I had my six month post-surgery check up today which went really well. I started with the dietician, whose main concern was that I'm still not getting enough protein, and being able to get down my vitamins. I'm probably going to have to try a chewable multivitamin just to try and keep them down as tablets are still not my friend. The dietician also gave me some snack and simple meal ideas that I can use which I think will be helpful.
My exercise physiologist appointment was up next. The trainer is going to email me through my measurements and exercise improvements so I will post those when I get them. Although I haven't overly improved in some of the exercises such as push ups and squats, I think that's because I was quite fit at the time of my surgery, whereas I am still only just getting back into a gym routine now.
Another good thing is that of the 40kg that I have lost, only 7kg has been muscle, whereas the majority of people will lose a much higher percentage of muscle in addition to fat through the surgery. Keeping that muscle will help me in the long run with maintaining my body weight.
We talked through my current gym program, and that she'd like to see me getting my heart rate up to around the 140bpm mark, but that it doesn't have to stay at that rate the whole time. I've had my heart rate monitor serviced recently, so I will have to put it to the test!
Finally I saw a Bariatric Assessor, which is basically a GP who specialises in Bariatric Surgery. In other words, I have graduated from seeing Dr Valibhoy! My Dr was just fabulous - I wish he worked closer to where I live because I would have him as my GP any day! Just really open, friendly and happy to explain where it's needed. He basically said that I am perfect! In perfect health that is. All my areas of concern have virtually disappeared, and he is thrilled with my weight loss. He basically said that, considering my blood test results, it doesn't matter if I lose anymore weight, and that anything else I lose now is purely for aesthetics, I don't need to lose more for health reason, which is kind of incredible to hear!
We went through all of my metabolic results and the changes are enormous
Area - August 12 - March 13
Weight - 126.3 - 86
BMI - 43 - 29
Neck Circumference - 43 - 35
Fasting Insulin - 28 - 9 ****
Insulin Resistance - 6.2 - <2 ****
Total Cholesterol - 5.8 - 4.4
The fasting insulin and insulin resistance are particularly noteworthy, as this result shows that I am no longer insulin resistant, which will have a positive effect on my Polycystic Ovarian Syndrome (PCOS) and my fertility! The Dr said that my results initially were very much textbook pre-diabetic, and that it has completely resolved itself! That, as well as the huge improvements in cholesterol and decrease in neck circumference (which is a factor for other issues) are really good results for me.
From the results, there are still two areas I need to work at. My HDL cholesterol (good cholesterol) is still quite low at 0.8, and needs to increase to reduce my total cardiac risk ratio. The Dr said that while this component can be hereditary (my Dad has high cholesterol as well), the best way to increase HDL is through exercise, which I hadn't really heard before. That's something I'm planning on doing anyhow, so I'm not too worried about it but will keep it in mind.
The second thing is that my B12 levels have dropped considerably. Back in August they were 329 and at the moment they are 146, and I believe normal levels are over 200. This has come up couple of times over the years so perhaps I just don't absorb it well, but the Dr has given me a script for three B12 injection which one of my friends who is a nurse can administer to me over the next few weeks.
The Dr did two things that really made me smile during our consult. Firstly he brought in 30kg of hand weights for me to hold (which I nearly dropped), and then made me hop onto the scales. It was still 10kg off what my starting weight was, and he told me to visualise what I was having to carry around with all that extra weight.
The second thing he did was show me a poster on the wall. I had glanced at it in the waiting room a few times but never really paid it much attention. He pointed to the outline on the right hand side with the BMI of 35-40 and said to me, "That's what you used to be". Then he pointed to the second from the left image and said, "That's who you are now". It was quite an emotional moment.
So things are really going well. I am still one kilogram away from my initial goal weight, but I have set myself a goal to be down to 75kg by the years end. I hope it will be quicker than that, but I'm not going to let myself worry about it. As the good doctor said today, my body is fine how it is now. I am just going to take what comes and do my best to lead a healthy lifestyle.
