Approaching 70 Yrs Old and Tired of the 40+ Year Battle with my Weight! - Birmingham, AL

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Had a consult in mid-September with a weight loss...

Had a consult in mid-September with a weight loss surgery center, but was unhappy with the negative attitude of the doctor, as well as the lack of information regarding insurance coverage from the staff, so I let them know I wouldn't be back. Discovered a major university hospital nearby has a bariatric surgery department, and have had nothing but a positive experience with the staff and the surgeon. My first appointment with them was on October 17. I was scheduled for fasting blood work and then an appointment with the surgeon. The meeting with the surgeon was what I originally expected. He is very personable, took the time to answer all my, and my wife's questions, explained in detail the process, including his timeline for recovery, and made us feel very comfortable. On October 19th, I received a message from him that my labs were A-OK; and yesterday, I received a call from his office that they've scheduled my barium swallow and cardiac clearance for mid-November. I am very busy the last three months of the year, and asked that we not look at surgery until after the first of the year, so we're proceeding on a relaxed time schedule. The only requirements I'll have to complete after the November appointments (both on the same day), will be to meet with the nutritionist and attend make an initial meeting with their clinic support group. After fighting the see saw battle with weight for the past 40 years, I have a very positive attitude toward having the surgery and hopefully watching the hypertension, diabetes, not being able to climb stairs, aching knees, not being able to get down on my knees, or get up off of them; and most importantly, not being able to have the mobility and energy to keep up with my wife and my two grandchildren. I have no estimate of the cost, as it's all covered by Medicare and my supplement. I am 69, 6' 2" and weighed in at 326. "Before" photos will be uploaded soon.

and the walk to better health continues

I've now got a couple of dates circled on the calendar - November 21 I'll have the Barium Swallow test done at 8 AM, and the cardiac clearance at 10 AM. On December 5 I'll attend the first of several required support group meetings.

All pre-op requirements almost done...

Had the barium swallow on November 21st, and all is well. The cardiac clearance turned out to be a meeting with the cardiologist, where we discussed my previous labs and history. He also scheduled me for a treadmill stress test on December 13th, which will complete all pre-op requirements. It will be just a matter of setting up the date in January for surgery....

Pre-op is done!!!

On December 13th, I completed the treadmill stress test! Yay!!! Was glad to get that done - the option was an injection that does to your heart what you do on the treadmill, but it comes with side affects that aren't all that pleasant (so they said). I had to return today (12/22) for "Day 2" which was the cardiac imaging "at rest". It didn't take very long, and I received a call later in the day from the cardiologist that I'm fully cleared for surgery now. Next step? Schedule the surgery, meet with the nutritionist, and begin the prep diet. Both my wife and I gave up bread, etc., a year ago, so that's not on my diet, and I have been essentially salt free for years. Depending on the surgeon's schedule, I'm thinking of having the surgery on my birthday - what a great way to mark turning 70!!

It's on!!!!

Just received my pre-surgery schedule......everything is a go!! Initial appointment with the nutritionist on 1/9, follow-up on 1/23. Pre-op to sign papers for surgery, weigh in, current medical history on 2/2 in the AM. Pre-admit testing to determine which of my meds I can or can't take the day of surgery on 2/2 in the PM. Start 2 week diet on 2/8: 4-5 shakes a day and meal in the evening. On 2/21, day before surgery, shakes only. Surgery scheduled for 2/22!!! Post-op follow-up visit on 3/2 .........

Another step forward....

Both sessions with the dietitian have been completed. Have the pre-op and post-op diet plans in hand. Post-op session was this past Monday (1/23), and was very informative. Their post-op diet is in 4 phases: Phase 1: clear liquid (day following surgery); Phase 2: 2-14 days post-op; Phase 3: 15 days-3 months post-op; and Phase 4: 3 months to life post-op. We're going on a cruise during Phase 3, and are planning now for my meals, etc., as we've obtained the ship's menu's and looking at what I'll be able to carry with me. Exciting times!!

Halfway through the pre-op diet......

I'm halfway through the pre-op diet and on track! By our digital bathroom scale I've lost about 10 lbs. Nothing was specifically said about "how much" I needed to lose, only that the diet was about thinning out my liver in order to make the surgery and recovery easier. I've increased my liquid intake significantly over what I previously drank, which is a very positive step; and have not cheated on my meals, ensuring I was within the limits established for the diet. I've got one more week on the pre-op, then a day of all shakes before surgery on the 22nd. I've been advised by my pharmacist that all but one of my meds is chewable, so that's a relief.

If you're reading this, are over 65 and on Medicare, and considering a VSG - go for it!

The last day before the first day of the rest of my life!!

Last day on the pre-op diet, and I have lost 20 lbs! Start weight was 328. This afternoon, I weighed 308. That translates into an easier and safer time for the Dr., and an easier recovery for me!! Have had three of my 5 shakes for the day - no food at all today! Nothing but water after 10:00 PM, and nothing at all after 5:00 AM in the morning except a swallow of water to take the two prescriptions the anesthesiologist said to take. I have to be at the hospital at 9:00 AM, but have no idea when they'll actually take me back to the OR. It's about a two hour operation according to what his assistant said when she called this morning...I'm excited! Let's just do this!!!

Photos - start of pre-op diet, and end of pre-op diet

Started the pre-op diet on February 8, and using Excel 2016, documented every calorie, carb, protein, sugar, and liquid I consumed. Liquids did not include the protein shakes, but just the coffee & water.
Used Atkins Protein Shakes & EAS Protein Shakes primarily, with a Premier Protein thrown in if I didn't make my protein goal for the day. By the end of the first week, I'd lost 10 lbs, weighing in a 318; and on the last evening when I ceased all intake in preparation for arriving at the hospital at 9:00 AM the following morning, I had lost another 10 lbs, with my final pre-op weight at 308. Attached are the pre-op beginning and ending photos. The "before" photos are in the yellow shirt.

What a roller coaster ride I had!!

I arrived at the hospital at 9:00 AM on Wednesday, February 22. By 10:00 AM I had been taken to the back, changed into a gown, hairnet and slippers, and was waiting for the next step in the process. Nurses and Patient Care Techs were in and out of the cubicle until finally I was rolled down the hall, around the corner to the patient elevators where we went up a couple of floors, then down a long hall to the OR. The nurse anesthetist, whom I'd met earlier was there, and put me to sleep. According to what the surgeon told my wife, the surgery was textbook, all went well, I was in recovery and as soon as they had my room ready, she'd be escorted up to it. The University of Alabama Hospital encompasses several buildings with over the street crossovers, so where you check in, where your surgery occurs, and where your room is may all be in separate buildings - which it appears, was the case for me! My room was on the 7th floor of the Spain building, one or two buildings removed from the hospital itself, but still part of the complex! I can't say enough about the professionalism, personal attitudes, friendliness, and helpfulness of the entire staff - from those assigned to simply wheel you around, to the surgeons, nurses, and other professionals who cared for you! The entire facility is spotless as well! Wednesday evening was uneventful - I had no pain to speak of, and only pushed the button for pain medication twice! I was sore, due to their using Co2 to inflate the abdomen during the surgery, which distends the stomach, and stretches the muscles. The Co2 is absorbed by the body afterward, but you're sore for a day or two after. I want to point out here that I had not had had any fluids after 10:00 PM on Tuesday evening the 21st. When I got to my room on the evening of the 22nd, there was a note on the white board that I was to have nothing by mouth - no ice chips, no water, Nada! When I inquired about that, I was told that I would have a barium swallow test Thursday morning, and if it showed no leaks, I would be discharged Thursday afternoon. However; not having anything since Tuesday evening, my system suddenly was experiencing dehydration, and my BP readings, even with the bags of IV fluids, were dropping. I had voided a couple of times, but it wasn't of any quantity - the result of not much in, resulting in not much out. About 4:00 AM, I woke my wife and asked her to get the portable urinal. As I turned to sit on the edge of the bed, I apparently lost consciousness and fell onto my face alongside the bed. I skinned up both knees, and was laying next to the bed, unable to help myself. My wife said I was damp, clammy, and sweaty. She called for the nurse and before long there were about 6 Doctors and nurses in the room, They had to get a Hoya lift to get me back into the bed, and of course a full assessment was done as they worried whether I had damaged my newly created stomach, or was bleeding internally, etc. While I was on the floor, they took a manual reading of my BP and it was somewhere in the 40/22 range - not very far from the critical, even terminal point! During the day, the readings increased, my output volume increased, they plied me with bags of IV fluids, but decided that I needed to stay overnight until Friday - which as that point was fine with me!!! My surgeon put me on the Phase One diet that day to stave off any further dehydration, and scheduled me for the barium swallow test Friday morning just as a "formality". I did very well through the evening, and with the barium swallow in the morning. I was released to go home and begin the Phase 2 diet shortly after Noon on Friday, Feb 24th.

We arrived home close to 3:00 PM, and within a short period of time I was asleep in my own bed! I nursed an 8 oz bottle of water through the night, and woke around 9:00 AM this morning (the 25th) still somewhat sore, but much more rested. I've had yogurt, vegetable broth, water w/Mio in it, and Premier Protein shakes, all at the recommended doses. I've started a new journal using EXCEL for Phase 2, and will continue it when I move to Phase 3 next month.

IMPORTANT NOTE for those planning surgery: Speak with your surgeon and health care team about your fluid intake right before surgery; and what they're going to do after surgery! Bariatric surgery is not like other procedures, where there's a large cup full of ice & water on your tray table next to your bed! If you can have fluids up until a few hours before surgery - by all means, drink as much as you're allowed to avoid any possible dehydration problems after surgery until you can start on Phase 1 diet.

Do I have any regrets? NO!! Would I do it again ? YES! The life long benefits far outweigh anything else! I am now looking to being a healthier husband and grandfather for my wife and two young grandchildren!!!

Moving forward again..

As I wrote previously, after my bout with deydration, Dr Stahl moved me into Phase 1 prior to the barium swallow test in order to get both my fluid intake and output back in sync. It took some time, but by Noon on the 24th, all vital signs were in normal ranges and I was released shortly after the swallow test. .....and the beginning of the long post-op adventure! I've had no pain, and other than the soreness from my fall out of bed early Thursday morning, have had no physical after affects. I am quite bruised on my right side, but that's because I sleep on that side and the capillary bleeding that comes after surgery has pooled there. Looks pretty ugly, but I saw my primary yesterday and he said it'll all absorb and be gone within a few days. I did have to have him re-dress the large incision area as the glue & steri strips weren't holding well and it was leaking a bit. It's now 34 hours past that, and everything is in place and holding. I have a follow-up visit with my surgeon on Thursday morning and will have a better idea when I can stop the sponge bathing and get in the shower!!! As for my diet - my wife has been a jewel! Even prior to the pre-op diet, she had purchased "Munchkin" toddler spoons, small 4 oz cups, and a wide variety of bariatric foods for the different phases! I'm having no problem tolerating Yogurt (which I'd never eaten in the past, and between Propel, Mio and Powerade Zero I'm making my daily liquid intake!! I'm a little behind in getting the protein grams in but think by the end of Phase 2 next week, I should be on track. Went walking yesterday around our local Wal-mart, and around our cul de sac today where I was steadier than in the store. As I progress, I'll add distance, and plan on having a good program of walking and using my recumbent stationary bike in place. More to come......

OK.....here's the bruising!!!

In some of the video's I watched of the VSG procedure, the large incision, often with a port in it for a day or two afterward was generally on the patient's left side. I was surprised when I came to and gathered my faculties that I didn't have a port, and that the large incision was on the top right center of my belly! It's the one I had to have my primary physician re-dress due to some leakage. I've attached a photo with numbers showing where the incisions were - two of them are on my left side and not in the photo. The bruising is starting to subside, but will probably be next week before there's much of a difference. I just took my BP and Glucose readings -- and after NOT having been on either of those meds since last Wednesday, the day of my surgery, I'm encouraged in that I may be seeing the end of having to take either or both of them! My BP is 147/74 and my Glucose is 95 - both within very "normal" ranges.

Weight dropping....Glucose dropping......

Weighed 290 last night - that's 38 lbs since February 8th when I started the pre-op diet! Weather hasn't been too conducive to walking, so other than rambling around Wal-mart and Academy, I haven't been able to get my half-hour each day outside accomplished. With the weight loss, and the diet restricted intake of calories, my Glucose readings have been between 84 and 95 for the past week. I'm only taking one Metformin a day now, and that's at night, so things are going in the right direction. Dr. at UAB changed by BP meds, and I'm getting the new one into my system, so am watching for my BP readings to start falling as well. Hoping by the end of the three month Phase 3 diet that I'll be off of both Diabetes and BP drugs!! Bruising has all but disappeared, and the incisions are healed. Still working on my diet - am finding chicken is not one of the things I can eat right now - even when it's pureed in a blender it still is giving me problems ...so will give it a rest and try it in a few weeks. Staying away from any kind of beef, but we have a freezer full of venison and I've not had any problems with digesting it.....and so we continue.........

5 weeks post-op update....

5 weeks post-op and my weight continues to drop. Adhering to the prescribed diet is a big plus - don't let yourself go at this point - you haven't reached your goal! Weighed myself on Wednesday, March 29th, which was my 5 week post-op anniversary and I was down to 280!!!! That's 48 lbs since I started this whole life changing event on February 8th with the pre-op diet. My wife got several pairs of jeans from storage - 48 waist - that I'd put away thinking someday I might need them, and they fit just perfect - in fact, I don't think it'll be too long before I'm having to buy some 46 waist sizes! That's down from a size 52 waist that I've been wearing for the past couple of years!! I'm having to constantly remind myself to eat and drink - when you don't have those hunger or thirst feelings, you don't think about it, which if left unattended can land you back in the hospital for IV fluids! Pinterest has awesome bariatric recipes, and getting yourself a Spiralizer and creating noodles, etc., from a variety of vegetables is a lot healthier than pasta (which isn't on the diet anymore) and no noticeable difference in flavor!! If you're having to crush your meds - here's a tip: We had a small pepper grinder that wasn't being used. I cleaned it out, crushed a couple of Tylenol just to be sure no pepper residue was left, and have been using it to crush my meds - I now get a very fine powder that goes down very easy with a mouthful of applesauce!!

and the numbers just keep on droppin'......

April 3rd .....weighed myself after my shower this morning : now 278! I have lost 50 lbs since the day I started my pre-op diet! 38 lbs since my discharge from the hospital!!
My blood sugar readings are consistently in the upper 80's/lower 90's, and my BP is coming down too. I knew the blood sugar would drop faster, especially with the diet I have to follow!!

and the weight loss continues...................

May 5th, 2017 .....................hit the scale after my shower......264 lbs!! That's 64 lbs since my pre-op weigh in on Feb. 8th, and 44 lbs since I was discharged from the hospital on Feb. 24th! I've "shrunk from a 52" waist to a 46" waist.......and I'm not done!!! We went on an 8 day cruise to the Southern Caribbean, that included 4 ports .....and I'm PROUD to say that I weighed the same when I got off the ship as I did when I got on!! Remember - the surgery is just a tool - the rest, and willpower, is up to you!!

More to come............

3 months post surgery!!

I now weigh 252 lbs -- that a 76 lb loss from my starting weight!!! I feel great - have had to buy smaller size jeans & slacks TWICE, and am about to have to get another smaller size! I've gone from a 52 inch waist to a 42". I have my 3 month check up with the surgeon tomorrow, and will move into Phase 4 of the diet! I continue to journal my daily intake of food & liquids. My last A1c was 5.1 and my primary believes my diabetes will be resolved and I will be off my meds later this summer!! My BP is coming down since he increased the dose of one of my meds, and he anticipates that will be resolved by the end of the year. I've been taken off all other meds and supplements based on lab tests & blood work. If you're considering the surgery, please remember, it's a TOOL -- you have to do the work -- if you're not committed it won't work!!

and the journey continues......

Last posted on May 23, and my weight was at 252. This morning, June 3, I'm now down to 245.4.....
I take my blood sugar every morning, and for the past 10 days it has ranged between 75 and 102.
My BP has also fallen as the weight has come off, and I take that every afternoon. Yesterday it was 128/80. My primary continues to tell me that he'll be weaning me off both my diabetes and BP meds this summer!!! Although I'm now officially in Phase 4, and can increase my meal portion to 6 ozs, I still "feel full" in most cases just before or right at the 4 oz amount, so am continuing to limit my meal intake to 4 oz - it's comfortable, I'm healthy, my labs are all good, so no reason to increase my intake (and I sure don't want to expand the pouch and reverse the great process I've made!!)
.....and I'm off to the lake for the rest of the weekend!!

I've hit a plateau!!!

Weighed 245.4 on June 3, and over the last 10 days, it's hung right around there....up to 248, and then hovering at 247. Hit a plateau earlier when I was in the low 260's, and then started losing again after about 10 days. Wearing 42" waist jeans, slacks & shorts, and XL shirts, so I'm okay - and I knew that this would happen. After such a great total loss, you hate to see it stop, but I'm not done, and it hasn't even been four months since I had surgery!!! I've got to pick up my physical exercise and spend more hours on my stationary bike (less stress on the knees than walking on cement or blacktop!). Still adhering to the 1/2 cup (4 oz) portions even though I'm allowed to increase to 6 ounces. When I feel full, I quit eating, and that's right about the 4 oz mark. I'm not going to reverse direction!!

I also had my first experience with food deciding it wasn't going to stay down.. I thought I'd try a small portion (1 oz - weighed) of angel hair pasta. Wrong!!! Although it was chewed to the recommended applesauce consistency, once it all got to my pouch it revolted.........so it's back to zoodles (zucchini noodles)! When they say avoid pasta - avoid pasta!!!

Boiled shrimp for dinner this evening....lots of protein!

A couple of photos..........

The photo in the yellow shirt is the "before" - when I weighed 328 lbs (around February 8th)
The photo in the green shirt is "now" - where I weigh 245 lbs (June 13th)

The yellow shirt is a 3X .......the green shirt is an XL.....
Birmingham Bariatric Surgeon

Initial visit was very positive. Dr. Stahl is very personable, and took all the time needed to answer any and all questions and concerns. He explained the procedure very clearly, and I felt very comfortable moving forward under his care.

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