Weigh-in (+5 Months)

Surgery +5 Months

Weight: 236.8 lbs (-6.1)
BMI: 31.7 (-1.9)
Fat: 28.9% (-2.7)
Neck: 18" (-0.5)
Bicep: 14" (-1)
Forearm: 11" (-0)
Chest: 48" (-1)
Waist: 46" (-1)
Hips: 40" (-0)
Thigh: 23" (+1)
Calf: 17" (+1)

See Rob. See Rob run. Run, Rob, run!

For the first time, I believe since college, I really ran. Don't get me wrong, I didn't experience a Forrest Gump moment. But I did run for a short period of time as part of my exercise this morning. It was actually easier than I expected; it still took a fair amount of exertion on my part, but I was surprised and excited by this little accomplishment.

4 Months Post Surgery

Surgery +4 Months

Today marks four months since my surgery.

Since I started this process, I have lost over 87 pounds. I now weigh 242.9 pounds.

This last month has been harder in many ways, including the rate of weight-loss. I only lost 7 pounds in the last month and almost all of it has been in the last week. However, as you can see from my last weigh-in, my body has continued to change.

So for today, I am choosing to focus on where I am today in contrast to where I was 4-and-a-half months ago.

April 16, 2012

August 26, 2012

Weigh-in (+4 Months)

Surgery +4 Months

Weight: 242.9 lbs (-11.3)
BMI: 32.6 (-1.8)

Fat: 31.6% (-4)

Neck: 18.5" (-0.5)

Bicep: 15" (-1)

Forearm: 11" (-1)

Chest: 49" (-1)

Waist: 47" (-2)

Hips: 40" (-1)

Thigh: 22" (-1)

Calf: 16" (-0)

3 Months Post Surgery

Surgery +13 Weeks

Today marks three months since my surgery.

Since I started this process, I have lost over 80 pounds. I now weigh 249.2 pounds.

Weigh-in (+12 Weeks)

Surgery +12 Weeks

Weight: 254.2 lbs (-9.5)
BMI: 34.4 (-1.3)
Fat: 35.6% (-2.2)
Neck: 19" (-0)
Bicep: 16" (-0)
Forearm: 12" (-0)
Chest: 50" (-1)
Waist: 49" (-1)
Hips: 41" (-0)
Thigh: 23" (-1)
Calf: 16" (-0)

75 lbs Lost!

Surgery +11 Weeks

As of this morning, I have lost over 75 lbs! It represents the halfway milestone to my goal of losing 150 lbs. 75 lbs to go!

2 Months Post Surgery

Surgery +9 Weeks

Today marks two months since my surgery. While it hasn't been easy, it has been worthwhile.

Since I started this process, I have lost 66 pounds. I now weigh 263.7 pounds. This is lowest I have weighed since using fen-phen before it was banned in 1997.

Weigh-in (+9 Weeks)

Surgery +9 Weeks

Weight: 263.7 lbs (-7.6)
BMI: 35.7 (-1.0)
Fat: 37.8% (+0.6)
Neck: 19" (-0.5)
Bicep: 16" (-0)
Forearm: 12" (-0)
Chest: 51" (-1)
Waist: 50" (-1)
Hips: 41" (-1)
Thigh: 24" (-0)
Calf: 16" (-0.5)

Relearning to Tie a Tie

Surgery +8 Weeks

For the last few weeks, I have had to tie my ties twice.

When tying a tie, my goal has always been to have the tip of my tie reach my belt buckle. This has meant, because of my girth, that it has become second nature to make the narrow end of the tie very short.

Now that I have lost almost 60 pounds, this habit has resulted in a tie length that extends well past my belt. So I retie my tie.

I don't mind. The too-long tie is a fun reminder of just how much weight I have lost.

Weigh-in (+8 Weeks)

Surgery +8 Weeks

Weight: 271.3 lbs (-3.7)
BMI: 36.7 (-0.6)
Fat: 37.2% (-1.5)
Neck: 19.5" (-0)
Bicep: 16" (-1)
Forearm: 12" (-1)
Chest: 52" (-0)
Waist: 51" (-0)
Hips: 42" (-0)
Thigh: 24" (-0)
Calf: 16.5" (-0)

Weigh-in (+7 Weeks)

Surgery +7 Weeks

Weight: 275.0 lbs (-6.4)
BMI: 37.3 (-0.8)
Fat: 38.7% (-4.4)
Neck: 19.5" (-0.5)
Bicep: 17" (-0)
Forearm: 13" (-0)
Chest: 52" (-1)
Waist: 51" (-1)
Hips: 42" (-1)
Thigh: 24" (-1)
Calf: 16.5" (-0.5)

50 lbs Lost!

Surgery +5 Weeks

As of this morning, I have lost 50 lbs! It represents the 1/3 milestone to my goal of losing 150 lbs. 100 lbs to go!

Weigh-in (+5 Weeks)

Surgery +5 Weeks

Weight: 281.4 lbs (-4.3)
BMI: 38.1 (-0.6)
Fat: 43.1% (-1.2)
Neck: 20" (-0)
Bicep: 17" (-0)
Forearm: 13" (-0)
Chest: 53" (-0)
Waist: 52" (-1)
Hips: 43" (-0)
Thigh: 25" (-0)
Calf: 17" (-0)

Sinusitis

Surgery +4 Weeks

I have been suffering from a sinusitis flare-up for the last week-and-a-half. This is not uncommon for me and often includes my sinuses bleeding. In the past this has given me a sour stomach, but with my new small pouch it has made it difficult for me to tolerate eating and drinking.

The major problem has been hydration. Besides suffering from dehydration symptoms, I believe this has hampered my weight-loss. It is strange to be in a position where I am forcing myself to eat and drink.

I did find some sugar-free popsicles that have helped. They are approved by my doctor and easier to tolerate than flavored water.

My sinuses have finally been recovering and I hope to see better results next week.

Weigh-in (+4 Weeks)

Surgery +4 Weeks

Weight: 285.7 lbs (-3.4)
BMI: 38.7 (-0.5)
Fat: 44.3% (-2.4)
Neck: 20" (-0)
Bicep: 17" (-0)
Forearm: 13" (-0)
Chest: 53" (-1)
Waist: 53" (-1)
Hips: 43" (-1)
Thigh: 25" (-1)
Calf: 17" (-0)

The Surgery - Part Two

The next thing I remembered were small snapshots of the transpiring events. I saw a ceiling; you spend a lot of time looking at the ceiling in a hospital. Nurses were rushing past. I believe there were patients on both sides of me, but I never had the inclination to move my head enough to look. I was in a recovery room.

I remember having some discomfort in my abdomen and I must of made my pain known, because a nurse came and gave me some medication. I felt better and went back to sleep. Then someone's alarm went off! In addition to that, a nurse got into my face and told be to take a deep breath. I was breathing — why wouldn't they let me sleep. I took a few deep breaths and the alarm finally was turned off. It turns out that the alarm was an oxygen saturation warning. The pain medication had relaxed me enough that I wasn't taking in enough oxygen.

The cycle of medication, sleep, and alarm happened once more before an orderly was called to taxi me to my room. The elevator ride was embarrassing. I am sure you have heard of the challenge to face the rest of the riders instead of the doors. This felt like that, except that it didn't because it was completely worse. There were doctors, nurses, and orderly all the way around the gurney and I was the spectacle in the middle (in my mind).

I didn't make this realization until after my surgery, but I felt that I would wake up feeling like some kind of cyborg. What would happened when I sneezed? Would I still burp? How much would I feel that my insides had been re-piped; Roux en-Y Gastric Bypass. I actually felt normal; it was surprising.

After the orderly spun the gurney around, I was pushed into my room where my lovely wife was waiting for me. At this point I felt awake and coherent, however my wife has a photograph proving otherwise — don't ask; you can't see it.

Weigh-in (+19 Days)

Surgery +19 Days

Weight: 289.1 lbs (-8.2)
BMI: 39.2 (-1.1)
Fat: 46.7% (-0.2)
Neck: 20" (-0)
Bicep: 17" (-0)
Forearm: 13" (-0)
Chest: 54" (-0)
Waist: 54" (-0)
Hips: 44" (-0)
Thigh: 26" (-0)
Calf: 17" (-0)

Weigh-in (+13 Days)

Surgery +13 Days

Weight: 297.3 lbs (-13.4)
BMI: 40.3 (-1.8)
Fat: 46.9% (+1.6)
Neck: 20" (-0)
Bicep: 17" (+1)
Forearm: 13" (-0)
Chest: 54" (-2)
Waist: 54" (-2)
Hips: 44" (-0)
Thigh: 26" (-0)
Calf: 17" (-0.5)

Weigh-in (+5 Days)

Surgery +5 Days

Weight: 310.7 lbs (-5.9)
BMI: 42.1 (-0.8)
Fat: 45.3% (-2.3)
Neck: 20" (-1)
Bicep: 16" (-0)
Forearm: 13" (-0)
Chest: 56" (-0.5)
Waist: 56" (-0)
Hips: 44" (-1)
Thigh: 26" (-1)
Calf: 17.5" (-0.5)

The Surgery - Part One

Annette (my wife) and I were 5 minutes early for my check-in time of 7:45 AM at LDS Hospital this last Wednesday, April 25th. After signing a few forms and being "tagged," we were called back by a nurse a little after eight. She asked a number of questions including my name and birth date. I learned through "much" repetition that my name and birth date were being used as a security check at each step. I wasn't sure what to think when they asked whether I knew my name and birth date — this was before any anesthesia.

We were led to a prep room. Here I was given my hospital formal wear, shaved (not my face), had blood drawn, given my first of four heparin shots (sting!), and attached to an IV drip. Around 9:30 AM, I was escorted to a waiting gurney. I was wheeled down the hall until we reached a waiting room door, where Annette was asked — of all things — to wait.

I got a quick glimpse of the surgery board as I was rolled by; and yes, it did look just like the one on Scrubs. It appeared that I was the third surgery for Dr. Smith this morning. I point this out because I know I was the first to signup for surgery on this day. I was told at the same time that this didn't guarantee me the first open spot and that a number of "medical" factors would determine the order. Sesh! So much for that early bird.

My gurney was stopped below a yellow sign that designated the area as the operating room parking zone. I was left to my own thoughts for a short period. It was at this point that the immensity of the situation began to hit. I was going to be put to sleep, have my abdomen cut open, and my guts rearranged. And, just in case you were wondering, from a reclined position, you can't see the exit signs.

I do feel I was very blessed in the hospital. I felt the thoughts and prayers of my family and friends; and I knew I wasn't alone.

One blessing came in the form of one of the operating room nurses. During some of the wait time, she told me that she had the same surgery, by the same surgeon, just seven months earlier. Now I know that Dr. Smith had performed this surgery hundreds, if not thousands, of times. However, knowing that one of my nurses had just gone through what I was going through — it brought me some comfort.

All quiet quickly disappeared as I was interviewed by another nurse, the anesthesiologist, and the surgeon. A little after 10 AM, it was time to be moved into the surgery room. The anesthesiologist stopped the gurney in the surgery room doors to give me my first dose of medication.

I was moved from the gurney onto a very narrow operating table. The nurses secured my arms to my side in foam. I think I was also belted to the table. I was given another dose of medication. The surgery room had some five monitors around the table. It appeared that a number of them were for the laparoscopic cameras and others for displaying vitals. It was about this time that I thought I heard something about a third dose of medication.

* * *

Around 11:30 AM Annette was called into a consultation room. A few minutes later Dr. Smith joined her and let her know that the procedure went smoothly. They didn't need to remove my gallbladder, even though it is very common to do so. He mentioned that he wished every patient was built so well for this surgery — I am not exactly sure what this means, but it sounds good.

Weigh-in (-2 Days)

Surgery -2 Days

Weight: 316.6 lbs (-13.1)
BMI: 42.9 (-1.8)
Fat: 47.0% (+0.6)
Neck: 21" (-0.5)
Bicep: 16" (-0.5)
Forearm: 13" (-0.5)
Chest: 56.5" (-1.5)
Waist: 56" (-2)
Hips: 45" (-2)
Thigh: 27" (-0)
Calf: 18" (-1.0)

Radiology Orders

Surgery -8 Days

This morning started with an ultrasound of my gallbladder and an upper GI series. The results were normal, which means fewer possible complications during surgery.

Here are some pictures from my tests for my 9-year-old daughter; she loves medical images (her medical knowledge is a little scary sometimes).

gallbladder

esophagus

Weigh-in (-9 Days)

Surgery -9 Days

This seems like a good time for my first weigh-in with photos — not for the faint of heart!

Weight: 329.7 lbs
BMI: 44.7
Fat: 46.4%
Neck: 21.5"
Bicep: 16.5"
Forearm: 13.5"
Chest: 58"
Waist: 58"
Hips: 47"
Thigh: 27"
Calf: 19"

Pre-Surgery Diet

Surgery -9 Days

Today I start my pre-surgery diet. It is a a high-protein low-carbohydrate diet with no more than 1,000 calories per day. I will be starting with a Slim-Fast shake for breakfast and lunch.

Roux en-Y Gastric Bypass

Surgery -13 Days

I have opted to have the Roux en-Y gastric bypass. The procedure has a good track record and long-term results. While the less invasive nature of the lap band was appealing, I felt the combination of restriction, absorption, and physiological changes of the gastric bypass was a better option for me.

Graphic depiction of anatomy of Gastric Bypass, Roux en-Y (Proximal Technique)
Courtesy of Ethicon Endosurgery, used with permission.

Gastric bypass procedures (GBP) are any of a group of similar operations that first divides the stomach into a small upper pouch and a much larger lower "remnant" pouch and then re-arranges the small intestine to connect to both. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different GBP names. Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and physical response to food.

The small intestine is divided approximately 45 cm (18 in) below the lower stomach outlet and is re-arranged into a Y-configuration, enabling outflow of food from the small upper stomach pouch via a "Roux limb". In the proximal version, the Y-intersection is formed near the upper (proximal) end of the small intestine. The Roux limb is constructed using 80–150 cm (31–59 in) of the small intestine, preserving the rest (and the majority) of it for absorbing nutrients. The patient will experience very rapid onset of the stomach feeling full, followed by a growing satiety (or "indifference" to food) shortly after the start of a meal ("Gastric bypass surgery," 2012).

Gastric bypass surgery. (2012, April 8). In Wikipedia, The Free Encyclopedia. Retrieved April 12, 2012, from http://en.wikipedia.org/w/index.php?title=Gastric_bypass_surgery&oldid=486249276

Prologue

Surgery -14 Days

According to my calendar, I will be having gastric-bypass surgery two weeks from today. The reality of the surgery is beginning to set in and my heart is starting to beat a little faster. Don't get me wrong. I am confident in my decision and the hope for a "thinner me" is intoxicating. The actual surgery, however, makes me want to run and hide.

I have really appreciated those of you who have chronicled your experiences with weight-loss surgery. Reading about you has added a sense of reality to the clinical documents I have read on the subject. This is my attempt to reciprocate and at the same time create a record for myself. My wife is a great writer. I am not. But I will do my best to record my story.

Once upon a time . . .