Friday, November 30, 2007
I am overweight because I suffered from undiagnosed depression since my late teens. I was only diagnosed a couple of years ago.
Depression went undiagnosed so long because I wasn't so crippled by it that I couldn't go school or work. Amazingly, I earned 3 degrees and several academic honors. It just screwed up a lot of the rest of my life. I was never suicidal or horribly sad during this time, except when I lost my dad last year. I was just ... listless when I didn't absolutely have to do something, like get my job done at work or study for law school exams. My condo (I was single until I was 40) was messy and I couldn't care less about how I looked. I was a loner a lot of the time.
And, of course, I self-medicated with food. Food, I think, was my drug of choice because I was raised as an evangelical Christian, and gluttony is probably the one vice or addiction that's not completely unacceptable to a lot of Christians. I mean, alcohol, sex or drugs weren't real possibilities! (Much of this time, I needed a security clearance for work, so I also stayed on the straight and narrow for that reason.) I had a serious addiction to premium ice cream up until my mid-30's, when my gallbladder went haywire. And I loved real sodas, especially regular Pepsi. I also ate a lot of fast food because I was too "busy" being depressed to cook.
Although I was an athletic (and slim!) youngster -- I was a competitive swimmer -- I was too depressed to exercise regularly after college. Of course, exercise would have helped the depression, but I was sort of stuck in idle and watched the tube a lot instead.
Every now and again, I'd start to feel like life was passing me by and go on a starvation diet and lose a significant amount of weight You can imagine how this affected my metabolic function.
When I was 39, I met a really nice guy who wasn't a fat fetishist but also didn't mind that I was hefty. I married him in a size 24 bridal gown. Of course, living with someone made it hard to binge, so I went and got myself some help in the GWU Obesity Management Program. I really cleaned up my eating habits, except for the soda pop. I also became a proficient cook and lost 55 lbs. in a year. Mr. Husband is Mr. Gourmet and it looked like a fun hobby, so I wasn't entirely strict that year. Thus, during the year at GW, I did happen to learn controlling your weight didn't necessarily mean asceticism.
Unfortunately, after the year was up, I started into private practice and the grueling hours meant lots of convenience food for me. I gained the weight back, all but 10 lbs. For the next 5 years I yoyo'd over a 30 lb range and my health started to be affected by the weight. Finally in late 2005, I was diagnosed with diabetes. Then, in the spring of 2006, my dad fell and hit his head and had a bleed on the brain. Two brain surgeries and four months later, he died of a massive hospital infection. He never quite came back after surgery #2 and was so weakened by being bedridden that he succumbed to infection.
I've never known pain like that in my life, but it made me realize that I had mental health issues, and had probably suffered from them for many years. Losing Daddy forced me to confront those issues once and for all. As part of talk therapy, my shrink and I brainstormed what I could do about my weight, since my metabolism was so obviously screwed up. The first thing was to start exercising, which I did. The second thing was to look at weight loss surgery. It came as a bolt from the blue, and I had never seriously considered it before. (Makes me wonder if Daddy was up there pulling strings in Heaven.) My shrink encouraged me towards the lap band because it was the safest, most conservative form of surgery one could have.
Depression and extra weight can be a pretty wicked vortex. One leads to the other, which leads to more of the other, and on and on. Like therapy and medications, weight loss surgery can contribute to breaking the cycle. And that's what I intend to do.
Tuesday, November 27, 2007
Back when Kevin and I were trying to become parents, we, like everyone else who wants to adopt, had to undergo a home study. A completed home study is a state's "parenting license" for people who plan to come by a child by any means other than the old-fashioned way. It involves handing over a lot of documents -- from fingerprints (which are submitted to the FBI for a criminal background check) to driving records to vaccination certificates for household pets to the results of medical exams to a statement of net worth -- to a social worker, who interviews the prospective parents extensively. The social worker asks the parents-to-be, together and separately, dozens of questions about their respective families of origin, as well as questions about how they intend to parent said child. And, yes, some people do fail home studies.
In Maryland, the home study process requires you to sign an agreement stating that you will never engage in corporal or any other form of humiliating punishment. And since Kevin and I had agreed that we would use other disciplinary methods, we gladly signed.
I've always had issues with parents hitting children, and apparently so do a lot of other smart people, including the American Academy of Pediatrics. There are good reasons for not hitting kids, and I'll leave explaining those to the experts in my links. As a lawyer, moreover, I wonder why on earth it's okay for a parent to hit her kid, but if the same parent were to hit me, I could (and would) charge her with assault and battery.
As parents, we've had great success with other methods, including our favorite, Love and Logic. Not to be one of those obnoxious bragging mothers, but my daughter's teachers just told me how much they enjoy having her in their class. Friends volunteer to sit for her. Mothers of friends comment about how she's a good influence on their kids. Strangers in restaurants -- the kind of restaurants that don't have children's menus -- have noted her good behavior. Last summer when we were on vacation in another country, the owner of one of those fancy restaurants (and a French restaurant at that!) told us we could bring her back any time.
Yes, she acts like a kid a lot of the time. She's certainly energetic, spirited and opinionated enough for three children, but she also knows who's in charge around here and who has the power to impose consequences for bad behavior. And we do.
And no, we can't take all the credit. The baby the nannies handed me in south China had already been described at age 13 months as "sweet," "smart" and "close to the nannies." So we had some pretty good material to start with.
As I've gotten older, seeing and hearing parents abusing their children in public has gotten more and more unsettling for me, and as I've gotten menopausal, I've gotten a hell of a lot more honest with people. The last couple of times it's happened in front of me -- both times in the supermarket -- I've called the mothers on it. Both times, they were trailer-parkish sorts of women in too-tight jeans and too much makeup, young enough to be my daughters. (Yes, I am a snob. Deal with it.) Both times, the discipline imposed went well beyond a whop on the butt. Both times, it involved multiple blows to the face or neck. One of the children was, in my estimation, around three years old. Both times, the scene that ensued was ugly, and I believe that only my girth and gray hair that protected me from the young woman's wrath. Both times, I had no doubt in my mind that if the mother acted that way in public, she was doing far worse in the privacy of her home. Both times, I wished fervently that if I whipped out my cell phone and called the cops, the young woman would leave the store in handcuffs and the child would leave in the custody of Child Protective Services. But that'll have to be my fantasy until the Maryland General Assembly decides to do something about it.
It's time, Maryland. It's time.
Monday, November 26, 2007
The Easy Way Out
“Well, you’ve lost 69 pounds. How do you feel?”I must have looked at the doctor like he was speaking Swahili. How do I feel? Lighter. Overjoyed. Smaller. Happy. Healthy. Exhilarated. Terrified. Doubting. Is weigh loss surgery a “cheat”? Is it “the easy way out?” That, unfortunately, seems to be the opinion of a lot of people, probably more than anyone realizes, since most people with that opinion seem to be smart enough to keep their mouths shut. Hell, if you had any balls, you’d lose weight the old-fashioned way!
The rest of us are toughing it out with exercise and the ability to push ourselves away from the table!
If you had any willpower, any self-restraint, you wouldn’t be fat!
Jeez, try a salad once in a while!
All you had to do was get some doctor to staple your stomach a little and, voila! Instant thin person! Anyone can that! I can’t imagine that two dieters would say to each other,
“You’re doing low-carb? You’re taking the easy way out!”
“Oh! Weight Watchers – that’s taking the easy way out!”
“Jenny Craig? Hell, you don’t even have to COOK! That’s the easy way out!”
But what damn difference does it make HOW anyone loses weight, as long as the result is the same: better health and a better quality of living.
“The Easy Way Out.” I wish I could have been reminded that I am taking the easy way out five minutes ago when I was throwing up my dinner. Again. You know what I ate? Two baby shrimp and two strips of chicken that, together, were the size of my little finger. Folks, this IS the hard way. It means that I’ve tried a lifetime of diets: Slim Fast, rice diet, high-carb/low fat, high-fat/low carb, cabbage soup. Hell, I even tried those diet candies called “Aids”. Remember those? Yeesh. What a publicity nightmare that product name turned out to be after about 1985! But they sure were tasty! The diets never worked or, rather, they worked for a while, then they didn’t. I lost weight, and gained it back. Lost weight, gained it back. It’s like the instructions on a shampoo bottle: lather, rinse, repeat. Diet, gain, repeat. And those returning pounds never came alone; they always brought a bunch of friends with them to take up residence in my ass.To make the decision to have weight loss surgery is to face the realization that this is it: the end. I’ve heard people call it “the last house on the block.” Your options are gone. You’re never going to get any thinner. You’re certainly not getting any younger. Those knees, hips and ankles are going to need replacing sooner rather than later. And chances are, you might not live much longer. The short time you have is going to be filled with can’ts and don’ts and never agains. Stares, giggles, comments.
“We don’t have anything in your size here.” “Wideload.” “Fatass.” “Orca.”
The short time will be full of big things like diabetes and high blood pressure, of osteoarthritis and edema and congestive heart failure. Of annoying things like recurring yeast infections and skin ulcers. Of little things, like not being able to cut your own toenails or wipe your own ass. Then, finally, it’s resignation; it’s just giving up. You reach the point of living the rest of your increasingly short life in discomfort, pain, illness and depression, or reaching out and praying that there is one last hope. It’s reaching the point of being willing to subject yourself to dangerous surgery, pain, and possibly even death. It should be given a scenic kind of name, like “Desperation Point”. They could sell postcards:
“GREETINGS FROM DESPERATION POINT” This IS the hard way. Every meal has to be as carefully and scrupulous[ly] studied as if you are on a diet: because you are. Not for a month, or until your vacation, or until the wedding.
For the rest of your life.
But it is so much more than just a diet. There is the missing element of eating as pleasurable. Instead, there’s constant worry. Is that food, which you always loved, going to “agree with you” still, or will it make you sick? Have a couple of bites of your half-cup sized dinner before your last meal has cleared your new stomach, and it’s coming back up. Have one tiny, pencil-eraser sized bite of food too many and it’s coming back up. One chew too few and it’s coming back up. Too much fat or sugar and you’ll get “dumping syndrome”. Not enough protein and your hair will fall out. Not enough iron and you’re anemic. Not enough potassium, and your heart will stop.This IS the hard way. It’s living with the terror of gaining the weight back and knowing that there will be NOwhere else to go. There are NO other answers. This is it: the last house on the block. It’s there, every minute of everyday. And it’s not “the easy way out”. This is the toughest thing I’ve ever had to do. THIS is the hard way. And is it worth it? Hell yes. The joy is overwhelming. To be able to buy clothes in a regular store. To tie my shoes. To be able to walk even a block again. To lose the painful edema in my feet. To sit comfortably in an armchair. To wear my cowboy boots again. To know that my blood sugar levels are down and that I don’t need to take as many meds. To know that I’ll be able to spend even a few extra years with the husband I adore.
Worth it? Oh, yes, yes . . . YES!
Friday, November 23, 2007
Wednesday, November 21, 2007
First, I am thankful to God, whom I know through His Son Jesus Christ.
I am thankful to be an American. This isn't a perfect place, but at least for me, it's pretty darned good. I think it's easier to succeed here than it is in most other places.
I am thankful to have grown up in a loving family, warts and all. I am thankful my sweet dad had 83 years here on Earth and that my mom survived breast cancer twice and is still with us at 81. I am thankful for 4 terrific siblings (and their spouses), a boatload of nieces and nephews, and now, great-nieces and nephews, too. I know so many people who hate one or more of their siblings. It's a mystery to me how people feel that way because I love of all mine and consider them friends.
I am thankful to have met and married my sweet Kevin, warts and all, and can't wait until I weigh less than he does. And darn it, that target keeps moving downward, despite the fact that he eats more than I do and drinks beer.
I am thankful for my daughter, Madeline. I cannot imagine loving any human being more. It's a privilege to be raising this child.
I am thankful for a veritable army of friends, both in the flesh and in cyberspace.
I am thankful for the chance to get a great education and for the generous people who made that possible for me by funding scholarships and seeing my potential. I am thankful to have done well enough that Kevin and I can provide a great education for Madeline.
I am thankful for a really good job. It's a job that uses my education, stretches my brain, teaches me new skills, pays pretty well, and gives me the flexibility to be a hands-on mom. I'm also thankful for really terrific managers and kind, mature colleagues.
I am thankful for having more than enough materially.... plenty to eat, a nice home to live in, a nice van to drive, a closet full of clothes, etc. While we are not our possessions and often take them for granted, or worse, feel entitled to them, life would be a lot tougher without them.
And last but not least, I am thankful for the band, as I'm over 30 pounds lighter than I was 6 weeks ago. I am thankful for the skilled hands and mind of Dr. Schweitzer and the entire crew at Hopkins Bariatrics and Bayview Medical Center. I'm even thankful that GEHA approved me on the first letter!
I'm sure there's more . . . .
Monday, November 19, 2007
Now, the other picture .... I had a teacher's conference today. The verdict: she's acing kindergarten academically, but she talks too much in class and doesn't always pay attention. Nothing we didn't already know.
Tuesday, November 13, 2007
Saturday, November 10, 2007
Here's the latest ticker:
We took Madeline to Mandarin class today, and afterwards, attempted our first meal out, at Lebanese Taverna in Annapolis. Note to Edie: Next time, order from the appetizer menu and not from the regular menu! This is going to have to be my rule now for most restaurant meals. I hate to waste money and food, and my tiny tummy certainly has its limits. A couple of stuffed grape leaves would have been enough lunch for me, and it sure would have cost less. Hey, I've gone from being a "cheap date" to being a "really cheap date"!
I ordered a chicken kebab, which came with a huge pile of rice and a salad. I didn't want to try salad yet -- technically, it's not part of a "soft" diet -- but I knew the chicken would be covered in tomato-ey sauce and sufficiently moist. Thankfully, nothing got stuck. I managed to eat about half the chicken and a bite or two of Madeline's hummous, wondering all the while if the tiny scrap of pita bread holding the hummous would get gummy in my tummy and stick in the stoma. Kevin and Madeline finished off my chicken and salad. I don't feel as guilty about wasting rice as I would have felt about wasting meat. Everything stayed down. No indigestion or pain.
The lunch out got me to thinking and me and Kevin to talking. A lot of the newbies in the weight loss surgery forums -- actually, the forum I read most is a bandster forum -- worry about what they'll have to give up. And a number of the veterans run off at the mouth (or is that "run off at the fingers"?) about how we shouldn't be enjoying our food and food is nothing more than fuel. Gad, I hope I never say that! I love a good meal! I appreciate good ingredients that are well-prepared. It's one of life's great pleasures, band or no band. Once a foodie, always a foodie.
Thankfully, my doctor's people don't seem to have a problem with my philosophy. (Some doctors seem to. I swear, maybe I'm imagining things, but from the stories I've heard, I've gotten the impression that there are bariatric surgeons out there who secretly hate fat people.) While I also have some healthier habits, including buying only 1% milk and cooking with olive oil, I told the nutritionist that did my pre-surgery eval (and could have rejected me for surgery!) that I use butter. Not Benecol. Not Smart Balance. Delicious, creamy butter. Accept no substitutes. And I use half-and-half in my coffee. None of this skim milk fake diet stuff. She didn't bat an eye. She told me that if I was a foodie before the surgery, I'd be an even pickier foodie with the band. If you can't eat much, what you eat must be absolutely divine. She's seen it happen before, and it's actually easier for someone who appreciates good food (read: someone who doesn't frequent the McDonald's drive-thru 6 nights a week and dine at TGIFriday's on night seven) to be successful with weight loss surgery. Ah, the value of mature and refined tastes! And though I'll still eat butter, I just won't be eating enough of it to hurt me with a band. Food snobbery will work for me!
So, after lunch we promptly walked over to Whole Foods and went shopping.
Friday, November 09, 2007
If you're diabetic or know something about medical testing, you'll know that the normal range for fasting a.m. blood glucose is 80 to 120. Yep! For the first time since I went off Metformin, my blood sugar is sub-diabetic!!! What a happy day this is!
If you're considering Lap-Band surgery and some surgeon tells you that only a Roux-en-Y will help diabetes, don't buy it. I'm not the only one who's gotten this kind of result.
Thursday, November 01, 2007
I would be losing every day if I'd had a Roux-en-Y or Duodenal Switch, but both of these procedures scared me. They both restrict the stomach size and cause a certain amount of malabsorption by removing part of the small intestine. In my research, I came to believe that causing malabsorpotion is like playing Russian Roulette. There's a small chance of getting the bullet in your brain, but if you do, you're 100% dead. If malabsorption causes problems for you, you're in big trouble. The Lap Band has an advantage over other restrictive procedures because there's no resection of organs, very little chance of bleeding during surgery and zero chance of leaks, which are a dangerous complication of the other surgeries. One OR nurse told me, "RNY patients don't look good when they come out of the OR. Lap Band patients just look healthier." I can understand the desperation of someone who weighs 400 or 500 pounds in wanting a fast rate of loss, but that's not me. I'll take the slower, safer route.
I'm feeling more and more normal every day. I have less indigestion and tightness in my stomach. For the first five or six days, I wondered what on Earth I'd done to myself. I have less soreness in the abdominal muscles. I was convered with bruises coming out of the hospital. Every time I turned around, someone else came into my room bearing needles for lab work, blood sugar tests, insulin and heparin shots, an extra IV line. I was so tired of getting "stuck." The bruises are now fading. The incisions are healing. My energy is coming back.
I found another really great post in my Obesity Help blog. This one discusses how I felt going into the surgery. I posted it October 8, the night before surgery.
Here, we are at 10:30 p.m. the night before. Since my surgeon does not do a pre-op liquid diet, I just ate a couple of slices of semolina bread and drank a big glass of water. That was on top of a lovely, healthy dinner of chicken breast, rice and green beans with pineapple sherbert for dessert. I have a huge stomach capacity, unfortunately, from years of major pig-outs in my late teens (when I actually burned 4000 calories a day) and my early 20's (when I didn't), which of course is why I'm having this surgery. I am concerned about being hungry in the morning and not even being able to drink water. My surgery isn't until almost noon. Going that long without food or water is rough on me. I'm a breakfast person!
Madeline's school was off today for a teachers' in-service day, and as a Federal employee, I was off, too, so we spent the day doing errands. Then, I came home and did as much cleaning as I could until it was time for dinner. Had a little time with Kevin after the kid was in bed. He is off to bed now. I'm staying up until midnight and drinking lots of water. I want to be well-hydrated. I'm also ironing, as the child will need school clothes later in the week.
I'm not nervous yet, or at least I'm not admitting it to myself. Kevin is more nervous, as is my mom. On an intellectual level, I know I'm being operated on by one of the very best bariatric surgeons in the world. This guy pioneered some of these procedures, and Johns Hopkins is still the #1 rated hospital in the country. I'm in good hands tomorrow and I know it. And that feels great.
But there's more than that. I'm riding along on this wave of love. I have so many friends ... on OH, on the various China forums I participate in, at my daughter's school, at our church, in my extended family. I'm hearing from these people today and have been for the past week. It's amazing, heartening. I feel so lifted by the love and the prayers and the messages of support. It's humbling to think about it.
The diva is a ladybug, in case you can't tell. She had planned to be a cheerleader and took her cheerleader uniform and appropriate accessories -- the pink and orange crepe paper (hey, that's what I had on hand) pom-poms and pink socks and sneakers -- to school for the parade and party. I thought this was great because I bought the cheerleader uniform for "football day" in pre-school and it hasn't gotten much use. Fortunately, the diva grows slowly and most clothes from last year fit. But some wicked little boy made fun of her (this seems to happen quite a bit), so she decided that the Redskinette look was unacceptable. She came home wanting to be something else. We had the ladybug costume on hand from "insect day" in pre-school. (Are you seeing a pattern? Last year, I procured quite a few special garments for the various "days" they had in pre-school.)
I told her to put on the ladybug costume with black tights and her black school shoes and we'd have a great costume. She happily did so, but came downstairs complaining that the costume was "scratchy." (Another common occurrence around here.) So I had her put the red leotard on underneath. She decided to forgo the wings, which attach with velcro, because she thought she might need to put on a sweater after we'd been out a while.
At this point, I'd like you to know that the procurement of the costume has nothing to do with one of the looniest traditions in the China adoption world. Through some bizarre set of coincidences (I won't relate the story because there are a gazillion versions and I don't know which one is true), ladybugs have become the de facto symbol of China adoption. All the nutty first-time entitled parents-to-be, particularly the mothers, run out and buy ladybug things for their future daughters, then brag about having done so in the online fora. I'm sure several thousand little Chinese girls adopted by Americans have been ladybugs on Halloween. BUT, my husband, who is definitely not into the looney traditions of China adoption, bought this costume. Last April, I went on a business trip and forgot about getting something to wear for insect day. Kevin went looking for bug costumes to buy over the internet and found this one. So there you have it, my little ladybug.