Lactose Intolerance...

Regular cow's milk is tearing my system up.  I have switched to soy and its better.  Cheese doesn't bother me - thank goodness, because cheese is a big contender in my protein intake.  

Update on Vitamin Help post

***UPDATE***

I recently found out that my B12 has to be sublinqual; being an RNY patient, we only have 1/8 of a normal stomach. B12 is absorbed in the stomach and since it being in the pouch for 30 minutes or less, doesn't leave a lot of time for absorption.  It is required that we dissolve them directly under the tongue (sublingual) so it'll go straight into our blood stream.

Also, my bariatric surgeon looked at my multivitamins that I found and he didn't particularly care for them as they don't contain very many minerals.  I have since switched to the following:

• Sublingual B12 - Cherry flavored
• One Source Prenatal vitamins (the size of a regular Tylenol tablet - 2 at a time, twice a day).

I may take prenatal vitamins in the morning and a regular multivitamin with no iron at night (the one with no minerals) because too much iron can throw me into another impaction and I don't particularly want to go there.

Another bariatic patient found some B12 that contained other stuff like folic acid, but I figure if I'm taking the prenatal with folic acid anyway, then it would probably be okay just taking the good ole' regular B12.  

Skipping stones

Have you ever skipped a stone across the water?  Have you ever noticed that a single rock causes multiple disturbances in the water and for each time the rock hits the water, it causes multiple ripples? Making an important decision for your life is like tossing the stone into the water and hoping for the best.  Once you take the initial plunge and make a "big decision", the consequences of those choices begin to affect things in your life and that change changes something else and its a domino effect. 

My decision was to have weight loss surgery (i.e. the stone thrown into the water).. The consequences of that choice.. my ripples (if you will) thus far are:

• I am losing weight - which I knew would happen, but its still the first ripple
• Less stress on my joints
• Seat belts fit me in almost every vehicle I am in
• My feet don't hurt as bad. At the end of the day, they would just throb.
• My clothes are hanging on me now and I am getting to the point where I will need a new wardrobe; always a positive thing!
• Tight places (walking between things) are now not as tight, even though I still instinctively turn sideways to go through narrow openings even though I can go through them head-on now.
• My stamina/endurance walking and doing other things (cooking, cleaning, etc) has multiplied. 
• When I stop to have a conversation with someone, I can do it standing and am not struggling to find a chair to sit down to take the pressure off my back. I am still having back trouble, but I think its because I slept funny on an air mattress. 
• My opportunities have broadened
• Options I didn't think were options have now become choices (i.e. having kids, going to medical school, taking jobs in other departments that wouldn't require me to be as sedimentary, etc).

I had an epiphany - the realization that my ripples have only begun.  The rest of my life will forever be little ripples and positive consequences of this one decision that I made.. and my life may be longer because of it.

Have a big decision to make?  Do you ever think about when your ripples will begin? They already have.. Your ripples can be the consequences of an important choice that you have or have not yet made. Think about that the next time you skip a stone across the water.  Your possibilities are endless.

Turds, Crap, Excrement, Poo... Whatever you call it, its a Sh!tty Subject

Like it or not, sh!t happens.  For bariatric patients, sometimes it happens less often than for most people. Seriously, as a bariatric patient, in my own experience, I am much less "regular" than I was before surgery.  I first thought it was simply because of the reduced intake of an RNY patient, but as it turns out, I had an impaction/large bowel obstruction.  I think what caused it was I was eating a lot of cheese because it's high protein and I had switched to a multivitamin with iron, even though my iron levels were within normal limits. I hadn't gone for almost 2 weeks and I passed a couple of squeaks of air but that was it.  It was to the point that I couldn't eat or drink hardly at all other than a few sips of water throughout the day because my system was full from one end to the other.  I was miserable.  I was trying to work and it was to the point that I couldn't sit upright because it felt like I was sitting on a ball bat - not that I know what that feels like.

I called my Bariatric surgeon and because I did pass a couple of squeaks of air, he was confident that my large bowel wasn't totally obstructed since air was able to get through.  He told me what to try first to get it resolved; he told me to add fiber to my diet, stool softeners, laxatives, and to try Miralax (which I think was named that because its a Miracle-Laxative), but still -- nothing.  I called him again and told him there was no progress and he told me my last two options were laculose and an enema.  I opted for the laculose (gladly).  He called in the prescription and I went to another pharmacy (one that they didn't know me) and got a 6-pack of enemas. I figured it'd be a long night.  
 





I took one teaspoon of laculose (which it called for 15 ml (1 tablespoon) but all I could get down at that time was 1 tsp.  I'm not sure why, but thick syrupy consistency liquids make me go into spasms.  Another bariatric patient that has become a good friend of mine has the same problem, or she did right after surgery; not sure if its still an issue with her or not, but it certainly is for me. 


It took several hours, but it finally passed.  I have been impacted 2-3 more times since and am having a hard time finding a balance.  It seems to be either feast or famine.  I have had trouble with my bowels my whole life and had IBS before the gastric bypass.  Bad news, I still have IBS AFTER gastric bypass too.  :-(  This will probably be a life-long struggle for me.  Did you know that they have a chart for your poo?  Yeah -- they do. I added it below for you to see.  

I'm not sure if any of you have been to a colorectal surgeon or a gastroenterologist (GI doctor) but I have had the "pleasure".. I guess you could say... of going to both.  They show you this chart and make you tell them extensively about your poo.. the color, the texture, the shape, the volume, etc etc etc.  I've never met anyone else who talked so seriously about sh!t.  I understand more now than ever though, how important expelling your waste is from your body.  I learned that from my cat having mega colon. My husband and I watched her suffer for 4 of her 6 years we had her.  It ended up killing her in the end and she died in my arms.

So after going through that experience with our first pet, I am neurotically emphatic on making sure my babies (my dogs) go potty and that they are 'productive'.  I never dreamed that I would actually have to track it though for myself.  My IBS that I had before surgery always leaned toward diarrhea, so not going was never an issue.  Normally the complications with RNY are more geared toward dumping syndrome instead of constipation, but honestly its a mixture of both.  Some things that are supposed to give me dumping syndrome don't and the things that aren't supposed to make me dump, do.  Right after surgery, I dumped for 2 weeks solid; it didn't matter what I ate or even drank it made me incredibly ill.  I'm not sure what changed but one day it just went away..   

Choices and their shades of gray

Have you ever felt like you had the world in your hands?  the bull by the horns?  A man by his ba-- . . . okay you get the point; but have you ever felt like your world was crumbling in your hands and you have no choice but to just let the pieces fall and try to fit them back together after you see how they land? Some choices in life are so very difficult and some are easy.

I know myself well enough to know that I obsess over important decisions and I overanalyze every aspect and every possible outcome of each choice. My sister and I were raised by loving parents who completely supported us in everything we did; they also disciplined us and taught us the difference between right and wrong.  My sister (Amber) taught me and instilled into my core that life is a series of consequences of not only your actions but also your choices and to not carry the guilt of someone else's decisions, actions, or choices.  I didn't fully understand that until I got older.

"Don't judge each day by the harvest you reap but by the seeds that you plant." - Robert Louis Stevenson

"Keep your fears to yourself, but share your courage with others." - Robert Louis Stevenson

"The best things are nearest: breath in your nostrils, light in your eyes, flowers at your feet, duties at your hand, the path of God just before you. Then do not grasp at the stars, but do life's plain common work as it comes certain that daily duties and daily bread are the sweetest things of life." - Robert Louis Stevenson

"You cannot run away from a weakness, you must sometimes fight it out or perish. And if that be so, why not now and where you stand?" - Robert Louis Stevenson

The last ten years has taught me the following things: 

• Just because you have moved out of your parent's house and are living on your own does not mean you are "all grown up".  Growing up starts with you and the choices you make. Sometimes the hardest thing to do is to put on your "big girl panties" and do the right thing, no matter the consequences; even if it puts you in a compromising position physically, emotionally or financially. 
• I had a conversation with a physician I work with last week and we discussed decisions and choices.  His group of doctors that he has worked with for years walked out on our hospital and left our facility without the appropriate medical staff.  His group took over another hospital in the area and he would go work for them from 5a-2p and then come back to our hospital and work from 2p-midnight, even though the other people in the group gave him a hard time because of it. His wife had just had their first baby, a little girl right at that same time and after working the double shifts, he would go home and walk his baby up and down the hallway to soothe her so his wife could get some sleep.  This was his daily routine for a few months until we got a new group of doctors in to take over the contract.  He did this everyday and never complained; he did it because it was the right thing to do. That spoke volumes to me about his character and who he is as a person and the kind of person I want to be. He humbles me everytime I think of him; he is such an incredible person, not just a kick-ass doctor who saves lives everyday. He taught me that the right thing to do is never the easy thing; struggle is a part of doing what is right, but it does get better and the struggle is worth it in the end.
• Just in case you are wondering, this specific doctor and another amazing physician, who is also an amazing person, have broken away from the original group and have started their own group and are still here at our hospital running one of the subspecialty departments. I could not be happier that these are the two men we have representing that branch of our facility and their hearts are right where they need to be.
• The people who are meant to be a part of my life will be and they will be there at the exact moment they are needed.
• Every encounter with another person is an oppoturnity to change your life or theirs. 
• You have to learn to follow before you can lead.
• Some people you will teach and some people you will learn from.
• Making a decision and sticking to it and following it through with every ounce of your being can be the hardest thing to do, yet will be the most fullfilling in the long run.
• Survival is the most basic human instinct but really living is a choice. 

I have met lots of people on this journey I am on. Most of the people I have met had the surgery for good, valid, important, sincere reasons; for improved health, improved quality of life, or to open the door of possibilities - no matter how big .. or small...

I have also met people who chose this road for vanity and selfish reasons; for the attention that drastic change draws to you.  I have not openly shared with everyone that I have had this surgery done.  Its not because I think I made the wrong choice, because I didn't, but I don't want the unneccessary extra attention.  But with it all and through it all, I have found that some what would be the hardest choices in life suddenly become simple when it really matters.  My weight loss surgery was a huge decision and a difficult choice, but when it came down to losing my father way too young and me following in his footsteps, my path became clear.

"It is not so much for its beauty that the forest makes a claim upon men's hearts, as for that subtle something, that quality of air that emanation from old trees, that so wonderfully changes and renews a weary spirit." - Robert Louis Stevenson

"Give us grace and strength to forbear and to persevere. Give us courage and gaiety, and the quiet mind. Spare to us our friends, soften to us our enemies. Bless us, if it may be, in all our innocent endeavours. If it may not, give us the strength to encounter that which is to come, that we may be brave in peril, constant in tribulation, temparate in wrath, and in all changes of fortune, and down to the gates of death, loyal and loving to one another."
— Robert Louis Stevenson

*******************************

I will leave you with an excert from another blog:

Written By Regina Brett, 90 years old, of The Plain Dealer, Cleveland, Ohio

“To celebrate growing older, I once wrote the 45 lessons life taught me. It is the most-requested column I’ve ever written. My odometer rolled over to 90 in August, so here is the column once more”:

LESSONS I LEARNED FROM LIFE

1. Life isn’t fair, but it’s still good.
2. When in doubt, just take the next small step.
3. Life is too short to waste time hating anyone.
4. Your job won’t take care of you when you are sick. Your friends and parents will. Stay in touch.
5. Pay off your credit cards every month.
6. You don’t have to win every argument. Agree to disagree.
7. Cry with someone. It’s more healing than crying alone.
8. It’s OK to get angry with God. He can take it.
9. Save for retirement starting with your first paycheck.
10. When it comes to chocolate, resistance is futile.
11. Make peace with your past so it won’t screw up the present.
12. It’s OK to let your children see you cry.
13. Don’t compare your life to others. You have no idea what their journey is all about.
14. If a relationship has to be a secret, you shouldn’t be in it.
15. Everything can change in the blink of an eye. But don’t worry, God never blinks.
16. Take a deep breath. It calms the mind.
17. Get rid of anything that isn’t useful, beautiful or joyful.
18. Whatever doesn’t kill you really does make you stronger.
19. It’s never too late to have a happy childhood. But the second one is up to you and no one else.
20. When it comes to going after what you love in life, don’t take no for an answer.
21. Burn the candles, use the nice sheets, wear the fancy lingerie. Don’t save it for a special occasion. Today is special.
22. Over prepare, then go with the flow.
23. Be eccentric now. Don’t wait for old age to wear purple.
24. The most important sex organ is the brain.
25. No one is in charge of your happiness but you.
26. Frame every so-called disaster with these words ‘In five years, will this matter?’
27. Always choose life.
28. Forgive everyone for everything.
29. What other people think of you is none of your business.
30. Time heals almost everything. Give time time.
31. However good or bad a situation is, it will change.
32. Don’t take yourself so seriously. No one else does.
33. Believe in miracles.
34. God loves you because of who God is, not because of anything you did or didn’t do.
35. Don’t audit life. Show up and make the most of it now.
36. Growing old beats the alternative — dying young.
37. Your children get only one childhood.
38. All that truly matters in the end is that you loved.
39. Get outside every day. Miracles are waiting everywhere.
40. If we all threw our problems in a pile and saw everyone else’s, we’d grab ours back.
41. Envy is a waste of time. You already have all you need.
42. The best is yet to come….
43. No matter how you feel, get up, dress up and show up.
44. Yield.
45. Life isn’t tied with a bow, but it’s still a gift.