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May 26, 2006 / 2-1/2 years post-op / 180

I truly thought that if I could maintain my weight loss for a year, I could maintain it for the rest of my life. I didn't think there was much of a choice, that my body would just lose the weight, I'd maintain my new weight easily, and I'd slip comfortably into the world of the non-thinking "normal" people.

Fat chance (excuse the pun).

The first two years were blissful, no question about it- I wasn't hungry, the weight seemed to just melt away - I didn't even have to work out that hard! And for the first time in my life, I didn't obsess about my body - about how it looked, how it felt to be in it. I was a size 12/14 and I felt great about it. . .

Then the calendar turned to 2006, and something strange happened. I started gaining weight. I examined my diet and exercise, and made a few changes. I was routinely drinking two cocktails/night - vodka and cranberry juice. I cut it down to one drink every couple of days at the most. I also started counting grams of protein again, thinking that maybe I just wasn't eating enough of the "good stuff."

And I scrutinized my exercise program, concluding that I wasn't pushing myself hard enough or exercising frequently enough. I hired a personal trainer, and started working ou out between 4 and 5 days/week. And I worked out HARD, too - harder than I had EVER worked out. I did cardio (walking and jogging on the treadmill) and lifted weights (free weights). I also did calistenics - push-ups, crunches, lunges, squats.

And yet. And YET, I'm GETTING BIGGER.

I know, I know - weight lifting builds muscle, and muscle weighs more than fat. But don't you think there should be some sort of trade-off? Like I could WEIGH MORE but LOOK LEANER? Granted, my upper body looks GREAT - my shoulders and arms are SO much more defined. But my BUTT, HIPS and THIGHS haven't thined out a bit - in fact, I'm certain they're bigger (confirmed by the tape measure, in fact).

"What about the scale?" you ask. Well, I'm far to nervous to even get on the scale. I suspect I'm hovering around 180, 12 pound more than my lowest post-op weight. 12 pounds more than I was only six short months ago.

I'm scared. I've already had to make some wardrobe changes - buy some size 16 pants and have them tailored DOWN to fit me (whereas I could easily buy a 14 before). I feel out of control, like my body is determined to re-establish its obesity, regardless of my behavior. I recognize that such a thought is irrational. . . .

No matter where you are, there you are.

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March 17, 2006 / 2 years, 4 months post-op / 175

REALITY CHECK

It's been 2+ years since my surgery, and I am more grateful now than ever for the decision I made and the results it has brought to my life. . . For example, today I wore a skirt WITHOUT HOSE to work. Pre-surgery, I couldn't have imagined such a choice - the thigh burn alone would have dissuaded me. I also wore 2-inch heels - again, something I couldn't/wouldn't have done pre-surgery; I would have required no less than a weekend to recover from not only the thigh burn, but the aching feet and strained back, as well. But not today. I returned from work no worse for wear - well, no worse for wear than is typical for a Friday night after a long week.

Having said as much, though, I'm hardly content. I'm obsessing about my body these days - seeing that the scale and the way I feel in my body is changing. The first year and a half was a cake walk (figuratively, at least). I didn't get hungry, I consumed little more than my recommended post-surgical portions, and thought, "This is EASY! WOW!" Well, no more. I get hungry now. And I can eat more. And I don't get full as fast. And I've gained five pounds in the last six months. This is not a good trend.

In my pre-surgical life, I would have hardly batted an eye at a five-pound gain, but now, after maintaining my weight for well over a year, this weight gain is alarming me. Those deep seated obsessive thoughts of yesteryear are returning - you know the ones: "What's going on? I'm not eating THAT much!" and "Is this weight loss going to be like all the others in my life - I'm successful for a while and then it all comes back?" and "Are my thighs getting bigger? I think they are. Maybe they're not. Maybe I'm just freaking myself out." and "I'm pre-menstrual. That's it. That's all it is."

You know. You've been there. We've all been there. . .

Do I have any answers? Not really. But it has been an eye-opener to realize that you can be relatively "normal" (size 12/14) and still feel fat - fat like when I was 24/26. The numbers change, but the feeling is the same. Isn't that odd???

------------------------------

April 9, 2005 / 1 year, 5 months post-op / 169

NO MATTER WHERE YOU ARE, THERE YOU ARE

I've lost a total of 151 pounds and while I am seeing a bit of continued weight loss, it's very slow. In fact, I consider myself as maintaining my weight, as opposed to losing weight.

I'm wearing a size 12 in most jackets and pants. The only thing in which I can NOT consistently wear a size 12 is a straight skirt - the kind that come with business suits. In fact, in those, most of the 14s are still too tight. Once a big butt, always a big butt. :) I'm not complaining, though, not really - I mean, it's NICE to be able to buy a suit, but how many women are truly proportionate? Not even BARBIE is proportionate! I've lived all of my life with a big butt, I'm used to it. As long as I can work around it with mix-and-match attire, I'm fine. If I could make it work at 320 pounds, I can certainly make it work at 167 pounds, right?!

My eating has changed very little over the last several months. I eat small portions of protein-packed foods whenever I'm hungry, which is about every three hours. There are times when I certainly feel like I could eat MORE, but I stop myself. I try to keep my total consumption to about a half-cup. That means I eat a small half sandwich and a quarter of an apple, and I'm done. In that case, I really AM full, which is nice.

For snacks, I have a piece of string cheese and a small handful of raw almonds OR a protein bar.

My only vice is the ubiquitous latte or mocha. Living in Seattle, we are bombarded with opportunities to consume coffee drinks at every turn. And I am as addicted as anyone. I make a grande non-fat hazelnut latte for myself every morning and buy myself a grande non-fat no-whipped-cream mocha every afternoon. I rarely consume them in their entireties, but it's very comforting to have them nonetheless. There's something about it that makes me feel like I'm wallowing in decadence without spending a lot of calories to do so. Yes, there's SUGAR (and for some post-op'ers caffeine is a no-no, too), but I watch it pretty closely and have never had any kind of dumping because of it.

My biggest "opportunity for improvement" is exercise. I was a total gym rat before surgery. I worked out five or six times/week, and was in amazing shape - even at 280 pounds, I could outlast most of the skinny minis at the gym. Since I had the surgery and the weight has melted away, I have had less and less interest in exercising. Isn't that odd???

And it's not like I dislike it! Once there, I'm ALL ABOUT EXERCISE - it's just the GETTING THERE part that's hard for me. Are you saying, "Yeah, well, join the club"? For a little incentive, I registered to participate in this year's Danskin Triathlon. The last time I did it, five years ago, I weighed 270, so it should be interesting to see what it feels like to swim, bike and run (walk fast) weighing more than a hundred pounds less.

No matter where you are, there you are. . . bigger or smaller, heavier or lighter, there you are. . .

------------------------------

January 1, 2004 / 1 year, 6 six-weeks post-op / 172

PLATEAU

I've been at the same weight, give or take a pound or so, for the past six weeks. I wonder if this is where I'll "land," and am a little anxious about it. I've spent my entire life obsessing about seeing that number on the scale drop, drop, drop, and if it doesn't, I'm CONDITIONED to think something is wrong, that I've screwed up somehow. I'm catapulted into thinking about what else I should be doing - fewer calories, more protein, more exercise, fewer carbs. . . It's become a reflex - thinking that something is WRONG just because the number on the scale has stopped moving substantially. Time to think differently.

I'm in a comfortable size 14 in pants/jackets, although am still plagued by a big butt. (It's amazing to me that I can have lost 148 pounds and still have the exact same shape as I did at 320 - my outer thighs still bulge in the exact same place, are the same nuisance. When/if I have plastic surgery to get rid of my extra skin, that's the FIRST thing I'm going to mention to the surgeon - get rid of those fat pods on my thighs - pants just don't look right!) I'd like to get down another 17 pounds - down to 155 - that way, if I rebound up 10% at the four- to five-year mark as I've read about, I'll have a good cushion. Besides, I'd love to be able to wear a size 12 in a suit - and it will take at least 17 more pounds to get there.

Having said all that, I really don't have much to complain about. I mean, a size 14 is nothing short of a miracle!

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November 21, 2004 / 1 year post-op / 172

THE ANNIVERSARY

I had my surgery on November 13, 2003. I look back in amazement, really. It's really easy, at this point, to say "La, la, la, this was a walk in the park - I'd do it all again!" And yet, when I take the time to really reflect upon my experience, I can easily recall how completely sick and depressed I was, how I thought I'd made the worst mistake in my life. . .

I was catapulted into the statistical catagory labeled "COMPLICATIONS" with the onset of C-Diff (infectious colitus), two weeks post-op. I was rehospitalized, then sent home to self-administer liquid antibiotics and saline (so I wouldn't get dehydrated) 'round the clock for 14 days. The side effects from the antibiotics were nearly worse than the symptoms of the infection itself - perpetual nausea and vomitting. And I couldn't eat anything - not only because the thought of food was enough to enduce my gag reflex, but because my body wasn't used to the bypass yet, and every time I ate/drank something, I'd get uncomfortably burpy and end up back in the bathroom, getting rid of it.

After 14 days, I was taken off of the antibiotic, and gradually started to feel better. I ate my first solid food on Christmas, some scrambled eggs - and I remember thinking "This is the best thing I've ever tasted in my life."

In early January, I had a relapse of the C-Diff and went back to the hospital. Fortunately, I was able to get a different antibiotic, one that could be put in an oral solution. The pharmacist flavored the concoction (which was absolutely MISERABLE tasting) like tutti-fruity, and although I still had to administer it every six hours 'round the clock, it was very do-able. And no side effects, either!!!!

Once I finished the second course of antibiotics, the infection left me for good, and my recovery really took off.

And now it's been a year. Wow.

Here's what I like best about losing so much of the weight I carried for so many years:

I can cross my legs at the knee.
I fit into a theatre seat, and can even put my purse next to me.
I can jog.
I don't have to use a seat-belt extender in the car.
I can easily buy clothes - bought my first pair of size 12 jeans the other day and LOVE them!
I can easily buy shoes in a "B" width.
My fingers look so much longer! I've had my wedding rings sized down twice so far, and am down to a size 5-1/2 - down from a size 8-1/4.
I don't have to compensate for my size by being overly nice and friendly. I'm still nice and friendly, I'm just not consciously trying to compensate for anything anymore. . .
I blend in - I'm anonymous.


The other thing that's amazing about the weight loss is that my friends don't treat me any differently, which is WONDERFUL. They say things like, "We loved you then, we love you now" and "In my mind, you've always looked this way" (smaller). Other post-ops warned me that my friends would be jealous, treat me differently, that they couldn't handle my transformation. I was skeptical that such changes would apply to me - because I've always had GREAT friends! I was relieved to see that my instincts were right.

Life is good. And I would definitely do it all again - even with the complications. It has been worth it!

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October 16, 2004 / 11 months post-op / 178
Overall weight loss of 142 pounds / 104 since surgery

THE POWER OF ANONYMITY

I recently started grad school, and it occurred to me when driving to campus that I'd be meeting people who had never known me as morbidly obese. I wondered how I would feel. I was alway so self conscious in large groups - of course, nobody would KNOW it, because I compensated for my self consciousness with humor and "facilitation." This is the term I use for turning the attention away from myself and getting other people to talk about themselves. I learned to do this many, many years ago and it became my most reliable coping skill. It worked consistently, thanks to many years of practice, but I always resented having to work so hard. It was never fun, it was never relaxing, it was never enjoyable.

After the close of our first session, the second-year students threw us a welcome party. I attended, thinking that I would resort to my winning formula - facilitate, get through it, and leave as soon as possible. The strangest thing happened, though - I didn't facilitate. In fact, I just kind of sat there, comfortably, not feeling the need to do anything in particular. I sat next to a couple of my peers (there are only 10 people in the program, and we go through the entire two-year course of study together) and had a nice, easy conversation. A real conversation where we EXCHANGED information (instead of my doing everything possible to keep the focus away from myself). I was still uncomfortable, in that I would have been much happier just to go back to my hotel room (it's an on-campus weekend program) and soak in the tub. But it wasn't miserable. It was actually pretty enjoyable.

For the first time, I was "normal" - I wasn't the one who looked different. I was anonymous, I blended in. And what comes with that camouflage of normalcy is a kind of calm. I didn't try so hard to compensate for my size. I didn't convince people - consciously or otherwise - that I was a good person despite my weight. I was just another person, no better or worse than anyone else.

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August 11, 2004 / 9 months post-op / 185

A NEW LIFE

It's hard to describe the extent to which my life has changed. Fundamentally, I am the same person - I have the same family and friends whom I love dearly, I do the same work, I enjoy the same activities. And yet every day, every moment is somehow different. It's the way I feel in my body and in my life that's changed. . .

When I met the man who would eventually become my husband, I didn't know the first thing about baseball, other than it was boring. I couldn't understand how anyone could actually be passionate about it, seeing as how it took so long and the majority of the time, people seemed to be standing around more than actually playing the game. After a season of his coaching, however, I started to see it for what it was - the Great American game, full of incredible excitement and energy if you knew what to look for. . .

After watching many games, reading a couple of books and viewing the majority of Ken Burns' BASEBALL, I thought it would be fun to go to a professional game. We in Seattle are spoiled enough to be able to see the Mariners play in a new, state-of-the-art ballpark called Safeco Field, which opened four years ago. Doug bought tickets for us and off we went to the big, beautiful field. . .

Only one problem. . . I couldn't fit in my seat. It wasn't big enough to accommodate my butt and thighs. Too humiliated to admit it, I crammed myself into the seat, thinking that it would get better - not that the seat would "loosen up," as it was made of plastic and metal, but that maybe my butt and thighs would get used to it, or go numb, SOMETHING. . .

I looked around at other people who I considered to be "big." I looked at their butts and thighs, wondering if they were in pain and if I looked as uncomfortable as they did. I looked at them eating their hotdogs and drinking their sodas and thought, "Oh my Lord, do I look like that???" Were they as embarrassed as I was? Did they feel as ashamed?

With all of these emotions flooding my brain, not to mention the physical challenges of feeling like my lower half was in a vice, how could I EVER pay attention the actual game? How could I enjoy the experience that was major league baseball?

That was three years ago.

Last night, Doug and I went to the ballpark again. And this time, my experience was different, very different. Down roughly 100 pounds from the first time we made the journey, I walked to my seat excited to see how differently it would feel. We got to the aisle, the row, the seat and I gingerly sat down, thinking that my thighs would still touch the armrests, but hoping that at least I wouldn't be in PAIN this time.

To my surprise, my thighs did NOT touch the arm rests. In fact, if I moved to one side of the seat, there was enough room on the other side to hold my purse. . . WHAT???? ME????? I was dumbfounded. I just couldn't grasp it. At first, I thought, "Maybe we're sitting in a section that has bigger seats in it than the ones we were in three years ago. . " My heart raced, my hands started to shake. I couldn't believe what was happening - I was actually FITTING into the seat. I was, for the first time, FITTING and FITTING IN.

I turned to my husband and with tears in my eyes said, "Look! Look at how much room I have!" He understood. . . He put his arm around me and said, "Isn't this GREAT?!"

I was the same, but I was different. The whole world was different.

---------------------------

June 15, 2004 / 8 months post-op / 192

THE DREADED PLATEAU

Everyone said to expect plateaus. I heard them, but thought that maybe I'd beat the system, and my body would consistently (if not slowly) continue to shed its extra pounds. Well, maybe that's true - maybe it IS doing that, and when I'm 18 months out from surgery I'll be able to look back and see that yes, I was losing consistently. But today, TODAY, it looks like I've slowed to nearly a snail's pace - and in the back of my mind I'm afraid that I've bottomed out, that I'm "done."

Rationally, of course, I know that my fears are unfounded. The probability is that my weight has simply and predictably plateaued. Irrationally, though, I'm at that place where I've been on SO many other (failed) diets - strong start, then slowing, slowing, slowing, STOP. And it's this kind of emotional knee-jerk reaction that's the most difficult to handle.

So what's a person to do???

1 - PUT IT INTO PERSPECTIVE
I've lost a GRAND total of 128 pounds (90 since surgery), and am wearing a size 14. I am where I NEVER thought I'd be. If I don't lose another pound EVER, I'm still in a GREAT place.

2 - FOCUS ON HEALTH
I had my annual physical and blood work done last week. I am in FABULOUS shape. My blood pressure is 100/70, my cholesterol is 186, all of my blood work came back normal and healthy. No problem with vitamin B, no problem with iron. AND my body has resumed menstruation. I didn't have a period on my own for 12 years - now that I've shed so much weight, I've become regular again. . .

3 - DEFINE "PLATEAU"
From what I understand, true plateaus are defined as staying at the same weight for at LEAST a month. I've only been at my current weight for 8 days. Maybe I'm over-reacting. . . .

4 - TAKE SOME ACTION
I've been in a rut with my food choices, and I'm sure can "shake things up" a bit. I can also increase my exercise. There is no down-side to doing either of these things, and if they happen to stimulate my weight loss, then all the better.

5 - ACCENTUATE THE POSITIVE
Life is great, GREAT. And if I AM at a plateau, and it does last for a while, then so what???

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April 24, 2004 / 5+ months Post-Op / 197.5

CROSSING THE THRESHOLD

I made the transition from weighing in the the 200s to the 100s last week. It was remarkable and tearful. I stared at the scale in absolute disbelief, trying to remember how long it had been since I'd seen my weight started with the number 1 instead of the number 2 OR 3.

The answer was 1988. I had willed myself to stay on NutriSystems for nine full months, living on rehydrated "hamburgers" and other just-add-water science experiments I talked myself into believing was food. I white knuckled my way into the hundreds and saw my weight loss - despite rigorous exercise six times/week - get slower and slower and slower. I eventually gave up at 192, and like a cork that had been pulled underwater and suddenly let go, my weight catapulted beyond the surface of 200, beyond 250, beyond 263 (where I started NutriSystems) and eventually buoyed at my all-time high of 320.

And now, after all this time, I find myself staring at the scale, seeing 199.5 look me squarely in the eye. I sprung off the scale and bounded for the camera. This time, THIS time it was going to be recorded. I took a few shots and reviewed them in the digital viewing window - the number and my feet with their bright red, well pedicured toenails in full view. There was no question that I was the one on the scale. I weighted less than 200. It was a beautiful day.

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April 8, 2004 / Almost 5 months Post-Op / 201.5

I am slowly but surely making the transitions from morbidly obese to obese, from obese to overweight, from overweight to normal. I am wearing a size 16 in jeans. I am wearing a Ladies L - XL in tops. I am feeling more "normal" than ever before in my life. Only 1-1/2 more pounds, and I'm going to say good-bye to the 200s. This in and of itself is miraculous. Miraculous!

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February 9, 2004 / 11 weeks Post-Op / 216

MAKING IT WORK

I am feeling stronger and more able every day. I look back on the surgery and the infection that followed it, and it is seeming more and more distant to me - like a bad, bad dream. At the same time, I am just now getting to the point where I am physically strong enough to go-go-go all day long, as I was able to do before the surgery. I can get up, get breakfast, go to the gym, go grocery shopping, get the dry cleaning, drop by the pet store to pick up some dog treats, get home and do some work, email friends, straighten up the house, get the mail, take the dog for a walk, make dinner, spend the evening with my dear husband, and strangely enough, still not feel like sleeping when the clock says it's time for bed. That's what my life was like before the surgery, and yet for a good, solid 2+ months afterward, a big day was doing maybe one or two things on my normally exhaustive list of things to do. So, it feels good (tremendous understatement) to be back IN my life, experiencing it fully.

My weight loss has been steady, but not remarkably FAST. I lose 1-1/2 to 2 pounds a week, which doesn't seem like much considering that I'm eating maybe 800 calories/day. I have not been exercising as much as I should, though, and I know that my metabolism has shut down a bit in order to compensate for fewer calories. So, I've started to crank up the work-outs - not so much in order to speed up the weight loss, as much for overall health and wellness. I feel so much better about myself and my life when I get to the gym 4+ days/week.

I'm eating pretty much anything that sounds good, eating protein before anything else. I get full very quickly - maybe 5 or 6 bites - and in fact try to stop eating BEFORE I get full. And if I eat too fast, I get burpy after about an hour, and it's somewhat uncomfortable. So, I do my best to eat slowly, slowly, slowly. . . most often, I get bored before I get full - so I stop eating.

Some days I miss being able to eat mouthfuls of food without concern about chewing it to the consistency of baby food (which takes time) and I miss being able to eat compulsively sometimes. When you've spent your life using food to cope with life's curve balls, it's hard to stop, with or without surgery. Of course, I have stopped - and in fact, stopped years ago except for the occasional Big Hunk candybar or unnecessarily big dish of ice cream. But, the impulse is still there, something that's hard wired into me. The IMPULSE - they call it head hunger, I think - to comfort myself with my old friend, FOOD. Knowing it's simply NOT AN OPTION anymore - it's harder than I thought it would be. And yet, I am grateful. And wouldn't choose to have the option available to me again, live the life I had before finding and having weight loss surgery.

I am wearing a comfortable size Petite 18 in pants and a 16 in tops. It feels GREAT to be this size - to be making my way into the Ladies sizes and out of the Womens sizes. One day at a time, one pound a time.

------------------------------

January 18, 2004 / 9+ Weeks Post-Op / 222

RECURRENCE OF THE C-DIFF

As it turned out, I did have a recurrence of the C-Diff, that nasty infectious colitus I contracted in the hospital. It took nearly a week and three stool samples to analyze, but I did have a recurrence. Fortunately, by the time the evidence presented itself, I was already on the antibiotics for it, and needed to do nothing more than to continue taking the meds for a full 14 days.

In a strange way, I'm relieved that my condition was diagnosable - that it just wasn't some sort of strange physiological anomaly. Knowing is, as they say, better than not knowing.

This round of antibiotics has been a walk in the proverbial park, compared to being on the Flagyl administered via IV three hours on/three hours off, 'round the clock. Instead, I take a teaspoon of liquid Vancomycin four times/day - from beginning to end, it takes about 5 seconds. AND, the stuff doesn't even taste that bad - I found a pharmacist who specializes in liquid suspensions of medicines and he added a bit of tutti-fruity flavor to take "gaggable" edge off.

All told, I'm doing well. I'm back to the gym, I'm eating real food with few intolerances, and I'm losing weight. I've lost close to 50 pounds since surgery, and close to 100 from my all-time high in 2000. I'm wearing an 18, a far, far cry from my years at a size 26/28. It feels great - even with the inconvenience of a recurrence of the dreaded C-Diff. I'm grateful.

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January 7, 2004

NOT A RECURRENCE OF THE C-DIFF, PLEASE

I woke up yesterday morning feeling fine. Good. Normal. By 3:00 in the afternoon, I was having abdominal cramping, was sick to my stomach and eventually had diarrhea every 20 minutes - diarrhea with the same sypmtoms I experienced with the C-Diff infection (namely - and sorry to be so gross - blood and mucous).

I called my surgeon, who encouraged me to submit a stool sample at the hospital as soon as possible. I planned on making the trip the next morning, but by 7:00 that night, I was in lots of pain due to the cramping, and I was seeing more and more blood in my stool. So, my husband and I ventured out into the biggest freezing rain and snow storm Seattle has seen in seven years. Now, compared to most places that get snow, this was hardly an "event" - but for us Seattlites, even a dusting of snow sends the city into a panic.

The ER was filled with snow-related injuries - victims of sledding, slipping, car wrecks. And in fact, the hospital was so overwhelmed with new admissions that it had to start sending patients to neighboring hospitals. Not a bed was to be had, and because of the storm, a huge majority of the workers were absent, too - so that meant the staff had to do more with less, resulting in long, long wait times.

I produced all of the necessary samples, got a huge bag of saline pumped into me and waited six hours to be told that my surgeon wanted me admitted for hydration until the test results would be available the next day. The only problem - no BEDS! Eventually I was shuttled into a ward so far out of the way that the next day my surgeon couldn't find me!

In the meantime, I waited and started a profilactic course of antibiotics, just in case the C-diff was back. It wasn't, though. My surgeon came in and showed me the work-up sheet from the lab - no evidence of C-diff. WHAT it was I had/have was unknown. Hopefully, it's just a case of the stomach flu/diarrhea???? Or maybe too much Splenda???

At any rate, I was told to go home and continue the antibiotic (which I have to grind up and suspend in water, then SHOOOT it down) 3 times/day for 10 days, just to be on the safe side. And I was directed to bring in two additional stool samples for analysis, to ensure that the first test was not a false-negative.

I pray that this will pass quickly and without any additional incident. And that the C-Diff is truly gone, gone, gone. The last three weeks of my life, since I stopped using the Flagyl, have been remarkable. I've felt like my life was finally MINE again, that I could be myself in the world again, instead of held captive by illness and suffering. . .And the idea that I could be taking a big step backward into that "otherness" again. . . it's just very scary.

Please hold me in your good thoughts, won't you? It makes a difference, I'm certain.

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January 6, 2004 / Nearly Eight Weeks Post-Op / 227

"TOLERATED"

In two days, I will be eight weeks post-op, which is something of a landmark because it means I'm "sugically sanctioned" to start eating regular food - as long as I stick to the portion requirements (no more than 1/2 cup at any meal/snack) AND it's "tolerated."

This word - "tolerated" - was kind of a mystery to me. It's used in almost all of the literature you read regarding by-pass surgery. Expert after expert say, ". . . as long as it's tolerated," and "You may eat it if tolerated." But nobody described exactly what's MEANT by "tolerated."

Well, I'm starting to learn exactly what "tolerate" means: you don't get gassy and burpy; you don't get diarrhea; you don't vomit. In other words, you don't get SICK from it.

The problem is, it's hard to know if WHAT you're eating or HOW you're eating is the culprit for problems. I find that when I eat too fast - no matter HOW typically tolerated it is - I'll get sick. And I mean MASSIVE gas and bloating (that can not be passed ANY other way but to be burped up) and, if it's bad enough, vomiting. No food comes up, because it's long gone into the digestive track, BUT the air comes up. The episodes are uncomfortable and somewhat violent when they occur - and last anywhere between 30 minutes and 3-1/2 hours.

The first time it happened, I was eating pureed clam chowder (no lumps) and mashed potatoes. My portions were tiny, but I ate them in about 15 minutes - too fast. The second time it happened (and this was by FAR the worst reaction I've had), I was eating baked cod, mashed potatoes and broccoli. Again, my portions were nice and small, and this time I ate very slowly (35 minutes), BUT, that broccoli did a big-time number on me. Pre-surgery, I was a big broccoli fan and ate it with regularity, seeing NO ill effects (like massive gas). But now - SHEESH - I had two, SMALL florets and BAM, BAM, BAM - the noises being produced in my gut were both felt and heard. My husband had to pat me on the back to try to get the gas to rise and exit - but even that didn't help much. Either did the GAS-X I took. . . It just took time, lots of time.

Note to self: no broccoli for a while.

Aside from these experiences, I've had very few problems "tolerating" normal food. Here's what my typical diet looks like:

Breakfast
Egg-white omelette with shrimp and cheese

Snack
String cheese

Lunch
Lentil Soup with whole wheat crackers
or
Homemade turkey chili

Snack
Unsalted peanuts (1 oz)

Dinner
1/2 flour tortilla with cheese, non-fat refried beans and chicken

Snack
Non-fat, sugar-free yogurt


I'm still struggling to get in my vitamins, because they taste horrible to me and I have SO many to take. The multivitamin is easy, as is the B-complex (although it tastes ICKY!). The calcium is harder, though, because I'm supposed to take FOUR big, chewable patties a day (two with lunch, two with dinner). They taste okay, but they're HUGE - practically a meal in and of themselves, so. . . I need to find an alternate, tasty method. . .

I'm back exercising again, although it's pretty slow going. Because of the infection, I was taken out of commission a lot longer than expected, and that resulted in a significant amount of my cardio and muscle strength being lost. I'm back to 35 minutes of cardio at light/moderate intensity and about 15 minutes of strength training three times/week. Slowly but surely I'm seeing improvement, though, and am confident that I'll continue the re-building process, one work-out at a time.

I experienced my first plateau a couple of weeks ago. I was stuck at 232 for 10-14 days. I suspect it was because I wasn't exercising or eating anything during the treatment for the infection - so my metabolism shifted into low gear. Now that I've increased both my calories and movement, I've started to see steady drops in my weight.

I've lost 36 pounds since surgery, which is slower than average, I think. It doesn't concern me, though, because I know that whether you're a fast loser or a slow loser, it all evens out around 18 - 24/months. In a way, I'm actually GRATEFUL for the slower pace of my weight loss, because it gives me time to adjust emotionally to the changing image in the mirror. And that's a whole OTHER story. . . .

It's all working.

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December 20, 2003 / Five+ Weeks Post-Op / 232

THE LAND OF THE LIVING

I have much for which to be grateful. I am gaining strength day after day and feeling better and better - physically and otherwise.

I have had no recurrence of the feared colitus, have been able to get in 48+ oz of water every day, along with a number of small meals of yogurt, pureed soups, fruits, sugar-free pudding, and/or mashed potatoes. I have had no bad reactions - no vomiting, nausea or diarrhea. I am growing stronger, stronger, stronger, with each passing day, and am feeling so much more hopeful.

It's strange that my mental state deteriorated so dramatically with the illnesss - how clouded with fear and dispair I became, and how I couldn't find a way to somehow put the experience into perspective, and trust that THIS WOULD PASS and it was TEMPORARY.

I still don't understand it - how completely immersed in the ABYSS I became. I'm sure it had something to do with my not being prepared for the particular complication I faced. In all of my research and in-depth reading, I NEVER came across a WLS patient experiencing C-Dif. Somehow I think that had I known how painful it was, AND how truly traumatic the treatment would be, I'd have been better prepared.

I also think that I'm someone who has experienced a lifetime of great health, with only minor physical challenges. I've never lived with constant pain, extended periods of diarrhea, nausea and vomiting, blurred vision, dizziness, feeling faint and lightheaded - let alone ALL at once. I have been healthy and active, thank God. So this was a complete SHOCK to me - how horrible you can feel in your body, how betrayed you can feel by its inability to do the simplest of tasks we are born to do - like eating, drinking, eliminating. . .

I also think that this time was SO hard for me because I have been diagnosed with dysthimia, a low-grade, constant depression. I have treated this condition with a relatively small dose of either Prozac or Wellbutrin for well over ten years and it has made a world of difference to me and my ability to cope with challenges. It doesn't make the bad stuff go away, but it helps me PROCESS it more effectively. Since having surgery, I've been taking Prozac in a liquid form. But because it was suspended in alcohol I could not take it in tandem with the antibiotic - it would cause SEVERE nausea, vomitting and cramps (as if what I had wasn't bad enough). So, I had to stop taking the Prozac COLD. This is, of course, the LAST thing you're supposed to do with anti-depressants.

To make matters worse, I couldn't use my old and new "friends" to get me through hard times. I used to be a tremendous compulsive overeater - running to the M&Ms or ice cream whenever confronted with uncomfortable emotions. I spent many years working on this issue and have learned healthy alternatives to help me cope in a non-self-destructive way. However, the compulsion is deep-seated, and when I am MOST stressed, I want to comfort myself with food. Being so sick AND a recent WLS patient, FOOD was OUT - no longer can it be the helper, the fix, the solution.

My other "friend" in stressful situations has been exercise. I've grown very used to channeling my frustrations into good, hard, sweaty work-outs. This, of course, was impossible for me to pursue when ill - rolling over in bed was a trial, let alone getting up and actually moving with some regularity.

I believe it was all of these issues that contributed to my depressive spiraling down, down, down: being caught blindsided by the complication; having experienced a lifetime of health; not being able to take my meds; not being able to eat for comfort; not being able to exercise.

I remember laying next to my husband one night, about 12 days into the treatment. I said, "It's my greatest hope that something good comes out of this suffering - that I learn something, that I am different in the world because of it - that I am a better person, able to make a bigger difference in my life." I really hated the idea that I would just endure it and POOOF, back to reality. My husband, who has truly been nothing short of a miracle to me said, "Well, honey, I'm not sure everything is that tidy. I mean, it would be great if the 'lesson' in all this came to you quickly - but it may be a long time, or a change may take place and you may not be conscious of it. ALL experiences change us, though, and what you've gone through will make a positive difference in your life. Trust that."

Doug was right. I am changed, and for the better. I look at people who are suffering with a renewed empathy. I think of those held captive by their bodies and have such love for them, for the people they are INSIDE, the people we can't see with our eyes. I never want to lose that sensitivity and compassion.

I also learned something else - that our lives are precious and vulnerable, so much so that there is really no time to hold hatred in our hearts. My (first) husband left me four years ago for someone I was seeing as a counselor (they married - his second, her sixth). I sued her for malpractice, and after years of legal wrangling, we went to court. I won, and was vindicated. And at the same time, I could not forgive them. I still fought the battle in my head, hearing the conversations, remembering their actions over and over and over. Coming out of this fog of illness taught me that there is no longer a place in my heart and my life for hard feelings over this. Life is, as they say, too short. So, I let go of those feelings, and I said these words out loud - "I forgive you. I forgive you." And I cried tears of liberation.

So, despite it all - good did come from my sorrow. And I am a changed person - a more compassionate, more loving, more forgiving one. And if you ask me if it was worth it, I'd have to say yes. I'd have to say yes.

----------------

As for the weight, which truthfully has been the LAST thing on my mind. . . I went into surgery weighing 263. I came home from the hospital weighing 273 (all that saline). Today I weighed 232 - down 31 pounds in five weeks. I'll take it.

--------------------------

December 16, 2003

SET-BACK

My progress back to the world of the living has been slow. Saturday night I awoke to the sensation of itching on the backs of my legs. Upon inspection, I saw that I had broken out in hives - the inside of my thighs, the backs of my legs, both sides of my torso. By the morning, my hands and feet were covered, too. When I got up out of bed, I felt faint and lightheaded. My husband rushed me to the ER, where I was found to have very low blood pressure. I was pumped full of Benedryl and saline and sent home.

We consulted with my surgeon the following day, and he directed us to continue the IV antibiotics for the full 14 days, and treat the symptoms of the hives with Benedryl.

I completed the antibiotic cycle last night at midnight. Now I wait to see if the infection has been irradicated. In the meantime, I continue to be terribly weak and shakey. I have no appetite, and have to force myself to drink even water - which surprisingly always tastes good to me. I have not gotten in more than 100 calories/day for the last two weeks.

My surgeon said that the antibiotic (Flagyl) was one of the more brutal treatments out there. The side effects were almost unbearable. He said that once I'd had it out of my system for a couple of days, I would feel markedly better, and things will begin to turn around. Can this be true? Oh, please let it be true.

I've realized throughout this experience that there are some people who are good a being sick and others who are not. I am NOT. I steep in the suffering and allow it to impair my identity. I look in the mirror and don't see my reflection, but the reflection of someone who is distorted and incomplete. I can not see past it - the illness, the physical pain and difficulties - I allow it to cast doubt and fear and I become paralyzed by it. I walk around in a dream-world, feeling so fragile and vulerable. This is not who I am, this is not how I feel in the world. And maybe that's why it scares me so much - because it is the antithesis of who I THOUGHT I was.

Someone once said to me "Adversity introduces a person to themself." I've always thought of myself as someone who could stand up tall to adversity, to shake hands with it and say, "Give me your best shot." I've always thought of myself as someone who, through her fear, could perservere, could remember what's good and true. This has been my experience throughout so many challenges in my life. And yet here I sit, beat up by illness, fearful, and filled with sadness.

------------------------------------

December 11, 2003 / Four Weeks Post-Op

LIGHT

I am growing stronger day after day. The road to recovery is a long and sometimes treacherous one, but I am making progress. I tire easily and am weak, but the pain, diarrhea and nausea has subsided substantially. I have also been able to take in several small servings of higher-protein soups (pureed), water, and about 6 oz of protein drink made with milk. Considering that I didn't ingest more than a hundred calories a day for the first week of the infection, this is progress - big progress.

Tomorrow I revisit my surgeon to determine if the IV antibiotic treatment can be discontinued or if it must go on for another four days. Despite the side effects of the treatment, I'm hoping he'll continue it - I'm willing to do anything to ensure that this doesn't recurr, which the infection has a tendency to do.

I feel I have turned the corner, and can see the light ahead of me. It is still a faint light, but it is a light. I'll take it.

-----------------------

December 9, 2003 Almost Four Weeks Post-Op

COMPLICATIONS

I was rushed to the hospital on the night of December 1, suffering from debilitating abdominal cramps and blood in my stool. I spent six hours in ER, finally getting some relief from a high powered pain killer and a liter of saline. They took blood and stool samples, and the next day I visited my surgeon for the results: I had C-DIFF (short for a long, medical term) in my colon, a bacterial infection caused most probably by the antibiotics I was given before and after my surgery.

The protocol for ridding the stubborn and serious bacteria was a course of antibiotics to last ffor a period of 10 – 14 days. Unfortunately, the pills were too large for me to ingest fully, and when crushed and suspended in liquid, caused me to vomit. My only choice, then, was to be readmitted to the hospital. I spent three days there, continuing to be hydrated with saline and receiving the antibiotic via IV.

The cure for this disease is nearly as bad as the disease itself. While the side effects vary from person to person, for me the drugs cause tremendous nausea and vomitting, depression, and a very strange and horrible taste in the mouth. And drugs (transdermal and suppositories) prescribed for the nausea and vomitting have their own set of side effects – dizziness and blurred vision.

After three days at the hospital, I was given the option to go home or to stay for the remainder of the antibiotic course. I opted to go home. However, in order to continue the intravenous therapy, I needed a special IV line installed into my arm – called a PICC line. It is administered into a deeper vein, run up over the shoulder and into the chest cavity. It can be in place for a much longer period of time compared to the lines installed when typically visiting the hospital.

After getting home, we were visited by a home care nurse, who explained how we were to administer the saline/antibiotics round the clock. In essence, it’s three hours ON and three hours OFF, 24/7. It’s grueling.

So how to I feel about all of this? I’m sick. I’m weak. I’m depressed. And I can’t even tHINK about eating/drinking anything without wanting to gag. I’m getting in maybe 100 calories a day.

I spend the majority of my day crying, to tell you the truth - SO convinced that having WLS was the worst decision I’ve ever made. Intellectually, I know that this too shall pass, but emotionally I am destroyed by TODAY’s experience and how I feel physically. I look at the world around me and feel so disconnected from all of it, so worried that I’ll never get my life back – never get back the life I LOVED before the surgery. I look into my husband’s eyes and through my tears I ask him, “Will I be alright?” And he says in the most earnest, loving way, “Of course you will, honey, of course you will.” I want to believe him, I want to believe that I will not only survive this time, but I will thrive. In the meantime, I’m mourning the loss of the life I had, I loved and treasured. And regretting that I put it in harm’s way. . . .

----------------------------------

November 29, 16 days Post-Op / 245 pounds

HEALING IS a NON-LINEAR PROCESS

I have been up and down, up and down for a few days now. I thought I was on the fast road to recovery once I was able to successfully get in my protein. Unfortunately, I've found that the road to recovery is not always a straight one - and that those blessed with patience are far better at this than those who are not.

I went in for my two-week appointment, and everyone said (including my surgeon) that things were healing nicely and that I was right on track. I got my staples removed, and was given the green light to "pureed foods." I felt positive about it, but at the same time have just not felt RIGHT since I had the surgery - especially since returning home from the hospital two weeks ago.

"Felt right" applies to both my physical and emotional state. Physically, there are two things I'm experiencing which are a challenge. The first is diarrhea, gas, bloating and cramps. It's a miserable feeling - and happens after eating/drinking anything. . . I talked to the dietician about it and she suggested I avoid all lactose products, as its intolerance is a typical symptom of newbies. I did make the transition (Lactaid and soymilk are my mainstays for now), and it is helping quite a bit. Of course, I didn't heed her warning fast enough - and had this wonderful pureed broccoli casserole for Thanksgiving dinner. It was made with cheese and butter, and both upset my stomach something awful.

The other physical issue is being truly exhausted all the time. I wake up around 10:30 a.m., do my best to get going, and after showering and dressing, I'm ready for a rest! I get in my food/protein, then do nothing but veg-out in front of the tv. Sometimes I walk a bit - but it hardly counts as "exercise." I take a long nap in the afternoon, eat/drink some more, then am ready to turn in by 10:00 p.m. This is hardly what I thought was going to happen with my recovery - especially since I'm doing such a good job of getting in all of my protein (50+ gm/day) and vitamins/minerals. I am told that this kind of fatigue is normal - but it's just DEVASTATING to me. It's the LAST complication I expected (although, let's face it - as far a complications go, this can hardly be included in the same category).

The emotional toll this has taken on me is actually much more disturbing - and I don't know which came first, really - the pain/discomfort and the accompanying depression, or the depression from surgery/anesthesia made worse from the pain/discomfort. There's a kind of hopelessness in me now - something I've felt before in my life, when faced with a long-term physical challenge. I feel like I"m looking at the world go by in front of my eyes, and that I can't for the life of me, be a part of it. I feel like everyone else is ALIVE and I am not, that I'm just kind of surviving for now. I feel very alone - no matter how much love and attention I'm given from my friends and (saintly) husband. I feel disconnected, disinfranchised. It's very strange and alarming.

When I went through this before (1996), it was a result of a stress-related illness that could not be easily diagnosed with medical science. Over the course of six months, the physical ailment (which caused me to go on short-term disability) gradually subsided, and I was returned to health. I learned a lot about myself and my world in that time and ultimately felt like it was a GIFT to me - because I learned to be IN THE MOMENT and to appreciate what I had at all times. I promised myself I would never forget that lesson - and whenever challenged with anything ever again, I would recall my journey. And I can say without reservation that I have been grateful for my health and wellbeing every day of my life since that day - despite tremendous emotional challenges along the way . And yet, when I got out of the hospital with this surgery. . . it all started again - that dread, that sense of hopelessness, that sense of deep, dark sadness. . . .

I talk to my therapist about this, and I am on Prozac, which helps greately. I am doing everything I can do to just get through it. It's my hope that this too, will pass - and that as I grow stronger and more able, the darkness will fade and I once again will see the light that life is. . .

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November 21, 2003 / 8 Days Post-Op / 255

WHAT A DIFFERENCE A DAY MAKES

What a week this has been. Two days ago, I was distraught, anxious, depressed, alienated, woeful. And afraid. Afraid I had made the decision to have WLS without understanding or hearing what it was really going to be like to live in a surgically altered body. I was afraid that I had heard what I wanted to hear while blocking out the important life-change information. . . I was just so afraid that my life was going to perpetually be as it had been since getting out of surgery - fraught with behavioral challenges and difficulties.

Thanks to my AMOS Angel, Karyn S., I was encouraged to reach out to others who have walked in my shoes and ask for support. BOY, did it help! Thank you to all of you who wrote to me, empathized and said, "Hey, post-surgery life is rough - been there, lived through it, it WILL get better." Just knowing that I was not alone was incredibly helpful. Thank God for peer support!

Here are a few things I have learned in the past few days - all of which I'd like to share.

Post-Surgery Depression:
Depression is sometimes a side effect of general anesthesia - and the longer you're under, the longer it takes to work its way out of your system. The more you can WALK, BREATHE, and DRINK WATER, the faster you'll be able to flush it from your system.

Water Weight:
It's very typical to gain lots of water weight at the hospital because of the IV you're given to keep you hydrated. It will come off relatively quickly, within the first two weeks, in addition to the fat you're losing. I lost all 13 pounds in about five days - and have lost another 5, too.

Protein:
My surgical program is HYPER about protein intake. For the first two weeks after surgery, they want protein intake to occur every hour on the hour for as long as you're awake - two or three ounces of protein, consumed over 20- 30 minutes. This is a great idea, of course, but difficult for many WLS patients. In fact, it was obvious from reading many testimonials that a lot of people can't tolerate the idea (let alone the consumption) of protein drinks until 2 - 3 months out from surgery. Knowing this helped me to realize that I was not alone in my intolerance, and that it may be completely unrealistic for me to get in as much protein as directed - at least initially. I committed to being HYDRATED as much as possible, drinking all day long (no more than one ounce in every 10 minutes). And I continued experimenting with protein drinks. Some ideas that were given to me:

***Experiment with temperature: sometimes it's easier to get it down if it's COLD or if it's ROOM TEMP.

***Experiement with dilution levels: a lot of people find that they do better getting the protein in if they dilute the proteins (especially the NECTARS) LESS than is directed - like putting the recommended # of scoops into only 2 or 3 ounces instead of 8. Others find that they do better the other way around - put only a teaspoon of the protein into 8 oz or water, so you can hardly taste the protein - and think of it as "nutrified" water.

***Look for recipes that appeal to you. Here are the two I've been using over the last couple of days and seem to tolerate pretty well (although not as well as I did before surgery, when I was in the practice phase).

Coffee Shake

8 oz nonfat milk
2 oz decaff or coffee
2 scoops vanilla protein powder
3 ice cubes
2 tsp Splenda (or Equal, if you like it better)

It tastes kind of like a coffee milkshake. I drink it very slowly over the course of a couple of hours. . .


Raspberry Treat

8 oz nonfat milk
Raspberry fatfree sugarfree jello to taste
2 scoops vanilla protein powder
3 ice cubes


Banana Chocolate Shake

8 oz nonfat milk
1/2 banana
1 envelope SF Chocolate Instant Breakfast
2 scoops vanilla protein powder
3 ice cubes


Anti-Depressants / Crushed Meds:
I have heard uniformily that there are no worse-tasting meds out there than anti-depressants. In fact, they are SO horrible, I'm convinced that they could be used and an event on FEAR FACTOR, if they had the right contestants involved :0 . I didn't hear from anyone who had had any experience getting down Wellbutrin with any kind of success. However, I did find out that two popular anti-depressants come in liquid form: Prozac and Zoloft.

I took Prozac for many years prior to making the transition to Wellbutin (which has a kind of anorexic effect in some users - which is why I started using it) - but promptly called my therapist who did some research and found that not only was the Prozac available - but that only a tsp./day was equal to 20mg. Hallelujah! I started using it yesterday, and can tell you that it tastes like minty mouthwash - not offensive in the slighest (well, considering that it's medicine). This one thing - getting rid of having to crush and ingest the Wellbutrin - has changed the quality of my life ten fold. WHAT a relief!!!!!


Tingling Sensations:
One side effect of having to lay flat for extended periods during sleep (unlike while at the hospital when you can adjust the angle of your legs/torso, etc.) is that your weight can press on various nerves and leave various areas numb/tingly - like when you cut off the circulation. I have had problems with this for many years - and have adjusted by changing positions regularly throughout the night. Post-surgically, there aren't a lot of comfortable positions because of the incisions, so you have to live with the tingling - which doesn't necessarily go away when you get up and walk around. I talked to my nurse about it and she said it's very common and that it usually "works itself out" after returning to normal sleep and activity patterns.

Sleeping (or not):
I found it very difficult to sleep flat on my back in bed, and was much more comfortably propping myself up with pillows and blankets on our sectional. I have consistently slept FAR better with this new situation - and since my husband agreed to sleep on the other side of the sectional, I'm all the happier (I couldn't believe he was willing to sacrifice our wonderful, big bed to keep me company - now THAT's dedication!).

Taste Buds:
Everything changes with surgery. Things that used to taste good don't, things that never used to, do. In the beginning, you may have no taste for ANYTHING. It will change within a few days and slowly but surely you'll start to recognize tastes again. . .

The Ritual of the Meal:
I have always loved eating dinner with my husband every night, and feel terribly left out when he gets to eat his yummy food and I'm stuck with a protein shake. So, what I've tried to do is create a kind of liquid "meal" for myself to have with him. I start with beef boullion (which takes me 30 minutes to consume - by which times he's WAY done with his meal), then have a sugar free popcicle for dessert. (Wow - what a trip - to see that I'm satisfied with beef boullion and a SF popcicle - times have changed!)

Burping:
I NEVER used to burb - and to tell you the truth, NEVER learned how to do it voluntarily. Note to self: post surgery, burping comes in handy! From what I gather, every time we ingest something, a little air goes down with it - and because our pouches are so small, we consistently find the need to burp. Don't be surprised if you burp a lot more often (as in after every drink!) - it's just the body taking care of itself.

Oh, and I found that RIGHT after surgery, there was a lot of gurgling of air in my chest wanting to come out and not coming out my stomach/esophogus/mouth! It felt SO strange. . . but it's normal - just air trapped in the body - it comes out on its own sooner or later.

Bowel Movements (if you can call them that):
My surgeon required a full-tilt clean-out before surgery, so there was NOTHING in my digestive tract when I started consuming liquids and proteins. For the first couple of days I was home from the hospital, there was nothing more than a little tiny bit of bile that passed through. As I've been doing my best to get in the protein, though, my movements have been much more like diarrhea. I talked to the nurse about it, and she said it is perfectly normal and expected to have diarrhea when you're on a full liquid diet.

All told, today is better - today is better than better, it's good. Thank God we have each other, you know?!


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November 19 / 6 days Post-Op

I have the blues big-time. And I'm plagued by the thought that this was a horrible thing to do and that I didn't make a good decision for myself.

The surgery went well, and I felt great for the two days I spent in the hospital. I was able to leave a day early, in fact, because my recovery was going so well. . . .When I got home, though, everything seemed to shift, somehow. I took a shower, and immediately started running a fever. It wasn't significant - didn't even break 100 - but still, I had the chills and felt absolutely miserable. My DH called the surgeon, who said that if my temp got above 100.5, I should go to the ER (it didn't). . . .The next day, DH called one of the program nurses and was told that it's very typical to run a slight fever at night - and that there's no reason to be alarmed.

The bigger challenge has been getting in enough protein. I did a lot of taste-testing before surgey, and was fairly confident that once I got back home, I'd be able to easly comply with the protein requirements. Unfortunately, what many others have said is true for them was true for me - tastebuds change with surgery. Suddenly, NOTHING sounded good or tasted good. Boost, Slimfast, Ensure - all of them - made me want to run for cover. For the first couple of days, I didn't get in more than 15 grams of protein, I'm sure. Now, six days out, I'm getting in about 50 grams. I'm hoping that this will be enough to prevent me from losing hair two- to three- months from now. . .

Another challenge is meds - how to get them down. I bought a pill crusher and started practicing a couple of weeks before surgery. I only take a couple of pills - once/day for cholesterol (Lipitor) and for depression (Wellbutrin), one pill three times/day. The Wellbutrin pills are BIG and when crushed, make a whole lot of powder. And truly, the powder is the most terrible tasting thing I have ever tasted, EVER.

I experimented with a number of approaches - putting it into a small amount of protein drink, putting it on my tougue and "chasing it" with the protein drink or anything else I thought might cut the bitterness. I tried diluting it, in soy milk, sucking it up into an syringe (no needle, of course), so that I could "place it" behind my taste buds. Once I tried to put it so far back in my throat, as not to taste it, that I inadvertently put it down my windpipe - and spent the next hour coughing it out. And with every cough, I had to taste it again