Day 21: Settling in to My New Current Normal

Day 21 post-op.  

Pre-pre-op (8/28/20) weight: 293.5 
Surgery (9/4/20) weight: 284.3 (-9.2)
Current (9/25/20) weight: 268.5 (-15.8, -25 total)

It’s pouring down rain this morning, but I am sitting on the front porch because the temperature feels great, and I feel great too.  Today is the three week mark since my surgery. I still am very pleased with the results and my progress. Since my last post 10 days ago (day 11), when I was initially advanced to the puréed foods phase, I have become more adjusted to my new (current) normal.

After I was allowed to advance to puréed foods, I did push the envelope probably more than I should have. I figured that anything that I could chew in my mouth to the point of puréeing it, would be fair game. Over the course of days 11-18, I did try one piece of margherita pizza, mashed potatoes, a bowl of cereal, coffee, half a bagel, a piece of toast, half of a peanut butter sandwich, a beer, and even a McDonald’s cheeseburger!  And in all of those cases, I can say that I did feel a little bit uncomfortable in my stomach, but I did not throw up and did not have any issues beyond the 30 to 90 minutes following my meal.

On Wednesday this week, I met with the dietitian as a regularly scheduled follow up. As a preparation for that meeting I completed a two page questionnaire about my experience so far after the surgery. I typed all my answers and color-coded them and attached screenshots of my food diary extracted from the MyFitnessPal app, which I use to track my weight and food diary.

I told the dietitian right up front that I was pushing the envelope, and probably was eating things that I should not eat.  She agreed!  She was quite perplexed at the paradox that I seemed to be to her. She said, "You are extremely organized and detailed, yet in some ways, you are not following the diet. At all!" 

She seemed very surprised that I did not have problems with some of the foods that I was eating in this phase.  I told her that I was not intentionally trying to derail my progress, but I figured that as long as I could purée a few foods in my mouth, that it would qualify for the puréed phase, provided that it did not cause me any physical issues such as stomach ache or nausea.  While she admitted there was some validity to that logic, she advised me to avoid those foods until I advanced a little further in my healing.  Of course, there were some things that I was doing right, including getting in all my protein and drinking enough water and avoiding soda. 

She also did observe that in addition to some of the foods I was eating prematurely, I was also eating portions that were too large. For example, I was eating two eggs, when I should have had just one. Or I was eating 4-7 ounces of meat/food when I really should only be having about 2-4, along with snacks of yoghurt or protein drinks in between meals. I had been getting 700-1000 calories per day, and she said it would be more expected to be getting 400-600.  Wow.  I do believe that everyone is different and that maybe my tolerance and healing are perhaps better than average. But I definitely don't want to stretch out my "pouch," which is bariatric lingo for "new smaller stomach."  She referred to this part of my journey as the “honeymoon phase,” because it is now when I will be losing the most weight. She said I need to capitalize on that. I promised that I would make some adjustments, and thanked her for the advice.

In a few days since that meeting, I have reduced my portions even further, and have avoided most if not all of the foods that she warned me about. It’s really hard to imagine that 2-4 ounces of meat/food would actually satisfy me right now, but it really does. For example, yesterday I scrambled one egg and crumbled some very thin crispy bacon on it along with some cheese, and made the world’s smallest omelette. It was delicious and it filled me up, and I had no stomach discomfort at all.  And it was mostly "in policy." :-)

So, speaking of the numbers, I have lost 25 pounds since I began the pre-op liquid diet four weeks ago. I think that’s excellent progress. I can definitely see it in the way I look, as can my family and friends.  I have already removed numerous pairs of size 48 jeans from my armoire, and am wearing some size 44s instead. Additionally I have begun wearing some of my treasured T-shirts that were much too tight for me over the last two years. I still have not made it to a size that will fit the unworn Rush concert T-shirt from 2015, but I expect to be there soon.

I feel great. And I feel satisfied throughout the day regarding my food intake. It really is quite amazing that I am not hungry very much at all, I do have cravings for certain flavors that I love so much. But I hope and believe that in the long run I will be able to enjoy those again, though in much smaller portions than before. 

I’ve been walking about 2.3 miles about five days a week. Lori has been joining me on some of those walks. When I walk alone, I’ve been listening to Travis Everette videos from his real estate class. He is an excellent real estate pre-licensing instructor, and has been instrumental in helping thousands of students pass the licensing exam, I’m sure. As for me, I just completed my course exam on Wednesday night and made a 90.8 on that test. I am glad to be done with that class. That lasted for 10 weeks and was four hours every Tuesday and Thursday night.

So I have submitted my application to take the official real estate licensing exam.  Once that is approved, I will schedule a date and take the exam, after which I will be a licensed real estate broker (if I pass both the national and NC portions).  There are still some other steps before I can legally do anything related to real estate, but those are formalities.  

It’s about time to start my regular day job for today, so I must wrap it up now. Lori and I are going to the beach this weekend to celebrate our anniversary and I suppose my birthday, which is next week. Also we really have both needed some time to get away alone, given all the above-mentioned activities that have been consuming me for most of the last several months. I’m looking forward to visiting one of my favorite restaurants at Wrightsville Beach, The Dockside Restaurant.  I might push the envelope again, but I’ll try not to.

Day 11: Graduated to Phase 2!

Day 11 post-op.  

Pre-pre-op weight: 293.5 
Surgery weight: 284.3 (-9.2)
Current weight: 276.2 (-8.1, -17.3 total)

Had my first post-op appointment today.  Everything is going great so far.  As noted in the prior post, I've been sampling a few things in the phase after the post-op full liquid phase, with no issues.  But now I have permission to move forward to the next phase.

That means I can now consume scrambled eggs, mashed banana, small amounts of mashed up baked potato, pureed (or extremely well chewed) fruits & veggies, cottage cheese, tilapia or other flakey fish, and 93% lean ground chicken/turkey (yech).   All of the above is subject to how well I can tolerate it.   

I can't tell you how happy that makes me.  I was soooo tired of all the liquid / yoghurt / soup / pudding meals for the last 18 days.  Wow.  That was the hardest part of this whole experience.  Anyway, I promptly made myself two scrambled eggs and a cup of milk.  I was only able to hold about half the eggs (aka 1 egg) but boy was it delicious.  Tonight, I'm already eyeing some tilapia that I'm hoping Lori will prepare while I am in real estate class (only 3 more classes to go!).

One of the outcomes of the meeting with the PA today was the discussion of a goal weight.  180 would be under 25 BMI, which is considered "normal" weight.  But I think that would be too much for me.  We settled on 200 as my goal which would be a BMI of 27.1 - "overweight."  LOL.  Oh well.  I'll take it.

She encouraged me to keep exercising, including strength training, in order to maintain muscle mass.  I'm walking about 2 miles a day on most days, so that is good.  Seth and I played pickleball last week and that seemed like a great exercise.  Not very good yet.  I'm starting to do some planks which helps with abs.  Guess I'll work on upper body strength at some point.  So far so good.

Day 7: One Week Post-Op

Today marks day 14 since I started the pre-op liquid diet and day 7 since my surgery.  I keep seeking wood on which to knock, but I cannot imagine this going any better than it has.  I was definitely prepared for issues like pain and nausea, but neither have been worthy of mention, though I will mention them later in this blog.

As for the numbers, from my heaviest weight, 305.1 on December 17, 2019, I lost and gained and lost and gained and lost and gained and lost 11.6 pounds down to 293.5 on the day the pre-op liquid diet started on August 28, 2020.  In that pre-op week, I lost 9.2 pounds down to 284.3 on surgery date September 4, 2020.  I've since lost another 4.9 pounds post-op until today's weight of 279.4.  So, total lost from max is 25.7 and total lost since starting pre-op is 14.1.  

The picture shown is a few days ago.  I'm not always showered and combed when I write these blogs, so...  Anyway, I can definitely tell a difference in the way I look and feel, and my friends and family might say "You look fine," but under that 3XL T-shirt is quite a bit of unwanted fat that will be history, eventually.

I'm a patient patient, and it is rewarding to see the 0.2 - 0.7 pound loss happening every day.  I know at some point the rate of loss will slow, but that's OK.  This is a long game.  Check out this graph.  It looks like a stock market crash!

Numbers aside, here's my assessment of how this has gone for me:  I am convinced I have, so far, experienced the best case scenario for weight loss surgery.  For this I am very thankful.  My pain has been minimal and has declined since surgery day.  My only pain now is if I stretch too far a certain way, I may feel some incision pain. The steri-strips are still hanging on while my incisions heal, but they're starting to wear away. 

As for nausea and related issues, that was my main concern going into this.  Many people talked about their issues with nausea and vomiting.  As for me, one of my meds is for nausea, so I have not had those issues.  The exception has been the last few nights I've woken around 3am to pee.  Then when back in bed, I've felt a little nauseous.  The night before, I soon went back to sleep, and last night I took the med I'd forgotten to take at bedtime, and then went back to sleep.  No throwing up.

My one mistake so far was yesterday at lunch.  I prepared a bowl of tomato bisque soup.  This was the entire can of concentrate plus a can of milk to mix with it.  It was delicious and I devoured the whole bowl quickly - out of habit - which was about 2 cups of volume.  Well, I guess I did that too fast, because I felt pretty crappy the next few hours while that digested through my banana-sized stomach pouch.  In case you're wondering, the volume of a banana is about a cup at most.  So I overfilled myself by 2x.  As I write this, I just completed a 24 oz (3 cup) combination of coffee and caramel Premier Protein drink.  I think the difference is that I consumed the 3 cups over a period of an hour, whereas the soup was devoured in about 5 minutes.  Lesson learned.  I used to eat that large bowl of soup with crackers, 1 - 1.5 grilled cheese sandwiches, AND sometimes chips!  So I've come a long ways, baby!

People keep asking me what can I eat.  The first two weeks of the post-op diet is considered "full liquids."  It's getting a little boring but is considerably better than the 1 week pre-op diet.  Here's what I'm having throughout a typical day: 

• Breakfast:
• Option 1: 12 oz regular coffee w 2 tbs half & half; Premier protein drink (30g protein)
• Option 2: 12 oz regular coffee w 2 tbs half & half; Oikos yoghurt with no fruit chunks - just creamy yoghurt (15g protien)
• Morning Snack: 
• Small container of sugar free applesauce or sugar free jello pudding or (if I'm feeling naughty) regular Jello pudding, or sugar free Jello (the jiggly stuff)
• Lunch:
• Option 1: Bowl of some liquid soup, strained of vegetables & meat (5g protein)
• Option 2: Smoothie with 1 cup of fruit and either a protein drink or protein powder (30g protein)
• Afternoon Snack:
• Same as prior snack, but probably a different choice.
• Dinner:
• Same as lunch, but probably a different choice.
• I'll have a glass (2 cups) of Stevia-sweetened iced tea during the day, and water throughout the day otherwise
• No sodas and no beer yet.
• Total calories per day is around 850-975.
• Plus I'm walking over 2 miles on most days.
• I'm not particularly hungry though I do crave new flavors.
• I have sneaked in the following foods that are not on this liquid diet: One Oreo cookie, 1/2 cup of pureed vegetables from a can of Campbell's vegetable soup, 2 club crackers, one water chestnut from Luke's PF Chang's Orange Chicken entree I helped him cook.  No issues with any of the above, though I do think I heard my stomach say, ever so softly, "What. The. F. Is. This...?" on each occasion.

I'm hoping that when I have my follow-up appointment on Tuesday, they will advance me to phase 2 of the post-op diet a few days early.  

Since I have all my photos and weights digitized and saved, I can go back in time and see the last time I was this weight ~279 lbs.  And the answer is January 2018.  Here's my girl Roxie, who just passed away last month.  Wish she were still here.  

I've spent way too much time editing this blog post, so I guess I should get back to doing something productive with my last day off from work.  Until next time...

A Beautiful Day

It’s truly a beautiful day to be sitting on the front porch, a pleasant 72 degrees and the sounds of birds, an occasional drip from some gutter repair needed, and the SUDDEN DRUM PLAYING COMING FROM MY NEIGHBOR’S GARAGE!  Well I guess you can’t have it all.  

I returned home from the hospital yesterday late afternoon. I had a great night’s sleep last night. My main symptoms right now are some occasional stomach cramps similar to having indigestion or gas, or perhaps a little muscle strain similar to doing a sit-up.  Last night I had a container of yogurt, which was good and without issue. This morning I woke up craving ice tea, so I had some of that, along with one of the Premier protein drinks, which gets me 30 of the 60 grams of protein per day I’m supposed to have.  So far I think my recovery is going great.  I am rarely experiencing any level of nausea, and I can sense the pacing in which I need to consume liquids in order to not get too full or sick.  Net: So far so good.

I weighed this morning and had lost a whopping 2 pounds since the day I went in for surgery. It seems like a small amount given what little I’ve consumed since Friday morning.  But I have heard that is not unusual because while you’re in the hospital they are pumping you with liquids the entire time. Lori and I did go for a walk last night for about 1 mile, which felt great - especially with my new Brooks running shoes!

For the next week or so I will be taking various types of medicine for pain, nausea, acid reflux, and blood clot prevention. I look forward to getting off of all of those meds soon, and feeling completely back to normal.

A New Beginning

This is what 1 ounce of water looks like. This has been my diet for the last three hours. 1 ounce every 15 minutes. So far I am handling it well. Actually the first goal was to do 1 ounce in one hour. But I misunderstood and did the entire ounce every 15 minutes.  I keep asking for a slice of pizza but no one is bringing that to me yet. I think after the 4 ounces of water per hour, I will be given some clear soup broth. All of this is to ease me into the transition diet that will be going on for the next six weeks. The goal and hope is to not throw up at any point along the way.  So far so good.

Surgery went well and I believe actually started and finished ahead of schedule. When I was awake and in the recovery room, I felt extremely groggy, due to the anesthesia. The guy in the bed in the next station was complaining that he needed to go to the bathroom, i.e. do number two. I just got out of surgery, and I’m not sure what type of surgery he had, but I can’t imagine awakening in the recovery room and having to immediately poop! That would be terrible, as I could barely raise my hand to scratch my ear!  Anyway, I think they tried to help him get to the bathroom, or use a bedpan, but I don’t think he ever pooped. I was in and out of sleep so it didn’t really matter to me.  But then again, I think I did smell something. 💩

My main issue at that time was stomach pains which felt like somebody kicked me in the stomach.  They gave me some good pain meds in my IV, and by the time I got to the room several hours later at 5pm, the pain was moderate and I rated it 3 out of 10.

They wanted me to pee in the urinal container by 6:23 PM. I don’t know what the point of the exact deadline was for that, but the threat was that they would install the catheter if I didn’t!  I was stressing a bit because I was not able to immediately do it at 5:30 when first asked.   So after slowly gulping down a whopping 5 ounces of water over a period of an hour and 15 minutes, I finally went potty and avoided the consequences.

The nurses here are very nice.  I can’t help but think of my dad when I am talking to nurses in the hospital! He always made so many hospital friends in his final years. I really appreciate all that nurses do around the world.  I’m sure they have bad patients. I try to be a good one like Dad was.

A few hours ago after I successfully peed, I decided to just go and put my regular clothes back on, which made laying in the bed much more comfortable.  Already breaking the dress code here.

They just took my vitals at 8 PM and promise to be back every four hours to do that again. I am still quite tired, as well as thirsty. I’m not particularly hungry but I do look forward to beginning to eat some real food some point.  

I’m looking forward to getting home tomorrow. Lori has been such a great supporter of me in this process. I really love her and appreciate all she does for me.  Thanks also to all my friends and family who have supported and prayed for me during this time. This is a new beginning for me and I’m looking forward to wearing some of my old (smaller) T shirts that have been packed away for many years.  I have many.

Ok blog writing done.  Nurse is bringing me a popsicle!!  Goodnight!

Hell Week is Almost Over

It's hard to believe I'm in day seven of this seven day liquid diet. It actually went by pretty fast and was not nearly as bad as I thought it would be.  What's also memorable is that I've gone seven days without eating out, which may save some $, though the bariatric foods can be more expensive than normal groceries or eating out.  As previously written, the first two days were the worst.  However, it is getting very boring, and I am definitely looking for a change beginning tomorrow, even though I know that will be a difficult one.  The good thing about the next two weeks will be that the progress will be in the positive direction, meaning that I will be adding more foods to my options over time.  I have stocked up on various Premier protein shakes, bariatric soups, and other protein powder mixes.  

The challenge over the next two weeks will be to get in the requisite 60g of protein per day.  With what I have been eating (drinking) the last week I have been easily getting 100g to 115g per day, so the thought of having a difficult time of getting in half that amount is hard to imagine!  I've lost about 8.1 pounds since I started the liquid diet, though I actually gained back 0.7 pounds yesterday.  I expect that is water weight or some other normal daily variance.  

I meet with my doctor later today for final instructions and Q&A. Then tonight I will drink some special liquid and take some special shower using some special soap.  And will then be sleeping on clean sheets, as recommended in the pre-op preparation.  :-)  Then tomorrow I will do the same thing again, and then head in to the hospital around 9:30.  I think the procedure is around 12:45pm.