4 Months Out with Stats and Goals

The last 4 months since my gastric sleeve surgery seem to have gone by in a blink, but also lasted forever. I MEANT to blog more, share more thoughts, daily challenges and such that I have gone through juggling Type 1 diabetes and having a new stomach through VSG, but wow – it’s like, I have 3 full-time jobs now…..1) The one that makes me money, 2) Type 1 diabetes, and 3) Learning how to eat/drink/take insulin/exercise/function normally with a stomach 1/4 of the size it used to be. And I still have a family and social life, and try to volunteer with JDRF and NC Schnauzer Rescue. It’s a LOT, and my brain hurts a little thinking about it.

I don’t have a ton of time to even write this, but wanted to sum up some current stats, accomplishments, results, and goals, in no particular order:

  •  I’ve lost 50 lbs, gone down 2 pant sizes, and at least 1 shirt size, maybe more (I tend to wear stuff a little loose anyways.)

    Cheese

    Happy me, with my ticket to see Duran Duran Unstaged (a concert film, of sorts) at a local movie theater. Sporting my FitBit, new hair-do, and go-get-em attitude.

  • My plantar fasciitis has improved 110% – I actually get out of bed in the mornings & put my feet on the ground *without pain*, and I only notice it if I’ve walked or stood still a lot throughout the day.
  • I need to exercise more, and build muscle – my energy level is still pretty low (only eating about 1,000 calories per day now), so I’m worried some of my weight loss is muscle.
  • My OB/Gyn recently diagnosed me with adenomyosis. We’ve got a treatment plan in place to hopefully correct it and allow me to remain fertile (and potentially have another baby sometime in the near future?)  Of course, the treatment involves progesterone, which tends to cause insulin resistance.
  • Speaking of insulin resistance, I’ve been taking less and less (and sometimes none) of my Metformin. I feel like my insulin resistance is starting to wane, but if the progesterone I start taking ends up raising my blood sugars, I may tweak things and take the Metformin along with the progesterone and see if they can cancel out each other.
  • I’ve gone from taking 100+ units of insulin per day – about 50 in basal and 50 in boluses – to around 50 units total per day (with 29 of that being in basal.) That should tell you how dramatically I’ve changed my eating habits & caloric intake. Low, low carb, baby.
  • Recent endocrinologist appointment yielded these results: BP = 124/72 – Back to normal for me, but right after surgery I had some serious *low* blood pressure.
    • A1C = 6.6 – Grrrr, it was 6.5 right before surgery, so it went up a smidge. BUT, I have ran high more than low recently, since I’m still tweaking basals and have had several days where I got dehydrated, or didn’t eat enough, and those tend to raise my blood sugar. Also, not many lows to bring down that number (which is a good thing!) I’m still working on getting into this new groove with my stomach, so I’m not going to beat myself up about this too much.
    • Cholesterol = 169, Triglycerides = 69, HDL = 56, LDL = 99.  LDL/HDL Ratio = 1.8. !!! ROCKED it, since I’ve been hanging out with a cholesterol of around 200 for years now.

GOALS for the upcoming next 6 months:

  • Exercise, exercise, exercise. I’ve been pretty good about walking a lot, using my exercise bike, going to the gym, and am way more active than before, but still have to get in a groove for strength training. I’ve GOT to build more muscle, but the challenge is still feeling like I have enough energy.
  • Lose 30-40 more pounds. I’m trying to be realistic here. Even though in 4 months I’ve lost 50 pounds, the weight loss is already slowing down. It is the nature of this surgery. It is a “tool”, not a forever fix. I still have work to do.
  • Drink more water, eat more vegetables. I know that sounds simple, but when you get full really fast, and thus, feel like you’re eating all day long just to get in enough protein, it’s hard to work in vegetables and also fluids, since I am not supposed to drink for 30 minutes before or after eating.

Next blog post will hopefully be soon, and will be about recent bloodwork (a comprehensive panel of about 8,000 things)  done by my surgeon. I am suspicious that I have low vitamin D, and possibly low Iron (hence, the fatigue and lack of energy.) I am taking vitamins and supplements out the wazoo, but still, I just feel lacking the majority of the time, and desperately want to feel more energetic. I’m sure it’s partially due to the minimal carbs and calories I consume, but it would be nice to know if there are any other underlying reasons.

E…a…t…i…n…g………S…l…o…w…l…y

I’m still alive! One month now post-gastric sleeve surgery, and I’m taking it day-by-day, meal by meal, ounce by ounce. I keep thinking back to all my fears with blood sugars and blood sugar management around this whole “changing my digestive system from what I knew before,” and now I can’t understand why I was so worried about lows. Honestly, lows have NOT been an issue. I’ve had the occasional, “Oh crap, my Dexcom shows 70 and a down arrow!” but I would take a few sips (literally) of a juice box, and things leveled out almost immediately.

One of the most interesting things about my “new” stomach that is taking some getting used to….food/drink hitting my system literally seconds after I consume it. I spent years figuring out when and how to take my insulin in order to have it be most effective at the time when my food would be digesting. I used square wave and dual wave boluses on my pump like it was my job (well, because diabetes IS like another job, after all.) I rarely pre-bolused before meals…I would wait until right before I ate, and then take insulin in a manner befitting what kind of food I was eating. You know, like for pizza – you take some, square or dual wave some over the next 2-3 hours, then take some more a little later, still go high, correct a bit, and then hope and pray you don’t over-correct. Stuff like that. That system and way of insulin-taking? Gone.

Now, I have to think ahead once again…take little bits of insulin (depending on what I plan to eat or drink) a good 15-20 minutes ahead of time. And I CAN’T forget to eat. I need all the nutrition I can get, and don’t want to waste an eating opportunity on scarfing down a juice box. Because, even though before this surgery, I planned my entire day around eating/insulin/exercise/diabetes, I STILL have to do that now, only adding in the caveat that my stomach will-not-allow me to consume more than a small amount of anything at a time. I get a full feeling very quickly. I cannot really “scarf” down semi-solid foods (I’m still in the pureed stage right now, so things like runny scrambled eggs are a staple.) If I try to take several bites one after the other, it feels like it gets “stuck” somewhere in my upper chest, and is VERY uncomfortable. The other morning, I was in a hurry, and ate my eggs too fast. Big mistake. I saw those eggs again very quickly when I vomited. Lesson learned, but still hard to adhere to.

Eggs and decaf coffee, breakfast of champions

Decaf coffee with Stevia & a little protein powder added into it, and a serving of an egg/egg substitute mixture with a smidge of bacon salt in them. I have to drink my coffee either 30 minutes before or 30 minutes after I eat the eggs. And I’m LUCKY if I can eat as much of the eggs as you see in this picture.

This is my biggest challenge at present: Eating slowly. I know I have to, I know it’s better for me, I know it will help me feel fuller longer (and also cue in faster to when my new stomach is getting full)…..but for years, I’ve been a “get the food in while it’s hot and while you can because your kid is going to need something soon, and then you won’t eat and then your sugar will crash, and then….” kind of person. That habit is really hard to break. But like a lot of things in life now, I’m working on it!

Quick Post-Surgery Update

I finally had gastric sleeve surgery (aka VSG) last week, and said goodbye forever to about 75-80% of my stomach.

Desperate times call for desperate measures (I think my next blog post should be called that) – I have TONS of material to share surrounding my surgery, hospitalization, and the recovery challenges so far) and having something like this done is no true “quick fix” to losing weight. It is a process, and a very tough one, especially when you add in Type 1 diabetes to the mix. Each day right now is an exercise in counting all the little victories. I WILL get there…..

Victory in a bottle!

See that empty bottle? THAT is my victory this morning. I drank *all 8 ounces* of that protein drink within the span of 3 hours as my breakfast. This is a GOOD thing – yesterday, it would have taken me at least 4 hours, or I would have given up and just started on the lunch one without finishing the breakfast one. My stomach is still swollen and inflamed from surgery, so it’s even smaller than it will eventually be once it’s settled down and healed completely. Getting in enough fluids each day, nutrition in the form of high protein shakes & drinks, and eating/taking all of my chew-able vitamins and minerals is yet another job on top of the other health-job I have in taking care of my diabetes. I wish I could tell you, “my blood sugars have been fantastic since the surgery!!!”….but they haven’t been fantastic. They are manageable, sort of, but running way higher on average than I like.  I have a whole new “normal” to get accustomed to, and so does my body and all it’s inter-working parts. I’m getting there, slowly but surely, and promise I will have an upcoming post on blood sugar management pre-, during, and post-surgery.

Another victory to note? NO blood sugar crashes, at least! Dealing with potential low blood sugars was one of my primary concerns around the surgery and recovery time, and so far, I haven’t had to scramble and test the limits of how-much-apple-juice-I-could-consume-how-fast to bring up a low, because I haven’t had any. Whew. Knock on wood, fingers crossed, and all that jazz.

The biggest challenge I am having right now is that I have ZERO energy. Mainly because, I’m lucky if I consume 500 calories per day. (MyFitnessPal keeps telling me I’m not consuming enough calories – like, I didn’t know that already??) I have some kind of protein drink, water, sugar-free popsicle, soup, sugar-free Jello, etc. in my hand all day long, and I literally just can’t consume more – my stomach says, “enough!” and I listen to it, or else pay the consequences in pain/burping, or potential vomiting. (Again, a victory I hope to maintain – no throwing up.)  I had my first post-surgery followup appointment yesterday, and my PA said I am doing great. I’m getting in a good amount of protein, and she says the calories and ability to consume what I need will come with a little more time – my stomach still has to heal.

And you know what? Here’s a pretty big victory. In the last 2 weeks, since I started on the pre-surgery all-liquid diet, I have lost almost 20 pounds. T-W-E-N-T-Y. It has not been an easy 20 pounds, but I am owning it, and it’s giving me even more motivation to keep on doing whatever I have to in order to use this tool of weight loss to make my life better and healthier. My stomach will never be the same again, and neither will I. I am committed, and I will do what I need to do in order to be healthy – for myself, and for everyone I love. And you know what I’m really looking forward to? Hiking long distances. Running and being carefree. Doing cartwheels with my daughter. So many things that I used to love to do, but couldn’t because of the weight. I WILL do them again, and soon!!!

 

3 Days In

In preparation for surgery (and the life I’ll have for several weeks after), I’ve survived 3 days of a mostly all-liquid diet. I am allowed to eat a couple of sugar-free Jello gelatin cups per day & sugar-free popsicles, and then the one true thing I can chew on is a special protein bar I can have 1 time per day, so I’ve been saving that as my “special treat” at night after my dinner shake. I thought it would be the best thing to do in order to help my sugars even out overnight, hopefully not allowing any weird crashes, and to also help stave off any possible over-the-top dawn phenomenon. The jury is still out on whether or not nighttime is the best time to have this so-called treat, that kind of tastes like flavored cardboard.

My Fitness Pal.

My Fitness Pal display of Nutrition for the day. Not too shabby.

A few notes and observations about this dramatic change in my eating habits:

  • I started using the My Fitness Pal app on my phone again to track what I’m eating, and assure I’m staying within the guidelines of calories, proteins, carbs, etc. I really like how it syncs up and works in tandem with my FitBit Flex. (Note: I am also taking a slew of special chewable bariatric vitamins – a multivitamin, Calcium, B12, a probiotic and iron. I will take these the rest of my life.)
  • In getting back into logging food and such, I realized I’ve gone from consuming between 100-150 carbs per day down to around 45-60 carbs per day these last 3 days. No wonder I could barely drag myself out of bed this morning.
  • I have not been exercising, and while I feel bad about that, I’d rather NOT exercise and NOT crash than to have to fall off the wagon and consume too much sugar trying to bring up a low blood sugar. The point of this liquid and reduced carb diet before surgery is to help my body go into ketosis (NOT ketoacidosis), and burn off some of the fat surrounding my liver so that laproscopic surgery on my stomach will be easier. Also, in preparation for having a similar low carb/higher protein diet post-surgery as well.
  • I miss coffee. I mean, I’ve been drinking some decaf here and there, but it’s just not the same. One day, in the far distant future, I’ll be able to drink it again, but only in small amounts. You don’t want caffeine to make you dehydrated, or interfere with vitamin/nutrient uptake.
  • Blood sugars have been…..weird. You’d think with the greatly reduced amount of carbs (and the ones I’m having aren’t the spikey ones) that I’d have perfectly straight Dexcom lines within range. NOT. After my morning shake breakfast, I will slowly creep up to the 150-180s, and stay there almost all day. When I eat lunch, and then dinner shakes, my sugars will briefly go down,
    FitBit Flex display

    The lack of exercise pains me, but check out the calories in versus out. I certainly should lose SOME weight before surgery, at this rate, assuming my body doesn’t go into starvation mode and shut down my metabolism.

    and might hang out in the 120s or 130s. Except for the 1st night on this diet (where I had a low in the 50s that I treated with 1 cup of 1% Lactaid milk. It barely kept me within the required amounts of sugar for the day), my overnight sugars have all been within range, 90-120 or so. Now, as this week wears on, maybe my body gets more “used” to it and will level things out? I’m afraid to change my basal rates on the pump, because I really think they are not the issue – I think it is my liver getting all riled up at not having as much sugar coming around, it thinks I’m starving (which, I do feel like that, occasionally), and it wants to spit out some to make itself feel better. Stupid liver.

While NOT getting to eat foods and things I’m used to eating is really, REALLY, tough sometimes (I almost swiped my daughter’s sausage out of her hand this morning. It smelled SO GOOD) I am OK. I just keep thinking of the end goal – losing weight, being healthier, and feeling better – and I can turn my head away, and go eat my sugar-free Jello gelatin in relative comfort. This is my new normal, at least for a few weeks. Once I am able to consume “normal” foods again post-surgery, I’m sure it will be a whole new ball game.

Liquid, It’s What’s For Lunch

Mmmmmm good?I started my all-liquid special high-protein-shake diet in preparation for surgery. This is what I had for lunch: a protein broth shake thingy. That’s it. I know it doesn’t look like much, but compared to breakfast – an “iced latte” flavored protein shake that was THE MOST HORRIBLE THING I HAVE EVER TASTED THAT WAS SUPPOSED TO TASTE LIKE COFFEE BUT DIDN’T – this chicken soup-flavored protein drink was deeeelicious.

Now, I can have the occasional snack of a sugar-free jello gelatin cup, sugar-free Popsicle, plain chicken broth, all the water I want, and moderate amounts of decaf coffee and tea (but only with stevia sweetener in them, no cream or milk.) But really, this is hard core dietary limitation in my book. And I am preparing myself mentally and physically  to do this for at least the next 3-4 weeks. Wish me luck!

Note to self: Never ever ever again consume anything with a coffee “flavor” that isn’t coffee. Except for Coffee Nips – I will always love you. 

Don’t Buy This

Whatever you do, don’t buy this stuff!!

Whip it goodI saw this in the grocery store and thought, huh – I should eat more protein and fat in the form of peanut butter, and need a little something different to eat with crackers when I need a tide-me-over snack and looky! (It probably didn’t help that I was shopping with a bordering-on-low-blood-sugar. That never helps with making smart buying choices.)

This stuff is *whipped* and  even has a smidgeon of chocolate in it. Perfect for when you just need a teeny bit of sugary goodness, and don’t want to go overboard on something that is more of a no-no.

One taste and I was hooked. The serving size is 2 tablespoons. Good luck ONLY having that amount on your crackers, strawberries, pretzel sticks, banana sandwich, etc. It was all I could do not to empty half the container at it’s first opening.

MmmmFor those curious, there is the nutrition information. Not the absolute *worst* thing in the world for you (but the calories….WAY TOO MANY CALORIES.) To be safe, just don’t buy it. You’ll thank me for this recommendation later.

Diabetes Awareness Month Photo-a-Day 3 – Snacks

My photo of go-to snacks I most always have on hand to treat low blood sugars:

Dark chocolate is my FAVORITE of these :)

  • Milk = for when it’s going low but not TOO low. One cup has just enough carbs, some protein and fat to stave off a low and also not send my blood sugar shooting for the stars.
  • Fruits = showing raspberries here, but I also like bananas, grapes, and blueberries. All in moderation, of course, and I try my best to measure out my fruit “dose” before eating it, so I know how many carbs I’m consuming.
  • Apple juice or other juice boxes = means shit is getting real, and it’s a REALLY low low, or I’m feeling the heady spiral towards an enormous crash. No guarantees that the juice will be the only thing I correct with in this case. Over-treatment of the low is a distinct possibility if I’ve resorted to juice. Forget the fifteen wait fifteen rule.
  • Dark chocolate = My sugar weakness. Pairs well with the milk for the low. Also, if I just barely have an arrow trending down on my CGM and I’m about to do some sort of activity, I’ll pre-reward myself. (But it must be specifically DARK chocolate. Milk chocolate just isn’t worth it to me anymore.)
  • No, I don’t keep my snacks outside for the squirrels to eat, I just get tired of always having my kitchen counter-top as the background of my photos.
  • I DO also keep GlucoLift glucose tablets in my car, in my purse, etc, but those are totally LAST resort. Over the years, I’ve restricted myself so much on having sweets, fruits, and things I really love because of diabetes. If the big D is going to screw up my day by giving me a hard crash, I’m going to have something I WANT to deal with it.