Sunshine

What a difference few hours makes.
I went outside, took my bike for a short - only 5 miles - ride and it felt wonderful.
I ate my supper made out of 2 teaspoons of cottage cheese, one teaspoon of yogurt, and about a teaspoon of alfalfa sprouts.
I also bought small (6 oz) container of organic blueberries, and slowly ate 3(!) fruits and could eat no more. BTW, I did not finish my cottage cheese / alfalfa mix.... I was definitely afraid to push my luck. At this rate this container will last me a week.

Under control

After miserable day, night, and morning, things calmed out.
I was going to cancel my class today, but after I threw-up early I felt better and class was just fine. After the lecture I went home and to bed. Now it is 7 PM and things are getting under control.

The infection is finally going away, I did not react in any bad fashion to my next antibiotic pill, and I feel reasonably fine. I will go for a walk...

As I felt before - it was just a temporary setback.

I am planning to spend all day tomorrow at work. I am well behind in preparation for the next year. The good news is - I still have plenty of time.

Adventures in eating, pills, and pain

Yesterday was one weird day. I think antibiotics are hurting my stomach. I was in pain yesterday, during the night, and this morning after eating something I felt like I have to call university and cancel my class. Withing 5 minutes after taking antibiotic I violently threw up, and that just does not happen to me. Fortunately 20 minutes after this incident I started to feel much, much better. I am at work - lecture in 30 minutes.
Now I am not sure if this was caused by breakfast or the pill. Seems like I am learning to eat again.

At work...

I forced myself to get out of bed where I ended up again. I will spend here couple of hours. Somehow comparing to last Thursday - I feel worse. But I also know that this is temporary setback.

Another weekend lost

I spent most of Saturday and all Sunday at home. Today it looks like infection is getting better, but still this was a setback. Well, I just have to take what comes in. I will try to make it to work for few hours. This morning my weight was down to 264, and BS at 147. That is a good news. Few more days of antibiotics...

Setback

The infection looks bad, oozing puss, etc.
Yesterday I decided to try solid food - a skinless chicken breast. For the second time, a piece just got stuck in my chest, a lot of pain, discomfort, lasted about 3 hours.

Energy gone

Saturday afternoon. I went to work for few hours, but I am back home due to the lack of energy similar to the early part of last week. I believe my infection is taking it's toll on my system. I started antibiotics yesterday and at least it is not getting worse, but it is painful, and fighting it takes some effort from my weakened stamina.
On my way home I stopped at the Saturday Market hoping that the Hippie vibes will help, but had to go home. I am off to bed, to sleep. So far sleeping was the best medicine - no reason to believe that it will not work again.

Blood Sugar - goal #1

This morning my BS was at 144. I have not taken anything for the diabetes, no insulin, no Byetta, no Metformin. The trend is unmistakable. About one month before the surgery I started to keep daily log of morning weight and BS. During that time before surgery I was dieting to meet my pre-op required 15 lbs weight loss. I think the chart tells the whole story. I am getting very excited about the results so far. Diabetes were my #1 reason for the surgery, and so far it looks like results are just fantastic, and it is only 16 days...

15 steps forward - small step backward

Today I saw the doctor for 2 weeks post - op checkup. Everything is just fine, except one of the incision holes got infected. I will be on antibiotics for one week. The infection is topical and it does not look like the origins are internal. All things considered, the problem is minor.

Two weeks!

Today is exactly two weeks after surgery. I feel great, even the sleepiness is gone. This morning my weight was 266.4 lbs (303 lbs in March, 285 lbs two weeks ago at the time of the surgery). Finally my head is clear and I can think and concentrate on my work.
Tomorrow is my post-op doctor's visit.

Day 13 - overfill by an ounce

I have never slept so much in my life. This morning I got up, ate small yogurt, and went to bed to sleep again. When I woke up, I sit down to have my dinner with paste #2. I had one teaspoon, two, three, and after fourth suddenly I almost exploded. I felt like I ate the whole buffalo, The food just stayed like a chunk in my chest. They warned me about it - but being warned is not the same as experience it. I went for a mile long walk and things calmed out. Lesson - measure food BEFORE eating, eat very slowly, and be 100% concentrated on it. That's new.

Culinary adventures one teaspoon at the time

Today I feel rather good. Lecture went smoothly, went home, had a little nap, and overall this is a very good day. I am tired of the protein mixes, I decided to experiment. I grilled two small chicken skinless breasts, cut them in little pieces, added little Philadelphia cream cheese and plain yogurt. Run it in the mixer until I had nice smooth paste. I sit down and slowly ate one small spoon of this mixture. Tasted great. I was not sure about the reaction as this was the first time I had some meat. After about 5 minutes and two more teaspoons, I was completely FULL. It looks like these two breasts will last few days. No adverse reaction, nothing.
So now I have two winning recipes, #1 - tuna paste, #2 - chicken paste. It reminds me the restaurant scene in the movie 'Brazil'
I do not feel tired anymore. Life is wonderful.

Stigma

I feel like there is a stigma associated with the bariatric (weight loss) surgeries. There is a stigma associated with being overweight. It is mostly attributed to laziness, lack of self control, being a glutton, and basically all fat folks are guilty of eating as much as alcoholics are guilty of drinking. I will be the first to agree that that stereotype applies to some. I have seen fat folks consuming huge amounts of junk. At the same time some people no matter what – will gravitate towards being fat – like some people no matter how much they eat will stay thin. Since the prevailing attitude is ‘it is your own fault’ the bariatric surgery is looked upon as a drastic, self-mutilating step, to become normal. In critics eyes, same could be accomplished with just a little bit of discipline.
Well, the decision to get such radical surgery is not easy one and not taken in vain. After 20 years of doing ‘other’ things I knew I lost the battle. I could always lose weight, but I could not keep it off. I lost probably 1000 lbs in those 20 years, while getting heavier and heavier. A lot of people I knew were hiding the fact that they had surgery. Just like this would have been something to be ashamed of. And deep down, there is some shame in my consciousness. I feel that what I did was self-mutilation. At the same time I know that this was the ONLY way for me.
Since coming back from the hospital I stopped injecting myself with insulin, Byetta, stopped taking Metformin. My morning blood sugar that used to be all over the scale – from 190 to 350 is now at the steady and narrow range of 150-160. Not perfect, but much, much better. I believe that it will stabilize at below 110 as it should, and without any medications. That is the victory I could not achieve before.
This morning my weight was 270, 15 lbs since the surgery, 33 since I applied for the surgery.
Stigma or not – so far it works and there are no regrets.

Day 12 - powered by eggs

After taking a nap, I woke up again very light-headed. I started to suspect the lack of food as a culprit and decided to break one more guideline. I soft-boiled couple of eggs and withing one hour my energy was restored. At 6 PM I rode for the support group meeting for 'novices' - folks before or withing 3 months after surgery. The talk was given by a local plastic surgeon about body contouring procedures. Fun.
It is evening now - I feel great, and preparing for my tomorrow's lecture.

Day 12 - energy gone

I packed to go to work, but had to stop in the pharmacy to pick up medicine. After that I rode my scooter to the store to get some ripe bananas. After that I was exhausted and went home. I will work from home...
But first - a little nap.
It is funny how drained of energy I am now. I hope the banana will help.

Day 12 - New energy

I guess 4 days of sleeping was needed to speed up the healing process. I woke up this morning with a lot of energy that was missing in the last few days. It is Monday - I am going to school for few hours.

Day 11 - Broken rule

I spent another day mostly sleeping. I decided to ignore the guidelines and make myself something different. I took two spoons of Tuna in Water (I opened a can to feed my cats), added two spoons of plain yogurt, and a dash of mustard. I mixed it into a very moist paste - and eat it. Two hours later - no adverse reaction!
Hallelujah!
Back to sleep!

Day 11 – Tired and sleepy

The allergic reaction got under control, ointment and antihistamine kept it in check. At the same time I feel like this bout took a lot of my energy. After 10 days of liquid diet I feel light-headed, sleepy, and tired. I noticed that after surgery I kept my AC at 70F, but every day it seemed like I was getting chills and AC thermostat was gradually raised to the present 78F.

Day 9 - Allergic Reaction continues.

Yesterday I took max doses of antihistamine and it knocked me out cold. The allergic reaction continues, but so far is not getting worse. The problem is that when I take antihistamine I am dizzy, and I would rather not put a shirt on as it aggravates the rash. That means not going out – and it is 4th of July weekend and weather is spectacular. So many things are happening in Eugene in the next three days, First Friday Art Walk, Maude Kern’s Art & the Vineyards, etc., but I will have to stay home half naked and on drugs… 8^)

I was told that my reaction is to the glue they used to keep the skin together. Stitches underneath, glue on top. They told me that this reaction is rare, but they have seen it before.

Day 8 - Allergic Reaction

Afternoon - slight step backwards. I developed allergic reaction to something. Big, bad rash around 2 inches around all 6 incision holes. I was able to see the surgeon and I should take some Benadryl and some prescription topical cream. I just hope it will not get any worse. Two years ago I had small procedure and I developed really bad allergic reaction with rash, sores, itching, etc. I hope I can avoid this. So this is the first unexpected negative happening. Hope it will stop right here.

Day 8 - Second Week

Today is one week after surgery. I had my second lecture, it went great. This week’s physical stamina was a big question mark before the surgery, but in reality all turned out to be just a speed bump. Back to cruising. From now on I will concentrate this blog on Bariatric Trip, not on teaching.

Sleeping is still the most bothersome part, but every night it gets better. One more week of liquid diet, and I am not bothered by it. So far I have yet to experience hunger. I was warned that my taste will change, and it really did. Everything is much more intense. I had some milk and I had to check the carton if it is the same stuff. It tasted incredibly aromatic, with some hints of smoke, all hard to describe.

Day 7

Six days after surgery.
I am amazed how well I tolerate all what happened. I mix protein powders with milk, pieces of banana, or peach, or apple. The mixture that I tried before surgery was not so good – now tastes great. I was warned that I will have nausea, or vomiting. So far nothing like that.
Here are the first stats:
In March when I officially filed all papers I was weighted at the doctor’s office and my weight was 303 lbs. By the time of pre-op my weight was 285. I lost 18 lbs before surgery (the condition was at least 15 lbs loss – or no go!). This morning I was at 273.4. Almost 30 lbs from the trip's start, and almost 12 lbs in six days since the surgery.
I hope that I can continue at the 30-15 lbs / month pace that would get me to my goal at around December / January.
I woke up today with some discomfort and I decided to work from home and get some pain med. Unfortunately, after taking it I will not take a chance on driving car or scooter.
Sleeping is still a problem – sleeping on left side is tolerable, right side is very painful. Unfortunately I woke up on my right side. But this is such a minor complaint.
This week is a week of reduced expectations. As long as I can stay on top of the lectures, students’ requests, and emails, I met my goal. Reduced expectations always make it easy.

Day 6 - First Lecture

First lecture after surgery went very well. I am so glad - I was very much worried about it.

Day 6 - early morning.

Five days after surgery. I woke up at 4AM. Yesterday I got exhausted in the afternoon, took some pain medication and went to bed. I am still out of the normal rhythm.
Sleeping in bed continues to be a problem, laying on the side is painful, I am trying to get used to sleeping on my back and discovered that it works if I remove the pillows with my head flat on the mattress. Unfortunately that up-pointed belly gives extra sleeping room for my cats, who never had much compassion for anything anyway.
So these are my new adventures in the bedroom. I don't think that is enough for a novel, might not be enough even for the blog...

First day at work

I am at work - few hours. I rode my scooter (slowly). I was going to take a bus or car, but scooter is the most convenient. Lucky for me, this is maxi-scooter  500CC Piaggio, plenty of legroom and power.
I will be going home soon, I am ready for my tomorrow lecture. I will be a zombie for the rest of the day.

Hospital

We are lucky in Eugene to have such modern new facility. Here was the view from my bed on McKenzie River and Coburg Hills. If environment heals, that is it. Private rooms for all. Wonderful staff. Totally different hospital experience.
Thank you all at Sacred Heart.

Expectations

One on my friends sent me an email with her expectations of outcomes for losing weight.

I am scared to have so many.

It is easy for me to blame failure in the relationship on my weight. But I also know I lot of fat people in great relationships. So I do not want to state a goal of having relationship – because it is possible that I have to change much more than weight.

Improving looks might not work very well for 62 year old. I might look like 100 after losing weight. Again – that is not my goal.

Etc, etc.

For me the fear of mental disappointment is great – so I keep my expectations simple. Everything else is in the wind.

Day 5

Four days after surgery. The ONLY complaint I have is discomfort sleeping on the side. I usually do not sleep on my back, in the hospital the bad was raised and facilitated laying on the back. I feel better taking naps in my recliner. Overall - if this is all - it is not too bad.

Rosemary from the Oregon Bariatric Center called me to check my progress. I am so impressed with them. Thanks to you Rosemary for facilitating that last minute insurance approvals, thanks to you Karlyn for offering advice, preparation, and being such patients' advocate, and big thanks to Dr. Yarbrough for his masterful work.

I have no problems eating protein mixes, I added some bananas and apple into a blender with mix, actually it tasted very good. I am walking with a small 18oz water bottle, sipping all the time.
In couple of hours I am planning to get to work. I think I will take a bus.

476 lbs Teenager

As I was flipping channels today I run across this: 476 lbs teenager (http://www.bbcamerica.com/content/284/index.jsp)

It is about the 19 year old girl who underwent the same surgery. Her obesity was significantly higher than mine, and her food addiction was without comparison greater. I watched with interest how her initial enthusiasm was met with the new reality and how the therapy was instrumental in reversing her mental state. I was thinking if this is something I can expect?

There are some major differences. First and most obvious is that I am not a 19 year old girl. Her life was threatened by weight; my life was threatened by diabetes.

I love food; I am not addicted to it. I love food for its social and ‘feel good’ aspects. Mostly I am not addicted to ‘wrong’ food. I was not a health food nut, but I can spend the rest of my life without chips, and junk like that. I love some stuff that is NOT a diet heaven – my epicurean paradise is Charcuterie - not a Patisserie. Love good (not supermarket) Polish sausages, Prosciutto di Parma, etc. Love good (translation: high-fat) cheese, and will not live without Époisses de Bourgogne once in a while. They are high in fat (bad) but relatively low in carbs. With the stomach reduction, this will be more acceptable (occasionally) than doughnuts. So I feel OK about not being left feeling deprived.

Ban on coffee and alcohol also is not a problem. Eventually I will be able to have some – but very small amounts – and that is fine with me.

Watching this documentary made me evaluate my goals again.

1. Get rid of diabetes. I could not control it without insulin which caused weight gain. That was one maddening circle.

2. Lose 130 lbs.

That is it. That order.

Day 4

Three days after surgery. The recovery is absolutely remarkable. But I started to believe that it will be a disaster. The first two days were just total misery. Somehow I expected less and my spirit sort of collapsed. Especially on the second day where I had so much pressure in my chest that I thought I am having a heart attack. The nurse forced me to walk, walk, walk, and it did help. By the afternoon of the second day I was off the pain medication and I welcomed day 3 in rather cheerful mood.
Here are my words of wisdom to anyone going through this:

1. Your waistline will increase substantially after two days of IV and internal swelling. The loose shirt I brought with me was too tight and hurt the incisions. I could not wear it. Bring something very soft and very loose.
2. Don’t get discouraged after first 36 hours discomfort, but be prepared for it.
3. After surgery – walk. Force yourself to walk.
4. Don’t be shy asking for a pain medication. At first I was. Later it not only made my life more bearable, but it knocked me out so time went by much faster with much less memories.
5. Don’t try to read – just ask for the pain medication.

I went for a nice walk today and I am planning to spend few hours at work tomorrow. I have a lecture to give Tuesday morning; should be ready.
I was suspecting a lot of back-questioning myself about doing this, creating such irreversible procedure that sort of handicaps me for the rest of my life. So far - nothing like that. I feel very euphoric about the whole thing.

Back Home

I am back home. The recovery is remarkably fast. Big, big difference between yesterday and today. I am going to take it easy for the rest of the day

Second day after surgery

The surgery went very well according to my doctor, however I am in a lot of discomfort. Yesterday it was just plain miserable. Today is better.

Last Supper

Time for the last supper. I debated what to have.
No more food after 5PM, no more water after midnight.
I could not think of anything special.
I was never a big fan of junk food, but my last meal turned out to be:
- 2 Famous Star hamburgers from Carl's Jr. - wrapped in lettuce - no bun. Special for $3.
- Diet Dr. Pepper.
How boring and how exciting.

Path of no return

Today:
Pre-Op - check!
Co-Pay - check!
Pre-surgery mandatory weight loss - check!

Ready, ready, ready, ready...
I think I am.
I think I am.
Definitely I am.
Ready, ready, ready, ready...
Put me to sleep now.

Tomorrow:
Anesthesiologist, lab, last minute shopping, laundry, cat litter, food, and water, no food after 6PM, no water after midnight.
Thursday: be there at 5AM.

Home Friday or Saturday.

New Life

Who needs all,
5% is fine.
Snip, snip, staple, staple…
Plumbing rearranged,
Welcome to new life.

The Fears

The fear I’m experiencing is not the fear of the surgery. That’s peanuts. I am not worried about possible complications, odds are slim. The fear of going through such drastic change afterwords, that is scary.
The fear of gaining back the weight after few years that would make this whole effort dangerously worthless.
The fear of looking like a shriveled prune. I better start saving now for some skin removal procedure next year.
The fear of mental adjustment. I have this stupid (or may be not) theory that by burning fat one also burns the accumulated toxins. That is why they do not advise to eat fish with the skin from the Great Lakes… Fish accumulate garbage in their fat tissue, so do us. Burning fat means burning toxins. But of course I am not sure if this is true, even if it sounds plausible.
The fear of handling my job after surgery. I am 100% confident that I will do fine, which of course is in denial of the fear.

I would like to believe that the weight loss will solve EVERYTHING in my life, but I also know that the only thing changed will be my weight. My normal other struggles will remain the same. And I have to keep repeating this to myself. ONLY MY WEIGHT WILL CHANGE!
I stockpiled on liquid whey protein supplements that suppose to be my main diet for the first 3 weeks. I bought my multivitamins, B12, Calcium Citrate; all suppose to be my supplements for the rest of my life. I have to say good bye to coffee (BIG loss), sweets (occasional loss), and carbonated drinks (substantial loss- I will miss you Pellegrino). The requirement to chew each bite at least 30 times is very difficult to practice.
I hope that former (and prospective) patients can find this blog and share their experiences and thoughts.

Surgery approved and scheduled.

Suddenly everything is clear! At least the dates are. Today the insurance authorization came through. Pre-Op will be next Tuesday, labs Wednesday morning and surgery on Thursday 6/25. Even though the wait is over and decision made, my anxiety is still there. This is going to be one of the most important decisions of my life, a truly life changing event.

The waiting was unnerving. Originally I was hoping for the middle of the August date. This would allow me to use my summer break as a recovery time. Unfortunately, the only doctor in Eugene decided to move to Corvallis on Aug 1, and the last day for the Gastric Bypass surgery was July 8. The Oregon Bariatric Center is actively hiring two surgeons, however realistically surgeries would not start until late fall. I teach at the University of Oregon business school, and I have very large classes, around 400 students in two sections per quarter, and that makes having surgery during the academic year virtually impossible. I will also teach Summer Term – but the class will be very small, I will cancel my Thursday lecture, but be back for my Tuesday lecture. According to the Bariatric Center, I should be able to that after 5 days. I am disappointed that I have to have that surgery during the class in session, however I am very glad I do not have to wait until December. By December I could be 100 lbs lighter…

I am 62 years old male. My weight is around 300 lb – and it was fluctuating between 250 – 320 lbs during the last 20 years. I am always able to lose 30-50 lbs, but then I will plateau and that was it. No more. Eventually the weight would slowly creep up. Two years ago I had my last and most serious attempt. I went from 305 to 245, and for 3 months I could not lose a single ounce. Frustrated eventually I gave up. Two years later I am back and I wished I would not have given away my ‘Fat’ clothes.

What I am looking forward:

• Of course weight lost.
• Get rid of my diabetes that I could not control without Insulin, but with insulin I gain weight. Bayetta did not affect my weight – but blood sugar stayed high (mornings on the average 200). Actually diabetes is bigger motivation than just weight loss. Gastric bypass suppose to eliminate 90% of diabetes and I hope I will be among that number.
• Increased energy level. At work I could be full of energy – but at home I collapse. Instead of doing some physical activities I use to love to do, biking, walking, etc, I prefer to go to bed. A lot of times I am just incredibly exhausted…
• I have become very conscious about my weight and for sure decided that I would not date any woman who is so overweight, and therefore I feel like a hypocrite when I expect women to ignore my looks.

What I am afraid:

• Changes in all food related activities, which really mean almost all social interaction.
• Replacing one disease (or handicap) with self-inflicted another.
• Lose skin and looking like 100 years old.
• I understand that many people who underwent this surgery develop depression. I guess this is my fear number 1.
• I am not sure how this procedure will affect my work. Teaching is not an easy job.

To be continued…

Welcome

I am not sure yet about this blog yet. I am waiting for an authorization for the surgery which might happen any day, but also might be postponed until December. I set up the sails, but I can not control the weather.