Hello, and welcome to me

Since I haven't figured out how to make a posting remain in place, this will always be the first thing you see. I'll just keep changing the date. Scroll down, the new post will be there. I promise.

First, a word to newcomers:

Welcome to my life. Sometimes it's boring, sometimes it's funny, sometimes it's a pain in the butt- hey, who's isn't? You're here- or, rather, why I'm here- because I'm documenting my husband's journey to a healthy weight, as well as my own life during the experience. This process began almost a year ago now, when my mother-in-law, shocker of all shockers, decided, after her second massive heart attack, that she had some amends to make and offered to pay for my husband, Jim, to have weight loss surgery. Thus began the exciting and terrifying process- make no mistake, any one who tells you that weight loss surgery is the easy way out is sadly mistaken. Read back through the archives if you have any doubts. I've tried to be as eloquent and extensive as I possibly can be without totally baring our souls, but there's no way I can completely explain the pain, terror, and joy that this process entails.

On July 7th, 2005, Jim had a surgery called the biliopancreatic bypass- duodenal switch, or D.S. (duodenal switch) for short. Basically, it entails trimming off the greater majority of his stomach, bypassing most of his small intestine, leaving about 39 and a half inches (the lower 100cm) of the small intestine attached to the large intestine and reattached to the stomach for use in digestion and absorption, and removing the gall bladder and appendix. A complete replumbing. The advantages of this more extensive surgery are that there is less stomach stretching, more weight loss, less physical problems concerning the absorption of sugar and protein, and a wider diet. There are more, but this is just the basic rundown. The disadvantages include a longer recovery time and a higher mortality rate on the operating table and in the initial recovery period. Also, your insides are completely reworked. I'm sure that factors in as a disadvantage for most people. However, unlike the gastric bypass, the stomach will not stretch back out to its initial size and there will, most likely, be fewer post operative problems. So far, all has been well.

We are now in the hardest stage- the postoperative process. This will be a life-long expedition and I'm sure there will be setbacks along the way. There is the initial 'sweet period,' which we are currently experiencing, when weight falls off almost without effort, and lasts for about 18 months to 2 years. During this period, mostly what Jim must concentrate on is putting in the protein, water and vitamins that he needs to stay healthy and getting in enough exercise to keep his muscles strong. After that, Jim's weight will directly reflect what effort he puts in, even more harshly than it does now. The good thing about the D.S. is that it is a tad more forgiving than the gastric bypass- and it is a life-long tool. It's benefits do not fad away as quickly as they do with the gastric.

So, that's where we stand. It's a bumpy road. I can't always promise that I'll be entertaining, nor that I'll always be particularly interesting, but what you see is what you get- I'll always be real. There will be lots, I'm sure, about me- my own health problems, school, work and life in general. There will be more about Jim, his struggles and my take on the whole shebang. Enjoy!

Happy Birthday to Me!

Not much to say, other than we got Jim's labs back at the beginning of the week- his vitamin D levels are horrifically low, despite taking a prescription D (which was gel based and probably went straight through him because of his malabsorption factor). Apparently, 'normal' D levels start at 32 points- Jim's was 9-point-something. And, considering that he was borderline 6 months ago, I think we can safely say that the script is not working.

Something interesting I've learned- apparently, there are TWO D vitamins that our bodies need to process calcium, D2 and D3. The blood tests can only test for the presence of D, not distinguish between the two, so when your D-levels are low, it could be either one of these two that are actually low while the other is normal. I'm thinking that, since the prescription gel cap (vitamin D2, from what I understand) didn't do a lick of good, that Jim is actually low on D3, which comes in a dry formula, fortunately. I'm getting the clearance from his doc next week (as soon as the dang things come in- I mail ordered them from a company that unfortunately had them out of stock, but that's the only place in the US that sells dry D in 50,000 IU) to start him taking mega-doses of the vitamin to get those D levels back up to acceptable ranges, then we'll test him for D again in a month. Don't worry, it's virtually impossible for DSers to O.D. on fat soluable vitamins because of the malabsorption factor, but we're still going to keep a close eye on it.

So, why is vitamin D so special anyways? Why did I almost freak out when I heard his levels were less than a third of what they should be? Well, for one, once those fat soluable vitamin levels get low, it's REALLY hard to get them back up, because DS patients malabsorb so much of them. Secondly, low D levels and normal calcium levels means that his body is leaching calcium from his bones, rather than utilizing the calcium he takes every day, because without the vitamin D, the pill form of the calcium isn't biologically available to him. And since Jim already has some issues with osteoporosis, particularly in his knees, he really doesn't need any help in that area.

The good news is, everything else of his labs was normal. Oh, and pictures... sigh. My camera, as you can probably imagine, has completely died, so I don't think that any photos will be forthcoming. We're still unsure if Jim has an incisional hernia, because, apparently, no one wants to check him for one without being his surgeon or his primary care doctor, who is no longer his doc- well, at least for the time being. She left the clinic we were used to going to for the purpose of starting her own practice, but so far it hasn't been able to open it's doors, due to one thing or another. We can't go back to the clinic we were going to because of a bunch of drama surrounding one particularly rude nurse, so we're kind of in limbo. You would never think that a simple physical exam would be so danged difficult to obtain- it's not like you're reopening his incision, people! You're just pressing on it to see if there's a hernia there, for goodness sake. I hope that he never has any kind of emergency complication- I can just see a bunch of doctors playing hot potato with his chart.

Jim's weight loss has slowed to almost a standstill. I don't think it's going to go much farther without removal of his panni and some other reconstructive surgery- and having a hernia (or two, one on each side of the incision) could be causing some of the trouble as well. Something about hernias and weight loss surgery don't mix real well, but the good news is, once the hernia is fixed, weight loss starts again. Despite the slow loss, he continues to gain mobility and seems to still be losing inches. I wouldn't be overly surprised if the majority of his excess weight were not in fact excess skin- maybe even as much as 80 pounds of it. I do worry though, that he may need a revision to be able to lose the rest of his extra weight- which is not entirely unheard of for individuals that were hundreds of pounds overweight to begin with. But, either way, that will be something for years down the road, when hopefully we have the finances to consider reconstructive surgery and/or revision.

Boo!

Welp, month nine, ten, eleven and the first year anniversary has passed me by. lol
I guess it's safe to update now. :-D

Jim's doing well. Not losing much at this point- we fear he may be suffering from lymphadema, which helps matters not at all- but still doing so much better. He's getting around 1000% better than he was a year ago, and can actually buy clothing from a 'normal' store now on occasion. We just did his 1 year labs this afternoon, so we're still waiting to hear how those are. I'm hoping to see that his vitamin D is back up where it should be and am afraid that his vitamin A might be low.

In the interim of my hiatus, Jim's surgeon made a career jump and moved out to San Fran, which means we'll probably never cross paths with that wonderful man again, though we'll remain in contact with him at his new office for Jim's follow up. We'll miss him, but the truth is that this was better for him all around, and we were never close enough to just pop in for a visit occasionally anyways. Who knows what the future might bring though? I've always wanted to see the Golden Gate bridge and Alcatraz, so we might see him someday after all.

I have pictures to post on the other site, with luck, they'll make it up there this weekend, assuming my twice-cursed digital camera doesn't completely wuss out on me.

Jim's beginning to have issues with protein- the carbohydrate demons are starting to catch up with him and protein has gotten (*shock and horrors*) boring. Can't blame him, only took a year. I'm hoping to get it together enough to do a little grilling, which might help.

The summer has been beautiful, but oh. my. god. hot. (or as Southerners like to say HAAAAWT) so we're not doing nearly as much outdoor stuff as I had hoped (like, none). I'm thinking about finding Jim some swim trunks this weekend (and myself my first bathing suit in god knows how long) and hitting the pool for a bit. Jim surprised me by doing a little Tae bo the other day, though I think it might be a little too intensive to start with, since I don't think he's done any since. It *is* pretty hard core.

Not much else to update on at this particular time- never fear, however, I will be back! (And sooner than last time. :-D)

Ack, ack and double ack!

Will post Month nine update soon- buried and drowning here... too much to describe at the moment, but a lot of it has to do with the fact that I have finally come to the conclusion that I *seriously* need a break (a big one) from school. The last time I felt like this, I didn't return for three years.

Summer break (and my following, extended, fall break... ahem...) is right around the corner. Lets face it, I might not come back from this one.

Assuming, of course, I get through the next three and a half weeks.

*sigh*

More later, when I can resurface- hopefully before the end of month 10.

We're entering new territory here...

Jim has officially crossed the 200 pounds lost mark- by 1 pound. He's now 399. Party is ON for his 9-month surgery date anniversary (April 7, 2005... details to follow ya'll... soon as I figure them out).

He now (and has for a while, I suspect) weighs less than he ever has since I've known him (seven and a half years now). He likely weighs less now than he has in over ten years. He is fast approaching the weight he was in high school (which we estimate to be around 325 or 350). We're entering territory unknown to him in nearly 15 years... and the landscape has changed greatly since the last time he was here.

Are we having fun yet?

I'm sorry ya'll. Life interveins.

Right after I last posted, I had a crapload of work dumped on me at work, which I ordinarily wouldn't mind (like I have much else to do), except that it has, as always, strings attached. Nothing in this world can make you feel like so much of a useless p.o.s. but when the entity you work for, for five years, and the people you've worked with, for five years, automatically assume that you're an idiot when things go wrong, even/especially when it's caused by a computer problem (which is completely not you're fault), but because they do not understand computers, need a scapegoat. And, instead of simply taking the work that they seem to think you are not, after five years, qualified to do, away from you, proceed to explain it to you, repeatedly, in intimate detail, over and over and over again.

Blarg.

I'm just glad I work alone and only have to deal with it for fifteen minutes or so in the early a.m. Oh, and nasty notes. Got to love them nasty notes.

We also got into an accident the friday before last, which has brought with it a whole host of hassle and paperwork and doctor visits. I was already knee deep in the doctor visits and extraneous paperwork. The accident? Oh, yah, entirely not our fault either. We were sitting in traffic. The guy behind us was sitting in traffic. Both of us were minding our own business, when the guy behind the guy behind us apparently decided that traffic laws don't apply to him and plowed into the guy behind us, and then plowed him into us. He then took off, leaving us and the poor guy who became the filling in our car sammich, standing around scratching our heads. We didn't get the license plate of the hit-and-runner, so, apparently, the insurance co.'s can't (as in, required by NC law, not their own policy) pay on the uninsured motorist part of our policy to repair the damage to our tailgate. Which, by the way, is an entirely ignorant law. How many times, in a hit and run accident, do you really think that someone is going to be *able* to get the license plate of the vehicle that caused the accident and then beat feet? I can understand them wanting to protect against insurance fraud and all that, but, honestly, if a police officer shows up at the scene, and can *see* that there was damage caused by another vehicle, which is no longer there, is there really any reason to completely lock the injured party out of the money they need to make things right? Anyway, no one got seriously hurt, though Jim and I have both had this ongoing headache thing caused by the whiplash. Thankfully, we had an addendum to our policy for something called medpay, which is going to take care of our medical bills (up to a point, anyways).

The moral of the story? After an accident, at least in North Carolina, first thing- even before you exchange info, even before you take stock of any damage, even before you call the cops- get the other guy's license plate number. Even if you and yours are bleeding all over the place, because if he takes off, and you *don't* get that precious plate number, you'll be responsible for your own damages and your own medical, once it exceeds the limits your insurance company is legally obligated to pay on your policy to you. If you're good at multi-tasking, you can jot it down while you call the ambulance. Do other states have this idiotic policy? Who knows. I'm having a hard time confirming it for myself on the net, probably because I don't really know what I'm looking for. I suppose I *could* just take what the insurance guy says at face value, but I'm not inclined to do so.

After all, I did spend an hour climbing all over the Greensboro City courthouse looking for the place I needed to go to get an accident report that it turned out that I didn't need (and didn't exist anyways), whilst dealing with the rudest of the rude individuals that the city could round up to work their various posts. Now, their 'official' information desk person was nice, once I found him, and I ran into a sweetheart of a police officer who directed me both to a bathroom (locked public bathrooms in a city facility? Really.) that I could use and in the proper direction to get to police records, but it took me the better part of forty-five minutes to stumble across them. It never fails that I always enter from the exact opposite side that I need to be on- directions be damned- and it also never fails that I get directed (by very rude people, who probably get paid twice what I do to do half what I do and can be as belligerent about it as they want to be, apparently) in the exact opposite way that I need to go, and that I get lost in halls that unvaryingly have little, if any signage. Rabbit warrens have better layouts, I'm telling you.

At least this time I didn't end up coming out in the parking garage when I thought I was headed to city records, get locked out and have to walk around the outside of the entire backhalf of the complex to find a door that looked halfway like it led somewhere.

Alice down the rabbit hole, anyone?

/rant

Now, after that, a quick update. Jim is in the last 10 pounds before he crosses into the 300s, a place he hasn't been in since god knows when. I fully expect that he will be there April 7, his 9-month anniversary. So, tentatively, I'm scheduling a celebration for that weekend. Party hats on!

And speaking of Jim, since the weekend of the accident, the poor guy has been suffering with kidney stones. This is the second time in two months he's had them, but unfortunately, this time around hasn't been as 'easy' on him as the first round (in which he ended up passing some three dozen pin-head sized stones in a week's time, but only had one day of real pain). Last Friday found us in the doctor's office begging for pain killers. I swear our doc thinks Jim is a pain killer junkie, even though he rarely asks for meds of any kind. I can only think of two times in the past year or so he's wanted pain medication- one time was for his knees (which no longer have cartilege and when he walks, it's bone on bone), and even that was before the surgery. This would make the second time, and I think it's pretty well warranted. I think her trouble lies in the fact that Jim can not take the more run-of-the-mill pain killers like oxycotin and hydrocodone, no so much because of an allergy, but because they simply do nothing for him. And what's the point of buying (not cheap) pain killers if they're not going to do anything for the pain? Much less the damage they will inflict on his already overtaxed-from-rapid-weight-loss liver?

So begins the dance to get her to prescribe percoset (the only thing he's found in recent years that does any good at all) and to get the pharmacy to give him the 'real' thing, not the generic endocet, which, don't let them fool you, is really just oxycodone and acedomeniphen- and what is oxycodone? Think Tylenol 3. Now, I'm aware that percoset is also oxycodone and acedomeniphen, but I'm also aware that different drugs have different formulations, and not all drugs with the same ingredients work the same way. I read something recently about how your genetics have a lot to do with how different drugs will affect you (or not) and that it really is not a one-size-fits-all kind of thing. And, even though most docs and drug companies will deny it, size has a lot to do with how well a medicine will affect you, especially if we're talking about something that has to be absorbed in tablet form. Oh, yah, and Jim's new 'plumbing' has *got* to have something to do with it. After all, most of the pill is going to be absorbed in his small intestine, and a lot of it is probably never getting dissolved at all. Our answer, however, is not to take more, but rather to decrease the size of the pill, and therefore increase the total absorption rate. It seems to be working. Jim is getting by with a half dose most times, whereas before a double dose would often have not phased him at all. He also has to wait a little longer than normal for the effects to kick in, I think, which sometimes means he gets a little more of the medicine than he originally intended when he is too quick to take a second half. It's out of his system faster too.

Which is a good thing. Percoset, however good it is to take care of pain, makes my hubby just a touch crabby. Makes me that way too, all of the pain killers in that family do, when they doesn't knock my butt completely out.

I do feel for him though. This evening he showed me a stone that he had passed- yikes. It was probably the size of a good sized apple seed, only round. That's been the biggest so far, and I'm hoping that it will be the last of that size. Anything larger would probably get stuck. I think this one only shook loose because the chirpractor used a machine on his back today that shakes the living bejeezus out of you. He's upped his water intake too, which is a good thing, as it will help to flush the stuff out of his kidneys that causes the stones (the stuff is actually called calcium oxalate, by the way- which is basically oxalates bound to the calcium he's taking in by pill and by diet... oxalates, however, can mostly be avoided in his diet, so that will help, in addition to the upped water intake, though it will probably not prevent them entirely).

Anyhoo, I'll try to update on time this month, and with pictures! My planned update of the blog's look, however, is on the backburner for now.

Surprise! An update!

I'm getting restless with my bloggie home, so be looking for some changes. If you're a reader of my other blog home, you know I've already dumped that one completely upside down and given it a good shake, so you'll have some idea of what's going to be happening here.

Life, for a mid-month update, is good. Finances are much better and, though Jim and I both are still doing the job hunt thing, we're both gainfully employed. Hopefully we won't be hunting for better employment for much longer. Jim is already down at least ten pounds this month, so that brings his total, as of about a week and a half ago, to 180 pounds gone. I think it's more, actually, but haven't got an up-to-the-minute update. I think we'll save that for the 8-month update. I also think we can officially say that the 6-month stall is over.

We're going this weekend, come heck or high water, and buying him a least a couple new pairs of pants. I can't take the M.C.Hammer/Harem harlot look any longer. Where once the material of his sweat pants was stretched tight over his calves, it is now hanging so loose that it's almost scraping the ground. I'm beginning to consider the extra cloth hanging around him a hazard, besides the fact that it just doesn't look good.

A new milestone? Jim actually went to CVS this morning and bought a knee brace, for a whole 11 bucks. I don't think people have any idea how extraordinary that is. For the past seven years, when Jim really needed some kind of knee support, the best we could manage was to fashion a hybrid knee brace for him out of two large braces and extra velcro. Not supportive at all, but better, I suppose, than nothing. The only way to get him a brace that actually fit him would be to specially order it from a custom-order company... and let me tell you, $11 would not even cover the cost of shipping. So, for him to actually be able to go to a regular store and buy a regular knee brace (granted, an x-large), and to be able to do this in less than a year since the last time we hunted for a brace for him, is absolutely amazing. I think it's still a little tight on him (it's one of those neoprene thingies, with spring- springs?!?!- on the sides), but he can wear it comfortably for several hours, so I'm thinking it fits just fine.

We did the measurement thing this weekend, again, and Jim now has a 20' neck, which, if I'm not terribly mistaken, is a large, but fairly normal, size. He's got 'body builder's neck,' if you catch my drift, so I'm thinking that, normal or not, that's going to be it. His extremities are beginning to normalize, meaning that they are slowly reaching the point they are going to be for the rest of his adult life- whether he loses another hundred pounds or not another pound at all, I'm not forseeing a lot of change in certain places, which is just fine. His wrist is now 7 1/2' around, which *is* normal, and his hands have lost most traces of pudge. Don't get me wrong, they're still paws, but they've reached this normal state that I don't think they're going to budge much more from.

For the next several months, on the weight loss front, I think he should be switching focus from simply losing weight to turning that weight into muscle. Let's face it- knowing what Jim's family looked like, I know what genes he's carrying around. He comes from big, burly, Nordic farmboy stock. That kind of body shape is just *not* going to slim down into a 100 pound weakling frame. Jim will, most likely, always shop in the big and tall men's shop, or at least in the x-large section of clothing stores, particularly for dress clothes, but it will not be due to fat- it will be because of his shoulder breadth, the depth of his chest, and the circumference of his neck.

Actually, 'turning' is too strong of a word here. The fact is, that muscle is already there, waiting- it's already peeking out to see how the weather is in certain places. At most, it just needs a little bit of attention to get it back up to speed, but Jim is, and always has been, a pretty built dude. It was sheer strength that got him around, still mobile, for the past couple of years, when, in actuality, he probably should have been home bound. Fat has just sort of packed in around the muscle where it could, which is actually really good news. He won't have to work too hard to get muscles cut. For this last hundred or so pounds (oh my goodness... the last hundred or so pounds), he'll simply need to be chiseling away the fat to reveal the muscles underneath.

I wish I could afford to hire a personal trainer to help him out with this. He could truly benefit from someone that knew just how to build up muscles and knew all the little tips and tricks to get there quicker (lord knows he's got the base needed and the genes to truly build up something that Mr.Universe could be proud of). His appetite has already hit an upswing, just with the little bit of extra exercise he's been getting in, so I know (especially since he's still losing weight by leaps and bounds) that the muscles are already starting to wake up and burn energy. The great thing is, for the most part, he's been craving protein. Gobs of it. And the 'tribble' is being agreeable, so getting in what he needs hasn't been hard at all.

Oh, and the energy thing? When I mentioned a fiddler's concert I was interested in going to over spring break, he piped right in with the suggestion that we hit the zoo at the same time. Let me tell you, it took me a few good solid seconds to just blink and let that soak in. In the past, the two times we've been, the zoo was too much for him to actually even cover the length of, much less actually consider going some place immediately afterward. Before, we would have gotten through *maybe* half of the zoo (and that's just hitting the highlights, forget about getting close enough to actually see the big animals, which involves a long walk about, and definately skipping many of the side buildings where they keep critters like snakes and birds) and then so exhausted and drenched with sweat (we've never been anytime other than early spring) that it was very nearly a camp-out-in-the-parking-lot thing rather than actually drive the hour or so home.

Any hoo, that's enough for now (got to save something for the monthly update *laugh*)- see you soon!