December Pic

Check it out! He's down to 233 at the time of this photo. That's right -- down SEVENTY FIVE pounds from his pre-op appointment. Isn't that great!?

My sister Kris was in town last weekend and brought Chris some Broncos items. The 2X t-shirt was too big! Granted, it was a giant 2X, but it was too big! More progress!

His monthly bloodwork results have been great, too. So good, in fact, that we don't need to continue with the testing at this time.

Coming up, Chris has his 6-month follow-up appointment scheduled for the beginning of January. Then his annual cardiologist visit is usually in April.

November 10 Pic

He went to the Cardiologist last week and all seems well. His blood pressure was below the 150 (for the high number) point. He said if it's consistently above 150, it's back to the medications.... so we'll continue to monitor it.

He's switched up his workout routine and isn't spending much time in the water nowadays. It's too darn cold! Instead, he's doing weights and interval training on an exercise bike.

Next up is Thanksgiving, his favorite day of the year. We're having guests, as usual. He's a great host and a wonderful cook!

October Progress

Chris worked very hard this month and he has lost even more weight! Actually, this photo was taken on the 10th, so he's half-way to another photo.

At the beginning of October, he hit the 250 mark and he was treated to an hour-long massage. Got rid of lots of toxins!

Bloodwork is still being checked every month. He's watching fluids (getting enough to maintain hydration) and off medications. Monday or Tuesday will bring a blood pressure check to make sure he doesn't need to return to any of his medications.

We'll be back with another photo next month! :)

Another Picture

Here's Chris' third picture on the 10th. He's down to 259 -- which is 49 pounds lost since his pre-op appointment. I know when he hits 250 he's going to be asking for a massage or a tattoo or a motorcycle. It seems that Dusty decided, once again, that he wanted to be part of the action. He loves his Daddy. Digit is a Daddy's girl, too.


We got the bloodwork back on Chris from the appointment in August, and he was doing better with the hydration. Dr. Mallea has ordered monthly bloodwork for a while to see how/if things stabilize.

We're waiting on a shipment of special bariatric chewable vitamins and hope those arrive soon. (Although I think Chris is looking more forward to the carb-free/sugar-free pancake mix & syrup. Aren't you, honey?) In the meantime, he'd better be taking his Flintstones chewables.

We did hit a new milestone today. Are you sitting down? A container of milk EXPIRED in our fridge -- and a half gallon, nonetheless! This has not happened for the nearly 11 years Chris and I have cohabitated. It blows my mind. He used to be a 3-gallon-a-week drinker.

So far, it doesn't seem that he's found himself intolerant of any foods he has tried. Salad went OK and he's eating beef, too. My friend from Grangeville said she planned to bring some venison and/or elk in October and he's chomping at the bit to try that too. He'll have to wrestle it from my dad. I hope they can share. :)

Progress

We had an appointment with Dr. Mallea on Thursday. It was a good meeting, but there was some concern about Chris' hydration levels. He has been instructed to drink more and then have some follow-up bloodwork done this coming week.

We're both still adjusting to this new life. Chris is on the go every single day... fishing, swimming, taking water aerobics classes. If someone would have told me in February that in six months Chris would be exercising at the Y sometimes TWICE in one day -- or that he'd be waking before dawn to go to fishing and be back in bed before my alarm rang -- I would have shook my head in disbelief. I would have to ask "Do you know him?"

I felt very overloaded this week. We had a big weekend event at work coming up and I have so many things going on... my brain went on vacation without me. That happens. Rarely. It happens to me when I'm on overload. I did laundry on Thursday night specifically so I could wear my red shirt to work. While putting the washed clothes into the dryer, I didn't see my red shirt. It was on the bed. *growl* At least doing another load of laundry isn't such a terrible consequence. It does, however, make me ever-so-thankful that the intersection was clear when I ran that red light during one of these mental disconnects.

Chris & I decided to take his picture every month on the 10th to show his progress on a consistent basis. I leave you now with his 10-day post op picture and today's.

Like a fish to water

I've recently changed up my exercise program. I now try and ride the recumbent bike at the IAC 5 days a week in the morning (I'm up to 35 minutes on level 2), then in the evening I go to the YMCA and swim in the lap pool for 30-60 minutes. Ok, I can't really call it swimming per say but I thrash with my arms, legs and sometimes both at the same time to get one from one end of the pool to the other (25 yards). I must be doing some work because it tired me out. I never really learned how to swim because the summer I was supposed to learn, I burned my face pretty bad in a fireworks "experiment" and I couldn't go into the pool for 2 weeks. Its hard work and because of my heart I have to take frequent breaks, but its good exercise and the Y has the nicest pools around.

In other news, I went "off the reservation" so to speak regarding my blood pressure medications, I'm currently only taking the attenolol at night and have been doing this for about a week now. Today the blood pressure machine at wal-mart said I was running 105/55, and thats without being on them for a week. Hopefully when we go to the doctor next week he won't yell at me too much, but my dizzy spells have been reduced to mere mild annoyances instead of falling over.

Sadly I'm having a new problem with insomnia. I have RLS (Restless leg syndrome) I run marathons at night in the bed, and its very hard to fall asleep when your legs wanna get up and walk to alaska even if the rest of you is bone tired. I was taking Requip for this, but my new stomach is super sensitive to this medication and within a few minutes of taking it I get some pretty violent dry heaves and nausea. That can't be good for my new intestinal arrangement. As a bonus when you stop taking requip, studies have shown your RLS gets worse. I'm gonna ask my doctor about a more stomach friendly medicine or possibly a sleeping pill prescription.

The other night I was up until 5 AM unable to sleep, I tried several different things. Eventually I ended up walking in circles from my front door to my back door for 25 minutes. For the first ten minutes the cats (Dusty and Digit) just watched me walk back and forth like I had gone insane. However, pretty soon Dusty was running the route I was walking and he did so for about 15 minutes, he slept better than I did I think.

In more swimming news I took Kim to the Y with me yesterday as a guest and we spent a couple hours in the pool, it was nice to be there with someone else. We are trying to get her signed up and get her dad signed up also. They have a bunch of free classes for Y members and I am looking at the water aerobics as some fun kind of exercise. I must admit at first I was nervous about taking my big white belly to the Y for swimming fearing they might try to harpoon me or shove me back into the pool whenever I got out, but hey, the Y is filled with people just like me. Now my attitude is yeah, I'm a fat guy in a pool, (though rapidly shrinking) what ya gonna do about it?

The scale says 277, which means my 2 week stall at 280 may finally be over, still not sure where the weight is dropping from.

Dizzy

Its been a rough couple days for me, I'm having trouble eating and drinking enough, so that is not good. Its hard to force yourself to eat when you just are not hungry. I see other RNY patients talking about head hunger but that is one problem I am not having.

My dizzy spells are getting worse, getting out of the hot tub at the YMCA on Saturday (After a nice refreshing swim), I was reaching for my towel on a chair, which suddenly became six towels on six chairs. Next thing I know I was half laying- half sitting on the pavement trying to look casual about it. None of the crack Y lifeguard staff even noticed the fat guy pass out and fall over, I'm glad I didn't pitch into the deep end of the pool. I sat there for awhile and slowly made my way to the locker room before heading home.

I've also been pretty sick to my stomach all week long, and I finally got fed up with it and called the surgeon to make sure nothing serious was going on. Sadly, Dr Oakley is out of town, so I had to wait for some on call guy to call me back. He gave me a prescription for nausea but I was pretty out of it when I picked it up (not feeling well) and when I got home, only then did I discover it was a suppository, which Kim found hilarious. I haven't used it yet, but its mere presence in the house seems to have helped cure me.

On the plus side, Kim found me some apple juice that is low in sugar, but its still sweetened with Splenda, its actually pretty good and its a nice change from the other crap I've been drinking. I dunno why they need to sweeten it at all, its freakin apple juice, even the stuff from the local co-op that was "all natural no sugar added" had tons more sugar in it. Bob was also kind enough to get me a pretty nice I-pod knock off, which I've already begun ripping songs to from my CD collection, The first day I used it I was able to go ten more minutes than I normally do on the stationary bike, on that was on level 2 even. Its always nice to listen to music you actually like while working out instead of that crap the health club pipes in.

Hopefully I can make my Cardiologist listen to me, or at least his nurse and get my blood pressure meds changed or adjusted in the near future, this standing up and almost falling over 8 times a day is getting on my nerves and freaking me out a little.

Meat, Glorious Meat

Today was my 2 week follow up, I've dropped 18 pounds since the surgery, but they are apparently mystical magic pounds as I have yet to figure out where they are going from. The doctor finally took me off clear liquids and tonight I made a turkey ragu (Kim got to eat pasta with hers). It was nice to eat some real food for a change. I need to start getting 80 grams of protein a day in 3 meals and 2 snacks + 1 protein shake. That is gonna take some figuring.

Pretty much no carbs and sugar, and fruits are a treat not a meal, so we bough some fish and chicken and ground turkey. No red meat for awhile, I'm a little skittish about it anyways, I want this to be as painless as possible. We got some Wyler's Light and the stuff is almost as good as Kool-aid, that and Crystal Light lemonade is seeing me through the day. Tomorrow I am gonna go to the athletic club and start working out, at least 5 days a week when I am up to it. My incisions are still a little tender and I can't sleep on my stomach yet, but I'm getting there. Also time for me to take over more of the chores around the house like the litterbox, although I did appreciate the 2 week vacation from it while Kim did it.

We are going to make an appointment with Doctor Mallea so I can get some bloodwork done, I'm very concerned about this. Also I am getting frequent dizzy spells when I stand up even though my blood pressure is within normal limits, I think its low for me, but we'll see how that goes.

And now for your moment of Zen.
Click Here

Home

I'm home now, if barely coherent. They gave me a liquid version of hydrocodone for the pain and this stuff is kicking the crap out of me. Its nice to be back in my own bed though, and I've stopped leaking from my surgical incisions, so I'm looking forward to a shower. Post surgery was pretty pain free and they took pretty good care of me at the hospital as I never felt nauseous or anything like that. Considering my intestines have been rearranged I thought I'd be feeling a lot worse than I do right now.

SUCCESS

I'm home to take a quick nap & pick up a few items for Chris that we forgot to pack. Surgery was a success. Chris is doing very well... already used the breathing therapy device. More detailed update (and photo) coming soon.

One Last Appointment, One Last Steak

Chris had his pre-op with Dr. Oakley today. Well, it started with Dr. Oakley... then to the surgical coordinator then across the street to get the pre-admittance 20-questions game and then an EKG. All in all, pretty uneventful. So glad I printed out two pill lists!!

The colon thing discussed on the last post turned out to be nothing. Chris won't have to use it at all, because it had warnings if you are on a low-sodium diet (CHECK), had kidney disease (CHECK), or had Congestive Heart Failure (CHECK).

He is to discontinue his aspirin therapy and Vitamin E (who knew it was a blood thinner?) until after his surgery.

We need to be at the hospital at 6:15 on Monday morning. Surgery starts at 7:30 and shouldn't be more than a couple of hours long. 1 hour in recovery and then off to his regular room on the 6th floor, we think.

Sunday he's not to eat any solid foods -- which means Saturday night he'll have the guys over and order (I suspect) Chicago Connection pizza. We'll also put together his travel bag Sunday and then hope he gets some good rest on Sunday night.

Speaking of last foods... Chris made awesome rib-eye steaks on Sunday for my dad's early birthday party, but he decided to have one more crack at beef tonight. We dined for the first time at The Stagecoach in Garden City. A review I read just an hour or so before said it has been open for nearly 50 years and tonight we learned why. Chris' filet was bacon-wrapped and magnificent. His shrimp were as big as his hands. {I grew up in South Florida eating seafood every chance I got... and I have never seen prawns that big.} Awesome. They have a spaghetti & meatballs special for $6.95 that even comes with a glass of red wine. I may have to try that with Dad one day.

Class Clown

It took me a week to get to the point where I could post about the class we attended last Wednesday without having tears stream down my face from laughter. Seriously, so many things about it were funny... but it wasn't supposed to be. I was doing so well and looking at the funniest presenter with a perfectly straight face, until Chris turned and looked at me. Dang it!

Having done the surgery and hospital thing before, lots of the props were familiar to us already... the oxygen delivery tubes, the fingertip oxygen saturation monitor, the grenade-looking surgical drain, etc.

We did learn a few things:

• He's going to be issued a giant rubber band at the time of surgery. It can be used to do tons resistance of exercises. I want one, too.
• We got suggestions on a few things to bring, so we're going to pack a bag with his slippers, a few copies of his list of pills, etc.
• There's some sort of colon thing that we need to ask about today at his pre-op with Dr. Oakley. (Since they're rearranging his stomach and intestines, I guess they need to make sure nothing's in there.)
• The nutritionist we so enjoyed from last week's appointment came and brought all kinds of cool recipe options that Chris can try. Ricotta, mozzarella, and a little spaghetti sauce can become a pasta-less lasagna. Yum.

We did some shopping. Okay, *I* did some shopping, with my dad. Chris now has his own area in the pantry (which I'm sure will grow, honey... don't be sad that it's only in a box right now). His box has protein powder in Chocolate and Vanilla, three pre-mixed protein drinks in these cool test-tube looking containers, sugar-free pudding, no sugar added applesauce and berry-flavored applesauce, lots of broth, and some ground flax seeds for later on in the food stages. We also found special bariatric vitamins at Walgreen's and grabbed B-12, since the nutritionist said that particular nutrient is lacking in that particular chewable multi. And who knew that there's a such thing as fat-free half-and-half?

Today is our pre-op appointment with Dr. Oakley, so we have a list of questions. At the top of the list is Chris' medications and how that's going to change... both right after surgery and later on. I suspect that the Requip (for acid reflux) is going away immediately because his esophagus isn't going to be connected to his stomach acid anymore. We also need to know how soon the pre-procedure eating restrictions start. [I'm going to be out of town on Friday night and probably Saturday dinner, too... and he's having the guys over on Thursday, so I suspect tonight is our "last supper" together. I wonder what he'll pick.]

And since you've read this far, you deserve a few gems from last week. The physical therapist was VERY enthusiastic about exercise. My favorite thing was when he said "if you're imaginary" when he meant "if you have a good imagination". Chris, however, liked his "when in Greece..." rendition of the "when in Rome, do as the Romans do". Oh and the "I'm a big fan of the gym." Yeah, we bet.

About the size of a dose of Nyquil

Go to your medicine cabinet, find a bottle of nyquil, see that cap for measuring the dosage? That will be the new size of my meals for a long time.

So yesterday was the meeting with the Nutritionist, who turned out to be very nice and tolerable. (Some of my previous health care providers have had the bedside manner of a concentration camp doctor, and I swear one guy flipped me off.)

So this is what I discovered some of my limitations will be after the surgery:

• No carbonated drinks, ever again.
• No alcohol for a minimum of one year, and after that, I'll be a "Cheap Date"
• No red meat for at least 6 months.
• No straws, no gulping, no guzzling.
• No drinking liquids while eating solids at the same time.
• I'll have to drink about 48oz of water a day, but since my stomach can only hold about an ounce at a time, I'll have to be sipping every 10 minutes (For the first few months)

Immediately following the surgery, I'll be on a straight liquid protein diet for the first two weeks. after that I'll be able to add foods like applesauce, cottage cheese, pudding and bananas. So I can imagine the first six weeks I'm gonna be a real joy to hang out with, especially if someone tries to eat a hamburger or something in front of me. I'm looking into the law to see if assault would be justified in those cases :)

I've mainly finished my list of final foods, we had the venison roast the other night crock pot style and it was delicious, all I really have left is lasagna, which I plan on making next week. This Saturday is we are having a cookout (burgers, hotdogs and Kim's most excellent potato salad.) I have to call a few people and see if they can make it, but most of my friends are already coming. I have an odd sense of humor, so I'd like the theme to be "Funeral for Fat Ross" but Kim is not crazy about that idea.

And now, for your moment of zen...
http://atvs.vg.no/player/?id=16995

Ch-ch-changes

Chris' surgery was moved to June 30th. The approval form from the insurance company stated July 1 specifically as the approved date of service, so we're leaving messages & trying to contact them to get that corrected.

We're movin' on down the list of foods. Chris has had his Bottle Caps, root beer float, French dip and has taken a stab at the meatball sub. He didn't like the Cobby's meatball sub (the bread wasn't toasted and that wreaked all kinds of havoc), so that's back on the list. I made strawberry Kolacy for him and dad, too. We do need to get that venison roast cooked one of these days. We may need to rework the list... can't seem to find it.

Couldn't resist adding a picture of Dusty I took this morning. This ramen soup box is sitting just a few inches from his very nice cat hut, but he chooses the box. He's a box-and-bag kind of cat. He loves them.

Lists!

It's been a couple of days since we learned about Chris' surgery. We've mapped out all the upcoming appointments and made a few additional plans to prepare. We've made lists of all sorts of things. One is a list of consumables that Chris would like to enjoy 'one last time'. These include a root beer float, Bottle Caps candy, and of course the venison roast that is in our freezer thanks to my friend, Judi.

If all goes well, Chris' recovery time should be greatly reduced from the "stomach stapling" surgeries of the past. He will be having a Roux-en-Y procedure done laparoscopically. He will only have a few little incisions in his abdomen for the camera and tools to be inserted -- no big open abdominal incision to worry about getting infected or healing. Of course, his internal organs are cut, sewn, and rearranged... so it's still a major surgery.

We're excited, scared, nervous, and happy all at the same time.

Day 1: Surgery Approved

Although getting here has been quite a journey in itself, we've chosen today as a new starting point. This morning, we got the unexpected phone call that Chris' gastric bypass surgery has been approved by his Medicare supplemental insurance provider.

To give a little bit of background, Chris has been sick since 2001.

I was out of town on business and caught a cold, which we thought Chris caught from me. Spring was preparing to turn to Summer and Chris still hadn't stopped coughing. We took him to a "doc-in-the-box" clinic on a Friday afternoon. They brought in machine after machine, then told us Chris' heart was enlarged. Who knew that was a bad thing? We were instructed to go directly to the hospital, where they'd be waiting for us. [Is this a good place to admit that we stopped at Taco Bell on the way? We had no idea how serious this was.]

We arrived and were taken quickly to admitting. The candy striper was taking our name, address, and pertinent information. A doctor handed her a small slip of paper with Chris' admit diagnosis. I saw "heart failure" on the paper and almost had heart failure myself right then and there. We spent all weekend at the hospital and then he was scheduled Monday morning for cardiac catheterization procedure, using dye to see his heart and system functions. They had already shaved his leg in preparation when the nephrologist hastily announced that they could not proceed. His kidney function was below 30% function and he could not tolerate the dye. So instead, he had a TEE (transesophageal echocardiogram) which he did not enjoy one bit!

Since then, he has been diagnosed with severe obstructive sleep apnea, a degenerating & arthritic disk in his back, gout, and eczema. He has had surgery to repair his deviated septum to help with breathing, and also a surgery to remove a gangrenous appendix which had ruptured the week before.

We know that his heart and kidneys (and therefore his other systems) are going to decline. The rate of decline is partially up to Chris and how well he cares for himself.

Chris tries to tolerate all the doctor appointments I set and all the pills I put out for him to take. These include:

• ALLOPURINOL 100 MG TABLET
  
• COLCHICINE 0.6 MG TABLET
  
• FLUOXETINE 20 MG CAPSULE (2/Day)
  
• FUROSEMIDE 20 MG TABLET
  
• LISINOPRIL 20 MG TABLET
  
• NEXIUM 40 MG CAPSULE
  
• REQUIP 1 MG TABLET (3/Day)
  
• ATENOLOL 50 MG TABLET
  
• ASPIRIN 81MG TABLET
  
• FLAXSEED OIL 1300 MG SOFTGEL
  
• MEN'S MULTIVITAMIN TABLET
  
• VITAMIN E 400 MG SOFTGEL
  

His kidney function had been stable with a creatinine clearance(ClCr) of 3.0, until our most recent annual appointment on Feb. 22. Now it's at 3.9 and he's having trouble with Potassium. So he got some new dietary guidelines. Dr. Mallea (nephrologist) also recommended looking further into the gastric bypass surgery because losing weight would be a BIG factor in slowing the decline of his kidneys.

So we started seriously looking into gastric surgery options. Lap-band vs. gastric bypass. Lots of research on treatments, insurance coverage, etc. We attended a presentation at the hospital and met Dr. Oakley (and listened to some thoughtful and some hilarious questions from other audience memebers). Our impression following the the meeting was that we needed to meet with a psychologist and also complete a six-month diet before moving forward.

We called the insurance company's special gastric bypass line. They said the 6-month diet and psych evaluation aren't necessary. So we called the surgeon's office and made an appointment. The meeting with the doctor was great. He was very nice and had a very good manner with us. (We've seen TONS of doctors and he ranks right up there with the nicest of them!) Then he had us meet with his insurance specialist. She told us emphatically that the insurance company representative we spoke with was wrong. We needed to work on getting a doctor for the six-month diet, and then we'd get the psych evaluation sometime in the fall. Exasperated by the differing information we've gotten, we asked her to just please submit a request for surgery based on what she has right now. This way, the insurance company can send us a denial LETTER and outline in writing what hoops we DO and DO NOT have to go through next.

This was on Wednesday, April 30th. And this morning, Monday, May 5th, Chris got two phone calls. One from the insurance company to let us know that they've approved the surgery and we'll have it in writing ASAP. The next was from the insurance specialist at Dr. O's office to schedule his appointments for a nutritionist, a pre-surgery support meeting/class, a pre-operative with Dr. O, and the surgery. We have a lot to do. He's going under the knife on July 1st.