It has been a saga, but I am cleared for surgery in to days. My a1c is 7.4. I was able to lower it .3 in 12 days. I went in yesterday morning at 7am to get a blood test. The lab is independent from the doctor's office. They said it would be 3-4 hours. At 11:30, I called the doctor's office. They told me I needed to talk to the MA, but she was with a patient then going to lunch. At 2:30, the MA said she hadn't heard from the lab and would call them. At 4, I had a message from her that the only people who could process my lab worked the night shift. We wouldn't know until morning. Finally this morning after calling constantly for 15 minutes, waiting for them to switch the phones on, I got the news. The MA almost cried with relief for me.
So, I am two days pre-op. I started a clear liquid diet. I had to take magnesium citrate (I call it pooping juice). It wasn't as bad as I feared. The trick is drink it ucold and with a straw. My stomach has been gurgly and unsettled. It started working about 1 1/2 hour after taking it.
Tomorrow is clear liquids and my pre-op at the hospital. I will try to keep everyone posted.
Wednesday, July 31, 2013
Friday, July 26, 2013
Lowering a1c
My surgeon's office called me late last week to tell me that my a1c was higher than where the doctor needs it to be for surgery. A1c is a three month measure of your blood sugar. Mine was 7.7. It needs to be 7.5.
I frantically called every medical professional I could think of to help. A nurse at the insurance company told me that she didn't think I had a chance of lowering it. The endocrinologist's office said that they didn't think .2 of a point mattered. They were not going to change any medication, but they could write the surgeon a note saying the .2 didn't matter to them. Real helpful!
A dietician at the hospital was the one who was able to help me. First of all, the goal is to get the sugar down. Second of all, labs can vary by .2 on the same day. Her theory is that I dropped my carbs too low. Since I wasn't eating carbs consistently throughout the day, my body was confused about producing insulin. When my liver dumps sugar at night, my body didn't make enough insulin to counteract. The dietician's suggestion is to eat one carb (15g) at each meal four times a day. I also need to do 10-20 minutes of hard exercise after each meal. I have been following her method. I am sore and tired, but my fasting sugar has dropped 45-50 points!
The surgeon's office has given me until Tuesday to do what I can. I go in Tuesday morning for a blood test. I will know by the end of the day. If it is a go, I start prep on Wednesday and have surgery on Friday.
So, what exactly is a1c and can I really change it that much in just under two weeks? We all, diabetics and non diabetics have some glucose floating around in our blood stream. Some of our red blood cells pick up the sugar and become glycated (real word, I swear). If you are not diabetic, about 5% of your red blood cells are glycated, meaning your a1c is 5.0. Red blood cells live 120 days. Therefore, a1c is a 3 month reading of your blood sugar control. Obviously not all of your red blood cells regenerate at the same time. I have read that 50% of your a1c is based on the last four months and more heavily weighted on the last two weeks. So there is hope for me.
I have learned a lot from this. Thank you to my friends who have helped me with these realizations. My surgeon may seem like an obstacle to me, but really she is my protector. Not all surgeons are this strict, but not all have her success rate either. This is all for my best health. My intent of having surgery is to lose weight and lower my blood sugar. If surgery is delayed a few weeks, it isn't a delay of my goals. I will continue to lose weight and lower my blood sugar until I have surgery. God is on my side always. The timing will work for my best benefit.
So Tuesday will be a very long day of waiting for me. If you know me at all, you'll understand that having the plans up in the air stresses me out (of course I have to try not to stress because that raises blood sugar). I will take all the prayers and well wishes I can get. I'll update when I know.
I frantically called every medical professional I could think of to help. A nurse at the insurance company told me that she didn't think I had a chance of lowering it. The endocrinologist's office said that they didn't think .2 of a point mattered. They were not going to change any medication, but they could write the surgeon a note saying the .2 didn't matter to them. Real helpful!
A dietician at the hospital was the one who was able to help me. First of all, the goal is to get the sugar down. Second of all, labs can vary by .2 on the same day. Her theory is that I dropped my carbs too low. Since I wasn't eating carbs consistently throughout the day, my body was confused about producing insulin. When my liver dumps sugar at night, my body didn't make enough insulin to counteract. The dietician's suggestion is to eat one carb (15g) at each meal four times a day. I also need to do 10-20 minutes of hard exercise after each meal. I have been following her method. I am sore and tired, but my fasting sugar has dropped 45-50 points!
The surgeon's office has given me until Tuesday to do what I can. I go in Tuesday morning for a blood test. I will know by the end of the day. If it is a go, I start prep on Wednesday and have surgery on Friday.
So, what exactly is a1c and can I really change it that much in just under two weeks? We all, diabetics and non diabetics have some glucose floating around in our blood stream. Some of our red blood cells pick up the sugar and become glycated (real word, I swear). If you are not diabetic, about 5% of your red blood cells are glycated, meaning your a1c is 5.0. Red blood cells live 120 days. Therefore, a1c is a 3 month reading of your blood sugar control. Obviously not all of your red blood cells regenerate at the same time. I have read that 50% of your a1c is based on the last four months and more heavily weighted on the last two weeks. So there is hope for me.
I have learned a lot from this. Thank you to my friends who have helped me with these realizations. My surgeon may seem like an obstacle to me, but really she is my protector. Not all surgeons are this strict, but not all have her success rate either. This is all for my best health. My intent of having surgery is to lose weight and lower my blood sugar. If surgery is delayed a few weeks, it isn't a delay of my goals. I will continue to lose weight and lower my blood sugar until I have surgery. God is on my side always. The timing will work for my best benefit.
So Tuesday will be a very long day of waiting for me. If you know me at all, you'll understand that having the plans up in the air stresses me out (of course I have to try not to stress because that raises blood sugar). I will take all the prayers and well wishes I can get. I'll update when I know.
Tuesday, July 9, 2013
If you can lose weight, why choose surgery?
Different doctors have different ideas on a pre-op diet. The reason for a pre-op diet is to shrink the liver to make surgery easier. I know a lot of doctors have you eat your normal diet and then two weeks before surgery you go on a liquid diet. My doctor doesn't do it this way. When you start the program, you are asked to lose 5% of your body weight before surgery. You are placed on a restricted calorie diet, usually under 1200 calories a day. In addition to various classes you are required to attend, you meet with a dietician who helps you adjust your diet. You are also asked to start changing your habits. No straws or carbonation. The air bubbles can expand your new stomach. No drinks with meals. Your new stomach is so small that you need all the room for fuel. Limit caffeine. Caffeine dehydrates you. Getting enough water will be a challenge with your new stomach. Eat high protein, low carb, low fat.
I've already been doing most of these, but I found that 1200 calories is a lot less than you think. I started using a calorie tracker app. It was a big shock to me.
So if I can lose weight on a diet, why choose surgery? Well, first of all, did you catch that 1200 calories is a lot less than you think? I can sustain dieting this way for a short period of time and lose 20 or 30 lbs., but than either I hit a plateau or a holiday or party or something. As soon as I eat more than 1500 calories a day, I gain weight. Before choosing surgery, I thought back on my dieting life. The only time I have lost weight is at 1200 calories. If I eat 1500 calories, I maintain. More than that, I gain. I can't seem to exercise enough for it to change my calorie count, although I am sure that if I exercised less I would gain. The only time I can really eat whatever I want is when I am at Disney and walking about 10 miles a day. See, I should just move there and life would be perfect! Once I hit a plateau or other event and my calories go above 1500, I gain. If you are a chronic dieter, you know that 1500 isn't a whole lot either. This is why Weight Watchers and other programs haven't worked out for me. Once I lose my weight, the surgery will still keep me at low calories which will help me not gain it back.
I think each person needs to learn to listen to their body and find what works for them. Some bodies do well vegetarian. Some of us need more protein. How many calories does your body need? What kinds of exercise do you like? Really all of us need to figure out what works and what we can sustain. If I need protein, becoming a raw vegan may not be my best option. Yes, I've tried that too!
I have met several people who have had weight loss surgery and have had a hard time with it. Some have been successfull, but feel like if they learned what their body needed before surgery, they could have lost weight without it. Some have not been successful because the waited until after surgery to change their lifestyle and found they couldn't sustain it.
I went to the doctor yesterday and was up 2#. Truthfully, I can lose or gain 2# in water a day. I was frustrated because the doctor questioned my committment to the program and I had to defend myself, but really, don't I want a doctor who will make sure I am ready for this huge lifestyle change?
I've already been doing most of these, but I found that 1200 calories is a lot less than you think. I started using a calorie tracker app. It was a big shock to me.
So if I can lose weight on a diet, why choose surgery? Well, first of all, did you catch that 1200 calories is a lot less than you think? I can sustain dieting this way for a short period of time and lose 20 or 30 lbs., but than either I hit a plateau or a holiday or party or something. As soon as I eat more than 1500 calories a day, I gain weight. Before choosing surgery, I thought back on my dieting life. The only time I have lost weight is at 1200 calories. If I eat 1500 calories, I maintain. More than that, I gain. I can't seem to exercise enough for it to change my calorie count, although I am sure that if I exercised less I would gain. The only time I can really eat whatever I want is when I am at Disney and walking about 10 miles a day. See, I should just move there and life would be perfect! Once I hit a plateau or other event and my calories go above 1500, I gain. If you are a chronic dieter, you know that 1500 isn't a whole lot either. This is why Weight Watchers and other programs haven't worked out for me. Once I lose my weight, the surgery will still keep me at low calories which will help me not gain it back.
I think each person needs to learn to listen to their body and find what works for them. Some bodies do well vegetarian. Some of us need more protein. How many calories does your body need? What kinds of exercise do you like? Really all of us need to figure out what works and what we can sustain. If I need protein, becoming a raw vegan may not be my best option. Yes, I've tried that too!
I have met several people who have had weight loss surgery and have had a hard time with it. Some have been successfull, but feel like if they learned what their body needed before surgery, they could have lost weight without it. Some have not been successful because the waited until after surgery to change their lifestyle and found they couldn't sustain it.
I went to the doctor yesterday and was up 2#. Truthfully, I can lose or gain 2# in water a day. I was frustrated because the doctor questioned my committment to the program and I had to defend myself, but really, don't I want a doctor who will make sure I am ready for this huge lifestyle change?
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