Updated Reality

Here it is December 2022. So much has changed since I last posted in Living Real With Carol. First, in August 2021, my mother died as I held her hand. In August 2022, my sister Beth died. Both of them died as a result of strokes. My life has changed forever. Beth was my youngest sister, and I still can’t comprehend that she is truly gone.

2022 was a year of major surgeries for me. In January I had total knee replacement in my right knee. The recovery was fairly easy. That’s in retrospect. At the time it was rough. I had to sleep in a recliner for several weeks because my knee was too sensitive to sleep in bed. I did all the physical therapy required, and although there is still some tenderness and numbness in my knee, I can walk all I want with no problem at all. I am so grateful for the surgery since my activity was so limited before surgery.

In July – just a couple of weeks before Beth died (which is why I couldn’t travel to be with her after her stroke), I had gastric bypass and hiatal hernia repair. Recovery from that surgery is STILL ongoing – although the first two months were particularly difficult. It was much MUCH harder to recover from than the knee replacement. When Beth had her first few small strokes and then her major one, I wanted so much to go be with her, but I couldn’t. And the doctors were right because it was such a difficult recuperation. However I did attend her funeral and even spoke at it three weeks after surgery – which took all I had at the time. The night before her funeral, I was so sick in the hotel room, but was okay by morning.

There is a story behind getting gastric bypass surgery. Last year I decided to look into bariatric surgery because I’d been through so many diets starting from when I was a teenager – Weight Watchers, Jenny Craig, Nutrisystem, Phen-Fen, Phentermine by itself, low-fat, Atkins, Keto, counting macros, fasting, and so on. Except for the Phen-Fen and Phentermine, I was not able to lose enough or maintain weight loss. And the drugs had horrible side effects which made me unwilling to continue them long term. I didn’t really plan to get surgery, I was just curious to see if I could qualify for it.

Most importantly, by last year I was battling so many health issues – high blood pressure, high cholesterol, pre-diabetes, fatty liver, mild sleep apnea, IBS, frequent diverticulitis, and horrible GERD. I had to take Nexium (proton pump inhibitor) every day and still sometimes the reflux was bad.

So I went to the Vanderbilt weight loss clinic since they were the only ones who would consider surgery on someone over 70 years old. That’s a good thing because Vandy is a “Center of Excellence” for bariatric surgery. I talked to the surgeon and he felt I would qualify for surgery. There was a long list of requirements from my insurance, and one of those was an endoscopy. I’m so thankful for that requirement because when I saw the photos of my stomach taken during the endoscopy, I was horrified. My stomach was basically wall to wall polyps – small, medium, and large. Dozens and dozens of them.

What is associated with the development of stomach polyps? Proton pump inhibitors like Nexium. I had taken Nexium every day for probably twenty years. I never even thought about possible side effects. it kept me from having heartburn and so I took it every single day.

I immediately went from casually considering bariatric surgery to being absolutely certain that I needed it asap because one thing gastric bypass does in almost 100% of cases is end acid reflux immediately. And with no acid reflux I could stop taking Nexium. I felt an urgency to get the surgery as soon as possible. With all my digestive issues, I felt that those polyps were at least part of it all.

I barely qualified for the surgery based on my BMI – and was told to definitely NOT lose weight before insurance approval. With my BMI I also had to have at least one serious weight-related condition to qualify. I had several. So I fulfilled all the requirements – psychological testing, nutritional counseling, support groups, a second endoscopy to “de-bulk” my stomach polyps (they removed about 40 polyps). On July 21st I had gastric bypass and hiatal hernia repair at Vanderbilt.

I’m almost five months post-op now. I’m ahead of my weight loss goals. I had hoped to be down 50 lbs by Christmas. I made that by Thanksgiving. I’m now about 54 lbs. down. Weight loss has slowed, but that’s fine. I’m content to lose a pound or so each week. At the beginning I was losing about five pounds a week. Then it gradually slowed down – which is exactly what is expected.

Most importantly, a week after surgery I stopped taking Nexium and haven’t had heartburn at all since then. I’ve cut my blood pressure meds in half. I’ve stopped taking daily gout meds and IBS meds. Since the Vandy weight loss clinic monitors my vitamin levels carefully, I’ve got those in balance now.

However, since my mother’s and Beth’s stroke – plus another sister, Joan, had a stroke in her eye last spring that left her blind in one eye, my pcp and I both agree that I don’t want to stop taking my cholesterol med since that’s my best defense against strokes. So Lipitor will likely be a part of life from now on.

The only negative is that one of my liver enzyme level and my bilirubin level are elevated. So I’m going in tomorrow for a ultrasound to make sure my liver and gall bladder are okay. I sure hope I don’t have to have gall bladder surgery.

2022 was a challenging year – so sad with Beth’s death, and so hard with my surgeries and recuperations. But also encouraging in other ways.

Time Out – Got Gout!

Last week I was so gung-ho – feeling good and energetic. Then Saturday morning came, and suddenly I couldn’t walk. I don’t mean that it hurt to walk. It means I went to bed Friday night feeling just fine. I woke up Saturday morning and literally could not walk because my left foot was so painful. It was red, swollen, and when I tried to walk, it felt like daggers through my whole foot. Even sitting still with it elevated and with cold packs on it, it throbbed with pain. So I spent Saturday, Sunday, and Monday sitting and sleeping – with as few trips to the bathroom that I could manage. That was the extent of what I could do.

Quiet time Stock Photos, Royalty Free Quiet time Images ...

Tuesday morning (yesterday) I finally got in to see an orthopedist. I thought perhaps I had a stress fracture or a bad sprain. However, it is gout. Gout is caused by too much uric acid in my system. The doctor gave me steroids, and my foot is much better today. I’ve been reading up on how to prevent gout.

Gout arthritis infographic Royalty Free Vector Image

Preventing gout has implications for my WW lifestyle because, for me, it’s mostly about food choices. The doctor may prescribe medication – but not for now. I’ve been looking at the graphic above on the foods to avoid. I have no problem with alcohol, liver, salmon. However, poultry and fish – especially tuna and Halibut – have been mainstays of my WW meals. And I have bacon (red meat) almost every morning. I will definitely need to re-evaluate my menus.

I drove today for the first time since Friday – picked up some groceries I ordered last night. I had tart cherry juice in the order since numerous people told me cherry juice was key in keeping gout away.

I’ve stuck with WW throughout this time. In fact, the pain made me feel less hungry. Thus I had leftover points at the end of several of the past few days. Up to 4 unused daily points can be rolled over into weekly points each day, and now my weekly points are up to 44 from 35. Hopefully I will have a good weight loss this week because of less eating.

I’m on the mend – just taking a little break from posting. My mind couldn’t concentrate on writing when I was in significant pain. LOL! Can’t imagine why.

Big shout-out to my husband, Ron, who has taken excellent care of me – he has cooked for me, brought me drinks and pillows and ice packs – helped me put on the orthopedic boot my daughter loaned me. Ron drove to Larisa’s house to get the orthopedic boot for me – and later he drove across town to get a scooter so I could get around a little more easily.

Change Clip Art EPS Images. 8,904 change clipart vector ...

What will I change? Here are six changes I will start today:

(1) I’m going to experiment with a sugar-free cherry and nonfat Greek yogurt something-or-other for breakfast. I will see what I can come up with.

(2) I will switch from pork bacon to chicken bacon. Chicken bacon isn’t quite as good, but daily pork bacon isn’t worth having another Gout flare-up.

(3) I’m upping the apple cider vinegar gummies and vitamin C gummies that I take each day since both of those are part of the preventive regimen.

(4) I’m also adding tart cherry juice to my daily menu. It’s 2 points for every 1/3 cup I drink. I will research to find out how much I should drink each day.

(5) I will research to determine what other supplements will be helpful.

(6) I will add more low-fat dairy, whole grain breads, and vegetables.

Eating well and losing weight affects one’s blood pressure

Today I have not been feeling well – headache and a little light-headed. Oh great, I thought, I’m coming down with Covid-19. However, one of my sisters advised that I take my blood pressure since a low BP could cause one to feel light-headed. So I did – four times over the course of about 30 minutes because I’m compulsive like that. Here are the readings:

117/58       98/57       110/58      110/59

It’s a fairly consistent reading – especially for the second number.  And all four are too low. That could easily account for the light-headed feeling I’ve had – and maybe for the headache, too.

I take BP meds each evening. It’s a fairly low dose, but I’m thinking that with my healthy eating the past 7 weeks, plus losing some weight, that it has affected my BP.  So tonight I will cut my dose in half. I will continue to monitor my BP, and hopefully it will be better after a day or two.