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!!!

 

Wordless Wednesday – The Near But Distant Past/Future

The old me, but someday new me again?I keep thinking of the “me I used to be” before Type 1 diabetes, but also before all the weight gain made even worse by Type 2-like insulin resistance tacked onto Type 1.

<–I want this again. This makes me want to work for it as hard as I can, because I remember this “me.” I felt good, and I felt healthy. (I know, I’m never truly “wordless,” and in the spirit of full disclosure, this picture has been photo-shopped to remove the person who was standing beside me. Better that one be forgotten.)

 

The Calm (?) before the Storm

Things have been really quiet for Fifteen Wait Fifteen over the last couple of months. Not for lack of material to write about, but mainly due to lack of time. “What have you been doing?” you may ask? Well……

  • March was filled with sleepover weekends, a trip to the mountains to visit college friends, March Madness & my husband traveling to Florida. Many, many birthday parties of kids we know, celebrations for birthdays of adults we know (which included a trip to Asheville to stay at the Grove Park Inn with girl friends for one birthday, and also a Biker Bar tour of Durham for another friend’s birthday), and the arrival of Frozen on DVD. (The DVD thing? Blessing + Curse.) My daughter LOVES that movie, and so far we’ve only had to watch it a couple of times since she got it. I know all the songs by heart now – because of course, we had to put the soundtrack in the car, and despite my best efforts to sing songs *I* like in my free time, I end up singing something from that movie instead. Drat.
  • April was also filled with birthday parties, including my daughter’s 3rd birthday party where – you guessed it – Queen Just Let It Go already!Elsa made an appearance. (Technically, she was the “Snow Queen” from Fairytale Dreamer, but the kids did not care one whit what we called her – she WAS Elsa!) Easter activities included several fun egg hunts, I hosted Book Club night at my house in April (we had read The Yonahlossee Riding Camp for Girls, which I liked a lot, and it was set in the NC mountains), Penny started swimming lessons, Game of Thrones season 4 began, we had several nights of playing cards & games with neighbors, and hanging out with the kids outside…all lovely times.

Throughout this time of much happiness and enjoyment, I’ve not allowed myself to become bogged down in the pain, but there has been a lot of it. My feet and plantar fasciitis hurt all the time. I have also been going to the chiropractor every couple of weeks for a new-ish pain in my right shoulder and neck – I’ve had it since November, and it just won’t go away, so I went back to my orthopedist and also started some physical therapy. Have an MRI scheduled this week to look into it as well. It could just be bursitis (ugh, that sounds like an ancient person’s disease, like having a goiter or gout, doesn’t it? Of course, some days, with as much creaking and aching as I have, I do feel ancient…) but we’re checking everything, just to make sure. My posture while working at the computer 9+ hours per day is terrible, so I’m also trying to fix that as a potential cause, and make my working area more ergonomic.

And let’s not forget all my appointments in working towards having the vertical sleeve gastrectomy…I’ve seen my surgeon 3 more times (for a total of 6 visits, required by insurance), been to 2 nutrition classes, attended 2 pre-op support group meetings, done a “protein shake” tasting class, and have now checked off everything needed, so my doctor has submitted all the paperwork (it was seriously about a 1.5 inch stack of papers. *Paper* – really? You can’t electronically submit that stuff yet???) All-in-all, I’ve had about 20 doctor or lab visits and tests to get to this point, including visits with a psychologist, having an endoscopy, blood work, and having a gall bladder/liver ultrasound. Now comes the “fun” part….waiting to get the approval from insurance, getting the call from my surgeon’s office, and scheduling a surgery date. I’m tremendously excited and apprehensive, all rolled into one. Getting to this point was easy, in the grand scheme of things. The hard part will be the liquid diet for close to a month (one week before surgery, and 2-3 weeks after), then moving to soft/pureed foods, then eventually up to eating/chewing food normally, but making sure to get in enough protein FIRST. One of these blogs, I’ll spell out all the rules around food and eating that I will be needing to follow. It’s a little crazy-town. But if it takes this to kick-start my weight loss, reduce the effects of insulin resistance, and help me get to a much more healthy place, I’m going to do it!

Hoping to get some major blogging action going on next week for the 5th annual Diabetes Blog Week!! It will also mark one year since I started this blog. Time is certainly flying! And oh, how things have changed in a year…..yet the really big storm of change is about to come!

Crazy Spa Day

I have GOT to write a post about this picture from my Spa Day at the Grove Park Inn.  Diabetes…you really pissed me off that day.

Commitment Issues (also known as, My Big 2014 Commitment to Change)

I have dubbed 2014 to be the “Year of Commitment to Change.” Because, really, I’ve always had some sort of commitment issues. Not with my relationship with my husband or my friends or family, but with myself.

Years ago, I (albeit grudgingly, because I was diagnosed at 21, which should have be the height of “fun” time for me in college) made a commitment to myself to take care of my diabetes. When I was diagnosed, my doctor basically said there are 2 types of people with diabetes: those who live with it, and those who die from it.
I chose to be part of the former, and have taken numerous steps and changed my lifestyle dramatically over the past 19 years to make sure I was going to live, and live healthy, for as long as I possibly could. I’ve worked diligently to learn how to count carbs, take the right amounts of insulin, discover settings on my pump that help me avoid post-prandial spikes, acquired a CGM – the list goes on and on.

I go to my regular 3 month endocrinologist appointments like clockwork. I get my labwork reports. Everything looks pretty darn good, like it has for many years. My HbA1c is 6.1, and has been hanging out in the 6’s ever since I went on the pump in 2003. When I was pregnant, it even dipped into the 5’s.

At my last appointment, my endo and I had one of the most serious conversations we’ve had in years (the last one being in 2008, which was the “I’m trying to get pregnant” one, and I was reduced to tears because I felt it was never going to happen. But it did.) Our new-and-serious conversation revolved around my weight, which has steadily gone up since I was diagnosed with Type 1. I was a healthy weight back then at 21, I was an avid hiker, and loved to exercise. Fast forward almost 20 years…..a sedentary job, maturing into my 30s (and now, 40s), a bout of depression,  the roller coaster of hormones when trying to get pregnant, and then the pregnancy itself have helped me put on so much weight, I am now categorized as “morbidly obese.” Just saying that makes me cry.  I have explored the gamut of diets, exercise, changed how I eat, and definitely lost some weight along the way, but never enough to get down to a weight where my feet don’t constantly hurt, where I can sleep well at night, where I have enough energy to play with my daughter for hours, or where I can take up an exercise regimen without hurting myself in some way and losing track. I’ve been stuck in a rut of metabolic syndrome that has made gaining weight, despite my best diet-and-exercise efforts, far easier than losing weight. It’s discouraging, and my body is so very tired of constantly fighting some kind of pain from carrying around all this extra weight.

The me I want to be, again

A New Year’s picture of me, when I was at a healthy, manageable weight – before type 1 diabetes and metabolic syndrome had set in.
I want to be this again.

My endo says, “You are healthy, except for your weight. The medical issues, pains, etc that you have all revolve around your weight. Have you ever thought of having bariatric surgery? I wouldn’t recommend it for most of my type 1 patients. But you….I think you can do it. And I think you’ll see that as a tool, it will help you get to a place where you can manage your weight once again, and not get sucked back into the metabolic syndrome.”  For some background…my endo is a Type 2 himself. He had gastric sleeve surgery 1 year ago. I’ve seen the change in him – he looks, and tells me most importantly, he *feels* AMAZING now. He told me that he would refer me to his surgeon, he would go to the pre-op and post-op support meetings with me, and we could even do group personal training sessions with his personal trainer. He is on board to help and support me, which helps calm *some* of my fears about having an elective weight loss surgery as a Type 1 diabetic.

So….here comes the commitment part. If I want to do this, it’s going to require a LOT of commitment to changing, well, just about everything. I have to commit to a LOT more doctor visits over the next year. I have to commit to going to support group meetings. I have to commit to learning about how nutrition and digestion will change with the surgery. I have to commit to a non-impact exercise routine (to save me from injuries and so much foot pain) and know I will deal with blood sugar fluctuations as a result.  I have to commit to overhauling my diet and changing the way I consume food and drink. My diabetes management, that I’ve spent so much time perfecting, will drastically change – both before, and certainly after the surgery.

I have already tried to track down other Type 1’s who have had gastric sleeve surgery to ask them how they have managed, and if they have had any major complications or issues.  I have yet to find any. I feel like I’m navigating un-chartered territory here, and it’s scary. But, I’m even more scared of what my life will look like (or, if I will even be alive/healthy) in 20+ years if I can’t get rid of this extra, exhausting-and-debilitating weight. I’m sure there will be people in the DOC who are going to frown upon this choice I’m making…who think I *should* be able to lose 125+ pounds just by diet and exercise alone. Unless you have been THIS weight that I am, and struggled with all my injuries and aches, you have no idea how daunting it is, or how excruciatingly  painful. I need a dramatic change, I need it soon, and this is what I am going to do.

My first steps:

1. I am owning up to this commitment I am making – to take a risk that will change my life and my health for the better.

2. I am sending out feelers everywhere I know to find other Type 1s who have had gastric sleeve surgery. I’ve posted to a few bariatric surgery pages already, and found plenty of Type 2’s who have done it, but not a single Type 1. I’m hoping the DOC can reach out it’s arms and find someone within it’s ranks who has done this as a Type 1 and is willing to chat with me about it.

3. I’ve had my 1st consultation with the surgeon, and have scheduled nutrition counseling and a sleep study. Still to come: psychological evaluations, support group meetings, and various other tests and examinations to make sure my body is a good candidate for gastric sleeve surgery.

Even if I end up on this journey not knowing or being in contact with anyone else who’s done it that’s “like me,” I can at least document what’s going on through my blog, and I hope it will help someone else in the future. Wish me luck & strength, folks, and here’s to a Happy New Year for all of us!!

2.5 Pounds on the Scale

Going to a monthly weigh-in at my doctor’s office the day after my birthday was NOT a good idea. How do you think I’ve been celebrating for the past 2 weeks with friends and family? With food, drinks, food, drinks, and more food, of course! There was a wine and dinner night out with my girlfriends last weekend, a big bash of BBQ and cake last night, various meet-ups with people for lunches out, etc. I wonder why it never occurs to us to say, “hey, let’s go celebrate your birthday by working out together at the gym?” Because That. Sounds. AWFUL. And sweaty. Ewwww.

Needless to say, it was no surprise this morning when the scale showed I had gained 2.5 pounds since last month’s weigh-in. Which is a real bummer since I have steadily been on the downward path for over a year now. I’ve lost 45 pounds since January of 2012, and my goal is to lose at least 45 more in the coming year. As a diabetic who has struggled with weight even before my diagnosis, that is no mean trick. It took a LOT of work and effort. Added onto the daily monitoring of blood sugars and carbohydrates intake, I added in the hard-to-measure variable of exercise, as well as religious calorie-counting through using MyFitnessPal on my smart phone.   I am proud beyond belief of that 45 pounds lost. (Why do we say “lost” as if we want to “find” it again? Trust me, I don’t.)

Now, I have to get back on the wagon again post-turning-40. Regroup. Get motivated. Implement some changes in my diet and routine that will help me continue the work I began last year. And let me tell you, this IS work. My doctor today had some suggestions for me, and while I don’t think I can incorporate them all at one time – terror, the terror of changing things and ruining my blood sugars! – I do hope to take on one or two at a time to attack and conquer over the coming months.

  • Reduce carbohydrate intake – eat more protein-based snacks in place of carb-based snacks
  • Choose more foods lower on the glycemic index
  • Take 200mcg of Chromium per day (supposed to help with blood sugars, will research that more later)
  • Reduce/remove as much processed food as possible – eat more fruits and vegetables (duh)
  • Don’t eat wheat – it’s genetically modified and she doesn’t like it
  • Drink more water (I feel I already do this-water is my favorite drink next to wine. Ha.)
  • Exercise more (always a struggle to find the time when I have a daughter I’d rather spend that time with)
  • (And the killer for me) Cut out the microwave meals, like Healthy Choice/Weight Watchers/Lean Cuisine

    Is this really so bad??

    One of my (many) weight-loss crutches

I could spend paragraphs going through each of those bullets, and I’m sure over time here I will be addressing each one in other blog posts, but today, I’ll touch upon microwave meals. As a diabetic who works full time, has a toddler, and a very busy life in general, I LOVE them. All the nutrition information is RIGHT THERE – I can take the right amount of insulin, they are low-calorie,  fast to fix , and most of the time, pretty tasty. The convenience is so alluring that I’m not sure I can give those up, not quite yet. I do know in my heart that anything I take out of a box & put in the microwave – even the more organic and “natural” meals I pick up from Trader Joe’s – can’t be that “good” for me, but they are a hard habit to break.

Do you all have this same problem, or a similar ease-of-convenience vice with regards to food? If you have overcome using the “crutch” of microwave meals, how did you do it?