I've blogged here about my decision and the reasons for gastric bypass surgery. I am definitely glad I had it, and I would chose it again. I am in so many ways healthier than I was three years ago before I had it. Poor habits, medications and depression have led to me regaining the weight, and I talked yesterday about the return of my critical self talk represented by Monkey Mind.
Gastric bypass is not an easy choice, came with months of complications, but may have saved my life. The surgery itself was a passive act to change my health. The active part - eating better, exercising and taking care of myself - was all left up to me. The bypass did its part 100%. I gave about 25-50%. Bypass is a tool, not a solution in and of itself.
As Monkey Mind returned and began her critical tirade, I decided I was actively going to make my life different. My bypass still works as well as ever. My eating capacity is very tiny - around the size of a large egg. I just eat the wrong foods (too much sugar, carbs and not enough protein, fresh fruits and veggies). So the good news is, I haven't undone the medical procedure designed to help me keep a healthy weight. So that is one piece of ammunition to throw back in M.M.'s face. I still have my tools. I just have to use them!
I met with the nurse practitioner that Kyle sees to monitor his diabetes. She set me up on a meal plan of 1600 calories per day, 100 grams of protein (yowie!), 15 grams of fat and set amount of carbs, etc. She also has me monitoring my blood sugars because I've been having hypoglycemic episodes. The 1600 calories are totally doable, the 15 grams of fat is harder. I don't stick to my meal plan 100% every day, but I'm making serious efforts. Far fewer sweets are in the house. Complex carbs are slowly replacing simple carbs. I'm choosing protein bars for snacks instead of crackers. I'm keeping a food journal to track my food, calories and protein.
But I have to be honest with myself. I have a weakness for sweets and carbs. I could care less about steak or hamburgers or even french fries anymore, but I love sweets and I could live on Olive Garden breadsticks. I know that the quickest way to make me binge on the not so good foods is to tell myself I can't have them. Monkey Mind goes bananas thinking she's deprived and her cravings become my focus.
I decided that I am never going to be one of those people who can just never touch sugar or white flour again. It's just not realist for me. For those that can, I applaud you a million times and envy you. I realized, though, that I can minimize those foods and counteract their impact on my diet by being more active.
I have never been a lover of exercise. Give me the option of going for a jog or curling up with Jane Austin, and I'd rather powwow in Pemberley. Flashbacks to high school PE are enough to keep me sidelined for eternity. BUT I've found ways of overcoming my aversion to exercise. I prefer the term "fitness" because M.M. doesn't have a negative connotation with it the way she does with exercise.
I also figured out that doing something I love to get in that movement every day makes it far more likely that I'll do it. Four years ago, Kyle and I bought cruiser bikes that we love. We haven't used them much, though. This year, with the early great weather, I started riding the moment my surgeon cleared me. Biking is fun, and if it's fun, it can't be exercise, right? The even better part about biking, is that I have a companion. With my gym membership, I went alone. Not great motivation for me. Even though I'm too out of breath to talk much, there's just something to be said about having someone to work out with. When we bike, Kyle and I are rarely side by side, but we're watching out for each other, and cheering each other on. That helps.
Kyle's health is also important to me, and I know that when I ride and bring him along, he's getting fitter, too, and that quiet's monkey mind as well. Monkey mind likes to remind me that he's older than me, lost a parent to cancer, has diabetes, etc. In other words, M.M. whispers, "What if you end up alone?" By biking, I'm telling M.M. to pipe down about my hubby's health, and that gives me more inner peace. It improves our relationship in general to do something together every day when he gets home from work. We even make an evening of it once a week, stopping for a picnic in the park.
Another source of motivation for me is Step Up Cheyenne, a local program that encourages citizens to get in their 10,000 steps per day, the surgeon general's daily recommended amount of walking. We can log our steps, convert our riding to steps, and even win prizes along the way. It's just fun to see how fast our steps add up, and to track the effect on our overall health.
So the overall best part of all this is that I'm making conscious, active decisions that are impacting my physical health primarily, but also mental health. When I get home from a ride on my bike, I get to log around 7,000 "steps". I am exhausted, red-faced and sweaty but I feel so good about getting off the couch and getting my heart rate up. It slowly boosts my self esteem which in turn slowly quiets Monkey Mind. That in turn reduces my depression and leaves me thinking much clearer.
I'm always amazed at the ways Monkey Mind tries to interfere with my good intentions. She mocks the way I look on my bike, how much weight I've gained in my face, the fat under my chin, the way my clothes fit. Sometimes she is so critical that I want to crawl in a hole and hide, but I'm learning that the more rides I go on, the stronger my will gets and the quieter hers becomes. Maybe I do have a fuller face than six months ago, but I'm doing something about it. And that's all I can ask of myself.
I can honestly say I'm doing my best to make my health better, and hopefully that will in turn decrease my jean size. But I'm still me either way, and it's time Monkey Mind learned that.
When I read Natalie Goldberg's Writing Down the Bones (the first of many, many times), I was taken with her description of "monkey mind", a Buddhist term for all the mental chaos that keeps us from focusing or hearing the our true heart. I knew immediately that she was talking of my inner critic. You know the one - that little gremlin on your shoulder that whispers negative comments in your ear, makes you doubt yourself and overall, causes general chatter in your mind?
I have always had a very active monkey mind. I look at pictures of myself as a child, and I wonder when M.M. showed up. I was a wild child until I entered school. Very silly, full of energy, ornery, hair never brushed, and probably very loud.
I bossed my then shy brother around and believed he was my personal doll baby. Then arrived my school years and I became very serious, quiet, disciplined and dutiful. The transformation didn't happen overnight, but at some point I became the polar opposite of my younger self. I'm guessing this is about the same time that Monkey Mind began having a field day.
I work hard to silence, or at least ignore M.M. on a daily basis. As someone with an anxiety disorder, I probably experience an excessive amount of M.M. babble. It's a sort of chicken and the egg issue. Do I have anxiety because of relentless M.M. banter, or is M.M. exceptionally noisy because I'm prone to anxiety? A bit of both, perhaps.
Lately, Monkey Mind has been super critical about my weight. I've blogged many times about my battle with my weight. I went as far as having a gastric bypass three years ago, and successfully lost nearly 100 pounds. Bipolar medications, poor eating and little exercise have assisted me in gaining back almost half that. I spent a lot of time in denial. I lie to myself by pretending an issue doesn't exist to delay having to deal with it. I can only deal with so much at once, and I get pretty overwhelmed, so denial has be my poor coping mechanism.
The problem with denial is that one day I wake up and I can't lie to myself anymore. I'm slapped in the face with the truth and it can be fairly disruptive to my emotional well-being. Denial is definitely where I've been with my weight. It started about six weeks ago through the course of two events, one minor and one significant.
The first was my breast reduction surgery. I awoke from anesthesia and was sitting propped up in bed. The surgeon came in to see me and my comment to him was "My stomach sticks out further than my chest." I was slightly amused by that at the time - perhaps it was the pain meds making everything amusing, but it didn't bother me then. Over the course of the next few days, though, when I would look in the mirror I would be more and more bothered by the fact that my stomach obviously was a lot bigger than I had previously noticed. By having a smaller chest, my stomach seemed magnified, even though it was no bigger than it has been for the last few months.
The second event that brought my higher weight to my attention was the changing of the seasons. I dragged out my storage bins of summer skirts and capri pants, and the clothes that were nearly too big last year can barely be squeezed into this year. Ugh. Monkey Mind went crazy. She started to berate me immediately.
"How could you gain back so much weight?! You're so lazy! After all you went through to lose weight, and you let this happen?" And those were the nicer comments she had for me. Normally I might sink back into denial and become complacent or resigned to my situation. This is one of the difficult symptoms of depression for me. I'm sometimes too emotionally exhausted to deal with a problem. I have to pick my battles, so to speak. Taking care of myself physically has not often been a priority in my life. It comes and goes depending on all the other chaos and life requirements.
Let's be honest. Lack of self-esteem means I rarely feel worth the effort it takes to make a difference. I've lamented my weight for six weeks and looking in the mirror lately has been agony. Monkey mind didn't forget any of the old way of speaking to me five or ten years ago when I was nearly 300 pounds. She picked up right where she left off when her voice faded after weight loss surgery. It never went away, but now it's back as loud as ever.
The difference is, this time I'm putting up a fight.
More tomorrow about that!
1. Grateful
2. Grumpy
3. Exhausted
4. Reflective
5. Impatient
6. Critical
7. Searching
8. Discovery
9. Wondering
10. Hopeful
Since I'm unemployed (by choice) at present, I don't have to take sick days anymore, but I'm taking one today. Usually I sit here feeling guilty about all the things I'm not getting done. The soda cans that need pitched in the recycling bin taunt me. The hair on the floor from my supposedly "shed free" mongrels screams "sweep me!" I spend 99% of my life feeling guilty for all that I haven't done in a day. The positive aspect of guilt is that it motivates me to get something done. The negative is that it's never enough. I could win the Nobel Prize and I would still be lamenting about all that I failed to accomplish.
But today I'm taking a sick day, and those soda cans and dog hairs can just sit there another 24 hours because I feel like crud. The likely suspect is the extensive list of medications I'm on. I'm caught in a horrible cycle of taking meds to treat the side effects of meds. Only in America! I've discussed my meds on here many times so I won't delve too deep into it, but the basic story is that I'm on a new mood stabilizer which knocks me out, and I'm on an anti-anxiety med for restless leg syndrome that also knocks me out, and when those two meds are used in conjunction with the meds I take purposely to knock me out at night, well, I end up walking around like a zombie, or worse, not walking around and needing an excessive and ridiculous amount of sleep.
Let's take yesterday, for instance. I took said meds around 10 pm Tuesday night, was out by 11pm and slept like a baby until my alarm went off at 7 am yesterday am. I had an early appointment with my internist in the am and then a follow up with my plastic surgeon in the afternoon. The am appointment went so - so. I am facing the possibility of iron transfusions for anemia and other iron issues, but my thyroid is doing well. Yay! My follow-up with the surgeon went fab! I have healed super well and am now cleared to exercise, do housework and even bowl (yes, I asked!). Now I just have this special little silicone tape to cover my scars and help them heal. And yes, there are a LOT of scars. I had to laugh that despite the fact that I had breast REDUCTION I still have silicone on my chest :D Hey, I find humor where I can. Even without it, he thinks my scars will heal nicely. I don't have to see him for six weeks, which is super nice, because as much as I LOVE Boulder, it's getting a little old to drive down there so often with the price of gas, not to mention I need naps like a 90 year old. And even the Cheesecake Factory goodness didn't restore me to good health. Now THAT is scary.
Anyways, my original point was that I'm getting a good 8 hours of sleep, but still exhausted. I am SO thankful that Kyle had arranged to come with me yesterday. I seriously do not know how I would have driven without him. I fell asleep singing to the radio on the way to Loveland. I slept from Loveland to Boulder. I slept from Boulder to Cheyenne. I then went to bed and slept, with the intention of being up in two hours to prep for running support group. But I slept three and then at the last minute asked a friend to facilitate, fell BACK to sleep and didn't get up until 11 this morning. For me, that is ABSURD. Generally I function on no to little sleep, so this is all a very odd experience. In the midst of all that I forgot to take my regularly meds that I take in the day, and so I'm dealing with consequences of THAT today.
So I'm taking a sick day. I know the recycling bins need put in the big bin. I know the trash cans need taken out. I know the floors need vacuumed (because it's been a month). I know laundry needs to be done and the dishes and who knows what else, but it may not get done today. And really, who cares? (I do!) I'm taking the Scarlet O'Hara approach and saying I won't worry about it until tomorrow. But I know I really will. And although I try to set aside Fridays for personal writing time and reading about writing, I will feel pressure to do all the work tomorrow that I neglected today. In the end it will all work out fine, but I'm really frustrated by the exhaustion. I'm sure an iron deficiency isn't helping matters. I'll find out more about that when my doc calls this afternoon with the blood work results. Until then, I'm going to enjoy these two little puppies on my lap.
A woman's relationship with her breasts is one I hadn't given much consideration to, but the last few weeks has really made me think about it. It seems few women are satisfied with their breasts. So many women opt for breast augmentation and reduction surgeries. My friends with small chests lament and express their desire for a bigger size. Those of my friends (and myself) who were given larger breasts wish, for a variety of reasons, to have smaller ones.
From about age 8 I was "blessed" with breasts, and I especially despised them when I went out for sports in fifth and sixth grade. Volleyball isn't so easy when you have breasts in the way. I never appreciated my breasts, and I certainly didn't appreciate their size. I came to resent them. I think my early development was responsible in large part for my withdrawal from physical activity and subsequent weight gain.
One of the only TV shows I watch these days is Giuliana & Bill. Bill was the original The Apprentice winner, and Guiliana is an E! TV star. I was drawn to their show when it aired their quest to get pregnant about three years ago as I experienced my own internal battle over whether to have children myself. I generally detest "reality" shows because they are so extreme, and rarely real, but I've somehow really related to Guiliana. Part of it is that we married at roughly the same time, and I related to a great deal of what she and her hubby experienced as newlyweds and then onto the journey to try to have a baby.
Because I can relate to her, I was devastated to learn last Fall that she had been diagnosed with breast cancer. Guiliana is 38 -only eight years older than me. Women aren't encouraged to get mammograms until 40, so she thought a mammogram was a waste of time since she's so young. It saved her life, though, and she went public with her medical crisis to prevent other women from the same fate. I tried to absorb what it would be like to have to make the decision in my thirties about whether to undergo a double mastectomy as Guiliana has opted to do. I am a rare crier, but I have teared up regularly as I've watched her discuss her diagnosis, its affect on her marriage, and the love/hate relationship she encountered with her breasts.
And then I underwent my own breast surgery recently. Not that what I experienced was even remotely close to what Guiliana has experienced, but it still made me think about the ways in which our breasts are tied into our identities, both as a female and just in general.
I wasn't aware of it at the time, but samples of my breast tissue were sent to pathology after my surgery. Fortunately my breast health is 100% great at this point, but it took me aback a little to think about my breast tissue being examined for any signs of cancer. I was glad I didn't know it in the first place so I didn't spend time worrying about the results.
I will have substantial scarring from my surgery. Special silicone tape will help diminish them, but I will forever have some reminders of this surgery. And I'm fine with that because the payoff was worth the scars for me. But I was able to make that decision without the sort of consequences a woman with breast cancer faces. Giuliana opted for a double mastectomy and reconstruction in order not to have to look over her shoulder constantly. She was scared, as anyone would be, and she worried how her new chest would affect her relationship with her husband. She voiced all those concerns aloud and asked her husband directly what he would think of her body. He, of course, just wants his wife healthy and wasn't concerned about her physical changes.
When I emerged from surgery, I was immediately pleased with some of the results. I felt better already when I noticed how much lighter my chest felt, but it was a bit daunting to wonder during those first five days what my body looked like under the bandages. I was worried, too, sitting in the doctor's office as the nurse unwrapped me, wondering what was going through Kyle's mind. I would potentially have lots of bruising, and with the stitches, the first couple of weeks look pretty gory. Kyle handled it though, and I was relieved that I had little bruising. I had looked at pictures online ahead of time, so I knew what to expect, and I knew I would have lots of stitches and long incisions. All of this was the price I gladly paid to physically feel better.
Women with breast cancer don't get the same benefit. Their life, literally, depends on it. They are forced into a decision and they know that either decision comes with some negative consequences and substantial fear. I didn't have any true appreciation for their pain - both physical and emotional, until I underwent my own breast surgery. While I'm healing well and happy with the results, I have a completely different understanding of the way we women - and even the men in our lives - relate to our breasts. I have a new understanding for how certain parts of our bodies tie into our identity. And I have new appreciation for the bravery of women who elect to have mastectomies to prevent the spread of the cancer.
I have a couple of women in my life who have battled breast cancer and won - and you know who you are. I dedicate this blog post to you, to your bravery and strength. I can't imagine the amount of courage you must have, and I thank you for demonstrating, so amazingly, what courage really is.
