My Mom

In order to go to my ever-so-long Dr. appt I had to figure out child care as Tim was working. My Mom usually has dinner with us on Thursday nights and since my Appt was on a Thursday I just asked her to come over right after she got off work to tend to the kids so I could go to my Dr. appt. I was kinda vague about why I was going to the Dr. since I wasn't sure how much information I wanted to share. But then the talkative Dr took over a freaking hour with me. Then add in the waiting room time and drive time and I was gone for 2 hours. So when I got back she had all sorts of questions.

She took the news sorta well. But she had some points that were a little strange. In rebuttal to me saying that the WLS would reduce my risk of getting full blown diabetes she said, "skinny people get diabetes too". Yes they do Mom. But I am NOT a skinny person. We have diabetes in our family. My grandfather had and Aunt Jeana have diabetes. My other 2 aunts have insulin resistance. And in my specific situation *I* have insulin resistance and one of the treatments is to lose weight. Thus WLS.

In rebuttal to me saying that losing weight would decrease my risk of heart disease she told me that skinny people get heart disease. I told her that we have a family history of heart disease. My Grandma (her Mom) had at least 1 heart procedure to remove plaque from her arteries and she died of a heart attack. On my Dad's side of the family my Grandmother died of a heart attack. And my Grandfather also died of a heart attack. Mom did say that both her Mother and my Grandpa on Dad's side had other health issues that could have strained their hearts. (Grandma had arthritis and Grandpa had cancer) But that still leaves my other Grandma and actually my Mom has high blood pressure too. One of the ways to reduce blood pressure and keep your heart healthy is to be at a healthy weight! Thus WLS.

Additionally my thyroid being out of whack may just make it improbable for me to lose in excess of 150 pounds on my own in a reasonable amount if time. And every month that I spend at this unhealthy weight is taking a toll on my heart and the rest of my body.

So even if I eventually lose 150 by myself it may take me 5 or 10 years (or I may NEVER be successful without surgical intervention) I am still losing years off my life while still at an unhealthy weight. And what happens if I just can't lose it on my own? In 5 or 10 years am I a better candidate for surgery? How will my recovery be? What is the benefit in waiting? I am not getting any younger. I just feel like this is the time for me to make a change.

And I really don't care about being "skinny". In fact I most likely will never be skinny. But if I lose 100pounds or more I would be at a healthy BMI and therefore reduce my risks of all the heath problems I mentioned as well as many more. I am not considering WLS to look better in a bathing suit.... sigh. So.Not.The.Case.

Talkative Dr

I met with Dr. W last week. He is my new Primary Care Physician (PCP). He is great in that he is thorough and and takes the time to answer my questions. His downfall is that he likes to talk but has the social aptness of a toad stool! He makes corny jokes and pauses in the conversation for reactions at the wrong moments. Think of your most annoying older relative and THAT is Dr. W! LOL! But hey he is smart and well informed and all in all a great guy.

We started off with getting my health history. I will take this one point at a time so I can cover everything...

My Thyroid: He said that probably the thyroid is the big reason for a slow metabolism and thus weight gain. He asked when it was diagnosed and I told him that when I got pregnant with Kaleb that I gained no weight while pregnant, initially lost like 40 pounds once he was born and then gained like 50 back in a very short amount of time. They checked my thryoid and found that I had Hypothyroidism. He said it is common for your thyroid to go Hyper then Hypo, thus my weight loss then sudden gain. Total yo yo.

My menstrual cycles and PCOS: We talked about how wacky my cycles were when I was trying to get pregnant with Harlie. He guess (before I told him) that I had PCOS. He asked what my Dr. had done for that previously. I told him I was on Metformin and we discussed my insulin resistance. He said that fat cells overproduce estrogen which prevents ovulation which is related to insulin resistance. (I can't remember how But I am guessing that Steph will know. Please post to remind me Steph). Anyway a few months ago I stopped taking my Metformin. Part of it was that I needed a prescription refill that would require a trip to the Dr. of which I didn't have the $ to pay for. The other part was that I wanted to know if I really still needed the Metformin. And how I would feel once I went off of it. Well that sorta backfired one me. I gained 38 pounds in the few months since I went off the Metformin. I have not changed my diet nor my activity level. The only thing that changed was I stopped taking the Metformin. He refilled my prescription. :)

My energy levels: I am TIRED ALL THE TIME! Even when I get a good nights rest the night before. I feel like I am always paying the sleep debt from my youth. He asked me to take a quiz about my sleep patterns. I scored a 14 (lower is better) and he took my neck measurement (16.5inches). Both of those numbers together mean that I am at risk for sleep apnea. Sleep Apnea is a problem that lots of people face. It can occur in varying degrees. But he wants to take a closer look at why I am not getting enough rest if I sleep for 8hrs at night and take a nap during the day. Harlie is now sleeping through the night and I don't get woken up at night anymore (except the occasional bad dream from Kaleb or Jasmyn). He ordered a "sleep study kit" to be mailed to me. I guess I wear it for 2 nights and then mail it back and they read the results and determine if more testing is needed. I will keep you posted on that. I have not recieved the "kit" yet. He also took a look at my throat. Apparently I have a level 4 airway. Basically when I open my mouth and say Awwww you can't really see down my throat because of the soft tissue (i.e fat) collapses in my throat. This was also a major factor in the decision to test me for Obstructive Sleep Apnea. He said I should mention that to the surgeon if I do the WLS since protecting my airway becomes important while I am under anesthesia. Scary!

My activity level: I try to walk and I was a member of a gym to which I went 2-3 times a week. (My gym went under because the building they were in refused to resign their lease) But getting exercise is super hard when I have 4 kids and a husband that works long hours. Dr W gave me some practical advice. He said that they way to burn calories is to work your muscles. So while the walking and elliptical are great, adding some weights to my work out would help me burn calories and thus lose weight. He gave me some exercises to do that engage each major muscle group and he recommends starting small (1 set of reps of each of 3 exercises daily) and working up (5 sets of reps of each exercise daily). The 3 magic exercises are truly *old school*. Exercise 1: Push Ups. Obviously he knows I can't do an ACTUAL push up. So he says to start doing them standing and pushing off the wall. Then work my way down to a table, a chair, then off my knees etc.... Exercise 2: Rowing. I don't have a rowing machine. So he suggests an exercise band held by my feet. Exercise 3: Lunges. Working to get my legs at 90* angles. Then add weights (milk jugs full of sand/water/etc) to my hands to increase resistance.

And lastly we talked about my mental status: We talked about the fact that I am on Prozac and why I started taking it. He asked me why I thought I overate. I told him that while I am an emotional eater that I really don't eat unhealthy-ily. But I could lower my portions. This is where he told me that the Jews in concentration camps lived on 500 calories a day and that that is all me *need* to live! LOL! Obviously he was not suggesting I do that, but it put into perspective on how much we as a whole overeat. But really this portion of the conversation was about how emotional stable I was and how I would battle the inner brain/emotional stuff of over eating. Basically the WLS can handle the physical but *I* still have to figure out the emotional stuff or it won't work. A high percentage of WLS patient gain the weight back by "overeating the bypass", basically stretching the pouch back out to accommodate more food. And over time that causes you to consume too many calories and thus gain weight. So the emotional side of this is really important. I personally think that I am much more healthy minded now then I was in my 20s but the problem is that I am still carrying the weight I gained in my 20s. I do have some work to do on my mind/emotional eating but I am in a better place in regards to this than I was when I was younger and gaining the weight.

So after all of that Dr. W gave me the referral to the Weight Loss Surgery Seminar. It is Scheduled for March 17th. I will keep you posted.....

Message board

I have been on a parenting website for a long time. I think I started reading the board when I was just trying to get pregnant with Kaleb. I started on that path in 2001. I have found a small group of women (well like 100) that have kept in close contact with, especially in the last 4 yrs. Anyway I was posting about my desire to look into a WLS and one of the ladies on my board had some great things to say. Her screen name is YAM. I know her real name, but figured I would keep her identity a secret. She deserves some privacy. Her words are so powerful and really put into perspective why lots of people myself included consider WLS. Here is her post:

I agree about the morbid obesity catching up with you. We don't have MO in our family, but we have dear family friends, extreme MO. He was 500 or so. They were mostly healthy fat people, you know active and otherwise fine just really fat. But the instant they got into their 50s, it all just started to catch up. THAT's why it's called MORBID obesity, you basically are blowing your good years twice or even three times as fast so that you don't have a long healthy middle age into old age. We were shocked. Sure, in his 30s he was like a 40to 50 year old but that's not that much different. But in his 50s he was like a 70 or 80 year old. By 60 he was dying, and it wasnt pretty. Horrible. Dh saw him in the hospital the week he died and he looked....oh I can't even explain it. The body can't handle the load, literally and figuratively, for that long. It is morbid, plain and simple. It's just not acutely morbid And easily ignored while your body is still tolerating it fairly well. But you just don't see MO 80 year olds. You just don't.

As wls was gaining in popularity, it seemed like an obviousnchoice for them but they were dismissive. This is how we've always been we're in good health, i don't want surgery. The methods aren't perfected yet, it's too disruptive and permanent, we're doing fine, just fat like we've always been. By the time it was obvious that their approach was flawed (i.e. the obesity was having far more broad disruptive effects on their life and lifespan than any post-surgery eating restrictions), he was too sick and fragile to handle it. He cried at one point, to my mom, about waiting too long to take things seriously. My mom was devastated. They were all lifelong friends. Teenage beach road trips, groomsmen and bridesmaids, seders together every year, through thick and thin. All along my parents were never judgmental or pushy, if this month they were down about it and on a diet, my parents were down about the fatness and on board with the diet. When they were "hey, look it's fine, I'm fat and happy and sick of trying to be something i'm not" then my parents were on board. I think once my mom had a talk with her alone about being concerned in recent years, and dropped it when she got no traction. And my dad had a word with him about it, in more forceful terms as men can be, and he shrugged my dad off, at which point they went back to following their cues again.

After he died, I think it was 6 weeks before she was in surgery for weight loss. She had the lap band.

She lost a lot of weight, of course. Still fat, but not MO. She looks, size-wise, like she did at my parents' wedding, which is certainly still fat, but not devastatingly so. And I just hate to think about how we'd still have Joey around if it didn't take them so long to realize that MO extracts its toll one way or another. And she's not happy, either. She's bitter and angry and widowed younger than she ever imagined. She's tried dating again (it's been two years) but she's freaked out that her jdate profile is this haggard woman in her 60s, and complained to my mom about the kinds of people who end up wanting to meet her. They had a fight last week about it. My mom was telling her to stop rejecting everybody out of hand, and she was pissed that my mom took such a dim view of her prospects and my mom told me last night she was dumbfounded that she thought that these 45 year old men were going to be knocking down her door. She wanted to say it, but didn't, that, uh, they can still snag someone in her 20s and 30s and you're no prize at 67. Harsh, but true. It's like all the joy was sucked out of their family the instant he died. It broke something. I SO wish they'd done something ten years ago. Hell, I wish there had been something like this back in the 70s and 80s because if ever there were candidates for it, they were them. They were so right for each other. That couple in your circle of friends everybody knew would "make it."

I don't know if that's where you are, but I just wanted to share that story in light of what you had said about your aunt. I think it's hard to see what it's doing because when you're still "otherwise" in perfect health, it's hard to take the problem too seriously. How can it be that big of a problem? It's easy to say that the only adjustment needs to be your own mind about just accepting it, and not feeling bad about yourself (which is a good thing of course, to not feel BAD about yourself because nobody should, fat or thin) but when the body ultimately has blown its lifetime reserves on keeping you non-diabetic and non-disabled and non-heart diseased through your 20s, 30s and 40s, it's a fast and steep dropoff. Just not the kind of medical issue you leave to your "personal resolution" to fix. If you are MO, and have been for a good long time without any real chance of it changing anytime soon, it seems to me you fix it like the medical issue it is (even if it's hard to see that angle of it when you're still relatively young and healthy) and then if you're still into it, fix the personal issues that got you there. The weight doesn't have to wait until your head is where it should be. Why should it? So you can make your body take another 5-10 years (10-20 in effect) of abuse while you work on your "personal resolve?" Frankly, I bet fixing the medical issue will SHOW you the kind of mental resolve you have, and one fixes the other, like it should, but just the other way around, if that makes sense.

And fuck the judgment, the "easy way out" people. Fuck them. Fix yourself. It's your body, and your life, and you don't owe them shit. Either own your decision and let them think what they want, or lie about it. Whatever is easiest for you, because they're not you.

Wow, I guess I'm angrier than I thought. My mom and I just had the latest conversation about her last night, so I guess it's fresh.

*sigh* I miss him. Seders are not the same.