Preop Diet Fears

We all know the drill....the dreaded preop "DIET" - that's right...diet.  THE four letter word.  The worst of the worst.  But, this time it's different.  Or, it's supposed to be!

My program requires that I follow a 1000 calorie diet for 2 weeks prior to surgery.  The 1000 calories are to come from 3 meal replacements (aka shakes, bars etc) and one real meal.  In addition, there are also a host of "free items" that I can choose from daily.  The free items are split into two categories...those that are limited to 3 times per day and those that may be eaten in any amout.

Examples of items that I can eat 3x per day: 1/4 cup salsa, 1 tbsp fat free mayo, ketchup, fat free or low fat salad dressing

Examples of items that may be eaten in any amount: broth, certain veggies, sugar free gelatin, mustard, tabasco and horseradish.  I don't know about you but I just can't wait to sit down with a big bowl of horseradish and pretend it's Ben & Jerry's!  Kidding.


My categories for my real meal include: protein, carbs/snacks, veggies, dairy and fat.  Some examples of real food items are:

• Protein: 4oz of baked chicken or turkey, 4oz lean deli meat, 1 cup egg beaters, 4oz low fat cheese, 1 cup low fat cottage cheese
• Carbs/snacks: 3 cups no butter added or light popcorn, 1 small dinner roll, 1/3 cup hummus, 3/4 cup dry, unsweetened cereal
• Veggies: 1 cup cooked veggies or veggie juice, 2 cups raw veggies
• Fat: 2 tbsp low fat salad dressing, 1 tsp margarine or oil (canola or olive)

You know what - this doesn't seem that bad...I think I can make this work.  Santa and I went shopping today and I loaded up on a bunch of preop diet items.  I purchased several different food items in addition to some new slippers to take with me to the hospital and a sippy cup and baby utensils to use postop.  My nutritionist was the one who suggested those to me.  In addition to never feeling full, one of my biggest problems has always been that I take HUGE bites...and, I don't chew nearly enough.  So, over the next two weeks, the plan is to follow my preop diet, practice taking small bites and to chew my food thoroughly!

In addition to the food changes, I am also required to exercise...30 minutes per day for at least 4-5 days per week.  I'm going to shoot for 7.  Got 30 minutes on the treadmill this afternoon - I felt great!  I saw my surgeon a few days ago and he really stressed that the better shape I'm in prior to my surgery date, the better I will feel after surgery.  I know I'll be miserable but I'm determined to be the best damn miserable I can be!

Life as a VSG Preop

Since late fall, 2009, at the time I decided to go forward with the VSG, I've tried a few different products that I hope to still use after surgery.  I've read time and time again that tastes and preferences change after surgery so I'm not planning to "stock up" on all that much...but, at least trying these items have helped in my preop lifestyle.  I also plan to use several of these for my 2-week preop diet (more about that it a later post).  Here are a few of the things I've tried and/or things I've incorporated into my preop lifestyle and my reviews...

Syntrax Nectar Protein Powder:  Chocolate Truffle & Cappuccino 

Rating:  A

This stuff is good.  Well, at least these two flavors.  There are a few other flavors like I like as well but these two would be my favorites.  I am very particular in how I prepare them though.  I always start with 1 cup of milk (I use 2% Real Goodness Lactose Free OR Almond Milk)...to that I'd add one or more of the following: to the chocolate....1 packet NesCafe instant coffee, a few ice cubes, Hershey's Sugar Free Chocolate Syrup, sugar free caramel flavoring, 1 teaspoon of all natural peanut butter, 1/2 a banana, 3-4 frozen strawberries, 1/4 cup frozen raspberries, 1 packet splenda ~ to the cappuccino...1 packet NesCafe instant coffee, a few ice cubes, Hershey's Sugar Free Chocolate Syrup, 1 teaspoon cocoa, 1 packet splenda.  Sometimes, if I wanted to mix it up a bit, I'd use 1/2 scoop of each powder!  Yum! The tubs are 2lbs each and sell for anywhere between $24-$40.  I almost always order my Syntrax Nectar from Nashua Nutrition - they are quick, reasonably priced and you can usually find a coupon code online!

Premier Protein Read-to-Drink (RTD) Protein Shakes

Rating:  B

I never imagined I'd be able to tolerate an RTD shake.  But, when I read review after review about how people loved these shakes from Costco, I figured I'd better give them a try.  The nearest Costco is a good hour+ from us.  So, Santa and I loaded ourselves into the sleigh and headed out.  Of course, you need to be a member of Costco SO we had to purchase a membership first.  After that, I purchased a case (18 drinks) of chocolate Premier Protein RTD shakes for around $32.  My first experience with them wasn't so hot.  There is a drink "opening" for lack of a better term covered with foil.  There is no straw to punch through this foil as it was designed for you to remove the foil and drink from the opening.  So, deciding that I'd enjoy my shake on the way to work...I went to open it in my vehicle.  Yeah, mistake #1.  Darn thing splashed all over me.  Regardless, they're not that bad.  My Syntrax drinks are much more tasty but I liked the idea of the convenience of these things.  And, for an RTD, they're not horrible.  I have yet to try the vanilla but hope to in the near future.  I also hear that they can be "doctored up" as well....haven't tried this though!

Isopure Zero Carb RTD Beverages

Rating: C-

I had really high hopes for these drinks!  I purchased the variety pack (shown above x 2 - 12 drinks per pack) through GNC for around $47.  The drinks are huge at 20 fl oz and pack a whopping 40g of protein per bottle!  I found that they are best when you drink them VERY cold - some people even drink them over ice...I never did but I'm not sure it would change my issues with them.  Out of all the flavors, I liked the Blue Raspberry and Grape the most.  What I hated about them...the protein within the beverages tends to coagulate after so long....so, I found myself having to constantly mix them up.  What's worse...they tend to leave the metallic feeling in your mouth along with some sort of nasty film inside your mouth and on your tongue.  Enough of a film that you can (TMI) scrape it off with your teeth.  Yes, I found it to be that bad.  All that being said, the amount of protein is really incredible and I plan to have a few around for post op...just in case.  And, who knows, maybe my tastes will change enough that they metal taste and film won't bother me as much.

ProteinBlitz Drinks

Rating: A

Love these things...SO far.  I first ordered these a couple of weeks ago from GNC. At $37 for 12 bottles, the price is about average for a RTD protein drink.  My hopes for them weren't so high as I hadn't had much luck with the other clear protein drinks (Isopure).  I was pleasantly surprised after my first sip!  Thus far, I've only tried the Punch flavor but I hear the others are just as good.  Back to that first sip....it was sweet.  Almost like an extra sweet Gatorade.  But, it was GOOD!  And, the best part about it...no metallic taste to me nor any weird kind of film left in my mouth!  Like the Isopure, the bottles are big at 20 fl oz!  But, these are much better, IMHO.  The best thing about them??  GNC is currently offering Buy One Get One Half Off ($36.99 for the first) and $4.99 flat rate shipping for all RTDs! So, that's about $2.50/bottle plus tax if applicable.  You can find the deal here: GNC Protein Blitz.  Update:  Just ordered my OrangeMango and Grape via the Vitamin Shoppe as their deal was the better of the two.  A case at the VS is on sale for $28.99 - I ordered 2 cases and got 20% off and $4.99 shipping....in addition to 6% cash back at Ebates!

Various Protein Samples

Rating: A+
Another reason why I love Nashua Nutrition is because you can order TONS of protein powder samples from them for only $1.95 each....that's not bad!  There are so many options to try from all different brands!  While it can be a bit pricey, it's sometimes easier to do this than get stuck with an entire 2lb tub of something you hate!  Love their samples and don't even mind the price!  I fully intend to order more just prior to surgery.



Vitamins & such...

Note: I am not a doctor, a nurse or a medical professional of any sort.  The vitamins/minerals that I take are at the advice of my bariatric team after several tests which determined that I am deficient in several areas. As with anything, check with your program/surgeon/doctor/nurse prior to taking any vitamins/minerals/supplements.  Here are my reviews on the things I take...

Target Up & Up Childrens Chewable Multi Vitamins

Rating: A

One of the first things my nutritionist and program director had me do was to find a multivitamin.  They suggested Flintstone children's chewables.  Being someone who is very price conscious (aka cheap!), I checked them out while at Target one night...as it turned out, they were exactly the same as the Target brand chewable...so, that's what I purchased.  They're not bad at all and come in fun zoo shapes!  Now, one may say that Flintstones and/or a generic is not sufficient for those of us undergoing bariatric surgery and will, instead, suggest an adult Centrum and/or a different bariatric vitamin.  That said, I would tell each person to compare your vitamins...if you have any questions at all...do your research!  I certainly have and have found that these do (for me) what I need them to do.  I'm certain my program director, surgeon, MD, bariatric nurse & nutritionist wouldn't have started me on them if they thought they were inferior.  Anyway, I love them - the red is my favorite!  I will say I tried other multivitamins and wasn't so fond of them.  I love Puritan's Pride as they often have Buy 1 Get 2 deals...sadly, their children's chewable multis are horrid!  I suffered through 3 bottles.

Puritan's Pride Sublingual B-12 500mcg

Rating: A
I take B-12 because I was found to be deficient in B12.  Prior to take 500mcg per day, I had to go for injections.  My levels seem to be stabilized now although who knows what will happen after surgery...I may need a bit of an adjustment to the amount I'm taking.  Anyway, these are good...very small and only take a minute or so to dissolve under the tongue.  Check out Puritan's Pride for other items as well!

Bariatric Advantage Strawberry Flavored Chewable Iron-18mg

Rating: B+
Again, my labs showed that I needed to take an iron supplement and these were suggested by my bariatric team.  They're good...the only reason I rated them a B+ instead of an A is because I find them to be quite hard.  I purchase them right from Bariatric Advantage and have always received great service!


VitaFusion Vitamin D3 Gummy Vitamins

Rating: A+

Like the rest of the world, I am Vitamin D deficient as well!  These were also suggested by my bariatric team after my labs were reviewed.  I love, love these Gummy Ds!  Fruity, gummy, perfect!  Beware though...if you have a gummy addiction, these could be dangerous!  I usually order mine through drugstore.com or Amazon.



* * * * * * * * * * *

That's about it for now!  Oh, another thing...while I didn't link to drugstore.com above, I use them for several different things.  They, along with several online stores I shop at, are listed on Ebates.  If you're not familiar with Ebates, check it out!  What it boils down to...you earn cash back on your online purchases.  That's it!  And, remember, when you're as frugal (aka cheap!) as I am, every little bit I can save helps! 

Have a product that you think I may enjoy??  Please, let me know! And, if you try any of the items I have, I would love to hear your reviews as well!  :) 

Looking forward...

Ahhh...if I was only thin, I would...  Or, when I lose weight, I will....  For me, I know I've said these things more times that I can count.  So, I've decided to make a list of the things I'm looking forward to...

~feel comfortable in public without thinking that everyone is staring at me
~wear a pair of shorts (it's been almost 19 years)
~wear a bathing suit (you guessed it...almost 19 years)
~ride a horse without fear that I will break it's back
~make love to my husband and feel comfortable doing so
~travel & enjoy life
~go to Disneyworld and know I can ride the rides
~feel comfortable in an airplane seat/have the belt buckle and know my jelly roll doesn't spill into the seat next to me
~walk up the stairs without gasping for air and without hurting
~feel full after a decent sized meal
~shop at a normal people clothing store
~never have to worry about whether or not a chair will hold my weight
~fit comfortably in a restaurant booth
~not be embarrassed to be seen in public
~increase the length of my life
~purchase life insurance
~feel better
~look better
~feel confident in public
~walk, run and feel good enough to exercise
~wear a dress
~redo my wedding photos
~cross my legs
~dance and feel (& look!) good doing so

I'm sure I'll add to this list in the days/weeks/months to come.  And, I'm looking forward to it!  What's on your list??

The realization

I can't do this on my own.  I can't lose the weight.  I have lost control and I need help.

Not many people want to admit those things.  I never thought I could admit those things....but, I'm very thankful I finally can.  Doing so has allowed me to seek help.  Not facing the realization that I couldn't do it alone held me back (for so long) from seeking the help I needed.  Why did I do that to myself for so long?  Depression.  Embarrassment. A vicious cycle.

I remember the day I brought up surgery to my parents.  I didn't even know about VSG at the time.  RnY was out of the question.  I was thinking the Lap Band was for me - imagine that!  We were in a chemo unit at Dana Farber - Dad was on round 3 or 4, I don't remember.  How horrible of me to be thinking of myself.  I had hoped that once Dad was "cured" of his ailments and Mom's surgeries were all out of the way, I would have some time to focus on me.  Mom thought the idea of surgery was a bit extreme.  Dad didn't say much.  He wasn't the type to.  But, I knew then - like I know now - that Dad wanted me to do what was best for me - and, my health.  I often think of the future and wish he was still here.  I imagine being much thinner and wishing that Dad got to know the thinner me.  Ahhh...our wondering minds.

Dad's illness had it's ups and downs over the next several months.  My thoughts of surgery were put on the back burner.  I had spoken to Santa about surgery a few times and had even let him know it was something I was considering.  He was supportive from day one.  "Whatever you want to do" - again...what did I do to deserve him? 

I had already been on OH, once or twice, in 2004.  After mentioning it to Mom, Dad & Santa, in 2007, I actually created an OH ID.  I visited for a month or so, decided I just couldn't do it and gave up - or, convinced myself that I could "do it the old fashioned weigh" one more time. So, in 2007, I got back on the Weight Watchers train.  It didn't take long - the train fell off the track.

I attended my first bariatric information session in late October, 2009.  My program requirements were as follows:

• attend two information sessions
• attend one-on-one's with: program director, program nutritionist, program nurse, program social worker
• attend group nutritionist session
• surgeon meeting
• group session with program nurse
• testing: prelim labs, EKG, ultrasound
• lose 10 pounds

By January 2010, I had completed all of my requirements and my program director submitted my VSG surgery to my insurance.  A month later - denied.  Not the surgery - the surgeon and the location.  The surgeon and hospital were not covered on my plan.  I appealed, on my own, and my appeal was also denied. After renewing my insurance and assuring that my hospital and surgeon would be covered under my new plan, I was required to redo a few of the program steps I had completed the year prior.  I spent October getting back on track and completed my program requirements. Again, my program director submitted to my insurance company and, again, my surgery was denied...this time: the VSG is "experimental and/or investigational" as my early November denial letter stated.  I was crushed.

At this point, I knew it was my last shot...I couldn't afford to not do this.  And, I knew it was balls to the wall.  If I wanted this tool, I was going to have to fight for it.  And, that's what I did.  I enlisted the assistance of the Obesity Law & Advocacy Center.  I prepared mounds of paperwork for them.  In a way, I almost felt bad that they had to deal with all my "stuff" - even though I was sure they had done this a million times before, I knew I had to be prepared.  And, I was.  It took me nearly a month and a half to get everything together and send everything off to them.  They submitted a 60+ page appeal to my insurance company in mid-January.  My denial was overturned and I was approved for surgery the second week in February 2011.  Needless to say, I had a "Holy Shit!" moment.  The range of emotions were overwhelming...scared, excited, thrilled, nervous, scared shitless. 

My VSG is scheduled for March 15, 2011.  As I said to Santa "This is the end of my life as I know it."  To which Santa replied "Or, just the beginning!"  I hope he's right!

Claus v. 1.1

So, getting back to me...

You know the drill....I've lost and found 100 pounds more times than I care to remember.  In my adult life, the maximum amount of weight I've ever lost was 50 pounds.  On Atkins.  Hardcore Atkins.  Not long after my RE informed me of my issue with today's PCOS, I joined a wonderful group of women over on the FIRST ever PCOS support site: pcosupport.org.  Now, keep in mind that this was during the internet's infancy.  Chat rooms were just beginning, message boards were first starting...this was really weigh back when!  Anyway, finally having women that I could relate to and who could relate to me was such a wonderful feeling!

My research and new found support system led me to realize that carbohydrates were the devil.  They were making me fat.  Well, that was reason #1.  I ate Atkins up.  Bought all the books, tracked every carb I put into my body, tested my ketones and I lost weight...10 pounds a month for 5 months.  I was finding the body I had lost in high school.  I was thrilled!!! And, I was miserable.

 In order for me to lose, I followed the following:

• 96oz (minimum) of water per day
• no more than 20g of carbs per day

In addition, I took the following supplements daily: chromium picolinate, l-carnitine, CoQ10 and a few others that I can't remember some 20 years later.  Now, let me stop right here and ask a question.
Do you know what 20g of carbs looks like?  If you've ever tried one of those low-carb fad diets...you know exactly what I mean.  It's not much, I'll leave it at that.  I ate a lot of steak, bacon, eggs, sausage and cheese.  And, I even tried pork rinds.  Blech.

I'm not certain what about my plan worked...I like to think it was the combination of things I was doing.  And, hell, I did get results.  But, like the older (more experienced) me would say - or anyone with half a brain - what I was following was NOT a sustainable model. 

After the initial 5-6 months, I watched my carbs but didn't let them control my life.  I needed to live my life.  Sure, I hated being fat, but, I was comfortable with my weight hovering around 220-230 through my early 20s.  As every doctor's office has ever told me the moment I step on the scale and the slide the little thingy magiggy over to 150 and I say "keep going..." 

"Wow, you hide it well!"

What the hell is that?  Really? Is it supposed to make me feel better? Are they genuine in saying that?  Are they really that clueless?  Can they honestly be that shocked that I weigh over 150 pounds?  I will never understand that.  You know, to be quite honest, there's only been a handful of times that someone hasn't said that to me in a doctor's office...once or twice in my regular doctor's office when I know I was no longer hiding it well and the other times would've been at my bariatric program office...they know what certain weights look like.  They don't need to throw a "You hide it well out there" because they know it doesn't help and they're not about thowing BS at the next fat person that steps onto the scale.

Fast forward.... ----->  enter the man I will marry.  Santa.  Mr. Claus.  My lifeline.  I like to think I looked good when we met.  We dated and lived together for 5 years before we tied the knot.  I managed to lose 10-15 pounds prior to the wedding and got back down to the 230 range.  I felt pretty good even though I didn't like the weigh I looked on my wedding day.  Don't get me wrong...it was a beautiful day.  I married my love, my best friend.  But, and hold onto your hats kiddos....it WAS the first time in 13 years I had worn a dress.  I should've felt beautiful on my wedding day.  I didn't.  I was too fat to feel beautiful.  Wah wah me...can I get any more pathetic?! 

Again, fast forward to today...my husband and I have been through good times and bad together, the illness of aging parents, death of my father, loss of a pet that was like a child to us (we are, and choose to be, childless), sale of a property, purchase of another, loss of jobs, new jobs...you know....LIFE.  And, somehow, life decided to add another 70 pounds to my fat ass.

When? Why? How?The important background BS

So, obviously, I'm not blogging about my journey with weight loss surgery for the hell of it.  There's always a how, a why, a when to how we got to where we are - isn't there?  You're reading this just as I would and thinking to yourself that it's true.  It didn't happen overnight, you didn't (I DIDN'T) wake up fat one day.  It was a journey to get here. Mine went a bit like this...

I'm told I was an average to large size baby.  I know I was a big kid.  Always the biggest in grade school...well, maybe not THE biggest but at least ONE of the biggest kids. Enter Mrs. C into North Pole High School. You guessed it...pretty much one of the biggest...don't get me wrong....certainly not where I am today.  Not even obese.  Put it this weigh...there were girls who had bodies built for cheerleading and those who had bodies built for softball/fencing/wrestling/football...umm, yeah...I was in that second group.  Side note...I didn't fence, wrestle or ball with my feet. Strike that, reverse it...only part of the weigh.  Even though I was in that second group, it didn't keep me from doing all the things (hint, hint) that the cheerleaders did (wink, wink).

Enter college...the Freshman 15 turned into the Freshman 115.  No kidding.  STOP...I know you won't believe this but TRY.  My diet really wasn't that bad.  But, like every ?good? college student, I supported the local "establishment" (aka watering hole, public house). Yes, I did my share of drinking.  Anyway, on a break home, I ended up at a nutritionist.  "Try this..." she said and handed me a diet plan.  You know the kind.  It read like this...Breakfast - six saltines, Lunch - Yogurt, 1 medium pear, 4 saltines, Dinner - 2.5 saltines, 2 apples, 6 grains of whole wheat rice.  That lasted a week.

My early 20s were filled with the same.  Just to get it in and because it's stuck with me...I have to share this goody...after college (no, I never did graduate), I ran into one of my best friends from high school.  I mean, such a best friend, I loved her like a sister. I still do even though she could care less if I was alive.  Anyway, we run into each other and she says "Wow!  You look the same!"  Mind you...it's only been a couple of years.  Me: "Really?! Geez, I've gained over 100 pounds!" with a look of despair.  Her:  "Whoa, that's like a whole extra person."  Me:

"Yeah, no shit.  Thanks for the reminder."

Eventually, I got hooked up with a reproductive endocrinologist.  Not because I wanted to reproduce in my early 20s but, rather, because this was still pretty new shit back then.  Endocrinologists were almost all "reproductive" back then because, well, quite frankly, if your lady parts didn't work the right way...who cared?  As long as you could get knocked up, right?! Anyway, this woman gave me some answers.  Oh, did I forget to mention?  I had had maybe 20 periods in my entire life (and I started menstruating - such a funny little word - at the age of 11).   And, by this point, not only had I gained 115 pounds and was not having normal (if any) periods but I was losing the hair on my head, growing it where I shouldn't have it and had a host of other oddities going on in my hot, young body (ok, ok, a girl can dream, can't she?!)  I had Stein Leventhal Syndrome. Stein WHAT - WhotheEffNThall???  Three little words - Stein Leventhal Syndrome.  Better known today as Polycystic Ovary Syndrome or PCOS.  That was pretty much it.  Here's some birth control pills to regulate your cycle, call me when you DO want to get knocked up as it'll probably be a struggle.  There isn't much you can do about the hair issues so you'll learn to live with it.    Now, that was then...and, that's how it went.  I'm thankful that there's more information out there for the young women of today.

You've made it through Claus 1.0 - happy you're still with me.  More about me & my jelly roll later.  Thanks for reading & have a great tomorrow!

-Mrs. C.

On Dasher, On Dancer....On your mark, get set....One, Two, Three, GO!

What have I done? Why am I here?  Holy shit, I have a blog.

Let's get down to the nitty gritty....

For so long, I've been one of those people who would come across a blog, read a few pages or more, leave it on my monitor for a day or two and maybe (if it really captured me) add it to my favorites - and, come on now...I know I'm not the only one!  But, I always wanted more.  I wanted to be one of the special people.  You know, there were some blogs that I wanted to follow.  I wanted my little picture under "Followers" - I wanted to belong.  I wanted a place where I could keep all these great blogs that I've read together.  But, I couldn't.  Why?  Long story short...the freaking Blog Gods decided that in order to become a "Follower" you have to have your own blog.  Imagine that!  So, with hopes of adding my cute-little-means-nothing-at-all image under "Followers"....yep...here we are!  So, maybe, if I'm really lucky, really good, maybe, just maybe...I'll get a follower or two! 

Regardless of why I'm here or how I found this place, I hope you enjoy my ramblings.  I fully intend to chuckle, smile, shed a tear or two, get mad at the world, love myself, hate myself and shake my bowl full of jelly.