The Fix.

Are you an addict?  Do you need a fix?

Addiction is essentially a compulsive dependence on a behavior (e.g., gambling) or substance (e.g., caffeine) that persists despite negative consequences. A hallmark of addiction is denial (‘I can stop anytime’); thus you must recognize that there is a problem before you can begin to address it.  Battling that addiction is tough. The habit is merely a symptom of the psychological condition. By definition, an addict is vulnerable, so it is easy to see why it is common for a recovering addict to transfer his addictive behavior to other parts of his life, sometimes without even realizing it.  This is ‘replacement’ or ‘substitute’ addiction, also called “switching.”

A dear friend of mine is a recovering drug and alcohol addict. She said that in rehab, they told her that the most common substitute addictions are sugar and sex, but they may also be exercise, work, smoking, dieting, overeating, drugs, shopping, cleaning, or a host of other activities. It’s still addiction. Even if the substitute is not in itself a bad thing, like work or exercise, it is clear that spending an excessive amount of time working or exercising can be harmful. You’ve changed the outward manifestation of your addiction, but you’re still addicted. You may not know it, but the people around you probably do.

I’ve known people who choose not to drink because their parents were alcoholics; their drug of choice is food, specifically sugar. One of my acquaintances quit drinking hard liquor and now only drinks beer. And we all know ex-smokers who gain weight because they eat candy instead of smoking. They simply replaced one habit with another – and that is not recovery. Your brain still craves the reward, the ‘high’ of whatever you did to satisfy the craving; it’s just finding another way to get the fix.

So let’s bring this closer to home. After a lifetime of obesity/food addiction and unsuccessful, yo-yo dieting, you have weight loss surgery. You have changed your eating habits; you are losing weight and getting healthier. However, you now smoke twice as many cigarettes as you used to. Or now, under the guise of ‘celebrating’ your weight loss, you max out your credit card at the mall. Or maybe you have become obsessive about working out. Or you become overly flirty and promiscuous in an effort to demonstrate your attractiveness. Or you become preoccupied with proving something at work, becoming an overachiever or workaholic. Or you spend countless hours online.

Whatever your replacement addiction may be, legal or not, it is like a rebound after a romantic breakup – it is a short-term, feel-better coping mechanism. It helps you escape the downside or negative consequences of your behavior. At best, it may not be harmful, but at worst, it certainly can be.

The problem is not the activity itself – it’s the obsession.

The need.
The craving.
The dependence.
The preoccupation.

So what can you do about it? Well, recognizing that you’re switching is a good start. Then you must realize that you need help dealing with it. Help might mean behavioral therapy with a professional. It might be a 12-step program, counseling, or a support group. It might be developing other ways to deal with the stresses in your life or adopting new pastimes. It might be as simple as enlisting friends and family to hold you accountable or to help keep you away from challenging situations.

To me, it proves that I can’t do this alone. Left to my own devices, I would substitute one thing after another after another. For years, when I dieted, I would smoke more; when I tried to quit smoking, I’d eat more. When I finally quit smoking for good, I gained a lot of weight. Now that I’m not overeating, I find that I’m shopping more and spending more idle time online. (I’m also writing more, but I think that’s a good thing.) I have to be very careful not to let the habit gain the upper hand because I know it can easily happen.  My brain still wants that fix.

I’ve come to the understanding that my obesity was not just about food. Facing myself and overcoming my compulsive behavior takes a lot of work and a lot of time. The key is in finding the balance in your life. You want to cultivate productive, healthy habits and behavior but not form detrimental attachments to them. It’s tough. I’m glad that Mr. Stuck and I are working on this together. I’m grateful to every one of the people who come to the same WLS support group we attend, because their insight and encouragement is what keeps us coming back.

I’m not a psychologist or counselor. I offer neither authority nor expert opinion on addiction. I know there are people out there in much worse situations than I, and I do not mean to downplay their struggles toward recovery. I just want to acknowledge that an addict doesn’t have to have a needle in his arm or a bottle of vodka hidden in the bathroom cabinet. It could be the guy on the treadmill, the boss who stays late every night, or the woman next to you with the Diet Coke.  It could be me.

Or it could be you.

 

For further reading on this subject, check out the book Eat It Up! The Complete Mind/Body/Spirit Guide to a Full Life After Weight Loss Surgery by Dr. Connie Stapleton, a licensed psychologist and certified addiction counselor.  Eat It Up! shows you how to create and maintain balance in your life and helps you on the journey to your well-being.  In addition, Dr. Stapleton is the ‘Doc’ to Cari De La Cruz’s ‘Post-Op’ on their Facebook page, A Post-Op & a Doc, where you can find wit and wisdom and lots of support.  Check them out!

 

photo credit Alan Cleaver

 

 

And How Was Your Week?

Finally.

So last Tuesday, the 10th of December, I went in for my surgery.

We reported in at just after 7 a.m.; actually, I was standing just inside the building near the reception door waiting for Mr. Stuck to take care of the parking fare when the check-in desk called to ask where I was.  I had been standing there a few minutes already, watching him through the window, but I hadn’t checked in because I was pocket-less and he held my ID and insurance card.  Eventually man bested machine, and then he was standing next to me, handing her my driver’s license.  We finished our paperwork and had just found a seat in the waiting area when they called me to prep.

At prep, all of the normal things happened: I was fitted with my bracelets, I changed into my hospital gown and non-skid, unisex tube socks, I settled into the gurney with a blanket (a heated-air blanket, even!) an IV was started, and my surgeon stopped in.  In between, I met several nurses, a nurse-anesthetist, my anesthesiologist, a patient care technician or two, and the assisting doctors.  I also said and spelled my whole name several times and confirmed my birth date to anyone who asked; in the fray I was also answering questions, the same questions I had been asked and had answered before: who is your doctor?  what is he going to do?

I remember being rolled out of there into an elevator and then into the operating room.  The last thing I remember is a nurse talking to me after emptying a syringe into my IV port and putting a mask on me, but even that’s a bit fuzzy in my mind.

Not me. photo credit Zdenko Zivkovic.

I guess it took me awhile to wake up; I was two hours in recovery before I was brought to my room and Mr. Stuck was allowed to visit.  Sure seemed warm in the room; I kept kicking off blankets and requesting ice chips and cold washcloths for my forehead.  No fever, but I was just too warm.  Besides my pain control IV, I was hooked up to a couple of monitors as well as oxygen, because my O2 level kept dipping.  My respiratory rate is slow and always has been, and the monitor didn’t like that at all.  Periodically, the respiration monitor (whatever it’s called) would go off because I wasn’t breathing fast enough and it apparently thought I had stopped.  No, I was still breathing, just at my own, slow, pace.

Each time I hit the button to get more hits of Dilaudid, a cycle began:  the narcotic entered my bloodstream; I would relax and drift off; the alarms would sound as my respiration slowed and my oxygen dipped; I would wake with a start and sharp inhale;  the monitor, assured I was again breathing, would go silent (most of the time), and with my muscles tense and heart pounding I would again feel the pain and need the Dilaudid.  Over and over and over this played out. The oximeter’s alarm was about four times louder than the respiratory alarm and sometimes the alarms wouldn’t cancel once my stats came back into their ‘normal’ zone, and I would have to wait for a nurse to silence them.  This went on from the time I came back to my room until after 2 a.m. — about twelve hours!  It was awful and it just wouldn’t stop.  If the nurses were getting tired of the routine, and they were, you can imagine how I felt.  When they called him, the doctor told the nurses that I was exactly the type of patient who needed those monitors on.  I’m sure he’s right, but it was a long, sleepless night.

Around 2 a.m., the doctor allowed the alarm to be turned off on the respiration monitor as long as they got me a better cannula (the nasal oxygen tube) so my oxygen saturation would rise.  Thank the Lord.  I was able to get a few hours of shuteye until the resident doctors made their rounds some time around 6 a.m..  But at least I finally — finally! — got some sleep.

OLYMPUS DIGITAL CAMERA
It’s me, but the pic’s a few years old.

It took a long time the next day to get discharged, but we finally did, and we made it home after stopping to pick up my prescriptions.  I suddenly took very cold and started to shake; even my teeth chattered.  I had been so overheated in the hospital, but now I was freezing!  This was the anesthesia talking.  Mr. Stuck tucked me into bed with extra blankets and got me my medication.  My belly was bloated and sore; I just wanted some rest.  After a few hours, I awoke to rejoin the family.

I’m glad everything went so smoothly for my surgeon; apparently, chaos reigned (rained, too) at home. Bo, the Epileptic Chihuahua had suffered a couple of seizures. Number One Son ran his car out of oil. Number Young Son’s car has to quickly be rendered safe and drivable to give NOS a way to work. Mr. Stuck’s truck has been inoperable for several days, waiting for a special tool, because it is leaking fuel.  But these are not things for me to worry and kvetch on; my job is to rest and get better.

Today, four days after surgery, here’s what I know:

  • Although at first disappointed that I didn’t get a heated-air gown, I found that the heated-air blanket is just as good.
  • I have five neat incisions from an inch to an inch and a half long on my belly, which is still a little sore inside.  No tape, because I’m allergic, but all 5 healing nicely.
  • I am still burping from a lot of trapped air (‘scuse me), but I am not so bloated now, and I am sleeping well.
  • I’m not hungry, but I am thirsty, so I am constantly sipping small amounts of fluids.
  • Last night I didn’t need to get up and take pain medicine at all during the night.  Yay!
  • I am tolerating strained soup, protein shakes, tea, jello, and water just fine.
  • Mixing ground-up prescription pills into your food and drink is worse than nasty, and I will stop doing it the very moment I can.  Bad memories of marshmallow creme and crushed aspirin came flooding back.  Mr. Stuck says Actigall is worse than anything I’m taking.  I’ll take his word for it.
  • Omeprazole is my new best friend.  After the couch and the heating pad, I mean.

And now, if you’ll excuse me…

liquids
a few of the things on my nutrition pyramid these days.