It's Faith AND WORKS!

Last Monday (February 22nd) I went to the monthly "Lap-banders" meeting and met Jana Sifuentes. She was at the original meeting I attended two years ago and learned that all the sensors that tell you that you are full are at the top of the your stomach and that the lap-band enables those sensors to be activated. It was an "AHA" moment I will never forget. So when Jana came up to me, it was very nostalgic. Jana had her lap-band in January 2009, a year earlier but due to two surgeries had sort of not been able to keep active and had lost only 50-60 pounds. To me she looked great and looked like she had lost a lot more. We talked about the monthly meetings and she said what they really should do is hook up an experienced lap-bander with a newbie. I turned to her and said, "Will you be my mentor?" And so together we are sending each other daily reports on our calorie intake and outgo and for this past week. With the daily return and report, I have had another epiphany.

Despite what I knew and had heard, I was hoping that the lap-band would be the final answer to a lifetime of being overweight. And in many ways it is. It is somewhat like the gift of the atonement of Jesus Christ. It is a free gift that enables us to change, repent, and become as He is. But for many Christians, the idea is that all you have to do is believe in Christ and you will be saved. Well, that's what I sort of hoped the lap-band would be. All I needed to do was to have it installed and it would keep me on the straight and narrow. But in the first few weeks after my first fill, I was still comfortable having butter on my Brussell sprouts and cream on my fish sauce. So when Jana and I decided to do Fitday.com every day, it brought me up to reality. I realized that I was eating a lot more calories than I should be eating and that I would need to work to stop letting these extra sins, extra calories, aka extra peccadilloes creep in the way. It was amazing. This week I have lost three pounds and can really see that my eating was inhibiting my weight loss. I realized that I need to aim for under 1200 calories a day and with the lap band that is not only a possibility it is a reality, but it takes work. You just can’t say, “I believe” and not keep the commandments. You have to conform to the program. You have to do your part and that is one thing I have learned. However, before it seemed overwhelming to fight not only the voice but also my natural inclination to want to “fill my plate.” Now, I think, I need to keep my calories down, so I will have strawberries instead of fried potatoes, I will choose the broiled fish instead of the fish in cream sauce. I still can only eat a small amount, but the calories have come down and with it, so has my weight. It is true. In order for the lapband to be effective, you have to work. It is only a tool. Likewise, in order to become perfected, you have to work and work hard. We are saved by grace after all we can do, but God expects us to do—He expects us to work! And losing weight is not just a matter of making your stomach smaller it is also a matter of making correct choices, just as in the game of life.

The Call of the Sirens

Odysseus knew about the dangers of listening to the Sirens, but that still didn’t keep him from wanting to hear them, so he stuffed his sailors’ ears with wax, tied himself to the mast, and got his wish, to hear the song of the Sirens and not be killed. For me the call of the Siren has always been food. Sometimes it has just been a low incessant whisper, “you’re hungry, you’re hungry” that can be disregarded for a time but never ever completely ignored. Sometimes it comes as a loud booming, “gotta eat now, GOTTA EAT RIGHT NOW!” which can send me into a full-scale binge. But that consistent, insistent hum has never been very far from my brain. Therefore, it came as a delightful surprise in December when the music was turned off, and again in February, when the voice was silenced. But only 5 days later after my first fill on February 2nd, I found myself in the swimming pool, “wondering what I would want for breakfast.” As I waded through the water, I realized I was listening to call of the Siren again. I had forgotten the power of the call in just a few days, kind of like how moms forget how bad labor really is. The voice was strong and I found myself wanting to eat, looking for things to eat, and I thought, “Hey, what is going on?!” So I called up the doctor’s office to schedule another “fill.” Anything to keep the orchestra from playing; unfortunately, they couldn’t see me until the following week, so for almost 2 weeks, I have been listening to the “Siren’s call.” This lets me know exactly what a lap-band does, it silences the continuous drumming.

When my dad was in prison camp, he said the Japanese fed you just enough that kept you starving and craving food; whereas if you just stopped eating eventually you would have no desire nor ability to eat and you would die. But just a little here and a little there kept the appetite whetted and screaming, and the prisoners going crazy with hunger. Despite the Siren’s song, the lap-band has luckily prevented me from an all-out inhaling of food, but it did add a pound or two and definitely allowed me to eat more calories than I needed. This break from my “fill” has given me a reality check of exactly what my lap-band does for me. It turns off the SIREN! And that is wonderful!

Sometimes, I keep thinking how effortlessly it is to eat small amounts, when before if I started eating, I just couldn’t seem to stop eating; it was like a continual foraging for food. Yesterday, I went in for my second fill and it was miraculous, truly miraculous. Food had lost its appeal. I was downstairs in the temple cafeteria eating a chicken pot pie with David and literally I ate 5 bites, that was it, that was all I wanted, I was full. FIVE BITES! I had the same experience after my first fill, 4 ounces of salmon and two Brussels sprouts and I’m finished. It’s hard to believe that a cc of saline solution can have that kind of effect and give that kind of result! This morning when I went to the gym (as I always do, I weighed myself) and I had lost 3 pounds in one day. THREE POUNDS! For a week, I had been struggling to get back under 300 pounds and in ONE day without any effort at all or pretty minimal, voila, I’m 298. So what is it? In talking to Katherine, who injects the saline solution, it is a matter of timing and filling. The first couple of days your stomach may “swell” because it is being tightened and then it heals and loosens up, so trying to find that perfect sweet spot is quite the trial and error chore. I assume that I need it to be a little tighter than normal the first couple of days because it will relax and become “too easy” to eat. So rather than wait TWO WEEKS, I have scheduled another appointment for Wednesday, February 24th. Of course, Katherine says I am right on schedule (according to her) I have lost a pound a week—who wants to lose just a pound? I am voting for 2-3 pounds a week, but then I have never been one to be patient! She looked at my scars and said, “Oh, these are healing up quite nicely, you will have very tiny, almost unnoticeable little lines, you’re incisions are great.” And I counter incredulously, “Really, they’re healing nicely—they’re all red!” “Yes,” she smiled and answered, “but it usually takes 6 months for the red to go away and you’re doing great!”

So, although I am impatient patient and “short”-suffering subject, I am feeling hopeful. Today was another red-letter day. I needed a cookbook and our cookbooks are located above the fridge. Usually, I have to open the fridge get as close to the books as possible and tug, but I couldn’t see the “Slow-cooker Cookbook” I wanted and I had to make a decision. Do I get on a chair? That may sound pretty straightforward and uncomplicated to you, but I haven’t stood on a chair for more than two years--a ladder, a stepstool, okay, but not a chair, too high, too wobbly, too much effort and far too dangerous. But I wanted that book and I couldn’t see it, and so I grabbed a sturdy kitchen chair and hoisted myself up and I made it! It was amazing! A few minutes later, I did it again to look on the top shelf of the pantry. These are big strides! I have been enjoying a little more freedom of movement. This morning, I worked out on the “bouncy” elliptical, (it’s harder than the typical elliptical, more like you are on a trampoline) for 25 minutes and the stationary bike for another 25 minutes, increasing my cardio by 20 minutes, then down to the pool where I pushed myself a little bit more. It is those “baby steps” that make me feel hopeful and excited. Before, I worked and worked and struggled and tried, but it seemed like my body was on an unwavering set-point and determined to hold onto every pound. Now with very little “will-power,” “self-control,” or self-discipline, I am seeing progress. Another little indication of my improvements are my eyes. Last night one of the sisters turned to me and said, “I bet you have heard this before, but you have the most beautiful blue eyes.” I thought, “Not really.” Rob used to tell me that a lot when we were first dating, engaged and married. But to me my eyes become clearer and blue-er when they are healthier, meaning unclogged by a lot of junk, fatty foods, etc. So on my journey to a thinner me, these are great baby steps!

Now, I must add one more note. I recently received the insurance costs for the “hospital” for my lap-band. If I had had to pay for it, the hospital alone would have cost me $14,521.10, but Regence was able to whittle off a mere $5,464.04 and so only had to pay $9,057.06 which brings the total outlay for Regence for my lap-band was $12,737.05 whereas it would have cost me $28,041.10. So the hospital worker who checked me in for my surgery on Thursday morning when I told him that a lap-band procedure cost around $13-15,000 raised his thumb up and said, “a lot more” was right! I have looked at that hospital bill and for the 5 hours I was on their property, it would have cost me over $2900 an hour! Gee, and I’m excited when I get $40 an hour! It is sad that the price is so high because I believe it will be the chief factor to my getting down to a normal weight and I know many others for whom a lap-band is really the only way to silence those Sirens! Thanks for reading! Love, Marilyn

What a difference a new stomach makes!

When I stepped on the scales this morning, it wavered a bit and my heart leaped in my throat as I saw it go 296 and then waffled up to 299, but you know what? I was thrilled! Why, because I have seen it up to 333 and 299 is 34 pounds less. And being under 300 is a "mini" milestone. Many people ask how much weight I have lost and I always tell them that that is a bit of a conundrum. In order to be approved by my insurance, I had to maintain or lose (not gain) and the weight I was aiming for was 320, which I met each doctor's appointment, but starving to get down to it. However, when I saw Dr. Clinch on December 1st, I weighed 325 and that is where I take my bearings from. I had to lose 10 pounds before surgery so that my liver would be shrunk enough not to block a good view of the stomach. Every lap-bander and gastric bypasser says, "If I could lose 10 pounds, I wouldn't be getting a lapband!!!" But they say you can do it and so I did, (10.5, yeah!) Then I lost another couple more after surgery and by the time I went back to see Dr. Clinch on Feb 2nd. I weighed 307. So today, 6 days after my fill, I have lost 8 pounds! Does it work? Yes, it does!

As I have pondered about the last few days, all I can think of is I feel I have been reborned! In talking to my sister today, I said, "Our family was always about food. We would sit around the table and eat until it was all gone, whether, we were full or not, the object was not to have leftovers." My mom proudly told me that in Panama I would just devour banana after banana after banana, as though I were winning some Olympic competition. Eating became an art form and as the serving sizes continued to be super-sized so did our ability to eat more and more. My friend Corinne said her family motto was eat until your sick. On my mission food was the only "recreation" a missionary had, I mean we couldn't sleep in, we couldn't swim, go out, play around, etc. Eating was our only break in our day after day after day schedule, it became a wonderful moment to relax and eat. Now, I did lose weight on my mission because I did the Atkins diet which was a diet that said you can eat anything as long as you stay in a state of ketosis. But looking back, that was probably one of the worst things I could have done to my body, but wanting to be thin makes us do lots of dumb things.

As time went by, I would try to lose weight and diet and exercise and go to Weight Watchers and write down every calorie and yet I still had this overwhelming sense that I was starving. My brain kept telling me, "You're hungry, You're hungry" and no matter how many times I told myself, "You've had enough calories, you are NOT hungry," it would say, "Yes, I am!" So it became a battle of the brain signals and my mental arguments and you know what, it feels good to be full and to have your brain say, "you're full!" So I ate. It was like an addiction, but the problem is you just can't avoid a bar or a drug dealer, you had to eat to live and one bite generally led to another.

Now, it's like I have a new stomach (which of course I do) but a stomach that says, "you're full" when I've only had 4 ounces of food. And you know what? That is a fabulous feeling. I am no longer arguing with my brain, we are on the same page. This sense of having enough, of being full is a wonderful gift. In a way it reminds me of when my friend, Bill Bennet,t got a new kidney and he said, "I never realized how bad I really felt" Well, I guess that's what I've learned. I never realized how wonderful it is to have your brain, body and mind all agree, "I'm full!!"

To fill and to be filled! that is the answer!!!

I got my first "fill" on Tuesday, February 2nd, Groundhog Day! I admit that I wasn't upbeat and positive, in fact, I'm afraid I was a little "Rob"ish, simply because Dr. Clinch said, "We don't want to make it so tight that you can't swallow your spit" and impatient me is thinking, "Make it tight, make it tight!" So I admit that I wasn't sure this first fill would do much for me. Imagine my surprise, when I honestly couldn't eat and didn't care! To be full, to be filled! What a wonderful experience! YEAH!! I have lost 4 pounds in three days! without even trying! I am just not hungry. Most of the time I have to say, "Gee, it's time to eat, I haven't eaten for a while, I should eat, what should I eat." That's what thin people say or at least rumor has it. For me, it has always been "gotta eat, gotta eat, gotta eat NOW!" Gotta eat till I'm full and I'm never full. But now, it's like, I feel like I should eat one more bit of cod or brussel sprout and I'm looking at it and I'm thinking, "If I eat this will it be too much?" Too much is when you get this overwhelming sensation of "you shouldn't have done that! I got that experience on Wednesday. I was getting ready to go to the Ward Activity and I had made Baked Cod with Spinach and I ate, what I considered about 3/4 of cup and all of a sudden, I felt really sick, so I just had to lie down and let it pass. It took an hour. Then when I went to the activity there were hundreds and I do mean hundreds of cookies, all yummy looking but for me, it was "please don't show me any food, I can't eat it!"

Today, Friday, I went to Costco, and it was Super Bowl Snack Time, every dealer was there hawking their wares and giving away lots of free samples. There was ice cream with blueberries, three different kinds of chicken wings, canned chicken sandwiches like Stephanie makes, avocados, salmon, salsa, meatballs, pulled pork sandwiches, it was a huge free for all. I ate ONE chicken wing and said, "Yuck, I can't eat another bite!" I walked past the salsa, the hummus, the chocolate cake, the juices, and stood in the detergent aisle trying to get my bearings! When I left Costco there were only three food items in my entire cart, a salmon, some scallops and bananas, that's it! There were napkins and laundry detergent, etc. but everything looked overwhelming to me and I would ask, "Why should I buy that, I really won't enjoy it." Then I came home and had some yogurt, because it goes down nicely. Dr. Clinch would not approve, he wants me to eat protein first and foremost to get that full feeling, but sometimes, I just want to be comfortable and now "fulness" has a whole new meaning to me. To be filled is such a good feeling and with so little effort.

The best thing is that when I stepped on the scale at the gym today, I wondered if I would have lost any weight because I am eating and I am not hungry and yet, two more pounds from yesterday were gone and I'm thinking what's going on? Is this really true? It's too good to be true. I am feeling like I will be able to lose weight. Today I pushed myself a little harder on the bike and the up/down pedal elliptical and it felt good. I walked up stairs a little better and for the first time, I actually feel thinner. Now, since I first saw Dr. Clinch, I have lost 23 pounds. Before when I have lost 20 or 30 pounds, I have never felt it. But this time, I do feel thinner and the nice part is I honestly believe it will never come back. On to the fill!!!! I see Dr. Clinch in 6 weeks, sooner, if I feel stymied on my weight loss, and more than likely I will get another fill because when the lap band was installed, it was installed around a stomach that had a lot of fat around it, so as the fat disappears, the band will need to get an adjustment or a fill! This is a great way to live! To be filled is wonderful. You can see in my blogging, that Shakespeare has a lot of influence, or maybe just Hamlet!!! So to blog or not to blog, to be filled and to be happy! YEAH!!

The joys of having a "funnel"

When people have asked, "how are you feeling?" "how are things going?" I know they are being kind and curious, and sometimes I give long answers and sometimes very short. Today I have decided to give a long answer. Having a lapband is somewhat of a journey of discovery. Right now, there is very little difference between the way I was on December 16th and the way I am now, except of course, I weigh a few pounds less, but not because of the lapband, but because I am trying to be good until the lapband is "filled." When the lapband was first installed, I was really happy because I was not hungry. What I didn't realize is that feeling was temporary. The reason why I didn't feel hungry was because my stomach was swollen from the surgery and having a band tied around its neck. It was not happy. But a few weeks later, the swelling went down and all of a sudden I was hungry. What happened? Well, it is the story of the funnels. When one bottles peaches, there is a handy, dandy device called a funnel with a mouth almost as big as the bottle so that you can slip peaches or any fruit for that matter into the bottle without getting the mouth of the jar dirty. You need clean mouths so the lids will seal correctly, but I just wipe it clean and throw the peaches in and forget the funnel. But that funnel is pretty wide. I have another funnel that I sometimes use to fill ketchup bottles, but I discovered that using a funnel was very long and tedious. The funnel hole was so small, that it made more sense to just pour the ketchup in my large blue Tupperware pitcher and then pour it into the ketchup bottle and clean up any drips on the bottle afterwards. My stomach right now has a "peach" funnel. Almost anything can slip right through the funnel to the secondary stomach, which means that I would have to eat an awful lot of food for it to reach to my little stomach where the satiety sensors are. However, on February 2nd, Groundhog Day! I will get my first "fill." This is where they inject saline solution into the button on my right side and it goes through a small tube till it reaches my lapband where the inflatable tire gets filled. Now my funnel has the opening of maybe a small pencil and the food has to "drip" into the secondary stomach, but I will feel full and satisfied after only a few bites. So just imagine the ketchup going through a small funnel and that's what my little stomach will be doing after the fill. I can't drink water an hour before I eat or an hour after because they don't want to dilute the "ketchup." Makes perfect sense if you think about it. They want the "ketchup" to stay in your little pouch for two or three hours slowly leaking out so that you have a feeling of being full and no desire to eat. Last night I went to a meeting in the hopes of getting some good feedback, but by in large I felt I knew more and had come to a lot of the conclusions by myself. The moderator handed out a sheet for goal making and I thought, this is what I drove over at 5:30 in the evening to do. But I did get my questions answered and I'm happy, so we'll see how it goes.

The Cost of Medical Care

In order to get my insurance to pay for my lapband, I had to jump through a number of hoops. I had to see a clinical psychologist who had to certify I was not a psychotic schizo in quest for the next new medical procedure, I had to go on a 6-month physician supervised diet/exercise/behavior modification program where I could not gain weight, I could stay the same or lose but not gain, I had to have another co-morbidity condition like diabetes or high blood pressure or heart problems, etc. (I have sleep apnea, which considering the other choices was the best) and basically I had to sign my soul away that I would be a good candidate for a lapband and do everything that I was told. After jumping through all the hoops, I was denied twice and going in for the final round where they get nationwide Regence folk to listen to your appeal. Luckily I was able to forgo that step because an independent reviewer looked at my case and said, "She did everything, give her the lapband." And they had to comply.

So many people ask me, "How much does it cost to get a lapband." I said about $13,000. But when I was mentioning it on the day of my surgery to the check-in guy, he raised his thumb and said, "much much more." So I have been anxiously waiting to see what the cost for my lapband really was and yesterday I got I believe all the bills, not sure, don't know if there is a separate hospital bill, if there is, then for sure it will raise the price a lot higher. Also when I went to the seminar about lapbands, they said that the lapband itself is $3,000, so I will look and see, but for right now, I am giving you the huge dispartiy between what it costs and what the insurance paid. David was with me when I got the mail and he told a story about a mammagraphy clinic that has two doors, one for insured clients and one for pay as you go. He said the insured door is pretty generic, you wait for your mammogram, you undress and get one of those cotton unfashionable open ended hospital gowns, the lab technician does the work and says you'll get the results in a week or so. On the pay as you go, there is no waiting, you get a fluffy white bathrobe, exquisite attention, the doctor talks to you, after the mammogram, he comes back and goes over the results with you. The cost for the insured was $100, the cost for the payer was $600. Now of course, that is totally hearsay, but here is the reality from my bills.

My doctor charged $9,600 for taking care of me, but the insurance has negotiated at $2183.90 cost of which I paid nothing (yeah), the attending surgical nurse charged $2400 but Regence only paid $327.59. and the anestheologist (this is why they are the highest paid medical professionals) charged $1520 and received $1168.50. So if I had had to pay out of pocket it would have cost me $13,520 and I might have gotten the fluffly robe, but Regence paid $3,679,99 and I was happy with my cotton, wide open frock. When I realized how little it cost them to give me what I feel is a great blessing, I admit I was a bit miffed at how much work I had to go through to get it. I mean I think the cost of delivering my babies was higher and I had Alexa at home! So you can see my frustration. However, David says with the Obama plan there will no longer be a cap on your lifetime maximum and you can't be denied for pre-existing conditions, to which I said, "it very well maybe the end of clinical care as we know it, or the profession will have to wise up and start allowing more people to go to medical school." So whichever turns out, I'm grateful I had the surgery when I did and happy that I have insurance!

My grandson Andrew

The good thing about getting older is my memory becomes very selective. I don't remember David ever being as active and curious as Andrew. Sure I remember his turning off my power strip and disconnecting my computer, but I think that was more out of frustration--he wanted on it so he could "paint" and his marking up my walls down in the basement and such, but Andrew is in a class by himself. He can climb on anything. Melanie LeFevre, in the nursery, turned her back on him for one minute and he had climbed on top of the toy stove unit, not on it, but on top of it. So on Christmas when our big screen TV had a glitch, Rob had pulled it out to find out what had happened. He got his volt meter and started investigating. But he got distracted and as Rob is wont to do, left everything just strewn all over. We were talking in the livingroom when David thought he had seen something and checked behind the TV to see if Andrew were there. He wasn't, but something was still concerning him, so he took a closer look, only to discover that Andrew had climbed up inside the guts of the TV and David had to pull him out very carefully so as not to electrocute him. I think the closest David ever got to that behavior was his story of how he and Seth pushed the "enter" key and entered into the guts of the computer, but that was fictional. Andrew is living the life!