tedthelightbulbexpert
Recovery, Or "How I Learned to Hate Aspartame"
Jan 05, 2011
I'd intended to keep more timely progress of my post-op recovery, but I'm afraid that between the chaos of the holiday season, coupled with the levels of pain I was in and some all-around stress at home, that wasn't possible. But, I'm here now, and figured I should relate some of the past few weeks.
The surgery went as it should have, I suppose. I was anesthetized, promptly knocked out, and woke up in the recovery room as the nurse anesthetist pulled the breathing tube from my nose. It was a surreal experience; I was in the blackest depths of unawareness, then suddenly I was in a room awash with light, in searing pain as they pulled the tube out of my nose. That was the worst of the pain, but fortunately it didn't last too long.
The next few days in the hospital were hit or miss. No food or water for the first 24 hours as they needed me to drink contrast and check the sutures. Dry mouth, cracking and blistered lips, feeling dirty and miserable, and in constant pain from my left side. I was on a hydromorphone drip, which spared me the worst of the pain, but at times not even the pain killers worked to abate the stabbing pains in my sides. My saving grace was a kind radiology assistant who carefully tended to me and helped make me as comfortable as she could. She was the nicest, kindest person I've met in medicine, and I actually looked forward to seeing her despite the pain of having to be transported there. I am eternally grateful to her for her compassion and kindness.
One of the worst aspects of the post-op recovery was sleeping; the breathing tube had ruptured and irritated my sinuses, filling them with bloody mucuous and making it hard to breathe. I'd drift off to sleep, snorting air through my nose and mucuous inevitably into my throat and lungs, which had to be expelled; i.e. coughing. Coughing was the bane of my existence, as doing so produced incredible bolts of pain, but I couldn't stop myself from doing it. It was only a few days ago that I finally returned to a point where I could actually cough without feeling too much pain.
The surgeon and the nurses also insisted that I try to walk as much as possible right after the surgery. With the patient-controlled hydromorphone, I was able to do so for a good distance and felt that my recovery would be speedy. Once they removed the PCA and instead gave me limited doses of hydrocodone (Vicodin), my pain levels became constant and where I could walk the length of the hospital wing twice before, I could barely go beyond 15-20 feet afterwards. I just had to stay in bed, as still as possible, to avoid more pain.
Hospital life gets boring quickly, so I was very ready to go home. My family came to pick me up, and I returned home to a warm welcome and a warm couch. Again, not a lot of moving around at this point as my sides and abdomen still hurt too much, I had to be assisted with nearly everything. Sleeping remained problematic for the aforementioned sinus/coughing problems, my back began to hurt from having to stay on it as that was the only comfortable position for me.
This was also the period of the liquid diet. Although I was pretty much on one in the form of Optifast two weeks prior to the surgery, the limited range of options ("clear" liquids) actually made this difficult for me. I couldn't drink beef broth because it made me queasy, chicken broth tasted too salty, etc. I tried eating sugar-free Jello as well, which ended up making me very naseeous and spending the night struggling not to vomit, so goodbye aspartame from my diet. I basically subsisted on the leftover packages of Optifast tomato soup and protein drinks, resulting in me apparently losing more than 30 lbs in seven days after surgery. I was pretty miserable, though. I wanted something with a bit of flavor, and took to sucking the salt off of sunflower seeds in order to sate my salty and savory cravings. Fortunately, the 'mushy' phase began a week later.
So here I am now, eating tuna fish and apple sauce. Not a combination I'd have considered prior to surgery, but its one I can appreciate now. Today was the first day I was able to go to work, a total of two and a half weeks on medical leave of absence. That suprised me and was a bit disappointing as I hoped to have a somewhat speedier recovery, but alas, my abdominal muscles had a number done to them and it took me a bit more time. I'm just glad I actually had the days off available, but now we'll see what the future as a slimmer man will hold.
0 comments
The surgery went as it should have, I suppose. I was anesthetized, promptly knocked out, and woke up in the recovery room as the nurse anesthetist pulled the breathing tube from my nose. It was a surreal experience; I was in the blackest depths of unawareness, then suddenly I was in a room awash with light, in searing pain as they pulled the tube out of my nose. That was the worst of the pain, but fortunately it didn't last too long.
The next few days in the hospital were hit or miss. No food or water for the first 24 hours as they needed me to drink contrast and check the sutures. Dry mouth, cracking and blistered lips, feeling dirty and miserable, and in constant pain from my left side. I was on a hydromorphone drip, which spared me the worst of the pain, but at times not even the pain killers worked to abate the stabbing pains in my sides. My saving grace was a kind radiology assistant who carefully tended to me and helped make me as comfortable as she could. She was the nicest, kindest person I've met in medicine, and I actually looked forward to seeing her despite the pain of having to be transported there. I am eternally grateful to her for her compassion and kindness.
One of the worst aspects of the post-op recovery was sleeping; the breathing tube had ruptured and irritated my sinuses, filling them with bloody mucuous and making it hard to breathe. I'd drift off to sleep, snorting air through my nose and mucuous inevitably into my throat and lungs, which had to be expelled; i.e. coughing. Coughing was the bane of my existence, as doing so produced incredible bolts of pain, but I couldn't stop myself from doing it. It was only a few days ago that I finally returned to a point where I could actually cough without feeling too much pain.
The surgeon and the nurses also insisted that I try to walk as much as possible right after the surgery. With the patient-controlled hydromorphone, I was able to do so for a good distance and felt that my recovery would be speedy. Once they removed the PCA and instead gave me limited doses of hydrocodone (Vicodin), my pain levels became constant and where I could walk the length of the hospital wing twice before, I could barely go beyond 15-20 feet afterwards. I just had to stay in bed, as still as possible, to avoid more pain.
Hospital life gets boring quickly, so I was very ready to go home. My family came to pick me up, and I returned home to a warm welcome and a warm couch. Again, not a lot of moving around at this point as my sides and abdomen still hurt too much, I had to be assisted with nearly everything. Sleeping remained problematic for the aforementioned sinus/coughing problems, my back began to hurt from having to stay on it as that was the only comfortable position for me.
This was also the period of the liquid diet. Although I was pretty much on one in the form of Optifast two weeks prior to the surgery, the limited range of options ("clear" liquids) actually made this difficult for me. I couldn't drink beef broth because it made me queasy, chicken broth tasted too salty, etc. I tried eating sugar-free Jello as well, which ended up making me very naseeous and spending the night struggling not to vomit, so goodbye aspartame from my diet. I basically subsisted on the leftover packages of Optifast tomato soup and protein drinks, resulting in me apparently losing more than 30 lbs in seven days after surgery. I was pretty miserable, though. I wanted something with a bit of flavor, and took to sucking the salt off of sunflower seeds in order to sate my salty and savory cravings. Fortunately, the 'mushy' phase began a week later.
So here I am now, eating tuna fish and apple sauce. Not a combination I'd have considered prior to surgery, but its one I can appreciate now. Today was the first day I was able to go to work, a total of two and a half weeks on medical leave of absence. That suprised me and was a bit disappointing as I hoped to have a somewhat speedier recovery, but alas, my abdominal muscles had a number done to them and it took me a bit more time. I'm just glad I actually had the days off available, but now we'll see what the future as a slimmer man will hold.
My Path to Surgery, Pt. 1 - The Revenge of Sisyphus
Dec 20, 2010
Armed with a new sense of purpose and the knowledge of the procedure, I consulted several surgeons in the area. I was very eager to get the surgery, and consulted with the one who could see me the soonest. Who that surgeon was is unimportant to the story as I only saw him once; once it became clear what insurance I had (Tricare), I was effectively dead in the water. At the time, weight loss surgery was still a novelty for Tricare and they would not consider approving me for surgery. Dejected, I opted to wait until the next year so I could find another job and another insurance provider.
That next job's health insurance provider proved to be Cigna, which was another insurer that proved wary of WLS. Granted, as opposed to Tricare obstinacy, Cigna was at least willing to consider approving surgery on a case-by-case basis. My case, as was the requirement at the time, required extensive documentation: everything ranging from a supervised dietary and exercise regimen, psychological screening, counseling, etc. 8-9 months later, after I'd jumped through all the required hoops, I was laid-off of that particular job. Unable to spare the extravagance of WLS while looking for a new job, I had to again postpone my quest for surgery.
Next, I found another job which provided a variety of insurance alternatives. I researched what was available well in advance and opted for Blue Cross Blue Shield Federal (FEHB), which I'd learned on this very site was one of the best insurers to have for WLS candidates. Armed with this more accomodating insurance, I went to Dr. Christina Li of the Baltimore Sinai Memorial Hospital's Bariatric and Minimally Invasive Surgery Department.
Dr. Li was wonderful. She was infallibly personable, warm, and understanding. She seemed to really enjoy her work as a surgeon and looked forward to helping her patients achieve their weight loss goals through surgery. I actually looked forward to seeing her, which is something I can only say for a handful of doctors in my life. What's more, I very much looked forward to having surgery with her. But, that did not prove to be what Fate would have in store for me. The problem resided in the way the Bariatric office handled pre-surgical testing and workup, and the staff's clear 'lack of enthusiasm' for assisting patients in setting up appointments. This may have changed since my time with Dr. Li's office, but there was no centralized scheduling of the necessary appointments, leaving patients with little more than a packet of doctor's orders and the numbers of different providers of necessary diagnostic measures.
This didn't seem particularly troublesome at first, and I assumed there'd be little problem in arranging testing myself. But, the combination of disparate service providers with a tight, yet overlapping schedule for required tests meant I ended up missing deadlines and repeating a lot of tests, wasting hundreds if not thousands of dollars in copays and lab fees. For instance, there'd be a requirement for a chest x-ray three months prior to surgery, lab work two weeks prior to surgery, and a psychological screening one year prior. Of course, I opted to complete the psychological screening first, but that would prove to be the single most difficult one at arrange. None of the providers seem to have appointments any sooner than six months before surgery, most wanted to see me for multiple sessions before they would approve or disapprove. I opted to see my old psychologist in Arlington, who was willing to do the screening and had the questionnaires sent from Dr. Li's office. What I had presumed would take only 2-3 weeks ended up taking three months of repeat sessions before I had an approval letter. By then, I needed to get a chest x-ray, among other tests, and found that I couldn't arrange such testing until it was perilously close to the scheduled surgery date. Without the chest x-ray, several other necessary tests (Upper GI, etc) couldn't be completed: I was pushing it perilously close. Too close, in fact, because by the time the psychological consult and chest x-ray came through, it was too late and my surgery had to be pushed back another six months. That of course meant repeating the majority of tests I'd already taken: blood work, chest x-ray, cardiological consult, EKG, etc.
As if that weren't enough, I had the misfortune of developing a blood clot in my leg after returning from a very arduous trip abroad. Understandably, but disappointingly, this put a halt on my surgery as I had to be treated with blood thinners for six months. That of course meant having to redo all the testing I had completed yet again. Once I was 'cleared' and taken off the blood thinners, a year had elapsed, meaning I had to do the psychological evaluation all over again. The same problem presented itself: either no one accepted my insurance, they weren't accepting new patients, they couldn't see me for 4-6 months, or they wanted to see me for an untold number of 'developmental' sessions before even committing to the surgical consult. It was a nightmare, and I was completely dejected. It had now been five years since I first sought out WLS, and now I faced having to go through the process all over again.
This situation was further complicated by the fact that my wife and I had two children during this time and opted to move to Virginia where it was easier to buy a house. The prospect of driving back and forth between Baltimore and Northern Virginia was just too much, especially when there was no guarantee that some unforeseen development would again hinder my surgery. I just threw in the towel, resolving to just 'live with myself' and my weight.
It seemed a reasonable enough prospect at the time, the only thing that was damaged was my physical vanity, something that married life had conditioned me to stop caring about quite as much. However, my two children provided another, unexpected reason to reconsider surgery. At 4 and 2 years old, my son and daughter are balls of boundless energy, who are always anxious to play with their parents. But it's been impossible for me to keep up, I'd always find myself aching too badly after a modest chase, or drained by the exertion of simply carrying my girth around through the course of the day. I thought about my children's future, the sort of eating habits I was inculcating in them. I became worried that I'd pass on my bad habits to them and I didn't want them to go through life the same way I had.
What really did it for me was a trip to a local park on a temperate spring day. As my kids ran around on the grass and my wife and I set up a picnic, I found myself sweating profusely and out of breath at the most trifling of physical gestures. It had been a long, slovenly winter and I was suffering for it. While considering my fate, I saw a father/son team running down one of the many jogging paths, keeping pace with one another, father encouraging his son along. That sight stirred me in a way I hadn't been since my son and daughter were born, and in that instant, I knew what sort of father I wanted to be. I knew what I had to do to become that father, to get in better shape, to have more energy to play, to inculcate them with an appreciation for exercise and good food and being healthy in general.
I needed to pursue surgery one more time.
0 comments
That next job's health insurance provider proved to be Cigna, which was another insurer that proved wary of WLS. Granted, as opposed to Tricare obstinacy, Cigna was at least willing to consider approving surgery on a case-by-case basis. My case, as was the requirement at the time, required extensive documentation: everything ranging from a supervised dietary and exercise regimen, psychological screening, counseling, etc. 8-9 months later, after I'd jumped through all the required hoops, I was laid-off of that particular job. Unable to spare the extravagance of WLS while looking for a new job, I had to again postpone my quest for surgery.
Next, I found another job which provided a variety of insurance alternatives. I researched what was available well in advance and opted for Blue Cross Blue Shield Federal (FEHB), which I'd learned on this very site was one of the best insurers to have for WLS candidates. Armed with this more accomodating insurance, I went to Dr. Christina Li of the Baltimore Sinai Memorial Hospital's Bariatric and Minimally Invasive Surgery Department.
Dr. Li was wonderful. She was infallibly personable, warm, and understanding. She seemed to really enjoy her work as a surgeon and looked forward to helping her patients achieve their weight loss goals through surgery. I actually looked forward to seeing her, which is something I can only say for a handful of doctors in my life. What's more, I very much looked forward to having surgery with her. But, that did not prove to be what Fate would have in store for me. The problem resided in the way the Bariatric office handled pre-surgical testing and workup, and the staff's clear 'lack of enthusiasm' for assisting patients in setting up appointments. This may have changed since my time with Dr. Li's office, but there was no centralized scheduling of the necessary appointments, leaving patients with little more than a packet of doctor's orders and the numbers of different providers of necessary diagnostic measures.
This didn't seem particularly troublesome at first, and I assumed there'd be little problem in arranging testing myself. But, the combination of disparate service providers with a tight, yet overlapping schedule for required tests meant I ended up missing deadlines and repeating a lot of tests, wasting hundreds if not thousands of dollars in copays and lab fees. For instance, there'd be a requirement for a chest x-ray three months prior to surgery, lab work two weeks prior to surgery, and a psychological screening one year prior. Of course, I opted to complete the psychological screening first, but that would prove to be the single most difficult one at arrange. None of the providers seem to have appointments any sooner than six months before surgery, most wanted to see me for multiple sessions before they would approve or disapprove. I opted to see my old psychologist in Arlington, who was willing to do the screening and had the questionnaires sent from Dr. Li's office. What I had presumed would take only 2-3 weeks ended up taking three months of repeat sessions before I had an approval letter. By then, I needed to get a chest x-ray, among other tests, and found that I couldn't arrange such testing until it was perilously close to the scheduled surgery date. Without the chest x-ray, several other necessary tests (Upper GI, etc) couldn't be completed: I was pushing it perilously close. Too close, in fact, because by the time the psychological consult and chest x-ray came through, it was too late and my surgery had to be pushed back another six months. That of course meant repeating the majority of tests I'd already taken: blood work, chest x-ray, cardiological consult, EKG, etc.
As if that weren't enough, I had the misfortune of developing a blood clot in my leg after returning from a very arduous trip abroad. Understandably, but disappointingly, this put a halt on my surgery as I had to be treated with blood thinners for six months. That of course meant having to redo all the testing I had completed yet again. Once I was 'cleared' and taken off the blood thinners, a year had elapsed, meaning I had to do the psychological evaluation all over again. The same problem presented itself: either no one accepted my insurance, they weren't accepting new patients, they couldn't see me for 4-6 months, or they wanted to see me for an untold number of 'developmental' sessions before even committing to the surgical consult. It was a nightmare, and I was completely dejected. It had now been five years since I first sought out WLS, and now I faced having to go through the process all over again.
This situation was further complicated by the fact that my wife and I had two children during this time and opted to move to Virginia where it was easier to buy a house. The prospect of driving back and forth between Baltimore and Northern Virginia was just too much, especially when there was no guarantee that some unforeseen development would again hinder my surgery. I just threw in the towel, resolving to just 'live with myself' and my weight.
It seemed a reasonable enough prospect at the time, the only thing that was damaged was my physical vanity, something that married life had conditioned me to stop caring about quite as much. However, my two children provided another, unexpected reason to reconsider surgery. At 4 and 2 years old, my son and daughter are balls of boundless energy, who are always anxious to play with their parents. But it's been impossible for me to keep up, I'd always find myself aching too badly after a modest chase, or drained by the exertion of simply carrying my girth around through the course of the day. I thought about my children's future, the sort of eating habits I was inculcating in them. I became worried that I'd pass on my bad habits to them and I didn't want them to go through life the same way I had.
What really did it for me was a trip to a local park on a temperate spring day. As my kids ran around on the grass and my wife and I set up a picnic, I found myself sweating profusely and out of breath at the most trifling of physical gestures. It had been a long, slovenly winter and I was suffering for it. While considering my fate, I saw a father/son team running down one of the many jogging paths, keeping pace with one another, father encouraging his son along. That sight stirred me in a way I hadn't been since my son and daughter were born, and in that instant, I knew what sort of father I wanted to be. I knew what I had to do to become that father, to get in better shape, to have more energy to play, to inculcate them with an appreciation for exercise and good food and being healthy in general.
I needed to pursue surgery one more time.
My Path to Surgery, Pt. 1
Dec 20, 2010
My story is likely a familiar one: I've been struggling with my weight most of my life, have always been fairly hefty save for a brief spell in my early 20's where I managed to "Atkins" myself down to a BMI of 8%. I followed a very rigid regimen: nothing but carb-free, protein-ladden food products (which included a lot of beef jerky and aspartame -- first mistake), liberal use of 'thermogenic' compounds that were all the rage back then (ephedrine/caffeine/aspirin combination 'stacks'), no less than 3 miles a day of jogging, combined with 200 push-ups and sit-ups. It took 9 months, but I lost all my excess body weight and then some, and became quite the young Adonis. Those were my 'salad days' (pardon the pun): I ran at least 30 miles a week in my peak, had the beginnings of a serviceable six-pack, biceps that postively exploded out of my shirts. I could (and occasionally did) just drop everything and go off running up sand dunes for 5 miles, just because I could. It was exhilarating!
That being said, mine wasn't a sustainable solution. I was in the 'enviable' position of having a very active job at the time (military), in addition to mandatory PT sessions and my own frequent forays to the gym in what was then my copious amount of free time. I ultimately found myself in a more sedentary environment, decided that after athletes started dying off that ECA stacks were probably not a great long-term solution to my problem, tried to deal with my weight gain through increased exercise. I never did modify my eating habits, with an appetite as ravenous as my stomach was bottomless. The more weight I gained, the more frightened I became, the more I tried to exercise, the more I stressed my body and ignored the pain day after day until I severly damaged my knees and abruptly ended my love affair with running.
In short, I had terrible weight control habits that were only possible thanks to the invulnerability of youth. Not so young anymore, so I can't exactly stress my body as badly as I once did. Over time, I gained more than double the amount of weight back, and it just kept piling on. I couldn't exercise as intensely as I once did, which frustrated me. With frustration came depression, and with depression came eating. A vicious cycle ensued, as is to be expected, and years later I found myself at the end of a long progression of failed diets and a thoroughly broken will.
I don't even remember how I'd come to learn about weight loss surgery, but when I did, it was a revelation. I knew my problem lay in my appetite and my sluggish metabolism. I had not stopped going to the gym during most of this period of my life, but I found my workouts more and more futile. Surgery could provide me with a powerful tool to again realize the benefits of modest exercise, to live a normal life.
That was at least my initial calculus, based more on vanity than much of anything else. But I pursued the surgery nevertheless, spending countless hours researching the options, the methods, the results. Armed with every conceivable bit of knowledge about the procedures I could stuff into my eager mind, I opted for the famous Roux-en-Y procedure and sought out a good surgeon in my area.
That was the easy part...
0 comments
That being said, mine wasn't a sustainable solution. I was in the 'enviable' position of having a very active job at the time (military), in addition to mandatory PT sessions and my own frequent forays to the gym in what was then my copious amount of free time. I ultimately found myself in a more sedentary environment, decided that after athletes started dying off that ECA stacks were probably not a great long-term solution to my problem, tried to deal with my weight gain through increased exercise. I never did modify my eating habits, with an appetite as ravenous as my stomach was bottomless. The more weight I gained, the more frightened I became, the more I tried to exercise, the more I stressed my body and ignored the pain day after day until I severly damaged my knees and abruptly ended my love affair with running.
In short, I had terrible weight control habits that were only possible thanks to the invulnerability of youth. Not so young anymore, so I can't exactly stress my body as badly as I once did. Over time, I gained more than double the amount of weight back, and it just kept piling on. I couldn't exercise as intensely as I once did, which frustrated me. With frustration came depression, and with depression came eating. A vicious cycle ensued, as is to be expected, and years later I found myself at the end of a long progression of failed diets and a thoroughly broken will.
I don't even remember how I'd come to learn about weight loss surgery, but when I did, it was a revelation. I knew my problem lay in my appetite and my sluggish metabolism. I had not stopped going to the gym during most of this period of my life, but I found my workouts more and more futile. Surgery could provide me with a powerful tool to again realize the benefits of modest exercise, to live a normal life.
That was at least my initial calculus, based more on vanity than much of anything else. But I pursued the surgery nevertheless, spending countless hours researching the options, the methods, the results. Armed with every conceivable bit of knowledge about the procedures I could stuff into my eager mind, I opted for the famous Roux-en-Y procedure and sought out a good surgeon in my area.
That was the easy part...
Introduction
Dec 13, 2010
I am an obese 30-year old male who has been struggling with weight issues my entire adolescent and adult life. After an initial period of success with the Atkins Diet and a very rigorous exercise regimen (running upwards of 30 miles/week), I suffered some skeletal injuries and found my weight rapidly rebounding to the point of being worse than before. In the last 10 years, I have tried several diets, supervised and otherwise. I have tried alternate forms of exercise, but my options for aerobic exercise are limited. Nothing I've tried has yielded results.
It's been frustrating to say the least, going from 6-8% body fat, running half marathons and training for Ironman, to being morbidly obese (almost 50% body fat) and handicapped by joint pain. My ultimate dream is to be able to run once more, which would require orthopedic surgery to my knees. However, no orthopedic surgeons have been willing to consider me a candidate for the necessary surgeries until I lose my excess weight.
After doggedly, yet unsuccessfully pursuing RNY gastric bypass surgery for the last five years, it appears that I can now expect a surgery date of 21 December 2010 with Dr. Amir Moazzez of the Bluepoint Surgical Group in Fairfax, VA. I am grateful to Dr. Moazzez and his staff for being so accomodating to me, and am looking forward to the surgery and embarking on another, healthier stage of my life.
In my pursuit of the surgery, I found this website tremendously helpful. Now, on the brink of surgery, I want to share my experience over the last few years with others, with the hope that they too will benefit in their obesity surgery decisionmaking.
0 comments
It's been frustrating to say the least, going from 6-8% body fat, running half marathons and training for Ironman, to being morbidly obese (almost 50% body fat) and handicapped by joint pain. My ultimate dream is to be able to run once more, which would require orthopedic surgery to my knees. However, no orthopedic surgeons have been willing to consider me a candidate for the necessary surgeries until I lose my excess weight.
After doggedly, yet unsuccessfully pursuing RNY gastric bypass surgery for the last five years, it appears that I can now expect a surgery date of 21 December 2010 with Dr. Amir Moazzez of the Bluepoint Surgical Group in Fairfax, VA. I am grateful to Dr. Moazzez and his staff for being so accomodating to me, and am looking forward to the surgery and embarking on another, healthier stage of my life.
In my pursuit of the surgery, I found this website tremendously helpful. Now, on the brink of surgery, I want to share my experience over the last few years with others, with the hope that they too will benefit in their obesity surgery decisionmaking.
