February 17, 2012

Celebrating 2 years since my surgery

2 Years Post-Op!

So, Wednesday February 15 marked the two year anniversary of my Vertical Sleeve Gastrectomy, and life continues to be pretty darn good! To "celebrate" I went to the doctor's office today to get a refill on my Nexium prescription and a lab order for blood tests.

Regarding the Nexium: 

While many people with VSG only need the Nexium for a few months and are able to stop taking PPIs, I have not been so fortunate. Every month I try to go without before refilling the scrip, and every month I find that just a day or two off results in pretty significant reflux. My reading has informed me that the shape and size of the VSG stomach tends to force the acid into the esophagus to a greater degree than with a normally sized and shaped stomach. It's a small price to pay for improved overall health, and the reflux is very well controlled, as long as I take the Nexium. I have tried over-the-counter PPI's but so far nothing else works as well.

Regarding Labs: 

I have a great relationship with my doctor, and he is very respectful of my knowledge about what tests I need and how often I need them. Now that I am a couple of years out, unless any of the labs are showing a downward trend, or are concerning in any other respect, I plan on having them done annually, rather than every 6 months. I feel pretty comfortable with this decision only because I have been tracking my labs consistently since immediately pre-op, and have not seen any concerning trends. I also am diligent about my supplements, so given that the VSG stomach doesn't have significant issues with malabsorption (with the exceptions of B12 for some people, and iron and calcium absorption being inhibited by low stomach acid, especially with the use of Nexium), it's not likely that things will go too far wrong, even in a year's time.


At this point, other than dropping the last 2-3 pounds of post -holiday weight, I am not really focussing on weight loss, but rather on maintaining a stable weight. This is a very nice place to be - and something that I didn't really think was even possible at the time I had my surgery.

In many ways though, maintenance is a bit tougher for me than the weight loss phase was.

Why it is tough
It's for life:
For one thing, although I "knew" that this way of life was going to be FOR life, we all have spent a lot of years living with a diet mentality - that is thinking that we eat and live one way when we are on a diet, and another way when we are not. This persists for a lot of people I think during the weight loss phase, and I am no exception. A few months into maintenance, and it sometimes seems that doing this for the rest of my life is going to be a long hard journey. At times I resent having to maintain a fairly restrictive way of eating (well, I have to if I also want to maintain my weight loss, anyway!) and want to be able to just eat what and when I feel like eating without having to always take into consideration the consequences of my choices for my health or on the scale.

No cheer-leading squad:
Another unanticipated thing with post-op life this far out is that you don't get the frequent reinforcement of watching your weight drop on the scale, or the pleasure of needing to replace your jeans with a smaller pair or two every month or so. The scale is as likely to show that I am a pound or two up as a pound or two down (normal fluctuations, and nothing to get all excited about). Despite doing weight training a couple times a week and looking a lot more tones, my measurements are not changing significantly and I don't actually NEED new clothes, because everything in my closet fits, and can't really afford to spend money on them anyway. My friends and family are now used to the smaller sized me, so I don't get all of the ongoing reinforcement from other people either. The work to maintain weight loss is about the same as the work to lose, but the ongoing positive reinforcements are diminished. Phooey!

Facing a couple uncomfortable truths:
1) My weight loss has left me with sags and wrinkles that sometimes I really don't like the looks of. I have to just deal with this and move on, but every once in a while I feel kind of sad and ripped off. I suspect some of this I would have faced due to normal aging anyway, but having been morbidly obese for 20+ years has certainly left its mark. Plastics are certainly an option, but they won't give me a perfect body either. Mostly I feel very good about my body, but there are certainly days when I feel a little down...

2) I don't think I will ever be able to eat like a "normal" person. I maintain on about 1000-1200 calories a day, even though I do exercise and do focus on quality and nutrition in my food intake. I am extremely grateful that my VSG allows me to tolerate this fairly reduced caloric intake with little discomfort or hunger, but do wish often that I was a bit more normal and could be a little more flexible.

What makes it better

Keeping food healthy and interesting:
As I mentioned above, the sleeve makes the dietary restriction possible and tolerable. I also do a lot of reading about low carb and primal/paleo eating and finding and trying new recipes keeps things interesting, although truth be told, our staple dinner is meat/fish/fowl and broccoli/asparagus/cauliflower, usually prepared either by sauteing, or roasting in the oven.

Finding other goals (body related, but not weight related) to pursue:
I have been doing weight training, (working with a trainer), and find that I can get very motivated about either increasing my weights (18 pound bicep curls this week!) or being able to do things that I couldn't do before (cable rows in a push-up position, jumping rope). I am definitely seeing a LOT more muscle definition in my calves and arms, even though my size is not changing much, and it is really, really good to be feeling strong and even a tiny bit athletic - not something I have felt in almost three decades.

Practicing gratitude:
Despite my undesirable tendency to whinge about the imperfections of my body and the restrictions of my diet I know these things:

Two years ago, I could never have imagined that I could possibly look and feel as good as I feel today. This body is functioning better and is stronger than it has been in decades, and I am grateful to be out of chronic pain, to be able to move through life with physical ease, and to have the potential for a longer and healthier life as I age.

Whinging about the need to be mindful of my food choices is a luxury. I have a more than adequate income, in a wealthy country, where my food choices are pretty much unlimited. I am grateful to be in the position to need to restrict calories, rather than, like many on this planet, facing malnutrition or starvation due to a lack of food resources. I am grateful that I have access to such abundance, that even with the need to restrict quantity, there is no restriction whatsoever of quality or variety in my daily diet.

I know that for many, this surgery is completely out of reach financially, or the wait list is impossibly long. I am grateful that I had the resources to find and access an excellent surgeon in a top notch facility for my surgery. I am grateful for the medical system in my country that makes it possible for me to receive and collaborate in the ongoing medical care required to keep me healthy over time.

I am so grateful for having had the opportunity to reclaim and continue to improve my health.

Here are some photos of me ready for my workout - no makeup, unflattering lighting and hair a mess, so beware!