Bruce Jr.

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Still happily married, happily living in Collingwood, happily sailing and being a dad to two of the best kids one could hope for.  Only its all so much better with me being healthy and thin now.  In case it hasn't been noticed, I've thankfully moved on from this place too.  Partially because it was a drain on my increasingly valuable time, and partially because my message has been trampled for now by government insurance more interested in the bottom dollar than on quality of life.  Below is a nice shot of my wife sailing our 3rd sailboat into home port with the Blue mountains in the background.  Be well everyone.

My DS transformation in pictures

Hopefully, everyone who has weight loss surgery, makes their choices based on their own personal needs. The following is a comparative list of statements taken from RNYers and DSers posting why they got the surgery they did. The worst thing is getting whatever is offered to you and not being fully informed.

I made this list, not to slam anyone's surgery choice but just to point out how differently we can look at the same thing:

RNY - I got the surgery so I'd dump and the fear of that would keep me away from sugar.
DS - I got the surgery so that I wouldn't dump.

RNY - I needed the restriction to correct my relationship with food.
DS - I didn't want the restriction because I want to enjoy my relationship with food.

RNY - I wanted/needed to change my eating habits.
DS - I've dieted my whole life -- I want to quit dieting.

RNY - I'm sick of dieting and failing.
DS - I'm sick of dieting and failing.

RNY - I want a tool that I can work.
DS - I want a surgery that does the work.

RNY - I didn't want to be able to cheat the surgery.
DS - I want to be able to 'cheat' from time to time.

RNY - I want to be healthy.
DS - I want to be healthy.

RNY - I didn't want someone cutting off my stomach.
DS - I don't want a blind stomach.

RNY - I don't want to have to eat massive amounts of food.
DS - I want to be able to eat what I want.

RNY - I needed to change my habits.
DS - I've been trying to change my habits my whole life!

RNY - I never want to eat sugar or fat again!
DS - I don't want sugar and fat to be 'off-limits'.

RNY -- I want the convenience of a close by surgeon.
DS -- I want the convenience of a one-time surgery.

RNY - My insurance would only pay for the RNY.
DS - I fought my insurance long and hard for what I wanted.

RNY - I need to not eat fat because of my high cholesterol.
DS - I need to not absorb fat because of my high cholesterol.

RNY - I didn't want to risk that much malabsorption.
DS - Based on my own diet history, I knew that I needed the added malabsorption to keep off the weight.

RNY - I need help to lose weight.
DS - I'm great at losing weight, what I need is help to keep it off.

Ontario Options
You are not alone. Many people take the first surgical option that they stumble on without ever exploring what options are available. In Ontario for OHIP covered WLS (Weight Loss Surgery) options you can either have RNY or DS. In country you are limited to RNY with up to 5 year waiting lists. OHIP will pay for out-of-country RNY or DS that you can have within months (but will not pay travel expenses). If you self pay in the tune of $16,000 you can have lapband done in Ontario with almost no wait time. With DS the average person loses over 83% of their excess weight, with RNY about 10% less, with lapband about 20-30% less. The quality of life with DS is in my opinion much greater than with other options. One can eat volumes much closer to normal and can eat anything. with RNY you must always watch for sugars as you may dump. The biggest downside with DS is upfront with the operation, OHIP only covers open surgery as it still considers Lap DS experimental (although it is not). With RNY you can have it done Lap (with a chance of having it converted to open if there are issues) and therefore recovery is shorter.

Near Death Experience?
So I over did it at the YMCA pool and pretended I was an athlete again doing a bunch of lengths at high exhertion including several doing butterfly. I spent 10-15 min in the hot tub after with my son and when following him out I started feeling woozy near the top of the concrete steps. After waking up feeling ephoric I realized I was under water. Whats weird is it still took me about a minute to figure out that I passed out, it was like hazily coming out from a dream, time had no meaning for a bit. I guess I'm lucky I didnt drown though I grew up around water and I doubt my instinct would have alowed me to breath in when submerged. My 6 year old was perplexed why I decided to go back in and with such a big splash. Also, I sink when I breath out now, I guess 110lbs of fat accounts for some serious boyancy. Weird eh.

To inform or not to inform to better support
Though I know that I am considered by some as an offender of surgical choice sensitivities I would like to point out that I agree with everything that is being said here by all thus far.  It is very hard to accomplish the two main purposes I feel I post here for as they are somewhat contradictory.

The first is the dissemination of accurate information and the countering of incorrect or misleading information about the DS, an option I feel very strongly about.  It is the first time in my life when I feel that I can help make a real positive impact in peoples lives (beyond my family and friends of course).  The second main purpose I post for is to provide both moral and specific support to everyone in our Ontario WLS family.

Obviously my touting my perceived superiority of one surgical option over another has the opposite effect I wish for in this second purpose.  It has been recommended to me by many that it is possible to tout the benefits of DS without even the mention of other options but I feel this is not really possible.  For example, by saying the DS keeps the pyloric valve intact and functional does not make a strong a point as saying this also allows you not to have an ulceration and stricture prone stoma, an artificially formed orifice that acts as a drain hole between your pouch and intestine that often causes dumping (dumping-a good or bad thing depending on how you look at it).

Unfortunately I cant aim my posts only at newbies, and I hate the fact that I am making some people feel that there is something wrong with the option that they already chose, because there isn't, RNY (and lapband, though I know less about it) works and works great!  I have been slowly shifting focus more to purpose 2 and simply aiming to support all.  It has been hard for me to handle the near hatred being sent my way through PMs and even learning that I am talked about spitefully at every WLS support group meeting in a particular location that I know of (not Owen Sound BTW).

I honestly think that everyone here has already done the right thing for themselves by taking a proactive role in their long term health through even simply through the consideration of what Obesity fighting options there are available.

Weird Bony Thing under ribs
"The xiphoid process, also known as the xiphisternum is a small cartilaginous extension to the lower part of the sternum which is usually ossified (the process of bone formation, in which connective tissues, such as cartilage are turned to bone or bone-like tissue) in the adult human. By age 15 to 29, the xiphoid usually fuses to the body of the sternum with a fibrous joint. Unlike the synovial articulation of major joints, this is non movable. Much the way the first seven ribs articulate with the sternum, the cartilage in the solar plexus joins on the xiphoid process, reinforcing it, and indirectly attaches the costal cartilage to the sternum." (from Wikipedia). I am starting to really feel my xiphoid too and its not tucked away and flexy like I remember it the last time I was thin (in my early 20s). I was aware of it back then due to CPR training as a lifeguard. We had to watch out for it to make sure we didnt break it off and have it puncture the heart (as if the idea of "just" breaking a skeletal part off wasnt bad enough).

Where the heck are all the really far out post ops?
By repetative I wasnt at all referring to your posting so please keep the snarky comments to a minimum ok. I was talking about answering the same questions by people new to WLS over and over. Though I enjoy being helpful, after a while it gets harder to keep the enthusiasum up. As others take up a leading role in passing helpful information on in terms of applying to OHIP or the pros and cons of different types of surgical options it is easy for people like me who have already pretty much successfully adapted to their new eating and living styles to move on to other things. This is one theory to help explain the mechanism of why we see so few post op people here many years out (as an alternative explanation to your ashamed of failure and huddled in pain theory). As for your dislike of when people claim there is no down side to WLS you could consider that compared to life as a fat person it may really feel to many that there is not down side to what they had decided to do. Sure its a honeymoon view, sure everyone is told about short and long term complications but it FEELS like a bed of roses and that shows through in the postings.

22-Oct-2007. DANGERS OF DRINKING.
Thursday I travelled by car for about 3.5 hours for a business meeting and met up with an old friend for an evening out. I had a Gin and Tonic at 5pm, another Gin and Tonic at 8:00pm, a shot of Baileys with a coffee at 9:00pm, another Gin and Tonic at 10:30pm and finally a Vodka and red bull at 11:45pm. I felt completely fine in the morning and had a tea and scrambled eggs and a bite of sausage. I spent the morning in meetings and had steak for lunch with a bite of salad and more tea. I drove 3 hours home and arrived at about 4pm. At 5pm I began to feel a strong pain in the middle of my upper abdomen, I drank a glass of milk and had a tums to ensure it was not acid reflux. My condition worsened and my wife Renata paged Dr. L for advice. On Dr. L's advice we went to Emergency and asked for a CAT scan. The Dr. refused and did a bunch of blood work instead. The blood work showed worrisome AST and ALT levels. My pain was treated with intravenous Advil and I was hydrated with saline solution. My pain dropped from a 9 to a 4 or 5 and remained there. I was put on Morphine. I slept. Finally the ER Dr. was convinced by my wife and Dr. L to order a CT scan. This was done Saturday morning and the results noted no leaks or obstructions. By this time I felt no pain and was released from hospital around noon Saturday. I slept much of the rest of the day and felt normal all Sunday and so far today. I would like to note that from about two months out I have had up to 3 drinks in an evening with no ill effects (not regularly however, perhaps 4 or 5 times total). According to Dr. L we are not supposed to drink anything alcoholic until our weight loss stabilizes. This is news to me and my wife (I relistened to all my recordings of our meetings with him and this never came up). Dr. L thinks I had a partial biliopancreatic loop obstruction that opened. He feels that the alcohol was for sure a contributing factor. Maybe all those here on Obesityhelp already know this but for those who dont, please learn from my errors. cheers-Ed

15-Oct-2007. Guilty Pleasures.
So there is this really cute 26ish year old on my floor in our office complex. She happens to be from the same town in Poland where my wife is from and about 6 months ago I think I gave her creepy vibes or something because she reacted funny when I offered to show her pictures of our 2002 family trip to her home town. I was shocked by this because how could it possibly be construed that fat ugly old me, the bastion of platonic, talking openly and happily about his wife would be trying to hit on her or something. I was pretty angry about it all since it actually made me undeservedly feel like a creep. Well now that I am somewhat less scary looking I have notice her double take me the couple of times she has seen me in passing. Her greetings have gone from barely polite to enthusiastic. In some weird sick way I kind of feel vindicated. Its as if some barely conscious voice inside is yelling "You had your chance to be nice to me and blew it biotch". Pretty effed up I know. Somehow my wife sees this the same way I do and is actually happy for me. Weight loss surgery has so many angles, its hard to see them all coming.

13-Oct-2007. FAT PEOPLE IN MOVIES.
It really pisses me off that Hollywood movies always portray fat people as people who eat like pigs. My wife was watching Americas sweethearts and kiki as a fat person was shown as always eating. Also a very recent post talked about a moderator on OH being on MTV and the first person they showed was a guy who looked like he only ate and ate and ate badly. Maybe this is this is reality, maybe most of us are big because we have some serious eating issues (I know I have heard this as the most common reason for welcoming the idea of dumping in the RNY procedure). All I know for sure is that I was really obese yet I did not eat like the fat people they portray in the movies. I wish Hollywood would take a step beyond the stereotype like they have started to manage to do with with things like homosexuality or the world not ending at the US border.

9-Oct-2007. AWARENESS OF THE HERD MENTALITY.
I almost chose going the RNY route because it was the most popular surgery. There is strong valid logic with going the route most travelled since often it is the best one (i.e. I shoot Canon and Nikon cameras, the two most popular brands). Sometimes the most popular option may not be the best one (Domestic cars still outsell Japanese ones though they are in many ways inferior and PCs far outsell Macs). My point here is that there is a tendency for people to go with the flow. WLS is not one of the things people should go with the flow on (which is not to say that the flow here is the wrong but you may want to tread water for a bit and look at your other options too). This really does happen, people choose a surgery solely because someone they know told them it was the only one worth considering. These people are naturally very persuasive because hey, they bet their own lives on the outcome. I ended up learning about the DS option because of a random post on a non DS forum and from further study chose it as the best option for me (and have been very happy with the outcome so far). I am trying to do my part to continue to keep the visibility of the DS just high enough to be heard above the roar of the herd. This has angered a couple of people that I know of and for that I am sorry. I would like to think that my attempts at passing on information have helped many more.

3-Oct-2007. Optifast Shmoptifast,
What a load of crock. You can lose any necessary preop weight through other means, any diet and or excersise combination will work. I used the same protien shakes needed postop for my preop diet to get used to them and to lose the pounds fast. These offices forcing this brand on their patients is just a ploy to make more money. I know you will want to use their stuff simply to not piss off your surgeon but it sucks that you have to and that getting it is so hard nonetheless. I have heard of RNYers being so fed up with the Optifast BS that they switched to centers like Barix where there appear to not be any bitchy secretaries or any asinine commercialized diet strategies. Being so close to your surgery date this is probably not an option for you so just grin and bear it I guess. I empathise with your pain.

28-Sep-2007. Progress.
So today I weighed in at 270.0 lbs (down from 357.5 lbs) and I am two and a half months out from my DS. This weight of 270 is a big deal for me because it is the weight that a bunch of people in Germany where I was living for work in 2000 started telling me that I had gained a lot of weight (funny benchmark I know but somehow really big for me). I had come off of a diet that had brought me down to 235 and sure enough I was creeping up fast. the 280s seemed to go pretty slow but the 270s just sailed by. 235 is naturally my next big benchmark followed by 200, 185 and 176 each of these weights having some personal significance to me. I was a bit bummed out yesterday as I went to the mall in Barrie I could still barely fit into "normal" people clothes but I am getting there (plus I was called an ass by someone on the forums here, and not in good humour either). I am probably within 15lbs of being an XL for jackets and size 42 pants (still fat guy store material but better than my old 52). I know that many people here have said it before but here it goes again, losing your weight is awesome but it will not turn you into a shiny happy person. I still get down over regular life stuff, perhaps even more so because I am living off of a lower grade energy source (fat). Food intake has not been a problem, I can eat anything but now that the portions are smaller I have learned to savor everything. For the first time in my life I will seek out the most expensive steaks since hey, half will do me for dinner and I even like sushi now (which is ironic because when living in Japan I hated anything fish related and sought out shit like Denny's). Anyway, hope things are going well for the rest of you in your WLS journeys.

I lived! Im doing good, I am now 280lbs down from 357. I feel fine, my energy levels are rising and I am getting used to the smaller meal portions. The trick was to eat slower and chew more. My meal size has doubled in the last month to about 1/2 to 3/4 that of a normal person (like my wife). No real foul odors and once a day bowel movements (strictly mornings). I am really starting to GET MY LIFE BACK! I went on a bunch of rides at Canada's Wonderland, I can easily fit into my old wetsuit and boyancy compensator, I am wearing clothes from University now (a bit dated but fun and cheap to wear nontheless). My face no longer looks sickly bloated, I have a jawline and my double chin is all but gone. I have not regreted WLS or DS one bit, it was the pivital decision in my life going forward. Do yourself the biggest favour you can and stop screwing around with yo yo dieting and the attitude that you can change your ways and get your life back too before OHIP pulls the plug on the out-of-country surgery option. Statistically speaking 98% of you folks with a BMI of 40 and up will fail with anything other than WLS. Or do nothing and get sicker (or perhaps even die suddenly) and raise the risk of surgery complications should you some point in the future smarten up to the only medically/scientifically proven solution to your affliction. No uncertain views here eh. cheers.

This is my first blog entry.  I briefly cover my WLS trek to this point.  In March 2007 I finally cracked and started looking into surgical options for weight loss, I had gained another 10 lbs even though I was eating right and being active.  I had found myself at 357 lbs at 6'2", a BMI of around 47.   At first Lapband looked the most promising with the least amount of butchering but I found OHIP (Ontario Health Insurance Plan) did not cover it.  After studying why I found that a meta study done by the Ontario government found results to be in the range of 40-50% of excess weight lost with Lapband as opposed to 60-75% for RNY and 70-85% for DS.  I did most of my research online and found helpful information on ObesityHelp.com and duodenalswitch.com and even YouTube.   I very quickly discounted RNY because the state your organs are in after the operation seemed barbaric to me (very unscientific but true).  The DS, even though a bigger operation did not freak me out as much mainly due to keeping natural control of how stuff gets out of the stomach through the keeping of the pyloric valve.   I searched the term OHIP extensively on all the WLS forums and figured out the best way to fill out the forms.  I put the package together and took it to my understanding doctor in Collingwood (Dr. Quigg) for processing.  I was approved by OHIP about a month after submitting my app.  Quick note: fill out both sections of part 4 even though DS is not available in Ontario (Dr. Hunt in Parrysound does not count as he is not accepting new patients). OHIP sent back and said form not fully completed.  Just mark yes for BOTH Death and Tissue Damage. I chose Dr. Lutzrykowski in Detroit as many Ontarians go there and I had a place to stay in nearby Windsor.  I put off the Surgery date by an extra month to take care of some work responsibilities and set a date of 5-July-2007. The day before the operation I had to drink Magnesium Citrate to clear out my digestive system.  The stuff tasted like shit and I felt like vomiting all day and then I had bowel movements reminiscent of that scene from Dumb and Dumber.  A fun start to my physical WLS journey. Operation Day I showed up at 5AM and checked into Critterton Hospital.  The place is nice and modern and things went smoothly.  I was put into a preop room for a nurse to hook up a bunch of IVs and shave my stomach and pubic area (!). I had already trimmed my stomach a week earlier and wished I had done my pubs as well, it was  awkward and I got a bit of a hack job too.  They carted me into the operating room which was well lit and very modern looking.  I got strapped down to operating table (way too tightly BTW) the pressure cuff on my left arm was crazy tight.  I don't remember going to sleep and I don't remember waking up.   My first day after sucked.  My morphine pump was broken and it took more than 12 hours to get it fixed, I was tortured and am a darker person for it.  Also my left arm was partially paralyzed for days(damn cuff). The nurses push you to get on your feet to walk just about right away. everything hurt, I hated them for it at first.  Day 3 they took me to the x-ray and got me to drink the disgusting radiation dye.  Moving around on the hard table to give operators them the best view of my digestive system was up there in the pain ranks.  Day 4 almost feel human again.  Day 5 Dr. L pulls out the 3 drains.  This was the most painful thing I have ever felt.  Each drain is a lot longer than the last and it feels like a knife going through you.  TAKE the MAXIMUM of your pain meds an hour before he does this, I wish I had.   The first week really tests your resolve and will make you perhaps regret your decision.  It really does get better after that.  The only thing bad to happen after that first week is some leakage from the top of my staple line of dissolved fat that was cut off from its blood supply by the retractors.  Gross but manageable.  Its almost not leaking anymore and I am two weeks postop today.  I am eating OK and the bowel movements are getting less explosive and more regular.  I think I am going to pull through!  Also I am now 315 lbs down from 345 lbs at operation and 357 lbs at first Surgeon Consult.  So down 42 lbs in about a month.  Feels good. Two more things, dont shave with a razor, use a beard trimmer so you do not get ingrown hairs or cuts that can get your operation postponed. Also post op they put pressure boots on you to help blood circulate in your legs, they really hurt the bottoms of my feet and I was able to get ankle/calf pressure cuffs that were way more comfortable. Just know that this is an option.