Ever feel like you're king/queen of stupid? That's how I'm feeling this morning. I swear, I'm a bright girl. Ask anybody. I went to school, managed to get decent grades in difficult classes (when I applied myself) and even went on to get one of those highly sought after bachelor's degrees that people proudly display on their walls as proof of their intellectual elitism.
Yet, sometimes, I do the stupidest things. Like most people, I don't typically go around bragging about my stupid behavior. Instead, I favor smacking myself in the head in private and vowing to use my head as more than a hat rack in the future.
But last night's senseless act can't be kept private for many reasons. First off, writing is therapy, and maybe if I commit this one to print where it can confront me in the future, I won't be so stupid again. Second, I know there are others out there in my shoes who are guilty of my same stupidity. I am posting today to give them hope. I'm sure that like misery, stupidity also loves company.
I have reactive hypoglycemia, a somewhat uncommon form of low blood sugar that is now known to be a side effect of certain malabsorptive surgical weight loss procedures. I say "now known" because reactive hypoglycemia didn't have a name or much attention untill 2007 when bariatric researchers started studying patients who had a very odd reaction to consuming certain foods.
Instead of causing their blood sugar to skyrocket, simple carbs and sugars (even natural ones like in fresh fruit and juices) caused their blood sugar to plummet. In the world of blood sugar, 80 to 100 is good; 50 to 79 is when even normal people start feeling shaky or grumpy and need to find something to eat quick; under 50 signals danger with big, red flashing lights. Scientist dubbed this condition "reactive hypoglycemia" to group the patients whose blood sugar fell in reaction to the very foods that should have elevated it.
So, see, I'm special...unique...everything my mommy said I was when growing up. She just apparently left out the other qualifiers to indicate my natural inclination toward senseless behavior.
I rode the reactive hypoglycemia roller coaster for about a year after my emergency intestinal surgery in 2007. Those knotted innards were either slowing nutrient absorption enough to allow my body to react normally to complex carbs and sugars (simple sugars and carbs were always my enemy) or the reactive hypoglycemia was triggered by the trauma of that health crisis. No matter what, 2007 was a nightmare year for me. I didn't understand the rhyme or reason of what my body was doing, and not one of my "expert" docs could help me figure it out.
Then I moved to Merced and met a physician's assistant to whom I owe my life. Not only did she know about and understand reactive hypoglycemia, she taught me to manage it. She even gave me a glucometer to help me monitor my sugar levels at home. It was a newfound freedom to be able to equate my symptoms with one of the glucose zones I listed above. It also helped me figure out my body's rhythm. For example:
On a typical day, I wake up with a blood sugar level of 100. Then I eat breakfast and it drops to 80. If that breakfast is high in protein, I stay at 80 till my next meal. If it is not -- or if it includes sugars like toast, jam, juice or their ilk -- then it drops to 70 and sometimes 60 within 30 minutes. And I find myself forced to eat regardless of hunger just to achieve balance.
In the last 18 months or so, I've learned a lot about my body. I've learned that my hypoglycemic episodes are triggered by stress in addition to food, which means I sometimes suffer severe low episodes during stressful times (like when a deadline looms at work or I'm confronted by a personal crisis) even if I'm eating like I should.
Enough back story, let's talk about last night.
Last night, I had dinner with friends. I'm usually really good when eating in social situations. The conversation and activity provide enough of a distraction to give me time to step back and make wise eating choices. My worst moments are when eating in a rush. We had a family-style dinner that featured lots of chicken, veggies, noodles and rice.
Typically I would serve myself tablespoon-size portions of noodles and rice with four times the amount of chicken and some veggies so that the protein and fiber in my meal could slow the absorption of the carbohydrates. I might feel a little fatigued after that -- what many refer to as "food coma" -- but I would be otherwise fine.
However, I'm four months pregnant. And pregnancy has added nuances to managing my hypoglycemia: I find meat less appealing than usual and I have to share my available blood sugar with the baby growing inside of me. The good news is that the baby will always get what he/she needs. The bad news is that there is not always enough left over for me.
So last night, I go to serve myself what I know I should eat only to realize the chicken is unappetizing to me. I have a mental battle with myself (eat it anyway; no, if you eat that, you're going to throw up in front of everyone, eat it or you'll get sick, don't eat it or you'll get sick...and so on). I tried to compromise by serving myself two small chunks of chicken with a heap of veggies and sauce in hopes I could disguise the texture.
My plan seemed to work. I got through dinner, making sure to eat enough to satisfy me without overeating. After the meal, we sat and socialized for 30 to 40 minutes. I felt that faint feeling of fatigue that told me I would need a protein boost when I got home, but the conversation wasn't lulling to the point that it was clear we'd leave anytime soon. One friend ordered a sweetened beverage. It sounded good, and for a moment, I thought it would give me a needed boost till I could get home.
This beverage is one I've had before and I know that if I order it before my meal, I can sip it super-slowly while eating and suffer no ill effects. I've never tried order it as "dessert" before. I've surely never tried drinking it by itself without some type of protein to balance it out -- and I've never been dumb enough to drink almost half of it in the span of 15 to 20 minutes.
But last night, I was apparently struck stupid and did just that.
By the time I got home, I was feeling queasy. I had a long list of work to do and couldn't be bothered to listen to my body so I drank a glass of water. Thirty minutes later, I was soaked in sweat: That's the first symptom that I'm in the danger zone. I went to the bedroom and tried to undress myself but didn't have the dexterity needed to accomplish the task. I manage to send Brian (who had just gotten home) a text: "C me." When he got to the bedroom, I was lying in the fetal position and tugging at my clothes. He helped me out of them and instantly knew the problem.
True hypoglycemic episodes cause sweating, shivering, shaking, brain fog, impaired speech and hallucinations. And I was in the throes of every symptom at that time. I didn't realize he left but he returned with string cheese and a glass of water. He started prepping my glucometer to test my sugar for a benchmark. I was at 30.
I had trouble wrapping my brain around the situation but I knew that something was missing. In the danger zone, you need 15g of pure sugar -- fruit juice, honey, candy, even cake frosting -- to give your body an immediate boost before consuming something equal in protein and carbs (like cheese) to balance the sugar levels and head toward normal.
I tried to think of what was in the house he could give me, but it was hard to think and harder to articulate. Finally, I muttered something about chocolate and he brought me a small piece -- less than an ounce. I grunted and stuck it in my mouth. It was a good choice because it melted without much chewing. Next was the cheese. Chewing was very difficult. I was having trouble getting my brain to cooperate with my body, but I was managing.
Brian helped me test again. 50. Getting better. Lucidity should have come at any moment, but I found myself still slipping in and out. I was trying to think of my trigger. I remembered my after-dinner drink. Stupid, stupid, stupid. I asked for another cheese stick.
Then I had a brief hallucination of dying and winner the 2009 Darwin Awards for doing society a favor by chlorinating the gene pool. Just my luck.
I tried to stay conscious while Brian soothed me with a cool cloth, but something didn't feel right. I had him help me test again. 40. Brian said 30 minutes had passed since it all started. Crap. Sliding backward...why was that happening?
Struggling to remember my doctor's instructions, I couldn't decide whether to have Brian seek medical help or try to eat more sugar. The backslide didn't last long, the fog lifted a little, and I remembered the final part of my doctor's advice: "As soon as you're stable enough to walk under your own power, get to the kitchen and eat something else...ideally, protein and carb.
I couldn't fathom eating more cheese or touching any meat so I settled on a little nectarine with a few spoons of heavy whipping cream. Small amount of protein, small amount of carb. Besides, I'd rather dump from the dairy in the cream than feel like I felt.
That did the trick, and it wasn't long before recovery fatigue set in. For me, episodes like this are followed by extreme fatigue. My body likes sleep while it heals itself. I can easily sleep 12 hours after an experience like this. Usually, it's a dead sleep. Sometimes, though, it's filled with vivid dreams. Last night was a vivid seven hours of dreams. I woke up as exhausted as when I lied down. I immediately went to the kitchen for more fruit -- just in case -- which I will shortly follow with another cheese stick. Today will have to be a good eating day so I can build up my body's glucose stores.
It's a stiff lesson. It's probably been a year since my last episode of this level of severity. Writing it all out is hard, because nobody likes to admit to being senseless. But it's also necessary. I know what I did last night is standard behavior for others with the same affliction as me. They feel out of control, maybe even desperate. Some may not even understand why their bodies do what they do. They need to read stories like this to know they aren't alone -- and that there is hope.
For me, it drives home the same message I've been telling myself since 2007: I am not anatomically normal, and I probably never will be. But, like most things, this can be managed. I just have to take care to do so. The best news ever, though, is at least I don't have to worry about my stupidity affecting my child -- unless stupidity is genetic. If that's the case, let's hope the baby has Brian's intellect.
My experiences with losing weight, and the lifestyle changes WLS requires — with a few unrelated tidbits here and there.
Thursday, August 20, 2009
Tuesday, August 18, 2009
It's a ... baby!
Yesterday's ultrasound showed me at 17 weeks and altered my estimated delivery date to be around Jan. 23. It also showed a health-looking baby with two arms, two legs, a brain, spinal cord and beating heart -- with all of the necessary parts to connect each. So far, so good.
We've chosen not to find out the baby's gender. We like surprises.
It was an amazing experience. Seeing the baby swim around, flip and flail was incredible -- especially since the amniotic fluid absorbs the impact at this stage and I don't feel a thing. We were also able to hear the heartbeat, which was a first for Brian but no less thrilling for me the second time around.
It's amazing how each new experience drives home the reality of what's to come in just a few short months!
Monday, August 17, 2009
Obesity and health care
On Sunday, the San Francisco Chronicle published "Obesity a Crushing Weight on U.S. Health Care," which points to the obesity epidemic as a driving force behind the high cost of health care.
Duh.
Seriously, it's taken this long for a reporter to make such a conclusion? And I thought us journalist types were supposed to ahead of the curve.
Obesity is linked to a variety of nasty life-threatening conditions: Type II diabetes, high blood pressure, congestive heart failure, certain types of cancer. Diseases -- especially ones like diabetes and cancer -- are expensive to treat. Therefore, it stands to reason that obesity is linked to high health-care costs.
I remember when I was originally researching surgical weight loss. There was a lot of controversy at the time over the BMI requirement most insurers had for patients to qualify as having a medical necessity to lose weight.
WLS experts and obesity researchers talked about the cost benefit of covering weight-loss surgery for people with BMIs of 35-40 because they thought it was easier for a smaller patient to physically withstand the rigors and trauma of major surgery. They also believed that patients who were able to drop a large amount of weight BEFORE their bodies sustained irreparable damage from excess weight would be more successful in the long run. Insurance companies, on the other hand, viewed weight loss as a vanity measure and didn't want to cover it until it had already caused life-threatening diseases. Only then did the cost of the surgery win out over the cost of managing a long-term disease.
I also remember being very angry back then that WLS was my only option for insurer-covered weight management. I couldn't understand why an insurance company wouldn't pay for a year of intensive nutritional counseling and personal fitness training in an effort to prevent a patient from ever needing surgery.
At that point, I was able to speak to someone in the insurance industry. She was blunt and to the point: Insurance companies could not justify the expense of an obesity treatment that depended too much on an individual's compliance. People are fickle, and they sabotage themselves, she said. Paying for a year of nutritional and fitness counseling offered the insurance company no guarantee. However, surgery did. At least with surgery, there was a higher chance of immediate and long-term results.
My, how the pendulum has swung in the last five years. Now, many insurance companies require potential WLS candidates to undergo six to 12 months of medically supervised weight management before surgery can be approved. Some programs are hosted in hospitals by third-party groups. Others are offered by bariatric surgery centers. And others are semi-private. The motivation behind the programs are as varied as their sponsors. Some are merely there to prepare patients for life after WLS, which is the patient's ultimate goal anyway. Others are focused on getting patients on the track to better health so they abandon their desire for WLS. And others fancy themselves to be objective, saying they don't promote or condone WLS procedures but that they don't discourage their participants from pursuing surgical weight loss either.
One thing is certain, despite the increase in WLS over the last five years, obesity is still an epidemic and those afflicted are getting younger and younger.
Solutions mentioned in the Chronicle article include limiting fast-food establishments, creating public gardens and taxing junk food. Making healthy living more convenient and affordable sounds like an easy answer. I wish it were.
But the reality is that humans are human, and we've created this conveniently unhealthy culture we live in. If there were a public garden in every neighborhood, how many people would truly take the time to tend it so that it reaped a harvest that everyone could benefit from? And would that truly reduce the amount of processed foods each family consumes?
And as far as taxing junk food goes, I think that will have a marginal effect on consumption as well. I remember when cigarettes were first taxed in the 1980s. My mother, a longtime smoker, was not about to pay an extra 25 cents a pack for cigarettes and she quit cold turkey. But you know what? Her friends didn't. They all complained about the tax, but they kept smoking. Some still smoke today, and I don't think they've cut back. I imagine a junk food tax would have the same effect. Some may quit fast food altogether, others might cut back on trips to drive-thrus and soda/candy purchases, but many will cut other expenses just so they don't have to be inconvenienced.
Looking at my own situation, I can honestly say I hope my children never know what fast food is. I don't want a drop of McDonald's, Jack in the Box, Taco Bell, etc., to ever touch their lips. But is that anything more than a pipe dream? Fast-food advertising is everywhere: TV, billboards, radio, vehicles, clothing, the list goes on. How do I shield my children from that when I can't even shield myself?
I don't want my children to suffer my fate. I don't want them plagued by the social stigma and physical limitations of obesity, but I also know I can't raise them in a bubble. I am glad that obesity is back in the spotlight as a public health issue -- because it really does affect the entire population. At the same time, though, I realize that it is my job to ensure my children develop a healthy relationship with food and that they maintain a healthy level of activity. It may not be easy for me to cook dinner every night and take the time to play outside with my children, but if I don't, who will? And if I don't take the time to ensure my children are active, who will I have to blame when they develop sedentary habits?
Duh.
Seriously, it's taken this long for a reporter to make such a conclusion? And I thought us journalist types were supposed to ahead of the curve.
Obesity is linked to a variety of nasty life-threatening conditions: Type II diabetes, high blood pressure, congestive heart failure, certain types of cancer. Diseases -- especially ones like diabetes and cancer -- are expensive to treat. Therefore, it stands to reason that obesity is linked to high health-care costs.
I remember when I was originally researching surgical weight loss. There was a lot of controversy at the time over the BMI requirement most insurers had for patients to qualify as having a medical necessity to lose weight.
WLS experts and obesity researchers talked about the cost benefit of covering weight-loss surgery for people with BMIs of 35-40 because they thought it was easier for a smaller patient to physically withstand the rigors and trauma of major surgery. They also believed that patients who were able to drop a large amount of weight BEFORE their bodies sustained irreparable damage from excess weight would be more successful in the long run. Insurance companies, on the other hand, viewed weight loss as a vanity measure and didn't want to cover it until it had already caused life-threatening diseases. Only then did the cost of the surgery win out over the cost of managing a long-term disease.
I also remember being very angry back then that WLS was my only option for insurer-covered weight management. I couldn't understand why an insurance company wouldn't pay for a year of intensive nutritional counseling and personal fitness training in an effort to prevent a patient from ever needing surgery.
At that point, I was able to speak to someone in the insurance industry. She was blunt and to the point: Insurance companies could not justify the expense of an obesity treatment that depended too much on an individual's compliance. People are fickle, and they sabotage themselves, she said. Paying for a year of nutritional and fitness counseling offered the insurance company no guarantee. However, surgery did. At least with surgery, there was a higher chance of immediate and long-term results.
My, how the pendulum has swung in the last five years. Now, many insurance companies require potential WLS candidates to undergo six to 12 months of medically supervised weight management before surgery can be approved. Some programs are hosted in hospitals by third-party groups. Others are offered by bariatric surgery centers. And others are semi-private. The motivation behind the programs are as varied as their sponsors. Some are merely there to prepare patients for life after WLS, which is the patient's ultimate goal anyway. Others are focused on getting patients on the track to better health so they abandon their desire for WLS. And others fancy themselves to be objective, saying they don't promote or condone WLS procedures but that they don't discourage their participants from pursuing surgical weight loss either.
One thing is certain, despite the increase in WLS over the last five years, obesity is still an epidemic and those afflicted are getting younger and younger.
Solutions mentioned in the Chronicle article include limiting fast-food establishments, creating public gardens and taxing junk food. Making healthy living more convenient and affordable sounds like an easy answer. I wish it were.
But the reality is that humans are human, and we've created this conveniently unhealthy culture we live in. If there were a public garden in every neighborhood, how many people would truly take the time to tend it so that it reaped a harvest that everyone could benefit from? And would that truly reduce the amount of processed foods each family consumes?
And as far as taxing junk food goes, I think that will have a marginal effect on consumption as well. I remember when cigarettes were first taxed in the 1980s. My mother, a longtime smoker, was not about to pay an extra 25 cents a pack for cigarettes and she quit cold turkey. But you know what? Her friends didn't. They all complained about the tax, but they kept smoking. Some still smoke today, and I don't think they've cut back. I imagine a junk food tax would have the same effect. Some may quit fast food altogether, others might cut back on trips to drive-thrus and soda/candy purchases, but many will cut other expenses just so they don't have to be inconvenienced.
Looking at my own situation, I can honestly say I hope my children never know what fast food is. I don't want a drop of McDonald's, Jack in the Box, Taco Bell, etc., to ever touch their lips. But is that anything more than a pipe dream? Fast-food advertising is everywhere: TV, billboards, radio, vehicles, clothing, the list goes on. How do I shield my children from that when I can't even shield myself?
I don't want my children to suffer my fate. I don't want them plagued by the social stigma and physical limitations of obesity, but I also know I can't raise them in a bubble. I am glad that obesity is back in the spotlight as a public health issue -- because it really does affect the entire population. At the same time, though, I realize that it is my job to ensure my children develop a healthy relationship with food and that they maintain a healthy level of activity. It may not be easy for me to cook dinner every night and take the time to play outside with my children, but if I don't, who will? And if I don't take the time to ensure my children are active, who will I have to blame when they develop sedentary habits?
Sunday, August 16, 2009
The sound of a beating heart
I had my four-month OB visit on Friday, and I was very excited to hear the baby's heartbeat for the first time. It's an incredible sound that really brings home the reality of having a little person quickly growing inside of me.
My ultrasound is scheduled for tomorrow morning, and I'm looking forward to another view inside my womb. It's been six weeks since the last one, and I can't wait to see the changes that have happened in that time.
My doctor and I had a great talk about hypoglycemia and pregnancy. I was comforted to know that my hypoglycemic episodes will have no effect on the baby. It's just a matter of trying to ensure there is enough glucose to support me so I'm not always fighting the symptoms of low periods. I have had a handful of moments where my sugar falls between 40 and 60, but I've been better about staying around 80 for the most part.
We redid my labs on Friday to see how my vitamin levels are doing. The results should be in this week, though I may not discuss them with the doctor until my visit in September.
My ultrasound is scheduled for tomorrow morning, and I'm looking forward to another view inside my womb. It's been six weeks since the last one, and I can't wait to see the changes that have happened in that time.
My doctor and I had a great talk about hypoglycemia and pregnancy. I was comforted to know that my hypoglycemic episodes will have no effect on the baby. It's just a matter of trying to ensure there is enough glucose to support me so I'm not always fighting the symptoms of low periods. I have had a handful of moments where my sugar falls between 40 and 60, but I've been better about staying around 80 for the most part.
We redid my labs on Friday to see how my vitamin levels are doing. The results should be in this week, though I may not discuss them with the doctor until my visit in September.
Wednesday, August 12, 2009
Vitamins, vitamins and more vitamins
The top priority for any women when trying to conceive or upon discovering she is pregnant is to get on a high-quality vitamin program to ensure her growing baby has all of the nutrients necessary for development. Normally, doctors prescribe a brand they prefer. Some docs are OK with patients taking over-the-counter vitamins, but my experience has shown a strong preference for prescription vitamins during pregnancy.
Since my bowel obstruction, I have struggled with ingesting and process pills and tablets. Even though, it's been four years since I had gastric-bypass, my digestive system has retained many sensitivities since the emergency surgery I had in 2007. For that reason, my doctor and I chose to augment my current vitamin routine to ensure I'm getting the necessary amounts of vitamins and minerals without overdosing on any one nutrient.
Here's what I'm taking daily right now:
I have to admit, though, that the daily B12 has really helped with my energy levels.
We're closely monitoring my nutrient levels, but it appears that so far, what we are doing works. The proof, however, will come when I deliver a healthy baby in a few months.
Since my bowel obstruction, I have struggled with ingesting and process pills and tablets. Even though, it's been four years since I had gastric-bypass, my digestive system has retained many sensitivities since the emergency surgery I had in 2007. For that reason, my doctor and I chose to augment my current vitamin routine to ensure I'm getting the necessary amounts of vitamins and minerals without overdosing on any one nutrient.
Here's what I'm taking daily right now:
- 2 Bariatric Advantage high-potency (extra A, D, E, K) chewable multivitamins -- Before pregnancy, I took 1 daily
- 10 Bariatric Advantage Calcium Chewy Bites (250 mg of calcium citrate each) -- Before pregnancy, I took 5 daily
- 1 Bariatric Advantage sublingual B-12 tablet -- Before pregnancy, I took 2 per week
- 1 Se-Vate iron supplement with succinic acid and B12 (generic for Repliva, which has since been taken off the market) -- This is the only tablet I swallow daily.
I have to admit, though, that the daily B12 has really helped with my energy levels.
We're closely monitoring my nutrient levels, but it appears that so far, what we are doing works. The proof, however, will come when I deliver a healthy baby in a few months.
Tuesday, August 11, 2009
WLS and Pregnancy
Now that the cat is out of the bag, so to speak, about my pregnancy, I find myself hammered with random questions. There are the normal ones: When are you due? When do you find out what you’re having? How are you feeling? Etc.
And then there are the ones that remind me that I’m not normal – at least not in the eyes of others: Can you do that? What has your doctor said? Will you be able to eat enough to nurture your baby? Are you high risk?
I hate feeling like an alien, but sometimes, I think the rest of the world views me as one. Being an expectant mom is stressful enough. Especially as a first-time mom, there are a million things to consider: Medicated or natural? Hospital or home? Breast or formula? Cloth or disposable? Organic or not? Vaccinate or don’t? Co-sleeper or crib? To wear or not to wear?
And let’s not forget all the people out there who feel the need to recount labor horror stories with every pregnant woman they lay eyes on. I think there should be a special place in hell for those people.
As intrusive as they may seem at first, the questions regarding how WLS will affect my pregnancy are fair ones. It’s common knowledge that surgical weight loss affects your insides. What seems to be no-so commonly known is how your uterus is/is not affected by your intestines.
The most common questions I hear are related to my vitamin levels and eating habits. People still think you need to eat for two when you’re pregnant. Not true. You need some extra calories (300 per day to be exact), but the baby will get what it needs – if not from what you eat, then from what you have stored up. All nutrients play a role in growing a healthy baby. Folic acid is key for brain development. Iron ensures healthy blood flow. Protein builds tissue. Carbohydrates offer energy.
I know WLS patients can have healthy babies. I’ve seen it firsthand. But I also know you can have healthy babies while compromising your own health. I don’t want to be Carnie Wilson and gain 75 pounds, but I also don’t want to be so obsessed over the scale that I harm myself either.
So far, I have really enjoyed the experience of being pregnant. I was nauseated and fatigued early on, but that has subsided. I devote a lot of energy on nutrition (more on that later) and try not to devote too much time to second-guessing myself. I figure there are plenty of people out there willing to do that on my behalf.
And then there are the ones that remind me that I’m not normal – at least not in the eyes of others: Can you do that? What has your doctor said? Will you be able to eat enough to nurture your baby? Are you high risk?
I hate feeling like an alien, but sometimes, I think the rest of the world views me as one. Being an expectant mom is stressful enough. Especially as a first-time mom, there are a million things to consider: Medicated or natural? Hospital or home? Breast or formula? Cloth or disposable? Organic or not? Vaccinate or don’t? Co-sleeper or crib? To wear or not to wear?
And let’s not forget all the people out there who feel the need to recount labor horror stories with every pregnant woman they lay eyes on. I think there should be a special place in hell for those people.
As intrusive as they may seem at first, the questions regarding how WLS will affect my pregnancy are fair ones. It’s common knowledge that surgical weight loss affects your insides. What seems to be no-so commonly known is how your uterus is/is not affected by your intestines.
The most common questions I hear are related to my vitamin levels and eating habits. People still think you need to eat for two when you’re pregnant. Not true. You need some extra calories (300 per day to be exact), but the baby will get what it needs – if not from what you eat, then from what you have stored up. All nutrients play a role in growing a healthy baby. Folic acid is key for brain development. Iron ensures healthy blood flow. Protein builds tissue. Carbohydrates offer energy.
I know WLS patients can have healthy babies. I’ve seen it firsthand. But I also know you can have healthy babies while compromising your own health. I don’t want to be Carnie Wilson and gain 75 pounds, but I also don’t want to be so obsessed over the scale that I harm myself either.
So far, I have really enjoyed the experience of being pregnant. I was nauseated and fatigued early on, but that has subsided. I devote a lot of energy on nutrition (more on that later) and try not to devote too much time to second-guessing myself. I figure there are plenty of people out there willing to do that on my behalf.
Monday, August 10, 2009
And now...we're expecting!
The biggest development in my life this past year has also turned out to be the biggest surprise. After we were told it wouldn't happen, couldn't happen, Brian and I found out that I was expecting in early June. This has been the ultimate answer to prayer for both of us. We knew the hows and whens of becoming parents would materialize in God's timing; we just didn't expect God to be so agreeable.
Longtime readers of this column when it first appeared in the Tracy Press (long before I even knew what Blogger was), know that my desire to become a mom is what originally prompted me to consider WLS. Back then, I didn't want to be thin; I thought I was healthy and happy; I just wanted to have a baby. My doctor at the time told me I had obesity-related infertility and that surgical weight loss was my best chance at regaining my ability to get pregnant.
Since that time, I have received conflicting information from medical providers. Visible signs of fertility took a long time to materialize for me. Docs attributed it at first to the trauma of having Roux-en-Y gastric-bypass. Then they attributed it to the rapid weight loss. Then I had a bowel obstruction and yet another traumatic abdominal surgery. I was told my body was in shock, that it had been through a lot and it needed time to heal. After a year of healing, questions of whether I was ever fertile at all began to surface. Lab results were no help. One batch would show normal ovulatory function. Another would show none. It was an emotional roller coaster that I soon grew weary from.
The idea of finding love again after divorce was hard enough, but with questionable fertility, it seemed pointless. It's not exactly first-date appropriate conversation, but it's not fair to string a guy along if you're aware of information that might change his opinion of you. So I didn't date. Avoidance seemed the most painless solution.
And then I met Brian and that all changed. I went from "not dating" to "head over heels" in what seemed like the blink of an eye. We had similar histories, similar backgrounds, similar values and similar priorities. It was like coming home after a long journey through the wilderness. It was warm, safe and reassuring. No surprise that our love blossomed rapidly.
And now we're going to be parents, and we're so excited we can hardly stand ourselves. Our friends are thrilled; our families are thrilled. Did I mention that we are thrilled?
The ultrasound shown above was taken in late June and show the baby as little more than a kidney bean with a flashing pulse. My next ultrasound will be in September. In the meantime, I'm focused on a healthy pregnancy.
We WLS moms are a special sort and have to be particularly attentive to our bodies during pregnancy. My hemoglobin levels are good and I still respond well to my iron supplements, but I can't be caught off-guard. I have other vitamin levels to be mindful of, and reactive hypoglycemia is still a tricky thing to manage.
I'm confident, however, that I'm in good hands. My family doctor has delivered a number of babies from post-WLS moms and has a solid record of successes. My health concerns don't alarm her, which means they don't have to alarm me either. The pregnancy is considered normal by all standards, and I'm enjoying the experience.
Longtime readers of this column when it first appeared in the Tracy Press (long before I even knew what Blogger was), know that my desire to become a mom is what originally prompted me to consider WLS. Back then, I didn't want to be thin; I thought I was healthy and happy; I just wanted to have a baby. My doctor at the time told me I had obesity-related infertility and that surgical weight loss was my best chance at regaining my ability to get pregnant.
Since that time, I have received conflicting information from medical providers. Visible signs of fertility took a long time to materialize for me. Docs attributed it at first to the trauma of having Roux-en-Y gastric-bypass. Then they attributed it to the rapid weight loss. Then I had a bowel obstruction and yet another traumatic abdominal surgery. I was told my body was in shock, that it had been through a lot and it needed time to heal. After a year of healing, questions of whether I was ever fertile at all began to surface. Lab results were no help. One batch would show normal ovulatory function. Another would show none. It was an emotional roller coaster that I soon grew weary from.
The idea of finding love again after divorce was hard enough, but with questionable fertility, it seemed pointless. It's not exactly first-date appropriate conversation, but it's not fair to string a guy along if you're aware of information that might change his opinion of you. So I didn't date. Avoidance seemed the most painless solution.
And then I met Brian and that all changed. I went from "not dating" to "head over heels" in what seemed like the blink of an eye. We had similar histories, similar backgrounds, similar values and similar priorities. It was like coming home after a long journey through the wilderness. It was warm, safe and reassuring. No surprise that our love blossomed rapidly.
And now we're going to be parents, and we're so excited we can hardly stand ourselves. Our friends are thrilled; our families are thrilled. Did I mention that we are thrilled?
The ultrasound shown above was taken in late June and show the baby as little more than a kidney bean with a flashing pulse. My next ultrasound will be in September. In the meantime, I'm focused on a healthy pregnancy.
We WLS moms are a special sort and have to be particularly attentive to our bodies during pregnancy. My hemoglobin levels are good and I still respond well to my iron supplements, but I can't be caught off-guard. I have other vitamin levels to be mindful of, and reactive hypoglycemia is still a tricky thing to manage.
I'm confident, however, that I'm in good hands. My family doctor has delivered a number of babies from post-WLS moms and has a solid record of successes. My health concerns don't alarm her, which means they don't have to alarm me either. The pregnancy is considered normal by all standards, and I'm enjoying the experience.
Sunday, August 09, 2009
And then Michelle Obama visited Merced
When the UC Merced Class of 2009 set its sights on having First Lady Michelle Obama deliver the keynote address at the university's commencement celebration for its inaugural class, I never thought in a million years that it would come to pass.
I stand corrected.
Mrs. Obama delivered an inspirational message to our graduates in May of this year, encouraging them to pay forward the blessings they had received so that others may have the same opportunities afforded to them. She talked about the daunting challenges that lie ahead for those entering the work force but reminded the 500-plus graduates that there were ample opportunities to make a difference in the world.
Her presence led about 12,000 people to brave the sweltering valley heat in order to catch a glimpse of her in person. Close to 20,000 people in all spent that day in Merced, some watching the commencement festivities from locations downtown or in the air-conditioned comfort of the homes of family and friends. Most local media outlets broadcast the event live on their Web sites. It was also broadcast on public-access cable television and on CNN.
As a public information officer for the university, I had the opportunity to coordinate media before the event and help journalists get the access they needed during the event. That meant that I, too, was bravely the 100-plus-degree weather and full sunshine. Anyone who thinks a journalist's job is glamorous hasn't been corralled in a press area without shade for hours.
Though I gave a lot of interviews in the weeks leading up to the First Lady's visit, my favorite interview came in the days after when Sam Matthews, publisher emeritus of the Tracy Press, called me up to see what I had to say about the experience. Never in all my years at the Press did I ever think I'd live to see the day when I was mentioned in Tracing Tracy Territory. I guess that makes me an official Tank Town veteran.
The experience of working with the White House is also one I won't soon forget. Politics aside, nobody can deny the fact that the Obama administration is highly accessible and gracious when it comes to working with others. I learned so much from the six short weeks we had to prepare for the event, and I am so much better for the experience.
I stand corrected.
Mrs. Obama delivered an inspirational message to our graduates in May of this year, encouraging them to pay forward the blessings they had received so that others may have the same opportunities afforded to them. She talked about the daunting challenges that lie ahead for those entering the work force but reminded the 500-plus graduates that there were ample opportunities to make a difference in the world.
Her presence led about 12,000 people to brave the sweltering valley heat in order to catch a glimpse of her in person. Close to 20,000 people in all spent that day in Merced, some watching the commencement festivities from locations downtown or in the air-conditioned comfort of the homes of family and friends. Most local media outlets broadcast the event live on their Web sites. It was also broadcast on public-access cable television and on CNN.
As a public information officer for the university, I had the opportunity to coordinate media before the event and help journalists get the access they needed during the event. That meant that I, too, was bravely the 100-plus-degree weather and full sunshine. Anyone who thinks a journalist's job is glamorous hasn't been corralled in a press area without shade for hours.
Though I gave a lot of interviews in the weeks leading up to the First Lady's visit, my favorite interview came in the days after when Sam Matthews, publisher emeritus of the Tracy Press, called me up to see what I had to say about the experience. Never in all my years at the Press did I ever think I'd live to see the day when I was mentioned in Tracing Tracy Territory. I guess that makes me an official Tank Town veteran.
The experience of working with the White House is also one I won't soon forget. Politics aside, nobody can deny the fact that the Obama administration is highly accessible and gracious when it comes to working with others. I learned so much from the six short weeks we had to prepare for the event, and I am so much better for the experience.
And then we got married
Brian and I were married earlier this spring after a brief engagement. Something my health issues have taught me is that life is precious and time waits for no one. And something that Brian has taught me is that when something feels right, there is no reason to put off what is inevitable.
Our wedding was everything I have ever dreamed of -- it was original, fun and true to our personalities. We had a rockabilly-inspired ceremony and reception in my hometown. Aside from committing myself to Brian forevermore, my favorite part of the event was that we were able to support so many small business owners by hiring them to help out with the festivities.
Texas Roadhouse of Tracy catered the event, providing a sumptuous dinner of grilled chicken breast, broiled salmon, mashers and Caesar salad. Christy LoBao of Atwater made our polka-dot wedding cake and Portuguese pastries. Phaedra Rhodes of For Always Photography in Turlock photographed the event. Amber Tucker of Modesto led the style team to make sure our hair and makeup evoked the classic 1940s/50s era. Debby Carper of Denair made the bridal attire, including my oh-so-fun party dress. Lester Knox made Brian's titanium wedding band. Our flowers were provided by the Pitman High School OH Department, which enabled high school agriculture students to get valuable work experience while earning money to support FFA programs in Turlock. Pastor Shawn Marshall of Family Life Center in Stockton officiated the ceremony. Ann Jayne of Tracy designed our tablescapes and served as wedding coordinator.
We had fun, our guests and had fun, and Phae's incredible talent for photography ensured we have every minute documented forever.
Our wedding was everything I have ever dreamed of -- it was original, fun and true to our personalities. We had a rockabilly-inspired ceremony and reception in my hometown. Aside from committing myself to Brian forevermore, my favorite part of the event was that we were able to support so many small business owners by hiring them to help out with the festivities.
Texas Roadhouse of Tracy catered the event, providing a sumptuous dinner of grilled chicken breast, broiled salmon, mashers and Caesar salad. Christy LoBao of Atwater made our polka-dot wedding cake and Portuguese pastries. Phaedra Rhodes of For Always Photography in Turlock photographed the event. Amber Tucker of Modesto led the style team to make sure our hair and makeup evoked the classic 1940s/50s era. Debby Carper of Denair made the bridal attire, including my oh-so-fun party dress. Lester Knox made Brian's titanium wedding band. Our flowers were provided by the Pitman High School OH Department, which enabled high school agriculture students to get valuable work experience while earning money to support FFA programs in Turlock. Pastor Shawn Marshall of Family Life Center in Stockton officiated the ceremony. Ann Jayne of Tracy designed our tablescapes and served as wedding coordinator.
We had fun, our guests and had fun, and Phae's incredible talent for photography ensured we have every minute documented forever.
Showered with shoes and purses galore
The best part of getting married the second time around is that you don't have to feel beholden to tradition or societal expectation. That means that wedding planning turned out to be a lot of fun for me.
My bridesmaids decided to host a shoes-and-purses shower on my behalf. It was a complete surprise to me -- and one I really enjoyed. I'm the type of girl who loves to accessorize but enjoy shopping for accessories so I end up with just a handful of staples. Now, thanks to the lovely women in my life, I have a whole collection of shoes and purses to go with just about every possible outfit.
Aside from shoes and purses, though, my maid of honor, Amber, made sure I had plenty of pouch-friendly tidbits to nosh on. Amber made a green salad, chicken salad, quiche and appetizers. She also made a decadent chocolate cake and ordered custom cupcakes for the occasion. A nibble of each was more than enough to satisfy my curiosity. In case you're wondering, those decorative shoes and purses on the cupcakes are edible but not yummy. Better left as decoration.
My bridesmaids decided to host a shoes-and-purses shower on my behalf. It was a complete surprise to me -- and one I really enjoyed. I'm the type of girl who loves to accessorize but enjoy shopping for accessories so I end up with just a handful of staples. Now, thanks to the lovely women in my life, I have a whole collection of shoes and purses to go with just about every possible outfit.
Aside from shoes and purses, though, my maid of honor, Amber, made sure I had plenty of pouch-friendly tidbits to nosh on. Amber made a green salad, chicken salad, quiche and appetizers. She also made a decadent chocolate cake and ordered custom cupcakes for the occasion. A nibble of each was more than enough to satisfy my curiosity. In case you're wondering, those decorative shoes and purses on the cupcakes are edible but not yummy. Better left as decoration.
And then I got engaged
Last fall was a whirlwind for me. In the span of a week, I earned the free use of a car from Mary Kay, became a director with the company, turned 31 and became engaged.
I'm exhausted just thinking about it. But then again, I don't tend to do anything halfway. I'm either all in or all out; tip-toeing has never been my style.
And that also sums up how I ended up dating and agreeing to marry a man after swearing off romance for all time.
I met Brian through a coworker when I went to a production at the local playhouse. Brian was in the cast, and I was instantly captivated. Pride wouldn't allow me to admit at the time, though. After all, I was the "never girl." I swore I would never date again, love again and marry again. I was wrong. I've learned to never say never again.
Brian swept me off my feet, and our story is a remarkable one, but it's not one I'm sharing right now. Suffice it to say that I found my soul mate and am enjoying my own version of "happily ever after."
Thursday, August 06, 2009
She did what?! Yes, I'm a Mary Kay director!
The catalyst for all the changes I've encountered in the last year was my decision in June 2007 to join Mary Kay. Surprised? Not nearly as much as I was when I signed my consultant agreement.
I did not go to college to peddle lipsticks, but facts were facts. I needed extra money and I didn't have a whole lot of extra time to earn it. So, I followed the advice of a good friend a took a chance that something I would have never considered might just be the opportunity of a lifetime. Turns out that my friend is pretty good in the advice department. I spent most of 2007 enjoying the extra money my Mary Kay business brought in, which allowed me to re-evaluate my priorities at the time.
But the big change came in Summer 2008. That's when I decided that I wanted more out of my Mary Kay business, and I was ready to do the work necessary to get more. So I began the process of qualifying for the position, debuting as the newest director in the Future Munguia National Area in October 2008 -- and I even earned the free use of a brand-new Pontiac Vibe along the way.
I haven't looked back since, as I enjoy working full-time at my day job and building my Mary Kay business in about 15 hours a week. It's a fun way to make money, and it's a career I can feel passionate and optimistic about building.
Along the way from consultant to director, I learned a lot about priorities and what truly motivates me. I have learned that short-term sacrifices pave the way for long-term rewards and that I deserve to seek out the things in life that bring me joy and personal fulfillment. It wasn't an easy road for me to travel. I had to give up a lot of resentment and negativity that was holding me back, but in the end, that freed me for the good things to come.
Apology and Update
This blog has gone neglected for some time – long enough to be kicked out of its Web rings and probably long enough to fall off the radar of most readers.
For that, I apologize.
It’s hard to take the time to write about life when you’re so busy living it. And I have been living it up this past year. Rather than recap in brief bullets what’s kept me so busy over the last year or so, I’d rather just take a little time to post on the major events.
We’ll call this one the “I’m sorry” post. It’s where I publicly apologize to all of the people who have felt neglected by my blogging absence, but consider that absence a nice, clean break that hints at something new on the horizon.
I’ve grown weary of looking back, of living in the past, and of being looked at as nothing more than this woman who writes about gastric-bypass. Believe it or not, there is move to me than how much I have weighed, do weigh or will weigh. I think it’s important to remember from where you’ve come so you can avoid the pitfalls that might lead you there again, but dwelling on the past is an exercise in futility. And I hate futile efforts.
So, look forward to a new angle on this blog from here on out. There will be lots of familiar aspects to it. I’m still going to post recipes, I’m still going to talk about what I love and don’t, and I’m still going to talk about issues related to obesity and surgical correction. But I am also going to celebrate. I want to celebrate what’s new, what’s different and choose to live life on the sunny side for awhile.
For that, I apologize.
It’s hard to take the time to write about life when you’re so busy living it. And I have been living it up this past year. Rather than recap in brief bullets what’s kept me so busy over the last year or so, I’d rather just take a little time to post on the major events.
We’ll call this one the “I’m sorry” post. It’s where I publicly apologize to all of the people who have felt neglected by my blogging absence, but consider that absence a nice, clean break that hints at something new on the horizon.
I’ve grown weary of looking back, of living in the past, and of being looked at as nothing more than this woman who writes about gastric-bypass. Believe it or not, there is move to me than how much I have weighed, do weigh or will weigh. I think it’s important to remember from where you’ve come so you can avoid the pitfalls that might lead you there again, but dwelling on the past is an exercise in futility. And I hate futile efforts.
So, look forward to a new angle on this blog from here on out. There will be lots of familiar aspects to it. I’m still going to post recipes, I’m still going to talk about what I love and don’t, and I’m still going to talk about issues related to obesity and surgical correction. But I am also going to celebrate. I want to celebrate what’s new, what’s different and choose to live life on the sunny side for awhile.
What happens to cravings after WLS?
A reader recently posted a comment about her insatiable craving for chocolate and her hope to be delivered of it after WLS. Without knowing which procedure she's having, I can't do anything more than guess. Then again, so much of life after WLS is guesswork. We never know exactly how our bodies will adjust to surgery, do we?
Assuming this reader has some type of bypass or even Lap-Band, I can say that just the trauma of surgery will alter taste buds long enough to eliminate cravings for some time. But cravings eventually return, though not always how we'd expect them.
Though I still crave ice cream, it makes me too sick for me to be tempted to give in that often. Usually a bite or two is plenty. I still have a sweet tooth, but I find foods often to be "too sweet," even if artificially sweet. A half-packet of Splenda is usually plenty to sweeten anything I might want to try. Gone are the days when I would need four or five packets in my coffee or tea.
I still enjoy chocolate from time to time, but I prefer darker varieties and favor bitter flavors.
That's just my experience. I'm sure others have different tales to tell.
The one thing I can say is that worrying about it now won't help or change anything. Your body will do whatever it is it wants to do. All we can do as patients is obey our tool as best as we can.
Assuming this reader has some type of bypass or even Lap-Band, I can say that just the trauma of surgery will alter taste buds long enough to eliminate cravings for some time. But cravings eventually return, though not always how we'd expect them.
Though I still crave ice cream, it makes me too sick for me to be tempted to give in that often. Usually a bite or two is plenty. I still have a sweet tooth, but I find foods often to be "too sweet," even if artificially sweet. A half-packet of Splenda is usually plenty to sweeten anything I might want to try. Gone are the days when I would need four or five packets in my coffee or tea.
I still enjoy chocolate from time to time, but I prefer darker varieties and favor bitter flavors.
That's just my experience. I'm sure others have different tales to tell.
The one thing I can say is that worrying about it now won't help or change anything. Your body will do whatever it is it wants to do. All we can do as patients is obey our tool as best as we can.
UCSD develops new WLS method
It appears that researchers at UC San Diego have figured out a new way reduce the size of the stomach, without cutting patients open or creating an intestinal bypass.
It's only been tried on a handful of patients, but this new method involves inserting an instrument through the oral cavity and down the esophagus to fold the stomach into a smaller size, which would reduce food capacity without causing nutrient malabsorption. That means post-ops wouldn't be at risk of nutrient deficiency, reactive hypoglycemia, dumping syndrome or any of the other potential complications linked to gastric-bypass procedures.
The article also states that the procedure is meant for patients who are not yet morbidly obese. This reminds me of a conversation I had with a surgeon some years ago at an ObesityHelp conference. He said that as surgical weight loss was growing in popularity, there was increasing talk in the industry about how to reverse obesity before it became a life-threatening condition.
I understood his point at the time. It's easier to operate on someone with a BMI of 35 than 55. The smaller you are, the better your body tends to handle the trauma of surgery.
But surgical weight loss shouldn't be a Band-Aid for people who need to lose a few pounds. I have always believed that it needs to be a weight-loss method of last resort. Because only when it's your last resort are you willing to make the lifestyle changes necessary for long-term success. Then again, if this procedure eliminates many of the problematic side effects associated with gastric-bypass procedures, maybe the lifestyle changes aren't as necessary. But then if you don't change your lifestyle, how do you keep the weight off?
It's only been tried on a handful of patients, but this new method involves inserting an instrument through the oral cavity and down the esophagus to fold the stomach into a smaller size, which would reduce food capacity without causing nutrient malabsorption. That means post-ops wouldn't be at risk of nutrient deficiency, reactive hypoglycemia, dumping syndrome or any of the other potential complications linked to gastric-bypass procedures.
The article also states that the procedure is meant for patients who are not yet morbidly obese. This reminds me of a conversation I had with a surgeon some years ago at an ObesityHelp conference. He said that as surgical weight loss was growing in popularity, there was increasing talk in the industry about how to reverse obesity before it became a life-threatening condition.
I understood his point at the time. It's easier to operate on someone with a BMI of 35 than 55. The smaller you are, the better your body tends to handle the trauma of surgery.
But surgical weight loss shouldn't be a Band-Aid for people who need to lose a few pounds. I have always believed that it needs to be a weight-loss method of last resort. Because only when it's your last resort are you willing to make the lifestyle changes necessary for long-term success. Then again, if this procedure eliminates many of the problematic side effects associated with gastric-bypass procedures, maybe the lifestyle changes aren't as necessary. But then if you don't change your lifestyle, how do you keep the weight off?
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