Life Will Never be the Same, But That's a Good Thing! - Rockville, MD

Just the Beginning...

I have been considering bariatric surgery for a number of years now and for a number of reasons, which I will go into further down. I always knew that I didn't want a Lap Band: I have more weight to lose than is feasible with a Lap Band, I don't want the hassle of the port and the continuous filling/emptying of the band and I'm not good with needles (needed to fill and empty the band). I had originally decided on a Gastric Bypass, however, after researching, reading and re-reading all the reviews I could find and talking to several doctors, I decided the risks were too great and I could get similar, dramatic results from a Sleeve Gastrectomy (also known as Gastric Sleeve). So, I have now decided on a Sleeve Gastrectomy, which will be performed in MD, by Dr. Barry S. Greene.

A little background: I was always a slim, active child. I played Netball (Similar to women's basketball) at school, went swimming 4-5 times per week and rode my bike everywhere. However, when I was young I suffered from very bad migraines, which doctors treated with steroids, which in turn piled weight onto me. I was still very active and was able to somewhat control the weight gain with all of my activities. However, at the age of around 10 I found out that my right hip bone had slipped out of place and it could only be fixed with surgery. The surgery and recovery period lasted for about 18 months, due to some complications, which basically meant I couldn't do any of the activities I was used to. Then, when I was 13 my other hip bone slipped and I had to have the same surgery. This time I was out of action for about 2 years. I was young so I was used to eating junk food, but I could control it with activity. However, when I had to stop all of that activity, my food intake never changed and so the weight gain began. By the time I was about 15 and finally able to start being active again, I had piled on quite a bit of weight and was definitely overweight and on my way to being obese.

In all honesty, after that period of weight gain and no activity it became way too easy to gain weight. I was eating all the wrong types of food, my portion sizes were too large and I had become accustomed to not exercising. This carried on into my adult life and led me to where I am today. I have finally started figuring out that there's a better way to live and that food shouldn't control me. I just wish I had of learned that sooner.

I'm only now realising how lucky I am to be in as good health as I am at the moment. I am technically morbidly obese. However, I really have no other issues. I don't have high blood pressure, diabetes, heart disease, etc. In the last few months I do think I have started to develop slight sleep apnea. However, considering the medical problems that my extended family have, and which are in my genetic make-up, I have been extremely lucky to not develop co-morbidities.

In the last year or so I have taken an educational class about food. It's taught me a lot about food, about all of the little things we don't consider or just don't know, such as: low fat doesn't necessarily mean low calorie; and what we, today, consider a normal portion, is usually about 3x more food than we actually need to survive.

I started making small changes to my diet, like only eating wholemeal bread and pasta, not overloading on carbs, filling up on more fruits, vegetables and salads, getting in more protein and trying to cut out soda (even though it's diet, it's not good for you). Soda is one of the hardest things for me to give up, it's been a challenge and I still haven’t fully given it up yet.

So, now I'm starting to get a handle on changing my lifestyle, I have decided that it's time for surgery. I want to start my 30th year out right and get my life on the right track. I live in England, so initially my surgery was going to be done free of charge on the NHS (National Health System). However, after all of my research and talking it over with my partner, I decided that I wanted an expert, someone who only does bariatric surgery day-in and day-out and who I trust. So, I began talking with Dr. Greene, of Advanced Weight Loss Surgery, MD. He's an expert in bariatric surgery and, from my personal experience, a great guy. He's answered all of my questions, of which there have been many, and has given me access to his full team, even before any money had exchanged hands. I, my partner and Dr. Greene decided that a Sleeve Gastrectomy was the right surgery for me. It's less invasive than a bypass, carries less risk and still gives similar great results.

Starting Monday 13th May, I am on a liquid protein diet, in order to lose more weight before the surgery happens. I will either:

a) Have 3 meal-replacement, high protein shakes per day, with two pieces of fruit, or

b) I will have 2 shakes and a healthy evening meal of a small amount of high protein chicken or fish, along with vegetables or salad.

I can also have clear, sugar-free liquids, such as jello, ice pops, decaf coffee, etc. I have been advised that I need around 1000 calories per day, but this is only short term, as you can't only live on 1000 calories long term. Once I have reached my goal weight for surgery, they will schedule the surgery and I will arrange for the pre-op tests to be done.

So, that's it for now. The next two months will be a liquid diet, lots of exercise and preparing myself for surgery, which will hopefully happen within the next 4-ish months. I have a great support system in my partner and extended family, which is really important in this journey.

I will be posting before photos soon and will continue to update both my review and the photos, as my journey continues. If anyone has any questions then please feel free to ask, we all need to support each other as best we can!

Hello Kirsty! I remember you being so thoughtful and positive when I had my surgery and I am thrilled you are having surgery too! I would like to support you the same way you did me.I was also afraid of the complications of the bypass. My sister had gastric bypass and has to get iron infusions a LOT and it's very expensive and also extremely time consuming. She's had to miss a lot of work due to it and that has caused her hardship. She has kept off her weight loss though. It's been 7 years since her bypass. I am still doing well with my sleeve surgery and grateful to have it. I look forward to reading about your journey as it goes along. The pre op diet does suck but there is an end in sight. Just remember you dont't have to be perfect on the pre op diet. If you slip up, just dust yourself off and get back on the wagon. Don't punish yourself for it. It just makes things worse. Good luck and I can't wait to hear more!
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Thanks for your suppport, it's really appreciated. I have slipped up once or twice, but I got back on the horse. The best thing was finally finding some protein shakes that I could stomach and drink without wanting to vomit!

I'm glad you're doing well still! The sleeve seems to be the way to go for me, the risks are just too high with the bypass, especially at my weight. I'm sorry you're sister has to go through that, I hope some of the positives still outweigh the negatives for her!

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Hi Kirsty, I am just in the referral stage at the moment, being handled by the NHS. I am in a wheelchair and unable to stand, plus I have 70% muscle weakness, worsened by exercise when I am in flare. I have polymyositis which is an autoimmune disease and causes muscle wasting, obviously exercise is a problem. I've lost 60lbs on the Atkins diet (hospital supervised) but there is no way I can keep it up. I'm interested in your decision to go to a bariatric surgeon, did you go to NYC for your consultation? Good luck!!!!
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Tests, Tests and More Tests!

It's been a while since I started this review and since then I have set my surgery date (September 4th), although this may change by one or two weeks, once I have my pre-op with my doctor. My pre-op is set for August 13th and at that point we'll set a definite surgery date.

Since starting the review I have lost about 20 pounds, but I still have a lot to go before surgery. I've finally found a couple of protein shakes I can stomach without wanting to throw up, which is helping me a lot with sticking to this diet. I'm trying to have protein shake for breakfast and lunch with a low calorie meal for dinner. For snacks I'm having a piece of fruit and some sugar free Popsicles.

I need to add more exercise into my routine, but I have a peri-umbilical hernia, which will be getting fixed during surgery. This really limits the amount to physical activity I can do, without being in a lot of pain. This week I am taking up swimming, which should be a good way to get some exercise. I'm also going to try and take some longer walks to get me moving a bit more (I work at a desk all day).

The last month or two has really been all about getting my pre-op tests done. I had my psych report completed a couple of weeks ago. It went well and I got the all clear for surgery, but it did bring up one or two issues with food that I have to work on. One being that I have a "the diet can always start tomorrow" mentality and two that I always rationalise my decisions. E.G. I can have this piece of cake because it's Friday and no one starts a diet on a Friday! After surgery I do think I'll have another session or two, to stop myself from slipping into old routines.

One week ago I had my endoscopy. The results are fine, which is great, but I never want to have to do that again. It was an awful experience having someone force a camera down your throat. I was gagging the whole time and felt like I couldn't breath. There was also a suction tube in my mouth, a mouth guard and another tube, so it wasn't the best feeling in the world. The good thing is that it's over in about 5 minutes!

Last night I had my sleep apnoea test. I get the results from that in 5-6 days. I really do feel like they set you up to fail that test from the beginning! Who can sleep with tubes up your nose, wires strapped to your arms and fingers, etc?

The only thing left is to arrange either a stress test or nuclear stress test. I will most likely have this done when I travel to the US.

I'll be staying in the US for about 2.5 months (I can only legally stay for 3 months as a visitor), from August to October. I'll mostly be staying with family in MD and travelling for appointments and surgery.

I still have a lot to do: Finish getting my tests done, lose more weight, arrange travel insurance, etc. It all seems real now, which is exciting and scary all at once.

Hi Allie,

Sorry for my late response, I've just seen this now!

I've actually changed my doctor now, to one in New Jersey. However, the process is the same. I haven't flown out for a consultation, I did them by phone/email/Skype. I sent photos and explained what I wanted, filled in the medical forms, etc. 

For me, the reason for going to the US was so that I could get what I wanted, instea dof what the NHS wanted to give me. Also, the NHS would not fix my hernia at the same time as doing the WLS, which is something I need fixed right away.

Have you already been referred?

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I've been referred to see the surgeon but that's as far as its gone, I've been seeing the hospital weight management team for a while. Because my disease is very rare I have to see one of the top chappies in the country, but luckily he's at a hospital only 45 minutes away. I was in hospital for two years and 10 months when I was diagnosed so I'm really not looking forward to any more time there. But if it happens, it happens. Thanks for your reply, I'll follow your blog.
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Oh, wow! I'm sorry you've had to go through all of that. Please do keep me updated and let me know how you're progressing through the system!

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Costs!

Being from the UK I'm not used to medical costs, as everything, even bariatric surgery, is usually covered by the NHS (National Health System). However, since I decided to go private I have had the pleasure of spending a lot of money in a very short period of time! My partner, who is American, is taking this all in her stride, whereas I am constantly saying something like "they want HOW MUCH for a blood test". Haha!

So, I decided to keep a running total of my costs, everything from surgery, to tests and travel. I will update as I go along, but so far they are:

  • $25,500 - Surgery (Approx)
    • $9000 - Doctor fees
    • $3000 - Anesthesia
    • $13,500 - Hospital fees
  • $2100 - Endoscopy
  • $800 - Psych Evaluation
  • $700 - Medications
  • $450 - Sleep apnoea test
  • $460 - Pathology tests (done while I was in hospital)
  • $300 - Blood tests
  • $155 - Gallbladder ultrasound
  • $325 - Echocardiogram
  • $300 - protein shakes
  • $210 - First Consultation fee with Dr. Greene
  • $200 - Doctor consult (for the Endoscopy)
  • $175 - Cardiologist consultation/EKG
  • $175 - Second Cardiologist consult/EKG
  • $35 - Chest X-Ray

Travel:

  • $2000 - Plane Tickets

Almost Time to Fly!

I got the results of my sleep apnoea test, which showed no significant sleep apnoea, which is awesome! I have also arranged to have my ECG with a Cardiologist in America when I arrive. That will be my last test before my pre-op appointment.

My pre-op is currently schedule for August 13th and we will then finalise a surgery date. It's currently set at September 4th, but I think it might be a week or two later than that once we finalise everything. I'm still losing weight, which is great. I'm trying to do a little bit of exercise everyday, whether that be swimming, boxing (punch bag), Zumba, taking a walk or playing catch. It really has been helpful in losing the weight I need to lose before surgery.

I'm definitely still struggling to cut out soda altogether. I only drink diet soda, but I know I can't drink it at all after surgery. It's definitely addictive, but I'm slowly winning the fight!

We fly in 8 days time, so now it's all about packing and making sure I have all my paperwork, etc.

Will update with photos soon.

You're doing great and we're all here to support you. Only 1.5 months to go! <3

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Why thank you, Ms. Sharon! ;-)

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Final Set of Tests

Last Thursday (8th August), I visited a cardiologist and had an EKG. The EKG came back fine, but my blood pressure was high, 150/100, which meant the cardiologist wouldn't clear me right away for surgery. Instead she asked me to get an Echocardiogram, keep a check of my blood pressure and go back to see her in a months time on 9th September.

Today I had my Echocardiogram and again had my blood pressure taken, still 150/100. I need to try and get it lowered before I go back to see the cardiologist, or she's going to have to put me on medication to lower it before I can have surgery. I'm going to check some Google info and see what I can do to bring it down. I know the basics of more water, more exercise, less salt.

I also had a chest x-ray, abdominal ultrasound and blood tests today. The blood tests neeed are:

  • CBC (Complete Blood Count)
  • CMP (Comprehensive Metabolic Profile)
  • Vitamin D/25 Hydroxy
  • Lipid Panel
  • TSH (Thyroid)
  • H-Pylori

The chest x-ray was quick. It took 2 minutes and was over. The abdominal ultrasound took about 15 minutes but was very painful. The technician has to press so hard that it feels like they're going to break your ribs. It's not a pleasant experience, but it didn't take too long.

All of those results will go to Dr. Greene in the next few days and then I have an appointment with him, set for August 27th to discuss everything and hopefully set a date for surgery, which I'm expecting to be mid-late September.

The only other thing I need is to get a cardiologist clearance, so I definitely need to work on getting that blood pressure down!

Holy cow, I had no idea how many tests had to be done - WOWZA! Well I'm glad you passed the psych eval. ;) Seriously though, so very excited for you. Your team is right here for you - you know we all love you. Big hugs being sent your way!!

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Ha! Yes, tests, tests and more tests! Thank you, I appreciate all of the support. Appointment with my doctor tomorrow, so we'll find out more then!

 

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I hope all goes well with the cardiologist . And thank you soooo much for sharing your journey with us . You've been so helpful to me & the other girls in the BBL community . Hats off to you Kirsty !!
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First Visit With Dr. Greene

Today I met with Dr. Greene and his team for the first time. He took some photos of me, went through all of my test results, told me a lot about his training and background and then explained the procedure and everything that would be happening pre and post-op.

First my tests. Most of them came back fine: my chest, lungs and heart were all good, so no issues there. The gallbladder ultrasound was somewhat inconclusive. It only showed a partial picture, which may or may not have gallstones in it. So, we decided that Dr. Greene would take a look at my gallbladder while he was performing surgery and if it had stones, he would just take it out then and there, to stop any gallbladder attacks later on. The ultrasound did also show that I have quite a large liver, which isn't good for this type of surgery. The liver has to be as small as possible, so that the doctor can get to your stomach, which is located behind the liver. So, now it's all about shrinking my liver in time for surgery.

My blood pressure is still high, but getting slightly better. It was 151/100, it's now 150/84. Bottom number is almost normal but I need to get the top number somewhere around 120. So for now it's less salt, more water, more exercise and less carbs.

All of my blood tests came back and were fine. My cholesterol and sodium levels were good, but I am deficient in Vitamin D. Apparently a vitamin D level of 30 or more is normal, 20 is deficient and I was less than 10. I think I blame the fact that I live in England and we don't get that much sun! ;-) So, I'm on a really high dose of Vitamin D to try and get those levels up.

I have been on a semi-liquid diet for a couple of months now, but in order to get ready for surgery, which Dr. Greene has set as September 25th, I have to now go onto a full liquid diet. I need 70-90g protein per day, with only 30-50g carbs and 700-900 calories. Basically, I have to cut out anything with carbs, so no: potatoes, rice, pasta, fruit, beans of any kind, bread or peas. That won't be too hard since I now have to go onto a full liquid diet. I can have protein shakes, broth, soup without bits in it, yoghurt, cottage cheese, sugar free popsicles, sugar free jello, sugar-free and fat-free pudding, etc. I can no longer (and for the rest of my life) have any soda or alcohol. I think the worst part of the liquid diet, is that I'm going to feel really bad for a few weeks. My body is going to survive on less than half the calories that an average person takes in and I was probably having more calories than the average person to start with. I'm also going to be going cold turkey and detoxing from sugar, caffeine and carbs, which Dr. Greene advised me will make me feel quite bad for a few weeks, so I'm not really looking forward to that and today is only day 1.

I am slightly disappointed that I may not be getting my hernia fixed, like I wanted, during the surgery. My hernia is quite large, but at the moment Dr. Greene said that the hernia hole is plugged up with fat, which sounds gross, but the fat deposits are plugging the hole and stopping it getting any bigger. If he fixes it, it's only a temporary fix and he basically cuts the fat away and stitches the hole up. However, there's a 50% chance that the stitches won't hold because of the weight loss I will be going through. Fixing the hernia also lengthens the surgery and creates more opportunity for complications as well as making the healing and recovery process longer. So, right now, the plan is for Dr. Greene to go in to the surgery not knowing if he's going to fix the hernia or not. If he can get to my stomach without having to fix the hernia, he will. However, if the hernia is in the way and he can't get to my stomach because of it, then he will fix it. The reason he could only do a temporary fix and not a full hernia repair (where they place a piece of mesh cloth to close the gap and stop the hernia re-opening) is because he is opening my stomach to do the WLS. Your stomach holds a lot of bacteria and when he opens it, some of that bacteria will come out. If he was to place the cloth inside me, the bacteria would get onto the cloth and could cause an infection. So, while I'm disappointed that the hernia may not get fixed, I do understand the reasoning.

The only thing now, which could stop me from having surgery on the set date, is cardiac clearance. While my EKG was okay, apart from my heart beating slightly too fast, and my Echo-cardiogram was fine, my blood pressure is still too high. I go back to see the cardiologist on September 9th and at that point, she will take my blood pressure again and re-do the EKG. Dr. Greene is hopeful that the liquid diet, along with more water and more exercise, will be enough to regulate my blood pressure. If it is still too high, then I will most likely have to be put on medication to bring it down, before I can have surgery. So it's fingers crossed for good blood pressure!

On September 5th I have an appointment with Dr. Greene's nutritionist and with the exercise team. I have to have some tests done before and after exercise. Then on September 12th I go back to see Dr. Greene for a pre-op appointment. At that point he will check my abdominal wall to make sure it's soft enough for him to get through it and to my stomach during surgery. This is also why the low-calorie, low-carb, high-protein diet is important. Right now my abdominal wall is right on the border of him being able to get through. The liquid diet should make it a lot softer and easier for the surgery to be performed.

So, as of right now, surgery is scheduled for September 25th as long as I can get cardiac clearance and as long as I can stick to this liquid diet. Fingers crossed!

P.S. What are the protein shakes that you're finding palatable?

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Great job of explaining the whole process! I had no idea how involved it was. You've worked really hard to get to this point. You go, gurl! ;)

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Thank you! I have a feeling no carbs is going to kick my butt, but we'll start out thinking positively and see how far that gets us!

Back in England I use a Protein shake brand named Maxi Muscle. Here in the states I've started the Oh Yeah! brand, I have to admit, they're slightly too sweet for me, so I've been splitting them in half, adding extra milk to each half and drinking them like that, in two seperate sessions.

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Day 3 of Full Liquid, Low Carb, High Protein Diet

So, as the titles suggests, this is day 3 of my fully liquid, low carb, high protein, pre-op diet. Each day I'm supposed to have:

  • 70-80 grams of protein

  • 30-50 grams of carbs

  • 20-30 grams of fat

  • 700-900 calories

Right now, I'm not doing too badly. I'm definitely hungry and the hunger usually kicks in around 8pm, when I start to get the evening muchies. I'm trying to go up to bed around 9/10pm, watch some TV and fall asleep. By the morning time I'm no longer hungry.

Apart from the hunger, the issues I'm having at the moment are fitting my calories in, while not going over my carb target. I'm sure I'll get better at it, but the most calories I've been able to consume in a day, since starting this, is 600. After that I would be having too many carbs.

I'm mostly eating (well, drinking):

  • Protein shakes (Oh Yeah! brand)

  • Danon light and fit yoghurts (high in protein, low in calories, medium on carbs)

  • Sugar free jello

  • Sugar free pudding

  • Smooth soups (home made beef and vegetable at the moment)

  • Crystal Light

  • Water (although not enough at the moment)

  • Cottage cheese

I don't have too many withdrawal issues at the moment, from the carbs. Everything I've read said that will kick in somewhere around day 3/4/5. So, something to look forward to! I've been slightly dizzy when I wake up, but it gets better as the day goes on.

Once I really start hitting the withdrawal wall, it is apparently your body going into something called "Ketosis". Which is, from what I have read/been told, the reaction your body/brain has to abnormally low levels of carbs/sugar/fat and abnormally quick fat reduction. In order to stop your body from using your muscle mass for energy, it takes Ketone from your liver to use. This is instead of the all of the glycogen in your liver being depleted.

Anyway, as of right now, I don't feel too bad. One of the things I really miss is being able to chew something. I'm wondering if I can chew gum, to give me the sensation of chewing, while not actually eating solid food.

Thanks Kirsty, not long now! I've already warned my husband that I might not exactly be sweetness and light, I get really ratty when I want something and can't have it, but, like your wife, he's a great support. It will get easier, after all it's pretty hard being heavy isn't it? And we seem to manage that okay, but no more. I can't wait until this time next year, people you've known for years will walk past you in the street! I know you're overseas for the op, but have you told many people back home? I'm thinking of saying I'm having gall bladder surgery for people who'll know I'm in hospital but I don't want to know, especially my teenage niece, I'm worried about the message y'know?
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Three hundred bucks for bloods!! Lol, you've got me at it now ;)
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I know, it's crazy, right?! ;-)

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Day 7 - Doing Pretty Well

Well, it's been 7 full days of the all liquid diet and I'm doing surprisingly well! I have a few headaches now and then and I get a little dizzy first thing in the morning, but by mid-morning I'm usually okay.

I'm still having some trouble fitting calories and protein into my diet without going over my carb allowance, but I'm getting there. I know that I need to drink more protein shakes and that would solve the issue, I just need to make sure I keep them down. Protein shakes and I don't usually go all that well together.

The one problem that this diet seems to have fixed is my blood pressure. I've been taking my blood pressure daily, in order to keep a month long log of the data for my cardiologist, who I see again on September 9th. For the past 4 or 5 days, since starting the liquid diet, my blood pressure has returned to normal, which is awesome. Even if it's high on the day I see my doctor, hopefully she will take the stats into account and note that it has been low for a good period of time.

I am now starting to get tired of eating soup for dinner every night and sugar free jello every day. Apart from the hunger, which really only bothers me at night (night time munchies!), the biggest issue on this diet is that it's boring and you have very little choice of foods you can "drink".

Anyway, I see my surgeon again on Thursday, after seeing the nutritionist and the exercise coach. So, I'll follow up again then.

Wow, just read your updates and the details of your diet.  The amount of self control it must take to adhere to that diet amazes me - good job!! Keep going Kirsty, you got this!!

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I was definitely hard to live with for a few days! ;-) It's not the easiest thing in the world, but at least there's an end date in sight!

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Well, I think some crankiness is completely understandable when you are doing something like that, and I'm sure your family was willing to put some grace around it and understood the "why". :)

I'm proud of you and am cheering loud in your corner!!

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Exercise, Nutritionist and Dr. Green Appointment... Oh My!

On Thursday I had 3 appointments, so pretty much spent all day at the hospital/doctors office. First I did my 1 hour exercise session, of which 2 have to be completed prior to surgery. I did this at Shady Grove Adventist Hospital, which is also where I will be having surgery. The session went well, the trainer spent time going over my file and figuring out which activities were best for me and my fitness level.

After the exercise session I had an appointment with Dr. Greene's nutritionist/dietician, Elizabeth. Elizabeth went over everything I should be doing/eating/drinking pre-op and post-op. She went over what to expect after surgery, the time scales for getting back to eating solid foods and what I should be eating at each stage in the recovery. I will see her again once pre-op, once in the hospital after surgery and then at the 3 week post-op stage.

Elizabeth advised me that if I want to get out of surgery super-fast then I have to be able to drink 1oz of water every 15 minutes for at least 6 hours after surgery. I have to be able to drink and keep down some protein shake and I have to have urinated enough to show that water is passing through my system okay.

After Elizabeth I had an appointment in Dr. Greene's office with Linda, his PA. She talked a lot about the psychological addiction to food that we have, how to break it, how to pass up food that I know isn't good for me and how to make this surgery work long-term, which is more about my mental process than the physical restriction from the surgery. Linda is very enthusiastic about her patients, which is awesome and she's always available to talk to. She gave me her mobile number and told me to call her day or night should I need her, even if it's to bitch at her because I'm hungry! Haha!

Linda explained a lot about Dr. Greene's practice to me. I knew Dr. Greene was a big player in the WLS world, but I didn't know how big! He's like super-surgeon! He trains a tonne of doctors, all over the country and world in bariatric surgery, he was the first MD president of the ASMBS (American Society for Metabolic and Bariatric Surgery) and only gave it up because he wanted to focus more on his practice and patients, but he still has a hand in the running of the ASMBS. The great thing I learned is that of all the surgeries he has done, which include 2600 gastric sleeve, he has never had a serious complication, no one has ever had to go into ICU and he's never had a death.

Dr. Cook, who is Dr. Greene's partner in the practice, also came in and introduced herself, as she will be assisting Dr. Greene with my surgery. She checked my abdomen and said that it was getting nice and soft. Another 10-15lb weight loss before surgery and we should be good to go. The abdomen needs to be as soft as possible, so that the laparoscopic equipment can get through it easily.

They also weighed me and in the last 7 days, while I've been on the liquid diet, I've lost 14lbs, which is awesome. If I can lose another 15 before surgery then I will be very pleased.

So, Monday I go to the cardiologist, to hopefully get signed off and then next Thursday I have my final pre-op appointment with Dr. Greene, fill all of my prescriptions and get ready for surgery!

Cardiac Clearance Received and Everything is Getting Real!

So, the good news is that after losing 14lbs in 8 days, my blood pressure dropped right down into the normal range. My Cardiologist gave me the all clear for surgery.

The scary news is that everything is now getting very very real! My surgery has been confirmed for September 25th at 3:15pm and I have to get to the hospital for 1:15pm. I have my pre-op appointment this Thursday, 12th September, when I will pick up my prescriptions, pay the doctor part of the fees and have a final check-up.

I also have to arrange with the hospital to have anaesthesia testing, along with a type & screen test and then pay the hospital part of the fees at that time.

I've been on this road for so long now that it seems like everything is suddenly going at super speed and there's no way to slow it down. I really do want the surgery, it's a life changing surgery that will allow me to have a better quality of life. However, it's also really scary and a lot of money!

I finally found a protein shake that I can drink without wanting to throw up! The Atkins Advantage shakes. They are a little less protein than I require in each shake, they have 15g, but at least I can drink them. So I'm having 4 of those per day, along with jell-o, broth, water, Crystal Light and sugar free popsicles. I tried the Oh Yeah! shakes and they were okay, but they just became way to sweet for me. My partner likes them, but then again she loves Captain Crunch cereal and I can't stand the sweetness of it!

Will update again Thursday or Friday, after my pre-op appointment with Dr. Greene.

What happens at the pre op, Kirsty?
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They will make sure my abdomen is getting soft enough for surgery. Make sure you're on track with the liquid diet and then go through everything that is going to happen during the surgery and while you're in hospital. They'll also give all of the prescriptions I'll need to pick up for pre and post surgery.

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Oh, and I'll have to pay for the surgery at that point, too!

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Quick Update and Video

Just a quick update. My pe-op got pushed back to this Tuesday coming (17th), as I wasn't very well last week. So, I'll update more after my appointment with Dr. Greene.

I'm including a video of how the Gastric Sleeve is carried out, just for those who want a more in depth look at the surgery itself. You'll see why it's so important to shrink the liver, with the liquid diet, as it almost completely covers your stomach.

Every day I see the date on my 'phone and think that's one day closer for us all. I'm praying for your soft belly and shrunken liver...which is not a sentence one types every day...
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Haha! I shall try my best!

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Final Pre-op Appointment

So today was my final pre-op appointment, postponed from last Thursday, because I was unwell.

First I did my final exercise class, in order to complete Dr. Greene's program and be eligible for surgery. That went fine and is now done and over with. I then paid Dr. Greene for his part of the charges, which were $8500, plus the $500 program fee, which I paid last week.

Once I got to Dr. Greene's office I had to sign the surgical release forms and then take a quick 5 minute yes/no test. This was so that Dr. Greene could gage how much I knew about the surgery and how much he still needed to teach me. I got 100% and the little schoolgirl in me said *Yay*!

I got weighed again today and have lost another 12lbs, which makes a total of 26lbs in the last 3 weeks, while on the liquid diet and 53lbs in the last 3 months. Dr. Greene was extremely pleased with my progress. My liver has shrunken quite a bit and my abdomen is suitably soft for surgery, so everything is a go! My surgery time had been changed from 3:15pm to 11:00am, which I actually prefer. I think Dr. Greene will be fresher and I don't have to wait around all day, worrying. Dr. Greene may remove my gallbladder, if it needs it and also he may fix my hernia, if it's in the way of my stomach area.

I picked up all my prescriptions, which I'll list out below and what they're for. One of the prescriptions I need is something called Lovenox, which is a shot that I have to give myself twice per day for about 12 days after surgery. That prescription alone costs around $500 and since I'm self-pay, Dr. Greene gave me samples from his office, to save me the cost. I thought that was awesome of him! He's doing everything he can to keep the costs down for me, while making sure I'm safe and the surgery is done well. He's also letting me leave hospital 1 day after surgery, to save me the extra hospital costs and has arranged for someone from a local pharmacy to come to my house each day for 3 days following surgery, to give me IV fluids.

So, the prescriptions are:

  • Lovenox - Thins the blood to stop blood clots. Pre-filled shots, given twice per day for 12 days
  • Nystatin swish and swallow - To cut down on any yeast infections. Used four times per day for 4 days prior to surgery
  • Hibclens skin cleanser - To clean the skin and cut down on yeast infections. Shower with it twice per day for four days prior to surgery
  • Diflucan - Anti-fungal pill. One to be taken 3 hours before surgery
  • Emend - Anti-nausea pill. One to be taken 3 hours before surgery
  • Oxycodone - Pain killer. Taken as and when needed, after surgery
  • Prilosec - Prevents acid reflux. One to be taken daily, forever

Dr. Greene, Linda (his PA) and Michelle (the RN), went over everything that will happen before, during and after surgery. They went through my medical history again and basically spent about 2 hours talking to me and answering any questions I had.

They told me that my partner could stay in the hospital with me overnight, which is really great. I didn't really want to be alone, so this takes some of the pressure off.

The last thing I need to do is have my type & screen test, my anaesthesia test and meet with Latesha, the bariatric co-ordinator at the hospital. That will all be done next Tuesday, the day before surgery.

So, right now I'm still on the liquid diet, which I will continue until midnight the day before surgery. It's basically on now, nothing left to do but to have surgery!

Good luck kirsty!
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Thank you, I appreciate it! 1 day left!

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you are going to be one gorgeous skinny girl in the not too distant future. keep on keeping on! very excited to hear your story.
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Day Before Surgery...

So, today I had a pre-op appointment at the hospital to have my anaesthesia test and blood test & type done. I also had a 2 hour bariatric class, which I had to attend before surgery.

The class was really nothing that I didn't already know, but it was useful to be refreshed on things. It basically covered: what a Gastric Sleeve is, how the surgery is performed, what the post-op drinking/eating stages are, what vitamins, minerals and supplements are required and when the follow-up appointment will be. We also learned that we can request copies of the pictures they take during the surgery, so I will be asking for a set of those.

After the class I met with Latasha, who is Dr. Greene's bariatric nurse. She took my medical history again, blood pressure and gave me a quick exam to make sure my heart, lungs, chest, eyes, ears, etc were all good and in working order for surgery. I then had my blood taken so they could do the type and test. This is to check what my blood type is in case I need blood during surgery and to also test it for things like HIV, etc.

After that the anaesthesiologist came in and went through his part in the surgery. I will arrive at the hospital for 9am, be taken back to get into a gown, have an IV put in and then they will give me an antibiotic through the IV, to help reduce infection and I wait for 11am, which is surgery time.

Once 11am comes, I will have to say goodbye to my family and will be taken through to the OR. They'll put some EKG stickys on my chest and put an Oxygen mask on me for a few moments. They want to get all of the Nitrogen out of your blood before surgery and replace it with as much Oxygen as possible. They is so your blood stays oxygenated for longer during surgery. After that they'll put the anaesthesia in, through the IV and (the possibly scary part) start to press down on my trachea. Apparently this is to stop any stomach acid travelling up and into the lungs, which can be toxic. After all of this I will be asleep and Dr. Greene has to work his magic!

Today I met the lady who will be having her sleeve done directly before me! I warned her not to tire out Dr. Greene as I want him fresh as a daisy for my surgery! ;-)

So, now I'm just packing my bag for the hospital and getting ready to be up early in the morning for the 90 minute drive down to Rockville.

Hey everybody,

Sorry for the suspense! Kirsty's surgery went great and she came home from the hospital on Friday. I know she appreciates all the support she's getting in here. :) She'll be updating really soon!

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I'm checking back all the time, I hope you're good.
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Kirsty .. Wereeeee waitingggg . Just kidding , Take ur time . I hope u are doing well
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Rough Recovery but Getting Better Each Day!

Hey all, so I'm still not totally recovered, but I feel well enough to sit up at the desk for half an hour and write a quick update. Thank you all for your lovely messages of support, they've been nice to hear!

It has definitely been a much tougher recovery than I had planned for, but it's getting better day-by-day and I'm finally starting to feel normal again. I'll start from the beginning...

Surgery Day (Wednesday) - We got to the hospital for 9am and surgery was set for 11am. We checked in at 9 and were taken back to the OR prep room. At this point they made me change into a gown, put in an IV, went over my medical history again, gave me some pre-surgery meds through the IV and then I waited with my family. At about 10am the anaesthesiologist came by to introduce himself, look over my records and let me know what was going to happen. After that one of Dr. Greene's PAs came over to pretty much do the same thing and then Dr. Greene himself came by. He explained the surgery to me again and took any questions I, or my family, had. After that it was about 10:50 and I had to say goodbye to my family. Honestly, at this point I was wanting to put my clothes back on and say "Don't do it". Mainly scared and nervous of the surgery, what was going to happen, how the recovery would be, etc. Anyway, I said goodbye and they took me into the OR. They then transferred me to the operating table, strapped my arms and body down and put my feet/legs in some inflatable massage wraps. The wraps massaged every 30 seconds, to stop blood clots forming. After that they made me breath some Oxygen in for 4 minutes, then they put the anaesthesia in my IV and that's the last I remember until I woke up. I will say that while I was being strapped down and given the anaesthesia I was terrified and probably looked that way, but Dr. Greene's two PAs held my hands and talked to me through it all.

My partner tells me that surgery took about 4.5 hours, after which Dr. Greene came out to talk to my family, let them know what he did and tell them I was in recovery. I was actually in recovery for about 4 hours, sleeping. I remember waking up to them pulling a tube out of my nose and trying to give me ice chips. I was then moved up to my room on the Bariatric ward. I was slipping in and out of sleep during this whole period, so I don't remember much, just a lot of nurses coming in and out of my room, taking my blood pressure a lot, hooking me up to machines and IVs, etc.

I had the Gastric Sleeve done and also had my gallbladder removed as it had stones when they inspected it. My hernia wasn't fixed, as they said they may not, as Dr. Greene advised me that he would only be able to temporarily fix it and it would likely re-rupture within a couple of weeks, causing me more pain.

I have 5 incision sites around my abdomen, the biggest being just above my belly button area, which is where they pulled out the stomach they had cut away. The incisions are sewn on the inside, with the final layer of skin being closed with glue. The glue stays on for a week or two after surgery. It lasts through showers, etc.

That whole night I know I was in a lot of pain, more than I had expected or planned for. I had a pain pump attached to my IV, which I could press every 10 minutes and I'm pretty sure I did. You can hit it as much as you want, but it only gives out medication at 10 minute intervals. However, they use the number of times you hit it to detect how much pain you're in.

Post-op Day 1 (Thursday) - I was hoping to go home today, but that didn't happen. Because I have my hernia I was in a lot more pain than they, or I, expected. I finally got out of bed around 8am on Thursday, with a lot of pain. I was still on the pain pump and an IV. I sat in the chair for a while, until I could get the pain under some sort of control.

The nurses are very interested in how often and how much you urinate, drink and pass gas. They come in the room every hour to ask about those 3 things, which while I understand why they have to do it, it made me anxious. I was always worried that I wasn't urinating enough and they were going to put a catheter in me, which they said they may do. Anyway, around 9am I went to the bathroom and urinated a little bit. Evidently it wasn't enough for them, so they put me back in the bed and did a bladder scan, to make sure I wasn't retaining water. It was extremely painful to get back into bed and have them push on me for the scan. I wasn't retaining water and at 11am I finally urinated enough to appease the nurses. However, they still came in every hour to check how much more I had gone!

I had a bit of shoulder/back pain from the gas inside of me (this is gas they use to inflate your abdomen during surgery). They try to suck it all out before they close you up but some always gets trapped. Over 3 or 4 days it dissipated, but it does get painful occasionally.

At about 1pm they brought me a tray with a protein shake, bowl of broth, cup of hot tea, bottle of water and packet of Crystal Light. They also bring a sheet of paper so you can mark down how much you're drinking. Honestly, I saw the tray and thought "That's optimistic"! They want you to drink 1oz of liquid every 15 minutes. That's enough to hydrate you, but not too much that it will put pressure on your new stomach and burst the staples, etc. Well, that whole first day I got in about 7oz of liquid. I just couldn't get it down. My stomach felt swollen and like the liquid was getting caught up and wouldn't go down. I was still on an IV, so I wasn't dehydrated, but the problem is that they won't let you leave the hospital until you're A) urinating enough, B) drinking enough, C) walking enough and D) can manage your pain with oral medication. Well, I wasn't doing any of those things, so I wasn't going home!

I did get a little better as the day went on. I started walking around the room and then once I knew I could do that I started taking small, 2 minute walks, out of the room. I held my partner's hand the whole time as not only was I in pain and not steady on my feet yet, I was also hopped up on narcotics, which made me sleepy and dizzy.

Oh, one thing they do every day is weigh you and don't be alarmed if you put on weight. Between surgery day and post-op day 1, I had gained 8lbs! It's only fluid, surgical gas and swelling, but it can be disappointing if you're not aware that it will happen.

The rest of Thursday I slept in and out.

Post-op Day 2 (Friday) - By Friday I was doing a little better. Still in some pain, but it was improving, I was urinating more, drinking a little more and walking a lot more. I was taking 4 or 5 minute, slow walks around the hospital. The girl next door to me had her surgery 4 hours before mine, with Dr. Greene, so I would stop in her room and have a little chat with her also. I started to be able to get 1-2oz an hour down, which isn't great, but was much better than Thursday. I also stopped using the pain pump, which is the only way they would let me go home. I moved onto oral medication, which didn't control the pain as much, but enough to get me home.

Dr. Greene stopped by the room around 11am to look at my incisions to see how I was doing. After checking me over and talking to me and my family for a while he decided I could go home as long as I had IV liquids with me. He also said I could shower, which was great as I felt gross and the nurses wouldn't let me shower without his approval. I think this was because they weren't sure if the incisions could get wet, but the glue they put on them protects them from everything.

Taking a shower was interesting and somewhat painful. My partner had to come in the shower with me and basically do everything for me. Stretching is uncomfortable, it feels like you're going to pull your new stomach apart, as well as your incisions, so washing my hair was out of the question. Thankfully my partner has been an angel! She helped me shower, washed my hair and then dressed me! It may have felt like I was being pampered, had I not been in so much pain. She also stayed in the hospital with me, the whole time I was there, which helped more than I can describe. Looking back on it, I really don't think I could have gotten through those first few days without her there, she was basically like a nurse the whole time. If you can have someone stay with you, in the hospital, then I would definitely suggest you do, it makes things so much easier and you don't have to call a nurse every time you want to reach for a drink, go to the bathroom or take a small walk. My in-laws were also there the whole time, which I appreciated. I had a lot of support!

Anyway, after my shower I had to have a new IV put in, then I got dressed, my family packed up everything, I got my discharge papers and we left around 2pm that day for the 2 hour drive home. The drive home wasn't all that nice. I felt nauseated the whole time and was in pain, but I made it and then basically went to sleep!

Around 9pm on Friday, Wallgreens came by with the IV fluids Dr. Greene had ordered for me.

Notes - Everyone at the hospital was awesome! Latasha, the Bariatric co-ordinator, came by my room several times per day to check on me, order any meds I needed and to push me along with walking, drinking and urinating. The nurses were great, they were very busy but did anything they could for me. One nurse, Admire, specifically asked to look after me because I was "That girl from England". Haha! I was a mini-celebrity on the ward!

You won't get much sleep the whole time you're in hospital. The nurses come in the room every hour from 6am to midnight and every 2 hours from midnight to 6am. They wake you up to ask if you've urinated, to see how much pain you're in and to give you meds. You have to urinate into a little bucket thing, which sits over the toilet, so that they can measure your urine.

You will be nauseated quite a bit to start, but they'll give you meds for it. You also won't be able to drink as much as they want you to and they will definitely push you, but they mean well while they're doing it!

The best thing you can do is drink, drink, drink! It's annoying and you won't feel like it at all, but if you want to get out of hospital then you have to drink your 1oz every hour and walk around a lot.

While you're in hospital and for 12 days post-op (timing may vary from doctor to doctor) you will be asked to give yourself 2 shots of Lovenox, or Heparin, per day. This is a blood thinner to stop clots forming while you're not moving around so much.

Oh and you cannot laugh! Laughing hurts a lot. Your abdomen stretches, your incisions stretch and it feels like your new stomach is being pulled apart.

Post-op Days 3 and 4 (Saturday and Sunday) - One thing I forgot to mention is that I cannot sleep lying down at the moment. My abdomen feels like it stretched too much and it's painful, so I have been sleeping in a chair since surgery, with my legs raised on a foot stool. My partner has been sleeping on the sofa, next to me, so that I'm not alone!

Saturday I woke up in a lot of pain but the Oxycodone that I was prescribed was making me nauseated and stopping me from drinking. So, I called Dr. Greene on his mobile and he faxed a prescription for Vicodin through to our pharmacy, which we picked up right away. Once I started taking that the pain went away a little.

I was trying to walk around the house, 4 times per day at least, for a few minutes at a time. Apart from that I would be in my chair, hooked up to an IV and trying to drink, drink, drink. I still wasn't doing very well at drinking, getting about 2oz per hour. When I spoke to Dr. Greene he advised me to start drinking regular Gatorade (vs. G2, which is what I was using) as he needed me to get the carbs and sugar because I was drinking so little. My father-in-law went right out and bought me a few bottles. One bottle of Gatorade lasts me about 2-3 days, with some protein shake in between.

All I can drink at the moment is:

  • Gatorade (regular for now, then moved to G2)
  • Protein shake
  • SF Jell-O

Protein shakes are hard to get down as they're so thick, so for the moment I mixing them with a little water.

Saturday afternoon a Wallgreens nurse came by the house to set up my IV. She showed us how to attach it to the IV in my arm, what to set it to and how to remove it when it's done. So, I'm on an IV of 1litre for 4 hours each day.

The rest of Saturday and Sunday was sleeping and being told when to drink!

Post-op Day 5 (Monday) - Today was my first follow-up visit with Dr. Greene. They weighed me and I have lost all of the post-surgery weight (8lbs) plus an extra 3. They went over what meds I was taking, which at this point I had moved off of narcotics and was simply on two Tylenol 3 times per day. I'm also taking a multi-vitamin twice per day and Prilosec once per day, to reduce my stomach acid.

Linda, doctor Greene's PA, did my visit today. She wasn't happy with me not drinking enough. I had one bag of IV fluid left and she said if I didn't start drinking more they would have to remove the IV and put in a PICC Line, which is a more permanent IV that they thread through your vein and sit just above your heart. Apparently that's all the threat I needed, as I started drinking 3oz per hour after that. It's funny what motivates you...

Linda ordered another 2 litres of IV fluid for me, to keep me going through Wednesday as they didn't think I was hydrated enough. She checked my incisions to make sure they were healing okay and prodded my abdomen a little, which hurt, but she said everything felt fine.

Because I wasn't hydrated she made an appointment for me to go back the next day, so they could check on me again.

When we got home I started keeping a chart of how much I was drinking and by the end of the day I had gotten up to 4oz an hour, most of the time.

I started to get really bad pain again, in my abdomen and around my hernia area, so I had to move back to the narcotic medication, which helped after about 24 hours. Apparently, because I no longer have a gallbladder, my body processes fat, carbs and protein differently. The protein I had drank (Atkins Advantage) didn't sit well with me and caused severe diarrhoea, which caused my colon to pull on my hernia, causing the pain.

Post-op Day 6 (Today)! - Today I woke up around 10am. The pain was there still, but much less and has gotten better throughout the day. It's now 9:30pm, I have a little discomfort but not too much and I haven't had any pain meds since 10am, so all in all I'm not doing too badly. I've had a headache all day, because I don't have enough calories or carbs in me, but it's getting better. I'm also sleeping a lot, but again it's because my body doesn't have much fuel for energy right now.

I went to see Dr. Greene again today and he was pleased with my progess. He weighed me again and I have lost another 4lbs, since yesterday! I'm pretty well hydrated, but he wants me to keep the IV fluid going until Wednesday. He gave me some samples of other protein shakes to try, since the Atkins is making me a little sick at the moment. We made another appointment for the 7th October, and we went home.

Today I'm much better than I have been. Pain is almost gone, I'm walking much better and it no longer hurts so much when I laugh. I'm managing to get my 4oz per hour in, but I'm not hungry at all. If I could just not drink/eat at all then I'd be happy, but apparently that's not allowed, especially when you have very cute, well-intentioned family bugging you to drink every 15 minutes! I still can't sit at a desk/table for too long without my abdomen aching a little, but it gets better every day.

While I've been at my follow-up visits in the doctor's office I've seen several people who I was either in hospital with or have chatted to at other visits. Everyone is so friendly and helpful, they all share their stories and are happy to give you advice. A lot of the new patients also ask for your advice, which is nice. It's like a mini-support group before your doctor visit, each time.

Before surgery I was told that I would regret having the surgery for the first day or two. Honestly, I thought to myself, "There's no way, I've been working towards this for a couple of years, I've researched, I've done the hard work and it's what I want". Well, that all went out of the window for the first 3 days. I was sitting there, in pain, not being able to drink or sleep and regretting ever having decided to go through with it. I was wishing I could go back in time and just walk out of the hospital before surgery. It's normal, natural and believe me, it does get better! I'm still not 100% recovered, I still have some pain, I still can't walk too far but I'm getting better day-by-day and I no longer regret having it done.

For now the schedule going forward looks like this:

  • Liquids for 3 weeks post-op - 1oz every 15 minutes, never exceeding 5oz per hour
  • Soft foods week 3-6 - 1 teaspoon 6 times per day for 3 days, then 1-2oz six times per day for the rest of the 3 weeks. Also having your liquids in between. Soft foods are: eggs, cottage cheese, very soft flaky fish like cod or crab and very soft, mushy vegetables
  • Week 6 onwards - start introducing poultry, vegetables cooked normally, raw vegetables,etc.
  • From day 90 onwards you can introduce beef, but it has to be very good cuts of beef, not hamburger.

You have to make sure you eat all of your protein first, then if you have room you can have some vegetables, salad, etc. Things vary from doctor to doctor, but specific to my doctor, I'm not allowed to have more than 50g carbs, until I get to my goal weight. So, no bread, pasta, rice, potato, fruit or starchy vegetables. Also, no drinking 15 minutes before and 45 minutes after a meal.

That's about it all covered for now. You will definitely have doubts, but if this is what you want and you feel it will make your life better, then do it! However, please make sure you have someone to support you and someone to support them. My partner has been my rock through all of this, but we definitely needed my in-laws to make sure that she slept, had food, etc.

I've included some photos of the hospital room, the food tray they bring you and my incisions. I will update in a couple of days with my progress and thank you all once again for your well wishes. I've appreciated them so much!

I am so happy for you. You will be amazed shortly when you start losing big time.
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Thank you, I appreciate it! It's still going to be a long road, but hopefully much shorter than if I were doing this without my new stomach! :-)

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I was pretty open mouthed through some of that, especially when you said about how much you regretted it. I'm trying to tell myself you had extra pain because of the gb op and your hernia. Plus I'm used to being very immobile so.... ;) I'm so proud of you, you're doing great! It's tough being away from home but your family sound great. Ha you're an Anglo celeb, isn't Admire a cool name! I'm dreading being in hospital without Malc but I'm trying to tell myself I did three years once, I can do a few days. Good for you honey, all uphill from now xxxx
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Surgery Photos

This is just a quick update. I received the photos, via email, which are what Dr. Greene took of my insides, while performing surgery.

The first set are mainly of my hernia. You can see an opening, with fat pulled through it. That is the hernia itself. Luckily mine is just plugged with fat and my colon hasn't gotten tangled up in it, which is what normally happens.

The second set are of my liver and gall bladder. The third set are of my gall bladder once it had been opened, with the stones showing.

Speaking of my gall bladder, I'm having lots of issues with drinking now that I don't have it any more. When a person eats, their liver expels bile, which goes into the stomach and helps digest food and push it along. However, it's your gall bladder that controls how much bile is produced. Without the gall bladder, the liver literally dumps all of the bile into your stomach, which has a laxative effect and gives immediate diarrhoea. Not everyone who has their gall bladder removed suffers like this, approximately 20% do and it seems like I'm one of those lucky 20%!

There are things that can trigger it, like dairy, high fat foods, greasy foods, etc. With me, it seems to be every time I try and drink one of my protein shakes. I'm trying to figure out if it's all protein shakes, or something particular in this protein shake (Atkins Advantage). The problem is that I have a very strong aversion to protein and I tried many, many shakes before I found that I could tolerate the Atkins. So right now I'm not getting any protein, which is an issue. I'm just going to have to keep trying more until I find one that I like, which also doesn't make me sick.

Hopefully the side effects of not having my gall bladder will go away, with time. It just may be a long, slow process. When I go back to see Dr. Greene on Monday, I'm going to ask if there's anything I can do, or take, to stop the effects being so severe.

Surgery pictures, how cool! What is not very cool is the runny tummy effect :( I'm hoping Dr G can either give you something for it or it just clears up very fast. It's a pity you have to try other protein drinks when you finally found one you like. Isopure do a clear drink, fruit flavoured. They are expensive and I think you'll only be able to get them in the US but they might tide you over, I hate to think of the pain the loose bowel movements are causing. It's not like you can run to the loo right now either :( that's a real nuisance but you'll get past it and win!
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Actually, after I called the doctor today they advised me to try some Isopure, until we figure out what's going on with the protein shakes. I've got a bottle of apple-melon here and it doesn't taste too bad. Best of all, it doesn't seem to be making me sick right away. So, fingers crossed!

Most of the pain I get from the loose bowel movements, is because of my hernia. My hernia sits in front of my colon and the colon pulls on the hernia, so it can be painful, but I'm holding up.

Things can only get better, right? :-)

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Whoah! The pictures. I've never seen gall stones. Thanks for the visual. I too had to pick my jaw off the desk. Kirsty, thank you so much for sharing and being so detailed oriented. I know there are so many grateful people who are and will read this to have a better understanding of what to expect. I'm so glad you are getting and feeling better. Waiting for your update was like waiting for the season premier after a cliff-hanger season finale. Loved the first episode. Can't wait to read the next one!

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What to Drink When Protein Shakes Don't Work...

So, since every protein shake I've tried so far as made me sick and given me diarrhoea, I called Dr. Greene's office today to find out what I could do about it. Not only is the diarrhoea making me dehydrated, because I'm not taking in that much liquid anyway, it also means I'm getting zero protein in my diet when I'm supposed to fit in about 70grams per day.

Linda, Dr. Greene's PA advised me to pick up a couple of bottles of Isopure (pictured above). It's a zero carb, 160 calorie, protein packed fruit drink. It has 40grams of protein per bottle and I'm supposed to drink 48-64oz of liquid per day, so I can totally get my protein from it. The only problem I now have, is that I may be able to get my protein, but I can't get my carbs, since it has zero in it.

It's a total juggling act, trying to fit in 70grams of protein and 50grams carbs per day. It's easier if you can drink normal protein shakes, which have both protein and carbs, but even then it's still difficult to do. So, I'm going to try and do some Isopure and some Milk or G2, which have some carbs in them.

I've had about half a 20oz bottle so far and I don't feel sick yet, so hopefully this stuff is working. It comes in a lot of flavours. I got: apple-melon, mango-peach and blue raspberry. It doesn't taste as bad as I thought it would. It has a slight after taste, but nothing I can't get over for now and it's not like I'm going to be drinking it forever.

I have my next appointment with Dr. Greene on Monday, so we'll figure out what to do long-term, then. I need to get something to bulk up my stools in general. Since having my gall bladder removed, everything has been quite loose and it's disconcerting, especially when having to leave the house.

I also has a blood test today. Just a standard CMP (Complete Metabolic Profile), so Dr. Greene can check my kidney functions post-op.

I will most likely update again on Monday, after my follow-up visit and once I get weighed again. That is unless anything happens over the weekend, which I kind of hope it doesn't! ;-)

Yay, that's the ones I saw, it seemed like it would be nicer because I cannot abide milk. What a pity we can't get them here, or at least I don't think we can. And yes, things will get much better, and it's forever too! I'm concerned about the incisions, I have to roll onto my sides to use my sling and I don't think I fancy rolling onto them straight after the op. Never mind, like you said it's not forever and the results are well worth the problems we'll go through at the start. You're a star, you're country is proud of you lol!
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I've had a look in the UK and you can get Isopure whey protein powder, but not the drinks. I'm starting to try very small amounts of protein shake at a time, to try and get my body used to it. It will be a slow process, but hopefully work.

I don't know how the doctors in the UK do the incisions, but I had this really strong glue over mine, which helped keep them together. The doctors didn't seem to mind rolling me around the bed while I was in hospital, so hopefully you won't have too many problems.

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Post-op Follow Up

Today I had another post-op follow up, with Linda, Dr. Greene's PA. First they weighed me and I'm down 19lbs in 1 week. I knew I would lose fast at the beginning, but I wasn't expecting 19lbs in 1 week. It will slow down soon, once I start getting more protein and start eating normal food again, but I'll take it while it lasts!

Linda checked me over and said I was fine: hydrated enough, most of my incisions are healing nicely, etc. She does want me to get more protein, more liquid and a few more carbs into my diet. Honestly, sometimes I just forget to drink. I'll be sitting at the computer, or doing something else and 2 hours will pass where I've forgotten to drink. I have to get better at that! Good thing though, she said I should be ready to fly home on November 3rd. I've had a great time catching up with family since I've been here, but I'm ready to get back home, pick up our dog and get back to a normal routine. We also have guests (my sister-in-law and brother-in-law) coming over for Christmas, so we need to get prepared for that also.

One of my incisions, which is placed kind of in a crease on my abdomen, isn't healing as well as the rest, it's still open slightly. So, Linda just put some steri-strips on it and said it should be fine. I've been keeping it clean with alcohol wipes, so I know it's not infected or anything like that.

My next meeting with Dr. Greene and Elizabeth, the Dietician, is next Wednesday (16th October). That is also the day where I will transition to soft foods. For the first 3 days I will need to ahve 1 teaspoon of food, spaced out throughout the day. It's a routine of 1 teaspoon of food, wait ten minutes, drink for two hours and repeat. After 3 days of that I can move onto 1oz of food and then after another week or so, 2oz of food 6 times per day.

I'm so ready to be off of liquids, especially the timetable of 1oz every 15 minutes. However, I'm definitely not going to cheat and burst my staple line or something. Today Linda told us they recently had a patient taken to the ER in a lot of pain. When they got down there to speak to her, turns out she was post-op day 12 and had decided to eat some chicken. You're not supposed to eat anything until post-op day 21 and chicken comes at post-op day 42. I honestly can't fathom why one would put themselves through this whole process and then cheat, but she obviously had her reasons! I hope she's well and can recover quickly.

Well, that's about it for now. I will most likely follow-up again next week, after my appointment on Wednesday. I'll take some new photos then to upload and see if there's a noticeable difference in my body shape from 3 months ago.

Glad everything went well for you. I look forward to hearing your progress as time goes on!!
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Thank you, I'll be updating very soon!

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How are you doing these days?
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Post-op Week 5

It's been a while since I last updated. Right after I got home from my last doctors visit, on October 16th, I threw my back out and have since then been laid up in bed trying to fix it. It's still sore, but I'm managing to get up and about a little bit. Currently sitting at a desk for the first time in 2 weeks, so I thought I should take the opportunity to post a quick update.

When I had my last appointment with Linda, Dr. Greene's PA, everything was looking great. I had lost another 10lbs, since my visit 10 days prior, which is great. In total that's 90lbs since June and 35lbs since surgery. I'll get weighed again on Friday, so keeping my fingers crossed for another decent loss.

My incisions are almost totally healed. Linda said it would be okay for me to go into a swimming pool or hot tub now, but I think I'll leave it another couple of weeks, until I'm happy that no infection would get in.

I started eating on Wednesday 16th October. I started off with 1 teaspoon or food, 6 times per day and then once I knew I could take 1 teaspoon, after 4 or 5 days, I moved up slowly until I reached an oz, 6 times per day, which is what I'm currently still doing. In all honesty, I probably only get food 3 or 4 times per day, not 6. I'm still struggling to fit everything in: food, 48-64ozs liquid, 70g protein and 30-50g carbs. I'm really lacking in the protein department, but it's better than it was. I'm currently staring at a peanut butter/vanilla cake batter protein shake, which has been sitting on my desk for 20 minutes. Protein shakes are thicker than G2, water, Crystal Light, etc. So, they're harder to get down and it takes much longer to finish them. My stomach is telling me I'm full right now, so the protein shake will have to wait a while longer.

I've also had a lot of nausea over the past week or so. I don't know if it's because I've been in bed with my back, so eating and drinking while lying down makes it more difficult for my stomach. I had some nausea pills left over from surgery, so I've been taking those, which have helped.

I've added a bunch of photos, to show what vitamins I take and what my food and drink has looked like over the past 2 weeks. As soon as my back is better I'll take some more full body shots, to see if there's a difference from the June shots I already have up.

My next doctors appointment, on Friday, will be my last for a while, as on Sunday I fly back home to England. Dr. Greene will just make sure that I'm taking in enough, incisions are good and I know the next steps in the process. Once I'm home I'll follow-up with my own doctor. I will be returning at least once per year for the first 5 years, so that I can follow-up with Dr. Greene. I'll also be keeping in touch with him and his office via email and Skype.

About 4 days after I get home, at day 42 Post-op, I'll start introducing other foods into my menu, such as: chicken, pork, raw vegetables, salad, etc. That seems a little daunting at the moment, as I'm only just managing to keep soft foods down, but we'll see how it goes. If it takes longer than 42 days, then I'll just take my time until I'm ready.

I'll probably post again on Friday/Saturday, once I've had my final visit with Dr. Greene and hopefully I can post some more full body shots then also.

I hope you're home and well and the journey wasn't too much hell on your back. I wished you could have delayed departure.
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Thank you a million times for the pictures of your meals. They have made me so excited. They look like something I might leave on my plate after I've eaten and so I am thrilled by the thought I may some day eat like this, even find it hard to eat this much!!! I like the look of everything you have there, so I can't foresee problems with that, but the protein drinks sound vile still. Sorry! I don't think I could eat that often either. I have a fatigue issue linked to my condition so I often don't wake until 12 noon, I wouldn't have enough day left :) I'm so pleased you're doing well, the back pain came at the worst possible time! How is the bile issue now, better I hope? You're doing so well, when you come home and see friends you haven't seen for a while they'll be astounded! Just think, the next time you go to the States your inlaws might not recognise you either. I think you're doing to be one of Dr G's huge success stories! Xxx
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Hi Allie, as always thank you for the positive words! :)

I'm still nauseous, but I think it has more to do with me trying to eat/drink while laying down, than anything else.The back is sore, but Linda, Dr Greene's PA, has written me a prescription for an anti-inflammatory and tomorrow she's goimg to write me up for a muscle relaxant. Hopefully they will start working fast.

You'll be amazed at how little you eat, or want to eat, after surgery. Where as some of us may have previously picked meals based on how much food is served, now you take 3 bites and you're full. It's so weird and things I used to like, now make me want to vomit, It's like everything I knew about my own tastes has changed and I'm learning to eat all over again.

How are you doing these days?

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Final visit with Dr. Greene at 6 Weeks Post-op and Finally Home!

On Friday I went to my last appointment with Dr. Greene before flying home on Sunday evening. They weighed me and I lost another 12lbs, which makes it 50lbs since surgery (5 weeks post-op at the time) and 102lbs since June 2013.

For the past 10 days I've had this constant nausea, which results in me vomiting once or twice per day. However, post-op vomiting (and this may be TMI) seems to be very weird compared to pre-op vomiting. I don't vomit any stomach acid, because the pills I take remove almost all of my stomach acid and I only bring up a tiny amount of liquid. It's mostly the retching that hurts my abdomen, more than the vomiting itself. The nausea seems to be settling down a little bit now. They said it's probably just gut hormones, taking a while to get used to my new stomach, but if it goes on for too long, I'll need to have my stomach checked to make sure there are no leaks, etc.

While I was there they also checked out my back for me, which they didn't have to do but I appreciated it. I have a muscle spasm at the base of my spine, which is causing all of the pain. They prescribed me some Valium, which is apparently used as a muscle relaxant and it seems to be working. I'm still sore and slow moving around, but it's definitely getting better and it got me through the plane ride home, which I'm thankful for.

I'm still not eating enough, but I'm getting better. I'd say on average I'm having 3 or 4, 1oz meals per day, but they want me to have 6-8 meals per day, so I need to work up to that. It's just a little difficult when I also have nausea. I'm still trying to up my liquids too. I need to get up to at least 50oz per day and I'm probably at about 30. I did a lot of research before having this surgery, I spent about 2 years researching everything, but the post-op struggles definitely took me by surprise.

Tomorrow is day 42 post-op, which is when I'm supposed to start incorporating things like chicken, pork, and raw vegetables into my diet. I'll take it slow though, maybe start with pulled chicken, cooked in the slow-cooker, so it's super soft to go down.

I flew home Sunday evening, getting into Heathrow on Monday morning and then catching a short flight up to my home town. I'm so glad to be home, I feel like I can start to get into a normal routine now, plan my meals and drinks and start to make progress that way. I need to folow up with my family doctor now I'm home, but that can wait for a few days. I'm still in contact with Dr. Greene's office, via email, phone and Skype and I have to travel back there once per year for the first 5 years.

Spending 3 months in America and catching up with family was really nice, but I'm so happy to be home. Our house is so quiet, it's only me, my partner and our dog, Maggie and I love it! We got home, picked up Maggie from my parents house and then locked the front door and breathed a big sigh of relief! I think I'm getting old though, because after 3 months away I forgot our alarm code, I couldn't find the flush for the toilet (ours is on top of the toilet instead of a handle) and I kept looking in the wrong kitchen cabinets for things I needed!

Once I take a shower and I no longer look like a girl that's just travelled 3500 miles in a flying pringle can that's full of germ breeding passengers, I'll take some more full body photos, so I can compare them to the photos I took in June and we'll see if there's any noticeable difference.

102 pounds is amazing, you are the poster child for success.  How was the chicken?

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Chicken was good, I had it twice yesterday and kept it down. Had a little piece of omelette this morning though and that came back up. I don't think my post-op stomach likes egg anymore.

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That reminds me of pregnancy.  Normal foods all of a sudden become revolting.  Hopefully as your body gets use to all these changes you will be able to keep more foods down.

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7 Weeks Post-Op - Updated Photos

Well I'm at 7 Weeks post-op and I'm doing so much better than I was, even from a week or two ago. The nausea is all but gone, only coming back when I maybe don't chew my food enough, eat/drink a little too quickly or put too much in my stomach.

I can drink almost like a normal person again. I drink from a normal bottle or glass, instead of measuring devices and I can drink a good amount of liquid at one time. I will never be able to chug, like I used to, which I sometimes forget, but I'm glad I don't have to sip any more.

I still don't get the 6-8 meals per day that they want me to have, but I can eat 3 2oz meals and I just try to get as much protein as possible in those meals. I have also started introducing 1 or 2 "snacks" in the form of a protein bar. This helps me get my protein as I still can't stomach the shakes.

If I forget to chew enough then I feel a lot of nausea and some pain. It's normal because at its biggest part, my stomach is only a 1/2 inch wide, so If I try to swallow something that isn't smaller than that, then it gets stuck. Also, if I eat too quickly I regret it as it tends to come back up.

I'm now eating all the normal foods, apart from red meat. It goes down well if the food is moist, but if there's a dry piece of meat or something like that, then I have to spit it out as no amount of chewing is going to make it go down.

All in all though I'm doing so much better than I was, starting to feel like my old self again. I'm even cooking again. I'm starting exercise again today: going swimming tonight and we've just bought our dog a little doggy coat (she gets cold in the British winters) so we can start taking her for longer walks.

I've added some Before/7 Weeks Post-op Photos. There's not too much of a difference yet, but I can definitely see things like: there's actually a waist showing up, some definition to my body instead of one big lump, my clothes look a lot looser, etc. The real difference is in my face, my double chin is going away and I have cheekbones, but I'm not quite ready to show a full frontal face photo.

I actually bought some new trousers on Monday (online, I hate going shopping!) and have had to send them back. I got my normal size and when I tried them on I looked like I had clown pants on, they were so big!

I haven't weighed myself yet, since the last time I went to see doctor Greene, so I'll be doing that soon.

Looking forward to an update!
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Hey Kirsty! it's been a while, what are the numbers looking like now, and more importantly, how are you?
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Gosh, looking at these pictures (especially the hospital ones) remind me how far you've come. You're doing SO well. I'm your #1 fan and we're all so proud of you.
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4 Months Post-Op - Updated Photos

It's been quite a while since I updated. I keep meaning to and then life, and work, gets in the way and I just don't get around to it. So, here we go...

Stats to date:

  • Weight loss
    • Pre-op (From June 2013 - September 24th 2013) = 52lbs
    • 5 days Post-op = further 8lbs
    • 2 weeks post-op = further 19lbs
    • 1 months post-op = further 10lbs
    • 5 weeks post-op = a further 12lbs
    • 4 months post-op = a further 40-50lbs*
  • Total Pre-op = 52lbs
  • Total Post-op = 89lbs
  • Grand total, so far = 141lbs*

*The asterisk is because my latest weigh in was on normal bathroom scales, which are slightly less reliable than the economy size scales that are used in bariatric offices. So my last weigh in was between 40-50lbs. I'm taking the lower number, just to be on the safe side.

I'll add photos also. I try to wear the same clothes, in all of my photos, so I can tell when they're getting bigger. The photos are my before (June 2013) and my current after (January 2014). I can definitely see a change in shape and the clothes are getting bigger and longer on me, so it's still working!

Since I last updated we've had the holidays, which was being hosted at my home, and we also took a pre-Christmas trip to France with my sister-in-law and her husband. I thought the holidays and traveling would be difficult, food wise, especially since I was cooking. However, it was actually fine. When it came to Christmas dinner, I had spent the whole day cooking and actually didn't feel like eating anything at all. I think I had one small slice of ham and a smaller slice of turkey, and that was it. 

Traveling was fine, just a little weird. At the moment I feel weird eating out, because I eat so little that I feel rude when the servers come to take my plate away and it's still pretty full. Luckily, my brother-in-law helped finish off most of my leftovers while we were in France. When we're eating out at home, I usually bring leftovers home with us and they make another 5 or 6 meals. Although, I usually get sick of that particular food by the end and end up throwing it out.

I don't really get cravings and I have no trouble from staying away from the things that I can't eat. It's easy to stay away from things, but harder to break old habits. I've always been a grazer, so while I cook, I graze and that poses two problems. 1) Most of the time I'm not consciously aware that I'm doing it, 2) If I graze, I can't eat a meal. Luckily, most of the time, the things I graze on are foods I can eat. Although at Christmas I was making brownies for the family and without even thinking, I licked brownie mixture off of my fingers (after putting them in the oven, for all the germaphobes) ;-) and I was quite sick. I haven't had sugar in so long and I got a really bad headache and felt quite dizzy. It passed after an hour or so, but I learned a lesson!

I do need to get the grazing under control though. I do it without thinking. I'll be preparing some salad, or chicken, and I'll nibble as I'm preparing and then I go to sit down to eat and I can't because I'm full. My partner tries to catch me and make me aware of it. It's definitely a process though. I'm trying to change 30 years of conditioning and it takes time.

I'm also still horrible at remembering to eat, take my pills/vitamins and drink enough fluid. I will give you a breakdown as best I can of what a normal day is like, if I do everything right.

*Disclaimer* sometimes I'm not the best role model. Because I don't get hungry, I just sometimes forget to eat and sometimes I forget to drink. If I start working and get into a roll, then I have been known to go 10-12 hours without something to eat or drink. This is where having a partner comes in handy, so they can nag you! Haha!

If I remember to do everything properly and get everything in, then it looks something like this:

  • Morning - Protein bar (I can't tolerate protein powder right now, so to give me the initial protein boost, I eat a protein bar). It usually takes me about 45 minutes to an hour, to get through a full 50g bar, depending on the brand.
  • About 30 minutes after the protein bar - Drink a sugar-free squash (something like Crystal light will do). I have about 10oz and can get it down pretty fast now, so it takes about 30-45 minutes.
  • Lunch time - something like 2 mini crustless quiche (made in a mini-muffin tin) with a very small handful of salad leaves. Alternatives may be: 1/4 chicken breast, 5 homemade chicken wings, 4 or 5 shrimp, etc. I would serve any of those with some salad leaves.
  • I'd then try and repeat my drink from mid-morning. I'd try and do this another 2 times before I eat again, to get enough liquids in.
  • Dinner - Something like: 1/4 of an omelet with cheese, 1/4 chicken breast, 2-3oz of baked fish, 3-4oz of homemade soup. I would serve this with something like a small amount of vegetables, such as broccoli, turnip, carrot, etc.
  • Then I'd try and repeat one more drink. I may have semi-skimmed milk, instead of the above squash drinks. Sometimes I'll have a low-carb cocoa.
  • In the evening, if I feel like it, I may have a 1/4 cup of fat-free jello pudding, or a 1/4 cup of sugar-free jello or a sugar-free Popsicle. Occasionally I'll have some almonds or walnuts (about 6-10).

I also have to take 5 pills daily. Four are vitamins (Calcium, vitamin D, multi-vitamin and Biotin) and one is to reduce stomach acid.

Like I said though, I'm not perfect and sometimes it takes a lot of well-intentioned nagging from my partner, to get me to eat and drink. I know I don't eat enough, so I have to work on that and on the drinking.

Every doctor is different, but these are the main rules set out for me, by my doctor:

  • Every day: 70-90g protein, 30-50g carbs, 700-900 calories
  • No heavy carbs: potatoes, pasta, bread, fruit, cereal, crackers, beans, lentils, etc.
  • 5 pills daily: mostly vitamins
  • 45-64oz liquid daily: all sugar free
  • No alcohol
  • No fruit juice
  • No caffeinated liquids

I keep forgetting to take photos of my food, so tomorrow I'll try and take a photo of everything I eat and drink. I'll upload the photos tomorrow night.

I still go swimming once per week. Actually I got the coolest pair of pool shoes for Christmas... who knew they made shoes to wear in the pool? Now I don't have to walk on icky, wet tiles where hundreds of other feet have tread! I also need to start doing more exercise through the week. I've had a cold, which went to my chest, but I'm in the home stretch now, so as soon as it's gone I'm going to start boxercising again, twice per week.

Still putting off buying new clothes, because I still have a lot to lose. However, I have clothes I can transition into. Things like my winter coat are REALLY big now though. I'm glad spring and summer are on their way. By the time winter comes around again, I'll probably have a couple of bags of clothes to donate.

Oh and one more thing, before I finish up... I have collar bones! I swear they weren't there before! Haha!

I love reading your updates!!! Thank you so much for all the details - I hope you know how much this helps prepare me for what lies ahead! I'm roughly following the same daily diet rules that you have (I try to keep my maximum carbs at 20-25 per day) - but I do this to get myself prepared for life after surgery. My hope is that the transition from pre surgery to post surgery will not be so drastic that I put myself into a depression. Please keep us posted - Congratulations on the wonderful weight loss and finding your collar bones (I look forward to finding mine someday)!!
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Thank you. :-)) Just another few months for you, right? July? It will be here before you know it!

Be careful with keeping your carbs so low. My doctor doesn't advise under 30, because you need enough carbs to give you energy and not make you sick. It's great that you're preparing though, it definitely makes the transition easier, if you start pre-op.

When do you start your pre-op diet?
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Love your update with all the great details. Your photos are starting to look like 2 different people side by side. Congrads on the collar bones...that's really exciting. Looking forward to your meal/food photos. You're doing an amazing thing for yourself and your family!
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Quick Update with Some Food Pics!

Photo 1: Ground Turkey with onion, celery and carrot in a marinara sauce with a sprinkling of Parmesan. There's about 1/2 cup in the photo and that's all I can really eat. I probably struggle/don't eat the last bite.

Photo 2: Roast chicken with sliced cucumber and a low fat dressing - What I started out with and what was left.

Photo 3: Chocolate chip protein bar. I try to eat one per day because I can't tolerate protein powder yet. You have to be careful of the carbs though. This has 20g protein, 15g carbs.

Photo 4: Home-made Pizza: One small (7in diameter) low carb fajita, with home-made pizza sauce and a sprinkling of cheese - I can eat 3/4 of this

Photo 5: A typical glass of squash (something like Crystal Light) - Approx 10oz liquid per glass - take sme about 30-45 minutes to drink this.

Photo 6: A cup of low-carb cocoa (photo bombed by Maggie, our dog) - I can usually only drink half of this. Cocoa is a lot heavier and more filling that water/squash/milk, so I'm not usually able to drink it all.

Photo 7: The pills and vitamins I have to take daily

Photo 8: My encouragement for taking said pills - smiley stickers! The days without stickers are where I forgot/didn't take my pills. Apparently this method works for adults too... or maybe I'm not yet considered an adult!

I gave up chocolate for Lent and I wasn't 100% successful. I can see how a lifetime of eating habits can be hard to change. I've also started exercising again and I'm putting a sticker on my calendar for each day I exercise. Thanks for the great idea. It really helps!

I'm with the rest of the community...we'd love an update, even a quick one! 
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Good job! Keep going girl:-)
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Thank you, I appreciate the kind words! :-)
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9 Months Post-op Update - More Photos, More Weight Loss!

It's been a while since I last updated (4 months), so I thought it was about time to add a quick update a few photos of me at 9 months post-op.

I don't tend to weigh myself at regular occurrences, in fact, I only weigh myself every couple of months. However, I can tell that I'm still losing weight through other things, like: I'm finding so many more bones than I thought I had! Wrist bones, shoulder bones, ankle bones and the latest discovery, ribs! Who knew I had a rib cage? I certainly didn't!

My clothes are also shrinking, or I'm shrinking and my clothes are getting bigger as a result. I've now gone down a couple of sizes in shirts/t-shirts and 3 sizes in trousers. I would be able to drop more sizes on the top half, if it wasn't for my umbilical hernia, which is huge. The more weight I lose, the more pronounced it becomes. I still have to wait to lose a few more pounds before they will fix the hernia.

I'm also noticing how much fitter I am. It's easier to do every day things, like walking. I don't get tired out easily, large inclines don't daunt me, my feet don't hurt after a day sightseeing, swimming is easier (although I need to get a new, smaller swimsuit, or the other swimmers are going to see more than they bargained for)!

So I weighed myself a few days ago (there's a really funny story around being weighed), at the end of June and 4 months after my last weigh-in. I have lost an additional 46lbs, which puts my total weight loss to date at very close to 200lbs. I have also dropped 30 points on my BMI, which is awesome. I'm hoping to drop another 60lbs by the end of the year, so around 10lbs per month and then after Christmas I can hopefully have my hernia fixed and there's a slight chance of also having a panniculectomy at the same time, but that depends on the surgeon.

So, the funny story. We went to London Zoo this past weekend for my partners birthday. Walking around we headed to the Gorilla section and we came across this giant scale that showed what a Gorilla weighs. You could then weigh yourself and compare. So, since I hadn't weighed myself in a few months and my review needed an update, we decided to both weigh ourselves. While I'm happy with the extra 46lbs I've lost, and 200lbs total loss, lets just say me and the Gorilla are still too close for comfort... onwards and upwards! Ha!

Food/drink wise, I'm still a horrible drinker. I don't take in enough liquid and as a result I'm often dehydrated, or sometimes dizzy. I'm trying to work on drinking more, I just never want to drink, so it's hard to motivate myself to do so. I still can't tolerate protein in powder form, or in drinks, so I get my protein from food (chicken mostly), or from protein bars. Protein bars have more carbs than protein powder, but they do allow me to get my protein in, which is the more important issue. I can eat slightly more at each serving now, but still not a lot. Protein dense foods, such as chicken and turkey fill me very quickly. I can eat more of things such as salad and vegetables, but they don't give me anything that I need, so my diet is mostly meat. My partner is vegetarian, so prior to surgery I would usually only eat meat about twice per week, so that I didn't have to cook two separate meals, however, now I eat meat several times a day and it's really getting old.

I'm better at taking my vitamins now and take them, probably around 90% of the time. My hair loss has slowed down a lot, which is probably due to A) getting more protein and B) regularly taking my Biotin.

I do need to exercise more. I walk a little more and swim once per week, but I really need to up my exercise more. It's really just getting into a routine. I'm somewhat of a work-a-holic, so If I'm home, I'm usually on the computer working and I just don't make time to do other things, such as exercising, but I need to.

I'm adding some photos of front, back, side and face comparison shots (please excuse the messy hair... I'm not sure what was happening then). I'm not sure how much of a difference you can see in the body shots, because my clothes hide a lot of the shape differences, but I can tell in my facial shots.

I shall try and update sooner next time! :-)

Kirsty: I'm so looking forward to your 1 year review. You have done amazing and I can't wait to see what's happened with you the past 3 months (since your 9 month review).
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Hi Christy, you look amazing! You are an inspiration to many. My sister has a thyroid condition that made her gain weight. You have overcome so much. God Bless you.
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Thank you, I appreciate the kind words!

Is your sister having WLS?
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Rockville Bariatric Surgeon

I thoroughly researched Dr. Greene and he is a very experienced bariatric surgeon. He is board certified and a member of ASMBS (American Society for Metabolic and Bariatric Surgery). His office has been classified as a Bariatric Center of Excellence, which means they have to meet a whole host of guidelines and continually meet those requirements, to keep their designation. Now that I'm post-op I cannot say how much I highly recommend Dr. Greene and his whole staff. They are all there for you, 24 hours a day, literally! Dr. Greene is an excellent surgeon and more than that, he cares about his patients and does whatever he can for you. I would never tell you to choose a particular surgeon, that has to be a personal decision. However, I will say that if you have an opportunity to go to Dr. Greene, at least have a consultation and make up your own mind, he's worth it in my opinion.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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