Monday, May 7, 2018

Weight 117.8, calories 844. I though my weight would drop back a bit more, but I just looked at my sodium yesterday - wowzer! I need to pay more attention to it as it was way too high because all of my choices for snacks yesterday had a lot of sodium. I hope my BP isn't up at my physical this morning as a result.

Todays agenda is physical, provide reference for former employee, and attend new Alzheimer's support group more local and frequent than our other one. Oh and get tha****ch set up if I can.

Here are better pictures of the tattoo (taken by DS yesterday):

Good morning, all and sundry earth travelers. 160 this morning. Tigger tats...Sweet.

Thank you so much for the warm welcome. It means something.

I was asked yesterday to say both what happened re the regain, and how I've been dealing with it. A bit of chronology.. Some is in my ticker, and then- maintained the loss for about a year and a half. From January, 2015 until last May, 2017- well, I can't hardly account for it other than I had stepped out of the wadding pool and jumped face first into a sea of alcohol and binge eating all day-night. No exaggeration, I went to bed intoxicated and woke up in the (whenever) drinking and eating.

So, why? I think maybe this- I used to believe I was depressed because I was fat, and so I ate to medicate. Now, I'm more inclined to believe I was depressed and ate to medicate. The fat was just a byproduct of the depression. There is a significant difference between those positions. Put a clinical depression together with an addictive personality alcohol,and slider carbs that a sleeve gasterectomy will gladly accommodate 24/7, and I got the inevitable regain.

What caused me to stop? I was literally, physically killing myself, and all the denial in the world can't stand up to that fact. I was talking to my sister on the phone, and the truth broke through. That one moment compelled me to open up to the doctor (you know-the one I was putting off seeing until I got my **** together) .

What have I done for this past year? Under supervision I stopped the drinking. I'm surely an alcoholic, and, please, Jesus, may it never pass my lips again. It also took about two weeks to detox off the simple carbs/sugar (they truly are the devil for me). I have been on anti depressants which enabled me to "act"--practice those behaviors consistent with a VGS life- just that. Oh, and perservance--progress realized over time.

Now, a year later, well, Gratitude is probably the one best word. I am just so grateful -

Bonnie

Thank you for your honesty. You have shown such strength in recognizing what the issues were and actively dealing with them.

"literally killing myself" I have had that thought, myself.

There is so much learning in your post! I am glad that you made it back, in so many ways.

Liz, I'm sure both doctor visits will go fine. My three year VSG anniversary is at the end of this month. I really need to find a bariatric doctor and group here to check in with.... before I NEED one. Bonnie, yes, thank you for your honesty regarding recovery from addiction. A long time ago, when I was a newby here, I made a statement that we are all either in relapse or recovery, indicating that there was no in between. That sounded harsh to some. In retrospect, it is a simplistic black and white look at a complex issue, but I still need that lense for myself. I define relapse as active addictive behaviors, whi*****lude refusing to collect and analyze data AND mindfully identify how to adjust behavior accordingly, and then do so. For me, to stop weighing daily is the beginning of a slippery slope. I slip up the most when I've identified adjustments I need to make, and then I repeat the undesired behavior. To me recovery is when I modify the plan or break it down into manageable steps, in order to successfully change behavior rather than just doing the same thing over and over expecting a different outcome. Make sense ?

Shel, you asked about my knees. I'm doing the ostrich regarding needing two total knee replacements. My limited range of motion does not keep me from doing most of what I want to do, riding a bicycle being an exception. My recent injury underscored how intolerable immobility is to me. It would take a lot for me to believe the surgery is worth the recovery, especially factoring in the possible exacerbation of lymphedema.

D.

The benefit of daily weighing was highlighted at recent conference as the number one weight management technique. I heard mumblings of "that just drives me crazy" around me. They all need an Ostrich t-shirt.

Speaking of which......I always hear that peeps know when it is finally time for joint replacement. I would guess you are less ostrich and more someone that still has enough quality of life to legitimately kick the can down the road.

I totally understand lymphedema being the wild card in this. We have a new plastic surgeon/lymphedema specialist that is likely willing to do excess skin surgery on my arm MOSTLY because that extra skin is giving a place for lymph to collect and causing additional swelling. I don't care much for this particular doctor, but I might go see his mentor at the U at some point for a second opinion. Still, very scary to even contemplate.

I absolutely agree on the daily weighing. It is something I never did in the past and now I see it as critical to keeping on top of my weight.

Subject change: My PCP wants to spend some time comparing my Dexa scan (the bone density part) to the bone density I had done prior to that. He thinks there is a chance that I may need to go on medication to treat osteoporosis (my daily calcium may not be enough). My mother broke her leg due to osteoporosis in her early 60's and never walked properly afterwards. All the oral meds have a risk of GERD, so I think that if it is needed I'd be better on an injectable. What do you think?

There was a osteoporosis guideline update last year which you can find here. I can send you a PDF if this link won't let you make one. The pdf is easier to read.

Do you know if you have osteoporosis or is it still perhaps osteopenia? It makes a difference in treatment tho the doctor, of course, can always make clinical judgment to treat how she/he sees fit. The guidelines are just that....there are no rules that they always be followed, 100% of the time.

The bisphosphonate drugs are associated with potential GI side effects whether they are given by mouth or by injection (their stomach irritation isn't limited to the oral formulations) Only one is available as an injection. But, not everyone would have GERD with them. You wouldn't know for sure til you tried.

The injectable denosumab has moved to a reasonable first line alternative to the bisphosphonates. The guidelines say it also is related to GI issues but I found that surprising but didn't have a chance to see where that info is coming from. I wouldn't personally think it has equivalent GI side effects compared to bisphosphonates but they must have some sort of info. But, not everyone tolerates denosumab, either.

I think another good question (one I didn't have a chance to look into) is that if a PO med is prescribed, where is it absorbed? Does it make a difference if the patient has an altered stomach? (Probably not, but worth a look see.)

I would guess that most PCP's are more experienced with the bisphosphonates in general. They have been around longer, there are more than one of them and they are easier to prescribe than denosumab from a logistical standpoint.

All drugs, including denosumab have potential for unpleasant side effects. And sometimes "expected" side effect never appears.

No matter what you start with, you always have a chance to move on to something different if needed.

The best news, is that there is effective treatment available for osteoporosis, and, better yet, more than one option.

Good luck!

Greetings Monday Miracles

148.5 today. Not liking this trend. But I agree its important to weigh regularly in maintenance. Dr. C thinks so too - even more so than in weight loss. Yesterday at the hippie lunch the food was mostly pretty healthy. I took hummus and carrots. Not too much rice. But I ate a piece of chocolate cake and even though it had zucchini in it, it was hardly health food. But I did get some studio time in and skipped my evening wine. I really have to cut back there. Hot milk in the evening instead. Its also getting to be iced tea season. I like plain old instant iced tea with no junk in it. You wouldn't believe how hard it is to find in this land of health food stores.

Thanks for sharing your story Bonnie. Good insights. I may pm you on a few issues if thats ok.

Shel, interesting about the lymphodema specialist. Seems like it would be worth the surgery if it reduces the chance of that. I had no idea it was such a struggle for breast cancer patients. Who needs that?

Great tattoo pic Liz. Perfectly done.

Well our new electric Bolt is on the way. Maybe late tomorrow or the next day. DH has the garage pretty well emptied out. Electrician comes tomorrow to install the charger unit. I think I am going to give my old Prius (205,000 miles on it) to our studio director who works for low pay and has made a big difference to lots of folks.

Interesting thoughts on the dexa Liz. I am fully expecting my doctor to want me on those drugs next time I do one. Last test I was borderline and he asked what I thought about those drugs and I told him I would rather avoid them. Gotta get with the weights.

Well time to get organized. Just called to arrange insurance on the new car and DH called the electrician. Gallery duty in Arcata today, banking for the Trinidad gallery and payroll for the studio. Whew, I am such a wheeler - dealer!!

And hey, good luck Cecily. Is tomorrow your surgery day?

Well take care all and remember, evil chickens lay deviled eggs.... Diane S

I'm getting your Humboldt hiking book ready for mailing. Also, if you haven't seen it, I have a Bryce posting on yesterday's thread. Too long of a post -- have lots of coffee on board.

My lymphedema got markedly worse after VSG. Before that, it wasn't that big of deal. I would agree it would be worth the surgery if loose skin is the driving force, but I am such a weird hybrid (breast cancer treatment plus VSG) no one has experience that I know of. Also, sometimes loose skin surgery peeps end up with lymphedema even tho they have never have nodes removed. So, the loose skin surgery can cause lymphedema, too.