New adjustment and the end of hunger pains... I hope

I'm a little frustrated because I am still at 347. Now I am quite bloated this morning. I can tell because my home scale weigh -in should have been better and I took my lasix (water pill) this morning and I have already peed like four times and it's only 8am.

On the 2nd of November I had an early adjustment in  the aperture of the band. They added one more cc. I'm sure I am at at least 5cc or maybe 6cc. I got a little confused by the doctors notes from the previous saline addition. Nonetheless, it seems to have worked. My food is staying in place above the ring and water only trickles through. I have to be careful with my meds because I could easily get them stuck and then I would have to wait until they dissolved.

So now I am sticking to the 1/4 cup rule three times a day. I really want to kick this weight loss up a notch. Last night I measured out exactly 1/4 cup of marinaded chicken bits and they stayed in place until I started sipping water. The idea is to keep the food above the ring so your body (stomach) stops creating the acid that makes you hungry. My biggest foe has been my raging appetite. If I can rid myself of the physical and mental hunger than I can lose the appropriate amount of weight.

This morning I made a scrambled egg with some ham bits and a pinch of cheese. When I measured it, it was too much by two times. So I divided it and I will have the rest for lunch. One egg is too much. It surprised me too.

My estimates of loss were too optimistic. I think I can weight 330 by November 21st. In December I should be able to lose at least 15 pounds, so I should finish the year at 315. If I only lose 10 pounds per month then I should around 290 to 280 by my birthday. At that point I really won't be that freaked out by slower weight loss. After all, at 280 by March 19th would be an overall lose of 130 pounds. I would settle for 120.

The best part of this weight loss tool is that I shouldn't ever gain the weight back. Life changer.

Successful weight loss methods

Elk Meadow Evergreen Colorado

This morning I weighed in at 364.8. That is a full 45 pounds lost in the month of August. I feel great. While the lap band surgery has helped thousands reclaim their healthy selves, I believe my results are atypical.

My extreme weight loss is due to a variety of tools that I don't believe most bariatric patients employ. First, let me say that I have not missed a single meal; albeit small meals. I think my meals edge more towards 1/3 cup rather than 1/4 cup of food. I'm probably eating 3-4 oz and I am supposed to be eating 2oz. I should get a portable scale and keep a fold up 1/4 cup in my pocket when we go out and I do challenge myself by going out with my wife and friends as often as possible. It's like a test of my will and so far I have been resoundingly successful. I have also gone out for drinks at which time I have been quite satisfied with pineapple juice. Obviously with my stage four liver disease, drinking is off the board anyway.

August 20, 2011 380 pounds

I have also been taking all of my vitamins and supplements as well as my bipolar meds. I was worried that I would have to adjust or split or crush my meds, but it hasn't been an issue. That is one of reason's that I had the lap band rather than gastric bypass. I was afraid my bipolar meds wouldn't absorb well, but, since my meds still go through the same gastronomic system, that hasn't been a problem at all. Maybe it will be more significant after I get my next band inflation on September 9th.

So why do I think I have been more successful than most? Because I prepared for the surgery since last November when I started going to weight related therapy and hypnotherapy to peel apart the layers of emotional crap that was partially responsible for my weight gain. In therapy, I found out that the sins of my past and the numerous suicides in my family had a greater effect on my psyche than I thought. The hypnosis helped me break my addiction to food. Mentally, I was ready for this opportunity.

Elk Meadow

I also worked on calibrating my bipolar meds so I would be able to manage, with the supervision of my psychiatrist, a steady course with the caveat that they may need to be adjusted as I lose weight. So far so good. I've felt somewhat in control of my symptoms. That doesn't mean that I don't float up and down or have anxiety attacks, but the frequency hasn't changed with the weight loss yet. I thought my body was purging fat stored Seroquel and it may have been, but I have recently stabilized and restored my normal prescribed dosages. It's important to emphasize the need for a healthy mind because, in the past, I ate to sooth emotional pain or reward myself with treats.

In addition, sleep is incredibly important and that is still a challenge for me. I can only sleep with heavy medication support. I recognize the importance of sleep and will continue to work on it. Last week was real bad and I have just regained control over my hypo-mania... I think.

Elk Meadow

Possibly the biggest contributor to my rapid weight loss has been exercise. Much like I was in 2009 as a vegan fighting to lose weight, I have been in the gym five days a week and I have been hiking on very challenging Rocky Mountain paths on the weekends with my thin and fast walking wife. I just try to keep up. It's important to note that exercise alone doesn't really effect weight loss directly, but it does make you feel stronger, lighter, and more healthy which only encourages you to stick to the diet. I love exercise. I love feeling fit. Even at my weight, people are amazed at my success with physical challenges. I am a lot faster with far more endurance than you could imagine.

My workouts always begin with 20 minutes on the treadmill. I don't just walk, I walk so fast that I just have to adjust the speed to send me into a fast jog (a run as far as I am concerned). This is a technique that I picked up from a exercise guru. Walk fast then run as fast as you can to trick your body into thinking you are running from life threatening threats. It's about working on your animal instincts. Your body says run and it automatically goes into a weight loss mode to try to protect you from said threat. Believe me it works.

Elk Meadow

The method I use is to walk fast for two or three minutes and then run like hell for a full minute and then go back to walking fast. When I am ready, I run for a minute again. Overall, I "run" for at least five times during the 20 minute treadmill. Two weeks ago when I returned to the gym after surgery, I could only go about a mile in 20 minutes, but now I am going 1.25 miles in 20 minutes and it gets a little better everyday.

After I am completed with the 20 minute "warm up" in which I become a sweaty mess, I work on the weights to keep my muscle tone. I don't want my weight loss to come from muscle breakdown. Besides, I want to look and feel big and strong. I naturally have huge arms and a wide chest so I look more like a body builder than an out of shape fat man. At least I like to think so. That is part of the reason I want to eventually be 190 to 200 pounds because I used to be more muscular than thin even when I was thin. One time I lost weight for modeling and I felt horrible. 200 is good for me.

Finally, if time permits, I shoot basketball hoops and go through drills for at least an additional 20 minutes or more. My entire workout can last 20 minutes when I don't have time to an hour and a half to two hours when I have the time.

Colorado trail 2009 at 350 pounds

I really didn't think I would lose 45 pounds in my first month, but I did and I fully intend on keeping the pace. If I do, then I should lose another 25 pounds in September and October and November thus making my weight around 275 when I have to start traveling again. There's nothing worse than not fitting into air plane seats on an overseas flight. 275 pounds?? No, that's insane. If I'm anywhere near 300 I will be ecstatic.

Regardless of the insane goals, I will continue to fight because the Obesity Warrior is back baby. The very best part of the lap band opportunity is that I won't ever gain the weight back. That is if I don't screw it up, but I doubt that I will. I need to be slimmer as fast as possible in case my liver and kidneys decide to fail. I become a better candidate for a transplant if I am thinner. I don't know the exact cutoff, but I imagine if I am 250 or so, then my weight should no longer be an issue. Tick tock.

Weight loss magic

Magic, I tell you. Magic

I used to say that I would pay anything to be thin. Well, I found out exactly how much I would pay to be thin. I used to also pray to God for some kind of miracle that would allow me to lose 10 pounds a month until I was the proper weight. This is the answer. Bariatric surgery can give you back your health and extend your life in ways you could have only dreamed of. Personally, I like the band, but the bypass is really better for those over 55 BMI.

As much as I may have been cautious about bariatric surgery, I am now changing my tune. The fact is that anyone can stick to a diet or life change for a year at most and then, particularly for morbidly obese people, the weight starts to come back and in a year or two your body's primal instinct to protect you from such foolish weight loss kicks in and you end up gaining all the weight back plus 10%. It happens to every morbidly obese person. It's 20 times harder for an obese person to lose weight and keep it off than all these skinny people who need to lose 20 pounds. Big babies.

But, this is magic. I have not skipped a single meal. I typically eat one scrambled egg with salsa for breakfast; I have some tuna salad or a small spring roll for lunch and then 2oz to 3oz of whatever animal protein that I have prepared for the family's dinner. I am the housewife. I do it all and I do it well. I have even gone out to restaurants and I have always found something tasty that can be eaten within the rules of size. The food itself should be healthy, but the real trick is consistency and texture.

I also have been drinking tons of water. Maybe as much as 100 oz of more. I allow myself one glass of decaffeinated tea in the late afternoon. If I feel an urge for chocolate or sweets, I just take one drink of my chocolate flavored "Boost" drink.

Oh yes, I also have found a way to exercise for 30 minutes or more per day. Because I am an overachiever, I have been hitting the gym every afternoon before I pick up my son from high school. So that's five days a week. First I walk/run 1.2 miles in twenty minutes on the treadmill. My goal is to get my heart rate up to 150. After the killer and dreaded treadmill I usually workout with some weights and I carefully hit all areas so I don't lose tonality of my muscles. And then I play basketball or do basketball drills against the walls. I'm usually there for 45 minutes to 90 minutes and I could out sweating like a roasting pig.

I also have been bathing myself in lotion so I hope all this will help avoid some of the sagging skin. The bottom line is that I thought I could lose 43 pounds in the first month. If we went from August 3rd to September 3rd, that would give me eight more days. Well, this morning I weighed 372 pounds (that's down from 413 before the surgery. I am easily going to hit 43 pounds in the first month. Weight loss magic. Considering the difference between the in office scale with clothes on and my in house weigh in's, as of this morning, I have lost 38 pounds! Wholly crap!

 

AWESOME First Post-Op Appointment LOST 24 Pounds in two weeks!

I've been hitting the gym everyday since Tuesday I think. Trying to fill one hour workout. Today I rode the stationary bike for one mile (still a little chaffed), walked a mile on the indoor track and played basketball. 

I'm eating well. I tried some grilled skinless chicken (1/4 cup) last night. No problems and felt full the whole night. The whole not drinking liquids for 45 minutes during and after dinner is a piece of cake. Today I ate tuna salad (80 calories!) and it was fine. As long as you chew well and only eat 1/4 cup or 2 ounces, this thing works fine.

Today I went into my first post op appointment and it went well. I officially lost 24 pounds since the pre-op appointment on July 29th. I have also healed well enough that Dr. Tillquist went ahead and gave me my first port fill injections. First he numbed the area about the port and then I didn't feel a thing. I can feel that the aperture is narrower, but it feels fine and liquid is flowing well. 

Soft foods and exercise

Gratuitous girl illustration 

Yesterday I went to the gym for one hour. First, I rode the stationary bike for one mile. I could have done far more, but I didn't want my butt to get chaffed. Then, I used the treadmill for twenty minutes alternating my pace from slow walk to gallop. I'm not allowed to lift weights for one more week, so I shot basketball for the remainder of the time. It felt nice to get a good workout in. I renewed my membership so I can go everyday even if it's just for a 30 minute walk around the track.

I experimented with more soft foods yesterday. I drank some Boost protein drink in the morning and then I tried some regular yogurt for lunch because the Greek yogurt was far too bitter. For dinner I had about a quarter cup of split pea soup and the rest of my yogurt from lunch. I actually felt a little guilty because I ate the four spoon full of yogurt at dinner. Silly. I made the family some ham and cheese sandwiches and corn and broccoli salad. It is hard to sit there while they are eating, but I feel that I must do it as a demonstration to myself of true will power. So far it's been surprisingly fine.

I don't have that much hunger pains, but my digestive track can sometimes sound like a slow rolling thunderstorm. I think it's just acid trying to figure out what to do with itself. This morning I weighed 388.4 pounds on my home scale right out of the shower. Even with my home scale benchmark of 400, I have still lost 12 pounds in one week. It's actually far more, but my scale only goes up to 400 so I had to wait until I lost enough weight to register on my scale. Realistically, I would guess that I have lost 18 pounds since my pre-op appointment.

Ridiculus weight loss

Rocky Mtns. '09 vegan diet 315 pounds

Weight loss recap to date: July 29th 2011 "in-office" weight with clothes on 413. Post-op "At home" benchmark without clothes set at 400 on August 5th (after four days of liquid diet). You could probably add 5 pounds for difference between doctor's scale and home scale. We'll get that calibration on Friday when I visit Dr. Tillquist. According to my "at-home" digital scale I weigh 391 this morning.

The big question is "Where does the fat go?" The short answer is that your body converts the calories stored in fat cells (and muscle) into useable energy.

The long answer: Ultimately most fat ends up as carbon dioxide and water, but only after many transformations. The fat in white adipose tissue consists of fatty acids, stored very efficiently as triglycerides, which can be released to provide energy when needed. You lose weight when the food you eat doesn’t provide all the energy your body needs and so some of these fatty acids are released into the bloodstream, transported by a special blood protein and taken up by cells that need energy. If there is sufficient oxygen available, a series of enzymes then converts the fatty acids into carbon dioxide, water and adenosine triphosphate (ATP) – the immediate source of energy for powering muscle, liver and other cells. Since most of the components of ATP are reused inside the cell to make new ATP, the end product of all this activity is that the atoms that once made up your fat leave your body as breath, sweat and urine.

Bottom line: I need to bump up the exercise.

Doubting Thomas

Sometimes I think people want you to fail. This weekend we had relatives over and all they could talk about is how many people they know that have failed with the lap band. The story is always basically the same. Someone go the lap band and lost 50 pounds and then started eating bad food or overeating so they could stretch their stomachs. The lap band is a tool. It gives me a fighting chance at a normal life in which I can get a new liver and live forever.

It is no the lap band that has failed; rather, it was the lap band that was failed. Anyone can mess up a good thing and if someone gets the lap band and then overeats or becomes an alcoholic, then it's their fault. For every person that fails the lap band there are 20 that have succeeded. People just don't want to hear good news because it's not as fun. Maybe it's not the "fun" factor. I think it's probably that people need to talk poorly about other people in order to feel better about themselves.

Nonetheless, most statistics gauge the amount of weight lost by the various types of surgeries. In every case, without complications, people lose weight. How much and for how long is purely the responsibility of the patient and not the surgical procedure. The fact is that bariatric surgery is necessary in every super morbid obesity case I have ever heard of. In terms of success rates, the long term weight loss from bariatric surgery far exceeds any traditional diet or extreme weight loss like the television show "The Biggest Loser." I am more interested to see the tv show's long term success rate with people that lost weight on the show. I am sure it is dismal. Anyone can lose weight for 6 months, 9 months, maybe even a year, but morbidly obese will eventually gain the weight back. That is where the surgery is different. I guessing here because good data is hard to find, but I wouldn't be surprised to hear that 95% of surgery patients lose significant weight and, of those, 80% keep the weight off for life. Those are stats that I can life with.

Where does the fat go?

Since my surgery I have lost an estimated fifteen pounds. On the doctor's scale on August 29th I weighed 413 with my clothes on (polo shirt shorts and tennis shoes). This morning, without clothes on, I scaled in at 393.6. If there is is a difference of five pounds between the two scales then I still lost fifteen pounds. On Friday I will go to the surgeons office and we can see what the difference really is.

My infection is gone and I am no longer constipated. I did a lot of walking this weekend and I think I'm ready for the gym without lifting weights. The most important thing is that I feel better already. My clothes are fitting better and I can get into and out of my low profile BMW easier.

Possible infection

Denver Art Museum Hamilton Bldg.

Hello, I'm going to try to keep this post short because I want to go to the museum this morning. Right now I am using places to make sure that I am walking around enough. Yesterday I went to the Douglas County Fair which was interesting from a scholarly point of view, but really not my cup of tea. I prefer the warm of the big city to cow pastures. However, I did walk around and I did not have any soreness nor did my incisions hurt.

Last night before I went to bed I noticed that the longer incision on my right side felt warm. It may be an infection that my body could fight, but I am taking no chances so I called Dr. Tillquist this morning and he called into my pharmacy a prescription for antibiotics. I am allergic to most antibiotics, but I haven't had any trouble with a super strong set called "Z-Pak." Z-Pak is the trade name for Zithromax which is actually Azithromycin which is in the group of drugs called macrolide antibiotics. 

Last week when I had my pre-op appointment with my doctor I scaled in at 413. Yesterday when I used my own scale without clothes on I weighed 400. This morning I used the same at home base line and weighed 397. Regardless of the accuracy between the doctor's scale and mine, I am losing hand fulls of weight. Now I need to exercise to make sure I'm not losing muscle. I am still on a liquid diet and I feel less hungry than I usually... did.

Day 3 after bariatric surgery

Special Heavyweight Scale

Last Friday, during my pre-op visit to the surgeon I weighed 413 pounds. This morning, on my scale, I weighed 400 pounds. I couldn't use my scale before because it only went up to 400. So this is good that I have an at home base weight. The scale I use is a high quality digital so I trust it, but I took my weight before I ate breakfast and without clothes so it is going to be a bit off. But, it is my base lien and I will try to take my weight under the same conditions each time.

Yesterday afternoon to evening the five incisions really hurt, but none were extra red and hot so I don't think that they are infected. I have to keep an eye on that. The first day I drank three 12oz bottles of Boost protein drink, but I was only supposed to drink one cup at a time which is 8oz so yesterday I only drank two of the bottles. I can definitely feel the funnel effect, but nothing has gotten stuck or backed up yet.

If I stick to the rules, backups or clogs shouldn't happen. If they do, I should first give it time to melt or slip through. Maybe a small sip of water and if those things don't work, I'll just spit it up. You don't want to get into the habit of spitting up because it can make the band slip out of place and, if it becomes common, then your teeth enamel will start wearing down and you can quickly develop tooth decay and gingivitis.

Yesterday my stomach muscles were also sore and it started raining, so I let my grocery shopping trip be my exercise. Today I will take a walk and maybe go to the Douglas County Fair where my cousin Bobby is working.

I received the New Life chew-able cherry flavored bariatric lap band vitamins and they taste horrible. For now on I'm going to chew them lightly and swallow as fast as I can. I'll also keep something good to drink to cut the nasty. I also received a bottle of probiotics for digestion and good pooping. I haven't pooped since Tuesday, but it's not that big of a deal yet since my body is still trying to figure out where the food is. I also got a sample bottle of hair and nail supplements. One of the biggest complaints about the surgery is that you lose hair for about three months while your body adjusts. I think these packets will help avoid that all together. They also sent a sample protein peanut butter bar and some easy to chew baked potato chips and a dry protein mix in a fill-able bottle if you find yourself away from your normal food supply

Day one after my surgery

My silly sons

I'll try to explain in detail about how I feel. I slept great last night. I started out sleeping on my back and then rolled to the side. Once I was there I got comfortable. Each of the incision points are sore, but my stomach muscles are the sorest so things like sitting up and bending down hurt, but it's not unbearable. I am on oxycodon so the pain is moderated. I am taking 5 mg about every four hours so I'm not all tanked up.

Last night I couldn't even feel any obstruction in my stomach, but I didn't chance it anyway. I took slow sips of my Boost protein drink and water. I was able to pee easier as the night went on. My walk down the block was uneventful. I didn't have any more pain than I do sitting down. I was able to take my medications without breaking them up. That was probably one of my biggest anxieties, but their rule about nothing bigger than a peanut is holding up.

Fat Man. No not me, the atomic bomb. Los Alamos NM

This morning when I woke I noted considerable bruising around the incisions, particularly the longest one on my right side. But no oozing or blood on my sheets this morning. Moving around is still easy. My bedroom is downstairs so I have to use them a lot and I haven't had any trouble. I did reach down and picked  up my nearly two year old niece without thinking. She's 28 pounds and I'm not supposed to lift anything over 25 pounds for two weeks.

Perhaps it the swelling, but I can now feel cold water slowing down before the lapband. I was once again able to take all of my morning meds without incident. I can feel the lapband when I swallow water or my morning Boost drink, but it seems to be completely bearable. I also don't feel real hungry like I did before. I've heard that the third and fourth week can be a bitch as far as feeling hungry, but then it goes away.

Realize Band

The lapband feels like a funnel at the base of my ribs. I have yet to venture with a large gulp so I haven't had any back up or any problems with the band. I don't think it's going to be as hard as I thought. I even sit with the family during meals and it's not a big deal watching them eat. Since I had been eating light over the weekend and having been on a liquid diet since Tuesday, I can already feel some of the bloating going down. I hate the feeling of being stuffed and I will never have to worry about that again. I feel pretty good in general this morning. I will be driving around a bit today and I will take the dogs for a much longer walk today.

I'M HOME!!!! The surgery went GREAT!!!

Just a short note because I want to go through all of the details later. And I made a video of myself in the recovery room. You are not going to believe it. The nurse that helped with the surgery is a patient herself. She had the lapband surgery two years ago and she's lost 175 POUNDS. She looked awesome!

My surgery started at exactly 7:30am as scheduled. I'm not completely sure how long it lasted, but I was in and out in the recovery room for about two and a half hours. I was supposed to be out an hour earlier, but I was taking a great nap! I went into the next recovery room where my wife was and stayed in bed for another hour.

I felt fine and my wounds looked great so they let me walk around and then they discharged me. I believe I got home around 2:30pm I was able to walk around including stairs with only a little bit of discomfort. The most painful spot was where they installed the fill port because it goes between skin and muscle and it was on TOP of my spleen!

I am just taking Oxycodone, but twice as much as I normally take. I had trouble urinating for about a half hour and then I went to sleep in my own bed. I slept for another two hours and then was woken up by a surprise visit from my in-laws who live in Booneville, Arkansas. And I was able to urinate.

As I write I am drinking a "Boost" chocolate protein drink very slowly and I will take another pain pill because I am a bit uncomfortable and I don't want to be "a lot" uncomfortable later. That's it for now. Thanks for visiting and pass my info to friends and family that are curious about the lapbad. I will also make a short entry onto the new website www.lose250.com .

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.

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 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 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.

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.

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 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.