Week 1 Pre-op

I'm a little behind on the blog, but trying to constantly catch up and include everything so I can look back at my entries and each point of the journey.

Week 1 of the pre-op diet was hard.

I started it the morning after my 'last supper'  with a shake.  After having that, it felt a little like - was that it?  It was gone within seconds!  What to do now....

Lunch was a bar with salad, and dinner was salad with 150g of protein (around the size of a chicken thigh).

That is my typical day of food.  Anthony my husband being an ex chef has taken upon himself to make my dinners as interesting as possible, and also challenge himself to vary the meals for me - yes he does cook dinner :).  I am lucky.

The negative parts of the week:

The TIREDNESS!!!!  It was all consuming.  Feeling really heavy with no energy was horrible.  Having to go to work and try to do all the same things and teach was also hard.  I was also pale apparently.  Anthony tries to put red meat as protein a couple of times a week to keep my iron up...bless!

My MOODS.  Yeah I became grumpy, and snappy.  Some said I looked depressed.  The students were the ones who later said I was very grumpy. Things ticked me off more than usual...surprise.  My worst day was Wednesday (day 5) when taking my girls volleyball down to St Orans for a game.  The noise of Year 10 teenagers and their dramas almost made me want to drive off the road.  However, I muttered a lot instead.  I came home pale as a ghost - red meat and a walk helped immensely.

Positive parts of the week:

From Thursday, I did start to feel better.  I am forgetting things more though, energy not there to remember.  But without the carbs, no bloating, no feeling blah after eating.  I feel healthier eating so many more vegetables.

Sleeping way better in general!  Yay!

After 1 week on the diet, I lost 4.5 kilos - and the surgeon saw (I had to see him again to go over procedures, ask questions etc.  Im not allowed to do NCEA marking this year as the meetings are two days post op - the surgeon looked at me as if I was crazy to even think to ask if it was okay.  Bummer about the money but it also means I have a full summer holiday this year (first time ever since I started teaching!) ), and Atul was happy - it also shows I have commitment to the operation and change of lifestyle the lapband entails.   :)

Week 1 got a little easier as the week went on and my body started to accept what was going on.  Don't do so many #2's now (he he).  Cardio exercise is a little harder with less energy but I still do it.  The actual weight loss was definitely an incentive to keep going!!!  On to week 2!!!

Wow...don't hold back on your feelings!

I took this link off my brothers twitter.  A woman from Marie Claire magazine (ok not the most reliable of sources), and her opinion on over weight couples on TV.  I'll give her dues for her post script and apology

Should "Fatties" Get a Room? (Even on TV?)

Overweight/obese people are some of the most persecuted people around.  They have views to not harrass people of different colour, intelligence, gender and ability, but for size it is a free market.  Even people who are very small get harrassed for being "anorexic", when they merely struggle to put on weight.

My counsellor mentioned how it must be absolute hell to be overweight/obese.  Sometimes there is some truth to that comment.  But what I have learnt is that most people have at least one thing about them that they don't like and are insecure about.  A person could look perfectly happy, but inside they worry about how 'big' their butt is or the fact everyone must be able to see their cellulite...etc....I guess being obese, the insecurity is easier for people to see.

The Before Pictures

This will be the biggest I will ever be hopefully for the rest of my life.  I cried when I saw the photos.  I also took some in my underwear, which will remain well hidden.  It was yucky!

The camera does not lie, how did I let myself get like this?  Looking at these photos only makes me more determined!

These pics were taken on Saturday 16th October 2010.  This day I also started my pre-op diet.

First up -  a chocolate shake - make with the optifast and water (no milk) - make up to about 250-300mL.  Not bad, but that is all until lunch.



The Last Supper

To celebrate my last 'big' meal for a long long time, and the night before I started my pre-op diet, a few of my peeps went to Lone Star -yum, couldn't have picked a better place!

Me and Kate with our meals - we got regular meals unlike the boys

Yum!

Johnny Cash Stash

Steve

Riki and Kelly

My wonderful husband Anthony

What I had really wanted - dessert!

Moro bar and kahlua cheesecake!

Steve and Fish with her yummy chocolate mousse

Randy Savage Cocktail -  Macho Man!

Fish, Steve and Kate

Kate brought me some gifts - chocolates for that night, epsom salts for relaxing, and gum for after surgery.  I loved the card - up on my noticeboard now.

Me and my bro Scott with cocktails at the Library......classy ;)

The Dietician, Counsellor and the Nurse

So instead of going back to school on the first day back after the holidays, I went back to centre to fulfil more requirements in order to have the surgery. In the end, a lot more pleasant than standing in front of teens again ;)

First stop - Dietician.

By this time I had made the decision 100% for the Lap band.  The purpose of this visit was to go over the pre-op diet which consisted of opti-fast shakes, soups and bars (high in protein) for two meals a day. 

Then for dinner, 120-150g of protein in the form of chicken, fish, red meat, or two eggs plus vegetables from the selected list below:

Eggplant
Tomato
Celery
Bean
Mushroom
Capsicum
Brussel Sprouts

Lettuce

Carrots (only in small supplies - apparently too much carrot = carbs - this was a new lesson for me!_

Brocoli
Cauliflower

Also to point out - I can have unlimited vegetables from the above list all day.

Foods to avoid:

Potatoes (or equivalent starch)
Pasta

Rice

Other:

No alcohol
No sugar
No fruit juice (although natural sugar - still too high in sugars)
Only trim milk
Coffee, tea okay with trim milk
Herbal tea, water also okay along with zero sugar soft drinks (in moderation of course)

Wow!  Quite a change!  However when you have a very set goal - you are going to do it - no matter what!

The other decision was to think about when I wanted to start the pre op diet.  At this stage, it was just over 7 weeks until the op.  The dietician pointed out it would be at least 2-3 weeks, but if I wanted to start earlier - all the better.

We also went through the first four weeks after the op.  Each week was building up to eating real food again.

To sum up (as will blog when the actual events occur):

Week 1:  Clear Liquids, and Protein based liquids (6 meals a day)
Week 2:  Pureed Foods - including protein with every meal (3 meals a day)
Week 3:  Soft Foods (low fibre, high protein, moist foods) (3 meals a day)
Week 4 and beyond:  Solid Foods - 3 small meals a day

Also constipation could be a factor - alpine tea, benefiber etc can be taken. 
Take a general multivitamin once a day.

To sum up - I have to learn to eat again.  Funnily enough in Week 2 - Baby food is on the list of allowed foods!  After being to a few baby showers and having to taste that - may not be on my list of choice!

The dietician was just lovely and freely available to email etc anytime (YAY!) - after a very full hour of a lot of information - it was onto the counsellor!!!

A long time since I had been to a counsellor....wondered what this would entail.

However, it was fine.  More like a big chin wag.  She was an ex science teacher so understood what teaching as a career was like.

The one thing I remember from the conversation was when she said - it is hell be overweight/obese.

People who are in this position have to think and pre-empt situations before they enter them to make the best out of them - eg -airplane/movie seats, where to shop, how to blend in.  Never thought of it like that, but she had a point!  I find myself analysing many situations before they actually happen. It does cause a lot of stress and often tears.

Through a short quiz - I also found out I have high stress and anxiety and a very high level of depression - no surprises there!  She said it was a snapshot, and something to look at later on after surgery to see changes.

Also looked at physical vs emotional eating and how to deal with the latter.

An hour flew by - was given more reading, and it was off to the nurse.

The nurse presented me with more reading - this time a book on the lap band process- before and after.  Something to read and then read again as I went through the steps of the journey. Easy to read and informative.

We decided to start the pre-op diet 6 weeks before surgery - maximum weight loss.  Apparently, if you don't lose enough weight - they will cancel the surgery.  NO WAY IS THAT HAPPENING TO ME!

Also discussed the actual procedure and shown the following clip - animated so not gross :)

From there, she asked me many questions, looked at my health now and exercise regime, and concluded I had made the right decision to have the lap band.  :)

Took my weight and height readings, and then I was off to get my first two weeks of optifast, and live my last few days before the pre-op diet began.

Process Part 2

So the next thing on the list to do was to meet with the surgeon about the operation.  At this point I had chosen Lap Band surgery.  I was nervous.  I have never had to meet with a surgeon before.  I mean I have never needed to - never been cut open!
My surgeon is Dr Atul Dhabuwala MBBS, FRACS.  A little Indian man who I had seen at the info seminar about a month before.  I had to do my research on the guy to know what he was about, and if any good or not.  This was what I found out:

Atul completed his medical degree in Bombay, India and started training in General Surgery. He moved to New Zealand, and had further training in General Surgery to become a Fellow of the Royal Australasian College of Surgeons in 2005. Following this, he did two years of Travelling Fellowship to centres of excellence in Germany (Heidelberg, Frankfurt, Essen and Cologne) gaining experience in Laparoscopic Gastrointestinal surgery, Upper GI and HPB surgery. He also acquired a Diploma in Laparoscopic surgery at the Louis Pasteur University of Strasbourg, France in 2008.
Since April 2008, Atul has been working as a Consultant Surgeon at Hutt Hospital with specialised interest in Upper GI and Minimally invasive surgery. Having had the privilege of training with two leading Obesity Surgeons in New Zealand, enthusiasm for Obesity surgery has been inevitable. He has been performing the Laparoscopic Adjustable Gastric Banding Surgery at Boulcott Hospital.
Special interests:

• Laparoscopic:
  • Adjustable gastric banding
  • Hiatus hernia / Anti-reflux surgery
  • Bowel surgery
  • Cholecystectomy
  • Ventral hernia
  • Inguinal hernia
• Upper GI tract and pancreatic diseases
• Thyroid diseases
• Pilonidal sinu

I has also read some of his research papers.  He seems pretty legit and capable :)  He has also never had issues with his lap band surgeries.  I'm fairly pleased about that.

During the conversation, I could not come up with reasons why I wanted Lap banding over gastric bypass.  It was like they were there in my head but couldn't put into words.  Atul went through both of the procedures, pros, cons, risks etc to give me all the information I needed.  Anthony was there with me, which was good. I thought (being female and getting my emotions caught up in it) that he was trying to sway me to the bypass, but no, he actually was just giving me all the facts I needed to make my own decision.

Leaving a bit overwhelmed, I chatted to the lady at the desk who has had the lap band.  Turns out she looked a similar size to me when she started, and looks awesome now.  After chatting with her, and doing some further reaearch on You Tube, books, and blogs, I was still definitely with the lap band, and this is why:

1. It is adjustable.  If I start to feel hungry and eat too much, more saline can be added to control this, and vice versa.
2. Gastric by pass interferes with the natural anatomy of the human body.  I feel we were given our stomach and intestines for a reason - don't mess too much with nature.
3. Along with the second reason, I don't really want pieces of me removed.
4. Gastric bypass is very permanent.  It can be reversed, but with great difficulty.  If it does not work - thats it tough luck really.  Lap band is easily reversed, and if something better comes along in the future, it can be a further option.
5. Adjustable in case I do get pregnant - although have to wait at least 9 months after the operation to try.
6. I have more control
7. Don't have to take endless supplements to combat malabsorption
8. Weight loss is slower, less likely to lose all my lean muscle mass, and after a couple of years works out the same rate as the gastric bypass.

Next stage - on to the dietician, counsellor, and nurse!

The Process So Far Part 1

My surgery date has been confirmed for the 26th November 2010.


Today, that is 44 days away....exciting!!!!

So what has been the process so far?  Well here goes.....

Since last year when my doctor recommended I look into Bariatric surgery, funding was first sought for a gastric bypass.  Unfortunately, in Wellington where I live - no funding available.  Health board ran out of money!  If I lived in another place in New Zealand, this story may have turned out differently.  While I am obese, I am healthy and don't suffer from various diseases such as high cholesterol, diabetes and the like - so I am not a prime candidate.

Anyway, months passed and in July I decided to find out more and take action.  Stupid parent teacher interviews stopped me from attending a information seminar until September, but I made it.  At the Surgical Obesity Service (lovely name I know) - we were given a slide slow showing the gastric bypass, the gastric sleeve, and the lap band - procedures, advantages and disadvantages, costs, etc - all you wanted to know.

After the seminar I was emailed further information, including a referral form from the doctor.  My doctor was over the moon I had made the decision, and referred me without hesitation.  Next day, got a call from the surgery practice and immediately organised appointments.  I love private health care!!! (When I was waiting in the public system to see a gynocologist regarding fertility etc - it took nine months just for the appointment!!).

The first appointment was with the GP to assess if I was suitable for surgery, particularly the lap band which was my choice.

Height, weight, measurements, blood pressure, bloods, etc were taken along with looking at my family history of disease and conditions - that wasn't a pretty picture.  I could see if I didn't act now - things like blood pressure, diabetes, mobility could all become issues in the future.  I already suffer from depression, wheather this will improve with weight loss will be seen in the future.  At the moment Im all good as long as I take my pills :)

Anyway, after being cross examined, it was determined I did not need an ECG to look at my heart, and I was cleared to go on to the next stage and closer to surgery :)

The Time Has Come!

I'm 32 years old.  I have been overweight/obese for my whole life.  I have tried a variety of diets, shakes, powders, hypnotism, and exercises to try and lose the weight to what I consider "Normal".  Some success yes, but always end up in the same place, plus a few more kilos.

Last year, after not being able to become pregnant, my doctor knowing I had tried various methods for weight loss, asked me to consider gastric surgery, either in the form a lap banding or gastric bypass surgery.  Then I was like...seriously, that is the easy way out, and it costs heaps!!!  However, a year has passed.  My mind has changed after an enormous amount of research, and I have started my lap band journey, using this blog to share with others (if interested!), but also for me to see my progress through pictures, and blog entries.

A friend pointed out to me in July it was time to look after myself.  I spend so much of my time looking out for others, that I leave myself to last.  After coming out of the worst part of 6 months being depressed about a future with no children, I finally agreed with her.  I need to feel better about myself.  The money is not important but my life is.  Has it really taken 32 years to come to this conclusion???  Maybe I am a slow learner ;)

Anyway, this entry will begin my story and my journey!!  Jump aboard!!