Archive | December 2011

What to do, what to do?!

So now that I have started down this journey, I need to figure out how I am going to get into shape as the weight comes off, so that not only can I be healthy – that remains the #1 goal, but to actually get into an exercise regimen that will be my signature for the rest of my life for goal #2 – a body that I am proud of.

When I attended the original seminar that got me into Dr. Snyder, one of the components was a panel of actual patients that were at various points in their post-op journey.  Most still had a way to go, some were at their goal (and still looked a little heavy to me, but definitely happy and much, much healthier) and one guy _ Richard – was training for his 3rd or 4th Iron Man.  He looked amazing.  I was inspired.  And of course that is the point of seeing real people with real results.  To show you what is possible if you put the work in.  And I am willing to put the work in.

I used to run in grad school – through a local cemetery (that’s a story for another day – I love the peacefulness of cemeteries)…..frankly, because I loved (OK – lived) to eat, and I was already about a size 10-12 and I wanted to hold it there if I could.  And I was solid as a rock.  I am – at my fighting weight – an athletically built, curvy gal.  And my muscles remember that.  It’s probably why the weight hasn’t actually done more damage yet.  Bless muscle memory!

Did I mention that Dr. Snyder’s team includes weight/exercise specialists – seriously, people with PhD’s in this stuff – free of charge post-op to work with you on a plan that works for you?  Their bare minimums are cardio 30+ minutes almost daily – think 5+ days a week.  Most obese people have never done that.  I did it in a far off land many, many decades ago.  I digress…

I have never been a team sports kind of gal.  I like to work out my own baggage in my own head.  Hmmmmmm, now that I wrote that last line and then re-read it, it occurs to me that at least in the area of working on my weight that has not worked. Something to ponder.

Back to the running idea.  I have watched the Biggest Loser for a long time.  Quick sidebar – I recently found out that 95% of those people gain all of their weight back!  I am quoting my surgeon for those of you that are curious.  Why do they gain the weight back?  I’m glad you asked – because in the real world where we all must live, you need a plan that you can actually MAINTAIN. FOREVER.  Or – you go right back to being obese.  Not too many people can live forever with a restricted calorie plan every day and work out 6+ hours a day.  It gets in the way of the rest of your life.  Remember, these are obese people who have already blown up their metabolism.  Dieting does not work for obese people.  We already blew up our metabolisms.  Again, I digress.

At the end of the last several seasons, those people have run marathons.  It occurs to me that they have nothing on me in terms of my desire to commit to training for something like that.  It is inspiring.

So my plan – and my commitment to me – is to train for an official 5K race to start.  That is a mere 3 miles.  I see people pushing strollers and toddlers finishing those things!  I literally walk that a few times a week with my Great Dane Asher.  I just have to start jogging it after I lose some of my weight.  Hard to jog with an extra 100lbs.

Then I want to do a 10K – doesn’t that actually sound impressive?  A mere 6 miles.  No toddlers or strollers here, people! I can do that in 2012.  And my ultimate goal for 2012 is a half marathon.  You heard me.  13+ miles.  Official races give you a maximum of 4 hrs to finish.  I could walk it in that amount of time today if I had to, so I am pretty sure I can pull this off – although the goal is to jog it.  The HUGE goal is a marathon in 2013.  Mostly because if I need to have surgery to get rid of excess skin (and I suspect I will), I don’t want to run a marathon while I am still dealing with that.

My plan is to start working with Dr Snyder’s team and then to graduate to a local running club.  Where I can be with other beginners who are also training.  Kind of cool and mind-blowing to think about.  But I really need and want to set some goals here, otherwise what is the freaking point of all of this?

Of course, I will research running clubs, running shoes, running gear and local races to death.  But as a time-waster, it’s a pretty good one.

And when I sign up for that first 5K, you are all invited to come cheer me on.  It will be a good show because I am very likely to be running with tears dripping down my face just from the pride and joy of it.  It’s been a looooooooong time since I had any pride in my physical self.  And I am competitive enough to think I can beat the toddler and the stroller crowd.  I like my odds.

This entry was posted on December 30, 2011. 3 Comments

The prerequisites and the Resisters

I was thinking last night about all of the hoops I am jumping through to get ready for the surgery….which is just the first step in this life change.  Here is what I have to do, or criteria that I have to meet to even be considered for this surgery with Dr. Snyder and to meet my insurance requirements:

1. Verify insurance or work out financing or pay up front.  Gastric Bypass (or RNY) is about $20K – 25K.  If covered by insurance (and mine is except for a co-pay for bariatric surgery) start working with my insurance-assigned case worker to coordinate all benefits.  This is a fair amount of almost daily work.

2. Have a BMI of 40 (look yours up and then see what you would have to weigh to get yours to 40, you will be shocked) OR a BMI of 35-39 with multiple co-morbidities (like sleep apnea, depression, arthritis, cardiac or pulmonary issues, you get the idea).

3. Blood work – they drew 14 vials of blood from me…yes, 14.  That is based on my medical history and surgical consult results.

4. Pulmonary study, and I may still need to do a sleep study – that is to make sure that I either stay in the hospital long enough or go home with the right equipment if I really have breathing issues while I sleep.  Apparently I snore like a truck driver, which I doubt is a turn-on for my husband.  Asher doesn’t care if I snore but he is only my husband when Scott travels.

5. Pysch consults – 2 for a total of 90 minutes.  I think that is a little light, but I had been seeing a counselor for over a year – and my weight and depression were a big part of those sessions, so I feel like I have a handle on it.

6. The initial seminar (2 hours and incredibly informative) and then the initial consult with Dr Snyder.  Those seminars are only once a month, so if you miss it, you have to wait for the next one.  Then there is a HUGE (pun intended) line afterwards for people to sign up for the consultations.  And he only does a few days of those per month.  They are 30 minutes each, and I must say he makes those 30 minutes very valuable.  I asked him how many of his consults turn into patients and he said over 85%.  Amazing.  He turns down some because they are not ready to commit to the lifestyle change or are not good surgical candidates at this time, and some just decide to not do it.

7. Research on which surgical option you feel is best for you.  I was clear all along after my research that I wanted and would get the gastric bypass….it has the most data and long-term success, makes you feel full, and an average excess weight loss of 71% versus 50ish and 60ish with the 2 other choices of lap-band and sleeve gastrectomy respectively.

8.  If I were 5 months older (50 years) I would have been required to have a full cardiac work up.  I didn’t need it so I don’t have to do it.  And a lot of people also require a gastro-enterology clearance.  I also did not need that.

9. Mandatory pre-surgical nutrition classes with a group of patients – about 10-12 – and my support person (Scott).  They really, really want to see your support person at pretty much everything.  The internet bariatric discussion boards are littered with people who “fail” post surgically because nothing changes in their life style including huge meals being eaten by other huge people all around the post-op patient.  If you cannot commit to the lifestyle change this surgery will not be successful, or at least not as successful as it should be.

10. Mandatory meeting with staff nutritionist at Dr Snyder’s office.  This is to specifically review my nutritional needs and expectations immediately post-op, then the stages after that as we move into what will be my new normal of 5-6 4-6oz meals daily for the rest of my life, comprised mostly of protein (70%) and complex carbs.  And you cannot drink with meals, that occurs when you are not eating for the rest of your life.  And you learn to sip, not chug.

11. Meeting and recommendation letter from my PCP (primary care physician) outlining that I am good surgical candidate and 5 years worth of records detailing my weight and what we have done to address it.  I had those.  If I did not…….

12. Most insurance requires a mandatory 3-6 month physician monitored diet prior to surgery.  I was actually able to get that waived.  I admit it, I cried on the phone to get the insurance to waive it.  You don’t ask, you don’t get……

All of these hoops are necessary and worth it, and I don’t think anyone who does this should take it lightly.  It is LIFE-ALTERING. Forever.  No turning back.  So this stuff is good, just a PITA.

In this process I have already unearthed a surprising number of people in my life that are very resistant to this choice I have made (let’s call them the Resisters).  I knew to expect it, yet it surprises me anyway.  Why would anyone want me to stay obese?  When nothing else has worked for me?  Anyone who knows me knows that I research stuff to death.  I can find anything when I research – I could have had a very successful career in research.  I did not arrive at this decision lightly.  My daughter Chelsea summed it up best…..she said that there are people out there that like having me as their “fat friend”.  Well, too bad for them.  And much like when I started my own business, I suspect this will give me a great opportunity to “weed” my friend and acquaintance garden.  And fair warning here, I am willing to weed deep, and I don’t care where these people are in my life.  I support the people in my life – probably to a fault – and I am worthy of the same.  I am all done with relationships that are 90% me and 10% the other person.  Life is literally too short to keep toxic people around, so I am going to consider this part a blessing. And I am going to start weeding away.  I need the exercise anyway.
This entry was posted on December 29, 2011. 3 Comments

Things that are on their way out / things that are on their way in

I am having some pretty hilarious conversations with myself right now.  Mostly because there are a lot of things that are leaving my life for good, or at least for a long time.  In no particular order:

1. White stuff – potatoes, bread, pasta, rice……..wow

2. Coffee….WOW

3. Sweets

4. Alcohol – for a year

So every time I eat something I really like, I am looking at it from a “last time” perspective.  How much will I miss it?  Will I miss it?  And I find myself trying to make all of the bites and meals between now and GB Day great bites…..because these will be memories.  I made taco pie a few days ago because I love it.  And now it is gone, and that is the last taco pie for me.  There ARE more burgers, steaks and sushi in my immediate future though….until GB Day.

I could literally care less about giving up booze for a year.  But coffee?  I will miss that.  And bread……I love bread.  And potatoes.  I love potatoes.  But, they are all full of sugar, and that is a no-no.

On the upside:

I will be FULL!  All the time.  I cannot even imagine what that feels like.  Dr Snyder told me people call his office in a panic after surgery when they start being able to eat food again all concerned about the really weird feeling right under their breastbone.  And it is always that they are FULL.  We don’t feel that way as obese people.  I am super excited to get that feeling.  To NEVER be hungry.  After eating 4-6ozs TOTAL of super good for me food. Wow.

And dropping through sizes for a while.  That will be awesome.  My plan is one pair of jeans and a pair of slacks at each size and just make it work until the weight loss slows down.  I will suck it up, because when this is over, I am buying myself a wardrobe.  With cute stuff.  That I love. From the mall.  OMG!  Like a normal person!!!!!!!!  And I am very likely going to be buying myself some body contouring surgery because I am not going to live with saggy skin after all this work.  I intend to look great.

My new favorite websites to cruise are clothes.  I have never ever done that before, because I have been fat since the internet started having shopping websites.  And I hear that I will drop a shoe size, so I get all new shoes!!!!!

But the biggest upside is getting back my health.  Getting back decades on my life.  Eliminating most of my health issues.  I want to run again.  To have energy.  To not be depressed.  I am less depressed just getting ready for this!

Giving up the food and booze and coffee?  Totally. Worth. It.

This entry was posted on December 28, 2011. 3 Comments

Prelude ~ Taking Back My Life!

I have been overweight my entire life, or at least it feels that way.  I remember feeling fat in highschool, and now looking back  at the photos I realize I looked amazing.  Youth really is wasted on the young, me included.

By the time I was in college I was 140ish, and when I was in grad school I was 160ish.  Looking back – still looked pretty great….but at the time, I felt fat.

When I got pregnant with Chelsea 24 years ago, I really lost whatever hold I had on a semi-normal weight.  I weighed 264lbs the day I came home from the hospital with her – so in theory I was 275ish when I went in.  Wow.  Some of that came off quickly, but a lot of it stuck around.  I started smoking to get the weight off, joined Weight Watchers for the first of many times and basically starved myself.  I lost 100 pounds (I did that again a decade later), and when Chelsea was 2 I was back to about 165.  I wore a large size 12 and felt huge.  Looking back at old photos, I actually looked pretty good.  Again – youth is completely wasted on us when we are young.

I needed to look decent for my job, so I continued a ridiculous cycle with food.  I could still take weight off, but it became harder and harder over time.  I now know that I trashed my metabolism, and that the massive weight losses followed by the immediate regains would become the pattern of my life.  And the smoking was taking its toll as well.  When my grandmother asked me to quick smoking right before she died, I quit cold turkey, and promptly gained 60 pounds….seriously, in under 5 months.  I can remember making meals for Chelsea, and then eating plain popcorn and drinking water to fill myself up.  I would wake up ravenous.

When I married Scott in October of 1999, I starved myself into a size 14 dress.  I weighed 168.  I was 37.  I came back from the honeymoon at 180.  I have not seen 180 since.

I have been over 200 for a decade.  For the last 5 years I have been mostly about 220.  For the past year, I have been a size 18 and recently went up into a size 20.  I weigh 240ish.  I should weigh 100lbs less than I am right now to be at my optimum weight for my height of 5’5″.  150lbs would be a great start.

I cannot remember the last time I shopped anywhere but Lane Bryant.  It is incredibly sad and depressing to have your fashion universe boil down to one small store, and to have to be satisfied with anything that fits reasonably well. My side of our closet is really small, because I just don’t care anymore about my clothes.  I would live in pajamas if I could.  Nothing is cute, and nothing is flattering.

I mentally and emotionally gave up the battle last year.  I was shocked to see myself in a photo where I had 3 chins from smiling.  Broke my heart, but I always put on a brave face, and I try really, really hard to not let anyone see me down.  I knew from experience that even when I was careful, ate like a normal person, counted calories, walked, did all the things normal people do to lose weight…..I just did not.  And……I am never full.  My stomach growls all the time.  I just stop eating because I am supposed to.  But I am always hungry.  I thought everyone who is thin was always hungry.

When I turned 49 I figured out that 50 was right around the corner.  I had this vague thought that now should be when I dig in and go for 150 at 50.  And immediately sighed and tossed that aside because I knew that while I could get to 150, it would be for a minute.  Dieting. Does. Not. Work. For. Me. Or anyone like me.  But, I didn’t know that yet.  And – I was really getting afraid for my health.  How long can I be this big and not have it take a gigantic bite out of my life expectancy?  I had already stopped golfing and skiing ages ago, and I quit running a long time ago.  I walk – a lot – with my dogs, but it’s not very quick anymore.

So, I started researching again.  And then I wound up overhearing a very normal sized guy talk about his gastric bypass experience to someone when I was sitting nearby a few months ago.  I literally stopped breathing while I listened to his story.  He was really happy.  He was back in charge of his life.  He said he was never hungry anymore.  He had energy.  He was doing things he had not done in decades.  I wrote down the surgeon’s name that he mentioned, grabbed my bag and raced home to look the guy up.

I discovered Dr. Michael Snyder.  The guy practices here in Denver.  He is the best of the best.  He has done well over 3000 bariatric surgeries – band, bypass, sleeve, revisions, and ‘hybrid’ procedures like band-over-bypass, etc, and he is starting to do bands with Plications.  Zero mortalities.  Zero – but he is so honest about it that he discusses one patient that died in 2004 about 6 weeks post-op of heart issues unrelated to the surgery.  Very strict practice in terms of requiring patient compliance and everyone loves his practice, and I mean everyone.  I researched the dickens out of him, out of gastric bypass surgical options in general and kept being amazed by what I found.  The guy even pays for as many classes as I want to take to stay on track, including support groups and nutrition classes.  Free of charge.  Forever.  I knew this was it.

I went to a mandatory seminar for Dr. Snyder – he does not let you in even for an initial consult without it because he wants you to know what it involves ahead of time.  Scott and Chelsea went with me.  I was so grateful for their support.  The room was PACKED….I am taking about a ballroom, and he holds these once a month!  I learned a lot that night.  There are a lot of people like me out there.  I was not alone, and there was a solution for me.  And I knew I could do it.

I made my consult appointment, and I did everything I needed to do ahead of time.  I verified my insurance, and I am indeed covered.  Bless Scott and Arrow Electronics and their great health insurance.  I did my psych consults.  I did pulmonary tests.  I did my blood work.  I met with my primary care physician, got my records and got a letter from her blessing me as a candidate.  She was very in favor, and loved Dr. Snyder as my choice for surgeon – in fact told me he was the only choice she would support.

Then I met with Dr. Snyder.  He loves me as a candidate for the surgery. While I am technically morbidly obese, I am in good shape considering, and should fly through the surgery, even with my co-morbidities of lupus, asthma, probable sleep apnea and rheumatoid arthritis.  I am also listed as hypertensive, but I was nervous at the appointment and it shot my BP way up.  And, if I am completely honest, I am clinically depressed, although I mask it well (I think).  More importantly, I am very aware of what I need to do for this to be successful and I am willing to commit to changing my life forever for this to work.  I just want the same fighting chance to keep weight off that normal people have.  That’s it.  I am willing to do the work.

Dr. Snyder accepted me as a patient.  And if all goes well, my surgery will happen in January.  That’s right, within the next 4 weeks, maybe as few as 2 weeks!  I cannot wait.

I cannot imagine what it will be like to be out and about and not have people give me that look that obese people get.  You cannot imagine how mortifying it is until you have been on the receiving end of it.  Being critical of fat people seems to be the last acceptable bias. No one is happy being fat.  No one.  And I am ready to get control of this and take back my life and my health.

To my family and friends, thank you from the bottom of my heart for your support.  It means the world to me.

Get ready world.  Here I come!

This entry was posted on December 27, 2011. 14 Comments