The idea of returning to work filled me with dichotomous emotions: a sense of joyful anticipation at seeing friends and doing the job I love versus and irrational trepidation figuring out how I was going to eat during my busy work day and how I might feel. In the previous eight weeks while recovering from surgery I had done exhaustive searches of the internet, learned useless facts and watched countless videos while healing from my surgical wounds all while learning how to eat again. My seventeen year old daughter was barely home, entertained by her friends, freely mobile with a car of her own. As she had little need of my assistance on a daily basis, apart from my making dinner, doing laundry, and cleaning the house, I spent most of my days recuperating from surgery alone. I journeyed out of the house for the occasional lunch with friends and shopping, but the majority of my days were spent in solitude. I felt all this time my daughter was giving me for self reflection was actually really her forcing me to prepare for her eventual departure to college. It will be a slow wean, as she prepares herself for the flight she will take, leaving me with a truly empty nest.
I was excited to return to work. To see friends. To do something other than mill around all day in my PJs. Granted my solo time was not a complete waste. I worked on a novel—which is half way done— this blog, and began oil painting again after a six year hiatus. I adopted a philosophy of “doing things now” instead of “do it tomorrow.” I’d spent years in the latter category and because I was faced with the possibility of an early death, not knowing how many more tomorrows I might have, I decided to make the most of the ones I get. It’s not to say that any of us get guaranteed tomorrows, but given my recent cancer scare, I don’t want to waste any time. Besides, no one will ever look back at the videos I watched on the internet and think of me, but they might look at my paintings and read my works and remember me.
As I prepared myself for my first day back to work, my main worry and focus was on food. My entire life revolves around it now. Not to say that other people don’t have to worry about food, because they do, but my eating schedule has to be more regimented. Failing to to keep to the schedule means I get behind and when I fall behind on calories, I lose weight. So I carefully packed a sundry of snacks and meals I felt would get me through the day. I had a game plan set out and how my day would go. The plan failed within minutes of setting foot in the building.
When I walked into our small office I was engulfed with love and support. Questions of “how are you doing?” were interspersed with compliments about how “well” I looked. While it is visibly obvious, the people who knew about my saga rarely commented on how thin I looked. However, when I was rounding on the floors, the nurses and staff who didn’t know what happened, the weight loss was the first thing they mentioned. They would say, “Doc! Where have you been? You’ve lost weight!” Some I would tell what happened, other I would say I had a surgery and because of that I lost weight. Everyone was empathetic, caring and supportive. But at the end of the day the comments of you look well that came from my colleagues can be paraphrased to mean, “Damn girl! You lost some serious weight, but you don’t look as sickly thin as we thought you would, so its all good.” It was very nice of them to dress up the obvious in a nice compliment, not pointing out the fact that I had lost over 10% of my body weight, which was made even more evident by the fact that I was a thin person to begin with.
Over the course of my first day back at work, my tale of the last few months became a concise streamlined story as I repeated it several times. All the while, my plans for eating were completely derailed. Fortunately, I had a small patient load, but I still fell behind with eating. It was inevitable and expected. However, once you fall behind with eating, its nearly impossible to catch up.
As a hospitalist, I work seven long days in a row and have seven days off. As the work week went on I altered my eating plans. I had to restructure my day completely from how I had done it before the surgery and all of it based on when I had to eat next. Initially, I thought my adapted plans were solid, but some days I found I hadn’t packed enough food, which left me no choice other than eating at the hospital cafeteria. I will say this for the record, while most hospital cafeterias don’t have the most stellar reputations for their food, our cafeteria leaves much to be desired, even in the hospital food category. The options are limited and the portions are far to large and saltier than sea water. Not only that, before my surgery the cafeteria food gave me GI distress, which usually exited my body in the form of toxic fumes. These fumes post surgery have became even more toxic and almost visible to the naked eye. Therefore it has been my preference to bring all the food I eat, but often I found myself at the mercy of the cafeteria, looking for anything to provide me calories while being somewhat palatable.
At the end of the week, I thought I had done well. I felt I had adapted my original plan into a functional, sustainable one. I was exhausted, but I was happy to be back at work. I was happy to have my day filled with something productive to do and to have human interaction again. I was able to put the miles in several miles per day walking around the hospital and I was able to stand for long hours talking to patients and families. I even took the stairs like I did before the surgery without any issues. I had been walking in the neighborhood in the two weeks before my return to work in preparation for the long days. So it came as a great surprise to me when I weighed myself at the end of my first week back at work. I had lost 2 lbs. I went from 117 to 115. I had been hitting my daily calorie goals and at work had been walking similar distances as I had practiced at home. The only thing I hadn’t accounted for was the stress of it all. I lost 2 lbs of stress weight. It made me think of when people say they stress eat. I always figured people ate because it made them feel good stimulating the pleasure centers of the brain. Now I’m starting to think they were actually eating because they needed it. Now that I was back at work and had the stress of my job to deal with, I needed to figure that into my calorie goal equation. As I finished my second week back at work, I added stress calories to my plan. This week I only lost 1 lb. This next week off, I need to fatten up a bit so I have a little to lose when I go back to work this next week, accounting for the stress.