It's the little things....

It's midnight and I can't sleep.

The day I was discharged from the NMCSD in February, my surgeon had instructed me to stop by dermatology and have an unhealed 'scratch' on my nose looked at. I had told him it had been there since September and I kept scratching it so it wouldn't heal. I was thankful to get some assistance. The little scab on my nose was driving me crazy!

I sat down on that bed/chair thing and the dermatologist said, "yes, it's a basel cell". I had no clue what that was. It seems it is the most common of the most common types of skin cancer and the easiest to get rid of. She educated me and set me up for a biopsy. I had the biopsy and was told before I left that it was indeed a basel cell and I was set up for surgery.

Had the surgery last week (lovely stitching, btw) with a procedure known as Mohs (named after the doctor that developed the procedure). They take a bit off, send it to the lab, and half an hour or so later they let you know if more needs to come off. They do it again, send it to the lab, and wait again. The do this repeatedly until no cancer cells remain. Minimally invasive. Mine took 2 procedures and thankfully, it was not deep. They stitched me up and did a skin graft.

Tomorrow morning they will remove the stitches and the bolster holding the skin graft in place. After all I've gone through, why in the world am I so nervous? They will perform plastic surgery to make it look pretty...so that isn't what's bothering me. I just don't know why, but I can't sleep. I keep thinking about the stitches.

This seems such a small thing...but to me, it's feeling like a major challenge....or am I making it just seem like it is?

The question of the day....Is it that challenges are really so big, or do we just make them seem that way?

Naval Medical Center San Diego - Superior Care!

I have a wonderful nutritionist. Her name is Eva. This very caring, health care professional, has taken so much time to meet with me, speak with me, explain, dictate, educate, and support me.

In December, I was admitted to the hospital with a 1.6 potassium level (normal range is 3-6) after I had had my blood work checked. I went into a panic when the meals I was brought were filled with sugar and carbs and all the things that are seemingly harmless. I called Eva's office and left her a message that I needed help. She had already been notified I was hospitalized and had a call into the head of the kitchen. How impressive. It took a few days, but my diet was stable and we were all on the same page. When I was readmitted 8 days later, the head of the kitchen was not on shift and Eva came to the rescue.

She met with the gentleman that ran the kitchen and planned the meals. Wow. Impressive. He came to my room and spent a good 45 minutes discussing my needs, likes, dislikes, requirements, etc. He even had me make a list of what I wanted to eat. Not only did he see to my diet personally, he was firm with those that assisted him, to the point that when I was missing a Greek Yogurt, his assistant refused to send it to me because of the sugar content. Good job! He called his boss at home and they worked it out. My Yoplait Greek 100 showed up half an hour later. (Low sugar)

I spent 8 days attached to as many as 4 IV's at one time. Almost the entire time, potassium was being pumped into me. My Internal Medicine team leader was awesome. Actually, all the teams were. The Chief Bariatric Surgeon headed the bariatric team. There were cardiologists giving input on the responses of my beloved heart, and then there was the Internal Medicine team. I will always be grateful to these men and women. All of the doctors. They cared. They cared enough to monitor me 24/7 for 8 days. Every so many hours, blood was drawn and someone would come in to discuss the results and what the IM team was recommending...no...ordering.

He found the vitamins that were fighting each other. He talked through possibilities of how/why my body was responding as it was, switched the way I took vitamins, quantities, and even something so simple as switching from chlorides to citrates.

Telemetry was a hoot. Telemetry is the dept that monitors patients hooked up to portable monitors, like an EKG machine but it's a handheld and you keep it in your pocket. I can't tell you how often I would hear someone's calm voice saying my name at 0200 or 0300. Each time there was a soft apology with the statement, "Telemetry asked us to check on you".

On the 9th day, I left with a stable potassium level of 4.5. I'd gone 24 hours with no drip, no IV's at all. I've only been back for labs.

So this is a thank you to the Doctors, the kitchen staff, my Nutritionist, the Nurses, the Corpsmen, even the volunteers who came in to see if I needed anything (loved the crossword books!!!).

It's so easy to complain. It's so easy to say...I didn't feel good and they just kept me awake. But you know, it's just as easy and it feels so much better to just accept that they did everything they could because they cared. And I am forever grateful each of them chose the medical field.

To the Staff at the Naval Medical Center San Diego....THANK YOU.

A Goal is a Goal is a Goal...or is it?

Guess what!" I DID IT!!!

Yesterday, I consumed 1,248 calories. And I was...WAS...so happy about it. I didn't plug in all I consumed until about half an hour ago. If I don't want to take time to post as I eat, I write it in a log book and return to MFP to update.

So, today was an eye-opener. My nutritionist has set my goals. She had me attempting to consume 2,000 calories a day in the hopes of gaining weight. Okayyyy.....not even close to the goal. After a lengthy hospitalization (malnutrition), I was discharged 20 lbs heavier. So I lowered the caloric requirements on my own to 1,800. After a couple of weeks of total disappointment and feeling like crap, I lowered them again to 1,500. (Yes, I'll tell Eva when I meet with her again.)

Because I made so many changes, on my own, I forgot I did it. I thought... THOUGHT I'd set the goal at 1,200. So I tried soooo hard to hit the goal yesterday and I succeeded. I ate and ate and ate. I hit my nutrition goals and I feel pretty darn good today...until I posted.

My goal is 1,500, not 1,200. Grrrrr

Decisions Determine Destiny

I have decided to stop beating myself up today and make an attempt to hit 1,500. I know there is no way I can do it.... TODAY. But I will make a valid attempt each and every day to get up there.

Another thought though.... When I hit the all done button it told me if I kept it up, I would weigh 124 lbs in 5 weeks. Well...I weigh 125 as of today. So here's my question...(and yes, I would love comments if anyone is reading this...LOL)...

Should I move up to 1,500 so I can see it tell me I'll maintain my weight or stick at 1,200 and just be 1 lb too light?

Decisions Determine Destiny...is this a good decision?

Decisions Determine Destiny

Decisions Determine Destiny....

I believe that is turning out to be my favorite little saying. I have it up on the bulletin board. I stuck it up there to remind me that I am in control of my life. I am the one that makes the decisions. I call the shots. What I do or do not do determines the path I travel.

I am determined to eat 1200 calories daily and keep my sugar below 40g. It's going to be a tough mentally trying to do this perfectly. I figure if I can do it just one day...really concentrating...then I can do a 2nd day and a 3rd day.....etc. I gotta do it. And if I don't do it one day... it's okay. I will just keep on trying every day until I can finally take in that many calories.

I have been using My Fitness Plan to track daily intake. A powerful tool. - www.myfitnessplan.com - I've met a few really nice people on MFP and have been chatting by way of private messages. Everyone has issues. From the youngest of us, to the oldest. We are all so different, yet all the same. Amazing.

A special thank you to all of you for your support and well-wishes. It's not making the challenges any easier, but it sure is making traveling down the road just a little bit nicer.

I need a fitness goal...

Here's a brain twister. I need a fitness goal. I know what I want my destiny to be. So, does Destiny Determine Decisions?

Hoping you have a great day.

Posing a question....

Holidays are over and we've moved to another state, starting a new life with the kids and hubby. My darlin' husband starting a new job. My apologies for not writing sooner...it's just been so busy. I'm back in the swing and ready to continue this....

I belong to an online support group.. American Bariatrics. Today there was posted a question. "If you're just considering some form of WLS, or if you're years post-op. What do you do to keep your eye on the prize?" I thought this would be a good start to the new year...so I responded this morning in this fashion...

Note: Dan's starting weight was 530lbs. At the time of his post last October, it as 290. What a HUGE achievement. Kudos to him for such a success! ______________________________________________________________________________________________________________________________

Wow! I just noticed how far you've come, Dan. Congratulations! You must feel GREAT!!!! That said, so do I. *smiles*

I no longer look to my goal of taking the weight off. My goals have changed. As you know, it's a lifestyle change. It's become a part of everything we are. I don't think I really "do" anything to keep my eyes focused...I live. I set new goals monthly, weekly, and even daily. If I've lost too much weight, I will stand staring down at the number and think to myself...I really need to eat some fat today...what can I do today to get that done? If I gain (LMAO...I wish) what can I do to remove a lb or two.

I have what I call my "comfort zone". I should weigh between 129 and 139. Both numbers feel good to me. I don't really like the 139 because I see myself as "getting fat" again. Ridiculous, I know. That is a mental thing I work on daily. When I'm at 129, I know I need to gain, but my mind loves the 120's. For my mental being I want to be in the 120's. Maybe that's a big reason why I can't gain weight...perhaps I have a mental wall up. Ohhh now that's a valid thought.

I believe I have yet another goal to add to my list. This one, however, being a much bigger goal...perhaps equal to the initial goal of reaching my ideal weight. How can I gain control of my mind and get past the brick wall and the self-image mirror that has been in mind so long that I actually see myself as being "fat" if I weigh in the 130's? Do we ever really get over this?

Doctors, doctors, doctors....would it ever end? (A look back at all the pre-op testing)

November 2008: the testing begins. I had it relatively easy compared to most WLS candidates. I was assigned to the Naval Medical Center in San Diego. So a lot of the testing I needed to have done could be done in one place and several tests could be done on the same day. Some of the testing one can expect is, first and foremost, a LOT of bloodwork...which is a good thing considering that's how they keep track of how we are doing. Lung testing, EKG's, chest x-rays, sleep studies, psych evals, nutrition visits, classes on pre-op and post-op, and diabetes testing to name just a few. I passed just about all of them. By passed I mean the results were within acceptable parameters. I was not healthy; I was "surviving". My A1C was so high, I immediately went on medication and my diet was restricted. Unless I could get my A1C down to 6.0, surgery was not happening. This proved to be my greatest challenge.

The chest xray showed an enlarged heart. During the sleep study, I stopped breathing for so long that I'm told there were two nurses standing by my bedside and one was in the monitoring room with her fingers resting on the alarm switch that would bring an ambulance. That's a bit scarey when I think about it. They didn't tell me until a week or so later when I went in for my follow-up. I was told I took a deep breath 3 seconds before the alarm switch was to be hit. Needless to say, I went on a CPAP machine. (Anyone need one? I haven't used mine in forEVER.) My lungs were okay just a bit strained. Nutrition was "fun". My nutritionist is wonderful; she's seen me through so much and showed such patience.

My psych eval was to me, amusing. She was my final visit with the exception of still working on A1C levels. I had had months of prep work. I knew what was going to happen and I was fine with it. I was ready. I had no misgivings. I'm one of these people that works things out on my own. I believe everyone is responsible for his/her circumstances. You don't like them? Change them. It's okay to talk to a friend, get some encouragement, but bottom line for me...stop whinning and fix it. And sure as heck don't go blaming others or the Lord for tough times. That's just not cool.

With that attitude, I think I disappointed the therapist. Seriously...I really think I did. We spoke for a long time, she asked questions about my past, growing up, etc. I was completely honest. I commented, she took notes. It was a fun chat. We laughed a lot. I tend to see the humor in situations. For me, it helps to heal. Then came the final question. She was smiling as she asked..and I will never forget this.."What are your fears regarding all of this?" I smiled back and said, "I don't have any". Well boy howdy, you should have seen her eyebrow raise. She was good at keeping her face unchanged, but her brow rose and wrinkles were all over her forhead and she slowly began to write down something. I panicked. I knew she thought I was a looney. I had to have a fear. So many thoughts tore through my brain within about a millisecond and I knew I had to show fear so I blurted out..."Well, I do have ONE fear. And it scares the life out of me". She stopped writing and looked up with a questioning expression.

I knew this was it, make or break. So I admitted apprehensively to her, "I have a big fear of going under and dieing on the table". BINGO. Her expression relaxed as she explained it was a healthy fear. She then went on to discuss the why's and what for's of the process. Don't get me wrong, I used to really have that fear but I have dealt with it and it's part of that preparation phase. I had crossed that bridge and it was behind me. The discussion was helpful and after we finished talking she said she felt strongly that I was absolutely prepared and ready to have the surgery.

Driving back home, the only issue left on my long list was A1C. Could I get the levels down? Would I be able to have the surgery. Would this ever come to an end?

Is it the doctors or other patients that help us the most?

I have been thinking about my first visit to the surgeon. There was one visit with him when two women, one older and one maybe early 20's were in the waiting room when I arrived. I had already lost just about all my weight so when I saw them I felt a pang of appreciation for them both and the road they were about to travel. No way was I going to ignore them or pretend I couldn't hear. They were 'newbies' and I wanted desperately to connect with them.

I sat down near them, pulled out my daughter's nintendo and casually started playing cards, listening to their casual talk. The younger one was scared. You could hear it in her voice. She told a heart-warming story about her life of obesity; being laughed at in school, not having a date to the Senior Prom, not even having been on what she called a "real date". It hurt to listen to her but I knew she would be fine. Heck, I'd done it, why couldn't she? The older woman was more confident but you could hear an aire of despair in her voice; some 30 years fighting the weight gain cycle that began after she married and started having children.

Listening to them is what brought the memory of my first visit back to the surface. I think about it a lot. Don't know if that is good or bad, but I can't seem to let it go. The younger woman went in first. After she'd walked down the hallway, I said hello to the older lady and asked if she was there to have WLS. We had a wonderful conversation. It was then that I realized just how badly I did want to help others. She asked question after question. And she really wanted to know my thoughts. She listened so intently to my answers and when she stood to walk down that hall she looked down at me, leaned and squeezed my hand and said thank you..it was what she needed.

A bit after she left the younger girl came out. I wanted to go to her and hold her, she was losing it...the tears were starting. She clutched the all too familiar paperwork in her hand and sat down two seats from me. She stared forward and you could see she was fighting the tears. I finally reached over with my right hand placed it on her left shoulder. I told her it really wasn't so bad, she would make it. She looked at me and asked if I had had the surgery. I wanted to just start rattling on about what to do, what she could expect, what she needed to do now...but you know that feeling you get sometimes that says to just shut up and listen? It's as if I had masking tape on my mouth. I nodded and just said, "yes". I put the game away and just sat there with her. She opened the folder and started looking at the list of doctors and procedures she needed to have done prior to surgery then she spoke without even looking at me and said, "I can't lose 30 lbs". Boy did I understand that! I chuckled and said something all motherly like, "Darlin, none of us can. They'll do the surgery anyway, just do your best." I could see a bit of hope in her eyes and she smiled.

The nurse called my name and I stood and walked toward her. I just couldn't walk away from that girl. So I turned and said something like, "We all have to start somewhere. This time next year, you'll be talking to someone just like you, trying to help her feel a little better." The girl smiled. It wasn't a big smile, but it was a hopeful one. I turned and walked back to the stats room feeling pretty good inside. Although I've never seen either woman since...dang, maybe I have and I just didn't recognize them!!!! Neither of them will ever know the impact they had on me that day. I can still feel them in my heart when I think about that day. As I write this, I feel the warmth I had then and I can't help wonder...

Is helping other people truly the best way we can help ourselves?