November's Pictures!

I forgot to post November's progress pictures!

More Food Discoveries

I recently had a friend who had gastric bypass. Her partner has been quite helpful in finding high protein food.

Jimmy Dean’s D-lights breakfast bowls have 23g of protein and 230 calories.

Chobani Greek yogurt with it’s impressive 18g of protein, 130 or less calories, and serving size.

How I'm adjusting 4 months out

To further follow up on how I’m adjusting to my surgery the progress is slow but steady. Here are some of the things I have realized over the last month. I am learning to listen to my body and when to stop eating. I have also learned that if I choose to eat dense food like meat I will get full quickly. I have continued to avoid bread. Protein is vital and because I have a very reduced capacity for foodstuff I simply cannot justify eating bread as opposed to or along with protein. I do not think I will eat bread until my protein needs are not so high. However, I didn’t really eat bread before my surgery so this really isn’t a big deal for me.

Psychologically, I think I’m making progress but it’s much slower. My self-image issues are still a problem. When I look in the mirror, I still see the person I was before surgery. However, when I look at pictures of me I can clearly see the difference and when I look at pictures of myself before surgery I frankly don’t remember being that big. Socially, things are improving. I really don’t feel the pressure of food anymore when I hang out. I eat what I can and anyone who expects anything different is politely told their expectations are impractical.

How to calculate percent of excess body weight lost

To calculate excess body weight lost is simple.

1. Using a BMI chart simply identify the weight that takes you from overweight to normal. For me that weight is 177 lbs.
   
2. Using your starting weight subtract your ideal weight.
3. Next, divide the number of pounds you have lost by the number of pounds you need to lose in order and this will tell you the percent of excess body weight you have lost.
   

The reason this number is important is that most surgeons will say that a specific surgery usually results in 75% of excess body weight lost.

From my research here are the generally accepted amount of excess body weight to lose is:

Lap-Band: 40%-60%
Sleeve gastrectomy: 60-75%
Gastric bypass: 75-85%

However, sleeve gastrectomy is a relatively new procedure and long-term statistical data is still being developed. My surgeon has stated that he sees sleeve gastrectomy patients and gastric bypass patients lose weight at the same rate and generally enjoy comparable weight loss. Returning to my results, so far I agree.

4 months out

Friday the 16th of October marks four months since surgery, today I got on the scale, and it read 272. I did not anticipate losing one hundred pounds within the first four months. Before surgery when I was doing my research, it was fairly common to lose one hundred pounds in six months. However, I knew this is just a number the real number that matter is the percent of excess body weight lost. So far, I have lost 51% of my excess body weight.

Today also marks the day I completed my second goal. My first goal was to weigh less than 300 lbs. and my second was to lose 100 lbs. Now I’m working on my last goal which is to lose 75% of my excess body weight or to weigh 225 lbs. The one goal I am not setting for myself is to weigh 177 lbs. or to lose 100% of my excess body weight.

I have two reasons for this, the first being my surgery is guaranteed to help me lose 75% of my excess body weight and the second is I'm not sure I want to be that thin. I have a feeling the dietary and fitness changes I'm making will gradually keep propelling my weight downward but at this time I'm not setting a goal to lose all of my excess body weight.

Surgery has Improved Me

Hello World, meet the new and improved Kevin.

I am happier, more positive, and enjoy a better outlook on things. I definitely was not a negative person before surgery but as impossible as it may seem my personality has improved.

Allow me to elaborate.

I have changed A LOT since surgery. My personality is definitely not the same as before I had the surgery. This past week I have came to the realization I have changed. And to be honest, I hope these changes are permanent. I asked my work partner if she has noticed a changed in me since surgery because I feel like I have changed. She told me that I'm happier and a lot more positive. The unimaginable thing is that I think I'm even more outgoing.

The only thing I am taking for granted right now is the fact I don't feel run down and tired all the time. However, even though my overall mood has improved, I don't necessarily think my overall personality has changed. When I look in the mirror I still see me weighing 372 lbs. I still have the same self image that I had before surgery. My brain has not caught up with my physical changes.

I have seen people who have negatively changed since surgery and those are the people who put on the fake act to compensate for being overweight. When it comes to how I interact with people I would like to believe I'm genuine. I'm definitely not nice to people just to make them like me. I believe I learned at an early age that if someone doesn't like me then it's their loss. I think the big the biggest factor is that I never saw myself as a 'fat person'. I didn't let my weight define who I am now or what I can do with our lives. For me, it has gotten in the way but it never defined who I was. Also, I think the biggest thing resisting change is the fact that I liked myself before surgery. I think the ones who change hated themselves before surgery.

Like I said above, when I think of myself, it's like the new and improved Kevin and not the Kevin that became Jack after surgery.

Self Image

I've never been one to hate myself for being overweight. And even when I was 372 lbs I never thought I looked that heavy. Basically stated, I never let my weight define who or what I was or am.

I'm not sure if it's this attitude causing the delay in my brain recognizing the changes or if it's other factors but when I look at myself in the mirror I really do not see a change. However, if I see a reflection of myself in a window or some other surface where it's not a direct image I do not recognize the man I'm seeing.

I am thinking my brain will catch up and that the change is happening so fast it's having a hard time catching up.

Literally, the only time I see the rather stark progress is when I look at my before photo and the most recent photo.

Why do I post shirtless pics?

The answer is simple. I'm hoping someone will find my journal and see real life expectations. Everyone looks great with clothes on but I don't want to hide anything. Plus, it really lets me see the progress I'm making. Enough said.

3 Months Post Op

According to the Wii Fit I now weigh 287. That makes for a weight loss of 85 lbs since surgery. Since my last update I'm now wearing a size 2xl uniform shirt. This is down from a very tight 3xl shirt. I'm not sure if I trust the Wii Fit's weight estimate. I return to the surgeon tomorrow for my 3 month check up and we'll see how accurate it really is.

Eating...

I'm two and a half months out and I've been facing quite an odd psychological battle.

Feeling full.

Let's face it, if I felt full when I would eat before the surgery I would not be in the position I am in today. For the past few years I could eat a lot of food in one sitting and not feel full. And if by some miracle I actually would feel full I would feel guilty because the realization of how much I just ate would set in. Through classical conditioning the feeling full eventually led to feelings of guilt.

Over the past two months things have changed so fast that my brain is still trying to catch up with my physical changes. And now when I eat half a cup of food and feel full I first feel guilty and then I realize I just ate half a cup of food and I'm feeling full for a very different reason now. However, in some corner of my mind I still feel guilty.

I have done much better in learning my limit of food intake. My big helper has been Weight Watchers Smart Ones and Stouffer's Lean Cuisine. Their portions are perfect for me. I can spread them out over two meals and they are quite tasty. I am also not too worried about the sodium content because they are my only real source of sodium throughout the day. I have also slacked off on the protein shakes and have started trying to get all of my protein through meals.

Considering my new stomach can only hold 3-4oz of food I am forced to make every meal count and not eat crap. I try to make smart choices by eating high protein foods or fruits and vegetables.

Socially, I am still having a difficult time adjusting to my new stomach. So much of my social life revolves around food. I really have to work on slowing my eating down. That way I can pace myself with everyone else. The other thing I have decided is that when I go out to a restaurant I will share an entree with whomever I'm with. This really takes the pressure of eating off.

All in all, I'm slowly working on things and each week is better than the last.

I like this one better... haha.

It's kinda funny, I don't think I look that goofy anymore when I smile. I guess I can start doing that for pictures. :)

2 Months Post-op Thoughs

So it's two months after surgery and things are still going well. At my last doctor's appointment which was a week and a half ago I was 315 lbs. I have not weight in the three-teens since 2002. It's a good feeling to know that in a few months I'll never see the three anything again.

The hardest thing for me since the surgery has been adjusting my social life. I never noticed how much people and social gatherings revolve around food. I am still adjusting to this change but I think over time it will not be so odd because my friends will know that I simply cannot eat in quantity and I won't have to explain to them why.

I'm still battling with the eating one bit too much thing. The chopsticks help tremendously with eating slow and taking smaller bites. Needless to say I have some mad chopstick skills now.

The last thing I've noticed lately is muscle aches are on the increase. Most notably in my back and groin area. I think my back is adjusting itself to not carrying around so much weight and my groin is sore because I'm sure my gait is different and I'm using muscles that I haven't used before.

But all said, I'm still happy I had the surgery and I do not regret it. Socially it's a pain in the butt but otherwise I'm very happy.

2 Months Post-op

1 Month Post-Op Photos

The Ups and the Downs

I want to end this on a positive note so I'll write about the bad first.

Really, I only have two complaints. They both revolve around food.

I'm three and a half weeks out and I'm still having issues with a lot of foods. I've had to purge myself four times in the past two weeks. I've discovered my stomach holds two tablespoons and not a drop more. I've vomited more in the last two weeks than I have in most of my adult life. It's not terrible but it's very discouraging.

Since I had such a terrible day yesterday I'm doing full-liquids today. I think that is a good policy.

And my second gripe, I'm still not able to figure out my portion size. Some days 1/3rd of a cup is just perfect, others it's excruciatingly too much food. I still think I'm eating too fast.

OK... now that that is over here is the good!

I've discovered Worldwide Pure Protein Shakes. It's so easy to get my daily protein. I have a shake for breakfast since I'm not much for food and I have a shake before I go to bed to give my body something to gnaw on while I sleep. The good part... 70g of protein is easy. I'm totally in love with the cookies and cream flavor. To me it tastes more like coconut than anything else. I also like the banana flavor.

My bowels are basically back to normal. This is very encouraging. The diarrhea was driving me nuts. I think they should warn patients pre-op that they will have rather significant diarrhea.

And my healing is still progressing rather well. Some days I have a slight twinge and others nothing at all. The bruising is 90% gone and my incisions are glue free.

But taking the bad in consideration with the good, I still do not regret what I have done. My habit is to consider the future is far more significant than the present and hopefully with enough time and "training" I will know my limits.

I do not regret this...

10-day check up

I forgot to post about my 10-day check up. The surgeon says I am progressing well and he removed the drain I had sticking out of my side. That was a rather weird experience. Not necessarily painful, just a very odd sensation.

I weighed 31 pounds lighter as well or better stated I have lost 11% of my excess body weight. My weight loss really didn't sink in until about a week later when I had a thought come to me as I was walking through Walgreens.

I will never gain those 31 pounds back again! That was a very good feeling.

Learning my limit

I'm 2.5 weeks out from surgery and things are going reasonably ok. I'm no longer sore from the surgery and my incisions are healing well.

On Tuesday I was able to progress to phase three of my diet which is "soft foods". I have been having a hell of a time with this phase. This may sound gross but I never knew I could make myself vomit until I tried to eat eggs. According to other WLS folks, eggs are notoriously hard to eat and it may take as many as five or six months before I can tolerate them well.

I'm having a difficult time learning the limits of my food intake. I'm constantly eating too much and it always seems like I'm eating one or two bites too many. I'm guessing I'm eating too fast and my stomach cannot tell my brain I'm full until things are literally backing up. So far I can eat about two or three tablespoons of food. Or it could be I'm eating the wrong foods. I'm not sure. I'm certainly not a fan of vomiting.

I ordered a food scale that should be arriving this week coming up. I'm really hoping this helps me measure my food intake and things.

Tomorrow's strategy: Measure out 3oz (1/3 cup) of food and see if that helps.

Emotions

Walks are a good time for reflection. The past week has been a blur for me which I attribute to anesthesia and IV pain medication. But it's still hard to believe that all the waiting and preparation is over and the surgery is complete.

The thing I thought about the most during my walk is the fact that 85% of my stomach has been removed. And that thought introduced some interesting emotions. I'm not quite sure how to write them out but I am going to say that one of the emotions is a mild state of shock.

It's not shocking the surgery is over or the things I have to do to recover, it's the fact that most of my stomach is gone and never coming back. Some of the other emotions are pleasing. This mostly has to do with the fact that I will never be able to eat the way I used to again and that my portion size will always be from this point forward small. I will never sit down to eat the same way again. And another feeling I had was motivation. The pre and post-op procedures are enough to keep me on the straight and narrow for a while.

I think something has changed since surgery. They were right when they said you have no idea how your thoughts and feelings for food will change after surgery. At times before surgery I was preoccupied with what I would eat after surgery and how I'm going to handle this and that but in reality, it's been a chore to eat and drink.

5 days post-op

I was released from the hospital on Thursday evening. The surgery went well and the doctor estimates that he removed 85% of my stomach or leaving me with about two or three ounces. So far recovery has been progressing slowly but surely. Each day I feel better. I don't really have pain, it's more of a sore feeling in certain spots of my abdomen. I have used two pain pills since returning home. I'm not really a fan of them so the bottle sits there basically unused. However, due to the fact I decided on the VSG procedure I can take ibuprofen. I have been taking 400mg about every 6 to 8 hours and that really helps cut down on the soreness. I am able to sleep on my right side for the most part. I have never been a back sleeper and frankly cannot wait to sleep on my stomach again.

I'm not sure if this is a product of the pain medication, change in diet, or surgery itself but in the hospital my blood pressure was very normal. I believe the lowest reading was 112/57. I cannot remember my blood pressure being that low. So the doctor advised me to forgo the blood pressure medication and see what it is when I return for my 10-day post-op exam.

Since surgery my diet has consisted of clear liquids with the exception of milk for protein drinks. I looking forward to Tuesday when I can introduce "full liquids" into my diet. This consists of yogurt, thinned cream of wheat, blended soups and even blended chili.

Exercise has been progressing. Today I decided to hit the street and go for a walk. I'm disappointed I cannot bring the dog for another week but I'm sure he doesn't mind. His time at the doggy daycare wore him out. I'm not sure if I over did it today but I walked a mile. I guess I will know later. I think I'll do the walks in the morning since it's cooler at that time. However, I'm still not convinced I'll do any outside exercise when it's raining.