Paul Gubrud
I am 51 years old and I have been overweight since I was a teenager. Whenever I went to the doctor I would be told to loose some weight, but I was never told how. When I was younger I was more active and didn’t gain weight as readily as I do now. When I wanted to loose weight, I dieted and exercised and the pounds would come off… for a while. Eventually I would fall off the wagon and the pounds would come back, usually with a few extra. I managed to loose 50 pounds when I was in my 30’s, only to gain it all back plus another 25. In my mid-40's, my wife and I did the low carb diet for two years and I managed to loose 90 pounds only to see 110 pounds return over the past few years. January 2, 2006 – I downloaded the pictures I took on Christmas. Fortunately I was the photographer so I’m not in the pictures, but the camera also had the pictures of my granddaughter and me carving pumpkins for Halloween. These pictures of Hannah and a jack-o-lantern were fun to see except for the ones that included BIG FAT GRANDPA! I don’t feel like a fat man and never have, but these pictures show that I am. The happy pictures of my granddaughter turned out to be very depressing for me. I thought of going on a diet one more time. Here is a picture of Hannah and me taken on October 22, 2005. When I first saw it I almost didn’t recognize myself. Look at my double chin. I should have shaved too… but it was Saturday. January 7, 2006 – My wife went to her sister’s in Minneapolis today and tomorrow so I went to Fargo to buy a new shirt to wear to a business meeting next week. I bought a big dutch oven (deep 14”) and a couple of nice shirts at Gander Mountain with the gift certificate I got for Christmas. The only shirts I could find that fit were 3XLT. They fit my belly fine but the tails and sleeves were too long. Big clothes that are nice and reasonably priced are just about impossible to find. I’ll have to roll up the sleeves and be careful not to pee on the shirttails. February 11, 2006 – I took my B-vitamins for the first time last night and they must be doing something as I could color Easter eggs with my urine. There is going to be a lot of yellow snow in the back yard now. I’ll have to pee on trees and tires so Parker gets the blame. My arms don’t hang straight down because I have so much fat around my chest and on my arms. I didn’t realize it until I looked at this picture. But I still don’t feel like a fat man. Look, no chin and no neck; it’s all fat. At least I have a friendly face. This is the picture I used for my first avatar. July 9, 2006 – I had Denise take more pictures of me today. I weigh 251 pounds in these pictures. My belly has gotten noticeably smaller. August 25, 2006 – It’s my 52nd birthday today and I weigh 238 pounds. I feel better than I have in years. The shirt is a large… and my double chin is all but gone. October 11, 2006 – I was scheduled for my 6-month check up today. I arrived at the clinic about ten minutes early and the nurse was calling for me before I got my coat off. She ushered me into the exam room and took my blood pressure right away. It was high, 148 over 90. Then she changed to a larger cuff and did it again. It was 150 over 80. I figured it was high because I had just walked in from the far corner of the parking lot and hadn’t sat down and relaxed. After I answered all the screening questions she left and I waited for Sandy Jones.
This was taken in November 2001, just after I fell off the low-carb diet. My weight in this picture is about 240 pounds. The shirt is an XL and the jeans are 42. I am once again wearing these clothes, although they are getting too big for me. 
While driving I gave the gastric bypass surgery more thought and pretty much talked myself into it. When I got home I called a friend to ask about his WLS experience and for advice as to how to proceed. I had a nice long talk with Tony and he made it clear that he has no regrets and would do it again in a heartbeat. He told me about being scared of the surgery and almost backing out at the last minute but is very happy with the way it has turned out. I asked him about his current diet and he said that it is pretty much normal, only in smaller portions. He told me his Saturday breakfast was 1 ½ fried eggs, 2 strips of bacon, and a piece of toast. He also made it clear that his wife was happy and very supportive; I could hear her talking in the background. They offered to meet with Denise and me sometime to talk about it more.
January 8, 2006 – Denise and the kids got home from the cities around 5 PM. I planned on talking to her about my plans but as soon as she got home everything was a bit chaotic. After the kids left she had to tell me all about the weekend at her sister’s. It was easy for me to put off the discussion until later.
January 9, 2006 – I finally got up the courage to tell Denise what I was thinking about. I was afraid that she would object but she didn’t. She was very supportive. We hugged, said we loved each other …. and I cried.
January 13, 2006 – I took the first formal step today by making an appointment to see a local doctor at the Perham MeritCare Clinic. It was hard to do and I almost put it off, but I’ve learned there is no comfort in procrastination. I’ve learned that eventually you have to fight the dragon. I guess that comes with age (its called wisdom). My appointment is with Dr. Thiel on Tuesday, January 31 at 9:00 AM.
January 23, 2006 – While eating my leftovers for lunch today I practiced eating very small bites and chewing it for thirty seconds. This will take some getting used to as I have taken large bites and eaten fast all my life. One bit of advice all diets have in common is to take smaller bites and chew thoroughly. It sounds like it won’t be an option after surgery.
I was also thinking about why I want to do this. The first answer that popped into head is that I want to be “Babe Magnet”. Just kidding, but I am going to write them all down.
I want to be healthier and put off the typical geriatric health problems as long as possible, nor do I want to experience any catastrophic problems like a stroke or heart attack that could make me an invalid the rest of my life. I’ve been saving and investing for retirement and I want to be able to enjoy it.
Some of the common health problems of the morbidly obese that I have:
High blood pressure – I don’t know if I have high blood pressure but I wouldn’t be surprised. No one has ever told me I should see a doctor after they have checked my blood pressure. Dad has taken medication for a number of years for high blood pressure and I don’t know about Mom.
Cholesterol – Again I don’t know what my cholesterol levels are. I am not aware of my parents taking anything for high cholesterol.
Diabetes – Again I don’t know what my blood sugar levels are. At the last company health fair it was fine. Mom has type 2 diabetes and has for about 20 years. My grandmother (mother’s mother) and one of my great uncles also had diabetes and both died at relatively young ages. There is no diabetes on my father’s side that I know of. Diabetes is something I expect to have to deal with someday but hopefully I can avoid it for a while.
Vascular problems – My grandmother (father’s mother) and at least one of her brothers died of a stroke or aneurysm, my grandmother when she was only 46. I am not aware of either of my parents having varicose veins, but I have them, particularly in my left leg. I used to occasionally wake up in the middle of the night with what I thought was a muscle cramp in my calf. One night it was particularly painful and wouldn’t go away. In the morning it was black and blue so I went to the doctor, only to be told that I had a vein that had thrombosed and that there wasn’t much that could be done after the fact. That was in about 2000. Ever since then my left leg has been noticeably swollen, edema I presume, but has not been painful in any way. It looks terrible though.
Sleep Apnea – Denise says I snore, but not too bad, and that I occasionally stop breathing momentarily. I most likely have sleep apnea to a certain degree, but I don’t believe its something I need to worry about. I’m expecting to have to be tested.
Acid Reflux – I have found myself waking up with heartburn more frequently the past few years. Usually a couple of Tums and a glass of water will make it go away. Sometime it’s so bad that I burp up stomach acid that takes my breath away for a few seconds. I have notice this generally only happens when I sleep on my stomach. It is very scary when it happens.
Arthritis/joint pain – This is something I have not experienced yet but I’m guessing it is only a matter of time. Arthritis runs in my mother’s family. My mother has had both hips replaced and has trouble with her feet. My father won’t admit to it, but I suspect he has arthritis in his knees and ankles. He has gotten rather bow legged in the past 10 years. I expect to suffer from arthritis someday as well and I want to put it off as long as possible.
Urinary problems – I have to pee more often than I used to, usually twice a night. I also have noticed that when I am sitting I get sudden urges to pee, but when I do the volume is not that great. Also, when I stand up and walk the urgency diminishes somewhat. My guess is that my belly is restricting the volume of my bladder, especially when sitting. Of course I am also at the age where men start to have prostate problems.
Psychological – The literature mentions depression as being a side affect of obesity, but I don’t believe I suffer depression any more the average person and probably less. I am generally pretty optimistic about life. I do find myself being camera shy and a wallflower. I don’t know if this would be any different if I were at my fighting weight.
Shortness of breath – I am generally out of shape. One flight of stairs will have me breathing harder than I should, but not huffing and puffing. I know I don’t exercise enough but it’s hard to do. I am usually tired, though not exhausted, at the end of the day and have no problem falling asleep.
January 31, 2006 – I had my consultation with my PCP, Dr. Thiel, this morning. I weighed 330.9 pounds. That makes my BMI 50.3, in the super obese category. My blood pressure was 122 over 60. The nurse said it was good. My pulse was 100 beats per minute, which she said was on the high end of normal.
I had a nice long talk with Dr. Thiel about gastric bypass surgery. I explained to him why I wanted to do it, to improve my health and keep diabetes at bay. He explained to me what the options are and what needs to be done for a pre-op physical and blood work. He was most supportive and said that he would be happy to refer me to Dr. Smith in Park Rapids. I also had blood drawn to get a reading of my cholesterol and blood sugar.
When I got home I was surprised when Denise told me that Barb from the Dakota Clinic in Park Rapids had left a message for me to call her to set up an appointment. Boy was I surprised at the speed everything was happening.
February 1, 2006 – I called Barb, the surgery nurse, in Park Rapids this morning. She scheduled me for a consultation visit on February 9th at 8:45 at the hospital. She said there would be two group meetings that lasted all morning, then in the afternoon, individual consultations. She asked about my insurance (Blue Cross Blue Shield) and told me that they usually didn’t require anything extra.
February 2, 2006 – Last night there was a message on our answering machine to call Dr. Thiel to discuss my blood test results. It scared Denise because she thought it unusual for a doctor to call with blood test results. I figured it was no different than Dr. Hammon calling to see if how I felt after a root canal. I called this morning and talked to Dr. Thiel’s nurse Lisa. She said that my blood sugar was 110 which is a little over normal but my cholesterol was 255 which is a little high. She said that I should tell Dr. Smith and then we could probably address it after it is tested again for the pre-op physical. I’m not terribly worried about it. If I have to take a cholesterol lowering drug it is no big deal. Hopefully a WLS diet and loosing a bunch of weight will make it not necessary.
February 9, 2006 – Consultation with Dr. Smith and his staff was a full day. I sat in the waiting room for 45 minutes, as the 8:45 class didn’t get started until 9:00. The class was run by the dietician, Mari Kadow, and the social worker, Laurel Hed; both who were disgustingly thin. I was asking myself ‘what do they know about being fat?’ but it was obvious they have had a lot of experience working with WLS patients. At least Laurel admitted she was a former smoker and knew how hard it was to quit. Mari told us what we should be eating before surgery, the importance of water both pre and post-surgery, what we would be eating in our post-surgery diet and how to eat it. The three C’s of what not to drink were also pounded into us; no caffeine, no carbonation, no calories. I was sure glad I could say with a straight face I don’t drink sodas and only decaffeinated coffee… since Tuesday.
They also told us stories of what can cause WLS as a “tool” to fail, namely grazing and drinking while eating. We also heard horror stories about eating too much, eating too fast, dumping, and not chewing well enough. After that scare, they said these things will happen to us too, but it is good it does, as it is a powerful incentive to change what we eat and our eating habits.
Then I went over to the Dakota Clinic for the personal consultations. They were supposed to be waiting for us at the clinic but we still sat in the waiting room for a half an hour. The first thing the clinic nurse did was make get on the scale. I weighed 328 pounds this time so I guess my practicing eating slower and my protein first has paid off, three pounds worth. I was measured at 5’ 7 ¾” which makes my BMI 50.3. My pulse was 82 bpm, which is less than in Perham but my blood pressure was quit a bit higher at 152 over 90.
My first consultation was with Sandy Jones, PA, who I have read so much about on this web site. She went through the normal set of questions, told me to start taking B-vitamins, and quit drinking beer. I had to take of my shirt and show her my belly. She grabbed it, squeezed it, and poked my fat. It was rather embarrassing but I know she does it all of the time. She told me that she thought laparoscopic surgery would be no problem.
I no sooner got my shirt tucked in than Dr. Smith walked in. I think he was talking to me when he opened the door and continued talking rapidly as we shook hands. Everyone says that he is a quiet soft-spoken gentleman who is warm and friendly. I found that to be an accurate description. He explained the Roux en Y and the advantages of the laparoscopic procedure. He told me I should go back to Dr. Thiel and get on medications for cholesterol control and have my blood pressure checked again. He said the glucose levels weren’t a concern at this time, as they would most likely go down within a few days of the surgery. He also said that the blood pressure and cholesterol would likely do the same but that they should be monitored a month or two after surgery. After that he explained the blood work that was going to be done at this visit but most of it went in one ear and out the other. I do remember him saying one of the tests was for liver function, which is often shows potential problems in the obese, but like most other problems, they usually go away with weight loss. Just in case, he will take a biopsy of the liver during the surgery if necessary.
My next stop was to the lab for a blood sample. I told the nurse about the problems I encountered the last time my blood was sampled. She expertly found the vein in my right arm without a problem and I quickly filled four vials. She told me that my veins would improve a great deal after the surgery. I thanked her and complemented her on her professionalism. She smiled and seemed a bit surprised. I bet she doesn’t hear thank you from very many people she has just poked with a big needle.
After the blood letting, I met with Arlys Hess, the other social worker and a very nice lady about my age. She asked me most of the questions I was expecting to hear about family life, social life, hobbies, eating habits, etc. But there were a few that came out of the blue, like what would I want to be able to do in two years that I can’t do now? I had to think about it but I said that I would like to be able to hunt pheasants all day without getting tired out. I got a good laugh out of her when she was asking questions about how I would rate my mental health, (excellent, very good, good, fair, poor). I didn’t realize the type of question so I said “good” not realizing that “good” was only average. She said, “Only good?” I then looked at her form and understood the type of question, so I said “Excellent”. She said, “Why excellent?” I came back at her with “Why not?” “Touché” she said with a laugh. I answered the rest of the questions “Excellent”.
She went over my dieting history and agreed when I asked her if I’m typical of the people she sees. I am. I told her that I don’t eat breakfast, a light lunch, and too much for supper after a few beers. I knew I was a bad boy when I said it so I braced myself for a good scolding, which I promptly received. She told me to cut out the beer and then proceeded to give me the raspberries about my eating habits, especially no breakfast, saying that you don’t start out on a trip with an empty tank of gas. I knew she was right. Now it was my turn to say “Touché”. All things considered, my conversation with Arlys was the highlight of my day.
When I was done with Arlys I was told I could go, but my mind was on overload. As I was being escorted back to the waiting room by Sandy, I asked for clarification about the insurance approval and if I had to do anything more. Sandy re-assured me that they would be submitting everything for approval. She would be dictating a letter to Blue Cross within a week and would be sending me the results of my blood tests at about the same time. I think I will have to be talking to someone to make sure things are on track.
The day went very well and I left Park Rapids full of encouragement. I felt overwhelmed by all the information and things I was told to do. The educational information was all presented in the handouts and the books so that wasn’t a problem. What overwhelmed me was all the things I was told and told to do by Sandy, Arlys, and Dr. Smith. Sandy wrote down some information about vitamins and aspirin. It would have been nice if they had had one common piece of paper that they all could have written their specific instructions for me to follow in the next weeks. I’m not sure I remember everything I was told.
February 12, 2006 – Last night I thought about some of the discussion I had with the staff at St. Joseph’s on Thursday. We heard various reasons why people get fat, such as heredity, metabolism, emotional stability, etc. That got me thinking about what makes me eat. I know I don’t eat from depression like some people do. I don’t “graze”, except at Christmas when it is a tradition for me. I don’t eat much junk food, even though I work for a junk food manufacturer. I don’t eat sweets or drink sodas. I don’t eat in fast food restaurants; in fact I don’t eat in restaurants unless I have to. I like preparing and eating the right types of food like meat entrees, salads, and vegetables. I don’t eat many potatoes or much bread. My genetics may have something to do with my metabolism and ability to store fat, but not entirely. My theory is that for some reason my mind never tells me when I’m full, my stomach does, but only when its stuffed. As long as there is food around I want to keep eating. By the same token, I almost never really feel hungry and that is why I never feel like eating breakfast. I can go comfortably go all day without eating, but then when I start, like at suppertime, I don’t want to quit. That is when I practice “plate management” and eat way too much and too fast. If supper was particularly tasty, I usually have seconds. I know that this is my downfall.
February 14, 2006 – I had another appointment with Dr. Thiel this morning to get on cholesterol reducing medication and possibly high blood pressure medication. My vitals were 328 pounds, blood pressure 162/100, and pulse 96. He prescribed Lipitor for the lipids and Atenolol for the blood pressure.
After I left the clinic I though about how feel mentally. I’ve noticed my psyche has changed since I made the WLS decision, and especially after my first visit with Dr. Thiel. I feel happier. I find myself smiling more and being more outgoing. I do not feel frustrated or get angry when things don’t go exactly right. My consultation visit with Dr. Smith, Sandy, and Arlys seemed to re-enforce my positive attitude even more, not that I felt that I used to be a down-in-the-mouth sour puss. I’ve always been a pretty happy guy and comfortable in my own skin. It’s just that now I feel even happier and more optimistic about life. God has truly blessed me.
February 22, 2006 – I stopped at the mailbox on the way home from work, hoping there would be something from the Dakota Clinic. Sure enough there was. It was my blood lab test report. They are as follows:
Blood sugar – 96
Kidney function – normal
Liver function – normal
Potassium – 4.7
Thyroid – normal
Hemoglobin – 16.8
Platelets – normal
White Blood Count – normal
B-12 – normal
H. Pylori – normal
Comments – Labs are normal
To me this is good news. My blood sugar was below even the threshold for a pre-diabetic condition, if just barely. It is still good news. The other thing that was concerning me was my liver. I have read at ObesityHelp.com that it is common for fat people to have elevated liver enzymes and that the surgeon will take a biopsy of the liver during the surgery. Usually it is not a problem and the condition goes away with weight loss like almost everything else, but sometimes it is a sign of cancer or cirrhosis. I am happy that I do not have to worry about this.
March 3, 2006 – I’m mad today, but I don’t know who to be mad at. Last Monday I called Dr. Smith’s office and talked to Loretta asking about my surgery status. I took her advice and called BC/BS today to inquire about my status. The customer representative told me that they have not received anything from Dr. Smith’s office. I told her that it had been faxed on February 17th and they should have it. She said they had no record of it. I could see I wasn’t going to get anywhere with her so I thanked her and hung up.
I promptly called Dr. Smith’s office again and explained what I had been told by BC/BS. I was transferred to the Dakota Clinic business office and talked to the manager. She said it had been faxed on February 17, and she remembered doing it. She said she would call Blue Cross to see what was going on. At 11:10 she called me back to say that she got the same result from BC/BS. She was going to fax it again and then follow up on it. I asked if she could put any pressure on them to expedite the process.
One of my biggest disappointments is when I trust someone else to do something and they either don’t do it or it somehow gets screwed up. This would appear to be the case here. There are many things that could have gone wrong:
1) The fax didn’t go through.
2) The business manager didn’t send it.
3) The business manager accidentally sent it to the wrong insurance company.
4) BC/BS lost it.
5) It is sitting under a pile of other paperwork at BC/BS.
6) The person in charge of receiving and distributing faxes at BC/BS routed it to the wrong person.
7) The person at BC/BS whose duty it is to review it is on a Caribbean cruise.
It is very frustrating!
My advice to anyone else pursuing WLS is that after you are told that your pre-approval has been submitted to the insurance company, call and make sure. You can’t call them to ask if it has been approved if they claim they don’t have it.
March 13, 2006 – Good news. I called BC/BS this afternoon and found out my insurance has been approved. This is the first FART moment (Fabulous Awesome Remarkable Tremendous) if my WLS journey. I also called Dr. Smith’s office to see if they had heard anything, but they hadn’t yet. Loretta said they would be calling me as soon as they got something. Then I can schedule the date.
March 17, 2006 – After a few phone calls this morning I was finally able to get a surgery date. It will be April 6th. Now my anticipation is turning into the nervous jitters, but I’m looking forward to a healthier life as a looser.
March 26, 2006 – I’m less than two weeks away from my date with Dr. Smith, eleven days in fact. Surprisingly I’m not nervous about it and I don’t think I will be even as the anesthetist starts to put me under. My attitude is, “Get ‘er done”. I want to be on the loosing side as soon as possible.
March 30, 2006 – My big day is a week from today and I’m not the least bit concerned about it. Well, maybe a little bit, but it is nervous anticipation and not fear. I just want everything to go smoothly and quickly.
I’ve been in kind of a mental fog the past few weeks because I’m so focused on having WLS on April 6th. Every free minute I get, I’m on the OH Men’s forum reading other men’s WLS experiences. It is a very interesting place to spend some cyber time.
March 31, 2006 – I had my pre-op physical with Dr. Thiel today and received a clean bill of health. I wasn’t worried, but it is nice to be told I am about as healthy as a 51-year-old fat man can be. I weighed 326.1 today, my blood pressure was 140/80, and my pulse was 60. Dr. Thiel said my BP was perfectly acceptable and the Atenolol was doing what is supposed to.
I also had blood drawn for another lipid profile and to check my liver function. The vampire had to poke me a couple of times before she drew blood. My hemoglobin was normal but the lab results for the lipids and liver function weren’t available during my visit. I’m curious as to what my lipids are after 6 weeks on Lipitor. Dr. Thiel said I could discontinue Lipitor before surgery but keep up the Atenolol unless Sandy Jones tells me to do otherwise.
The final thing was to have an EKG. I had never had one before and I was a little concerned that it might show something wrong with my heart. It took Lisa several minutes to get me wired up and then about 15 seconds to run the test. The results showed that everything was normal and I was relieved. As Lisa was unhooking all of the wires she said she didn’t get to do very many normal EKG’s. Most of the time she does them is because the patient has a heart problem. I’m glad I’m not one of them.
I walked out of the clinic with a smile on my face and a little more spring in my step.
April 5, 2006 – Well tomorrow is my big day, the beginning of a new, healthier, life for me, and I am so looking forward to it. I have to be at the hospital at 7:30 AM so that means we have to leave home about 6:00. Everything is packed and ready to go, including my comfy terrycloth bathrobe and moccasin slippers. I have no idea how my body will feel 24 hours from now, but I’m confident I’ll be happy.
I am a bit nervous, but I have no fear. Dr. Smith is an experienced surgeon and the hospital has a floor that specializes in bariatric care. They will take excellent care of me. I know God is watching over me, I know all of the guys in the OH locker room are praying for me, and I have Psalm 23 in my heart.
All of the support I have received from the guys on the OH Men’s Messageboard have made my journey up to this point so much easier and I am completely comfortable with my decision. The guys have been wonderful. May God bless them all.
This will be my last update until after I get home.
April 6, 2006 – Surgery Day
April 10, 2006 – I had my surgery on the 6th at about 10:30 AM and my brain has been filled with cobwebs ever since. I got home yesterday morning and tried to write an update to this journal except there was no way I could write a complete sentence and my spelling was so poor it almost caused the computer to lock-up. Things seem to be a lot better this morning. It’s amazing what a good night’s rest and dose of milk of magnesia will do.
I will now fill in the gaps of the past few days and relate my hospital experiences.
We arrived at the hospital at 7:15 and didn’t have to wait; they were expecting me. I got registered and escorted by the pre-op nurse Rose to a room in the second floor where I was told to disrobe and put on the classic hospital gown. She showed us where my room (232) would be and explained that I would be taken into surgery in a wheel chair and brought back to the room already in my hospital bed. She told me about what to expect from a catheter and what IV’s I would be on, including the Demerol button.
She then said it was time to put in the IV. First she wrapped my left hand in a warm washcloth for a few minutes and then tried to find a vein. The left hand failed to produce a productive vein so she started over on the right hand. This was no better, so she started hunting for a vein on my forearm. Finally she was able to get the IV connected, but I was starting to get needle shy.
Rose turned on the TV for me and started making idle chitchat. I think that was in the plan to calm patients down. She was pretty good at it, almost to the point of being sickening. Then she brought me a warm blanket and put over me. She said it would help me relax and it did… a little. After a few minutes Dr. Smith came in to explain what he would be doing and that they would be ready for me in about an hour. He was followed by Sandy Jones who went over a things about my medical record and what drugs I was taking. Finally the anesthetist came in to explain what he would be doing to me and how I would be waking up. He then went on to tell me about the Demerol pump and that I shouldn’t be afraid to use it. He assured me that I wouldn’t turn into a drug addict in three days but that pain management was critical to a speedy healing process.
Denise and I were about as relaxed as we could be waiting and watching the 24/7 news. It wasn’t long before they came to get me and wheeled me downstairs to the operating room. They stopped just outside the door and said this was the “kissin’ corner”, where everyone got to say their good-byes. Denise and I kissed. I thought one or both of us would have been crying, but we weren’t. As I write this now, four days later, I am fighting back the tears. Then I was whisked into the operating theater.
I have never seen the inside of an operating room before so I didn’t know what to expect. It seemed rather dim and spartan with gray walls. There didn’t seem to be much equipment, at least not like you see on TV. In the center of the room was a tiny bench that they asked me to hop on to after they untied the back of my robe. I commented that it was cold in here, because I have read that on several other profiles. The anesthesiologist immediately said it was 64 degrees, like he was expecting my comment. I looked up at the banks of lights that weren’t turned on yet and started to ask why…. That was the last thing I remembered.
I woke hearing someone saying, “I think he’s awake. His eyes are open.” Funny thing, I could hear what they were saying but I couldn’t see anything for minute or two. Finally my eyes were able to focus on the frame of the bed so I knew I was in the recovery room. Then someone told me that they would be taking me to my room in about half an hour. My eyes focused on the clock but I have no idea what time it was. I dozed off and didn’t wake up again until I was in my room
I don’t remember much about the rest of the day except being very thirsty, hitting the “button”, and sleeping a lot. Sleeping helped the time go faster and I wasn’t thirsty when asleep. I knew I had to walk and had told Denise that I wanted to get up and walk as soon as I could. All the advice from the guys on the Men’s Forum was to walk as soon as possible as it makes you feel better. So, sometime in the afternoon, around 4 PM I would guess; I told Denise I wanted to go for a walk. She called the nurse to help. They helped me get out of bed, one on each side holding me, and I distinctly remember wanting to close my eyes and go back to sleep standing up. I kept hearing, “Open your eyes Paul.” I would open them, look around, get my bearings, and stand there for awhile; then my eyelids would get heavy and close. I couldn’t help it. Eventually I could keep them open long enough to start walking. We walked to the nurse’s station, which wasn’t very far, and I had to stop to rest. As soon as I got back in bed I must of fallen asleep. I don’t really remember much else until Denise went home around 9 PM. I think I managed to walk some more, but I wouldn’t swear to it.
At some point, a nurse brought me a little cup of blue ice and started spoon feeding me, two or three small chips at a time. Oh, did that taste good! I would never imagine that ice could have flavor, but it was only in my head. She cautioned me to go slow, taking tiny spoonfuls and resting a minute between bites. I was supposed to let the ice melt in my mouth. I sat in bed watching TV and sucked on my ice. Eventually the spoonfuls got bigger and I wasn’t letting it melt in my mouth anymore. I paid the price. I started to choke on the ice, but I managed to spit most of it out. That scared me… and made my tummy hurt.
The first night went fairly fast even though I woke up every time the blood pressure cuff engaged. I was automatically recording my BP every hour, but as soon as it was done the slow pulsing massage on my leg wraps and the “button” put me back to sleep.
I woke up in the morning feeling a lot better than I did the day before. I don’t remember what time it was, but it was fairly early. I was wondering how long I would have to wait for my leak check because I knew this was a very important hurdle to get over… and if I did, I could have water. It wasn’t more than a few minutes and someone from radiology was there with a wheel chair for me. Apparently they didn’t have much of a waiting line and I was first.
I drank the liquid that I heard was so horrible, but it wasn’t. I had to take four gulps about a minute apart. The radiologist let me see what was happening on the screen. I could see the juice traveling down my esophagus into the pouch and then out. I could faintly see my lungs moving and heart beating in the background. The radiologist pronounced that I had no leeks and was good to go. Yippee! I can have some water.
And I had water waiting for me when I got back to the room. My nurse, Susan Nelson, poured blue water into a little medicine cup and told me I could drink it, but I should drink it in two or three sips. I obeyed, but it was just barely enough to wet my parched throat. Then she poured me another shot that I slowly sipped. Sipping like this didn’t seem to quench my thirst. I wanted to DRINK! Susan told me that I should make sure I drank at least 2 shot glasses of water per hour and gave me a notepad to write them down. She said I could drink more if I felt like it. I definitely felt like it. In fact I was eyeing the big glass of blue ice water with lust. As soon as she left the room I poured another cup full and sipped it down, then another, and another… until I had recorded seven cups in the first hour. The second hour I did another 7 but I wasn’t being as careful about sipping anymore. Then came a minor tummy ache and I didn’t want any more water for a while. Susan told me to cut back to two cups per hour and make sure I sipped slowly. I had learned my first pouch lesson about sipping. I over did it with either too much water or drinking too fast and my new pouch rebelled. Fortunately it wasn’t any worse than a tummy ache and it subsided within a half an hour.
The next big event was to have my catheter removed. I figured Susan would get one of the male nurses to do it, or at least ask if that is what I preferred. Nope. She said its time to do it and lifted my hospital gown above my waste. I blushed and the little guy hid with fear. She told me to take some deep breaths and exhale completely. On the second exhale I felt a little twinge and it was out. Painless.
Then it was time for a shower. It felt so good I almost started to cry. I let the warm water run over my head while Denise washed my back. When I got back to my room my first breakfast was waiting for me; a little cup of Jell-O and a small glass of apple juice. The Jell-O had an unpleasant acidic taste to it and the apple juice tasted way too sweet, but I slowly and carefully ate and drank them anyway. Within a few minutes I had a queasy stomach. I think it was the apple juice. The next time they brought me apple juice I asked for something different. Cranberry juice, diluted with water settled with me much better.
The next day I got pudding and milk for breakfast a then tomato soup for lunch. I slowly sipped it from a spoon making it last. I don’t think a bowl of soup has ever tasted so good, tiny as it was.
I could also feel my intestines starting to wake up. There was no pain but I could hear and feel things moving. Pretty soon I started to get some “baby burps” that gradually increased with intensity and frequency. Gasses were moving in the other direction as well and I started letting some rather nice farts. Getting the gas out of my guts really helped me feel better. The nurse asked me if I felt the need for a bowel movement, but I didn’t. I thought I was empty… but I wasn’t.
I had a hard time sleeping in the hospital, never managing to sleep more than a couple of hours at a time. I was never very comfortable in bed, no matter what position I set the bed in. Sitting up in a chair was much better and that is where I spent most of my time both watching TV and sleeping.
Sunday was parole day and I was wide awake by 4:30, so I got up. I tried one more time to get a bowel movement going but to no avail. If you can’t go… you can’t go. I shaved, washed up, and brushed my teeth. Now all I could do was wait for Dr. Smith to give me his blessing and get my drain tubes pulled.
Dr. Smith showed up at 7:30, asked how I felt, and told me I was ready to go home. He had just left when Denise showed up to take me home. But first my drainage tubes had to be removed. My day nurse, Karie, said she needed help pulling them so she went to get another nurse. She had given me a dose of Lortab elixir earlier to dull the pain. When it came time to pull them Karie had me take deep breaths, like for pulling the catheter, and on the count of three they both came out. It didn’t hurt but it made my asshole pucker in reverse…a weird feeling.
The dogs were very happy to see me when I got home. Molly couldn’t get close enough to me and Parker was whining with joy. I immediately took them for a short walk so I could get a breath of fresh, moist, country air. I walked back to my deer stand and stopped to reflect on the events of the past few days and how good it was to be home. Then I found myself crying uncontrollably. I was so happy and relieved the ordeal was over.
I was exhausted so I spent the rest of the day in my easy chair relaxing and watching the History Channel with Buck & Six in my lap.
I was still constipated in the evening so I took a dose of milk of magnesia to get things going. In the middle of the night it finally took hold and cleaned me out. It felt like I was passing a watermelon, although it really was quite small. I felt immediate relief, even if my hemorrhoids were a bit sore.
April 11, 2006 – I had a normal, but small bowel movement today. What a relief! I was afraid I would still be constipated. I can’t say enough about old-fashioned oatmeal, although I think I ate a little too much this morning. I felt a bit queasy all morning, but I was better after my walk and a nap.
The following is a rather lengthy reply I made on the Men’s board today in a discussion about surgical pain and pain management that DxE posted as information for the pre-op guys.
Dx,
Once again, a great post with lots of good information. I wish I had read it before my WLS. Here is my long reply.
While its still fresh in my mind, I would like to relate my pain & pain management experiences for our pre-op brothers. Last Thursday when I was waiting for the show to begin the anesthesiologist came to talk to me about what drugs would be used and pain management. He emphasized that I would heal faster without pain that with pain. He told me that I would be on a Demerol pump but not to be afraid of it, as I wasn’t going to turn into an addict in three days. I would also be getting an anti-nausea patch behind my ear. He told me how to use the 1 – 10 scale when the nurse asked and emphasized the need to use the pump frequently and before the pain gets too bad. Apparently the pump is only effective at controlling pain as long as it doesn’t get too severe.
When I woke up I didn’t really feel any pain, just numb. I guess the anesthesia still had a pretty good grip on me. After short time I started to feel like I’d been kicked in the stomach by a horse. It ached all over. When the nurse asked my pain level I said 6 or 7, which is probably a high estimation. I hit the pump and listened to the clicks. The pain subsided to about a 3. I took the anesthesiologist’s advice and hit the button frequently, sometimes before the timer would let me. The pain stayed around 3 – 4 for a couple of hours and then subsided even more. Then it only hurt if I took a deep breath or moved in bed. It stayed that way all night and I kept hitting the “button” whenever I woke up. The Demerol helped me sleep and I wasn’t thirsty when asleep, which was a blessing.
The next day only hit the “button” when I knew I was going to do something that might hurt, like get out of bed for a walk or when they pulled my catheter (painless). My pain level during the second day was 1 – 2 without hitting the “button” and 0 with it. I didn’t use it more than 5 or 6 times all day and not at all at night.
My IV was pulled on the third day and I went without any medication all day, nor did I need any. In the evening the nurse wanted me to test drive the Lortab elixir to see if it caused me any problems as that is what I would be going home with. I took a dose and felt no effects, but I had very little pain by then. It didn’t seem to make me drowsy as I was hoping. I did not sleep well after the first night.
My drainage tubes were pulled just before I was paroled. They gave me another dose of Lortab about half an hour before and I felt no pain, just a weird feeling in my stomach.
As far as the drug side affects, the nurses were concerned about me retaining water and not peeing enough volume. My ankles were noticeable swollen. They also kept encouraging me to try a bowel movement to no avail. If you can’t go… you can’t go. It seems that the anesthesia and Demerol had made both my kidneys and bowels pretty sluggish. This has turned out to be one of the more unpleasant aspects of my WLS experience. They sent home some milk of magnesia which I took right away, but it took at least 12 hours for it to do it’s work. I wish I would of had it a day earlier.
I took two doses of Lortab after I got home mostly to try alleviate the discomfort from constipation and help me get to sleep. It did neither; in fact I’m sure it prolonged the constipation. I haven’t taken Lortab since nor do I expect to. What do you do with a $480 bottle of Lortab?
I hope my experience with pain management this past week helps the pre-op guys to relieve some of the anxiety of WLS. I was expecting more pain than I experienced. It’s not that bad, especially if you know what to expect. One word of advice, deal with the constipation as soon as possible.
Right now, I have no pain; only a little tenderness when I push on my stomach. Like everyone told me, “it gets better every day”. It’s true.
May Your Lantern Burn Bright,
Paul
April 14, 2006 – I had my one-week check-up with Sandy Jones today. I weighed 315, fully clothed, my BP was 132/70 and my pulse was 74 bpm. That’s excellent compared to my pre-op vitals. I have officially lost 7 pounds since surgery but if I take into account the last pre-op weigh was a naked weight, I estimate my loss at 12 pounds. Sandy gave me the green light to progress to phase thee of my diet. We stopped at a grocery store and I bought some string cheese and a bottle of V-8 for the trip home.
In the evening I lit the Weber and grilled some salmon fillets for my first meal of chewable food. The salmon, along with a few bites of cooked carrots was wonderful. It didn’t take more than 2 ½ ounces to fill me up.
April 20, 2006 – My surgery was two weeks ago today and I feel great. This morning I had my first post-op FART when I stepped on the bathroom scale. I broke the 300 pound barrier weighing in at 299. That is 22 pounds lost forever.
I have not had any problems eating and I’m gradually adding new foods. Last night I tried crock pot pork cooking in cream of mushroom soup with extra mushrooms along with a tiny bit of coleslaw. Everything was delicious, but I think I ate a bit too much. Three ounces of meat was pushing it and I should have stopped at about 2 ½ . I’ll keep that in mind for next time.
April 29, 2006 – This morning I weighed in at 293, down 28 pounds from the morning of my surgery. I’m not loosing weight as fast as some of the men I read about in the OH men’s profiles, but they were generally bigger than me to begin with. Some of them loose 2 – 3 pounds a day where I am dropping about a half a pound a day, although I have had a few 2-pound days. I think it might also be because that they are often restricted to liquids & pureed foods for a lot longer whereas I was allowed to start with soft solid foods within a week. I’m not in race with anyone and I must only consider my goal, to get under 200 pounds.
I am eating between 800 & 900 calories a day and getting about 75 grams of protein. I usually drink a half a protein shake plus I’m eating chicken, eggs, fish (salmon & cod), hamburger, and chopped liver as my protein sources. I compliment these with small amounts of salad, a few slices of apple, or some grapes (I spit the skin out). Tonight I’m going to try shrimp. When I eat so little I’m not afraid that more expensive foods will break the grocery budget.
I have had a few instances of not having things settle very well and it is not a pleasant experience. It starts as a feeling of a trapped burp that can’t get out and it seems to grow in my pouch. It hurts and I have to get up and walk around for a bit of relief. If it doesn’t go away I head for the bathroom and await the inevitable. Projectile vomiting provides instant relief.
Some of the things that I know have bothered me are: 1) B-100 vitamin tablets. Sandy Jones told me to cut them in half and I shouldn’t have any problem. I have no problem swallowing them, but if I take them on an empty stomach, anything I eat in the next few hours will cause me discomfort to some degree. This has caused me to blow some crock pot pork that I had eaten with no problem the night before. I have switched to taking them after I eat and I crush them and mix with a teaspoon of applesauce. That seems to work pretty well. 2) On Thursday I ate baked chicken breast that sat in my pouch like it was concrete. It didn’t come back up but it took a half an hour before the discomfort went away. I think it was too dry and I possibly ate too fast, not chewing well enough. The next day I had a smaller portion of chicken smothered in gravy that went down fine. 3) This morning I ate one egg that made me sick almost immediately and for no apparent reason. I have eaten a lot of eggs the past couple of weeks so I don’t know why I had problems this morning.
May 17, 2006 – I had my six-week checkup with Sandy Jones today. My blood pressure was 124/70, which is pretty darn good for a 51-year-old guy with a deep navel. I have dropped 40 pounds to 281 and got a pat on the back from Sandy. She said I was doing great.
Sandy wanted to look at my incisions and as I was unbuttoning my shirt I told her that I was under strict orders from my wife today to buy some new pants that fit. Sandy took one look at my belt and added, “Get a new belt too!”
I also spent an hour in a group meeting with the dietitians and eight other people, mostly women, who had surgery around the same time as I did. I was surprised how many of them have had problems. There were three of them that had at least one stoma closing that had had to be dilated. One gal said she couldn’t eat anything and was depressed. She was wishing that she hadn’t had the surgery.
The dieticians didn’t tell me anything I didn’t already know and I was surprised when they said we should now try to get from the 40 grams of protein stage up to 60 grams. Many of the gals in the group were asking how to do this and seemed to be afraid to try eating anything other than soft foods. I told them that I get around 80 grams in a 900 calorie day and that I’m not afraid to try anything within reason. Getting sick isn’t the end of the world, just an ending to the unpleasantness caused by a mistake. I also told them that I use Fitday to track my food intake. No one had heard of it including the dieticians, another surprise for me.
On my way home I stopped at Walmart in D.L. to by new pants. I took several sizes into the dressing room and found that the 44w/30i the stretch waste fit the best. That is down from the 52 inch stretch waste that I was wearing a couple of months ago. FART.
All in all, I had a very good day.
My face has too, and my double chin is starting to dissapear. This photo was used for my second avatar.
October 6, 2006 – It’s been six months since my surgery and life is great! I’ve had no complications. This morning I weighed in at 222 pounds, down 99 pounds from April 6th when I weighed 321 pounds. I’ve blown through all of my clothes, going from a 52-inch waist to a 40-inch waist, and I’m confident that I’ll make it down to 36 inches in the next six months. My shirts have gone from 3XL to just plain L. I don’t ever remember buying shirts without at least one X on the label. I weigh less today than when I got married, than when I graduated from college, and even probably than when I graduated from high school. I weigh less now than at any time in my adult life! I also feel so much better. I enjoy walking again. I can bend over and pick things up off of the floor without getting dizzy, seeing stars, and blowing the ass out of my pants. I can walk up stairs without getting winded. I sleep better and I don’t snore. And, no more heart burn either. In fact, I feel twenty years younger.
I’ve gotten comfortable with what and how I eat. Often people will ask me about eating and I just tell them, “I eat anything I want, just much less than I used to, and I’m full and satisfied.” Of course there are things I don’t want to eat, like fried or fatty foods. I’ve learned from experience that about 40 grams of fat in one meal will make me nauseated. I haven’t eaten any sugar, except for the incidental sugar in processed foods, as I don’t want to experience dumping. The few brushes with dumping I’ve had from fats are no fun so I steer clear of sweets as well. I don’t miss them either.
I also avoid eating much bread and other starches. Bread used to get stuck in my pouch for the first couple of months but it hasn’t bothered me for a long time now. I generally avoid bread and potatoes only because they are empty carbs… and I’d rather have a beer once in awhile.
I am still tracking my food intake with Fitday and it helps me stay focused. I generally eat around 1200 to 1500 calories a day and get about 125 grams of protein. I try to restrict my carb intake during the week to less than 30 grams as it helps keep the scale moving down. Last summer when the sweet corn was prime, I was eating about an ear a day. I also noticed a plateau in my weight drop. As soon as I stopped eating so many carbs, the scale started to move again.
I get a lot of compliments from people at work about how good I look, which makes me feel good. Then after I tell them “thank you”, they often ask with a sympathetic tone in the voice, “But how do you feel”, like they think that I am sick with some terminal disease. I tell them “I feel like a million bucks. In fact, I feel like I’m twenty years younger.” I know they are just uninformed, thinking that WLS makes you sick and unable to eat like a “normal” person.
Next Wednesday I’m scheduled for my 6-month checkup with Sandy Jones in Park Rapids. I’m curious to see the results of my blood work.
October 9, 2006 – I had Denise take another picture of me for a new avatar. I noticed that I am more comfortable in front of a camera than I have ever been. Can you tell from my smile?
Sandy showed up in about 10 minutes, and I now felt relaxed. She took my blood pressure and it was 138 over 78 this time. She said we could live with that. She asked me the routine questions about how I’m feeling, how I’m eating, asked about any pains or problems, etc. I told her everything was fine and how happy I am with WLS. She checked my incision scares and my belly for signs of a hernia and found everything to be fine. She said that my belly is mostly skin, but I grabbed it and said that I thought there was still plenty of fat underneath. She told me that I was healthy and I said, “That’s why I started this journey in the first place.”
The next stop was to visit the vampire to get my blood work done. The nurse felt for a vein and drew blood with the first poke. I asked her if I could kiss her and she laughed.
My next appointment will be in another 6 months
