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 .

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... 

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.

Sunday July 3rd 2011 - Anticipation

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

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

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

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

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

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

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

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

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.

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

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!!!!!!!!!!!!!!!!!! :-))