Thursday, December 31, 2009

Misery, misery, misery, that's what you've chosen.

New Years Eve.

Could I possibly have chosen a worse two week period during which to under take an all liquid diet?  I'm four days in now, and this is just miserable.  Since Monday, I haven't eaten a bite of solid food.  Nothing but protein drinks (low sugar, low carb, low fat, high protein) and some broths with a little sugar free jello to shake things up.  And it's like the week I decided to do this, every food that I love is right around me.  Monday, Tuesday and Wednesday weren't too bad because I had work to keep me occupied and I don't tend to eat a lot during the day anyway.  But coming home each night to the wonderful smells of home made dinner, etc., was just torture.  My wife's family is in town and my home and been something like home base for the whole crew so they've all eaten here.  One night I came to huge plates of barbecued ribs.  One night it was four roasted chickens w/ rice and fresh bread.  It was the bread that was the most tempting! 

Yesterday, I attended the funeral of a cousin of mine who died really young from a heart attack.  He was also skinny as  a rail for his whole life, so is there really a point to this weight loss thing?  Anyway, after the ceremony we retired the church where the proceeded to serve baked ham with cheesy potatos and rolls and then dessert.  Whose idea was this? 

Funny thing is I can't say that I've been all that hungry.  The protein drinks do a decent job of knocking down actual hunger pains, but it doesn't do anything for the smells of food and look of food and desire to have more flavors available to you than just vanilla and chocolate.   The first few times I drank the broth I thought it was good too, but right now just the thought of broth makes want to hurl.  The depressing part is that I'm only 4 days into this thing.  I've got 10 days more to go!  Maybe next week will be easier once I get back to work and I'm not moping around the house all day.

Oh, and did I mention I sick also?  Got a wonderful little head cold that has my sinuses clamped shut tight.  Makes it hard to sleep at night because I can't breath so I end waking up every few hours.  Oh, and my baby boy seems to have it too!  So he comes to my bed about 3:00 a.m. and from then until about 7:30 a.m. we just hack and cough at each other. 

My wife has been a wonder during this whole thing, probably because she suspects that at any moment I'm going to lose it and go on a food binge and start gorging myself on ding dongs and slurpees.  Hopefully, we can avoid that spectacle.  She keeps telling me that it's only two weeks and I can do it.  It broke my heart to tell her that it's actually 4 weeks because I have to stay on this misery for two weeks after the surgery!  Yeah, the lady from the doctor's office forgot to remind me about that when we decided to do the single incision operation.  I wonder if I can't just be put into suspended animation for two weeks.

Sunday, December 27, 2009


I promised photos, but I didn't promise they'd be pretty.  So here I am in all my glory.  Don't say you weren't warned.  I've told my kids that I'm bald because all my hair slipped down onto my back.



The side view is even nicer....



And how about those buns...


    If that doesn't give you some idea of why I'm doing this, perhaps the measurements will.  I had my wife get out the tape measure.  I haven't done this in years and now I know why, and it's not because the tape measure is cold.

Arm:  19 1/2 inches around.
Chest: 54 inches
Stomach/waist: 56 1/2 inch across the navel
Hip: 51 inches
Leg: 31 1/2 inches.

Honestly, I'm a bit curious as to how these numbers will be affected by the diet I'm starting tomorrow.  My wife continues to be agitated as the time for the surgery grows closer.  She asked me to write a letter to each of my kids, to be opened on my death, I assume.  That seems a little extreme, but it ought to give you some idea of how scared she's getting as thing draws closer.  I'm still not feeling that uptight, at least not yet.   Perhaps its just that I'm so sick and tired to looking and feeling like this that the risk of complications don't scare me.  All I can focus on are the things that I want to do once I get this weight off. 


The Real Work Begins

I'm likely repeating some stuff here that I've commented on before but I don't remember and I'm too lazy to ready back through everything to see for sure. Maybe if this blog had received more than 8 hits in the past few weeks I'd worry about something like that. 

At any rate, today is December 27, 2009.  That means that tomorrow I start my "liquids only" diet which I must remain on for the next two weeks.  There's something vaguely sadistic in telling a fat person that they have to go on a radical diet for two weeks prior to having their stomach stapled shut.  Let's face it, the fact that I'm this fat is a pretty good indicator that I've never been particularly good at dieting prior to this point in time.

Everyone who gets this type of surgery is required to do this diet prior to the surgery.  However, because I'm getting a single incision (small cut just above the belly button) i've got to go for two weeks.  The purpose of the diet is to shrink the size my liver and make it more pliable because they essentially have to push it out of the way when they do the operation.  If they open you up and you've cheated on your diet then you can't have the operation and you've wasted several thousands of dollars.  So, I guess there is some incentive to stay with it and not cheat.

So, I've decided that since this whole thing starts in earnest tomorrow, my wife is going to take few photos of me tonight and we'll take my current measurements and weight and post them so that we can start to track the changes beginning with this diet and going through the operation.

On another note, my wife has begun to get really antsy about this whole thing. Personally, I've trended toward being excited with just a note of trepidation from time to time.  She, however, has tended to focus on the possible negative outcomes.  The other night she asked me what I wanted to happen with my business should something go wrong.  As that is such a remote possibility, I haven't really thought that much about it but I suppose it's a legitmate concern.  I gave her the name of the person she should contact to take over my cases should I be incapacitated in some way.  My clerk is really good and would be a great help if that were the case.  I'm sorry that she has to feel that way and I'm sorry that I've let myself get into this position such that I have to take such drastic steps to fix it.  I'm just don't see a better option that has any realistic chance of succeeding.  If I''m diligent and this thing is successful, it will change both our lives in nothing but positive ways. That doesn't make it any less scary for her.

It's also becoming fairly clear that trying to keep this a secret isn't going to be very realistic.  Some folks are going to have to know.  My wife's family going to be hanging about for the next week and with all the food that flows around the holidays, someone's going to notice that the fat guy isn't eating any of it and just keeps downing those silly protein shakes.  Also, my wife already had to tell her sister because he sister is going to watch the kids on the afternoon/evening of the 11th of January when I have my surgery.  Furthermore, I suspect that once the weight really starts coming off there are going to be some questions. 

Pictures and measurements to come.

Monday, December 21, 2009

More Doctor Visits

So, I had my second visit with my primary care physician today.  I like my PCP, he's seems a good guy, even though he kept me waiting for over an hour today.  The blood pressure was down to a more appropriate level.  Now I just need to finish up the blood tests, which I'll do tomorrow morning.

I've noticed lately that I still feel guilty about deciding to have this procedure done.  I'm not sure how to explain that but it seems to me that most, if not all, fat people are looked down upon in some degree or another by society.  Especially when you weight gets really out of control.  People roll their eyes and in some cases even wonder out loud how someone could let their condition get to that point. Inside, we all live with the idea that it's really our fault and if we were just a little "stronger" that we could just lose the weight.  Perhaps that is true, I don't know.  However, it strikes me as telling a person suffering from depressionary issues that if they'd just try a little harder they'd be happy.  Nevertheless, in my own case it's certainly true that I live with the guilty idea that I'm just copping out and if I'd try a little harder, the weight would roll right off. 
I think that may be why I've decided to keep the fact that I'm having this procedure a bit of a secret.  Not that it can be a secret for long but I'm not Star Jones so I suppose folks won't be nearly as nosy since I don't have my television show or anything. 

Sunday, December 20, 2009

Jumping Through the Hoops

Interestingly, one the "requirements" that I have to meet before I can have the surgery is that my primary care physician has to "sign off" on the surgery.  I guess that means he has to send a letter recommending me for the surgery or stating that I'm healthy enough to have the surgery.  That seems a bit bizarre to me since fat folks don't have the reputation for being all that healthy.  Ironically, according to the data that I've seen this surgery can be very helpful to people suffering the side effects. People with type 2 diabetes get huge benefits.  Blood pressure drops, cholesterol levels go down, etc.  So, essentially, my PCP has to verify that I'm healthy enough to have an operation that ostensibly will make me healthier.  In reality, I think it's more CYA.  My problem is that I don't really have a PCP because I haven't been to a doctor in over 5 years.  In fact, I don't even remember my former doctor's name and if I recall correctly she moved out of state several years ago.  So, I had to find a doctor and essentially inform him that I am going to have this surgery and he is going to sign off on it. 

I am also required to have a full panel of blood tests done.  Several years back I had blood tests run for the first time and I was really scared as to what they'd show, especially with regards to cholesterol levels and the like.  Those tests came back and showed that, despite my weight, my levels were really, really good.  I'm not sure how that is, but it has remained true since then.  About a year ago my wife was shopping for health insurance and they needed blood again.  My tests again came back clear.  Not sure how I pulled that off but I'm glad for it. 

I may have mentioned before that the only long term "side effect" that I've ever had from my weight has been my blood pressure which has always been borderline.  I remember having the county health nurse take my pressure when I was in high school and tell me it was high.  It's just always been that way.  Well the new PCP noted that it was heavy too and he put me on a pill to help out.  Funny thing is it's just a water pill that means to extract excess water from my veins, making them more pliabe and lowering the blood pressure.  I'm due to go back to his office on December 21 to get looked at again.  I don't know if my blood pressure is down but I do know that for the past month I've been peeing out my ears!  Seriously, every time  go to the bathroom it's like I'm 6 years old again and having so much fun playing that I forgot to pee and then have to spring to the restroom at the last moment before I wet my pants.  So far I haven't done so.

Saturday, December 19, 2009

Moving Beyond Mere Talk

After our discussion in bed that night I called a local clinic that specializes in weight loss surgery to figure out exactly what it is that I have to do.  They said I have to attend a seminar held once or twice a month in my area.  I can't say that this thrilled me all that much.  I've wanted to keep my interest in this on the down low and somehow sitting in a room with a bunch of other fat people just didn't sound all that appealing.  I signed up anyway and took my wife with me so I wouldn't be answering a bunch of question when I got home.

The lady presenting the seminar was a nurse who worked at the clinic, but she was also a patient, having had the Lap band surgery approximately 3 years prior.  She'd lost about 80 pounds and looked pretty good.  She gave us info on three separate procedures, two of which I was familiar with and another which is relatively new.  First, she talked about the Lap Band system.   After that, she talked about Gastric Bypass.  Even when I started thinking about doing this I just couldn't bring myself to do the Gastric Bypass.  First of all, it's about five thousand dollars more than the Lap Band.  Secondly, Gastric Bypass means exactly that: not only do they staple shut the large section of your stomach, they also cut apart and reattach a large section of your colon/intestine.  That causes malabsorption of nutrients and makes you lose weight even faster.  That just seemed a little too scary for me.

Finally, she told us about something called a "sleeve gastrectomy."  This procedure is more invasive than the Lap Band but not nearly as radical as the Gastric Bypass.  In a sleeve gastrectomy, they basically cut out the lower "pouch" end of your stomach then sew it up to form a "sleeve" shape.  The woman presenting that night said this was a relatively new procedure and it fell somewhere between the Lap Band and the Gastric Bypass.  She also said that if she had it to do over again, she'd have gotten the sleeve gastrectomy.  It costs only slightly more than the Lap Band but you lose weight faster and you don't have the constant adjustments, etc., that ou get with the Lap Band.  The one draw back is that, unlike the Gastric Bypass and the Lap Band, the sleeve is not reversible. 

I'm not sure when I decided, but sometime a couple of weeks after the seminar, I decided to have the sleeve gastrectomy rather than the Lap Band.  I'm not sure why I've made that decision, but I'm comfortable with it.

One of the interesting things about this process is the very different views my wife and I have of it.  We are both scared, but we are scared by different things.  Frankly, the only thing that really scares me about the whole deal is the money.  This a pricey procedure and I'm self insured, which means I pay this one out of pocket.  We have a decent savings, but this is going to put a real dent in it. 

On the other hand, my wife is really worried about me dying on the table (or shortly thereafter) from some complication or other.  The statics are really against it, but that is her fear.  Of course, her other fear is that I'll drop dead of a heart attack next weeks so in some sense it is six of one, half a dozen of the other.   Strangely enough, I've never worried about the remote possibility of dying.  Perhaps that speaks to the desperation that people who are overweight, and have been overweight all their lives, can feel.  I've known women who were really overweight who secretly prayed to get cancer just so they'd lose weight.  It's hard to imagine that sort of desperation and, yes, self-loathing.  But I suspect that everyone who is morbidly obese really dislikes themselves to some degree or another.  Personally, I've never gotten to the point of wishing cancer on myself, but the fact is that I can understand how it gets to that point. 

Anyway, after attending the seminar, I signed up online for my appointment with the doctor.  They called me a couple of days later and got me set up for an appointment.

I ought to point out that even tough this weight loss clinic advertises their services fairly heavily around the state, the seminar I attend and the subsequent visit with the doctor both made me feel like they were trying to talk me out of it!  They kept going off about all the potential complications and horrible things that could go wrong.  I realize that they are just covering their asses, but it was still a little disheartening.  One thing they kept pointing out is that, even with the surgery, it's still possible to fail.  Apparently, some folks can eat themselves right out of a Gastric Bypass.  My wife said that even Al Roker on the Today Show has regained some weight, though I caught it one morning before work and he looked pretty good to me still. 

At any rate, we've just come upon my biggest "fear" in this whole thing. That I'll be the one to fail even with the surgery.  That I'll be weak and just fail.  I mean, let's face facts here, I'm in this position because in 39 years of living I've haven't shown myself to be particularly adept at self control in this particular area.  Now, they are talking about how I'm going to have to change my whole life around.  I keep telling myself I'm ready to do that, and I think I am.  But at the same time I have to admit that in some quiet moments I get some pretty good size waves of self doubt breaking over me. 

Part of that doubt is fueled by the fear, not of losing food per se, but of the rituals that I've built up around food over the years.  The Superbowl parties with the wings and the nachos.  Going to the Japanese grill with my wife on Friday nights.  The part of me that anticipates and craves food has built up these rituals that go with it, and I'm going to miss those because I think they have to change. 

My wife has mentioned several times over the past couple of months that she thinks I'm going to "replace" food with something.  In other words, food has played a larger roll in my life than merely providing sustenance.  It has provided comfort, and relaxation, and release.  It's even provided a little excitement and anticipation.  I see what see means about replacing that with something else, but I'm not sure how that's done or what I do it with.  However, I told her that she'd better be ready because right now I'm considering replacing it with sex and so I'll need her to be available about 2 to 3 times a day.  I don't think she thought that was funny. I'm not sure I was kidding.

Oh, and the doctor's visit.  I drove up to Salt Lake and immediately got lost and went to the wrong building.  No biggie.  First thing, they put us in another group meeting.  This time, the lady we met with first was  a dietitian.  She was good and very reassuring.  She made sound like it wasn't quite as hard as I thought it might be.  It  was in this meeting that I actually saw how much hope  this procedure can  bring to some people  thought.  Off to my right was a young lady; she had to be in early twenties at most. And quite frankly, she was beautiful.  Long, blond hair, gorgeous face, etc.  Probably she probably weighed about as much as me and probably has for many, many years.  And I could just see on her face how ready she was for that part of her life to be over.  She, like me, was simply tired of it.  She'd just gotten there 20 years sooner than I had. And hey, good for her!

The rest was just meeting with the insurance lady, the psychologist (I guess they only want sane people getting this operation), and the office manger.  At this point, the whole thing started to get very "real" because that's when they started asking me to pay money.  Once you start opening the old wallet, you've kind of locked yourself in.  So, I walked out that day with firm date for my surgery:  January 11, 2010.   I'll be 40 years old.

Friday, December 18, 2009

December 18, 2009. Less than 3 weeks to surgery.

There are likely several dozen other blogs that deal with this exact same subject.  I don't know.  I didn't check. 

Here's the deal.  In less than three weeks time I'm scheduled to undergo bariatric surgery to have a large portion of my stomach removed.  I decided to use this blog as a method to share my experience and my thoughts leading up to the surgery and then relate my experiences after the surgery.  I've decided to keep this relatively anonymous on my part mainly because only my wife and my son know about my decision to undergo this procedure.  So, I'm trying to be careful about the amount of details that I post regarding my personal life.

I will tell you this: I am 39-years old and live in Utah.  Yes, I am a Mormon an proud of it.  I am an attorney and I love my job.  I also currently weigh about 348 pounds on a 6"1' frame.  I have struggled with my weight for most of my life.  I started gaining weight in the third grade and have been chubby ever since.  As a freshman in high school I was 5'6 and 187 pounds.  Fortunately for me I discovered sports and weight lifing around that time.  I also hit puberty and gret 7 more inches.  By the time I graduated I was 6'1 and weighed 230 pounds, though at that time I carried a lot of muscle along with the fat and I felt that I was in relatively decent shape.  Even at that weight I could dunk a basketball and exercised fairly regularly.  Still, I never lost weight.


Entering my first year of college I finally tried to get serious about dieting.  Over the next year I was pretty good and lost about 19 pounds, bottoming out at 211 lbs.  Shortly thereafter, I left on a Mormon mission to Central America.  I contracted a case of amoebic  disentary  which caused quite a bit of weight loss.  I  eventually bottomed out at  about 189 lbs.  I was thin and looked pretty good (though not very "toned" as I'd lost a lot of muscle mass as part of the weight loss). 


After returning to the U.S. I re-enrolled in college and I was able to exercise fairly regularly, though I did being to gain weight again.   When I met my wife, I weighed approximately 220 lbs, but I still felt I was in decent shape as I carried the weight pretty well.  That I "carried the weight well" was a motto of mine for a long time. 


Since that time I've steadily gained weight.  Marriage, children (I have six) and school combined to make my life more sedentary.  I tried the phen/phen thing for about 3 months in the mid-90's and it worked well.  However, I discovered long ago that I would make a fabulous drug addict as my body very quickly becomes accustomed to drugs and they tend to lose their effect on my rather quickly.  Since that time I've tried phentermine alone (with some success) and another amphetamine called Didrex, which was supposed to be even more powerful than Phentermine, but which I thought was total crap as it did nothing fore me.  At least with Phentermine I'd get the occasional heart flutter and the "buzz" that goes with an amphetamine.  Didrex did nothing for me.  I've also tried various herbal remedies (Ma Huang and that silly cactus plant from South Africa).  No real results from those either.  Finally, I tried Alli (the poop diet) which also didn't do anything for me. 


When it comes right down to it, I really like to eat.  I'm sure there are all types of psychological reasons for that but I've no real interest in exploring them here.  Just know that over 16 years of marriage I've slowly gained over 130 pounds. 


As I've gotten heavier, my wife has become more and more concerned and even hurt to some degree.  I know that she feels that my weight gain is, in some way, a reflection on her.  While I know this isn't true I can certainly understand why she feels that way.  My weight has also become a practical concern for her.  Because I am self-employed we have to self-insure, but my weight prevents me from being insured without paying literally thousands of dollars a year extra.  She's concerned that I'll either drop dead and leave her with nothing but bills and unpaid mortgage or that I'll get very sick and bankrupt us because I don't have insurance.  Fortunately, I have had blood tests and EKGs done over the years any my cholesterol levels and my heart have always been healthy despite the weight.


About 2-3 months ago I finally got tired of being fat.  If you've never been fat it's hard to know what life is like.  Your clothes never quite fit right.  The waist of your pants is too tight but you are always pulling them up.  You have to buy extra long shirts because your stomach pooches out below a normal shirt.  Airline seats are too small.  Getting in and out of your car becomes a chore.  But even beyond such little indignities, you start to lose your family many ways.  My oldest boys are in scouts, but as I've gained weight it has become nearly impossible for me to go on hikes and camp outs with them.  Not just because my back screams when I hike, but because I can't really fit into a sleeping bag anymore.  My daughter want to play catch and I just don't have the energy.  Finally, my relationship with my wife had suffered.  Sex, quite frankly, is hard with a fat guy.


So, one night in bed I approached my wife with the idea of having bariatric surgery.  Specifically, I was considering the Lap Band system, which is essentially a little inflatable donut they put around the outside of your stomach and then inflate to create a small pouch on the upper part of your stomach.  To tell the truth, I was worried about how she'd react.  In my own mind, this was  a surrender and a cop out.  I was essentially admitting that I was a failure.  But I also felt that maybe I was just taking the easy way out again, as I did with all the pills and diets, etc.  Anyway, to her credit, she jumped at it, which should have probably told me something about how deeply concerned she's been about this problem. 


More later.