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

One week to go...

Coming down to the wire. I am feeling pretty good about all of this. Not that I am 100% sure -- but that is the result of an active, questioning mind.

I am very happy that I shared what I am doing with my friends. The responses I received back were great! All of them very supportive and very helpful.

I need to figure out a way to add some humor to all of this: it wouldn't be like me not to find a funny side of all of this. I think there might have been a comic yesterday that might apply.

Food-wise, I have made it through one week of the two week pre operative diet, which wasn't that bad: three high protein meal substitutes and one "real" meal per day. Nice discovery: there are high protein bars that taste good and the frozen fruit/whey/yoghurt smoothy that Ben recommended is quite tasty. I could even recommend these for people not having surgery.

I also have been having a great time on my new crank forward bike: exercise that I can do without feeling as if my knees are going to come apart. This is going to be great in Florida. My knees and feet are feeling much better today -- perhaps due to bike exercise? Let's see if this continues...

This week I will gather together all of the literature I have been reading as well as all of the stuff recommended for the hospital and days after to make sure it is all in order. End of post, so don't ...

Click to read more...

Message to my friends

Yesterday and today, I sent out the following letter to my closest friends. Initially, when I started this, and not too sure about what I was doing, I kept most of this information to myself. Now that I have been through all of the screening and read a lot more about this operation, I am ready to go public with my closest friends.

Folks,

After having struggled with being overweight for many years, I have finally decided to do something about this. I have decided to undergo weight loss surgery -- the so-call "lap-band" operation. I have not come to this decision without considerable thought and research. As a result, I am very comfortable with my decision as well as the changes this will mean to my life and the lives of the people around me (you included).

Being comfortable with this decision doesn't mean that I am not anxious -- the grownup word for scared. Scared or anxious, I am still convinced that this is what I need to do to have a chance at living a better life.

I have already told some of you about this when we were able to have private conversations. You already know about this. Unfortunately because I have not been able to talk with others of you alone, I haven't been able to tell you this face to face.

Since September, I have been undergoing evaluation and tests at the Beth Israel Deaconess Medical Center in Boston for "bariatric" surgery -- the formal name for a set of surgical procedures intended to help morbidly obese (nice term, eh?) patients loose weight.

My evaluation has gone well and I have passed all of the tests -- it is really somewhat surprising to me that there haven't been more irreversible side effects of my being so overweight, but there apparently haven't. Don't get me wrong, I'm not in love with the sleep apnea, onset diabetes, knee pain, foot pain, low energy, etc, but these are at least mostly reversible with weight loss.

I have decided to have a gastric band installed laproscopicly -- or the so called "lap-band" operation.

I have been keeping a diary, recording my experiences with weight loss surgery. If you desire, you can find out more about this operation and my thoughts about all of this at:

http://www.forsdick.com/reboot/

I will keep this diary updated as I go through this process. In addition, I am happy to answer any questions you may have about this process.

At this point, I am not keeping this a secret so you are free to mention this to others. Sometimes I wonder if I am too open -- but that is who I am. I like to share what I am doing -- to talk about and discuss what is going on in my life. I think people understand this about me.

I will be in the hospital one night and then will come home. I am expecting the first couple of months to be a challenge -- and that is OK. Important to this entire process is exercising every day. To improve my chances of doing this in the Winter months, Marsha and I have decided to go to Florida for February and March so that I can be in a warm climate to build up my exercise habit. Ben and Will likened this to a Florida "rehab" session much like injured Red Sox players do before coming back to Boston to play. When you are a Red Sox fan, everything looks like a baseball...

Please keep me and my caregivers in your thoughts on January 5th when I will have this operation -- as well as for the rest of my life, as I am making a lifelong commitment to change.

Thanks,

Harry

End of post, so don't ...

Click to read more...

Loosing confidence, limitless support and some small victories

Last night as I was sitting in Church at the Christmas Eve service, I started thinking about some things that I had been reading -- not all of which were supportive of the decisions I have made about WLS. In particular, I started thinking about an article I saw on a website of a bariatric surgeon where a table indicated that Lap Band surgery was both more disruptive and restrictive in what you can eat, as well as less effective than Gastric Bypass surgery.

Then I read the whining of someone who was 3 months post Lap Band surgery and discouraged about her progress.

Together this put me into a funk about whether I was doing the right thing.

I decided to talk about this on the drive home with my family. I told them what I was thinking about. My older son shot back immediately that he was so relieved that I was going through with this operation.

His gut reaction reminded me that although this operation and the significant effort I will spend for the rest of my life is not going to be easy, my need to do this is not a vanity, but rather a requirement, if I am going to get my life back from the destructive results of overeating.

I thank my family for being straight and direct with me. It is so easy to get off track when thinking about this emotional topic and their unswerving support is going to help get me through the confidence dips.


On a brighter note, I am now on the 2-week pre operative diet which is really not too bad -- although as my wife points out, I have had a long time to get used to all of this and you, the reader, may think that some of the things I think are "normal" take some getting used to.

From now until the day of my operation I am eating 4 meals a day: 3 "meal substitutes" and 1 "normal" meal. The substitute meals are some form of high protean meal (a bar or a shake). I've found one brand of bar, Balance Bar Gold, that is pretty good. Still trying to find a shake that tastes OK -- with most of them the taste of whey is a bit strong for me.

I've actually lost about 13 pounds since I started the screening process back in September (343 down to 330) -- that is encouraging, although I am no fool on this weight loss stuff to think that if I can loose 13 pounds myself, maybe I can continue without the surgery. I've lost 13 pounds many times before -- in fact I've lost 70 pounds before, only to gain it all back. I am expecting the Lap Band surgery to help counter the "gain it all back" component of most diets.

I am also realizing that there are many elements of this that are just like the diets I have been on before -- that the principles of weight loss (control food intake & exercise regularly) are the same. The only difference is that my appetite will be decreased and controllable by the adjustments to the band.

When people say that this is taking the easy way out, they are quite wrong. This is no easier than going on a regular diet: it will be hard work. But the difference is that part of my limitless appetite will be decreased. The emotional appetite won't be impacted and I will need to concentrate a lot of effort to defeat that component of my overeating. End of post, so don't ...

Click to read more...

Ups and Downs

Monday I was down because I seem to be in this never ending cycle of injuring my legs (because of my excess weight), hurting, healing, feeling better for a while and then repeating the cycle. Today, I am on the mend -- but this isn't the first time I have gone through this cycle, and until I actually loose some weight, probably not the last.

Throughout the lead up to this operation, I haven't actually lost weight even though I have been doing this for three months. Not that I would be expected to do so. (I actually have lost a bit because if I loose a little before the operation, that will make things go easier).

But, I am ready for the loosing to begin, so that the other forms of recovery can kick in. It is difficult to think about exercising when most forms of exercise result in stress on joints. The two month trip to Florida will allow me to be in the pool a lot and this is a good place to start. Our new crankforward bikes will also be good devices for getting less stressful exercise.

I do find that writing about this forces me to sort things out from the random set of thoughts that go through my mind. Writing lets me make sense out of many disorganized observations and feelings. End of post, so don't ...

Click to read more...

Exercise

Exercise is an important part of weight loss with a lap-band. I hate to exercise on machines or in a gym. Better for me is exercise obtained by doing something else. My favorites are walking and bike riding

Recently, those have gotten difficult because of the pain in my legs (walking) and difficulty riding a bike due to my weight. It's a dilemma and I need to figure out some way to move off this difficult place.

Today, I am nursing a swollen foot that is due to some sort of stepping on it in the wrong way. This makes me a little depressed about my chances of increasing my exercise so that I get 30 minutes of walking for 30 days before my operation. End of post, so don't ...

Click to read more...

One month to go

I have started on a pre-surgery diet. For the next two weeks, I am on a pretty normal but somewhat restricted (for me) diet. It isn't a big deal to be on it, even though the surgeon when describing it understood the irony of asking people who clearly have problems dieting to go on one. But, it is relatively easy to go on any diet and loose weight -- it's keeping the weight off for a long period of time that is difficult.

On December 15th I will have my pre-operation examination where they will go over anesthetics to be used and some other stuff. After that appointment I will be on a significantly different diet: it consists of two meals of protein drinks and one normal meal per day.

Then several days before the operation (and for about 3 weeks after the operation) I will be on strictly liquid protein meals.

I know to someone not involved in this, what I am describing sounds wierd and extreme. But, I have been preping for this for 3 months so far and I am accoustomed to how my eating will change -- and change for the better. I know that this surgical procedure is only a tool to help me loose weight -- but it is the one tool that I have proven time and time again that I need: something to help me reduce my sense of hunger. I will still be changing the things I eat, and changing the amount of exercise I get. The major benefit of the lap-band is that I won't have that dreaded time when I overeat and then give up. I won't be able to overeat in the first place. End of post, so don't ...

Click to read more...