What Happens When You Spend Your Life Carrying Around 100 Plus Extra Pounds

Your knees go to pot.

I had a follow up with my ortho to go over my MRIs and the progress from my PT.  Sigh.

I have severe arthritis in my right knee (well, duh).  It came from favoring it for years while my left knee walked around dislocated.  Plus, an additional 136 pounds on my frame didn’t help.  The arthritis in my right knee is going to require surgery.  I’m to continue PT until my surgery date (July 13).  Then my ortho is going to do a sugery which requires a cartilage grapht.  This means he’s going to open my knee up, take out my knee cap and turn it over.  Then he’s going to clean it off, attach a cartilage grapht to the back, and put it back in.  I admit, I kind of stopped listening when he said “Take out the knee cap” and had to get him to repeat it.

I asked if he couldn’t do the sugery he did three years ago on the left knee, but he said this sugery will last longer and stave off the knee replacements a little longer.

I’m going to spend my summer in a knee immobilizer.  Four to six weeks without being able to bend my knee.  Which to me, seems excrutiating.  I had to deliver this news to my boss (we are trying to work out the details of my disability).  I plan on taking two weeks of short term disability (at least) and then working the rest of my rehab at home.  I don’t want to leave work high and dry and I don’t want to screw up my chances at a promotion this year.  So sad that I’m considering that.  But I won’t be able to go to work.  I don’t see how I can.  I won’t be able to drive, and the thought of navigating the mean streets of Baltimore through public transportation while having my leg in an immobilizer squicks me out.  Getting on the train will be a bitch.  And Bob will not be getting up at 6am to drive me too and from the train station.  But even then, once I get downtown, I’d have to rely on the bus system…and walking to the bus station in the afternoon up one of the steepest hills in Baltimore.

I’m also worried about putting weight back on.  Terrified in fact.  I won’t be able to exercise except at PT.

And the fact that I know already that this is going to hurt like a mofo.  When I had my left knee operated on, they did a lateral release of the knee cap which involved cutting the tendons that hold it in place.  That hurts.  A lot.  Bending and straightening your left is painful.

So, send me some prayers.  I won’t chicken out, but the thought of this surgery is mindbending for me.  I guess it will prepare me for my eventual knee replacements.  Which I already know I need but no doctor worth his salt will to them on someone my age.  I did find out that I had bad knees when I was 18.  I have degenerative cartilage disease, which would have happened whether I was overweight or not.  Unfortunately, years of being obese sped up the knee problems.

So, if you are considering bariatric surgery, I say do it now.  And do your knees a favor.


15 Month Blood Work Up – Low Vit D

I had my 15 month blood work done last week.  Everything is great except for my ever persistant problem – low Vit D.  I had an issue with it even before surgery, and between you and I – it always comes up in the summer when I get outside more.  But they never do my blood work in the summer.  Sigh.

So, they now want me on 5000 IUs of Vit D3 per day on top of the amount I was taking in my calcium supplements.  As well, three servings of low fat or skim milk per day, plus yogurt, cheese, etc.  I was taking chewable D on top of my calcium (2000 IUs per day) since as a RNY’er I can’t absorb the gel caps, but it wasn’t enough. 

I went ahead an ordered the 5000 IU dry capsuls from Bariatric Advantage.  We’ll see if those work.  I’ve had a ton of advice – but none of it will help (advice was unsolicited – FYI).  May have told me to take the D caps (um, can’t – oil based – my body doesn’t absorb oil), fish oil caps (um, again, no oil), and increase my sun time.  HAHAHAHAHAHAHAHA…half the time the only sun I get is going to or leaving work I’ve been so busy (hence the significant lack of posting here).  We’ll see if the dry D caps work.  I hope so – it’s annoying.

On a good note, I’m not anemic.  My iron is fine, so they took my off my iron supplements because I have such an issue with constipation (ugh – you have no idea).  My b12 is perfect.  Cholesterol, spot on – total is 116 and HDL was 52.  HGBA1C – right around 6 (I’m rounding up).  The picture of health. 

I love my RNY.

The Good, The Bad and the Ugly

So – the good – I’m still losing (yay!).  And my doctors are thrilled at that.  As am I.  My pouch has remembered what restriction is.  I’m upping my protein and lowering my carbs.  And I thank God every day that I can’t tolerate sugar.  I was watching a news blurb the other day (I think on CBS, but don’t hold me to it) that said that Gastric Bypass (as compared to the lapbad and the sleeve) is still the gold standard for weight loss surgery.  I don’t know if I agree with that article (they were comparing the amount of excess weight loss and the instances where diabetes was made better as a result of the surgery), but it was the right decision for me and my sugar and crap food addiction.  I’ve now lost 75% of my excess weight (going by a goal weight of 150), my diabetes is in remission, my heart disease has reversed itself, my sleep apnea is gone, and I feel so much better.

The bad – the excess skin is start to cause issues.  My eczema has flaired where there are larger amounts of extra skin on my back and under my breasts.  Not much the doc can do for it except tell me to take quick showers with lukewarm water and moisturize.   At least it wasn’t skin infections (although I am starting to get sores on my rear where my extra skin hangs down over the tops of my thighs – how pretty).

The ugly – the right knee is buggered.  I have to call today to set up an x-ray.  It’s grindy and poppy and sore to the touch – the same as the left knee was before my last surgery.  And it’s not attributed to excess weight but instead it’s a result of degenerative joint disease which runs in my family.  Oh well.  I don’t want more surgery.  EVER.  But oh well.

So, that’s what’s going on.

A Recipe for Breaking A Stall

Sigh- so I had my 12 month follow up today.  Seems the only one being hard on me and my stall is myself.  They reminded me that I’ve lost over 100 pounds in a year, and that my body may just be happy where it is.

I’m not.

But I realized that just by going today and not cancelling my appointment (because of no weightloss) means I’ve won an important battle in this war.  I went.  And I asked for help.

First of all – I need to start really diarying again – both my food and my feelings.  And they hooked me up.  They made me realize that I’ve gotten too comfortable and in a routine – which is not good.  So, that’s step one.

Step two is to teach myself how to deal with stress and cravings.  They have given me an exercise to do to deal with the cravings – a tapping technique.  I’ll give it a try – what the heck do I have to lose?  And they recommended a book to deal with the snacking that’s come back in – 50 Ways to Soothe Yourself Without Food – I ordered a copy tonight.

Third – I need to remember how far I’ve come.

Fourth – I need to kick up my exercise intensity and level.  And make sure that on top of that, I get in 10,000 steps a day.

I have come a long way, and my team is thrilled.  I’m going to go see them again in 3 months to see if the tips and techniques they’ve given me work.

Keep your fingers crossed.  I just know I’m not done yet.

9 Month Surgical Follow Up

Yesterday I had my nine month (and one week) surgical follow up at Upper Chesapeake Bariatrics.  I met with the exercise specialist, my nutritionist and the behavioral therapist, and I briefly saw my surgeon who was in the office yesterday seeing new post ops.  He gave me a big hug.  Lord I love that man.

So, things I’m doing right:

  1. protein – I’m getting in at least 60g. per day even though my surgeon’s office doesn’t give me a “goal”
  2. fluids – I always hit at least 64oz of fluids per day, if not more
  3. portion control – I’m keeping my meals generally between 3/4 of a cup and 1 1/4 c depending on the density of my protein
  4. pictoral history of my weightloss – I’ve been keeping a scrap book of my journey from two days prior to my surgery, and then updating the pictures on the 10th of every month.  In the scrapbook, I’m tracking not only my pictures, but what goals I’ve accomplished on a monthly basis.  They are thrilled with this and are going to suggest it to their other patients.  Look at me, a role model!

Things I need to work on:

  1. Exercise – time to get serious about it – 1/2 hour per day of cardio and 3 days per week of strength training (upper body, rest, lower body, rest, abs).  I need to add weights to my routine to kick start my metabolism.  They believe this is why I have stalled out so long lately.  Although they are thrilled with my weight loss, they told me that I need to build my muscle mass at this point to KEEP LOSING.  In my head I knew that – the motivation, though, wasn’t there until they measured my body fat percentage – 41%.  My goal is 35%.
  2. Snacking – stop it.  I find myself grazing and even though its on good things (fruits and veggies) I need to cut it out.  3 meals per day, period.
  3. Food diaries – I am to start journaling my food – time eaten, what eaten, and how was I feeling.  I have to fax them to the behavioral therapist on a weekly basis.  The idea behind it is for me to identify what is causing me to snack, and then on top of that, to give myself accountability to maintain portion control and maybe, if I have to write down everything, I’ll realize that I’m not actually hungry.  Good points, all of them.
  4. Adding in one protein shake per day – I’d gotten away from this, but it really will up my protein after a workout.

And so, my goals for my next appointment are to:

  1. Body fat percentage under 40%
  2. weight under 200 lbs

Easy enough…right?  The thing is, I have to recognize that this ISN’T easy.  The honeymoon is over, and this is when the real work begins.

Another Wow Moment

Seven years ago I was sitting in a hospital ICU recovering from a heart attack.  At the time, I weighed roughly 250 pounds – about 250 more than I weigh now.  My blood sugars were well into the 300s.  I had high cholesterol.  I had high blood pressure.  I had one artery that was 100% blocked (Hell-o stent) and one that was 50% blocked.  I was 30.  It didn’t help that at the time of my heart attack, I had been on Phen-fen, was smoking and taking the pill at the same time.

The cardiologist who treated me when I first went into the ER was Dr. Barry Wohl.  He was an angel of God as far as I was concerned, and I’ve seen him as my cardiologist ever since.

On Monday, I saw him for my normal six month cardiac check.  In his opinion, not ONLY have I erradicated my high cholesterol, high blood pressure and diabetes, BUT he feels that my Coronary Artery Disease (CAD) is in REGRESSION.  YEP – RE-GRES-SION.  Going Away.  He feels that more than likely, the blockages in my arteries are actually reducing themselves.

When I had surgery 8 months ago, I was on high blood pressure medication, two cholesterol meds, a beta blocker, plavix, and a host of diabetic meds.  Today – nothing.  All I take is Protonix (and that is for acid reduction due to the surgery).

I am healthier at 37 than I was at 30.

I’ve truly gotten my life back, and it is amazing.

Thank you Dr. Wohl for saving my life then.  Thank you Dr. McKenna for saving my life and saving me from myself.

One Year Ago Today

One year ago today, I attended the Bariatric Seminar for Upper Chesapeake Bariatric Surgery, and I met this man:

Dr. Stephen McKenna.

After months of searching, I found the surgeon who I knew made me feel like home.  One year ago today, I met the man who would save my life.  And I am eternally greatful.

Dr. McKenna – thank you so much for giving me my life back.  You have no idea how much I love you.

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