Tuesday, December 31, 2013

Goodbye 2013, Hello 2014!

This year was really amazing for me. I managed to maintain my weight loss and once I was more than half way through my pregnancy, I started to gain weight, but it was an appropriate amount. In August, I welcomed a beautiful new daughter. Life has been great since then. I quickly lost the majority of the weight that I gained during pregnancy. And then, I got lazy. I started eating more often, and quite often more than not, foods that I know I shouldn't be eating. When I had my last baby (in 2009) I was determined to breastfeed. I did okay, but after a couple months, had supply issues. Still, managed to nurse him until his first birthday, so I'll consider it a success, even if we did have to supplement with formula. This time around, I was even more determined to not have to use any formula. And so far, so great! Ruby is nearly 5 months old, and not a drop of formula. Go me! Because I have more than enough milk this time, I'm using all these excuses to justify the over eating. By exclusively breastfeeding, I've been told I can allow myself at least 500 more calories a day. And boy have I. And it's starting to show. I weigh a lot more than I'd like to, though I'm still 100 pounds down from where I was before having surgery. In a few minutes, the clock will strike midnight. 2014. A new year. I've decided to make a more conscious effort to pay attention to what I eat, etc. I'm certainly not going to go on a hard core diet or anything. I still have a milk supply to maintain and although I'm unhappy with myself for slipping back into old habits, what I'm doing is working. I know how that sounds, but it's true. I'll be making small changes. Things like, less sugar, more water. Not eating out as much. Just getting off the couch and being more active. With our schedules, it'd be hard to have a gym membership, but I know I can do things around the house and yard to get physical. We did get a puppy last month, so maybe she'll start being less afraid of the snow and we can take her out in the yard and play a lot more. My husband took some pictures of me tonight for 'before', and I'm really hoping that by implementing some small changes, in a couple months I see a difference in the 'after'. Maybe I'll even feel brave enough to share the pictures one day. I'm just really disappointed in myself lately because of the weight gain. I had been doing so incredible and now, not so much. I know I can find the will/determination/strength to do it though. I did it before, so I know it's possible!

I've got about 10 minutes until midnight. Everyone in the house is asleep, except myself and my 7 year old daughter. She can't wait to watch the ball drop. I'll be ringing in the new year with a glass of water, so I guess I'm off to a decent start. :)

new sneakers. hoping to get more use out of them in the new year. :)

Saturday, September 7, 2013

The Kingrys: Party of Five

Now that it's been a month, I figured I had better type my birth story while the details are still somewhat fresh in my head. 
This story starts when I found out I was pregnant in early December. Having had two previous cesarean sections, I knew that I wanted to avoid a third if at all possible. I immediately started looking into a VBAC (vaginal birth after c/section). In my case, a VBA2C. Most doctors think this is much too risky and are hesitant to 'allow' a woman to have a VBA2C. To make matters worse, I have a history of having 'big' babies. My first baby was 10 pounds 14 ounces and my second was 10 pounds 8 ounces. Still, I had hope. I had to. I was dreaming of having this birth. I mean, literally. Night after night I would have dreams of being in labor and then reaching down and helping pull this new baby into the world. I'd pull him or her to my chest and do skin to skin bonding while nursing this new tiny human. I wanted as little medical intervention as possible. The more I researched, the more I was positive that I could do this. My body was made to do this. Sure with my first two children things happened and their births required medical interventions and major surgery, but I was confident that this time around things would be different. I was very hopeful.
And then I went to visit my OB. I love the man, I really do, but right away I could tell that it was going to be an uphill battle to get him on board with my dream. I first saw him at 13 or 14 weeks into the pregnancy. (That's when my OB practice usually starts to see pregnant patients.) For the first few visits, he seemed open to my desire to VBAC. After a while I was sent for a more in depth ultrasound. It was wonderful seeing this tiny human just dance around in me. He/she measured right where he/she should be. I asked that doctor if he would be okay with me attempting a VBA2C. Long story short, his answer was no. He did say however, that if I were to come in to the hospital in labor and mostly dilated, he would be okay with me trying to birth vaginally. Yay! Not all hope was lost! More time passed, and when I saw my regular OB we didn't really discuss an attempted VBAC. These visits were usually just very quick. Check my weight, urine, BP and the baby's heartbeat. Once I hit my third trimester, pretty much all hope of a VBAC was gone. My doctor was not on board with me attempting one at all, and he made this clear at every visit. I was crushed. He started to discuss a planned c/section date. I wasn't happy at all, and it was not what I wanted for myself or my baby. Being as I had gone through this two other times, I knew what to expect, and I knew that babe and myself would be okay, but still, I had these dreams and visions of a different type of birth. I did have one small victory though; I somehow got my doctor to agree to the scheduled c/section on my due date. He would under no circumstances let me go longer than that, because he wasn't even happy with letting me go that long. At every visit he would mention the scheduled c/section, and I would tell him that if I ended up going into labor before then, I was going to labor at home as long as possible before heading to the hospital. I was desperate and willing to do what I had to do to avoid this major surgery. 
As much as I dreaded being cut from hip to hip again, after my results for the Group Strep B test came back positive, I started to make peace with the thought of having another c/section. I knew that being positive for strep b meant that I'd have to have antibiotics in an IV prior to delivery. If I wanted to VBAC, I'd have to go to the hospital right away if I went into labor. If I went to the hospital right away, they'd just be doing the section then anyway. Though I was coming to terms with the c/section, I just felt so defeated. Crushed. I felt like I didn't have any control at all. Pretty much any hope I had of a vaginal birth was just gone. It still didn't stop me from bringing up a VBAC at every appointment with my OB. 
My c/section was scheduled for my due date, August 13th. I was so sure I'd go into labor before then. So sure of it. With my second child, I went into labor on my own at 38 weeks. I was confident that my body would do this again. I could go into labor on my own and labor at home for a bit before going to the hospital. They'd hook me up to an IV and I could get the antibiotics. I would be mostly dilated and I'd eventually push my baby out, and pull him/her to my chest, just like all those nights I had spent dreaming of this moment. Wishful thinking, I know.  Around 38.5 weeks, I saw my OB again. And again, I brought up the idea of a VBA2C. I was met once again, with a 'no'. At this point, I was just done being pregnant. I love it, I really do, but I was just done. I was convinced that this baby weighed close to 20 pounds. I mean, I did gain about 20-22 pounds, so it had to be all baby right? Haha. 
Since my doctor was so adamant about me not going into labor before my scheduled c/section date, I asked if we could discuss moving the c/section day up. He checked his schedule and we checked ours. It looked like August 8th or 9th would work the best. He didn't want me to take a chance of going into labor over that weekend and risking uterine rupture. At this point, I had come to terms with the surgery. My baby would soon be here, one way or another. The days passed by and there was no signs of labor. Though I was on board with a c/section, I still felt a little sad and defeated. I felt like my body was going to fail me once again.
Th day came and went. Finally, it was August 7th.  I hadn't gone into labor yet (boo!) which just meant that the next day, I'd be having a baby (yay!). We were told to arrive at 7 am for an OR time of 9:30 am. We made the proper arrangements for childcare for our two kids, and prepared for some last minute things. And then things changed. We got another phone call saying we needed to be to the hospital by 5:30 am for an OR time of 7:30 am. Oh my gosh, this was happening, and it was happening soon! We took our kids out to dinner and bought last minute items. We took them to grandma and pop pop's house that night. I kissed and hugged them like crazy. The next time we were going to see them, they would have a new brother or sister. As my husband drove us home, my emotions got the best of me and I cried. I missed Zoey and Ford so much already. They have stayed overnight before, and I knew I'd be seeing them the next day, but it was still so emotional. That, and what if something happened and that was the last time they got to see me? I love them so much and I would hate for them to have to grow up without a mother. I know it's morbid, but these things go through my mind. By the time we arrived back at our house 15 minutes later, I was fine. I went into a cleaning frenzy. I was like some kind of mad woman! At some point that night, we decided we better try to get a couple hours of sleep. We were both kind of nervous but still so excited. Before heading to bed we checked things off our list. Hospital bag packed and ready to put in the van? Check! Camera and cell phone batteries charged and ready to go? Check! Baby names 100% agreed upon and finalized? Check! Okay, time for bed because we are having a baby in the morning! 
The alarm went off early on the morning of the 8th, and I did not want to get out of bed. I guess I managed to get some sleep after all, though it wasn't much. I quickly remember that it was baby day! After waiting months and months, we were actually going to have the baby today! We showered and got around fairly quick. You tend to do that when you've been told you can't eat or drink anything, haha. Soon after the van was loaded, we were off! The half hour drive to the hospital seemed to take forever. We arrived at the hospital and made our way up to the Labor and Delivery floor. One of the nurses at the nurses stationed asked my name and what I was there for. It was such a strange feeling just walking in there, not being in labor or even having any kind of contractions or pain at all, and saying that I was there to have a baby. Once they verified who I was and that I was in fact, there to have a baby that day, we were taken to our room. A friend of ours from high school is a L&D nurse and we were lucky that she was there when we checked in. It was nice seeing a familiar face, and I guess if anyone had to poke me for an IV that day, I was glad it was Jada. During the two hours between arriving at the hospital and actually going back to the OR, things happened so fast. I'm actually a bit surprised that I still remember it as vividly as I do. I was visited by several doctors, nurses, and the anesthesiologists. It was funny because the two anesthesiologists kept going on and on about how great my airway looked and using all these medical terms. After a while I asked him to explain it to me like I was a child, and he said "Basically, it means you have a big mouth." I laughed because it definitely wasn't the first time I'd ever heard that in my life. It was good to know that if something happened and I needed to be completely knocked out for the surgery, they wouldn't have a problem with the tube going down my throat. Hopefully it didn't come to that. We did have some down time in those two hours, and my husband and I managed to watch Game of Thrones on the laptop. (Thank god for wi-fi and HBO-GO.) After 7 am, time started to go by quickly. It was such a whirl wind of activity in and out of the hospital room. People coming and going. Monitors going off and on. Finally, a new nurse came in to say it was time. (Jada had gone home for the day as it was shift change.) I got up to use the bathroom one last time, and after, we started to make that walk to the Operating Room. 
It was such a strange, surreal feeling. It went by so quick, yet at the same time, took forever. This surgery was the 4th time I've ever had surgery, and the first time I'd ever walked into the OR. I've always been in a wheelchair or on a  bed. At 7:28 am, I walked into the OR. It was freezing cold. It was funny because this entire pregnancy I'd been so warm and hot. I could never get cold. And now here I was, a half hour or so from not being pregnant anymore, and I was freezing. A nurse quickly found some warm socks for me to wear, but when the only other thing you're wearing is a thin cotton hospital gown, socks don't help at all. Still, they were very much appreciated. 
The anesthesiologists came in and started to prepare. The first needle (to numb my back) wasn't nearly as painful as it was the last time, and I was grateful. Though it still did hurt. However, that pain is temporary and the relief you get from the drugs is just heavenly. After I was completely numb from the chest down, the catheter was inserted. It was awesome that they did it after I couldn't feel anything, because it hurt like hell with the first two kids. Since, like I mentioned before, I was group strep b positive, I had to have antibiotics in my IV so we needed to let them go through for so long before my doctor actually did the first incision. While waiting for the antibiotics to do their thing, my blood pressure suddenly dropped. Like, pretty low. I was given something to bring it up and everything was nice and stable after that. Right after that, my husband was brought into the OR and was by my side. At this point, I was confident and secure in the decision to opt for a repeat c/section. I knew we were going to be fine. The doctor and rest of the medical staff came in soon after and we were off! I loved having my husband right there by my side. We were exchanging I love you's and he was snapping as many pictures as possible. I'll let the pictures tell the rest of the story. :)
(Warning, some of them could be seen as graphic. Though I think they are absolutely gorgeous.)

One last pregnancy picture. 39 weeks 3 days.

Let's do this! Just moments away from meeting my new son or daughter!

Head is out! The nurses kept going on about how much hair there was. 

The doctors and nurses mentioned that baby was 'so big'.
What's it gonna be? What is it gonna be?!

Baby is out and it's a girl! A daughter! 

First glimpse of my beautiful new daughter. 

Big, beautiful and so healthy!

Such a proud daddy!

I'm so in love.

Ruby Eleanor Jo
August 8, 2013
8:02 am
9 pounds 3 ounces
20 inches long

This was the first picture I posted on Facebook after having her.
It's been my profile picture ever since. 
I have to say, I don't think I look too bad for just having surgery. 

Zoey, Ford and Ruby.
I love the three of them so incredibly much. They are my entire world. 

I went in to the hospital that day with a healthy frame of mind, and I really think it helped calm any fears I had. I know most women would not opt for a planned c/section like this, but for me, I was okay with it. I trust my OB and I know he's a skilled surgeon. I really was at peace with my decision. 

Ruby will be a month old on September 8th, and overall, life has been pretty wonderful. She's such a joy in our lives, and a great addition to our family. My recovery has been rather slow. I've seen the doctor a couple times regarding my incision (I'll spare you all the nasty details.) and finally after a month it seems to be healing. Breastfeeding has been pretty good (though we have been dealing with thrush and a couple more issues.) I feel as though a planned c/section makes for a boring birth story, but I still wanted to share our story. With my first two c/sections, I felt like I was almost like a failure of a mom because I couldn't have a 'normal' birth. I felt a lot of guilt over it. This time around, I don't feel like that at all. I'm finally realizing that, for me, how my children entered this world doesn't determine my worth as a mother. 

I can't believe she has been here for a month already! And yet, at the same time, it seems as though she's always been here. 
Thanks for taking the time to read. :)

Thursday, August 8, 2013

Almost There!

So I'm due with this baby pretty much any day now. I'm excited and nervous! I can't wait to meet my new son or daughter, and I know it'll happen soon. Just have to be patient. 
This pregnancy has been my healthiest pregnancy so far. Don't get me wrong, my other pregnancies were pretty healthy especially consider how crazy obese I was, but this one has just been even better. At my last doctor appointment I was up 21 pounds from where I was the week I found out I was pregnant way back in early December. My blood pressure has been amazing, and no signs of gestational diabetes. I never had GD with my other pregnancies, but due to my weight, they definitely watched me like a hawk. My first two babies were born weighing nearly 11 pounds each, so this pregnancy and baby's size has been monitored. Do you know how tempting it is to find out the sex of the baby with all those ultrasounds? Haha! 
Like I said before, I'm so excited to meet this little one, as well as 'get back on the wagon' to continue with the weight loss that I was totally rocking before we decided to try to get pregnant. I was getting so close to my goal, and while I'm still nearly 100 pounds lighter than where I was a year and a half ago, I know with a little hard work, healthy habits and determination I can get there in no time! Both my OB and my weight loss surgeon said that by breastfeeding, I should have an even easier time losing weight again. Let's hope so! I know when you are a nursing mom you actually need to bring in more calories a day than while you're pregnant. Let's just hope that while nursing I make some better choices when it comes to what food I put into my mouth. I'm happy I've 'only' gained 21 pounds, but I'm sure if I had been eating properly it wouldn't have even been that much. At the end of the day though (or rather, pregnancy) all you care about is a healthy baby, and that is one thing that it looks like I'll be having very soon. I feel as though this baby is HUGE, even bigger than my other two were, but it's not measuring nearly as big on the ultrasound scans, or when he does my weekly fundal height check. I'm almost more excited to see the size of the baby than to see if it's a boy or a girl. :)

Oh, and just because, here's a picture of me from about 3 or 4 weeks ago. I forget, haha. I was on my way to officiate at a wedding. It's the same dress I wore to a wedding in early May. I thought I looked huge in it then!

This will be my last post while I'm still pregnant with Stormageddon. (Yes, I refer to the baby as Stormageddon. It's a Doctor Who thing. LOVE that show!) I can't wait to start posting once he/she arrives and I am back on the wagon! 

Wednesday, May 15, 2013

Third trimester already?!

This pregnancy seems to be flying by! I'm now 27 weeks, which according to one of my pregnancy tracker apps, means I'm in the third trimester. Because I've had two previous cesarean sections, my doctor is recommending another. I did manage to convince him to do it on my due date (that would be 40 weeks instead of the 39 weeks when he wanted to do it.) Technically I have less than 13 weeks. It won't be long now!
We don't know if the baby is a girl or a boy, but it looks healthy, and of course that's all that matters. We have names picked out, and I can't wait to find out which one we will get to use. I've had no morning sickness, my blood pressure is perfect, and overall, I just feel pretty incredible.
At my appointment last week, I was up about eleven pounds from where I was the day I found out I was pregnant. I admit that I've been pretty hard on myself, worrying about weight, during this pregnancy, but I try to just keep telling myself that it's normal to gain weight, and a healthy baby is the goal, no matter what. My OB isn't worried though, saying that even if I gain another 15 pounds by the end of the pregnancy, it's still a good number. Also, I tend to have 'big' babies (my first was 10 pounds 14 ounces and my second was 10 pounds 8 ounces) so obviously I know that a lot of what I gain will be lost immediately.
I've always been fortunate enough to have pretty easy going pregnancies, even at my biggest weight. I'm finding though that at 100 pounds less, it's even better. Energy levels are good, and if these Braxton Hicks contractions would stop for the next 10 weeks or so, I'd say that things could be pretty darned perfect.
In my previous pregnancies, I had to do the glucose tolerance test a couple times. My levels always came back under the number you have when you're diagnosed with gestational diabetes. I remember with my son, I needed a 130 or less on the one hour test, and I ended up getting a 131. I had to do the three hour glucose tolerance test. Passed that one with flying colors. This time around, because I've had the surgery and sometimes cannot tolerate a lot of sugar, I told my doctor I wasn't comfortable doing the standard test. My fear was that I'd drink the stuff, get sick, void the test and have to do it again. Luckily, he was pretty understanding and instead we did an A1C. I wasn't sure what it was, so we discussed it and once I understood, it was definitely the way to go. Last weekend I fasted for 12 hours (which let me tell you, even after you've had the portion of your stomach removed that sends out hunger signals, fasting for that long while you're pregnant is still pretty much hell). I had my blood work done and I was so anxious for the results. They said I'd have to wait until at least Monday when my doctor office opened. I called that morning, and he hadn't reviewed the results yet so they were unable to tell me. I was afraid I'd have to wait until my next appointment to hear the results. The alternative of course, is them calling me and telling me that my levels  came back super high and I was being referred to the diabetes specialist. The call came the next day. I was terrified. Thankfully, the woman on the phone just wanted to talk to me about scheduling a c/section, and I was able to ask her for my test results. After a bit of phone tag between her, the nurse, and myself, I got them. And again, I passed with flying colors! I did better than that really. My A1C level was a 4.8 (on the low side of the ranges) and my average glucose level for the past three months is a 91. So if 130 is the cut off, I dare say I'm doing pretty awesome. It would be a lot lower I'm sure if I wasn't eating so many carbs, but that's a whole other vent/blog post. One I'm not too proud of. :/
Overall though, pregnancy is going great. In the beginning I thought it would be a lot different having a pregnancy after weight loss surgery, and while I guess on one hand it is, on the other, it's not. I'm so thankful for this little babe I have growing in me, and I cannot wait to meet him/her!

And just because, here are a couple pictures. One is from 25 weeks and the other is from 26 weeks. I think I definitely look bigger in the 26 week one!

Thursday, March 7, 2013

One Year!

Today marks my one year anniversary from having weight loss surgery! Has it really been a year already?! It doesn't even seem possible. Seems like it was only yesterday that I was preparing myself for all of these tests and procedures that were required before I had surgery. And it seems like I was just starting my pre-OP diet. And here I am, a year later! It's been a pretty incredible year. I'm down 117 pounds as of this morning. I have heard so many stories of people who regret having the surgery and though I'm only a year out, I have zero regrets! I have so much more energy and I can actually keep up with my kids. Well, or at least I don't feel like I'm going to die when I try to. They are three and six and have way more energy than I'll ever have. My health has improved tremendously over the last year. I've never had a really big problem with blood pressure or cholesterol, but both are now well within the normal ranges. Before surgery I was labeled as being 'pre-diabetic' and now when I have my sugar levels tested, they are very much normal. The only big issues I've had since surgery and losing weight is that my B-12 levels got pretty low (I guess it's fairly common in WLS patients though) and the other is that I feel cold more often than not. But it is wintertime in Michigan. But I'd still rather have to wear an extra sweatshirt or use an extra blanket than have those hundred pounds back!

Just because I love posting pictures, here's a comparison picture from a year ago and today. And remember, I'm almost four and a half months pregnant!

Wednesday, February 13, 2013

February's Update

It's been about two months since my last update, and things are going great. Better than great really. 

We have had a couple of busy and exciting months. Christmas has come and gone and I did really great, though I was worried with it being my first post-surgery Christmas dinner. 
(Well, dinners. We have a big family.)

A month after Christmas I had the honor of being the matron of honor, as well as wedding officiant, at my best friend's wedding. It was such a perfect and emotional day. The day of her wedding also marked one year of being soda AND caffeine free. Addiction is such a bitch, whether it's alcohol, drugs, food, or something else. I'm proof that you can beat addiction though and while it seems silly to some people, I'm proud to say that I beat my addiction and that I've never looked back. 

I think it's kind of crazy that even though I haven't lost that much weight during the fall I still manage to look different. I can definitely tell that things are shifting. It can be frustrating at times. I've been hearing for almost a year now that you can tell that I've lost weight and how great I look, etc etc. For the longest time I couldn't see it. There are days when I still cannot see it, and I'm down around a total of 115 pounds. (Depending on which scale I use, haha.) When I put two pictures side by side though, I can definitely tell. These two pictures were taken about 18 months apart, with the one on the left being from just two weeks ago. Huge difference right?! Also, my kids are growing so fast! 

A friend from school recently contacted me on Facebook and told me that she had started her very own weight loss surgery journey. Like me, she has struggled with her weight for years. She's read my blog and knows what I've gone through. She knows what she is getting herself in to; the good, the bad and the ugly. She's having the surgery for all the right reasons, and I am so excited for her and I wish her loads of luck and success.

I really am amazed at how far I've come this past year. On Valentine's Day last year I my appointment for my psychological exam. I was so nervous! It was the most nerve wracking experience because if he said I was crazy I wouldn't be approved to have the surgery. After several hours of mini panic attacks and sweaty palms, I was told that I was 'boring and completely sane'. (And yes, I do have the paperwork stating this. Maybe I should frame it.) 

This Valentine's Day I'm still just as nervous about the future, but for good reason. 
My kids have a special message for everyone.

Yes, you read that right! We're having another baby! I know what a lot of people are probably thinking. I've talked to my weight loss surgeon and my OB and they both wish us nothing but the best. My weight loss surgery shouldn't interfere with a pregnancy at all according to my doctors. (I'm considered high risk, but not because of the WLS. I have a history of having big babies and have had two c/sections.) We are going to monitor the baby's size throughout the pregnancy, and I'm really hoping that since I don't have the food addiction like I did for the other pregnancies, I'm hoping to birth a baby that isn't well over 10 pounds. My kids are absolutely thrilled with the news, and they're both already coming up with names and asking when the baby will be able to come out and play. 

It's looking like 2013 is going to be an even more exciting year than 2012. :)

Wednesday, December 26, 2012

Small Victories

I know that I haven't posted in what seems like FOREVER, but I've been busy. My two little munchkins are a handful (and really, I wouldn't have it any other way. I love those stinkers.)

About two weeks ago I went to my doctor for my 9 month post-op check. For the last few months I've been stuck on this plateau and while I'm not gaining, I'm definitely not losing. It's been interesting seeing how my body has changed and adapted to this weight loss. My doctor assured me that I am doing great, and that what I've experienced is totally normal. So whew, that made me feel a ton better. I go back in March for my one year check (seriously, cannot believe it's been nearly that long!) and while I'm hoping to lose a bit of weight before then, I know if the scale doesn't budge, it's still considered normal. My doctor keeps telling me that I lost in 6 months what most people lose in the first year. So yeah, I'm doing fantastic.

Yesterday was Christmas and we've been to a few family get togethers, which in our family, involves a ton of awesome food. I may or may not (okay, I did) eat more than I planned on yesterday. We were at my mom's house for about 9 hours and the food there is always the best. I was afraid to step on the scale this morning (why torture yourself like that, haha) but to my surprise when I stepped on the scale this morning (after I had slept on and off for about 10 hours) I was actually four pounds LESS than I was yesterday morning! I'm sure it was some kind of fluke, though I did weigh myself several times and still got the same number. I'm still going to claim it as a small victory.

Oh, and one final tooting of my own horn. Today marks ELEVEN months of being soda and caffeine free!! I remember eleven months ago thinking that giving up soda and caffeine was going to be the biggest challenge for me in this whole weight loss surgery journey, but I've surprised myself. When I stopped drinking the crap, I never got that nasty migraine that everyone talks about, and honestly, I don't even miss the stuff. Okay, that's a fib. There are times when I miss the caffeine (like I said, I'm trying to keep up with two young kids! but I have a vitamin B-12 deficiency and I do monthly injections. They help with the lack of energy issue. I'm super proud of myself!