Martin Family Adventure

First "official" bariatrics program appointment

My appointment at the Bariatrics center on Monday was very different from the last time I went for my psych evaluation. I was surprised when I came home from Florida and got the phone call to set up my appointment to meet with the surgeon so I assumed I must have passed the psych eval. I went to my therapy appointment yesterday morning and my therapist told me that she had gotten a chanced to talk to the center psychologist and made it clear to me that she would be here to support me in any way possible through therapy. 

I weighed in for the official start of the program, had my blood pressure and pulse taken, then answered a bunch of questions about allergies and medications. One of the dieticians stopped in to talk over with me what I need to lose as a pre-op requirement as well as diet requirements. She gave me the Calorie King book and told me I needed to keep a food journal (ACK!). Food journals are the bane of my existence when it comes to weight loss. Two years ago, I kept track of all my food on SparkPeople and got so obsessive about it. Even without using a food journal, I know all the calories that go into my mouth. I tally them up in my head, but for some reason, writing them down or recording them online scares the crap out of me. I'm always afraid of hitting that wall when I get so obsessive and compulsive about recording everything that I end up feeling guilty about anything and everything I put in my mouth. I really do need to let go of the black and white. I tell myself this all the time and one of my therapists also tells me this every time I go to see her. 

The dietician also talked about exercise and said that I need to get at least 150 minutes in each week. She asked what I love to do and walking was my answer. I do love to walk and bringing my dogs along makes me happy so I'm going to try to get out more often. This summer has been pretty brutal with heat and humidity but that's starting to break and cooler air is on the way. The kids will also be heading back to school at the end of the month and I always seem to be more motivated to go for a walk right after they get picked up by the bus. 

Then I met with the surgeon. He was an absolute peach. He's an older middle-eastern man with a lovely accent and a bubbly personality. He made me feel right at ease and comfortable from the moment he walked in the door. I felt like he really understood where I was coming from. After we talked for a while, he ordered some tests for me. 

So.....coming up at the end of the month, I go in to drink barium and have my insides checked out, as well as an ultra-sound. The day after Labor Day, I go in for an upper endoscopy. I still haven't decided whether or not I want to do the surgery, but I'm going to proceed with the program in case I do decide on it. It's a 6- month process until the surgery is done, so I want to proceed now and can always back out later if I decide to. 

My scale had a nice surprise

I got on the scale the night I got home from Florida. I was surprised by what I saw, so I decided to check again the next morning to double check what I was seeing. When I woke up, I got back on the scale and sure enough, I'd lost 6 pounds the week that I was away. I ate a LOT of salads and did a lot of walking while I was gone and it paid off even though it wasn't really what I was aiming for. I usually crave salads when I'm traveling because it tastes real compared to all the fast food and carbs that I could be eating for a quick hunger fix. I think I ate about 6 or 7 salads while I was gone and I don't even have an estimate of how much I walked while I was away. Considering all the hiccups that this trip had, it was nice to come home to a sweet surprise on the scale. 

I'm really trying not to put that weight back on now that I'm home. I'm also trying not to let myself get too obsessed with thinking about it. I could easily let myself get overly restrictive and hard on myself but I'm fighting that as much as I can. 

I guess I didn't fail my psych evaluation like I thought I did because I got a call from the Bariatrics center to make an appointment for me with one of the surgeons. I'll meet with him on Monday afternoon and in the meantime, I have video links they want me to watch that explains the surgeries and risks. I've done one out of three so far and it's really imformative. It's a pretty cool system. If I have questions in the midst of the video, I can click on a link to email a question directly to the surgeon so that we can talk about it when I get to the appointment. 

I'm still keeping my options open and will go to the appointment as a means of educating myself. I think this is one of the hardest things for people to understand even though I've said it many times in this blog as well as on Facebook. I'm not settled on what I want to do. I'm NOT pursuing the gastric bypass (which is what quite a few friends are concerned about and is the one that comes with the most risks surgery-wise). I'm interested in either the gastic sleeve or Lap-band, but neither one are set in stone for me. I'll be talking to the surgeon next week about my options and the risks involved, but that doesn't guarantee that he will even move me through to the next step. My insurance may decide they won't cover any of the procedures and then that decision will be made for me no matter what I want to do. I realize that people care about me and love me and have concerns and I appreciate those so much. This isn't something I'm going into lightly. My doctor wouldn't even give me the referral for a Lap-band for the last two years. I've been going to the same doctor since Zach was a baby and I know that he wouldn't give that referral if he didn't think that it would be a helpful tool for me. This is all something that I really want people to understand. 

I did really well yesterday, but I'm finding that as much as I like to be home, it's a really difficult place for me to be when it comes to food. When I'm traveling, I don't crave all the stuff that I usually do when I'm home. I don't have easy access to a cupboard or fridge full of food and I have to eat out. I'm really careful with money and so I don't overeat at restaurants because I know it will cost money. Yes, I know I should think about the considerations as to what it costs to buy food for home, but there's a huge difference in buying food in the store and the minimal cost of it compared to buying a prepared meal at a restaurant. Add to the fact that I love salads while traveling and their minimal cost while dining out and it's a perfect choice for me. 

I've had to reset myself today already, but unlike I used to do, I'm not beating myself up about it and I'm dusting myself off, giving myself a pep talk, and having my do-over right then and there. I'm plugging along and I have some new motivation with the 6 pounds I lost. 

Living with intention - letting go of the black and white

Since I posted about my re-do every hour, I have to admit that I've struggled quite a bit.  Of course, I completely expected that because I don't assume to think that I can change my habits and an eating disorder overnight. I've surprised myself in not feeling overwhelmingly guilty when I stumble. I fully expect this to be fleeting as I make changes in my eating habits and confront my Binge Eating Disorder. I think that going into it with this in mind has given me the ability to see the grays and not just the black and white. I know that this will also be fleeting and fluid, going back and forth until I can master it or at least grasp a hold of it while trying to master it. 

One of the most important things I've learned from therapy over the past year is to live with more intention. I've been able to do this in other parts of my life and so this gives me hope that I can do this when it comes to making decisions about what I put in my mouth, what I do with my thought patterns, etc. Some areas of my life have been so easy to incorporate this practice into, but I know this one will be a little harder to do. However, I'm determined to do it. 

My friend, Anna, posted a comment on my blog that has stuck with me the past few days. 

"But it's harder with food. With smoking, it's almost easier because you can stop. be done. be a non-smoker. But you can never be a non-eater, so the key is learning how to become a moderate eater. Not a strict dieter. Not an obsessive dieter. But someone who can eat healthy foods that are nutritious, in moderate portions... and who occasionally, when appropriate... also partakes in food celebrations without binging or feeling defined by them. For instance, piece of funnel cake at a carnival is normal. A chocolate ice cream cone with your grandpa is special. It seems simple, but there's so much fight involved. Fighting against what is comfortable is UNCOMFORTABLE. And is harder than anyone who has not had to do it could possibly understand. It involves emotional pain."

Moderation is something I've never been good at with food. For so long, I've been such a "black and white" type of person when it comes to how I view food and eating. I actually didn't realize this until I started seeing my therapist that specializes in eating disorders. I'd always thought of myself as someone that could be flexible and see the gray. it wasn't until I started to confront my BED that I saw this part of my character for what it really was; inflexible. This really is one of the few parts of my life where I am "black and white." For the most part, I AM flexible. I've learned to be gentle with myself, just not in the area of food. That's another thing I'm determined to work on. 

Recently, David said I should reward myself with something when I reach my goal weight. His suggestion was a Jack Russell Terrier. I've wanted a Jack for a very long time, but we have three dogs and two cats already. I really can't see us adding another dog to the mix in the next five or so years. He also suggested getting a tattoo to symbolize this journey. I can never justify the money for another tattoo. I recently got my second tattoo, but only because my sister bought me a gift certificate to the tattoo studio as a gift. The more and more I thought about it, I kept finding myself going back to a dream that I've had since I was 16 years old and something that got put on the back shelf when I found myself  struggling with my eating habits. It would symbolize a journey in a way that few rewards could. I still want to walk across the country. I would love for THIS to be my reward. 

I'm a big quote collector and this one came in my inbox yesterday, but I didn't open it up until I started writing this post. I find it very timely and appropriate:

"Watch your way then, as a cautious traveler; and don't be gazing at that mountain or river in the distance, and saying, "How shall I ever get over them?" 

Just keep to the present little inch that is before you. 

The mountain and the river can only be passed in the same way; and, when you come to them, you will come to the light and strength that belong to them."
  
~Mary Ann Kelty, 1789-1873

Speaking of living with intention, I really should be getting more sleep. On that note, I must stop all this rambling and get myself to bed. 

A re-do every hour - I can start anew

I had one of those moments last night when I told myself that today would be different. Today would be the start of a "new me." After a day of grazing, and the subsequent guilt, I decided that things would change. I would wake up with a new view and determination that I could do this without the bariatric surgery. I didn't want to be dependent on waiting for a yes or a no from the bariatric center.

I know the dietician told me to maintain my weight so that I didn't disqualify myself for the procedure but after thinking about it, it seems like such a contradition of what I'm trying to do.  If I have to make changes for the surgery and my insurance can veto their decision to pay even hours before the surgery, then where will I be? Will I throw all that hard work away and go back to my compulsive binge eating again?

So I went to sleep with the decision that today, I'll start working on those changes now and do the best I can. It's going to be a struggle either way - with or without the knowledge of an impending surgery. 

I'm reminding myself that there are people that have overcome BED without having the option of bariatric surgery. I have a good support group and my therapists are here to support me and help me to overcome the mind block. I'm not going to put the bariatric surgery on the back shelf. I'll leave that option open and continue with the program and see where that takes me. I can always back out if I feel that I can do this without it. I have the feeling that I haven't exhausted all the other options out there for me that don't include surgery so I'm going to pursue those and try my damndest. 

I know that I'm going to have some days that I feel like a failure, but one of my therapists told me that I should view my day as a failure just because I stumble. I should take it as one hour at a time. There's a new opportunity each hour to start over. I like that approach. I think I can do that. She said I should also find something that I can do that will signify a new start. It can be a prayer, a yoga pose, writing an affirmation down, etc. This all sounds very doable for me. I'm going to start today.

Part 12 - You know it's time to lose weight when you break the toilet seat

This is the twelth part in a series, CLICK HERE to start at Part 1.

 

If you remember, I started on my medication for acute depression and anxiety on July 25, 2009. I didn't share any of this with David because I didn't need the stress of listening to how he felt about it. While I didn't tell him about taking the meds, I also didn't hide the fact that I was taking them. The bottle of meds was right in the front of the medicine cabinet and right next to his bottle of vitamins, so he could see them at any time. I figured this was the easiest way to go about it for the time being. If he happened to see them and ask me about it, that would be the best timing. I decided that the opportunity would present itself when the timing was right. 

That timing came at the end of September. A dear friend of mine was moving back to Vermont from the Philadelphia area and she needed help with packing and driving the moving truck. I made myself available to be her helper and headed to PA via Amtrak train. It was a long trip down (around 11 hours), but a pleasant one as I had brought a book to read and my daughter's iPod with great music to listen to. On one part of the trip, I was privileged to sit next to a fascinating older woman that had great stories to tell. For the rest of the trip, I was happy to have the seat to myself so I could get lost in reading the biography of Rita Marley and her life with Bob Marley. 

Just 5 minutes before pulling into the Philadelphia train station, I got a call from David on my cell phone. He said that he was cleaning off the desk in our room and found a paper from the pharmacy for Celexa and read that it was an anti-depressant. He wanted to know who it was for and I told him it was mine. 

David: They're yours? You're on anti-depressants? How long have you been on them?

Me: Yes, they're mine and I've been on them since July. 

David: Why didn't you tell me?

Me: And what would you have said if I told you?

David: I know....you're right. 

Me: You said yourself that you've noticed a big change in me and that I've really blossomed. Why do you think that change happened so quickly? If I had told you that I was on meds, you would have argued with me about it and discouraged me. I needed to take care of ME and get myself better for the sake of all of us. I didn't need the negativity. 

David: I know. I'm so sorry. Is your depression because of me? Is it my fault? I try to be a good husband and father. I'm so sorry if I've fallen short. I love you so much and I'm so sorry. 

Me: It's no one's fault, it's just how my reality has been and I needed to get better so that we could ALL be better. 

 

And with that, he began to cry on the other end of the phone and I had some tears in my own eyes, though I smiled through the whole thing. This was a definite breakthrough and one that we both needed badly. 

 

David: I'm so sorry. I'll try to be better and different. I love you. 

Me: I know you do. You're a great huband and father, but I need you to be supportive of this decision. I never hid any of this from you, it was there in plain sight. The paper on the desk, the bottle next to your vitamins....but you needed to know in the right timing and apparently, this is it. I hope this isn't a life-long thing, but if it is, then you need to support that, too. 

David: I will be. I hate that you're so far away from me right now. We have so much to talk about. I know you'll be home tomorrow, but I wish you were home right now. 

Me: We'll talk all about it when I get home. In the meantime, my train is pulling into the station, so I need to get going. We can talk on the phone later. I love you!

David: I love you, too. So much!

 

I hung up and got off the phone and met up with my friend, Anna (not the one that I was helping to move), and we headed off to a little restaurant to chat and get a bite to eat. As we were walking there, I told Anna about the phone call I'd just gotten. Anna knew that I had started taking the meds and how David had felt about it. It was so nice to connect with someone that knew what I was going through and who could give me some encouragement.

While we were sitting outside on the restaurant patio, my phone rang again. It was nearing 11 pm and it was David. He said he was heading off to bed and that he wanted to tell me again that he loved me and that he was so sorry if he was the cause of any of my depression. I assured him that everything was okay and that I loved him, too. He was all choked up again on the phone and told me that he couldn't wait until I got home. We said goodnight and hung up.

This was a discussion that I had been dreading with him since the day I popped that first pill. I didn't even tell him I had gone to the doctor for a diagnosis. I was convinced then more than ever that the way he found out was truly meant to happen that way. I'm glad I was gone when he discovered everything. I feel that it gave him the opportunity to process it all before I got home and allowed us both to have some distance. I was able to go home knowing that the subject had been approached and we'd each have had time to think about what we were going to say to each other. This was a great opportunity for us to talk about it with the right intentions. I wouldn't be on the defensive and he would have time to think about my reasons for doing this. 

My psych eval at the bariatrics center

On Tuesday, I went to my first official appointment at the Bariatrics Center. This was to meet with the program psychologist for an inital psych evaluation. The appointment did not go as I had hoped and I left feeling a bit defeated. 

The center pyschologist was very sterile and stand-offish. I guess I've been spoiled by my two therapists that I see. Both of them are very approachable and have a nice "bed side manner" (for lack of a better term). The center pysch gave me a quick run down of what the meeting's purpose was and then ran down her list of questions while typing the answers into her computer. There was no warmth to her at all. In between questions, there was awkward silence as she looked at her computer and then back to the paperwork that I had done before the appointment. It was extremely uncomfortable. I felt like I was sitting in front of the judge and jury all wrapped up in one person. 

The questions were pretty straight forward: what was your lightest/heaviest adult weight, do you smoke, do you drink, do you do street drugs (no, no, and no), why are you pursuing surgery, how do you think this will alter your life, etc. 

When I talked about my past struggles and my current BED, the feedback that I got was pretty discouraging. She talked about the fact that I would have to overcome that in order to get things on track before the surgery and if I haven't been successful in doing that now, how did I think I was going to be able to do it before the surgery. That got me really irritated. I understand all of these things. I've been reading up on the different types of bariatric surgery for two years so I'm not ignorant about any of it. The part that really set me off inside was when she asked how I thought I could get on track with the possibility of surgery in the future but I couldn't without the surgery in the future. How do I even answer those questions? So much of this process is psychological- the surgery and the BED. 

The upside to this appointment was that the center psych wants to consult with both of my therapists so that she can get a better picture of who I am and how they feel about the surgery. I realize she can't get to know me well in an hour's time and I know that my therapists are very supportive so being able to talk with them will hopefully give her a more comprehensive view of me. 

I walked out of the appointment feeling discouraged, defeated, and like it was a waste of my time. I've never been in a room with a therapist and felt so....not sure of the word.....invalidated, maybe? I guess I wanted to be seen as someone that was looking for a tool and not a quick fix and I didn't get that feeling from the psychologist. Maybe that's just her default mode because she sees a lot of people in her office that expect they don't have to make any changes and think that the surgery will fix everything. I'm not one of those people so when I tried to make that clear, I didn't get any indication from her that she understood or that she believed me. That was disheartening. I felt like I completely blew the whole evaluation. 

Since that appointment, I've tried to distance myself from her demeanor and lack of warmth and have told myself that maybe that's just how she is and I'm over-interpreting it all. I have a wonderful group of friends and family that support me and so I'm sitting tight until the center psych gets back to me after she's talked to my therapists. 

Part 11 - You know it's time to lose weight when you break the toilet seat

This is the eleventh part in a series, CLICK HERE to start at Part 1.

Instead of writing a bunch of stuff from memory, I figured it was easier to post an entry I made in my online journal. 

August 23, 2009

I look forward to my walks every night with the dog and if I don't get one in, I miss it. 

One of the things I am trying to watch is making this into a new obsession for myself. I've been there once before and it was devastating on my body. I practically starved myself. I over exercised. I watched everything I ate. I was insane about it. I'm 5'7" and by the time David and I got married, I weighed in at 115 pounds. I hid the contour of my ribs under baggier clothes. My cheeks and eyes were sunken. My arms and wrists were like sticks. I can easily take it to a whole new obsession and I don't want to have it control me like it once did. 

One bit of confirmation that I've gotten that makes me realize anew that it was a good decision to not tell David about the meds is that he's noticed a difference in me. 

We also had a conversation when we were camping last weekend. He said that if anything were to happen to him mentally, he would want me to promise that I wouldn't put him on medication but to get him alternative help and he thinks anti-depressants are poison. I tried to explain to him that even though people can make healthy changes with their diet, which does affect the rest of them, there are times when you just can't wait for the time that it takes to make a difference with diet when it comes to mental instability or depression. You need to take out the big guns first and get yourself help RIGHT AWAY and then work on the diet changes over time. 

That's when I realized that I made the right decision (not that I doubted it before...but this just solidified it for me) in not telling him that I'm taking the Celexa. I really don't have the stress level or patience level to deal with him telling me that I'm doing something wrong according to him...especially when I'm finally thinking clearer, I finally can laugh again without abandon, I can handle my life better this way. I finally have motivation to do the things that need to be done. I feel amazing and I've been craving this normal feeling for a while now. Amazing IS normal for me and I haven't felt that way in a long time. 

I've got a new garden project that I'm working on. I feel energized by it and have big plans for it. I put a couple of "wanted" posts on Freecycle and was able to score a bunch of free stuff for the garden. They were all a bit far from us, but it worked out that they were on our way to David's dental appointment last Friday, so I made plans to pick everything up while we were out. Usually David HATES making a ton of stops. He was also getting a molar pulled out, so I knew he wasn't going to be in the best of conditions to put up with having the kids with us, along with making stops. Surprisingly, he was okay with it. I thanked him on the way down for not bitching about making the extra stops and that it meant a lot to me. He said that he knew this was something I was excited about and that it made me happy and so he didn't want to take that away from me. He said that he's noticed that over the past few weeks, I've really blossomed and that I'm losing weight and he's so proud of me. That really DID mean a lot to me that he's noticed a good change and that my positive changes have also made positive changes in him, as well. 

Last night, we were talking as we were laying in bed and he told me how glad he was that I was his wife and that he wouldn't have chosen anyone else. He said that he's so happy I'm making good choices in my life and he's noticed that I've really come alive lately. He said that it makes him happy that I'm taking care of myself. 

And THAT'S what I wanted to hear from him. It confirms to me that if something isn't broke, not to fix it. In other words, he's noticed the positive changes that have come from me taking meds and if this works and I don't have the stress of him telling me to go off of them and how horrible they are for me, then why bother say anything. We both love that I've gotten my life back and that I'm doing things for myself - taking care of myself and doing things that are fulfilling and making me happy and everyone is benefitting from these changes. 

I'm not letting go of this. 

And just to prove how sickly I looked when we got engaged:

Orientation at the Bariatrics Center

On Wednesday, I went to the bariatrics center for the group orientation. It was very informative and I left with an appointment for next week for my psych evaluation with their center psychologist. 

One of the nurses came in and did a PowerPoint presentation that included info on the doctors, nurses,dietician, and psychologist involved in the bariatrics program. It also showed the different surgery options available, the pros and cons, and what would be included in each as far as recovery, success rate, and post-op requirements. Then the dietician came in explained her role in the program and what their expectations of us would be along with the eating schedule post-op. After the PowerPoint was over and we were able to ask questions, each of us (there were about 20 of us there) sat down with either the dietician or the nurse to go over what procedure we were interested in and to make an appointment for our psych evaluation. We were also told what amount of weight we should be losing required for the surgery. I was actually told to maintain my weight because I was just over the line for qualifying for the procedure. If I lose any weight before I officially "check in" to the program, I could be disqualified for it. 

I went to my "food psychologist" that morning (she specializes in eating disorders) and told her that I would be going to the orientation. She asked how I felt about it and I told her that I had a nervous excitement. I had already been prequalified for any of the surgeries due to my BMI but actually taking this first step towards pursuing this was a big deal for me. She asked if I was set on the Lap-band or if I had contemplated any of the other procedures (gastric bypass or gastric sleeve). She wondered if either of the others were even an option in my mind. I told her they weren't. I was surprised when she told me that I should leave my options open and seriously consider the gastric sleeve. That really surprised me because that is the one procedure that is not reversible and the one that something is actually removed from the body. I'm not sure I can be so open to that, but I promised myself earlier this year that I can't be as black and white with myself as I've been for so many years. Even though I'm not contemplating the sleeve, I do want to remain open to learning and so I'm educating myself on all of the procedures strictly as a gathering of information. 

While David has his opinions about baraitrics surgery, he is being supportive of my right to choose. He feels that I don't need it but he is willing to support any decision I make. He really has come a long way in being respectful about my choices especially when they don't jive with his opinions on it. He has also been very respectful about my boundaries when it comes to how much or how little I want to discuss my eating issues and my weight. Therapy sessions have been immensely beneficial for me over the past year. I've learned to be more assertive when it comes to setting my boundaries with the person I love the most. I've learned to not feel guilty for setting boundaries. Tonight, I talked a little bit to him about the orientation meeting and then things move on to other topics. A little later into the night, he brought something up and I made it known that I was hesitant to talk about it. He asked what was wrong and I told him, "I just feel like we're talking about this too much." I surprised myself by not feeling overly defensive and he definitely responded to the calm and even tone that I used. He said, "Okay," and that was it. I certainly don't have this method perfected by any means, but I was excited inside to have shut down something that was making me feel uncomfortable without feeling bad about it and without either of us getting all riled up about it. That makes me hopeful that I can do that again in the future and the response will be just as gentle and understanding. 

 

Just one of those days....or a couple of them

The rest of my tribe is asleep. Even the dogs and cats are conked out on the floor. I'm sitting here wide awake. I took my grandfather back to his house last night after poker night at our house. It was 11:30 by the time we pulled into his driveway and I was so tired, so I spent the night. I went right to bed as soon as I got there and it didn't take long for me to fall asleep once my head hit the pillow. I woke up at 8 am feeling like I'd been run over by a truck. My back and hips ached and felt like ripping my uterus out due to the most horrible cramping I've experienced in a long while. The only redeeming part of last night's sleep was that I slept hard and had the most amazing dreams. Dreams are hit or miss with me. They are always so vivid and many years laters (decades for some), I could recite them to you from beginning to end in all their bright or morbid detail. I popped 3 Tylenol, said goodbye to my grandfather and headed the 45 min. back home. I struggled to stay awake while driving. As soon as I got home, I lay on the couch and was doing a slow motion writhe on the couch because I hurt so much. It took a little over an hour for the Tylenol to finally kick in. I started to doze on the couch until David suggested, at 9 am, to go lay in our room. It was about 12:30 pm when I finally woke up. I felt a bit more human by that point. 

I've been dragging all day. I took Zach down the road to our little town beach so he could catch minnows and brought along my textbook for the Gender Roles course I'm taking this summer and didn't get much read because I had to keep redirecting myself in my book. On the drive home, we stopped at the creek so Zach could look for more fish. I opened all the doors of the truck, put my seat back and fell asleep again. 

This has been my default mode the past few days. I try putting on the brave face for everyone around me. I don't want people to worry about me and wonder what's wrong. I just have those days, now and then, when I feel like I'm simply passing through life without really experiencing it. My mind plays tricks on me and it's those days when I feel like there are people that might be happier without me around and so I retreat inside myself.

Without giving too much TMI, for 7 days every month, I'm emotionally unavailable and useless to those around me. Over the years, I've learned to medicate and cope with the pain and infections that come along with the wonders of being a female every month since I was 13 years old. Spending time sleeping it off helps, but over the past few years, I've struggled to come to terms to the emotional, mental, and physical upheaval that has come with it. About a year and a half ago, the way that I felt, emotionally and physically, were so intense that it scared me. I set up an appointment with my doctor who then suggested that I see my OB/GYN. I was diagnosed with Premenstrual Dysphoric Disorder (PMDD). I'd never heard of it before then, but have become well acquainted with it since then. When I got the diagnosis, I read everything I could about it, including the booklets that my OB/GYN sent me home with. Everything started to make sense, but at the same time, none of it made sense. It was shortly after this diagnosis that I started seeing my therapist. 

There are months that have gone by since I've been in therapy when the emotional/mental toll isn't nearly as extreme, but there are months, like this one, that I feel completely and utterly useless. Last night was the deepest point and things are on their way up. There is a lot more going on in my life since last year so the dynamics have changed for me, as well in the relationships that I have. I think back to probably 5 years ago and never would I have imagined that I'd be in such a weird and different place emotionally, mentally, and physcially. I figured I would hit all of this at menopause. It's been a lot for me to take in and process at my age. 

Tonight, though, has not be an easy processing session for me. I've blown through a bowl of multigrain cereal with bananas and skim milk, another bowl of rice krispies with bananas and skim milk, half a bag of stale salt and vinegar chips (that I rummaged in the back of the truck for while it was raining), 2 diet iced teas, 2 peanut butter and jelly sandwiches on wheat bread, 2 nectarines, 2 more bananas, a pint of blueberries, and 5 Newton's fruit thins. I've never shared an itemized list from one of my bingeing sessions before other than in a food diary a few times but I thought it was important for people to see that people dealing with Binge Eating Disorder (BED) don't always binge on crap food. For many people dealing with BED, it's not about junk food, but food in general. And now I deal with the guilt and shame, along with the PMDD on top of it. Suddenly it makes sense to me why I feel like sleeping and not waking up till it's all over.  

Like every month that I deal with the PMDD and BED jackpot, I feel like I don't have the luxury of showing the world who I am in "real time." Who I am at this moment would most likely scare people. They're not used to this "me." They're used to seeing the girl with the smile, the girl with the positive outlook, the girl that has it all together. And so I put on my mask and brace myself for the emotional and physical roller coaster of those 7 days. 

Answers...

I really appreciate all the feedback I get when I post here. It means a lot to me. I also appreciate when people ask the hard questions because it gives me the opportunity to think about my journey and my intents for the things that I do and the choices I make. This blog is here to share my story but to also learn from each other. I'm very open and honest and I don't mind when people ask questions. Sometimes I write things here that I realize aren't quite as clear as I would like them to be so when you ask questions, it gives me the chance to clarify and explain things further. 

I've had a few people off the blog ask some of the same things that have been asked in comments so I'll try to answer them as best as I can in this post. I hope that those of you that have commented don't mind if I quote some parts of the comments so as to put my answers in the proper context.

"I fear that the surgery is a band-aid, and though I think it could be a valuable tool for you, until you can cope with your BED I wonder how this will help."

"I think it might be better to take some time to work on the issues in therapy, and maybe have the surgery at a later date when you know you're in a good position to be able to follow the food restrictions afterwards without going overboard."

"I'm a bit concerned about how the lap band and the eating disorder will interact."

These are really great points to bring up. The Bariatric Surgery Clinic in my area has a lot of pre-op requirements that have to be met before surgery can take place. There is typically a 6-7 month wait from the time you start with the program until the surgery takes place. During this time, there are meetings with support groups, the dietician, testing outside of the clinic, meetings with the surgeon and nurses, a full psych evaluation, therapy, and counseling. There is also a minimum of 5% of body weight that has to be lost (sometimes more, depending on the procedure and your starting weight) pre-op. 

I have actually been in therapy for a year and a half with one therapist and for 6 months now with a psychologist that specializes in eating disorders. Both of them are working with me on different aspects of learning to cope with BED and to make behavior modifications. One of the things that my psychologist (the one that specializes in eating disorders) said, as well as my primary physician, is that therapy is going to be key in any behavioral modification program, even more so than the part a surgery plays into modification. All three feel that with where I'm at now, the Lap-band will be used in conjuction with a LOT of therapy, dietary changes, and a behavioral modification plan as a tool to achieve success not only in weight loss, but primarily in learning to manage and overcome my BED. 

One of the requirements for being able to have the Lap-band surgery is that I would need to follow nutritional guidlines and undergo therapy. One of the reasons the clinic requires a full psych evaluation and behavioral modifcation to be put into place before the surgery is to make sure that their patients are mentally able to handle the surgery and the life-style changes reguired for it to be successful. The paperwork from the clinic makes it very clear that acceptance into the bariatric surgery program is not a guarantee of surgery. There is a lot that has to come together in order to get the green light for surgery. If I'm clearly not ready to handle the commitments of the procedure and the psychologist at the clinic doesn't feel that I'm ready, I won't get the go-ahead. 

There are many different types of therapy, aversion therapy being one of them. Traditionally, aversion therapy was quite brutal with its electrical shock therapy and such. Today, though, there are different ways to use this therapy while still being ethical. In fact, aversion therapy is a commonly used therapy in treating OCD and other compulsive disorders. Think of the Lap-band as a modern version of aversion therapy. When the Lap-band is first put into place, bingeing is pretty near impossible and trying to binge becomes painful and unpleasant with vomiting, etc. 

"I believe that in a previous post you said that you would not treat cancer with radiation or surgery, so I am wondering what the difference is for you here."

Another great point to bring up. I don't put the Lap-band and chemo/radiation on the same level. For me, using chemo/radiation would be too high of a risk with introducing something into my system that has the potential to kill off not only cancerous cells but also the good cells. My personal opinion, from watching friends and loved ones go through these processes, is that they have great potential to do harm. I know there are many sides to the chemo/radiation do-or-don't-do argument, but this is where I stand on it. I watched my grandfather die a slow and painful death while going through two years of chemo and radiation and I have watched it unfold in other people, as well. That's just not something I'm willing to do to my body. Surgery, however, I see a little differently. If there is a highly positive prognosis of surgery being able to remove cancer without harming the rest of the body further, I would be in favor of it. In other words, if I had breast cancer and the doctor told me that it would be easy to remove and with very few complications, I would most likely consider it. If the doctor told me that the surgery had a lot of complications and health risks, as well as the possibility that removing the cancer could potentially spread it if something went wrong, that I would rather find alternative routes to combat the cancer. These thought processes will probably not make sense to some, but they are something I've felt passionate about for many years. When it comes to the Lap-band, the complications and risks are very low. There are no chemicals being spread through my body to kill cancer cells. It is something that can be removed (unlike the chemo and radiation once it enters your body). These are where the differences lie for me. 

"From an outside perspective, which you can take or leave with no offense to me, it seems that the overwhelming problem you face is the compulsive disorder... not your weight."

I think it's very difficult to separate these two issues. Binge Eating Disoder (BED), which is a compulsive disorder, often causes obesity (there are some cases in which it doesn't because of other factors). Those with BED not only struggle with complusion, but they also struggle with the weight caused by it. Compulsive disorders have their own set of issues, but BED also usually carries with it depression, guilt, frustration, and anger due to the weight issues. The obesity that often happens as a result of BED causes a lack of energy, self-esteem, and mobility. From helpguide.org:

The binge eating cycle

Binge eating may be comforting for a brief moment, but then reality sets back in, along with regret and self-loathing. Binge eating often leads to weight gain and obesity, which only reinforces compulsive eating. The worse a binge eater feels about themself and their appearance, the more they use food to cope. It becomes a vicious cycle: eating to feel better, feeling even worse, and then turning back to food for relief.

It's also important to know that people with BED don't always binge eat due to stress or for comfort. They may eat simply because that is what they find the compulsion to do. Many bingers don't want to eat when they binge. 

"Because from an outside perspective, you seem like an incredibly healthy woman- in mind, body and spirit."

I like to think of myself in this way, but the reality of it is that there is a part of me that doesn't feel any of that at times. There are parts of me that I'm just beginning to be comfortable in sharing and those are the parts that totally contradict being that "incredibly healthy woman- in mind, body and spirit." Just like everyone, I have those days that are hit-or-miss when it comes to feeling this way. For a long time, I've been quiet about my struggles and come across as that woman described above so I think it takes people by surprise when they see a part of me they're not used to. 

"Also (I would be saying this on an earlier post, but I don't know if you see new comments on older posts), I really, really hope that you're bringing David along for some therapy sessions, or that you do so in the future."

As a heads up, I see every comment that's posted no matter when the blog post was made as they come to my email when you post them. 

I really do want to take David to some of the therapy sessions provided by the bariatric surgery clinic. The psychologist that I see that specializes in eating disorders also wants to do some family therapy because we all, as a family, contribute to each others successes and shortfalls. There are many ways that I think David would benefit from going to my therapy sessions and I also feel that my kids would benefit, as well. 

Wow.....I didn't realize that I was going to end up writing so much. Thanks, again, for the feedback and questions. I always welcome them.