Of Puppies and Babies

Last night as my husband and I were chatting before bed and planning out the rest of our week, somehow the topic of babies came up (maybe because we have several friends with new babies, and others are pregnant, etc), as well as the topic of our family getting another dog sometime.

It’s been a year now that Xena has been gone, but I swear sometimes I still think: “I need to make sure to let her out to go potty before we go to bed.” Often, I don’t put down the recliner foot rest without checking for her underneath. I’ll come home after being gone a while, and look for her to greet me at the door. The house just seems empty without a dog, especially since I’d had Xena with me for almost 13 years. I work from home a lot, and wish she was still here to keep me company, to go on walks, to demand that I throw toys for her. She was so full of personality and spunk – the best miniature schnauzer, best dog, best canine friend I’ve ever known and had the luck to have in my life for as long as I did.

My husband said he would be totally on board at any time if I wanted to get another dog. And every now and then, I see rescue dogs come in, or get an email about a schnauzer puppy, and I’m like, “Ooooooo, I could get this one!!!” But then, reality sets in. Work is crazy busy for me right now. I’m in the midst of revamping my entire lifestyle around food and exercise, and working towards having weight loss surgery to help me get my active life back and to help make sure I am healthy and around for many, many years to come. Type 1 diabetes is a 24/7 job in itself, and will be even more so once I have the surgery. I can’t bring a new dog into the family when I’m already being pulled a hundred different ways. It just wouldn’t be fair to the dog, or to my husband and daughter.

Then there’s also the baby thing. Despite mulling over the pros and cons on several occasions, I don’t think I’ve quite resolved in my head and heart that I’m never going to have another baby. In the back dark recesses of my mind I frequently hear, “If you lose a ton of weight within the next year or so, it may help your fertility issues as well, and you MIGHT get pregnant!!” But really, do I WANT to be pregnant or have a baby at 41, 42, 43 years old/ however long that would take??? I just don’t know. And until I know with absolute certainty that we’re never having (or adopting) another baby, I also don’t want to bring in a dog to add onto the already monumental responsibilities of our household.

So, there’s the conundrum. It’s doubtful that I’ll solve it anytime soon. But boy, will I always have some seriously wonderful memories of Xena, the Warrior Schnauzer, and she will always hold a special place in our hearts and our family.

I miss Xena so much....

 

Sleep Study Update, and More

As you may recall, I was required to complete a sleep study as a pre-requisite for becoming approved for any type of weight loss/Bariatric surgery.

I got a call with my results from the sleep study clinic, and the gist of the conversation went like this:

Sleep Clinic Lady (SCL): “Hi, we got your results from your sleep study, and you tested positive for mild OSA.”
Me: “Not *severe* sleep apnea, like I was diagnosed with before? What exactly does ‘mild’ mean?”
SCL: “Well, below 5 is normal, and you had 12.1 during most sleep. During REM sleep you had 34.3.”
Me: “OK.” (insert a look of deer-in-headlights here….those numbers meant nothing to me since I had no point of reference. Was “severe” something like 500 during some allotment of time? Is this during one hour? During 5 minutes? Who knows.)
SCL: “Next, we need you to come in for a CPAP titration study and get you setup to use a CPAP machine.”
Me: “Oh, no you don’t. My whole reason for having this done was because I don’t want a CPAP machine, I would rather use a dental device to help correct it, and my surgeon just wanted this study done to see what level of OSA I had.” (I think that is why, anyway.)
SCL: “Hmmm, well, OK, I’ll put a note in here for the sleep center Doctor and forward your results onto your surgeon. I will contact you after you’ve met with your surgeon to go over the results.”

CPAP machines equal PANICAnd I’m thinking: Yeah, you do that, lady. Remember, I have NO desire to use a CPAP machine, and was worried that my refusal to do so would hinder my chances of getting the bariatric surgery done. I was stressing out just a little about this. I’m not kidding when I say, using a CPAP machine feels like you’re being forced to drown in air, all night long. It made me too panicky, and also irritated my sinuses so much I ended up with sinus infections every time I had tried to use it in the past.

Fast forward a week to my next followup appointment with my surgeon. He reviewed my chart and brought up the sleep study results.

Surgeon: “It looks like you did your sleep study, is the sleep clinic putting you on a CPAP machine?”
Me: “They said it was only mild OSA….do I really need one? If I have to use something, I’d rather find out more about using an oral appliance/dental device instead.”
Surgeon: “Well, if it’s only mild OSA, it is really your choice as to whether or not you wish to treat it in whatever way. You’ll just be taking on the risks of poor sleep, etc, that OSA causes.”
Me: “I’m fine with that.” (….since I really don’t feel OSA wrecks my sleep as much as the stupid sleep study people say it does. I also recently got a FitBit Flex, and over the past few weeks, it is solidifying my conclusion that my sleep is not as bad as the sleep lab people lead you to believe.)

The surgeon said all my blood work looked great, advised me to up my exercise each week (always a struggle), and went over some of the upcoming things I needed to have done:  psych eval, nutrition counseling, gallbladder ultrasound (oops, didn’t have this on the first list – one more thing to do!!), and an endoscopy to check out my upper GI tract. With the sleep study hurdle overcome, I am hoping for smooth sailing from here on out as I work towards final approval to have the surgery!

I thought you were supposed to “sleep” in a “sleep study?”

Last week, I had one of the worst nights of sleep I have had in a LONG time. As one of the many required doctor visits and tests I have to complete before I can be considered as a candidate for gastric sleeve surgery (which is also abbreviated as VSG for “vertical sleeve gastrectomy”), I had to complete a sleep study to determine if I have obstructive sleep apnea (OSA). OSA is apparently very common, and more common in people who are overweight. “They” say that if you have untreated OSA, it can actually *cause* weight gain, due to continually interrupted sleep, and also from not getting enough oxygen throughout the night.

Some background: I did a sleep study 2 years ago, when I was originally entertaining the idea of weight loss surgery. I got the heebie jeebies from the moment I entered the sleep center’s building at 9pm. The “technician” conducting my sleep study was a male, and smelled like smoke. I was ushered to a room with all sorts of machines and wires, and a very obvious camera pointing at the bed.  Long story short, that sleep center diagnosed me with “severe” sleep apnea and required me to use a CPAP machine.

Suffice it to say, the CPAP machine is NOT COOL. It sent me into a panic almost every time I put it on because it covered my nose and mouth, and basically shoots air into your mouth and nose all night long with varying pressures. That doesn’t make *getting* to sleep easy, much less *staying* asleep. The best way to keep the mask on was to sleep on my back. (I am a stomach sleeper, and sometimes a side-sleeper IF it doesn’t tear up my shoulder joint or make both my arms fall asleep. Which happens a lot, so we’ll just say I’m a stomach sleeper.) On my back made it difficult to fall asleep, and it made me wake up with all sorts of aches and pains no matter how many pillows I had surrounding me. Then, to add insult to injury, I got sinus infection after sinus infection when I would wear the CPAP machine on a regular basis. After a few months, I gave up. I didn’t feel like I was sleeping any better at all – in fact, I felt worse because I was sick with sinus issues all the time. And let’s not mention how tore-up my blood sugars were, due to continual sinus infections. Those were my worst A1C’s in that time frame than I had had in a LONG time.

When I went to the new bariatric surgeon and talked about it, I asked if I could please use a dental device for OSA treatment instead of the CPAP machine. That’s why he signed me up for yet another sleep study – hopefully to assess if I could use the dental device effectively to treat my OSA.

Once again, I went into the sleep study lab (a different one this time), and got the heebie jeebies. The man who was the technician was nice enough, but he was trying to make jokes that just weren’t funny. Like: “Feel free to change into your pajamas in the room, but I would suggest you go into the bathroom across the hall, unless you are an exhibitionist,” and he nodded up at the camera pointed towards the bed. Ewwww.2014-01-16_SleepStudy01

The bed was the most uncomfortable-looking thing I have seen in a while. The technician gave me the 6 pillows I requested, hooked me up to a boat-load of wires and things on my head, face, chest, legs, and also to a pulse ox finger monitor. I was not allowed to bring my own pillow, blankets, or sleep on my stomach. I just don’t get it – how are they supposed to truly “study” how you sleep, if they don’t let you actually sleep the way you normally do??? On top of all that uncomfortable-ness, you know someone is watching you all night. It totally creeped me out.I always feel like somebody's watching me....

I was finally left to my own devices around 10:30pm, alone in my room, so I called my husband to say goodnight, and read some of my book club book (Firefly Lane – a good beach read/chick lit/ tear jerker.) The nightstand – that I could barely reach with all the wires attached to me from the OTHER side of the bed – held my phone, my CGM, my finger-stick meter case, a juice box, and a granola bar for just-in-case. I was running a smidge on the high blood sugar side (130-140s), but I really think half of it was due to my emotional state. I was so stressed out about this whole deal, it was 11:30pm by the time I turned the lights off. Then I laid in bed for an hour. Then I pulled off the pulse ox monitor to signal to the technician to come in my room (I had to go to the bathroom.) He came in, unhooked me, I carried along the 8 billion set of wires with me to the restroom, came back, he hooked me back up, and it was off to try to sleep again. I think I laid in bed for yet another hour trying to wind down, but all I could hear was the roaring freight-train-snoring-guy in the room next to me. Seriously, it’s a SLEEP LAB – shouldn’t the rooms be a little more sound proof?

At 4am I woke up and needed to change positions, but couldn’t because the wire from the pulse ox monitor wouldn’t reach, so I signaled the technician again, he came in and changed it, and I said, “Can this be over yet?” And he replied, “No, we still need about 45 minutes worth of data.” Grrrr.

6am finally arrived, the technician came in to wake me up and I got dressed and hauled it out of there as soon as I could. Ironically, I was wide awake, even though I despise getting up at 6am and was running on minimal sleep. Since I was already on that side of town, and hadn’t eaten since 9pm the night before, I stopped by the hospital where I needed to go at some point anyway to get fasting bloodwork done, with orders in hand from my bariatric surgeon. Their lab opened at 7am, and a very nice phlebotomist lady ended up letting me in early at 6:30am so I didn’t even have to wait very long. Even though it was the worst night of non-sleep and I was running on empty the whole next day, I got two things checked off my huge list of stuff-to-get-done-before-I-can-even-do-this-surgery. Win!

Shake It Out

Driving home from dropping my daughter off at preschool, “Shake It Out” came on the radio. I got home, sat in my car in the garage, cranked up the volume, and sang along with it as loud as I could. What’s up with the radio universe always playing the song that completely fits your emotional state right when you need it? (Kind of like when you would break up with someone, all you would hear on the radio were love songs/breaking up songs. Geesh.)

I am about to make a huge change in my life after years of feeling I was in a dark place of helplessness that I could never get out of with my weight. “It’s always darkest before the dawn.” I’ll admit, there was some emotional crying going on as I was singing, too. The words don’t fit perfectly, but they are pretty close. I’m more than ready to shake off that devil, and dance for the rest of my life.

(And thank you all for the very kind words, comments, and offers of support to my post yesterday. I’m still a little nervous about sharing all this, but if it can help me work through this journey as well as possibly helping someone else in the future, it will all be worth it.)

“Shake It Out” ~ by Florence + The Machines

Regrets collect like old friends
Here to relive your darkest moments
I can see no way, I can see no way
And all of the ghouls come out to play

And every demon wants his pound of flesh
But I like to keep some things to myself
I like to keep my issues drawn
It’s always darkest before the dawn

And I’ve been a fool and I’ve been blind
I can never leave the past behind
I can see no way, I can see no way
I’m always dragging that horse around

Our love is pastured, such a mournful sound
Tonight I’m gonna bury that horse in the ground
So I like to keep my issues drawn
But it’s always darkest before the dawn

Shake it out, shake it out, shake it out, shake it out, ooh whoa
Shake it out, shake it out, shake it out, shake it out, ooh whoa
And it’s hard to dance with a devil on your back
So shake him off, oh whoa

And I am done with my graceless heart
So tonight I’m gonna cut it out and then restart
‘Cause I like to keep my issues drawn
It’s always darkest before the dawn

Shake it out, shake it out, shake it out, shake it out, ooh whoa
Shake it out, shake it out, shake it out, shake it out, ooh whoa
And it’s hard to dance with a devil on your back
So shake him off, oh whoa

And it’s hard to dance with a devil on your back
And given half the chance would I take any of it back
It’s a fine romance but it’s left me so undone
It’s always darkest before the dawn

And I’m damned if I do and I’m damned if I don’t
So here’s to drinks in the dark at the end of my road
And I’m ready to suffer and I’m ready to hope
It’s a shot in the dark aimed right at my throat
‘Cause looking for heaven, found the devil in me
Looking for heaven, found the devil in me
Well what the hell I’m gonna let it happen to me, yeah

Shake it out, shake it out, shake it out, shake it out, ooh whoa
Shake it out, shake it out, shake it out, shake it out, ooh whoa
And it’s hard to dance with a devil on your back
So shake him off, oh whoa

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!!