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

Questions for my first checkup

My report is that things are going well, but I understand that what I really have done is recovered from the installation of a surgical implant and now that device needs to be activated and used in conjunction with diet and exercise to start significant weight loss.

Nothing worse than listening to an enthusiastic patient talk about his/her operation. If you really want to read my punch list of things to ask my medical team (surgeon, nurse, nutritionist) on Thursday 1/29/2009 when I have my "3 week" check up, click below.

Topics to discuss:

1. Lack of Significant Feelings of Fullness
   
   1. Some fullness, but still get hungry
   2. Is this to be expected?
   3. What is the progression on filling the band?
      
2. Gout
   
   1. Is there a cure? Diet? Medication?
      
   2. What should I do when I detect an attack? How to relieve pain when it happens?
   3. Suggestion: In the future, mention this to patients before the operation.
      
3. Medical Contacts in Southwest Florida
   
   1. What do I do about Gout attacks?
   2. Who do I contact, where do I go if I feel I am having problems with gastric band?
      
4. Next stage eating
   
   1. Nutrition: Protein vs Gout -- sources of protein to reduce gout?
      
   2. Specific Foods:
      
      • Fruit: Types? Citrus?
      • Bread: no? Pasta: no? Pizza: no? Rice: no? Sushi: no?
        
      • Salad?
      • Carrots?
      • Decaffeinated vs caffeinated? Tea, Coffee?
      • Trailmix: Raisins, Seeds, Nuts?
      • Hamburger, Ground turkey, Chili w/ground meat?
5. Upper part of stomach
   
   • What actions to I need to avoid so as not to stretch the upper stomach and possibly dislodge the band?

End of post, so don't ...