Perhaps more realistic goals beyond bariatric surgery

Although I worked out pretty good yesterday, I might have had too many roasted salted almonds which kicked up my water retention. At any rate, my weight stagnated and I'm not ready to accept that quite yet. I know there will be a week real soon where I will only lose maybe 4 pounds, but that's still 16-17 pounds in a month. Today I will go back to liquid boost for breakfast and lunch and a regular 2oz dinner. And only clear water today.

I need more realistic expectations. I can't possibly support losing a pound a day. So by the end of this month, I want to reach 370 pounds, but lets say I only lose enough to be 375 by September 1st. Then I will try to lose 15 pounds in September and in October so that on November 1st, I want to weigh 345. Then lets say I do a blitz and get down to 335 by the time I have to fly to NYC (Nov 22). I have to give a keynote address for an exhibition so that would be awesome. I go to NYC at least once a year and it is normally in November. I'm pretty sure I weighed well over 400 last year. My NYC friends will be amazed.

At that rate I should be around 320 by the end of the year. That's a full 15 pounds more than my previous prediction. It's still a massive amount of weight. I have been "bathing" in special lotion at least three times a day to keep my skin as healthy and as moist as possible to try to shrink it up naturally. I also bought a surgical waist wrap that is supposed to hold everything in place like organs. I am going to use it to support the fat that in hanging below my belt line. Of course, it is like 52 inches so it will be a bit before I can use it.

Goals and expectations with the Realize band

First let me say that this subject is close to my mind because... I only lost two pounds since Friday. I know, it sounds stupid even as it leaves my lips, but I'm competitive; even about weight loss. For instance, if I only lost one pound a day for the rest of the month, I would have still lost an incredible and unrealistic 43 pounds. I don't expect to lose 43 pounds, but that doesn't mean I'm not going to shoot for it.

I couldn't set any weight loss goals before because I didn't really know the power of the adjustable band. Let's say that I do lose 40 pounds this month; then what do I, personally, expect to lose each month? I was thinking around 25 pounds per month for the first 100 pounds which would leave me with 60 pounds to lose and, thus, place me in about mid-November. Is it possible? I'm not sure, but I like to aim high and then raise the bar. Actually, by the time I go to my late father's solo exhibition and film screening in NYC on November 22, I hope to have reached the 300 pound mark. I sounds completely unreasonable and beyond rational expectations, but I'm going to leave it at that.

Even I admire his body

I know that it will take extreme culinary discipline and crazy exercise, but why not? I can do that. Wow, what a Christmas I would have if I were under 300 pounds. It would be awesome and why beyond my initial expectations. If I were able to reach 300 by the end of the year and I kept losing at the rate of 15 pounds per month, I could be around 180ish one year from now. Oh, do I dare dream! I haven't been 180 since I was 26.

In terms of a realistic to silly monthly goal:
By October 2011: 350 pounds
November 2011: 335
December 2011: 320
January 2012: 305
February 2012: 290
March 2012: 275
March 19th 2012 (My 47th birthday): 265 AWESOME!

Can I do it? I say, "Yes, I can!"

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.

A photo of my liver

During the bariatric surgery, my surgeon was able to take a photo of my liver. I have been diagnosed with stage four grade one liver cirrhosis and this is what it looks likes. Yup, going to need a new one soon.

Healthy liver

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.

Post operation video of myself in the recovery room!

Hello,
In case you didn't catch my post-op details, they are on the previous blog post. I am posting these from my home computer. Amazing surgical procedure. Surgery in the morning, home by 2:30pm. Awesome. After I upload this video I'm going to walk around the block.

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 .

Leaving to the hospital

It's 4:30am in Colorado and it's time to go to the hospital. I'm not really nervous. I'm still excited. It's been a long road. I'll try to get my wife to tape me in the recovery room. I do wonder what the appliance will feel like. Will it feel like a lump in my throat? Will I feel it a all? I'm sure I'll notice it when I start eating ice chips. I think the hardest part will be swallowing water. I like the to guzzle ice water. Time.

New companion website launched today!

I thought I needed a companion website to this blog to post daily post surgical stats and an easier way to find important information about bariatric surgery and bipolar disorder. It can be found at www.lose250.com I'll add information as time goes on.

Day of surgery instructions

Tomorrow is the day of my surgery. Today I feel as if I have been waiting in line for two hours to get on a roller coaster ride. As the coaster pulls into the loading area, butterflies prevail and I am wondering how this coaster stays on the tracks. If I were afraid of flying which I am not, it be would be as if I were about to take off. I'm really more excited than scared. Actually, I don't feel scared at all. Maybe I should be, but I am not. 

I will be at the hospital at 5am; precisely 2 1/2 hours before surgery (7:30am). Today I am on a liquid only diet; not a clear liquid diet so I can drink instant breakfast drinks or products like Ensure up until mid-night, but I will try to only have three today. The rest of the day will be clear liquids by choice. Between 12am and 3am I may drink clear liquids. Absolutely nothing four hours before surgery. I will take my morning dosages of my normal medication around mid-night. 

According to the directions from my anesthesiologist, on the day of the surgery, I am not supposed to take any medications that require food or milk; no oral diabetic meds; glucophage?; diuretics (water pills), OR anticoagulants. The only one of these restrictions that even applies to me is the water pills and I took one today so I won't need one tomorrow anyway. I AM supposed to take my other meds, particularly my pain meds (Oxycodone).

"Sleeping man" by Ron Mueck

When I arrive at 5am an IV will be placed and... I'm not sure why I have to be there two and a half hours early. I have already had my pre-admittance and pre-op appointment on Friday, but it seems to be normal procedure. Again, the surgery will take one to one and a half hours if they don't have any complications. After the surgery I will be in the recovery room for another one and a half hours. I will be allowed to eat ice chips and I should be able to walk around the hall before they discharge me. I'm sure that I will sleep most of the rest of the day after I get into my own bed.

Quick note about daily medication: After surgery I can only take medication that is less than the size of a peanut which means I will either get the liquid forms or split or crush them. Due to the limitations on drinking capacity, it may take me a long time to take all of my pills.