Introduction

[Note: The entries in this diary appear last in first out, after this Introduction.]

This is my diary of my experiences with weight loss surgery. I use this general term, because there are two (actually more) types of weight loss operations: gastric bypass or lap-band. But, I am getting ahead of myself. Click to see more...

[Note: in the rest of this blog, you will see the "Click to see more..." message at the end of each posting. Many times,there is actually nothing more. So, at the end of those posts, I have proceeded the "more" link with "End of post, so don't ...".]

Friday, September 26, 2008 I had my first set of appointments in the preliminary examinations for Weight Loss Surgery. Here are the facts:

• Weight: 343lbs (350lbs with clothes on, but I will use 343 as it seems to be my body weight set point)
  
• Height: 5' 11"
• Body Mass Index: 47.8 (non-overweight BMI: 18.5-24.9)

(go to BMI Calculator to figure out yours)

The standard qualifications for WLS patients are a BMI > 40 and an age between 18 and 65. I qualify.

I had an electrocardiogram which was judged OK, but there was one little dip where there should have been a rise and so, since I am 61 I am scheduled for a stress test to make sure everything is OK.

The subject of the appointments I will have, ending with a meeting with my chosen surgeon, are:

• Two seminars on Weight Loss Surgery
  
• Blood work
• Introductory meeting with Bariatric nurse
• Introductory with director of WLS program at BIDMC
• Ultrasound to determine if I have gallstones
• Stress test
• Nutritionist
• Psychologist
  
• Exercise physiologist
  
• Surgeon

i.e., extensive.

On my application to the Bariatric Surgery Program at Beth Israel Deaconess Medical Center, my answer to the final question of "Tell us about yourself..." was:

My primary reason for wanting to get control of my eating and consequently my weight is because I am fearful of all of the adverse health conditions that have accumulated in my body due to being significantly overweight in the last 15 years. Yes, there are many activities that I no longer can do because of my excessive weight. Things like walking, hiking, enjoying the adventurous aspects of traveling. Then there is the self-loathing that results from my lack of discipline to "just eat less" and my appearance.

I'm pretty smart and that has worked against me. Although I was very successful in loosing weight in Overeaters Anonymous, after a while I started to fail because I started to ignore the advice that "Thinking is not on of the tools of OA". And indeed it has taken me several years to fill out this form, because after I investigated everything there was to know about weight loss surgery, I thought "Why go through that? I can always exercise the discipline that you will need after the surgery and loose weight without going through the surgery." The only problem is that I never got around to exercising the discipline, and so the weight stay on. I have finally realized that all of this intellectualization has resulted in me weighing 350 pounds and on the verge of diabetes, the third or fourth medical condition due to my obesity. My biggest fear is how to deal with the stress I currently relieve by medicating myself with overeating. Then, of course, there are the unknowns about what it will feel like after the surgery, and the well publicized surgery complications.

Having said all of this, I want you to know I am both enthusiastic as well was watchful about what I am going to do. Please wish me luck.

Harry

P.S. Why did I choose the name "Reboot" for this blog? Well, in computers when the machine starts to perform badly because of the accrual of lots of junk, mismanaged memory, rogue processes, etc., the best thing is to reboot the machine and start from scratch. I find this a metaphor for what I am about to do regarding my eating: lots of bad habits, reasons for eating, out of control behaviors. The best thing is to start again with learning how to eat and WLS surgery is the only 100% foolproof way to do this. -- HF

Two months later...

Well, I have been through all of the tests, seminars and appointments. I have decided to have a "lap-band" (laparoscopic inserted Adjustable Gastric Band) operation and I have selected a surgeon (Dr. Benjamin Schneider) to perform the surgery. Finally I have a date for my surgery: January 5, 2009.

Most importantly, I have read a lot about all of this and am convinced that I am doing the right thing. I was concerned that I wouldn't reach a definitive conclusion, but that is not the case. It is very clear to me that this is the right thing for me to do.

I had lots of fears about what other people would say when I told them what I was going to do. As a result, I have been cautious about who I have told, although I have gotten more comfortable with telling more people as I have progressed through the pre-operation process. Amazingly enough, absolutely no one has questioned my decision. This has been the most surprising thing that has happened so far. I am grateful to my friends for their strong support.

I still do have a lot of questions which I don't think I will get answers to -- and perhaps don't need answers to. These are think like:

• What will my stomach feel like when I eat? It is pretty hard to imagine what a stomach the size of an egg will feel like -- especially since I don't have a really good idea about what is the current size my stomach.
  
• What will it feel like when it is full? I know what it feels like when I am currently full -- but that is so infrequent, that I don't normally feel this after meals.
  
• What will happen when I get an upset stomach -- although I did ask about throwing up and was told that it can happen, although there isn't ever very much in your stomach to throw up...
  

Of course there are many changes that I won't be able to imagine and I will just have to put my trust in my doctor's hands.

I have been a little surprised that I haven't reacted to all of this the way I usually react to new things: manic, euphoric, etc. I now believe that these styles of reactions are counter productive to establishing long-term behaviors. The manic euphoria lessons the hard work needed to accomplish something. I have used this frequently to my advantage since I can accomplish some impressive things using this mechanism. But it is difficult to sustain that level of productivity over a long period of time.

For example, when I was in Overeaters Anonymous, I was able to be euphoric about the message of gaining control over overeating. In fact from my perspective OA tries set up unrealistic eating patterns which can only be sustained by following continual unquestioning rules and procedures to establish your abstensnce from overeating. Although such restrictions are welcome by someone with an out of control eating problem, eventually something will break the spell, and along with that break come down all of the other fragile supports that have been established. At least, that is what happened with me.

So how will this surgery be different? Since I have not had this operation, I don't know for sure, but I have read that the band reduces the volume of food you can hold in your stomach before you feel full -- there is no conscious decision you must make about whether or not you should stop eating.

So that reduces the ability to overeat. The question still remains how to reduce the impulse to overeat. Prior to the operation, I overeat when I am sad, stressed, tired, and even when I am successful, happy, etc. It is at these moments of extreme of emotional feelings that I overeat -- and such extremes will not disappear once I have the operation.

I suspect this is why the Beth Israel - Deaconess Medical Center (BIDMC) workbook on weight loss surgery emphasises that diet AND exercise are essential in addition to the surgery for successful weight loss. It is the exercise that reduces the stress of the extreme emotional feelings that are normal for everyone.

Well, that's enough for tonight. I am going to review the workbook to make sure I am doing all of the things I'm supposed to be doing leading up to the surgery. End of post, so don't ...