Fat all my life.  I'm the guy who got valentines from classmates with pictures of elephants on them. Yes.. it even hurts a second grader.  I was picked last for baseball by the neighborhood guys because I couldn't run.  In fifth grade, the doctor had me on diet pills.. (speed).  As a senior in high school I experienced my only ideal weight. It didn't last. . Every time I would lose weight. I would gain it back, along with more weight.   Two years ago I weighed more than 500 lbs. The scale would go no higher. I developed high blood pressure, sleep apnea, lymphadema, leg wounds that wouldn't heal, gall stones.. and finally blood clots in my leg and lung. But I was so large.. the local hospital said I was too big for their equipment. I went to the Cleveland Clinic to have my gall bladder removed. Even that doctor said I was too big. He referred me to the bariatric program.  Back in April, I went to the bariatric workshop. I weighed about 450 by then. I had lost some weight over a few months, but was starting to put those pounds back on.  I listened to the surgeon talk about the various weight loss options, and how I would be considered a high risk patient because of my weight and my history of blood clots.  But since doctors couldn't even operate on someone my size.. I figured I was on my way to an early grave unless I did something drastic.

That's partly the reason I chose RNY over Lap band. Besides the fact that my  surgeon felt that I was a better candidate for RNY,  I also don't like the idea of having plastic tubing in me that needs to be refilled every once and a while. And I needed to have my digestive system permanently changed.   I also wanted to have the operation done Laproscopically instead of having a big slice down my stomach.  But to do that, I would have to lose alot of weight.

So Easter Sunday was my last large meal.  From that day until now, I got a free account on fitday dot com and a food scale. I began  a 15 hundred calorie per day diet.  I measured everything, and put everything in my food journal.  Month by month.. I began reducing my daily caloric intake.. From 1500 to 1400.. to 1300. to 1200.. to 1000.

Then two weeks before surgery, the doc put me on a high protein, low carb diet (Slim fast)... which was only about 900 calories per day. I  thought.."900 calories.. how can I live on that?"  But I drank lots of water.. and still went for my daily walk.. I got through it.

From the day of that weight loss surgery workshop in April, when I weighed 450 pounds... I dropped to 323 lbs!  The doctor said he would do my surgery laprascopically.  Some of my friends were saying that I was doing so well on my own, I didn't need the surgery. But I know I did. You see, I went through this process about three years before. I loss weight to qualify for the surgery.. But then I backed out. It was another hospital. I wasn't confident in the doctor. And at the time, my wife wasn't very supportive. But since my increased health problems, this time she was my biggest backer.

Three days before surgery, I was nervous. "Am I doing the right thing?", I asked myself.  "Am I being selfish by risking my life, since I have a wife and family to leave behind if something should happen to me?"   But I knew the alternative without surgery. I would probably die anyway. I had confidence in Dr. Schauer and the bariatric staff at the Cleveland Clinic.  The last thing I remember was just for a couple of minutes after they rolled me into the ER.  The next thing.. I was in my room. I don't even remember the recovery room.

I spent three days in that room.  Before surgery, I remember worrying about the pain from the five small incisions. But they didn't bother me at all.  Although the drainage tube was a pain in the butt. the biggest discomfort was from bloating and gas.  In fact, it took about a month for that to really go away. 

Recovery seemed very slow at the time. But patience is NOT one of my virtues. I keep walking every day, but I felt very tired. I still measured and recorded my nutrition from my food. I found the gas and nausea was reduced by avoiding carbs and eliminating sugars. Plus I ate seven very small (2-3 oz) meals per day. One meal or snack every two hours. In fact it took me three months until I could eat five slightly larger meals every three hours. Which is what I eat today nearly four months after surgery. 

The most surprising aspect of this to me is how little I eat while I am still losing weight.  Every since surgery my daily food intake is as follows:

80 -90 g protein
less than 50 g carbs
15 g of fat
670 Calories

Yes, I live a normal life with on 670 calories a day.  I'll continue that until I get to my goal weight of 189. Then I'll talk to my nutritionist about a maintenance diet. 

I take 15 pills a day.. Most are vitamins, but I still take blood pressure meds.  But my pressure is pretty normal, so I'm hoping the doc will take me off those meds someday. I also drink lots of liquids and water. 

Since surgery on Sept 21, I have lost 63 more pounds.  My pants once had a 74 inch waist. My size 46 pants are now falling off of me.  I used to wear 9XL shirts.. I am about to buy an XL shirt in a store that sells clothes for normal people.  My arthritic knees and hips no longer hurt. I can walk up the stairs, instead of crawl.  I can go shopping without breaking into a sweat and using a shopping cart as a walker.  My wife and I go to the theater together because I now fit into the seat.  We go out to dinner once and a while. I try to pick a place that has food I can eat, and lists the nutrition online. (I still write down all my food).  But I limit those "special occasion" meals to once a month. And that includes holidays. 

I can no longer eat endless amounts of food. I use to eat until food was gone.  Now, if I eat poultry in bites that are too big.. and if I eat to fast.. it can get stuck in my chest. I have to suffer for up for an hour.. almost like I am strangling.. until the meat can flow into my body.  If I eat slowly, and chew for a long time. I'm okay.

I haven't even tried sugary food.  Like I said earlier.. when I was immediately post op... even the small amount of sugar in some yogurts would make me feel nauseous, bloated and tired. I would fall asleep.

I am considered by WLS veterans to be in the honeymoon stage. I don't feel hungry, or even miss various foods. They just don't appeal to me. I eat food as fuel right now. However, my psychologist told me that for most RNY patients, the effects of the pouch only lasts 18 months to two years.  Sometimes it can stretch after that.  So I need to use this time to permanently change my attitudes and habits about eating and exercise.

Weight loss surgery is not magic. It is a tool to be used with other tools such as patience, knowledge and support from others.