Once again it feels like March 31st to me since I'm posting this at 2:16 AM on the morning of April 1st. April Fools Day... hmm...
Today was my dad's birthday. He turned forty-four today. He was mostly okay today, but everyone is really starting to see the side effects of him being off his anti-depressants. I hope he finds a way to work it out soon because he feels better when he's not depressed, duh. He handles things with more ease. Although I will say for all of the explosions I've been seeing, I've also seen them tempered with an attitude of humility and seeking forgiveness. I still hope he gets back on those meds, though!
I had an Isopure Dutch Chocolate shake this morning with a little DaVinci Caramel, (DaVinci is a line of sugar-free syrups they use to flavor coffee in a lot of places, but I also have raspberry and Kahlua along with my caramel to flavor my protein shakes). It had fifty grams of protein, which was a nice start to the... er, afternoon. My sleeping patterns have been so whacked lately. We went to GNC today and I told the ladies there my story. They were both so nice and said they want to see me there as much as possible, so I promised them I'd be back. I WILL be, too... gotta keep those Bullets a-coming! I like telling my story, for some reason. I think it gives people hope, and I like giving people hope. At GNC we picked up two Oh Yeah! Good Grab Protein Bars so that I could try them. I had one for lunch and it was delicious.
My dad wanted nachos for dinner. Rather than eat the chips, I layered some fat-free refried beans with a little taco meat and some cheese in a bowl. I melted the cheese and topped it with a little low-fat sour cream and a dab of salsa. It was yummy! My pre-op sheet said that "last suppers" should be tempered, which I understand. I had a piece of cake tonight, which I'm not proud of. I justified it to myself by saying it was dad's birthday, but I know that's no excuse! For my credit, I was able to stop at one piece and not gorge myself. The brain switch-on happened a little late this time, but I'm glad it came.
So today begins day three of the pre-op diet. Wednesday. I have, counting Wednesday and not Monday the 6th, five days until surgery. It's nerve-wracking, but I know I'm ready now. On Saturday I have a brunch date with a friend of mine. I'll be eating, but it'll be small, protein packed, low-carb and low-fat. I'd also like to take a bottle with some dry Nectar powder to fill up to keep me going. I still have a headache, but now I reckon it's from lack of sleep and not lack of food. I feel like a zombie.
Things are getting better and I'm glad of it. I'm confident in my ability to land with my feet firmly planted in a brand new life after this surgery, with no looking back.
Tuesday, March 31, 2009
Monday, March 30, 2009
3/31/2009: Pre-Op Diet Day One (Discovering What This is All About)...
As the title states, today was the first day of my one week pre-operative diet. I call it a liquid diet most of the time, but it's really not. The sheet I was given says I need to drink a protein shake for breakfast, one for lunch, and that I may have a small meal for dinner consisting mainly of a protein source and possibly a low-carb veggie.
Today I found I had trouble eating or drinking at all. When I have to be mindful I sometimes become fearful, but I realized today that just because you have to be in control doesn't mean that you cut yourself off. It means that you control yourself and switch your brain on. My mom went to GNC today because I asked her to pick up an IDS New Whey Protein Bullet; a small, three-ounce plastic vial of a viscous-like liquid that has forty-two grams of protein. I wanted to try one because I really wanted to buy a case to take with me to the hospital. Usually, they give Bariatric post-ops diluted apple juice, which can actually make you dump. Also, protein helps the body heal much faster after an invasive procedure so the sooner you begin drinking it, the better. My mom decided to buy a whole case of the Fruit Punch flavor and brought them home.
They are DELICIOUS! I can see how the texture might bother some people, but it's fine with me. It tastes like a melted cherry popsicle and the texture reminds me of a bite of Jell-O that one has swished around in their mouth to liquify it. They have very little if any protein taste or aftertaste... I just love them. So it looks like my mom made the right decision in buying a case. I'll be holding off on drinking them, though, because like I said, I'd like to take them with me to the hospital. I had a chicken breast for dinner which was very good and I later had a tablespoon of peanut butter. Other than that, I've had water and Crystal Lite today. I have a rip-roaring headache that I know is from carb withdrawl, but it's okay. They say it gets easier each day and I'll take their word for it.
A few things were brought to my attention today that made me question whether or not I was really ready for this surgery. In the end, I'm quite aware that there are things that will never cross my lips again. Sometimes it makes me feel sad, but for the most part you know what? I. DO NOT. CARE. I've eaten enough for five nineteen-year-olds lifetimes and I'm ready to reclaim my health, my spot on the "Loser's Bench", and my life. I am ready to spread my wings and to be strong and to live. Simply live.
It's not going to be easy. I know that it will require extensive therapy and effort every single day on my part. Every day that I wake up from now on, I'll have to make the decision to wake up and fight my battles with food. I know I'll win. I may stumble, it happens to the best of us from time to time, but I am winning this battle every second that I choose the right path. I am ready for this life change. No one can stop me now!
Day two of the diet should prove interesting, as well. It's my dad's birthday today. I don't know food wise, but I do know that he's agreed to go with me again today to GNC. Whether it comes to pass or not is yet to be seen, but I'd like to pick up a bottle or two of the Oh Yeah! RTD (Ready to Drink) and see what they taste like. If they're good, I might buy a case for when I'm switched on to full liquids. It's a week of clear liquids after my surgery, (that means water based and sugar free) and then three weeks of full liquids, (when I can add milk-based products like pudding and cream soups, but they still have to be sugar free and low, low-fat) and then I'll be switched on to soft foods at the month mark, (mushy consistency like cottage cheese) and then they'll slowly work me back to foods that contain meat and are a bit more solid. The sugar-free, low-fat, low-carb remains in place for the rest in my life. And I've come to realize today: I'm perfectly okay with that.
Time to fly!
Today I found I had trouble eating or drinking at all. When I have to be mindful I sometimes become fearful, but I realized today that just because you have to be in control doesn't mean that you cut yourself off. It means that you control yourself and switch your brain on. My mom went to GNC today because I asked her to pick up an IDS New Whey Protein Bullet; a small, three-ounce plastic vial of a viscous-like liquid that has forty-two grams of protein. I wanted to try one because I really wanted to buy a case to take with me to the hospital. Usually, they give Bariatric post-ops diluted apple juice, which can actually make you dump. Also, protein helps the body heal much faster after an invasive procedure so the sooner you begin drinking it, the better. My mom decided to buy a whole case of the Fruit Punch flavor and brought them home.
They are DELICIOUS! I can see how the texture might bother some people, but it's fine with me. It tastes like a melted cherry popsicle and the texture reminds me of a bite of Jell-O that one has swished around in their mouth to liquify it. They have very little if any protein taste or aftertaste... I just love them. So it looks like my mom made the right decision in buying a case. I'll be holding off on drinking them, though, because like I said, I'd like to take them with me to the hospital. I had a chicken breast for dinner which was very good and I later had a tablespoon of peanut butter. Other than that, I've had water and Crystal Lite today. I have a rip-roaring headache that I know is from carb withdrawl, but it's okay. They say it gets easier each day and I'll take their word for it.
A few things were brought to my attention today that made me question whether or not I was really ready for this surgery. In the end, I'm quite aware that there are things that will never cross my lips again. Sometimes it makes me feel sad, but for the most part you know what? I. DO NOT. CARE. I've eaten enough for five nineteen-year-olds lifetimes and I'm ready to reclaim my health, my spot on the "Loser's Bench", and my life. I am ready to spread my wings and to be strong and to live. Simply live.
It's not going to be easy. I know that it will require extensive therapy and effort every single day on my part. Every day that I wake up from now on, I'll have to make the decision to wake up and fight my battles with food. I know I'll win. I may stumble, it happens to the best of us from time to time, but I am winning this battle every second that I choose the right path. I am ready for this life change. No one can stop me now!
Day two of the diet should prove interesting, as well. It's my dad's birthday today. I don't know food wise, but I do know that he's agreed to go with me again today to GNC. Whether it comes to pass or not is yet to be seen, but I'd like to pick up a bottle or two of the Oh Yeah! RTD (Ready to Drink) and see what they taste like. If they're good, I might buy a case for when I'm switched on to full liquids. It's a week of clear liquids after my surgery, (that means water based and sugar free) and then three weeks of full liquids, (when I can add milk-based products like pudding and cream soups, but they still have to be sugar free and low, low-fat) and then I'll be switched on to soft foods at the month mark, (mushy consistency like cottage cheese) and then they'll slowly work me back to foods that contain meat and are a bit more solid. The sugar-free, low-fat, low-carb remains in place for the rest in my life. And I've come to realize today: I'm perfectly okay with that.
Time to fly!
Sunday, March 29, 2009
3/30/2009: Liquid "Diets"...
It is technically March 30, 2009. I say "technically" because to me it still seems like the 29th, Sunday night. However, since it's 2:45 AM, it is definitely March 30th. Today, March 30th, starts my one week liquid pre-operative diet. The purpose of the pre-op liquid diet is to reduce the size of the liver and the amount of fat in your abdominal cavity. It makes the organs more accessible and it also makes it easier to maneuver the tools and the scope once I'm on the operating table.
Truth be told, I'm absolutely terrified. Truth be told, I'm absolutely thrilled. Right now, currently, the terror is sort of out-weighing the ecstatic feeling, but it changes from minute to minute, I kid you not. Earlier tonight I kept thinking, "I can't believe my stomach is going to be normal-sized again." And then I thought, "Dur... Bariatric patients don't have normal-sized stomachs you dummy!"
But then a little epiphany came: This IS normal for me. A stomach the size of a chicken egg, only being able to eat three to six ounces at any given meal... that seems NORMAL to me now. It's funny because the more I talk about, the more excited I get. The more I think about it, the more terrified I get. I think it's because when I talk, I get to talk about all of the good things that I KNOW are going to come from this surgery. When I think, I can allow myself to think about the pain and the drugs and the hospital and the pain and the car ride home and the pain and the sitting in a chair for two weeks and the pain... see a common theme? I'm just afraid I'll be a complete wuss who screams her fool head off trying to get out of a chair like I was last time. Then again, I have about one hundred and thirty pounds LESS to hoist out of that chair then I did last time. Ha.
Tomorrow's menu is as follows (I'm only allowed three shakes, much to my chagrin. I would much rather it be a shake every two hours, but that'd be WAY too high in calories)
Truth be told, I'm absolutely terrified. Truth be told, I'm absolutely thrilled. Right now, currently, the terror is sort of out-weighing the ecstatic feeling, but it changes from minute to minute, I kid you not. Earlier tonight I kept thinking, "I can't believe my stomach is going to be normal-sized again." And then I thought, "Dur... Bariatric patients don't have normal-sized stomachs you dummy!"
But then a little epiphany came: This IS normal for me. A stomach the size of a chicken egg, only being able to eat three to six ounces at any given meal... that seems NORMAL to me now. It's funny because the more I talk about, the more excited I get. The more I think about it, the more terrified I get. I think it's because when I talk, I get to talk about all of the good things that I KNOW are going to come from this surgery. When I think, I can allow myself to think about the pain and the drugs and the hospital and the pain and the car ride home and the pain and the sitting in a chair for two weeks and the pain... see a common theme? I'm just afraid I'll be a complete wuss who screams her fool head off trying to get out of a chair like I was last time. Then again, I have about one hundred and thirty pounds LESS to hoist out of that chair then I did last time. Ha.
Tomorrow's menu is as follows (I'm only allowed three shakes, much to my chagrin. I would much rather it be a shake every two hours, but that'd be WAY too high in calories)
- Double scoop Dutch Chocolate Isopure
- Single scoop White Chocolate Whey Gourmet
- Double scoop Nectar Strawberry Kiwi
- Lean Cuisine for dinner, (I'm allowed per the surgeon's instructions since my BMI is under forty. However, the meal must be free of pasta, rice, or potatoes.)
- All of the water, Crystal Lite and tea my little heart desires
3/29/2009: Now and Then...
I've started this blog because I have many friendships that are carried solely via computer screen. Many people that I consider to be my friends have never met me and will, sadly, never meet me. I also created this blog to show people the trials that one is faced with on a daily basis when one chooses the path of weight-loss surgery AND to show them that it can be done. In a way, I'm creating this blog to keep myself accountable to my new lifestyle and to those of you who read it, I'd like for you to do the same. So, some history and background!
I've struggled with weight my entire life. At the age of five I weighed one hundred pounds. Around the age of eight, I was tested for all kinds of disorders, diseases and imbalances including Diabetes and Hypothyroidism. The doctor couldn't find anything. I was never a very active child. I went through a time where I particularly enjoyed riding bikes and playing outside during the summer, but for the most part I stayed inside because one of my hobbies as a child was movies. I adored Disney movies and TV. The problem was that I also adored food.
My reasons for being so in love with food are too vast and complex to delve into on an internet blog. Suffice it to say that by the time I was seventeen, I weighed four hundred and nine pounds. When I was fifteen, my parents had approached me with the idea of Gastric Bypass surgery. My dad had undergone the procedure in 2003 and had lost nearly two hundred pounds and my family was concerned for my health. My answer was quite firm at first: absolutely not. I hated doctors, needles, hospitals, pain, and everything that the surgery involved. My parents had planted a seed, though. I couldn't shake the idea that maybe this was something that would finally be able to help me conquer the "unconquerable".
I started researching the surgery online and joined a group on Myspace dedicated to it. One night, as I was chatting with a woman I met from this group, she recommended the site Obesity Help, which I looked up immediately. They had a breakdown of surgeons by state and I spent all night looking for surgeons in Michigan. None of them would operate on someone under eighteen. I was devastated.
Then, a genius idea occurred to me. Why not look at other states nearby? We weren't THAT far from parts of Indiana, Illinois, and Ohio. I found a surgeon in Illinois who was nationally recognized for his work. He had helped to develop many of the tools used in laparoscopic surgery (a type of surgery where they don't use a large incisions, but many small incisions through which scopes with a tiny camera and the tools needed for surgery are inserted). This man had so many letters after his name that you could have fashioned a new name with them. I wrote down his number and begged my dad to call him. It took a few weeks, but I finally got an appointment for the end of January 2007, right after I turned seventeen.
I was thrilled. When I met the surgeon, I was even more thrilled. He seemed cool and confident with a good bedside manner. His secretaries, assistant and fellow were all wonderful women who put me at ease. We talked about surgical options and insurance and he assured me that we'd make it work. He said that he suspected I had a condition called a Hiatal Hernia which causes Acid Reflux Disease. His plan was for me to have a test done to confirm the presence of a Hiatal Hernia and work some magic with the insurance company so that they would approve my surgery.
It didn't work. The insurance company wouldn't budge. There were many circumstances as to why they wouldn't approve my claim, but I thought all hope was lost. I'd have to try my best to get by without dying until I was eighteen and then start the process all over again.
At the end of March of 2007, I was riding home from school one day and my mom said, "Your dad has a huge surprise for you when we get home." Wonderful girl that I am, I thought to myself, "I bet we're going out to dinner." HA! When I walked through the front door, dad said, "Sit down. I've been on the phone with the surgeons office all day." Huh? Why? "Well, you know we were going to call them to see if there was a way we could work out a self-pay plan, but his secretary had told us they didn't do that. Then she told me to hang on a minute. When she came back, she said, 'Mr. Montgomery, I have to be honest with you: no one has been able to stop talking about Ashlee since January. We know she needs this surgery and we've been chewing the doctors ear off about it since she was here. At the same time, we've been contacted by the CBS Early Show. They'd like to do a piece about juvenile weight-loss surgery and currently, Ashlee is our only file in the practice whose pre-operative. The doctor would like Ashlee to appear on the Early Show. He'd be willing to perform the surgery pro bono.'" For those of you who don't know, "pro bono" means "free".
We thought it was a miracle. I did all of the pre-operative testing that Wednesday, the CBS news crew was at my home that Friday, and on Tuesday, April 3, 2007, I had Laparoscopic Roux-en-Y Gastric Bypass with Hiatal Hernia and Adhesion Repair. The surgery was quite extensive and I was in the operating room for much longer than was expected. I lost fifty pounds in a month and eventually got to my current weight of two hundred and eighty pounds. That's a one hundred and twenty-nine pound weight loss.
In January of 2009, two years after my initial appointment with the old surgeon, I had an appointment with a new surgeon. I discovered that the reason why I had noticed a dramatic increase in my Acid Reflux and appetite, and the reason I could eat tons more than I should have been able to is because I have a rare post-operative complication called a Gastrogastric Fistula. Essentially what has happened is that scar tissue that built up between my new pouch stomach and the old stomach, (called the Remnant Stomach), wore down due to acid, I believe, and left a big, gaping hole in my new pouch. Food travels down my esophagus, into my pouch, through the hole into my old stomach and is digested as it was pre-op.
The worst symptom according to my surgeon, Dr. Laker, is the horrible Acid Reflux. I'll agree it's not fun. The worst symptom according to Ashlee is the fact that I don't get any of the benefits of my surgery. My weight loss stalled at two hundred and sixty-five pounds and then I regained fifteen of those pounds, maybe more, (I haven't weighed myself since my last visit to Dr. Laker). I don't keep feelings of fullness, I don't have "dumping syndrome", (a classic post-op complication that causes intense nausea, intestinal cramping and other horrid things... kind of like a built-in food cop to aide in the hinderance of incorrect eating as a post-op), and I can't lose any more weight.
My revision to correct this is scheduled for April 6, 2009; two years and three days after my original surgery. I start a one-week liquid pre-operative diet tomorrow, actually. I'm nervous as hell, but I'm ready to reclaim my spot on what the weight-loss surgery community calls "The Loser's Bench". So tomorrow, I'm going to eat some final meals... I'll be having everything I shouldn't even be able to eat.
Life is only just beginning. I'm thrilled to be along for the ride.
I've struggled with weight my entire life. At the age of five I weighed one hundred pounds. Around the age of eight, I was tested for all kinds of disorders, diseases and imbalances including Diabetes and Hypothyroidism. The doctor couldn't find anything. I was never a very active child. I went through a time where I particularly enjoyed riding bikes and playing outside during the summer, but for the most part I stayed inside because one of my hobbies as a child was movies. I adored Disney movies and TV. The problem was that I also adored food.
My reasons for being so in love with food are too vast and complex to delve into on an internet blog. Suffice it to say that by the time I was seventeen, I weighed four hundred and nine pounds. When I was fifteen, my parents had approached me with the idea of Gastric Bypass surgery. My dad had undergone the procedure in 2003 and had lost nearly two hundred pounds and my family was concerned for my health. My answer was quite firm at first: absolutely not. I hated doctors, needles, hospitals, pain, and everything that the surgery involved. My parents had planted a seed, though. I couldn't shake the idea that maybe this was something that would finally be able to help me conquer the "unconquerable".
I started researching the surgery online and joined a group on Myspace dedicated to it. One night, as I was chatting with a woman I met from this group, she recommended the site Obesity Help, which I looked up immediately. They had a breakdown of surgeons by state and I spent all night looking for surgeons in Michigan. None of them would operate on someone under eighteen. I was devastated.
Then, a genius idea occurred to me. Why not look at other states nearby? We weren't THAT far from parts of Indiana, Illinois, and Ohio. I found a surgeon in Illinois who was nationally recognized for his work. He had helped to develop many of the tools used in laparoscopic surgery (a type of surgery where they don't use a large incisions, but many small incisions through which scopes with a tiny camera and the tools needed for surgery are inserted). This man had so many letters after his name that you could have fashioned a new name with them. I wrote down his number and begged my dad to call him. It took a few weeks, but I finally got an appointment for the end of January 2007, right after I turned seventeen.
I was thrilled. When I met the surgeon, I was even more thrilled. He seemed cool and confident with a good bedside manner. His secretaries, assistant and fellow were all wonderful women who put me at ease. We talked about surgical options and insurance and he assured me that we'd make it work. He said that he suspected I had a condition called a Hiatal Hernia which causes Acid Reflux Disease. His plan was for me to have a test done to confirm the presence of a Hiatal Hernia and work some magic with the insurance company so that they would approve my surgery.
It didn't work. The insurance company wouldn't budge. There were many circumstances as to why they wouldn't approve my claim, but I thought all hope was lost. I'd have to try my best to get by without dying until I was eighteen and then start the process all over again.
At the end of March of 2007, I was riding home from school one day and my mom said, "Your dad has a huge surprise for you when we get home." Wonderful girl that I am, I thought to myself, "I bet we're going out to dinner." HA! When I walked through the front door, dad said, "Sit down. I've been on the phone with the surgeons office all day." Huh? Why? "Well, you know we were going to call them to see if there was a way we could work out a self-pay plan, but his secretary had told us they didn't do that. Then she told me to hang on a minute. When she came back, she said, 'Mr. Montgomery, I have to be honest with you: no one has been able to stop talking about Ashlee since January. We know she needs this surgery and we've been chewing the doctors ear off about it since she was here. At the same time, we've been contacted by the CBS Early Show. They'd like to do a piece about juvenile weight-loss surgery and currently, Ashlee is our only file in the practice whose pre-operative. The doctor would like Ashlee to appear on the Early Show. He'd be willing to perform the surgery pro bono.'" For those of you who don't know, "pro bono" means "free".
We thought it was a miracle. I did all of the pre-operative testing that Wednesday, the CBS news crew was at my home that Friday, and on Tuesday, April 3, 2007, I had Laparoscopic Roux-en-Y Gastric Bypass with Hiatal Hernia and Adhesion Repair. The surgery was quite extensive and I was in the operating room for much longer than was expected. I lost fifty pounds in a month and eventually got to my current weight of two hundred and eighty pounds. That's a one hundred and twenty-nine pound weight loss.
In January of 2009, two years after my initial appointment with the old surgeon, I had an appointment with a new surgeon. I discovered that the reason why I had noticed a dramatic increase in my Acid Reflux and appetite, and the reason I could eat tons more than I should have been able to is because I have a rare post-operative complication called a Gastrogastric Fistula. Essentially what has happened is that scar tissue that built up between my new pouch stomach and the old stomach, (called the Remnant Stomach), wore down due to acid, I believe, and left a big, gaping hole in my new pouch. Food travels down my esophagus, into my pouch, through the hole into my old stomach and is digested as it was pre-op.
The worst symptom according to my surgeon, Dr. Laker, is the horrible Acid Reflux. I'll agree it's not fun. The worst symptom according to Ashlee is the fact that I don't get any of the benefits of my surgery. My weight loss stalled at two hundred and sixty-five pounds and then I regained fifteen of those pounds, maybe more, (I haven't weighed myself since my last visit to Dr. Laker). I don't keep feelings of fullness, I don't have "dumping syndrome", (a classic post-op complication that causes intense nausea, intestinal cramping and other horrid things... kind of like a built-in food cop to aide in the hinderance of incorrect eating as a post-op), and I can't lose any more weight.
My revision to correct this is scheduled for April 6, 2009; two years and three days after my original surgery. I start a one-week liquid pre-operative diet tomorrow, actually. I'm nervous as hell, but I'm ready to reclaim my spot on what the weight-loss surgery community calls "The Loser's Bench". So tomorrow, I'm going to eat some final meals... I'll be having everything I shouldn't even be able to eat.
Life is only just beginning. I'm thrilled to be along for the ride.
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