Day 1 of the rest of my life: today

10/11/12 = Day 1 of the rest of my life!

I had my first appointment with the bariatric department today.  My wonderfully supportive husband came along.  I can't tell you how lucky I am to have him in my life.  He was there, he was asking questions, he was encouraging me...he is in this with me and will be there every step of the way.

So here we go - this first step is hard for me.  But to be honest with myself and to truly "put it out there," it is something I need to do for myself.

Day 1 - 327 pounds, BMI 52

Mike and I on our Anniversary

At the Arch in St. Louis

These pictures are the most recent ones I have of myself, June 2012.  They accurately show me at my present weight/size.

So today's process was interesting, encouraging, and very informative.

8:00am:  I arrive at the Center for Digestive Diseases.  Mike and I joke with each other that I have no trouble digesting food - that's the problem!  LOL

8:10am:  As I stepped off the scale today and said, "ick" the nurse said, "You will never see that number again, today is day 1 of the rest of your life."   That was a very encouraging way to look at this and really started my day off on the right foot.

8:20am:  I meet with the Nurse Specialist, Bariatric Surgery Coordinator.  She goes through the packet I received with us.  She is in charge of the education part of the program.  She explains that I will have a series of 6 appointments to meet the requirements of the pre-authorization for the insurance company.  I meet with the dietitian each of those 6 times.  The first, fourth and sixth appointments I will also meet with the whole bariatric team (her, the PA for the department and my surgeon who is the head of the department).  On the 6th visit (in March) I also do the psychiatric evaluation that is required by the insurance company.  NO - not to make sure I'm not insane, we know I lost m marbles years ago!  LOL.  But to make sure I understand the risks, life-long commitment, and the reason I am doing this.

9:00am:  I meet with the PA for the bariatric surgery department.  He goes through the whole medical side of the procedure.

Picture of the Gastric Bypass procedure.

They go in laproscopically, so no huge incision, but 6 small cuts that are "super glued" and band-aided over.

They cut the top portion of the stomach off.  The resulting pouch is the size of 1/2 an egg.  Yes, tiny.  Then they go down about 74 centimeters and gut the small intestines.  They then take the lower portion of the small intestines and attach it to the newly created pouch.  Then they re-attach the top part of the small intestines further down, closer to where the small intestines joins the large intestines.

THIS made both Mike and I happy.  We thought the stomach and that portion of the small intestines were just "hanging" there unconnected.  We didn't realize where that small intestine section looks like it is touching the other section, they are actually connected.  That made us feel much better.

Why do they do this - at some point on that section of small intestine there is a connection to the pancreas and liver (I believe) and those enzymes are what digest and break down the food.  And your stomach will still be making acid and such and they use all of that to digest the food, just lower down closer to the large intestines.

9:30 am:  Mike and I and the other two new gastric bypass patients head to the education portion of the day.  Here we watch a power point about the procedure and the specifics.  We learn that we stay 2 nights in the hospital and take 1-2 weeks off of work.  They would prefer 1 month off work, but go with 1-2 weeks.  And NO lifting over 10# for 1 month.

Here is where I learn what kind of weight loss to expect.  The statistics for gastric bypass is that you will lose 2/3 of your "excess" weight.   What does that mean?

I currently weigh 327 pounds.  I am 5'6.5" and my "ideal" weight is 140 pounds.  That means my "excess" weight is 187 pounds.  66% of that 187 pounds is 123 pounds.  So I should expect to finally settle with my weight down approximately 123 pounds - that would put me at 204 pounds in the end.  No, not at my "ideal" weight - but a whole lot lighter than I am now!!!!

Things I can also expect to have change post-surgery:
 - sleep apnea:  I could very likely get rid of my sleep machine!
 - blood pressure:  I will most likely end up off my blood pressure meds
 - stress incontinence:  I might not wet my pants when I sneeze, cough, jump.  This won't clear as much, but it should get a lot better!!

10:30am:  The dietitian comes in and gives us our new "bible" for eating.  I am now on a 1400 calorie diet until surgery.

I have met with a dietitian before, it was pathetic.  I remember her telling me that if I am having pasta, no white sauce, only red sauce.  I explained that I don't like red sauce and I'm not supposed to have acidic foods like that and she said, "Oh, you are going to have a hard time then."  Seriously - and this person was supposed to help me?

The dietitian today, amazing.  She talked us through, very specifically, how to figure out your food and what to and not to eat.  She gave us a booklet that has every food in it.  We can look up in the directory in the back to find a food and then find out what to "count" if you eat it.

She gave us a food record sheet that has this cool "bubble sheet" at the top.  So not only do we write down everything we eat and drink, we "bubble" in the appropriate areas (grain/carbs, meat, milk, veggies  fruits, fats, water).  What a great way to SEE what you have eaten and what you have left to eat.  A visual that will really help me stay on track.

This is where I learned all my new NO foods.
 - sweets, ice cream, candy, anything delicious!  LOL
 - carbonated beverages - NONE
 - Alcohol - NONE
 - Acidic beverages - NONE
 - juice - NONE

AHHHHHHHHHH - however, the rationalization made sense.  In my new "pouch" there are no gastric juices to neutralize acidic foods or beverages and so that would set up my pouch and possible ulcers.  AND, with that part of the intestine bypassed, take a sweet or juice and that pure sugar would hit my system hard and cause diarrhea and vomiting.  Yuck.  And alcohol - ha - nothing to process the alcohol so straight to the blood.  Yikes.  I'm already an easy drunk - can you imagine this?!?!  NOPE.

I have to start now, learning to not drink anything while I eat.  I need to stop drinking 30 minutes before I eat and not drink anything for at least 30 minutes after I eat.  WHY?  Because when we drink while we eat, our receptors don't get the "full" feeling they should get while you eat.  And that causes over eating.  So, even if not having surgery, what a great way to help your body get that full feeling.  Do not drink anything before or after or during eating.  Can do.

Chewing food - who knew, I now have to chew all my food to mush.  Yes, 28 times before swallowing.  Why?  There are not gastric juices in your pouch to start digesting the food, so whatever goes into your pouch is what is going to pass into your intestines.  The size of the route from pouch into intestine is the size of a pencil.  If you don't chew your food to mush, you can have blockages and cause real problems.  So, chew, chew, chew.  And let me tell you, if you have never tried to chew EVERY bite you put into your mouth 28 times.... it is really, really hard.  You are fighting the urge to swallow all the time!  Oh, and it's hard to not drink with a meal too.  This is going to be tough.

My new snack?  8 oz of skim milk.  Yep, all day long you are to be drinking water, at least 48 ounces throughout the day.  But 3 times a day (mid morning, mid afternoon, before bed) you need to drink an 8 oz glass of milk.  Why?  The protein.

The new rule to live by will be 50 grams of protein/50 grams of carbs.  And you make sure you get all that protein first - that is the most important.  Add in the 48 ounces of water and 30 minutes a day of exercise.

12:15pm:  I meet with the surgeon who will do my surgery.  We go over all that I've learned today and make sure I understand everything.  At this point he stresses again the importance of stopping the pop, juice and one thing I forgot, no more ibuprofen for the rest of my life.  I cannot have ibuprofen for the rest of my life - issues with stomach and ulcers.  So, Tylenol products only.

Also talked about the vitamin supplements I will need to take post surgery for the rest of my life.

Discussed when the surgery would then happen.  I told the doctor that if I had my way, the surgery would have been last week!  But that I also have obligations with my job.  Basically, once I have completed the 6 month program the surgeon and I can determine the date and go from there.  What am I thinking now - the end part of May.

12:45pm:  Mike and I leave the hospital and head to my "last supper" at Red Lobster!


So - the results of today.  I am still excited and energized and ready to do this.

I am thrilled that as I go into this 6 month process, Mike is joining me on the journey.  I told him that he can't drink pop either or I might go crazy trying to steal his!  :-)

But mostly, he is going to do the 1400 calorie diet with me and do the exercising with me as well.  He is going to be my partner in this 100%.  He is so supportive, I am so fortunate.

My new life started today.  I am excited, I am ready and I can't wait.  I have been given the goal of trying to lose 30 pounds pre-surgery.  But no pressure and no judging if it doesn't happen, the important part is I follow the plan and try.

My plan is to post updates on the progress as we go.  Here we go...............