"I am going for the fun, not the food"

So the other day, I realized that I had been invited to several occasions that involve food in the next few weeks – first was my daughter’s Ice Cream Social at her preschool. After about 45 minutes of feeling sorry for myself before I left, I had “a-ha” moment (you know, when the lightbulb suddenly turns on in your brain?). I was going to the social for the fun (little kids performing a song and a juggler), not the food. And that was it, I felt better, and viola, I had a new motto: I’m going for the fun, not the food!

Then yesterday, I had my first band adjustment (or fill as it’s sometimes called). After a band adjustment, you go back to square one with your diet – nothing but clear liquids the first day, then advance as you can, taking it slowly. So last night when I went to the board meeting for my daughter’s preschool (I’m a member of the board, and also a parent, so I provide a unique perspective – at least through May!), I brought sugar free Jello with me to share with my board friends, because there are always treats (it’s at a Lutheran church, which my husband likens to “worshipping God through Potluck!). When I mentioned my new motto to them, they loved it! Apparently I’m very wise for 33 years – lol.

But it doesn’t end there – This weekend will be spent with my best friends in my former state at a wedding shower and a casino, then next week I have a Pampered Chef party – three places where I could absolutely sabotage myself, But I’m not going to. I have my motto. I can bring or buy protein shakes and bars. I can order 1 egg, or a cup of soup, or some fish at a restaurant. Nobody is going to force me to finish my food.

And because of that, I feel empowered. I feel renewed. I have 1.5 pounds to go until I reach my first goal of 10% of my body weight. And when I reach that, I will get my mani-pedi, which is another milestone. It’s the first time that I will reward myself with something other than food. And that makes me proud!

Sabotage

No, I am not speaking of the Beastie Boys, though when I first heard that Sabotage (as in doing things that would sabotage ourselves and our diets) was the topic of my last WLS support group that was the first thing that popped into my head. But hey, give me a break, I was born in the 70s, and grew up in the 80s and 90s!

According to the Psychologist that ran the group, the main reason that people sabotage themselves is that they have a carbohydrate addiction. Think about it. If you are craving some kind of food or a snack and you are overweight (a little all the way to morbid obesity), you are usually not craving veggies. It’s chocolate, or chips, or bread, or pasta or ice cream or (name whatever you crave here). And there is a reason for it – just like the alcoholic craves alcohol and gets a response for it with a pleasurable effect in his brain, people who have carbohydrate addiction get the same reaction within their brain.

When a person is an addict, many things can set off a binge, but a lot of the reasons are the same: stress, family issues, financial problems, medical issues, and the more a person reacts to these situations, the more likely they are to binge, which brings about a vicious cycle that is hard or almost impossible to stop.

The other problem with carbohydrate addiction is that when you are a difficult situation, simple carbs are the most affordable way to eat. Mac n’ cheese, raman noodles, white bread, junky cereal, fake potatoes… I could go on and on. While for ever it seems, I was blaming my needing to be on Seroqual and the weight gain on the fact that I was on the medication, the truth is that was only a part of the picture.

Yes, Seroqual is linked to weight gain, diabetes, and a dozen more issues that I have developed on it, it wasn’t the medication that was spending the food budget on simple carbs. It wasn’t the medication that put the white bread smothered in butter, the mac n’ cheese or the banana hot fudge sundaes down my throat. It was me. And I accept full responsibility for that.

And that stress cycle that was how my family lived until my husband started his new job last summer, and I started working on myself. Now, I’m not saying things are perfect, and I have had a sip of pop here and there, and the jelly belly’s called my name loudly from the Easter baskets, but each time I have given into that carb craving, I have found myself very unhappy afterwards. But I’m learning, and will continue to learn as I go. From my understanding, this can take years, and some of the most successful people with their lap-bands have moments of self-sabotage.

Surgery

Surgery

During March, I had my consult with my surgeon, Dr. Raymond Taddeucci. When I weighed in, I was 334 lbs, so I had already lost 4 lbs. from “eating right and exercise”. We talked, and he answered my questions about what might happen with me and my medications for my mental illness post surgery. I told him about how I have usually experienced a mania or a “mixed” episode after any of my surgeries, followed by a humongous crash that left me unable to function. He told me that I shouldn’t have any problems post op, but that I’ll want to cut my larger pills (such as Seroqual) in half. I was fine with that arrangement, and went on my merry way.

Two weeks before surgery, I started my slim fast plan, though I used Soy protein drinks with 8^th continent light vanilla soy milk for added protein (One cup of the soy milk is 60 calories, has 7 grams of protein, 1 gram of heart healthy fat, and more nutrients than are found in skim milk, plus, being lactose intolerant, these shakes are much better for my digestive system!)

The day before surgery, I was on clear liquid only. My wonderful mother-in-law had come in the day before from Michigan, where we used to live to help with the girls. As a fun activity, we went to the Shrine Circus, which we all loved. Since I had been told I could have 7-up, Mom got me a Sierra Mist. Now, in the past few weeks, I had completely cut out pop (or soda, or coke depending on where you’re from), so when I drank it, my whole body felt like I was filled up with air. I guess I learned the hard way that I really need to stay away from anything carbonated!

The next morning at 4:30, after having the kind of sleep where you wake up every hour on the hour to make sure you are not late, I got up, woke my husband up, and got ready for surgery.

We got there at 5:30, checked in, and I was weighed-I was down another 16 pounds, which made my total lost before surgery twenty pounds! I was so thrilled! About 7, they wheeled me back to surgery, I was given anesthesia, and the next thing I remember it was about 11:00 and I was in recovery. My first thought was what had gone wrong because the surgery is supposed to take only 45 minutes to 1 hour and a half, and here it was about 3 and a half hours later. My second thought was my back is killing me!

It turns out that I have a very unique anatomy. Most people who are obese carry their fat on the inside of their muscle. Not me. My fat lies on top of the muscle, creating a challenge that my surgeon had never before faced. Basically, one of the reasons it was so difficult is that the tubing that connects the port to the lap-band, doesn’t have much slack, and in order to place the port on a muscle, they had to create a place where the muscle was available. When I first had the surgery, the port are looked very strange because of all the swelling. Now that I am three weeks out, it kind of looks like I have another belly button.

I couldn’t have anything to eat or drink until I did a swallow test the next morning at 7:00. But I was on an IV. I did have a minor panic attack as I was in the recovery room, but I was fine all day until it was time for me to have my Seroqual, Klonopin, and Ambien. Because I could not take them by mouth, I wasn’t able to hve them. That night was miserable – a combination of hypomanic behavior, racing thoughts, being tired but unable to sleep, and panic attacks. I couldn’t wait until I could go home and take my medications, but by about 8 am, I was in a full-blown mania.

After they were sure I could handle clear liquids, they sent me a “full liquids” lunch. After I had “passed” the test that I could handle cream soup and a sugar –free carnation instant breakfast, my husband had arrived and I was sent home. As soon as I got home, I took my Klonopin, and sat down in my comfy chair to relax. My husband went out to get my medicine, then went to Target and bought me the storage ottoman that I had been drooling over so I could be extra comfy. Even my snuggie was ready for me.

That night, I took my normal night medications, having cut all the “hoarse pills” in half. Then I swallowed one pill a ta time, 5 minutes apart. While I didn’t sleep perfect, I did sleep ok and long. The next day, I was still hypomanic, but I was getting better control about my thoughts and actions. It only got better, though the pain was more than I had imagined.

Next- weeks 1-3 after surgery. Look for this posting within the next week. Thanks for reading. Email me at WLNutjob@gmail.com with any questions or suggestions regarding dealing with WLS, a major mental illness, or both!

Prologue

Prologue

March 42010

Since I was eight years old, I have always been between 50 and 100 pounds overweight. I was the “fat kid” in elementary and middle school, and my weight did not go unnoticed by my mom and by the doctors in charge of my physical care. One doctor told my mom, if she continues like this, her size will match her age. And so it did. I was a size 14 at 14, a 20 at 20, and a 30/32 on top at 32.

At eight, my mom signed me up for Shape Down, a weight loss program designed for children and teens. There I learned that I could have 100 pretzel sticks or one Reese’s cup. My mom made me a deal. Lose 10 pounds and you can get your ears pierced. So I lost ten pounds, and got my ears pierced. A few weeks later, my sister got hers pierced and then got ice cream. I was as mad as an eight-year-old could get. So I got back at my mom buy doing the only thing I ever knew how to do….. I snuck food, stole my dads pocket change to buy candy, and I gained back the 10 pounds, plus extra.

Over the rest of my childhood, my weight issue became a family affair. We were all going to eat healthier so that Kathy will lose weight. Well, after our healthy meals, my dad would take one of my siblings out to run errands that always included a stop to a Coney Island restaurant for hot dogs.

At twelve, my mom was diagnosed with cancer. My weight took the backburner. I took on a lot of adult responsibilities. I believe I was also suffering from child hood depression at the time. I ate to feel better because I couldn’t handle my mom’s illness.

In high school, between my mom’s relapses of cancer, I tried other weight loss plans. I did weight watchers, went to a psychic specialist who looked at my eyes and told my parents to basically put me on the Atkins diet. Then I simply tried the starvation diet. I would eat a banana in the morning, drink diet Pepsi all day, the stuff my face with anything and everything available when I got home from school. That got me to stay at a size 14, and my mom was happy with that.

The summer I was turning 17, I went on tour with a choir to Europe. We walked everywhere, and almost all the food I ate was fresh, non-processed food. I was gone 3 weeks, and when I returned, my size 14’s was loose, and I felt like I never looked better. It also helped that I met my boyfriend on the trip (almost seventeen years later and we are still together, married for about 8 years, and have two beautiful girls).

In college, I learned that my mom’s cancer had spread through her body to her lungs, bones, and brain. I had gained the freshman 15 and more, and was a size 20. I knew that my mom would love to see me thin, so I joined Jenny Craig, and began walking 5 miles a day. I took the summer off from college and moved home to take care of my mom. By the time I returned to college, I was a size 14. I stayed that size until my mom’s funeral in November. Then I ate my way up to a size 22.

After I graduated from college, I began working out at a gym while watching what I ate. I was a solid size 18, but I felt great and I looked great. I was happy with myself, and that happiness helped me make really great food choices along with workouts 4 days a week.

That next summer, I moved in with my now husband and his roommate, and started eating like them. I went up to a size 20 and stayed there until six months before our wedding, when I joined both Weight Watchers and Curves at the same time. I lost 24 pounds, but more impressively, lost 48 inches from the Curves workouts.

Now we get to the hard stuff….

When I came home from my honeymoon, I discovered, and was thrilled, that I was pregnant. But that joy did not last long. Soon I developed hyperemesis (basically puking too much during pregnancy). I started losing weight instead of gaining. Then my blood pressure went up. I was put on bed rest for Preeclampsia in early January, even though my due date wasn’t until April. On January 19, 2003 I woke up in the hospital feeling like I had the flu. Later that day, my preeclampsia progressed to HELLP Syndrome, and my vital organs like liver and kidneys started breaking down. I was rushed to the other hospital in town – the one with a Level 4 NICU, and my first daughter was born via emergency C-Section at 12:12 am January 20, 2003.

Three days after she was born, I had my first anxiety attack. Then I had my first manic episode, not able to eat or sleep and not knowing why. Then I crashed into a deep depression, and overdosed on blood pressure medication. I passed out in the bathroom, and my wonderful husband called the paramedics. I had to have my stomach pumped, and then was sent to the cardiology floor until I recovered enough to be moved to the psychiatric floor. I was so embarrassed. Here I was, a grad student in Counseling, and I needed the mental health help. In the hospital, I lost more weight, and was down 10 lbs from my wedding day, just 40 days postpartum. I was diagnosed with major depressive disorder, but looking back, I really was experiencing a Post-Partum Psychosis. (It typically takes several years from onset for a person to be diagnosed with bi-polar disorder, which is my main diagnoses). Then the meds they put me on started my weight gain. I gained 35 pounds and went up to a size 24. I stayed at a size 24 until they discontinued my atypical anti-psychotic drug. I went down to 250 lbs and a size 20.

I stayed off psychotropic medications for several months until I had a manic episode after getting steroids for a severe allergic reaction. Then I went back on a SSRI antidepressant and an anti-anxiety medication. In January 2005, I learned I was pregnant again. This pregnancy was also wrought with problems. I had hyperemesis again, and it caused severe stomach pains that were so bad I was hospitalized and given morphine. Then the really scary stuff happened – I had severe gallbladder disease and could not keep food down. I also started a new psychiatric problem three weeks before she was born when I began hearing voices that weren’t there. Freaked out, I called my OB, and she prescribed me the same medication I was on post-partum in the hospital after Emily was born. Then 4 weeks before my baby was born, my baby wasn’t showing adequate growth. We scheduled a c-section, and my youngest daughter was born on September 17, 2005. She needed help breathing and digesting food, so she was hospitalized in the NICU for 2-3 weeks.

Even though I hadn’t gained weight during her pregnancy, once I was put on the psychotropic medication, I gained 20 lbs in three weeks, and I was hardly eating. On the day of my c-sectioned, I weighed 279 lbs. I figured just like my first pregnancy, that I would lose about 20 lbs in the next few weeks. Unfortunately, when I was hospitalized for post-partum psychosis a few weeks later, I still weighed 279 pounds. I was put on Geodon, and stayed on the drug for over two years. I didn’t gain any more weight, but I didn’t lose any either.

In 2007, I was taken off the Geodon, and my weight settled back at 250. Unfortunately, this did not last long. This was because I was about to crash.

In 2007, I went back to teaching, but soon fell into the deepest depression of my life. I ended up in the mental health hospital, lost my teaching job, and filed for both Social Security disability and bankruptcy. Everything went through on both accounts, and I started a new “cocktail” of medication that I am still on to this day- Seroqual, Effexxor XR, and Klonopin. On most days, these meds help me function as good as I possibly can, they have a nasty side effect – weight gain. From 2008-2010, I put on weight so fast it wasn’t even funny. At my peak, in January 2010, I hit my high of 338 lbs, and a size 30.

However, from 2008-2010, I worked with doctors to get my health back. I had a sleep study, which revealed sleep apnea. I had blood tests that showed high lipids and triglycerides, and ended up on a statin medication and fish oil to lower my cholesterol. My thyroid medication needed tweaking. I showed signs of metabolic syndrome, a pre-curser to diabetes. With my Medicaid insurance in Michigan, I had to be on a doctor supervised weight loss plan for a year to be approved for weight-loss surgery. During this time, my husband became employed with the government. After he was finished with training, we joined him in Nebraska.

Even though the Lap-band surgery was always on my mind, and I knew our insurance would cover it, I began to become afraid. I was afraid that I didn’t try hard enough to lose the weight on my own. I was afraid I wouldn’t ever again be able to enjoy food. I was afraid they would deny my request because I am on the psychotropic medications.

But in January, I had my consult, and it went better than expected. Then in February, I jumped through the final hoops of the psych evaluation and the nutrition evaluation. I was approved for the surgery in mid February. When I had met all the requirements, I scheduled my surgery for March 22, 2010.

While I was waiting for surgery, I went on the “slim-fast plan”; you know, two protein shakes and a sensible meal daily. It wasn’t easy, and some of my dinners were not sensible – especially if I followed them with desert. But on the day of surgery, I was down 20 lbs. to 318 pounds.

20 lbs! I couldn’t believe it! Never before had I lost weight so quickly, and never before had I been so motivated to keep going!

Please check back, as I will be chronicling my journey as I pass milestones. Please feel free to contact me at wlnutjob@gmail.com with any questions or comments. Thanks!