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.

New Picture added...I've offically lost the first 20 pounds!!!

Hi all. So I passed the first 20 pounds lost checkpoint this weekend (Yay!!). 

As promised I have posted an updated picture showing my change so far. You can see some differences, the shirt fitting a little looser, my face looks a little thinner too.

I know part of it is because of the exercise I have been doing along with dieting (I love eliptical trainers by the way) but I am feeling quite a bit better already and my average blood pressure has dropped by a little bit.

Anyway, hope you enjoy the new pic...20 down, 180ish to go!

Again, thanks for your support and prayers.

Second nutritionist appointment (2 down 4 to go)...

So this will probably be a short post, but I said I would try and do an update after any surgery related appointment.  So here goes…

So I had my second appointment with the dietitian doing my 6 month medically supervised diet.  It went pretty well. The dieticians (they were training a new staffer) were impressed with my weight loss, especially since I had lost 6 pounds in 6 days.   I personally think that is too fast but am also sure that was not true weight loss. My appointment last week was later in the day and I had drank a lot of water that day and had a big yet healthy lunch, yesterday I went in earlier and hadn’t had much of anything to eat or drink yet.  I am guessing 3.5 to 4 pounds actually lost and then a difference in what I had eaten the 2 days.

We went thru what I had been doing diet wise and they thought it sounded great, their only thing they wanted to adjust was adding more protein to my breakfast, should be easy enough to do.

I am also supposed to be making some small changes to how I eat.  You may recall that last time they wanted me to try cutting out milk from my diet and try cutting my food into smaller pieces.  I have almost entirely cut milk from my diet, I still have some on my cereal a couple mornings a week and a glass of milk maybe once a week (for anyone that knows me, this is a significant change).  I have tried cutting the food small, it is just hard to remember, guess that is the point, try and form the habit now so it feels more natural when I have to do it.

The new adjustment starting this month is cutting out pop; this isn’t about the calories or the possible negative effects of artificial sweeteners in diets.  The reason is because of the carbonation and the effect that all the carbonation and extra gases can have on my stomach at the size it is going to be after surgery.  I don’t think this one will be too hard, but we will see.

So that is pretty much it for the appointment. 

I started working out again yesterday after having to take a few weeks off die to a hamstring injury; I jumped on the scale at the gym too (using the gym scale as my weekly baseline scale).  I am down to 393.8 which is a total of 18.6 pounds since I officially started this blog.  

Pretty sure I will cross the first 20 pound mark this week so, as promised, I will get a couple new pictures up this weekend showing the progress so far…so stay tuned.

Thanks again for following me on this journey and thanks for all the prayers!

First appointment with the surgeon...

Sorry it’s been a while since the last post. Just didn’t have much to report. I’ll try and post something after each appointment.  I am sure they will increase in frequency as the surgery eventually gets closer…probably mid February at the earliest.

Had my first appointment with my Surgeon (Dr. Michael Snyder) yesterday.  Aside from them losing my file and needing to fill out all the first time paperwork again it went well.

The appointment was basically just a quick one-on-one consult. We discussed which actual procedure I want to get (roux-en-y gastric bypass), Dr Snyder thinks I am a prime candidate for this particular procedure. Discussed medical history and co-morbities due to excess weight (in my case primarily sleep apnea and high blood pressure). 

We also discussed what the doctor thought would be a good ideal weight for me to get down to.  Dr. Snyder thought that 215 sounder like a good goal based on my body frame size. I had initially wanted to aim for 200 but in all honesty I have never seen what I look like as a full grown adult at approaching a “healthy weight” so for now I am more than happy with the idea of 215 pounds for a goal.  If I get there and think I can afford to lose more I will cross that bridge when I get there.  For the record getting to 215 would be a total weight loss of 200 pounds, basically losing a full grown healthy man.

We also discussed some tests and labs that I have to have done before the surgery.  Some are just for Dr. Snyder’s benefit, some are to qualify for insurance.  Basically I am going to be getting a full blood lab workup, a psych eval (that should be fun, or at least interesting), and a test to check my heart.

After that I also had to talk to the case manager to make sure I knew everything I needed to do to satisfy the insurance guidelines.

For the record I am now under 400 pounds, hopefully never to return.  I am at 399.6 pounds.

I have an appointment with the dietician next week number (2 of 6 with her), I will post another update after that appointment.

Thanks for following and thanks for all the prayers.