I Should Be Doing Math....

But I don't want to right now.

I just got back from my appointment with my doc in Kansas City.  He took my blood and pee and x-rayed my knee.  Now I just have to wait for them to call me and tell me the results.  I swear to god he's my favorite doctor ever.  He asked how things were going and after expressing that I was too fat for the chairs in the waiting room, I told him I was bursting with self hatred.  He's seen me struggle with getting my weight down and is even keeping my thyroid levels slightly too high in an attempt to help me lose it.  Alas, it hasn't worked.  I asked him to write me a letter to give to the bariatric center so they could give it to my insurance company.  I also asked him to use the word 'plight' since it sounds cool.  So here's the letter:

Tiffini has been a patient of mine for close to 10 years and has struggled with thyroid problems, hormonal problems and weight problems.  she has tried every diet there is and still suffers from the plight of obesity.  She has combined weight loss programs, exercise programs and treatment with thyroid hormones and still doesn't lose weight.  She had a hysterectomy about a year ago and has gained 135 lbs since, despite diet changes, exercise and taking 5 grains of thyroid daily.  She has developed osteoarthritis in her right knee and ankle stemming from what would have been a minor injury had it not been aggravated by her weight.
As a rule of thumb, when approximating what a patient should weigh, I give everyone 100 lbs for 5 feet tall and then add 6 (small female), 8 (large female, medium male), or 10 (large frame male) pounds per inch.  At 5'6" that would make her ideal weight in the range of 136 to 148 lbs.  At 315 lbs, she is between 2 to 2 and a half times that figure.
She is looking forward to early adult onset diabetes, knee replacements, cardiovascular morbidity events and a whole lot of expensive medical procedures.
I think it would be in the best interest of this young lady to pursue bariatric surgery as she has tried everything I know available.

So now I need to get this letter to the insurance chick at the bariatric center.

Oh yeah, I also went to my first fat class last Wednesday.  Nathan hates me calling it fat class, but self deprecation suits me right now.
The nutritionist, who is just adorable, taught us about the deception of food names, like Wheat Thins and what not.  Using the words all natural, thin, organic, blah blah blah.  I already knew that.  She was like, "there are always fads.  That doesn't make them right.  First it was low fat, now it's low carb, which makes me laugh.  I'm predicting the next one will be low dairy.  We'll have to wait and see if I'm right."
She taught us the finger method.  Vitamins A and C, iron and calcium are required on all labels, even if it says "not a significant source of....."  If the daily value for each is at least 10%, you raise a finger.  Then you look at protein.  If it has at least 5 grams, you raise a finger.  Next is fiber, and if you have at least 10%, you raise a finger.  Next is sodium.  If it's under 300 g, you can keep a finger up, but you don't get to add one.  If it's over 300, you lose a finger.  The last one is a choice between fat and calories.  The nutritionist says she likes to go by fat most of the time.  If the total fat content is 10% or less, or it's under 200 calories, you keep a finger but can't add one.  If the fat is over 10% or over 200 calories, you lose a finger.
The idea behind this is, after surgery, the amount of food you can eat is severely limited, so there's no room for empty calories.  You have to eat things that are nutrient rich.  So, if you evaluate your label, and you have any less than 2 fingers remaining, your food is shit.  You HAVE to have AT LEAST two fingers.
She said everybody goes home and checks their cupboard after this lesson, and sure enough, Nathan and I started plowing through.  My Chewy granola bars get zero fingers.  Surprisingly, Nathan's pop tarts got two fingers.  (One of the slides she showed us was comparing Kellog's pop tarts and organic toaster pastries.  The organic had zero fingers, and the Kellog's had two, so beware of shit that is organic, it's not always best.)
We also found that my protein shakes get 2 fingers, but I can add a finger for the almond milk I put in them.  Nathan's goddamn Ovaltine gets 4 fingers, without the milk!  I was pissed.  Aside from unlabeled fruits and veggies and meats, the fucking Ovaltine was the most nutrient rich food in the cupboards.  Even the lentils only had 3 fingers.  Duh.  It kinda forces me to look at food differently.  I don't like snacking on carrots and fruit and whatnot because I never feel full, so I end up eating crap in addition to anything good.  After this surgery I'll actually feel full and satisfied by good stuff.
The class gave me a little bit of hope, but not enough to make me completely optimistic.  I have this fear that something is going to get in my way and I won't be able to have it done.