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I think the title says it all. I am still alive and healthy. Without surgery I would probably be dead by now. Let's see HgA1C is 5.9 on only Glucophage. My cardiologist has my two remaining heart meds so low that he says, "well at least lick the pills every morning and night." I struggle to keep my Iron high enough, but other than that I've met almost all of my goals EXCEPT.... I still don't exercise or move enough. I still miss NSAIDS terribly and have heel pain. All in all, it's no big deal compared to the huge improvements I've seen in my health.

 I made it! Now to keep it.

 Saw my nutritionist yesterday. My MD's goal is 173 and I'm only a few pounds away. My goal has been 160, but I've already lost so much weight that my butt has completely disappeared. NUT is concerned that I am being compulsive with my record keeping. Hmm... I thought I was doing what I was supposed to do. I guess most people don't actually follow the instructions. It is hard to adjust my brain from being a heavy person to recognizing that the guy in the mirror is out of shape, but actually pretty thin. I still have a small gut, but nutritionist called it mostly skin. FORGET BMI she says. The charts weren't designed for someone with 10 pounds of extra skin. So, I am going to try and relax. 

 Several years ago I fell off of a ladder and splattered my heel bone. The twenty odd pieces were originally formed by my orthopod like a hamburger patty. Three surgeries and five years later I have been walking with a limp and didn't realize how much I was using Ibuprofen until I lost it. So, I visited a good podiatrist who ordered a fresh orthotic and referred me to a physical therapist. After five years I really had no hope that the PT would help. I am glad to admit my error. ATSYM is a miracle procedure that reduces pain and increases flexibility. I'm impressed. 

 A few days ago I went to see my PA about my pouch inflammation. Stay on the carafate for a while longer and rescope in a few months. I can accept that as a decent course. In the meantime I am moving back to chewable vitamins. One discouragement was that I am off of NSAIDs forever. The suggestion was to take Percocet for my heel pain. My goal for this surgery was to get off anti-cholinergics and I have succeeded by dropping them in half. I don't want to take narcotics which only blocks the pain in lieu of NSAIDS which actually reduce the inflammation as well as the pain. I am not happy with this course of events.

On the brighter side my surgery has improved my symptoms of diabetes and hypertension. I am off Byetta, decreased Glucophage from 2500 to 1000 per day, decreased Glyburide from 7.5 mg per day to 1.25 and dropped the HCTZ. My weight loss is progressing well and I can even slow down the speed of loss if I want to. NAH! I'll lose what I can ASAP and try to get off the glucose meds ASAP.

Pros and Cons - Reduced meds, but no NSAIDS. 

 Today I hit a BMI of 29.9 and a weight of 196.5 - I am well past Onederland and heading into my new life. The most prominent change is that I am giving all of my pants away. They no longer fit. I've only purchased three sets of new clothes while I wait for the weight to go away. 26 pounds to go until I hit my MD's goal. In the mean time...... Off of Byetta, Glucophage is cut in half, Glyburide in half and no more HCTZ. I'm pleased with the results. The last time I hit this weight was in a 2001 bounce down before a heart attack and bounce back up after a Coronary Artery Bypass Graft.

 I don't want to focus on every little detail, but today I started feeling human again. On Thursday night after coming home I had a terrible gas attack through most of the night. After that I had a sharp pain in my left ribs and shoulder. On Saturday afternoon I spiked a low grade fever. I spoke with the surgeon who directed me into ER 55 miles away ASAP. When I walked in the door they began treating me like royalty. I have never been walked through the process as efficiently in my life. And this from a guy that worked ER for about 10 years. They had my records at registration with a wrist band, I was walked to a room, worked up and then walked to a comfortable room with TV and chairs where I saw the surgeon within 5 minutes. WOW! From there it was an upper GI looking for a tear or leak (negatory) then an MRI with contrast looking for a clot or hidden tear. This is not a small hospital, but a four hundred bed level one trauma center with helicopters flying in, but still such rapid personalized service. Turns out it was probably an irritated diaphragm. Breath exercises, drink, drink, walk and if ANYTHING changes call back. Changes indicate that the data used to release me may have been incomplete. 

Well done Dr Monson and team. Cheers for Meritcare Fargo.

Each day I feel better, but today I am already down 22 pounds since starting this exercise and I feel better than I have in months.

 It's done. I went in Wed 9/9/09 at 08:00 and was discharged Thursday at 13:00 - 29 hours door to door less the use of my stomach, much of my bowel and my gall bladder. What a machine the Meritcare system is. I never felt rushed and almost always felt well cared for. I am impressed.

At my final surgical pre-op visit I learned that I will be in and out in 36 hours. This is longer than some but RNY hospitalization is getting shorter and shorter. When my wife had her RNY several years ago by Dr Smith in Park Rapids her hospitalization was four days and we thought that was fast.

As a benefit of this fast I am not using Byetta or Glyburide. My blood glucose is low and I am concerned that these medications will produce hypoglycemia. If I'm wrong I can always add some back in tomorrow. The strange thing is that I feel super touchy... almost like a low voltage touch in my muscles. Now this could be from the fast, but I've fasted before without these symptoms. I think it is from the withdrawal of the anti-cholinergics. One of my primary goals is to get off of these destructive meds. It's already begun.