I don’t think there has ever been a time in my life when I have considered myself a Type A personality. What I would say about myself is that based on my life experiences and choices I have made, I’m a determined person and like to see things through to the end, and to be done successfully. So needless to say, it has been disappointing to me, and I have been a disappointment to myself (if that’s even possible), that I have been failing at eating.
Yes. I have been eating. I am trying my best, but it is hard. I literally have to put food in my mouth from the minute I wake up until I go to sleep. I was an avid watcher of calories before I had surgery making sure I stayed under a certain amount and now I watch my intake closely to make sure I get in enough protein and calories. On good days I would get 1500 calories. Bad days, 1100. What this math equates to, is that I am still losing weight. I have lost weight even since I got back from San Francisco (SF). Before surgery I was about 130, after surgery, before I left SF I was 120. Today, I’m a few ounces above 117. I see it in my body and how I feel. I’m starving.
This is why I feel disappointed. Who better to have a total gastrectomy than a health nut physician? Someone who knows about nutrition. Someone who knows about physiology. Someone who knows what to do. The problem is, no one told my body or digestive tract this. Sure the dietician said I can have dairy and yogurt and cottage cheese. But the dietician didn’t tell my gut that. Almost every time I eat the stuff, I get a near dumping syndrome reaction. Maybe I don’t get the diarrhea, but I still get the diaphoresis, lightheadedness and tachycardia. It sucks, but fortunately it last only about 30 minutes. Either way, its still 30 minutes of feeling like shit. The problem is, there isn’t a whole lot of calorie and protein dense foods my gut has decided it likes. To make matters worse, my taste buds are acting like I’m pregnant, making the food I normally love, taste funny. Every day I try something different. I sort of have a plan down, but I still don’t have a good one.
A couple of days ago I went to see my primary care doctor to get clearance to go back to work. She saw my weight, asked what I was eating, and asked about an average day at work. She said to me, “How are you going to do this?” My honest reply was, “I have no idea.” Because I don’t. I don’t have a formulated food plan yet. Right now, I go day by day experimenting with what I can tolerate and what I can’t. I tried to rationalize with her that it was going to be okay for me to go back to work and said told her when I go back in about two weeks, “I’ll be better. I should have a plan by then.” Her response was, “What if you don’t.” My response, “I don’t know then.” And then I broke down in tears. I have this bizarre old school work ethic where I feel bad being off of work and feel like I need to be there. Why? I don’t know. As of right now, I have no idea how I am going to run around the hospital, which on a typical day involves at least 15 flights of stairs and 8000 + steps, plus standing talking to families and staff all while making sure I get enough calories. As it is I barely am getting enough food to do the basics. Actually, I’m not even getting enough to do that, which is why I’m losing weight.
When I do manage to get food, I feel okay. But when I don’t get it on schedule, my day is ruined. The other day I had to re-certify my Basic Life Support (BLS) which was an hour long class. After that I needed to run to the hardware store for some things for the house and then to the grocery store. My plan was to eat at the hardware store because they have an awesome (so I hear) vegan food truck out front. The problem was, after I got done with my shopping and walked up the truck I discovered it was closed. I told myself it would be okay if I was a few minutes late getting food because I was going to the grocery store. I even bought myself a snack, but it was too late. I felt terrible. My body was so hungry (since I don’t feel hunger anymore) I was so nauseated I had a hard time eating. Plus I had to make dinner, because I’m a single mom. That day, I was lucky if I had 1000 calories. The problem is when you get that behind, you can’t catch up because you can still only eat a cup full of food at the time. Also being that behind on calories made the next day hard because I woke up famished. And so goes my week. I plan everything around when I’m eating next. I barely leave the house for more than an hour or two because I worry about food and where I will get it and if I do, if I’ll tolerate it.
I think part of the problem with my disappointment is that I look okay. When people see me, they don’t see a super skinny person who’s slowly starving, but that’s what I am right now. My guess is what people see when they see me, is societies idea of what an ideal woman’s weight should look like. Thin. I’m sure by societies standards 117 is ideal, an goal for many people. I know when I was working out a lot, my goal was to get to 125, but that was a muscular fit 125. At the time I figured if I could get to 120, that might be good too, but I didn’t want to lose my muscles as I had worked so hard for them, so I figured 120 was a weight that would never be attainable. Famous last words. Now I’m well below that goal. None of my pants fit, hanging off what I feel to be a near skeletal frame. My chest muscles have withered away and I can clearly see the ribs which form my rib cage and how they attach to my sternum, the breast bone. When I watch TV, I see women running around fighting with a similar physique and it makes me sick. Ironically these woman are supposed to be strong action heros, but there is no way these waifish women could take down their enemy in hand to hand combat as the shows would have you believe. It’s a farce. Really though, most TV is, but this is just another way TV is selling women a lie. When I was 130 lbs and working out a lot, I could have had a fighting chance in a fight. At 117, I’m a sitting duck.
This eating thing is a giant mental game and I have to learn how to play it better. I have to get over myself and be okay with the fact that I can’t go back to work just yet. I have to get stronger and eat better before I do it. I have to give up ideas of eating food I like and food I want to eat. I need to think of it as medicine, not something I enjoy anymore. A medicine I have to take every 2 to 3 hours to make sure I survive.
Jeanine Hinde
Raquel…Steve and I are sending healing thoughts. It must be a huge deal to have connected with someone who’s gone through the first couple of years without a stomach and can help you navigate the radical changes you’re going through. As for work, when the time is right, maybe working part time would be an option while you make progress managing the eating and nutrition challenges.
cantstomachanymore
Thank you both! Every day does get a little bit better, and having a friend who has been through this before is super helpful.
cherry pascual
Hang in there Dr. Tello and be easy on yourself. You will figure it out in time.
Always thinking of you. So proud of your tenacity and your strength.