WTF?

Just shy of the 3 month mark... UPDATE!

On Saturday, Feb 25th, I was sitting in a movie theater with my hubby when I suddenly felt pressure in my abdomen. It wasn't bad--more like the feeling you get when you need to find a bathroom soon for a BM. But, after leaving the theater and finding a restroom, it rapidly got worse. It went from a bit of pressure to feeling like food poisoning in less than 5 minutes. We'd just come from lunch at hubby's favorite fish place before the movie. We both had the same thing, so I'm starting to think that hubby may be in the same situation soon...

It rapidly went from bad to worse and I was hit with the worst pain of my life. I'm talking within 40 minutes I was having abdominal pain that trumped the pain of labor and delivery! After about 20 minutes in the restroom, I finally made it back to the theater and sat down next to hubby. He was getting anxious and would have come to find me if it weren't for all my crap I left in the seat next to him. He said he was about to walk out when I showed up... He asked me what took so long and I gave him a simple answer--I don't feel good. He asked immediately if I wanted to leave. I told him yes. He then asked if I wanted to go to the hospital and again I responded with a yes. Now he KNEW something really bad was wrong because I have a very high tolerance for pain and would never go to the hospital if it weren't serious. We were less than 5 miles from the hospital. He went to the parking lot and got the car and picked me up in front of the theater as I couldn't make it to the car. We went to the hospital and they took me back within 20 minutes, which NEVER happens at this hospital! After that, they left me in a room waiting, and waiting, and waiting and all the while the pain was intensifying. By the time I was writhing on the gurney and had tears rolling, all the while breathing like I was breathing through a contraction, hubby ran one of them down and told them that they HAD to give me something for pain. A few minutes later, they gave me a dose of Dilaudid which relieved most of the abdominal pain, but didn't touch the pain I had across my lower back.

They then did a CT scan to see what there was to see. Because I've experienced sensitivity to iodine, they did it without contrast and could only see that I supposedly had some unexplained fluid in my abdomen. Next, they did an ultrasound to see how much fluid and checked my gall bladder and assorted female parts for potential clues. Nothing to be found there, so they told me they were admitting me for observation. At this point, it had been 2 hours since the Dilaudid, so I asked if it was possible to get something for the back pain. They got me up to a room before that happened. Once in the room, I asked again and they brought me something, but didn't tell me what it was--just put it in the IV port and left. Shortly, the back pain was finally letting up. I thought they'd given me more of the same drug and that all I'd needed was a larger dose in the first place.

After all this strain and stress and combined with the narcotic pain meds, I was getting sleepy and it was getting late. Hubby had my daughter drive over with things I would need and then they both left about 9:30. I passed out with the next dose of pain meds. When they came to give it, they asked if I wanted the Dilaudid or the morphine again. Apparently the second dose was morphine and it worked so much better than the Dilaudid had, despite the fact that I was told it was much stronger than morphine. I stuck with the morphine and passed out for about 3 hours of much needed rest.

They kept me on the morphine ever 4 or 5 hours for over 2 days. Over that time, they redid the CT scan with the contrast and yummy (ugh!) barium. Though he doesn't normally use this hospital, my bariatric surgeon showed up Sunday evening to see me. He said that the CT scan showed nothing out of the ordinary. The abdominal fluid was a very small amount and nothing to be concerned with--not the cause of my current issue. He checked my tummy and found that I do have a hernia deep below the belly button--again not the cause of this. He told me that their best guess on this was that I had a kink in my bowel. That was the cause of the great discomfort and the pain. Over the time I was in the hospital and on the morphine, it straightened out and the pain was decreasing, but not gone. This he said was due to the fact that this was a strain on the bowel and that LIKE ANY OTHER MUSCLE, when strained, it bruises and will take time to heal. Bowels as muscles...never thought of it that way! He went ahead and ordered a full round of bariatric labs ("since you're here anyway...") and told me he'd see me in the AM.

SO, the outcome--it happened, we don't know 100% why and it could happen again. Their instructions? Don't eat any meals that are too large as it could cause the bowel to strain again... Uh, hello! I had an RNY and don't eat large meals. I don't normally eat till I feel full! I hadn't eaten till full the day this all happened! I don't really know what happened. I don't really know what caused it. I don't really know how to keep it from happening again..... Double UGH!

I can honestly say though that this is the very first time I've had any sort of issue since my RNY in August 2006. I was in the hospital from Saturday evening till Monday afternoon. Thank the school district for United Healthcare! As a teacher, my health insurance doesn't cost me anything, and it sure saved me on this one financially. Preliminary billings show a bill of more than $15,000 so far. I will have to pay my deductible of $1000 and they'll take care of most of the rest.

Long story short--sudden extreme pain led to a hospital stay of 2 1/2 days and no real answer/explanation.

Other than this incident, life is good. We've had the world's greatest grandbaby home since Jan 28th. He's a handful, but so much joy. He's growing like the proverbial weed... He's currently quite obsessed with the WWE--particularly John Cena, Kofi Kingston, Rey Mysterio, and Sheamus. He finally learned how to ride a bike with coaster brakes. His first bike had pedals that would pedal frontwards and backwards alike. Now, we get a bike that only goes forward...what's up with that? LOL

We only have him till March 24th... Then he goes back to WV for 8 weeks again. The BEST part though is that he comes home on May 19th and won't have to go back to WV till Christmas! He would go back on July 14th, but school will start in August and he is to start school in a pre-K program this year. According to the divorce decree, once he starts pre-K at age 4, he is home all year. His father only gets him for a week of his Christmas break, a week of his spring break, and 8 weeks in the summer. We want him to know his father...don't get me wrong. It is just that all this back and forth every 8 weeks is a huge mental strain. He will be 4 in July and is still in pull-ups as they don't work on potty training while he's there. We get him almost trained and it is time for him to go back to WV. He comes back totally back where we started... His speech is still not where it should be. I want to cry sometimes when I am out in public and hear some kid talking to his mom or dad and their speech is SO clear. When I ask how old they are, I get answers like 2 1/2... Matt's speech starts to be clearer and more developed each time he's home. Then, while he's at his father's home, he regresses. I honestly don't think they TALK to him there! Oh how I hate this cruel situation he's been put in. He's so smart. He deserves better. Now, he'll finally get a chance to live a normal life. Granted it is the normal-for-a-child-of-divorce life, but he'll finally be fully potty trained. His speech will grow in leaps and bounds. He'll be in pre-K and socializing with others his age, not just adults.

BTW, thanks to Randy for nagging me to post!

A post WLS first for me....actually, first time in over 25 years!

So, yesterday was a teacher open house day at Busch Gardens in Tampa, FL. Teachers who signed up in advance were given free admission to the park for the teacher and one guess, plus free parking (which is $12 normally, by the way). Even as a resident of Florida, admission to BG is still $69! SO, this day was hard to pass up... Hubby and I went and took our oldest with us. She posted to her Facebook that she was having fun with her "parental units!" It is good when your 21 year old child still finds you fun--even if only for brief stints!

I checked in at each of the teacher stations, heard their spiels about the field trip programs they offer for students of different ages, got my sheet stamped... You know the drill! Then, the three of us had the rest of the afternoon to do whatever we wanted in the park. We saw sooooo many different kinds of animals! And, to culminate the events of the day, my daughter and I rode KUMBA! This is a huge, fast, wild roller coaster. It was the first time I'd been on a roller coaster since the summer of 1984! I tell you, it is amazing the things you will do when you weigh 200 pounds that you won't dare try at 400 pounds!

The Perfect Boiled Egg...

A fellow postop shared the following egg boiling info on the Graduate-Low-Carb-Lifestyle group over at Yahoo. I'm no Martha Stewart either, but this is how I have boiled eggs for years and it DOES work and works well. There are so many people who say that they can't boil eggs that I thought I'd post this for the masses!

http://www.goodegg.com/boiledegg.html
Extremely fresh eggs will not peel easily. In fact, an egg that is just a day or two old is almost impossible to peel. As eggs age, the shells will peel more easily. It is advisable that eggs used for hard cooking (including Easter Eggs) be at least 2 weeks old before cooking for easiest peeling. Hard cooked eggs that are cooked slowly over low heat (and not `boiled') will be more difficult to peel.

http://www.marthastewart.com/article/boil-a-perfect-egg
Despite its name, a boiled egg shouldn't be boiled (which will yield rubbery results) but rather immediately removed from the heat once the cooking water comes to a boil. Place eggs in a saucepan large enough to accommodate them in a single layer. Fill pan with cold water, covering eggs by 1 inch. Bring water to a boil over medium-high heat. Turn off heat, cover, and let stand 90 seconds to 2 minutes for soft-boiled eggs, 1 minute 45 seconds to 2 minutes 15 seconds for medium-boiled, and 11 to 12 minutes for hard-boiled. Once the hard-boiled egg is cooked, transfer it to a bowl of ice water (this will prevent discoloration and facilitate peeling); let stand 2 minutes, then crack by gently pressing egg against a hard surface. Peel under cold, running water.

Read more at Marthastewart.com

Are you getting the right LABS done??

Lots of people get labs done after WLS. Do they get the RIGHT labs done though? Some yes, but most NO. Vitalady Michelle created a thorough list of post-op labs that any WLS postop should take to their doc (whether their PCP or their WLS surgeon) and request that they be run AT LEAST every 6 mos. If you have insurance that will cover it, go for every 3 mos. Do not go more than a year without a complete set of labs though! I'm borrowing the list via copy/paste, but this is the list that Vitalady and Andrea both share regularly with fellow postops:

*80053 Comprehensive Metabolic profile: (sodium, potassium, chloride, glucose,BUN, creatinine, calcium, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase) (10231)

* 84134 Pre-albumin:

* 7600 Lipid profile: (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio)

* 10256 Hep panel: includes ALT (SPGT) & GGT)

* 84100 Phosphorous – Inorganic: (718)

* 83735 Magnesium:

* 84550 Uric Acid: (905)

* 7444 Thyroid panel: (T3U, T4, FTI, TSH) (84437; 84443; 84479; 84480)

* 85025 Hemogram with platelets: (1759)

* 7573 Iron: TIBC, % sat

* 83550 Ferritin: (457)

* 84630 Zinc: (945)

* 84446 Vitamin A: (921)

* 82306 Vitamin D: (25-hydroxy) (680)

* 84052 Vitamin B-1: (Thiamin) (4052)

* 84207 Vitamin B-6: (Pyridoxine)

* 7065 Vitamin B-12 & Folate: (82607; 82746)

* 83970 Serum intact: PTH

* 83937 Osteocalcin:

* 84597 Vitamin K:

* 85610 PT:

* 85730 PTT:

2^ND GROUP

* 593 LDH:

* 31789 Homocysteine, Cardio:

* 83921 MMA:

* 367 Cortisol:

* 84255 Selenium:

* 84590 Vitamin E:

* 82525 Copper:

Recipe: Frank's Buffalo Chicken Dip (sort of a casserole...)

This one is actually a repost... I am making it tonight, so when I thought about it, I thought I'd reshare it for anyone who may have missed it! This is an awesome bake and take dish for covered dish stuff--especially with WLS postops! Tasty and full of protein! I double the recipe, but I only use about 2/3 cup of the buffalo wing sauce as no one here really likes too much spice! I've made it with the canned chicken AND with freshly cooked chicken breast that I shredded myself. Either way, it is delicious, nutritious, and a hit with any group--family or potluck!


FRANK'S® REDHOT® BUFFALO CHICKEN DIP
Servings: 3 1/2 cups dip | Prep Time: 5 min. | Cook Time: 20 min.

INGREDIENTS:
8 oz. pkg. cream cheese, softened
1/2 cup blue cheese or ranch salad dressing
1/2 cup FRANK'S® REDHOT® Buffalo Wing Sauce
1/2 cup crumbled blue cheese or shredded mozzarella cheese
2 cans (9.75 oz. each) SWANSON® White Premium Chunk Chicken Breast
in Water, drained

DIRECTIONS:

1.HEAT oven to 350°F. Place cream cheese into deep baking dish. Stir until smooth.
2.MIX in salad dressing, Frank's RedHot Sauce and cheese. Stir in chicken.
3.BAKE 20 min. or until mixture is heated through; stir. Garnish as desired. Serve with crackers or vegetables.

Tips:
1.Microwave Directions: Prepare as above. Place in microwave-safe dish. Microwave, uncovered, on HIGH 5 min. until hot, stirring halfway through cooking.
2.Tips: You may substitute 2 cups shredded cooked chicken.
3.Slow Cooker Method: Combine ingredients as directed above. Place mixture into small slow cooker. Cover pot. Heat on HIGH setting for 1 1/2 hours until hot and bubbly or on LOW setting for 2 1/2 to 3 hours. Stir.
4.Tailgating Tip: Prepare dip ahead and place in heavy disposable foil pan. Place pan on grill and heat dip until hot and bubbly.

Even Jillian Was Fat As A Teen....

Most WLS postops can tell you a tale of woe that goes way back to their early childhood. I know I can. And, if I had them handy, I could scan pics that go back to my childhood and show you proof. I have them, but they are packed away at the current moment (project for the future!). I was a fat kid. I was a fat teen. I was a fat adult. It all lead me to become super-morbidly obese and 410 pounds! Well, in a Redbook article, well-known fitness guru and hotbod Jillian Michaels

reveals just the same story! At age 14, she carried 175 pounds around on her five foot two inch frame... Who'd have thunk it to look at her now! And, she lost the weight before the skin got all stretched beyond return. Good for her!

She tells Redbook that her mom noticed that she'd gained weight (she was 50 pounds overweight) and enrolled her in martial arts classes. If only it were that simple for some of us! If only our moms recognized and dealt with the problem. If only.... If only my mom had pursued my health issue (I was not diagnosed at hypothyroid till I was married and having my second child). If I, myself, had known that help was available and that I wasn't just a fat loser.... Well, that is how you feel when you try for years to lose weight and nothing works. Every time you see a doctor, you get the butt-chewing about your weight, but no suggestions as to what you can do about it other than "go on a diet...." Yeah, been there, done that!

I missed it...

My 25th high school reunion that is... It was last weekend and was right here in town too. But, for various reasons--including $$, I didn't get to go.

I saw pics taken at the reunion on friends' Facebook pages... They had a blast! Sure wish I had been there. It would have been so awesome winning that award for having NOT gained the most weight! I am at least 50 pounds lighter now than I was in high school and I'm probably 200 pounds lighter than at the last reunion in 2005 as I was near my highest ever weight just then. I remember when we were packing to move from WV back to FL last summer and I came across the pics from that reunion. OMFG I was huge! When I can get to that stuff again (still packed away till we buy a house again), I will scan and post that pic. Ugh! Never, EVER, again!

Glad that is over!

So my knee work DID get done this time... June 29th, I had my left knee scoped again. I had already had it done back in August 2009, so not quite a year had passed and it has been painful for a long time already. The orthopedic surgeon thought I might have had a bone chip floating in the joint (my knees are both bone-on-bone) and that this bone chip was chewing up the meniscus that I have left each time it was caught against the bone in the joint... Well, he didn't find any bone chips, just more shredded meniscus. I see him on the 9th for the "full report" but it doesn't sound like he really found a cause for this new damage.

On another front, I had my full labs done on June 22nd and will get those results today or tomorrow in the mail. I'm hoping my iron is at least 100 or higher (ferritin level). I won't be on it because I'm pretty certain it won't be, but we'll see!

Revision?

So, December 21st I was supposed to have my surgery... I went in. They took me back. I got changed into the gown. I had labs drawn. I had an IV running. The anesthesiologist had already been in and explained that "you'll be asleep for this..." and asked me if I knew that. I told him it certainly was my preference! They gave me the "shot to help you relax." And I was waiting for my turn when one of my doc's nurses came in and asked me if I'd be okay with rescheduling for Weds, 12/23 (two days later).... UGH! Are you freaking kidding me? Well, she wasn't! The case before me, an RNY on a very heavy woman who'd had numerous previous abdominal surgeries and had tons of scarring and hernias inside, was running WAY longer than anticipated. The doc didn't think he'd be 100% to do me when he was done. SO, we rescheduled...and I went home...and I was still mad though I had to respect his decision.

Then, on 12/23, I went back and did it all over again. But, nothing went well. Took 4 tries to get an IV in and when it finally worked, it was at the hand of Atilla the uncaring doctor who gave me no choice in how he did it and basically had me in tears from the pain by the time he got it running. Then, more waiting. The anesthesiologist this time was cool too. Answered my questions and told me that he'd see if he couldn't get that IV out of my danged hand while I was under in the OR. That didn't happen, for whatever reason. But, he did get one in my arm in recovery. I was in a room shortly, but freezing and in a lot of pain--more than I remember after my RNY... I was using the morphine every 2 hours and taking Percocets every 4 hours for two days! The very first night, I got a roomie at 11 pm. LOTS of noise and suddenly losing control of the TV when I was in too much pain to do anything else! Not a happy camper!! LOL Plus, the darned nurses kept pulling the drape between us and they'd pull it so far it blocked the TV screen anyway, so even when this other chick was asleep, I couldn't make use of the TV. By the third day, I had walked enough to get the gas moving in my chest (they pump your abdomen up with gas so they can move around and see easier for the laparoscopic procedure). That pain was letting up, but the surgical incisions were still awful. And, they'd used that Dermabond (superglue) to close me up instead of stitches and it itched like a demon!! I would MUCH rather have stitches after this experience! The only good thing??? No drain!!

After I got home, I was doing more than I should have been, but you know how hard it is to sit there and see things that need done and know that no one else is going to do them......SO, I really did not take the proper amount of time to heal before I was back at it. And, I caught whatever the grandbaby had and got sick on top of it all! When I went back to work on Monday, Jan 4, I was more tired than I was before we got out for break.....UGH!!

Now, I am pretty much healed, but still have times when my abdomen sort of knots up for no known reason. I'll ask the doc about it at my followup this week. I was told that he took my pouch from "about 80 CCs" to "about 50 CCs," so I should feel more restriction to the amount of food I can eat, but have not really experienced that. I did have one incident with eating too much and some of it coming back up. Yuck! Hadn't had THAT happen in about 2 years! I guess I can eat a bit less than before, but it still seems like I can eat a lot more than I could early on... I have not seen any additional weight loss other than dropping the water weight I put on in the hospital from all the IV fluids... We'll see! This surgery was NOT about losing additional weight though! It was about fixing my hiatal hernia and the candy cane hook on my intestine below my pouch. I have seen a drop in the amount of burping and belching, but not a total alleviation of that problem. Maybe with time.....
Current weight? 210

Wow, 3 mos and so much has happened!

When I signed in just now, it said that my last post was posted Sept 11, 2009! OMG, that is 3 months ago! And, there has been SO much happen in my life since then...

I seem to recall posting about my knee scopes. I think I posted about hubby having health issues. Maybe I need to go back and read it again myself to see just what I have posted already! BRB LOL

Okay, so I posted about my knees, but not much more health-wise. I did tell you guys that I had found a bariatric doc here in FL. Dr. Shieh is great! He did my EDG on 9/23 and determined that my bypass is sort of messed up. The end of my intestine, which SHOULD come straight up to the bottom of my pouch, is hooked over like a candy cane with the end of the intestine closed up and connecting to the bottom of my pouch from the top of the candy cane hook. This means that I have my pouch, then below my pouch the food flows into this hook/chamber area and fills up there before my pouch fills up, so I essentially have TWO pouches and can eat a lot more than originally intended. In addition, I have a hernia that needs fixed. It causes lots of burping/belching every time I eat or drink ANYthing (and I do mean anything--even a sip of water!). At the time it was all diagnosed, I was not working and doc didn't think the insurance I had would cover the surgery to repair it all. Well, I have just gotten insurance approval to have this all fixed. It is technically a revision of my original RNY, but is a surgery specifically to correct the hernia and this hooked over intestine/pouch area. I will be having surgery on 12/21 and will be all fixed up afterwards. The hard part? It is really like having the RNY all over again! Teeny little pouch (as he'll make sure all is good on the actual size when he is done--it is a little large now plus the extra pouch space from the intestine), full liquids for days, etc. The good part? I have done it before and know what to expect this time. Hopefully there won't be any of that what-the-hell-did-I-do-to-myself phase this time!

In the meanwhile, I got a full-time teaching position! I am teaching social studies (world history, American history, geography, government, etc) at the very same high school that I graduated from way back in 1985. How cool is that? In a time when most of the counties here nearby laid off oodles of teachers at the end of last school year, I move back to town and get a position in the middle of the school year! Just had to be meant to be! There is a downside. The position requires dual certification--social studies AND ESE. My current certification is social studies, so I have to obtain the ESE certification. I am taking the FTCE for that this week. I'm studying and trying to get prepared. I take the test Thursday afternoon. Fingers and toes crossed and all prayers are greatly appreciated!

The World's Greatest Grandbaby has been in his dad's custody since 10/9/09. We've been to WV for court twice since then in my daughter's attempt to get him back. We've been waiting since 11/18/09 for the judge to render a ruling. How ridiculous is that? It has been almost a month now and we were told that he'd do what he could to render a quick ruling. If this is quick, I'd hate to see a slow ruling! Geez Louise! I have gotten to spend just about 18 hours with him since October 9th and we miss him dearly. We hope to have him home by Christmas.

Hubby has been through the wringer healthwise, but suffice it to say he is finally on the mend! He has had cellulitis that caused him to have a toe amputated. He had a heart attack and a quadruple bypass. Now, all that is left is the healing and that is going well.

What else??? Well, let me think and I'll post again soon!

Iron Update...

The bariatric doc called me back today and confirmed what I already knew (my hematocrit and hemoglobin numbers are in the "low" range and my ferritin is just 6.7). He wants me to do iron infusion therapy to get the numbers back up and start working on finding an iron supplement that will help keep it up once we get it there... They referred me to a hematologist and that office called me this afternoon to schedule that appointment. I will see them on 9/21 and may have the first iron infusion treatment on 9/22. Progress--finally!

Confession is cleansing, right?

Starting weight for me was 410 pounds in 2006. These days, I range from 202 to 208 MOST days. That is a 200+ loss. My all-time low was 197. I know I will never see my goal of 185 without removal of LOTS of excess skin/tissue. But, I have also gone from a 36W or a 4X or 5X to a 14/16. I can also wear mediums in some stuff and larges in others. That is HUGE--being able to shop locally for all types of clothing! Trying stuff on in front of a mirror instead of shopping from a catalog... You all know what I mean!

I'm dealing with iron deficiency and will probably start iron infusion therapy soon. I'm getting my vitamin D up finally--51! I was down to 11 a year ago!

I have fallen off the calcium supplement wagon and only recently realized it. I hadn't taken a dose in almost two months! I had a routine before we moved from WV in June. I took them without fail, twice a day, EVERY day. Then, packing, moving, getting settled--my routine as broken, my supplements not located where they had been... Ugh! I just got them back in their place, took a dose and will start working to get back on track there.

I still battle DAILY with constipation.... How about you guys?? Had both knees scoped this past month and with the pain pills, that was even worse. Just getting back to normal (for me) now.

Eating....not sure I want to discuss that! LOL Confession time... I'm eating too many carbs (mostly complex, but still too many) and not really enough protein. I have changed my night-time snack from carbs (junk food) to nuts and or cheese, so hat is progress I suppose. But, still need to really get my eating back on track.

I moved from my home of the past 10 years, and my really strong WLS support group in June. I am back close to my immediate family, but they are not exactly the most wls friendly folks. Their eating habits are atrocious! And, they do NOT want to hear about it either. I have no support group here yet either. Heck, I only just found a new doctor Aug 27th! I'm still sort of stuck between home in WV and my interim home here. We are renting till we find/buy a house and go through another huge move. Everything seems sort of "in limbo" if you know what I mean. I think that is part of what has me so off track in everything.

Dr. Shieh, my new bariatric doc AND Labs results...UGH!

I saw Dr. Moses Shieh on 8/27. He seems to be a knowledgeable bariatric doc and even has a lab routine I can live with. I as impressed at his list of periodic labs as compared to what so many other docs request. He was happy with my surgery outcome and the fact that I've lost and kept off over 200 pounds. We talked about my iron concerns and he seems to agree that iron infusions are going to be necessary to get my numbers up again. He does want to start trying all iron supplement options again though and find one I can tolerate long term so that we can keep the numbers up once we get them there via infusions.

He ordered my labs and was going to do an EDG scope on 9/2 but had a family emergency and had to leave town, so the scope was cancelled for now. I had told him that I had reason to think my stoma may be enlarged and allowing food to pass more quickly than it did originally.

My lab results showed that my HCT and HGB were both low (lower than in Feb 09) and my Ferritin is at 6.7. It was 5.4 in February, so all the attempts at supplementation and the single dose of IV iron did practically nothing. Now that I have insurance again, I am hot to get that iron infusion therapy going. I am not going to take any chances on losing insurance again and not being able to pursue that option. I am sick and tired of being sick and tired! I feel SOOOOOOO tired all the time with my iron in the crapper!

Knees....

Mine have hurt for YEARS! In 1984, I injured my right knee in a bicycle accident. I used it (my knee) to stop a bike which ended up having no brakes. I stopped at the bottom of the hill when I hit a car fender with my knee. OUCH!! I have had a water pocket on it ever since then--25 years. And, since then, I have favored that knee and put more weight and strain on my left knee. UNTIL 1999, October to be exact, when I fell down some steps and totally wrenched my left knee. I'm talking wrenched, literally...twisted that puppy round and went down. And, in October of 2000, repeat! I re-injured that same knee in a fall down a longer set of stairs. We don't know whether I blacked out for a sec or the knee just went out from under me, but the result was the same either way.

Fast forward all these years and factor in the loss of 200 pounds. For all those years, 25 of them, I was using injured knees. And, for all but the last 3 years, I was packing around all that extra weight. Both knees were arthritic and bone on bone when I had my RNY. I was having cortisone shots in both knees every 3 mos like clockwork. Then, I stopped that in March of 2007 when I had the last set of shots. I hadn't had much problem with either knee since then. I have exercised, walked in marathon relays and other walking events. I was walking 3.5 miles every day Monday through Friday in less than 50 minutes each day. Almost all of a sudden, I started having pain in my left knee on a daily basis. It ached so badly at night. I finally gave in and sought medical attention. After xrays and an MRI, it was decided that it was primarily torn meniscus that was at fault and that the best fix was arthroscopy and trimming up the tears to get rid of the ragged edges that were probably the cause of most of the pain. They put cortisone shots in both knees and scheduled the surgery.

I had the left knee scoped on 8/18. It went fairly well. It was painful, but I was able to put weight on it after a few days and get back to normal stuff with minimal pain after a week or so. It went well enough actually that when I went for my followup appointment on 8/28, I asked about doing the right knee as well as it had begun bothering me more since the surgery on the left knee and the favoring of that knee again. One doc said "let's do an MRI and some xrays and see what we are dealing with..." His partner, who scoped the left knee, said, "Nah, let's just get in there and clean it up. It is probably just about the same as the other was..."

I had the right knee scoped on 9/1. I was told afterwards that I had "lots of tears in the cartilage..." It has been MUCH more painful and was very stiff to begin with. Since then, it has begun this lovely popping/clicking noise with each and every step I take. My brother says it is "musical, like mine" as he has the same issue in one of his knees--the clicking. The doc says it is still very inflamed and needs anti-inflammatories (such as NSAIDs...) and ice and time. I'm not patient, so the time has been hard. I am not supposed to take NSAIDs as an RNY postop, so that hasn't been easy either. Ice...well, getting back to that lack of patience, you sort of have to sit around and be patient for ice to work, right? Not happening very much! So, to get the pain and stiffness and clicking taken care of, I am going to do a hopefully short round of anti-inflammatories and see what happens. If I don't notice any improvement in a few days, we'll see what the doc says on 9/11 when I go back for followup.

Think I've found a new bariatric doc...

As some of you may know, but many may not, once you have had surgery with a bariatric doc, it can be HARD to find a new doc who will take you on as a patient. When I found out I was moving back to Florida, I contacted my surgeon. He has contacts seemingly everywhere, so I had hoped he would have a comrade here that I could use once I got moved. No Such Luck! SO, I was on my own once we got here to try and find a doc that would take me AND a support group. I think (fingers crossed) that I have done both now! I am waiting for the doc to get my surgical report from Dr. S and will see what he says! It looks good. Plus, the hospital he works out of has a support group every month. I missed it this month, but will be there with bells on next month and hope to have good things to report there. It won't be MY support group and my surgery buddies and angels, but I can work to help make it what I like a support group to be! I'll have those folks thinking marathon by next year!! LOL

You're Not Done Losing Till YOU Say You're Done...

There was a post on OH lately that stated that the person was 2 years postop from RNY and still 60 pounds from their goal weight. They asked what info could be shared about losing weight in the 18 mos to 2 year postop timeframe and that they really wanted to lose that last 60 pounds. One response to that post stated that you are not done till you say you're done. I really liked that attitude... If you give up, then you probably are done. If you stop really trying,then you probably are done. BUT, until YOU decide that this is it and you are not going to try anymore, then you are not necessarily done losing weight! We are told over and over that the surgery we had merely gives us a tool which we can use to lose weight. That tool is there for the rest of our lives. What we are often missing though is the motivation to USE that tool.

At any time, we can decide to utilize this weapon against fat! We can go back to what we've been taught and start using that tool/weapon again. We can eat properly, boost our protein intake, and increase our exercise. It really can be just that simple!

I post this because I am in that spot right now. I've moved, as you know already, from the hills of West Virginia (the foothills of the Appalachian Mountains) back to the flatlands of southern Florida. Walking is easier. Biking is more possible--even with my old bone-on-bone knees... I truly have no excuse for not exercising. Now, I am trying to DO it. I've gone from walking 2.5 miles per day Monday to Friday at about a 3.5 mph pace to walking almost 3.5 miles Monday to Friday at that same 3.5 mph pace. I am going to ride my bike today if the sky doesn't fall early (it rains most afternoons here). My sister and her best friend walk (at a MUCH slower pace) most evenings just before dark while their kids are riding bikes. I may start doing that too. It is just a matter of deciding that I want to do it, I am worth it, and it will help me AND make me feel better. I have made that decision. I am ready to do it. Let's just see how it goes!

before pictures....found a couple!

I've always made sure I was the one TAKING the pictures just so that I didn't have tons of pics with my big ole butt in them. I hated seeing pictures of myself when I was heavier. So, that made finding any full body "before" pics hard to do. As we moved though, I came across these... They ain't pretty!

This first one was from the Spring of 1997. We were at a get together for my hubby's family. It was the first time I ever met those folks in the picture and was the last time I've ever been around them. They live over in northern Ohio and we have always been somewhere else. We actually made that trip because my own grandmother had passed away and she lived in Columbus...


Then, the second picture I found was from my student teaching during the fall of 1998. I look so danged happy in this picture!

Thankfully, those are BEFORE pics and not current pics! Here's a pic of me at my current size just for perspective:

Emotional Aftermath of WLS...

In an interesting post yesterday by Therese (Miss Redd) over at OH, the term "emotional aftermath" was used in reference to the period after WLS when we all have such turbulent emotions as we attempt to get used to living in the "normal" world without so much extra weight to pack around... It was discussed how the journey is more than just a period of weight loss. It is a time of really finding ourself all over again. We were fat for SO long. During that time, we were rejected for various reasons. We were too fat. We were unable to do things. We were unhealthy. We had no self-esteem or confidence. Sometimes it was other doing the rejecting. Sometimes it was just our beating ourselves up.

Now, as we lose the weight and take our lives back, we still beat ourself up! We are still fat in our heads and will probably always feel that way. Once the fat chick, always the fat chick--even if only in our own mind... We still struggle with SO many things. And it is more than just not really feeling comfy shopping in the juniors or misses department at the clothing store!

I related a story about shopping for cars. I looked at cars I would never, ever have even glanced at before solely based upon the proximity of my belly to the steering wheel! Someone else told about skipping a pedicure with friends because of her weight. We can get so depressed even after losing the weight that we stop going out and being with others! How can we get past this? I truly think that the emotional impact of the weight loss journey needs to be addressed more before surgery is performed. They want to know that we can deal with the eating changes that are required before they do the surgery. How about starting to help deal with the thinking changes???

Centers of Excellence--Same death and complication rates...

Some insurance companies require that you go through a Center of Excellence for them to cover bariatric procedures. Why is that? Well, we assume it is because they are the best of the best and really know their stuff, right?? And, by that way of thinking, you'd also expect much lower rates for complications and deaths as a postop. BUT, according to a recent study by Dr. Edward Livingston of the University of Texas Southwestern School of Medicine, that is NOT the case! He writes, "Designation as a bariatric surgery center of excellence does not ensure better outcomes."

Livingston's study, which appears in The Archives of Surgery, analyzed data from patients who had surgery in 2005--19363 total patients and 5420 who utilized a center of excellence. Of those people, the patients who had surgery at a bariatric center of excellence had a death rate of 0.17% and a complication rate of 6.3%. Of the patients who did NOT use a bariatric center of excellence, the rates were a death rate of .09% and a complication rate of 6.4%. So, despite the fact that centers of excellence are usually better staffed and more costly to run, their outcomes are not better! The extra cost is apparently not warranted.

This information is quoted in a Reuters news article.

Did you have to use a bariatric center of excellence? Was it your insurance company's stipulation? or was it the only choice in your area? When you compare your experience with that of others, do you think things were better or went more smoothly? Do you think it made a difference?

What have YOU lost??

I've lost an average adult man AND an automobile tire!

WHAT HAVE YOU LOST??

Your weight loss =

1 pound = a Guinea Pig
1.5 pounds = a dozen Krispy Kreme glazed donuts
2 pounds = a rack of baby back ribs
3 pounds = an average human brain
4 pounds = an ostrich egg
5 pounds = a Chihuahua
6 pounds = a human’s skin
7.5 pounds = an average newborn
8 pounds = a human head
10 pounds= chemical additives an American consumes each year
11 pounds = an average housecat
12 pounds = a Bald Eagle
15 pounds = 10 dozen large eggs
16 pounds = a sperm whale’s brain
20 pounds = an automobile tire
23 pounds = amount of pizza an average American eats in a year
24 pounds = a 3-gallon tub of super premium ice cream
25 pounds = an average 2 year old
30 pounds = amount of cheese an average American eats in a year
33 pounds = a cinder block
36 pounds = a mid-size microwave
40 pounds = a 5-gallon bottle of water or an average human leg
44 pounds = an elephant’s heart
50 pounds = a small bale of hay
55 pounds = a 5000 BTU air conditioner
60 pounds = an elephant’s penis (yep, weights more than his heart!)
66 pounds = fats and oils an average American eats in a year
70 pounds = an Irish Setter
77 pounds = a gold brick
80 pounds = the World’s Largest Ball of Tape
90 pounds = a newborn calf
100 pounds = a 2 month old horse
111 pounds = red meat an average American eats in a year
117 pounds = an average fashion model (and she’s 5’11”)
118 pounds = the complete Encyclopedia Britannica
120 pounds = amount of trash you throw away in a month
130 pounds = a newborn giraffe
138 pounds = potatoes an average American eats in a year
140 pounds = refined sugar an average American eats in a year
144 pounds = an average adult woman (and she’s 5’4”)
150 pounds = the complete Oxford English Dictionary
187 pounds = an average adult man
200 pounds = 2 Bloodhounds
235 pounds = Arnold Schwarzenegger
300 pounds = an average football lineman
400 pounds = a Welsh pony