Monday, 23 April 2018

Taking the plunge

Friday I was due to meet the doctor (a professor, no less) who would do my surgery.  “Are you nervous?” asked P that morning.  “Oh no”, I replied “it’s just a chat”.  And as soon as I got there, I was instantly nervous.  So nervous that I forgot most of the questions I was going to ask.  Doesn’t bode well for the nerves I am likely to have when going in to be sliced up.

One thing I did remember to  mention was the reaction to the option of the band by the NHS doctor.  She had said that it’s no longer used because it doesn’t work and the risk of complications is so high.  The prof was frustrated but resigned.  He said that it is a difficult procedure if you don’t do it properly – and he’s been doing it since 1990 and almost every day since then.  You have to site it correctly – and he uses some stitches to ensure it stays anchored (slippage being one of those complications).  And, as I had suspected, the fact that it requires quite a lot of very personalised aftercare, makes it impractical for the NHS.  He said that there is pressure for the more drastic forms of surgery as they deal with larger people (as a rule) and with those forms of surgery, they can be in and out without the tinkering necessary for the band.  As he pointed out, there is only a difference in terms of loss of 10-20% (of excess weight) – and why would you put yourself through such drastic surgery for such a little extra ‘reward’.  He said I was too young (bless him) and not sufficiently overweight (again, bless him) to start out at a point which requires 2/3 of my stomach to be removed or my stomach re-plumbed and the very significant impact that would have on me for the rest of my life.  I mentioned the study I’d seen that said when you’re 5 years out (I think) it the loss rate actually converges.  He became very animated in a very Italian way (for, dear Reader, he is indeed Italian) and waved his hands about and agreed – he’d seen this study too.  I felt very confident in him and reassured in the process.  So as of today, I have paid the deposit to secure my slot of 16 June.  Eeek.

The Prof was ambivalent – at best - as to whether I need to do the pre-op diet.  Other surgeons working for the same company are insistent, I believe.  I thinkit’s partially down to the skill of the surgeon, although this is by no means what is said.  I had read that the diet is in part to shrink the liver, so that it’s easier to get underneath it to the stomach.  The Prof thought this was hilarious when I raised it – and gave me to understand that he has no truck with livers getting in the way (and btw, he thought mine would be v pliable.  Not sure how he knows this other than having had a good push around of my abdomen).  He said there is some value in doing it just as a mindset for post-surgery, and in any case, not to go for a blowout meal the night before the op.  I want to do anything and everything that I can to ensure this surgery is a success so on to the diet I will go.  There seems to be some ambiguity over whether it’s a week or 10 days.  I’ll probably do 8 days, not to make it utterly wretched (it’s a VLCD).  I imagine that the night before, the last thing I will want is a blowout meal.  I will be terrified by then, I am quite sure.

16 June is timed so that I am not doing the pre-op diet until after our weekend with friends at the end of May (the other June date was 2 June) and I have a big project which launches on 12 June, so I’ll be able to finish that off.  I’m taking the week after the op off – apparently I should feel pretty well after 3 – 4 days, but I have to say that commuting in London is a bear fight/scrum at the best of times, and I don’t fancy being elbowed in one of the five wounds.  Also, you can’t shower for a week to 10 days until the wound heals over.  My boss is keen that I don’t come back until I can shower!  I can have a shallow bath – and apparently wash my hair over the side of the bath – so I shouldn’t be too rank.  

I haven’t gone into specifics on the nature of the op with my boss.  She is excellent in many respects, but empathy is low and I’m pretty sure she would be scornful about this.  I’ve said it’s too embarrassing to discuss and that I’d rather take leave than have to divulge the nature of the op.  She’s been absolutely fine with this – I don’t have to take leave and although I’ve offered to work from home, she said I should just recuperate.

It is my sister-in-law’s party the following weekend – which is a problem.  I will either have to skip it or just go along and sit quietly (it’s just in a local pub to her).  It’s not something I’d enjoy at the best of times tbh, but is something I feel I should go to if I can (and if I have been able to wash my hair and have a bath/shower!).  In truth, there is never going to be an ideal time (unless I waited until January which is, after all, the misery month).  This way, I should be pretty au fait with what I can and can’t eat and how best to manage life with a band before we go on holiday in mid-September.  As ever, I am all about the secrecy.  The only people I am telling is my husband and you, dear Reader.  Not quite sure how I’m going to manage my mother though, especially as we’re due to go walking in Wales in the last week of July.  I suspect the week won’t happen however, as I’m leaving it to her to sort out!  I shall worry about that if and when it happens.  Okay, I’ll worry about it anyway, but hope it won’t happen.

Wednesday, 18 April 2018

In which I cross my fingers and take a deep breath

As I ‘trailed’ on  Monday, I want to come back to this point about ‘how do you know it will actually work and you lose weight’?  It was a good point Seren made, and I have been worrying about this myself.  The consultant on Monday eventually admitted that there was a number of people for whom the operation didn’t work – she was talking here about the more dramatic surgery.  I’d queried it as she had said you need to follow the diet and exercise a lot (not exactly revolutionary advice, admittedly).  You may (or may not – it was a long time ago) remember my year of running (on the Couch to 5k programme) which yielded no weight loss.  Ditto my couple of years cycling in to work.  She reckoned there were people who surgery would not work for.  I’m assuming that most of these are people who (and she told me this) liquidise a McDonalds meal or just eat ice cream as it’s easy to slide through the physical restrictions.  But even so, that means that there may be people for whom this just didn’t work through no fault of their own.

Obviously it’s a really worrying thought.  Especially since my track record is so pathetically poor.  Can you imagine spending all that money (including our joint money – by which I really mean mostly P’s money), being cut open and still not succeeding?  I would be beside myself with misery and guilt.  Even the thought of it makes me feel anxious.  So I need tomake it work.  Lesley said I sounded hopeful: well, tbh, despite giving myself a VERY stern talking to, every time I start a new diet, I do get hopeful. Every.  Flipping.  Time.  Varying degrees of hope of course, but it’s idiotic of me in any case, given my record.  The thing I’m clinging to here is that I DID lose weight on Lighterlife – admittedly the minimum they said that anyone would lose, but I did – in that 100 days I lost 3 stone.  I’m hoping that this (band) – which is of course another portion restriction – will work.  After the initial spurt of loss (which would be a great motivator), I am resigned to 1-2lbs a week (actually, 2lb would be wonderful) with some STS along the way – even the odd week with a small gain if it’s been a birthday (his or mine), holiday or Christmas.  If it takes 2 years, I don’t care (well, I do a bit) because eventually I’ll get ‘there’.  ‘There’ is defined as the top of the healthy BMI.  That’s the ideal.  But I’d be delighted to be in the stone bracket above that and pretty happy with the one above that.

And apart from the sliced and diced thing, I think it will be easier than LL – I’ll be less hungry and I’ll be able to eat (healthy) real food instead of rank packets of highly synthetic flavoured dust.  I wasn’t fond of milkshakes before, now I can’t face one ever again.  And that was the good packs – the bars!  Ugh, the bars.  I was starving and I still spat it out.  Anyway, I believe for post-surgery they recommend a high protein diet – which suits me.  And I really like salad and vegetables anyway.  I simply have to succeed – because if not, where do I go from here?  There’s no way I could fork out for more surgery – and P is dead against me having the more radical options.  I see his point.  I guess, despite everything, I’m not ready to give up – the very thought of it makes me feel panicky.

Please cross your fingers for me.

Monday, 16 April 2018

Confusion

Although I have pretty much decided to get my band privately, I went to the appointment for surgery on the NHS.  All information being useful.  Now I’m really confused.  The surgeon said I would not be able to have a band: they don’t do them anymore because they have a poor success rate and a high risk of complications.  She said it would either be the sleeve (where a tube is created out of a small part of your stomach and then the rest of it is removed) or the bypass (where they kind of ‘replumb’ you so that food passes straight through the lower intestine – I think…).

I know these two options offer a much higher rate of weight loss – 70-80% of excessive weight compared to 50-60%.  They are both classified as ‘major surgery’.  When I initially talked to P about this, he was very troubled by the irrevocability of having your stomach removed or re-assembled.  I of course had just looked at loss.  But as we talked it through, I could see the advantages of the band:
  1. it’s keyhole surgery, it takes 45 mins and you don’t have to stay in hospital.  You are okay to go back to work after a week (versus a hospital stay of a couple of days and a recovery of three weeks)
  2. pretty much all the way through, you have to put the effort in – it seems to be a bit like an electric bike: you still have to do most of the work but you have back up to keep you going longer and stop it being so much of a slog
  3. but you can eat more or less normally.  Sure not as much but with the other two, for instance, you cannot eat and drink at the same time (and by that, I even mean water).  That’s weird.  And once the novelty wore off, how limiting would that be?
  4. And because you can eat more ‘normally’, you don’t have the inability to take in enough vitamins and minerals through food alone.
  5. if anything were to go wrong, you can have it taken out.  It feels like less of a gamble.

My hunch is that it comes down to the person at the end of the procedure.  Those two women talking about ‘still eating McDonalds’ or fish in batter and not following the advice to puree for a week weren’t following any sort of surgery rules.  I did what anyone in that situation would do – yes, I googled.  I found an article which said that the loss is actually better over a two year period, and for the reasons I thought – ie that the long term discipline of finding what works and sticking to it is less of a quick fix and more of a long term, slow burner.  Anyway, I will have the other side of the story when I meet a professor (no less) who DOES do band surgery – and would do mine if I do go down that route.

Cynically, I wonder if the NHS are loath to do a process which uses up more precious NHS £s (and, to be honest, I have some sympathy with this).  Because the band is fiddly – after c5 weeks you go back and then the band is ‘filled’ with saline – and sometimes defilled until you reach the magic point at which you can eat a reasonable amount without feeling hungry or throwing it straight back up.  Then it’s a process of keeping that level – possibly fills every month.  It only takes about 15 mins, but you can see from an NHS perspective the admin involved would be a nightmare – and they couldn’t be responsive in the same way, you’d get your appointment for 3 months hence and too bad if that didn’t fit with your needs.

Hoping to address Seren’s point tomorrow, as it’s something I’ve been agonising over (from before you said it Seren, don’t worry!) and in an attempt to not do a post so long it should be in chunks to make it remotely digestible. 

Friday, 13 April 2018

Keeping op appearances

I dedicate this post to Stephbospoon!

For someone who works with words everyday, I think I have somehow botched explaining about this op.  I do want it.  I mean, in as far as anyone is looking forward to having five holes put in them, their liver taken to one side and a silicone ring being put around the top of their stomach.  Sure, that process is not likely to be fun – I am quite sure there will be times when I curse myself.  But what I’m focussing on is the results.  It’s not a miracle ‘cure for fatness’, I get that.  And I would absolutely fight for anyone to feel they are entitled to live the life they want, at the weight they are.  It’s just… I can’t.  My husband says it’s a “vanity op” and I know what he means.  But I hate looking like this and I hate how it makes me I feel.  I think if I didn’t have to leave home to go to work, I just wouldn’t leave home much at all.  It makes me feel ashamed, and less than, and apologetic and hyper, super-sensitive.  So actually, I would argue that it isn’t vanity alone – it’s that my self-esteem and my mental health are so closely tied to my appearance (as shallow as I know that is) that it will make me feel so much better.  I am constantly hunched against the words I feel will be chucked my way, or at least the looks of disgust and/or pity.

I know that people say that your size isn’t everything – that you can lose weight and still have the same problems.  I see that.  But in my case, it’s not simply a theory – I know, I absolutely know, that my self-esteem and self-confidence perk up no end at a certain point.  I know this because for a short period of time after Lighterlife when I was still shrinking, I felt better about myself.  Lighter – yes in weight, but also in spirit.  Even with the band, that weight point is a long way away.  But, I get a little hyperburst of swifter weight loss for around 3 months and it seems common to lose a stone a month – and for it then to settle to 1lb-2lbs a month.  That’s what ‘normal’ people have, right?  That 1-2lbs a week.  I am afraid of doing the maths thing (of by X time I could be Y) because it’s never caused me anything but bitter disappointment, but maybe, I can now.  Maybe by the time we go off to Canada and USA in late September I’ll be several stone lighter. Maybe by Christmas I could be within striking distance of that weight bracket where I feel better about myself.  Maybe by this time next year, I’ll be able to see the ‘healthy weight’ BMI from afar.

Currently I’m losing around 1lb a month.  I’m not exaggerating: on my weight app it tells me that I have lost 1lb in the last 30 days, 4lbs in 90 days.  It’s so energy sapping, so utterly emotionally draining to carry on doing what I know to be right, even if every day I get on the Scales of Doom, only for it to laugh at me.  I just want some help.  I don’t want it to be something that happens to me, I want to be actively involved in losing the weight, I want to be able to feel proud of what I’ve achieved.  I am going into this with my eyes (and, okay, my purse) wide open.

I have a consultation this time next week with the surgeon.  It’s less expensive a procedure than I’d feared.  I spoke to P to ask about borrowing the money from savings (they’re joint savings) and paying it back rather than paying interest to a bank.  I hate talking about money, I was shaking.  But I did it.  He listened – and challenged me about some things, useful things – and ultimately agreed.  Then the next day, he said I only had to pay back a third – that the other two thirds I can just have.  After all, he said, he would benefit from it too.  And I know that he means I would be more confident and happier – I know he doesn’t mean aesthetically.  He talked me out of the more radical forms of surgery that I was considering on the basis that you lost more weight, more quickly.  He was right.  The band is harder, longer work – but enables me to live a more ‘normal’ life, now and in the future.  I won’t have to have injections and a cocktail of pills to ensure I have sufficient vitamins and minerals, for example.

So, for me, the end justifies the means.  It’s not for everyone.  I’m a bit ashamed that it is for me, tbh.  Why can’t I just do what everyone else seems to be able to do?  (And okay, I know there are more people like me out there but sometimes it feels so lonely and isolating – when you pick up a magazine to see an article on someone’s “transformation” and they show their typical day’s food before and after the diet and I want to scream and howl and throw things because OF COURSE they’d lose weight, given what they were eating before).  But I can’t and I have to face up to it – I’ve been slogging at a variety of diets for so long.  I knew that when I got engaged, if I couldn’t get slim for a wedding dress, that I couldn’t do it.  Hand on heart, I did everything.  The spectre of that dress haunted me.  I was terrified of looking awful.  Reader, I didn’t look awful – I looked as okay as a fat girl in a dress could look – but I look at the photos to this day and feel sad.  The only thing that stops me having a meltdown about it on a daily basis, is knowing I did everything I could do – that I have nothing to reproach myself about.

Anyway, this has turned into a torrent of getting things off my chest in the form of a gargantuan post.  It probably should have been serialised.  Sorry for trying your patience dear Reader (including Stephbospoon – and SBS, yes the low carb, high fat route suits me best too.  It’s not easy to do but it’s easier to eat less and not feel furiously hungry all the time). 

I’m off for my stepson’s birthday dinner so for tonight at any rate, there will be cocktails and possibly a pudding (as well as a starter and main) – but the place we’re going to does very beautiful but very small portions of a healthy nature.  Have good weekends, one and all. 

Monday, 9 April 2018

A snip

Things are still tough at work.  It’s been a long time since I’ve felt so demotivated and demoralised.  Which, in a way, is a good thing – the fact that it’s so sporadic.  Doesn’t help me for now though.  You never know what is around the corner though and I’m hoping that that corner will come up soon and that it will improve things for me.

So, Friday.  It was a very odd experience and again, really disappointing.  On the plus side, I did not cry.  I almost did but I managed not to.  So I’m proud of that.  The assessor was really nice – she even told me that I was doing the right things and it was very unfair.  One of the things you have to do to qualify for surgery is lose 5% of your current weight.  Given that I’m averaging 0.5-1lb a month, that is a tough thing to achieve.  And they’re clearly not keen on the band (preferring the bypass or the sleeve – both of which are much more radical in terms of surgery and in terms of permanence)  But it’s pretty much a moot point now – the waiting list is 1-2 years.  I don’t even know where I’ll be then.  Well, probably here but really, who knows.  When I was waiting to go in, there were a number of other people at various stages.  I was listening to ladies talking who were post-procedure, oooh they were moany.  There didn’t seem to be any appreciation of how lucky they were to get an expensive procedure for free.  The first woman, who was probably the largest lady I’ve ever seen, said she’d lost 10st – good for her, I thought!  But she went on in tones of aggrievement that since she’d had a hysterectomy, she’d not lost a lb, she then got quite aggressive about not being told about this, not seeing the same person every time she came and she “wanted some answers”.  Lady 2 said she had no complaints about the medical team – then went on to say that she still eats McDonaldses (I hear “McDonaldses” quite a lot and it’s irritating beyond belief).  Oh yes, said lady 1, in tones of ‘well, duh’, she still ate McDonalds too, of course.  Then lady 2 went on to say that she hadn’t followed the advice post-op (you’re supposed to be on liquid for a week, then puree for 1-2 weeks, then mushy food for 1-2 weeks).  Oh no, she said, who’s going to puree a roast dinner?  She isn’t a baby, why would she eat puree.  Lady 1: “Do you like fish?”, Lady 2: “Yeah, in batter”.  Those women have stopped or delayed people who might have taken it all a bit more seriously – it’s an abuse of privilege.  I feel really sorry for the medical team lady 1 was clearly going to tear a strip off too, she clearly didn’t feel she should have to do anything.

Anyway, I shall, I guess, pootle along the process but there are several thing that, I think, is likely to mean it is not to be.  First is the wait: I know that nothing is likely to have changed before then (I wish I felt otherwise) except feeling more desperate – and I’m not sure how much more desperate I can feel without imploding.  Second is the actual process – the team carried out around just over 160 of each of the two other types of surgery but only 3 bands.  This makes me nervous both in terms of familiarity with that op but also in being steered strongly towards the more radical types of surgery.  Thirdly, the ongoing maintenance would be an issue.  And I think this touches on point two.  The sleeve and the bypass are both longer ops with more recovery time but little is required in terms of ongoing care.  With the band, you have to have it filled up a bit (or unfilled) – a process that initially takes quite a bit of fiddling to get right and thereafter probably monthly to 6 weekly adjustments.  So more labour intensive from a medical perspective.  And of course, it’s difficult to get an appointment and it will invariably be at tricky times of the day.

I had read about a company that offers it privately.  They have good reviews, they do a lot of bands so the expertise is kept constantly up-to-date, they do the op in 45 mins and you can go home that day as long as there are no complications and I could go for fills after work or on a Saturday (I believe).  But of course it depends how much it costs.  I suspect (and it’s kind of an educated guess) it’s about £8k.  This is a lot.  I would have to get a loan to pay back over 5 years.  But at this stage, I don’t know what else to do.  I will go for a consultation I guess and see how I feel after that.  It’s hard to think when a ‘good time’ is for doing this too, not too close to when we go on holiday in mid September and I think I would be very sad to do it so I was on mush at Christmas.  Meagre portions I am absolutely resigned too, but sitting at a table with a bowl of mush whilst other people enjoyed Christmas lunch, would be very hard.  And tricky to manage on the secrecy front too.

Thursday, 5 April 2018

Still here

You probably thought I’d gone again, dear Reader – I wouldn’t blame you.  I’ve just had a really busy couple of weeks at work (our busiest time).  I’m also feeling particularly low which brings with it a kind of apathy that means I do the bare minimum of social engaging. 

I had my work evaluation yesterday.  I know I do a good job, and I’ve had effusive (written) praise from the top of the organisation, I have a manager whose style is more stick than carrot.  She knows I’ve applied for another job that is a little more senior than my current role (for a different organisation) and essentially told me I wasn’t up to it.  Apparently I not only need to do my job well, which she reluctantly agreed, but also to “find something every day to do that benefits the organisation”.  “Every day” I queried, incredulous.  Not every day she conceded, but often.  It’s not enough to work to a high standard and they will – apparently – expect more.  I spent the whole of Easter working on my application.  I thought it was a long-shot but now I feel that if I get an interview, it’s pointless putting myself through it. 

This woman is my friend – I alerted her to a job here and helped her to get through the interview.  She was having a horrible time in her previous job and I buoyed her up, told her that it was them, not her and that she should go somewhere where she would be valued.  I know she has to do her job, but she acknowledges – if pushed – that I do a good job.  Just not good enough, apparently.  She has a friend who is very senior at the organisation I have applied to.  She’s too senior to be involved in the application I’ve made – but of course it matters.  They had two jobs a bit below what I’m doing now.  I wish I’d applied for those.

It’s particularly exasperating as there is someone in our small team who is that higher grade already – and she is one of the most useless individuals I have ever encountered.  She shunts her work on to more junior members of the team, seems to do very little but is quick to try and blame others for her mistakes.  My manager – her manager – seems to do nothing to tackle the poor performance.  I honestly can’t understand it and the comparison stings.

I was useless afterwards – luckily it was late afternoon.  I managed not to cry – or at least I had a small, private weep in the loos.  I went home and told P, who was furious.  I knew he was furious for me, but it manifested itself in being furious with me.  He called me a wuss, spineless and a coward.  I am not sure what I could have done.  And yes, I am those things, but it really didn’t help.

So, after 4 hours sleep, I’m back at my desk, feeling as if it’s a supreme effort of will not to just bolt for home, trying to act as if I’m okay for my team.  Today cannot go quickly enough.

And tomorrow I’m off.  Not for a fun reason, but to spend a day being evaluated for weight loss surgery.  I don’t rate my chances of not crying at frequent intervals.  My resilience is paper thin at the moment.  I’ve done all the form (it really was a super fun Easter) and of course I’ll go but it just seems exhausting.

In other weight loss news (and it IS supposed to be a weight loss blog after all) I lost 0.5lb last week and put on 0.5lb the previous week.  So, that’s going swimmingly. 

Hopefully I’ll be less gloomy next time I post.  And will have some interesting things to tell you about the assessment day.  Until then, then.

Thursday, 15 March 2018

Pasta la vista, baby

Numbers have never been my friend.  If there’s a god of maths, he hates me.  I think I have dyscalculia as I find it hard to see groups of numbers more than four digits long, they sort of dance about and I’m likely to switch them around when writing them down, unless I’m very, very careful.

What’s that got to do with anything? I hear you cry, dear Reader.  Well, numbers controlled by Scales of Doom have had the power to ruin my weeks since time immemorial. 

Did I tell you I was diagnosed with diabetes about three years ago?  Well, my blood test result for my 2nd year showed that, with medication, I no longer had it.  I’ve just had my results for this year.  To put it in context – with medication they hope to get your blood sugar after fasting to 43 (no idea 43 whats).  Last year I was 40.  This year I was 100.  Shocking, eh?  Well, I was shocked.  I sat down and thought about what it might be: firstly, my diabetes tracks my weight (which is why my specialist is keen for me to have surgery) and I think I’ve probably put on a stone or even a stone and a half since last year.  Secondly, I have allowed carbs to creep back in.  I think the one that’s probably the biggest problem is pasta.  I like pasta generally.  I like rice but I’m a bit more fussy.  I’m even more fussy about bread.  I eat potatoes infrequently.  But pasta is so easy.  And two of my comfort food dishes are pasta – both made by P, carbonara and spaghetti with meatballs and spicy tomatoes.  I also make a pretty good crab linguine.  

Last year I did monitor my blood sugar levels with a kit I’d bought myself and was ticked off quite unpleasantly by the GP: I had no business doing this, apparently.  But if I had been able to carry on, as I told the (different) GP today, I might have spotted the rise in my blood sugar before a full year passed.  They’re still not keen but I probably need to do it, even if I buy the expensive testing strips myself.  People in the know say you should test first thing in the morning and then before and after every meal (two hours after each meal – but some people also do three hours!).  I’d whip through those strips alright.  And that’s if I remember to do this.  The fasting one is easy to remember – less so, the others.

In other numeric news, I lost precisely 0lb last week.  The last week I lost 1.5lb.  So my usual breakneck whipping through the numbers on the way down.  The site I use says I lose 0.5-1lb a month on average.

My life is governed by numbers.