Mandajuice

Once upon a potty

Well apparently mushrooms are more of an acquired taste than I thought!  For me mushrooms are a food group.  I should definitely note for the record, though, that I'm not a big crab fan.  I generally don't like foods with such a high effort to edible quotient.  But that dip is SO not crabby; in fact you'd hardly guess there was crab in there at all.  Next time I make it in a bread bowl, I'll definitely post some additional photos of the final product. 

Also, I didn't mean to jump straight from I USED TO BE FAT right into GO MAKE THIS FATTENING CRAB DIP.  I swear I'm not that schizophrenic!  I'm still working on my next few gastric bypass surgery installments and I promise to get to the part where I talk about how it's been five years and now I basically eat whatever I want and get to stay a size 14.  Diets are evil.  Hallelujah!  Amen. 

So yesterday Genoa walked up to me and said, "Mommy! I go pee-pee in a potty!"  Her diaper was dry, so I shot out of my chair and helped her hover her tiny buns above the porcelain to no avail.  It's scary up there for such an itty bitty girl!  So I ordered her a couple of potty chairs.  I learned my lesson with Alex and the constant scrubbing of all the stupid potty chair parts, so I got two: the Baby Bjorn for upstairs and this one for downstairs:

I can't wait till it gets here!  We actually chose it together and I know she's going to love it.  It's hard to believe she's already showing signs that she's ready to train (she holds it all night, warns me when she's going to go, immediately asks to be changed, etc.).   I remember trying in vain to train Alex at this age when he was showing similar signs, though, so we'll see how it works out.  Kids are ready when they're ready and there's really nothing I can do except recognize when the time is right.  She's been telling me when she needs to go for months now, so I think I'd be remiss not to at least give it a shot.

Recipe for Crab Dip Stuffed Mushrooms

(Because imitation is the sincerest form of flattery, I'll be doing this recipe in the style of the infamous and fabulous Pioneer Woman Cooks.  Although this recipe doesn't have any butter in it, so I'm not sure it counts!  Special thanks to the Elmo in Numberland episode of Sesame Street for playing the role of babysitter to Genoa while Daddy stayed late at work on Monday night and I cooked.  Unfortunately, I'm a one woman show, so I had to take all the photos with one hand while holding stuff with the other hand.  Next time I'll have to hire myself a Hyacinth to help!)

This is a two part recipe.  First you have to make the dip, which you can either serve in a sourdough bread bowl or use to fill the mushrooms.  Or, you know, both.

G'Ann's Special Occasion Crab Dip

This recipe is very near and dear to my heart because it was served at every special occasion I ever got to share with my childhood best friend, Jill.  It's her mother's recipe and since G'Ann has always been like a second mother to me, it's basically become a family recipe.  Some of my fondest memories are of Jill and I waiting until all the party guests had gone home and then warming, slicing up and devouring the sourdough bowl her mother had used to serve the dip.  For as simple and easy as it is to make, it's mind-blowingly delicious.  I've made a few changes to G'Ann's original recipe and almost every time I serve it, I get asked for the recipe, so here it is.

The basic cast of characters:

2 cans of white crab meat, 6 ounces each
juice of about half a lemon, maybe more
3 cloves garlic minced
1/2 a medium yellow onion, finely chopped
3 packages of Philadelphia cream cheese, 8 ounces each
1/2 cup mayo (Best Foods/Hellman's or none is my motto)
1 cup sour cream
1/3 cup chardonnay
1-ish tablespoon Dijon mustard
4 oz shredded Parmesan cheese
2 large round sourdough bread bowls (if you're planning to serve this as dip)

If you're planning to use the dip to stuff mushrooms, you'll also need:
A big package of large white mushrooms
Dried parsley
Ritz crackers
More Parmesan cheese

First up, if you're a pansy like me and your winter hands love to crack and peel if you so much as look at the kitchen sink, put on your latex gloves.  Or not.  Whatever.  Then drain the heck out of that crab meat.

This particular brand comes wrapped in parchment paper, so be sure to pitch that in your trash bowl.  Then throw the crab meat into a big pot, like this one:

Then rinse every. single. drop. of crab out of those cans before you throw them in the recycle bin.  Trust me on this, it was a lesson I learned it the hard way.

Then cut up a lemon.

and squeeze about half of it right onto that crab.  It helps diffuse the fishy flavor of canned meat.

I use anywhere from half to three quarters of a lemon.  The last time I made this recipe, I was a little too heavy on the lemon juice and you couldn't taste any of the other flavors in the dip.  Before adding any other ingredients, mix the lemon juice into the crab with a big wooden spoon. 

Then peel three cloves of garlic:

And mince them directly into your pot:

I never EVER chop garlic with a knife because the best tasting part of it is the juice and I want every drop in my food, not on my chopping block.  (Also, I'm lazy and this is way faster).  I have one of those cool garlic mincers with the steel handle you can rub under running water to get the garlic smell off your hands.  I don't know how it works, but I know it does.  Of course, I usually wear latex gloves while I chop and cook, but whatever.

Then peel and halve a medium onion:

Put half away and finely chop the rest of it:

I like to make the pieces as small as possible because the onion in this recipe never gets all the way cooked, so you don't want any big chunks.

Here is a picture of what my trash bowl looks like at this stage in the game, in case you're interested:

Next comes the good stuff: the cheese.  There's really no substitute for Kraft Philadelphia cream cheese, so I highly recommend just splurging for the real thing.  I think I paid a whopping 97 cents each for name brand.  Technically, if you're so inclined, you could go for the reduced fat kind, but really, I assume you're not eating crab dip for its health food qualities.

I don't why, but I love peeling cream cheese.  I like the way you don't have to rip the inner package to get to the cheese.  Anyway, plunk those puppies right into your pot.  You don't have to start mixing anything yet.
I always flatten and recycle as much packaging as I can.

It's not because I'm some big environmentalist so much as that our trash can isn't quite big enough for us, even though it's the biggest one the garbage company allows.  I can recycle as much as I want, though, so that helps make room in our trash can for all those dirty diapers.  Here's what our recycle bins look like on a Sunday night, six days into our weekly trash cycle:

Next, add the mayo.  I don't mean to inspire a debate about brands, but when it comes to mayo, there is basically only ONE kind: Best Foods (aka Hellman's).  Measure out about a half cup, I like to let it heap a bit since I love mayo so much.

Add that to your pot and then take out your sour cream, this time measuring out a full cup:

Yum.

Then squeeze some Dijon mustard into the pot. 

I generally don't measure it, so just give it a healthy squirt.

Next measure out a third of a cup of chardonnay.

And add it to your pot.

Then get out your cheese grater and a block of Parmesan cheese.

I LOOOOOOOOVE tasty, fresh parm.  It's my favorite cheese.  When we lived in California, a usually cost me upwards of $ five ounce block of the cheapest kind, Stella, cost upwards of $5.  FIVE DOLLARS.  That's a dollar an ounce.  Here in Washington, the same exact block costs $1.98.  That right there is reason enough to move up north.  Anyway, grate the entire block.

Add half of it to the pot and keep the rest ready if you're planning to make the stuffed mushrooms.

Then it's time to start mixing this puppy up on the stove over low heat.

This part usually takes about ten minutes or so.  Just keep stirring the pot until the whole thing is warm, smooth and creamy.

Now comes the best part.

You can use a chip, a cracker, a piece of bread or your index finger, but as the head chef it's your job to give your work a nice, decent quality test at this point in the work.  Don't skimp.  You want to do a real thorough job with this part.  It took me a few chips to be 100% satisfied with my final product here, but satisfied I was.

So far so good, right?  Totally easy to make.

It's time to reward yourself by pouring a nice, pretty cocktail.

I apologize for not having photos of this next part, since I didn't bother doing the pretty bread bowl thing just for myself.  But if you want to turn this into a dip to serve to guests, then at this point you would take out your sourdough bread bowls.  Cut a big square opening into the top of one of them, then scoop out as much of the bread guts as you possibly can and put them into a ziplock bag to use for leftovers.  Cut up the second bread bowl into one inch chunks and set aside (in a ziplock bag to keep it from drying out) to serve  later with the dip.

Fill up the empty bread bowl with the warm dip.  You can refrigerate this dip ahead of time, but it MUST be warm when you put it in the bread bowl or it will burn in the oven long before it's warm enough to serve.  Put the sourdough lid back on your bread bowl, wrap the entire thing in tin foil, place on a cookie sheet and heat in the over for 45 minutes at 200 degrees.  Remove the foil, arrange on a pretty plate and serve with the cut up sourdough bread.

If you're planning to make the stuffed mushrooms, go ahead and get those started.  You can pick any type of mushrooms you like, but I find the medium sized white ones like these work best.  In fact, the smaller the better because you can eat them in one bite and they're less messy.

Begin by removing the stems.

Like this:

But see all that weird leftover stem gunk?  I like to clear that out too to make as much room as possible for the dip.

Eventually, you'll get through the entire carton.

Next is my least favorite part because it's the part I could've avoided if I'd shopped a little smarter.  I made the very time-consuming mistake of purchasing UNWASHED mushrooms.

Which means I had to wash them.  By hand.  I know, the horrors!  But here's the thing - you can't just throw mushrooms into a colander, rinse them off and call it a day because they are little sponges and they will absorb every bit of water they can.  It's their job!  And if you then try to bake them, they will turn out extra soggy and you will have done all this work for nothing.

Instead, you have to clean them with a damp paper towel. 

It takes forever, but when you're done, you can put the clean mushrooms onto a baking sheet lined with tin foil, or if you're out of tin foil like I was, you can use parchment paper.

Note the lovely "seasoning" on my baking sheet.  I virtually ALWAYS line them with parchment or foil, so my food is always clean and I don't ever have to scrub my baking sheets.  I prefer the lazy woman's method of rinse, dry, and put away for next time.

Now that the mushrooms are ready, it's time to finish the filling.  The first step is to steal some dip from your pot.

Again, I didn't measure, so just eyeball it.  I used this much dip:

Remember that parmesan cheese I told you to save?

Throw it all into your dip bowl.

Next take out some dried parsley.

And healthily season your dip with it.  As such:

Then stir it up.

And begin filling your mushrooms.

Keep going until their all filled.  Be sure to lick your fingers a lot.  But not if you're planning to serve this to company.

Technically you could pop them in the oven just like this and they'd be fine, but I like to put a little topping on them for some crunch.  I already had a bag of crunched up Ritz crackers mixed with Parmesan cheese in the fridge since I had just used it as a topping for some chicken.  It's easy to make yourself: 50% crunched up crackers / 50% shredded parm.  Sometimes I add a shot of parsley flakes for color.  Easy peasy.

Sprinkle over your mushrooms.

Then pop them in a 400 degree oven for about twenty minutes.  My oven tends to be slow, so I'd check them at ten and fifteen minutes to make sure they don't burn.  If you need help getting them nice and brown after twenty minutes is up, then pop the broiler on and stand there and watch them carefully until they look like this:

These are beyond delicious.

Never mind the fact that some of them have spilled over onto the parchment.  Those ones belong to the chef and here's a secret - they actually taste better that way. 

Serve hot and enjoy!

PS - If you decide to make this recipe (and I highly recommend that you DO) and post a review on your blog, send me an e-mail and I will link to it right here.  My favorite part of reading recipes is seeing how other people modify things to match their own tastes.

REVIEWS:

Brea made them for the Super Bowl.

Doahleigh made them with a few short cuts.

Gastric Bypass Surgery: Part FOUR of [many]

MY FIRST POST-OP MEAL
For the first 24 hours after my surgery, there was a big NBM sign on my hospital room door.  (NOTHING BY MOUTH).  I wasn't even allowed to sip water or eat ice chips.  I was on an IV, so I wasn't as thirsty as I feared I'd be, but still, I was really looking forward to that first sip of water.  I was also totally freaked out about it.  For whatever reason, I thought I'd be able to FEEL my new stomach, and not in a good way.  I'd spent my whole life chugging down food and never giving another thought to what happened to it after it disappeared down the rabbit hole, but after my surgery I was afraid it would hurt, that I'd be able to feel the staples and that until everything healed, every bite would be excruciating.  If nothing else, I thought for sure I'd be able to feel my old stomach floating around unattached to anything.  I don't know, I was just weirded out by the idea of eating again after being all chopped up and rearranged inside.

Of course it wasn't weird at all.  I started my post-op diet with water, an itty bitty tiny bit at a time.  We're talking one sip, and then twenty minutes later taking another sip. I couldn't feel the sips going down, so that was good news to me.  In fact, in the beginning I couldn't feel my new stomach at all.  My first actual meal was sugar-free jello.  I was allowed to pick any color other than red because they wanted to be able to see if there was a leak in my staples.  I think I chose green jello and I remember carefully watching the drain for several hours after those first few bites and imagining a greenish tint.  I was fine of course.  I also wasn't hungry at all, so eating a few bites and watching the drain was basically what I did for the next several days.  Until the drain came out, I pretty much continued on a clear liquid diet.  I ate sugar free jello and sugar free popsicles and chicken broth.  I knew I wasn't allowed to chug water yet, so I didn't even try.

THE FIRST MONTH AFTER SURGERY
After the drain came out (OUCH), I was upgraded to a pureed diet.  I would personally rather starve than eat pureed meat, though, so I just stuck to an already-soft-foods diet.  I never pureed a darn thing.   I only ever served myself food in 1/4 cup servings, so I never tested the limits of my pouch until about a month after my surgery.  I ate scrambled eggs and Laughing Cow cheese and sugar free jello and tried not to suffocate myself with protein shakes.  I was never very good with protein shakes.  They're just nasty and I choked them down for the first few months after my surgery never to return to them again.  I don't think I ate many vegetables at first either, mostly because I've never been a fan of baby food.

After a week of soft foods, I started a modified regular diet.  I began eating lunch meat and ground beef and fish.  I had to chew everything about a million times before swallowing, but that worked fine.  I totally avoided carbs and by "carbs" I mean anything that Weight Watchers would've deemed a "bread" item on the old food groups diet.  I started eating vegetables and even salad, I think. 

FOODS I COULDN'T EAT FOR A WHILE
One of the big surprises was that many "soft" foods don't work at all with a beginner’s pouch.  Pasta, for example, which you'd think would be easy to digest, is a total nightmare.  It expands as soon as it hits your saliva and becomes almost impossible to keep inside your pouch.  The same thing goes for rice and bread.  Anything that could potentially absorb liquids and expand is just horrible when you're a fresh post-op.  I remember the first time I ever tried to eat half a hot dog with half of a bun - it came right back up almost as soon as I got it down. 

Soda also became an instant no-no.  Before my surgery, I had been warned that I would not be able to drink soda again for quite some time, if not forever.  I vowed never to go back to drinking regular full-sugar soda again, which I haven’t, but I was really looking forward to that first diet coke.  It’s been over five years now, so I can’t remember exactly how far along I was when I discovered that I could drink soda again, but I know it was during the first year.  I still get EXTREMELY burpy if I try to drink soda directly from the can or through a straw.  I have no trouble drinking it from a glass, though, and I regularly consume all types of carbonated beverages, including chick beer and wine coolers. 

BARF-O-RAMA
Another interesting surprise was that for the first couple months post-op, if my pouch didn't like something I ate, it just sent it right back up.  And since I no longer had a stomach, it would send the food back up EXACTLY as it was before I swallowed it.  You couldn't even call it throwing up since it was almost as if my esophagus was a two-way street.  For something that was technically barfing, it was pretty benign.  My body just automatically rejected any food it couldn't handle.  Fortunately (and unfortunately), that food eject button expires pretty quickly.  I think the last time I upchucked was maybe around three months post-op and since then I haven't been able to barf no matter how much I want to or how hard I try (see morning sickness).

THE NUMBERS
After my first month post-op, I was down 30 pounds.  THIRTY POUNDS.  That was more weight than I’d been able to lose on my own in the previous five years combined.  For the first time in my life, I threw out my fat clothes.  I knew I'd never need to wear them again.

School was canceled

For this:

I'm working on my next surgery installment and I should have it up any minute.

On girl toys and mothering with kindness

On Friday morning one of the other moms in Alex's class invited me over for coffee.  She lives right across the street from the school and she and I have always had a good rapport, so I was looking forward to it.  After spending the morning with her, I realized why I like her so much: she reminds me of my California friend Jamie, who I miss dearly.  Of course this realization was totally bitter sweet.  On the one hand, woot! new friend!, but on the other hand, boo-hoo! I miss my old friend!

We did have a great time chatting, but even more than me, GENOA enjoyed herself.  This friend has only one child: a daughter.  The big kids were at school, but Genoa was in seventh heaven the entire time as she played with baby doll after baby doll and shopping carts and baby puppies and dress up clothes and GIRL GIRL GIRL stuff.  I never really realized how macho all of our toys were until I saw how happy she was playing in this little girl paradise.  I called Dave on the way home and we agreed that we've been spoiling her a lot less than we do Alex.  Buying her new toys doesn't seem necessary when we have a house full, but after seeing how thrilled she was with a more feminine toy offering, I think I'll start slowing (and inexpensively) adding to her chick toy collection.

After coffee, we had a couple hours to kill before I needed to pick up the boy and I didn't want to trek all the way back home, so Genoa and I ran errands together.  It's been a long time since I didn't feel like I was in a rush to get some place or do something and I forgot how much fun it is to just hang out with my baby and kill time.  We ended up having "chick-in" at Burgerville together and I can't tell you how much I enjoyed that hour with Genoa. 

This is absolutely my favorite age (18-24 months).  She's talking and expressive, but the baby hasn't completely rubbed off of her yet.  She's happy-go-lucky and as long as you listen carefully and give her your attention, she's absolutely delightful.  It reminded me how important it is to stop and smell the roses every once in a while.  I always feel like I'm telling my children, "in a minute" when really, nothing I'm doing is more important than they are. 

Enjoying that time with Genoa made me realize that I spend almost zero time alone with Alex anymore.  He's always got to play second fiddle to Genoa, who totally pwns my lap these days.  The second she sees him going in for a snuggle, World War III begins and it's a match to the death for strategic mommy real estate.  So I made a point of it and instead of going out as a family last night, I took my boy to the movies so we'd have some alone time and I could give him my undivided attention.

We saw Alvin and the Chipmunks, which while lame was actually the first movie I've seen in well over six months.  It was certainly the first movie I've been to in Washington.  Alex was such a good boy.  He mostly remembered to whisper and while he didn't get most of the humor, he'd turn to me and laugh along with the rest of the audience at the appropriate times.  The highlight of the movie was actually the part where we played the motorcycle video game in the lobby. 

We sat next to another mom who was there with her two boys, one on either side of her, and she was exactly the mom I never want to be.  She didn't have a kind word to say to either of her children the entire movie.  Instead she slept through the whole thing and every time either of her (totally well-behaved) boys laughed out loud or whispered a question to her, she harshly told them to be quiet.  There was no love in her voice and it broke my heart.  Because I couldn't hug hers, it just made me squeeze my own boy that much tighter.  Some people just really aren't cut out for this job.

Gastric Bypass Surgery: Part THREE of [many]

THE DAY OF THE SURGERY
I was crapping myself (almost literally), but mostly from the excitement of it.  I'd worked so hard to get there and I was relieved that it was finally going to happen for me.  I woke up at the crack of dawn and Dave and Carol drove me to Sutter Roseville hospital, which was about an hour away from where we lived in Davis.  The hospital was beautiful.  It seemed more like a Hilton than a hospital (of course I didn't have to try any of the food, though!)  Dave stayed by my side I honestly never got scared or shed a single tear until the nurses came to wheel me into the operating room and I had to say goodbye to Dave.  That, I’ll admit, was pretty hard.

WHAT THEY DID TO MY GUTS:  THE ROUX-EN-Y SURGERY ITSELF
The specific surgery I underwent is called Laparoscopic Roux-en-y surgery.  Here is a pretty picture of what RNY surgery sometimes looks like:

(Photo courtesy of Robyn Anderson)

See those two lines of staples?  Well surgeons have different ways of approaching this, but my understanding is that in my case, my stomach is now completely separate from that little pouch.  I wanted it that way because I’ve heard horror stories about people busting their staples loose by overeating and basically undoing their surgeries.  Once those staples are gone or stretched open, you would basically be back where you started and you would easily be able to gain back any weight you had lost.  In my case, that’s not possible because my pouch is completely separate from my old stomach, like this:

(Illustration courtesy of Melting Mama)

Contrary to popular belief, I still have all the guts I was born with.  With the exception of my gallbladder and its lovely stones, absolutely NOTHING was removed during the surgery.  It was all just rearranged.  I would never want to, but I suppose if it was necessary, they could somehow reconnect my guts in the future because everything is still there.  I've never heard of it, but people have definitely asked me if I would have it reversed after I lost all my weight, which is ridiculous.  If I did that, I'd get fat again.  Duh.

Technically, there are a bunch of different types of weight loss surgery.  Some rearrange the stomach differently; some purposely bypass additional length of intestines to increase malabsorption.  Gastric banding is becoming more popular as insurance companies are beginning to cover the procedure more often.   It’s very different, less invasive and almost impossible to die from.  Basically the death risk with RNY surgery is that they accidentally perforate your bowel and you end up with bacteria floating around inside of you causing all kinds of nasty, horrible, deathy trouble.  It really is a scary surgery, but statistically, it’s also the most successful. 

That said, my surgery, including my gallbladder removal, took the doctors a whopping 50 minutes.  It’s a quick and easy surgery, particularly if you chose a surgeon who does a lot of them.  (Did I mention yet how important it is to CHOOSE A SURGEON WHO SPECIALIZES IN OBESITY SURGERY?!)

THE HOSPITAL STAY
This was the first time I'd ever had general anesthesia in my life, so I was surprised to wake up and feel like literally ZERO time had passed.  I remembered the freezing cold operating room and the giant metal cross I was laying on when the anesthesiologist asked me to count backwards from 100 and then BAM, I was awake again.  Being medically knocked out is totally different from sleeping.  Your brain loses the time and you wake up in a weird, hazy time warp.  I think a lot of people, myself included, wake up thinking, OH NO, SOMETHING HAPPENED AND THEY DIDN'T DO THE SURGERY.  But then I looked around and realized I was already in the recovery room.  All was well.

They got Dave as soon as I started to wake up and I was super happy to see him again.  Fortunately, the pain was never all that bad and I didn't get nauseated from the anesthesia.  All I had to do was ask and the morphine was right there. 

Unfortunately, there was a bit of a snafu with my IV after I got moved to my room.  I had very specifically indicated that I was allergic to NSAIDS (Aspirin, Advil, Motrin, Aleve, etc).  They make my stomach BURN LIKE IT'S ON FIRE.  By the time Dr. Waldrep came in to visit me, maybe three hours after I woke up, he asked me how my pain level was and I told him the truth: that my stomach was on fire.  He was totally surprised because the pain from the surgery is never, EVER burny.  It's supposed to be achy, but not burny.  I told him about my allergy and he checked the IV bag only to find that one of the drugs being pumped through me was technically an NSAID.  He immediately had the nurse change the bag and I started to feel better after a couple hours and with a little help from Dr. Morphine.  Having my own private hospital room and bathroom didn't hurt.

Your mileage may vary, but I did not find this surgery to be painful at all.  If natural childbirth is a ten (and we all know it is), then the post-surgical pain from gastric bypass surgery is a two, if that.  It was easy to manage and mostly amounted to post-operative soreness near my port sites.  It only took me about three days to get my energy back and I don't remember spending any of that time popping pain pills.  The most painful part is that they have to fill your abdomen with air during the surgery and that air then loves to travel all around your insides and wreak havoc for literally WEEKS after your surgery.  It feels like gas pain, but it happens in the weirdest places.  I remember a particularly painful bubble that manifested itself in my right shoulder and lasted for several days.

THE DRAIN
My surgeon left a drain in my largest port hole, the one underneath my ribs on the left side or my belly, the one through which they'd removed my gallbladder.  He did this to make sure that there weren't any leaks in my plumbing.  Some surgeons do it this way and monitor the outflow from the drain for several days; other surgeons do a barium test before they let you leave the hospital.  Either way it's the least fun part of the surgery.  And it's really yucky.  You have to clean it with alcohol pads and seriously, you don't have the stomach for it (har har har).  I actually went home with the drain on day three and then had to come back a few days later to have it yanked out.  The yanking-outage was NOT pleasant.  After that, I healed up almost immediately.  There are no stitches with laparoscopic surgery, just a little surgical tape.  It's been five years now and my scars show less than my old stretch marks do.

COMPLICATIONS
I had none, so I'm not much of a resource there.  Suffice it to say that I dodged some pretty nasty bullets and I personally met people who spent MONTHS, almost YEARS in the hospital after their surgeries because of leaky staples, drainage problems and a variety of other crap.  For the first few surgeries my doctor performed (way back when), he had a faulty stapler and a handful of his patients had horrible complications, from which he learned A LOT about the surgery.  I'm just glad I was his 350th patient and not his first.

[Next installment: FOOD.  The immediate post-op diet.]

Gastric Bypass Surgery: Part TWO of [many]

A LITTLE MORE ABOUT MY DOCTOR
I can’t emphasize enough how important a role choosing the right surgery group played in my success.  I specifically chose a WEIGHT LOSS SURGERY CLINIC, a group of surgeons who continue to make their living helping obese people become healthy.  This is literally 100% of their business; it’s all they do.  They aren’t rushing off to perform an appendectomy or repairing gunshot wounds.  The doctors and staff at SALSA deal with fat people ALL DAY LONG.  They know what to expect and in turn, their patients have a better chance of long-term success.

Risk-wise, I was given an extremely lengthy and thorough list of every possible problem that could result from the surgery, medically speaking, which Dr. Suh, the assistant surgeon, read OUT LOUD to me to make sure I understood.  He also pulled up a chair next to me and spent an hour going over the procedure, using the rolled up paper on the exam table to draw me a very specific illustration of exactly what he was going to do to my guts, which was awesome.  I kept it as a souvenir. 

Of course there’s all kinds of stuff no one can prepare you for, like when your husband innocently eats cookies in front of you for the first time and all you've eaten in three weeks is pureed dog crap and you want to kill him.  But seriously, I went to a top-notch surgery group.  They knew what they were doing and made sure that even if something went wrong, there would be no surprises. 

INSURANCE
Technically, I had dual insurance at the time of my surgery.  The strange thing is that I was initially rejected by Dave’s insurance plan and decided to pursue having the surgery covered by my temporary insurance from UC Davis, where I’d been working in the temp pool while I tried to start my own financial planning business.  The temp pool insurance plan had a $3,000 deductible and would only cover major medical.  Fortunately, the surgery was covered and we agreed that $3,000 was a lot less than we’d have to pay for fertility treatments.

Even though my insurance pre-approved me, I also had to pay the surgeon over $5,000 up front before they would schedule my surgery.  Apparently they had never dealt with my insurance plan before and they were unwilling to bear the risk that my insurance wouldn’t come through.  I was promised a refund as soon as they were paid by my insurance.  We used the money we had been saving from our wedding for a house down payment with the agreement that even if we never saw it again, it would probably be money well spent.

It wasn’t until after my surgery, when I went to have the cafeteria plan from Dave’s firm send me a check for our plan balance, that I discovered his insurance technically covered the surgery after all.  Apparently, when I had initially called them for pre-approval, they misunderstood which surgery I was having and thought it was elective.  Gastric bypass surgery is considered medically necessary in most cases, so all I had to do was prove it, which was easy given the mountain of documentation I’d already obtained.  They ended up paying everything that the UCD policy didn’t, including the $3,000 deductible.

In the end because of our dual insurance, my surgery was covered 100% and we paid literally zero dollars out of pocket for any of it.  Of course it took me over a year to work out all the coverage and get all my money back from the insurance companies, but I was eternally grateful.

THE WEEKS LEADING UP TO THE SURGERY
After literally months of preparation, I was scheduled to go under the knife on August 8, 2002.  I decided to keep working right up until the day before my surgery and since my job was temporary, that ended being my last day of work at UC Davis. 

Sadly, three days before my scheduled surgery, Dave’s father unexpectedly died.  He was 82 and seemed to be getting around just fine, so it was a bit of a surprise.  My first thought was that I was going to need to reschedule my surgery.  And even though I was sure I would be able to get back on the calendar in a few weeks and I reassured him it was totally okay with me, Dave insisted that I follow through with it.  His father did not want a funeral and there was almost nothing for Dave to do except grieve.  Focusing on taking care of me turned out to be a nice distraction.

Being the big fat blabber mouth you all know I am, I decided not to keep my surgery a secret from anyone.  I got a variety of responses from bewilderment to excitement.  My family was very much against it.  I won’t drag up the past by going into it because I know they were reacting out of fear, but my side of the family was not supportive.  The fact of the matter is that once I make up my mind to do something, nobody’s going to change it.  I kept a positive attitude and Dave was right there by my side the entire time.  He was scared, but he was solid.  More than anything else, I was excited.  I felt like this was the beginning of a new and much better life for me.

Carol (Dave’s mom) came up to stay with us the day before the surgery and she stayed for a few days afterwards to help out.  My parents ended up visiting me at the hospital the day after my surgery, which was a nice and very welcome surprise.

MY PRE-OP DIET
Since my surgery clinic didn’t require pre-operative weight loss, I ate what I wanted right up until the week before my surgery.  I can still remember what I ate those last few days!  A lot of fast food.  Tons of sweets.  Virtually buckets of ice cream.  Full sugar soda.  Like everyone who ever had surgery before me, I thought I would NEVER be able to eat anything I loved ever again.  I had many a last meal, but on the night before I had to start my liquid diet, we went to Cattleman’s.  I ate an entire potato skins appetizer, a strawberry daiquiri, two plates of salad with ranch dressing, and an entire filet mignon dinner with a baked potato.  Then I had mud pie for dessert.

I don’t why, but I just assumed I’d never be able to enjoy food the same way ever again.  In my mind the only way to lose weight was to suffer – to eat things I really didn’t enjoy and to not eat the things I did enjoy.  I also guess I focused a lot on what I would be able to eat immediately after my surgery and didn’t realize that the post-op dietary restrictions wouldn’t last that long.  After a few months, you can eat pretty much eat whatever you want.  But of course I still had that, “my diet starts tomorrow” mental fart going on, so I probably gained five pounds that final night.

THE LIQUID DIET
Five days before my surgery, I had to stop eating solids.  For two days, I could drink anything I wanted to and then for the three days before the surgery, it had to be clear liquids.  Again, there was no restriction on what that meant, so I mostly drank soda to keep from feeling hungry.  It was a short period of time and we were so distracted with the death of Dave’s father that this was really easy for me.  It went by in a blink.

WHAT GOES IN MUST COME OUT (TMI!)
That said, a certain percentage of people don’t handle liquid diets that well.  For me, if liquid goes in, liquid comes out.  And I’m not talking about a little innocent pee pee here.  Once I started that liquid diet, I didn’t get off the toilet until five minutes before they wheeled me in for surgery.  I had constant diarrhea.  I called the advice nurse two days before the surgery in tears because I was sure they would have to cancel my surgery.  I literally couldn’t walk five feet away from a bathroom, so I figured there was no way I’d survive being unconscious for an hour so they could perform the operation.  The nurse reassured me that this was totally normal and she prescribed me butt wipes and diaper rash cream, which I found hilarious and unnecessary. 

[Tomorrow: The surgery itself and the immediate aftermath]

Genoa, would you like a cookie?

"Yesh!  I wud!"

Titches Wit

Wow.  I had no idea gastric bypass surgery was such a hot topic or I'd have talked about it years ago!  Thanks for all the comments and questions, I'm working hard to answer all of them, so keep them coming.  I'm going to try to put out another installment tomorrow and keep plugging away until I get my whole story out.  Tonight I even took pictures of what I ate for dinner so I can show you how normal my eating habits are now.  I'll post them when I get to that part of the story.

In other news, Genoa is now putting on her own diaper.  We've had her in Pull Ups for at least six months now (neither of my kids would lay down for diaper changes after around a year of age), so she sits her nakie butt down on the floor and pulls a new diaper on over her toes.  She even figured out how to reach down under buns and hoist the diaper up in the back.  It's a thing of beauty. 

People, it's COLD here.  Like, FREEZING cold.  Over the weekend, Alex broke the top layer of ice on the outdoor toy box and several large chunks flew onto the patio where they STILL remain frozen.  It hasn't rained in days and I'm actually beginning to miss it a little.  While Lynne and John were here, we made potato salad and instead of putting the potatoes in the fridge to cool them off, we just put them out on the patio.  It worked just fine.

I had to use the outside ATM at the bank today and it was literally the coldest 90 seconds of my life.  It HURT it was so cold.  I realize that many of you live in places where it's like this all the time and it's no big deal and you're probably laughing at me and thinking I should suck it up, but cut some me some slack here, I've spent the last 31 winters in California, which means that this is technically my first ACTUAL winter.  I think I'm doing pretty well.  I mostly just stay inside where it's always 69 degrees and sunny.

Gastric Bypass Surgery: Part one of [many]

WHY I DECIDED TO HAVE THE SURGERY
On the day I met my husband, I weighed 216 pounds.  That was 1996 and I was 19-years-old.  I thought I was fat.  Of course, I was fat, but I wasn't yet morbidly obese.  My weight fluctuated greatly during those years (never marry an Italian man if you want to stay thin!), but on my wedding day two years later, I weighed 220 pounds.  I'm about 5'6.5".  My dress was a size 18.  I had tried everything in the world to get into a smaller size and I just wasn't able to lose weight.  At the time, I thought I just wasn't trying hard enough and I was very optimistic that someday I'd be able to lose weight.

Of course, the very second the words "I do" escaped my mouth, I began to gain weight.  Fast.  Within a year, my guess is that I was up to 250 pounds.  When I graduated college in 2000, two years later, I looked like this:
 
Within three years, I was close to 300 pounds.

[Sorry about the quality of the photos.  Getting my picture taken wasn't exactly my favorite thing back then so the pickings are slim.]

So yeah.  I got fat.  It happened fast.  A lot was going on with Dave and me.  It felt like it was taking us YEARS to get our life going.  We were broke and unhappy.  I played a lot of video games and had almost no friends.  Instead of turning into a fairytale, my life seemed to have stalled.  I was adjusting to being an adult and taking care of myself for the first time ever and frankly, I wasn't doing a very good job.  I just wasn't happy in my life and instead of doing anything about it, I ate. 

Also, there was that pesky issue of not being able to get pregnant.  We started trying almost as soon as I graduated from college and nothing was happening.  I had stopped ovulating somewhere along the way.  Every doctor I talked to said the same thing: lose weight if you want to conceive.  I finally met a nice doctor in Sacramento who offered to give me Clomid to help me ovulate, but I decided against taking it.  I figured I would keep trying to lose weight with the (totally ridiculous) idea that if I wanted children badly enough, I should be able to lose weight.  Every month that I didn't ovulate, I ate to fill up the gaping hole left by my disappointment.

It wasn't until we'd been trying for more than two years that we decided to try more drastic measures.  Dave was initially very scared and against my pursuing the surgery but fertility treatments weren't covered by insurance (did I mention we were broke?!) and gastric bypass surgery was.  At 309 pounds, my highest weight ever, the choice wasn't so hard.  I had considered the surgery an option for me ever since the very first time I'd heard about it (See Carnie Wilson).  Even if losing weight didn't get me pregnant, at least I'd be healthier and thinner when I finally broke down and tried the fertility drugs. 

THE PRE-OP PROCESS
I immediately found a surgeon.  In Sacramento, there's an excellent surgery clinic that specializes exclusively in gastric bypass surgery (called SALSA).  I worked with their office to get through the pre-operative requirements.  They sent me to a bariatric MD who examined me, monitored my weight for several months, and eventually wrote a letter to my insurance company to get me pre-approved. 

In order to qualify for surgery, you have to have more than one co-morbidity.  First you have to meet the BMI requirement, which with a BMI of over 47 was no problem for me.  I also had infertility, in the form of polycystic ovarian syndrome (PCOS), constant back and joint pain, and high cholesterol.  Because my weight was so high and my health was otherwise fairly decent, I was an excellent candidate for surgery.

The surgery practice I chose did not require pre-operative weight loss.  I was encouraged to start exercising, which I did in the form of riding my bike to work.  I was also required to undergo several sessions with the psychologist of my choice, who then also had to send a letter to the insurance company supporting my surgical candidacy.  I had to undergo many blood tests, an echo cardiogram (to check my heart valves since I'd previously taken phen fen before it went off the market), an EKG and an ultrasound of my gallbladder, which ended up revealing that I had gall stones and would need to have my gallbladder removed at the time of my surgery.

Even though I didn't get to meet the infamous Dr. Waldrep until  the day of my surgery, I immediately knew I was in good hands.  He was extremely experienced.  He performed three surgeries a day.  He'd done over 300 gastric bypass surgeries already and most importantly, he'd never lost a patient. 

GASTRIC BYPASS SURGERY AND MORBIDITY
I think it's complete and total BS when people say they didn't understand the risks of surgery before going under the knife.  I practically had to sign my life away before they'd even put me on the surgical calendar.  I specifically remember the assistant surgeon sitting me down and explaining to me in clear, plain, painfully understandable English that there was at least a 1 in 300 chance that I would die from the surgery.  As in D-E-A-D, DEAD.  The chance that I would suffer painful, life-long, horrible complications was even higher.

I still thought it was worth the risk.  I also knew it would not kill me.  I don't know how I knew this, but literally every fiber of my being knew that I would not only be fine, but that it would the best thing I ever did for my health.  I was lucky and my hunch turned out to be correct.  I also knew that statistically, if anyone was going to die from the surgery, it would be a 600 pound invalid, not a 26-year old infertile.  I felt that my odds were worth the risk.

[more to come on this topic again soon so stay tuned]