9-month post-op with nutritionist

I saw my nutritionist today, which was interesting. I weighed 204 in their office, which was the lowest weight I've posted thus far. Our conversation was mostly the same stuff; we went over my bloodwork, and her response to my "elevated" folate and B-12 was to say, "That just shows me you're taking your vitamins like you should! That doesn't cause any adverse effects to you at all."

We discussed my still-high cholesterol; the center has an ARNP on staff that specializes in metabolic syndrome and cardiovascular disease, and she can do a workup called the Berkeley HeartLab Cardiovascular Tests. They draw your blood (which has to be frozen and shipped to Berkeley, CA, hence the name) and do genetic testing to determine exactly how your cholesterol is high and specific treatment your body will respond to. It also makes it possible to determine how to tailor your eating habits to your genotype for the healthiest dietary choices you can possibly make for yourself. This is their website:

http://www.4myheart.com/

Their phone number is (800) 432-7889. They have a special kit to take to the lab where the blood is drawn that includes their specific vials and such. Usually detailed bloodwork of this nature is extremely costly, but apparently it is their policy that even if it is not covered by insurance, it will not cost any more than $150.00 out of pocket. It does have to be done through a participating physician from the looks of the website.

I am going to discuss it with my primary-care doctor tomorrow, but I think it would be $150.00 well spent in my case--especially since I just found out from one of my uncles that statin drugs exacerbated his alopecia areata to the point that he lost every hair on his head (including eyebrows and eyelashes) as well as much of his body hair, even leg and arm hair. He joked that it made him look like he had mange! I really,really don't want that to happen to me! Apparently, cholesterol and hair are intrinsically linked in general. I had no idea--and his doctor prescribed Lipitor and didn't bother to share that particular side effect, if she even knew about it herself!

The one thing that made me nuts today at the nutritionist was the calorie-counting conversation we had. In yesterday's vent on this blog, I said I would have to eat 1500 calories a day for the rest of my life. When I said something to her about it, she told me she actually recommends that people try to stay between 800 and 1000 calories during the first two years after surgery and between 1200 and 1500 calories per day thereafter for maintenance. I politely blew my stack. 800 CALORIES A DAY? What is that, like four protein drinks and half a banana? I've been on as low as 1000/day and that urged me to kill (of course, I was a teenager and living mostly on SlimFast, but still). I told her I'd shoot for the 1200 but that was the best I could do, as I have to live in the actual world. She said something along the lines of, "Well, if you get dizzy or anything, you should eat more." I (barely) refrained from spouting, "DUH!" I just reminded her that as a former eating-disorder sufferer, I knew all too well about how it physically feels to starve myself. Sheesh!

Since my weight is still going down, we basically concluded that all is well. That was basically it. My next appointment with both her and the surgeon is my year surgery anniversary.

20 pounds--gone.

I weighed myself this morning, and I have lost a total of 20 pounds since August 3. (25 since the blog photo.) That's about a pound a day. I can't even get my head around it; I don't look any different to myself. I guess some clothes are looser, and I feel pretty good, but it's just like, holy cow, 20 pounds already. Maybe this is really going to work!

My stamina is still just not there at all. I tested it by going to Costco with Mr. Salted this morning. He wouldn't let me lift anything, of course. By the time we were leaving the store, my face was pouring sweat, like I'd had an aerobic workout. He made me sit in the car while he put the groceries in the trunk, and I was grateful because I was completely tapped out. When we got home, he instructed me to go sit or lie down and he would unload--he didn't want me overextending myself. I immediately stretched out and took a nap. It's humbling to have your body say to you, this is all we can do now. I believe in listening to it! But like I told him, I want to make myself do little things like that and not just be bedridden constantly so I can begin to build myself up again for real life. When the twisting and bending over stops hurting, I'm going to start doing Sit and Be Fit (because of my ankle). I have that surgery coming up in about six weeks as well. (I hope I can get back to work for a couple of weeks at least and make a little money in between.)

I had also been concerned about my calorie intake since my nutritionist appointment. Actually, I'd been obsessing about it and I finally emailed my nutritionist for guidance. I was fixating on "300-400 calories a day post-op", which I had read somewhere, and I told her I fall more in the 600-700 category. Every protein shake is about 160 calories. Four tablespoons of Amino 2222, which I like to put in a bottle with water and sugar-free drink mix, is 160 calories. It seems to be the magic number, and it adds up quickly. She told me my goal should actually be about 400-600 calories a day and that I was right where I needed to be and doing a great job. She also told me she was glad I emailed and to email anytime (she's so nice). Weighing myself this morning, of course, made me feel better. Just like not obsessing about calories, I have to really work at not obsessively weighing myself. Old bulimic thought patterns is all it is. I'm just glad it's working.

I think I am going to be able to go off pain pills this week and just do ibuprofen and muscle relaxers or something. I hope so, anyway--then I could conceivably start driving before too much longer.