Weight Loss

Created by MyFitnessPal - Free Calorie Counter

Saturday, February 28, 2009

Four Things

Four names that people call me (other than by my first name):
1. Gwendy: my nickname growing up
2. Gwendolyn: my father calls me that (my actual, given name)
3. Paltrow: my friend Kerry calls me that, and I call her Strug.
4. Gwennie or Gweneth: some of my friends use those interchangably

Four jobs I have had:
1. Farm labor, when I was 13
2. Delivering pizza, when I graduated from high school
3. Home health aide, at many places, the longest being an AIDS hospice while I was in nursing school
4. RN: I’ve been a ortho/trauma floor nurse, a burn ICU nurse, PICU, trauma ICU, medical ICU, and a traveler doing most of those things. And trauma resuscitation nurse in ED. And charge nurse. I’m tired now.

Four movies I would watch more than once: (I have seen all of these at least 5 times)
1. Bull Durham
2. Shawshank Redemption
3. Green Mile
4. The Color Purple

Four places I have lived
1. Fort Lewis, WA
2. Seattle, WA
3. Las Cruces, NM
4. Portland OR

Four places I have been:
1. Placencia, Belize
2. Florence, Italy
3. Vancouver Islands, British Columbia
4. Isla Mujeres, Mexico

Four Animals I have known or had in my lifetime
1. Buffy, my first cat (he was a boy)
2. Houdini, a mouse
3. Sissy Hankshaw, the first cat that was mine after I moved away from home
4. Sophie, my kitty now

Four of my favorite foods:
1. Salmon belly (saketoro) nigiri sushi
2. Gelato--my current fave flavor is honey lavendar
3. apple pie (made by me)
4. fresh baked bread

Four places I'd rather be right now:
1. Mexico
2. Sauvie Island, OR, in the summertime
3. Somewhere where there is no snow on the ground
4. Talking to my grandma

Four things I am looking forward to this year:
1. Getting close to graduation
2. The summer
3. Going to DC in April
4. Improving my marriage

Four TV shows that I watch:(All on DVD, not real time)
1. Mad Men
2. 30 Rock
3. The Sopranos, even though I have seen every season more than once
4. Sex and the City, still watch it from time to time although I’ve seen them all many times as well

Four Songs that I love
1. Beautiful World, Colin Hay
2. Sleep Don’t Weep, Damien Rice
3. Landing Gear, Ani Difranco
4. Constellation, Jack Johnson

Four modern conveniences I wouldn't want to live without
1. My laptop
2. My iPod
3. My Lapband—is that a “convenience”?
4. Microwave

Tuesday, February 24, 2009

"Sisters", You've Been On My Mind...

Let's talk about the "girls". I noticed in my last post about clothes that I mentioned my breast reduction but had never really talked before about what a good decision this was for me, or about the thing that a lot of MO ladies worry about.

For many of us, one "silver lining" of being morbidly obese (MO) is having large breasts. We worry about what will happen to our shape when we lose weight. Indeed, what will happen? It depends entirely on what is IN your breasts. If you are young and the tissue is firm and not very fatty, not much will change. The older we get, the more fat is deposited there, and the more the size changes with weight changes.

When I was in my 20s, I gained weight and lost weight, but my girls just got bigger. As I mentioned in the previous post, eventually I outgrew all the "standard" sizes and had to be fitted at Nordstrom, where I was deemed a 38H. There in the fitting room, I decided that my idea of having a breast reduction was going to become reality. To me, H meant "Have to have a breast reduction." Things were outta control. I was tired of people staring at my chest, not in any sort of admiration but in freakish amazement. And I was sick of not being able to really exercise without pain in my shoulders, neck, back and chest. It was too much. I really felt like I couldn't lose weight if I didn't do something about this situation.

So, I went to a surgeon that a coworker of mine had gone to. His name was Dr. Kropp, in Seattle. I would refer everyone in the area to him if I could, but he is retired now. He related to me and my friend Val because we were burn nurses and he had done much of his training in reconstructive burn surgery. He had a special place in his heart for burn nurses. He was also extremely kind and caring. When he did my consultation, he took measurements, had his female nurse take photos (this is routine; the photos do not have your face on them, and go to the insurance company for approval), and then met with me, telling me "If you were my daughter, this is what I would want for you." He explained the 2 different ways that he could do the procedure. He assured me that there was no chance my insurance would not cover the procedure, given how much there was to remove, and he was right.

I knew how good he was from Val. She had been a 42MM prior to her reduction. (They used to call her Valcano.) She was reduced to a C cup. She told Dr. Kropp, "All I want is to be able to jump rope again!" She told me all about her surgery, and her results were beautiful. So I felt very confident in his abilities. I scheduled my surgery for late September 2001--about 2 weeks after 9/11, it turned out.

When he did my surgery, he was able to explain why they had never gotten smaller when I had lost weight. I was 28 years old, and there was almost no fat tissue in them. He took about 1000g (1kg) off each side. (The most expensive 5 lbs I ever lost.) There were no drains, but about a zillion tiny sutures. When I went to have them removed in the office 2 weeks later, it took him and a nurse about 20 minutes, and they looked like tiny insect antennae. He told me to wear a sports bra (one the office provided) after my dressings were removed, and I wore it at all times except when showering for 3 months. This is very important for shaping. When I first saw them post op, they looked completely flat, and there was a lot of tissue around the sides. Wearing the sports bra causes the side tissue to mold into the reconstructed breasts and creates a nice shape.

As an ICU nurse I have seen numerous women post breast reduction (for unrelated reasons, mostly because they have been in car accidents and such). My results were much nicer than most others I saw, so I would recommend that anyone looking for a surgeon shop around, get someone with a lot of experience, and talk to other patients. It makes a big difference.

I am very glad I had the reduction before WLS, because I've been able to exercise vigorously the entire time, and was exercising for over a year before WLS. When I lost 35 lbs in 2003-2004, nothing changed at all. However, when I gained weight again, and got older, I did start getting more fat in there. They are now a bit deflated, enough so that I am considering some additional work whenever I get around to getting a tummy tuck (in a few years most likely). The shape is still pretty good, but there is definitely less volume. You can't really tell when I am dressed and wearing a good bra. My initial post-op size was 38C. Now I am 34D.

Everyone I've ever talked to about having had this surgery has said the same thing: she wishes she'd done it years earlier. Truly, if you have very large "girls" that are impairing your ability to exercise or are causing you neck and back pain, and you have health insurance, I'd encourage you to consider it. It was an emotional decision for me, but ultimately a very smart one. My health has been immensely better since doing it, since I have been able to be so much more active. The scars are not bad. It took about a year for them to start really fading. They are definitely still visible, but they look better than what I had pre-op.

A lot of women worry about what their mates will think if they have a reduction. To that, I'd say that most caring partners will want what is best for your health and happiness, when it comes down to it. They might like the large breasts, but they'll like the active, comfortable you more. My hubby didn't know me pre-op, but has been very happy with what I have post-op. It's not worth suffering over any longer than you have to, or not losing major weight over. That's my perspective, anyway.

Tuesday, February 17, 2009

How To Shop For Clothes While Losing Weight

It seems that sooner or later, you are going to have to face this question if you are undertaking a major weight loss project--whether by surgery or not. After all, you have to stay covered. First off there is a practical matter--jeans simply won't stay up if they are 3 sizes too big, and stuff starts to look ridiculous. Then you have to decide how important your clothes are. This is a big question for anyone who has been morbidly obese; after all we don't have a lot of selection or choice when we outgrow the "normal" sizes in the stores. If you have a job where you have to keep up a certain dress code or appearance, you are going to have to budget in some new clothes in sizes that you might not live in very long. Consider this when you decide if you can afford WLS; we don't get to jump from size 20 to size 6 overnight, no matter what your friends might think. Still, there are ways to make this a little less painful and expensive.

I think it helps to decide what is the most important thing in your wardrobe. For me, while I was in active weight-loss phase, it was very important to me to have jeans that fit. They didn't have to be expensive or any designer brand, but they had to fit, so I committed to buying 1-2 pair of Old Navy jeans in a cut that flattered me in each size. That was 5 different sizes once I started losing weight, at $30 per pair (unless I found them on sale). Not an insignificant expense, but one that I decided was worth making. I spent anywhere from 3-6 months in each size; for people losing more rapidly, this might not be practical.

Beyond this, I stuck to a few basic rules:
1. Skirts are forgiving, and often can be worn simply lower on the hips when they get loose, or can be altered.
2. Dresses in knit fabrics work for a lot of sizes.
3. Knit fabrics in general allow for a lot of use while losing weight.
4. A good belt goes a long way.

One thing that I don't think some people plan for is the fact that buying clothes becomes dangerously fun once you really lose some weight. Even when you aren't near goal, just looking and feeling so much better, and being able to fit into smaller sizes and new brands, can make shopping addictive. I think it helps to set your ground rules and your budget for transition size clothes. I accepted the fact that I would buy some clothes that I wouldn't wear very long, and tried my best to hunt for bargains and minimize wasting money.

Some things that people losing weight have done to keep things cheaper include:

-shopping cheap stores and sales (duh, I know)
-exchange clothes with other people losing weight--message boards like LBT or OH are helpful, and others I'm sure, as well as support groups
-thrift shops and consignment shops
-having a good tailor alter clothes that are too nice to just give up. Some items are too complex for this, but having a waist taken in on a skirt or pair of pants is pretty simple. This isn't necessarily cheap, though, so I save this for really nice things I can't part with. If you can do it yourself, great--but even though I'm a pretty good seamstress, there are many things I'd just rather pay a pro to alter.
-Ebay can be a big help, or not. I have found that I can do okay when I am looking for very specific things, but if you frequent Ebay, you know not everything there is a good deal. If you like to sell there, you can unload your stuff that no longer fits. I don't have time for Ebay selling these days, but I used to do it, and it's okay--it never made me so much money to make it really worth putting the effort into.

A lot of this is kind of obvious, I guess, but I think just thinking about the issue of clothes is important when preparing to lose significant weight (or once you've started and realize the problem). Shopping in your own closet is fun, digging out old things that ceased to fit when you gained weight--but for most of us this only takes us so far, until we either surpass our previous lowest weight and run out of old things, or get to the stuff that is just too old and out of date to wear. I eventually got to the old shirts that I bought several years ago that did fit again, but were purchased in that (painfully long) era when all shirts were shorter, even if they weren't midriff-baring exactly (and how happy I was when they finally started making shirts a little longer again, more suitable for us larger-breasted and larger-bellied ladies!). I was so happy to be able to buy shirts that were a longer length and toss those shorter ones to Goodwill.

I discovered some interesting things when I went through this process, too. For example, I found a lot of skirts that I liked but were just a little shorter than I was comfortable wearing nowadays--but if I bought a size or two larger, it would just sit lower on my hips and appear longer, and I could just wear a top over the lower waist. My waist has always been significantly smaller than my hips, so this works great for me. I also discovered which styles of inexpensive knit dresses were easily taken in at the sideseams to make them fit when I got smaller. Overall, my wardrobe became a lot more versatile as I had to change it around to accomodate my changing size.

Shoes and purses and accessories are the main shopping obsessions of obese ladies who like to shop but don't like to suffer the indignity of shopping for clothes. I found as I bought more clothes in transition sizes, I had to stop buying shoes and purses. I just couldn't afford it. Luckily, I had a lot of years to collect nice ones, so it wasn't that hard to do. I'm a lot more intentional now about buying things in general--I shop for a specific item that I need (especially now that I don't have my own income). I'm also lucky that my shoe size didn't change when I lost weight; this does happen with some folks, especially if losing more than 100 lbs total.

Underwear becomes an issue, too. I'm addicted to Costco's Itsee Bitsees panties, and bought them in mediums, then smalls. So I have about a million pairs of them in 3 sizes total; oh well. I have one style of Victoria's Secret bra that I love, and have had pretty good success getting them cheaper on Ebay. Don't forget to be refitted. The sisters shrink for most of us when we lose weight; we need to give them as much help as possible by making sure we wear bras that fit. Especially if your shirts aren't perfectly sized, it really helps to wear bras that fit underneath. I know this is a challenge when you are starting with very large bra sizes. Years before my WLS, I had breast reduction surgery, and I remember how expensive those H cup bras are. (Once I reached "H", I only bought one bra, and immediately pursued breast reduction surgery. The bra was $60 back in 2001.) So this might not be practical to keep up with perfectly if you start out a 44J or something. But again, Ebay can be your friend here, especially if you have a specific brand that consistently fits well for you. I've heard some people swear by some of the bras at Walmart; I don't shop at Walmart myself, so I can't help you there, but if you do, I'm sure you can save a ton of money doing that. Just be sure you know how to fit it properly.

What do you do with your bigger clothes? Well, for most things, I actually have kept them. The reason is that I hope to be pregnant in the next year or two, and I think I'll be able to wear a lot of it as maternity clothes. After I am done with childbearing, I will get rid of the big stuff. Things that I am pretty confident I won't be using again, I donate to Goodwill. If you are a part of a clothing exchange group, you're all set. And if you have really nice plus-size clothes, you can make pretty good money on Ebay, as that stuff is hard to find and a lot of us hated shopping in stores when we were morbidly obese. Consignment would work well for the good stuff, too. The undies are a loss, but that's why I don't spend a lot of money on them. The bras should be donatable, or possibly resale-able if in very good condition. Unless you think you have a good reason to need bigger clothes, like an upcoming pregnancy, it's usually considered best to let go of them when you reach goal and are maintaining it for some time. I had a few times before my surgery where I lost weight and thought I'd never regain, got rid of things, then had to buy them again, in shame, when I regained. So I would not be the one to tell you to chuck it all as soon as you shrink out of it. I'd make sure that you are really maintaining, at least within a few sizes of wherever you end up. But some people would say that is just allowing yourself to regain. Choose for yourself.

I hope this helps pre-ops and non-surgical folks (or recent post ops, or anyone really) at least in starting to think about how to tackle the problem. Nothing about major weight loss is cheap, although I'm sure there are ultra-frugal ways of doing it like there seems to be for everything else, if you want to put in the effort. Having a game plan and sticking to it is what worked best for me.

Monday, February 16, 2009

Karma, no drama

I am missing my boring, normal life I used to have. It seemed boring and normal to me--in fact a lot was going on without my knowledge, but I miss the ignorance-is-bliss part, anyway. Even though I am all about the Truth these days and knowing what is really happening, tonight I'm having a weak moment and wishing for what I don't have.

Legal troubles abound for hubby. He's in serious trouble, without going into details. It's hard to watch him go through this, and hard to have all this uncertainty for us both. I am afraid of the financial fallout for us both over the next several years. Whatever he has to do as the consequences of his actions, that is just what it is. Karma is a real thing, and I'm grateful that he is facing everything with a clear head and no illusions (or delusions) about it. He's trying to remind me that while a lot of bad things are happening right now, some good things will happen too. I do appreciate that.

I've missed more school time--Friday and Monday--and I hate that. I feel so behind, even though I'm not really, and I hate for the CRNAs to frequently see me marked off the schedule. I think I'm not that much fun to hang out with in the OR, either, because I'm so freaking stressed about things these days that I don't make any small talk or chit chat while we sit together (not all of anesthesia is exciting or busy stuff, surprisingly). I don't have energy for it, and so be it. Mostly I try to lay low and get as much out of my clinical time as I can.

There is something good coming up. I am going to D.C. in April for our national organization's annual political meeting. We meet with senators and talk about healthcare and nurse anesthesia. It's pretty cool. I discovered, upon looking through my closet last week, that none of my business clothes fit anymore. The suit I interviewed in for school is a size 18. Needless to say, that isn't going to work this year. So, despite both of us being unemployed, I had to find some business clothes.

I got some good deals at the outlet mall (Presidents' Day sale) and got some pants on sale elsewhere. All in all, I actually got quite a bit for the amount of money I spent, and now I have two suits (size 8) and all I need to meet Congresspeople and the leaders in my profession. The trip itself is paid for by our state organization, WANA, which generously allots money in their budget each year to send students from our program to this meeting. One great thing about our professional organizations is that they work hard to include socialization and political education about our profession when we are in school. It's very important to maintain our profession and assure that quality care is going to continue to be available to people who need it. There are other groups that would like to see us limited in scope of practice, which would put a lot of people whose areas are served only by nurse anesthetists at serious disadvantage. So the political stuff is important, and I'm excited to go to this meeting. Plus I've always wanted to go to DC. There will be lots of pictures!

Thursday, February 5, 2009

A better month

As advertised, February is starting out much better than last month. I got my big assignment for the beginning of the semester done at last--my presentation on pediatric congenital heart defects. If anyone wants to ask me anything about Tetralogy of Fallot or hypoplastic left heart syndrome, now is the time. It will all be leaked out of my brain within the next 3 weeks. Anyway, I had to put it off for a while because for a few weeks things were way too crazy around here for me to be able to think about anything that complex and make sense of it. Then I went to do the presentation this Tuesday and the last 20 slides I had spent the previous evening making did not save--which was more than I could take. So I spent Tuesday night recreating them, and gave the presentation on Wednesday. It went fine, and now I have a little time to relax before getting into starting our thesis and research project.

I am down to my new low weight: 165. Woot! Only 5 lbs to goal. I hope I get there, but it's probably okay if I don't. I bought a new pair of jeans last week (Target has pretty nice jeans, actually) and thought they were 8's but when I got home learned they were 6's. It's my second pair of size 6 jeans and I can't believe they fit, still. When I interviewed for this program in February 2007, my suit was a size 18. It's easy to be excited about losing 6 sizes.

Running at the GU gym is going fine. I'm not running as far as I do outdoors, because treadmills are boring. I do listen to podcasts instead of music, which I like, except that there is a bank of TVs in front of the treadmills, which gets distracting when I'm listening to a podcast. But all in all, it's fine. I find now that I am running more for stress relief and enjoyment than for exercise or doing something "good for" myself. I am also lifting weights--upper body only, I think running is enough for my lower body. And working on my core. It feels good.

We've been getting to know the new freshman class at school. They are all pretty nice. One of them is an old friend of mine from my first ICU job, a guy I always got along with really well but never really got to know that well. So it's been fun getting caught up and all that. I've gone out with the freshman class for drinks a few times and it's been interesting. Most of them are younger than our class is, and most of them don't have kids. They are struggling with the same classes that we struggled with, the same personality issues and all. It's nice to be in a position to offer some (hopefully) helpful advice.

Things at home are going well. Hubby seems to be doing well on his recovery path. I went to see a therapist this week and he basically told me that I seem to be coping in a normal and healthy way and I probably don't need personal therapy right now. I thought that might be the case and wasn't sure if I should see this therapist individually or for couple counselling (which he also does). We are going to see him next week for a couple session to see if we can do some work that way. I think it sounds like it will be helpful and interesting.

Hope everyone is well out there. Thanks for all the kind comments and well-wishes. They mean a lot to me, truly.