So much to be thankful for

As we celebrate Thanksgiving this week, I am reminded of how lucky I have been – even with the last couple of months taken into consideration.  So to make it easy here are 33 things I am thankful for in 2015 – from the serious to the silly.  (in no particular order)

  1. The love, grace and mercy of God
  2. James – my love who has been so supportive
  3. Mom – a role model for compassion
  4. Grandma – she loves me fiercely
  5. Heather & Jeff – my sister and her husband who I don’t always understand but I always love
  6. Hayley – 13 years of smart, defiant, strong-willed girl love
  7. Jake – 10 years of smart, cute, cuddly boy love (he would hate me saying that)
  8. Penny – mentor and friend
  9. Sara – my other sister and Facebook partner in crime
  10. Matthew – we don’t talk often, but I know he loves me and I love him.  Friends as always.
  11. Work – for keeping my mind off things in my real life some days
  12. My boss – who has been overwhelmingly supportive in this last couple of months
  13. My co-workers – who remind me I am not alone in this
  14. Culpeper Baptist Church – for being sweet sweet people
  15. My Sunday School class – who have allowed me to be open about a very difficult time
  16. The Praise team at CBC – who have let me serve with them
  17. Singing – my form of expression
  18. Adele’s new CD (I know it’s cheesy but I love it so)
  19. My apartment – home is such a great place to be
  20. My pillows – for supporting my head as I rest
  21. English bulldogs – for being so darn cute
  22. Hulu & Netflix – for entertaining me
  23. The Bible – for guiding me
  24. iTunes – for allowing me to fall asleep to only my favorite songs
  25. Facebook – even though it drives me crazy
  26. My computer – my daily companion
  27. My cancer diagnosis – it has caused a course correction I needed
  28. My doctors  – at least most of them
  29. Crafting which I am in love with again
  30. Coloring books and puzzles – for keeping me company
  31. My memories – when I get lonely, they help me out
  32. Small towns – I love living in one
  33. Text messaging – for keeping me in contact with J and my mom who now will not answer her phone


A different kind of holiday season

Due to all of the things that have been going on this fall, I have not really thought about the holidays very much.  In fact, for maybe the very first time, I am not just unprepared, I am not really excited about it.  At all.  My mind is just not there.

Several times already this month, I wished that we could put the holidays on hold and celebrate some other time.  Some time when I am not so overwhelmed with other things.  I know how selfish that sounds…like the holidays are all about me and my issues.  But, all the same, I would love to have about 3 more months before I had to face the holidays.

I doubt I am alone in this and I am pretty sure there are people who feel this way every year.  Christmas is not overwhelming in and of itself – we make it that way.  We push ourselves to find the perfect gift, make the perfect dish, host the perfect get-together, be the perfect guest and be perfectly thankful and gracious during all of it.  I also find the need to sing the perfect song and go to all of the perfect events and make time for all of the perfect activities (favorite movies, Christmas TV episodes, concerts, traditions).  Oh and in my case, celebrate my December birthday that I normally have to squeeze in between other things. It is overwhelming in a normal year.  This year, it is impossible.

I have heard that there are people who attempt and in some cases pull off a stress-free holiday.  I used to laugh at that idea.  This year I am trying to embrace it.  No pressure.  No pushing.  And the fact that i may have to slow down due to my health makes it even more imminent.

Assuming I will have surgery at the end of this month, and there is a 3 week recovery period before I am fully up and running, and my voice may need additional recovery time after being intubated during surgery – I am/will be paring down this year.   And if i call you to celebrate my birthday in March – don’t be surprised.  :)

What a difference one DOCTOR can make

After my cancer diagnosis and subsequent visit to an oncologist at UVA Medical Center, I had a “sort of” game plan.  IUD to hold the cancer off, bariatric surgery to lose the weight quickly, and then eventually a hysterectomy to rid my body of the cancer.  My meeting with bariatric went well and I felt like the pieces were finally coming together.  And then yesterday happened.  And once again things are changing.

I met with a new oncologist in Annandale and well, let’s just say he didn’t agree with the doc in Charlottesville.  He told me that by delaying the hysterectomy I was putting my life at stake.  He told me I needed the surgery sooner rather than later.  He told me that I am not only eligible to have the surgery, but that he has treated patients larger than me.  And he told me that he wants to do surgery before December.

He also said:

  • The IUD should be used only for women who really want to try and have a baby – it essentially CAN temporarily make the cancer go away giving them a window to have a baby – but the cancer will always come back until you either have the hysterectomy or you “solve” what caused the cancer in the first place.  For me that would mean a significant amount of weight loss and a hope that my estrogen levels would then regulate.   It is not a guarantee however that would work.  The only real treatment to get rid of all possibility of it coming back is to do the hysterectomy.  In that way, the doc in Charlottesville was correct – it could allow me time to have the bariatric and lose weight.  However, I was taking a risk it would not work and the cancer would get worse in the meantime.
  • The IUD should be prescribed in conjunction with hormone therapy – which I was not on – for maximum effect.
  • When I was first diagnosed, i thought for sure the process would move fast once I was in the office.  Well it didn’t then, but it is now.  In a couple of weeks I will be hiding under the knife so to speak.

So I have a few prayer requests for any of you willing to pray:

  1.  I will have to be intubated and it is my #1 concern about having surgery.  Having a tube pushed through my vocal cords puts them at risk.  And that scares me more than I can say.  So pray that everything goes well and that at the end of this, I can still sing.
  2. Pray for my mother as she will have to come and stay with me after surgery for a while.  I know this means walking away from her normal life for a little bit, but I can’t be alone and due to the stairs at mom’s place, this is the best option.
  3. Pray for my doctor and his ability to perform this surgery quickly and safely.
  4. Finally, pray for this to be the last time I have the word cancer associated with my name.

So what about bariatric?  Well, to be honest, I have not gotten that far.  I will still talk to my doc about starting a new diet.  I may not try to start my official 6 month medically managed diet until this surgery is over however.  My gut feeling right now is that I will still have the surgery next year. But, and the oncologist said this, the cancer has to come first.  After that it is my call.



Bariatric Surgery Appointment 1

Yesterday I had my first visit to the Bariatric Surgery Center at UVA.  It was an overwhelming amount of information and emotion as J and I sat there and listened to the experts tell us about this journey I am about to embark on.

The morning started with me being off schedule.  If you know anything about me, one thing I have serious anxiety about it time.  I can not be late.  It doesn’t just stress me out to be late, I have borderline panic attacks – my heart beats faster, I start to sweat, I breathe heavier.  There is a physical reaction to being late that is hard to explain to someone who doesn’t view time the same way.  So I had a schedule of when to get up and I missed it by 20 minutes.  And from there my timing went out the window.

The 45 minute drive to Charlottesville finally got started (almost on time) and we made a quick stop for breakfast as I had not taken the time to do that before leaving.  Finally we made it to the hospital – almost 10 minutes after I had scheduled to be there to catch the shuttle bus from the parking garage to the building where the surgery center is.  But we had missed it by about – you guessed it – 10 minutes. And they only run every half an hour.

We then started to walk out to the West Building.  I had to be there 15 minutes early for my appointment for check in.  The paperwork said if you were late, you could be turned away from the 2 hour seminar that is required to start this process and was scheduled for 8am sharp.  The building is not that far but it is on a hill, and I was already starting to hyperventilate from being late, and I was walking too fast which kicked my asthma in, and by the time we got to the building, a mere 8 minutes before my appointment I was wheezing and huffing and puffing as if I had just run a race.

So up to the 4th floor, sign in on the sheet, and wait for them to call my name.  Then finally, I was called, checked in, and then waited.  The seminar actually started about 8:20 as someone was out sick and others were covering for them.  Now, I know to many of you it seems like this is where I could have calmed down about being late as it worked out in my favor…glass half full right?  But the thing is, the threat was real for me to have missed this chance.  They only hold these seminars once a month, the guidelines had been clearly laid out about lateness, I had taken an entire day off work (not an easy feat) and there is so much on the line that I would have been devastated to lose my spot this month.

Anxiety was starting to take on a new form at this point – fear.  We were finally led into a small classroom and someone told us what each of our specific insurances required to have this surgery.  For me, this will mean psychological testing (to ensure that I don’t have any barriers that could lead me to make a decision I am not ready for) and 6 months of medically supervised weight loss.  In other words I need to work with a doctor or nutritionist for 6 months, document my attempts to lose weight, and have all of that sent to the hospital/insurance company before I will be allowed to come back and have the surgery.

A very nice nurse then came in and she told us about the physical changes that come with surgery – what happens to the stomach and the intestines when you do this, how food is then processed in contrast to how it does now, and she talked about how food volume is different after the surgery.  She talked about the types of surgery (only 2 are offered there: the gastric sleeve and gastric bypass).  She talked about a food diary and the importance of seeing this as step by step change and how it is not the easy way out.  The medical info matched everything I had read so there was little surprising about it.

Finally, to round out the seminar, a nutritionist came in to talk about food post surgery: the importance of protein, cutting sugar and fat, adding exercise, and starting to make small changes now so that by the time you have surgery you are prepared.  She advised you to try the types of foods you can have after the surgery now so you can find brands and types you like.  And most importantly, she talked about how these small changes now will set you up for success later.

It was a lot to take in.  We were let back into the waiting room for step 2.  I was called back to a room where I had my weight and vitals taken.  Then the nutritionist, Elizabeth, came in and she talked to me about my specific food issues…highest and lowest weight as an adult, what diets have you tried, how much do you exercise, what are your pitfalls when it comes to food.  And I told her – honestly.  She thanked me for that but really, what good would it do me to lie about it?  She can’t help me if i don’t tell her the truth.

We made 3 specific goals to start with:

  1. Behavior: Set an alarm to have breakfast (and stop skipping breakfast)
  2. Exercise: Start doing 2 10 minute walks each day – 1 at lunch time and 1 after work
  3. Food: Reduce fast food eating to no more than once a week.

That doesn’t seem all that intimidating when you see how small the steps are.  But in terms of the long-range viability, they are huge.  Each is patterned to a specific weakness of mine and each will help me achieve something until it is time to set a new goal.

The surgeon came in while we were finishing the nutrition info and then it was time to talk surgery.  Dr. Fason asked me about my medical history, talked about the types of surgery a little and asked if I had a preference, and in the end told me it was my decision.  Either would work for me, but I needed to be comfortable with the final choice.  It was like music to my ears.  That is what I had been waiting for a doctor to tell me.  This whole time, I have felt like I had no choices and here he was telling me it was my decision to make.  I asked a couple of specific questions:

  • First, I have an overwhelming fear of being intubated.  Intubation is when they insert a tube down your throat to attach you to a breathing machine – a ventilator.   This procedure is necessary when you are under general anesthesia for surgery as the anesthesia paralyzes the muscles of the body – including the diaphragm – making it impossible to breathe on your own.  Here’s the thing – I worry about my vocal chords.  I don’t really want someone shoving a tube down my throat and then having to pull it back out the same way.  I knew someone who had to be intubated for her asthma and she has never sung again.  Now the difference is of course that she had to have it done in an emergency vs a planned surgery, but the threat is real.  And while I know that singing is now what I do for a living and I will still get a paycheck if I can’t sing, I don’t know that I want to survive not being able to anymore.  It would for me be like (and please forgive the analogy) the Little Mermaid giving up her voice for a change to walk on human legs.  It got her what she wanted technically, but it is no way to live.
  • Secondly, I asked him about the cancer and treatment for it while undergoing this process.  He told me the exact opposite of the oncologist – he said to take care of the cancer first and the weight loss is optional surgery.  We can always plan that for later if I need to move it due to the hysterectomy.  I will touch on this later, but it was as I had expected – the cancer has to take precedence over anything else at the end of the day.

After meeting the surgeon, the final meeting was with his nurse, who came in to introduce herself and to send me down for blood test to check on vitamin deficiencies, sugar (for diabetes) and other issues that could pop up later.

We had planned to be there until 2 pm and we were done by noon.  J and I left and went out for lunch.  My mind was running a million miles a minute by this time and honestly it is going to take me a while to read all they gave me and absorb the information.  Next is to call my regular doctor today and make plans to come in and start the supervised diet plan.  And calling my insurance company to see what is going to be covered during this time.

Finally, I have an appointment with a new oncologist next week and I think that will fill in some of the rest of the missing pieces here.  Is a hysterectomy completely out of the question?  Do I need to wait for the next biopsy to see if the current treatment is doing any good?  If I do need to lose weight first, how much before we can consider the hysterectomy?  And finally, what do we do if the IUD treatment doesn’t work?  What other options are there?

I have enjoyed my time at UVA Medical Center with the exception of the oncologist.  They have been kind and caring and treated me with the utmost respect.  Now to find an oncologist who will do the same.

Loving Myself First

I have been reading about Bariatric Surgery for a month now – stories of those who did, medical info about types of procedures, diet restrictions of those who have had it.  It tells me a few things about this process:  everyones journey is a little different, there is no one way to accomplish the surgery and recover from it, and that there are just as many psychological issues with the surgery as there are physical ones that need to be dealt with.

One of the recurring themes however is the shift that happens when you need to learn to love the new you – something that is difficult when you have spent at least a portion of your life hating the current you.  Body image issues do not go away when you lose a lot of weight.  And I would imagine it is much harder for people who have had a lifelong struggle with weight vs those who were thinner and gained as they got older.  But I don’t know.  I fall in the life-long struggle group so I will never know what the other group is like.

I have spoken many times about what it is like to be fat.  But what i don’t tend to spend a lot of time on is how I feel about my weight – or more specifically my own body image.  So here are a few facts about me:  I am under no misconception about what I look like or how my weight has affected the way I see myself.  I don’t look in the mirror and see someone skinnier.  I don’t see my own picture and think – who is that?  And while I am sure that some of my so called fashion choices make it look like I am trying to hide the fat, at best I am just trying to cover it so it is not sticking out.

So how do I feel about my own body?  Not that bad actually.  I accept it for what it is.  I celebrate the things I can do and while I find myself lamenting the things I can’t do at times, I have been overweight for so long, that unless it is something new I can’t do, I just accept it and move on.  I know it is hard to believe that someone my size doesn’t hate their body.  But I don’t.  That doesn’t mean I LIKE my body all the time.  But I feel like there is a difference between hating and not liking.

And honestly when I feel the worst about my body is when someone else makes me feel that way – they humiliate me, they point it out, they ridicule, they stare, they get that look of disgust that anyone with a weight problem can see coming.  It is part of the reason I spend so much time alone and at home.  It is so much easier than running the risk of having someone make me feel that way.

If the bariatric surgery happens, one of the first things I really want to do is try to force myself out of the home and family/loved ones comfort zone.  I thought moving here would do that, but it has actually made it worse.  I can go days without ever leaving home.  And that is not good for my mental and physical health overall.

Now it is time for me to love myself in a new way.  To take some risks and push out of my comfort zone.  To grow as a person and love myself first.  And everyone else will just need to deal with it.

Endless questions

The last week has provided some challenges to me – both emotionally and physically.  The odd thing is that I can deal with the challenge itself.  It is the questions that it brings up that I have a hard time with.  The why is harder than the actual issue itself.  I guess that is always the way, but when challenges are coming hard and fast you really notice it.

So here is where my brain is lately:

  1. How do doctors balance the line between too much technical info and too little?    I realize that is a generalization and I am the perfect candidate to make things more difficult.  I want you to tell me as if I am a child – simplify it, but I don’t want you to treat me like a child – as if I am incapable of understanding eventually.
  2. When you are diagnosed with something – anything really – how in the world are you expected to wrap your brain around the technicalities of it in such a short amount of time that you have to make decisions?  And isn’t that exactly where doctor’s need to help patients?
  3. When you have a doctor that doesn’t take the time to help you understand, what then?  How do you make decisions about things you are not sure of?
  4. Why is it that I don’t have the right to copies of my own medical records without a fee, but other doctors can have it for free?
  5. How is it that I can call a doctors office one week and need a referral to see the doc and call the same office 2 weeks later and set up an appointment with no mention of a referral?
  6. The scariest part of the bariatric surgery is the eating plan – the strictness, the potential for regaining the weight if changes are not permanent, and the fact that I could go through all of this and still be fat.  So why is it that I can’t seem to be happy about the possibility instead of focusing on it going wrong?
  7. Finally, when this is all over, I am sure I will look back and see all of the ways that God has helped me through this and all of the ways he put people in my path to walk this with me.  But I am worried about some of the changes that are coming – not the day to day things but the “who am I” type questions.  I have never been anything other than a fat adult.  Being overweight has been my identity in many ways for as long as I can remember – as young as 8 or 9 years old.  I don’t know what it is like to be thinner.  I don’t think my personality will change as much as my options will change and how I respond to those options will make a great deal of difference in my life.  That will be a lot for me.  But it will also be a lot for those people who love me.  And that concerns me most of all.

The Dreaded Word

I have cancer.

I don’t like to say it.  I especially don’t like to say it to other people because I know the images that come to mind.  I know the immediate fears that it brings to people.  And I know the look – the one that says “oh my goodness I am so sorry”.  The thing is I feel guilty when I say it.  My prognosis is good.  I don’t feel bad.  I am not currently facing chemo or radiation.  And the surgery I need can wait apparently.

I know that when I have my next biopsy, things could change.  The cancer can get worse.  But for now, things are ok.  And I am ok.

But the truth is the cancer is there.  It is weighing on me some days – the fear of the unknown.  And then I feel guilty again because I am so much better off than many cancer patients.

I am trying to come to terms with the word.  To be able to say it without having to apologize for not being sicker.  To accept that this is a part of my life for now and no matter what I will be a cancer survivor the rest of my life.