Weight loss surgery

I posted on Facebook that I’m going to have weight loss surgery. In this space I want to go into more (sometimes embarrassing) detail.

It is no surprise to anyone who knows me that I have struggled with being overweight for most of my adult life. Right about the time I got married at age 30, I had just crossed over the line between overweight and obese. Then I gained quite a bit of weight after getting married. I decided to try to reverse the trend. I tried Weight Watchers, Slim Fast, NutriSystem, the Mediterranean diet, and a nutritionist-supervised low-sugar diet. The only thing that worked was NutriSystem, where I lost 30 pounds. But there was one major problem – I couldn’t afford to stay on it. My wife & I spend about $100 a week on groceries, and we eat out once a week. So we spend about $130 a week on food. NutriSystem costs about $90 per week, and that doesn’t include drinks, fruits and veggies you are supposed to use in conjunction with it. And that’s just one person. So it was an unsustainable cost. Everything else I tried was a failure.

I had my annual physical on May 25. Most things that are checked in a physical were OK. My cholesterol is slightly out of healthy range, but everything else was good – except my weight. Depending on which consultant study you read, I am anywhere from 120-140 pounds overweight. I’m way past the line of morbidly obese. I told my doctor that I thought it was time to explore surgical solutions before my heart pops like a zit and that’s the end of me. He agreed and sent a referral letter to the bariatric practice affiliated with his practice.

They moved very swiftly. Since these are 2 offices under the same hospital umbrella, they already had all of my info, including insurance. By the time I got to my first appointment on June 5, they had already done a lot of the legwork. I had already seen another nutritionist 3 times in the previous year, and those counted toward the 6 visit the insurance requires. I have seen the bariatric nutritionist once already (more on her in a little bit). I’m also required to see the bariatric practice’s nutritional therapist. I see a therapist and psychiatrist regularly for treatment of my depression, and right now that is going remarkably well. I almost never have anxiety attacks anymore, and the depressed days are getting fewer and further between. My regular therapist quickly agreed to send the bariatric practice a letter verifying I am in a good emotional state for the surgery and subsequent life changes. Also, I already know my out-of-pocket cost for the surgery is only going to be about $750. (That’s because I am getting very close to hitting my out-of-pocket maximum, at which point the insurance company must pay 100% of all medical costs for the rest of the year. My new CPAP machine, my wife’s new wheelchair, and her 2 medicine pump refills went a long way toward approaching that max dollar amount.)

With all this prep work done so quickly, I saw the surgeon. I originally was planning to ask for the lap band, the device that acts as a belt around your stomach that can be adjusted to ensure you lose weight slowly and steadily. There is also what the world knows as a traditional gastric bypass, where your stomach is reduced to the size of a spoon, and food is re-routed from the bottom of your stomach to nearly the end of your small intestine. Then there is “the sleeve.” This is a more targeted gastric bypass. About half of your stomach is removed, leaving a stomach about the size of a big banana. Upon exiting the stomach, food only bypasses the first third of your small intestine. Doc said this was probably the best option for me, and I could reasonably expect to lose 90 pounds in the first year after the surgery. I decided to go with her recommendation.

That same week, I saw the nutritionist. Now this was truly fascinating. One of the biggest factors in people overeating is the speed at which they eat. I learned this in junior high school, when we had a 30-minute lunch period and it took 20-25 minutes to get through the line. I became very adept at swallowing food whole like a snake does. I never got out of the habit. So this crazy nutritionist tells me to chew each bite of food 30 times. Thirty. THIRTY!!!! Are you freaking kidding me???????? What kind of crazy heifer are you??????? Real crazy, because she wasn’t done yet. As my other nutritionist had said, I need to do whatever I could to avoid sugar, less than 40 g per day, and never more than 7 g at any one time. Go big on protein – 80 g per day. Stay below 55 g of saturated fat. None of that is too weird, but the calorie count….. 1,600 per day. Per day? DO WHUT??? I can do that at breakfast if the food on the buffet is good enough. But that’s why I’m as big as I am. But that still wasn’t the biggest bombshell she had for me. After surgery, with the smaller stomach, it’s likely that I won’t be able to tolerate ANY carbonated drink. So get ready to say a permanent goodbye to beer and soda. I told her to stop so I could observe a moment of silence. I was not kidding. No Pepsi Max? No Bud Light Lime? YIKES!!!!!!!!!! But like I said, all this stuff contributed to my current condition. So let’s give it a shot.

Next was a phone interview with the United Healthcare nurse. We went through all the prep work and what was still needed. Having already had 3 visits with my previous nutritionist and 1 with the one at the bariatric practice, I just need to have 2 more of those visits, plus the visit with the bariatric therapist. The UHC nurse said if that came together quickly, I could possibly be ready for surgery by the end of the summer.

At this point, I feel compelled to say that when it comes to doctor’s orders, I am not a typical man. I actually do what they say. You know how most guys are – “Aw, that’s just his opinion. I’ll handle it my way. Maybe I’ll take those pills, maybe I won’t.” I downloaded the My Fitness Pal app, which is a fabulous tool. You can track all your eating, exercise and water consumption. If you dine out, the app is surprisingly full of most of the well-known places. It has a bar code scanner so you can just scan anything you buy at the grocery store. It’s been amazingly easy to track my eating. Staying within the 1,600-calorie limit? Not easy at all. In fact, most days I end up going over by anywhere from 50-150. But just to maintain my enormous gut, it takes about 2,250-2,500 calories a day, so I’m still much better than I was. On Monday I weighed myself, exactly 7 weeks after my first visit to the bariatric practice. I’m down 9 pounds. Off to a good start!

Next up was a procedure known as an endoscopy. This is where a camera is sent down your throat so your stomach can be inspected to make sure it is in proper condition to undergo the surgery. I suppose you could call it the opposite of a colonoscopy, because instead of the camera going into your back end, it’s going into your front end (throat). There was some very rotten timing involved. This was to be done on July 13 in the afternoon. My beloved High Energy Toastmasters had scheduled our year-end celebration for the same day (year-end meaning the end of the Toastmasters fiscal year, which is June 30). We had achieved President’s Distinguished status (meeting at least 9 of the 10 basic club goals) for the 13th year in a row. A party was in order. To prepare for my endoscopy, I could not eat or drink anything, not even water, from 5 AM until my procedure. No party food for me! I had told everyone I was having this procedure, but I had not yet made it publicly known about the surgery I was pursuing. I ended up being OK. The celebration was great, our executive sponsor was there to experience the club’s awesomeness, and the club’s outgoing president, who I mentor and get to call a very close friend, gave a great speech. This was extra special as she just returned to work from medical leave herself. The incoming president gave a speech that had me looking for a brick wall to run through. I was fired up. Then immediately after the celebration, it was on to the hospital.

I was not at all nervous. I have had arthroscopic surgery on one of my knees and the “sleep apnea correction” surgery that removes your tonsils, adenoids, and shaves down the sides of your tongue. I have had severe arthritis in both knees for nearly 20 years. I barely notice when getting stuck with needles. So I have a high pain and drug tolerance and enough anesthesia experience that this kind of stuff doesn’t bother me much. Coming from the Toastmasters party, I was in a good mood. I entertained myself earlier in the day by listening to comedian Bill Engvall’s routine about his colonoscopy when he turned 50 (Go to YouTube and search Bill Engvall colonoscopy, and prepare to laugh) because he has no drug tolerance and was scared to death. I was making jokes with the nurses and poking fun at the one preparing my IV, because she was born the year I started college.

This procedure is simple. You don’t even have to fully undress, since all the work is on the top of your body. You get a bag to put stuff in. I just put my shirt and shoes in, and made a note to myself to steal the socks with tread on them for my wife (she loves those things). They put a mouth guard in your mouth with 2 holes in it, sedate you, and insert the camera, which is on the end of a long tube, down your throat, and examine your stomach as they see it on a TV monitor. It takes less than an hour. I was having fun and yukking it up all the way until I went under. When I first came out of it, I saw the surgeon and my wife talking. I would later learn she was telling my wife they found a little inflammation in my stomach, and she had prescribed some Prilosec for me to take for a month. Then I blacked out again, and when I came to, I had put my shirt and shoes back on and we were ready to go. We checked out, went back to the main entrance and called up an Uber to take us home. It didn’t occur to me until the next day that I had that big ol’ gap in my memory. I asked Netta about it, did I do anything stupid, and did I steal the socks for her like I intended to? “Yes, we got the socks, but you wouldn’t let me keep the bag.” What was my reason for that? “I didn’t ask,” she said, “I just looked at the doctor and said, ‘Isn’t he cute when he’s high?’ “ Okay. Let me get to my computer and see if I’m on YouTube….. No videos of me, so I guess I’m good.

Yesterday, I decided to go ahead and let my friends & family know what’s going on. The next bariatric nutritionist visit is August 9, and the visit with the bariatric therapist is on August 15. After that, one more nutritionist visit and I should be all set. So right now, we’re probably looking at an October date for the operation.

In the meantime, I have one “last fling,” if you will. It’s time for the annual Summit conference for the International Association of Administrative Professionals in New Orleans, which kicks off Saturday morning, July 22. Our flight leaves Thursday afternoon and we’ll be there for a week. I’m not going to go absolutely hog wild, but I’m not going to deprive myself of that fabulous food either. 🙂