Monday, December 26, 2011

Exercise, Water, and Weakness

The nutritionist in my program has been very insistent on exercise 6-7 days a week. I managed that fairly well pre-op, but her expectation of post-op was daunting. Dr. Fuzz said even 10-15 minutes would be a start, but clearly her expectation was to be back up to 45 minutes to an hour a day pretty quickly. I've been working on getting back up there, both in duration and in speed (my exercise of choice right now is walking on a treadmill I've got set up in the basement). Today I did 28 minutes at 2 mph. I've been adding another minute every other session or so - I'll stop at 30 and work on getting the speed up a bit and once comfortable there, I'll gradually add more time. I've got the entire series of Battlestar Galactica to re-watch while I exercise, so I won't be bored for quite a while, which is good - my worry is more about strength. Part of that strength certainly has to do with water - if you're dehydrated, you're not good for much. I've been struggling to meet the expected minimum of 48oz a day. Pre-op, this was pretty easy, as after a work-out, I could practically chug 16 oz, and do so several times a day. But now - I can only get in 2-3 large swallows at a time. I've taken my water bottle down to the treadmill with me so I can drink while I walk, which has helped both the thirst and getting that first bottle of water consumed, but the remainder tends to be troublesome. Not only do I have to sip,sip,sip the water, but I'm not supposed to drink 30 minutes before a meal, nothing during, and refrain for 30 minutes after a meal. Given that the meal is expected to be stretched to 30 minutes too, there's at least 3 90 minute periods in a day that I can't be drinking. I honestly didn't think it would be this hard to accomplish, but it has been. Weakness, however, has been the major surprise. In some ways, it really shouldn't shock me - I'm consuming barely 500 calories a day, sometimes less. Granted, within that I'm getting the recommended amount of protein (the one major dietary component your body can't make for you), but still - that's less than a fairly standard single meal for most people. I knew from all the information they gave me that it would take some time to "completely" get my strength back - some people it takes months. But I didn't really think I'd be starting from this low of a point. My first adventure out of the house by myself came on the 23rd - I desperately wanted to get out and get the Man a few gifts for Christmas (his major gift is on an IOU - he needs to present to pick part of it - and we haven't had the time to shop together). The crowds weren't really an issue, I went pretty early in the morning, but just the act of driving about 8 miles to Target and Kohl's, and finding what I needed, literally wiped me out. I had to rest in the car between stores, and find a spot to sit in the shoe department at Kohl's as I felt I was about to faint a few times. When I got home, I had to have him take the bags in from the car - I hadn't the strength to carry anything more than my purse. I spent the rest of the mid-day and afternoon in bed, utterly knackered. In the days sense, I've felt just as weak - wrapping presents on Christmas Eve, sitting at the dining room table made me tired. I slept a decent amount that night, woke up about 8 and was asleep on the couch within the hour, napping for nearly 2 hours. Another nap in the early afternoon still didn't entirely cure the fatigue. Dr. Fuzz had asked that I pick up a home blood pressure monitor to determine if we should continue some medication I'd been on for being borderline hypertensive. I checked, and I was at 104/65 - the lowest reading I've ever seen on myself. It's still within the low end of normal range, so I wasn't overly concerned, but it did seem to give some credence to feeling so listless. My first follow-up with Fuzz is on Thursday, I'm composing a list of questions and concerns I have. I'm still less than thrilled that Aetna decided they know better than anyone, and I only deserved 4 weeks of short term disability coverage - and should be thankful that I got a bit extra because my follow-up appointment was later than normal due to holiday scheduling. I need to find out what Fuzz would need to do if he wants me out longer - they've got about 24 hours to process that request since I'm expected back at work Tuesday January 3 (the bank observes New Year's Day on January 2). As much as I'm not feeling completely up to sitting here working for 8 hours in a row, I also can't really afford to take unpaid medical leave either. This is going to be an interesting transition. Thankfully, my boss is pretty understanding, and as long as I don't have meetings I'd miss, he'd probably be OK with an extended lunch that could include a nap if necessary. What really gets me, is that if I had to commute to the office I used to work in, rather than work from home, I think I'd be wiped out by the time I got there (40 mile drive) and hiked through the building to where I used to work! Now, I have very good health coverage, and I know I'm lucky to have 100% short term disability coverage - but the strict actuarial decision making processes frustrate me - particularly the one that left me with 24 hours to get any modification submitted and approved. But most of all, I'd really just rather not be this weak. As of this morning: ~281 (guess I was a bit unsteady on the scale, it couldn't decide) Total loss: 57 lbs Post-op loss: 23 lbs

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