Surgery Day...

...was finally here.

This is probably gonna be a long one, just so you know.  I will try and make it not to graphic.

Monday February 13, 2012, our day started at 4:00 a.m., I had already gone 48 hours on the liquid diet and was feeling a little runned down.

We got to the hospital at 5:30 and waited in the waiting room for them to come get me and get this fun started.

Once they took me back they weighed me (surgery day weight 381lbs) and took me to a prep area.  The nurse tried to get an I/V going in me, but me being related to my mom and grandma I am a bit of a tricky stick and she eventually had to bring in somone from the "I/V team" they finally got an I/V st up in the top of my hand.

They gave me some Fragmen (an anti coagulation drug) and a patch behind my ear to help with nausea.

They went over my medical history probably 5 times, seemed every one i spoke to (surgeon, Assistant, anestiologist, nurses) needed to cover it one last time.  They also called back my wife and parents  to see me before taking me to surgery and to see if they had any questions and to let them know what to expect from here on.

They then took me to the operating room introduced me to everyone in the room and moved me to the table and put me on oxygen.........
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(Most people say that from that point they don't remember much of the rest of the day, I was not that lucky.)
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........my first memory was of them rolling me out of the operating room and into the recovery room,  it was an absolutely terifying few minutes.  I remember very clearly knowing exactly what was going on and why. I was in SEVERE pain My abdomen felt like it was on fire, my neck was throbbing with pain, both on the right side whre they had put in the central line in my jugular but also on the left side for some reason.  I also felt when I first woke up like I was gonna hyperventilate, I couldn;t get enough air because of the pain but my body was screammin gfor more.  I also felt like I was trapped on the bed.

I ended up spending about an hour longer in recovery than most because it took longer to get the pain under control. but then they finally rolled me up to my room where my family was waiting for me.

Most of the rest of Monday was spent with my wife and parents setting in the room with me talking while I faded in out of sleep. This being interupted every few hours by having to get up and go for a short walk (yes, I had to get up and walk that first day) and then spending a half hour or so sitting up in a chair before going back to bed.

One of the worst parts of the day was that I had cotton mouth really bad from being intubated during the surgery and really wanted a big drink of water but until they were sure I had no leaks all I could "eat" was one ounce of ice chips per hour, this sucked.

I had been sleeping off and on all day but it hadn't been real restful so I had been looking forward to putting on my cpap mask on and getting a decent night's sleep.  No luck, they don't want you wearing the cpap mask that first night, and my night was not exactly restful.  I am not a "back sleeper", yet that is the only position I could lay in and all the time sitting at an incline to keep my abdomen from hurting had left me with a throbbing tailbone.

Tuesday I felt somewhat better. The day started with having to go and have an upper GI study to make sure I didn't have any leaks.  I had to drink some nasty contrast stuff and make sure it all went thru the pouch alright.  Everything went perfectly, no leaks.

I ended up going for six walks down to the end of the hall and back and felt progressively better with each walk.

April had planned to work this day because she was saving time up for when Evren comes but she ended up calling in because of what ended up being hip bursitis and spent the entire day at the hospital.  My parents had stayed in a nearby hotel overnight and came up to stay with me longer,  my in-laws came up to see me as well. My friend Marie who had her surgery a few weeks earlier came to see me as well. I had a good day visiting with everyone when I wasn't napping or walking or taking one ounce shots of liquid

Tuesday night they had to do a sleep study but that was ok with me because I got to wear my cpap mask.  I slept far better that second night.

Wednesday was mostly just a waiting game. I had to get clearance form several departments then had to get approval to go home.  I finally got to go home about 2:30 in the afternoon.

So my Surgery day weight was 381, I took one of my comparison pictures the day before, I an also using it as my 40 pounds lost shot since that point is just another 6 pounds down at 375 (i slightly revised my starting weight up 3 pounds to 415 just to simplify things) I took several other pictures in the preceeding days of me and how I fit into my life, I will take some more later just for comparison.We took several pictures while in the hospital as well, They are posted on their own picture page here (look for "Hospital stay pictures"), take a look and enjoy.

Sorry it took a few days to get this posted, I am sure you can understand but I haven't been much in a writing mood the last few days.  I will try and have a post up for the first few days after getting home int the next few days.

As always, of course, thanks for reading and thanks for your prayers and support.

Coming down the final stretch...

Most of my posts have been pretty long, I find I tend to get a little verbose when doing this (that and I have gotten lazy at times and had a lot to cover when finally getting around to posting something new).  This one is shorter and I am expecting that over the next few months my posts will be more frequent and somewhat shorter.

My last work week before surgery is finally over, and man it was a slow one.  Gotta say thanks to my TAC family for all the well wishes today.  I am really looking forward to coming back and showing y'all how much I will have lost after just a month.

I have to go on a clear liquid diet starting tomorrow evening so I have been splurging this evening.  Right now I am enjoying some Dryers Vanilla Bean ice cream, its good stuff, and although I know I will take some heat from some saying it was a horrible choice those that know me well will not be surprised at all to learn that my last real food meal for the foreseeable future was an extra value meal at Mcdonalds.  Yes I have seen "Supersize Me", yes I know it is bad for me but on this last day of normal food I don't care.

I came across another gastric bypass related blog, and the cool thing is it is by a woman that had the same surgeon as me and just had her surgery a few weeks ago.  It is really neat to have someone that is going thru the same things I will be going thru in just a few days. I plan on trying to learn as much as I can from her experiences.  Her name is Marie Silverstein and I have put a link to her blog here on my site, I wold highly recommend giving it a read, she is a good writer and has a good story.

So, here I am coming down to the final stretch.  People keep asking me "Are you scared?", of course I am a little nervous.  However I can honestly say my excitement far outweighs my nervousness right now. I have put in a lot of hard work already and have done massive amount of research on this and now there are very few choices in my life that I have been more certain about.

That being said I still appreciate all the prayers and well wishes.

Thanks again for reading.

Just a bit excited...

To say I am excited would be an understatement.  I have previously mentioned I have been looking into gastric surgery for 10 years now and for a variety of reasons it has never happened.  Now here i am only nine days away from my surgery.  Yes I am somewhat nervous but definitely more excited than nervous.

The fact that my surgery is so close and approaching quick has really began to sink in during  the last week and I am sure it will hit me even more this week.  I ordered and received my post-surgery multi-vitamins and sub-lingual b-12 pills.  We have started cleaning out the fridge and pantry of food I wont be able to eat and that April won't eat.

We also started buying some of the food I will be eating the first week or so, lots of jello, protein shakes, and broth.  We still have some other stuff to buy but we have it planned out and we will be ready for everything by next weekend.

I had my pre-op appointments (my very last appointments before surgery, yay!).  The first one was basically pre-op testing, getting blood and urine samples, and another EKG just to make sure the ticker is good.  Second was an appointment with my surgeon where we covered my medical history again, made sure I knew what I needed to do and bring the days before and of surgery (clear liquid diet, bring my cpap machine, etc)  We also revised his view on what my goal weight should be, he said between 210 and 200 pound goal weight, which seeing as I started this journey with my heaviest weight being 420 I will be loosing at least half of me.  My surgeon also said I can expect to loose my first 100 pounds in 4 months.  That means I should be down by 70 to 80 pounds by the time Evren is born.

My surgeon also wanted to make sure I was planning on taking lots of pictures.  I told him about doing this blog , he thought that was really cool and wanted the link so he could read it too (Hi Dr. Snyder, welcome to my blog!).  I think that is pretty cool.

I had mentioned that during the Holidays I had gained back some of the weight I had lost during the first few months of the 6 month diet.  Well I have lost some of  the weight that I gained back and should be back down to just under 380 by surgery.  While I am doing better at sticking to my diet and I have completely cut out all pop from my diet, I am also taking some time to enjoy some favorites for the last time.

My wonderful wife had me put together a sort of pre-surgery "bucket list" of restaurants back around Christmas and then each weekend we have tried to hit some of those restaurants tomorrow after church we are hitting what will probably end up being the last one off that list.  We are going to The Cheesecake Factory, not sure if we will hit the Downtown one or the Park Meadows one but I am sure it will be good.

I am going to be getting some more pictures posted in the next couple of weeks of how I fit into my current life and of course one last of my front and side comparison shot for comparison.  I will let y'all know as they are posted.

So now we are down to it and it is just a matter of waiting this last week, if the last few weeks are any indication this coming week is going to crawl by.

I have found that a lot of people I did not expect are actually following my blog, which is awesome.  I would like to get a better idea of who all is following so if y'all don't mind I would appreciate it if y'all could sign up as followers of my blog, thanks.

As always thanks to reading and thanks for all the prayers, I really appreciate it.

"I can do all things through Christ who strengthens me." Philippians 4:13

Playing the waiting game...

So, this will probably be a short post, not a whole lot of details to go into on this one.

I finally got all of my insurance pre-approval stuff out of the way and submitted.  My surgeon's office and I must have been really thorough in getting everything in place to send to insurance.  Usually they say it takes 2-3 weeks to hear back from the insurance about if you are approved or not. They got the response back for me in a week.

I've been approved!! :-)

We are actually putting of the surgery a few weeks because we have some stuff to take care of first (like tickets to Cirque De Soleil that my brother-in-law and his girlfriend got us for Christmas. Thanks Alan and Alicia).  

So, my surgery is scheduled for first thing in the morning on Monday, February 13th.
We have to be at the hospital at 5:30 in the morning, which as many of you know, I am NOT a morning person so that is gonna kinda suck .  But at the same time it will just be nice to get it out of the way first thing in the morning.

Now it's all about having to wait patiently  for the surgery to get here...and continuing to prepare for the coming change in lifestyle.  Gonna need to refocus on all the diet and behavior adjustments I started during the diet.  Granted it was a crazy holiday season and I did get somewhat lazy during last month or so...But now is the final stretch down to the surgery, so in the recent words of Rick Santorum..."Game On!"

My other big news today is a development in my other big life change this new year...We found out today that we are having a boy!! (I've noticed I am using a lot of exclamation marks today...!!!!!)

So that's the excitement in my life right now.  As always thanks for reading and especially thanks for all the prayers.

So close I can taste it...

Hey everyone. 

Sorry it has been so long since my last update.  I have been really busy with work and a Christmas show and way too many doctors’ appointments (mine and April’s).  Those are probably not good excuses and I am sure I could have found the time to do a post (or two).  Anyway…

So I am really close to being ready for surgery.  I had my last 2 appointments with my dietician.  At this point it is just a matter of basically checking in, see how I am doing with the changes and see if I have any questions or concerns.

I think that I am well prepared mentally for the change that is coming my way.  I know what to expect, or maybe more accurately I know as much as I can about what to expect without actually going thru it.  Or put a different way it is kind of like my upcoming foray into fatherhood, I understand that I don’t even know what I don’t know about being a parent (and a post op person) but I know enough to know I can handle it and get thru both of them.

I am feeling good about the surgery but I am starting to get a little nervous.  When I started this blog I talked some about different theories and forms of diets and weight-loss and about how statistically none of the work at all for the morbidly obese, that is save gastric bypass.  Unfortunately I have been reminded of that recently via my own life.  I had been doing really well on the diet, I had gone from 415 pounds down to about 385 and then plateaued somewhat but eventually did get down to about 380.

In the last month I have actually backslid somewhat and gone back up to just under 390 pounds.  My dietician said that is actually pretty normal with this 6 month diet leading up to the surgery because you get to a point where you can see the light at the end of the diet tunnel and the surgery is in view.  Along with this you also have to come to terms with the fact that there are some foods that you will likely never have again and you actually go thru a sort of mourning where you revert back to your old habits and indulge a little more than you should.  When you combine that with it being the holiday season you end up putting on some of the lost weight.

My dietician also reminded me that while losing some of the weight before surgery is a good idea  the reason I am having the surgery is because diets don’t work for guys my size.

I also went to a pre-op class that the surgeon and hospital require.  A lot of it was on nutrition and specifics of what I would be eating and how.  They also covered what I needed to do during the week leading up to the surgery and what to expect in the weeks just after surgery.  Most of the nutrition stuff I already knew although it was good to get some specifics and some tips on how to choose some products.  The general nutrition rules are that I need to get my protein first and foremost then get my complex carbs. For protein they taught us some simple math to do, in almost everything we eat they want it to be adding some protein their ratio they want us to look for is at least one gram of protein per 15 calories we eat.

As far as the days right before surgery they want you to already have anything you are going to need right after surgery already bought before surgery.  That includes my protein shake of choice for the first week or two, chewable vitamins and sublingual B-12 lozenges. Also need some gauze pads for changing out over the incisions. They said they also get some form of good prescription pain meds for me as well.

They said I will be in the hospital for 2-3 days after surgery and out of work for 3-6 weeks (I am aiming for a month).  I will be on a liquid diet while in the hospital and a few days after and then progressing kind of like a baby but hopefully faster thru varying degrees of soft food to normal food (that I will be cutting to the size of M&M’s…plain, not peanut and chewing to a smooth paste).

While they say that there are no foods that we can absolutely never have again there are some that they say will be in our best interest to avoid completely.  First is anything with a lot of sugar because it causes something called dumping syndrome which sounds really unpleasant.  The other one is rice, pasta, bread and anything really starchy, not because it is nutritionally bad for you but because of what happens to it after you swallow it and that is that it turns into a big gummy mass of starchy goo that ends up getting stuck in trying to pass from stomach to the intestines.

Now that I have my last appointment with the dietician behind me I have everything in place for the insurance approval.  Unfortunately my liaison between me and the insurance company is out of the office on some personal family business and won’t be back until probably first of the year but I am still aiming for having the surgery the first week of February.  I will let y’all know as soon as I have a date.

I also recently let my management at work officially know about the surgery, they are being really cool about it.  Even though I don’t technically qualify for FMLA yet they are going to go ahead and approve it anyway , which is really cool.  The rest of the office is doing a office version of  “Biggest loser”,  starting a week or so before my surgery.  I figure I will track my progress alongside them  but think it would be cheating to actually be eligible for the prizes, it will still be fun.

On the other significant life change for me in 2012.  The pregnancy is going splendidly; the baby seems to be developing exactly as he/she should, mommy is definitely starting to show, although not as much as my sister who is a month ahead of us.  We should find out the gender at our next appointment…assuming Little Noble cooperates with the ultrasound tech.  The appointment is January 6^th, I will let y’all know about that as soon as I know as well.

Once again thank you for reading my blog and of course thank you for all your prayers and support…for both the surgery and the baby.

Almost forgot, one last thing.  Hope all of you have a wonderful Merry Christmas and a fabulous New Year...Hopefully as great as mine is shaping up to be.

Doctors, Doctors and More Doctors...

So, first I have to apologize for not having an update recently. I have been making process towards meeting the prerequisites for insurance and the surgery itself, I just kinda let the blog slip.

I have had a few different appointments recently, with a cardiologist, my dietitian and a psychiatrist. Between my appointments and my wife's that I am going to with her I am getting a little tired of doctors offices.  We have 2 different offices that we have to go to in the same building at Rose Medical.  I actually accidentally went to the wrong office the other day.  Luckily I caught myself before walking in, I don't think they would have been able to help me much with my diet since it was my wife's OB/GYN.

I'll start with the Cardiologist.  I had to get a cardiac stress test to make sure my heart was healthy enough for surgery.  I also have come to the conclusion because of this one that I have an adhesive allergy.  When I first got there a really nice lady got me set up with all the sensors on me for monitoring my heart rate, she was really nice but new and apparently needing some more training. All the sensors had to be redone and they had to shave part of my chest for some of them.  I ended up with a bunch of red circles from the adhesive form all the sensors, those sensors stayed for about a week and a half.  

So after getting that straightened out they got me up on the treadmill and had to get my heart rate up to 165 bpm, they made the treadmill pretty steep and a really fast walk so it didn't take me too long to get up to that point (that is about where I get most of the time when working out so I was tired but alright).  The only part that kinda freaked me out is my blood pressure spiked to 200/100. I asked if that was normal for someone my size when working hard, they said that a spike is normal but that was somewhat higher than normal, however they said it returned to normal pretty quickly which set my mind at ease somewhat.

My next appointment was my psych eval.  I had actually been looking somewhat forward to this one but it ended up being somewhat undramatic. That is unless you find tests consisting of a combined 800 true/false questions riveting, I do not.  I spoke with the psychiatrist for about 20 minutes then took the tests.  

I consider myself pretty well rounded and stable from a psychiatric standpoint, granted given enough time I am sure they could diagnose me with something (and my parent might object if they didn't find something wrong with my head), and I do have a history of depression (however that is completely gone now).  I wasn't really expecting any surprises from the eval...and I was right, I am a bit like Mary Poppins mentally..."Practically perfect in every way".

They rate candidates on a high, medium and low risk scale.  They can't say anyone is a no risk candidate but they said I was at the extreme edge of the low risk range.

My last appointment was my dietitian, this was my 4th appointment in a total of 6 that I have to have. This appointment went fine, no real surprises here.  I am still sticking to my diet for the most part and while my weight loss has definitely slowed I am still loosing but the truth is I didn't really need to loose any before the surgery, it's more about making the necessary changes to my diet before surgery than loosing weight, especially since one of the reasons to have the surgery is that normal diets don't work for guys my size. 

They have been having me integrate changes into my diet each month in preparation for life after surgery.  Last month I supposed to start trying different protein shakes since that is what I will be on for a while immediately after surgery.  I have tried a few and really don't have strong opinions on any of them other than I think I will primarily stick to vanilla and fruit ones, chocolate is good but gets old fast.

My change for this month is to stop drinking water with my meals.  Actually they say to stop 15 minutes before and not start again until an hour after.  Their reason is that with the new configuration of my stomach and the lack of capacity they need the food to stay in the stomach longer and water would wash it thru to quick.  This one has actually been easier than I thought it would be.

I am still working on taking small bites, this one has definitely been the most challenging. I think it's because it's the most significant change.  We develop our technique for how we eat a meal very early and it is definitely by adulthood an ingrained part of our behavior. Changing something this significant in behavior is hard. but I will master it...eventually.

So I am actually getting really close to having everything in place for the insurance and surgery qualification.  I just have to finish out the mandatory 6 month diet (2 more months), take a nutrition class that the hospital does (which I am doing next week) and get everything submitted to insurance.

Hopefully, everything will go smoothly with insurance and I will be scheduled for surgery somewhere around Groundhog day (hopefully I wouldn't have to go thru that day over and over again).

As I mentioned in my last post my wife and I are going to be parents, our due date is May 23rd, needless to say 2012 is gonna be a watershed year for our family.  I am hoping I will be able to hit the 40 pounds lost mark in the next month or so and post an updated progress picture, but for now I will post a picture of our little one, enjoy.

Once again thank you for the prayers and support.

Third nutritionist appointment (half way there)...

Sorry it's been a while since the last post.  I'm in sort of a lull in activity between appointments right now. I am pretty sure it will pick up in the next few months as the pieces fall into place.

I had my third appointment with the nutritionist today, everything is going great.  I was actually a little bit down going into this one because my weight loss hasn't been what I had hoped recently, I seem to be hovering right around the 24 pounds lost point even though I am doing great on the diet and working my butt off at the gym (I may do another post about that in a day or two).  The dietitian didn't think it was a problem at all and reminded me that one reason I chose this route is because "traditional" means of weight loss  don't work well for most people my size.  That along with the realization that even though the scale may not be moving much I am feeling better and it is very early in a very long and important journey.

With each appointment I am given new steps to integrate into my diet and discuss how I did with the previous month's changes.  Last month my big change was to really reduce the amount of pop ("coke" for you Texans that are reading) I drank. This actually went better than I thought it would, aside from the occasional one when going out on the weekend I have cut it out almost entirely, which is a big change from the not to distant days of having probably 4-5 a day.

I was also supposed to work on taking smaller bites.  This is important since my new opening from my stomach to my lower small intestine will be pretty small after surgery, about the diameter of your pinky.  This one I have been struggling with just because it is hard to remember to do it.  We train ourselves in how to eat from a very early age (not only what we eat but the mechanics of how we do it) and these are habits that are very hard to change because it is so ingrained in us.  The dietitian had one tip to try with this that I may try and that is to try using smaller utensils (which we are eventually going to have to buy anyway, more on that later). The thought being that it is a physical reminder to eat  smaller maybe somewhat more dainty bites.

I kind of like the change for this month.  After surgery I will have to rely somewhat, especially in the first few months, on protein drinks.  So my task for this month is to start experimenting with different protein drinks to find some brands and varieties that I like (think I might have some more blog posts as I go thru that process).

That was pretty much it for the nutritionist appointment.  I went to My PCP the other day to get all the lab work done that I need and it all came back good.  I still have a pulmonary stress test to do and the psych eval (that one I am actually looking forward to).  I will keep all y'all informed as these progress.

One thing that is so important in this process is having support of others in your life to help motivate you, I can't thank all of you for all your support and prayers and my wife has been wonderful but I now have one more reason to be motivated in this journey.  For those who don't already know I found out this last weekend that I am gonna be a daddy.  If being healthy enough to enjoy raising a child and actually being around to see him or her grow up isn't adequate motivation I don't know what would be.

I said I would post pictures for every 20 pounds I loose but I also said I would post some other pictures along the way of some other events in my life along the way just to share them with you.  My wife and I went to see the musical "Les Mis" a few weeks ago and we got a good picture out in the atrium before the show (which was absolutely amazing).

Thanks everyone for reading and for your continued prayers.  I would really appreciate it if those of you that are really following my journey would sign up as followers just so I have a better idea of who is following regularly.