TheSecondTimeAround

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September 1, 2021 was the day I started my fast to prepare for surgery.  So today, I commemorate that important decision and the results arising from it.  The actual surgery date was September 14th, a date I will never forget as being very special, as it has changed my life.

My starting weight was 294.  My weight today is 165.8, for a 125.5 pound weight loss over the last year.

My highest weight ever was 307, for an overall weight loss of 141.2 pounds (46%).

My original BMI was 42.8

Today, my BMI is 23.2

Over the course of the last year, I set three weight goals, somewhat readily blasting past each one.  Starting with 207, then 199, then an absolute lower limit of 170.  The lower limit was based on published data for the healthiest weight for my age/height.

As of May 20th, 2021, I achieved that lowest (170 pound) goal.  Actually, the goal was to never vary more than +/- 5 pounds of 170.  This is an entirely different exercise, trying to track to a fixed weight, when, during my entire life, I was always trying to track to a weight loss goal.  Hence, weight stability has been the current goal for ~ the past 90 days.

Frankly, it has been a struggle, as this BPD/DS surgery is so effective, that after having attained my most optimistic weight loss goal, I have had to eat to excess, sometimes, even, to discomfort, in order to stabilize my weight within the desired range.  I am fairly confident, that if I was not intentionally working hard to keep my calories up, that I would easily shrink to 150 or 155 pounds.  My wife would have none of that.

What a strange journey.  It's like living on the other side of the looking glass!  To a very large extent, this new norm has taken away much of the pleasure of eating.  (food isn't supposed to be meant for that purpose anyway, when you have had a life of being overweight, though.)  Right?

With a base metabolic rate of about 1,700 calories, and absorption of only 20-80% of calories depending on if it is protein or fat, one can quickly do the math and realize how hard it is to maintain weight without eating a HUGE number of calories.  With the reduced size of one's stomach along with the abbreviated intestinal tract, it means there is only so much food you can cram in and process.  Hence, its a major challenge to get all of those calories to stabilize the weight.  Of course, there is always that beast - sugar - with over double the calories of fat and protein, and 100% of it being metabolized, it is a way to top off your calories to get to goal.  HOWEVER, with a BPD/DS surgery, carbrohydrates play havoc with your system and how you feel, so chasing the balance of how many carb calories I can get away with before having adverse symptoms, seems to be my new hobby.  Miscalculate, and either the scale goes lower (don't want that), or you get very uncomfortable for up to 24 hours.  Weird balance.

When I was morbidly obese, my limits on taking a walk were "how long can I go before I run out of energy?"  Now, with literally boundless energy, and not a lot of weight to carry around, the new question is "how far away from home can I get, without having to go to the bathroom?" unless I've managed my carbs really well.

Still, I'd take the new life over the old.  There is no question.  I no longer feel like I'm trying to carry 3 bags of rock salt every where I go.  My knees are not throbbing.  Its easy to tie your shoes.  You can fit in spaces where your mind says "don't even try it, its not even close", then you easily go right through them.  Airplane seats - NOT A PROBLEM!  I always flew first class so I could physically fit in the seat and not impose, embarrassingly, on the person(s) on either side of me.  The other day, I was on a connecting flight in an RJ.  In coach.  Those seats and the leg space - are TINY.  NOT A PROBLEM!  I could have sat in one of those seats all the way to Hawaii if I had to.  And frankly, people do look at you differently.  Its not to much a look of acceptance, but definitely not one of rejection, which would have been more common a year ago.

One other thing I noticed, which I had anticipated, but now I live with this reality - you can't lose 140 pounds without becoming deflated - even - emaciated.  This means that I look ten to 15 years older in the face than I did a year ago.  I see some people defer and make way for me, as they see me as a very old man.  This is disheartening.  But maybe this is what people who are NOT inflated look like at my age.  I'm still finding out.  And, when your body sheds weight - it does not discriminate - it eats the muscle along with the fat, which took away my muscular strength.  So I have been working hard on pressing weights and walking.  It's fairly amazing how fast one can add muscle with lots of weight lifting.  Like one to two hours a day, three days a week.  But I also found that if you are in a caloric deficit, your body CANNOT gain muscle.  Hence, the need to always try to take in a little more fuel than you need, in order to promote muscle growth.

But it's working.  I have skinny arms with significant, defined muscles and almost no fat.  So definitely a different look.  Kind of what I imagine a farmer working out in the field might look like.  Shredded, but with limited bulk.  Except for all of the loose skin around the middle.  That's depressing.  So, I will be looking to get plastic surgery for the floppy neck and the floppy belly next spring.  I am not thrilled with the anticipated scarring, but I accept that it is a reasonable expectation that this needs to be done.

Oh, and now I can buy clothes anywhere, and the look REALLY good on me, and I actually have a silloutte (when dressed) that I can be proud of.  And that's what I get to experience every hour of the day.  And nothing else feels as good as that!

In conclusion - I would do it all over again in a hearbeat.  No question.  It's different than I would have expected, but i'ts manageable.  Being flexible, having energy, fitting into clothes and seats, and society, and not running out of breath, and being largely free of joint pain (the damage was done, but its 90% better), makes it all worth it, and I would never, ever, accept going back to all of the comorbidities and loss of freedom and embarrassment the extra weight represented. 

I hope this too-long essay helps you decide what you want to do, based on what you can tolerate and what you want to achieve.  If you have any questions, get in touch!

 

 

 

 

It's like a whole new life!  Check out my photos, including before/after, trend analysis, published data on optimal weight, write up on the journey and metrics, tracking, and ultimately going from manual tracking to automated.  I hope this story will inspire you to start or to continue on when things get tough!

Well, fellow bariatric patients, from this vantage point, this looks like the end.  Aparently, this new current weight of 175 pounds is about where I am going to settle in, since it has been my average weight for the last 20 days.  Having busted through all initial goals (207, 199, 195) and ultimately missing my latest, "new" goal of 170, it seems time to accept this new normal and be happy with the outcome.  

175 is technically above the highest "normal" weight for my height (according to the only website I checked).  But at a BMI of 24.4, it's below the 24.9 BMI target of normal, and if correctly understood, it also represents 100% excess weight loss (EWL).  This outcome is well below the newest published "be a rectangle" guideline where the experts state that you should have a maximum waist circumference to height ratio not to exceed 1/2 of your height.  

Hence, 5'11" (71"), at a 50% ratio produces a 35" waistline target.  Well, my waistline is now 33", so I met the healthy weight standard, but missed my somewhat arbitrary goal of weighing 170 pounds.  I guess the line has to be drawn somewhere in order to avoid trending towards anorexia or uncontrolled weight loss.  This is new weight is healthy, yet oddly alien to my experience set.  (body dismorphia, anyone?) - (Do you perceive my trying to rationalize to myself why it's time to stop?) - I do!

This means:

- 119 pounds down from my immediate pre-surgery weight of 294, 7 months ago.  

- 132 pounds from my all time high of 307, 15 years ago.

 

Because of the BPD/DS procedure, I have been able to start eating more, and have carefully watched my diet and measured weight fluctuations in order to maintain stasis. (I was trying to very carefully manage a "soft glide path" in order to strictly avoid going under 170.)

This is the takeaway: If you are anywhere beyond 100 pounds overweight, obviously it is up to you, but for me, the BPD/DS has been a great choice.  I hope you make the one that best serves you.

Best of luck on your bariatric surgery journey and to a healthy life!

Well, fellow DS'ers, I am so excited to report that this morning I arrived in Wonderland!  199.2 pounds, down from 294 pounds when I started, and an all-time career-high of 307 at the beginning of my first go around with a band around 2005.  With the DS, my 94.8 pound net weight loss took a mere 130 days.  Kind of shocking.  This morning, my 37-year-old athlete son mentioned "Dad, you know weigh less than me".  How weird is that?  

Noticing a lot of body dysmorphia whenever I see that unfamiliar thin man looking at me when I pass a mirror.  I don't recognize him, and my wife says that sometimes she doesn't either.  It will take a while to get used to him.  Perhaps never?

My energy is way up, my knee pain is down 85-90%, and my back NO LONGER HURTS.  After the last 20 years of constant pain, inflexibility, and pseudo immobility.  Also reduced my meds from about 11 down to about 3, while upping the vitamins.  I just don't need the meds anymore in order to stay within prescribed metrics.

Still looking to get down to that magical "normal" weight of 170 pounds, which, before seemed absurd to even consider, whereas now, it seems to be within striking distance.  Perhaps my biggest overall concern at this time is: "How do I arrest my weight loss once I get to goal weight?  I don't want to weigh any less than that. What a strange thought - I've been on the other side of the looking glass my whole life, and now I worry about weighing too little.

Overall, the diet has been a pleasure, as I don't need to eat a lot to be sated, and I really enjoy my food.  The rare craving is resolved by a cheese stick, or a handful of peanuts, then the craving goes away.  The only real difficulty is figuring out how my new "digestive system" works.  It's tricky.  If I am not thinking about what I take in, my body predictably reacts in a negative way the next AM, and sometimes even at night.  More discipline, enforced by disadvantageous bodily responses, is what seems to be the order of the day.

Check out the graph of my weight loss so far in the pics.

I'm happy.  Best of luck to you on your journey!  

Hi Obesity Help friends.  Sept 14th was a date that changed my life.  2 weeks prior, I started my preop 1,000 calorie a day diet, so, Sept 1st, and on November 21st, about 80 days out, I hit one of my big goals - 217 pounds, with a starting weight of 294 pounds.  Reached it 3 days earlier than goal, based on careful caloric and weight tracking and trending.  That's 77 pounds lost in total, darn near a pound a day.  These numbers are so compelling that I keep second guessing if I got my math right or not.

I haven't ever starved (post op), my energy has been good, I am starting to understand how to eat (70/30 protein veggies are key), avoid heavy protein including sashimi and beef late at night, steamed vegetables at night is my friend.  (otherwise, plan on an unpredictable BM experience 2-3 times in the early AM, which I'd rather avoid.

Hoping that I'll get this morning thing worked out as my new "system" gets worked out better.  Still hard to get 64 oz of water down every day.  Just not used to that.  Easy to take the ADAK vitamins.  I rather enjoy them.  So much more energy and mobility.  I know I'm old, but I'm starting to feel like some of my youthful vigor is coming back.

I wish this would have been my first bariatric surgery instead of my second. (got the AGB 16 years ago, and I never lost as much weight, and certainly not this fast, and I don't have 1/3 of the chronic band problems.  So glad to be rid of it.

Totally and completely recovered from severe GERD.  It just stopped the day after surgery and never came back.  No need for a ramp, even slept the other night with my feet propped up above my head due to gout.  Could have never done that before.  Life is good!

Estimating that I'll reach "Wonderland" by December 17th.  So happy, makes me want to cry.  Take care!  To a new life!!

This has been so great that I wonder when I am going to wake up and realize I am dreaming.  Sure, there are significant difficulties trying to get used to my new "system", but as I see those pounds peel off, it is super-rewarding.  And, as we all understand, the weight loss has slowed significantly.  On most days, I still see a half-pound coming off.  That's great.

Biggest problem right now - As I am moving into a somewhat more flexible post-op diet, I have not been as good about measuring.  That has resulted in three times of eating more than my allotted 4 oz meal sizes.  Also, red meat - fuggetaboutit!  Cramps, bathroom issues in the next AM.  So I am settling down with Chicken, TV dinners (only the allowed parts of it, eggs (scrambled with veggies), etc.  It's been good.  I've got no complaints!

I am officially in a size 38 pant down from a 44.  That's a great reward.  And wearing a size "L" sweater today.  I was up to some number of XX's before the "L".  It was getting so bad, I don't even want to mention how many X's.

Right now, I am feeling confident that this BPD/DS is going to get me to the size I want.

Hi fellow sincere seekers of a lower BMI!  Great news!  Today is my two-week anniversary from having my surgery.  Including the weight lost from the pre-op diet, I am now down 40 pounds! (294 to 254) I almost can't believe it, but there it is!  

From this vantage point, I can't think of anything I could have done to produce already this significant of an improvement in my health.  Already, knees, bending, flexibility, and walking are so much easier.  Life gets better every day!  If you haven't made the decision to have your surgery and get on this new life plan, please seriously consider doing it.  

Looking back at the fear and concerns that I had in making the decision, they seem kind of silly compared to the reality I am living now.  It's also very weird, that I can look at those post-op 4 oz meals, and instead of wondering "who survives on this little food?", I now wonder - "can I really get down that much food? - it looks like a LOT!  And I think I enjoy it more for some reason now than I did before.

Also down one pant size and the smaller size is actually loose now, too.

*30* pounds lost in 20 days Woaaah! since pre-op fast started. (includes one-week post-op)

I AM SO HAPPY!

This is so over the top, that I won't expect you to believe it.

Here are some pictures from my new favorite toy: "the scale".

 Start of pre-op sub-1,000 calorie diet 

 7 days post-op from my BPD-DS. (includes 13 days pre-op diet)  

Here's what I've learned so far:

1) No hunger.  None. I was planning on starving myself to lose weight.  Not necessary.

2) Post Op pain was unbearable, but quickly subsided.  Off pain meds in 3 days.  Worth it.

3) Surgery was no problem.

4) Single biggest reservation/fear about getting the DS proven to be unfounded: "what if I am one of those 10-20 times a day people?"  That would not work for my busy life.  However, as it turns out, it went from 7 sudden BM's on day one (uh oh, did I make a horrible mistake choosing this surgery?) to 2 times a day, (with advance notice from your gut) - completely manageable. 

5) I actually *enjoy* eating my little (very filling) 4 oz portions of food, because now I really pay attention to it and savor the flavor and texture of it.  

I AM SO HAPPY!

In about 2005, I had a Gastric Band installed.  It helped my weight loss a lot.  I started at 307 pounds, the highest I had been in my life, and I got down to a weight of 217 pounds.  This was based on hyper athleticism (riding 100 mile bike rides occasionally and 70 miles daily.)  After a couple of biking accidents, which made it so I could no longer ride, my weight ballooned to 294.  The band was no longer working, and I was so debilitated by back and joint pain, as well as the limited mobility that comes from obesity, I knew I had to take more drastic action in an effort to restore my health to a tolerable level.  

Since I had already been banded, and since my body had figured out how to fight simple caloric restriction, I decided that something more aggressive was needed.  Thus, I selected a BPD/DS surgery.  This is a little frightening, since I know that it will likely create significant "other" "issues", which I will have to manage.  Not really too worried about the mortality issue as my surgeon reports less than a 1/10th of 1% mortality rate, if I got my notes down correctly.

(Dr. Simper, Rocky Mountain Associated Physicians at St. Marks hospital).

In preparation for my surgery, to deflate my liver, and the lifestyle that follows, I have been aggressively dieting, nay, almost fasting, for the past 8 days.  What a shocking impact!  From 294 lbs to 276 lbs already, in about 8 days.  Maybe my home scale just likes me more than the hospital scale.  We'll see.

Losing this much weight by near-fasting, of course, gives me second thoughts about the surgery.  Do I really need it?  But I've been through this experience many times before - eventually, I'll get so hungry and so tempted, that I will return to eating normally, and would definitely be defeated.  So, here we go with the BPD/DS.  I hope it doesn't wreck my life!  I am, however, looking forward to less joint pain, more energy, and being able to be active again.   

If you have any advice on how to avoid the dreaded BPD/DS side effects beyond what's been posted, please let me know.  

Surgery is in 5 days....