Weeks 4-6 were full of milestones and surprises. I advanced to a more adventurous food stage, stopped a medication that I'd had to take after surgery, went back on a different medication that I'd had to stop for surgery, dealt with some interesting mood swings, and went back to the world of the working woman.
Some of the highlights of hitting the 4 week out from surgery mark were stopping the liquid Colace (a.k.a. puke juice), going back on my OC (oral contraceptives, to help treat my PCOS), and having even more diversity for my food choices, both in terms of variety and texture. With the soft foods stage, the instructions are to continue getting 60g protein and 48-64oz fluids, but you can eat things that are tender enough to cut with only a fork. I got excited and went grocery shopping for all kinds of tasty things. The only problem was that I still hadn't (haven't!) adjusted to what a grocery list should look like now, and found that by the end of the week I had plenty of things sitting in the fridge that were starting to go bad because I just hadn't been able to get to them yet. I attempted making some spaghetti squash with meatballs and red sauce. The squash came out alright and the pre-made sauce was fine, but the meatballs were a trainwreck. Turns out there's more to it than meat in ball form. Thus, all 18 portions beyond the original taste tester were actively ignored in the fridge.
The diet outline also encouraged adding small amounts of starch and veggies when it became no problem to get all the protein in during the day. I'm not sure what kind of "wonder pouch" I am supposed to have in order to achieve that goal...I was pleased, however, that I was down to 1 protein shake per day and, as long as I got out of bed at a reasonable time on the weekends, was able to get everything in. Fluids were still somewhat annoying - it's not that I couldn't tolerate the volume required, but that forcing down the same old water hour after hour, day after day was getting dull and frustrating. I always got in the minimum requirement, but knew that aiming for more would only help.
On 1/22/13, I went back to work. All during my month off, I had been itching to get back on a schedule and be productive. During the last week and a half I had suddenly stopped needing an afternoon nap and had started adding in fun activities, like helping my friend work concerts in Wilmington. Turns out that all of this time off had started to agree with me after all! The night before I was to return to the world of the working, I had major doubts and found myself wishing I was independently wealthy so that I could structure my time exactly how I pleased. It didn't help that it was I had to wake up before 7 AM and it was damned cold out and the days were more cloudy than bright - always a mood depressant.
The first day back I didn't eat or drink enough. Not by a long shot. However, I turned to my old friend technology for a solution and set daily alerts on my Outlook to remind me to do so. If someone had told 2011 me that I would have to be reminded, even forced, to stop to eat every day, I would have laughed and pinched myself to see if I was dreaming. My energy level stayed good all day and I got a lot accomplished, catching up with almost all the backlog that I had missed over the last month. I felt propelled forward by the kind, welcoming words of several coworkers, including one that I had in the past sensed had an aloof attitude towards me, which was a very pleasant surprise. Receiving a brightly decorated large envelope in the mail the previous Friday had also been very motivating, as it contained hand-drawn cards from one of the 1st grade classes in it. One favorite message said that a student loved me "like a teacher", assumedly to point out that there would be no hanky-panky. My sister and I laughed a long while over that. By the end of the day I was a bit worn out and planned to go straight home for a snack, some water and a nap. I surprised myself by instead turning into the packed gym parking lot and spending 40 minutes on the treadmill. The following afternoon, while in the same frame of mind, I put in another 60 minutes. It was really starting to seem like I could handle this!
By the end of my first week back to work, I was fully back in the swing of things. However, it seemed like I was starting to have a grumpy pouch on my hands (more accurately, in my abdomen). Nothing tasted good or was mentally appealing. Hot things were too hot, cold things were too cold, and room temperature liquids tasted bad. It was becoming a real chore to eat and drink. The thought of even looking at another chewable vitamin made me want to curl up and cry in a corner. I had also had no weight loss since the 19th, which was very vexing. From frequenting the forums on ObesityHelp.com, I knew that these feelings and the likelihood of stalling out from time to time were completely normal, so I took some small solace in that knowledge. By the 27th I was getting very weepy at the oddest times, which I reasoned was probably the consequence of the OC building back up in my system and hopefully from having estrogen flood my system as fat cells were being released. I predicted a restart to the weight loss in the next few days and, on the 30th, was rewarded for my patience by a 3 pound drop. Thankfully, reason and logic had prevailed and I had managed to get through the last 10 days without a frantic "am I broken" call to my surgeon's office.
Upon checking in for my 6 week post-op appointment, I was informed that all appointments up to 90 days post op are no charge, which I think is a great policy, especially for those who might have complications and need more care.When I went back to weigh in, I found that I had lost 35 pounds since getting out of the hospital, which averages out to just under 6 pounds/week. Put into perspective, everything seemed pretty good. Dr. Murayama said I was doing great as far as all things medical were concerned, and that I should return at the 3 month mark for another follow up and to have my first set of labs drawn. The thought of this tickled my left brain, as I love data. I knew that I would soon be researching what each result meant, as well as its numerical value. However, the most exciting part of this appointment was verifying a few facts that I already suspected to be true, namely that I could now eat without category or texture restriction as tolerated, that I could do exercise of any kind as tolerated, and that I could switch from chewable to regular vitamins in just 2 more weeks.