Month: February 2017

WLS Chronicles – HELP!!!

On By mrsjmejonesIn Weight Loss Surgery2 Comments

There are a ton of resources for weight loss surgery.  The FIRST one you should listen to is of course your medical team.  But once you’re not at the physician’s office – where do you turn?  It was (and is) a combination of things for me, so I thought I’d share.

APPS

  • Baritastic – This is a great food journaling tool.  You can also set reminders here for taking meds, for drinking liquids/proteins, and for taking vitamins.  I hear that some doctor’s will be integrating with it in the future so they can receive your activity and monitor while suggesting/commenting on your habits/choices.  I think that would be WONDERFUL.  Accountability is an amazing tool.
  • Monitor Your Weight – This is a very simple app that tracks your weight.  You enter your starting weight and target weight (height, age, gender) and it provides BMI info.  When you weigh, you log your stats and it calculates your new BMI, pounds left to target, how much you’ve lost…etc.  VERY simple but the graphing and info is probably my favorite of all weight loss apps (and I’ve tried SO MANY!)
  • BariatricPal – This is more of a forum-based app that connects you to others going through the same experiences.  To be honest, I didn’t use this one much as it has SO MANY members and forums that it was overwhelming for me.
  • Lose It – I have used this app for years.  The free version is pretty simple and great for food journaling and weight tracking.  Personally I used this one for a while until I found Baritastic and just found that it served the purposes of tracking protein better for me.

There are tons of other apps but the above are the ones that I found worked for my journey.  In addition, many surgeons have their own app as well with recipes and tips!

 

SUPPORT

  • My number one support was prayer.  Knowing that I was praying for God’s will to be done in my life and my health has helped me more than anything else.  When you are submitting to His will, you are not praying to lose weight or to be approved for the surgery…you are praying for God’s will be to revealed in your life.  You are giving it all to God and, in doing so, knowing that He will equip you for the journey He sets you on.
  • Support also came in from my family in a huge way.  My husband and I talked at length about this and we prayed together too.  My parents and my in-laws all were rooting me on.  My kids were all excited about their Mom feeling better and ready to help however they could.  My closest friends knew I was going to start the process and were with me all along the way.  It has been wonderful to have cheerleaders in this process.  I can’t imagine having someone be negative about this decision (to my face).
  • A very unexpected resource for me was Instagram.  I was up late one night and decided to search “#weightlosssurgery” and “#gastricbypass”.  I was AMAZED!  Other users were sharing what they had eaten on different phases of the pre and post op diets…they were sharing their solutions for pain/pressure/loneliness/protein.  It was ALL just what I needed.  I quickly created a separate account for this purpose and am still very active in it.  (My username is:  rnyftw – follow me to see what I’m eating or how I’m progressing!)
  • A recipe source OF COURSE was Pinterest.  I don’t even think you can say the word “recipe” without thinking of Pinterest anymore!  You can search by the type of surgery or the phase of diet you are on.  I created my own post-surgery board so I could easily pin to it.  It was very helpful.
  • There a zillion blogs on weight loss surgery.  The one I found the most helpful was The World According to Eggface.  She is 11 years out from her surgery and has been amazingly successful.  She offers pics of her “bento box lunches” and recipes galore.  She is the creator of the famous “ricotta bake” that SO many of us enjoyed during the pureed phase of life!  She also includes any tools/appliances that she acquired before or after surgery to make life easier and that helped me so much!  (BUY A MINI FOOD PROCESSOR, TRUST ME!!!)

I hope the above list helps know where to turn if you have questions, need inspiration or need to vent.  The combination of all of them have helped me through this journey more than I can say!

 

WLS Chronicles – Emotions

On By mrsjmejonesIn Bariatric, Weight Loss Surgery3 Comments

Something I think is not talked about enough is the emotional toll that weight loss surgery can take on someone.  The doubts, the stress, the WORK…it is all so much.  I still say (8 weeks out) that it is ALL worth it.  I’m just saying, that there is a lot of “it”.

It starts before you have surgery, when you are deciding.  When you’re evaluating the work, the cost (again, praise God that I was able to benefit from this w/ zero out of pocket), the time, the sacrifices, the changes – all those things that make up this journey – your brain is on overdrive.  You are researching, talking to friends, to people who have had the surgery (and bonus if those two previous sets are the same people), talking to doctors, feeling your family out to see how they would react….you’re talking to YOURSELF, wondering is this the answer?  You doubt.  You worry.  You think people will think “you took the easy way out”.  (Spoiler alert:  Some do.  You start to care less when you realize how WRONG they are!)  You worry it won’t be worth it.  (Another spoiler:  It is.)  You fear the pain, the judgements, the structure…the sacrifice.  You wonder if you can really do it on your own.  These thoughts really haven’t ended for me, specifically.  There are days that I feel on TOP OF THE WORLD…so happy and healthy and have no fear.  There are days that I can barely get out of bed because my tummy is in pain, I can’t even THINK of eating another bite of ANYTHING, and I fear dehydration.  There are days that I get tons of compliments and still go home and cry because I feel fat.  There are days that I post a picture on Facebook…get 100 likes…and notice that one person in particular hasn’t liked it and it makes me self-conscience.

When I say it’s the hardest thing I’ve ever done, I’m not exaggerating.  I’m not being dramatic.  Knowing that the eating habits of my past are just that….my past, knowing that sometimes it means I’ll be left out of things…knowing that people are judging me…knowing that my family’s eating habits have had to change…knowing that I can’t rely on food to comfort me (seriously, that’s a thing!)…IT.IS.HARD.  There are so many things that you don’t think about this affecting.  So many ways it changes you.  So many ways it shifts your priorities.

I’ll say it again…….it is so worth it.  My family is worth it.  Growing old(er) with my hubby is worth it.  Saving damage to other organs (from meds for diabetes & high blood pressure) is worth it.  I am worth it!

WLS Chronicles – Post-Op Diet (Days 4 -13)

On By mrsjmejonesIn Bariatric, Weight Loss Surgery1 Comment

On around Day 3 or 4 after surgery, things get exciting!  You graduate to a Full Liquid Diet.  This is particularly exciting because it includes Strained Low Fat Cream Soups.  You will never realize how much you love these until they are all you have!  🙂  For this phase you can have all of the things from Days 1-3 with the addition of:

  • Low fat skim or 1% milk, soy milk, almond milk, Lactaid
  • Strained low fat cream soups
  • Low sugar low carb protein supplements

I was so happy!  I used Fairlife fat-free milk to make my soups to fortify them with protein.  This milk has 13 g of protein in a cup (and only 6 g carbs) so it was a great choice (and still is) for me.  It tastes great too.  I made my soup on the stove top so that I could be sure it wasn’t lumpy….strained it twice to remove any meat, lumps or veggies…and then separated it into 2 ounce servings that would be ready when I was.  My favorites were Cream of Chicken, Cream of Asparagus and Cream of Mushroom.  It was just nice to have something different at that point.

The schedule is the same – protein at the top of the hour (2 oz, taking 15 minutes to consumer) followed by hydrating liquids (2 oz per 15 mins).   A large part of the day is spent prepping, and when you are not prepping you are SIPPING!  It is like a job.  I was constantly sipping something, recording it in my journal, warming up soup, or some combination of those things!  It. Was. Exhausting!

WLS Chronicles – Post-Op Diet (Days 1 -3 Clear Liquids)

On By mrsjmejonesIn Bariatric, Weight Loss Surgery1 Comment

One of the questions I get the most (after the dreaded, “How much have you lost???”) is “what do you eat?”.  That answer has changed over the last seven weeks, dramatically!

The first three days after surgery are ALL about sipping.  The diet is ALL clear liquids.  The focus in on hydration and protein.  One of the biggest concerns after weight loss surgery is dehydration, and this fact is really driven home by all medical staff at the hospital, at the Dr’s office and from the weight loss community – so I took heed.  The goal for hydration is 64 ounces a day.  Here is a sample of the suggested hydration liquids:

  • Decaf Coffee or Tea (Splenda, Equal, Truvia & Stevia are allowed)
  • Clear Fruit Juice (Diet or Sugar Free)
  • Sugar Free Jello
  • Sugar Free Popsicles
  • Chick, beef or vegetable broth
  • Water
  • Sugar Free, Non-Carbonated beverages (Crystal Lite, SF Kool-Aid, SF Lemonade)
  • Vitamin Water Zero
  • Mio drops
  • Dasani flavored water
  • Skinny Water
  • G2

You also have to focus on protein.  For days 1-3 the list of protein (in liquid form) is pretty short.  The goal is to get 60-80 grams of protein in a day (for my surgery).

  • Nectar Protein Powder
  • Health Wise high protein fruit drink
  • Cytomax
  • Healthwise Bouillon
  • Isopure Liquid
  • New Whey 42
  • Healthwise Sugar Free Protein gelatin
  • Unjury chicken soup

For me, the list was pretty disgusting too!  😦  I was NOT a fan of most protein drinks.  Also, your taste changes from the pre-op to the post-op period.  I was fine with the Isopure drinks prior to surgery…but after…ugh!  It made me nauseated to think of sipping on that!  I LOVED the Unjury chicken soup.  It was wonderful since most of my hydrating liquids of choice were “sweet”.  I craved the savory and it satisfied!

The SCHEDULE is the hardest part of this.  The easiest way to explain it is to think of a clock and break it up into 15 minute increments.  From the top of the hour until 15 minutes past, you are sipping on your protein liquids.  From 15 mins past the hour until 30 mins past, you are sipping on your hydrating liquid.  From 30 mins past the hour until 45 mins past, you are sipping hydrating liquids.  Finally, from 45 mins past the hour until the top of the next hour, you are sipping on hydrating liquids.  EACH 15 minute interval you should consume 2 ounces of liquid by SIPPING slowly.  You start over at the top of each hour, so that each hour you are having your protein first.  You are literally sipping every minute of the day, if you’re doing it right.  This stressed me out so much!  I didn’t feel like I could rest at all because I was worried about dehydrating and not getting my protein in!

Again, I missed chewing and I missed my life not revolving around sipping but STILL WORTH IT.  I went into this on diabetes and high blood pressure meds and I stopped them the day before my surgery.  Have not had a blood sugar level over 105 and my blood pressure is normal, if not low, at all times!  Praise God for this opportunity to be HEALTHY.

I found it most helpful to write everything down.  I kept a notebook detailing what I drank, how much and what time.  It was the only way to stay on track and not forget where I was for the goals I had (64 ounces of hydrating liquids, 60-80 g protein).  Here’s a snapshot of one of those days (this was during the next phase – full liquids):

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I also measured everything out (2 ounces at a time) in either shot glasses, small Dixie bathroom cups (they are 3 ounce, so you have to measure liquid before), or clear plastic mini cups (they are 2 ounce – PERFECT) with lids.  You don’t want to chance gulping from a large cup or serving and it helps to visualize as you are drinking.  I remember thinking “Okay, it’s 7 minutes after, I should be halfway done…” and it really helps when you are trying to do everything by the book.

Next post will be from the next phase of diet!  The FULL LIQUID phase!

 

 

 

 

WLS Chronicles – Surgery Day!

On By mrsjmejonesIn Bariatric, Weight Loss Surgery1 Comment

My surgery date was December 27, 2016.  It was two days after Christmas….two weeks since I’d eaten anything “bad” for me….even longer than that since I had a soda.  I was mentally ready for this and was beyond ready for my physical body to match my mental state.  We had to be at Wake Med (in Cary) at 8:30 am.  Once I got all checked in, things moved pretty fast.  I have ALWAYS had a hard time with getting an IV started (it took SIX sticks, a fancy machine to show them my veins and four nurses to do the one for my hernia surgery!) but this time it was like magic!  Off to a good start!  🙂

I was so afraid I would be super anxious but I was pretty calm.  I know there were many praying for me and I am confident that it made the difference.  In the presence of Jesus, there is PEACE and it was mine that day – believe it!  I remember them wheeling me back and talking to the anesthesiologist and saying, “I’m not asleep yet!!!”  as if he did not know!  🙂  The surgery was pretty routine, according to my Dr and the surgical notes with their $900 words and phrases!

In the recovery room, I was very groggy and just wanted something to drink.  They brought me water and meds and I was taken pretty quickly to my room.  (It’s usual for a gastric bypass patient to stay one night in the hospital…I was SUPER worried about how I would feel so I had even inquired about staying up to three nights!!)

Once I got into my room, I felt very at ease knowing the surgical part was over.  The nurses were GREAT…my sweet hubby and my parents were right by my side.  (My in-laws were on MJ duty.)  I sipped on liquids and honestly did NOT feel a ton of pain.  That night, I even got up to walk the hall a bit.  I made sure to do it right after a dose of pain meds so that in case I started hurting, I would not be chasing the pain.  Walking was fine.  The only nuisance was that I still had a catheter so dragging that around was just annoying.

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I slept as much as possible that night (as much as one can in the hospital) and Mike stayed with me.  At 6 am, they removed my catheter (JOY!) and I was determined I was going to go home that day – I was feeling great!  I walked SEVERAL times and felt really good each time.  I didn’t have to take any more pain meds at that point and I sat up a good part of the morning.

The Dr came by after lunch and I let him know that I was SO ready to go home and he agreed!  Yeah!!!  I left the hospital around 3 pm.  I was ready to get home and get on with the recovery and figure out all the planning and sipping that was ahead of me!

Personal tips –

What to pack?  My surgeon and hospital team advised me to bring my own liquid protein, so I did.  (Isopure)  Phone chargers, iPad/tablet, books/journal, picture of family, chap stick, Gas-X strips (they pump your abdomen full of air – it will get trapped – it HURTS), brush/makeup/lotion, your own socks/slippers if you don’t like the BEAUTIFUL ones they have at the hospital…the slippers help when you are walking the halls!, mouthwash/toothbrush/toothpaste, pillow, robe.

 

WLS Chronicles – Pre-Op Diet

On By mrsjmejonesIn Bariatric, Uncategorized2 Comments

Let me start by saying, every individual is different.  Every surgeon is different.  If you are reading this and you are on your journey to weight loss surgery, ALWAYS ALWAYS ALWAYS listen to YOUR surgeon and medical team.

My surgeon instructed me to start a “liver reduction diet” two weeks before my surgery.  The purpose of this diet is to make it easier for the surgeon to move your liver out of the way so they can focus on your stomach during surgery.  The first week of the liver reduction diet is made up of a daily diet of 2 bariatric protein shakes, 2 bariatric snacks (crisps or bars) and one meal of lean meat and green veggies – NO/LOW carbs, NO caffeine, NO sugar – and 64 ounces of liquids.  I started on December 13th and this part of the diet was not THAT complicated or difficult but that one meal a day was CHERISHED let me tell you!

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Hamburger Steak, asparagus, green beans and a pickle!

The second week of this diet was very simple.  Five bariatric shakes a day.  Only that.  No solid foods, no snacks, no cheating.  This was HARD.  I missed chewing.  I missed real food.  I could still have hydrating liquids and that included sugar-free popsicles so they were my jam.  They still are.  Yummy.

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My protein shake – Bariatric Advantage Cookies & Cream

The liver reduction diet requires planning, willpower and commitment.  Basically this sets you up for success after surgery as well.  It also gives you bad breath, low energy and dry skin!  By the last few days, it was all I could do to get those shakes down.  The last day, I think I only drank three.  There was just no way.  I was tired of them and just tired in general.  Keep in mind that on Christmas Eve and Christmas Day I was on liquids only.  My family was so kind and understanding and did everything they could to make things easier on me.  During this time I still cooked for my family and was around food…I knew that it was going to require me to keep doing that after my surgery so I figured I should start learning to resist temptations!  Easier said than done but I did it!

Twenty-four hours before the surgery, I had to stop all red and purple liquids.  That means only orange sugar free popsicles!  🙂  As usual, nothing to eat after midnight the night before surgery.  My surgery was scheduled for 10:30 AM so I had to be there at 8:30 AM.  I was so beyond ready.  Prayer helped me so much here.  I felt a peace that I couldn’t have come by alone.  I was ready.

WLS Chronicles – Pre-Op Testing

On By mrsjmejonesIn Bariatric, Weight Loss Surgery1 Comment

Unrelated to weight loss surgery, on August 16th I had a colonoscopy and endoscopy.  Since I was having pain that we thought was associated with endometriosis on my colon, Dr Tyner wanted to check out everything to ensure we weren’t dealing with a bigger issue.

The first pre-op test that I had was on August 22nd at Central Carolina Hospital.  It was my Upper GI/Ultrasound/Chest Xray) tests.  This was pretty high on the list of the easiest appointments I had on this journey.  No eating after midnight the night before.  Arrive at 8 am.  They did my chest x-ray, the ultrasound and then the Upper GI.  Drinking the liquids for the upper GI was the worst part…but it was over very quickly and I was on my way!  I did, of course, worry that I was going to have some defect that I never knew of.  Whew.  Worry is evil, y’all!!  I also worried that I was going through all of these things and would still get denied by my insurance for the surgery!  **In case I have not mentioned or you do not know…you go through ALL THE PRE-OP testing and THEN they submit your information for final approval to your insurance company.  There are NO guarantees that they will approve it!

On August 30th, I went to the office to pick up my remote sleep study materials.  I was SO thankful that I could do the test from home!  It was the first one I had done but knew of many people that were required to use the sleep clinic’s facilities to sleep in – and I knew I’d get NO sleep!  The instructions were very clear and easy.  Basically you have monitors around your chest and abdomen as well as a monitor that fits like a tiny oxygen tube in your nostrils. I did it that night and just had to take the machine back to the office the next morning for them to read the results.

I had my stress test, EKG and Deep Vein Thrombosis screening on August 31st.  The EKG and DVT were NO big deal…and were surprisingly stress free.  🙂  The stress test…..whew.  I have never been one to overexert myself for the sake of exercise but MAN that was tough!   It was on a stationary bicycle and the tech was pushing me so hard to keep going!  I did but it was NO FUN!

On September 6, I had two appointments at the surgeon’s office.  (Their office is a complex that houses the surgeons, physician’s assistants, nutritionists, psychologists, labs, sleep study clinic, stress test facility, and food/vitamin/supplement store!)  I attended a class held by the Dietician…with about 6 others.  It was very informal and informative.  We talked about the things that we could start immediately to ready ourselves for surgery and the ways the diet would advance over the weeks prior to and just after surgery.  I am SO thankful there were handouts because there was SO much information.  It was very helpful to be able to look back on the information once I got home and was talking over it with my hubby.

My other appointment that day was with the psychologist.  He asked me some general questions and then a little more personal questions related to my home life, weight issues and emotions.  It was not too deep but enough to make me realize how this surgery was going to change EVERYTHING.  Looking back, I still don’t think I grasped how very much my life was about to be flipped upside down!

On September 9th, I had my second “insurance required weight loss check”.  It was uneventful and again we discussed types of surgeries and the results of the endoscopy/colonoscopy that was performed in August.  The endoscopy showed weakening in the sphincter that connects my esophagus and my stomach.  Because of this, Dr Tyner was confident that I would one day face acid reflux.  He suggested that gastric bypass would be my best option since it would knock that out.  I agreed and we moved forward with that plan!

When I had my earlier stress test, there was an issue that they saw so that prompted a nuclear stress test that I had on September 13th.   I was so scared!  I had never even heard of this so knowing that I was about to embark on this was worrisome!  I had this test at Capital Heart Associates in Raleigh.  This facility was wonderful and the staff were so intent on making me comfortable, which helped so much.  Mike went with me and that made the morning fly by.

On September 30th, I had hernia repair surgery (by Dr Tyner) at Rex.  We did it there because he wanted to do it robotically as well as to do some exploratory surgery to ensure that there was nothing else going on that was endometriosis related to my colon.

On October 10th, I had my third “insurance required weight loss check”.  This time it was with the PA and he was helpful and very comforting.  It was nice to know there was an entire team supporting me there.

On November 14th, I had my fourth and final “insurance required weight loss check”.  It was getting real.

On November 17th, I had NINE vials of blood drawn at Wake Med for labs related to surgery.  It was rough!  My veins are not what they once were and it took a village to retrieve all that blood – but it was one step closer!

On November 22nd, my packet of information was turned over to Cigna for approval.  I was anxiously awaiting the word…either way!

I got THE CALL on November 28th.  MY SURGERY WAS APPROVED!!  I was so excited….but now….the worry – WILL I GET A DATE IN TIME???

On December 5th I had my “Results Visit”.  This appointment basically summarizes all the tests you’ve been through and talks about any test results that are related.  I knew by then that my heart, veins, gall bladder, mind, blood, colon, and lungs were ready.  At the end of the appointment, I met with the scheduler.  I took the LAST SURGERY SLOT AVAILABLE for my surgeon.  Talk about God looking out for me!!!  My surgery would be Dec 27th.  I was finally entering another stage of this process!

 

 

WLS Chronicles – The Initial Visit

On By mrsjmejonesIn Bariatric, Weight Loss Surgery2 Comments

Once you have committed in your mind that you’re going to go for it, the work begins.  You may not even commit until after the first appointment…or the third…or the tenth!  Personally, I had to commit in my mind before I even walked in to the office.  My first appointment (Aug 8, 2016) was a flurry of activity.  I was assigned a caseworker (Kevin, very helpful) and weighed (ugh).  I sat down with Kevin and he presented me with two important documents:  Surgery Estimate and Bariatric Checklist.  The estimate was FABULOUS:

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Now, this is not normal.  However, when your sweet husband spends a week in ICU due to double pneumonia, you have certainly met your out of pocket maximum for the year.  Thank you Jesus for health insurance.  Yes, you are seeing that right.  This surgery cost me exactly ZERO dollars.  (Hmm, I guess that should have been on my first post about this!  It was a factor!)

The Bariatric Checklist was the piece of paper that looked the most intimidating.

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All those highlights were something I had to do…which meant (to me) something to worry about.  (Let me just pause here and say that my prayer life was being tested and built at this time and I believe it was God’s plan to teach me how important it was!!)  The first thing I heard Kevin say was:  “Okay, your insurance requires four months of weight loss visits – basically four months of us weighing you – before surgery.”  I thought I had NO chance of getting this surgery squeezed into 2016!!  He then told me that this visit would count as my first one…so my window was TIGHT!  I had a ton of things to do in a short amount of time and we began scheduling appointments and making plans!  It was organized chaos and I was up for the challenge.

I met the surgeon and we discussed the types of bariatric surgeries and the pain I was feeling in my left side as well (my aforementioned femoral hernia).  Dr Tyner was very helpful with the tons of questions I had already and gave me some information on apps to use and diets to read up on to get myself ready for this huge change.

When I left the office that day, I cried like a baby knowing that this was going to be hard.  I cried harder out of joy, knowing that I serve a risen Savior who would equip me for this battle.  I literally and figuratively leaned on Philippians 4:13, “I can do all things through Christ who strengthens me.”

xoxo

Small J

WLS Chronicles – The Decision

On By mrsjmejonesIn Bariatric, Weight Loss Surgery2 Comments

There are many steps of Weight Loss Surgery and possibly one of the hardest is making the decision to go for it.  Many weeks or months or even years go by while someone considers it, most often.

For me, it was a few factors.  I had been diagnosed with diabetes and put on meds for it.  I had been diagnosed with high blood pressure and medicated for that.  I lost an Uncle last March who was obese and we believe that led to his passing.  I had more time on my hands than EVER, after retiring from my job in July.  I was referred to a surgeon for a pain I was experiencing (that we thought was endometriosis related and turned out to be a femoral hernia) and this particular surgeon performed bariatric surgery as well.  I prayed.  I talked to my hubby.  I talked to my Daddy (who had lap band surgery in 2013).  I talked to my Mama (who was the chief cook/warden/support for my Daddy!).  I stressed, I worried, I prayed, I read, I researched, I cried, I decided.

I needed to do this for my family, for my health, for my LIFE.  I have ALWAYS battled with my weight.  I have hypothyroidism as well, which does NOT help.  I am an emotional eater.  I had a very stressful job for 5+ years with travel and meetings and “no time” to plan to eat healthy – so I didn’t.  Yes, that’s an excuse.  🙂  I was all about convenience.  I was being selfish.  Why not be selfish enough to take the time and energy and opportunity to push the reset button on my health?  My family was the most supportive.  I knew I would face criticism and the whispers of “why can’t she just diet and exercise?” and worse.  The thought of this negativity made every little bit of positivity mean that much more.  I clung to it and decided to move forward with the surgery, not really sure of which procedure I would land on.  I was open to all options and began praying that I would have peace and clarity about which one.  The procedures (lap band, gastric sleeve, duodenal switch, gastric bypass) all varied in their effectiveness as well as their chance of complications.

Research online helped tremendously as well as information from my surgeon’s office.  (I went to Bariatric Specialists of North Carolina.  Cannot say ENOUGH about how awesome they are.)

If you are considering bariatric surgery, my advice is this:  Research, be patient and ensure you have a support system that understands the full process.  Research the surgeries as well as the surgeons.  Don’t settle for mediocre care as you may end up with mediocre results.

I plan to chronicle each phase of this journey and would love feedback or questions!  You can reach me at mrsjmejones@gmail.com.

xoxo

Small J