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Entries in Eat to Live (2)

Sunday
Feb172013

Hernia

So, I have a hernia, an incisional hernia that burst through my former Open Roux en Y Gastric Bypass (which was in 2001) scar. The outer scar goes from just above my belly button to about 3 inches below my sternum. The hernia, an opening in the layers of my abdomen, is small, about 2 inches in diameter, but when I saw the surgeon, she said she’d rather see humongous ones than small ones because small ones can constrict more than large ones. Great, of course I get a small one. 

I sat up in bed and the hernia burst through the tissues and I was in enormous pain. It took all day to get the intestine back into my abdominal wall, but I finally did. If they stay out and constrict, it’s emergency surgery time. I didn’t/don’t want that! 

I spent the time waiting to see the surgeon sitting still. Thank goodness I had no babies due. The hernia only popped out one more time, but I was able to get it back inside my belly without a problem.

I saw the surgeon last week and she was awesome. She explained the whole hernia experience to me, what happened, what’s coming down the pike (surgery) and recovery after surgery.

Regarding surgery, before I saw the doc, I’d gone online and checked out surgeons’ sites and saw that almost all of them required their hernia patients to have a BMI of 30 or less. Oh, criminy. That would be about 130 pounds from now! While I am on the Eat to Live Diet Plan, I just don’t think I can wait to lose 130 pounds before I have surgery. They do that so they can do the surgery with a laparoscope instead of an open procedure (with a long incision). The more incisions you have in your belly, they more complicated your insides become… adhesions and more possibilities for incisional hernias. This doc was great and told me that even if I didn’t lose any more weight than the 20 I’ve already lost, she would still be able to do the surgery laparoscopically. There would always be the risk of having to revert to an open surgery, but she felt comfortable with the laparoscope. Even so, it’s best if I lose some weight, so we put the surgery off ‘til June, so I can try to lose about 40-50 more pounds. (Wouldn’t that be awesome? Sounds great to me!) I want the surgery to be as safe as possible.

So, what about working? I have one client due now and will attend her birth, but I am having to pass off the rest of my spring and summer clients. Bummer all around. I have a binder to hold in the hernia as I do the upcoming birth, but the surgeon told me that binders don’t always work, so no lifting anything above ten pounds until surgery. Afterwards, no lifting anything more than twenty pounds for six weeks. That’s a long time! I’ll have to be creative at the upcoming birth. I can do it, though.

I did really well not getting a hernia after the gastric bypass. About 50%-70% of patients get one within the first couple of years post-open gastric bypass. I went 12 years! Pretty good.

Now, the goal is to keep the hernia inside as much as possible so I don’t have to have an emergency surgery between now and June.

During the surgery, the doc will put a large mesh over the hole in my abdominal wall and she’ll staple it there. I might feel the staples until they disappear (3 months or so post-op). It’s outpatient surgery, too, so that’s great. She said I’d feel like crap for a few days, but then will feel fine unless the staples hurt on the inside, which is rare. We talked about the risk of a seroma and she told me if I get one to NOT let anyone try and reduce it with a needle, to just let it disappear on its own. She said the needle, no matter how sterile, introduces bacteria into the mesh and the mesh gets infected most of the time and that’s a huge mess if that happens. No aspiration of seroma; check. 

Otherwise, everything sounds surgery-straightforward. I just need to keep myself as safe as possible during the surgery. 

Isn’t this fun?

Tuesday
Feb122013

OT: Eat to Live

This is my blog and it is midwifery oriented, but there's something going on in my life that I want to blog about and it's just going to have to be here. At least it will make the site more active again!

And it is relevant to midwifery.

I am fat. Very, very fat. As I've gotten bigger, it's gotten harder to doula more than once a month because it is really hard on my body. While I am at the birth, I am totally mobile and active, but afterwards, it takes days to recover. This is so hard to admit, but so important to talk about, especially for fat doulas who continue gaining weight. I am the fattest doula I know, in real life or otherwise.

I am damn tired of being fat. It can't be good for me, not just physically, but also emotionally. It has caused me to limit my interactions outside of the house, so much so that I get anxious even leaving the house. I am so sick of that!

So, Zack and I were channel-surfing in December and I stopped on PBS with Dr. Joel Fuhrman talking about Eat to Live, a diet/program that focuses on vegetables and fruits as its base for health. It isn't vegetarian/vegan, but certainly could be depending on how one does the program.

I've been doing Eat to Live (E2L) for a month now and am already down 19 pounds. In a month! Before those 19 pounds gone, when I walked down stairs, I had to go one step at a time, sideways. Now, I can walk down stairs normally and that small change alone has been really cool. Otherwise, I haven't felt much different. My skirts are getting longer, showing that my belly or butt is getting smaller. I think it's stomach, which is great; less chance of recurring diabetes.

I have no health problems at the moment. Hemoglobin A1c is a normal 5.9 (although I will find out the most recent one in a couple of weeks), Blood Pressure is normal. Kidney & Liver labs are all normal (my kidneys are doing so well I've gone from Stage 3 Kidney Disease to Stage 2!). Lipid panel is all normal, but my HDL could be higher. So many of those who start E2L are really sick and have that motivation. Mine is fat and a desire to continue with my healthy labs.

I've been on diets my whole life. I was on Phen-Fen in 1996 and lost 111 pounds. I had a gastric bypass in 2001 and lost 190 pounds. Blessedly, I never got up to my fattest, but I sure did damage to my GB weight loss. The idea of another diet is depressing, which is why E2L is something more for me.

I have not had a second of hunger. It takes almost zero discipline to do this except for choosing the foods to eat. I never did well with structured plans... failed miserably with Weight Watchers, Overeaters Anonymous, the Lean Cuisine Diet... anything that made me measure or eat smaller portions failed. This gal wants to eat and the E2L allows me to do that, even though the choices are not the typical Standard American Diet (SAD).

Don't get me wrong. I miss my peanut butter toast, cheese and casseroles, but I am enjoying walking down the stairs better. I know I will never be able to go back to eating the old way and that has created mourning in my heart (food addiction, anyone?), but I cannot be this fat anymore.

The main focus for me is Gabriella. My 17-month old granddaughter. I want to play with her, run around with her and enjoy her life as a toddler and growing kid. I want to be alive to see her find a loving partner one day. I want to see my other grandbabies that aren't even here yet.

I can do this. I have to do this.

So, I'm going to write about my journey on E2L here. I will continue to put OT in the title so those who couldn't care less can pass it by. I do, however, know I will intertwine the weight loss with doula/monitrice work. I eventually want to take 2-3 clients a month... and look forward to do that.

Those who continue reading, welcome!