10 month post-vsg update.

Prepare yourself: Long update.

Ahh It's finally summer time! Sorry I haven't been updating as much. I've been busy at the pool. (;

Anyways. It's almost 9pm. I'm bored. Figured I'd come on here and update.. and start a few posts that I can put up in the future.. so if I ever don't have any ideas, i can put one of those up and i won't feel guilty for not posting anything. (:

Currently I'm 197lbs. I broke the 200lb mark. So I'm happy. I've been at 197lbs though now, for a month.. I emailed my dietitian today asking what she thinks... And she thinks I'm not eating enough actually.. So I'm waiting on an email back from her to see what she thinks I should change.

I'm having issues with Metformin... It's really started bugging my stomach.. Something it never used to do. I've been on it since i was like 8 years old.. So it's surprising. I'm afraid to be off of it, or on a lower dose.. Because i tend to not lose weight when I don't take it... But The nausea/stomach pain isn't the only issue.

I've sort of become hypoglycemic (To have low blood sugars).. I haven't had a doctor confirm it for me.. But there are a lot of times that it gets really low.. A few times it's gotten into the 40's, which is really scary.. I mean I know how to get it up.. It just takes awhile.. and I mean, I can't eat a ton.. So it's hard to manage it right.. If i get down to 40 something.. I know i need to eat something sugary or simple carbs.. along with protein/complex carb to get it back up... and keep it up. I don't enjoy math. I've never liked it or been good at it. It's a pain in the ass. & That is pretty much what it is.. trying to squeeze all of that into 4-8oz depending on what it is, is kind of hard.. Especially when you're shaking so much from it being low, you can't hold a glass of lemonade without it dropping and/or spilling..

So yes, that's very frustrating.. But I'm working on it. It's getting easier to manage.

I also need to figure out what's going on with my PCOS... The pill (birth control) pill I'm on is constantly changing.. and the one I'm on now isn't strong enough. I break through. So.. That's something else I need to bring up with my doctor. But I've been regular.. Which I never have been in my entire life. I hardly ever had it before.. So.. bittersweet thing. :P

I will admit I have had drinking issues.. Not alcohol.. :P I mean.. getting the minimum of 64oz of sugar free fluids in each day. I just don't remember! I'll go and take a few big gulps. then I'll feel full and bloated. set it down. and then forget to go back to it... I'm never as thirsty as i was pre-op.. so it's an adjustment. I've lost my thirst, along with my hunger.. Ha! Fantastic. anyways..

Food porn announcement!:

I'm a Mexican food junkie. I love spicy things. My dad and I went to this Mexican sports bar (Else's) the other day and I got this... This was the half. They had a whole option. Both were huge. I could only eat one slice.. but this chicken quesadilla was fucking amazing.. and stuffed with grilled chicken and cheese... really high in protein.  and just flat out amazing. Pretty cheap too.. I will definitely be going back there.

Okay. food porn over. Back to the update.

Uhm... Exercise! Yeah. Let's start that.. I'm working out close to an hour a day... Going on walks/jogs.. and toning. I do palates and light weight lifting (3lb weights)..  I do this 4-5 days a week.. and the other days I go swimming (and sometimes on the same day).. The pool i belong to is sort of like a mini water park.. there are water slides and a vortex pool and stuff.. lots of hills in the grassy area, steps, slopes, etc... Just walking in and out of the place is a work out in itself. And I love swimming. It works all your muscles. You don't really sweat.. or you don't feel it anyway, because of the water.. it's easy on bones/joints.. It's fantastic. and you don't really know you're working out when you do it. which is fantastic.

Surgical scars:

I know the lighting sucks.. sorry about that. But.. You can hardly see them. My stretchmarks I have are fading, and the surgical scars are fading with them. (Sorry there is one you can't see. it's in a really awkward spot. But it's the smallest out of all of them... and is the most faded. you literally wouldn't be able to see it at all.)

Lets see.. what else... Oh. NSV. (non-scale related victory).. there are actually  few, which I'll put here.

Had a bonfire the other night.. 2 neighborhood kids were moving to Michigan (I live in Ohio).. So.. All the neighborhood kids were over. The 2 that were moving, plus 3 other kids.. plus my 3 little brothers.. and the drummer in my brothers band (the kid in the Nike shirt.. the other 3 kids in the picture are my little brothers.) They roasted marshmallows and made s'mores. (Yes.. I had one. Sue me. I regretted it twenty minutes later. I learned my lesson.) Quinn (brother on the far left) and tommy (drummer.. kid in the nike shirt. all the other kids in the picture are my brothers. (: ) and I  all took turns with a guitar.. playing, messing around.. Kept the fire going for over 8 hours. (from a little before 7 till a little after 3 in the morning..) we were just fucking around.. having a good time.. The victory in all of this? I was actually in pictures... Usually I'm the one hiding behind the camera... But I actually wanted to be in pictures this time. Most the pictures I have of myself.. I trust myself to take, at the right angle, so I don't look bad, etc.. I'm really into photography so I know how to edit too, and all that.. Well.. not this time. I handed my $300 camera (carefully.. and hesitantly) to my little brothers to take turns.. and i ended up in some pictures.. that I didn't feel the need to edit.. Which is happening more and more lately.. Which is amazing. <3

Second NSV?

For over a year I didn't sleep in my room.. stuff accumulated... you literally couldn't walk 2 steps into the room without tripping on something... I had no bed. My friend broke it. I had a couch in there to use as a bed, but I couldn't fit on it.. I was so claustrophobic and my blood pressure was always so high.. I was so overweight.. i just felt tight and confined in the room.. so i slept on the couch out in the living room.. well... I finally got the motivation to clean my room last week... and actually sleep in there... and I'm not claustrophobic anymore. Oh. and I'm actually getting a real bed this weekend too. (; Life is good..

Last nsv.. for now..:

I played soccer for almost 10 years.. I quit when I was 13. I was closing in on 200lbs.. It was physically becoming too difficult for me to play and keep up with the other girls.. I was on 3 teams one year! A competitive select team, my school/church team, and a rec team... I loved soccer... I always have. It's honestly a part of me.. I still watch games. and play outside with my little brothers.. I'm looking into refereeing now. Well.. That bonfire I mentioned above? I was FREEZING. (another nsv.. no mater how cold it was outside.. i was hot. i never wore coats. now i get freezing so easy it's not even funny.. and i love it.) i went inside but all my sweatshirts i couldn't find because i had just cleaned my room! so they were all int he wash, with all the other shit i found. WELL. i found this hoodie on the top shelf in my closet... It was my old select soccer team hoodie.. has my last name on it and everything.. It used to be skin tight. So even when i was at soccer practices and stuff i wouldn't wear it... Guess what? it fits now. it's big. it's comfy. and i love it..... <3 I seriously almost started crying.. I miss soccer so much... I'm starting training now.. to hopefully try out again next season.. I miss it. and That is a huge goal for me.. to get back into it. it was my lifeline. It was how I took out my anger. Something I'll actually admit I'm good at. And i miss it. I will make that team again, some how.. some way.. <3

Alright.... Enough NSV's for now... anything else i can think of..

OH. okay. last thing. for now. Lose skin is getting really fucking annoying. I can't wait to have it all cut off.. The nurse prac. at the hospital doesn't seem to think I'll need much.. if any at all.. because i started at a lower weight than most their patients.. But... I know I will.. I keep getting cysts where the lose skin is. and it's annoying. and painful. I'll do a separate post in a bit about what I'm looking into.. PS wise.. But yeah... my legs are amazing. Years and years of dance and soccer and swimming and tennis... I've built up a lot of muscle.. and I've always tried to keep it. i like my legs. but when i sit down... it's just disturbing. my friend took this picture of me when i wasn't looking the other day:

You can see my thighs just.. flatten out. spread out. and over lap each other. It hurts to walk sometimes because the skin rubs together and what not.. I get rashes. It's a pain in the ass. Those bug me even more than my stomach... So yeah.

Over all.. yes I'm having some issues.. with the loose skin, low blood sugar, and some meds.. But. I"m happy! It's summer! I go to the pool a few times a week. I'm actually ENJOYING exercising.. something I never thought I'd say. yes. I'm eating too little right now.. But... even though its bad.. and this is probably a bad way of thinking... I almost see that as an accomplishment.. Simply because... It isn't the other way around. I'm not eating too much for once in my life..

Life is fucking fantastic. I can't wait to get to my goal weight.. I"m 57lbs away. And then get all this skin chopped off. and to be able to get this tattoo on my ribcage I've wanted forever... to keep training and get back into soccer..

I'm feeling extremely optimistic. And I'm happy. Loving life right now... VSG = best decision ever.

I love you Chewbacca. <3

-Ashley.

An interesting thought...

So, even thought i've lost 87lbs in the past year.. (about 52lbs since surgery..) It still hasn't really registered wtih me yet.... i still feel really fat (I know in pictures i look better... and at certain angles my legs look totally normal... when you can't see all the skin that i'll need to have removed.. lol), overweight, unhealthy, whatever. I don't see much of a difference in myself,.

I was carrying a milk jug today.. 1 gallon.  and one gallon of orange juice,.. just taking them into the house, from the car. they're about 8lbs a piece, i believe.. maybe a little over like 8.3lbs or something.

I've lost 87lbs. that's almost 11 gallons of milk.

Holy Crap.

I was carrying around that much weight. on my body. and my body is still functioning? not crippled and crushed? how the hell does that happen?
i'm thinking if i had those gallons attached to me as i walk around.... I'd probably pass out...

No wonder I had so many issues with my blood pressure before... dear lord!


I've had an epiphany today. That is all.

-ashley.

www.facebook.com/justashley1637
ashleyellen1637@aol.com

6 month post-op bloodwork..

Here were all my lab results.. I'm starting to make sure I get a copy of everything (and I mean everything.. even the research stuff.) when I go to these appointments (and appointments with my endocrinologist..)

Everyone (well, all of my doctors) know I have this blog.. and they're usually pretty leniant (is that the word..?) with me.. Haha.

Next time I see my endocrinologist I'm gonig to ask if she can write down, or show me so i can write down, (or just print off the graph there is on the computer..) of my bmi over the years and all these different things they've showed me over the years.. i forgot to ask last time i was there.

But yeah. here it is!! i'm pretty sure if you click on the pictures, you can enlarge it all or zoom in to see clear-er. (: [actually, I just found out you can't zoom.. so i'm going to add links to the pictures below each one.. if you click on it the picture will come up.... and if you click on the picture, it'll zoom and you can read it all.]

http://i39.tinypic.com/2pzk3dy.jpg

http://i42.tinypic.com/4q1k6u.jpg

http://i43.tinypic.com/2n7nwgw.jpg

http://i42.tinypic.com/1onn2t.jpg

http://i40.tinypic.com/349dx4x.jpg

Haha alright.. Yeah. That's about it. Just thought I'd share.. I'm not entirely sure what half of this means... I mean, I have a basic understanding..  (I didn't at first.. I called my mom who is an RN who helped me out.. but what she didn't know, i just googled, or asked my endocrine when I saw her.. lol) But a lot of it is still foreign to me.. obviously.. i've never been to med school or in any advanced science/biology/chemistry classes or anything.. lol.

well yeah. I'm gonna go now. (:

Bye.<3

-Ashley

www.facebook.com/justashley1637

www.twitter.com/ashleyohara_ (don't forget the underscore.. for some reason it wasn't added into the link.. :P but yeah.. the twitter isn't just for this.. its my personal. majority of what i tweet about is music.. but i'll put it anyway.)

feel free to email me at ashleyellen1637@aol.com (I really should actually make an email specifically for this.. but its my personal) if anyone has any questions or concerns or suggestions for/about my blog, or anything related to it... Or just hit me up on facebook. (:

Have a great day. <3

Update - march 2012

So I went to my wonderful Endocrinologist today.. and she confirmed I'm not diabetic anymore. Still Insulin Resistant, but not Type 2... So that kind of made my day. (: But my face has been breaking out pretty badly....

Not the most attractive picture.. But most of the pictures on this blog arent. Metabolic issues have a lot of physical side effects that arent attractive, unfortunatley. And I guarantee you the flash on my camera made my skin look better than it is... I purpously didn't wear any makeup today so my endocrin could see how bad my skin was. I guess I usually do my makeup REALLY well.. and it's even fooled some of my doctors in the past..

But yeah. What I found out today: I'm still hyperinsulinemic(is that the word.. i still over produce insulin.. my insulin levels have gone from 25 (preop) to 18 now... but they're still pretty high. my hemaglobin A1c is down.. and everything that goes along with diabetesispretty much down i guess other than the insulin piece. So.. I'm not diabetic anymore. (:  She's going to run another glucose tolerance test.. but not untill i see her again in four months.

Reason behind that being: She increased my metformin from 500 2x a day to 850 2x a day. and put me back on aldactone. a blood pressure medicine. my blood pressure isn't nearly as bad as it was in the past... my top number was a little elevated today.. (I hadn't slept... I'm assuming that's partially why.) but it's also a mild diuretic.. and the last time i was on it my skin was perfectly clear, and i lost mad weight... so we'll see what that + the higher dose of metformin does. Hopefully it helps some.

Hm. What else... Oh! she showed me a chart... of mybmi from the time i had been first diagnosed (6-7 years old..) my bmi was 26... at 7 years old... I'm at a bmi of like 36/37 now..  I should be at a bmi of around 26 right now... but I'm 16... a 7 year old with that bmi is terrible...

Doctors told my mom I wouldn't make it to my 40th birthday, when i was that little, if they didn't get it under control.... and now I am. It's amazing how things can change.

I'm going to be honest... I love my endocrinologist. She's the one who sent the referral for me to have weight loss surgery... And I think with her I would have been able to lose a lot of the weight on my own (as i did pre-op..) that i have with surgery.. And my surgeon even knew that.. (not the endocrine piece.. but that i had lost a lot of weight on my own for the first time in my life..) and asked if i was sure i wanted to still have surgery.. and why? My answer to that is it's permanent. It is a tool that will help jump start everything, and my stomach will most likely never be the size it was again... So if i ever do fall off track.. (hopefully that doesn't happen) it'll be there t ohelp me. and yeah.. the word permanent stuck out in my mind. ---- But out of allll the doctors I've seen my entire life she is the one who ran all the tests as a teenager.. once the problem got really out of hand.. she put me on higher doses of meds than I've ever been on in my life.. and in turn, i lost weight. Something I was never really capable of doing.. No matter how much I exercised and restricted my diet. So I have her to thank for all ofthis.

People always say I"m the one who did it all... I'm the one who has worked for it.. But I cuoldn't be here without the doctors... I do have them to thank. I can't write the medications for myself.. and the lifestyle changes i made when i was really little (and even since surgery) wouldn't have the effects of what they've done for me... not even just the drugs, but really getting it through my head and teaching me what's going on.. so if any of you ever see this blog, thank you.

-----

So yep... drugs i'm on now:

Zantac 150mg 2x  a day.
Altavera birth controll 1x a day.
Metformin 850mg 2x a day.
Aldactone 50mg 2x a day.
Synthroid 50mg 2x a day.
Multivitamin 2x a day.
Calcium Citrate 250mg 4x a day (or 500 2x a day)
Vitamin D 1000ui 1x a day
B12 shot 1x a month.

It seems like a lot.. but it could be a hell of a lot worse.

I'm exercising about 1 hour a day.. sometimes a little less.. sometimes i miss a day.. but it's been pretty consistent.. now that it's warmer i'm actually enjoying it a lot more. (:

alright. well i'm gonna go now. have a great day!

-Ashley.
www.facebook.com/justashley1637
www.twitter.com/justashley1637
ashleyellen1637@aol.com

Oh, and here is the paper I got at the appt. (:



What is insulin resistance?

I've been asked this a few times lately, and I realized I've enver actually posted about what it is... So here we go. (:

(side note: other names for insulin resistance: metabolic syndrome, pre-diabetes, syndrome x, IR, being insulin resistant.)

"Insulin Resistance (IR) is a physiological condition where the natural hormone insulin becomes less effective at lowering blood sugars. The resulting increase in blood glucose may raise levels outside the normal range and cause adverse health effects, depending on dietary conditions. Certain cell types such as fat and muscle cells require insulin to absorb glucose. When these cells fail to respond adequately to circulating insulin, blood glucose levels rise. The liver helps regulate glucose levels by reducing its secretion of glucose in the presence of insulin. This normal reduction in the liver’s glucose production may not occur in people with insulin resistance.^{[citation needed]}

Insulin resistance in muscle and fat cells reduces glucose uptake (and also local storage of glucose as glycogen and triglycerides, respectively), whereas insulin resistance in liver cells results in reduced glycogen synthesis and storage and a failure to suppress glucose production and release into the blood. Insulin resistance normally refers to reduced glucose-lowering effects of insulin. However, other functions of insulin can also be affected. For example, insulin resistance in fat cells reduces the normal effects of insulin on lipids and results in reduced uptake of circulating lipids and increased hydrolysis of stored triglycerides. Increased mobilization of stored lipids in these cells elevates free fatty acids in the blood plasma. Elevated blood fatty-acid concentrations (associated with insulin resistance and diabetes mellitus Type 2), reduced muscle glucose uptake, and increased liver glucose production all contribute to elevated blood glucose levels. High plasma levels of insulin and glucose due to insulin resistance are a major component of the metabolic syndrome. If insulin resistance exists, more insulin needs to be secreted by the pancreas. If this compensatory increase does not occur, blood glucose concentrations increase and type 2 diabetes occurs."

Thankyou Wikipedia.. http://en.wikipedia.org/wiki/Insulin_resistance

Now.. Lets break this down.

Insulin.. a hormogne that is used to break down all the food/liquid we take into our body, to use as energy... The pancreas makes it.

With Insulin Resistance, the Insulin doesn't work properly. It has trouble breaking down the food and drinks that we take in, and the body notices this. so the pancreas continues creating insulin to use.. and none of the insulin works. So its just free-floating in your blood, while everything you take in... is basically just stored as fat, in your body, because your body doesn't know what else to do with it.. resulting in you not getting the energy you need from the food, and your blood sugar is raised.. which causes a whole bunch of other issues, in itself.

Signs and Symptoms of IR?

**Fatigue.
**Having a hard time focusing.
**Bloating
**Feeling tired, especially after eating.
**Weight gain, fat storage, and difficulty losing weight.
**High blood trigliceride levels.
**Hypertension (high blood pressure)
**Depression (because of a messed up metabolism with IR, depression isn't uncommon.)
**Increased Hunger
**Acanthosis Nigricans (dark patches of thick velvety-feeling skin onyour neck, chest, back, groin, or underarms.. caused by high insulin levels in your blood.. I have pictures of this in a post about signs and symptoms of metabolic syndrome, here: http://ourfightnow.blogspot.com/2011/12/metabolic-syndrome-signs-and-symptoms.html )

and here are Risk Factors:

Genetic:
**Family history of Type 2 Diabetes
**LMNA mutations
**African American's, Hispanic;s, American Indian's, and Asian-American's are at higher risk for IR.


Physiological and Enviromental:
** age 40+
**Obesity
** central obesity (again, look at this post i made a few weeks ago: http://ourfightnow.blogspot.com/2011/12/metabolic-syndrome-signs-and-symptoms.html )
**Lack of much exersize, not a very active lifestyle.. "Couch Potato".
**Hypertension
**Low levels of 'Good Cholesteral" (HDL)
**Gestational Diabetes during pregnancy
**Giving Birth to a baby more than 9lbs.

Causes? There isn't any one specific cause for IR... poor diet, and a sedentary lifestyle and/or obesity have been known to cause it. Other causes:

Cellular, Molecular, and Disease..

"Recent research and experimentation has uncovered a non-obesity related connection to insulin resistance and Type 2 diabetes. It has long been observed that patients who have had some kinds of bariatric surgery have increased insulin sensitivity and even remission of Type 2 diabetes. It was discovered that diabetic / insulin resistant non obese rats whose duodenum has been surgically removed also experienced increased insulin sensitivity and remission of Type 2 diabetes. This suggested similar surgery in humans, and early reports in prominent medical journals (January 8) are that the same effect is seen in humans, at least the small number who have participated in the experimental surgical program. The speculation is that some substance is produced in that portion of the small intestine that signals body cells to become insulin resistant. If the producing tissue is removed, the signal ceases and body cells revert to normal insulin sensitivity. No such substance has been found as yet, so its existence remains speculation." Thankyou wikipedia, yet again..

(side note: I had the Verticle Sleeve Gastrectomy.. Which doesn't mess with your intestines at all... Which is why i'm slightly worried my type 2 diabetes won't be fixed, like i had thought before.. I guess we'll just have to wait and see..)

HCV has also been known to increase the likelyhood of getting Insulin Resistance.

and PCOS (Polycystic Ovarian Syndrome) has been linked to IR being known to cause it, or be caused by it..


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Most of that is on the wikipedia page that i posted before, but i tried to make it a little easier to understand... If any of this concerns you at all, bring it up with your primary care doctor.. See what they have to say, and they'll probably order some bloodwork.. but a quick way to tell?

If you have access to a kit, check your fasting blood sugar on one or more occasions.. if its higher than 80-90 you should call your doctor. that is a pretty tell tale sign of insulin resistance.



So, I hope this helped whoever's reading this. Have a good day, anddd i'll talkto you all later. (:

If you have any questions or comments feel free to comment me n here, or talk to me on facebook, or email me! i'd be glad to help in any way i can. (:

-Ashley

Sources: Wikipedia & Google & own knowledge.