Friday, April 29, 2011

Friday April 29, 2011 - Does weight loss have an effect on your bipolar disorder?

This is the copy of an email and my response.
Sent today:

Hi Chris, 

I have a question that I hope you can help me with.  I had the Gastric Sleeve surgery in August 2008.  I have been diagnosed as Bi-polar for about 10-12 years now.  I was wondering if you know, or have heard of any person with bipolar who's had a weight loss surgery and then had their bipolar get worse?  I am a 50 year old female and I am having a terrible time with mood swings and depression.  Actually, for the past 6 months I have also started drinking, which does not help the depression.  I have just started researching, and I haven't found that much info., so I was just wondering if you knew of any cases where the surgery had a negative affect on the Bipolar symptoms.  

Thanks for reading my e-mail.  Best wishes for a happy, healthy life.  I'll keep checking in on you.

~ xxxxxxx

My response:

Hi xxxxxxxxx,

I have a story that may be topical. In 2007 I felt like shit. Nothing acute; just plain bad. In July 2007 I was diagnosed with everything from diabetes (not true), h-pylori, mono, and leukemia. Not my favorite phone call. 

After some slow diagnostic progress, I was admitted to the hospital. My body cavity had filled with water (I still don't know why) and they put me on IV lasix and I lost 56 pounds water weight in four days. Plus, I had spots all over my lungs so they put me on blood thinners. In retrospect that was pretty stupid considering my critically low platelet count. And no, I don't smoke. 

Anyway, after two weeks I left the hospital and I just stopped eating. The medications, particularly the heparin, left a metallic taste in my mouth that wouldn't go away. Everything tasted horrible so I didn't eat. By New Year's Eve I had lost 40 additional pounds and began to go psychotic. On Jan 2 2008 I was institutionalized. I finally came back to reality near the end of the month. All I remember is snap shots of my hallucinations. Several haunt me to this day. We don't know conclusively why it happened, but we think that the weight loss had caused lithium poisoning. I don't take lithium anymore. 

So, in part, the weight loss had a very dramatic and nearly lethal affect on my physical and mental being. I know, my wife knows, and my doctor and psychologist knows that I may have side effects from the weight loss surgery and constant monitoring will be needed. I guess 2007-08 taught me some good lessons. 

I'm sure you know that bipolars tend to gravitate towards "self-medications" in times of trouble or glee or Thursday. Anyway, alcohol only compounds everything. Your meds won't work and your depression will get worse. So have one more martini and give it up. The last time I tried to become an alcoholic I was sent to rehab and the mental health facility. Talk about a buzz kill.

Also, many bipolar meds tend to make you gain weight. So, your body is at war with itself and the medication. You need to find a better doctor. 

I have a big question for you! How much have you lost and how has it changed your life? 

I genuinely hope you feel better. Please stay in touch.

~ Christopher

(PS: I am going to make this today's post without your name.)

I welcome and answer all emails.

Thursday, April 28, 2011

Oh man! I can't believe it's Thursday the 28th - The long answer to a short question

Hello fellow humans,

Today I received a business email from a very nice blogger and she had a good and serious question. And, I had just finished and sent off all of my articles that were due tomorrow so I had a minute and I felt like talking. I'm sorry for the long answer; scratch that xxxxx, long essay. I think I may be a bit manic today because I was pretty depressed yesterday. Ouch. I sound so bipolar. Anyway folks, I wrote such a long email reply that I decided to post it. I will get to the blow by blow of yesterday's surgeon consultation, but not today. I have probably written about 8,000 words or more today and I think I may be getting "typer's finger."

Here's the email:

Hello again Anne,

Great question! I am bipolar and an insomniac. I take enough prescription drugs to kill a horse. So... 

Yes! My meds are a HUGE weight gain contributor. While they do cause weight gain, but they do something far worse. They make it just that much harder to lose weight and then the psychological effects wear you down. I lost a ton of weight when I went vegan. Part of it was the animal protein, but most of it was watching and counting everything that passed my lips and then an absolutely extreme exercise schedule of five plus hours in the gym each week and then I rode from 70 to 100 miles per week on my road bike. 

After six months I started gaining weight back anyway. I even toughened up the regime and still, I gained weight. It was so frustrating I didn't know what to do so I went to a vegetarian diet plus fish because I was losing hair on the vegan diet despite all of the added supplements and soy drinks. Then my weight just went up by 10 pounds each month and I lost faith entirely. I still go to the gym, but not nearly as much. I would say that 50% of my weight gain since discontinuing the vegan diet was just slacking off. 

I did all of that after I had tried every diet under the sun. There was a time that I took diet pills and seriously put my health at risk. I wrote an article about diet pills back in 2009 . 

I have been on at least ten to fifteen diets in my adult life. I am a very determined person and I always willed my way to losing weight, but then six months or more would pass and I would gain back the weight plus 10%. Your body only know one way to fight change due to weight loss or even stress and that is to gain extra weight as a protective barrier. Its that primal psychological effect that makes it so hard for everyone and even harder for obese people. 

Being obese is mostly psychological. That is why I am going through therapy and hypnosis to attack the emotional scars that I wear. For some, its childhood abuse; for me its the suicide of my father, my grandmother, my uncle, two of my grandmother's siblings. It goes further back than that, but you get my point. I also had this weird thing about needing the weight to protect myself from bullies and cancer. I thought I needed the weight to pull me through cancer. Pretty silly until I was diagnosed with leukemia in 2007. 

The bariatric surgery is a tool to get me down to my ideal weight and the psychological work is to help me keep it off. So many people fail to take care of the fat in their minds and, regardless of surgery, they fall back on the old routines and start gaining weight. Their are dangers in any kind of surgery, but I have decided that I simply have to do it. I have exhausted all of my options. I can't handle losing 100 pounds just to gain it back in two years. I'm strong in every way and incredibly motivated, but I'm tired of my war against obesity so here's fingers crossed. And yes, I do intend on dramatically increasing my exercise and by way of the surgery, eating healthy is not just good, its mandatory.

Your method of weight loss is absolutely the healthiest and particularly good for people that have to lose 50 pounds or less, but for super obese people like me, it just doesn't solve the problem fast enough. I'm pretty sure that I am committing suicide through fudge. My body HAS to shed this weight if I plan on seeing my grandchildren grow up. And I am a big lover of life and I enjoy my resurrection as a writer. I don't want to die.

Well, now that I have used up 30 minutes answering a simple question with an essay, I guess I'll just have to use it as a blog post :-)

I feel for your relative and I don't have an easy answer. I am bipolar. Most of my family has committed suicide. I will always need medication. Period. But, I can't grow into Jabba the Hut because that's not living either. What a nasty circle. And that is why I write that particular blog. I am also near completing a book about a suicidal bipolar teen. I figure... write what you know. I'm also starting to outline a fiction novel about a fat man. Again, it's what I know.

Maybe the worst part of being fat and I'm sure your relative is already feeling the effects of fat discrimination. Kids will giggle when you pass. Some people (not you) can offend you by making comments like "just put the fork down and pull away from the table." It like when I wear a business suit. All of a sudden I become "Sir." When people see me they immediately size me up as someone who is weak and maybe stupid. Of course, anyone that talks to me for a few minutes realizes that I am first manic and second intelligent. When compared to a monkey maybe, but smart nonetheless. 


Wednesday, April 27, 2011

Wednesday April 27th 2011 - Bariatric options

Today was the first real appointment. I actually had this type of appointment before in June 2009 when I started this blog so I didn't have to go through the whole one hour introduction to the types of bariatric surgery. My consult was only 1/2 hour. The options are stomach reduction and gastric bypass. Both of these are invasive surgeries and extremely difficult to reverse. I'm not even sure that you can. It would definitively be difficult. These two surgeries are the fastest weight reduction procedures. They are recommended for the super obese like me, but I have declined these two options in favor of the realize band.
Gastric bypass

The Realize Band was my choice because it is done larthoscopically (three 1/2 inch cuts and one 1 inch cut to insert hardware. The "hardware" consists of a plastic band that they put around the upper end of the stomach. It contains small saline pouches that can be inflated/deflated as needed. The inflation point is a disk implanted just below the skin to the lower right of your ribs. You can't see or feel it. Well, maybe if you try you could feel pressure, but it wouldn't hurt or make you feel uncomfortable.
I chose this option even though weight reduction to target (200) could take two to three years because I am concerned with cancer and the digestion of my bipolar meds. The downside is that the band can trap food and require medical treatment, but you should be able to manage that. The other weird thing is that you can't have water for 15 mins before a meal and 30 minutes after the meal. It keeps you from getting hungry. You should be eating a strict diet low in gluten (it gets stuck and swells in the belly) and rich in ground protein. 
The Realize Band is a tool not the solution. I think the real solution is in your fat head. I recommend therapy before during and after to solve the root issues that made you fat. I believe that the lack of therapy is why some people fail to take full advantage of the surgery. It is possible to mess this up by over-eating. The trick here is that your stomach thinks it full much much much faster. 
NEXT: blow by blow on the appointment

Saturday, April 23, 2011

Saturday April 23rd, 2011 - Appointment set

Quick update on life stuff: I've been working on articles for Food Service Daily News which has taken me away from writing the book. Hopefully, I will spend two hours completing a tech article on social media and mobile devises as it pertains to restaurant owners. I think I'll submit one longer piece and then re-write two smaller comprehensive pieces because I have way too much data collected once again. I also will complete a photo journalist piece on cuisine trends 2011. I have some other ideas on tech articles about wireless ordering and paying by mobile. I also want to do a piece on the "restaurant" catering truck. That's where a favorite restaurant takes their show on the road. When we were in NYC we saw a lot of this new phenomena. My favorite was a muffin cupcake van. Personally, I would love it if my favorite Indian restaurant went wheels. Maybe they could stop at a parking lot closer to me and communicate their locations via facebook and twitter. Cool stuff.  

My diet has been stable. Not really losing weight, but also not gaining weight. I think mentally I have know when the end game begins. The end game being the day of my bariatric surgery.

I made an appointment with my surgeon Dr. Tillquist and his assistant CJ on the 27th. Usually, the first appointment is about an hour while they go through a gamut of health questions and nutrition ect, but I've already been through that and they have an extensive file on me from my prior interest so my appointment will only be 30 minutes.

So my next post will be all about that first appointment. Isn't it strange that when someone says you can't have something, that something becomes all you can think about. My wife said cut out sugar now and reduce your caffeine, so all I keep thinking about is espresso and a nutella covered croissant.

Have a good weekend and thank you for all the supportive email. I encourage comments. My European friends always call me Christophe so that is how I will sign out. ~ Christophe 

Monday, April 18, 2011

Surgery Updates : Setting up the first appointment with Dr Richard Tillquist

About 4 or 5 years ago I attended a seminar given by Dr. Richard Tillquist at the Swedish Medical Center in Englewood Colorado. He was highly recommended by several of my doctors. Initially, the cost was prohibitive. My insurance at the time had no coverage.

Two and a half years ago when I began this blog, I went to the seminar again and decided to move forward. My new insurance covered $7,500 of the surgical cost and I had to come up with $4,000 to put into a hospital escrow account to cover part of the surgery and any over night stays or complications. I went to their recommended shrink and paid $180.00 for the appointment and received a letter of approval which meant that I was psychologically sound. I also collected letters from my primary physician and oncologist. I had my primary consultations done with Dr Tillquist and I just needed a surgical date.

I put on the brakes and tried the vegan diet and extreme exercise. That worked for about 6-8 months but then I started gaining the weight back. Now all the weight is back and I have called for my initial appointment. I already know that my initial qualifiers are out of date, so I will be starting from the beginning.

However, sometimes the insurance requires proof that your over 40 BMI (Check) and that you have tried and exhausted traditional methods of weight loss. At the end of June this blog will have its third anniversary. The blog alone would be sufficient proof, but I also have medical records of prior diets.

So here we go again. I will record each visit and step with the heading Surgery Updates. 

Monday April 18th 2011 - Panic Attack (s)

After my oncologist appointment I lost about 14 pounds. I'm sure I haven't lost more. Perhaps I even started gaining some back. When I'm at my heaviest it's hard to get out of my car and it was hard this morning.

However, that could be due to this weekend's storage adventure. Last Saturday, the 9th, my wife and I worked for 11 hours trying to consolidate our three storage areas into two. One of our storage rooms is climate control and alarmed with additional cameras watching the inside hallways. I use that for art and stuff like our fishing and camping gear that needs to be readily accessible. The other two, one medium and one 24x8x8 contain our furniture and household belongings (we temporarily share my in-law's house with my wife's aunt). Anyway, we made tremendous progress on the 9th, but we didn't quite finish. After the 9th my bad left knee swelled and required ice and pain killers for four days.

Last Saturday, the 16th, we took two of our boys and miraculously finished off the consolidation. This time I immediately iced my knee and it didn't hurt nearly as much as it had, however, my back hurts like hell this morning.

So, on to the panic attacks. I shouldn't have any because I am on three anti anxiety medications. Past panic attacks had been scary and frequent. On Friday the 8th I took my wife out for Sushi and a movie. We saw "Arthur" and it was hilarious. On the way home I started feeling hot like I had a fever. I got the cold sweats and got real uncomfortable like I needed out of my clothes and started shaking. By the time we made it home I was a mess. It took me a few minutes to walk into the house. I felt as if I was going to collapse and I was totally panicked. I finally made it in with my wife's help and I sat and drank water and took some Lorazapam. I ate a piece of baked chicken and things calmed down. It was frightening because I didn't know what caused it.  

On Wednesday night I was having trouble getting comfortable in bed and I finally gave up and got up to get some water. I like ice water so I headed to the kitchen. By the time I made it I was having a full fledged panic attack. And I took the appropriate measures and it went away, but I slept with horrible nightmares.

I don't know what's up. Maybe I'm upset about money. Maybe I'm upset by the pressure of having to write 20 articles by the end of the month. I don't know and I don't like it. For now I am carrying extra lorazapam in my pocket and I will be calling my shrink.


Wednesday, April 13, 2011

April 13th, 2011 - and ye shall receive

I asked God to help me find a way to get the surgery which basically meant asking for money. I believe God answers all prayers in His time and it isn't always yes. His Will reigns.

I really didn't expect a quick answer. I thought He would show me how to save enough money for the operation. After my health insurance, I'm pretty sure my share is $4,000 into a hospital escrow account.

First answer: I found the deeds to some burial plots. I have enough room for 15 people in either plots or mortuary. I don't need all of those so I decided to put four plots (potentially 8 people) for sale. The retail cost of these plots would be $16,000. I compared my plots to others on craigslist and decided to try to sell the four plots for $7,000 for all four or $2000 each for twin plots. It is advertised so we will see.

Second answer: I contracted with Food Service Daily News for 20 articles by the end of April and more beyond that publication date. In addition, I will be editing other author's work. My title is staff editor. Income potential for April alone = $4,000.

Third answer: My gallery in Paris asked for pricing on some of my late father's drawings. They have an interested collector from Switzerland. Potential income = $60,000. My cut would be $30,000.

One week ago I really didn't have any idea for earning $4,000. I would say God is great.

Friday, April 8, 2011

Friday April 8th, 2011 - Worried about liver

Well, I have an appointment with my GI doc on the 13th. Back in 2009, when they said my kidneys were shutting down, I went to see the same doctor. He told me as many have that I have NASH, but, again, he didn't make a big deal out of it. I am fat so I should have a fatty liver. But, this time I am requesting a liver biopsy just to be sure. Like every doctor, he will undoubtedly recommend bariatric surgery.

I can't understand why health insurers won't pay for the entire procedure. They already have rules and safeguards to make sure people aren't using it as a diet plan. You have to be over a certain fat ratio like in the 45 percentile. Something like that. The surgery will most likely cost around $10k and the insurance pays $7500 lifetime benefit. So, out of the $4000 you have to have in hospital escrow, you will probably get back $1500 but only if there are no complications or if they hold you over night.

Anyway, I've been losing weight and my clothes are fitting better. My diet is okay, but I have tried to cut down on sugar and quantity, both of which are pretty big obstacle for me.

My writing has been going well and I am making great progress.

Sunday, April 3, 2011

Sunday April 3 2011 at 1:45 am - Giddy

I am almost giddy at the prospect of being thin. I was looking at all of my "normal" weight suits and sports shirts and I could hardly contain my enthusiasm for the Realize Band. A friend who worked at my old oncologist is now assisting my primary care physician. She had the surgery in December 2008 and my wife told me she's thin. I can't wait to see her.