Now the Waiting Begins

I have had my last visit with my PCP. Now the waiting begins. Waiting for my PCP to send his notes to the specialist. Waiting for the specialist's office to call to schedule an appointment. Waiting for the surgery to be scheduled.

On my last visit, my PCP and I were talking about the surgery and my reasons for having it. My knee pain, my newly diagnosed foot pain, the heart disease that runs in the family, the cancer that runs in the family.

I knew that those were all good reasons to have the surgery. All reasons to improve my health.

Today I found out a co-worker died yesterday. He was 46 years old. To my knowledge he wasn't on any medicine. He wasn't overweight. He didn't smoke. He didn't drink to excess. He did leave behind a wife and 2 young daughters under the age of 6. Gone in an instant.

If that doesn't provide me with yet another reason to have the surgery to improve my health, I don't know what does. But his death does prove that when it is your time to go, there is nothing that can be done to stop it.

God bless him and his family and may he rest in peace.

2nd month pre-op nutritionist follow up

So in this waiting journey that my insurance company requires me to do before having the surgery, I am now in the second slow month. This month the insurance company requires me to have a follow up conversation with the dietitian and the exercise guy. This can be either done through email, phone or an office visit.

My follow up with the dietitian was via email. In the email she asked some basic questions and wanted me to either email or call in a response. I answered them honestly and I'm sure that she didn't like some of the answers I provided.

Here were the questions she asked in red and my answers in blue:

1. Please list any food and beverage consumed in the past 24 hours.
Sunday
2 BBQ chicken sandwiches on Poppy Seed Kaiser Roll
2 all beef fat free hot dogs on white buns
1 grab & go cup of Kraft Mac & Cheese
1 serving meat Lasagna
3 pieces garlic Texas toast
4 20 oz bottles of water
6 mini powdered donuts

Monday
4 tootsie rolls
2 miniature Hershey bars
2 tootsie pops
4 slices of turkey with gravy
2 scoops mashed potatoes with gravy
8 oz of fountain Pepsi
8 oz of water so far

2. How many times per day do you eat? (Including snacks and meals)
2 big meals - usually lunch and dinner I normally snack on stuff through out my work day

3. What kind of beverages do you drink throughout a typical day?
Water and for the moment usually less than 12 oz of Pepsi

4. When considering your daily intake, would you say you eat “normal portions,” “more than normal,” or “less than normal?”
more than normal I found this question difficult to answer. It really depends on when and what I am eating.

5. How many times per week do you eat away from home? (Includes restaurant dining, fast food, convenience food, etc., but not a lunch you may pack yourself and take to work)
lunch is usually 5 days a week, dinner is usually 1 sometimes 2 times a week I guess I should have clarified my answer on this one. I don't normally pack a lunch, so I either eat in the company cafeteria or go out for lunch. Usually if I go out for lunch, it is usually to Subway or Panera Bread.

6. What obstacles do you face in preparing foods at home?
time Isn't that the obstacles that everyone faces? Not just fat people?

7. Stress is a part of everyone’s life. When under stress would you say you eat more or less than usual?
More Doesn't everyone? I'd really like to meet the people who don't eat more when they are stressed!

8. If more, what foods are you eating when stressed?
sweets, salty items Can you say Chocolate? Hello?!?!?!

9. What would you say is your biggest obstacle to weight loss success, and how do you plan to overcome this obstacle?
I snack at my desk while at work. I think the biggest problem for me will be breaking that habit. I have been trying to prepare myself, but have not had much success.

Needless to say the dietitian did not like my answers. Here was the response that I got back after supplying my answers:

Based on your nutrition evaluation, I would like for you to work on the following things before your next follow up visit. These goals will be important expectations after your surgery, so let’s see if we can start forming some new, healthy habits now.

* Eliminate your intake of carbonated beverages
* Decrease your intake of fast food and the number of times you are eating away from home (except lunches that are pre-packed and taken with you)
* Drink at least 64 ounces of water daily.
* Decrease your portion sizes. You can do this by using a smaller plate, smaller utensils, or eliminating second helpings.
* Start reading nutrition facts labels. You are going to be focused on consuming a high protein, low carbohydrate diet after surgery.
* Try to consume three meals per day, with only one snack between meals. You mentioned that the snacking between meals was your biggest obstacle, and the best way to get over that is to make sure you are getting in adequate protein at your meals so that you do not get hungry for snacks in between. Try to have something high in protein at each meal, and do not keep snacks at your desk at work.

Be prepared to explain how you have made these changes in your life at our next visit, and also to give a recall of the foods you consume in a typical day.


Sure that's easy for her to say! Some of the things she has talked about in her response, I have already started doing. I didn't mention that I used to drink 3 or 4 or more 12 oz cans of Pepsi a day and I cut back to less than a 12 oz glass of fountain Pepsi 5 days a week.

Or how I started paying more attention to labels from when I was active in Weight Watchers.

Anyway, just waiting on the follow up with the exercise guy. I get to tell him that I walked in 2 Society walks the past 3 weeks and walked a total of 7 miles in those walks. I really want to get a pedometer so I can see how many steps I make in a 1 job day and on those days were I work 2 jobs. Maybe as an early Christmas present to myself.

I also need to follow up with my PCP. I told his nurse that I needed the 5 year history by the 16th. Letting her conclude that I meant the 16th of November rather than the 16th of December. Hopefully he has gotten that information to the doctor already. I want to hurry up and get this surgery over with so I can start my new life as a new me!

Another reason for the surgery...but one I tend to forget about.

So the past week I had a reminder. A not very good reminder.

Deep inside I always know that I am fat. Even though I try to imagine myself not fat. There are the little reminders, such as being able to sit in a seat and not having the arms of the chairs cutting into my hips or thighs.

This past week it was a snide comment that someone said that I ended up taking offense to. Even though that comment was not directed at me personally, I still felt it as a blow to my confidence.

I am one of those many people who post tweets on Twitter. Just for fun, I follow some celebrities. There are several celebrities on Twitter, all at various stages/levels of celebrity. The celebrity in question is not a "big" national celebrity but depending on what type of music you listen to, would determine if you know this person or not.

Part of the thing that makes this comment shocking and unbelievable is the fact that before this celebrity became well known he/she made a living as a personal trainer. A personal trainer. As in someone who helps fat people become healthier and thinner.

This person posted a picture of a fat person at a grocery store. She was wearing a short white skirt and the wrong type of underwear. She was bending down to pick something up from a bottom shelf. Unfortunately for this person, she was bending at the waist to pick up the item rather than ladylike bending at the knees.

Now I had seen the picture before. It had come in a email about rednecks or the people of Walmart. When I get them and kinda chuckle at them and hope to God I never get spotted doing something like that and then move on.

Had the celebrity posted the picture and made no comment I would have been fine. The celebrity had posted funny pictures on his/her Twitter account before. Put he/she didn't stop at that. Nope, he/she had to make a snide comment as well.

The comment was "this is why I don't shop at Kroger anymore. They tend to be smaller at Whole Foods."

It's thoughtless, mean comments like this that cause us "big" people to have lack of self confidence and just feel even more like shit.

The thing about it was, if it had been a picture of a black, or Asian, or Latino person, it would be considered racism. But because it was just a snide comment against a fat person, society seems to think that it's okay.

Back in the late 19th and early 20th century, a woman with curves was considered the most desirable. Even Marilyn Monroe wore a size 14 I've heard. When did society deem a woman with curves undesirable? When did stick thin girls become the preferred standard of what is considered beautiful, sexy and desirable?

** In the process of writing this post I happened to go back to that celebrity's twitter site and he/she had removed the offensive picture and tweet. Guess my little rant about his/her meanness and rudeness hit the mark!

A Little History

I am a 33 year old female. I currently weigh over 400 pounds although my weight is spread throughout my body and not located in a specific area. This is the biggest I have ever been.

I have been fat for as long as I can remember. There is a picture taken of me when I was 3 1/2 years old when I look like an normal child. Skinny. The next picture I can remember was me taken in nursery school (about 4 years old I guess) and I have started to become a chubby child.

I don't honestly remember when that transition began, but during that span, my older brother passed away very suddenly under unusual circumstances. I am not sure if that was the trigger or not.

I can remember going school shopping with my mother for either 4th or 5th grade and having to shop for size 14 clothes. At least I think it was a 14.

By the time I graduated high school I was in a size 28. I grew up in the country and considered myself very active when I was growing up. I swam, rode my bike, hiked in the woods, etc.

I did come from a family where several members were overweight. My mother has fought the battle with weight her entire life. My maternal great aunt has fought it but has managed to lose a lot of her weight with Weight Watchers. My paternal grandmother was big for all of my life. (But grandma's are supposed to be right?) She had very heavy legs: calves, ankles, knees and thighs. This is one trait I have inherited from her that I really wish I hadn't.

I have had 3 arthroscopic knee surgeries. At 18 I was told that I needed a complete knee replacement but my doctor at the time said I was too young for the surgery. Part of the reason for that was genetics but a lot of it was the weight.

Was I teased when I was growing up? Of course. I went to a small school for the first 5 years. In 5th grade we combined with 2 other schools to form the middle school. New kids meant fresh teases.

But the comments weren't just restricted to classmates. I can remember my father looking at a picture of myself and a cousin taken at the Lincoln Memorial or someplace in Washington DC with columns and making the comments about "well, her butt is about 2 feet wide so that means the column is 10 feet." I remember him saying it, he doesn't. I also had an aunt who never hid her preference for my skinny, popular cousin and I was treated more as a tag-a-long.

Did these things hurt? Of course they did. But I have long ago learned to bury and ignore things that hurt me. I would just let them sit and stew and build.

I grew up never really showing my true emotions. I was so good at hiding my emotions that when my grandmother died when I was in college, no one knew it with the exception of my roommate.

I moved to the south in the late 90's fresh from my 3rd knee surgery and graduating from college. I had managed to maintain my size 28 up until winter of 2006. I noticed that a pair of size 30 jeans that I had bought was tight around my waste. I figured I had gained weight. Spring of 2007 I joined Weight Watchers and a gym. Things seem to be going well until I hit a plateau that I couldn't get past. After going to the doctor and a series of tests, a tumor was discovered. By early summer I had had the tumor removed but that meant that I had to stop the exercise.

Once getting out of the exercise and Weight Watchers habit, it was hard to get back to it. Not to mention financially difficult.

Last December a husband of a co-worker under went the gastric bypass surgery. By June of this year he had lost a total of 180 some pounds. I could not believe it. He has done so amazing well. I him-hawed around until I decided to force my PCP to give me the referral so that I could at least talk to the gastric doctor.

Now my doctor has been against the surgery. I can remember questioning him about it after hearing that celebrities like Al Roker and Carnie Wilson had the surgery and seeing their amazing results. When I brought it up several years back, he thought that a person should be able to lose the weight on their own. He told me then he didn't believe the surgery and had only referred about 5 patients for the surgery. Because of me remembering him saying this, I went into his office ready for a fight. Much to my surprise he said ok.

I attended one of the free seminars put on by the gastric surgeons at a local hospital. Got the paperwork, but was unsure how to answer some of the "history" questions, so I had to schedule another appointment with my PCP. Last Thursday, September 17th, I met with my PCP to finish the history questionnaire and to have him start the paperwork trail process on his end.

Today, September 21st I took that paperwork to the gastric doctor's office so I could start the process. They weighed me in, 403.7 pounds, BMI of 56.3, and a body fat percentage of 51.6%, and scheduled me for the first appointment with the gastric doctor.

Unfortunately I have found out that my insurance carrier will be changing January 1st. So the rush is on to get everything done before December 31st. I have an online class to take, 2 support group meetings to attend, a psyche evaluation to undergo, meetings with the nutritionist, a second doctor's appointment, getting insurance approval and then hopefully the surgery.

The thought of having my 34th birthday in February with me being 50 to maybe 75 lighter is an amazing prospect.

Let the journey to a thinner, healthier, happier me begin.