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?
Friday, June 28, 2013
Healthy, not thin
Since today is the day my surgery was originally scheduled for, I thought it appropriate to blog. First off, God blessed me by having the surgeon's office need to reschedule. Last week I was hit with a horrible cold. This week we have been battling a sometimes working air conditioner. Yesterday it hit 105 here. Everything is working now, but I can't imagine how stressed both my husband and I would be if I also was having surgery.
People keep telling me that I don't look heavy enough to have this surgery. I think it is partially because I am fit, but partially that we all compare ourselves to others. The surgeon told me that we don't know what normal looks like anymore. Teaching water aerobics means that I have a lot of muscle mass. Unfortunately, I also have a lot of fat on top of it.
The other question I get is how much weight do I want to lose or what is my goal weight. Honestly, I am not sure. It seems so far away to me right now to choose a number. Really, what I want is to get my body fat percentage down. A number on the scale doesn't take into account if those pounds are fat or muscle.
It's interesting to note that a lot of the focus is on how I look now and how I will look later. My goals are more based on health. My main reason for choosing surgery is get rid of diabetes and sleep apnea. The physical things I pray for are health and vitality. I want to have more energy. I want to not be afraid of physical activities. I want to be able to go up the stairs at a waterpark 10 times in a row and not have my blood sugar plummet (or have my knees creek, or have my thighs scream, or be huffing for breath). I feel like, my body will settle wherever is best for me. Looking good will be a bonus, but being thin is not my goal. My goal is to get this body strong and healthy.
People keep telling me that I don't look heavy enough to have this surgery. I think it is partially because I am fit, but partially that we all compare ourselves to others. The surgeon told me that we don't know what normal looks like anymore. Teaching water aerobics means that I have a lot of muscle mass. Unfortunately, I also have a lot of fat on top of it.
The other question I get is how much weight do I want to lose or what is my goal weight. Honestly, I am not sure. It seems so far away to me right now to choose a number. Really, what I want is to get my body fat percentage down. A number on the scale doesn't take into account if those pounds are fat or muscle.
It's interesting to note that a lot of the focus is on how I look now and how I will look later. My goals are more based on health. My main reason for choosing surgery is get rid of diabetes and sleep apnea. The physical things I pray for are health and vitality. I want to have more energy. I want to not be afraid of physical activities. I want to be able to go up the stairs at a waterpark 10 times in a row and not have my blood sugar plummet (or have my knees creek, or have my thighs scream, or be huffing for breath). I feel like, my body will settle wherever is best for me. Looking good will be a bonus, but being thin is not my goal. My goal is to get this body strong and healthy.
Wednesday, June 19, 2013
All for the best
I came home from vacation this Monday to a letter from my insurance company. Apparently the doctor's office and the insurance company had a misunderstanding of when my surgery could take place. The doctor's office can't even submit a request to insurance until July 10. Last time I checked, July 10 is AFTER June 28, so no surgery June 28. The doctor is already booked for July. My new date is August 2. Needless to say I was extremely disappointed. Was, you say? Well, a few hours after talking to the doctor's office, I started getting a tickle in my throat. Now it's turned into a full blown nasty cold. I have hopes I will be better next week, but I am sure it's probably better that I am not having surgery next week.
I truly believe that God has a plan that is better than mine. Even though I feel like my plan has less stress attached and it was a better time table, God has me covered. When I recover from this cold, I now get to call subs for my classes again (most are vacationing in August), work out arrangements for the girls (dance team kicks off the end of July), and figure out how to recover during the beginning of the school year; but I definitely feel it all happens the way it is supposed to.
I truly believe that God has a plan that is better than mine. Even though I feel like my plan has less stress attached and it was a better time table, God has me covered. When I recover from this cold, I now get to call subs for my classes again (most are vacationing in August), work out arrangements for the girls (dance team kicks off the end of July), and figure out how to recover during the beginning of the school year; but I definitely feel it all happens the way it is supposed to.
Thursday, June 13, 2013
Firsts and lasts
First: My surgery is scheduled for Friday, June 28.
Last: I just bought hopefully the last refill on my diabetes medicine. I didn't even get a full month. The doctor is very confident that I won't be taking it when I leave the hospital.
Last: I just bought hopefully the last refill on my diabetes medicine. I didn't even get a full month. The doctor is very confident that I won't be taking it when I leave the hospital.
Three types of weight loss surgery - A lay person's perspective
Keep in mind that I am not in the medical profession and in fact am a bit squeamish. This is all from my perspective.
There are three common weight loss surgeries these days, lap band, gastric bypass, and gastric sleeve. Here is a brief description of each with pros and cons. If I was more blog literate, I could post illustrations, but let's face it, I'm not.
The lap band is basically a big rubber band that is filled with liquid that is inserted around your stomach. The more liquid, the tighter it squeezes your stomach. You can adjust depending on how much or little you want to be able to eat. I have heard of people abusing this by expanding their band so they can eat more on vacation. This surgery used to be very desirable, but a lot of surgeons don't do them anymore. There have been a lot of problems with the bands getting clogged up and/or slipping down the stomach and causing problems. Studies also show that lap band patients are actually hungrier than non-surgical people. So basically you are hungrier than before and can't eat much. A lot of band patients have their band removed for various reasons. The band patients average a loss of about 35% of their extra weight in the first year. Vitamins should be taken because of limited food intake.
Pros: Reversible, least invasive. Cons: Still hungry, problems, least weight loss success
In a gastric bypass, the doctors form a small pouch in your stomach and re-route part your intestines to the pouch. With a gastric bypass, part of the digestive process is bypassed. The part of the stomach that isn't being used contains hunger hormones so you aren't hungry. The pouch is small and can't hold much food. Some patients report that their tastes change. I think it has something to do with how the pouch goes straight to the intestines. Because the process of digesting sugar has changed, bypass patients can have what is called dumping syndrome. Basically if they eat a high sugar or high fat meal, they may get light headed and their heart may race. Then the food is "dumped", resulting in a very quick run to the bathroom. Because the way sugar is digested has changed, this surgery reverses diabetes in over 85% of patients. In fact, studies are being done to perform the surgery without the stomach pouch in normal weight patients to reverse diabetes. The way they do this surgery has changed from the early years. Apparently in the beginning, too much of the digestive process was bypassed resulting in malnutrition. The way this procedure is performed has changed. There is still malabsorption, but the surgery is much safer. Bypass patients can expect to lose 70% of their extra weight in the first year. Vitamins should be taken because of limited food intake.
Pros: Reversible, most weight loss, not hungry, can reverse diabetes. Cons: Most invasive, dumping syndrome, taste changes
The surgery I opted for is a gastric sleeve which is kind of in between the lap band and gastric bypass. Basically, doctors lop off 85% of the stomach and sew it back up. The stomach is then a small tube about the size of a banana. The digestive process is not disrupted. The sleeve started as a pre-surgery to the bypass in patients that were very large or too at risk for the bypass. The sleeve would help the patients lose enough weight so that the bypass surgery could then be done. Studies found that a lot of patients were so successful in losing weight with the sleeve that they opted not to have further surgery. The part of the stomach that is removed has the hunger hormones so you are not hungry. The stomach is small and can't hold much food. No studies have been done to see how many diabetics are in remission from this surgery, but it does cure diabetes in a lot of cases. This is thought to be due to weight loss and not the digestive process like it is for the bypass. Sleeve patients can expect to lose 60% of their extra weight in the first year. Vitamins should be taken because of limited food intake.
Pros: Not hungry, normal digestion, might reverse diabetes. Cons: Not reversible.
There are three common weight loss surgeries these days, lap band, gastric bypass, and gastric sleeve. Here is a brief description of each with pros and cons. If I was more blog literate, I could post illustrations, but let's face it, I'm not.
The lap band is basically a big rubber band that is filled with liquid that is inserted around your stomach. The more liquid, the tighter it squeezes your stomach. You can adjust depending on how much or little you want to be able to eat. I have heard of people abusing this by expanding their band so they can eat more on vacation. This surgery used to be very desirable, but a lot of surgeons don't do them anymore. There have been a lot of problems with the bands getting clogged up and/or slipping down the stomach and causing problems. Studies also show that lap band patients are actually hungrier than non-surgical people. So basically you are hungrier than before and can't eat much. A lot of band patients have their band removed for various reasons. The band patients average a loss of about 35% of their extra weight in the first year. Vitamins should be taken because of limited food intake.
Pros: Reversible, least invasive. Cons: Still hungry, problems, least weight loss success
In a gastric bypass, the doctors form a small pouch in your stomach and re-route part your intestines to the pouch. With a gastric bypass, part of the digestive process is bypassed. The part of the stomach that isn't being used contains hunger hormones so you aren't hungry. The pouch is small and can't hold much food. Some patients report that their tastes change. I think it has something to do with how the pouch goes straight to the intestines. Because the process of digesting sugar has changed, bypass patients can have what is called dumping syndrome. Basically if they eat a high sugar or high fat meal, they may get light headed and their heart may race. Then the food is "dumped", resulting in a very quick run to the bathroom. Because the way sugar is digested has changed, this surgery reverses diabetes in over 85% of patients. In fact, studies are being done to perform the surgery without the stomach pouch in normal weight patients to reverse diabetes. The way they do this surgery has changed from the early years. Apparently in the beginning, too much of the digestive process was bypassed resulting in malnutrition. The way this procedure is performed has changed. There is still malabsorption, but the surgery is much safer. Bypass patients can expect to lose 70% of their extra weight in the first year. Vitamins should be taken because of limited food intake.
Pros: Reversible, most weight loss, not hungry, can reverse diabetes. Cons: Most invasive, dumping syndrome, taste changes
The surgery I opted for is a gastric sleeve which is kind of in between the lap band and gastric bypass. Basically, doctors lop off 85% of the stomach and sew it back up. The stomach is then a small tube about the size of a banana. The digestive process is not disrupted. The sleeve started as a pre-surgery to the bypass in patients that were very large or too at risk for the bypass. The sleeve would help the patients lose enough weight so that the bypass surgery could then be done. Studies found that a lot of patients were so successful in losing weight with the sleeve that they opted not to have further surgery. The part of the stomach that is removed has the hunger hormones so you are not hungry. The stomach is small and can't hold much food. No studies have been done to see how many diabetics are in remission from this surgery, but it does cure diabetes in a lot of cases. This is thought to be due to weight loss and not the digestive process like it is for the bypass. Sleeve patients can expect to lose 60% of their extra weight in the first year. Vitamins should be taken because of limited food intake.
Pros: Not hungry, normal digestion, might reverse diabetes. Cons: Not reversible.
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