Thursday June 30th 2011 - Happy Two Year Anniversary Blog!!

On June 29th 2009 I decided to start a blog about my trek through bariatric surgery. Shortly after I started the blog I had determined that I had not "tried" everything to lose weight so I stopped the surgical process and went vegan. I indeed lost weight and then gained it back. 


When I was originally researching bariatric blogs I was very disappointed to see the bloggers dropping out of their blogging shortly after surgery. Most of the blogs I found had less than 20 posts. This is my 336th post. I pledge to continue my blog until I reach my ideal weight and even then I will continue as a sounds board for bariatric patients.


This month is my best readership month yet with just shy of 1,000 visits. In the last year I have had 7,500 visitors. My stat program got changed in June 2010 and I lost track of my visits in 2009, but, according to my notes, I had at least 3,500 visitors making my grand total 11,000 to date.


The following is my very first "Welcome" post from June 29th 2009. Surprisingly, my goals for the site have remained the same:

Welcome

Hello, welcome to my first blog. This blog is intended to encourage obese people and friends of obese people. I wanted to create an honest and frank website about losing massive amounts of weight. This is not about "losing 40 pounds in 60 days". This is my trek to good health. You can join me, post responses and questions as I enter the next chapter of my personal weight loss. I will be reproducing this blog site in the third part of my new book about "Morbid Obesity: Eat to live, not live to eat". It will follow my past path from young and fit to 44 years old and fat. The second part will be leading up to and life after bariatric surgery. More than an autobiography; the book and this site, in cooperation with medical professionals and trusted resources, will answer many of the medical questions about obese complications and the steps necessary to obtain your ideal weight and live a long and happy life.

Wednesday June 29th 2011 - The Dangers of Diet Pills

I have a friend who is starting to take some very powerful diet pills. I can't express strongly enough how much I despise diet pills. I think they are dangerous. They may work for a while, but the long term effects of the medications can be horrible and permanent. The biggest problem with diet pills is that once you stop taking them your body goes into overtime to restore the previous weight. And, mind you, I have tried several with temporarily successful results until I stopped taking them. Instead of helping me, they just contributed to my long term yo-yo upward spiral.

Back in 2009 when I was first preparing for the Realize Band surgery I wrote the following article. You may also find this article at http://ezinearticles.com/?Dangers-of-Diet-Pills&id=2571489

Dangers of Diet Pills
by Christopher Sharits

American's spend more than 6 Billion dollars a year on diet pills. There are literally hundreds of diet pills. At any given time there are dozens of "lose weight quick" schemes in the media. They usually involve some "miracle" drug or supplement foods. Whether the pills or ingredients are over the counter or prescription, they can be very dangerous to your long term health.

Remember fen/phen or Ephedra. Both caused heart trouble and were banned by the FDA. That's two out of hundreds of pills, many of them unregulated. Most diet pills contain caffeine (a stimulant added for that "burst of energy"). While almost everyone drinks or takes caffeine, it can be dangerous in large quantities. Caffeine stimulates adrenaline which increases blood sugar and begins to emit cortisol which destroys the nervous system. Imagine a person who drinks coffee all the time and takes diet pills. They would have greatly increased their risk for cushings disease. Other common ingredients are Xenical (which can cause unexpected fecal discharge), Adipex, Phentermine, and Merdia. The side effects from these drugs can be chest pain, racing heartbeat, depression, heart problems (even failure), high blood pressure, dizziness, tremors, diarrhea, and nervousness. Even "organic" diet pills are dangerous and, for the most part, unregulated.

If you still believe in these "short cuts" you should consult your doctor (especially if you are taking prescription drugs). If you insist on taking diet pills you will probably need to stay on them for a long time to maintain the desired results. Like any conventional diet, once you stop, the weight may return. Long term use of diet pills greatly increase your risk of permanent bodily damage. There is simply no substitute for a moderate balanced diet and exercise. Forget about the ingredients in foods and watch your calories. As I continue to argue, morbidly obese people need to have a balanced diet, exercise, and strongly consider bariatric surgery.

Bariatric surgery is for the morbidly obese. It is not the solution or a quick fix for weight loss. Rather, it is a powerful tool for the morbidly obese to finally obtain an ideal weight. Like any tool, it requires a balanced diet and exercise. There are two basic types of bariatric surgery performed today. There is the traditional Roux-en-y gastric bypass for the super morbidly obese that actually redirects food around the stomach. It is an invasive surgery. The more popular weight loss surgery is the "Lap-Band" or "Realize Band" that simply reduces the size of the stomach through an adjustable ring. It is performed laparoscopically and is much less invasive. Both of these bariatric surgeries have proven to be very successful for permanent weight-loss. There are pros and cons to both surgeries. You should find an experienced surgeon to find out if bariatric surgery is for you. If you do chose bariatric surgery, you will avoid nearly all of the organ damaging effects of diet pills. As with any successful weight-loss program, the common variable is life long balanced diet and a regular exercise program.

About the author: I am super morbidly obese and currently jumping through the hoops to have the "Realize Band" installed. I write articles about my journey to my ideal weight. You can follow my trials and tribulations on Twitter and my "Super Morbid Obesity" daily blog at http://lose250.blogspot.com

Article Source: http://EzineArticles.com/2571489

Tuesday June 28th 2011 - Dieting in the mean time

I was pretty upset about the surgical delay. It definitely didn't help my week long bipolar depression. Yesterday was a better day emotionally and I feel pretty good today so I must be cycling back up. At least I hope so.

Good thing because I am trying to finish writing part two of my book "Night in Positano." If you're new to my blog here's a two liner about the book... "Night in Positano" tells the story of a young man from Boulder Colorado who is struggling with onset bipolar disorder and psychosis. While visiting his father in Positano Italy Nick has a major bipolar episode and attempts suicide. You can read a free preview at NightinPositano.com.

The last few months have been marked by overeating and sneaking sweet snacks. This weekend I started to really crack down on my diet. Just for this week I am eating oatmeal with nuts and raisins for breakfast and lunch. At dinner, I am only eating one small plate of food. Hopefully that will help me feel less bloated and uncomfortable.

My downfall is peanut butter and jelly at night. I get so frick'n hungry if I stay up past eleven. On Sunday I did great until my 15 year old's birthday BBQ. I only ate one plate, but I had cake and ice cream. I felt so bloated I thought I would burst. As much as I hate feeling hungry, I really hate over eating.

I am also going to return to the gym... this afternoon. I am going to renew my six month membership because I feel guilty not going four or five times a week. I want to be in as good of shape as I can be when I get my surgery so that I can really hit it like I am on the "Biggest Loser" television show.

Before I go back to writing the book I wanted to briefly address a disturbing issue. Okay, maybe two parts of an issue. First, my wife has a friend who is also losing the battle against morbid obesity and she feels horrible, defeated, and ugly. She is not ugly. As for her other thoughts, I completely understand. My wife told her that I was embarrassed to go out into public because I feel like everyone is judging me based on my weight and that I just look disgusting. That part is true. She said that she couldn't believe I thought I was hideous because I don't look that bad. I think I do. I can't wait for the surgery. But, it brings up an important point; fat people usually have a negative opinion about themselves as if their self-worth was based on their weight. I always think people has a negative opinion of me until they hear me speak and realize that I am more than a fatso.

Second, fat people are routinely picked on. The politically correct world says we can't use words that offend people, but it seems like there is an open season on making fun of the fat guy. We don't actually eat people... unless we have some good BBQ sauce. Oh and hide your babies cause we'll eat them. Oh yeah, we are so stupid and weak because we can't put the fork down. You know what  I say to all that crap? F%*#$ you! No one wakes up says, "Hey, I feel like getting fat today." And becoming obese doesn't happen overnight. It is a gradual process that reaches a point of frustration where people just give up. But, why can we accept that celebrities actually need to go to treatment for being horny and we can't accept that many fat people, like me, are dealing with an addiction to food. Oh yeah, I am going to eat the next kid that snickers when I walk by.

Saturday June 25th 2001 - SURGERY DELAY!!!!!!

Our insurance is through my wife's employer and it crossed its annual renewal date July 1st. Since my surgery was scheduled for July 11th the insurance told the surgeon's office that they would have to refile the packet that had already been approved. It took the insurance eight days last month and, considering the July 4th holiday, we don't think they will be able to get the new approval before my surgery date.

Considering and estimating the timing of events, we have rescheduled my pre-op appointment for July 20th. By then we will have the new approval. The actual surgery is now scheduled for August 3rd.

While I am disappointed, I believe it was God taking care of me. For one, I'm taking a working vacation to Santa Fe, New Mexico the week of July 24th. It was never a good idea to travel so soon after surgery, but I wanted the surgery so bad I was willing to ignore the obvious red flag.

In addition, it gives me more time to formulate my funding strategy. I've marked down my cemetery plots to the point that I undercut all of the competition so I am sure I will sell them soon. Losing the previous sale was near disastrous for the July 5th pre-op meeting where I needed to pay my portion of the bills. I could have done it, but it meant maxing out three of my credit cards.

As I had written previously, the peer to peer loan wasn't working because most people are unfamiliar with the lending practice. However, I did receive an approval from a medical financing company for $3,000. The loan is fine, but the origination fee is $1,000. Their justification for the huge fee is that my credit risk is too high and the fact that they would have nothing to re-possess like a tangible item like a car or a house. So basically, this company would be loaning me the money without any security. I don't like it, but I get it.

I have until July 8th to accept or decline the loan. Hopefully I won't need it, but I would rather accept the fee than max out my credit cards or borrow money from family. If you look at the whole picture, I am saving $2,000 because the hospital classified my surgery at the lower rate plus I can save $1,800 by paying the anesthesiologist and the surgical assistant early. And, of course, its just money and I would have gladly paid far more than I am actually going to pay to have the surgery. If they had told me I needed $12,000 it would have been a challenge, but I would still do it.

The main thing is that I am frustrated and seriously depressed by my weight. I do not like being fat. No one does. This surgery will literally save my life by weight loss and increasing my potential ability to have a liver transplant. I hate the delay, but it is probably a good thing.

Wednesday June 22nd 2011 - And some days just suck

Today sucks. I'm wired different than most people. Bipolar suffers are wired differently than others. We take chances and hang ourselves way out on a limb. We go for broke and fail to see the barriers of normal life. That is why so many bipolar people do such fantastic over the top things. That's why some of our greatest bipolar leaders like Lincoln or Churchill have done the impossible. Its because they fail to recognize impossible.

I'm that way. I can't do anything half way. I'm all in or not. When I'm manic nothing is impossible, but, when I'm depressed, nothing works. Today sucks. It seems like everything is working against me. I do so many positive things. I know that. I do things that other people wouldn't even consider trying. I genuinely think there is nothing I can't do if I apply myself. Of course, that's silly. Everyone has limitations, I just don't recognize mine.

But today, I just feel defeated, frustrated, lonely, and hopeless. On the bright side, I'll probably bounce out of this despair when I cycle up. Just have to hang one until then.

Oh yeah, remember that great idea about the peer to peer financing? It only works if other people care. Even though I sent out info to my friends on facebook and my family and friends via email, no one that I know has even invested $25. So I guess that's what my life is worth. Less than $25. Being bipolar sucks.

Tuesday June 21st 2011 - A better way to fund bariatric surgery!

I thought I was all set, but my financial plan needed the sale of two cemetery plots that I thought I had closed, but, on Father's Day, the elderly couple's grown children told them not to worry about pre-planning. Someone else could buy the plots, but I can't rely on that payment by July 5th when I need to pay the hospital. 

I could use my credit cards or a personal loan, but I decided to try a different route to close my $3000 gap. I have listed my loan request on Prosper.com which facilitates "peer to peer" investments. The idea is that any site registered investor could go to my request and invest as little as $25 or more towards funding my loan request. The collective investments will quickly fund my request in days. 

Unlike Kiva.com micro-loans, peer to peer loans generate a strong return on their investment. It's really a smart way to help out a friend without all the personal crap.

My loan request is for : This loan will be used to... prepay balance of $3,000 from a $16,000 Realize Band surgical procedure on the 5th of July for the surgical procedure on July 11th, 2011. 

To see my loan listing and hopefully invest in my request, go to https://www.prosper.com/invest/listing.aspx?listingID=512627&utm_medium=email&utm_campaign=system_event&utm_source=borrower_listing_created&utm_content=view_listing

June 19th, 2011 - Bipolar panic attack

I really have no idea why this happens other than to say that it is a symptom of my bipolar disorder. About a month ago I had several unexplained panic attacks. They happen the same as today's did.

You'd think I was happy about father's day and the surgery approval. Plus, yesterday I went with my wife and 20 year old son to Breckenridge Colorado to tour the Country Boy Gold Mine. It was awesome. I should post some pictures. I will definitely post on my facebook account. You can become my "friend" if you add a note that you are a lose250 blog reader. I think you can find me as Christopher Sharits (Lakewood Colorado) or by my email address csharits@comcast.net. After the long tour into the bowels of this picaresque rocky mountain we panned for gold. Cheri and Jeff found gold. Well, some flakes.

So anyway, I've had a great weekend and there was no reason to have a panic attack. It happened in the grocery store. I do almost all of the shopping, but today I had my wife with me. It was only a $100 trip and I was finding everything I needed on my list. All was good and then in the laundry soap isle I started to sweat. By the end of the next isle my heart rate shot up and I started to lose my breath. I told my wife we had to hurry and get home because I didn't have any lorazepam with me.

Everything became, well I think I was hyperventilating, so everything looked bright and flashy. I could hardly mask my distress. We got out to the car and I was nearly in tears. My wife tried to talk my off of the ceiling and I got back to the point where I was just hyperventilating. I slowed my breathing and we made it home. I got a huge glass of ice water and took two lorazepam. I sat and tried not to show my emotions because I knew I was irritable and could easily transfer my distress towards someone else who obviously didn't deserve it. I chilled in my bed and fell asleep until dinner. Now I feel better, but I still feel as if I was in a marathon.

Sunday June 19, 2011 - Insurance approval letter

I did a mental cartwheel when I received this letter from my insurance company approving my Realize Band procedure and I thought I might share it.

My favorite sentence is "Based on the information provided to us, we are pleased to authorize your admission for the service(s) list above." Procedure listed above: "Lap place gastr adj device."

June 17th, 2011 - READY TO GO: Surgery date July 11, 2011 !!!!!!

I just received the call from the surgeon's office! My insurance has authorized the surgery!


Important Dates:

• Meet with Swedish Hospital on July 5th for pre-surgery blood draw and medical review. It will take at least one hour. Apparently, there is a lot of paperwork and review of my doctors notes.
• Meet with Dr. Tillquist (surgeon) after I finish with the hospital on July 5th for final prep. It is at this time that I will pay the hospital $4500 and pre-pay the anesthesiologist $1080 and pre-pay the surgical assistant $270 (for reasons unknown, the assistant must be paid in cash or check).
• SURGERY DATE : JULY 11, 2011 !!!!!!!!!!!!!!!!!!!! I will find out the exact hour next week. It will be in the morning and I should be on my way home before evening!

At this point I have the $4500 in cash as well as the $270. I may have to use my credit card for the $1080, but it is a green light. It is going to actually happen. I'm so excited I could eat an entire cheese cake! (kidding) Actually, now that it is real I am going to hit the gym everyday (starting Monday) and try to lose a good 10 pounds before the surgery. YEA!!!!!!!!!!!!!!!!!! :-))

Thursday June 16th, 2011 - Final cost of Realize Band Surgery

Finally!!! Quick note: Costs in the United States vary according to insurance stipulations and contracted cost controls with the hospital and the surgeon.

As stipulated by my insurance, I had to use a surgeon who has been awarded "Center of Excellence" status. My surgeon, Richard Tillquist with Swedish Hospital in Englewood, Colorado, was awarded this recognition through a history of great patient outcomes from the operation and a clear commitment to comprehensive, high quality bariatric care.

My healthcare insurance is Anthem Blue Cross/ Blue Shield PPO. Our particular plan is on the high end of our choices because we wanted the extra coverage's and smaller deductibles ($1,000 per person). Plus, the pharmacy coverage is great. It is a group policy through my wife's employer and I believe the healthcare insurance premiums cost our family of five about $1,300 a month.

After the hospital did some research, they decided that I qualify for the contractual lesser amount of $9,000 for the surgery. My insurance will pay the hospital $4,500. I will have to pay the hospital an additional $4,500 before the surgery.

The contractual insurance limits my surgeon to $1,800 for his cost which includes the first three post-op appointments. The insurance has $3,000 limit for the surgeon so the remaining $1,200 will go towards additional office appointments. I do not need out of pocket money until the $1,200 is exhausted.

The anesthesiologist costs around $2,000, however, if I pay in advance they will reduce that to $1,080. The only other cost is for the surgeon's assistant. I believe it costs $800, however, if I pay in advance they will reduce that to $270.


In conclusion, due to insurance contracts with the surgeon and the hospital, the total cost of the operation is an astoundingly low $13,350. That's compared to the estimated cost of $17,000 to $20,000 that I found online for the larthoscopic Realize Band surgery. Overall, I am responsible for $5,850 which is lower than I ever imagined.

Now I am waiting for the surgeon's office to call me once they have the final insurance approval. Then I can pick a date for the surgery. I will pick the earliest available appointment.

Saturday June 11th 2011 - How I got fat revisited

I am waiting impatiently for my insurance approval. I should get it this week and then I will schedule the surgery. I can't wait. I am going to workout like I did in the summer of 2009. In the mean time I reflect...

When I was in high school I was at my ideal weight (175 pounds). After graduation in 1983 in Lakewood Colorado, I got a job in warehousing in Hayward California. For the first three years I worked on the swing shift between 5:00pm to 2:30am. I was a forklift order puller. It was a very physically strenuous job and it went way past my bedtime so two significant things occurred. The men of my shift ate like mad men and then turned around and drank gallons of coffee and no doze.

Anyway, this is the point where I started losing control of my metabolism. Binging and then voluntary malnourishment. I worked for that company for seven years and received promotions almost annually. When I left that environment I was a warehouse manager and had not worked a physically strenuous job for at least five years, but I still ate like I did when I was 19 and strong. So eight years after graduation I weighed 245 pounds.

I fought the weight while I worked as General Manager at a different warehousing company in Oakland California and got back down to 235, but then my dad committed suicide and we moved to Buffalo New York and I was not handling his death well. When we left Buffalo to Denver for graduate school in 1998, I weighed 285. When I finished working as CEO of a dot com in 2001 I stressed out and reached 310 or so.

After that I consistently dieted and lost lots of weight, but then I gained it back as usual. When I got super sick in 2007 I was admitted into the hospital at 456 pounds. In the hospital I lost almost 50 pounds of water weight through IV lasixs. Then I had a serious bipolar episode that lasted for two months and I lost another 50 pounds through literal starvation and reached back to 350. I stayed there for a while and then I went vegan in 2009 and began working out about 20 hours per week and I lost 35 pounds in 8 months. Then I started gaining weight even though I was still vegan. I got discouraged and slid back to regular eating and ballooned to 360. Then I got more discouraged, tried a few trendy diets and gained back enough weight that I know sit back at 400.

I relish the thought of never seeing 400, then 380, then 350, then 300, then 250 once I have lost them. I will not gain the weight back. Some people start stuffing their faces with cheating foods and start gaining weight after a year or so with the lap band. But my weight loss will literally extend my life and make it possible to get a liver transplant. No, I will loss the weight. I will be 190 pounds within two years and I will live everyday thankful to have part of my life back. I can't weight to shop off the normal sized racks.

Wednesday June 8th 2011 - More information on the progress and cost of surgery

Before I bore you with my accounting, I would like to update you on the calendar expectations. My insurance file has been sent to the insurance and Eileen from the surgeons office thinks we could have an approval within a week. Possibly Monday.

Once I have insurance approval I can schedule a date for the surgery. Yea! If my approval comes in quickly, I could have a date as soon as after the Fourth of July. Hopefully before I go on a working vacation in Santa Fe New Mexico. I believe that would be one the week of the 25th or so. Unless there are some unforeseen complications, this should be an outpatient one-day surgery.

Now for the money:

• The insurance splits my benefit of $7500 as $4500 for the hospital and $3000 for the surgeon.
• The hospital requires either $6500. They require this amount to be paid one week before surgery. If they do not need all of the money, I will get a refund. Then again, if things get complicated, I might need all of that money.
• The surgeon has a contracted rate of $1800 so there will be money left in the benefit for the post-surgery appointments (the first three are covered in the initial $1800). They will use the benefit until it is gone and then I will have to pay out of pocket, but the $1200 will go pretty far.
• Since I am paying the anesthesiologist in advance, I will only need $1050.
• Since I am paying the surgical assistant in advance, I will only need $270.

The surgery is total costs  $15,320 USD. After the hospital rebate it could be ultimately $14,000. I am going to need $7,820 by the week before surgery so basically by the end of the month.

I have the 2500 Euro ($3,500) from France and potentially $2,800 from the sale of the two Cemetery plots. Roughly I have $6,300 leaving a difference of  $1,520. If I had to I could put that remainder on a credit card.

Then again, maybe I'll get a surgical loan for $5,000 and stash the extra $1,000 or so in savings.

Bottom line: I can afford this and I am ready for this. I need this. I could potentially have the surgery done by this time next month. One more month of being this weight! If I work as hard as I did when I became vegan and exercised like I was on Biggest Loser, I could have lost as much as 110 pounds by January 1st 2012! And by this time next year, considering a slow down in weight loss, I could have lost as much as 160 pounds in the first year! Then I will only have 50 pounds to my target weight of 190 pounds. That would be awesome. Ideal weight within the next two years!!!

Tuesday June 7th, 2011 - Cousin Vicki's card; finances; and book idea

First, an update on the finances of the bariatric surgery (Realize Band). I don't have all the answers yet, but some of my questions have kind of sort of been addressed. According to the hospital, my insurance has a contracted rate for the hospital fee of either $9,000USD for BMI's of 45 or less and $11,000 for BMI's above 45. She thought I might qualify for the lesser amount, but I seriously doubt a BMI of 59 is "borderline."

My insurance is Anthem Blue Cross Blue Shield and it specifically has a $7,500 weight loss benefit. So, the hospital gets $4,500 and the surgeon gets $3,000.

Lets just deal with the hospital for a moment since I know this variable. Assuming that the hospital's contracted rate with Anthem is $11,000, less the insurance benefit of $4,500, then I need to have $6,500 just for the hospital.

I do know that I can pay the anesthesiologist $1,080 in advance and save more than $800. There is someone else that I can pay $280 in advance and save another $600. So, as far as I know I need $1,360 for these other services. The surgeon gets $3,000 from the insurance, but I have no idea what that will cover. It has to include his services and the post surgery appointments so I doubt that $3,000 will cut it. For now let's assume I need $7,860 out of pocket. Due to family financial surprises I will probably only have $6,000 plus $2,000 if I used my credit cards. I'm thinking it would be safe to assume that I will need a medical loan of $5,000 so I can be prepared for any other surprises.

I'll know more by the end of the week. I do know that the surgeon's office is submitting my file to the insurance on Wednesday. I have no idea why it took that long, but at least its in. I don't know how long it takes for insurance approval and then I do not know how far out their surgery schedule is. I'm still hoping for August. I won't need the money until the week before my surgery date. Okay, that's the finances.

Quick note on my book idea: I will be finished with my current fiction novel by this August (see www.NightinPositano.com). I think I am going to write my next book more autobiographical and basically make a book that follows the same trek as I have recorded here since June 2009.

Finally, the card from my cousin Vicky regarding my liver cirrhosis:

"They say what doesn't kill you makes you stronger. Well, what if you didn't sign up for extra-strength training? What if you'd rather catch a break once in awhile? 
At some point you'd think you'd be entitled to a free pass or two. Avoid that crisis. Delete those problems. 
It's not that you're not strong or that you don't have what it takes to get through this. You are, you do, and you will. But you've built enough character already, and it's time for things to lighten up a little!
I know it's not my call, but if I were in charge of life's wheel of fortune, you'd get a free spin. And I'll be right there cheering you on!" (written by Linda Barnes).

Saturday June 4th 2011 - Bariatric impatience like a child

As it stands this morning I still do not know how much my Realize Band surgery is going to cost nor do I have a date for the surgery. I know that I have the patience of a child. Usually I am the opposite of procrastination. I try to react and respond to situations or requests as quickly as possible. If you send me an email, you can expect a reply within 1 to 12 hours depending on my email access. I like to be very prompt with paying bills and especially, being on time for any appointment even if it is social.

So it irks me that I have had to leave three messages with the surgeon's assistant. She's the only one that can tell me my insurance progress. Additionally, the financial lady from the hospital didn't return my call, but she may have a better excuse seeing as she might have just returned from vacation.

Part of my frustration is family finances. I've dropped a good $5000 in my bariatric savings and I keep having to dip into it to pay urgent bills. Take for example my middle son's Jeep. It had some kind of Jeep death wobble and it cost me $500. Then on Monday I have to register my youngest for summer school. He failed US Government which drives me crazy sine I have to advanced degrees in politics. The summer school costs $300. If it's not one thing it's another.

I really shouldn't be stressing. I've always had a knack for pulling money out of my butt when I needed it. Eh, I probably shouldn't take credit. God's always given me just what I need. Usually not more, but He always pulls through when I need it.

I guess it goes back to the unknown. If they tell me I need $10000 on top of my insurances $7500 then I would be fine. I would have a goal and I would reach it. The problem is timing. I do not want to slow the process down. I have another $5000 coming in from Europe this week and it is earmarked for the surgery. I just need to know how much I will need. In the end I could just get a medical loan, but I would like to avoid that if I could.

Thursday June 2nd 2011 - Alternative Pain Management

The liver doctor said that the pain in my enlarged spleen probably wouldn't be reduced even after weight loss. My primary care physician (PCP) gave me some oxycodone, but its fairly addictive so he probably won't refill it more than once or twice. So that leaves me with nothing really. Vicodin has too much Acetaminophen (Tylenol). He did say I could take up to 1mg of Tylenol a day. That won't even touch my pain and I'm not convinced that it won't promote more inflammation.

However, both doctors said that medical marijuana won't hurt me and it would probably be effective. In the State of Colorado medical marijuana is legal with a permit. In order to get a permit all you have to do is go to a doctor that is willing to write an affirmative consultation and then file with the state for certification. Even though the state has been cracking down on the medical marijuana industry, it is still relatively easy to get a permit.

Perhaps if I didn't have three impressionable young men I might consider it, but I do and I don't think its the right thing for me right now. I reserve the right to change my mind. Even if I did use medical marijuana, I wouldn't smoke it. To be honest, I don't like smoking anything. It makes my lungs feel congested. If I ever tried marijuana as pain management, I would use edibles like brownies or... I don't really know what's available, but I've heard that there are a lot of options. Probably my biggest hesitation is the fact that, while it is legal at the state level, it is still a federal crime.

At the time of this writing, my spleen is about a 6 on the 1 through 10 pain meter. Not enough to cry out, but still distracting. Maybe its more scary than painful. Every time it hurts like this I know that the blood flow through the liver is slowing enough to bloat and enlarge my spleen. That's scary. I'm afraid of bursting my spleen and needing a splenectomy.

Wednesday June 1st, 2011 - An email to friends and family

Hello Family and friends,

Last week I received the results from my liver biopsy to check on the progress of my nonalcoholic steatohepatitis (Nash). I have stage four grade one liver cirrhosis. Stage four is the highest measure of liver scarring and beyond repair; however, grade one is the second level of inflammation which is good news. 

In general, I feel okay today except the grade one inflammation and subsequent blood flow disruption is just bad enough to cause mild to severe pain in my enlarged spleen and I have chronic swelling of the abdomen and legs. It may also be the cause of my chronically low platelet count. For these I am medicated. I am a bit fatigued and I don't always feel so good, but nothing major. I have to continue seeing my oncologist because my leukemia has not been excluded and the liver disease dramatically increases my cancer risk.

My mission is to stay at grade one as long as possible. In order to do this I must have bariatric surgery (Realize Band). I was already running down the lap-band path so I am just waiting for the final financial requirements and a date for surgery. Hopefully, I will have the surgery this summer. The extreme change in diet that is required for the lap-band surgery pretty much mirrors the requirements of the liver diet. And, of course, I need to continue exercising, but I can't put myself in danger of an abdominal injury. Obviously, I can't ever even take a sip of alcohol which really isn't such a big deal for me. Work isn't a big deal since I am writing from home full time now.

Cheri and I are focusing on the bariatric surgery right now so I can become a better candidate for a transplant when the time comes. In no way am I giving up or flipping out. It's not good news, but it's not the worst news and I can survive this.  

Thanks for your support,
Christopher