A Thin Girl Inside a Fat Chick!

No pun intended of course…

A few days ago I had my psychology clearance appointment, which was iteresting to say the least.  Now I’ve never been to a psychologist before, the closest I’ve come is in college.  I went to a counselor because I was feeling depressed. She was less than helpful telling me in a nutshell that I had it all together, there was no reason to be depressed and why the heck was I sitting in her office?!  The psychologist was a totally different experience.

It’s very close to Halloween as you all know and in true fashion on the way to this appointment it was pouring out and I was stuck in suburbia hell where every house looked alike and my over-active imagination was thinking I’m walking right into a horror movie.  The receptionist that made the appointment told me the doctor’s office is out of his home and please do not go to the front door, please use the side door.  The office was very quiet very zen and the receptionist, at least I assume she was a receptionist asked for the usual and handed me a clipboard with a packet of papers on it.

Psychological testing is very interesting I fail to see how drawing a house, a tree, or a person is going to get into my head and be able to allow the doc to figure me all out.  The pictures were actually my favorite part of the whole process;  there were also tests for depression and self esteem as well as a complete the scentence questionnaire.

Although the paperwork was very thorough the actual interview was mediocre at best.  When I walked into the reception area there was a woman sitting there who was also heavy and, I shouldn’t assume but did that, she was there for the same thing had already filled out her papers.  She was called in and I’d just started my paperwork figuring it was going to be awhile until she came out.  When I tell you she was in the office for probably 15 minutes that would be generous. I probably finished my papers about 10 minutes or so after the woman before me left and was called into the office about 5 minutes later.

I sat on the proverbial couch to have my head “shrunk” to find that it was more of an interview than a talking session.  Typical medical history questions were asked, if I had support and if I knew exactly what the surgery and post surgical care entailed.  Of course I did and I sat on that couch thinking where are the difficult questions the questions that were supposed to dig into my brain and tell this guy who I was and how I may do with all of this?

Basically this man was Captain Obvious and told me that I was mildly depressed, nothing he thought I needed medication for and that most likely it was due to my weight.  He was of course recommending me for surgery and to see how I felt after I lost weight and if I was still depressed then I could start therapy.  I was maybe in his office for 15 minutes.

You may say to yourself well this doesn’t tell me anything.  Through my experience all I can tell readers who may be thinking about surgery is to be honest when you answer the questions because if you need help presurgery this is a way for your doctors to know so you can get it.  I’m pretty sure those tests have a way deeper meaning and can identify any dysfunction that may exsist in a patients life.  The only other thing I can say is if the doctor finds that you do need presurgery assistance take it seriously and get the help you need it could make a world of difference in your pre and post surgical experience.

Hello all, I know I’ve been bad haven’t posted in awhile.  Motivation and infuriation says quite a bit right now, as does frustration.  Let’s start with motivation, which I do not have on many levels especially to exercise.  I have a very demanding career with long hours and yes I know not an excuse, but most of the time I just want to go home and crash and if I’m off the next day I just want to vegetate on my couch.  No I do not set a good example in getting up and moving.  I have taken some small steps though: parking my car farther away from the building at work and hoofing my behind around to the front entrance instead of the closest entrance, lifting weights while watching TV, as well as using a small stationary elliptical.  I know in the long run this is not enough exercise but it’s a start.  If anyone out there has any motivation tips for me feel free constructive criticism is always welcomed.

Now the frustration comes with trying to train myself to start eating the way I would post surgery.  This no drinking with meals thing is definitely way tougher than it sounds.  Even eating a meal over 30 min is tough.  I mean at home I can consciously make an effort to eat that slowly, but at work I don’t have time to stop and think “hey I’m supposed to eating like a turtle!”  The first time I tried to eat like that I had to set a timer on my phone.  I suppose there’s a science to it.  It felt as if I was taking a super long time to eat, but you know something when time was up I honestly was full and didn’t even eat everything on my plate.  This of course was coupled with trying not to drink while eating and thoroughly chewing my food.  As busy human beings we literally inhale food and sometimes large portions of food and because we are eating so quickly don’t even realize we’re full and how much we actually ate.  This has got to be a huge contribution to the obesity epidemic in this country.  Other cultures take time to savor their meals, they close up for 2-4 hours in the middle of the day and open back up later in the evening they don’t live the rat race must keep up with the Jones’s type of life style most American’s do.

Lastly, my infuriation comes from dealing with all these surgical clearance appointments.  The nicest staff to deal with on the phone so far has been for psych clearance.  The receptionist was lovely and knowledgeable and I didn’t picture for one second Janine from the Ghostbusters hollering into the with the cig hanging out of her mouth “what d’ya want?!”  The pulmonologists office on the hand was definitely a Janine.  I had to basically argue with her and tell her what I needed which was so much fun.  Because I’m not a medical professional or anything I can’t just show up for a test without a doctors script.   My biggest aggravation of all came just last night actually.  Expecting to have my second nutrition appointment at 730pm and the bariatric nutrition area of the hospital is locked up tighter than a drum.  Of course they were very apologetic when someone was able to get in touch with the director and they would figure out a way to make this up to me.  That does not compensate me for my time, gas and knowledge that was not obtained because there was an error on their part.  They did reschedule me I did receive copious amounts of protein and vitamin samples, however this lack of communication is seriously aggravating.  My advice to all of you going through this stage of the game is learn some meditation oh and patience because I have not learned either, trust me it will benefit you in the long run.

As you can guess from the heading this is what today’s post is all about.  My first nutrition appointment was today and after getting stuck in traffic and ending up about 10 minutes late, which I apologized profusely for, the session was worthwhile and very informative.  The nutritionist has been one of the most knowledgeable people regarding this surgery, besides the RN in the surgeons office, that I have met thus far.

I am still wrestling with fears that I will not be able to live this lifestyle, and trust me once you start this process you will see that it definitely is a lifestyle.  It’s a lifestyle of making conscientious food choices that in a nut shell aren’t going to interfere with the healing process, and later on aren’t going to send you running for the nearest rest room to relieve your agony either from the front or the back!  As the nutritionist said today all your favorite foods are still going to be there or you’re still going to be able to enjoy them but on a much smaller scale.

This is not a bad thing.  America really is obsessed with food and the portion sizes are incredibly rediculous.  We could feed a small third world country with what some restaurants throw away because they make meals for 4 and they’re only serving 1.  That being said I learned the “plate” method today.  This is based on a 9 in plate.  I had already switched over to eating off of smaller plates awhile ago so this did not surprise me.  The plate method consists of half the plate being protein and the other half being split between veggies and a startch.  Nothing so crazy.  What is crazy to me and something that I have to work on way before the surgery is this whole no drinking while eating.  This concept boggles my mind and I don’t know if I can do it.  The rule is no drinking 15 min before a meal or 30-45 min after. Maybe I won’t miss liquids that much aftet surgery, but right now this is going to be a challenge.

Some other fun facts to know:

• Limit caffeine, alcohol, and carbonated beverages.
• Eliminate fruit juices.
• Drink water like it’s your job, at least 64oz!
• Eat protein at each meal.
• Eat more fruits and veggies–2 choices of each every day.
• Choose more whole grains.
• Limit high fat, high sugar foods.

We also came up with some goals to work on prior to surgery.  Some are going to be more difficult than others, especially motivating to get my butt up and move more, but that’s a post for another day.

My best friend called me yesterday as I walking out of work and as I was fumbling with my bag to get to my phone I had this feeling it was not going to be good news.  I was right.  She called to tell me that her father had passed away.  Although not altogether unexpected I do know that she was not ready for it.  What child is ready for their parent to pass?  Of course I tried to console her told her I’d come down and be with her the next day and then I thought about her father and how long I’d known his daughter.

We weren’t always best friends we grew up in the same town went to the same schools so we’ve known each other for about 22 yrs, we’ve been best friends for at least 15 so I’d say I know her pretty well.  We’ve battled our weight together in the past going to the gym and working out, but this never works when you go out and eat afterwards.  We’ve also done various weight loss programs together none of which really worked, but it was good to have a buddy.

Back to her father he was always a large man, but I wouldn’t say he was morbidly obese until way after high school.  As we got older he developed a book full of severe health issues including prostate cancer and later stage IV lymphoma.  Complications of this are eventually what caused his death but obesity contributed    to many of his ailments.

Her mother would tell me all the time that he just won’t stop eating, that he brings a chair into the kitchen and sits in front of the refrigerator and picks out what he wants.  I never believed her until one night my friend and her sister and myself were sitting in the kitchen and her dad came in and did exactly what her  mother described and I was shocked.

Now that he’s gone, looking back I realized that yes her father had an issue with food as do many obese people.  But unlike some who want to change her father seemed stuck in his habbits which ultimately led to difficulty in diagnosing and treating his cancer.  His daughter still works on her own weight knowing that she does not want to end up like her father and as her friend I will continue to be her voice of encouragement and support as she is mine.

I wanted to take a little time and write a bit about self image, relationships, intimacy and weight.  For the average person it’s easy, there may be some hesitation to engage in an intimate relationship, however there may not be the constant worry that “Oh my God” this person is going to see me naked and run screaming for the hills!

In an ideal world weight could be put aside and people could be loved for who they are, not what they look like.  Unfortunately, we do not live in an ideal world.  We are socialized from a very young age that “beauty is in the eye of the beholder”–it’s all about the physical right?!  As a woman the media has bombarded us with images of young, stick thin models in skimpy bathing suites living it up in exotic places and they are all fawning over drop dead gorgeous men with, forget six packs, try twelve packs.  This model image, as I was growing up, seemed to be what every teenage boy had in his mind.  I did not fit that image.

Although not as heavy in high school and college as I am now I can not tell you how many times I have heard “you would be so hot if you just lost 5 or 10 more lbs.”  Some of you reading this can’t imagine a person saying that, but those are the words that were placed in my head so long ago they’ve just stuck.  Of course now it is so much worse and way more difficult to engage in a normal intimate relationship where weight is not the main focus.

It’s no surprise that overweight women suffer the most from image insecurities.  A vast majority of my life I have either felt like the elephant in the room or the invisible man.  Either way feeling like you are being passed up for someone or something better basically, in a probably inappropriate blog word, sucks.  The character of Eeyore in Winnie the Pooh is very relatable to the way I feel at times regarding my size–“Woe is me nobody loves me.”  It’s been so long since I’ve felt sexy or beautiful; I can’t even remember the last time I’ve felt comfortable in my own body.  Half the time I feel trapped.  I feel like there is another person in there trying to claw their way out.  I have built up walls so high and so thick I refuse to communicate about my weight and its affects on those around me.

This is where I’m hoping the psychology evaluation helps, not only with my relationship towards food but with self esteem and self image.  Because as an outsider it’s so easy to say that you shouldn’t have to be made to feel like less of a person because of your weight, but that is simply not the case.  The world seems to take a liking to shunning and belittling the overweight.  Yes I have been in relationships where everything is fine and my size seems to be overlooked just to be told down the line “I can’t be with you anymore, do you see yourself?”  Of course I see myself!  Just remember none of us asked to wake up suddenly 100lbs or more overweight it just seems to happen.

So I’m going to close with something I posted on my personally facebook page a few months ago:

“Let me start by saying that larger people have feelings.  We are hurt by others who stare, snicker, and make rude comments.  You are not inside my body or my head.  You do not know how I think, where I have been or what my struggles are.  And yes those that comment out of love and concern we take that to heart.  Please know we are not like this because we want to be.  Some of us are just trying to be happy in our skin and trying to change their life one step at time and that doesn’t happen overnight.”

So, the skinny on the consultation–no pun intended–is waiting.  Waiting seems to be what this surgery is all about.  Let me say that the first red flag for me was the parking lot, not a space to be found.  It’s a good thing I work down the street and am not so out of shape that I can’t hoof it a few blocks because that’s exactly what I did.  Then I couldn’t find the elevator which I’m sure was right in front of my face, but I didn’t see it.  So by the time I hiked up the two flights of stairs and stood in front of the surgeons door I was beat red and breathing like I’d just run a marathon!

A bit of advice talk to the people in the waiting room.  I don’t often strike up random conversations due to the fact once people find out I’m a nurse they want to give me their whole medical history and then some.  I most likely would not have spoken to anyone had I not recognized a woman I worked with who looked absolutely amazing and was a couple months shy of her 1 yr weight loss surgery anniversary.  I believe she told me she lost something like 150 lbs and had a few more to loose before her goal weight.  She admitted that even though she was almost at her goal weight she still had a long way to go, but that she felt amazing.  She was able to breathe, her blood pressure had gone down and so had her cholesterol and she was able to keep up with her kids.  All good things as far as I’m concerned.

She was sitting across from me in the waiting room and next to me was a woman I didn’t think was even a bariatric surgery patient.  Afterall this is a general surgeon specializing in weight loss surgery she could have been there for any number of reasons.  She told both of us she was a year out maybe a bit more and now loosing too much weight.  She went on to say when she was at her heaviest she did nothing but eat, she’d even wake up in the middle of the night to eat.  I’d be overestimating if I told you this woman’s weight was maybe 110 lbs.  She looked absolutely freakin’ amazing!

I also learned from this woman that she wanted her daughter to come to this same surgeon to fix her lapband.  Apparently the nausea and vomiting she’d been having were taking a toll on her and as a mother she was of course concerned.  She could not say enough about how wonderful this surgeon and all his staff were.  All good signs I hoped.

When thinking about major surgery like this definitely do your homework.  Call your insurance company ask them what is and what isn’t covered to avoid surprises after all is said and done.  This particular surgeon works with the hospital I’m employeed at and has an excellent reputation, plus coworkers who have had the surgery had nothing but good things to say about him.

So back to the keyword…waiting. I waited about an hour and ten minutes in the waiting room, every seat was filled; 10 minutes in an exam room with quite a few scary surgical supplies hanging out on the counter when finally what did appear before my eyes but the surgeon and a nurse.  He spent 5 minutes with a stethoscope barely listening to my chest, lungs and stomach and another 5 maybe 10 minutes “explaining” to me what the sleeve procedure entails.   The nurse, god bless her, did most of the explaination to guide me through the packet of information given to me.

The surgeon acted as if he was reading off a script giving me the wherefores and the what ifs.  Maybe he figured as a medical professional myself I’d know the complications and the nuances of bariatric surgey, let me tell you all something I haven’t stepped foot on a medical-surgical floor in almost 5 years!

This is where the packet of patient info comes in and the nurse who gave it to me.  She of course explained that for my insurance there would be a 6 month waiting period and I’d have to have nutritional counselling, see a psychologist, pulmonalogist, gastroenterologist, and a cardiologist for clearance plus my general practitioner for some bloodwork.  Here’s where I started thinking,”oh man what have I gotten myself into?!”

Here’s some of my advice for that initial consultation:

• Do your research find the surgeon and the office that best fits your personality and your needs.
• Call your insurance and see what you are and are not covered for.
• Definately write down any questions you may have for the doc, because he or she may not be able to spend as long with you as you’d like them to.  Plus they aren’t mind readers they don’t know all the concerns you may have.
• Talk to people in the waiting area, if you’re not shy and they seem friendly.  They’ve been through the surgery and have great insight on what’s in store for you.
• Take advantage of the nurses in the surgeons office they are a fount of knowledge and will happily explain anything you need to know and more often than not will use layman’s terms to do it.  Yes I’m biased I love my profession and most of us do it so well.
• Lastly, read! Read every bit of information they give you.  As many of my elementary school and high school teachers used to say “knowledge is power” and Dr. Google doesn’t know it all!

Let me start out by saying I don’t know if this will be the best thing I’ve ever done or the worst mistake of my life; but “the journey of a thousand miles begins with a single step.” Lao-Tzu.

And so my single step started at the bariatric surgery weight loss information session about a month back where a surgeon stood before a room of hopefuls, like myself, and after giving the facts said that this surgery has to be all about you.  And that you needed to be selfish.  Was this man seriously standing there preaching to me, a nurse of 8 years who has done nothing but take care of everyone else, to be selfish?  You could have knocked me over with a feather.

The weeks following the seminar leading up to the surgical consult I reflected on my weight loss journey–more like steep climb and swan dive off a rocky cliff.  I was not always a “fat chick.”  Once upon a time I was actually much thinner, although always on the chubby side of normal I never felt as isolated as I do now.

In high school I was always trying to loose that stubborn 5 or 10 extra pounds that the doctor had put in my head that I had to loose, but they always followed that with but you’re active so don’t worry about it too much.  Well this extra 5 or 10 pounds turned into the freshman 15 and that came about because I preferred ramen noodles, cheese doodles and Ben & Jerry’s to anything gross that came out of the school cafeteria.  After my first year away I came home and tried various ways to loose that freshman 15, but the weight just seemed to stick and get worse.  One day I stepped on the scale and couldn’t believe the number I was seeing.  291 pounds was a crazy number to me and everything felt like it was spiraling out of control.  I needed to get real about this and soon.

Now on the way to the consult and super nervous, it feels like I’m actually having surgery today.  I filled out the barrage of paperwork weeks ago and been nothing but anxious since.  I’m expecting the flood gates to open and to have a total breakdown right there in the surgeons office.  The only thing I do know for certain of the three popular weight loss procedures: lapband, gastric sleeve and gastric bypass I’ve settled on the gastric sleeve.  Hopefully the surgeon will see eye to eye with me on that choice.