Wednesday, April 20, 2011

Pity Party Hangover

I haven't had much to say because I've been too busy feeling sorry for myself. I'm not even sure why, really. I think maybe the "Yay! I'm not sick anymore!" euphoria was wearing off and I was left with the reality of what I still have to deal with before I get to the finish line of this thing. There is no doubt that I will hang in there and see this thing through, but sometimes the road is windy or bumpy and we just need to have a seat and pout for a few minutes.

I'm struggling a good bit in the weight loss arena. Several things have come together in a perfect storm of making it more difficult than it was before surgery. I do Weight Watchers so I follow their points system for how much food I can eat in a given day and still lose weight. You get extra points for being a nursing mom. I have since weaned the baby, so those are gone. You also earn points for exercise and running earns a ton in a relatively short time span. Running is not close to being on the table right now, so those points are gone. So here I am with a much tighter food "budget", so to speak, and it's not something I'm used to dealing with. I have to really scrutinize every single thing I eat.

Add emotional eating to the equation and you can see how this can get ugly really fast. I am not eating large quantities of food, mostly thanks to the ileostomy. My appetite is pretty good again, but I have to chew my food so thoroughly that it takes forever to eat much of anything. After awhile I just get physically weary of the act of eating. This is not all bad, as it also gives my body a chance to recognize it is full and send the appropriate signals to my brain, etc. So my problem right now is mostly a matter of selecting better food when I do sit down to eat. I am hampered a little bit by the soft foods diet. In the past my approach to WW was lots of fruits and veggies, now my choices in this area are really limited. It makes things tough. I also find myself justifying pure comfort food under the guise of deserving it because I'm recovering and junk excuses like that.

The thing is, I have to get my act together in this area or there won't be any Step 2 j-pouch surgery this fall. My surgeon has already told me this and the reasons he is basing on are sound. So, it's time to take it all seriously and get more motivated than I've ever been. I got my food journaling back on track today and did well with staying in my points target. I also got on the treadmill for some walking. I managed to walk for an hour! I was surprised to learn this earned me 5 points which is great! I'm going to do it again tomorrow. I covered 5k (3.1 miles) which made me feel good. We will walk in a Race for the Cure 5k in May, so I'm thrilled that I can already cover that distance without difficulty. I need to be more consistent with the walking. True, it's not running, but it's something. It helps and it will make me that much more ready when I do get cleared to run. I need to keep these things in perspective. Right now I have 39 more pounds to get to my goal weight with WW. I can, and I will, do this.

I think I've also been psyching myself out about some aspects of life with the ostomy. I did learn one thing: when I order new pouches I have to get the opaque ones. I tried one that Hollister sent me as a sample and it made such a difference in allowing me to relax and not worry about what was going on in there! I was so sad about the idea of taking it off and going back to the clear pouch that I actually waited 5 days to do my change (instead of 3-4). I think that is just a little too long based on what I found when I took the pouch off. Those white pimply bumps are not a problem anymore (I think there was one new one and that was it). The skin right above my stoma was all red and irritated. As my stoma has shrunk, it kind of rotated so the opening is pointing upward. This isn't a huge problem, but the opening is kind of close to my skin now (it's not the whole stoma retracting, as there is plenty above the skin...it's just a positional thing with where the opening is). I've been using a convex wafer, which I need because my stomach is squishy. I also have been using the Adapt barrier ring. I think I need to switch to only using the barrier ring on the bottom half so the edge of the flange will be completely below the opening of the stoma. Otherwise, the output slowly compromises the barrier ring and then a little bit gets on my skin and causes that redness. Unfortunately, I didn't think of this until after I placed this new pouch, so I will wait and try it out when I change here in 3 days. I hope it helps. If not, I guess I'll be making a call to the ostomy nurse for some tips and ideas.

The other thing weighing on my mind a bit is knowing they will be slicing me open again. I'm four weeks out from surgery now and the incision is healing pretty well. It's still tender sometimes depending on what I do or how active I am. I know I still have a couple of more weeks before I can expect to actually feel somewhat good in that arena. It's been difficult only because of the time involved. Nothing has been horribly painful or unbearable, but it's just the constantness of it and how long it's taking to get over the whole thing. And I have to do it all over again at least once. (I get the impression this giant incision won't be needed for Step 3, but I need to clarify that with my surgeon.) I know it will be worth it in the end, but right now the idea of starting all over with this lengthy recovery is too much to think about. So I really try not to.

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