An assessment

Next month will be the second anniversary of my bariatric surgery and I think it is time to assess where I have come from, where I am right now, and where I am going in the future. I had a heart attack and double bypass surgery in 2006 and while I recovered nicely, my weight, the major factor in the heart problem still existed. I went back to work in environmental consulting and tried to reconcile what I did, what I wanted to do and how all of the physical factors coalesced into a cohesive whole. I realized that after all those years working with my first wife’s issues and her weight that I really needed some help in getting the weight off. When I saw the 60 Minutes program on weight loss surgery in the spring of 2008 and its obvious associated effects on diabetes I knew that I really needed to do this. My insulin-dependent diabetes required four insulin shots per day to keep my blood sugar under control. The associated physical and medical effects from the diabetes were also weighing heavily on me. I really knew that my life would be shortened substantially unless I could get control of the diabetes.

I was remarried and was trying to deal with a new wife, a new life and soon a new culture living in Italy. Elizabeth’s support was important in the consideration to have the weight loss surgery. So in May 2008 I discussed the options with my surgeon and began the relatively rapid pre-operative run up to the surgery scheduled for June 4, 2008 at California Pacific Hospital in San Francisco, California. Dr. Jossart did asked me to see if I could lose a bit of weight before the surgery since I weighed in at 300 pounds (137 kg) at that first appointment in May. That small loss would help make the surgery a bit easier. I began to get all of the pro-operative testing and assessments done including an endoscopy, colonoscopy, heart assessment, blood work, and most importantly the pre-assessment psychological evaluation. By June 1 all of the information had been provided Dr. Jossart and I was ready both physically and psychologically to have the surgery.

My son drove me to the hospital on the morning of June 4, 2008 and I checked in at 10AM. At the time of my surgery I had lost about 8 pounds and I weighed 292 pounds. They dressed me in an over sized surgical gown and Garth and I sat talking for an hour or so. At noon they came in to pre-op me and I walked over to the preoperative area where I was given some medications to ready me for surgery. At 1PM I walked into the surgical suite and met the anesthesiologist, the surgical nurse and Dr. Jossart. All was ready, as was I. I climbed up on the operating table and laid back. The anesthesiologist set up an IV and the next thing I was aware of was being back in my room at 430PM. The nurse gave me a cup of ice chips to wet my mouth and I fell back to sleep. I had no significant pain or discomfort. The surgery had taken one hour and twenty minutes and had gone well (at least according to the surgical report Dr., Jossart gave me). The morning of the 5th, I was offered a small liquid breakfast of a protein drink, some juice and some Jell-O. I ate a little bit but was not particularly hungry. Dr. Jossart came in that morning to check on me and told me that after lunch (?) I could go home. Garth had stayed overnight in the city and was with me later in the morning. They served me another light liquid lunch which I ate some of and then they discharged me. Garth went and got his car, put the top down, and drove me back to Santa Rosa in the afternoon of June 5, 2008. Things were ready to change in my life. Elizabeth had returned to Italy in April to resume her seasonal responsibilities and I was alone in the house on Powderhorn.

Those first days seemed go by quite slowly. I was drinking high protein drinks and walking around a bit. I was keeping as active as possible. I had no pain or discomfort. My small abdominal incisions were healing nicely and I felt quite well. I was not hungry. At the time of my surgery I wore a size 54 jacket, had a 46 inch waist and wore a 3XXL shirt (19 to 20 inch collar). I stayed on the liquid diet for about three weeks, then I started eating soft solid foods. At six weeks I was eating solid foods and was losing weight quickly. It was the middle of July and I was preparing to move to Italy in early August.

I took my last long acting insulin shot the evening before my surgery on the 3rd of June and my last short term shot in July 2008. I have not given myself an insulin injection since that time. My blood sugar level in the morning is now at 70 which is a terrific level (100 or less is normal). My blood pressure was down. I had stopped snoring and I had no sleep apnea.

At the end of my first year post-surgery I weighed 168 pounds (71 kg). I felt good and when I had my annual blood work and vitamin analyses, things seemed to be going in the right direction. I was down in physical size to a 42 jacket, a 32 inch waist and a size 16 shirt (large in Italy sizes). I was getting up earlier in the mornings and had a good amount of energy. I was exercising regularly and felt wonderful. I had begun cooking with the AmoreSapore team in August 2008 when I got to Italy and was rapidly learning the recipes we used in our dinner catering and service. I was learning a “new” trade and felt great about it. Working was the best thing I could do for myself.

So that is where I have come from. And here at the start of my third year after surgery is where I am right now. I have maintained my weight with no difficulty at 165 pounds (70 kg), and I feel that the weight I have is being redistributed a little better on my body. For the first time in my life I have been able to wear a double-breasted sport coat. I had never had a double breasted sport coat body before. I weigh 30 pounds less than I weighed in high school. I feel and look pretty good.

I have been able to eat anything I want to without restrictions other than I can only Eight Bites per meal. That has been OK. I love to taste the tastes now, not necessarily to consume the volume. The only food that is a still a bit problematical is red wine. The tannins cause me some stomach pain so I avoid them and stick to small amounts of white wine when I want to have a bit with dinner. I have become well-known in local dining circles for my antipasti which to me are the perfect food, since they are small, tasty bites that are pretty to the eye and bring excitement to the dining experience. I often make my meal of several antipasti and will often order a plate of antipasti if we go out to eat. The transition from heavy to lighter has been an easy one. Both in terms of the eating side as well as the living side. I feel that I have a new lease on life and expect to live a long and healthy life.

So where do I go from here? For one thing I will never go back to being heavy again. The surgery I had was a one-way ticket, and there is no turning back. Why should I? I was unhappy heavy and am happier weighing less. Why go through all this just to return to being heavy again? Having maintained my weight loss for one year I know that it can be done. Dr. Jossart has asked me to counsel pre-surgical patients about what to expect in their new lives. And I have been able through this blog to provide clear information and advice to several patients who are considering the surgery. These include those folks referred to me by my surgeon, as well as former classmates and friends. The one significant issue I see with this process is the lack of sufficient pre- operative psychological counseling and evaluations. I have seen where the desire to lose weight can override a person’s problems with eating issues or disorders but those problems don't just go away. When they feel better having lost weight (100 pounds or more often) the “treat” themselves to more and higher calorie foods and can begin an inexorable weight regain. I have discussed this area before and the reader may wish to reread that blog entry.

This blog is being written to assist those who are heavy or who have had weight loss surgery to come to grips with the issues involved in good life choices. Weight loss surgery is not for everyone. But it can change your life.

So now I will get back to why I started this blog last year, food and how to enjoy it. New recipes and food ideas are in the works. Stay tuned. The best is yet to come.

So Happy Re-birthday Kurt. And to all of you reading this blog, thanks and stay with me. Life is just getting better by the day. Mangia!