Day 5 Post-Op: It's Getting DEEP Up in Here!

I was so focused yesterday on getting an update posted, and I started late, so what ended up happening is that I wrote a wall of text that really didn't say much of anything.

There is so much going on in my brain over the past few days that it seems impossible to untangle it and dump it all out somewhere and make it make sense. What ends up happening is that I find anything else to talk about. Not because I'm trying to hide it or avoid it, but because I just don't know where to start.

But that's kind of the point of this whole blogging adventure, isn't it? Put it all out there in the open and hold myself accountable for it.

So, let's try, shall we?

I mentioned previously that in the beginning there's kind of an overwhelming feeling of "what the fuck did I just do?" and the physical pain really makes you feel like you've been sold a raw bill of goods. I don't really get it, honestly, because I don't think any of us go into surgery thinking that it's going to be a cakewalk. I mean, for one thing, by the time we are finally wheeled into that operating room, 99% of us have been coached for months on what needs to happen before we have the surgery, what recovery will look like, and how drastically different life will look afterward. And even for the small percentage of us who don't go through a program (which I think is most often people who self-pay, because the months-long programs are usually an insurance requirement in order for surgery to be authorized), there is no shortage of information thrown at you about what you're signing up for.

I think any feeling of regret I've had can be attributed to this weird construct in my head of being... I dunno... unaltered? I don't think that's the right word for it, but I don't know a better one. Or maybe... it's the fact that it's irreversible. There's no undoing it. It's one of the same reasons I haven't gotten a tattoo; I can't decide what I want, and once I pick something, I'm stuck with it. So with the surgery, it took a lot of effort to mentally get to a place where I could come to terms with that. That if I followed through with this process, it was done and I was "stuck" with the consequences.

So, then the question becomes "what's wrong with being stuck with it?"... Here's the thing: I've been fat for like, 30 years. Three decades. For at least two of those decades, I have been engaged in some sort of attempt to change my eating habits, lose weight, fight the demons. Every single one of those attempts has failed. Sometimes because I didn't do what I was supposed to do, sometimes because life got in the way, sometimes because I did the best I could and my body and my brain were like "hahahahfuck you." So throughout this entire process, from when the seed was planted to look into surgery, through, well, now, there's an elephant in the room (aka, my brain) reminding me that this could fail too.

I need to be clear -- despite what it sounds like, this isn't negativity or doubt, really. It's just... paralyzing realism. There's a part of my brain that cannot just.. be hopeful... and holds too many facts and figures and data to believe that everything will be a-okay. It's the same reason I had the intense fear of death going into surgery -- despite everyone's reassurances, kind words, logic, all my brain could see was "well, SOME people do die from this, you know, and there's no way to know that it won't happen to me." It doesn't matter that what the data doesn't tell you is that the 0.04% mortality rate is usually in patients with serious comorbidities or other factors that made surgery -- any surgery -- high risk. No, my brain sees "a very minuscule number of people die from this surgery" and sees "it could be you. Get your affairs in order."

It's funny, really. A therapist I had a long time ago told me that I thought too much in absolutes. Typically, the worst thing is going to happen to me. Or, the best thing is going to happen to somebody else instead of me. No in-between. But on a deeper level, my problem is that I can't see absolutes at all. Nothing is certain. Crazy, unforeseen things happen every single day. My brain tells me that I can't be confident that generally, things will be okay because there are a zillion and five ways that it could be unokay.

My brain is an asshole. Have I ever mentioned that before? Anxiety is a motherfucker.

So anyway, when it comes to the surgery, I mustered up enough courage and enough "STFU, BRAIN!" to get there, get it done, and get through it. But now that surgery is over, my fear of death has to go somewhere. It has to find something to transfer onto. So now the panic is caught between "you know, risk of complications doesn't really drop until the 30-day mark, and you're only on day 5" and "alright, you made it through surgery! what's the over-under on how long it takes you to fuck it up and gain your weight back?"

Seriously. Big. Giant. Asshole.

I should be clear, though, before anyone starts to worry -- I am hopeful. I am seeing the positive throughout all of this as much as I can. Even at the peak of my pain, I felt proud that I had gotten through it and made this commitment to myself. FOR myself.

It's just that no matter how committed and hopeful I am, on the inside, where no one can see, I am an anxiety-ridden mess that has to fight herself every day to get what she wants from life.

Over time, one of the things I realize that I do in order to manage my anxiety, which I originally just attributed to ADHD and OCD (though they're still not blameless) is over-prepare. Learn everything. Make lists. Have ideas. Fill the arsenal with ways to succeed so that I'm not left standing, mouth agape, trying to figure out where things are going wrong. Sometimes it can make things worse, but in this case, I think that it's doing some good.

I learned a lot about the surgery from a procedural perspective, how it was developed, how and when it started to become so much more widely performed and even preferred in some cases, and the turning point at which insurance companies started to recognize it as a coverable procedure.

I also soaked up every single bit of information offered to me by the program about what to expect, what was next, what to do, what to eat, where to go, etc. One of the things I've loved about working with VCU Health has been the fact that they're so forthcoming with information. Packets and handouts and classes and guidelines... everything you need. Nothing is hidden or sugarcoated, but they don't dull the sparkle of the chance at a new life.

On my own, I've researched and pored over programs in other places, to see other ways that things are done, and why. What the different schools of thought are. I'm in a handful of bariatric surgery-related groups on FB, and people are always asking for guidance on what they should do, what others have done, etc., etc., and it can be really tough to stay confident in your own "journey" (gag) if you're following guidelines that aren't what someone else is following. For example, Some programs perform the surgery on an outpatient basis. Some programs only require a couple days of pre-op liquid diet. Some move you to the next phase of the diet quicker post-op. I didn't want to spend a lot of time mired in wondering why other people had "easier" rules to follow and ultimately doubting if I was making the right choice, so I learned about it all and tucked it away for later.

Now, on day five, since the pain and discomfort are easing up (it just occurred to me now, at 12:15 am, that I have not taken any pain meds since around 2:30 this afternoon), I can focus on where I'm going from here and how I am going to stop at nothing to be successful. And of course, anxiety-brain says there's still a chance I will fail, but you can be damn sure that it won't be for lack of effort on my part.

I spent a lot of time today trying to find meal ideas and recipes for the next two phases of my diet: pureed food and soft foods. Pureed food especially, because there is literally nothing appealing about eating only foods that have the consistency of applesauce. Seriously. My instinct says "okay, just eat applesauce for two weeks", but something tells me that this is not only ill-advised but also unsustainable, haha. Looking for ideas and recipes has helped me to overcome a little bit of the impulse to turn my nose up at the idea of eating things like pureed meat. Still not thrilled about it, but I've at least come up with enough ideas of things that don't disgust me that I could avoid pureed meat altogether and still get through the two weeks unscathed. Fingers crossed.

The other thing I have to keep in mind is that one of the biggest barriers to success in the past has been overcoming boredom. I get bored of eating the same five things over and over again. I get bored with tracking every bite I put into my mouth. I need to keep things exciting, and I need to have variety. So getting ideas now will keep me from panicking in the moment and making an "easy" choice that isn't in any way a "good" choice.

As far as the tracking thing goes, I will still need to track what I eat, especially in the early stages, but it's much more simplistic post-op than it has been with any other weight loss program and I will primarily be focused on consuming an appropriate amount of protein. The limits of my pouch will more or less manage themselves if I'm doing the right thing otherwise. If I'm staying within my protein goals, it will be almost impossible to eat too many calories, too much sugar, or too many carbs. With a few exceptions, high-protein foods are generally lower in carbs and calories. And the foods I should avoid or eat far less of are largely devoid of any significant protein, so focusing on that one number, that one goal, will theoretically keep everything else in line. It'll also leave me some space to enjoy a treat every once in a while, knowing that the rest of my food consumption is within my guidelines and achieving my goals.

Aside from protein, the only other thing I have to prioritize, which will require tracking (again, especially in the early stages), is fluid intake. Because my stomach is now so small, and food spends less time in it just hanging around before being shuffled along through the rest of my digestive system, I won't get as much fluid or nutrients from what I eat. This leaves me susceptible to dehydration and malnutrition, which both, well, suck. I think all of us have a hard time drinking enough water on a daily basis, but there's so much more that stands in the way post-op that it has to be a focus. The normal cues that the body gives you to tell you you're hungry/thirsty have been altered. Feeling full quicker means that if you're not purposeful in your meal planning, you will be too full to consume enough liquids, or vice versa. Timing is critical, amounts are critical, it's all just a big ol' critical mess. I've seen a lot of people in FB groups who literally have timers on their phones or watches go off every 5-15 minutes to remind them to drink. I'm not sure yet if that would work for me or just annoy the fuck out of me, but I think I have to at least start there. I can't just rely on my own body's urges to tell me when to drink. Already I have seen that a lot of time is passing between when I'm taking sips, and since I can only sip about an ounce at a time, my goal of 60-ish ounces of fluid per day are not being met. So... more work to be done, and for my broken brain that means obsessively searching for best practices, tips and tricks, and ways to make water (and other fluids) more appealing. Thankfully, though, I actually really enjoy drinking water (when I remember to do it).

Okay, I think I've prattled on enough for the day. My plan for my next post is to create my official list of goals or NSVs (Non-Scale Victories), so that I can keep track of what has been achieved in posts thereafter. I've discussed my weight goals, and how they're not really firm or long-term at this point because I don't know what these weights will look like. But I also know that lots of things can happen to your body that are good, goal-worthy, and a measure of success, without the scale budging a millimeter. If I focus only on what the scale is saying, I may set myself up for failure before I even really get started.

Plus, I've got big plans for the "new me" (gag), and I need to get them all written down so that I can reflect on my accomplishments. Officially.

But for now, though... I should try to sleep. I think tomorrow if my pain is as well managed as it has been today, I'm going to take a big step -- actually, like, several of them. I'm gonna try to actually leave the top level of my house and go downstairs for the first time in 5 days. WHAAAAAAT.

One billion [sugar-free, high protein] brownie points for anyone who has made it this far. I love you and you deserve an award.