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Sunday, July 31, 2011

Sunday July 31st 2011 - My diet for the next week pre-op and post-op

1 1/2 hour surgery
I have to be in the hospital by 5am on Wednesday August 3rd. My surgery begins at 7:30am and should conclude around 9am. I will be in recovery for at least an hour while the anesthesia wears off. Then I have to hang around for a while until I am fully hydrated and able to walk around the hospital halls. If everything goes as it should, I will be home in my cozy bed by mid-afternoon. If I am not hydrated or if I have difficulties walking or various other quips then I may have to stay in the hospital overnight. I will do everything I can to write a post on Wednesday and obviously everyday for the first month. Depending on how much relevant news I have I may go back to four posts a week.

The countdown to surgery has it's own restrictive diet with the goal of a clean digestive tract before surgery:

4 days before:
July 30th ~ On Saturday I stayed away from heavy foods like red meat and I probably ate half of what I regularly do. I had a regular home sized cold cut sandwich for a late breakfast. I didn't eat anything until dinner. I had three servings of a cranberry walnut spinach salad with a light vinaigrette dressing and a small portion of spaghetti with olive oil, Greek olives and some kind of a dry crunchy cracker cheese topping. Later I ate baby carrots and three small Swedish lemon cookies. I drank a lot of decaf iced tea and water.

I prefer soy over cow juice
3 days before:
July 31st ~ That would be today. I had a regular sized bowl of granola fiber cereal with soy milk for a late breakfast. I am planning on having a bowl of spinach for a late lunch and then a small portion of lobster/crab raviolis and salad for dinner. I may have a few slices of Tuscan bread with butter. Then that will be it. I will also be pushing as much liquid as possible.  

2 days before:
August 1st ~ I'll only be eating raw vegetables like salad and steamed veggies and lots of fluids.

1 day before:
August 2nd ~ Pure liquid diet. I'll have a Chocolate "Ensure" drink for my three "meals" and then heavy fluids throughout the day.

Day of surgery:
August 3rd ~ I can have liquids up until 3am. After the surgery I will be sucking on ice chips. Pain management after the surgery isn't any different than my normal spleen pain management: Oxycodone 5mg up to four times a day.

August 4th through August 6th ~ First three days after surgery ~ Liquid diet: At breakfast, lunch and dinner consume one cup of milk or a protein drink over the course of one hour. Sip as much water as possible. Plus a minimum of 32 ounces of water.

1/4 cup or 2 oz. of anything here
August 7th through August 31st ~ Three meals a day of no more than 2 ounces consisting of a soft diet including foods like tuna salad, deli thin sliced meat, an egg, cheese, and ground meats.

Foods I will NEVER eat again: Steak, roast beef (unless deli sliced like Arby's), bread including wheat and rice, wheat noodles, caffeine, carbonated drinks, and alcohol.

Simple rules: Always chew your food into a puree. Take your time eating. No liquids 15 minutes before meals and 45 minutes after meals (helps keep you feel full longer). Since your bodies metabolism can't possibly catch up to 2 ounces three times a day, the diet is more of a trial and error consistency and not as much as calorie counting. Of course, foods to avoid at all costs: greasy foods, ice cream, chocolate and candy. Obviously, the better your diet the more effective the results.

Could eat 2oz. of the ground beef
If you eat too much or drink carbonated drinks you will stretch out your stomach and render the operation useless. I had a good friend who stretched her stomach in the first three months to eat a whole bag of popcorn. He also has a problem with fast food. Predictably, he has started getting tooth cavities because he messes up his diet so much that he throws up thus eating away at his tooth enamel.

This surgery is a tool. A second chance. In my case, success is a necessity.

Saturday, July 30, 2011

July 30th 2011 - What can I expect from the surgery?

Here is a piece from my bariatric folder:

"What can I expect from the surgery?"

This is probably the most important question. Certainly all patients lose weight, but success with the procedure is not measured in absolute weight loss, but more importantly, in the improvement in one's quality of life. Specifically, if the medical problems related to your obesity improves and the number of medications you need to take to control those  medical conditions decreases, or hopefully is eliminated, then clearly the surgery has provided a dramatic improvident in your quality of life and could be deemed a success. However, success is best measured by you and how close you come to meeting your specific goals.

Weight loss surgery is not the solution to all of your problems. The surgery will help you lose weight but you must continue to work through exercise and diet to obtain the maximum benefits of the surgery. After surgery, you will not be able to eat nearly as much food as you are used to eating. Most social and family events seem to center around food, and usually large quantities of it. Some patients find these situations much more stressful after the surgery, and the temptation to overeat during these times is great. Patients must understand this, and be disciplined to fight the temptation to overeat and keep the primary goal of improved health and quality of life in mind. Support groups are very important in helping patients get through these crisis periods. 

Helpful websites:
www.coloradobariatrics.com
www.obesityhelp.com
www.lapband.com
www.realizeband.com
www.realizemysuccess.com

July 30th 2011 - Video of an actual lap-band surgery!!!

BAD NEWS! I wanted them to video record my surgery for this blog, but they can't because of their insurance. At one point they would give every patient a DVD of their surgery, but then someone used it as evidence in a malpractice suit and now they won't let me film it!!!

GOOD NEWS! Someone else did get a video... 





Friday, July 29, 2011

Friday July 29th 2011 - This mornings pre- admissions appointments

The surgery looms closer. And yes, I am still excited. And yes, I know eating is going to suck... forever, but I'll get used to it because I have to. It's simple for me. What was a desire is now a necessity for life.

Swedish Medical Center Colorado
This morning I am going in for a 10am pre-admission testing appointment. I do know that I will be giving another blood lab and an EKG and lots of paperwork. My surgeon's office said that the appointment could last as long as two hours so they must be doing something else. I'll let you know exactly what happened this weekend when I write about my first week's diet.

Dr. Richard Tillquist
Directly after my appointment with Swedish Medical Center, I will be headed over to my surgeon's office for a pre-op physical and medical history review with Dr. Tillquist.

The hospital and my surgeon require payment in full before the date of the surgery. That day is today. Here is a quick review of the charges (in USD):

  • Hospital surgical charges = $9,000 ($4,500 from my health insurance and $4,500 from me)
  • Surgeon's fee = $3,000 ($3,000 from my health insurance)
  • Anesthesiologist = $1,080 after $900 discount for paying in advance ($1,080 from me)
  • Surgical Assistant = $270 after a $200 discount for paying in advance ($270 from me)
  • TOTAL OUT OF POCKET TODAY =  $5,850 
If I didn't have insurance, the total amount for the entire surgery would be at least 40% higher. My insurance has contractual agreements to pay only a certain amount for each part of the surgery.

This evening will be my last full meal. On Saturday, Sunday, and Monday my meal have to be super lite and then on Tuesday, the day before surgery, I am only allowed to have liquids.


Finally, on Wednesday August 3rd I have to be at the hospital to start my IV at 5:30am. My surgery is scheduled for 7am or 7:30am. It should last about an hour and, if everything goes well, I could be on my way home by mid-afternoon.

Thursday, July 28, 2011

Thursday July 28th 2011 - Back from vacation with SIX DAYS TO GO!

My work-cation (part vacation; part work) went well. We actually had all three of my sons 22, 20, 15 in the same minivan and it was fun! We laughed the whole way. We had a blip in our family mental health, but that has been remedied and I can't remember a better vacation.

Seven years ago we went as a family to Disney World in Florida and took a Disney cruise down to the Bahamas and six years ago we went to Germany and France, but since then, we have had to go on vacations without my reluctant oldest son, so this Santa Fe New Mexico may not have been our most exotic port, but it was the nicest family vacation we have ever had.

In November, the whole family will fly out to New York City for an exhibition of my late father's work and I am sure it will be another great vacation. Soon the boys will be off living their own lives and we will most likely not be able to get  them all at the same time, so we are cherishing these current vacations.

Yet another benefit of being on vacation was the diversion from the pending surgery and... being able to eat whatever I wanted. I'm excited and my wife is worried about life after the surgery. It will be, by far, the biggest health change in my life. My love affair with food is about over, but a new healthier life will emerge.

I like the idea that I will no longer be able to rely on my willpower alone. I've tried and tried, but this will be a sustainable and conclusive weight loss. As I walked around on vacation I felt the urge to become a bariatric evangelist. I wanted, but I did not, to talk to everyone that I saw that was a 45 BMI or higher. Some people struggle so much just to move around. So many more are obviously self-conscious and uncomfortable with their weight. Some jerk was staring at me walking down the street. I really don't know why, but in my head he was watching me because I am so fat. Soon I will be on the downward spiral and I can't wait!

Friday, July 22, 2011

Friday July 22nd, 2011 - Santa Fe New Mexico USA

Old downtown Santa Fe New Mexico
I'll be spending the rest of the day preparing and packing the whole family for a trip to Santa Fe, NM on Saturday morning. Mine is a Work-cation and theirs is a vacation. Even still, I will have internet access the whole trip. I will post anything of particular interest. Right now I'm in a holding pattern until my surgery on August 3rd.

Thursday, July 21, 2011

Thursday July 21st 2011 - Back when I use to model

Yes, I used to be a model for formal wear. This is 1993 right before my first son was born. I was 25 years old and 175 pounds. I was modeling part-time because I was getting bored with my management career. I only modeled for about six months before I started feeling like a prop. The money wasn't as good for male models so I quit taking gigs. I had recently lost about 15 pounds for the modeling. I starved myself and knocked my metabolism out of joint. After that it was up and up and down and up and up and up and down.... and boom 456 pounds. I'm now just below 400, but not for long :-)

This is not my wife. My wife is much prettier. 


Age 25 probably around 175 pounds




July 21st, 2011 - Just a touch of cold feet

July 2011 Mt Evans Colorado
There are several things that I needed to do before my surgery. First, I had to give up alcohol, but I kind of cheated with that one because I can't drink a drop with my liver cirrhosis. The last time I had some serious drink was my birthday on March 19th.

Second, I needed to quit caffeine. This is the first day I will be 100% caffeine free so it's still on my mind. As I said in the previous post, caffeine is so addictive that even the causal coffee drinker will get a massive headache if they miss more than one day without caffeine. I can go longer than that without side effects from my bipolar meds ~ Lamictal, lorazepam, Seroquel, hydroxyzine, and Oxycontin for my spleen pain.

July 2011 ~ Before surgery
If you were to wean yourself off of caffeine and then have a couple cups of coffee you would be so charged up it would be like you were on meth. Don't believe me. Try it, but wean slowly. It's taken me over a week of weaning down from modest consumption to the point where I only had one glass of caffeinated ice tea yesterday. I now have decaf tea so that is all I will be drinking. Even decaf has a trace of caffeine, but not enough to dehydrate me.

June 2011 ~ Country Boy Gold Mine
So, I was more excited than scared of the surgery, but now I occasionally think about the radical changes that are about to take place. After the surprisingly uncomfortable transvenous liver biopsy, I am a little wary of the surgery itself, but I have more anxiety about the full sedation. Nothing serious, just a bit of the pre-surgery jitters.

Monday, July 18, 2011

July 18th 2011 - Caffeine and alcohol

So you're not supposed to drink caffeine after bariatric surgery because it's not a good source of hydration. Actually, coffee dehydrates you. You are supposed to drink one glass of water for every cup of coffee. People should drink by the 8x8 rule. 8 glasses of 8 ounces of water.

After my Realize Band surgery, my surgeon wants me to stop drinking liquids 15 minutes before a meal with no drinking during the meal and on out to 45 minutes after the meal. And you can only sip on water because of the reduced stomach path. It is a bit of a challenge to drink 64 ounces of water, let alone the replacement volume from a cup of coffee.

I love espresso. I love coffee, but I only drink one or two cups of coffee per day. Plus, I drink maybe 50 ounces of light iced tea a day. I love tea. So I tried to back off like I did about a month and a half ago and I got a massive headache that went away as soon as I had a cup of coffee.

I'm trying to wean myself now, but it isn't easy. I don't think people realize how addictive caffeine is.

Of course, my surgeon also recommends no alcohol for the same reasons plus the empty calories. That, of course, is not an issue for me and my broken liver. The last real drinking I did was March 19 before I found out about my liver. I've never been even close to an alcoholic, but I do enjoy craft beers and wine and the occasional martini. I've now been totally dry for two and a half months. I kind of miss the flavor, but not the alcohol.

Saturday, July 16, 2011

Saturday July 16th 2011 ~ Preparing for the Realize Band shock

Make no mistake. Life after the surgery is going to be a shock to my system. I'm not afraid of it because I know I can master the situation. Other than struggling with bipolar episodes and panic attacks, I am in full control of my life. I have reinvented myself several times.

When I was 20 I told my wife I would be a vice president of the warehouse company where I began as a forklift driver in ten years. True to my word, I worked my tail off and took on every detail they promoted me to and after ten years I had the title of General Manager over seven large warehouses and I was working out of the former VP office complete with a personal secretary. They wouldn't give me the title of VP only because I hadn't completed my college degree. It was suggested that the college barrier could be circumvented through my enrollment to night school at Cal State Hayward or Berkeley. I had two young children and a devoted wife who was working as a stay at home mom and I worked over 60 hours a week. There was no room for college until my father died and left me enough money to take a professional break and return to college full-time.

The first day of college a counselor told me this was my opportunity to graduate with straight "A's." I took the challenge and graduated sum cum laude and third in a class of 900. I had my choice of graduate and law schools, but my wife was warned by other wives that law school would be the most demanding yet so I choose to return to Colorado and attend The University of Denver's School of Law. While preparing to move from NY to Colorado the university's graduate school of international studies offered me a scholarship and a prestigious fellowship so I transferred from the law school to GSIS and worked on a master's in international security.

In my last year of graduate school I had co-founded an internet company that immediately started to expand beyond our expectations and I successfully presided as the President/CEO until we lost funding 3.5 years later. That's when I had to be hospitalized for a severe bipolar episode. I was suicidal. The medication I was prescribed increased my weight by over 100 pounds.

A few years later I was working as a successful auto broker and I returned to graduate school and completed a Master's in Education/ Instructional Design. For a short time I served as CEO for a snow board company, but I realized it required far more funding than I would be able to raise so I returned to brokering autos.

Then I got sick and they told me I had leukemia. I also was hospitalized while having the most severe psychotic/bipolar episode in my life. I literally can not remember the month of January 2008. It was sad and scary for my wife because no one knew if I would ever come back to reality. But, I did and I struggled with my health while my financial life was in ruins and we lost our $500,000 home and we had to share a house with my wife's aunt.

One day I woke up and decided I was going to work from home as a writer. Two years later I have this blog, several freelance writing gigs, and I am about to complete my first book. I already have several literary agents interested in publishing my book and requests for two other books; the first of which is a book about my trek to bariatric surgery and beyond. I have also been asked many times to write a book about my famous late father. Today I earn a living managing my late father's film and art career and writing.

My point is that I have always been able to over achieve professionally and personally. I've been happily married for 27 years and we have raised three wonderful sons. Out of everything I have accomplished, I am most proud of my family. Successful marriage and parenting takes a lot of commitment and hard work. It doesn't just happen.

But there is one area that I have failed and that is in the category of weight control, but I am taking control over it through this surgery. I have no illusions about life after surgery. It is going to be an emotional struggle as I break my addiction to food and bring my body into the shape it needs to be in in order to be a good candidate for a liver transplant.

What things are going to change:

  • I will go from eating basically anything to eating one quarter cup of specific food three times a day. That is going to require a severe change in diet. I will no long be able to drink alcohol (done), drink caffeine (almost done), eat bread, grains including rice and oats, drinking anything carbonated, and nearly eliminating sugar. My diet will now be about proteins and more proteins. What I can eat will be dictated by texture and nutritional value. Basically meat, but not all meats (no more steak), eggs, cheese (within limits), fish, and soy products. It's going to be hell for a while until I adjust, but I'm stronger than my weight and I will succeed because I want to and I must.
  • Medications are going to be a challenge. I take medication for my thyroid, bipolar disorder, anxiety, sleep, and pain management (my spleen and liver to a lesser degree). They suggest that you switch to liquid medications, but only a few of my medications are available as liquids. The rest I will have to split or crush. A few of my pills are small enough to swallow through my new stomach, but only a few out of many.
  • Psychological struggles will no doubt arise. I am a healthy muscular man trapped in a morbidly obese body. As I start losing weight people will treat me different. At some point children will stop giggling at the fat man and people my stop calling me big man. I have a sincere smile and people smile back at me, but it's going to be a fun day when someone flirts with me. It's been a long time. I will have to overcome the emotional scars of being fat and ridiculed. Make no mistake; fat people are constantly discriminated on and it seems that we are the last frontier of open season for politically incorrect jokes and snide comments. I will do whatever I can through my next book to bring attention to the ridicule that society dishes out on fat people. People see obesity as a weakness. I propose that food addition is the most pervasive addiction known to man.
  • Let's not forget clothing. I have a lot of clothes to wear as I descend from 400 pounds to 300 pounds, but after that I will have to be constantly buying new clothes that are not as visibly baggy. I suppose that's okay since style has changed since I was thin. 
  • One other change that, perhaps, people don't think about is floppy skin. I think my skin is still somewhat pliable, but I will undoubtedly need to have plastic surgery to remove excess skin. So, my next little nest egg of savings will be for skin removal.
  • Of course there are huge upsides beyond the obvious. It will be easier to fit into cars and economy airplane seats. Personal hygiene will get easier right away. Right now I shower often because toilet paper is just not good enough. I will fit into more chairs without worrying about their capacity load. I will be able to scoot by people and obstructions better. Perhaps one of the greatest things will be ease of putting on socks. I can do it now, but it's hard and I need to be sitting on my bed to do it.
  • Oh yeah, then there is general motion. If you are at an ideal weight, imagine carrying yourself around everywhere every moment. Simple walking and exercising will become easier. I can't wait for that. And then there sex. Of course I am perfectly capable now. I have found creative ways around my obesity and I have a very healthy sex life, but it's going to get even better when I become... more flexible. Yes, I am looking forward to feeling sexy again.
My life is about to change in so many ways that it will be a shock to my food addiction, my body, my psyche, my self-esteem, and to basically everything and you know what? I can't frick'n wait! 18 days to go!     

Wednesday, July 13, 2011

Wednesday July 13th 2011 ~ Blogging with purpose

As I near the joyous day of realizebandedness I am reminded of my original purpose in this blog. I was talking to a friend about my 2009 trek (aborted trek) to bariatric surgery. If you remember back 341 posts ago you might recall that I changed my mind about the surgery just before I was to pick a date because I stumbled into a pro-vegan book "Skinny Bastard." I thought that I better give vegan a chance. Combined with a grueling exercise regiment I lost about 35 pounds that summer and then gained it back as my metabolism adjusted and I just gave up on it.

Anyway, my friend told me that I should share my struggle in an honest and frank way so that others may benefit from my experience. At some point I added bipolar post because I am... bipolar and it does have a substantial affect on weight loss. For one, most of the bipolar meds cause weight gain and as an emotional mess that eats when he's stressed, being bipolar is an extra umph to the struggle.

At this point I am going to start Google-izing (advertising) on Google because this is the eve of my life changing surgery. I will be posting everything about the surgery; how it felt, how I felt, how my wife felt, ect...

I fully expect the first week after the surgery to suck big time because your stomach swells as a reaction to the surgery and I'll be on a liquids only diet for that week. And I have no illusions. This surgery is going to give me my body back, but the trade off is that eating and drinking will suck. Cup your hand. You probably have about one to one and a half cups. That's more than I will be eating in any given day for the rest of my life.

What happens when you cheat? First, you throw up anytime you eat too much or something gooey or something stringy or something greasy or anything that might get stuck in your new little tummy. If you repeat overeating or cheating you will defeat the purpose of the Realize Band. Remember: it is a tool not a cure. If you overeat consistently, you will stretch your little tummy out and probably force the ring out of place. The nurse said that if you vomit too much or too strong you may also dislodge the ring and... bam! Back to surgery. It is possible to get something so stuck that it requires a visit to the emergency room.

I have no illusions. This will be the hardest thing I will be doing in my life, but it is necessary if I want to get onto the liver transplant list (stage four liver cirrhosis caused by being fat). But, I'm ready. Bring it on! I am going to set the record for miraculous "healthy" weight loss! You can be with me everyday. It'll be fun. Bring a friend.

Tuesday, July 12, 2011

Tuesday July 12th 2011 - Another bipolar episode

First, the good news; the surgeon's office called my insurance to start the approval process again and my health insurance, Anthem BC BS, told them that the date of operation just had to be changed and everything was ready to go. So, the hospital/surgeon pre-operation appointments are set for July 29th and the surgery stands at August 3rd. Just twenty-two days away!

Last night I sent in my loan paperwork and I'm going to the cemetery this afternoon to close the final deal on the sale of the last two plots. The loan is $3,000 and the plot sale is $2,200. Combined with the $2,000 plus in savings and I easily have my rough $6,000 covered plus I can pay off all of my credit cards. My credit cards were nearly paid off until I had the car repair and my son dropped coffee into his laptop.

So, I thought I had my father's death anniversary under control, but I was wrong. On Saturday, my wife and I had a nice lunch with friends and then went to see the new movie "Horrible Bosses." The movie was hilarious and returned home in a good mood. And then it hit me. I'm not sure what set it off, but I started snipping at anyone and everyone as soon as I entered the house. I knew I was being irrational and no one deserved my attitude so I left the house and drove into the mountains by myself.

My attitude was quickly slipping into a panic attack so I took the appropriate medication (a mood stabilizer and an anti-anxiety pill). By the time I was 20 minutes into my drive I was feeling better, but not well enough to go back home. Instead I drove up to a National Park just north of Evergreen Colorado. It had just rained so the air was crisp and the park bench was a bit wet.

As I sat next to a beautiful mountain meadow the only noises that interrupted complete silence was the occasional dart of a bird and the incessant call of a mother Elk to her baby Elks. There were so many Elk around me that at any given time I could watch young Elk frolicking about 30 yards from me and many female Elks grazing in the meadow right in front of me. I sat real quiet and four Elk walked within 10 feet of me. It was beautiful and it knocked me back into shape. I returned home a changed man and the rest of the weekend went well.      

Saturday, July 9, 2011

Saturday July 9th 2011 - Weight gain associated with Bipolar medications

Weight gain is one of the most common and difficult side effects of many of the medications used to treat bipolar disorder and other psychiatric illness. The most common types of bipolar meds are atypical anti-psychotics, anti-depressants, anti-anxiety, anti-manics or “Mood Stabilizers” and anti-seizure medications.  

When I was initially diagnosed as Bipolar in 2001, my psychiatrist put me on a combination of anti-psychotics including Seroquel, Lithium, Depakote, and clozapine. All of these drugs are in the highest weight gain risk group. I was already obese, but these drugs made it impossible to lose weight. True to the claims, I gained weight like a sumo wrestler. 


Through the years I have adjusted my bipolar "menu" to Lamictal, Hydroxyzine, Seroquel, and Lorazepam. Lamictal is an anti-manic mood-stabilizer. Hydroxyzine and Lorazepam are anti-anxiety meds. Seroquel is an anti-psychotic. I've been on these drugs for over four years and they are very effective. I still suffer from the symptoms of being manic-depressive and I still have panic attacks, but I'm not totally incapacitated by them. I'm sure that I would be incapacitated and a puddle of useless poop without these medications. 


I have borrowed the following quick reference guide from a Candida Fink, MD's blog article at http://blogs.psychcentral.com/bipolar/2008/10/preventing-and-reversing-weight-gain-associated-with-psychiatric-medications/


Atypical Antipsychotics

Almost all of the atypical antipsychotics are notorious for causing fairly significant weight gain in most (but not all) people who take them. Here’s the list of culprits ranked from most to least risk for causing weight gain:
  • High risk: Olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), aripiprazole (Abilify), and clozapin (Clozaril)
  • Little to no risk: Ziprasidone (Geodon) and older first-generation antipsychotics such as perphenazine (Trilafon)
The weight gain from antipsychotics appears to come from increased appetite (“hyperphagia”) and some changes in metabolism. This family of medicines also has varying degrees of risk of certain health risks such as diabetes and elevated cholesterol, which may be related to the medication’s effect on metabolism.

Antidepressants and Antianxiety Medications
Antidepressants and antianxiety medications all have some risk of weight gain, although not typically in the same severe range as the antipsychotics. The risk seems to be more individualized – some people notice a lot of change in appetite and weight and some notice little. Occasionally, some people actually lose weight on these meds. In addition, these medications do not carry specifically the risks of diabetes and high cholesterol.
The most common antidepressants and antianxiety medications are the SSRI’s and SNRI’s (the weight gain risk really depends on the individual):
  • SSRI’s: Fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa) are some examples.
  • SNRI’s: Venlafaxine (Effexor) and Duloxetine (Cymbalta) are the most common.
Bupropion (Wellbutrin), which is in a class of its own, is the only antidepressant without any risk of weight gain – but it is not particularly effective for anxiety.


Anti-Manics or “Mood Stabilizers” and Anti-Seizure Medications

Mood stabilizers and the anti-seizure medications often used to treat or prevent mania may also carry the risk of causing weight gain, but the risk varies depending on the medication and its effect on the person taking it:

Curbing Weight Gain via Medication

When medication triggers weight gain, one of the more obvious solutions is through medications – either selecting a different medication that’s less likely to cause weight gain or adding a medication that has a track record for negating the weight-gain side effect.


The most important factor here is good communication with your prescriber and regular monitoring of the medications and their effects – both good and bad. Some weight gain may be unavoidable, but try to be honest with your doctor about what you will and will not live with in this department.

Thursday, July 7, 2011

Thursday July 7th 2011 - Financing the bariatric surgery

Try as I might, after two more auto repairs and a laptop repair, I'm not 100% sure that I will have the $6,000 on time for my July 20th appointment with the surgeon, so I have elected to accept the $3000 medical loan with the high origination fee. It comes with a "First year interest free" payback clause, so I should be able to dodge the 19% interest rate. I really don't need the full $3,000 but I wanted to have some money left in savings in case something else breaks. Of course, I always have credit cards, but I don't like to carry more than a collective $500 of credit card debt.

Based on the amount of paperwork and verification needed by the finance company, I believe that Medical Financing dot com usually makes loans for much higher amounts. I received via email a loan application with about six pages of gobbly gook. Not only do I have to provide proof of income and two forms of identification for both my wife and I, I also had to have our signing of the financing agreement notarized. I should be able to file the application tomorrow if I can get a signature from the surgeon's office. 

Of course, as soon as I receive the loan, the sale of our extra grave plots will close. At the very least I can pay off the medical loan early. Either way, I wanted to guarantee that I would have enough for the surgery by July 20th. I'm sure that if I had to raise $12,000 I would have found a way. I know this because God has always given us just what we need; never more and never less.

Tuesday, July 5, 2011

Tuesday July 5th. 2011 - Independence Day weekend

The July 4th US Independence Day is full of BBQ's, picnics, family, friends, and fireworks. Yesterday, the weather in Denver Colorado was smoking hot. I believe it was in the mid-90's and the sun was blazing down until around 4PM when some welcomed clouds appeared.

My brother was initially going to have a relatively small BBQ at his house, but some more people got invited and he decided to have it at Delaware Park in Littleton. The park was hosting a huge fireworks display so there were at least a thousand people with picnic blankets and overhead tents. Children were running freely between the families. Frisbee's and footballs were being thrown around all over the park. We had about 20 people in our group.

My brother had brought his huge gas grill to our spot and we had hamburgers, hot dogs, bratwursts, baked potatoes, broccoli salad, chips, soda, beer, and a 40th anniversary cake for my parents, plus someone brought a cherry pie. Out of those I had a bratwurst, broccoli salad, iced tea, and then I had cake. 

The fireworks were great as usual, but my wife complained of stomach pains when we were finally headed to bed and then I woke up with an emergency diarrhea situation. After I was relieved I fell back to sleep. I still have a stomach ache, but it can't be from the BBQ. Actually, it could have been the mayonnaise. I'll have to compare notes with anyone else that got sick.

As I was sitting watching my cousins twins chow down on bottles I realized that this would be the last 4th of July picnic where I could eat anything I wanted. And my second thought was GREAT! Still can't wait!

On a sad note; On July 8th 1993 a good friend of ours found my father, Paul Sharits, dead in bed in Buffalo New York. He had told his friends that he was heading to Toronto for the July 4th weekend with his girlfriend and then he cancelled with her because he said he was sick. So most people assumed he was taking a bit of a vacation when he was really committing suicide.

While he was found on the 8th, I think he started the process of overdosing on July 4th because it was his favorite holiday. He was 50. I mention this not only because I get sad between July 4th and July 8th, but also because it was one of the events in my life that caused some considerable weight gain.

Some people have strained relationships with their father's, but I did not. I was his only child and he treated me like an intelligent young man. I miss him deeply. He is a famous artist and filmmaker. He was also bipolar and an alcoholic. His work can be found at PaulSharits.com . Have a good week.

Sunday, July 3, 2011

Sunday July 3rd 2011 - Anticipation

I keep looking at the calendar. August 3rd couldn't come fast enough. It may be the biggest life changing event in my life. It's just below August 11th 1984 when I married my wife and high school sweetheart. It would also fall below the births of my three sons, but that's about it. I hold my education, both formal and in life, in high esteem, but definitely below bariatric surgery. None of my professional feats can even compare. If I won the lottery, it would still be below bariatric surgery... maybe.

Think about it. I am going to time travel back to the days when dieting was something that other people had to do. As a young man I had a physically demanding warehouse job and I could eat like a bear and not gain weight. I looked great in a speedo. Sexy muscular legs. I miss my sexy legs. But, then I entered the ranks of supervisory management at age 20 and never went back to blue collar work. Back when I was thin I could buy clothes off the rack of any store. Back when I was thin Ronald Reagan was president. I'll be going clear back to B.C. (before children).

But life is about to change in other ways. I will never be able to chug water again (drinking too fast will cause a biological backup and could possibly stretch the stomach) or drink carbonated drinks of any kind (they stretch the stomach). I will have to stop caffeine once and for all. No more peanut butter and jelly sandwiches. This one's huge for me: NO more bread. No rice. No expandable grains.

I am a little nervous about taking all of bipolar meds. They suggest that you get your meds in liquid form, but mine are not available. I will have to split them into small enough pieces to pass.

My eating will be restricted to less than a half a cup of food in any sitting. Actually, the goal is 1/4 cup or 2 US ounces. The type of food is dictated by texture more than calorie content which means I can pretty much take a bite of anything that isn't too thin like cream of wheat or greasy like fried chicken.

The reason bariatric surgery works is the same reason it can be blown. The purpose of the Realize band is to restrict the volume of food consumed. It also decreases the stomach acid that makes you feel hungry. When maintained properly, the opening can only be controlled by filling and draining the saline lining of the band.

The way that many people blow the surgery is by cheating. Eating unhealthy food or overeating. When you overeat it stretches out your stomach. I actually know some bariatric band patients that tried to expand their new stomach pouch. It primarily because their still addicted to food. If you stay fat in your head you will probably become fat again regardless of the surgery. It's a tool, not a cure.

Right now I avoid airplanes. I should correct that... I avoid flying economy. I can't fit into those tight chairs in coach. Starting in November of 2011 I will be flying around a lot more. I will have art related travel to NYC, Buffalo, Toronto, London, Paris, Berlin, and Italy in 2012. It is going to be much nicer after I lose my first 60 pounds. I can't wait for this surgery. Only 30 days of regular eating left! Yeah!!!