Dave's Bariatric Surgery

I graduated high school in 1964, weighing 165.  I attended a junior college, and weighed 185 after 2 years. In 1966, the Vietnam War was raging, and draft deferments for college folks were being altered, and a lottery system based on birth date was in effect for the military draft.  At that point I joined the Navy Reserve, taking tests, and ending up designated as a Communication Technician (R branch). The Navy later changed this rating's name to Crypto Technician.  This CT rating required a Top Secret Crypto security clearance, which had to be updated every 2 years and was maintained for 25 years. I attended Reserve meetings for 2 years, and then went on my 2 year active duty in the State of Washington at a Navy Communication Station in Marietta, WA.  After that I still had to attend Reserve meetings for at least two more years and I began schooling as a computer programmer. I worked in that capacity at Hughes Aircraft for less than a year, when government cutbacks cancelled the military contract I was working on, so I was laid off. I then joined the Carpenter's Union, in their 4 year apprenticeship program. At the Carpenter Apprentice ceremony in 1974, I was voted the Number One Carpenter Apprentice in the 11 Southern California Counties.  My skills as a carpenter came were instrumental in developing the majority of the cattery innovations at our cattery over the years.  I worked as a Union carpenter until 1991, when I developed heel spurs. I had two surgeries, and then developed other problems, and ended up on permanent disability in 1996. I smoked for most of the years between 1967 and 1991, but quit in the last year because I wanted to. The "magic bullet" for stopping smoking for me was to attend one session put on by a hypnotist.  I stopped smoking that night in 1991, so it worked very well for me. I also participated in the Naval Reserve program, having to retire as an E6 Crypto Technician, after 25 years in 1991, due to the heel spurs.  So the combination of quitting smoking, and the stopping of heavy activity at work, and stopping the Naval Reserve participation, led to a slow but steady weight gain. At my heaviest, I was 350. I had tried many "diet regimens" in the past. These included Weight Watchers, Healthy Lifestyles, and Herbalife. These offered temporary weight reduction, but that weight always was gained back over time.

    I almost forgot to mention that I suffer from major headaches daily. I've had many tests over a 5 year period of time, with no diagnosis as to the cause. This condition began around 1993, and has continued daily since. Although I've had an MRI, spinal tap, x-rays, and countless medical consultations with a host of different doctors, not diagnosis or cure for the headaches has been established.  I'm hoping "beyond hope" that these headaches will diminish as my health improves from surgery.

In mid 2005, I weighed over 325, and it was affecting my health. I had checked in to bariatric surgery (intestinal Roux-en-y) some 10 years ago, but found my health insurance did not cover the expenses.  Today this surgery, and the 2-3 day hospital stay cost my insurance company $27,000.    To fully understand what this surgery is about, please go to  http://www.crownsurgery.com/p158.html . In mid 2005, I discovered I might qualify for the surgery. I consulted my regular doctor, and found that I met the criteria for the surgery, and I signed up for the classes that were a pre-requisite for surgery.

photo of me in 2004 at about 350 pounds.

Photo of me 9/28/05, two weeks before beginning classes on surgery. Wt. about 340 pounds.

Certain criteria must be met for this surgery. You either have to have a BMI (body mass index) of over 40, which is considered morbidly obese. Or you can have a BMI of 35 plus certain co-morbidity conditions. I had high blood pressure, sleep apnea, high cholesterol, and weighed 330, which put me into the co-morbidly obese category (for my 6 foot 3 inch height), with a BMI of 41.9 ,that qualified me for surgery. I signed up for the mandatory 8 classes that began in October 2005, and were completed in February 2006. I then went on a waiting list for surgery. In the middle of March, 2005, I was notified that I was scheduled for a surgery consultation with a Dr. David Sah, a general surgeon, who was selected by my Kaiser insurance to do any of their bariatric surgeries.  I had an initial consult on April 5, 2006, where the doctor said I was in good enough health for surgery.  On April 17, I had another consult with the doctor. I weighed 325 at this visit.  I had a pre surgery consult on May 1, where I weighed 314.5 pounds. I had made an effort to maintain or loose weight since the last doctor visit, as the doctor said he would not do the surgery if I gained weight, and if I lost weight, the surgery would be easier for him. I was scheduled to have surgery on May 10, 2006.

Photos morning of surgery,315 pounds.

I got to the hospital at 6 AM as my surgery was scheduled for 7:30 AM. This is the first in hospital surgery of my life, so I was somewhat nervous. I was prepped for surgery by the staff at the hospital, and I spoke to the doctor and anesthesiologist for a few minutes. At 7:30 I had the surgery.  I'm told the surgery lasted about 1 hour and 20 minutes.  I spent May 10 and 11 in the hospital, going home at noon on May 12. I was quite amazed at the fact I was not hungry at all. I was on a liquid diet for the first 2 weeks, which allowed me to eat chicken broth, pure fruit juices, water, and non sugar popsicles. I went back to the doctor  on May 18, where I found out I lost 14 1/2 pounds, putting me at an even 300. I was now allowed to eat semi soft food, such as cottage cheese, scrambled egg, yogurt in TWO OUNCE portions every 2 hours. I also have to drink a protein shake every afternoon to make sure I get enough protein. I bought some Isopure Whey Protein shake powder from GNC Stores, that has 25 grams of protein per scoop of powder. I normally have a 2 scoop shake (50 grams of protein) every afternoon about 3 PM.

    One month past surgery, my doctor visit put me at 290 pounds. I was feeling well. I guess I'm doing better than a lot of patients of this surgery, as I've only thrown up twice since surgery. Once was due to drinking a larger than normal amount just after eating, and a the second time was due to slightly over eating. Every meal must be 2-3 ounces at this point. I do eat some soft fruits, chicken, turkey, sliced deli meats, boiled and scrambled eggs, a little beef, cheese, and yogurt. Basically most of my current diet is almost pure protein.  I am due to go in for my 3 month check up with the doctor on August 8. My weight scale at home was calibrated as close as possible to the doctors, and I note that today I weigh 265 on 8/5/06. 

I do have to do some exercise every day. This normally is a brisk walk with my German Shorthaired Pointer (Madison) around the block in the cooler part of the day. This walk is about 1 1/4 miles. Some days I do this twice, and one day I had "extra energy" and I did 3 walks around the block.  But I'll see what I weigh in a couple of days.

Photos 8/5/06 at 266 pounds

    On August 8, my 60th birthday, I went to the surgeons office for my 3 months check up. Although my scale at home was calibrated as closely as possible, my official weight there today was 266. This meant that I had now lost 49 pounds since surgery. The surgeon stated that I was loosing an average amount for this time frame.

    BTW, there are some restrictions on this surgery as far as diet is concerned. Some of them are:

• You cannot drink carbonated beverages, such as soda or beer any more. The carbonation could cause the surgery to separate, meaning a trip to the hospital for emergency surgery.

• Most people have problems digesting white bread, most pastas and rice--primarily high carb type foods.

• A high protein diet is a daily requirement. After a few months, 3 ounce portions of protein (fish, chicken, cheese, etc.) are to be consumed first at each meal. Then you can have a very small portion of starch or vegetable, about 2 tablespoons of each. You eat the protein first, to make sure you get enough protein. You would not want to eat the starch or vegetable first, and then feel too full to eat the protein.

• You have to avoid refined sugar foods. These are candies, cakes, pies, etc. The new stomach area cannot digest the sugars, which are then fed into the blood stream in an undigested form. This causes a "dumping syndrome", which involves fainting, heavy sweating, rapid heart beat, nausea, anxiety, and possible diarrhea.  So you do have to give up your "sweet tooth", if you have one.

• You have to eat protein with almost every meal. This means that a minimum of 75 grams of protein must be in your diet daily. This is almost impossible to do on the smaller portion sizes, so daily protein drinks are a must. A daily amount of protein drinks that provide 50 grams or more of protein are recommended.  I heartily recommend the Magic Bullet to mix your protein drinks. These machines are compact, come with mixing/drinking mugs, and are available from department stores (such as Target) or are available for ordering on TV ads.  The Magic Bullet is far easier to use than a conventional blender, are easier to clean up, cost less, and take up less counter space.  Sometimes I add peaches or berries to the protein powder, and mix it up in the Magic Bullet, making a smoothie.

• Chewable vitamins, at twice the RDA adult dose, must be taken daily.  The smaller "pouch" stomach area cannot dissolve some tablets, so vitamins in tablet form are not recommended. Also, chewable calcium is recommended. Calcium Citrate is the preferred form of calcium, as it is digested easier than Calcium Carbonate. The Calcium must be taken 2 hours later than the multivitamin, to avoid Calcium malobsorption, and depletion of iron in the multivitamin.

• You have to drink 48-64 ounces of water daily. This is to prevent dehydration.  You may also drink no calorie beverages like iced tea, or Crystal Lite, but no sugary drinks, or you may spend a lot of time in the bathroom.

• You have to adopt some form of a daily exercise regimen. Exercise is a part of the process in loosing the weight. Without the exercise (walking at a minimum), the surgery will not be of benefit to you.

• This surgery is a new "lifestyle". Modifications of your old habits have to happen, or you will have problems. So I would recommend that you start some of the regimen prior to surgery, so that you are in practice. I know that I used to consume 4-6 cans of Pepsi 100, the no calorie diet soda. I stopped that prior to surgery, as I know it would probably be difficult to do after the surgery.

        On August 9, I saw the doctor that follows my progress with my insurance carrier. I had labs done on August 2, and got to see the results today. I guess I'm doing OK, as all of my blood levels were acceptable to the doctor. The doctor told me that they do worry about dehydration, B-12 levels, protein levels and a few other things with bariatric patients. All of my blood work came out acceptable, and the B-12 levels and protein levels were at the upper end of the acceptable levels. My doctor told me that this indicated I was doing well.  I asked about cholesterol levels, but that is checked at 6 months after surgery. If my B-12 levels were low, I would be required to take monthly B-12 shots at the hospital. Good news to me.

    On August 10, we had a nice surprise. The Ragdoll mink male, Ragnarok's Hershey Barr,  we saved from last year, produced 4 minks in one litter today. Nice way to start the day. I've decided to begin "stepping up" the exercise. I now go for two walks per day. It's a 100 degrees here now, and I have to do the walks at cooler times of the day. Last night I took a walk at 9:30 PM, as it was still about 85 degrees here.  This morning I took my walk at 8 AM, before it began getting to warm. Also of note today, my weight is under 260---so that is a total weight loss of 67 pounds in a little over 4 months since my first visit with the surgeon.  I've been taking two walks per day, one early in the morning and one in the evening. On August 13, I took 3 walks for a total of 3 3/4 miles.

    Weight seems to now plateau at a slightly over 260. I've dusted off my wife's exercise machine, the one she used during rehab after shoulder rotator cuff surgery. This is it: 

This is a Nu Step TRS 3000, Total Body Recumbent Stepper. The seat is fully adjustable, so that your legs feel comfortable against the foot platforms. The arms are also adjustable to fit your arm's length. There is also an 8-level  tension adjustment to control the amount of effort to push against the pedals. Thirty minutes on this will really make you sweat, so be sure to have either a ceiling fan or stationary fan on in the room. It does have a heart and pulse monitor that came with it too. Got on this machine for 20 minutes on 8-17, instead of doing my second walk. 20 minutes was enough for me for the first time in years. It's my wife's machine that she had used in rehab for a shoulder injury. She liked the machine so much in rehab, that she bought one for home usage. She told me that the therapists normally start people out for 10 minutes on the machine per day, and then step up to 20 minutes after a few days.  Anyway, I got up the next morning and now am at 258, so I'll probably adopt a new exercise regimen, one walk in the morning and a work out in the afternoon.

    I've been taking two walks daily as of this date, 8/24, one in the AM and one in the PM. Yesterday I did not do a walk in the morning due to a busy schedule, so I walked the dog on my standard 1 1/4 mile walk, came home and dropped off the dog. Then I continued on for another 35 minutes until 8 PM. So I had an hour walk, about 2 1/2 miles in the cool of the evening, ending about 9 PM. I rested very nicely last night.  I'm driving to LA Airport tonight, so that will preclude my normal evening walk, as I have to ship 3 cats on a "red eye special" to get around warm temperatures. 

    Today is September 3, 2006. I've been doing two walks daily since my last update. I think I'm loosing more inches than pounds at this point. Although I truly do watch what I eat and how much, weight seems to come off slowly, even though it is just under 4 months since surgery.  This morning my scale said I weighed 254.  This new weight puts my BMI at 31.9, which is the lower end of the "obese" category.  Once my BMI gets to below 30, I am then considered "overweight" which is far better than the morbidly obese condition prior to surgery. Currently my diet consists primarily of some of the following daily:

• 4 pieces deli meat, usually turkey, providing 20 grams of protein.

• 4 ounce portions of reduced fat raspberry or strawberry yogurt, about 5 grams of protein taken 1-2 times daily..

• reduced fat string cheese, 2-one ounce sticks, about 14 grams of protein, once daily.

• about 2/3 cup of Special K breakfast cereal, with 2 ounces of 1% milk, giving about 4 grams of protein, for breakfast.  I recently found Special K Protein cereal, which gives 10 grams of protein on a 2/3 cup serving. I only consume a 1/3 cup serving for breakfast.

• at least one 2 scoop shake of Isopure Whey Protein drink, giving about 50 grams of protein, normally about 3 PM.  Make sure to read the labels on the Isopure. You want the type that has 0 carbs and zero or minimal grams of sugar. They do have an Isopure powder that is for body builders that has a high carb level, and this is the one you DO NOT want. It currently comes in 4 flavors at my local GNC stores--vanilla, chocolate, strawberry, and peach-mango.  I normally mix one scoop of vanilla with one scoop of another flavor for my protein supplement.

• a couple of snacks per day consisting of a small peach, a few almonds, etc.

• and a dinner. Example: last night I had one chicken leg, 2 tbsp of oven roasted potatoes, and about 2 ounces of vegetables. This meal was probably about 15 grams of protein.  I have very little pasta, some fish, some beef--eating the protein portion first before the rest of the small meal.

• As a "treat", I sometimes have a "no sugar" popsicle or an "all fruit juice" popsicle, when I have my evening walk.

• A small cup of pre-made sugarless jello.

• I try not to eat past 7 PM, but sometimes have a 4 ounce reduced fat yogurt.

• And this yields  a target diet of 75-80 grams of protein that I must have daily at this time.

`My current daily routine also consists of a 1 1/2 to 2 hour nap daily around 1 PM. I adopted this routine several months prior to surgery. Taking the nap allows me to get through the balance of the day without major headaches, which I have daily.

    I attend monthly bariatric surgery support group meetings in Corona, CA. These meetings have pre-op patients as well as post-op patients in attendance. I feel that attending these meetings is important to stay "on track" with the post operative diet and exercise program. We share experiences, and often have dieticians or surgeons that speak at these meetings.  One thing I learned on the September 12 meeting, was that a doctor at a recent Obesity Helps seminar had recommended a minimum of 100+ grams of protein daily, especially for men. So now I'm adopting the practice of having two of the 50 gram protein shakes daily, one in the morning, and the other mid afternoon. These meeting have some of my surgeon's staff in attendance, with the $2000 Tanika scale to check on our weight progress. This is the same scale the surgeon charts are post surgery progress. I weighed 255.5 pounds on his scale that evening.

    Today is Sept. 15. I got up at 4:15 AM as my nasal passages were plugged and I could not breathe with my CPAP machine. I weighed myself this morning. Good news--I'm now 251. Yesterday I had one walk in the morning, spent 30 minutes on my Nu Step machine, and took another walk at 6 PM last night. Each walk was around the block, 1 1/4 miles. Diet of yesterday consisted of: 3 ounces of Wheat Chex/Sugar Twin/2 ounces of 1% milk at 6:30 AM, one 50 gram protein shake at 10 AM, one small peach at 11:30, 4 slices of deli turkey sandwich meat, a second 50 gram shake at 2:30 PM, one small serving of sugar free Jello at 5 PM, another serving or Wheat Chex at 6:30 and one 6 ounce serving of low fat strawberry Yoplait yogurt between 7:30 and 8 PM (ate it slowly).  I think I'll try the same eating and exercise program as yesterday, and hopefully my next entry will be at 250 pounds. Just checked my weight at 5 PM and it's 249, and that was before my evening walk. I'm really hoping tomorrow morning weight will still be under 250.

    Sunday, Sept. 17. Woke up today, and I'm now at 249.  Did two walks yesterday, and spent 30 minutes on the Nu Step machine. Only had one 50 gram shake yesterday, had my normal mid day diet, but "splurged" and had an order of 5 beef taquitos, no guacamole, and dipped them in mild sauce (no calories in sauce). Ate 2 1/2 of them and was full. Guess I'll have the second half for lunch today.

    Today is Sept. 29. Got a new electronic scale the other day to make sure my weight is measured accurately. It's Health O Meter digital scale. Before you weigh yourself, you just tap on the corner, and it calibrates itself. Weight today on this scale is 248. The other scale became difficult to get consistent readings, so my wife got me this new scale the other day. I was wearing 4X and 3 X shirts, but they were getting too loose. Now I fit into 2X shirts, and 1X shorts instead of 2X shorts.  Keeping up the twice daily walks. Went to the post office today to make a large envelope, and got compliments from staff there who had not seen me in a few weeks. Then I went to the local small hardware store to get a plumbing part. Women staff there also noted the difference in my appearance. Got many questions on the surgery, that I was very glad to answer.

    Today is October 10, 2006. This is exactly 5 months past surgery. New photos below:

October 10, 2006

In this photo taken today, I'm wearing a 2X shirt and 1X shorts.  When I started I was wearing 4X shirts and 2-3X size shorts.  Today I weighed in at 245. This is a total loss of 70 pounds since surgery 5 months ago, plus the 10 pounds I lost the two weeks prior to surgery, for a grand total of 80 pounds. My goal weight is 220-225 pounds, my normal weight when I was working many years ago.

The photo above shows some items of my daily routine. The four left bottles are the Isopure whey protein drinks I drink twice daily. Two scoops of these powders, mixed with about 6 ounces of water and two ice cubes, provides a 50 gram serving of protein.  The black/silver item on the extreme right is the Magic Bullet machine that works very well for mixing these protein drinks. The clear plastic shape on top is the mixing and drinking mug for the protein shake.  Second from the right, is an individual cup coffee maker, where I make decaffeinated coffee every morning. Not seen in this photo is a "non sugar" French vanilla coffee creamer.  These items are a way of life for me now, and they are quick and convenient to use.

    Today is Saturday, Oct. 14. Friday the 13th was a busy day here. I had cat litter delivered, had a return call for my exterminator service due to poor service, and then had a cat client here for 5 hours. Then I had to pick up cat food, as I ordered it too late for delivery.  So yesterday was a productive day. Today I weigh 244. This past week I had some minor constipation problems. Due to the smaller amounts of food, most people with this surgery only have bowel movements every two days. At my support meeting this past Tuesday, we discussed this issue. A member of the group, who had surgery 18 months ago, stated that she takes two generic Colace stool softener gels every morning and every evening. I've used this sporadically since surgery. But now, I've adopted her routine too, and have not had any problems since.

    My surgeon's office gave us a card to keep in our wallet. It states we have had this surgery, in case of a medical emergency. On the back of this card, is a note addressed to eating establishments. It simply explains that the cardholder has had this surgery, can only eat about one tenth of a normal meal, and asks the establishment to offer a child's menu, senior menu, or some form of reduced cost meals. Several member I've spoke to at the support meetings have said that they seldom choose their own meal, but eat a portion of their spouse's meal on a separate plate. I recently went to a Mimi's Restaurant, and ordered off of the child's menu that they were promoting that week. Even though I showed the waitress and the cashier this card, they still charged me $2 extra, since I was over 9 years of age. So not all restaurants will offer this reduced cost menu. 

    Just checked one of the Body Mass Index calculator indexes over the Internet. I'm 6' 3" and 244 pounds, and that means a BMI of 30.5 today. When I started I had a BMI of 39.5.  This current number is still in the "obese" category, according to US standards. Once I get to a BMI of 29.9, then I will only be considered overweight. Once I loose 5 more pounds and get to 239, that equates to a BMI of 29.9, putting me out of the "obese category", into the overweight category. Checking these BMI sites further, in order for me to get to the "normal" BMI category of 24.9, I would have to weigh just under 200 pounds. My goal weight was 220-225 pounds, which was my weight when I worked as a carpenter for many years. I have my doubts if I can get down below 200 pounds, so I'll probably never be in this "normal" weight category. The doctors tell you that few patients get down to their "ideal weight" but most are successful at a major weight loss, and the health benefits that are a result.

    This next week I get lab work done for my 6 month check up since surgery. I'm hoping my cholesterol drops significantly, which means I can now get off of one more medication. My blood pressure has been about 109/73, as I monitor it twice a week or so.  With the doctor's permission, I may be able to get off of that one last blood pressure pill I take daily. Prior to surgery, I would take two blood pressure medications, totaling 3 pills daily. I'm down to one pill daily now, and with any luck, I can get off of that tablet shortly.  From my support meetings, I've learned also that the vast majority of diabetes patients are off of their diabetes medications within 2-6 months past surgery, and these patients feel significantly better almost immediately past surgery.

    It's early on October 15. Today I weighed in at 243.5 pounds. I spent 4 hours straight working on my cattery management book last night. It now has 65 pages, with 54 photos, and the book is less than 50% complete.  I stopped using my CPAP machine this week. I seem to sleep well, and feel fully rested in the morning. So sleep apnea is no longer a problem.

    On October 22, I had a few "dizzy spells", falling down one time at home. I called my general practice doctor, and I am now off of all blood pressure pills. My BP was about 96/66 that day. I began monitoring my BP for several days, and had to get a new BP monitor, as my old one just failed. New BP tests around Oct. 27, are around 117/76. I've just had my 6 month lab work done, and I see the surgeon on November 7 for my 6 month check up.

    Today is November 7, and I went for my 6 months checkup.  One of my doctors noted that my labs showed that I was slightly low in Vitamin D, even though I do daily walking. So, I'm taking a prescription level Vitamin D for 3 months, and then I will have a new lab test. Photos below are from today, just after I had my late afternoon walk.

    The surgeon's office weighed me today, and the result is 237 pounds.  I recently have had a few dizzy spells, and asked the surgeon about this. He said that I may not be drinking enough water, and that I probably need to eat a better combination of carbohydrates and protein, as these are the primary reasons for feeling somewhat dizzy. Blood pressure today was 125/80, pulse of 63. Below is a chart showing blood levels before surgery and at 12 months post surgery:

                                        1/20/2005                2/2/2006                    10/20/2006            5/31/2007

Cholesterol (total)                   183                        174                               109                       134

Triglyceride                              152                        199                                78                         71

HDL (good cholesterol)             43                          42                                43                         52

LDL (bad cholesterol)             110                          92                                 50                        68

Cholesterol/HDL                       4.3                        4.1                                2.5                      2.58

    As you can see the cholesterol levels have come down significantly. This means I can now stop taking my cholesterol lowering tablets. I've been taking these for over 5 years.  Today's doctor visit also reflects a total weight loss of 88 pounds in 6 1/2 months.

    Today is December 13. Today I weigh 228, making a total weight loss of 97 pounds. I will post photos when I make the "century mark", loosing 100 pounds.

    Just prior to Xmas, I hit the "century mark", loosing 100 pounds. I now weigh 225 pounds. This is the weight I hoped to attain from this surgery. The surgeon also told me I would continue to loose a little more weight in the next 6 months.   In late November, I had an accident with my table saw. The material I was cutting fractured, and I cut my left thumb, requiring 7 stitches. I was put on antibiotics for 7 days to prevent infection. After a few days of using the antibiotics, I had constant diarrhea, even though my diet remained the same. Foods I had eaten for weeks now caused diarrhea. I went to my doctor a few days later to get help. I discussed my surgery and diet with him at length. Then he noticed on my electronic record that I had been seen in the emergency room. He asked me if I had been prescribed antibiotics. I said yes, and he said that was the answer. He verified the antibiotic, and told me that my good bacteria in my lower tract was killed off by the antibiotic, causing diarrhea.  I now know to be cautious of antibiotics, and to mention my bariatric surgery when a doctor prescribes them. I went to the doctor on December 27 for another minor problem, and the "urgent care" doctor prescribed antibiotics. I told him of my surgery, and he changed the antibiotic he was prescribing, noting that the chosen one would not cause "gut problems". So, if you do have bariatric surgery, please keep this in mind. Antibiotics can prevent infections, but they can also have other side effects. So, it's important to let the doctor know of you surgery when antibiotics are prescribed.

    I consulted with my general doctor about the dizziness. He ordered a Holter Monitor study for me. This is a machine that records your heart's activity for 24 hours. These dizzy spells had me worried. I finally got the results of the Holter Monitor study. The results showed a condition called  PSVT, which stands for Paroxysmal Supra Ventricular Tachycardia. This condition is a sudden rapid heart beat, which is causing the dizziness. It has a sudden onset, and disappears within a few seconds. Sensors in my body "trigger" this condition, such as stress, etc.  My doctor told me to begin taking a small dose of my blood pressure medicine once daily, and that seems to be helping.  I was worried about these dizzy spells, but my doctor assured me that my condition was not serious. On this low dose of blood pressure medication, the dizzy spells are now almost non-existent.

    I just had my one year checkup. All of my blood work was excellent, except I'm having some problems with Vitamin D. My doctor has put me on another 3 months of 50,000 units of Vitamin D once weekly, and we will retest in 90 days.  All of my protein levels, other vitamin levels are well within normal levels--only the Vitamin D seems to be a problem.  Blood pressure was 118/76 with a pulse of 60.

    On September 11, 2007, I had a review of my recent blood test.  My doctor had ordered another 3 months of the same Vitamin D units as noted above. My weight checked in at 218, and my blood pressure was 118/76.  I began taking a new higher standard dosage of calcium and standard vitamin D, with 1800 mg of calcium and 800 units of vitamin D about 4 weeks ago--taking 4 "horse pills" daily.  My doctor explained that the normal range of vitamin D was 30 to about 80 units.  My previous blood tests had shown a vitamin D result of only 14.  My most recent test show a new level of 37 for vitamin D, so now I was finally in the "normal" range.

    I also take two of my blood pressure pills (Verapamil--generic Calan) daily. I had experienced an occasional dizzy spell under stressful times, even while taking one blood pressure pill daily.  Taking two of these blood pressure pills seems to prevent any dizzy spells at this time. I take one pill when I get up each morning, and the second when I go to sleep at night.   Even though most patients go completely off of blood pressure pills, I've resigned myself that these pills will probably be necessary for the rest of my life.

    My weight does fluctuate slightly. I seem to stay between 218 and 222 pounds at this time.  My diet and my activity level vary slightly, as I do not eat the same menu daily, and my exercise routine (walking) is sometimes disrupted by a change in my daily routine.

    One important factor to remember is vitamins.  I've been taking the GBG 10-in-One Liquid Multi Formula for a few weeks now. I attend monthly bariatric surgery support group meetings. These meeting are designed for pre and post operative patient, so that they can learn the most knowledge on how to daily deal with the results of the surgery.  I brought the GBG Multi Formula to a recent meeting, and gave out free samples. Everybody loved the taste. I gave a copy of the Supplement Facts of the GBG Multi Formula to the office manager of my surgeon, to get his opinion. I received a phone call from the office manager 2 days later. I was told that my surgeon had reviewed the Supplement Facts sheet, and found nothing that would be detrimental to by-pass surgery patients.  The surgeon was impressed enough with the vitamin levels that he has authorized me to hand out brochures on the product at the monthly bariatric support group meetings. By-pass (bariatric) patients have to be cautious of their diet, and must take a daily regimen of a high quality vitamin supplement daily for the rest of their lives. So finding a good one can be difficult. I've tried several types over the past 1 1/2 years. I began with another brand of liquid vitamin, but found the $59.95 price per month to be expensive. I compared the supplement fact sheets between the GBG Multi Formula and the "other liquid" I had used for 3 months, and I found the GBG product to have higher RDA levels of almost every vitamin !  I'm convinced this is the highest quality product you can get at a reasonable cost, when ordered on autoship.  There are additional health benefit formulas included in this vitamin that are beneficial by weight loss surgery patients--natural mood enhancers, joint health, eye health, stress relief, digestion aid, immune enhancer, etc.--all at no additional cost.

 Go to www.bariatricliquidvitamins.com

Liquid vitamins work faster in your body.

    Good news again. Today is October 10. My weight has leveled at 215 for the past 10 days. So it appears that I'm still loosing a small bit of weight, even when it exactly 17 months since the day of my surgery. Many bariatric surgery patients consider their surgery day as their new "birthday", as it's the beginning of a new chapter in their life.

Today is November 6, 2007. This morning I weighed 210.  I've been doing the same daily routine as far as exercise and diet, but I'm again slowly loosing weight. The only thing I've done differently in the past two months is I began using the GBG Liquid Vitamins.  Even though it seemed I had "plateaued" at around 220 pounds for months, I'm again slowly loosing weight some 18 months past surgery.  I'm guessing it that I may have been missing some needed nutrients with the chewable vitamins that I now get with the Liquid GBG. Anyway, I'm feeling great. Here are some new photos:

These photos were taken on 11-6-07 after I got home from a local bariatric support group meeting. I find these meetings very important to proper weight loss after surgery. Photo was taken in front of my 52"screen Sharp LCD TV that was my Xmas present.  It was a present to myself at Xmas, 2006 for loosing my 100 pound target weight that I had mentally established at the time of surgery. Using a index tool on the Internet, my new Body Mass Index is 26.1.  I'm wearing a XL shirt and XL shorts in the photo above. This is a massive difference from the 2-3X size shorts, and the 4X shirts I had to wear prior to surgery.  I weigh 207 pounds in the photos above. 

    Today is December 12, 2007. I now weigh 200 pounds, with a BMI of 25, which rated as healthy on BMI charts.  I take my vitamins daily, do my exercise, drink water, and take my calcium supplements. My doctor changed my blood pressure meds to an ace inhibitor, as he felt that my slow pulse (now around 45-50) could be subject to problems with my old blood pressure meds.  I now attend 4 support groups monthly, which I find to be beneficial to my weight loss. At a recent meet, I learned of a new snack food--dried peas.  They are crunch in texture, $1.35 per pound, and the best part--1/4 cup has 6 grams of protein.  Inexpensive source of protein. I now keep a sealable snack bag or two of these dried peas in my car to assure I have a source of protein when I'm away from the house. To learn about the many health benefits of dried peas go to  http://www.whfoods.com/genpage.php?tname=foodspice&dbid=56 .

    Shortly before Xmas, 2007, I passed out in my kitchen. I'd mentioned I'd been having problems with faint feelings. I went to my GP early in January and he did an ekg in his office. He noted my pulse was slow, and said to case taking the Verapamil blood pressure tablets, as they could stop the heart on a patient with a slow pulse. In in mid January, 2008, I was fitted for a 2 week Event Monitor. When they initially monitored the unit, my pulse was 38, far below normal. I wore the Event Monitor for the two weeks and nothing showed. I got a referral to a cardiologist the end of January.  The cardiologist ordered another Holter Monitor test, which recorded my heart activity, etc. for a full 24 hours.  One week later I had a consult with the cardio doctor. On that day, my pulse was 45, still below normal. the cardio doctor showed me a readout of the Holter test. It showed periods of rapid heart beat of around 130 beats per minute, then back to normal, then elevated, then sometimes there was a lag in my heart rythym returning to normal. According to the doctor, this lag in my heartbeat was probably when I felt faint or actually passed out.  This consult was on February 8, 2008.  The cardiologist said we could fix the rapid heart beat with using Verapamil again, and that I'd need a pacemaker implant surgery to fix the slow pulse rate.

    On February 12, 2008, I was admitted to the hospital.  The pacemaker surgery took about 1 hour and 15 minutes, under local anesthesia.  I spent the night in the hospital for observation. I came home and felt fine. I returned to the cardiologist on Feb 19 for a check of the pacemaker. My pulse is now a steady 60, and my blood pressure is 124/83 under medication.  My chest felt bruised for a few days from the surgery, and the surgical glue used to close the wound was very difficult to wash off. Otherwise, everything is wonderful. I walk daily again, after a 3 day rest from surgery. My only restriction is that I cannot lift my left arm higher than my chest for 4 weeks. This is to prevent the two wires of the pacemaker from becoming dislodged from my heart. I will return in 2 months for another recheck from the cardiologist. 
   On April 21, I had an appointment with my cardiologist. Everything was looking great she said. The pacemaker would not need another check for 6 months. Nor more dizzy spells, YES !!

    From attending support meetings for 2 years, and participating in forums on multiple weight loss forum sites, there seem to be a couple of common complaints. One is that energy is down for many people, and many people have difficulty reaching their attainable goal weight.  Many patients tend to begin eating too much or the wrong foods as they get further out in the post op period.  On 4-24, the GBG vitamin company whose vitamins I use daily, began a new web site with a product that may help these complaints from post op patients. Their new product is called enRgy, an energy enhancer. It helps with energy levels with a 2 capsules a day containing the same amount of caffeine that is in 1-2 cups of coffee. I would not recommend this product to new patients, as the surgery needs to heal for several months. But, if caffeine does not bother you, then this may solve your lack of energy problems and/or your desire to lose a few more pounds. The second effect of enRgy is that it is also an appetite suppressant. So it not only gives you additional energy, but it helps suppress your appetite so you can control you bad eating habits. They make one product for men and another for women. To receive FREE SAMPLES of this enRgy product, go to: www.shopgbg.com/lcp/314143 and fill out the brief address form.