One week post op

I have now been banded for one week. I went in for my post-op appointment today. It was a group session with everyone who had been banded last Monday. There were 6 patients, plus some spouses and the nurse. We talked about entering the next phase of eating, which I will describe, plus what is to come.

The good news is that my pain is all gone, just some discomfort due to the healing process. But the best news is that I can now eat soft/mushy foods. I am done with liquids only. I did start the day with a 50g protein shake for breakfast, knowing that I might not get a whole lot of protein the rest of the day because for lunch I had...

Christmas leftovers! Becky's dressing, mashed potatoes, spinach and broccoli casserole were perfect for lunch. They were all very moist after being microwaved and I was able to smash them just a bit, and enjoy them. I even had some apple pie. Well, at least the apples from the apple pie. Total I ate about 1/2 cup of food, but it was the best leftovers meal I've ever had. Thanks Becky! :)

I also stopped by the grocery store on the way home to get some food for the week. For this week I can have canned chicken/tuna, canned or overcooked (?) vegetables, canned fruit or overripe bananas, overcooked pasta and Cheerios! I guess the overcooking is to make sure the food is mushy enough. So for dinner tonight I am going to make roasted squash, zucchini and carrots, that after cooking long enough will be mashy. I am also going to make Chinese Chicken Salad. I also bought some potatoes to make more mashed potatoes later on this week and of course I have canned tuna.

The appointment itself was very uneventful. I scheduled my first adjustment, if you will, for 1/31/09. This is where I will start to get liquid injected into my band to begin restricting food. Right now the only restriction is due to swelling since they sort of sew part of the stomach around the band to keep it in place. The goal is to get just enough injections of saline into the band to get to the "Green Zone" which is where you are not hungry, you get to eat just the right amount of food, and are losing weight.

My bandages are now all off and I am going to work tomorrow. I am now going to wait until an hour has passed since lunch to take a sip of water. You can't drink 30 minutes before or 1 hour after eating so that the food sits in the little "pouch" and slowly funnels into the stomach - hence the feeling I have now that I just ate the biggest Christmas dinner ever!

Christmas Dinner

My mother, grandmother and sister spent Christmas Eve with us. Beth Ann made a wonderful dinner: Coquilles St. Jacques with Creamy Mashed Potatoes. Luckily I was able to enjoy that dinner when Betty made it for Becky's birthday in November, so I was not upset that I could not have any now.

Beth Ann set a lovely table with our wedding china and festive decor. Here is a picture of the table:

And here is a picture of my setting:


It was a nice Christmas Eve. Singing at Church was painful though- too much breathing, too quickly- but it was a nice night that we will remember.

It's all about protein.

So I have been banded for 5 days now. The first few days I struggled with pain and discomfort. Then I struggled with getting all of my protein in. I have to have at least 60 grams of protein a day. And since I am on a purely liquid diet until the 2nd week (to give my stomach time to heal from all the activity down there) I have to get my protein in the form of liquid and powder supplements.

Before surgery my doctor's office sold me a box of liquid vials and a box of powder packets. The liquid vials were packed with protein--42grams in a single 3oz tube. The flavor was fruit punch and for some reason I actually expected it to taste like fruit punch. Like Capri Sun. Instead it tasted like the devil's juice. It was thick and sweet in the most artificial way. So if anyone is interested I have about a dozen that need a good home.

The powder mixes are another story. Beth Ann says they taste like Carnation Instant Breakfast. The sampler box gave me a variety of flavors, but the best was chocolate. While it doesn't quite taste like a Braum's milkshake, it's as close as I can get.

Yesterday I went to the Vitamin Shoppe to get more protein supplements. I am now out of the sample box, and I refuse to drink any more of the "punch." I read online at the Lap Band Forum (www.lapbandtalk.com) reviews of different supplements and settled on 2 new ones. One is a kiwi-strawberry flavor (you mix with water, kind of like Crystal Lite). The other is dutch chocolate that you mix with milk.

I also read a posting about ideas when you are still on a liquid diet but crave the taste of real food. I can't yet just mash up meats and things like I will next week. But I read that another lap bander pureed up refried beans and thinned it out with canned enchilada sauce. The result was a tasty Mexican tasting soup. I did make some last night after I finished getting my protein supplements in and I was quite pleased. I also tried some tomato soup which was good but did not settle well for some reason.

Beth Ann and Lindsay are about to get some Italian takeout for lunch. I am going to go make a milkshake.

48 Hours Later & It's Christmas Eve!

Today has been the best day so far. I was able to sleep through the night. I got rid of the CO2 gas pains and I was able to lay on my side, like normal. Luckily the side I usually sleep on is the opposite side of my port incision so I feel no discomfort during sleep.

I woke up around 7:30 today, and had some tea, then water. We went for a car ride which was pretty rough. I was hoping not to have to take any of my anti-nausea or pain medicines today. After about 5 minutes in the car I had to take the anti-nausea medicine. At about noon I took my first shower. I took off my band-aids, shaved my face, washed my hair. It was a nice shower. I did put my patch on over my port incision after that but have not had to take my pain medicine at all today.

To celebrate me being done with the strict clear liquids only diet, Beth Ann made me a chocolate protein milkshake. It's technically a meal replacement since it has about 27 grams of protein. It took me about an hour and a half to drink one cup. It makes 3 cups. So I still have some work to do there.

After my shake, I went for a walk around the block. It took me about 15 minutes to do, but I felt a little better afterward. I feel so bloated and just gross and walking seems to be the trick.

I have enjoyed the smells of the dinner Beth Ann is making for Christmas Eve for my family. I can't have any of it, and I am still so full from my shake that I don't want any, but it is still nice to smell real food again.

Tonight we are going to church for Christmas Eve service - so it will be another test to get through the car ride. I will say now that I might stay seated during the service. I'll let everyone else get up and down and up and down.

Ouch.

Whoever told me that the pain I would feel following surgery would be the equivalent of an intense workout must have been smoking crack as well as taking their pain meds. After I got home from surgery yesterday I was in a lot of pain. I could not sit or lay down really. I finally managed to recline a bit on the couch using the coffee table as leg support. The pain patches seem to help over my port site. The port site is the area in my abdomen where they will inject my fluid in the future to adjust the band. It's the largest incision and the sorest. The other incisions do not hurt. There are 4 incisions plus the port incision. I think what hurts the most is my back. I think it might have to do with the CO2 that they put into me to expand the working space yesterday. I was told it would collect in my shoulders and really hurt there but I think it's really in my back. The only things that alleviate the back pain are walking around the house and a heating pad.

Last night I was able to finally lay down in bed on the heating pad and get some sleep. I would only sleep for an hour at a time but I do feel somewhat rested today. I had planned on being active already and doing stuff around the house, but I am going to have to take it slower than I thought.



The other thing I am working on today is my liquids, specifically my protein supplements. I am literally full after a few sips - of protein, water, broth...anything. I can eat a popsicle but I am stuffed after 1/2. It is a very odd sensation, one that I was not sure would exist. I know it's the point of the band, but I was still skeptical. It does not feel any different from feeling full pre-band. The feeling just comes on much sooner.

Finally.

Today is my surgery day. I had my last meal for dinner. We just threw it together - chicken, eggplant, mushrooms. I was so tired of everything being the last thing...the last pizza, last diet coke, last mexican feast. I did not care anymore, so we had a nondescript, kind of blah meal. But I was happy with that.

In about 15 minutes I am leaving for the hospital. I am nervous, but excited at the same time. I am nervous because I have read a lot of crazy things online...It seems a lot of people go to Tijuana to have lap band done because they don't have insurance and it's very inexpensive to have surgery in Mexico. So I have read lots of stories that people go to Mexico, have surgery and come back only to discover that they were scammed and did not actually get the band implanted. That's my fear. Aside from my fears of having my organs stolen, this is another.

I know that the success of my surgery depends on me. I am prepared for that and I know I can do it, but I just keep thinking... "What if...?" What if I die? What if it's a scam? What if I get really sick? What if it does not work? I guess I just have to have faith that it will work.

To wrap up, I am excited and thankful that my surgery is finally here. It's the beginning and also an end. A beginning to an exciting, joyful experience and and end to fruitless struggling and a life where I looked and felt like this:

The Pre-Op Diet Week 1

I have just finished the first week of my pre-op diet. I am basically following a modified Atkins diet for 2 weeks. The good news is that I've lost 14 pounds since my first weigh in :). The bad news is that it was the week from hell. I was going through terrible withdrawals- I had headaches, nausea, a poor attitude and...diarrhea. I did not want to mention it but after looking online and talking to other people I find that it's common.

I wish someone would have told me! Someone wrote on a blog, "What goes in liquid, comes out liquid." Yeah. True. I am not sick, and I don't feel sick, but still. It won't end.

I have basically been living on meat all week. I guess if I were able to do this permanently, I would not even be talking about lap band, but obviously the Atkins diet is difficult.

I actually followed the Atkins diet religiously for a summer in high school. I lost 40 pounds, then gained it all back immediately once school started in the fall. That's what I am looking forward to most about lap band - having a solution that finally works for good. Well, I take that back. I am looking forward to not being hungry the most. I have been hungry my whole life. I am hungry right now. This time next week though, I will be far from hungry.

Tomorrow I am going to the hospital for my pre-op appointment - blood work, x-rays, ekg, etc. I will provide an update then.

I have a date

Beth Ann and I went to my nutritionist's appointment last Wednesday. We sat down together and talked about the changes I would be making in terms of what foods I can or cannot eat in the future. It was kind of a formality more than anything. This was the last requirement before I could schedule my surgery. I was told that she would turn in her report immediately and that I could probably have my surgery scheduled the next day. So I emailed the person in charge of scheduling and asked if she had received the nutritionist's report. "Not yet," she said. I followed up Friday, Monday and Tuesday. "Not yet," "Not yet," "Not yet."

Later Tuesday morning I received an email that she had finally gotten the nutritinist's report but they could not find my psych evaluation. I told her that I went to my psych appointment on November 3 and that they should have had the report a long time ago. "Not yet." So I called the psychologist's office. Twice. Her assistant finally called back and said she would fax it by 3:30pm. Good God. Why is this taking so long??

So finally I received an email saying, "Call me so we can schedule." I was so excited, my heart started thumping.

So, the surgery is scheduled for Monday, December 22!

Approval

I called the insurance company on 11/3, 11/4, 11/5, 11/6 and on 11/7. When I called on 11/7, the usual "I don't see any record. Please call in 15 days." was replaced with "what doctor? what hospital? what month?"...I told the representative all of the information and she said "There is an admission number."

"Does that mean that I was approved?" I asked, slightly nervous, confused, and excited.

"Yeah, I guess so." was her response.

All weekend I was secretly a nervous wreck, just knowing that the rep was confused or did not understand what I was asking. Then when I got home today (11/10), there was a letter from the insurance company. Bad news: I am morbidly obese. Good news: I am covered under insurance.

So the next step is to see the nutritionist, then I can schedule surgery. Stay tuned.

The first consultation

On Wednesday, October 29, I went to my first consultation with the Dr. He said I was the perfect candidate for lap band and he told me that he too had a lap band. We spoke about his experience and about the medical community in general. I told him that when I had gone to my PCP to get her opinion on the lap band, I had been berated and belittled. I told him that my wife had been shocked that I was spoken to that way...kind of in a way that seemed like I did not know anything, especially about how to eat. She told me to stop drinking regular soda (I don't) and to stop eating chips, cookies, cakes, and candy (I don't). It was horrible. Then she said she would not give me a referral (I didn't need one) and told me she was going to put me on a diet pill and a strict diet and would see me in a month. I did not go back.

After I finished speaking to the doctor, the insurance specialist came in. She told me that for my plan I needed medical records...I whipped out my organized packet. She was impressed that I had all of the records ready to go. As far as the 2 missing years, she had me just sign a note stating that I had not been to a physician those years. She faxed over the information on 10/31. She also told me to call the insurance company every day until I heard from them.

Medical Records

So there are 2 ways to pay for lap band: insurance or cash. There are "packages" that run between $10,000-$15,000. Obviously I don't have the means to pay cash, so I have to go the insurance route. Thankfully, I have very good insurance through my employer. They do require a 5 year medical history with a BMI of 40 or more. BMI is calculated based on your height and weight. Currently I have a BMI of 43. I was very determined to get a head start on this process.

When I made my appointment at the seminar, it was a month away. This gave me time to try to obtain medical records. Thinking back, I had only been to a couple of doctors within the past 5 years. I searched the internet to get phone numbers and addresses. I also found a template online of how to submit a request for medical records. I mailed off the requests. Over the next several weeks I checked the mail every day. I became obsessed with getting the medical records. When all was said and done I was able to get records from 3 of the past 5 years, all showing a BMI of at least 40. The other two years I did not see a physician but I was able to get some records from about 6-7 years ago. I compiled everything and waited the next few days for my first consultation.

The first steps

So when I decided I wanted to explore lap band, the first step was to attend a seminar to learn more about the procedure and the doctors. I searched the internet for seminars, saw tv commercials and read ads in the newspaper.

The first seminar I attended was for True Results. It was a random office building. the surgery center was in the basement. It was clean...enough, but very shady. The doctor did not show up for the seminar, without explanation, and the receptionist was left to try and sell a bunch of fat people on using their company for the lap band procedure. Of course I had already done lots of research online and I assumed that anyone who would venture out to a seminar would have done the same. Not the case. I had to sit through an hour and a half of stupid people's stupid questions. And the receptionist's stupid answers. I could not get out of there quick enough.

The next seminar was at TLC Edge in Grapevine. Again, in a random shopping center. This time the presenter was an actual lap band patient, so I enjoyed that. The surgery would take place in Richardson though. Not interested. We were in a small waiting room area. There were about 6 of us in there who were trying to listen to the lap band patient. The problem was though that some woman brought her son (grandson?) who was about 5. He ran laps throughout the small waiting area during the entire presentation. And at the very end knocked over the presenter's screen. This presentation was better though. I did not feel like I was going to have my organs stolen.

The next seminar was at Baylor Hospital in Grapevine. Getting better. There was actually a doctor there this time. However he had only been doing lap bands since...April. I would have been patient #23. Not acceptable. Again I sat through the whole thing and left as soon as I could.

About this time Beth Ann (my wife) spoke with a coworker to see if she knew any good surgeons. As it turned out she had worked with a weight loss surgeon in the past and highly recommended him. I googled his name and sure enough he had a presentation coming up. So I signed up. The 2nd google search result though linked him to True Results. The scary "we'll put you under and steal your kidneys" place. Not good.

The next seminar I went to was at the Worthington Hotel in Fort Worth. The company was called...Lap Band Solutions. Very creative. There was another surgeon here too. And they gave me a $20 Target gift card. There was also a lap band patient there. Unfortunately there was also a salesman, for lack of a better title, trying to convince us to use their company. I waited patiently until the end of the seminar to speak with both the surgeon and the patient. Oh and surprise. They also used the scary surgery center in Hurst. I told the surgeon my concerns with using this particular establishment, and he said the surgery could be performed in a hospital. But then the sales guy interrupted and could not believe I would not want to use the surgery center. I said I was afraid of complications and did not want the surgeon to just have to call 911. He said he's only heard of a few people having complications during surgery there. I did not want to be one, even if there were only a few. So then I talked to the lap band patient and she was very nice. She told me she would not go back on it but said the most important part of the process was to go to the aftercare support group meetings. It is going to be a very emotional process, I am told.

So finally the day comes when we get to meet Dr. Smith at the Baylor Surgical Hospital in Fort Worth. It's technically a hospital, they have an onsite ER, and they are right across the street from Baylor All Saints Hospital. Dr. Smith was the only person leading the presentation - no salespeople. And get this, Dr. Smith has a lap band himself. Big plus. But not the reason I chose to go with him. Everything felt right - like it was the right choice of a surgeon. So I made my appointment for my consultation.

But first I needed to collect 5 years worth of medical records to send to the insurance company...

Introduction

I want to remember every step of this journey. My journey to a new life. Well, if not a new life, to a better and more fulfilling life. I'm not vain or superficial, but being fat is not fun. Growing up overweight I tried to make the best of it. I tried to fit in and make friends. My parents did not make it easy by uprooting us every year or two and moving us to a new city. But I did the best that I could. So here I am at 25. I weigh about 300 lbs. The heaviest I have been (that I know of) was 323 lbs. That was back in 2006.

I'll never forget the day that really woke me up. I was boarding an airplane. I sat down at my window seat (because for whatever reason I feel like I have more room there) and barely fit between the armrests. The armrest on my left, closest to the window, was fixed -- it did not move. So I kind of had to wedge my left thigh under the arm rest. The armrest on the right was movable, so I lifted it up, got comfortable and rested the armrest on top of my right thigh. Then came the last step - the seatbelt. It did not fasten. It would not fasten. I tried to wiggle around, suck in...nothing was working. I don't know why I did not just ask for an extender. I guess I was afraid they would march me up to the cockpit to get the extender and everyone would know what was going on. I also don't know how I finally managed to secure myself, but I did hear the magical click and knew I had to do something.

When I returned home from that trip, I joined Weight Watchers. Again. For the 9th time. This was at 23. I did lose about 65 pounds that time. I remember it all came crashing down when I came home to visit my family for thanksgiving. I just did not feel like measuring and counting points. Before I knew it I was back to 300+ lbs. And two years later I am still around 300 lbs.

During my successful run on WW I was very much against weight loss surgery, of all kinds. I thought it was for people who just weren't willing to try, or work, hard enough. I thought it's working for me, anyone can do it. I knew I would never subject myself to surgery even if I had the chance. But then everything reversed itself and I am now in the position of attempting to get approval for lap band surgery.

I don't remember exactly when my attitudes and beliefs changed. Probably close to the time that my dear wife and I decided we were going to try to have a child. I got into gear again, joined not just one gym but two. I got a personal trainer. It was just so much harder this time. I thought that since I had lost so much weight before I would pick up right where I left off. But the prospect of having to do this over and over for the rest of my life -- lose 30 lbs, gain 60 lbs, lose 60 lbs, gain 50 lbs, lose 5 lbs, gain 20 lbs -- was a very discouraging and depressing thought. I did not want to live a life full of these ups and downs.

So around the middle of September I decided for the last time that I had to do something.