The Transformation Journals

Some of you have inguired so I posted some pics of what I will use for the starting point.  They are are not from the very beginning but as my workouts have not been what I wanted, or needed, them to be they will do.  In a lot of them you cannot see much except the excess skin and the fact that I really need some sun.  I am not sure how much definition will be evident but overall mass should show as it improves.  Come next summer when school finishes I will give serious thought to having the skin removed.  Just have to wait and see how work, school, finances, insurance, etc plays out.  I put up some measurements from the same day as well.  More later.

Be well and safe.  ~!~

After pondering on whether or not to put up some progress pics I realized there is one more part to the whole process that I have not mentioned very much if at all.  After you have the procedure and lose all the weight, there is going to be the issue of the excess skin.  In some cases it can cause some health problems but most of the time it is a cosmetic issue.  My doctor recommended that I wait at least 18 months before having the excess skin removed.  This gives the body time to completely heal after the surgery.  It also allows time for the weight loss to even out, and to make sure you are not going to put weight back on by falling back into old habits.  Having the skin removed is a procedure done by a plastic surgeon and not usually covered by health insurance.  With the amount of skin I will have to have removed I am sure it will be at least two procedures.  I would like to have it all done at once and be done with it but will just have to wait and see once the time comes.

More to the point here is the progress pics.  You have undertaken this huge step and gone through all that comes with it, and now, you feel better, stronger, more healthy, yet there is a down side.  You don’t see the fat person that was there, you see something else.  For me it occured in the gym. I was sitting on a bench doing curls and I looked to the side in the mirror to check my form and I saw it.  I saw the loose skin on my face.  Okay, I expected it everywhere else, but on my face?  So I finish the workout and get home and take a serious look.  Took an inventory of it if you will.  There is a lot of it.  Now the mental part kicks in and you wonder if now you look worse than before.  Did your body look better when you were fat versus with all the hanging skin? 

Will I put progress pictures up?  Yes.  Will there be some of the excess skin?  Yes.  Does it make it difficult to see the progress?  Yes it does, even to me so I know it will be hard for others to see in the photos that go up.  The purpose of putting them up is the same as the purpose of this entire section.  To help those who are considering, having, or know someone who is dealing with this process.  The best way for you to judge your progress is by tracking your goals and gains and by feel.  You can feel the muscle growth underneath even if you can’t see it.  Stay at it and in time it will be evident.

Be well and safe.

This will more than likely be the last entry in the bariatric section unless I get some comments or questions that need to be addressed here.  Perhaps one more after this one if I see that I have left something vital out. 

As with any major life change there is an adjustment period. That will vary with each person.  There are still things I am getting used to 16 months post procedure.  In the beginning changes are happening so fast it is hard to keep up sometimes.  The weight, in my case, came off very quickly.  There were times I was wondering if it was happening too fast, but my surgeon was not alalrmed bu it and all the blood work was normal so I just went with it.  It took a while to get used to seeing myself in the mirror.  To me, I looked sick.  I knew I wasn’t but losing 20-30 pounds a month for the first few months can do that to you.  Add to it that it was winter and I was not outside very much and looking mighty pale.  You may feel or get cold a lot easier than you used to.  You are not as well "insulated" as you once were and more than likely will be a little anemic.  The anemia can be fixed with diet for the most part and if it is severe your doctor will treat you for it so no worries there.  You will get used to the new you.  For me that was about the one year mark.  The weight lose slowed down and I began to get some strength and energy back.  My diet had progressed to a point where it was easier to get in fluids enough so I didn’t feel dry all the time.  I always had a dry mouth and throat and my voice never sounded the way it used to, but that is back to normal now too. 

Reflecting.  There are a few things I miss.  Food wise I mean.  My diet is to the point that I can eat anything I want, not quantity mind you, but type.  Meat of any type, fruits, veggies, breads, etc.  For the most part I stay away from breads.  They are very filling and have no protien, or very little, so I rarely eat them.  Same for cereals, excluding the oatmeal I am trying to eat every morning.  I need to get more fiber in so I am using the oatmeal and adding wheatgerm to it.  There are times that one serving of instant oatmeal is too much when I have it with my morning shake.  It takes about two or three hours to get the oatmeal and a 16 ounce shake in.  Okay, back from that sidetrack and on to the foods I miss.  Number 1 on the list and will I am sure remain there.  A good hamburger.  I am not talking about a fast food one here.  I mean a quality burger.  One with red meat.  Beef, bison, venison, kangaroo or wallaby (yes I have had it and yes it is very good, very dark red meat and very lean).  All the trimmings, just sing the Jimmy Buffet song here and you know what I mean.  I don’t have to have the fries, just the burger.  Number 2 is a big fresh salad.  Cobb or chef or just start pilling the greens and veggies on the plate.  A good dressing, it can be low/no fat and I don’t drown the salad either.  Number 3 is a "country" or "grandma" breakfast.   I was always a big breakfast eater.  It can be a healthy one and still have all good breakfast type foods.  Number 4, a plate of vegetables.  So much of my diet centers around protien that I miss my veggies.  I do still eat them, as well as fruits, but there is something to be said about a nice plate of fresh cooked vegetables, or raw in a salad. aside from number 1 these are in no particular order.

 I am sure I will have more to say on my diet now but I will post that in the training and supplement sections as they will be more relivant to those areas.

 I hope this section has been informative and of some help to any that are, or know someone that is, considering some type of bariatric procedure.  Questions and comments are welcomed.

Be Well

The diet after surgery is very much like the liquid diet I followed pre operatively.  It starts out with a full liquid diet and the amount is very small.  The total meal is one quarter cup ( 1/4 cup ).  Imagine your stomach the size of your fist.  Your nutritionist or dietician will provide you with a list of foods you can eat and when you can eat them.  The list and time table I was given was a good guide but I found that the amount I could take in progressed much slower.  As far as fluids, one ounce every 15 minutes.  Nothing to drink 30 minutes before a meal and 45-60 minutes after a meal.  I am 14 months post op and there are times when the average healthy choice/lean quisine type meal is too much for one meal. 

Don’t force it.  You will get more in as time goes by.  Eat too much and you will make yourself sick.  Be patient, go slowly, and listen to your body.

I will re stress here that once you have decided to have the procedure, that is the time to change your diet.  You will need to get used to concentrating on protien and avoiding alot of carbs and fat.  Your body has enough of that stored and you will be burning it so protect the muscle you have as much as you can.  You will lose muscle, there is no doubt of that, just do as much as you can to limit it.

My pre op diet started two weeks out as instructed by my surgeon.  It consisted of a full liquid diet.  Any liquid, ice cream, jello, cream soups, cream cereals, protien/meal replacement shakes etc.  Get the picture?  Nothing that has anything that has to be chewed.  You can have some regular soups in week one but try to limit it.  The meat and vegitables are so soft that they do not cause a problem.  One week out CLEAR LIQUIDS ONLY.  Broth, jello, water, etc.  This where I had trouble getting the protien as I was unaware of some of the products out there.

You might think the purpose of the diet is to clean out the intestines and colon.  Not so.  It is to de fat and shrink the liver.  It makes it more firm and helps get it out of the way during the procedure.  This is a good thing.  I did learn that this practice is not done by all surgeons, or was not at the time I underwent my procedure.  Ask about it if it is not mentioned in your consultation with the surgeon.

I’ll talk about the post operative diet in another part.  Be well.

The first thing that happened was I talked to my primary care physician about some of the health issues I was having.  Sleep apnea, depression, blood pressure creeping up, some irregular heart beats, arthritis in the knees, and some abnormal blood tests indicating the possible onset of diabetes.  I decided it was time for a major change.  They agreed.  I had always been able to lose weight but it was always hard work.  Like most, the weight always came back plus some.  Time for something more permanent.  So I get a referral to a surgeon and we decide to go with the lap band procedure.  Less invasive and less complicated is always a good thing.  But wait, insurance does not cover the lap band so we change to the full gastric bypass procedure, which is covered.  (The name of the procedure is Roux-en-Y).  It costs more so the insurance covers it, go figure. 

As part of getting approved for the procedure there are a couple of hoops you have to jump through.  I think they are good ones as it helps you understand what it is you are undertaking.  I had to go see a dietician and a psychiatrist.  The dietician explains to you about the diet limitations post operatively and the timeline for advancing your intake.  What, when and how much etc.  The psychiatrist, it may be a psychologist, makes sure you are of the right mind set to under go the ordeal.  So after you are cleared by all the specialists, this may include an internal medicine or cardiology specialist for pre existing conditions, you make the final decision to go forward.  

If you do not have health insurance or if it is not covered be prepared for a substantial hospital bill.  The cost in my case was about $38,000.00.  I had an out of pocket expense of $2,500.00 to $3,000.00.  I was fortunate enough for mine to be covered. 

Some things to consider that I never thought of until after the fact.  Plan your procedure for the fall.  You will have a hard time staying hydrated because you just can’t get enough fluid in.  This would be even more difficult in the heat of summer.  Start working out long before the surgery.  You will lose muscle mass afterward due to the protein deficit you will be in.  Again, you just cannot get that much in.  Know ahead of time that your workouts will have to come to a halt immediately after the procedure.  You do not have the intake to expend that kind of energy.  Your metabolism is still running on what you used to eat and not adjusted to what you are able to ingest now.  You can add aerobic and light toning exercises in a couple of months if approved by your health care team.  Listen to them.  Do too much; you will make yourself sick or worse.  Eat too much; you will throw it up.  Most importantly; LISTEN TO YOUR BODY.  It will tell you what you are doing wrong.  You will make mistakes.  That’s okay, just learn from them. 

Next time I’ll discuss the pre operative and post operative diet.

Any information I post in the bariatric section of my blog is based solely on my experience.  The information I was given by those involved in my case was for me and my circumstances.  My goal in putting this information out here is so others who may be considering one of the bariatric procedures will have some idea of things to consider before, during, and after having it. There are things I had not realized that I could have done differently in the beginning that might have helped right after going through the procedure.

 This is in no way intended to be medical advice.  If you are considering having a bariatric procedure you must seek the services of your primary health care provider and follow their instructions, advice, and referrals.