Third Anniversary

Few days ago I had third anniversary of my surgery. I had my usual yearly checkup - and doctor sounded an alarm. There was a possibility of gallbladder problem and I needed further tests. The likelihood of another surgery was not something I looked forward; since I recently recovered from second hernia surgery (first one was year ago). However additional tests and ultrasound proved negative and I am clear... But I waited with this post until I had more info. Gallbladder complications are usual for bariatric bypass patients and 30% experience its removal. I am happy with not having that problem. Somehow I did not know that statistic (or may be just did not pay attention).

My weight stabilized at around 210 lbs. That is NOT where I was hoping to be, but it's also not a bad place on the scale… This is the weight I had when I decided to have abdominoplasty, and then I dropped to 188 lbs. with all the infections, etc. I would like to get down to 180, but I am not totally unhappy with where I am.

 The side effects of the surgery after 3 years are minimal. I can eat anything, and still in small quantities, meaning that the pouch did not stretch.

Overall, I never looked back – the surgery was the best present I could give myself. I would have been very sick by now with diabetic complications, but I am much healthier now than 10 years ago, and in much better shape.

Two years went by…

Today is my second surgiverasary. My life is changed. It changed dramatically, and for much better. My health problems like Diabetes, Apnea, and neuroma are all gone. My energy had come back to almost previous level. This was different from other WLS patients who seem to get an energy boost almost instantly. For me it took almost two years.
I never reached my goal of below 170 lbs (the weight of my youth) but may be this goal was not rational. What worries me is that I leveled off at around 195, and that is 15 lbs (at least) too much. Well, still it is work in progress. The recovery from abdominoplasty (almost one year ago) was also long and only recently the pains disappeared. So I can honestly state that for me it was two years of painful process, but life is finally ‘normal’. 
I am very glad that I went through this all. At times it was a nightmare, but eventually I woke up to a bright new day. I almost forgot what it feels to be obese. Next month I will be 64. Until I was 40 my weight was OK fluctuating between 170 and 200, however it exploded after my back injury and the following 10 years of lack of exercise (plus some serious overeating). In 1986 I was married (happily divorced now) and my wedding weight was 170 lbs. The back injury happened later same year. By 1996 I was way over 300 lbs. I do not know how much – I stopped weighting myself, but from doctors records I know that I hit 330+. The weight loss/gain yoyo continued for many more years, health problems developed. So now, being at less than 200 lbs. feels normal, because in reality I spent half of my life at this weight, not the last 25 years before the surgery. I feel like I am BACK!
I still desire to loose additional 15-20 lbs. But I am OK if I do not.
I enjoy being diabetes free. I enjoy not having sleep apnea. I enjoy not having the neuroma and horrible pain in my feet. I enjoy shopping for clothes.
I turned back my weight, and in some strange way I also turned back the clock. I feel I have 30 more great years ahead of me; working, bicycling, motorcycling, writing, and living.
I never regretted the choice I made to have these two surgeries, but now I am just very thankful I had them.

Sailing, sailing...

On Saturday, August 29, 2009 I wrote about Predictable Unpredictability
I tried quinoa on that day, and the result was violently unpleasant. Well, long time had passed by and since I am almost two years from the surgery I tried that super-grain again. The result was exactly same as in 2009. Very unpleasant. Only after this I did some research and found out that:

Quinoa is a very nutritious grain, and an ideal food as part of a gluten-free diet. It is very popular with celiacs and those with a gluten allergy. However, a small minority of people report becoming sick after eating quinoa, usually after consuming it for some time. This is a real shame, as quinoa is very tasty, extremely nutritious, and easy to cook. It is versatile, and can be used in many ways. The most likely problem is saponin, which protects the plant from insect and fungal attack.

(from http://www.allergy-details.com/food-allergy/cooking-quinoa/)
The solution is to wash it, but I am not sure if I will try it again....

---

My tailbone is healing slowly, I might need another cortisone shot.  I also have some real discomfort around the abdominoplasty scar - even coughing causes sharp pain. I had seen my surgeon and he just told me to be patient and wait few more months... So few steps forward, few steps backward, few sideways, few up and down.
The bariatric bypass second 'surgeversary' is in one month.  I still cannot believe that trip, and how it still continues, hangs over my head, changing my life, and still is not predictable.

Cortisone Shots

Next Thursday I will get cortisone shots in my tailbone. It really got sore, really sore.

Off All Those Pounds I Lost, I Miss My Butt The Most

I have a big BMW motorcycle with a very comfortable custom seat, but my scooter, even though it is very big for a scooter (400lbs+, 500cc), that I use almost every day, crated problems. My tailbone hurts like crazy. It started on my flight to Italy and back, thanks to the terrible airplane seats, and riding scooter just hurts. I miss my butt! Today a new custom saddle is being built for me. I am waiting impatiently.
Since my last post my weight went down substantially into very low 190s, but in the last two days it jumped up by 5 lbs. I see that this is going be a lifelong struggle. I wish I could stop eating at all, just as I quit smoking over 30 years ago. I’ve got rid of diabetes 5 weeks after R-N-Y bypass, but I am still hypoglycemic, and if I don’t eat, my sugar drops to the point of being shaky and almost passing out. I have great craving for carbs – and do not deal well with meat. That is total reversal of my pre-surgery eating preferences.

Visited by Deamons of the Past

Just returned from 2 weeks in Italy - over 10 lbs heavier. Traveling is a good excuse - but still only an excuse. My old daemons hunted me. I am not posting this new weight as my 'last' - I will wait two weeks and if I am not below my lowest weight than I will publicly chastise myself here.

Food log, calorie count, bicycle - here I come!

Two major trips survived

I just returned from a conference in Orlando, Florida, and week before another one in Austin, Texas. I was wined and dined, and survived. The amount of food served at these occasions is enormous. At Saturday dinner I had to stop after appetizers and went for a walk when everybody else had been devouring their full plates. I had some dessert later though...
I started to drink regular coffee, and had some light beer.
Life is really good.
The other day Associate Dean of the Business College stopped me and noticed: Whoa, you look so slim!
No, I responded. I AM SLIM.
He laughed.
Boy, do I have kick out of those things.

As Promised!

The year started as promised.
I have great energy, bike, walk fast, I am restless, meeting people, this is and will be my best year ever.
Many trips are planned and booked.
Pants size dropped to 32-33!
After the infection healed - the recovery was remarkably fast, with almost daily noticeable progress.
I am riding to school three times per week on the bicycle, and each day I am doing it faster with much less effort. It is noticeable when I have to cross the bridge over Willamette river - and the little climb is no longer even noticed.
I keep replacing clothes, and the motorcycle gear I bought last summer is way too big. Spending money on new outfits never felt so good.

This bariatric trip turned out to be a miracle.

Looking Back...

On June 19, 2009, one week before the Gastric Bypass surgery, I wrote this here:

What I am looking forward:
•    Of course weight lost.

Accomplished!!!

•    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 supposed to eliminate 90% of diabetes and I hope I will be among that number.

Accomplished!!! Diabetes is a long forgotten history! Sweet!

•    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…

Gee, I somehow remember that I had more energy than I have now, I guess I was not that good… OK – I am working on this one. I believe that the 'old' tiredness was caused by diabetes - not an extra weight.

•    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.

There was a time after couple of failed relationships that I blamed my weight for their collapse. It does not matter if that was true or not, but that is how I ended up to see it. I am very happy with my looks now.

As Steward Smiley (I mean Senator...)  used to say: "I'm good enough, I'm smart enough, and doggone it, people like me."  8^)

What I am afraid:
•    Changes in all food related activities, which really mean almost all social interaction.

It turned out to be true, but not so difficult to cope. No problem!

•    Replacing one disease (or handicap) with self-inflicted another.

Yes – but this one is very much controllable – take multivitamins, calcium, D3, B12, make sure that you have enough protein… No problem!

•    Lose skin and looking like 100 years old.

Not too bad – still looking younger than my 63, but the extra skin and loose muscles were fixed.

•    I understand that many people who underwent this surgery develop depression. I guess this is my fear number one.

Did not happen.

•    I am not sure how this procedure will affect my work. Teaching is not an easy job.

While it was physically difficult – the two major surgeries caused me to miss two lectures total. No problem!

Happy New Year

Somehow the New Year finds me in a reflective mood. I feel like finally I arrived at my destination after a very long and exhausting trip.

I re-read my blog again - from the beginning. I forgot so many events and I am glad that I have this (public) record.

I feel great, my weight is at 190 (plus/minus couple of pounds), and all discomfort is gone. I don’t remember me being so optimistic and forward looking in a very, very long time.

It has been year and a half, and since the process started, almost two years. My life has changed. All of my health problems are gone, my diabetes is a long past history, apnea is forgotten, and CPAP machine is sitting in the garage. The only medication I take is Armour Thyroid. I know that the insurance company will get ahead financially and recoup the cost of my surgery. My prospects are bright. My energy is really coming back, something that was lacking for most of that year and half.

This is not an empty talk, but I do believe that 2011 will be the best year of my life. When I put on my size 34 pants I have an instant happy grim. At most I was at size 48, most of the pre-surgery time at size 46. Roughly each inch of my waistline represents 10 lbs.

There are some funny negative consequences of this weight loss. I do ride motorcycles. Almost daily I ride my maxi-scooter to the university, but for the long trips I take my big BMW. And I tell you, I miss my ass! I feel that loss of padding after few hours. But that is fun in the scope of things.

I am still the same person, but I think about myself differently. When I was 30 I quit smoking after many years of strong addiction. That was the most difficult thing I had done and something I was most proud - until now. I am so glad that before the year was over I healed, and I am facing new life with unrestrained enthusiasm.

Happy New Year to all of you who followed this blog, who just dropped in once in a while, who are just checking in considering similar trip, or to many people who will visit here in the future.

I will keep updating this blog, not as frequently, but I will continue to report.

Middle of December

For sure the ordeal is over. I can state that I am fully recovered from these two surgeries. I need to work on my strength, stamina, etc., but that is all. I feel great, worry about my appetite, which is a good thing. I am determined to loose another 15-20 lbs, but will do it slowly. Finally I am in no rush...
Next year will be my best year ever, and I will make it so.

No more complications - back on the recovery track!

Today's surgeon's visit showed that all complications are gone. Yippee!
What a relief...
Now big thanks to Dr. Dariusz Zawierucha (Dr. Z.)  and PA Marvin McAllister at the Radiology Associates for working with me and getting rid of this persistent problem. Also big thanks to Dr. Movassaghi and his wonderful staff. I always felt their concern, encouragement, and relentless desire to help.
I believe that my year-and-a-half  trip is coming to a very happy end.
I feel the energy coming back, and the desire to do things instead of going to bed is a welcome change. Looking forward to bicycling, walking, and may be even jogging, to the stomach muscles exercises...
Back into shape, loose additional 15 lbs.
Easy!

Drains Removed

Today I hope is the beginning of the last chapter of my recovery. The drains were removed.
I am also realistic knowing that in the last three months the drains were removed 5 times before, only to be inserted again week later. Let's hope that this is not a repeat...
But it feels great not to have them.

More progress

Today's radiology report:
The seroma cavities are closed and healing is almost complete but the drains will stay inserted until Monday.

188 lbs!

Today I dropped another few pounds - down to 188lbs.
I have a lot of pain in the morning - I think one of the drain tubes is touching the nerve... 
But feeling better overall, hoping for the removal of both drains tomorrow. Swelling is almost completely gone, and the drain output is minimal...

Keeping my fingers crossed.

Yes - the progress is here!

When I am healing - I sleep a lot. Last two days 13 hours each night. That is a good sign. The swelling is 80% gone. I feel much, much better. Friday I hope that they will take the drains out, but I was there before. But I see the end. I am upbeat again.

Finally Progress! (again...)

Today I felt some improvement in the morning.
At the radiology new X-rays showed that the seroma cavity got significantly smaller.
By the evening the swelling is much smaller and much more bearable than yesterday.
I did the Betadyne flush again tonight. Now I will wait and see if I will be set back with new reaction... May be it was Betadyne....
It might be that the corner is turned... Keep fingers crossed.
Morning update: Slept all night without pain/sleeping pills. There is definitely a progress.

It is NOT Betadyne, stupid!

Tonight the swelling is exceeding 2 inches. Pressure and pain as before. It is not betadyne. At least not for now.
Fever at 100.4F

It's Batadyne, stupid

By about 6 AM I definitely see the improvement. Swelling is down, I was able to sleep without any chemical 'help'. Yes, I woke up few times, but that is OK.
I feel stupid that I did not make the connection before. I was suspecting it, but also discounted as something that should not be happening - according to Dr. Z. that is not usually the case. I will skip the betadyne flushing until Friday when they will x-ray all this using high contrast dye. So this is another good news - bad news. If betadyne is the cause for my reaction, than another, more invasive options will have to be considered, like flushing the cavity with alcohol, which hast to be done in the hospital under anesthesia. There is always surgical option. Betadyne flush would have been the simplest solution. I am also afraid that having drains which are NOT regularly flushed with something as sterilizing as betadyne would expose me again to the possible infection just as I had before.  

Noon update: 
Noon is not looking as rosy as morning. The swelling and pain is very uncomfortable...
I wish I could just stay at home for few days, but I can't.

No progress

I can only function for few hours. After that the swelling and pain becomes intolerable. I contacted my doctors again and decided that I will stop injecting myself with betadyne. At least I will eliminate one variable. The swelling is over 2" high. I also begin to worry about my rapid weight loss. Normally that would have been great news. But that is not "normally"...

I saw the end, but it was just a mirage.

I am waiting for phone call from the Radiology about fixing my drains. Have to go over there ASAP.
The night was OK - but heavily induced by pain pills. I need to find a better alternative.
The swelling is still there, not as big, but bigger than it was yesterday morning.
In 4 days it will be three months since the surgery and I did not expect to be in such shape. Sometimes I see the end, and sometimes the end is a moving target.
I lost another two pounds, I'm down to 193lbs.

Relief is not long lasting

The fever came back to 99.8 and swelling returned. I am off to bed and sleep.

I am still in the woods...

But at least I spent 6 hours at work.

Alien Encounter

I feel that there was a major battle inside my system yesterday, and I won!
I slept 12 hours, woke up with no fever, swelling significantly down, and feeling MUCH, MUCH better. Energy is back.
I still have no clue what was all this, I will call it an alien encounter. Some invasion of a body snatcher... You get the picture. But I see that I am getting over it. I will have to go to school today to catch up with a lot of work, but otherwise will take it easy.
I lost more weight, and I am down to 195 lbs!!!
That latest weigh loss has more to do with me being sick than anything else.
I have some technical issues with one of the drains which leaks when I inject the betadyne. No big problem, but it will be more wasted time by going to the hospital - and nothing there takes less than 2 hours...
I will have to go there Monday.

Fever - and reduced swelling

I feel really shitty today - fever at 99.7-100F, etc. At the same time this morning the swelling went down. Is it my system fighting it? I wish I knew what is happening, but the reduction of swelling is a welcoming sight. I will see where I will be tomorrow.

Evening update: fever at 101F (38.3C)

Chills

I got out of bed as I could not sleep only to have the attack of the incredible chills. My temperature is at 99.9F (37.7C), not too bad, but elevated. As before, the thermostat at 76F and electric blanket at full blast had restored normalcy. The shaking was very violent.
I DO NOT KNOW WHAT IS HAPPENING!!!
So far nobody knows.

Good news, bad news, same news

The good doctor ordered CAT scan when he saw the swelling.
But...

CAT scan showed nothing abnormal. Good news.
CAT scan showed nothing abnormal. Bad news.
We all are puzzled. I feel sorry for my doctors.

Swelling, pain, and nobody knows why

This swelling is very pronounced and "should not be there" - all tests and x-rays did not show anything wrong. But it is there, very painful, shown here with my new two drains...
Two weeks ago that area of the bulge was totally flat.
I am back to pain pills, otherwise the night would be absolutely sleepless

Betadyne Flush Skipped

Yesterday I knocked myself up with pain pills. I was really hurt. I decided not to make the situation worse and did not flush the the cavity with Betadyne. I also skipped it this morning. After my last lecture I will try to do it. But I was afraid that if I would have same reaction, I would not be functional...

I will see what happens tonight and tomorrow.

Radiology

I went to the hospital again and they x-rayed me injecting some high contrast dyes. They did not find anything as root cause but of course the swelling is very visible (and very painful). They think it is a reaction to betadyne injection. I cancelled my office hours and took some pain pills - they knocked me out. I will see Dr. Movassaghi and Radiologist on Friday. We'll see which direction I am going. Now back to the drug induced sleep.

And I thought about downhill

Just as yesterday I was pumped out, this morning I woke up significantly swollen on left side and in a LOT of pain. Could not put my motorcycle pants on, even regular jeans seem like too much. I am waiting for the radiology doctor to call me back, but something is happening that was not suppose to happen.
I am hurting a lot, not sure if that is the reaction to the betadyne, or something else. The swelling on the left side is very pronounced, and I cannot touch it, it is so sensitive.
BUMMER!!!!
Cannot wait to go home and knock myself out.

Progress (at least mental kind)...

Doing something is so much more invigorating than waiting for something to happen...
Today I have seen the whole team working on me at the Radiology Associates inside the Sacred Heart. I am impressed about the involvement of Dr. Z (Zawierucha, but nobody other than me can pronounce his name), his PA, and  4-5 other people assisting. I am impressed. I feel they are on my side. Dr. Z. is experienced in fighting persistent seromas  and I feel good about it.
He inserted two drains, and flushed the insides with 100cc providone-iodine. I was expecting some burning discomfort, however that is totally painless. I am suppose to inject myself twice daily, keep it for one hour, and drain it. They also did not find anything deep, at the radiology they used X-Rays as well as ultrasound.
I also seen the very concerned Dr. Movassaghi. That is another team that is on my side. I feel blessed to have so much support. He informed me that all my lab results are just great, I am as healthy as teenager 8^) (his words). So may be the very rapid and voluminous seroma build up created all that pressure making me sick, and there is nothing more. I know that this recovery is a real challange, but I could not have a better support than from Dr. M. and his staff, and now from Dr. Z, and his staff. They all have my gratitude.
Dr. Z will be in charge for the next few weeks until it heals - which he promised it will! That will spare the otherwise necessary surgery.
Tonight I am wiped out, but I have new dose of optimism.

I have to cancel my classes

They just called me from the radiology and they bumped me to 9:30 AM. I canceled my classes.
I feel energized that something is being done!

Tomorow: Sclerosis

I am going to the Sacred Heart tomorrow for the Sclerotheraphy. To my understanding that will involve inserting most probably two drains and injecting the insides with some irritating agent. I will suppose to do the injection and draining few time myself, I will know more tomorrow. Since I am suppose to be at the hospital at 7AM, I worry how well would I last lecturing until pass 7PM...

We will see, worse case - I will cancel the class

Speculation

I know that something is wrong. I am swollen, specially on my left side. I came to the totally unscientific and strictly intuitive conclusion that my problem is on the inside, and the seroma accumulation on the surface is just a symptom and byproduct of the real issue. I feel great internal pressure, and I can push the swelling that it resonates all around. It is really hard to describe. I am waiting to the Tuesday appointment with my doctor, however I think I will request consultation with the bariatric surgeon. I feel like I need to get real with it. I might need another MRI to look inside. I don't know - but that is getting very hard to tolerate. Just as I was very passive patient waiting to heal, now I feel the sense of urgency the I must do something, be active, take the charge. Again, I was able to catch one hour of sleep before waking up and staying awake in the middle of the night. Now I am getting really upset about this situation. It just cannot continue like that.

Decision

Yesterday the drain came out, followed up by a flood from the hole...
It was not pretty or pleasant.
"Treatment strategies for persistent seroma include aspiration, drain placement, sclerosis, and surgery."
Well, the first two so far are not working.
We all agreed that:
1. I am not healing and will not heal unless something else is done
2. That something else will be chemical treatment, called sclerotherapy (or sclerosis). They will inject some alcohol based solution into the space (cavity) where the seroma accumulates. That should aggravate the lining of the tissues and facilitate the subsequent healing. That will require insertion of one or more drain tubes and possible multiple treatments.
3. It that will not work, I must have another surgery that will be performed to open up the cavity and scrape up the lining.

The problem is that the 'cavity' is almost my whole belly. Second problem is that my doctor does not want any abrasive chemicals to aggravate my muscles stitches. He wants them to heal first, so we will buy some time by visiting him twice weekly for the seroma extraction using syringe.

Well, what can I say...
Overall, I feel (as I wrote before) that something is happening internally. I generally feel sick, no energy, no appetite, no restful sleep, swelling in the abdomen, pain on the sides and back...

I still function OK - but it takes very large effort.
I can be very tired, go to bed, and sleep only one hour. That's it.
In the long term this is not sustainable.

Sleepless in Eugene

For a while this blog was sort of friend of mine I can confine to without the 'social' obligations to discuss it further... It was suppose to document my change - and overall the positive one. Lately however I feel like I am just writing doom and gloom.
Well, this is how I feel.
I feel like a 90 years old fellow. My walk is slow, have some strange pains and almost every step hurts on the side, and sometimes just standing straight is a painful effort. It seems like I swell internally and then the pressure around my waist feels like a vise grip.
I can only sleep few hours, and with the help of sleeping pills, melatonin, etc. I usually wake up at around 3AM and sometimes force myself to go back to sleep, again, with the sleeping pill. I am not sure - is it the stress, or something is really happening.
Tonight I experienced incredible chills. Had to set up thermostat at 76, added extra comforter, and turned an electric blanked to the max. My hands were icy cold, and I was shivering like as standing naked outside in the sub-zero weather. I checked my sugar and temperature. Both were normal.
I am upset, since I just cannot afford  to be in such shape. Over 400 students keep watching and listening. Somehow in the classroom the adrenaline kicks in, and I am OK, but not afterward.
I know that something is wrong.
That is not normal, at least not normal for me.

I needed to do something nice for myself and yesterday I purchased this fabulous and expensive motorcycle leather jacket. I rode it to school on my big BMW...
Yes, the retail therapy works! I'm not sure what I will buy today...
8^)

Wet Awakenig

Last night I woke up at 3:30 AM WET!
The drain container apparently filled up, popped open, and spilled everything in bed. That, of course, followed up by a mandatory one hour of swearing and cleaning.
How gross, and how it only adds up to my upset about this persistent problem.
I had a hard time sleeping anyway...

Below 200lbs!

As I am waiting for the new drain tube to be inserted at noon today, I had a pleasant observation. My weight dropped to under 200 lbs (for the first time in 20 years).
197.8 lbs! Yea!

New Drain Tube

The date is set - tomorrow new drain tube will be inserted.
This is the fourth time (including the ones inserted during the surgery).
I am really upset. Now I worry that a new surgery will be necessary to clean up the previous surgery site. 
Keep fingers crossed.

Water Mattress Effect Again

This morning a very disheartening observation. I can push the seroma and it will bounce back and forth across my belly like water mattress. I am very disappointed and sad, as this means more drilling tomorrow and possible reinsertion of new drain. Today is 10 weeks since the surgery and that was suppose to be all over. I cannot stand the thought of having new drain installed, but I am afraid that this is what is going to happen.

On the positive side, my University of Oregon Ducks are ranked #1 in football and today at 6PM is their first game as the best team in the nation! I had to cancel my two classes as all my students will be at the stadium or in front of TVs drinking beer. 
GO DUCKS!

Progress, but no cigar

The drain is gone - what a relief, two days shy of 10 weeks from the surgery. However, and it seems like lately there is always 'however', the doctor had to take his favorite syringe and drew 20cc from two or three places. So as long as seroma accumulates, I need to see him. Friday's next visit. So there is progress, but not the finish line.

Still Dripping

As Burt Bacharach would say:

...Those drain drops are falling on my side, they keep falling

But there's one thing I know
The blues it sends to meet me won't defeat me
It won't be long till happiness steps up to greet me...

Today's verdict - the drain stays on. Not only, the good doctor used his syringe (but this time with a normal needle - or may be the previous one scared me so much that it looked much bigger...) to draw some stuff from the other side.
I REALLY hoped that today will be it and drain be gone. Did not happen...
On the positive side, the seroma packets now seem to be isolated and much smaller. According to him, I am healing. According to me - not fast enough.
I have real trouble sleeping, only two hours last night.
At work the landslide of troubles, but this blog is about my weight, not work 8^)

I want this *^%$# drain thingy out of my side! And out of my sight!

Still Dripping

Last Tuesday Dr. Movassaghi refused to remove the drain tube. I am still on antibiotics, still dripping. Friday is my next checkup. May be I should bring flowers and chocolates and bribe everybody...
I'm really annoyed by this tube and ball hanging from my side. The seroma liquid, that used to be very clear now has become cloudy with white specs. I am not sure if this is good or bad. I have to use syringe daily to pull the stuff out from the valve - otherwise it get plugged. That little maneuver keep the juice flowing, But why it is not healing?
I wear an elastic binder with extra foam to put pressure in my waist. I wear it 23 hours per day, just taking short breaks. It is annoying. Still have problem with sleeping. The doctor prescribed Ambien, and yesterday one pill made wonders - I slept all night. Today another single pill only lasted less than 2 hours, and I am wide awaken again.
I have too much work to do to feel so tired. I am not a happy camper now...

Who'll stop the drain.

With the apology to the Creedence Clearwater Revival:

Still the drain kept pourin', fallin' through my side.
And I wonder, Still I wonder Who'll stop the drain.

Wednesday the drain stopped leaking, at least that was what I thought. Today, at the doctor's visit I was expecting the drain to be removed. It turned out it was just plugged-in and after he used syringe to pull some of the blocking stuff, the drain started to flow freely. It is over 8 weeks now.
From my web searching I know that persistent seroma can lead to smoothing out the surfaces to the point that they will not adhere. Also, there is a chance of a fibrous seroma, encapsulated form with the membrane, that has to be removed surgically. Both of these complications are bummer, on top of the infection (I am suppose to continue on antibiotics for another 11 days). If anyone had similar experience - please share.
Next visit on Tuesday

Infection Continues

Last week on Friday I went to Radiology at the Peace Health hospital and they inserted new drain tube. I could have pushed the liquid under the surface of my belly from left to right like a water bed. Today I went to see my doctor for a change of dressing, and he put me again on antibiotics. The drain still drains, I do not feel that I have infection, but apparently I do as they got the culture results. May be I just got used to it. Well, I just have to take it as it is, day by day, and see where it goes. I try not to have an opinion now, just do what I am told. In two days it will be 8 weeks. since the surgery.

Liquid is Still Accumulating

I am disheartened as I can feel the liquid bouncing back and forth. I called doctor's office and need to see him in the morning. I am afraid that I will have to have new drains placed, but in the morning I will have a meeting with his HUGE syringe with a major league needle. Somehow it resemble turkey baster.
I am now getting mentally exhausted. I feel like this thing is robing my energy, afternoon swelling and pain is taking it's toll. And I have to stay on top of lectures. There I feel like an actor on stage. When I lecture, I forget about my problems. I am 100% there. But after the performance - I am totally worn out.
Since it is  seven weeks since the surgery and the liquid is still accumulating, I also worry that my healing is not going the way it should, and now I just cannot afford to be anything less than 100% all the time.
Tonight I went to bed early hoping to have a nice long sleep. Unfortunately, one hour later my phone rang - wrong number, but it was over one hour ago and I cannot go back to sleep.
I do not want to turn off my phone as I expect call from doctor's office early in the morning about the time for visit, which has to be in the morning as I teach the whole afternoon.

Tough Day

Today after the 'suction' at doctor office I had to spend the day at school. Two sessions of almost 2 hour lectures, each attended by well over 200 students. I ended up after 7 PM  really exhausted. The left side of my belly, where he drained that stuff, hurts somehow.
I needed to check my emails, catch up loose ends, and ready to go to bed.
This, I feel, is funny: I asked doctor about why after seven weeks the surgery site still accumulates liquid. He told me - "you had a major, really major surgery, not like some woman who had four pregnancies". Somehow when I think about it tonight, I almost feel proud.
Isn't that stupid?

Drain that stuff

I was seen by the wonderful Dr. Movassaghi today. Everything looks good, however the fluid is still accumulating. He tried to send me to the radiology again to locate and install new drain tube. I was VERY disappointed, as going back to that %*^%$#  drain with the reservoir ball hanging on my side, repeat of the evacuation of cats, etc, was something I did not want to deal with. Luckily he could not get an appointment soon enough, so he just drained it himself. We will check back on Friday and see if this will have to be repeated.
BTW, this will sound like a plug, but it is not. I am so impressed with this doctor. The result so far is greatly exceeding the expectation. I think he is a fantastic plastic surgeon, and very nice person on top of it. Thank you Dr. Movassaghi. We are lucky to have you here in Eugene, Oregon.
Today I am also finishing my antibiotics. I feel reasonably good, however I have my first two lectures today and the last one ends at 7:15 PM. I do worry about my stamina and potential swelling. We'll see how it goes.
So the continuous fluid accommodation is my major concern right now.

Yearly (late) Checkup

Yearly checkup was a stunning success. All my very comprehensive lab work was great. I finally made picture comparison from before surgery, 6 months post, and now. My weight was slightly up or down after 6 months, so the six months picture shows my shape before abdominoplasty.
I cannot stop watching it myself. I am still in disbelief. All this was WORTH it - and I have pictures to prove it.
Now - get completely well and work those muscles!
(...what muscles?)

Another 'End' is Near

This morning, two days shy of the 6 weeks from the surgery, the drain came out. I feel very much better, almost 60% normal. That is still not a lot, but comparing to the last few weeks it feels like heaven.
Today my cats will be sleeping in bed, on top of me, wherever they want. They were remarkable throughout this ordeal, like they sensed that there was something wrong and they just could not bother me. They have my great gratitude.
I am back at the University trying to catch up with my preparation for 450 students awaiting me next week. My TAs were keeping the preparations afloat, and like my cats, they have my utmost gratitude.
I am finally feeling glad to go through it. I hope this blog will come to the nice and happy conclusion soon.

Improvement

Yesterday I felt real improvement. My head cleared up, the pain level and swelling went down. It seems like the last set of antibiotics is working. Yesterday I saw my doctor, he confirmed what I felt. The antibiotics will be extended for another seven days. The drain is still there and will stay until at least next Tuesday. That means almost 6 weeks!
I canceled my appointment at the Oregon Bariatric Center last week and will have it next Thursday. I'm still looking forward to having the pictures taken.  
The school starts in a week - and I am still not ready!

Third set of antibiotics gets me worried.

I honestly thought that by now I will be wrapping up this blog – as it supposed to document my ‘bariatric trip’ and now it should be almost over. Well, it is not.
Today I received a call from my surgeon and they switched (AGAIN) antibiotics for me. The first (Cephalexin 500mg / 4xDay) was started last Thursday. Friday it was replaced by Doxycycline 100mg / 2xDay, and today (Monday) switched to Amox/Clav K 500-125mg / 3xDay. As a reasonable person I do worry. Of course I have no clue about their differences, and if any of the readers could help, I would appreciate. (Actually this is the first time I made a request to my readers).
I felt better on Saturday, went out for few hours, and Sunday went to work. After just couple of hours the swelling around the incision felt like a very tight bicycle tube around my waist. I had to go home and knock myself out.
Sunday and today I feel pain (not great, just very unpleasant) and I am mentally exhausted. On top of it the school starts in two weeks and I am NOT READY. However I am not going to rush it though, since I feel that I aggravated my condition last week by going back too early.
So the grand finale of this blog will have to end.
Thursday I will go to the Bariatric Center for my yearly (in this case belated yearly) checkup. This always involves the ‘official’ photos. I just can wait.
Even though I am very frustrated by the recovery, I am also incredibly happy with the results. As soon as I will have these pictures – I will post them here.

New Drain

The drilling at the hospital was successful and new tube installed. The procedure was done in the old McKenzie-Willamette hospital, and that is now a very depressing site. Hope to avoid it in the future. The culture was analyzed and the antibiotics I was started on yesterday do nothing for it, so new series started today. I am hurt and sort of depressed, and mostly tired. Time to knock myself out and go to bed.
One really cool thing was to watch ultra-sound display, and see the 'reservoir' being punctured by the tube and shrinking out, knowing that this was inside my belly.
Now I wonder how much that thrill will cost me. It took them about one hour to do it.

Bummer

OK - Doctor removed the drain today, however only because there are early infection signs. He started me on antibiotics. Tomorrow I'm going to the hospital for a small procedure to pinpoint the 'bubble' and to insert new tube - of course I'm disappointed.
On the positive side - I look great.

Four Weeks

The drain on the right side is still there and draining a lot (around 150-220 cc daily) and no &^%#$ end in sight. I am very frustrated, not sleeping well and still hurt. I had to go back to work since my preparation for the Fall term turned out incomplete with the University switching to Office 2010/Win 7. My publisher's tools do not work!
I am getting pissed.

Useful Post

I found this very helpful post about medications after bariatric surgery.
Please check http://www.obesityhelp.com/forums/amos/MEDICATIONS-After-Bariatric-Surgery-wls.html
Otherwise no major changes. I am planning to go to work for few hours today.

Three Weeks

After three weeks from the surgery I still have one (very productive) drain tube. It means that I will be tied to home until at least next Tuesday. I feel much better, but still long way from being well. I wish I would have a remote controlling my life with the fast-forward button.
Actually having fast-backward button would also be nice 8^)

Things Are Looking Up

I am starting my third week with only one drain tube and container. Pain is much lighter now, however my right side is still very sensitive. Since handling one drain is manageable, today I put on some lose clothes and drove to the farm market. This was my first escape.
I can do more around the house, however few things happen to be beyond my capacity. I opened (lifted) the window in the bedroom during the day, however closing it created a rip that made me sit for 20 min in a lot of pain. My next appointment with surgeon is Tuesday and I hope that the last drain will be removed. I think that by the end of next week I should be relatively mobile.
But every time I look into a mirror I am so glad I went through it.

Just grind your teeth

I went to see my doctor today about that pain. Two major suspicions:

1. The right drain tube is touching some nerve
2. One of the stitches broke

Unfortunately he could not do anything for either one. I am still draining way too much so the removal of the drain is not possible at this time. If the stitch broke, again there is nothing that could be done and with time it will heal.

So what the solution - nothing - pain pills, and wait until next visit on Tuesday. Once the drain tubes will be removed I think there will be some relief.

Back to the zombieland.

Not as fast....

Yesterday there was a step back. I started to hurt badly on right side, became very uncomfortable, could not sleep well, and went back for the pain pills. They helped. Today the pain continues, but no signs of infection or other trouble. Back to the pain med and back to the zombie land. I am still draining a lot. They will remove the drain tubes as total drainage will be less than 30 cc per day, but it still ranges at around 250-300 cc / day. Somehow I was hoping it would have been faster. So I wait, wait...

One week

Tired of sleeping in the chair, tired of still having tubes, tired of not being able to escape problems at school, clock - fast forward please.

Day Five

Great. Don't cough, don't sneeze. Great. Don't cough, don't sneeze. Great. Don't cough, don't sneeze. Great. Don't cough, don't sneeze.
Recovery is fast, but don't cough, don't sneeze...

Day four

The recovery is truly amazing. I am totally off pain medication (other than pain pump on my neck) and relatively pain free as long as I do not do anything stupid, like sliding my netbook off my knees into my stomach... My biggest complaint is sleeping in the chair (last night was pretty much sleepless), still having that pain pump, drain tubes, and no shower. I feel like I will be able to get to somehow normal life soon, ahead of the schedule and doctor's prediction. I can get up from chair pretty well, as long as I bend my knees I can stand pretty straight. Tomorrow morning I'll see the doctor, and hopefully he will get rid of some of the drain tubes, pump, and containers. Actually I am looking forward to see myself in the mirror for the first time without all these pads, tubes, etc. Speaking is still more difficult...

Three Days After Abdominoplasty

Thursday 8/12/10 early in the morning I had my tummy tuck. I had many concerns, from the caregiver help I need to hire, to keeping my cats away from me. First, the caregiver, who is an old acquittance and in the middle of her 2-year nursing program, turned out to be just great. Big thanks. My cats somehow sensed that they have to stay away from me, after couple of attempts to jump on the recliner, they just watch me from the distance. This is amazing.
The recovery:
Day one as predicted. Sore, bent in 90 degrees. Thankful for the pain killers. I went to see doctor that day - and he seemed to be very proud of his handiwork. From the repositioning of the belly button, to proclaiming some kind of record of stitching the muscles first at the edges (9 cm), but because that was still very loose, he went for 14 cm stitch, and finally for his record 28 cm. It was very reassuring to see him being so excited and proud. He warned me that the next two days will be worse as swelling will increase and should be at the max during day 3. Well, the next day was much better and today is even better. Friday the swelling and the new tightness made it difficult to breathe, but that is no longer happening. I will cut down the pain pills today, and see how I am doing without them. I am beginning to feel very ecstatic about that surgery knowing that worse is behind me. All is paid - at the tune of $10K, but that does not include other expenses like supplies, lab work, and caregiver. Overall this adventure will cost me about $13K. Out of pocket, as insurance does not cover anything. I suspect an additional bill because the surgery took an extra hour. After bariatric bypass I had an infection which resulted in ugly scar after one of the incisions. When Dr. Movassaghi called me after surgery, his first question was: "Do you know when do you have your belly button?" Trying to be smart Alec I guessed "Above my knee?"
I should not make jokes. He repositioned it exactly where I had the scar (and hernia underneath).
Overall I am in much better shape that I was expecting and that I was told I will be. That is why I can sit in my recliner and use my laptop...
To be continued...

Surprise - more like an explosion...

I need to share it almost in real time.
It is 1:10 am. Close to midnight I was ready to go to bed, and before I decided to try a glass of alcohol for the first time since the surgery. I was warned that it will hit me fast, but since I was going to bed...
I did not want to open bottle of wine, but I had a bottle of sweet liqueur in my fridge, so I had a glass. Within few minutes I hated the world around me, myself, liqueur, and all. I was like a heart attack. My breath was rapid and short, I could not sit, standing was not better. For about 15-20 minutes it was MISERY!. If this would happen without me drinking, I would call 911. That was 'dumping' I was warned, but unlike ANYTHING I experienced before. Now, one hour later I am almost OK, but I just cannot imagine having glass of wine outside as I was tempted many times...
What a punishment.
I am getting ready for my abdominoplasty and diastasis repair next week. I hired someone to stay with me for the first three days. Finding someone I could trust and depend on was not easy, but it was just too much to ask friends to do it. Such is single life.
At the university - many changes for the next academic year, some of them unexpected and will require significant amount of work. I am not sure to what degree I will be ready. Just one more thing to worry about.

It is now 1:20am and I am almost recovered. What an unpleasant trip.

Getting ready for the knife - again

I had my 3-hour pre-op yesterday and I am not excited at all. From all I heard the recovery from abdominoplasty with diastasis is nasty. Drain tubes and reservoirs, pain pump, unable to sleep in bed, well - hope that it will be worth it. My belly muscles are separated by 9 cm (about 3 ½ inches). That's a lot. Unfortunately, the doctor was not making any guarantees about the extent of the flattening of the stomach or sides. He promised significant improvement, but it’s extend will not be 100% predictable. I decided to hire someone to be with me 24hr for the first 3 days. I think it is too much to ask friends. This surgery means that second summer in a row will be spent mostly on recovery. I am still teaching and will be until the day before surgery.
I feel very much being under pressure, I have to deliver presentation for the department and the associate dean on Monday (very important), close out two summer classes, prepare everything for before surgery, and hire help. One of the new concerns will be my two cats. They have to be kept away from me – but since I will be in the living room recliner, that means problem. Of course they favorite sleeping place on my belly will be out of question, but also the cats’ hair represents a major infection concern when cleaning and replacing drain tubes. I am not ready to keep them locked out in the bedroom, as they have special healing powers.
My weight was at 213. Well, I am not in the mood for punishing myself.
BTW, today I turned 63!

@^%$#&^%$!!!!!

Today (7/13/10) my weight was 215lbs.
Still way too much but 7lbs loss in one day?
What's happenning?
I am not even updating the left column as I will go back there in no time.

Horror!!!!

Today (7/12/10) I stepped on the scale and it showed 222lbs! I feel terrible and totally ashamed, to the point that I was very hesitant about making this post until I drop at least 15 lbs. I am failing!!!
I do not feel that I gained this much, my waistline is pretty much the same.
Stupid metabolism!!!
Lately I have been walking and biking daily. I have to keep strict food intake log again. I am such an efficient machine and it seems like I squeeze every last ounce of energy from anything I eat.
I am angry at myself. I hope that's for good.

It's My First Surgiversary!!!

Today is my WLS one-year anniversary.
Good news: I lost almost 100 lbs, diabetes and apnea are gone.
Bad news: I never reached my goal (so far).
My scheduled abdominoplasty is in 7 weeks and saga continues.
Overall, I am very happy about my decision, and 80% happy with the results.
I am not sure if my goal was realistic as 165 lbs was the weight when I was in my thirties. However, I still hope to get there.
Long time ago I quit smoking and after I quit, I had some nightmares that I took a cigarette again. I knew that one cigarette would bring the old addiction back. However, now it is different, because I have to eat. It is like quitting cigarettes, but in order to survive you must have few… 8^)
It is difficult to stay focused as my cravings have returned, and the fear of getting back to old habits is very real. I decided not to make any resolutions, as I did not keep so many before. Resolutions not kept made me feel like a failure even when there was great deal of success.
The journey continues, the destination is still NOT within the sight, but much, much closer.

One year anniversary approaching - abdominoplasty scheduled.

I am approaching one-year anniversary. Many thoughts, reflections, and resolutions.

• My weight stabilized at slightly over 200 (last was 208) and it is not going down. To be honest, I do not exercise as much as I was hoping for, and I have plenty of excuses, but no good reason for not doing it.  I feel great, healthy, the tiredness is gone, but there is no great deal of newfound energy. It is sort of coasting on neutral.
• I am very scared that my brain is still unchanged as I experience cravings for foods that are not exactly post-bariatric staple. I crave carbs, don’t care about meat. The fear of falling back to bad habits is real.
• I made decision to have abdominoplasty with diastasis. Today I paid $4,000 down payment toward the surgery. The total cost will be around $10,000. Expensive, but part of my ‘reconstruction’. The surgery is scheduled for middle of August.
• I am so glad I kept this blog as I can revisit my trip and read about stuff I already forgot.

Free and Clear

OK - finally I had a visit to evaluate the CAT results - and I am free of any worries. The changes as compared to 2007 are non-existant - and life is sweet.
I had to admit that it was a little bit scary...

After CAT

I went to see the surgeon today to evaluate CAT scan results.
I had good and bad news.
First (expected), there is no abdominal hernia. There are two small ‘inguinal hernias’ that are stable comparing to CAT scan in 2007.  However, the abdominal wall is very thin; therefore I need to have plastic surgeon to the rescue to repair the belly and the muscle, so I contacted one.
Second (unexpected), the CAT scan indicated ‘Urinary bladder wall is diffusely thickened. There is apparent defect at the superior portion of the prostate gland…’
Doctor recommended to see urologist, and I already made an appointment for June 4th. Thickening of the wall bladder could be a symptom of many problems, so I am not ready to speculate.
As Gilda Radner used to say: “There is always something…”
Cheers.

Welcome 4000 Visitors

Hi,
I was silent for the last two weeks. In the meantime, 4000th ‘unique’ visitor visited me. From the emails I received and feedback posted, it looks like few people out there were influenced and somehow I feel that I contributed to their life or their decisions.
Thank you all for sharing with me that difficult navigation, Now the sailing is clear.

OK – so what is new?

Looks like I lost all the fat I should loose, but I still did not reach my weight goal. I just have to accept it. What is bothering me more is my still large belly (of course much smaller from what it used to be, but still sort of out of proportion). When I started to exercise and specially tummy workout, my belly was just exploding. When I tighten my muscles, I have a ridge running up and down the front. I visited bariatric surgeon and she suspects that:

1. There is a small probability of hernia
2. I have separated stomach muscles that would have to be surgically ‘stitched’ together.

I am scheduled to have a CAT scan on Wednesday to see what is inside. Hernia can be very easily repaired however full abdominoplasty would be difficult, expensive, and with significant recovery time. On top of this, insurance covers hernia repair, but considers abdominoplasty‘cosmetic’ and therefore not covered.
Other than this – I feel great. I do not regret this decision for even one moment.

Great progress but only for these who knew me before. 8^)

I just returned from a conference in Seattle. Before I flew out, I took a walk around Westlake Center since I had about 40 minutes to kill. In front of the center four cops on horses stood in a nice line overlooking lively crowd. I walked to one and started to chat.
- Why horses and not bicycles or scooters? (possible crowd control),
- Is each horse being handled by a single cop? (yes),
- Is the other cop's horse a real Clydesdale? (no, he is half Clydesdale, you see that cop is a large guy like you - he needs a big horse)....

At that moment my shoes lost their shine,  my eyeglasses fogged, and thunder shook my whole foundation.
OK - I knew I still need to loose 30 lbs, but I didn't expect to hear it from a Seattle cop on horseback...

Fun Continues

The energy is still there. I am going to the gym and enjoying it. I even placed my profile on couple of dating sites

Somehow finally I feel very contend about who and where I am.

I have been walking or biking to work daily, and the inner-energy reversal is truly amazing.

But - my weight still did not dip below 200 lbs.

However - I lost few inches on my waist, and yesterday I purchased athletic shorts size SMALL and they fit!.

So I will not panic - with the exercise there will be a balance of muscle building (added weight) and loss of fat (weight loss). I am not happy about my still larger then wished for belly, but overall I feel (and look) great!

Good turn-around, finally

I sound like a cliche broken record when I repeat this recent roller-coaster ride. Things looked bleak for a while. After my visit to my doc and after the labs returned all OK results, I started to look for clues somewhere else.

Sometime few months before the surgery I was stressed out and I lost some of my trademarked realistic perception, and my doc suggested to take Prozac which should put me on the right track. Since one of my biggest worries about the surgery was the depression that many patients experience afterward, I decided to continue taking it until I know that I am out of the woods. That decision was actually suggested by my bariatric surgeon, who also warned me about serious possibility of depression. To make the long story short, after the lab results came in and showing nothing wrong, I decided to get off Prozac. It took couple of weeks, but the vail of energy loss and physical exhaustion had lifted. Just as before I could not stay awake, now I exercise, sleep only few hours and being rested rest of the day, etc. Another amazing thing happened - my suddenly increased appetite went back to the new 'normal' behavior where few bites are generally satisfying and more is not needed.

I finally joined and attended regularly scheduled class at the gym that combines cardio and strength exercises, my head is clear, body is willing, and life is wonderful.
On the negative side - I am still above 200lbs and my weight oscillates between 201-204, but now I know for sure that I am back on track and the forward trip will continue.
Stay tuned.

Soul Searching

Few facts first:

1. I have not lost a single pound this year so far

2. I can eat anything

3. That is bad combination.

4. Not feeling great

It was a long silence from me - reasons were few. I was finishing the class, preparing for the final exam, had a conference in Phoenix, then three sessions of finals, finally caught a bad cold and spent few days in bed.
During the conference, which just happen to be in five star resort with abundance of food and liqueur, it was hard to stay focused on picking the 'right' food, avoid temptations, etc. I stayed away from alcohol, coffee, but I had discovered that I can have a piece of pastry without punishment. Sorry, the punishment was strictly mental. Last few days I am recovering from the cold. I feel weak, I see that my muscles deteriorated, and I am still feeling without any energy. Going to the gym is still a future project, going to bed is much easier accomplished. I am becoming worried that my surgery was limited to my 'gastric' system and not my brain, do I need some kind of hypnosis? Weight Watchers help as a weekly reminder, bariatric center support meetings are monthly reminder, but I feel like I need it every hour. For the first time I have doubts, I am afraid that I am failing. I am still 35 lbs away from my goal and I will not accept compromise.
I made an appointment for tomorrow with my general practitioner to see what can be done with my total lack of energy, but as of now I have been trying to evaluate what is happening. I am not sure. I see the cycle of no energy, no exercise, increased hunger, no weight loss, and I seem to be powerless to break out of it.

Country road...

I think I am beginning to understand what is happening to me, and once I 'got it', it was so obvious...
About 13-14 years ago I developed diabetes, and doctors instead of checking for it - checked everything else. Looking back it seems almost impossible how they could miss it.
As I already wrote about, lately I felt tired, with attacks of hunger and almost instant need to eat. I started to exercise and noticed that I am just passing out. I tested my blood sugar next time when the bottom hit me. Today I rode my bicycle to school, and when I arrived there I felt really strange. Instead of reaching for a protein bar or something else I reached out for my meter. Sugar at low 70s. Glass of water and two glucose tablets - within 10 minutes sugar at 105 and I felt great.  Next bottom, sugar at 60, glucose, not food, to  the rescue. From now on I declared a war. Hypoglycemia, you have met your match.
Before I was very angry at myself for eating more, for being hungry, I felt like I was getting back to my former life and all this effort is wasting away. I feel stupid that I did not think about such obvious cause.
Later I  measured my sugar often, and amazingly could keep it at around 100 for rest of the day. No more downs, no more hunger. I still feel tired but I am sure that I have a handle on the problem.

This trip is not on the super-highway, but on the bumpy, twisted country road without pavement. There are thousands or millions roads just like this, but this road, just like others, was never traveled by anyone else.
We all are pioneers, trailblazers, however I also know that nobody else will travel that same path again, even though millions of identical paths exist, this one is mine.
Otherwise it would have been easier..
I don't look back, and I know that going back would be the easiest since that's the only direction where familiar places are, but I cannot look back.
Hope my experiences help other fellow travelers who find themselves stranded somewhere in the wild.

Weight Watchers (at work)

I took advantage of the free Weight Watchers program offered for the University employees and today I signed up and attended my first meeting. I need weekly dose of brain wash. I will see how the high protein post-bariatric surgery diet blends with points from WW.

Much better...

These were tough few weeks. Real crisis. I haven't felt zombie like this in a long, long time. Slowly things started to get better. Increased iron and B12 might have helped, however I also made a conscientious decision to eat more  as I was suspecting that eight months of very limited diet might produce that tiredness.  It worked, at least it appears that it is working. Yesterday instead of going to school to prepare for Monday I decided to take advantage of beautiful Spring weather and went on 250 mile motorcycle trip along the incredible Oregon coast. The energy is coming back as well as desire to to something else than just recline in the chair. I also started to take Melatonin and that helped to get good night rest. Before I would wake up at 3AM, not anymore. So this was just one more pothole on the road. They warned me it will not be smooth.
Thanks you very much to all of you who send me emails with your wishes and worries. I will respond individually today. Yesterday's open road, sun, and ocean was finally a game-changer. On the negative side - I am still waiting to break 200lbs barrier. It will happen.

Low Energy and No Weight Loss Continues

I really tried last week. I biked to work, went to the gym and joined Strength and Conditioning class. People were jumping, music was blasting, it was hard to keep up. Lets face it, I am not 20 year old, not even 60 8^)
Eventually we used mats to do some exercises laying down. As soon as I lay down, I felt like falling asleep. I was suppose to be reinvigorated, but was not.
I started taking 5000 mcg B12 daily (instead of weekly), extra iron. I will stick with extra physical activities and give it two more weeks.
I'm also scared that I still did not develop healthy habits for eating three meals at scheduled times. I am OK in the morning, but later things are getting hectic and I just grab a piece of the protein bar when get hungry. That meal planning is my priority #2. I started to log all food I consumed and keep the total calories/protein current.
I feel like I am at the crossroads and old life is still hunting me. I am still 35 lbs away from my goal, traveled long distance, but have not arrived at the destination.

New Challenges

I am facing new challenges at this stage. I blame myself for few problems, like not sticking to the regularly scheduled only three meals per day. I eat little, but more often than three times, as hunger strikes. Before, in the recovery stage, it was not an issue, now I see it as BIG issue. I still do not spend enough time to concentrate on meals. I still do not spend enough time to exercise. So these will be corrections I have to take soon, starting today.
On the other hand I feel like something is wrong. I am very tired, I fall asleep in the evening, but wake up at 5AM. I feel like an old lady not able to lift a bag of groceries. (I'm exaggerating, at least I feel like not willing to lift that bag). My tests are OK, thyroid went back to normal, so I am puzzled. In a week or two I will see my doctor if this continues.
My weight is still a notch above 200lbs, and it is stuck there. I am waiting for a new down step.
I am waiting for new found energy fountain. I need to find it soon.
In the meantime I am increasing doses of Iron, B12, and D3.

Seven Months

Today is 7 months since the surgery.

What's changed in these 7 months?
Everything. That is a short answer. Absolutely everything. That is a long answer.

My weight stabilized at 203 - which means 100lbs loss - but it is not going down... however - the belt is being tightened and new holes drilled. So I guess it is the weight redistribution. I went from pants size between 46-48 to 34-36. That is just about right, usually each inch in waistline corresponded to 10 lbs.
Today I decided to go back for two days on liquid protein diet - just to fight new bouts with hunger. I am as determined as ever to continue.

The challenges of the first few months were to cope with the surgery aftershocks. The future challenges will be more of the normal life adjustment. I can eat almost all, that is good and bad news. I still did not master slow and deliberate chewing - I am working on it. I still fight too many old habits, like not focusing on food while eating.
I still feel tired. So far other patients were telling me about their excess energy - I have none. My gym membership is still merely symbolic. I have a lot of excuses, and I know that they are only excuses.

Six months medical checkup

Yesterday I had my 6-months checkup. All the lab tests looking great. They also took photographs. Here I am at the start of the process and yesterday. It shows how far I traveled already, but it also shows the road ahead.
My weight is coming off slowly, but I reached new low of 103.2 today.

New Year

Back to the new yearly routine.
I recall when I was waiting for approval for the surgery and facing with the possibility that either it will be soon or in December as no surgeries were scheduled for Aug-Nov, on June 19 I wrote:

By December I could be 100 lbs lighter…

well, by December I was 97 pounds lighter. I also wrote about my fears and hopes. Fears did not materialized, hopes were met.
For this year resolutions:

1. Exercise - I am still not very dilligent. I still feel tired often.
2. Continue to loose weight until my goal of 165 lbs is met 
3. and keep it FOREVER under 170 lbs.

Back from Mexico!

This morning I returned from 10 day trip to Mexico. I went sightseeing old pyramids of Monte Alban, enjoyed the sights of Oaxaca, tropical beeches of Huatulco, and the warmth of Cuernavaca. And of course the food! I knew this will be the challenge. I do not want to live a crippled life, which is not why I underwent the surgery. I wanted NEW life. It turned out just fine. At the fancy restaurants the food of choice was Ceviche, which is raw seafood marinated in lemon juice, and served various styles, but usually as an appetizer or cocktail. It is a perfect combination of low fat good protein, veggies, and no starches. Only once my little pouch rebelled when I decided to have a Fillet-Mignon medallion, but it lasted not too long. The end result – I lost 4 lbs on the trip and I reached a new low of 104.2. 
Tomorrow it will be 6 months since the surgery. I am in the totally new world.  Even though I have not achieved my weigh goal yet (I will) I’m facing different challenges. As I can eat more foods, tolerate more variety, there is a danger of getting back to old habits.  Like a recovering alcoholic, I pray to be strong and resist the temptations. The stomach surgery took couple of hours; the resulting brain ‘surgery’ will be a lifelong process.

To Lisa:

You wrote:

“I have to ask you...did you have a fear of dying during the surgery? This is what scares me the most. I'm not afraid of the diet afterwords, or what I'll have to endure pain wise...I'm afraid of dying during the surgery.”

I know what you mean – especially since you are a mom to two little girls and have no other medical problems. I did not have your dilemma; other than my two cats I have nobody who depends on me, and my diabetes was out of control. I knew that diabetes will cripple or kill me, and for me the probability of dying from the surgery was significantly lower that dying from the diabetic complications.
I think it is VERY WISE to be afraid. This should NOT BE a cosmetic surgery or something that should be considered frivolously. Only you can weight all pros and cons. If you decide on the surgery, please consider also other less invasive options like a gastric sleeve.
For me my surgery worked fabulously, but that does not make it a universal rule.
Good luck!

Change in record keeping

I stopped the daily checking of my weight and blood sugar. I will check weight weekly, and sugar at random. BTW, today I was still at 210.4 - matching my previous low - but not breaking it.

Long Wait

After 15 days of waiting my weight finally went down, but only .6 lb from the previous low on 11/19/09...

Plateau

I have reached another plateau, as for the last 13 days I have not lost a single pound. I suspect it has to do something with my thyroid function. After I started to take pills, I experienced HUNGER, but that lasted only few days and was replaced by lack of hunger and almost aversion to food. I also started to ride bicycle daily. I see no reason to have that weight loss freeze (other than waiting for thyroid to get to normal). I am not worried, but slightly disappointed. I still have most of the hypothyroid symptoms: cold intolerance, fatigue, weight loss problem, dry skin, etc...
Somehow I started to believe that the surgery was a miracle cure for ALL, but it turned out to be a miracle cure for MOST. If thyroid will remain my only problem, I can live with that.
To be continued.

TSH at 17.5

This afternoon when I got back from my bike ride I received lab report in the mail (I was expecting it on Monday). As I suspected my TSH was at 17.5 - very high. I am glad I listened what my body was telling me.

Abnormal normalcy

After 5 months the changes are still happening, but not on the daily basis. Since I got rid of almost all major problems, I was sure that I could get rid of them all. My thyroid is bad, and for the last 10 years I have been taking supplements. I tried all, even homeopathic sulphur. The synthetic replacement did not really work, as I had to increase the dose every few months. Homeopathy worked (!) but not for long. The one consistently good product was Armour Thyroid. It combines T3 and T4 and generally is not favored by doctors (my doctor laughed that this is throwback to 50s and Elvis lives) but he could not argue with success – my TSH went down from mid teens to under 1. I have been taking it ever since. Unfortunately, the supply of Armour was greatly affected by production problems and I was not able to get it. I thought that this is a good blessing and I will try to see how I am doing without it. After four weeks I knew something is wrong. I was constantly cold, my skin was dry, and all old hypothyroid symptoms were there. Before Thanksgiving I had lab work done but I did not get results yet. Nevertheless, I dug out the 5 stashed pills and started to take them. The results are instant – chills are gone. In two days I will get lab work back, but I felt like I could not wait.
Other observations: after of 5 months the hunger came back. I am analyzing it. Is it real? The fact is I did not lose a single pound in 9 days now. I did not overeat for sure, but I think I need to have more exercise. Today a bike ride is planned.
So things are getting back to normal, but they are far from normal yet.

5 Months

Tomorrow will be 5 months since the surgery. 92 lbs lost, 74 since the surgery. My system is getting used to my new stomach and digestive tract; pouch is no longer as angry as before. I remember when I was applying for the surgery and there was a very good chance that it would have to be postponed until December. In my conversation with the B.C. manager, I said “By December I already could have been 100 lbs lighter”. Well, almost there.
I am still 46 lbs to my goal, but I am beginning to see the horror of loose skin. I am sure that the next 46 lbs will create more dramatic change. I will deal with it later, when my weight stabilizes.
Diabetes and apnea are gone FOREVER!

Am I Losing My Mind?

Since the previous weekend proved that I could handle salad, I decided on my way home to stop at the store and take some home. I went to the salad bar, and carefully picked what would seem like sensible choices. I was ready to leave, when I glanced at the miniature watermelons and thought – why not. As I was walking to pickup watermelon, I remembered that I am out of milk. On my way to the dairy cooler, I walked past the meat counter, and they had these little NY steaks (about 6 oz each) at greatly reduced price. Last weekend I also successfully had piece of prime rib, so I decided to buy few and stack them in the freezer. After I loaded gallon of milk, I also recalled that I am out of yogurt. Getting yogurt, I also got some frozen cherries and blueberries. My basket was full and my little salad trip was $50.
Because of the terrible parking situation I usually ride to the university on my very large scooter. I have side bags and very spacious trunk. I had to remove all stuff and distribute it in my scooter luggage. In my garage I had to move everything again into a cart and finally I made it home. Since it was cold and rainy, I changed into my comfortable warm robe, and unpacked the grocery. But I could not find my salad. I left it in the store. There was no way I would dress again and ride there, so I just decided to forget about it, and prepared one of the steaks. The grilled steak turned out absolutely perfect, I had only half of it, with some beans, and I started to feel ‘funny’ (unfortunate word as I was not laughing). Within no more than 5 minutes the steak ended up in the toilet in sort of unusual violent vomiting.
So I went to get a salad, which I left in the store, purchased all kinds of stuff I was not planning. The punishment was instant. Is there a lesson here, or just coincidence?

To Stella:

Stella;
I am not sure if there is a real difference in soy based and whey based protein powder. There are also organic health food alternatives, based on rice, hemp, and nopales (cactus). Of course they claim that whey protein will kill you 8^).
Since I switched to unflavored protein, I found that soy changes the food taste more than whey or rice. Also, there is a link on thyroid deficiency and soy based products, but I am not sure how serious this is.
Yogurts are great, but plain yogurt (which I like) is eventually getting to be too boring. Fruit flavored yogurts, on the other hand, are full of sugar. I started to buy frozen berries and cherries, and blend some plain (preferably organic) yogurt with frozen fruits and a little bit of Splenda. This creates very good tasting 'smoothie'.
Good luck to you.

Normal Life Returns

I am able to return to almost normal food. I had piece of Prime Rib, salad, spinach salad without any adverse reaction. (Still, some fruits, like grapes, feel like I am swallowing acid.) That return to normalcy is welcome, but scary event. I fear old habits. I hope that that fear will be my guardian.
My energy levels are constantly going up and definitely I know that the worse is behind me. I am determined to have that past suffering not go in vane. I will reach my goal and will stay there. And I pray that I will never lose my fear.

First Weekend out of Town Survived

Last weekend I went out of town and for three days I was depended on eating out. Well - I survived without any problems. Of course, I had to be careful, and light string cheese save me couple of times.

The more I think about the surgery, the more I consider this to be a miracle. Now my sleep apnea is gone. I was sleeping with CPAP ( a noisy 'breathing machine') since 1997. This time I could travel without it and sleep without it.
I was nervous about the surgery, I was worried about possible complications, threat of depression, etc. As it turns out, the surgery was a blessing, a gift. That gift was absolutely worth the discomfort, pain, nausea, and other side effect. They almost all had disappeared, but the weight loss, end of diabetes, end of apnea is here to stay.

To Melanie

I am not sure if you received my response. Just in case, here is 'public' version:

--------------------
Hi Melanie,
Congratulations on your surgery - big step!
To answer your question, try to get unflavored protein mix and add it to chicken broth. Greek yogurt (which has a lot of live cultures and is thicker) is good easy start. Also try Kefir - not many people know about it - but it is not just pro-biotic but PRE-biotic, in other words it has nutrients to feed pro-biotic bacteria.
I live only a block from Trader Joe - and the books are:

Cooking with all things Trader Joe
(http://www.amazon.com/Cooking-All-Things-Trader-Joes/dp/0979938414/ref=sr_1)

And
The I Love Trader Joe (http://www.amazon.com/Love-Trader-Joes-Cookbook-Delicious/dp/1569757178/ref )

Good luck to you - and do not get discouraged. The first three months could be unpleasant, but every time I test my blood sugar and step on the scale - I and incredibly happy.

Best wishes!


___________________

Thaddeus

4 Months

Today is 4 months since the surgery.
I started with BMI above 40 as 'severely obese', at the day of my surgery I was in the top of 'obese' category. Only yesterday I crossed from 'obese'  into  'overweight' range below 30.
So I am just 'overweight' now. Sweet.

100 Kg Milestone Smashed

This morning, after few days of reverse direction, my weight dropped to 218.8 lbs, well below 100Kg mark.
The bad news: my belly button is now 2 inches lower than it used to be. 8^)

Zombie Attack

Yesterday I had another zombie attack. I slept most of the day and night, and today I am just fine. I guess that was what I needed and the rest helped. I know that out of over 1600 (!) people who read this blog, many are either expecting surgery, or already had it and I am just few steps ahead. Of course nobody states that my experiences are 'typical' but generally you might expect similar situations. Just like nausea and puking in the beginning, tiredness later. I am trying to listen to my body and follow its requests. No time to be macho...

Practical Tips (2)

After bypass surgery there is unbalance in fiber consumption. I solved it in a very simple way. I use two kinds of Benefiber. One, unflavored, purchased in large 1.6 lb containers, dissolves almost instantly and does not change (significantly) the flavor of drink. I add it to coffee substitutes, etc. Another kind, flavored, comes in little convenient tubes, each suppose to be dissolved in 16 oz. of water. I use one for my 32 oz bottle. Makes a pleasing drink, and two bottles like this satisfy the 64oz water consumption requirement. Since I started doing this about month ago, I have no problems where I used to get 'stuck' before.

Practical Tips

I would like to share some of the practical 'survival' tips that I use.

1. Fortify the protein:
   I use unflavored protein mix (many varieties).  For example: one container of Nile Organic Potato and Leak soup, just add boiling water and wait 5 minutes, has 110 calories and only 4 grams of protein. That means only 16 calories are from the protein - less than 15%. I try to keep my daily ratio of protein calories to total calories above 35%. By adding half scoop of protein mix (60 calories, 12 grams of protein, 80% ratio), my soup meal becomes 170 calories, 16 grams of protein, 37.6% ratio. I am still not dealing well with meat, so this 'trick' is sure way to boost protein intake and still create easily digestible meal.
2. Eat soups:
   I work a lot, live by myself and cooking is not really what I want to do. Soups (fortified with protein mix) solved my problem. Some of my favorites:
   
- Trader Joe Beef and Barley (200 cal, 14g protein - serves two meals) - a small carton. 

- Nile Organic few varieties - single meal, a cup with dry soup - add boiling water.

- Health Valley Organic - microwavable.. - meal and a half. 

1. Other foods - quick, convenient, and tolerable:
   
- Light string cheese 

- Cooked shrimp 

- Fish (sashimi or broiled) 

- Cottage cheese (organic with live cultures - many store brands are 'dead') 

- Organic yogurt and kefir (again, live cultures!) 

- Canned tuna - go for better ones. 

- Trader's Joe reduced fat smoked Gouda. 

1. Grain beverage as a coffee substitution and use DAIRY dry non-fat milk based creamer.
   

Energy is Back

I cannot explain and I wish I knew. Yesterday I had a heavy day of lectures in front of 450 students, Bariatric Center Support group meeting, etc. I was expecting my lately usual crash, but as of 11PM I was still full of juice. Today - same thing. I will go to the gym, just returned from nice one hour walk, had my Office Hours with number of students, life is great!
I am puzzled, but also relieved as I suspected that something might be going wrong...
I am glad I did not call my doc for an appointment.

To Billy in N.C.

Billy, I responded to you but the email bounces back. Good luck to you and thank you for the email.

Status

The fourth month after the surgery starts with two major themes.

• I can eat more different foods, however still stay away from solid dry textures. I have to eat slowly, or face the punishment. I have to chew, chew, which somehow I forget as old habits die hard.  
• Second prevailing motif is my tiredness. I feel great, but tired, tired, tired. I sleep 12 hours per day, and that's not enough. I was told that it's normal, but doesn't feel normal to me. Even though I signed up for the gym membership, I am just too tired to go there. Sounds like an excuse, I know, but it is not. I go home instead, to bed, and in 5 minutes I am sleeping like I was on drugs. I am wondering if this is a symptom of some deficiency and I am planning to see my doctor. However at the Bariatric Center last week they told me that any deficiencies will not show up on the tests until 6 month after surgery. At the same time they said that being tired is normal at this stage. My system went through a major surgery, rearranged digestive system, lost 75 lbs, all this puts a stress on me. May be the sleep is what I need more than exercise at this juncture. I am planning to take an easy day today - go for a walk, watch the Ducks game on TV, sleep. Tomorrow I will be mostly in my office working.
  

Misguided Search

On July 17 I made post entitled Adventures in Vomiting - gross - but what a relief! - I wrote about how this disgusting activity spells abatement to some of the early post-surgery problems.
Recently I was looking at the visitors lists, looking where people came ‘from’. One person from Germany used Google to find this blog. I looked up that keywords (s)he used was: “Relief from Vomiting”
Poor person, I probably nauseated her even more. I was going to say ‘sorry’ but I am sure that (s)he will never be back. 8^)

3 Months

Yesterday passed 3 months since the surgery. I also had my 3-months checkup at the clinic. Good news! My high blood pressure was caused by a faulty automatic machine, and nothing else. At the office my BP was perfectly normal!
I am still a fraction under 230 lbs.
Reflections:
If someone would offer me a surgery to get rid of diabetes, with all the consequences like this surgery, I would take it in no time. If the weight loss would be a side effect - I would take it in no time.
The last 3 months were not easy and there are still many adjustments left, but my conviction that this was THE RIGHT decision is unshakable.
By strange coincident my surgery was moved ahead by 8 weeks. At first I did not like it, since it interfered with my summer class teaching. Now I'm extremely thankful that it was moved. I'm starting new school year in much better shape as compared to the state I was 8 weeks ago.
I did not like the nausea, pain, vomiting, tiredness, but in the final analysis, I feel blessed to have this surgery. This is a lease on new life, different life, new life full of the advantages to be harvested.

Under 230 lbs!

Today I went under 230 lbs. Writing this is one of the rewards 8^)
I also finished my shrimps/lime/cilantro - but this time carefully chewing and focused. No problem!

Focus!

Yesterday I purchased cooked shrimp with cilantro. Shrimp (cooked) is a great source of protein, low fat, and something I could tolerate very well. After few shrimps I realized that I ignored warning about fully focusing on eating and the first 3 or 4 shrimps went down with only slight effort to chew. I knew I made a mistake right away, but was hoping that it will pass (or shrimp will pass). The opening between new pouch and attached intestine is very small and 'the chew, chew' recommendation is incredibly important. I ate them around 8 PM, and until 2:30 AM it was in constant agony. What a lesson to learn. Now I wonder if my previous experience with beef was really caused by beef or just inadequate chewing...

Kawa Zbożowa

I stopped at the health food store, looking for coffee substitutions. I found few grain beverages from Switzerland and Poland. Ironically, when I was growing up in Poland, the grain based 'kawa zbożowa' was a symbol of the hated communism. It was a cheap substitute for real coffee that was either not available or too expensive. It was generally despised and ridiculed, usually in the same sentence. Interesting that I find it now, many years later, in USA, as a health food alternative, costing twice as much as coffee. No wonder we were so healthy growing up.
I had my first slice of pizza  and it was no problem. It is almost three months, and number of foods I tolerate is increasing. But the next day I had some roast-beef, that caused 5 hours of misery. I still cannot tolerate meat very well.
My weight dropped down again, and finally I was able to eat some fruits.
Another new development is higher than normal blood pressure. Average 160/88. Next week I'll have checkup and will consult about it. I used to drink mass quantity of coffee, tea, and I was adding food to my salt. Now - none of that, and pressure's up.
I still oscillate between being tired, sleepy, or full of pep. Higher blood pressure might have something to do with it. I sleep like a proverbial rock. I used to take melatonin - otherwise falling asleep was difficult and I needed only few hours of sleep. Now I sleep without melatonin, takes me 30 seconds to be in the vivid dream zone, from which I will not awake until 10-12 hours later...  What a waste of time!

Half-Way #1

Today I reached the half-way mark for my total weight loss. 69 lbs down, 69 to go. 51 lbs since the surgery. Piece of cake! (No, I can't have one...)
Since I had to 'prove' the weight loss to qualify for the procedure, I lost 18 lbs before the surgery. Therefore I'm only 9 lbs away from my next step - half-way goal since the surgery - at 225 lbs.

No More Zombie!

Just as the tiredness suddenly came over and grabbed me for more than one week, as unexpectedly it disappeared. Since the weekend I am in great shape, great mood, not tired, not sleepy, not a zombie.
I have no explanation, and no understanding. I just went with the flow. I feel the energy coming back, my mind could stay sharp for the whole day. Fabulous.
I signed up for a gym membership in the Downtown Athletic Club (to actually start next week). The lectures preparation is going great, and I am so upbeat about all of this.

Sleeeeep!

I mentioned this before - but somehow this is another annoying aspect of recovery. Almost daily I go back home in the middle of the day - and sleep for couple of hours. Makes no difference if I walk, bike, drive, the mid-day tiredness comes up - and I sleep very, very hard. Like on sleeping pills. I checked my sugar to see if it is the cause, but the blood sugar levels are perfect - around 100. I feel great otherwise, great spirit, great mood, but at 2 PM I am a zombie. I don't like it... I am lucky, it is summer, no classes to teach, next year preparation on track (with the help of two VERY capable Teaching Assistants - thank you D. and J. - if you read this!).

Mixed Feelings

I definitely see the change happening. Not the weight or sugar, but changes in my reaction to food. Some of these changes are very surprising. First - I seem to be able to eat almost anything. But by saying that, I do not mean to say that I can eat almost all. I used to love fruits, now they taste like an acid. One plum, one grape, is all it takes to make me look the other way. Meat, my favorite, is no longer something I can stand. I prefer veggie-burger patty any time. I use to have some cravings for specific foods. I don't. No food is tempting, but also surprisingly, I am experiencing hunger more and more. This is another new experience to me, when I am hungry and no food looks appealing. Natural cottage cheese comes to my rescue. 4 oz, half a cup, that is all I need.