If Only She Were Thinner

It all began with five little words...

..."if only she were thinner".  Those were the words I overheard a boy, who I had the biggest crush on at the time, say to one of my best friends when she told him how much I liked him. He started off by saying how I was "cool to be around" and "how nice and sweet I was" but ended with "if only she were thinner".  Neither of them knew I was listening from the hallway that night and to this day I haven't told them.

That was the first time I experienced the feeling of discrimination. It was at that moment, with those five little words, that I realized I was not viewed in the same category as my "thinner" friends. With my spirits crushed and my self-esteem deflated, I went home and cried myself to sleep. The next morning I started the first of MANY failed diets.

After high school, and after the birth of my son, I buried my lack of self-esteem into a series of bad relationships (and I mean BAD). I thought that if I acted a certain way or said "yes" to every favor that I would be accepted and loved. I became obsessed with doing more for others than for myself but only ended up deeper in depression (and deeper in debt). Those five little words were screaming at me every day.

In 1997, I went to see my doctor about my weight and he prescribed Phentermine and Pondomin (a.k.a. Phen-Fen). I lost 75 pounds in four months and I never felt better about myself. Those words were not echoing so loudly in my head.  My self-confidence was riding high until the FDA pulled the Pondomin from the shelves six months later. The reason the drug combination worked so well is the Phentermine sped up your metabolism and the Pondomin tricked your brain into thinking you weren't hungry.   The weight came off so fast and I was so caught up in it that I didn't teach myself how to eat properly. I didn't get the chance to ease off the medication before it was abruptly seized and over the course of four years, I gained it all back plus an additional 40 pounds. I have carried that weight ever since.

I was a sophomore in high school and at least 50 pounds overweight when I first overheard those five little words. Flash forward to more than 20 years later (and more than 100 pounds overweight), those words still haunt me.  I hear them every time I walk into a board room, get on a plane, or get on a ride at Disneyland. I felt them when I was trying on my wedding dress, when the arm rest of the stadium seat was digging into my thigh leaving a bruise, and I see them every time I look into a mirror..."If only she were thinner..."

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It is time to focus on myself so on Thursday, February 24, I will finally embark upon a life-altering journey of weight loss.  I need to rid myself of those five little words that taunt my every move and with the help of a Vertical Sleeve Gastrectomy, I pray that my self-esteem will be exonerated and I can be free from their bond.

I wanted to share this journey through a blog because most of my friends and family have no idea just how much I am falling apart on the inside.  Some people view weight loss surgery as a short cut or the easy way out but I know that this will ultimately save my life...in more ways than one.

I hope you'll come along for the ride.

What is a Vertical Sleeve Gastrectomy?

Preparing for Surgery

They call me..."Butthead"... 

I was 12 when I had surgery for the first time. It was July 4 and I was spending the holiday celebrating at my dad's house. Despite the fact that we lived in the Pacific Northwest, it had been a very dry summer.

My dad was having a party that day so the house was full of people, inside and out. Air conditioning is not something people living in Western Washington typically have so every door and window was open to keep the air flowing through the house. Running around barefoot, all the kids were running in and out of those doors all day long and more particularly the sliding glass door in the middle of the house leading to the main party area outside. I was quite good at running up those three little steps and leaping into the house before making a quick dash down the hallway.

The 4th of July was one of my dad's favorite holidays and he would spend hundreds of dollars on fireworks. He loved putting on a good show and would carefully plan the "firework launch sequence". The kids always got to light the Bottle Rockets, Firecrackers, Flowers, Bumble Bees, Smoke Bombs, and of course, every little girls favorite, Sparklers.

As guests were preparing for the "big show", my brother and I were busy firing off Bottle Rockets. My dad's house was in the middle of 19-acres of what used to be strawberry fields and with the unusually dry summer, our rockets were starting small fires in the fields. Being prepared, we had our water hose but the hose would only reach so far. My brother and his friends would run out the field and stomp out any little fire that had been sparked. I wanted to do this also but I did not have my shoes on. Knowing that the big fireworks were about to start I figured I should get them on just in case they needed me to help stomp them out (I was such a tomboy).

Now...that sliding glass door I had been running in and out of had been wide open ALL day long so as I was running full speed ahead it didn't occur to me to stop and check to make sure it was actually open. I hit that first step with my right foot and took one giant leap "into the house" thinking I was going to land on my left. You can imagine my surprise when I was "slowed down" by that glass door that someone had closed. I actually made it into the house but was on my knees staring at the back of the couch. The only thing I was thinking was "Oh crap. I am going to get in SO much trouble". That was all I could think of until I overheard my grandpa say, "She’s bleeding". At that point, I looked down and saw this puddle of blood that was growing larger and larger and I had no idea where it was spewing.

After I was pulled out of the window (I was about half way in the house as my left leg was stuck in the glass that was left in the frame), I was placed in a lawn chair and my step-mom was holding a towel over my forehead. I still had no idea just how badly I was cut but figured it could not have been that bad because I did not feel any pain. I was more concerned about how much trouble I was going to get in for breaking the window.

I arrived at the hospital and watched as doctors came in and out of my room. They would come in and look at my head, talk amongst themselves, and leave. The next thing I knew a doctor came in, introduced himself to me, and told me that I had to have an operation. They told me that I had a big cut on my head that needed to be closed but it was too big for stitches. They needed to take skin from another part of my body to "patch" up the hole. Well, I tell you what...I was not about to have an operation. No way, no how, not me. Needless to say...I didn't win that battle and I ended up having a skin graft that night.

Now...the skin on your forehead is a little different from the skin on your leg or your arm so they took two patches of skin from my left cheek and I am not talking about the cheek on my face. They told me that they wanted to take it from a place that would not be visible when I wore a bathing suit. They said that the grafted skin was only temporary until my new skin grew in below it. Whatever! No matter how many times they explained, it did not stop my beloved brother from calling me...."Butthead".

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I have had several surgeries since that first one in 1986 including a c-section, oral surgery to remove my wisdom teeth, exploratory surgery, hysterectomy, gall bladder removal, and knee surgery. Needless to say, I am no stranger to surgery and am not nervous about this procedure I am having on the 24th. What I do not like is - the anesthesia. I do not react well when coming out from it. I always wake up a little paranoid and feel like I am having an out of body experience. Kind of like when my friend had a bad acid trip in high school...

Anyway - I had to go through several labs before I could get medical clearance (abdominal ultrasound, chest x-ray, upper GI, echocardiogram, treadmill stress test, and tons of blood work). I also had to submit an Advanced Directive and Durable Power of Attorney, a standard procedure in case something happens and I cannot make my own medical decision. After I completed those documents, I decided I should update my will since I had not updated it since I had my hysterectomy in 2002. I was married now so I figured I should include my husband in it.

Before I started designating my belongings, I asked my son if there was anything I had that he would like to have. At first, he said no. After I told him that he was already getting my car he started listing all kinds of things, which turned out to be very sentimental. In addition to my laptop, cell phone, iPad, iPod, etc., his list included the Christmas decorations (we have been decorating the house together since he was old enough to place an ornament on the tree), all my cookbooks, my rings so he could wear them around his neck, all of the family pictures, the cat, and a recording of my voice so he could play it every day [insert weepy eyes and a sniff, sniff here]. I love that kid.

So as I have been preparing for surgery, I not only did a little emotional housekeeping, I learned a little more about the character of my son.

Hospital Forms Crack Me Up

During my lunch break today, I decided to read the hospital forms I had to sign for my upcoming surgery (since I did not read them before I signed them last week) and I have to giggle at what they say, as they are actually quite funny.

The PreOperative Instructions form tells you not to bring valuables or money with you, including your purse or I.D. (keep this in mind as I'll get back to this one in a minute).

Under the heading "ON THE DAY OF SURGERY" one of the instructions is to wear comfortable clothing but just below that under the heading "ONCE YOU ARRIVE ON THE DAY OF SURGERY", it says "Upon arrival, you will be asked to remove all of your clothing and put on a hospital gown and robe". So...what the heck does it matter what I wear or how comfortable it is since I am going to be removing my clothes anyway? If I want to be truly comfortable, do I have to wear a bra?

If you are an outpatient, the form says, "Prior to discharge you will be fully awake and comfortable". Well, it is good to know that those patients will be awake when leaving...

The hospital provides you with an uuber antiseptic soap to use for several days prior to surgery to reduce the number of bacteria on the skin...apparently their antiseptic they use when prepping you for surgery isn't strong enough?

The PreOperative Skin Preparation instruction form for the special soap says, "Wash with the antiseptic soap from the neck down". This is highlighted in yellow and is the only thing on the entire page that is highlighted. It is also noted that you are to "avoid contact with your eyes, ears, and mouth". Guess that highlighted note about washing from the neck down was not clear enough...

The Surgical Patient Safety Orientation form is the one that cracks me up the most. It is two pages of bulleted items and it starts with Patient Identification. It says that your name and date of birth will be confirmed each time you sign any consent/paperwork, receive medication, or when a procedure or treatment is performed. Remember that instruction from the PreOperative Instructions form about leaving your I.D. at home? Well...how do they know who I really am if I follow that instruction? I could be anyone.

The next bulleted item is Medication Safety. They want you to tell the doctor and nurses about all the drugs you are currently taking. Pretty typical BUT it follows up with "allergies will be checked upon admission and prior to each dose". So...I do not know about you but I think I would know if I was allergic to my current medication in which I was taking before I was admitted. It ends with "upon discharge, you will be provided a list of current medication and instructions on them"...because apparently I did not know what I was taking or how to use them before I arrived.

For Fall Prevention, they tell you "your risk of having a fall will be assessed when you are admitted. If it is determined that you have a high risk of falling, protective precautions will be taken to reduce your fall risk". So...what the heck is "protective precautions" and exactly who are they protecting?

The fourth bullet is Surgical Care Improvement. Now...I don't like this one right off the bat because the word "improvement" implies that there has been a failure in this area thus the need for an improvement. It goes on to read, "Before surgery, the surgeon will mark with his/her initials the site on your body to be operated on. Site marking happens when you are awake. Make sure they mark only the correct site." Really? I am having several holes poked in my abdomen. What if I do not agree with their "suggested" marking is placed? Am I supposed to say, "No, doctor, I don't think you want to put that mark in THAT spot. Don't you think it should be about an inch higher?"

The Surgical Care Improvement paragraph continues with "the team will also do a "time out" just before surgery when you are asleep. This is done to confirm your identification (again, how do they know who I really am?) and that we are performing the correct surgery on the correct body part". Gosh, I really hope they do not mistake my stomach for something else on my body...

Tick Tock Doc

One more day!

In preparation for surgery, I have been on a full-liquid diet for the past two weeks. The doctor requires this so that the stomach is as small as possible and your liver can shrink up a bit so it isn't in the way during surgery (yep, kind of important not to mistake that for anything else or cut into it...).  Had I known that my last full meal was going to be on Wednesday, February 9, I would have eaten something more exciting than a four-piece Chicken McNugget mini-meal from McDonald's.

Since being on full-liquids, my diet has consisted of: protein shakes; sugar-free pudding, jello and popsicles; chicken broth; and tons of water. The first four days were the worst. The late afternoon calling of my dear friend chocolate was hard to resist but I did.  It got easier after four days and I am proud to say that I have lost 12 pounds so far.

To prepare for the actual procedure tomorrow, I have to drink nothing but clear liquid all day long today. My instructions are to drink 1 gallon of total fluids and to top it off (if you don't mind a little T.M.I.) I had to drink three tablespoons of Phillips Milk of Magnesia at 7am. Needless to say, I have become very close friends with the restroom.

I met with my nutritionist last week and she gave me this "sample menu" (if you can even call it a menu) to follow for today:

Breakfast

• 1 Cup Chicken Broth
• 1/2 C Sugar-Free Lime Jello
• 1 Cup Crystal Light (no red color)
• 1 Cup Water

Snack 1

• 2 Cups of Water

Lunch

• 1 Cup Vegetable Broth
• 1 Sugar-Free Popsicle (no red color)
• 1 Cup Crystal Light Lemonade
• 1 Cup Herbal Ice Tea

Snack 2

• 2 Cups of Water

Dinner

• 1 Cup Beef Broth
• 1/2 C Sugar-Free Orange Jello
• 1 Cup Crystal Light Peach
• 1 Cup Herbal Ice Tea

Snack 3

• 2 Cups of Flavored Water (isn't the same as Crystal Light?)


OK, admit it! You are all very jealous of my snacks. It's OK, we're friends.

Believe me, I am not really complaining. I know that all of this is done for a reason. The next few weeks are going to be interesting but I am SOOOO looking forward to a new beginning (...and silencing those five little words...).

Final Cravings

Puff Pastry? What the heck!?!

I have about 3.5 hours before I have to leave for the hospital and I am not allowed to eat or drink anything today. I can't even chew a piece of gum. I'm cool with that though. It's only a few more hours and then I won't care.

Since I cannot eat or drink ANY thing, I am having some really strange cravings. For whatever reason I am craving puff pastry stuffed with chicken, cheese and broccoli. I don't think I have had this before but it sounds amazing right now.

One of the benefits of having this particular surgery (vertical sleeve gastrectomy) is the hormone that stimulates hunger (Ghrelin) that is produced in your stomach is essentially removed when the majority of your stomach is removed. This means that most people who have this surgery don't get hungry. Of course there will always be "head hunger" so it will be interesting to see what the difference is after surgery.

The size of my new stomach (a.k.a. sleeve) will only be able to hold about 1/4 cup of anything for the first few weeks and will eventually allow 1 cup. Knowing this, I will be able to make better choices about what I eat because I know I will have to be very particular about what goes in my mouth so I can be sure to get all the proper nutrition. Gone will be the days of finishing off an over-filled plate of food only to be hungry an hour or two later.

Watch this video from ABC News to learn more about the surgery...if you are interested in knowing. It is kind of graphic.

While I type this, I am watching the Nate Berkus show and of all things...they are cooking right now...WTF? Isn't a home interior design show?...Arrgh. But hey, at least they aren't making puff pastry stuffed with chicken, cheese and broccoli.