Frisco-**2 Years-Long Post-Pics and Swagger**xPost

Frisco-Two Years !!!

Well folks, Sept. 30th makes 2 years. I weigh 148lbs. for 11 months now.

In some ways it feels like time went fast......In other ways it feels like 5 years.

I started at 338lbs. With a BMI of 54, not morbidly obese.... “Super Morbidly Obese"

I have lost 190lbs. (Well.....over 200 if I used my highest recorded weight which I recently found out was 352lbs)

Surgeon: Dr. Paul Cirangle LapSF.com

Hospital: CPMC San Francisco

Procedure: Vertical Sleeve Gastrectomy

I was obese than morbidly obese than super morbidly obese for so many years, missed out on a lot of things, never felt great about myself physically.....Than in one short year I was of normal size??????

Now at the two year mark holding my weight for 11 months..... I’m kind of in no mans land. Yes, I’m confident I can continue..... But I told myself I couldn't claim to be any kind of success till somewhere between 3-5 years out.

Changes:

- BMI from 54 to 24.6

- Pant Waist from 54" to 31"

- Shirt from 4X to M

- Shoe from 10 to 9

- Motorcycle Helmet from XL to L/M

- Watches all needed to have links removed.

- Airline seatbelt extender not needed.

- Not ashamed of my self image and can post my photos on OH.

- Turn the camera on when using Skype.

My story:

A few years ago I looked into WLS...... The first thing that comes up is the Lapband. Than you find out about all the problems associated with it. Than you read about RNY and that just plain scared me away from the whole idea of WLS for a about a year.

Than I discovered “Mini Gastric Bypass" by some guy in Las Vegas. Sounded doable! Than you wonder why nobody else does this procedure??? Than a guy that works for a friend of mine has WLS and I ask him about it.... He explains the VSG to me! Ding Ding... I’m interested! Long story short.... I research VSG...discover OH....read and read and read for a couple of weeks.

I'm sleeved by Dr. Cirangle within a month of making the call to his office. I explain more about surgeons a little further down.

I got to say, It seems to have been fairly easy in a lot of ways. But don’t let anyone tell you that this is an easy surgery. You hear laparoscopic, in one day out the next. People....This is major surgery!.... Granted, not a heart transplant, but this is very serious stuff and it takes a skilled and experienced surgeon.

Yes, the first month is pretty hard and it does get easier. And yes I had my share of stalls.

It takes about 6 months to get your head adjusted to new normals and just how much food you can eat and that you will never eat a normal (American) plate full of food ever again.(a good thing)

Things I think I did right:

     -     Followed my surgeons program and eating instructions as best I could.

     -     Walked most days.

     -     Went to support group meetings.

     -     Read/contribute on OH daily to keep my head in the game.

     -     Learn NOT to believe everything you read on OH

     -     Get medical information from my doctor....not an online forum.

     -     Bought a good scale. Health O Meter 349KLX

     -     Weigh everyday (this is questionable-keeps me in check)

     -     Went to follow up appointments with Dr. C

Things I did wrong:

     -     Never ever wrote a single thing down. Never charted my weight. I know my start weight, six month weight and one year weight and current weight.

     -     Never ever charted my daily food intake. (I used a simpler method)

     -     Signed up for a food charting online service (livestrong?) never used it.

     -     Probably didn’t meet protein goals everyday.

     -     Probably didn’t meet fluid goals everyday.

     -     Probably didn’t exercise as much as I could have.

Time to get brutally honest........For Pre-Ops and Post Ops

I’ve been on this board for over 2 years now. I can’t say I’ve seen it all....I can say I’ve seen enough and I’ve seen a big change in the whole VSG scene. As much as I want the VSG to be the “Gold Standard" for WLS...... I have my doubts....Until the VSG becomes standardized...... there is going to be a huge range in results.

In this last year as more and more insurance companies approve the VSG.....more and more surgeons are doing it. Problem is..... A lot of them are starting with VSG specs from 5-10 years ago. And most of them need to go through a learning curve to get any valid results and personal data.

Also there is a lot funky surgeries going on right now with some very wonky eating plans. I question if a 46f bougie and 1400 calorie diet is a plan for success?

I suspect as a little more time goes on and certain studies come out. There will be a greater divide in results from the VSG. It is already pretty obvious that certain surgeons have better results than others. Surgeons like Dr. Cirangle will be backed up with surgeries because it will be quite obvious who is doing it with the best results. We really need to hope that some sort of standardization occurs so more people can have this procedure done and more people can get the benefits.

Here are some realities as I know them. I’m sure to **** some people off.....But I’m not lying or making this stuff up.....and besides.... I don’t even need to mention anything.... I could just fade off of OH like most everybody else.

Surgeon

Once I decided to pursue the VSG I researched the Nation, I was gonna go anywhere I needed to for a top VSG Surgeon. Sure money is always an issue....But I thought this was no time to look for a deal. If I didn’t have the money...I would get it. I was playing my last card. If WLS didn’t work..... I was a dead player. Mexico was never a consideration for me..... Nothing against others going to Mexico....Just wasn’t for me. I have many friends here on OH that have done the Mexico route with great results. Most with one of the two A’s

I found my surgeon right here in my own backyard.....Didn’t have to travel after all. My research always came back to Dr. Cirangle in San Francisco.

What do you say about a guy who basically gives you your life back? He still, after 2 years takes care of me and guides me through this process.

With Dr. Cirangle I knew I was getting an up to date correct VSG. He has a long list of successful WLS patients and I wanted to be one of them.

Dr. Cirangle makes it pretty easy. He gives you the proper tool with the proper instructions. You really don’t have to think much....you just need to do. Leaving you with time to learn about the Science that's involved in the VSG and develop the proper lifestyle changes for long term success.

Never in this process did I not know what to do......Oh yes, I had questions, lots of them and I had/have a lot to learn, but all I have to do is “ask my surgeon" what a concept !!!!! I have probably seen him a couple times a month for the last 2 years. He runs his own support group meetings and I have the option to go to both San Francisco and San Jose as well as personal appointments at his office.

Without any exaggeration.... Dr. Cirangle and the VSG helped me get my life back.

Picking your surgeon can be Mistake #1 or Victory #1

You want results?????

First, look around.... see who has lost the weight.....see who their surgeon was....... ask the questions.....Do what they do.....

Don’t think that you can read about a successful VSG patient that went to a noted successful VSG surgeon and than you go to Dr. Joe Blow and expect to get the same surgery. Not saying you could not get a proper VSG......Just saying not all sleeves are created equal......The VSG is NOT standardized. It takes years of experience to come up with a successful procedure and program.

If you want the best statistical advantages:

     -     Starts with a great (not just good) surgeon.

     -     Commitment and compliance.

     -     Making the lifestyle changes.

Commitment & Compliance

The words Commitment and Compliance mean the same thing. Without it..... Your done....ain’t gonna happen. Most people who don’t make goal either have some other medical issue or just plain ran out of Commitment.

Stalls

Stalls happen. Stalls are real, most times it’s an adjustment period your body is going through. Stalls don’t normally last 2 months(unless there is other medical issues).....Guess what.....if you haven't lost weight in 2 months.....It’s not a Stall.....In most cases your eating to much! Stall is probably the most miss used word on this forum.

Most times when WL slows or stops it’s probably a new food you added to your diet.....for me it was Peanut Butter and Beef Jerky..... Both WL stoppers for me.

I can't tell you how many people have contacted me at 6 or 8 months asking for help because their WL has slowed/stopped. Most of them were on 1000 to 1400 calories plans with very little carb restrictions. I would always urge them to try the LapSF plan (also used by many other surgeons) for 7 days. Those who tried it.....started losing weight again, but only a few stuck with it and have done well.....the majority just fade off into the sunset.....who knows what happens to all the people that come here all gung ho.....than at about 6 months.....there gone.....never to be heard from again....and you know they were no where near goal........

Big Sleeves:

Although there are exceptions.....and a few here have done well with a bigger sleeve. In most cases....If you have a big sleeve....be concerned.....a 42f can end up with a 16oz. capacity.

Don’t listen to the person that says sleeve size dosn’t matter.....of course it matters....that’s why there are different sizes.....someone 3 months out with a big sleeve saying they are losing weight just fine. You can lose weight on just about any size sleeve.....long term regain is where the difference is......and constant over eating is the culprit.

You can do this with a larger sleeve.....it’s just harder and takes much more long term commitment, discipline and effort.

Now all that said..... 32, 42, 52 what ever size....you gotta commit yourself and try.

Now keep on mind this is "Generally Speaking" I know there are there are success stories with larger sleeves..... my point is to be aware.

NEVER push your surgeon to make a smaller sleeve. Sleeve size should not be negotiable. If he/she tells you that they make a big sleeve because there are fewer complications..... Believe them. They are telling you they are not comfortable making a small sleeve. To make a small sleeve correctly takes skill and experience for high percentage results. If you want a smaller sleeve.....go to a surgeon that does them.

Under Eating

I can tell you for sure that the number one thing I did/do and recommend to all sleevers is to always “Under Eat" your sleeves capacity. I took this on from the get go. Sure....I have over eaten or ate to fast a couple of times.... Thats gonna happen by accident sometimes. Hasn't happened in a while and I’ve never puked post-op.

It took me about 6 months to get my brain used to the new normals.....

The benefits of under eating are huge. I have retained the same restriction as about the 4-5 month mark. I would guess that I have very little stretch if any. I read about people eating more than me 1 month out. Dr. Cirangle built me what he called a “tight 32"

I probably eat 1 more small meal per day than most Cirangle patients to come up with the numbers.

Moderation-

Moderation is a dangerous word. For me.... Moderation is NOT a WL stage word. Some people can do it....most can’t. How well did moderation work for you pre-op? For me it was half the bag of cookies or chips not the whole bag!

Moderation is something you add back into your vocabulary after WL and your firmly into maintenance.

Maintenance-

Maintenance..... I have failed this part every other time I’ve lost weight. This time I went into maintenance with much confidence. I now have the tools and I’m way more educated. But it’s still has been a whole new learning process. I’m maintaining fine and have learned to adjust as I go along. I’ve been on several long trips, eat at restaurants for most every meal. Once I counted 21 straight restaurant meals...... No problem....fine....used the deck of cards method for everything.

I have all confidence that this will be a long term solution to my Obesity. I wish that anybody who goes through any WLS get the most out of it !!!

Many thanks to the OH community for the help and support.

frisco

Night Before Surgery

Same Shirt and Hat

Big Pimpin !!! Size 38 Calvin Klein..... Not John Goodman Big and Tal Wear !!!!

One of my Harleys...Yes I'm wearing Chaps !!! Bought them over 20 years ago thinking one day they wouls fit !!!!

Summer 2011 Indianapolis Motor Speedway

Summer 2011 Laguna Seca

On Set Photographing the MythBusters

Airline Seatbelt Slack