Saturday, October 31, 2009

Oct 31 2009 - Halloween! and Gators vs Bulldogs football game from Jacksonville, FL

Happy Halloween, All. Today was a good day, but moreso for the anticipation of the Florida Gators vs Georgia Bulldogs football game today. I had another egg for breakfast today (omlette tomorrow!) and my wonderful protein additive, and was off for a bit this afternoon. I stopped on the way home to get Laurie's Borrego cleaned up and since it was nasty outside, there was no crowd - and no workers! It took the skeleton (!) crew a while to get to the Borrego, so I watched the first few minites of the football game at the car wash - when the Gators scored so quickly in the 1st quarter, I relaxed a bit.

My weight loss continues, my body continues to heal from the surgery, the bruising is, well, still there. But all else is kicking along just fine.

I found a great recipe for noodle-less lasgna that meets my Phase 2 requirements and is high in protein, gonna try it tomorrow.

  • 3/4 cup cottage cheese
  • 1/4 cup marinara sauce
  • 1/4 tsp oregano
  • 1/4 tsp basil
  • 2 egg whites.
  • mix together, bake at 350degrees for 30 minutes.
Have a great Halloween, all. See you tomorrow.

Happy Gator on WDUN/AM

My mother has a Friday broadcast on WDUN-AM here in Gainesville, GA where she is known as "Happy Gator", a Florida Gator football fan. The two morning hosts, Bill and Joel, talk to "Happy Gator" for a few minutes around the Friday 8:30am timeframe during the football season and often pit her against Georgia Bulldog fans, all in good fun. I have a brief clip of "Happy Gator"s latest broadcast on Fri 10/30/2009. Go Mom!

Friday 10/30/2009 Post-Op followup with Dr. Richard

I had a great Post-Op visit with Dr. Richard. As I walked into the Dr's office, I noticed the others in the waiting room. There were at least six other "big" patients there, and some looked very unhappy. I figured the unhappy ones were probably there post-op and suffering through that two-week liquid diet, like I was two weeks ago. Others that were leaving with bags of vitamin supplements and protein powder seemed much happier (like me!). As I waited, the receptionist asked me to fill out a standard form that described my post-op status and had a list of 16 (sixteen!) maladies that often affect weight-loss-surgery (WLS) patients - and I was able to answer 'no symptoms' to all of them. I hope and pray that continues just like it is.

The doctor first noticed my Gator shirt. As a Harvard grad, he said he didn't have a "dog in that fight". Bad euphemism! He then "inspected" my abdomen and said everything looked good (other than the bruising, which he thought would get worse before it started to get better). I asked my questions (diabetes, blood pressure, goal weight) and he said I was free to move on to Phase 2 of the recovery diet. That means I can start to add softened solids, like fish and chicken. big day!

It was a cold and rainy day outside, but I felt pretty good! My brother Ken and I went to Sams to look at an item he is thinking of buying, and since it was lunchtime, we went to a Thai restaurant nearby. I thought I could find something on the menu that met my dietary needs - and I did. But I think my stomach (pouch!) overruled my brain, and my selections were not the best :o) I enjoyed eating the limited amount that I did (5 or 6 shrimp, soup, some veggies well chewed), but the rest of the day was uncomfortable. I see that the predictions that my new stomach would dictate my dietary comings-and-goings were indeed correct! A good friend who also had this GB surgery said that I would step over the line once, but not twice. Well, consider that done!

Today is 10/31/2009, Halloween, and the Florida/Georgia football game. And tomorrow is November! The Christmas tree goes up next weekend (why wait?).

Have a great day! Steve

Thursday, October 29, 2009

Thu 10/29/2009 7 days Post-Op.

Today was a very good day. I was able to add refried beans to my diet, cutting them with chicken broth, or the tomatoe soup that Lisa and Ken have so graciously provided. Yum! But my big day is tomorrow. I have a 10:45am surgery followup with Dr. Richard. Tomorrow morning I get to have a single scrambled egg! I can put a tbsp of salsa and a pinch of shredded cheese on it. A real meal! I am guessing that the reason for the doc wanting me to have eaten "something of substance" is so that he can listen as it moves through my newly routed intestinal tract. Sounds OK to me! Bring on the EGG!

But this is interesting. I am down 18.8 lbs from my preop surgery weight!

Well, tomorrow is trash day, so I better start gathering the trash before it gets too dark out.

More tomorrow! Mmmmmm. An egg!

Wednesday, October 28, 2009

Nice day! Wed 10/28/2009 Day Six Post-Op

Today was very pretty outside, so the dog, Koko, and I went for a walk before noon. Meals have been going good, the coffee drinks (2) have been really beneficial in the mornings, and I had to go restock on gelatin and pudding this evening. My sister in law Lisa and brother Ken fixed me up with a generous supply of homemade soups, each neatly stored in a 1-serving storage container. Heat and eat!

I didn't sleep very well last night, Laurie was restless and Koko threw up twice for some reason. He seemed OK today, we switched him to a "s/d" vet supplied diet for the day, and he ate it up! Strange. But in this household, anything can be expected! I do mean that in the nicest way.
My Post-Op checkup with Dr. Richard is on Friday! Kinda excited about that for some reason.
Have a great evening, all. BTW, the "woot off" at is going into its 2nd day. When will the madness end? :o)

Tuesday, October 27, 2009

Tuesday Oct 26, 2009 Day 5 Post-Op

Today was a good day. Well, sortof... it rained the entire day, and the dog and I had every intention of getting some exercise! It was a nice, steady rain, something that this area has needed for years - and one that has been wreaking havoc with neighbors to the south of us for the past few weeks.

But I digress. Today started well, with me again enjoying the "cappuccino" style coffee drink(s) this morning that got me 50g of the required 95g of protein for the day. I am down 17 pounds so far (since the start of the liquid diet) and can really feel the difference. Today was the 2nd day of being 'on leave' from work, add that to the bad weather, and it seems that I have been cooped up in the house for almost a week.

I tried a lentil soup recipe from the web page recipe page - 300 calories total for two servings, and I can add salsa and a bit of hot sauce -and puree it thoroughly. I have to watch my liquid intake, making sure that I get at least 64 oz of water each day - that is 1/2 a gallon! It's not all bad - I get to count the coffee, tea, and SF popsicles towards that goal.

I still had the hunger confusion today, but with splitting the lentil soup into two separate "meals", that helped to keep my mind off the hunger aspect. My energy is good, my health and recovery seems to be very good, and I am quite blessed.

Monday, October 26, 2009

I read this somewhere....

"Chewing is the first part of the digestive process".

It does make you thing, doesn't it? Chew your food! I have to be especially conscious of this.

new pics of the grandsons!


Monday 10-26-2009 4th day Post-Op - Am I hungry?

I have to get past a mental block. I think that I am hungry, but am I really hungry? Yesterday was a tough day for me, and I am just 4 days out of surgery! I thought about food all day – of course the TV and periodicals are slam full of advertisements for every kind of food you can think of, so that doesn’t help, but it is life – and I really have to get over that.
My abdomen is still tender, but I had major surgery! My stomach was split in two pieces and stapled, my intestines were disconnected and reconnected – I will be swollen for quite a while. But why am I hungry? I am doing a great deal of reading about what others have gone through and found several good resources out there – it is interesting to differentiate between the “amateurs” out there and the corporate-sponsored sites. Everyone seems to have an agenda.
I read of some folks that are weeks or months post-op and can’t even look at food without getting sick. I see some that pop right back from surgery (like me?) and never look back. And there are some that suffer for weeks or months with medical complications. I am indeed fortunate.
Today I tried a recommendation I found on (an amateur site that has now morphed to a corporate-sponsored one). As part of my post-op therapy, I have to make sure I get 95grams of protein a day. I use a powered protein supplement (like bodybuilders use!) called IsoPure. One blogger there mixes their IsoPure with their morning drink. Hmmmm. 2 scoops – 50g of protein, so I tried one scoop with a cup of coffee, 1 pack of Splenda, and my hand mixer (this little iGo hand mixer is a jewel!) and Poof! I have a very tasty cappuccino-like drink. Very nice. I’m on my 2nd cup this morning, which ensures one-half of my daily protein requirements. I also found a nice “liquid diet” approved soup recipe: one can of black beans (drained), ½ cup of salsa, 1 cup chicken broth. Mix in blender, makes 2 servings. EAT ONLY ONE SERVING at a time. (Remember, you dumb schmuck, you are NOT hungry, you only think you are!). I’m going to try this for “lunch”. I get my supply of wonderful soups on Friday afternoon from my brother Ken, his wife Lisa, Mom Happy – frozen and ready to eat!
Also found a neat recipe for Phase 2 (soft foods), cottage cheese pancakes! Cottage cheese, diced onions (from )

  • Half a medium onion, chopped
  • 1 tablespoon butter (I actually don't use any butter. I just sauté with PAM and some butter spray instead)
  • 1 egg (I use egg substitute instead)
  • 1/2 cup low fat cottage cheese
  • 2 tablespoons flour
  • saltpepper

I feel much better with a bit of caffeine in me. Today is my first day “on leave” from work (at my workplace, any time away from work is considered “leave”). I am taking it easy, trying to stay busy (and keep from thinking about food), and healing well.
Thanks for reading, thanks for caring, and thanks for being part of my life – my new life! Onward, friends.

Sunday, October 25, 2009

Sunday 10/25/2009 - broth, jello, coffee!

It's Sunday morning and I am home. The doc kept me an extra day to make sure my kidneys and bladder were working properly. Shortly after the catheter was removed, I quit peeing. For five hours. The doc said it would be a good idea to keep me one more night, for if this were indeed a problem and I was sent home, I would have to come back to the hospital through the emergency room. He wrote orders for 1000ml of fluids via the IV, and I got to enjoy dinner (broth, jello) and another night in rm6717. during the evening I quickly converted the 1000ml of fluids into an equal amount of urine, and after a rousing breakfast of - broth and jello and decaf coffee - Dr. Richard released me and I was home by 11am on Saturday.
I return on 10/30 for my followup, with instructions to "eat a scrambled egg" before the followup visit - I guess Dr. Richard will want to see how I handle solid food.
I feel pretty good, though sleeping is a bit rough with the abdominal pain I have. Dr. Richard prescribed Lortab Elixir for pain, but the pain is not really that bad - just uncomfortable as I move around - I didn't realize how much you use your abdominal muscles.
I also get to start on my vitamin regime - b12, b-500, calcium citrate, iron (sub lingual), multivitamins. All but two are chewable, the iron is under-the-tongue. Documentation states that anything in a pill form may not be absorbed properly by my new stomach and need to be either liquid or chewable.

Friday, October 23, 2009

I'm back! Sitting up, eating 1oz of ice, feeling pretty good. Not hungry!

Courtney and the boys picked me up at 6:15am and took me to the hospital. Laurie stayed behind; I was worried that she might pick something up at the hospital in her weakened state, and she reluctantly agreed with me. As we pulled up to the entry way, Happy and Doc (my parents) were right behind us! Hugs were exchanged all around.
Dad and I proceeded to the Surgery Waiting Area while Mom and Cournty ran an errand, and about 7:50am (right on time!) I was called back for PreOp. The nurse gave me the ever-popular hospital gown that ties in the back :o) and a set of compression socks (knee high) and the non-skid footie socks. An IV was started, the Anesthesiologist came in and talked for a bit, and I was ready! The nurse I was assigned revealed that she had gastric bypass surgery five years ago, dropping from 287 to 137. She had Obesity Solutions do her surgery as well. And sure as “grits are groceries”, the OR Nurse came for me at 9:30AM. These folks are on time!
The Operating Room was very cold, with three HD monitors hanging from the ceiling and three of the large OR lamps. The operating table was a very thin mattress, maybe 2 ft wide. When I arrived, two of the OR nurses started to build-out the table, increasing its width, installing arm boards, and installing a foot board. I scooted from the hospital bed to the OR table and the nurse put a blue hairnet on me. I asked about the foot board and was told that for this procedure, I will be rotated so that my head is higher than my feet, and the footboard (along with a seat belt at my knees) will keep me from sliding off the table.
The anesthesiologist peered down at me next and placed a mask over my nose and mouth and said “breathe very deeply, Mr. Jones”. And that was all that I remember.
My next memory is waking up in recovery and having to go to the bathroom badly. I tried to get out of bed (nope! Can’t do that!) and the nurse told me that I had been catheterizedand was urinating just fine. I had my BiPap machine on my face, which made my recovery a biteasier. I felt this intense pain around my midsection, again like someone had hit me in the gut with a bat. About 1pm I was wheeled to my room (6717) and got settled. My brother Ken was there (I think), and I kinda went in and out of consciousness for a short while. I was allowed to have some ice chips, and boy were they good ice chips! I called Laurie and told her that everuthing went well, and later in the evening Courtney and Lisa came up to visit for a bit, it was good to see them. I watched a bit of TV and went to sleep around 9pm. I woke up at 1am and wanted to sit up for a minute, and proceeded to knock over my ice, drop the TV controller, get my feet caught up in the covers and pull loose one of the compressive leg sleeves. I was a mess! I did see the TV controller and was able to press the “call” button with my big toe. Success! When the nurse came in she got a good laugh out of my predicament. Once I got settled we went for a short walk – it seemed like a marathon, but I am sure it wsa just 30 or 40 feet down, and back. Still just in my hospital gown – commando!
Well one thing is different. I am not hungry!
More later. It is 4am on Friday, 10/23/2009

Wednesday, October 21, 2009

Wed 10/21/2009 PreOp Day 14 - surgery is tomorrow!

Today is “the day before” – surgery. I have survived the two-week liquid diet, but the thought of the surgery has really taken my appetite anyway. I have read and re-read the “what to expect before” and “after” material, and kept good records as requested by the docs and nurses. Now it is just a matter of getting the surgery over with. I’ll be back online sometime Friday – the surgery is Thu 10/22 at 9:50, and after an overnight stay, the plans are to release me “around dinnertime” on Friday 10/23/09.

And with that, the rest of my life begins. There is no turning back on this decision, which in itself is reassuring to me. I have found wonderful support from my family and friends and employer, and want to make each of you proud of me and this decision that each of you helped me make. I regret deeply having to have this surgery, but as they say, “it is what it is”. I got myself into this predicament, and I will endeavor, with each of your help, to extricate myself from it, whole!

Check back periodically, friends – there is more to come!

Tuesday, October 20, 2009

Two days to surgery. Mon Oct 19 and Tue Oct 20

The diet continues. I am getting things lined up for the short hospital stay and the 2 weeks at home afterwards. The diet immediatley after surgery is pretty strict, but from what I hear I will not be interested in eating anything at all for a while. I have a followup visit on 10/30 (one week post-Op) and prior to that visit I am to have eaten one egg, scrambled, and to do so in very small bites. Prior to that, no solid food at all! Lots of liquid, but no more than one ounce at a time for the week after surgery. From the material, I understand that my new stomach will essentially be a pouch the size of an egg - one ounce. This pouch will expand over time, but care has to be taken not to overeat, or face possible hernias and "strictures" (narrowing around the suture area?) So I will be taking it easy and enjoying my new lifestyle.

Mon Oct 19 1050 caolries; 141 carbs, 89 protein
Tue : in process

Surgery is Thursday 10/22/09 at 9:50am.

back material part 3

The application packet became more of an endeavor than I thought it would:

* The sleep apnea study that I did in Feb 09 was acceptable, but if you snore or think you snore, a sleep study will be required – if for no other reason than to document that you don’t have sleep apnea. In my case, I have been using a BiPap machine for over five years (BiPap machines are similar to a CPap machine, but force air both into and out of the lungs.)
* I needed to write a “Letter of Understanding” to the doctor’s office outlining my understanding of the pro’s, con’s, lifestyle changes, medical monitoring and such required – and also have my ‘support group’ to write one.
* I was surprised at the different requirements that different insurance companies have: some require a weight-loss program for the six-months prior to applying for approval. Some require a loss of 10% prior to approval. Aetna requires a physician-monitored weight loss program for 2 years. One thing for sure – check with your insurance program early early early. In my case, United Healthcare required: a BMI 40 or greater or a BMI 35 to 39.9 with at least one related “co morbidity – cardiovascular disease, hyperlipidemia (cholesterol), type-2 diabetes, hypertension, moderate-to-severe sleep apnea.
* I needed a 5-year medical history from my family doctor. Luckily his office “went digital’ over the summer of 2009, and he had my records right at his fingertips. He was able to document our discussions, my weight at various points during the five year period, and his comments encouraging me to “do something about” this.
* The psychological test took about 4 hours. Written exams, multiple-choice and fill-in-the-blank, and an interview. Interesting. Took 2 weeks to get an appointment.

Sunday, October 18, 2009

PreOp Day 9 and 10 (of 14). Saturday 10/17 and Sunday 10/18/2009

Here is another picture of my grandson, Caden. Great kid!

The weekend was..... the weekend. I am oncall this past week and this weekend, and that keeps me pretty close to home and available should the system have issues. I am continuing to enjoy the wonderful soup that my sister-in-law Lisa Jones made to meet my PreOp requirements. Add some hot sauce, and you have quite a meal. Well, quite an improvement over the cream of mushroom and cream of chicken soups I have been having..... Thank goodness for sugar-free gelatin!

Four days to go till surgery.

Sat 1210 calories; 183 carbs, 87 protein.
Sun 1055 calories; 130 carbs, 92 protein.

Part 2 of background material.

After I attended the informational seminar and filled out a questionnaire, I got a call from the staff at Obesity Solutions. One of the first considerations is who will pay for the procedure. Obesity Solutions has a price sheet for the gastric bypass at two different hospitals - at NGMC in Gainesville the facility fee is $15,500; the anesthesia is $1200; the surgeon $8000, and surgical assistant $700, for a total of $25,400. Lapband surgery at NGMC is $14,500. At Northside hospital in Cumming, the bypass surgery goes for $17,186.00. A good bit of the detail is covered at the Obesity Solutions web page, which is here.

I received a very large mailing early that next week (april 2009) that contained all sorts of documents that had to be filled out, signed, completed, notarized - you name it! When I spoke with the staff at OS, the nurse encouraged me to complete this application as quickly as I could, for it could take months to do. I thought that was somewhat comical - months? But in all reality, it took three months for me to get the applications "complete". Not all of that was my time, but waiting for others to get things done, too. It was a timely and laborious process.

The documents that I had to complete included

  • a demographic and insurance info sheet (3 pages)
  • Medical History (very detailed) 5 pages. I had to document attempted weight loss - as far back as I could remember, but for at least the last 10 years. 10 years! My family physician was a big help with this (more later).
  • Insurance Verification (who did I talk to, when?)
  • Authorization to share health information
  • Type of surgery and hospital preference
  • Contact information
  • PCP Acknowledgement (to be signed by my family doctor)
  • AGreement to pre-surgery criteria
  • Agreement to pre-surgery screening
  • Alcohol consumption warning - no alcohol of any kind for at least a year
  • Agreement to the Plan for Success
  • Insurance Verification continued (document in-network and out-of-network costs and deductibles)
  • copy of drivers license front and back
  • copy of insurance card(s) front and back
  • document family history
  • frequently asked questions
  • sleep study (sleep apnea?)
  • psychological test info
  • need two letters of understanding, one from me, one from my support person/group
  • need for nutritional counselling
  • attend support groups
It took about three days for me to fill out my part. I had undergone two sleep studies over the past 10 years, the latest one less than a year ago. I scheduled the psych test and the nutritional class (2 classes), and found out about the support groups. I contacted my family doctor about my medical history and he said he had records on me back to when I first began to see him in 1988. That is a good thing!

I'll post Part 3 in a day or so. the psych test!

have a great week, all. three days till surgery! Amazing.

Fall pictures of my grandsons, Peirce and Caden

this is the latest pictures of my two grandsons, Caden on the left, Peirce on the right. Peirce does not like to have his picture taken (by a professional). Can you tell?

Saturday, October 17, 2009

Preop day 7 and 8!

Thu Oct 15 was a miserable day. I awoke feeling very dizzy and unstable. I checked my blood sugar, it was 140. I came on in to work and asked 2 good friends to check in on me periodically. I had a bowl of grits (no butter) for breakfast and a pudding cup and started feeling a little better. By lunchtime I was OK. But when 4:30 pm came around, I was again feeling a bit shaky. I didn’t get enough protein on Wed (no shake at all), I wonder if that was it?

Thu numbers: Calories: 1530 (a bit over the 1200 limit); Carb 220 ; protein 114

Today, Friday, has been a very good day. I had to work late last night till about 3am as I was oncall, but I slept till 7am and then came in to work. My blood sugar was at 67 this morning, so I ate a bowl of grits before I left the house. I brought a “box” of soup for lunch, V8 Corn Vegetable. No shakiness today. But right as I left work and got in my car, the cold sweats started. It is really odd. I stopped on the way home and got an unsweet tea from QT and ate a few sugarfree jellybeans. For dinner I had another V8 soup, Butternut squash. Very good!

Fri 1035 calories; 197 carbs, 24 protein (way too low protein. I need to make sure I get at least one protein shake in each day)

Part 1 of “back material”
As part of this blog, I want to revisit where this whole journey began for me. I turned 50 this year and am “obese”. Way too obese. It is obvious that I cannot or will not do anything about it, though I have tried several diets, exercise regimes and such. Nothing stuck. Except the weight! My father also was overweight, and he had a “lap band” inserted several years ago. He has lost some weight but it seems to be a battle for him to lose, gain, lose. I thought about the lap-band, but when I hit the big five-oh, I decided it was time to do something. Laurie and I talked about it for a long time – months – and I started a conversation with my family doctor, who has been encouraging me for 20 years to take care of this weight problem. I asked if he had a preference here in the Atlanta area – and also one that my health insurance company would work with. He gave me two choices: Atlanta Bariatric (Emory) and Obesity Solutions. Each group had a slick web page, and each offered a “informational seminar”. I decided to go with Obesity Solutions in Gainesville, GA based on that seminar. At the seminar there were about 30 people, along with one of the surgeons and several post-surgery patients. The surgeon, Dr. Richard, spoke to the group and showed a short video outlining what Obesity Solutions offers and briefly describing each of those options – be it lap-band, gastric bypass, or sleeve gastronomy. At this time Sleeve Gastronomy is not an “approved” procedure by most insurance companies and is primarily used for the super-obese as an in-between measure before performing gastric bypass. That ruled out the sleeve procedure for me! A Q&A session followed the video, then Dr. Richard turned over the rest of the session to the post-surgical patients for the group to ask questions of. Pamphlets were available and there were several staff members who were eager to answer any and all questions. A questionnaire was offered for those interested in looking into this procedure further, and I filled on out.

More to follow!

Wednesday, October 14, 2009

PreOp testing today, Wed 10/14/2009, day six of the preop liquid diet. Surgery date set for 10/22/2009 at 9:50am

Today was my preop appointments with the surgeon and the hospital. Appt at the surgeon was for 9:45am, I was actually called back at 10:30. OK, first thing. How can a doctor be 45 minutes behind at 9:45am? Enough of that.... The entire preop with the surgeon involved signing another stack of forms regarding the use of a surgical assistants (and understanding that my insurance will probably not pay for this surgical assistant) One form said that if my insurance would not pay for this assistant, my bill from said surgical assistant would not exceed $250.00. The other form, for another surgical assistant group, said their bill would not exceed 10% of what the surgeon charged. I asked the nurse why the two forms? she said they would not know which group would send a S.A. till the morning of my surgery. :o)

After all that the surgeon came in and asked me if I had any questions. Then he brought out a rubber model of the stomach and small intestine and showed me what the surgery would entail. No surprises there!

The only question I had was regarding diabetes. Since the surgery eliminates diabetes in 98% of patients, why are people still dying from diabetes? I have lost three associates at my workplace in the 20-plus years I have worked there. All three were not obese, but had rampant diabetes. They lost feet, limbs, and eventually their lives. Why didn't the medical community offer this surgery to "cure" diabetes?

The surgeon smiled and said if he could absolutely prove why this bypass eliminated diabetes in practically all patients, he would be awarded the Nobel Prize for Medicine and be a rich man - and smiled. He showed me how the pancreas interacts with the stomach and liver, and how surgeons outside of the US are redirecting the intestinal tract to bypass the area where the pancreas secretes into the digestive tract. And with no stimulation, the pancreas does not excrete insulin - and that - they believe - is how this surgery eliminates diabetes.

He said that surgeons in Brazil and Europe are indeed performing this kind of surgery for problematic diabetes sufferers, but the FDA has not approved this surgery for that malady at this time. But if I walked in with the necessary cash and asked for the surgery, could "he" do it? He just smiled. It seems so odd that people are losing their lives to diabetes when there is a treatment that "might work" for them. I just don't get it.

I digress! Back to the exam. The surgeon pressed around on my liver and listened to my chest and shook my hand and said he would see me in a week. The entire exam took less than 30 minutes. :o)

From there I headed to my brothers house for a quick bowl of homemade soup (liquid diet!) Lisa Jones, my wonderful sister-in-law, made some wonderful tomato soup - oh my, it was good. It was better than good. It was amazing!

After that short break, I headed to the hospital for preop. Nothing surprising there other than the efficiency and friendliness of the entire staff at the Northeast Georgia Medical Center in Gainesville, GA. They are just top-notch. The equipment is state of the art, even the chair I sat in for the bloodwork raised and lowered to bring my veins to the most optimum level for the nurse to draw blood or do the EKG.

The last lady in was from Respiratory. She said she needed to draw some blood for an "Arterial Blood Gas" test. an ABG. I didn't think anything about it till she opened the test packet and drew out a syringe with a very long but very fine needle. She then asked me to turn my left wrist over (palm up) and she felt around at the base of my wrist, then proceeded to insert that damn needle way up into my wrist! She did warn me - "big sting!" - before she assaulted me, but the big sting was a big sting! There was another nurse in the room with me interviewing me and she could see my face contorting as this ABG test went on. It turns out that the ABG test has to get blood from an artery instead of from a vein, like most blood draws are made from. Just thinking about that needle makes my entire left arm tingle..... well, she got her arterial blood alright. From there I went to xray for a cursory chest xray and then I was released.

I drank too much coffee today and my blood pressure was up (I gotta wean myself off caffeine), and my diet today was enriched by Lisa's Tomato Soup.

Calories 980; Carbs 180; Protein: 26. (Protein needs to be 95 or more. I did not make a Protein Shake today. I have to watch that! Protein ingestion will be quite important after surgery).

another cold and rainy day in NE Georgia. At least Lake Lanier is back at "full pool". It has been almost 5 years since the lake was at "full pool".

Oh, and the big date: Thu Oct 22 2009 at 9:50am is the surgery. I need to arrive 2hrs earlier than that, but no "bowel prep" prior to the surgery! Hey, I am grateful for the small things at this point. If all goes as planned, I''ll spend one night in the hospital and go home "around dinnertime" of DAy2.

Over the next few weeeks I'll post not only the present information, but also go back five months or so and discuss what has happened as I traveled from deciding to look into surgery till now. It has been an interesting trek! Stay tuned.



Tuesday, October 13, 2009

more psych fun!

Here are some more interesting questions from my recent pre-surgery psychological evaluation. There were 400 of these; I’ve included just a sample of the more interesting ones. The answer choices are True/False.

Respond True (T) or False (F)
· I have a good appetite.
· Evil spirits possess me at times
· I enjoy detective novels
· I am very seldom troubled by constipation
· I am an important person
· I sometimes tease animals
· I like poetry
· My soul sometimes leaves my body
· I think I would like the kind of work a forest ranger does
· I see things or animals or people around me that others do not see
· I believe my sins are unpardonable
· I don’t blame people for trying to grab everything they can get in this world.
· Often I cross the street in order not to meet someone I see
· Someone has control over my mind
· Given the chance, I would make a good leader
· At one or more time in my life I felt that someone is making me do things by hypnotizing me.


btw - the doc said that of the 1,500-plus times he has given this exam, over 90% of the participants answer "true" to the first question.

PreOp Diet, Monday Oct 12 2009

Today was a tough day - the first day back at work, which I thought would help to keep my mind off eating, but all it really did was keep me from eating - is that all bad? My numbers for Monday were entirely too low, even with the Tortilla Soup broth. I did not fix a Protein shake at all, again with being oncall this week and not home till after 6pm, a milk-based Protein shake just didn't sound appetizing. On top of that I had to work from 11:45pm Mon till about 2:30am Tue for an oncall issue, so I went to bed around 8:30pm. I have to be careful with this - I need at least 95G protein a day.

Cal: 660; Carb 122; Protein: 21

On Sunday, I went to Publix to get some "rations". The experience was very unique! Sunday was Day3 of this liquid preop diet, and the moment I walked in the doors, I was overwhelmed by the stimulus! first was the aroma from the bakery, and then the deli! The SF gelatin is located in the Deli, so I had to wind through there. Then past the Seafood counter - even the smell of seafood was so amazing. I then walked down an aisle to get coffee.... and the bright colors of the breakfast cereal boxes were so amazing! It was sensory overload. Even the refrigerated milk box was bright and enticing. When the cashier asked if I "found everything I was looking for", I had to smile quite broadly. If she only knew!

Preop meeting with the Doctor on Wednesday, then with the Hospital that afternoon. Both want me to bring my checkbook and pay my part of the cost not covered by my insurance. These folks are getting pretty savvy!

Monday, October 12, 2009

As part of my Gastric Bypass approval by my health insurance company, I had to undergo a psychatric evaluation. Part of that evaluation was an IQ test. Here are some of the “fill in the blank” progressive questions that were asked. I wasn’t given the “answers”; what would your answers be?

1 2 3 4 5 _

12321 23432 34543 456 _ _

Tot tot bard drab 537 _ _ _

Knit in spud up both to stay _ _

3124 82 73 154 46 13_

Two w four r one o three _

57326 73265 32657 26573 _ _ _ _ _

Surgeon 1234567 snore 17365 rogue _ _ _ _ _

Tar pitch throw saloon bar rod fee tip end plank _ _ _ _ _ meals

Mist is wasp as pint in tone _ _

Sunday, October 11, 2009

PreOp Liquid Diet Day 3 Sunday 10/11/2009

Today was a difficult day. It seems that everywhere I turned there was food - being advertised, talked about, cooked (Laurie has to eat!), in the newspaper (Sunday papers are full of FOOD), on TV, the radio - and I went to Publix for some more gelatin. Can you imagine that assault on my senses! Every aisle looked so colorful and smelled so good - the bakery, the deli, the lady fixing the sample dishes....

I think it will get easier tomorrow when I go back to work. And I start on-call, too. It should be a busy week. I also have Pre-Op with Dr. Richard and at the hospital on Wednesday.

Rather than labor with what I ate, I'll just post my totals for the day

980 cal, 115carbs, 86protein.

The Gators won, the GA Bulldogs lost, and Jimmie Johnson won the NASCAR race. It was a good weekend!

Saturday, October 10, 2009

Preop Liquid Diet Day 2 of 14 (10/10/2009)

B'fast today
  • protein shake 220cal 26 carbs 68protein(!)
  • Cottage Cheese 110cal 5carb 11protein
  • yogurt 120cal 17 carbs 7 protein
  • grits 140cal 31 carbs 3 protein
  • pudding 80cal 19 carbs 1 protein
  • protein shake #2 220cal 26carbs 68 protein
  • soup 185cal 27carbs 19protein (used FF chicken broth instead of water, much tastier!)
  • applesauce 50cal 12 carbs
  • gelatin 45cal (3serv bowl)

total 1170cal 159carbs 164protein

much closer to the top end of the 800-1200cal goal.

I was home all day, and it seemed that everything around me made me think of food. But I made it!

Preop liquid diet, Day 1 (Fri 10/09/2009)

So far, so good. I took gelatin, pudding, and applesauce to work today. For the day, I ate the following:
  • 1cup grits (more than you think!) no butter. salt/pepper only. I do use the yellow grits.
  • 1 serving cherry flavored sugar free (SF) gelatin: 5cal, 0carb, 1protein
  • 1 serving chocolate pudding, SF. 80cal, 19 carbs 1protein
  • 1 service applesauce, No Sugar Added (NSA), 50cal, 12carbs
  • 1 light yogurt Fat Free (FF) 100cal, 17 carbs, 7protein
  • 1 Protein Shake, 50protein
  • 2cup milk, Lowfat, 220cal, 5carbs, 18protein

total 795cal, 101carb, 85protein

This was actually below the 800-1200 calorie goal for the day. I never really felt hungry, but food was on my mind all day.

I did have 3 cups of caffeinated coffee at work. and a 32oz Diet Coke from QuikTrip

Friday, October 9, 2009

fantastic post

the first post at this link, by "Lisa", is very powerful.

PreOp Liquid Diet, day 1 of 14

Today is the first day on my journey to lifelong weight loss. I will be posting background material over the next few weeks, but to sum things up: I am scheduled for Gastric Bypass Surgery on October 22, 2009.

I will be undergoing the Roux-en-Y version of the Gastric Bypass Siurgery,. To be performed by Dr. Robert Richard of Obesity Solutions in Gainesville, GA. Their web page is . here is a high-level explanation of the procedure that I will undergo.

Gastric Bypass
Gastric bypass uses surgery to form a smaller stomach (making it a restrictive procedure) and bypass part of the intestine (making it a malabsorptive procedure) to slow the eating and the absorption of calories and some nutrients. The potential lack of nutrients is what made the first bypass procedures so dangerous. But since the inception of bypasses in the 50’s, they’ve evolved into today’s gold standard of safe weight-loss surgeries, called the Roux-en-Y gastric bypass (RNY). The gastric bypass offers the most weight-loss potential, because the body no longer tolerates so many high-calorie foods, such as sweets and those high in carbs. But this means that patients must be prepared to never eat the types of food that may have been a large part of their enjoyment in life. The upside to this permanent and highly restrictive diet is a quick and ongoing weight loss. (learn more)
As part of the preparation for this surgery, today I get to start a 2-week liquid diet. The purpose of this diet is to “loosen up” the liver and reduce its fattiness prior to the surgery, since most of the procedure will take place behind the liver. Dr. Richard said that the easier the liver can be moved around, the better.

Todays weight 334.2

Decaf coffee
Decaf unsweetened tea
Sugar-free gelatin
Sugar free popsicles
Crystal Light
Sugar-free Kool-aid
Skim, 1% or Lactaid Milk **
Soymilk **
No-sugar-added fudgesicles
Low-fat cottage cheese
Protein supplements
Low-fat creamy soups (strained) **
Tomato soup
Unsweetened applesauce **
Sugar-free pudding **
Cool Whip Free
Cream of Wheat, oatmeal or grits (1x day) **
Light yogurt **

Not Allowed
Soft drinks
Caffeinated drinks of any kind
Carbonated drinks of any kind
Fruit juice
Sweetened tea
Sweetened gourmet coffees
Other solid foods
All others

Combine foods allowed above to provide no less than 800 and no more than 1200 calories per day
Consume 1-2 servicngs of protein supplement (meeting above guideliens) per day.
Begin a multivitamin supplement.
Record all intake daily using a food journal

For diagetics (I am diabetic)
Monitor blood sugars regularly
Consume 15g total carbohydrate every 4 hours. Foods containing approximately 15g total carbohydrate per serving are marked with the double asterisk (**)

Sample Mneu: PreOp Liquid Diet
Breakfast: ½ cup Cream of Wheat, protein supplement (50g protein)
Mid-morning: 1 cup light yogurt, 1 sugaqr free popsicle, Sugar free drink
Lunch: 1 cup low fat cream of chicken soup (strained), ½ cup unsweetened applesauce, ½ cup low fat cottage cheese, ½ cup sugar-free gelatin, 2 tbsp Cool Whip Free, sugar-free drink
Afternoon: protein supplement (50g protein), 1 no-sugar-added fudgesicle
Dinner: 1 cup low-fat cream of broccoli soup (strained), 1 cup skim milk, 1 sugar-free popsicle
Evening: ½ cup sugar-free pudding, 2 tbsp Cool Whip Free, sugar-free drink

Nutritional Information: 1140 calories, 136g protein, 10g fat, 126g Total Carbohydrates.
Notes: this sample menu contains approximately 15g total carbohydreates every four hours and is therefore appropriate for people with or without diabetes. Be sure to consume sugar-free liquids throughout the day between meals.

I brought a sugar-free pudding, sugar-free gelatin, and unsweetened applesauce to work today. I did buy a 32oz fountain Diete Coke at QuikTrip on my way in – I will have to cut that out, according to the preop diet. I am going to wean myself from caffeine slowly, starting today with ½ reg ½ decaf, and do the same with tea – at work we have a Flavia portion brewer that makes coffee and tea, so that shouldn’t be a big deaql. At home I can brew my own tea and coffee and slowly decrease the caffeine in both. The nutritionist says caffeine is a natural appetite stimulant, and I do not need any appetite stimulant.

But my history shows that if I do not get my caffeine fix, I get headaches. How can I deal with that?