Friday, July 4, 2014

My gastric sleeve experience.

Well, the surgery is over and done with. I decided to tell everyone my experience before, during, and after the surgery. All the gritty details that I can muster.

During the weeks leading up to surgery I was very nervous. I knew people that had this done and they all assured me it was easy, but I didn't want to bomb them with questions every time one popped into my head. So this will be a good entry for those of you that are considering the surgery.

Before I get started, please remember that everyone is different! My experience may be different from yours.

First of all, if you are scared, stop it. They aren't kidding when they say it's not painful. Now that I got that out of the way, let's get started.

For 1-3 weeks leading up the surgery, the surgeon will put you on a diet. Every surgeon has a different diet. Some do all liquids, some do a super low calorie diet with shakes, protein bars, and 1 pre packaged "meal" per day, and rarely, the surgeon may not put you on one at all. This is literally the most miserable part of the entire surgery. I'm serious! It is very important that you follow the diet and don't cheat. The diet helps to shrink your liver and makes the surgery easier. Some surgeons will actually cancel the surgery if you don't stick to the diet! You will only be miserable for about 4 days. Then the diet gets easier.

A couple of weeks before the surgery, they will do a host of tests. Bloodwork, EKG, Endoscopy, Chest X-ray, ETC. If anything comes back as "not ok", then the surgery may be postponed so the other items can be treated. For instance, they found 5 ulcers and H. Pylori in my stomach during the endoscopy. Luckily they didn't postpone the surgery. He just gave me a prevpac, and told me to take them. If you have an abnormal EKG, they will make you see a cardiologist to get a release that you're safe for surgery.

Then, typically a few days before your surgery they will do one more blood test to check your blood type. That's it!

So, I rolled into the hospital at 5:30 AM on 6/23/2014. My mom brought me. I went into a room and changed into a gown, and laid there for about 30 minutes before a nurse came in and started my IV and put an anti nausea patch behind my ear. About 30 minutes later, they wheeled me back to some type of triage. My parents were still able to hang out. The anesthesiologist came in and explained to me what type of meds I'd have and asked a few questions. A few minutes later the Dr. came by and said hi, and checked my chart. Then about 15 agonizingly anxiety filled minutes later, the nurse came and wheeled me into a freezing cold OR. Seriously, it must have been 55 degrees. They moved me onto the OR table and strapped my arms and ankles down. My arms were stretched WAY out to my side. The anesthesiologist told me I was going night night. He put the oxygen mask on me, and I suddenly felt not nervous, and then went to sleep.

I came to, and I couldn't breathe. The anesthesiologist was telling me he needed me to breathe, and I suddenly realized that I still had a tube down my throat. I was trying to gasp for air, but I was panicky, and suddenly, I vomited. He sucked it out with a little wand and pulled the tube out of my throat. I still don't understand what happened there, but it was pretty terrifying.

From there, they wheeled me to recovery, which I have ZERO recollection of. From there, I was in my room. I awoke and saw my entire family in the room with me. At this point, the ONLY pain I felt was a sore throat, and an INSANELY dry mouth. I remember the next hour or so in bits and pieces. I was really stoned. When I finally came to, the nurse was giving me 1/2 teaspoon of crushed ice. That's it! I could have 1/2 teaspoon of crushed ice per hour, and it felt like the Sahara desert in my mouth, and all I could have was crushed ice!

It was shortly after this, that I realized I had a catheter in, and I also had a small amount of pain in my side. When I looked, I saw a drain hose sticking out my tummy that led to a bulb. This drain would be the BANE OF MY EXISTENCE for the next 10 days.

I had a pain pump on the side of my bed that only made me sleepy. I had a small amount of pain from the drainsite, but mostly it was my intense thirst that was bothering me. The nurse came around about bedtime, and checked on me. I explained that I wanted my CPAP, and she said I couldn't have one. This was my first surprise. I asked to see the Dr. He came in and told me NO CPAP for 6 weeks. I was instantly pissed, because I need it to sleep, and I wasn't expecting to not be able to use it. Apparently, it promotes the swallowing of air, therefore, had the chance of ripping my stitches.

They kept coming in to do my vitals and complaining of my oxygen saturation. NO SHIT SHERLOCK! Because I can't breathe without my CPAP. They finally put me on oxygen, and sat me up to sleep. I stayed in the hospital for two nights.

Gas pains came to me on the second day. Not the type of gas pains you think. You see, they inflate your abdomen with air for this surgery. Some of this air gets trapped in your body cavity and causes a lot of pain. Mainly when you breathe in. It was manageable pain though. Kind of like when you are out of breath and you have a catch in your side when you breathe in. That's what it felt like. These can last up to a couple weeks. Mine lasted about 5 days.

When I got home, they brought oxygen supplies to my house, since I couldn't have a CPAP. Here is where things get reallllly crappy.

Fun Fact. IF you have gout, as I do, you will have a flare up. I promise. It's common for post op patients, and I promise, it will be INTENSE. After 2 days at home, my gout flared up in BOTH ANKLES at once. I was absolutely completely immobilized. Here's the worst part. They can't treat it. No anti-inflammatories as they eat your stomach lining, no pills yet, No steroids because they prolong the healing period of the surgery. Nothing except for pain meds. For anyone who doesn't know how painful gout is, a female podiatrist said that it is more painful than when she went into labor. So, don't dismiss me. Gout is no laughing matter.

I felt NO pain other than gout pain for the next week. I couldn't even feel my surgery wounds. So, I'm sure it would have been easy without that issue.

Now let's talk about this drain. It sucks. Not because it hurts. It honestly doesn't. Until you are laying on it and try to roll over, or get up and forget it's attached and let it fall to the end of your hose and yank on the suture. Showers sucked too, you have to hold it in your hand or pocket constantly for a week or more depending on your surgeon.

I finally got the release to take colchicine and percocet for my gout. It is still flared up at this moment, and has made my recovery lengthy because I am unable to walk. It's important to be able to walk after surgery to relieve gas pain and promote drainage. I finally got release on Wednesday to work from home next week, but I am still not even released to drive yet. They don't know it, but I was working from home last week as well. Daddy has to pay the bills.

In 10 days, i have lost 35 lbs. That's right. 35 freaking lbs! I weighed in at 349 yesterday.

I'm not that hungry, I feel good (except the gout). The most important thing I can tell you is to SIP WATER. Constantly. Sip all day to stay hydrated. You will be miserable otherwise.

If you guys have questions, post them here. I'll be blogging my progress as it happens!

Wednesday, May 21, 2014

The Truly Scary Part of Bariatric Surgery

Since I announced the surgery, I have had a lot of people ask me if I'm nervous or excited about the surgery. Obviously, it's a mixture of emotions. While the surgery is a large commitment, I am not really nervous about the procedure itself. Dr. Jones does more of these surgeries than I care to think about, and at this point I'm sure he could perform it with his eyes closed (although, I'm not volunteering for that). The hospital where I am getting the procedure is brand new, and high tech. I don't expect any problems.

However, I am scared of what comes after the surgery. I know what to expect in terms of my body and my health. I know what I need to do to ensure a successful surgery and recovery. What is NOT predictable is how the surgery will change me as a person. What do I mean when I say that? Well, I have known several people that have had bariatric surgery done, and it completely changed them. It transformed them into self entitled monsters. Granted, it doesn't affect everyone this way. I haven't noticed any changes in my family member that has had it done. However, out of the 5 people I know that got it done, only 2 of them have remained similar to their old selves.

Let me tell you story of my (former) best friend. He had a Gastric Bypass done. Before the bypass he was truly my brother. I spent every waking moment of my life with him from age 16 until he moved away to Houston. Amanda and I went and visited him about a year or so after his surgery, and he looked fantastic! My initial thought was how confident he was. I could tell he was happy in his skin. The longer I spent there, the quicker I realized that it wasn't only his confidence. He seemed a little different. He spoke of his friends there in Houston, and they were not the type of people we would normally hang out with. These people weren't good people. They dabbled in things and activities that he would NEVER have participated in before. He explained that he had "come out of his shell". He had the confidence now to meet new people and get out of the house. I dismissed it, because after all, he had always been overweight, and maybe it was time for him to sow his wild oats.

Fast forward to about 5 years in the future. I got a phone call one day from him. He was back in town, and wanted to visit. So, without hesitation I invited him over. We had some drinks, and I offered to let him crash at my place.

To cut a long story short, and because it's a little painful to talk about, it ends like this.

He hacked into my PC, he stole my credit card numbers, and he talked ALL night about people that were out to get him. Like some type of weird paranoid tweaker. He said filthy things about my ex wife, and was incredibly vain. Insisting I feel his arms because he was "ripped", and this went on all night.

I later learned that this surgery can change you. It can transform you into a different person. With confidence comes great risks. Especially if you have lived as a fat guy for most of your life. You get attention that you normally would not get. This can result in pretty nasty personality changes.

I am FAR from perfect. I have some issues with being selfish, and I can be a bit of a cynical asshole. However, I pride myself on my manners, and try to have respect for others. I like me. I like my personality. Moreso before I started suffering with depression. However, I remember how I use to be, and I want to be that way again. I am terrified to let this surgery change me into someone that my friends don't like to be around.

I tell myself that the fact that I even acknowledge that this could be an issue may be a good sign. Being aware of my actions and behavior is the first step of  preventing negative personality changes.

I learned from my psych eval, that as much as I would like to avoid it, Anti-depressants are going to be in my near future. With my past struggle with depression and anxiety, I simply can't afford to take any unnecessary risks.

Wednesday, May 14, 2014

The wait is over. I'm getting the Gastric Sleeve.

After just over 3 years of trying every angle to get approved for weight loss surgery, it has finally come to fruition.

Since gaining employment at CUSI, I was able to pick up health insurance. Luckily my health insurance covers bariatric surgery if certain criteria are met. Such as BMI over 40, co-morbidities (like sleep apnea, high blood pressure, gout, etc). The coverage is still pretty loose as far as insurance goes, and it is definitely going to be a financial undertaking, but at this point, I think it's completely necessary, and my doctor's agree with me.

My health has been getting progressively worse over the last year. The mini-stroke, the gout, my back. I have unfortunately missed a lot of work over my health, and frankly, I'm sick of it. The financial burden now will pay for itself in due time.

I went to the surgeon last night and signed my consent forms and made my first payment. While they weren't able to give me an actual date of the surgery, they estimated it for early July. I still have to undergo a bevy of tests including an endoscopy, bloodwork, and a very strict 2 week liquid diet (right before the surgery), all of which will need to also be paid for. I left the Dr.'s office last night feeling like a bobble head. A bit overwhelmed. It felt like a whirlwind of facts and dates and things I need to do, and money I need to pay.

Meanwhile, I have work on the back of my mind, because I know that this endoscopy, and bloodwork are going to cost me precious work hours. Hours I need to be able to make ends meet financially. Both leading up to, and after the procedure. Not to mention the amount that I have had to miss due to illness already.

It's times like these that I wish I had someone in my life to lean on a little bit. I don't mean family. I have plenty of family support, but the thought of going through this alone is pretty daunting and depressing. On the other hand, I feel like this would be a lot to ask of any woman that I don't know very well.

I am currently sitting and waiting for a phone call this week that will fill my schedule with dates. All of the procedures and testing leading up to the surgery, and then of course, the surgery itself. Once the surgery is complete, video blogging will commence, since I finally feel I will have something to talk about rather than just ramble on about boring daily occurrences.

I'm not particularly nervous about the surgery itself, even though the consent forms I signed yesterday were scary to say the least. I am more concerned about the next month leading up the surgery and making sure there are no snags. I am already invested at this point and would like for this to go well. Hopefully no unexpected costs or medical surprises.

I am very lucky and thankful to have the understanding family and employer that I have, and I can't wait to start this new chapter of my life.

Friday, April 4, 2014

My initial impression of ketosis.

I started the Keto diet on Monday as many of you know.
Monday and Tuesday were just kinda meh, nothing special. I didn't feel like crap, but . didn't feel great either.

Wednesday morning I woke up with a terrible metal/tin taste in my mouth. I also experienced something I never experience. Energy, and hunger. I am always dog tired in the mornings, and I am never hungry. So I whipped up some eggs and sausage and within minutes, I felt like I was shot out of a cannon. Crazy energy levels, great mood all day, lowered cravings. I upped my water intake just in case. I started drinking just over 1 gallon of water per day. I have read that keeping hydrated is a great way to stave off the "Keto Flu".

I rode this high all through the day and all day Thursday. I tested my ketone levels with a keto test strip last night, and my assumption was correct. I am in ketosis.

However, I woke up this morning feel like I have been hit by a truck. I am guessing this is the part where I fell like crap for a week or so. I was really hoping that I avoided this phase since I felt so great Wed and Thur.

My scale will be in early next week. I had to order a livestock scale. I kid....I did have to order a heavy duty scale.

I will post the weight next week. In the meantime to look at my food diary on myfitnesspal.

I am going to *TRY* to cut back on sodium. However, I have read that you don't really have to worry too much about sodium on the keto diet, but I don't like seeing 4000mg of sodium on my diary.

Tuesday, April 1, 2014

Keto Diet: Day One

Day one went pretty well, but I am already seeing that carbs are sneaky little bastards. They creep into the most innocuous places. I managed to stay under 50 carbs yesterday, but the spaghetti sauce in the keto friendly stuffed peppers I made killed me.

Of course, now that I think about it, it makes sense. Spaghetti sauce is kinda sweet.

I have found that I can have a cup of black coffee with heavy cream instead of breakfast. It gives me the caffeine I need, and curbs my appetite until lunchtime. If I get hungry in the morning, I'll eat a 1/4 cup of dry roasted peanuts to hold me over, but so far, so good.

I came down with a head cold, so I am hoping I can kick it in the ass before "Keto Flu" kicks in, or I will be miserable.

The Food diary is up and going, and can be viewed by clicking the Bacon Heart on the right over there.

If you are a member of myfitnesspal.com feel free to add me!

Sunday, March 30, 2014

Back to the Drawing Board...

So, a big blow to the morale!

Back in January I got call from Michael at AR Rehab congratulating me for being approved for the Gastric Sleeve through a state program that would pay for my surgery. This came after 2 years of work. Doctors appts, food journals, sleep studies, psych evals, and much much more.

He explained that funds would be available in March, and that I should call him back then to discuss it further. I waited until about the middle of the month to call him, and tried for over a week. He was either out of the office "temporarily" or on the other line, or a myriad of other excuses. Finally last week I received a call back from him and he left me this voicemail. (The name was distorted on purpose)





I was left scratching my head after this voicemail, because it was pretty unclear. "Is he saying that they aren't going to pay for it?" I was unhappy with the voicemail, and so I called him up. I could tell by his tone he was immediately on the defense. I asked him to elaborate what the VM meant.

Michael: "You listened to it didn't you? I said everything in the voicemail"

Me: "Well, yea, but what does it mean that you are re-evaluating spending? Are you saying you are cutting the program."

Michael: "Look Ronnie, I could have just told you no back in January, but I went to bat for you. You are being ungrateful"

Me: "No Sir, I was very grateful when you told me I was approved. I told my entire family, I blogged it, and I have been expecting this surgery ever since. I would have rather you told me no in January than to congratulate me on something that wasn't a done deal."

Michael: "I feel like you are being rude."

Me: "I feel like you lied to me, and my whole family."

Michael: "I can see that this conversation isn't going anywhere, so I am going to let you go and get back to work."


That was all she wrote. I stared at my phone for a minute. I literally felt like I was punched in the gut. My next call was to Blue Cross Blue Shield. I would have to be out of pocket 4 Grand, but I was confident that I would have support to help me get the surgery. I explained that I had a packet put together already with everything they would need to approve me. Doctor's notes, medical records, (about 60 pages of information). The rep said that they would not be able to accept that from me, but instead would have to receive it from each perspective doctor. I explained that it took over 2 years and thousands of dollars to gather this information and I can't afford to go back to the doctors and get the same paperwork I already had. They insisted....

So here I am, back at square one. 400 lbs, and no closer to surgery than I was 2 years ago. So unless I squat and lay a dozen golden eggs, and shell up $16k, I'm starting over. However, I am not going to be stagnant while waiting for this to come together (if it ever does)

The fact is, ever since I learned I was getting the surgery I have let myself go. Red Bulls, fast food, alcohol. All because I thought, what the hell, I'm getting the surgery in 2 months anyhow. NOPE NOPE AND NOPE. I immediately regret that.

Starting tomorrow, I am going to give the Keto Diet a shot. A real shot. It is a little controversial and defies common knowledge of how diets work, but I have seen a lot of success stories revolving around this diet. And, it's gaining popularity among medical community. However, it is expensive. Let face it. Meat, Cheese, and fresh veggies are high. My health is more important though and I need to make sacrifices elsewhere so I can afford it.

For those of you who are not familiar with the Keto Diet, here are some references for you to look at.

Reddit /r/Keto FAQ
Scientific American Article
Obligatory Wikipedia Link


I am also going to start my food diary again. I'll post a link somewhere on the side bar. If I'm grumpy over the next couple of weeks, I apologize in advance. The first 2-3 of the keto diet are pretty miserable.


LET'S MAKE IT HAPPEN.

Tuesday, January 14, 2014

On the Road

So, I had the opportunity to get out of the state this week for an on-site training in Kansas....

I gotta say, it's nice to be out of the house. Unfortunately, I normally can't find the extra funds for these kinds of trips on my own. So work trips give me a sort of vacation from home. Although, I have to work through the day, I feel it's more than worth it.

I really love Jonesboro, but this is the 2nd time in two months that I have been in the Kansas City Area for work, and I gotta say, it's a great area. There is some decent landscape, and KC is super nice.

Bill invited me to a St. Louis Blues game this weekend as well. I am still considering taking the trip as it will be mostly paid for. Getting out of the house really makes me feel better. Especially, suffering from depression, it's a great thing for you to get out and do something rather than sit at home and watch netflix.

Work is still going very well, and I plan on redesigning the website this weekend. Check back here for Kansas updates through Thur.

For now, I am going to soak in the hot tub.