Today is one of those strange days that I’m having trouble keeping my blood sugars up. It’s not that I’m dangerously low, just that I keep trending downward.

I got up to an 82 and my after breakfast/before lunch sugar was only an 84. Usually, that’s my highest reading of the day. I don’t always eat before rehab but at 84 it seemed like a good idea so I had a piece of toast with cheese. Half an hour later, I was trending downward at 77. And I seemed to be staying there so was watching it carefully during exercise. Finally, I made it up to 111. Within half an hour, I was trending downward to 100 again and so I’ve had a snack with fresh tomato, a piece of cheese and a couple crackers. I even put some pepper jelly on the crackers so probably next time I check I’ll be at 200!

I’m thinking this is possibly a result of the lap-band. Chances are, the nice piece of toast sat in my pouch and didn’t make it to the stomach for up to an hour. I probably need to watch this a little more carefully and if I’m headed downward, I should eat something like yogurt that will move through a little more quickly.

Still learning.

I’ve noted that not only I am having trouble with the reward concept in our weekly goals. It’s one of the hardest parts of goal setting for me. I guess my head says I’m an adult and I ought to be able to just *do* these things that I know are good for me. A lot of times my “reward” seems to be simply not beating myself up over not doing something – not the best reward, especially since there’s a definite flavor of waiting to screw up so I can beat myself up.

In that vein, I was reading Geneen Roth’s column in the October (I think) Good Housekeeping last night. [note: some of her articles are archived online but I don't see this one listed] She wrote about not only how to stop bingeing, but not hating yourself when/if you do. My only immediate reward for not bingeing or grazing is not putting myself down for a behavior that is legitimately hard to break. Yes, the big picture rewards are important but they can feel really out of touch.

Geneen wrote about how to treat yourself after a binge:

Be unspeakably kind. In the empty fullness left after bingeing, the “I can’t believe you did this again, what’s the matter with you, you are a failure now and forevermore” voices sense a place to step in. And when they do, they roar.

Don’t let them. …Treat yourself as if you were doing your very best. Live as if you deserve to be here, regardless of what you have just eaten. And know that every time you remind yourself that you belong here regardless of what you weigh, you are speaking the truth.

And that is unspeakably hard and makes my eyes tear up to think about. Particularly right now I am afraid to screw things up. I’ve worked very hard to get the progress that I’ve made and I don’t want to resume old behaviors. Trust me, old behaviors are there just waiting to happen. My tendency is to blame myself and go even further once I screw up a little. “Well, I’ve already blown today,” I say. “I may as well……”

So, in the spirit of trying to change behavior and not have an all or nothing attitude, I need to remember that all behavior training involves successive approximations. Remember, we’re building on success, not setting ourselves up for failure. Therefore, in my reward plan which is loosely forming on crediting myself with $1 for something I want for each night I don’t graze or binge, I’m going to give myself half credit for stopping the behavior even if I got off track a little. I think that’s a good plan.

Oh, and yes, reward is incredibly important when changing behaviors. The moral superiority of being able to say “See, I did it” doesn’t really do enough for most of us. If the behavior has no reward you simply aren’t going to continue to do it. If you’re breaking a habit – like smoking – and your only reward is the jitters, cravings, and irritability – how long do you think it’ll take to return to smoking?

I’ve been meaning to post a little update. I’m really doing quite well. I have been able to sleep on my side again, which is helpful. I have to be a little careful as I move about but it’s doable. The pain, other than that, is pretty much gone – I’m just left with my usual back and knee, etc., pain.

The first couple days I wasn’t hungry at all. If I drank even water even slightly too quickly I felt like I was overly full. The band is not inflated at all at first, just the swelling from the surgery makes you feel as if it is. I’m still on a full liquid diet for another week and I have started feeling hungry. They didn’t really place any restrictions on me except for the liquid but I’m still keeping my calories between 600 and 800. Mostly that’s okay but if I had something solid to digest it’d sure be nice!

I’ve decreased my diabetes meds further and am staying pretty much between 80 and 100. I probably ought to be testing more often than I am but when I do feel low-ish, I test and I’m still in that range. In some ways, I feel like I’m always eating because when it’s not meal time, I’m drinking those protein fruit drinks trying to get my protein for the day. It makes it hard to have a clear window for testing but it also may be keeping my BG pretty steady.

I’ve noticed in the past couple days that it’s easier to get around. Not just it’s easier to get around post-surgery, but it’s easier to get around in general. I think it’s probably a good sign! I feel like I have a bit more energy, too, but I also tire out pretty quickly.

And that’s how I’m doing…

I spoke with Schnukiputz the other night – she is having some further testing but it seems possible that they may have an idea of what is causing all her pain. It will still be a long while before they get anything fixed but it seems to be a bit of a light at the end of the tunnel.

I’m home from all my adventuring and feeling quite a bit better this afternoon. I believe that hospital stories are really only interesting to the person telling them so I’ll just hit the highlights.

The weather stayed pretty much on the line between awful and okay. Mom had a panic attack because we weren’t planning on having the folks actually at the hospital the day of surgery. Dad was supposed to take me up Tuesday and pick my up Thursday. I stayed in the hospitality rooms at the hospital Tuesday night since I needed to check in at 6:30 AM. Mom and Dad ended up staying in a hotel room so she could be there just in case something unexpected happened. Probably it was just as well given the state of the roads.

After a mostly sleepless night I rolled down to the North Entrance of the hospital and found a nice person who found out for me where I was supposed to go and took me there. They really do have nice people working there. I don’t have a bad word to say about anyone. From there, I went to the angio lab where I had a Vena Cava Filter installed which prevents possible pulmonary embolism. It’s a little weird to think that this little tiny metal umbrella is going to sit in my vena cava from now on – but there you go. It’s apparently possible to remove it should that ever be necessary.

Then we sailed through the hospital up to where I was supposed to have a room before lap-band surgery – but I guess it was time for surgery already ’cause off I went to pre-surgical holding where a parade of people came to talk about the procedure and I saw the doc briefly. Mom and dad were brought in for about 10 seconds and I was able to reassure her that I was doing fine. I don’t remember much of anything between “we’re going to give you this shot to relax you” and coming out of anesthesia in recovery. I was in such a lot of pain waking up that I remember thinking that I had changed my mind and didn’t want to have this done after all.

They pump your abdominal cavity up with gas while they do the laparoscopic procedure and apparently my rib cage and sternum were not amused by this. I have not had that much pain from the actual surgical sites but my chest was miserable. It’s feeling a lot better today and I’m even able to take some deep breaths. Apparently my heart wasn’t happy about the gas either as I heard them talking about the number of PVCs I was throwing. All of that improved when I could start getting some air in my lungs.

Finally, off to a very comfortable room that was not at all where they said I’d be. By that time, the worst of the pain was done. My chest hurt from time to time but I don’t have a lot to complain about. Still, I admit I was missing the intravenous morphine last night when I tried to sleep at home. Mom and Dad visited only a few minutes while I was still groggy but it reassured Mom and they were able to go home before the weather got worse. I was up and walking around about an hour after I got to the room and changed into my jammies from home which were way more comfortable than the hospital gown. I “ate” dinner a few hours later and I was actually a little hungry. It was a challenge to get down the little bit of soup and milk and lemon fluff but it also made my throat feel better. That’s weird feeling. I’ve been eating a half a cup of strained cream of chicken soup the past forty minutes while I’ve been writing this and I have probably a third of it left to go. I imagine that will improve as the initial swelling from the surgery eases off in a couple weeks.

And that’s pretty much it. They decided at one point that I wasn’t peeing enough so they started pushing the iv fluid, yippie. It gave me the opportunity to get up and walk several times during the night. Between that and getting my vitals done every half hour I didn’t sleep a lot Thursday night. Saw Dr. Fattie in the morning and he pronounced me well enough to go home. He said the surgery was hard because my liver was still very large. That was just weird! I’ve been on reduced fat and calories for months and I did pretty well on the liquid died. I won’t claim 100% perfect but pretty close! Oh well, it’s done anyway. The weather was damp and foggy all day – it’s finally cleared up nicely today, isn’t that a surprise?

At any rate, that’s the whole story. I’m home, I slept okay last night but I’m still tired and sore. I’m up and down – and at least getting off the bed is becoming easier, yay! I follow up in a couple weeks and will be on an all liquid diet until then. Thank you all for your kind thoughts, healing energy, positive vibes and prayers!

I should be on my way to Springfield shortly. The weather has not been cooperating – or at least the forecasts have been nasty. Most of the winter stuff ended up north of us so no excuses to eat hamburgers and stay home.

I’ll let people know how things went probably Thursday night. Thanks for your good thoughts, positive vibes, healing energy, and prayers.

I’m only kidding a little. A couple people have asked what I’m eating on this liquid diet so I posted a “recipe” over on my food blog.

Click me!

This week I enter the final stage of preparation for lap-band surgery. This is scary but it’s also a decision that I’ve researched and considered for several years. It wasn’t a decision made lightly.

I am in a wheelchair because of injuries I sustained in a fall – but, if not for the weight I might have healed better and be able to walk at least a little more than I do now. In addition, not being able to walk has limited by exercise options and just makes the weight that much more of an issue.

This is a life-changing choice in many ways. I know there are kind people here who will help support me during the next couple weeks. During this process, well-meaning friends have sometimes told me that I should try this diet or that program first. I’ve tried them. This is my best chance to regain my health and improve my life. Even if I can’t walk again, I’ll be able to roll around a lot more easily. And there is a good chance that if I get healthier and lose the weight, I’ll be able to walk better or have reconstructive surgery on my knee.

But it’s still scary. It’s frightening to make the choice to permanently change some unhealthy habits. Sounds kind of silly – but how many of us go on a diet, just waiting until we can eat whatever we want again? It’s hard to do things that seem like they should be simple like getting rid of clothing that no longer fits. I’m not sure who I’ll be without the weight.

I’m mostly ready. It’s just a little strange that after waiting and thinking and jumping through the program hoops – it’s only two weeks away. So thank you for listening. Thanks for your support.

Long time… I haven’t had a lot of news. My work on improving my diet and blood sugars continues to go pretty well. I won’t claim perfection – it’s still really hard to resist cravings at night, especially if I’m not sleeping. Still, my morning blood sugars are pretty “normal” at 80-90 mg/dL and since I don’t eat immediately upon getting up, they bounce up to 110-130 before “breakfast.” I still find that kind of weird. If I ever get back to a normal sleep pattern it will totally screw my eating schedule up!

I have the final test to determine acceptance for surgery next week. It has been such a long process and now it’s almost over. Sort of. I take the test, I’m sure there’ll be another appointment to talk about the test, then there should be an appointment with the surgeon, then don’t forget the filter then maybe…..maybe we schedule surgery. Could be April, right?

The possibility of surgery ahead of me has been a real motivator on the diet front. I am doing okay but I can sure see the places that I’ve lost it in the past. It’s so easy to slip back into old habits if I give myself even a little freedom. With luck, the lap-band will be a tool to help prevent those old behaviors.

Anyway, I’m feeling pretty good most days. Tired, but that’s me and my dear old insomnia. How is everyone else? Awful quiet around here!

Oh, and by the way, I started a recipe blog if anyone is interested! Chickens and Eggs

I was challenged by the program shrink to show that I understood what was expected of me – I’ve spent the past couple days working on a menu plan. It’s true that doing it helped me to understand more clearly. It’s hard to get 60-80 grams of protein + 2 vegetables + 1 fruit + some starches for 600 calories per day. And of course, I have to keep in mind that I won’t tolerate all foods right away. No tomatoes or beef for the first six months.

At any rate, for anyone interested, I created a pdf of the first week of sample menus. Got to finish up another week.

Sample Menu Plan 1

ALSO!

I keep meaning to post that I’ve spoken with our friend Schnuckiputz a couple of times since her surgery. She says that she is doing some better but has to wait until next month to let her eye stabilize before getting new glasses. Right now, the computer is too painful for her to spend any time looking at the screen so we continue to send her good wishes for recovery.

I said I would report on my progress toward the lap-band. I’m a little slow! I have finished nearly everything pre-surgery except meeting with the surgeon again. Before I do that, I need to “prove” that I understand the diet and exercise goals, but that’s another story.

On the positive side, I saw my endo on Tuesday. Dr. Endo was, as always, a nice and encouraging guy. My total cholesterol is excellent. And my bad cholesterol is even better – it merited gold stars for being so gosh darn low. My good cholesterol as not as high as it should be but apparently the really low bad cholesterol makes up for that. Go me. My triglycerides were down about 200 points – not at target but headed in the down direction. Again, go me. Plus, my a1c was down about half a percent – 8.0% which is still high but it’s only been in the past month that my numbers have started coming down. After all, I have been working really hard at making changes as part of the pre-surgical preparation.

In the past few days, my blood sugars have come down like magic. If I keep this up my next a1c will drop to below 6! We’ll see. My fasting sugar was 98 this morning – after months of 180+. I know Dr. Endo will be happy as if he had good sense.

So, surgery (if it happens) looks like it’ll be some time in October. I will keep plugging away.