Two month update

A little update since it has been two months since my surgery.


Weight loss
I remember reading that it is percentage, not pounds, lost that matters in this experience. On my day of surgery I had 225 excess pounds. I've lost 26% of that weight. In total number terms, I started this journey in February at 520 pounds, had surgery in May, and today weight 396 pounds. I don't remember life in the 300's. My clothes - especially my pants - are unwearably big and the new pants that fit three weeks ago are falling off of me, falling off of me in Whole Foods, falling off of me in front of my landlord, this is getting to be a problem. New bones are poking through. And if one more person notices my 124 pounds of weight loss by asking if I've lost some weight in my face I'm going to scream! What, was my face once the size of a blimp?

Food
I don't get hungry anymore. I have to remind myself to eat. I get full quite fast. When it came to food I loved fat and salt. I like meaty savory things. I wasn't so much into bread or sweets. So for me, my experience has looked more like the "eat what you want when you want" people because what I want to eat is meat and when I want to eat it is a few bites a few times a day. If my "food triggers" were pasta, bread, and sugary, I think things would be more difficult and slow going now.

The Long Way Home

I got to go home yesterday! HOORAY… well, in theory anyway. The trip home started off bad and ended that way. I got a noon time visit from Dr. Lane who authorized my discharge. The nurse took about two hours doing something else before she came in with discharge instructions… for the RNY, a procedure I didn’t have. When I alerted her to this she said “well, some things will apply to you and some things won’t.” She, of course, failed to notify me of which things those might be. Meanwhile my IV had been removed and my pain was rising to a 6… a 7… an 8… First, the nurse told me she was not able to give me injectable pain medication because my IV was removed. I told her to put it back in… after stabbing me several times with the new IV needle she admitted defeat and left to go get help. She returned not with a help, but with an excuse that she couldn’t place the IV because I had been discharged. By this time the pain was so immense that I was crying. The nurse then told me that there was no such thing as an intramuscular pain injection. My mother then stepped in and called Dr. Lane who authorized an intramuscular pain injection, you know, the ones that don’t exist. In addition the nurse applied a pain patch for the long term. Before she applied the patch she asked “where do you put these” and then swabbed my arm with alcohol, a practice that later I read was warned against. A warning that said failure to follow may result in death! Finally, I got out of the hospital. The ride home was a little painful but not horrible. When I got home I went upstairs to my room immediately. There my family, one of whom is a nurse, helped give me crushed up Vicodin. This caused me to vomit what little my stomach contained. The pain and fear were great and my energy fell through the floor. I spent the rest of the night in a dark room hoping I would be knocked out soon. Sleep finally came… amen and amen.

In Hospital Update

Every two hours somebody is in my room doing something to me. Taking a measurement of this or that, injecting something, or filling up or emptying something. I know, it’s their job, but my goodness EVERY TWO HOURS! Let’s see, what else? Oh, I’ve had my upper GI done. They thought they saw a leak, but Dr. Lane confirmed that everything was fine and I am leak free. That gave the go ahead for them to bring be popsicles and jell-o and water and protein drinks. The only trouble is I have NO inclination to eat or drink. I have dried little bites or sips here and there. But it’s not enjoyable. Amy or Dr. Lane come and see me every day. My mom is in by 10:00 AM and sits guard for me while I nap the day away. My only complaint is that the nurses can take a long time giving me my pain medication. The other night I had to pull the call button out of the wall to get a response. That sent them running. Fortunately, with my pain meds. My friend from OH came to spend some time with me! She brought a cheery hello and GIFTS! Thanks M!!!!! Oh, and today I got to get the tube (Foley catheter) taken out of my penis! My nice female nurse was there and she said it was okay to take out now. Then, she called some MAN to come up and take it out. I know, I know, either way there is nothing sexual about getting a tube ripped out of your manhood (unless you’re into that thing… no judgments) but the thought of some guy grabbing my junk and yanking wasn’t appealing. I asked my nurse “can’t I do it myself” she laughed and said “no.” And, of course, I’m doing lots and lots of walking (every two hours)!

The Day of my Surgury... Begining a New Life

The night before my mom and I stayed in a hotel. It was there that I prepared for surgery with a “bowel prep” which is basically like drinking concentrated salty water from the sea. There is a weird determination that comes with sitting on the toilet for hours on end. It was as if I thought to myself, if I can shit for three hours straight, I can do ANYTHING. (SIDENOTE: If you’re going through this bowel cleanse period, bring baby wipes! I won’t go into details, but let me just say that hotel toilet paper is like a low-grade sand paper on the tush!)

I took this determination with me to the hospital the next morning. I got naked and sat in the pre-op area, and I was at peace. I didn’t fear for my life. I didn’t wonder if I was gonna make it. I knew everything would be alright. Dr. Lane came in and he and I had the conversation where I told him “if you wake me up before you have completed the whole DS, I want you to be able to tell me exactly how I was going to die if you would have continued.” They put the most comfortable leg wraps on me which created pillows of air surrounding my calves that inflated and deflated to give me a massage (and ward of blood clots). Then they took me back through a series of hallways, people staring at me, and then into the OR room where I was greeted with many more people than I expected. I felt like asking some of them to leave – “excuse me please, but I’ll need some of you to go. I don’t know if my insurance will pay for this many of you.” They were going to lift me from my gurney to the operating table but I told them I could manage the trip on my own two legs. I sat up… carefully slid to the side of the gurney… got up to my feet whist acrobatically holding my gown closed in the back… when one of the nurses says “on, you don’t have to hold that closed, this is the part where you flash us all” and just like that my ass and other parts said “HELLO!” to the theater of spectators. They took a while adjusting the table making sure I wasn’t hanging off in any place. And then, I was out.

I woke up someplace, I don’t really remember where. I was in and out of consciousness. Then I was wheeled to my room. I don’t remember being in much pain. But then came the nurse. After surgery they wrapped my abdomen in an elastic binder to keep everything tight and together. Well, Ms. Nurse decided to take off the binder causing my fat to flap down and incision to get pulled on. Let’s just say, I was in more than a little pain. Then came the walk. By this time I had been given a wonderful pain shot and was able to get up out of bed and walk out into the hallway. I wasn’t comfortable, but the ever present fear of developing a blood clot made me take step after step after step. I came back to my room escorted by mom, said my goodnights, and was done for the evening.

T Minus 8...

Well, look, I seem to have missed blogging in the month of April... sorry about that. I've been SUPER busy with school. But, finals are now over - HOORAY! - and I'm now in super-surgery mode. Here's a (long) update:

Diet and Exercise:
Dr. Lane asked me to walk 30 minutes a day and have been compliant! I walk in the park next to my house late in the evening. It's the self-conscious fatty in me that likes to walk under cover of dark. And, while this practice has lead to several... interesting situations (read, masturbating perverts)... I am more fit now then I was when I started and am loosing weight. The dieting has helped too. I started with mostly frozen dinners. Let me say, these are not your mother's mushy unidentifiable frozen dinners - Healthy Choice's Cafe Steamers Beef Merlot is amazing! But, days of scrumptious frozen dinners have turned to days of liquid meals. As directed, I started my pre-surgical full-liquid diet a week ago. It's not that bad. The cravings for substance get bad sometimes. But, for the most part, they are not hunger cravings. Six more days to go, then onto the clear liquid diet, then surgery. I'll move on now by saying I REALLY REALLY WANT A STEAK!!!

Supplements:
I ordered and received my supplements from vitalady. It was like Christmas opening the box! Here's what I'm taking every day:

Upon waking
1 – Iron (Ferrochel) Complex (27mg Iron)
1 – Vitamin C (1000mg)
1 – Multi-strain pro-biotic

Plus 2 Hours
1 – Multivitamin
1 – Vitamin A (Acetate) Sublingual (10,000IU)
½ - Dry Vitamin D3 (Cholecalciferol) (25,000IU)
1 – Dry Vitamin E (400IU)
1 – Dry Vitamin K (Phylloquinone) (100mcg)
2 – Bone Calcium (2 pills totals 500mg Ca, 250mg Mg, 100IU Vitamin D)
1 – B12 (Methylcobalamin) Sublingual (1,000mcg)
1 – Coromega Omega-3 Fish Oil Supplement

Plus 2 Hours
1 – Calcium (Citrate) Complex (500mg Ca, 250mg Mg, 200IU Vitamin D)

Plus 2 Hours
1 – B Complex
Thiamine (B1) (200mg)
Riboflavin (B2) (28.6mg)
Niacin (B3) (80mg)
Pantothenic Acid (B5) (45 mg)
Pyridoxine (B6) (23.4mg)
Biotin (B7) (80mcg)
B12 (100mcg)
Folate (200mcg)
Choline Citrate 40 mg
1 – Zinc (Picolinate) (50mg)


Plus 2 Hours
1 – Calcium (Citrate) Complex (500mg Ca, 250mg Mg, 200IU Vitamin D)

Plus 2 Hours
1 – Multivitamin (see, page two for contents)
1 – Vitamin A (Acetate) Sublingual (10,000IU)
½ - Dry Vitamin D3 (Cholecalciferol) (25,000IU)
1 – Dry Vitamin E (400IU)
1 – Dry Vitamin K (Phylloquinone) (100mcg)
2 – Bone Calcium (2 pills totals 500mg Ca, 250mg Mg, 100IU Vitamin D)
1 – Siliphos (Milk Thistle) (180mg)
1 – Selenium (L-Selenomethionine) (200mcg)

Anyway, I've stopped taking the Vitamin E pre-surgery, as directed by Dr. Lane. And, I feel like by body is doing better with the liquid diet thing because of nutrients I'm getting from the supplements.

I've been dealing with some pre-surgery anxiety, but this post is getting long so I'll post more about that later...

To Tell the Truth

This has been a week of "tellings" about my weight loss surgery. I told my aunts, uncles, and cousins (the ones who live close anyway) that I will be having the surgery. I love my family and they, clearly, love me. Some people experience rejection, scepticism, or jealousy from their family when they discuss WLS with them. But, my family seemed put at east with my choice. The looks on their faces seemed thankful and relieved, like I had provided the answer to a problem they had been searching to solve but didn't know how. One of my aunts started to tear up. I am so fortunate to have such a strong support network of people who love and care for me.

I also officially told my RNY surgeon's office that I would not be having the RNY and asked them to please return my $300+ "membership fee" check. It was bitter sweet. Diane, my contact there, has been so kind and helpful. But, I knew it was the right choice for me. However, I was a bit late on the draw because y insurance company had already sent them four letters saying I had withdrawn my request for RNY approval!

A good week it's been. Being honest about such a personal decision has a calming effect.

Approved for Weight Loss Surgery in 30 Minutes!

My surgeon, Dr. Lane's office told me they would be sending in my insurance paperwork today. But, when I called at about 4:00 PM today, the papers still hadn't been transmitted. Just after 6:00 PM today I got a call from one of the Nurses at my insurance company:

Caller: "Hello, may I please speak with Justin?"
Me: "Speaking."
Caller: "Hi, Justin, It's Mary-Ann from Anthem Blue Cross Blue Shield. I'm calling to let you know that I've just approved you for your Duodenal Switch and inpatient stay."
Me: FREAK OUT...LOTS OF THANK YOUS!!!

I spoke with Mary-Ann last month and she pointed me to Anthem's Surgery for Clinically Severe Obesity "Provider Tool" for Northern Ohio. It's a three page questionnaire that your surgeon fills out, dates, signs, and faxes. She told me that once she got the "tool" she would be able to make a determination in 30 minutes. I thought "yeah, right" thinking that there would be stalling and delaying and avoiding approving me while they reviewed and demanded more paperwork. Those three pages is all Dr. Lane's office sent in. No reports, no notes, no charts, NOTHING else. And, as promised, in about 30 minutes, I was approved!

So, on May 20, 2008, God willing, I shall be have my Duodenal Switch!

The Doctor is in... and Staying Late Too!

I made my way to Bowling Green to meet with Dr. Lane and his people last Friday. What a wonderful time I had.

My whirlwind tour began with a meeting with the nutritionist. She was the "backup" nutritionist and disappointed me in that she lacked a command of the dietary needs of Duodenal Switch patients. I had to correct her several times about things she said applied to Duodenal Switch patients that, in fact, only apply to RNY patients.

Next, I met with the bariatric internist. I have nothing but wonderful things to say about him. The Doctor examined me more thoroughly than I think I may ever have been. When he told me that he had no objection to me having the WLS I felt like I could REALLY trust that opinion.

My appointment with Dr. Lane himself was slotted for 4:00 PM. However, he was in surgery and wasn't able to meet with me until about 6:15. This in not a complaint, but rather a testament to his commitment to his patients. It's hard to find a doctor who will "burn the midnight oil" just to answer the questions of a patient who may, or may not, choose to have surgery with him. And burn we did. First, Dr. Lane took 45 minutes to explain the surgery and his approach to me. Then he took another half-hour or so answering the four and a half pages of single-spaced type written questions I had prepared and brought to him for review. And you know what? He answered each and every one of them with precision, accuracy, and professionally. He stayed with me until after 8 at night! And, I trust him. For me, that is critical, and I am SO glad I have found it.

Now, to notify the "other doctor" that I'll be getting a Duodenal Switch, not an RNY.

DS Dreams Dashed by Damned Dimensions?

So I had my whirlwind tour through Dr. Lane's office today. I'll talk more about the visit later. But one thing in particular is really concerning me and I'd like some feedback.

Sometimes weight can be an issue with completing WLS without surgical complications. Although my weight is high, it is balanced out by my height. But, my height presents it's own issue. Being 6'8" means my torso is longer and rib cage more expansive. This means that my stomach will be further up into my rib cage. Also, positioning the small intestines as they need to be for the DS across such a long space is more technically complex. All this translates to a longer time on the table. Dr. Lane is concerned that this "extended stay" may cause rhabdomyolysis where the pressure on the muscles I am laying on may causes them to die and send me into kidney failure.

So he proposed that we do the DS in two steps. Gastrectomy first, followed (if needed) by the switch. Well, my insurance won't cover that. They cover the whole thing done in one shot or nothing at all. SO, he said we'll get approval for the DS in one-part and if he goes in and everything goes ok then he'll do the full DS. If, however, my body starts to break down because of the length I've been on the table then he'll tell my insurance company it was do half, or kill me.

I am nervous about only having 1/2 of the DS done. I am concerned that I'll wake up and not have what I hoped for. BUT, I KNOW that my LIFE is more important that expected results.

Soup's On!

I am slowly coming to grips with the fact that I will be obsessing about one thing or another until I have my surgery. Right now, that thing is what to eat after my WLS.

Some of my online friends have made great suggestions and I thought to myself, why not put things together into a cookbook?! So, I signed up for this site called TasteBook.com where you can make your own cookbooks. For under $35 you get 100 full color recipes of your choosing in a hard cover book. So, I have been scavenging for WLS appropriate recipes today. Have one? Drop me a line!

If your looking for an AMAZING resource for after WLS eating check out Michelle's blog at http://theworldaccordingtoeggface.blogspot.com/

Now, if I could only figure out what's for dinner...