Sorry about that, folks, and sorry about the goofy spelling. I'd rather not attract a bunch of disgruntled medical folks to my blog that is NOT about anesthesia politics, so I'm trying to get around the Google.
Today was a beautiful, sunny Spokane day. Hubby and I got up and went to breakfast, then I did a bit of studying before we headed out to a sports bar to watch Tiger in the US Open. We enjoy watching Tiger on Sundays, it's a bit of a tradition for us. But we don't have a TV in Spokane (the giant TV lives in Portland, it's better that I don't have the distraction here) so on the rare occasion that we do want to watch something (usually a sports event) we go to a bar. Then, it ended quite late, so he had to leave once we got home. Not to worry, though, he'll be back later this week. :)
After he left, I went back to the People's Park by the Spokane River for a nice 3.9 mile run. It was still at least 75 degrees although the sun was going down by then. What a lovely day. The run was tiring, but since we had nachos at the bar I really needed the run! Now it's time to shower, look over my cards one more time, and go to bed.
Sometime this week, if the weather holds up, I'll go back with my camera and take some photos by the river. It's really a beautiful spot. And if my weight loss survives the nachos, I'll be a happy girl.
Sunday, June 15, 2008
Coward
I received an anonymous comment from an anesthesiol0gist today. I'm not going to post it because this is my WLS blog, not a public referendum on anesthesiol0gists vs. nurse anesthetists. The comment was longer than most of my posts on this blog, and essentially consisted of a laundry list of all the inc0mpetent CRNAs he has worked with, and how he will never work with a CRNA again.
Anonymous, if you wanted a dialogue about the qualifications and competency of nurse anesthetists vs. anesthesiol0gists, the honest thing would have been to include a name or an email address. I have it all hanging out here--my name, my pictures, my city, all the details of my bariatric surgery and my schooling-- even my weight is posted on this blog. And you don't have the courage to include your name to make this an actual discussion.
Furthermore, you detail the ways in which the CRNAs in your (former) practice were unpr0fessional and unsafe. Yet your practice didn't do the obvious things, which would be to report the practitioners to their state licensing board, or fire their asses. Rather than go after unsafe practitioners, your organization would rather simply hold these people up as representative examples of the profession to the public, as a reason why the public should only accept MDs for their anesthesia. Yet, you continue to hire CRNAs in your practices, because you can "supervise" 4 of them at a time, and bill at 50% for supervising them. (Yes, folks, that's 200% billing at one time.) All this, and you earn at least 4x the salary of a CRNA.
If your complaint is accurate (and I've only heard your obviously biased side of the story), your practice hired some incredibly unpr0fessional nurse anesthetists. The practice shares the blame in allowing them to continue to work. We all know that your professional organization would rather replace all CRNAs with anesthesia ass1stants, who are under your complete control. However, unless you are going to make your salaries affordable for rural hospitals, there would be no anesthesia providers for most hospitals in the country, because they can't afford an anesthesiol0gist, let alone one plus an anesthesia ass1stant. CRNAs will always be around because a, you guys make money off us, and b, you aren't willing to work in Backwater Oregon's 100 bed Level 4 hospital for half of what you make in Seattle or San Diego.
That's great that you're moving on to an all MD practice--but if you feel so great about that, why do you feel the need to Google "crnas+inferi0r" and leave anonymous comments on some student nurse anesthetist's bariatric surgery blog?
That's all the space you get here. Back to my regularly scheduled WLS content.
Anonymous, if you wanted a dialogue about the qualifications and competency of nurse anesthetists vs. anesthesiol0gists, the honest thing would have been to include a name or an email address. I have it all hanging out here--my name, my pictures, my city, all the details of my bariatric surgery and my schooling-- even my weight is posted on this blog. And you don't have the courage to include your name to make this an actual discussion.
Furthermore, you detail the ways in which the CRNAs in your (former) practice were unpr0fessional and unsafe. Yet your practice didn't do the obvious things, which would be to report the practitioners to their state licensing board, or fire their asses. Rather than go after unsafe practitioners, your organization would rather simply hold these people up as representative examples of the profession to the public, as a reason why the public should only accept MDs for their anesthesia. Yet, you continue to hire CRNAs in your practices, because you can "supervise" 4 of them at a time, and bill at 50% for supervising them. (Yes, folks, that's 200% billing at one time.) All this, and you earn at least 4x the salary of a CRNA.
If your complaint is accurate (and I've only heard your obviously biased side of the story), your practice hired some incredibly unpr0fessional nurse anesthetists. The practice shares the blame in allowing them to continue to work. We all know that your professional organization would rather replace all CRNAs with anesthesia ass1stants, who are under your complete control. However, unless you are going to make your salaries affordable for rural hospitals, there would be no anesthesia providers for most hospitals in the country, because they can't afford an anesthesiol0gist, let alone one plus an anesthesia ass1stant. CRNAs will always be around because a, you guys make money off us, and b, you aren't willing to work in Backwater Oregon's 100 bed Level 4 hospital for half of what you make in Seattle or San Diego.
That's great that you're moving on to an all MD practice--but if you feel so great about that, why do you feel the need to Google "crnas+inferi0r" and leave anonymous comments on some student nurse anesthetist's bariatric surgery blog?
That's all the space you get here. Back to my regularly scheduled WLS content.
Saturday, June 14, 2008
Break On Through To the Other Side
Plateau...busted.
I finally lost 2 lbs. Yay! I'm hoping they don't come right back. I don't know what I did, except be more aware of what I was eating. I also haven't really eaten out in the last week or so, which probably helps (can't hurt).
I am inching soooo close to "overweight" in my BMI, after years in the obese (and morbidly obese) category. I'm looking forward to just being overweight. I figure my BMI with a height of 5'3", even though I am 5'3.75" (which if I rounded that to 5'4" puts me under 30, I think). But I try not to think about that difference. I started with this, so I'll finish with it. I can't believe I only have 12 lbs until I reach goal!
Today is a beautiful day, sunny and lovely. Hubby will be here in an hour. I'm off to do some studying, then enjoy his company for a while.
I finally lost 2 lbs. Yay! I'm hoping they don't come right back. I don't know what I did, except be more aware of what I was eating. I also haven't really eaten out in the last week or so, which probably helps (can't hurt).
I am inching soooo close to "overweight" in my BMI, after years in the obese (and morbidly obese) category. I'm looking forward to just being overweight. I figure my BMI with a height of 5'3", even though I am 5'3.75" (which if I rounded that to 5'4" puts me under 30, I think). But I try not to think about that difference. I started with this, so I'll finish with it. I can't believe I only have 12 lbs until I reach goal!
Today is a beautiful day, sunny and lovely. Hubby will be here in an hour. I'm off to do some studying, then enjoy his company for a while.
Friday, June 13, 2008
Here Comes The Sun
The sun has appeared. It was beautiful this morning when I woke up, and stayed that way all day. High temp around 78 degrees, and still balmy now at 9pm. Most of the day, however, I spent studying. I still have a lot to do, too. I am going to make this final physio exam my bitch.
I got a new haircut, too...decided to go a bit shorter. Of course it will never look as good as it did after she styled it today, but I like it and I think it will be nice for the summer.
I decided to go for a new route for my run today. I was aiming for a 3 or 3.5 mile run today. I found a new route on mapmyrun.com, that looked like it went by the river...I ran and ran, but it just seemed to sort of go through the 'hood, though it was near the river...eventually, after about 2.5 miles, I discovered that I was in the wrong place. I could see the park where I was supposed to start, down below. So I drove my car down there, and ran another 1.5 or 2 miles in the riverside park, which was really pretty and has a lot of routes in there to explore at later dates. The first part of it is up a big hill, though. For me, right now, it's a barf-up-a-lung hill that I ran about 1/2 of. Maybe by the end of summer I'll be able to run it all. One of these times I'll bring the camera and take some pictures. My weekly mileage ended up at 14, which is about what I was aiming for. It felt great to finally run in shorts!
Below: my new haircut, and pics from the High Drive run I usually do, which is near my house.
I got a new haircut, too...decided to go a bit shorter. Of course it will never look as good as it did after she styled it today, but I like it and I think it will be nice for the summer.
I decided to go for a new route for my run today. I was aiming for a 3 or 3.5 mile run today. I found a new route on mapmyrun.com, that looked like it went by the river...I ran and ran, but it just seemed to sort of go through the 'hood, though it was near the river...eventually, after about 2.5 miles, I discovered that I was in the wrong place. I could see the park where I was supposed to start, down below. So I drove my car down there, and ran another 1.5 or 2 miles in the riverside park, which was really pretty and has a lot of routes in there to explore at later dates. The first part of it is up a big hill, though. For me, right now, it's a barf-up-a-lung hill that I ran about 1/2 of. Maybe by the end of summer I'll be able to run it all. One of these times I'll bring the camera and take some pictures. My weekly mileage ended up at 14, which is about what I was aiming for. It felt great to finally run in shorts!
Below: my new haircut, and pics from the High Drive run I usually do, which is near my house.
Tuesday, June 10, 2008
Shout-Out Time
Li'l shout-out to Jenn for completing Bikram Yoga's intensive 9 week Teacher Training! I have a link in my Lap Band blogroll (to the side) to her blogs (sheshrinks and yogabootcamp)...Jenn had lap band surgery some time ago (is it about 2 years? Maybe 3...) and lost 100 lbs. Now she's fallen in love with Bikram Yoga, went to the "yoga boot camp" known as Teacher Training, held in Acupulco, Mexico, and blogged every single day about the experience, for 9 weeks! She is a true inspiration for anyone who wants to change their sedentary, overweight lifestyle to make the most of their body and their health. Kudos, Jenn! Make sure to check her blog out and congratulate her for her amazing accomplishment. Teacher Training includes looooonng days of lectures, intensive posture clinics, learning and performing the specific dialogue that goes with the 90 minute long class, and of course, 2 yoga classes per day for the whole 9 weeks, all performed in a 105 degree yoga studio. Wow! I don't think any of us who have been banded could have imagined that something like that was within the realm of possibility when we were being wheeled in to surgery, whatever day that was for us. But it is...and she is living proof, if you love it enough, are willing to put in the work and take yourself to the limit, you can achieve unbelievable things with your body (and your mind, my impression is that this experience is even more of a mental and spiritual challenge than a physical one).
Checking out her back-at-home pics in Seattle made me a little nostalgic for my years living in Seattle. I have reasons that I don't live there anymore...but still, it does hold a lot of good memories for me there. Her favorite coffee spot is just a couple of blocks away from my condo that I sold 6 years ago--gosh, has it been that long already?!? Truth be told, the condo wasn't a very good idea for me. It was more than I could afford, but I was just divorced and refused to go from owning a home to owning nothing--and so, it sort of sucked me into much more debt than I could handle, which necessitated my selling it a few years later. Turns out my ARM mortgage would have sucked me under even worse if I had kept it any longer, even though my home appreciated quite well in value--I frankly wasn't in a position to own that place. So I sold and started traveling, and I wouldn't give that back for the world, even if I could have afforded to stay in that little 1 bedroom condo in Fremont. It brought me to different cities and different work experiences, which helped me focus on what I wanted out of life and out of my career...eventually brought me to Portland, which I fell in love with, and someone else I fell in love with, my husband. And then, to this new adventure of anesthesia school. But it all started there, in Fremont. Ahh, the memories.
While I'm shouting-out, I saw another good post on Tulip's blog, The New Me (Thinspiration). Her title says it all: Motivation is what gets you started. Habit is what keeps you going. I had a similar conversation recently on LBT with some folks who wanted to know how to get motivated to start exercising. I responded that I don't think motivation is so much the issue as just making a decision. I didn't really find the motivation to start exercising--I just knew I had to do it, and I decided to do it. You are motivated by wanting to lose weight and be healthier--that gets you started. But you don't really find "motivation" to work out, you just put on your gym clothes and get out there. The beauty --and the curse, in a way--is that once you get your butt out there, the real motivation comes in the form of the positive feeling you get from exercising and moving your body. It's a curse because you have to overcome the inertia to get that positive feedback of endorphins and so on that brings you back. But I use that as my reason to work out. I know I will feel so much better if I move, than if I sit on the couch.
In Tulip's post, she talks about hitting a plateau (hi, me too) and just keeping on trucking because she's formed the habits. You do lose that motivation boost when you aren't actively losing weight, and you have to rely on your habits and your long term goals to keep at your new healthy lifestyle. I'm glad that my exercise habits aren't so easily derailed when I'm not losing weight, because I don't really connect the two in my head--but the eating habits are so hard to keep on track when you aren't seeing "results".
Ahh, results. Last week's plan to break my plateau did not work--I tracked calories and they were not terribly off track. I planned meals better, and cooked more. I couldn't find any major problem areas, just little derails here and there that I'm sure add up, but even when counting them into my days, they didn't seem to be the culprit. This week I am prepping for the big exam, and you know what? I think that's going to be my focus. I'll just keep doing what I've been doing eating wise, try to be conscious about not snacking or eating stuff that's going to sabotage me, and otherwise not stress it. I'll just spot this week to the Plateau--okay, Plateau, you get week 6 on me. I don't think a fill is the answer. I "can" eat a lot of food if I push it, but if I eat the right amount, I stay full for 3 or 4 hours, or more, so that seems fine to me. I can keep eating the right amount of food without too much stress, and I do, routinely. So no fill for now. Who knows what will happen? Maybe something good will come of easing off the (food) stress for the week. Will keep you posted.
Checking out her back-at-home pics in Seattle made me a little nostalgic for my years living in Seattle. I have reasons that I don't live there anymore...but still, it does hold a lot of good memories for me there. Her favorite coffee spot is just a couple of blocks away from my condo that I sold 6 years ago--gosh, has it been that long already?!? Truth be told, the condo wasn't a very good idea for me. It was more than I could afford, but I was just divorced and refused to go from owning a home to owning nothing--and so, it sort of sucked me into much more debt than I could handle, which necessitated my selling it a few years later. Turns out my ARM mortgage would have sucked me under even worse if I had kept it any longer, even though my home appreciated quite well in value--I frankly wasn't in a position to own that place. So I sold and started traveling, and I wouldn't give that back for the world, even if I could have afforded to stay in that little 1 bedroom condo in Fremont. It brought me to different cities and different work experiences, which helped me focus on what I wanted out of life and out of my career...eventually brought me to Portland, which I fell in love with, and someone else I fell in love with, my husband. And then, to this new adventure of anesthesia school. But it all started there, in Fremont. Ahh, the memories.
While I'm shouting-out, I saw another good post on Tulip's blog, The New Me (Thinspiration). Her title says it all: Motivation is what gets you started. Habit is what keeps you going. I had a similar conversation recently on LBT with some folks who wanted to know how to get motivated to start exercising. I responded that I don't think motivation is so much the issue as just making a decision. I didn't really find the motivation to start exercising--I just knew I had to do it, and I decided to do it. You are motivated by wanting to lose weight and be healthier--that gets you started. But you don't really find "motivation" to work out, you just put on your gym clothes and get out there. The beauty --and the curse, in a way--is that once you get your butt out there, the real motivation comes in the form of the positive feeling you get from exercising and moving your body. It's a curse because you have to overcome the inertia to get that positive feedback of endorphins and so on that brings you back. But I use that as my reason to work out. I know I will feel so much better if I move, than if I sit on the couch.
In Tulip's post, she talks about hitting a plateau (hi, me too) and just keeping on trucking because she's formed the habits. You do lose that motivation boost when you aren't actively losing weight, and you have to rely on your habits and your long term goals to keep at your new healthy lifestyle. I'm glad that my exercise habits aren't so easily derailed when I'm not losing weight, because I don't really connect the two in my head--but the eating habits are so hard to keep on track when you aren't seeing "results".
Ahh, results. Last week's plan to break my plateau did not work--I tracked calories and they were not terribly off track. I planned meals better, and cooked more. I couldn't find any major problem areas, just little derails here and there that I'm sure add up, but even when counting them into my days, they didn't seem to be the culprit. This week I am prepping for the big exam, and you know what? I think that's going to be my focus. I'll just keep doing what I've been doing eating wise, try to be conscious about not snacking or eating stuff that's going to sabotage me, and otherwise not stress it. I'll just spot this week to the Plateau--okay, Plateau, you get week 6 on me. I don't think a fill is the answer. I "can" eat a lot of food if I push it, but if I eat the right amount, I stay full for 3 or 4 hours, or more, so that seems fine to me. I can keep eating the right amount of food without too much stress, and I do, routinely. So no fill for now. Who knows what will happen? Maybe something good will come of easing off the (food) stress for the week. Will keep you posted.
Sunday, June 8, 2008
Recap before bedtime...
Today we got a bit of sunshine, though it was cloudy in the afternoon. I spent about 3 hours studying in the library, which was good.
My run yesterday was good and I stuck to my 3 miles, almost exactly, which was also good. Then I went to the Y and did upper & lower body weights. Nice and sore today--not too much, just enough to know I did some good. I like that.
Mostly, I studied this weekend. Hubby is starting a new job this week, but hopefully will be coming to Spokane later in the week. I sure hope so! I have a big exam next Monday so all week and all weekend will be about studying for it. I can't really go to Portland until that's over, so hopefully he can come here this week. I sure miss him a lot.
I've been reading the boards at nurse-anesthesia.org this weekend. It's a great site, full of CRNAs, SRNAs, and wanna-be's...but it's also depressing hearing what things are like at other anesthesia programs. CRNAs who "pimp" the students in their charge (ask them hard, often esoteric questions designed to make the CRNA look good), MDAs who belittle or sabotage CRNAs and students, the political environment of anesthesia in general...it can be overwhelming. But we have a pretty good thing going at Gonzaga. Our program directors are supportive and so are the clinical staff. The environment is friendly and warm, not militant. The US News rankings came out for 2007 and our program came in 23rd place, which is a pretty good showing for a tiny program on the West Coast. 8 students a year is nothing compared to a lot of these programs. And we came ahead of programs like Duke, Vandy, all the East Coast schools that my friends are at... These rankings are subjective and don't really mean a whole lot, in truth, but still it's nice that at least our reputation gets us ranked fairly highly among all the programs in the country today. Sometimes I read about the political issues within anesthesia and I wonder if there is going to be a career waiting for me at all when I am out of school. Anesthesiologists wish to have CRNAs work, but only if we accept their "medical direction" and they can bill for our work. I could expound on all of the issues here, but I'm not going to...because this blog isn't about that, and because I'm tired. But this is going to be a major health care issue in the near future so watch and support your local CRNA!
Weight loss...not happening right now. The rhubarb pie surely didn't help, even if it was made with 1/2 Splenda. I'm still stuck in Plateau Land. This week, hopefully I can make some progress.
My run yesterday was good and I stuck to my 3 miles, almost exactly, which was also good. Then I went to the Y and did upper & lower body weights. Nice and sore today--not too much, just enough to know I did some good. I like that.
Mostly, I studied this weekend. Hubby is starting a new job this week, but hopefully will be coming to Spokane later in the week. I sure hope so! I have a big exam next Monday so all week and all weekend will be about studying for it. I can't really go to Portland until that's over, so hopefully he can come here this week. I sure miss him a lot.
I've been reading the boards at nurse-anesthesia.org this weekend. It's a great site, full of CRNAs, SRNAs, and wanna-be's...but it's also depressing hearing what things are like at other anesthesia programs. CRNAs who "pimp" the students in their charge (ask them hard, often esoteric questions designed to make the CRNA look good), MDAs who belittle or sabotage CRNAs and students, the political environment of anesthesia in general...it can be overwhelming. But we have a pretty good thing going at Gonzaga. Our program directors are supportive and so are the clinical staff. The environment is friendly and warm, not militant. The US News rankings came out for 2007 and our program came in 23rd place, which is a pretty good showing for a tiny program on the West Coast. 8 students a year is nothing compared to a lot of these programs. And we came ahead of programs like Duke, Vandy, all the East Coast schools that my friends are at... These rankings are subjective and don't really mean a whole lot, in truth, but still it's nice that at least our reputation gets us ranked fairly highly among all the programs in the country today. Sometimes I read about the political issues within anesthesia and I wonder if there is going to be a career waiting for me at all when I am out of school. Anesthesiologists wish to have CRNAs work, but only if we accept their "medical direction" and they can bill for our work. I could expound on all of the issues here, but I'm not going to...because this blog isn't about that, and because I'm tired. But this is going to be a major health care issue in the near future so watch and support your local CRNA!
Weight loss...not happening right now. The rhubarb pie surely didn't help, even if it was made with 1/2 Splenda. I'm still stuck in Plateau Land. This week, hopefully I can make some progress.
Saturday, June 7, 2008
It Was a Dark and Stormy Day...
...and I did not want to run.
But, alas, weather.com says it will rain all day. Do I want to run in the rain or on a treadmill? I'm going with the rain, I think. Just have to work myself up to it.
Yesterday was my run day, but I took the day off. Just wasn't feeling it. Today I need to run AND go to the gym and lift. I haven't lifted all week! Bad me.
I didn't do fitday yesterday either. Double bad! I'm thinking that when I don't track, my calories are in the 1600 range; when I do, closer to 1100-1200. I THINK if I kept it around 1100, I would probably still lose weight; so maybe the answer is more tracking? But this week is a hormonal weight-gain week anyway, so I'll look at this all again next week.
But, alas, weather.com says it will rain all day. Do I want to run in the rain or on a treadmill? I'm going with the rain, I think. Just have to work myself up to it.
Yesterday was my run day, but I took the day off. Just wasn't feeling it. Today I need to run AND go to the gym and lift. I haven't lifted all week! Bad me.
I didn't do fitday yesterday either. Double bad! I'm thinking that when I don't track, my calories are in the 1600 range; when I do, closer to 1100-1200. I THINK if I kept it around 1100, I would probably still lose weight; so maybe the answer is more tracking? But this week is a hormonal weight-gain week anyway, so I'll look at this all again next week.
Wednesday, June 4, 2008
Bitchfest
I did it again. I headed out for a run that I thought would be around 4 miles and it turned out to be 5.1. I'm trying to be good and not increase my mileage too much, but once I start feeling really good, about 25 minutes into the run, I just want to keep going. I didn't feel so good going out, though. I was up this morning at 0445 for IV's in the SAU (surgical admit unit), then an intubation in the OR at 0630, then 2 classes. I felt like a blob when I got home, zero energy. So I headed out with my iPod this time, hoping the music would pep me up. I found that it did, during my warmup, but once I was running, it kept me out of tune with my body, and I was slogging along instead of feeling strong and enjoying the run. So I finally figured out that I should turn the music off & take the earbuds out--duh! So much better. No more running with the 'phones. I'm better off without them.
IV's sort of sucked...I missed a few, and we had to leave at 0630 instead of 0645, which got the charge nurse all bent out of shape. They are very used to having students there to start all their morning IVs now, and take every opportunity to call our program directors and complain when something doesn't go the way they think it should. Luckily, our PDs take it all with a grain of salt and know that we don't pay tuition to start IVs...that is a small part of what we do here. I have a feeling the charge will complain to John about us leaving early this morning, even though we leave early EVERY WEDNESDAY because we have airway on Wednesdays... Whatever. I finally figured out "who" this person is...she is exactly like a nurse that I used to work with in Portland who was difficult to deal with...and now I know how to approach her, so it doesn't really bug me anymore. At least I got my intubation, and had a pretty good OR experience.
I'm finding myself getting anxious as clinicals approach. I've pulled out every flash card I've made since January, and I'm reviewing and gathering info that I'll want in the OR, while also doing my current studying of course. I'm tense at school, too. It's impossible to overestimate how hard it is to go from being an expert nurse in the ICU to a complete newbie who knows nothing. Not only do I feel anxious about not knowing anything and looking dumb, but also about everything I have to learn, and being safe, and keeping my patients safe. I know I'll get through it, but the anticipation is killing me. To make me feel better, I guess, my CRNA today (Larry) told me not to worry, I'd always feel dumb in clinical! Even when I'm near graduation. LOL. I had to laugh. But he meant that in a nice way. It's okay to be new and to know nothing, that is what is expected of us and we have to learn to put our egos aside and allow ourselves to be novices.
The fitday logging continues. I had a day around 1000 cal, yesterday was about 1200 as today will be as well. I hope this is enough fewer than what I had been eating to stimulate some weight loss, because it will be more difficult to reduce it further than that. At some point I'll have to do that anyway, but I'd rather put it off.
I read something on the lapband board today that really irritated me. There's a thread for nurses, and of course there are many nurses who have been banded. (We have a reputation for being fat, and for availing ourselves of everything medicine has to offer, for better or worse.) It's kind of nice. But someone posted today about having been banded 2 weeks ago, and how the liquid diet was "killing" her so she advanced herself to solids. Okay, I did that too, for a day, until I read about WHY my doctor had required this (and why they all do, it really is for a reason) and then I went back to my prescribed diet. I was going to reply with the reasons for following the diet as prescribed, until I saw her ticker. Her STARTING BMI was 30--what mine is after losing 60 lbs! Her goal is a BMI of 19. Who the f*@! banded her? What is that? I considered myself a "lightweight", with a starting BMI of 42--which was high enough that Regence (BCBS) covered my surgery. A starting BMI of 30? I just couldn't be bothered with giving her advice. I'm sorry, maybe that's snotty or catty or whatever. I don't care. Is this like "gastric bypass light?" Do people think if they have a little extra weight--40 lbs or so--that they should just get banded? This is serious surgery. There are serious risks. The health risks of having a BMI of 30 are not sufficient to warrent having bariatric surgery. That really got me riled up. If she wants to go get a lap band and then ignore the prescribed aftercare, fine, have fun. Don't come crying to us when your band slips or you can't deal with figuring out fills and restriction and you're barfing all the time. Gack!
I can say this because I am one--Nurses are Crazy!
IV's sort of sucked...I missed a few, and we had to leave at 0630 instead of 0645, which got the charge nurse all bent out of shape. They are very used to having students there to start all their morning IVs now, and take every opportunity to call our program directors and complain when something doesn't go the way they think it should. Luckily, our PDs take it all with a grain of salt and know that we don't pay tuition to start IVs...that is a small part of what we do here. I have a feeling the charge will complain to John about us leaving early this morning, even though we leave early EVERY WEDNESDAY because we have airway on Wednesdays... Whatever. I finally figured out "who" this person is...she is exactly like a nurse that I used to work with in Portland who was difficult to deal with...and now I know how to approach her, so it doesn't really bug me anymore. At least I got my intubation, and had a pretty good OR experience.
I'm finding myself getting anxious as clinicals approach. I've pulled out every flash card I've made since January, and I'm reviewing and gathering info that I'll want in the OR, while also doing my current studying of course. I'm tense at school, too. It's impossible to overestimate how hard it is to go from being an expert nurse in the ICU to a complete newbie who knows nothing. Not only do I feel anxious about not knowing anything and looking dumb, but also about everything I have to learn, and being safe, and keeping my patients safe. I know I'll get through it, but the anticipation is killing me. To make me feel better, I guess, my CRNA today (Larry) told me not to worry, I'd always feel dumb in clinical! Even when I'm near graduation. LOL. I had to laugh. But he meant that in a nice way. It's okay to be new and to know nothing, that is what is expected of us and we have to learn to put our egos aside and allow ourselves to be novices.
The fitday logging continues. I had a day around 1000 cal, yesterday was about 1200 as today will be as well. I hope this is enough fewer than what I had been eating to stimulate some weight loss, because it will be more difficult to reduce it further than that. At some point I'll have to do that anyway, but I'd rather put it off.
I read something on the lapband board today that really irritated me. There's a thread for nurses, and of course there are many nurses who have been banded. (We have a reputation for being fat, and for availing ourselves of everything medicine has to offer, for better or worse.) It's kind of nice. But someone posted today about having been banded 2 weeks ago, and how the liquid diet was "killing" her so she advanced herself to solids. Okay, I did that too, for a day, until I read about WHY my doctor had required this (and why they all do, it really is for a reason) and then I went back to my prescribed diet. I was going to reply with the reasons for following the diet as prescribed, until I saw her ticker. Her STARTING BMI was 30--what mine is after losing 60 lbs! Her goal is a BMI of 19. Who the f*@! banded her? What is that? I considered myself a "lightweight", with a starting BMI of 42--which was high enough that Regence (BCBS) covered my surgery. A starting BMI of 30? I just couldn't be bothered with giving her advice. I'm sorry, maybe that's snotty or catty or whatever. I don't care. Is this like "gastric bypass light?" Do people think if they have a little extra weight--40 lbs or so--that they should just get banded? This is serious surgery. There are serious risks. The health risks of having a BMI of 30 are not sufficient to warrent having bariatric surgery. That really got me riled up. If she wants to go get a lap band and then ignore the prescribed aftercare, fine, have fun. Don't come crying to us when your band slips or you can't deal with figuring out fills and restriction and you're barfing all the time. Gack!
I can say this because I am one--Nurses are Crazy!
Monday, June 2, 2008
The Joy Fit Club
I'm a news junkie, and an avid MSNBC.com reader. Every Monday, the Today Show (whose website is part of MSNBC's) inducts a new member to the Joy Fit Club. If you haven't seen this before (either watching the Today Show or online), it is "run" by Joy Bauer, who wrote Joy Bauer's Food Cures. The idea behind her "Joy Fit Club" plan is simple: she wants to promote weight loss through basic nutrition and fitness methods, and uses a large emphasis on positive attitude. That is the part that Today Show viewers, and other fans, take part in, and apparently lots of people do it. On Mondays, she features a new "member" who has lost at least 100 lbs by any diet--not necessarily her plan, and actually I have seen few members who used her plan--as long as there is no surgery involved. Here's what the Today Show's website says:
"Twice a month, TODAY will induct new members into nutritionist Joy's Bauer's Fit Club. These are determined people who have lost and kept off a significant amount of weight -- 100 pounds or more. Read their inspiring and motivating stories of how they lost the weight the good old-fashioned way, through diet, exercise and no surgery."
I look forward to reading about the latest member inducted every week. I love a good before & after story as much as anyone else. But some things about this "club" have always rubbed me wrong.
First, this program really touts losing weight "the good old-fashioned way." No surgery. The intent, outwardly, isn't to say that surgery is wrong, per se, but I think they want it to inspire people to try weight loss "the good old-fashioned way" before jumping to surgery. Unfortunately, they don't really mention this much. They do mention frequently when an inductee lost weight as a "last-ditch effort" right before having surgery, or to qualify for surgery, but then changed their minds and did it "themselves".
I think it's great that people can lose massive amounts of weight through diet and exercise. Fact is, most of us who have WLS actually HAVE lost massive amounts of weight before. That brings me to the second thing that bugs me: there is no focus on keeping it off, which is the hardest part. The club members supposedly have "lost weight and kept it off", but the clips I see on their website rarely, if ever, mention when the goal was achieved, how long they have been at goal, and how they maintain. Am I wrong, or is that the answer that obese people are really looking for here? We all know how to lose weight. But keeping it off is the hardest part, and this "plan" has no focus on that. To me, it's just setting people up for the inevitable regain--all the weight loss, plus an extra 10-20%, is the norm, because the body tries to compensate for the next time this famine occurs with some extra insurance.
Also, Joy Bauer takes a lot of credit for these peoples' successes. But as I mentioned before, most of the 100+ club members lost their weight through some other diet--the most frequent ones I see are NutriSystem, Weight Watchers, and South Beach, but I've also seen Atkins, Jenny Craig, etc. on the list. But not the Joy Fit Club weight loss plan. Yet she implies on the TV segments that she has helped these people lose weight, even though they only "join the club" AFTER they've lost weight.
It just rubs me the wrong way. She implies that having WLS isn't "natural weight loss" or "good old-fashioned work", and that the "good" way to do it is D&E. I think she could do a lot more good if she (A) focused more on maintenance, and (B) talked about how people who have had WLS can benefit from these methods too. Be a little more inclusive. Or at least make it clear that she's trying to provide inspiration and options for people who already don't want to have WLS. Perpetuating the negative attitude that there is something wrong with that choice only hurts people more. It's not a choice for everyone, but for many people it is ABSOLUTELY the right choice. And lumping all the procedures together into one big, bad "surgery" ball is also misleading. I can personally relate to a lot of these weight loss stories, having had lap band surgery--the methods for weight loss are exactly the same, but I have assistance with appetite control, and to some extent with portion control. In that sense, it's not the same, but it's not that different either, and the band is very different from a lot of the other things that they make sound so scary (which themselves are ALSO the right choice for some people).
I wanted to put today's video in here, but Blogger wouldn't accept the embedded video. So, here's the link. In it, "Kathy" says that she started NutriSystem in August of 2006 and it took about 11 months to lose 140 lbs. So she has been maintaining for less than a year--which is great, but I'm not sure it qualifies as "keeping it off" just yet. Check it out and let me know what you think.
Here's the MSNBC feature as well.
"Twice a month, TODAY will induct new members into nutritionist Joy's Bauer's Fit Club. These are determined people who have lost and kept off a significant amount of weight -- 100 pounds or more. Read their inspiring and motivating stories of how they lost the weight the good old-fashioned way, through diet, exercise and no surgery."
I look forward to reading about the latest member inducted every week. I love a good before & after story as much as anyone else. But some things about this "club" have always rubbed me wrong.
First, this program really touts losing weight "the good old-fashioned way." No surgery. The intent, outwardly, isn't to say that surgery is wrong, per se, but I think they want it to inspire people to try weight loss "the good old-fashioned way" before jumping to surgery. Unfortunately, they don't really mention this much. They do mention frequently when an inductee lost weight as a "last-ditch effort" right before having surgery, or to qualify for surgery, but then changed their minds and did it "themselves".
I think it's great that people can lose massive amounts of weight through diet and exercise. Fact is, most of us who have WLS actually HAVE lost massive amounts of weight before. That brings me to the second thing that bugs me: there is no focus on keeping it off, which is the hardest part. The club members supposedly have "lost weight and kept it off", but the clips I see on their website rarely, if ever, mention when the goal was achieved, how long they have been at goal, and how they maintain. Am I wrong, or is that the answer that obese people are really looking for here? We all know how to lose weight. But keeping it off is the hardest part, and this "plan" has no focus on that. To me, it's just setting people up for the inevitable regain--all the weight loss, plus an extra 10-20%, is the norm, because the body tries to compensate for the next time this famine occurs with some extra insurance.
Also, Joy Bauer takes a lot of credit for these peoples' successes. But as I mentioned before, most of the 100+ club members lost their weight through some other diet--the most frequent ones I see are NutriSystem, Weight Watchers, and South Beach, but I've also seen Atkins, Jenny Craig, etc. on the list. But not the Joy Fit Club weight loss plan. Yet she implies on the TV segments that she has helped these people lose weight, even though they only "join the club" AFTER they've lost weight.
It just rubs me the wrong way. She implies that having WLS isn't "natural weight loss" or "good old-fashioned work", and that the "good" way to do it is D&E. I think she could do a lot more good if she (A) focused more on maintenance, and (B) talked about how people who have had WLS can benefit from these methods too. Be a little more inclusive. Or at least make it clear that she's trying to provide inspiration and options for people who already don't want to have WLS. Perpetuating the negative attitude that there is something wrong with that choice only hurts people more. It's not a choice for everyone, but for many people it is ABSOLUTELY the right choice. And lumping all the procedures together into one big, bad "surgery" ball is also misleading. I can personally relate to a lot of these weight loss stories, having had lap band surgery--the methods for weight loss are exactly the same, but I have assistance with appetite control, and to some extent with portion control. In that sense, it's not the same, but it's not that different either, and the band is very different from a lot of the other things that they make sound so scary (which themselves are ALSO the right choice for some people).
I wanted to put today's video in here, but Blogger wouldn't accept the embedded video. So, here's the link. In it, "Kathy" says that she started NutriSystem in August of 2006 and it took about 11 months to lose 140 lbs. So she has been maintaining for less than a year--which is great, but I'm not sure it qualifies as "keeping it off" just yet. Check it out and let me know what you think.
Here's the MSNBC feature as well.
Sunday, June 1, 2008
Attack Plan: The Last 15
The current plateau stands at 1 month.
That's not a crisis, but I'm tired of it.
So, I decided, since my exercise is clearly adequate, that I'm eating the amount of calories it takes for me to maintain my current weight. I need to reduce the calories. My plan for this week will be to track what I eat for the next 3-4 days (on fitday), and plan my meals. Then I'll figure out where to cut down my calories.
Today's eating has felt out of control. I woke up with an irritated stomach that has been making me feel hungry all day. I think my evening pills stayed in my stomach pouch all night and irritated it. Ugh. I tracked what I've eaten today and came up with about 1800 calories--which is clearly too much if I'm trying to lose weight, but not as bad as I expected it to be for today. Usually, I think I'm probably around 1600--but I'll track to see. I'm going to bed soon, because I have to get up at 4:45 for IVs in the morning--so that's my calories for the day, I'm not eating any more.
I think I probably need my calories around 1200 to continue losing weight. Probably not as hard as it sounds to me right now--but I want to do it without getting another fill. So, plan of attack:
Losing the last 15:
1. Track eating on FitDay.com
2. Continue exercise program (running, weights, swimming)
3. Plan meals ahead, following band rules.
4. Figure out new calorie target
5. Bike to school a couple times a week
6. If I do all this and am not losing weight or am hungry, then consider a fill.
It's summertime, which means grilling and doing outdoor things, so this should be doable. It's just back to basics, which I've done many times. Tomorrow I am done with school by noon, so I should be able to get in my run and get some studying done without much trouble (although it's supposed to rain in the midday, so I may go in the evening). Oh yeah, I'm going to go easier on my mileage this week--probably about 14 miles--and work back up slowly.
I'm going to get to goal before the end of the year, I swear!
That's not a crisis, but I'm tired of it.
So, I decided, since my exercise is clearly adequate, that I'm eating the amount of calories it takes for me to maintain my current weight. I need to reduce the calories. My plan for this week will be to track what I eat for the next 3-4 days (on fitday), and plan my meals. Then I'll figure out where to cut down my calories.
Today's eating has felt out of control. I woke up with an irritated stomach that has been making me feel hungry all day. I think my evening pills stayed in my stomach pouch all night and irritated it. Ugh. I tracked what I've eaten today and came up with about 1800 calories--which is clearly too much if I'm trying to lose weight, but not as bad as I expected it to be for today. Usually, I think I'm probably around 1600--but I'll track to see. I'm going to bed soon, because I have to get up at 4:45 for IVs in the morning--so that's my calories for the day, I'm not eating any more.
I think I probably need my calories around 1200 to continue losing weight. Probably not as hard as it sounds to me right now--but I want to do it without getting another fill. So, plan of attack:
Losing the last 15:
1. Track eating on FitDay.com
2. Continue exercise program (running, weights, swimming)
3. Plan meals ahead, following band rules.
4. Figure out new calorie target
5. Bike to school a couple times a week
6. If I do all this and am not losing weight or am hungry, then consider a fill.
It's summertime, which means grilling and doing outdoor things, so this should be doable. It's just back to basics, which I've done many times. Tomorrow I am done with school by noon, so I should be able to get in my run and get some studying done without much trouble (although it's supposed to rain in the midday, so I may go in the evening). Oh yeah, I'm going to go easier on my mileage this week--probably about 14 miles--and work back up slowly.
I'm going to get to goal before the end of the year, I swear!
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