.
• B-complex is optional, but 1 serving per day is recommended.

Here’s what I’m currently taking:

• Two bariatric advantage multi’s per day. It meets the above requirements except for iron.
• Two bariatric advantage calcium citrate lozenges per day. This equals 200 IU of D3, 20mcg of K, 800 mg calcium citrate, and 20mg magnesium.
• One bariatric advangtage chewable iron per day. 29mg with 60mg C.
• One sublingual B12 per day.   Mine is 500 units daily.

And here’s how it’s going to change:

• I’m going to add 3 citrical petites every day. That will give me a grand total of 1745 mg calcium citrate. I may do 4 citrical petites for a while to make up for lost time! I’ll finish the bariatric advantage calcium citrate that I have and then probably begin using citrical petite exclusively… the bariatric advantage come out to 15 cents each whereas citrical is about 7 cents each for the same nutrition. But the bariatric advantage ones are so yummy!
• Keep the bariatric advantage chewable iron before bed… I haven’t been able to find another substitute for the type of iron we need, so I’m going to stick with the bariatric brand for now.
• Double sublingual B12. I use the store brand.
• Add B-complex. I’ll grab a store brand as long as I can find a small enough tablet.
• For the multivitamin, I’m going to finish up what I have and then switch to a cheaper “complete” formula like centrum silver, flintstone’s complete, etc. There’s nothing special about the bariatric formula, it just costs more.
• Add dry D3 from vitalady. Better safe than sorry I say.

As for timing, this will take some adjusting. It’s a lot more pills!

• breakfast: first multi, dry D3, citrical, B12
• snack: calcium citrate
• Lunch: second multi, citrical, B12
• snack: calcium citrate
• Dinner: citrical, b-complex
• Bedtime: iron/c

Am I missing anything?? How is this similar or different to your routine?

Earth to Meghan

It’s time for one of those periodic check-ins that keep me grounded, healthy, and engaged with my overall wellness. It’s difficult to keep close tabs on all of this during hectic mid-semester rushes with my coursework, but this summer I’m doing an independent study and an online course, so it’s a bit easier to spend time thinking about my health & wellness.

So here are the areas I’ll be thinking through and addressing:

• Counseling: is it time to stop? do I keep going? I started counseling right before surgery simply because it’s recommended for us. My appointments went from every week, to bi-weekly, and now they’re every 4 weeks or so. I don’t mind going, it doesn’t hurt, it’s just one more thing to keep track of. My sense is that it’s better to keep going even if I don’t think I need it. When I don’t have anything to talk about weight/body wise, I still get lots of great advice when it comes to PhD work (since my psychologist has been there, done that!) and so forth. So I’ll continue through summer, re-evaluate before things get busy for me again this fall.
• Nutrition: I need to do some serious work on this front. Sure, I’d like to lose those last twenty pounds so I can be officially “normal” at 145 pounds. Today I’m back at 165 and this is where my body seems to want to stay! I’m not as worried about the numbers now (since I’m healthy and strong and I feel good), but I do want to pay attention to how well I’m nourishing my body. Based on the bible study at work, I’ve been learning more about the food pyramid and we’re all trying to do better as far as that goes. So I definitely need waaaay more vegetables, more fruit, and less processed crap. I will be working on reaching a balance I can live with throughout the summer, and then working off those meal ideas throughout the fall when I’m too busy to pay attention.
• Exercise: I’ve done okay on this, but I’m down for the count right now after surgery. Beginning June 3rd after my tapes are off, I’m committing to 5 days per week in the gym, consisting of a mix of spinning, weight lifting, yoga, and whatever else I feel like. Then on Saturdays I’ll pick back up with the bike trail. It’s a privilege to be able to workout 6 days a week, and I don’t want to waste the opportunity while I have the time!
• Supplements: I’m currently re-evaluating my supplement regiment based on what other long-term post-ops are recommending. I haven’t had many of the blood tests most people get… my surgeon only checks the CMP/CBC/and B12. I’ll be researching this and I’ll report on what I decide!
• Relationships: It’s important to me that I make time this summer to touch base with some of my friends, my mentor (an old boss), go visit my sister in Jacksonville, etc. I don’t have time for this stuff during semesters, so I want to do it while I can!
• Plastics: Depending on how my arms heal and how they look once swelling is done, I’ll make a decision about what I want to do next. I thought a thigh lift made sense for the next thing before we have kids, and I still think that’s the plan. But we’ll see how the arms turn out before I decide if I want to jump right in or find another surgeon, that kind of thing. Either way, I’ll want to have a decision made by the end of August so that if I’m doing it, it’s booked for December break. Just one more thing on my mind that I’d like to have resolved this summer!

So that’s where I am and what I’m working on. I’ll be focusing on each “pillar” of my health, reporting back here, and asking for any feedback you might have! In the meantime, I’m researching my little heart out!

I’ve never started a day like this before…

So. We all have our morning routines. Mine has never before included a phone call to my surgeon to get the serial numbers for my boobs. So that I can buy an extended warranty for them.

Ha!

My boobs have serial numbers, can you believe that? My boobs have a warranty, can you believe that?!

As for pictures, I’m hesitating. Why? Because I can’t wear a real bra and I have to tube-boob effect of a sports bra going on and, well, that’s just not the look I’m going for in the Big Reveal. But I can share this picture from the weekend… you can’t see much, except that my boobs are not humongous. They look proportional and not at all “whoa fake boobs!”

(Please try to ignore my crazy hair. Without use of my arms, Lee has been in charge of the ‘do.)

I had my first lymphatic drainage massage last night and… wow. I think I peed like eight gallons of fluid out afterwards. I can tell a different on my underarm area, and my boobs feel more like boobs and less like basketballs because they’re not so darned swollen. I can’t wait until the next lymphatic drainage next week!

And then following week, tapes come off! And I can go BACK TO THE GYM!! I cannot even tell you how bad I miss exercising. I never thought I’d say that, but I feel like a lump of flubber. I want to work this body out dangit! Two weeks!