Biology: It’s All Greek to Me

Posted on August 1, 2012 by Erika

I consider myself lucky that my BFF is a midwife and my husband is a scientist because I have no idea how bodies function. Take thyroids, for instance — or maybe it’s just thyroid, no plural — mine was wacky, then not wacky, then really wacky twice, then totally normal.

I have no explanation for it. Six months ago my TSH was high, which actually means thyroid function is low. On a repeat blood test, it was normal. Recently I had another blood draw — the psychiatrist I saw suggested that maybe my depression was related to anemia or low thyroid — and once again it was that high-that-means-low on the test.

Confused (Flickr: CollegeDegrees360)

I did some research and learned the following: thyroids are important; thyroids are small; 10% of women take thyroid medication; diet changes can help; diet changes do nothing; the medication has side effects; the medication is really helpful; you have to take the medication for life; take the medication; don’t take the medication; doctors don’t know what they’re talking about when it comes to thyroid.

The last part kind of made me mad; my cousin just left for medical school and he’s got the smart genes, dammit!

Meanwhile, all the thyroid drama ended when the doctor tested me again — I’d been gluten-free for a week at that time — and my thyroid was completely normal.

What does this mean? I haven’t a clue. All I know is that my body wants me to pay my 20% coinsurance every week, only to be told I’m FINE.

The labs also showed iron deficient anemia. I have this thalassemia trait — understanding it makes even less sense to me than the whole thyroid thing — and the doctor wants me to give a poo sample to prove I’m not bleeding from my ass. Which, I still am, from the surgery with Dr. Assropractor. But not enough to cause anemia!

Blood (Flickr: bedrocan)

I keep insisting that if I were having blood poo, I WOULD KNOW IT. He insists I’d be blissfully ignorant; calling it occult blood. Oh my gawd, this is totally how zombies are made, isn’t it?

But before we get to the zombie-poo debate, I need iron infusions to get my ferritin and hemoglobin and hematocrit up to normal. I’m seeing a hematologist/oncologist today and hope to start infusions soon.

I will fight zombie poop! (Flickr: Jem Yoshioka)

Filed under: Daily Life, weight loss surgery | Tagged: , , , , | 3 Comments »

Why I Chose My Weight Loss Surgery

Posted on July 30, 2012 by Erika

20120730-141743.jpgThree months AFTER surgery

This is not why I chose to have weight loss surgery (I was a giant fatass) but why I chose a Biliopancreatic Diversion with a Duodenal Switch.

You see, most people who have weight loss surgery have a lap-band or get a Roux-En-Y Gastric Bypass. But I chose a DS.

And even though I’m about to start another round of iron infusions because my intestines do not absorb iron, even though I’ve had enough ass-related issues for a lifetime thanks to those same intestines, I know that a Biliopancreatic Diversion with a Duodenal Switch is the most effective weight loss surgery of all. Here’s why:

1. No “dumping” syndrome
Unlike those who have a RNY Gastric Bypass, I have my original stomach, my original intestines (although they do less) — my anatomy is the same as before. My plumbing is a little more effective. At any rate, there’s no concern about “pissing off the pouch” (or the band) which leads to indigestion and vomiting.

2. I can take NSAID medication, and get scoped if I need to
If you have RNY surgery, you get a pouch, rather than a stomach. One concern is that you can’t take NSAIDs with a pouch. Nor can you have an endoscopy if you’re having problems that could be diagnosed using that test.

3. Long-term, it’s a more effective wls
When “long-term” means “Statistically, how much excess weight is still off at 10 years post-op,” the Duodenal Switch wins.

Also, you can eat more normally with a BPD-DS since you still have a stomach — although my lactose intolerance has increased exponentially since surgery. And obviously my body doesn’t digest gluten like it once did, since I feel way better physically when I’m gluten-free.

This is not to say that the BPD-DS is without problems; obviously vitamin deficiencies are a huge concern. Taking lots of supplements every day to compensate for malabsorption is a necessary by-product of the surgery, and good vitamins aren’t cheap. I admit, I haven’t been as committed to my vitamins as I had been previously, and now I’m paying the price. My iron is a mess and I’m starting infusions on Wednesday. But I’m recommitted!

Even with the complications — and the fact that the first few weeks post-op were horrendously painful — I don’t regret my decision to have weight-loss surgery. And I’m really glad I had a Biliopancreatic Diversion with a Duodenal Switch instead of any other surgery.

20120730-141607.jpg
I can eat cake!

****Note: the Bpd-DS isn’t available everywhere; it’s a more complex surgery and fewer surgeons perform it than rny or lap-band. Also not all insurances cover it.****

Filed under: weight loss surgery | Tagged: , , , , | 6 Comments »

Almost Four Years Post Weight Loss Surgery

Posted on June 27, 2012 by Erika

I weigh 145lbs, at 5’6″, and I wear a size 8 in pants and a med or large in shirts (my b00bs are kind of big, still, compared to the rest of me. They’re also deflated). My BMI is 23, which is in the normal weight range. My lowest weight, in which I kind of resembled skeletor, was 130, at which time I wore a size 4 — and they were loose — and a med in shirts. I wore a lot of shirts back then because I was freezing all the time. Below is a pic from 2009

2009: It was probably 95* out and I was cold.

I have complications. These are mostly due to the fact that a key component of my surgery is malabsorption

The most commonly quoted absorption percentages following DS are approximately 20% of fats, 60% of protein, 60% of complex carbohydrates but 100% of simple carbohydrates. The 2005 study by Gagner et al. [68] demonstrated that DS surgery decreased fat absorption by 81%

Gagner performed my surgery in 2008. I email him regularly with questions or concerns.

When I was visiting my parents, my dad asked if I regretted my surgery due to my complications. He did not specify a complication. He could have been talking about

1. Being hospitalized in 2009 for dehydration and malnutrition

2. My first butt surgery, in 2010

3. Which healed poorly and led to the most recent butt surgery, Assgate.

4. Iron-deficient anemia from malabsorption.

4. The sheer amount of time I spend in the bathroom every day.

Another complication is my gut flora, which seems to change daily — based on what I eat — so I take a probiotic called VSL3 every day to keep it in check.

Sometimes My Chemical Romance does not like sharing a bathroom with me. Sometimes I don’t blame him!

I’ve also nursed in here. Yes.

Sometimes my extra skin causes chafing that leads to sores. But there’s no way I’m ever having surgery again unless I’m in dire need.

In all, I do not regret my surgery. It’s not entirely the free pass to eat whatever I want that I hoped for. It’s not as easy and thoughtless as I want it to be. There’s no such thing as a free lunch. But I can’t say that if I’d continued at 270+ lbs, I wouldn’t have had equally-sucky complications.

Last week, when I fell completely on my ankle and broke my foot, one of my first thoughts was, I’m really glad I only weigh 145. This would be a lot worse if it happened four years ago.

Night before my surgery, in 2008.

Filed under: Daily Life, food, weight loss surgery | Tagged: , , , | 4 Comments »

Paula Deen: How do you like them cookies?

Posted on January 24, 2012 by Erika

I do not know much about diabetes. My grandfather (papa) had type 1 diabetes and injected himself with insulin regularly. He used to show me how he would pinch a layer of his belly and use that spot to inject it, although he never let me watch him do it. I know that it basically has to with how the body processes insulin and reacts to consuming sugar (thank you, wikipedia!) and although I do not know much about Paula Deen, I know she cooks fried butter and has diabetes.

Honestly, I’m not sure how I feel about this. I eat fried butter. (Or I would, if I could figure out how to fry it. I believe you can freeze it first, and then it fries up nicely. I will have to try it.) I’m also, left to my own devices, morbidly obese and would have become diabetic, had I not have weight loss surgery. And so are a lot of Americans (obese, morbidly obese, etc). Everyone knows that obesity contributes to a lot of diseases, including diabetes. And yet, to the cure (diet and exercise) we say: FUCK THAT SHIT, I WANT MY FRIED BUTTER. (Or at least, I did.)

Night before my weight loss surgery

I don’t think Paula Deen should apologize for cooking once-in-a-while treats like fried butter. I rarely watch cooking shows (although every time I watch one, I think, “I should watch these more often!”) but I haven’t seen Sandra Lee pushing viewers to eat Kwanzaa Cake after every meal. Paula Deen is paid to cook on television. Her schtick is that she cooks “comfort food” — which, to her, means fried everything and a hamburger with two donuts as the buns. She’s good at that schtick, I’ve seen her on Oprah and she seems like a southern, female version of Santa Claus.

But she’s also a chef and a woman who has a disease that is linked to unhealthy eating and being overweight. Given her platform – her publicity and her television show – she had a unique opportunity to promote ”natural” treatment for diabetes, lifestyle changes. Instead, she waited three years to reveal her diabetes – coincidentally, just after she got a job to promote diabetes medication. It’s not surprising, but it is kind of disappointing.

Filed under: cooking, food, Pop Culture, weight loss surgery | Tagged: , , , | Leave a Comment »

Longevity after Weight Loss Surgery

Posted on October 7, 2011 by Erika

I have a weight-loss surgery twin, Amy. We met in our surgeon’s office in Miami, the day before our surgeries. I was nervous and talking even more than usual; she was nervous and quiet to the point of being standoffish. We had the same exact surgery on November 4, 2008: a Biliopancreatic Diversion with a Duodenal Switch. She had a superfast recovery, even making her hospital bed the next morning and walking the hallways. I was in so much pain that I kept nodding out from all the narcotics. She left early to go back to Texas, missing her 7-day post-op appointment. I stayed — and got a prescription for dilaudid because I was still aching in pain.

We’ve stayed in touch ever since then, talking on the phone at least once or twice a week. She eventually got over her standoffishness, I eventually let her get a word in edgewise. Together I think we’ve lost about 300lbs.

We both have side effects, although they are polar opposites. I think it speaks to the nature of our surgery, which is that our intestines are re-wired to work differently/hardly at all. We both follow our vitamin regime, which includes all the fat-based vitamins, as well as calcium and iron, and get our labs done regularly. We’re both doing okay. And yet, Amy is always nervous.

There’s not a vast amount of research on our surgery; it hasn’t been around for that long. Scientifically, it’s the most effective way to lose weight and keep it off. And that’s really all it says. Go forth and lose weight — thanks to malabsorption! Amy is incredibly anxious about the long-term implications of malabsorption, especially with regards to vitamin K and calcium, assuming that we’re going to get old and brittle and frail. And I’m… not. Actually it’s not that I’m not worried about it, it’s just that I don’t think I can do anything about it.

As I’ve mentioned before, life at nearly 300lbs is a giant suck. Had I stayed at that weight, I know I’d have issues — diabetes, hypertension, asthma, heart problems, the list goes on. With this, I may someday have brittle bones, or I may have some issues with clotting — or I may have no more problems than the average woman who lives to be 90 (which is my plan). I’m doing my best to mitigate the malabsorption by taking my vitamins and getting my labs drawn, but I accept that I may have complications. I’ve already been hospitalized for dehydration that was never really explained or fixed, I’ve already had a hemorrhoid-turned-fissure-turned-fistula that needed surgical repair, I’ve already gotten iron infusions, I’ve already made less breast milk for Porcelain — all because of the surgery. And I also credit it with making that pregnancy last 42 weeks and Porcelain weighing less than my other full-term babies.

It’s a trade off. I give 20 vials of blood every few months, and take 30 pills per day. I can run around and chase my kids and carry Porcelain everywhere and shop at H&M. I’m going to live to be 90.

Filed under: Daily Life, friends, weight loss surgery | Tagged: , , | Leave a Comment »

Dear Daughters, Here is Your Voucher for Cosmetic Surgery

Posted on June 12, 2011 by Erika

Please use it wisely.

If, like your mother and grandmother and great-grandmother, you develop watermelons upon your chest, I will allow you to have breast reduction surgery.

However, please note that breast reduction may inhibit your ability to produce milk and nurse your future children. I hope that I’ve instilled upon all of you the importance of num-nums. I did nurse My Masterpiece exclusively for a year; however by the time she was born it was more than a decade after I’d had my surgery. Also, if I’d been a more concerned mother (maybe a first- or second-timer) I might have worried about my supply and her growth. I never leaked breastmilk and I never had any “extra” of which I was aware. My Masterpiece was not a cute chunky rolly polly ball-of-squish baby. She was on the small side. We got through it, but now that I’m having issues nursing Porcelain, I wonder if My Masterpiece couldn’t have used a little extra daily milk. She took heartily to solids and gave up nursing without fanfare.

If, like your mother and several great-aunts, you become morbidly obese, I will allow you to have weight-loss surgery.

I sincerely hope none of you, nor your brothers, become morbidly obese. It’s unhealthy and miserable. There are fat-activists out there who claim to love being large and in charge and fiercely real and morbidly obese is the new little black dress (in a size 22, naturally) and work it, girlfriend! They’re few and far between. In my experience, and the experience of my other formerly morbidly-obese friends, morbid obesity is sad and lonely and scary, and I hope you never experience that.

Additionally, it may inhibit your ability to produce milk and nurse your future children — more so than a breast reduction. Nursing post-breast reduction surgery was not difficult; nursing post breast-reduction surgery AND weight-loss surgery has been the most challenging experience of my life. More challenging than being a single mom of twins. More challenging than being the kind of person who takes aspirin when I have a headache — and then having two natural homebirths, both of which were very physically painful. 

I know that The Informant and My Masterpiece bear witness to the challenges: you see various friends nurse Porcelain for me, you see me make bottles of donor breast milk, and you see me take 160mg of domperidone daily, all in an effort to keep Porcelain exclusively breastmilk-only, and I think you can see it’s not easy. I can tell you — it’s not easy. I’m constantly worried that I’m not nursing her enough to keep up my own could-be-better supply; I’m constantly worried that one day Porcelain is going to refuse to nurse from someone who isn’t me; I’m constantly worried that we’re going to lose power and all her milk will thaw and leak. Speaking of leak, I spend most days covered in sticky warm sweet-smelling breastmilk that isn’t mine. I would say my bottle-leaking average is 50%; however my frozen-milk-thawing-leaking average is at least 80%. (For the record, the least-leaking scenario is frozen flat and used quickly.)

If you want your ears pinned back; no. I happen to think airplane ears are adorable, so you’re going to have to hold out til you’re 18 — and save your allowance because I won’t pay for that.

If you want your nose fixed; no, but I would maybe consider revisiting that if you had a severely deviated septum that was affecting you. And I do not mean affecting you in the Barbra Streisand way.

The Informant, you will probably need jaw surgery since your teeth don’t line up at all and your mouth is tiny — oh, irony, how you mock my never-ending chatterbox daughter! — and I’m all for that, especially if your mouth will be wired shut for a few months weeks.

I will allow you to get your eyebrows waxed if you really want, but not your bikini line. Because at the ripe old age of 32 I just had that done for the first time and YOWCH. I think I’m going to cross that off my bucket list and walk (gingerly) back to the world of electric “personal trimmers,” thanks. I’ll explain it when you’re older.

Filed under: attachment parenting, family, weight loss surgery | Tagged: , , , | 5 Comments »

Complications after weight loss surgery: “I’d rather be fat.”

Posted on April 24, 2011 by Erika

No you wouldn’t.

Or, that’s because you’re skinny.

Okay, maybe you’re not skinny. Maybe you’re average. Maybe your BMI puts you in the overweight category, or even obese. Maybe you struggle to find clothes that are slenderizing – but you can still shop at Target.

When I tell people about my chronic diarrhea — and yes, of course, I tell people about it — most of them say, “I’d rather be fat.” When I was hospitalized for dehydration twice, I’m sure some of my friends thought that.

Honestly, I am not a huge fan of my chronic diarrhea. It does inhibit me in some ways — I doubt I’ll ever go camping unless it’s a special camping site with private bathrooms — and I’ve been hospitalized twice for dehydration when nothing would stay in. I don’t like it when I feel kind of nauseated when I eat too much sugar in the absence of any protein. I didn’t enjoy getting iron infusions while pregnant with Porcelain because my body had so little iron leftover after what she took. There are aspects of my life post-weight-loss surgery that give me some pause.

(If you want to read about a Biliopancreatic Diversion with a Duodenal Switch, you can find some here. And here. And some research studies here.)

But being fat — being morbidly obese, being nearly 275lbs at 5’6″ with no clear limit in sight — I wasn’t a fan of that either. It came with complications too. My blood pressure was rising, I was pre-diabetic, and when a piece of my liver was sent to the lab it came back as severe fatty liver, like what an alcoholic would have. I was tired and lethargic. I wasn’t able to enjoy spending with my kids the way I can now (sometimes). Or my dogs.

And oh, the sweat! Moving 275lbs around is not easy. The regular sweat. The underboob sweat! The sweat-dripping-into-my-eyes-and-blinding-me sweat!

The comparison is not FAT versus SKINNY WITH DIARRHEA AND A FISTULA.

The comparison is fat with potentially life-threatening complications that would not have improved on their own and skinny with definitely annoying complications but I don’t think they threaten my life and I can help them somewhat by what I eat. 

I rarely regret having my weight loss surgery. I can’t say never — right afterward surgery, when I was in a lot of pain, I thought, “My god, why didn’t I try Weight Watchers one more time?!?!?” — but every day I’m glad I did it.

Filed under: weight loss surgery | Tagged: , , , , | Leave a Comment »

Transitioning…

Posted on November 26, 2010 by Erika

For the last few days I’ve noticed some hormonal changes, and I’m hoping wondering if this is my body getting close to labor and birth. I’m starting to have night sweats again, I’m breaking out on my face, and I’m getting more crazy with each passing day. I kind of feel like I’m back in my first tri, except with 40 extra lbs. I originally went to the doctor because of the night sweats, thinking I was having some kind of endocrine issue. Nope! Just pregnancy!

I’m so excited to find out if Tax Deduction is a girl or a boy. I’ve gone back and forth so many times in this pregnancy, first thinking it was a boy, then girl for a looooooooooong time, now boy again. I just don’t know. This pregnancy has been a weird mixture of more and less intense than my others. It’s more intense because of my weight loss; I can feel a lot more than I could with all the others, and I’m more knowledgeable about the process. It’s less intense because — duh! — I’m a lot more busy with the older kids. A clerk at Tar*get will say something to me about how it’s getting close and I’m thinking, “Close to what, exactly? Oh, yeah. I’m having a baby.” I feel like not knowing the sex inhibits the bonding I’ve felt with the other kids. With the others, I would think, “Hey, The Informant, how did you like this Thanksgiving meal? Pretty good huh?” but now I think, “Hey baby who might be XX or XY and we’re still not 100% certain on a name, what do you think of…” and by the time the sentence is out I’m totally distracted by something else anyway.

Last night I was having some intense back pain, thinking, “This is it… maybe…?” but nope. I took a bath and went to bed. It was probably from doing “too much” on Thanksgiving. All that cooking, plus I moved a Graco Nautilus car seat from my garage into the house, so that The Happy Mathlete could borrow it.

Next Friday is My Chemical Romance’s birthday and it might be sort of cool if the baby shared his birthday.

Filed under: birth, family, weight loss surgery | Tagged: , , , | Leave a Comment »

Open letters RE: Baby Tax Deduction

Posted on May 21, 2010 by Erika

Dear Dr. Gagner,

It’s me again, the girl who had OBAMA written on her arm in permanent black marker on the day you performed my surgery. In my defense, it was election day, and I was a proud absentee voter. I’m sure you remember how the anesthesiologists whined about my arm being “unsterile” (their word) and threatened to leave me awake while you rearranged my intestines. In fact, that’s probably why my recovery was so freaking painful that I had to all but pay the nurses to score me some dope on a street corner since mor*phine is clearly a total waste of time. Why not just some tylen*ol? UGH.

Anyway, Gagner, I just found out I’m pregnant. I’m 11 weeks. This will be #5 for me and I’m planning a homebirth.

I assume that as a non-American doctor, you are enlightened enough to realize that homebirth is just as safe as hospital birth for low-risk pregnancies. I realize I’m not quite low-risk, but my labs look good and I’m continuing my supplements and eating every ounce of protein that isn’t physically nailed to the ground. I’m even back to drinking those absolutely disgusting protein shakes. SHUDDER.

I’m seeing an OB along with a homebirth midwife, and having growth ultrasounds done every eight weeks to make sure Tax Deduction (due in December) is growing properly despite my malabsorption. If he or she is a little smaller than the four older ones — or at least has a slightly smaller head — I won’t complain. Honest.

Any other suggestions? – Skinny pregnant Mommy Soup

Dear My Chemical Romance,

I love you. Clearly even after four kids we can still find time for each other, since I’m pregnant and all. I’m not exactly sure when it happened, but I think sometime between January and when I took the kids to Disney World and ended up needing ass surgery, and you had to come rescue the kids and me and drive us home and I took too many painkillers and threw up in a paper bag in the car and the bag tore open and the dog licked up all the vomit and you and the kids gagged and insisted we drive with the windows down despite the fact that it was 45 degrees outside. I’m feeling much better now — and I still love you!

I’m very sorry that the health department wants to shut down our kitchen because it’s “toxic levels of nast.” I’m also sorry that you had to go commando to work twice this week because the laundry isn’t done. (Next time try borrowing a pair of my underwear!) Thank you for coming home from work early because I was having afternoon sickness — and bringing Kris*py Kre*me! Thank you for yelling at the kids when I was too tired to do so and could only wave my arm weakly at them while narrowing my eyes and trying to give THE LOOK.

I hope that in a few weeks, when I’m in my second trimester, I will have some energy back. Until then, I will buy you more boxers this weekend.

xoxox Mommy Soup

Filed under: family, food, weight loss surgery | Tagged: , , | 4 Comments »

The Old-Fashioned

Posted on May 9, 2010 by Erika

I love old movies. When Animal and Mineral were about 18 months old, and we went through that phase with twins were you can’t.go.anywhere (twin moms know what I’m talking about) we watched old movies every day. Mostly musicals, like Sound of Music, Singin’ in the Rain, Seven Brides for Seven Brothers, and The Music Man. We watched them over and over. (Years later, when my sister-in-law and brother-in-law’s son was a few years old, we asked what we could get him for a holiday or birthday gift. My sister-in-law said he’d like some videos — but she specified not to get any musicals.)

My children consider me old fashioned because I will not get them a Wi*i, DS, Ninte*ndo, etc. We only have two TVs — one downstairs, and one in our guest room. We eat dinner together every night that we’re all home. While I cook, I wear a really cute paisley apron I got online.

I let my kids run all over the neighborhood with their friends, which is not very au current. It hearkens back to my own childhood, when I did the same thing. (Nowadays, I could probably be arrested for it.)

I found out I was pregnant with #5 in much the same old fashioned manner: I went to the doctor because I felt sick, and he told me.

Yes.

Overall, I felt exhausted and unmotivated. I didn’t want to take the kids out. I didn’t want to cook. I didn’t want to blog — obviously, since I didn’t for a few weeks. I actually told My Chemical Romance that I thought I might be having a depression; I didn’t feel sad but I just wanted to sleep.

My first step was seeing the hematologist. I was certain that my general exhaustion and lethargy was due to low iron. I don’t know who was more surprised when my hemoglobin came back at 12.1 — nice and high — him or me. He asked me a few other questions, but we didn’t determine anything, and I left with a shrug and a promise to come back if I didn’t feel better in a few weeks.

Next I called an endocrinologist. I told the nurse my symptoms, and talked about my thyroid issues post weight loss surgery, and she said it sounded like an endocrine issue, but I needed a referral from my primary care provider first.

I saw him the next day. I said, “I’m so tired I can’t keep my eyes open.” I said that after I sat up, from laying down on the examination table with my arm over my eyes, trying to catch a few minutes of sleep. He had me pee in a cup and give a blood sample. Then he came back in and told me I was pregnant.

Yes, I was shocked. Yes, I was surprised. No, I wasn’t planning on being pregnant, and being pregnant after weight loss surgery. No, when I was eating vico*din sandwiches after my recent surgery, I didn’t realize I was pregnant. My cycles have been messed up — forget it, I don’t need to share that much info. I’m pregnant. That’s really all you need to know.

I’m due in mid-December. I’m having a homebirth, although I’m also seeing a homebirth-tolerant OB because of my weight loss surgery. I’m going to have growth scans every two months, which grates my “ultrasound is dangerous” belief, but they are medically prudent. I am going to wear a sleep mask during the scans so I don’t find out the sex.

I’m not quite “excited” yet, but I’m kind of looking forward to doing the things I haven’t done before: not finding out the sex; extended breast-feeding; elimination communication; cosleeping. I’m trying to focus on those exciting things. And, other than the tiredness, I feel fantastic. No sickness, no nausea, no heartburn or indigestion. I feel great.

Filed under: attachment parenting, birth, family, weight loss surgery | Tagged: , , , | 6 Comments »

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