Sunday, February 27, 2011

10 Reasons Why I Am Commited to Reach My Goal Weight

So, I'm a year older. My birthday was yesterday. I've had to work all weekend, so it has been less than amazing.

I also had a job interview on Thursday. I would really like to get the job, as its 6 blocks from my house rather than 53 miles, and will probably pay a whole lot better. It would mean that I would have to put my surgery on hold for a while, though.

I've been working on my "homework" for my next appointment at the weight-loss center. One of which is "10 reasons why I am committed to reach my goal weight". Here's what I came up with:

1. Have a baby
2. Have more sex
3. Go shopping, pain-free
4. Buy clothes in a store, instead of online
5. Be able to go running or hiking
6. Be able to play with my kid(s) someday
7. Be able to play with my grandkid(s) someday
8. Be more comfortable sleeping
9. Ride rollercoasters again

They advise making a small copy of the list and carrying it around for whenever you're tempted by an unhealthy decision. I'll probably just put it on my Android!

Wednesday, February 23, 2011

At my 2/14 appointment at the Bariatric Center, they sent me home with a small stack of homework. The Social Worker briefly explained it, but I didn't look at it more closely until yesterday. They are as follow:

1. A Genogram ( I'm somewhat excited about doing this, though I'm not sure where to start. They want it the size of at least 2 regular sheets of paper taped together. I have zero drawing/art skills. I don't have to work tomorrow or Friday, so I'll sit down and take a crack at it.

2. A food diary, and a page of questions about how I plan to change my unhealthy habits. I've been keeping my food diary via an app on my Android phone. I've been finding it rather fun and informational. I also find that I avoid anything that I don't want to have to look up and find out how many calories it has to add to my diary.

3. A self evaluation about how my eating habits and weight have affecting my relationships with family, friends, work, activities, etc. There is a part of me that is afraid to do this. It will likely be a real eye-opener.

4. 10 reasons why I am committed to reach my Goal Weight. Peice of cake. When I finish this one, I will likely post my responses.

On another note, I think I'm ready to start some kind of exercise routine, but I'm not sure what will work best for my busy schedule. I'd like to be able to walk with JP, but the weather is going to be an issue for a few weeks. I'll have to brainstorm.

Monday, February 21, 2011

I'd mentioned that I was going to post about how I've been dropping the few pounds that I've lost, so here goes!

The overall focus is calorie counting, low fat, and low sugar. I downloaded a nifty android application, myfitnesspal, that allows me to search for foods, or add my own. I told how what I weight, my goal weight, and how quickly I want to lose it, and it sent me a calorie goal for each day. It's a food diary that tracks calories. I find it very helpful!

Here is my typical day:

Breakfast is usually one the go, as I have a 53 mile drive to work. I stop at Subway and get a Western on an English muffin, with no cheese or sauce. It's a wheat muffin, white egg, onions, and green peppers. I add spinach to it to get a few more nutrients, and because I like spinach. It's 155 calories. I also grab one of their things of sliced apples (35 calories), for in case I get nibble further along on my trip.

For lunch I'll have a salad or a mix of raw veggies with 2 tablespoons of lite dressing (it is important to check the sugar content on anything "lite", they often make up for less fat by adding sugar). I'll also have 4 oz of either chicken breast or turkey deli meat in a wheat pita, or sometimes I'll throw it all in the salad. To add some dairy, I'll have either a low carb yogurt or a low-fat string cheese.

Dinner has been very similar, though we've been experimenting with different types of fish and pork loin. One of my favorite meals so far was a seasoned 4 oz. Ahi tuna steak that I seasoned and baked in a foil packed in the oven, along with bite-sized pieces of onion, red bell pepper, and yellow bell pepper. I also boiled some brown rice spaghetti noodles and seasoned them with a tiny bit of margarine, garlic, a tiny bit of Parmesan cheese, and a spice mix.

I generally have a mid-morning and a mid-afternoon snack that will consist of an apple, an orange, some pineapple, some carrots, or a red or yellow bell pepper.

I've been doing this for 8 days now, and I've lost 11 lbs! I just hope it keeps up. Soon I'll add some kind of exercise regime, but I don't want to try to start too many new routines at the same time, or I'll be setting myself up to fail.

Wednesday, February 16, 2011

Appointment #2: Lab work

For anyone that has any kind of a lengthy commute, I would like to high recommend audio books. Since I started my job at the end of April, I've listened to 15 or so novels. It makes my drive seem to go by faster, and I find that I even look forward to it at the end of my work day.

I got to the Bariatric Center about 15 minutes early this morning, before they opened. I had Neil Gaiman's America Gods to keep me company. Great book, in case you were wondering.

I met the nurse for the first time. She was very nice and sweet. She explained everything she was doing before she did it. First she drew 11 vials of blood. That's not a typo, she took ELEVEN vials of my blood. Needless to say, it got very difficult about halfway through, and my arm is very sore. She mentioned what some of them were for, but I can't remember anymore.

Next I climbed on to the scales, where I was pleased to find out that I'd lost 4 lbs since Monday (I'll explain my self-imposed diet plan in another post). She took my measurements, and then took a "before" photo. Next I got to strip off my top and have an EKG, followed by a lung capacity test, and then the whole experience ended with a urine sample. I feel poked and prodded, but accomplished. At some point I have to find the time to go to the hospital and have a chest x-ray. Not sure when I'm going to do that.

My next appointment is March 2nd.

My first appointment at the Bariatric Center

On Valentine's Day, JP piled in to my car with me, and we drove to my work. Where I work and where the Bariatric Center is, is an hour away from our house. JP took the day off in order to accompany me. He is extremely supportive, and wants to be in on the whole process. I worked for half of the day, then we grabbed a quick bite to eat, and headed to the appointment.

Let me preface the rest of this by explaining some of my expectations. At the informational meeting, they gave us a BMI (body mass index number) of which they need, that makes the surgery safer. I knew that my BMI was higher than that number, and that they would help me lose weight in order to reach it. I was expecting to be given a diet plan, an exercise regimen, and some other useful information. I know basically what I need to do, I just need help with a plan to be able to implement it. These people are the experts, I'm not.

First we met with the dietitian. She went over the very basics of what you can and can't eat after the surgery, the stages, and whatnot. Nothing about pre-surgery.

Next came a woman that was to answer any questions about my insurance coverage. I did my homework beforehand, because I'm smart enough to know that I'm not going to even attempt something that my insurance wouldn't cover. Therefore, I didn't have any questions for her.

Third was the social worker and her student intern. I answered questions about my mental health, my job, my family, my marriage. I can understand the need for this, they want to make sure I'm going through this for the right reasons, and that I have enough support to get me through it. I am, and I do. They next asked my husband to leave the room and I took a 140 question bubble quiz, the type that you'd take before being evaluated for therapy. I guess this is just in case I was lying to them about being stable and happy and supported. Lame.

The end of the appointment provided me with a goal weight to be at by the time of surgery. I have 38 lbs to lose. I next set up my next 2 appointments, one for lab work, and then a follow-up with the dietitian, and a meeting with the doctor.

All in all, I was very disappointed, and depressed for much of the next day. I don't like feeling like I'm wasting my time. Now that I've had some time to think it over, I'm realizing that maybe baby steps are for the best. My habits are about to change for the rest of my life. No need to rush in to that at full-speed.

This is my story so far

Hi, I'm Jamie. I don't expect that many people will read this, as I'm kind of a niche market. I'm infertile and overweight. This is my story of our infertility journey, which has taken a detour for weight-loss surgery. There will be a lot of diet and exercise talk, as I struggle to change my lifestyle and figure out what works. If none or only one of these issues is of interest to you, you may find the information contained herein to be a little bit TMI. If you come across something that makes you uncomfortable, I encourage you to stop reading. This blog is for me, to let me see my progress in black and white. If I happen to help someone out there going through the same things, that would be wonderful.

I'm 30 years old, turning 31 in a few days. I'm newly wed to my wonderful husband (JP), but we've been together for about 5 years.

Starting at an early age, my sisters and I were all diagnosed with malfunctioning glands, which subsequently affected our development. We were medicated with various things to replace hormones, and slow down development. The overall results were that we're all very short, heavy, and were told early on that we would have trouble conceiving. By the time treatments and doctor's appointments were over (I was about 18), I had stored that last bit of information in the back of my brain.

Fast forward to early 2008. My future husband I were living together, neither of us were getting any younger, and was just about to finish a pack of birth control pills, with no refills available. We decided to forgo the refills, and see what happened. I didn't have high hopes, but I was ready to start the process. I quickly discovered that I don't cycle naturally off of BCPs.

Fast forward to May 2010, when I first talk to my OBGYN about my desire to conceive. She orders a bunch of blood work (pre-diabetic, but otherwise fine), an ultrasound, and refers me to a Reproductive Endocrinologist (RE). The ultrasound confirmed her suspicions, and I am diagnosed with PCOS (Polycystic ovarian syndrome). I am prescribed Provera to jump-start my cycle. It doesn't work.

Shortly after, we had our first appointment with the RE. Dr. G is wonderful, charismatic, thorough, and assures us that one way or another, he's going to get us pregnant. He prescribes more Provera for me, and an SA (semen analysis) for JP. The 2nd round of Provera again fails to get my cycle going, but the SA came back excellent. After one more try, a healthy dose of PIO (progesterone in oil), fails to yield any result, RE says that we can move on to IUI (intrauterine insemination) anyway.

My IUI history then goes as follows:

7/31/10: Start Femara 2.5 mg twice daily
8/12: IUI,
2 Follicles, 12mm & 17mm
8/26 - HPT & 8/30 Beta =

8/31/10: Back to Femara, 2.5 mg twice daily
9/02: Start Follistim, 50 a night for 8 days
9/13: 8 am: IUI,
2 follies at 19+

11/04 - HSG shows 2 clear tubes! Hooray!
11/9: Femara
2.5 mg twice daily, 5 days
11/11: Follistim, 100 units nightly, 8 days
11/17: US - follie check, 2 @ 16, several around 10-12
11/22: IUI (trigger 11/20, evening)

After the 2nd failed IUI, the RE wanted to talk to me before we proceeded with another. He tells us how everything looked fine on the ultrasounds, the blood test results were good, JP's counts and motility were great. He wanted me to have an HSG (hysterosalpingogram), to make sure that my fallopian tubes are not blocked. It'll be a few weeks before we can get it done, so we can't cycle that month. I start to feel depressed for lost time, and angry that we didn't do this in the first place, and terrified that my tubes will be blocked.

Fortunately, the HSG, although painful, revealed 2 clear tubes. Dr. G tells me that HSG can even clear small blockages that might have been hindering us. "Clearing out the cobwebs", as he so cutely put it. We are to start meds again in a few days. I start to become super optimistic the next cycle, even though the cost of the meds nearly put us in the poor house.

When the BFN (big fat negative) came, I was devastated. My nurse called me with the negative beta results, and we decided that we would skip December, because of the Holidays, but I wanted to talk to the doctor again before we started in January. I asked if Dr. G had ever recommended patients for weight-loss surgery, and she said that yes he did, and would likely be happy to get me any of the paperwork I needed to get it approved by my insurance. I spent the rest of the month and most of January depressed, but doing my research about the different surgeries, and discussing it with my husband. I was never able to find very much info on infertility after weight loss surgery.

My RE, while convinced that he could still get us pregnant without, is fully supportive of my having surgery. He says that I'm plenty young enough to go through the process, recover, and then go on to possibly even get pregnant without help. He refers me to a reputable center nearby, and I go to an informational meeting. I decide on Roux-en-Y (gastric bypass), fill out all the paperwork, and schedule my first appointment.

That, pretty much, brings you up to speed.