First Mistake

Today marks my first screw-up. I made instant grits at work and didn't water them down enough and they swelled up in my stomach. I nearly threw up - had a couple of weak dry heaves - but they eventually went the right way, after some discomfort. I called the nurse and she congratulated me on not screwing up before this, and told me that I had no need to worry, just be more careful with grits and oatmeal in the future.

I'm 292.6 this morning. 40 pounds lighter. It seems like I'm losing about 2 lbs a day.

Sunday Morning update

This morning, the scale upstairs (The one that reads heaviest) said 297.

Dec 26 meals:
Breakfast: soft-scrambled egg
Lunch: pureed hot dog with cheese sauce
Dinner: refried beans with cheese sauce
Protein goal met
Water goal met

Dec 27 meals:
Breakfast: soft-scrambled egg, milk added
Lunch: Soft cheese (I chewed until it was liquid before swallowing)
Dinner: Beef rib puree
(I cooked this for four hours at low heat in the oven, then put in the food processor with the broth that cooked out of it and it was delicious)
Extra: A scoop of sugar-free ice cream
Protein goal: Failed - I didn't make a shake all day.
Water goal: Failed, but I drank a whole 20 oz bottle of G2 over the course of the day.

We walked around the neighborhood on the 26th for exercise, and yesterday, though we didn't walk, we did go to the Super Wal-Mart twice and walked around the store while shopping.

299

299

Season's Eatings

First of all - the bottom line: Dec 25 - 301 lbs. That's 32 lbs lost. I expect I'll be well below the 300 mark by Monday, when I go back to work, and I'll never ever see that "3" digit in the first position on the scale again. Once I'm cleared for strenuous exercise, I'm going to work my butt off to get to 250 as quick as I can. I'm beginning to think that sub-200 lbs is a distinct possibility by the end of 2009. I've been slack on the walking due to the holiday. That will change tomorrow, I promise.

I got a totally cool 3-cup food processor for Christmas. The huge one we have was impractical to keep cleaning for such small portions.

Meals (approx 1/4 cup portions):
Dec 24 - breakfast: grits
Dec 24 - lunch: shepherd's pie
Dec 24 - dinner: refried beans with guacamole, cheese and sour cream
Dec 25 - breakfast: runny scrambled egg and grits
Dec 25 - lunch: ham puree with green pea puree and turkey broth
Dec 25 - dinner: organic peanut butter

I probably didn't get my protein goal on Christmas Eve. I'm pretty sure I did today, since I had a double-strength protein shake in the afternoon, and three high-protein meals.

Christmas Eve dinner and Christmas lunch were absolutely delicious, and Christmas lunch was made using my new food processor. Awesome!

Good Tidings

Not only do I convey good tidings to my readers for the holiday, but I have good tidings to convey of my recovery as well.

No more stitches. They all dissolved today. The tape over them was itching like crazy, so I peeled it all off after softening them up in my shower this morning and there were no stitches underneath. The wounds look 90% healed, and after getting rid of the tape, the itching has stopped.

I did hit up against the stomach capacity limit today while drinking a protein shake. Felt like I had a reflux coming up (not a burning acid one, though). I kept it down, but now I have been reminded to not drink thick liquids so fast. Cheap lesson.

Tonight we go over to my folks' house for Christmas Eve dinner. We'll see what I'm able to eat.

Arguments

I would like to reflect on an issue that will come up for just about anyone having weight loss surgery.

Family - and what to do about their opinions and attempts to control you.

I have in front of me a printout of the pureed/blenderized diet guidelines that the doctor and nutritionist gave me. To summarize, it says:

• You will be on pureed/blenderized foods for a month, in addition to the clear liquids you have already been taking. (and it explains why)
• You may not have concentrated sweets or simple sugars. (and it explains why)
• No gum (for obvious reasons, but it explains why anyway)
• Avoid gastric irritants like chili powder and hot sauce and caffeine.
• No carbonated beverages.
• Don't drink within 30 minutes of a meal.
• Portion size should be 1/4 of a cup of pureed foods, 3 times a day.
• Increase fluids to 64 oz a day.
• Protein goal is 70-90 grams a day.

So, my mom calls me yesterday and asks what I've had to eat. I tell her I had grits for breakfast, and had mushed up Turkey Spam into a puree with chicken broth and mayo for lunch. She went ballistic. You see, the rules given above - which couldn't be any clearer to me - were interpreted differently by my mother. She thinks it means:

• Only eat wholesome foods
• Don't mix ingredients
• Nothing out of a can
• Nothing fattening
• You should be eating baby food

So we argue. Despite having written in black and white the absolute rules and the freedom between the lines - she wants to criticize my choices.

Folks, being fat means that you are at the mercy of every well-meaning person out there that wants to criticize you. Because, as we all know, if we had just followed their advice, we'd have never gotten fat in the first place. There's an idiot on a sports message board that I go to whose opinion is that fat people are all losers because we're incapable of following a few simple rules regarding burning more calories than we take in. Like it's that simple. Well, he thinks it is and therefore all the fat people in the world are just losers.

Anyway, one of the most important reasons for having this surgery was to get "My Diet" off the list of things that it's OK for someone else to criticize. Really, who asked for their opinions in the first place?

So get ready, anyone who wants Weight Loss Surgery in the future - these people will not give up their favorite subject easily. Critics will be critics, and after you lose your hundred-or-so pounds, they'll find something else to criticize.

Advice for Future Roux-en-Y Patients

Here's my first round of advice for those who are contemplating doing this surgery in the future:

In the hospital:

1. Gas-X strips (the ones that melt on the tongue). Take them to the hospital with you.
2. Walk as much as you can while still in the hospital. Do it 30 minutes after every dose of pain medicine - right when it kicks in. Walking prevents pain.
3. Get someone to stay with you in the hospital. If you wait for a nurse to help you walk, you won't walk enough. Don't be at the mercy of the call button.
4. Males - get the catheter out as soon as you can. Make whatever deals you have to make with the nurses or doctor or devil. Walking with the catheter really sucks. If you prove to them that you can get to the bathroom whenever you need to, they should agree.
5. Learn your pain meds and how long it takes for them to kick in and how fast they wear off. Try to be asleep when they wear off and plan activities for when they're fresh.
6. Sit up in a chair as much as you can. Heck, you can use the hospital bed to do no-effort sit-ups. The idea is to move things around in your abdomen to get the gas to settle out.
   

At home:

1. Continue walking as much as possible.
2. Find a nice recliner to sleep in, preferably one that rocks so you can use momentum to get out of it instead of your abs.
3. Figure out ways to avoid using your ab muscles.
4. You won't start passing solid waste until you start on pureed foods. Have Milk of Magnesia around in preparation for that day. Take it before you have to. Your pain meds cause constipation, and your ab muscles are NOT ready to push that hard.
5. Ever consider a bidet? Mine saved my life today. It beats a hot-water bottle.
6. Get off the pain meds as soon as you can.
7. Don't get impatient with your 'nurse'.

Checkpoint 1: Start of Week 2

Original Weight: 333 lbs
Current Weight: 305 lbs
Total Weight Loss: 28 lbs
Weight Loss Since Surgery: 15 lbs

This morning, I ate some thin grits made with chicken broth - about 1/4 cup. They seem to be digesting comfortably. After eating that much, I am no longer hungry. So far, so good.

UPDATE:
Lunch and dinner were Spam Turkey mushed up with mayo. The big news is that the digestive system became fully functional today, with the help of Philips' Milk of Magnesia and the bidet I installed in the master bath. Thank God for that thing.

No pain meds today. I am now officially medication-free. We're going shopping tonight at Wal-Mart to find some tastier things to puree. I have in mind some sort of pizza-mush, or hot dog with mustard puree. I haven't had meat in weeks, folks.

Some Questions Still Remain

Here I am, six days removed from surgery, and some mysteries haven't been solved yet.

For instance:

• So far, all I've had are clear liquids and I haven't noticed any "full" sensation from my new small stomach pouch. Either the fluids (and this includes Jello) are pouring right through the stomach without pause, or I haven't approached the limit yet. Not that I'm anxious to push it. I wonder just how small that pouch actually is?
  
  
• I've had "interest" in food, but no hunger pangs. I wonder when this will occur, or is that something I'll never have again? (God, please let it be so)
  
  
• I keep wondering what will happen to the larger part of the stomach that no longer has a full-time job. It's still complaining loudly and producing gas and nothing else of benefit. Is it eventually going to accept its new role and shut up? Is it going to go crazy and dump a bunch of acids into my bowels when I start on pureed food?
  
  
  
  
• Also regarding the unemployed stomach - what happens in the future if I catch a stomach virus? Do I have two separate cases of nausea?
  
  

Saturday Update

I slept all night horizontal in my bed and felt like a million bucks when I woke up. I feel strong, but probably a little too much, as I started mouthing off at Bernie when she scolded me for not taking my vitamin and before I knew it, I'd started a fight. I feel so stupid. I know I can't treat her the same way I do when my mom is looking after me. Mom's got a much thicker skin than Bernie does and just shoves it back in my face, but when I sass Bernie, it hurts her. I had to spend a couple of hours putting things right after that.

Anyway, I put on some "man pants" and went and got my hair cut, which was badly needed thanks to the pre-surgery high protein diet making it grow ultra-fast.

Later on, I persuaded Bernie to take me to the pharmacy so I could buy some Gas-X strips and Milk of Magnesia, which is what the doctor recommended for whenever my digestive system starts working again.

Bernie isn't eating properly. She's sympathy dieting and I have to put a stop to it as she's only 100 lbs to begin with. I'm not certain she had lunch or dinner today.

Anyway, I'm doing great. I've got ketone-breath, so I know I'm losing weight and burning fat. I'll step on the scales in the morning and see what I'm down to. I'm also working on photoshopping some slides to explain exactly what was done to me, which I will post on here eventually.

Only two more days, and I can have blenderized real food.

Friday Update

Not much new to report. Discomfort level is better today. Drank a lot of water and protein drink. Actually ate some jello, which went down smoothly - better than some of the stuff I'm drinking. I'm starting to show some small level of interest in food, although I can't have solids yet. I'm going to try to sleep in the bed tonight and see how hard it is to get out of it in the morning.

The drain wound oozed just the tiniest bit - enough to make a little stain on the gauze. I think it's starting to close up. Gas pains are no longer a problem.

I really think that the good night's sleep I got last night paid off handsomely. I hope to improve on that tonight. I might let Dad take me in the car to get a haircut in the morning as the protein diet from the past two weeks made it grow amazingly fast.

In other news, I heard that a childhood friend passed away from cancer last month and it's bummed me out a bit. I learned while I was in the hospital that a college friend had been arrested for something heinous, so that's two tragic stories in the same week.

First Day Home

I spent the night sleeping in the recliner last night. Good choice, because I can get in and out of it without using too many abdominal muscles. I got a 1.5 hour stretch of sleep and then about 4 hours after I walked, took some meds, and had my vitals recorded by my mom. Bernie finally got some sleep in a real bed.

This morning, I went upstairs (under supervision) and showered. My incisions aren't bad at all, but they are beginning to show purple bruises so they look 'interesting' - especially one on my right side. The place where the drain used to be is a big hole that looks like it was made with a corkscrew and it is an open wound. They told me to shower as normal and to leave the drain wound uncovered so it would stay dry. Well, I'm compromising, since I don't like to look at it. I've covered it with a layer of gauze so that it still gets plenty of air, but it's not getting touched accidentally. I've got very little pain, and none of it is specific pain, just general discomfort, like a huge bruise.

Now that I'm clean and presentable, I feel much more human.

Irritating note of the day: The scale that has already incurred my wrath once now says I weigh more than I did to begin with. I think I'm going to have to pitch it and get another one.

The Skinny on Weight Loss Surgery

Cool title to this post, huh? :)

I'll start this narrative with waking up from surgery. The nurses in recovery gave me ice chips (only a couple of pellets, though) which they probably shouldn't have. I felt like I couldn't get enough air, which is a common theme for me when I'm in pain. They gave me oxygen and put me on my C-PAP machine (a little machine that delivers pressurized air to my nose so I don't stop breathing while I sleep), but it still didn't help me feel like I was getting enough air. Eventually, they moved me to ICU so they could monitor my blood oxygen continuously. I stayed there through the first night. The surgeon visited, then gave orders that I was not to use the C-PAP machine that night (he didn't want it to inflate my stomach pouch and stretch it), which meant I had apnea all night even though they gave me oxygen. I must have woken up every fifteen minutes from midnight to 6 am. I was lucky to have a chatty nurse that kept me company. I got up and walked around a little with her help.

The next day, they moved me to a regular room. I walked twice more. It isn't easy to walk with a catheter. My abdomen felt like it was inflated to twice normal size and everything inside was bruised. My abs were cramping and standing up stretched them and all the stitches inside and out very painfully. This is when I got to know my pain medicines. Toradol is an IV analgesic which they gave me every 6 hours. It lasted for four. I had the magic morphine button, but I quickly discovered that all morphine did for me was make me sleepy and didn't kill pain at all. Midway through the second day, they gave me Lortab liquid, which is what I have here at home, and that seems to actually make it bearable.

The worst part? Gas. The large portion of the stomach which they leave behind and disconnect from the esophagus is having denial issues about its demotion and is producing huge quantities of gas which have nowhere to go but down the intestines. Since they use a muscle blocker on the entire digestive tract, this gas doesn't move fast and hurts like a real SOB. The best remedy? Walking. The most painful thing to do in that situation? Getting out of a hospital bed when all your abdominal muscles are cramping up and standing up and stretching all those muscles and incisions. Once I figured out the timing of the pain medications, I was able to walk more often.

Today, I woke up and I was determined to do two things: Get rid of the catheter, and pass gas. I managed to do both by 6am and my life improved dramatically.

I forgot to mention that day one, I was allowed nothing by mouth - no water, no anything. I got to swab out my mouth with a little sponge on a stick and moisten my throat and lips with it. Day 2, I was allowed 30ml of water each hour. That means I got to wet my tongue and breathe the fumes every fifteen minutes. Today, I got all the water I could handle, which still wasn't a lot.

So anyway, tonight, I am at home, sipping Isopure clear protein beverage, and feeling almost human, and passing gas like crazy. I'm probably due to take some Lortab in a few minutes. Oh, and I can actually get real sleep tonight because I'm finally allowed to use my C-PAP machine again.

PS: I had a drain in one of my incisions. I had no idea how deep this drain went until they pulled it out right before I was discharged. I now know EXACTLY how it feels to be run through with a sword.

Der Tag ist Hier!

Well, tomorrow's the big day. I had a protein shake at 7:30 and that's my last sustenance before surgery. The bag is packed and ready to go. We'll leave the house around 8am and the operation starts at 11am.

I am not nervous for some reason. I am just ready to get this over with and get on with my life. Bernie, however, is terrified.

Anyone that has free time tomorrow after 11 o'clock, would you mind giving her a call and trying to settle her nerves? I'd appreciate it.

The doctor called me this afternoon and wanted to know if I had last-second questions or concerns. I sure didn't expect that. We really didn't have much to ask, since they've done a good job of keeping us informed of what we need to do.

I probably won't be back on the blog until I get home. If everything goes right, that'll be Wednesday. Stay tuned!

Monday, Monday...

Had to work in an actual store today. My company asks us to spend a day working in a store that needs "holiday help" once a year. As usual, I come through it wondering what I'd do if I had to work that hard for that little money. It also makes me appreciate the work that actually keeps the company afloat. We have some smart people running our company (the ones at the very top, I mean - middle management, as usual, is full of morons).

I stepped on the scale Sunday morning and it said I had lost 20 pounds. I took the "one serving of meat per week" option as a reward. This morning, the scale took back 12 of those pounds, so I have no idea what I weigh, and I'm ticked off that my expensive digital scale is so inconsistent.

The point of the two-week liquid (plus veggies) diet is to shrink the liver and not necessarily to lose weight, anyway.

So now, I'm back on liquids and veggies only for the rest of the week, then a day of starvation prior to undergoing the knife next Monday. Somewhere in there is a holiday party that will tempt me greatly with lots of finger-food around. I'm going to it anyway and I'll just have to be strong, that's all.

I'm debating skipping band practice tomorrow, but I think I need to go. I'm just feeling lazy and as insignificant as one last rehearsal before a month-long break is, I'd probably feel bad for missing it.

That's all my thoughts for today.

Computer Troubles

Today is day 6 of the liquid diet, and it's officially gotten old. Today for dinner, I mixed curry paste with my cream of chicken soup and dumped in my veggies to make some sort of neo-laksa. It was about 5% as good as the real thing, which is about 100 times better than anything I've eaten lately. I'm eating a sugar-free snack pack of chocolate pudding as I write this, while Bernie is entertaining Fio and James at a Chinese buffet.

I'm trying not to think about chinese buffets.

Earlier this week, my computer decided to start randomly rebooting like it did when it was new and needed warranty work. Since it is now long out of warranty, I made an appointment at a local repair place (thereby losing my geek card permanently). After disconnecting it, I realized I should probably clean up any sensitive information on the hard drive first, and then I discovered it wouldn't boot up at all. So much for that idea.

Anyway, it turns out the power supply is toast and the video card too. The video card was probably the cause of the reboots, because it continued to cause them after the power supply was replaced. Once it was removed from the equation, the system was stable again. The repair shop replaced the power supply for me ($75 labor, $25 part).

In the meantime, Bernie's new PC arrived (this was a Christmas present, which I don't feel like wrapping, so she gets it early), and it needs a video card, so we drove down the street to a computer shop that the repair guy recommended. I bought two video cards, and decided to expand my system's memory to 2GB so I wouldn't be too far behind my wife's new PC, which has 3GB.

It turns out the guys who run the place are Chinese, and their parents are Malaysians who moved to Hong Kong, then moved the family to Charlotte 15 years ago. This probably marks only the third time we've run into Malaysians (I consider them Malaysian, even though they were born in Hong Kong) in Charlotte in the last 3 years, and all of them own their own businesses. Bernie got to chat with them in Cantonese, which made her happy.

So, to sum up, I've lost about 15 pounds in a week on the liquid diet, which I'm getting tired of. I have my PC working again with more memory and a better video card. Bernie has a new PC. Fio and James are visiting us, and we met a couple of Chinese Malaysians from Hong Kong in Charlotte. Oh, yes, I nearly forgot - the Christmas tree is up.

Day Two of Liquid Diet

Well, I checked this morning and thanks to the stomach bug and day one of the liquid diet, I'm about 10 pounds less already.

So far, it's not so bad. The shakes taste good and fill me up for about an hour. I'm filling in the gaps with carrots and Weight Watcher's yogurt. Some cream of chicken soup is lunch, and a salad with low-fat, low-sugar dressing is dinner. I even skipped the fourth shake last night because I didn't need it once I quit watching TV and all the McDonalds commercials.

The real trouble is when I smell food that I can't have. So far, that hasn't been so bad.