A Smaller Target

If it's Tuesday...

Weight: 193.4

... I should try and answer some of the questions so kindly asked in the comments. 

• Many thanks to everyone for the good wishes.  It's true, I was down for a while.  I'm not anymore.  In fact, quite the opposite, despite the lithium. 
• Alison and *S*: I'm still afraid about the loss of both productivity and general brightness with the taking of medication, but I've promised myself to try it for a year (assuming it remains a good medical choice). The fact is, even not feeling especially smart, I seem to be able to work, something which was impossible for months.  As I've thought about my past more over the last few months, I've realized that my highs are associated with some behaviors that make me cringe even to remember let alone talk about.  Basically I'm trying to do what I'm told here and not think about it too much.  Easier said than done and all that.
• *S* - I like Power Crunch bars more due to their texture because they're structured like a wafer cookie rather than a big chewy blob.  Cinnamon roll isn't my favorite flavor (that would probably be strawberry cream or vanilla) but isn't bad.  The protein in them comes from whey not soy so they'd probably be okay for you in that sense. GNC carries them (at least the ones in Oregon and California do) so you might want to pick a couple up before deciding you want .  We're all different, but they do work for me.
• About Theo:  I am going to talk to Dr. Friend and ask that Theo be sent home should he not be interesting to the child anymore.  I've also had the offer of another Theo (who had been a gift to Harriet) but I think she needs a bite-y T-Rex as much as I do.  Finally, as Paul mentioned to me after reading my post, I do have a female version (a T-Rex named Dora) so even if Theo doesn't return, I'm not without an attack dino when one  is needed.
• Finally -- I'm back from Portland.  My dad has gone from getting ~14 mpg to getting ~27-30mpg. 

And that's about it.  Did I miss anything?

PS.  I love the idea of everyone getting a Vespa.  Me, I'm looking for the perfect bike.  I suspect when I find it, it will be orange.

In Answer to the Why Question

[Someone asked why duodenal switch rather than RNY.  It's a pretty common question and I thought I'd answer it, though of course it's also answered in the early pages of this blog.  Still, just in case you have a life and don't want to go reading through the over 300 back entries.]

First, I'm not a "it was duodenal switch or nothing" person.  Had the DS not been there, I would have gotten an RNY.  I needed weight loss surgery.  I was fortunate and had the choice of both gastric bypass surgeries (duodenal switch and RNY) and the Lapband-- USC does all three.  After meeting with my surgeon (who generally tends to prefer the RNY for most patients, partly because he can do it lap rather than open) and doing my own research, I opted for the duodenal switch.

My surgeon's opinion was that the Lapband would not be a good choice for me given the amount of weight I had to lose.  In addition, I was really freaked out by the idea of having something inserted in me (feel the same way about breast implants).  It's just an odd phobia.  Finally, I wasn't sure how my insurance would cover the longer-term fill question.

So it was between the RNY and DS.  As I said, I opted for the DS.

Why?  There were a lot of reasons, the first of which was as a pre-op I already had problems with constipation, something that my surgeon said would probably be made worse by the RNY but improved or resolved by the DS.  Also, I didn't like the idea of worrying about dumping or having a list of foods I couldn't ever have, especially if that list was going to include a whole category like sugar.  I've got a ton of allergies and already have a huge "avoid" list which includes wheat and yeast and an even longer "limit" list.

Honestly though, the final deciding factor was that my surgeon said that research shows that DS surgery has the greatest success at getting patients who have BMIs over 50 to lose 80% of their excess weight and keep it off.  Since I had a BMI of 61 at that point, and had failed at so many other attempts, I wanted to choose the option with the greatest chance of success -- the support group I attend has several DS patients who had the surgery after either RNY or LapBands.  So part of my choice was motivated by my fear of failure.

I had a text-book perfect surgery and recovery.  I don't have any of the worse side effects of the surgery, aside from terrible smelling and painful gas if  I eat too many simple carbs.  Since I love my husband (and don't like being in pain) I'm very very careful about that.  I do have issues with vomiting sometimes.  This is related to the restriction in my stomach size and the fact I have nasal drip from allergies.  Certain foods like rice are just impossible for me to tolerate.  My constipation issues are no worse, but not much improved.  A lifetime of anal retentive behavior cannot be solved so easily!

By the same token, my sister opted a month before me to have RNY surgery as she worried that with her carb addiction being able to eat sugar post DS wouldn't work for her.  Ironically, she's one of the ones who doesn't dump on anything.  But she avoids sugar all the same.  She's also had a great outcome, losing down to 190 from her high of 417 .    She has her own side effects -- the most serious of which is she can no longer absorb B-12 by any means other than IV treatment (pills and shots didn't work for her).  It's under control now, but was a bit scary for all of us at first.  Like me, she can't tolerate rice.  But even so, the trade off of improved heath and mobility was worth it for her.   She's very very happy with her choice and outcome, and well she should be.

You asked about supplements and their cost.  I take 1 Rx prenatal vitamin a day, 1 Allergy A&D vitamin and 1500 -- 2000 mg of calcium citrate in chewable form.  Total cost is about $40 a month, and that's with buying the more expensive chewable calcium (tablets are cheaper).  I also have 1 - 2 protein drinks a day -- I spend maybe $10 a month on the drink powder and bars.   My labs as of 20 months post-op are perfect.  There are other people who require more supplementing -- it just depends on how your body responds.  But the vitamins are really important and can't be overlooked post-op.

Another Day

Another post-op day spent "recovering" --something which largely consists of napping on a comfy chair, trying to remember to eat (did I mention that my desire for food has been quite low since surgery?) and counting the hours between doses of pain medication.   If I haven't been blogging much, it's basically because I'm rather bored with my life and so feel guilty writing about it it here and thus spreading the boring around.

Someone did save me, however by writing and asking a few questions.  I can't really call them "frequently asked" but hey, any port in a storm. 

So here's the first of a few questions and their answers:

I used to read your comments and things on some of wls forums.  How come you don't post there anymore?

When I was pre-op and in the early days post-op, I was a very active poster on both the forum on the duodenal switch website (highly recommend this community) and also on the DS part of the Obesity Help site (reservation there).  I've disappeared from both over the last several months for different reasons. 

Since I can be frank here --my blog, my thoughts, my rules and no I won't delete your comments either...  There are wonderful people who participate on the DS board on the Obesity Help site.  I miss them.  However, the way OH runs their forums represents (to me) the worst in Internet forum management.  They tend to censor / delete that which they don't want to read / hear, are arbitrary in the enforcement of rules and allow a vocal (and overly-"Christian"* oriented) minority have sway over everyone else.  Basically they create a world that encourages adults to act like children.  The DS board tends to be relatively free of this, but in my experience, it does spill over from the main forum every few months.  I'm very attached to my words, be they clever or not, and I don't like the idea of anyone but me having the right to delete them.  So when Obesity Help started censoring a regular poster on the DS forum, I stopped reading and posting there.

The exact opposite management style can be found, btw, on the Duodenal Switch website.  The manager there (Melanie) generally only deletes post / entries at the request of their authors and goes out of her way to be fair and allow conflicts to work themselves out.  I stopped posting and reading regularly there when life got so complicated this summer.  It's always been my intention to come back there, though I felt kind of bad doing it right before my tummy tuck, I guess because I thought it would seem like I was fishing for sympathy.

A final point is a structure thing.  I like the way that topics stay current (that is on the first page) of the Duodenal Switch site so long as they are actively being discussed.  It was always annoying to have to page back to discussions on the OH site forums even if the discussions were still actively engaged.

--
*I put "Christian" in quotation marks because my experience of them wasn't of Christianity as I know it, but rather of the worst sort of mean-spirited hypocrisy cloaking itself under the name "Christian"

WLS Afterthought No.1

Weight: 181 (parents' scale)

A HUGE congratulations to MaryBeth who is celebrating 4 years post-op in this post today! As I've written previously, MB's earlier blog,  The Fat Diaries, was a great source of inspiration and information in my early days as both a pre-op and blogger.  She's an amazing writer and person and has also had a fantastic weight loss, not only because of her surgery, but because of her dedication to exercise and lifestyle modification.   MB's also got a great sense of humor and amazing fashion sense.  Kudos chica!

This has been said before, but if you're planning to have wls in the next few months (or are a recent post-op), don't forget to budget for clothes.  Really.  As I remarked to my dad yesterday NOTHING I wore 18 months ago (including gloves, shoes and socks) fits me now.  I'm not saying this to be discouraging, but as something to keep in mind.   Hats, glasses, whatever.  Nothing fits that I had before except a couple scarves and my earrings. Watches, necklaces and rings are all way too big. 

Mostly being smaller sizes is a great thing, except for shoes.  I wasn't an especially large shoes size pre-op,  (8.5 - 9 if the shoe was pointy).  I had lots of shoes I liked.  Now I wear something between a 7 and 8 -- depends on the width of the toe box.  I've got a few pairs of really nice new shoes, but as the season is changing again I'm starting to feel the lack.

And no, I don't save much (any) money on food.  Really.  I don't eat  much and my junk food is way down, but the food I eat is expensive.  As anyone who's ever worked at a food bank knows, low fiber carbs are cheap.  Protein is expensive.  Plus I'm really much pickier now, especially about leftovers.  And yeah, I eat smaller portions when we go out, but again they bring me the same amount anyway. 

But the whole dining out issue is worth another entry.  Maybe later.