Thursday, May 21, 2009

The Road to Gastric Bypass Surgery

This photo was taken in April 2009. The author, at 5 feet, 10 inches and a bit, weighs in at 294 pounds.
I have always been a 'big boy' - forever on the heavy side. No one however would call me 'fat' and certainly not obese. (In the Caribbean, I am always called "big mon"). Yet according to the official Body Mass Index (BMI) scale, I am "morbidly obese". (Google BMI for your own reading) A score of 30 is Obese. Morbidly Obese is 40 plus. My rating is 42.4. (Steve Veale)
(photo by Cathie Stanish)

Stepping over the Tipping Point

A suggestion from the Doctor...
It was my physician - Doctor Ronald Porter a.k.a. 'the miracle medical man' - who first suggested Gastric Bypass operation as a method of controlling my weight - among other health factors. "Have you ever considered this?" he asked one day out of the blue. Well, no, I hadn't. Isn't this surgery only for hugely obese people? Why would I consider this? I was a little taken aback. True, I was somewhat overweight; at 5 feet, 10 and a bit, my weight had ballooned to 294 pounds. The real poundage started to accumulate after my knee gave out about five years before.
(note: I stood up one morning and my left knee seemed to snap backwards. From that point on, I was in constant pain. I could only hobble about three blocks before I had to stop and rest. No amount of chiropractic or therapy could help. My doctor sent me to a surgeon; arthroscopic surgery revealed that I had no cartilage left in my knee. Six months later I had Oxford Knee Replacement surgery - through the skills of Dr. Jose Guera at Toronto's Scarborough Grace Hospital). But the weight I had packed on remained. When I was younger, and dieting here and there over the years, I always lost the weight very quickly. After entering my 50s - not so much.
As well, three years ago, my doctor sent me for more tests and discovered I also had developed Obstructive Sleep Apnea - again likely due to my sudden increase in weight.)
Note: I have always been a "big guy" although no one has ever guessed that I was approaching 300 pounds. I seem to hide my weight very well. As I tell my friends - perhaps semi-facetiously - "I am very dense".
It is very simple to discover your BMI. Just Google Body Mass Index and you will find many charts. Just fill in your height and weight and this will produce your BMI.
* Underweight = 18.5
* Normal weight = 18.5-24.9
* Overweight = 25-29.9
* Obesity = 30 or greater
* Candidate for Gastric Bypass = 40 or over.
Basic Criteria for Laparoscopic surgery:
* BMI (Body Mass Index) over 40
* BMI between 30 to 40 in conjunction with other associated diseases that may improve with weight loss such as: Diabetes, High Blood pressure, Sleep Apnea, Arthritis, Painful Joint condition, etc.
* Must be over the age of 14.
* Be over weight for more than five years
* Have tried to diet and exercise with little success.
* Be prepared to make substantial changes in your eating habits
* No dependency on alcohol or drugs
* Acceptable operative risks
But still, I was skeptical. But then in a fortuitous bit of timing, Dr. Porter told me that the Centers for Laparoscopic Obesity Surgery (CLOS) - one of the clinics in the USA that specialize in Mini Gastric Bypass Surgery - would be presenting an afternoon information seminar in two weeks time in downtown Toronto. (
The session was held at the Marriott in downtown Toronto and the room held about 250 people. Dr. John Peraglie, MGB surgical specialist, introduced himself and gave a brief overview of the operation. Then he asked how many in the audience had undegone the surgery - in this case, a Mini Gastric Bypass. About 70 people raised their hands. He asked each one to tell his/her story. I was sitting at the back just observing; by about the tenth person, my journalistic objectivity gave way to astonishment. I think my mouth was hanging open. I couldn't believe what I was hearing. A number of women were crying, thanking the doctor for saving their lives. Some of the men even got choked up as well. The stories were all amazing. Such as:
* Nick, 28, who went from 396 pounds to 185 pounds in 18 months. (" I was craving a hot fudge sundae before my operation," he told the crowd, " and I woke up thinking of watermelon".)
* Mark who dropped 62 pounds in his first three months.
* Tiffany who shed 100 pounds in eight months.
All these people were happy, excited, thankful...and slim.
I went from skeptical to sold. I started researching this - getting information online as well as talking to people who had the surgery and asking about their lives.
Dr. Porter filled out the forms and sent them to OHIP (Ontario Health Insurance Program) to request permission for the surgery. In my case, not only did I meet the BMI qualifications but I had also had knee replacement surgery as well as a terrible case of Sleep Apnea. All these things combined made me a serious candidate for weight loss surgery.
"60 Minutes"
One of the reasons that I wrote this journal is because everyone needs support when they are considering an operation - any operation. This is very, very important. I was fortunate in that I was put in touch with Debbie who had the surgery in August 2008. So far she has lost 87 pounds. She answered all my questions and alleviated my concerns. One of the first things that was passed along to me from my support-buddy (we still haven't met - only emails and phone conversations) was this segment from "60 Minutes". Reporter Leslie Stahl interviews people who have had the bypass as well as doctors and support personnel. Note the fact that Diabetes disappears after the operation - not when the patient loses weight but days after the surgery. They discovered this almost as a 'by-product' of the surgery and are now doing studies to determine how and why this occurs.
This is a great video. Paste it in your browser and Check it out!
http://www.cbsnews. com/stories/ 2008/04/17/ 60minutes/ main4023451. shtml
What the heck is Gastric Bypass Surgery anyhow?
This is in no way a medical journal - there are other websites and information centres for that. But basically, you are going to be 're-wired'. The basic human stomach is about the the size of a football - and often stretches beyond that during those huge Thanksgiving dinners and all-you-can-eat buffets. After surgery, however, your new "holding area"will be a specially designed pouch the size of a small egg!
With the Roux-En-Y surgery, the stomach will remain where it is but will no longer be used to process food. It will still function and secrete the bile and gases used to break down the food but it will no longer combine with the food until it reaches the intestines.
This Laparoscopic surgery (a surgical instrument that is inserted through the abdominal wall) cuts and staples the top of the stomach. The surgeon will then fashion a new 'stomach pouch' at the bottom of the esophagus - the pouch will actually act as a reservoir. A part of the small intestines are repositioned in your abdomen to make the "Y" connection of the Roux-En-Y. So basically, the bottom of your pouch is now attached to your small intestines instead of being connected to your stomach.
It is a difficult process to explain as well as to understand. Do your research and ask the doctor lots and lots of questions.
(* See diagram. It will help explain the process.)
(NOTE: What does Laparoscopic Surgery mean to you? First of all, it is less invasive - instead of a long cut or post-surgery scar down your stomach there will only be four or five little 'nicks' - about an inch long - in your stomach and abdomen area. These disappear very quickly, especially with the aid of a good skin cream. The healing process is much, much faster.)
(Diagram from the Henry Ford Macomb information binder * and Art Director George Shewchuk)
First of all, please note that you cannot just sign up for Gastric Bypass Surgery - this is not like cosmetic surgery to trim down your nose or enhance your breasts. Your doctor must fill out the medical application and then (in Ontario) you have to be approved by OHIP.
Dr. Porter filled out the necessary forms and we applied for OHIP's permission to proceed with the surgery - my BMI of 42.4 combined with my recent knee surgery and Sleep Apnea (plus the possibility of Adult onset Diabetes) put me over the top and OHIP declared me a sufficient enough health risk and approved the surgery. I received a letter from OHIP in early February 2009 and a call from the Henry Ford Macomb hospital the same day.
(Some people find it odd that OHIP refers patients outside the country but there are very few bariatric surgeries performed in Ontario. The people I spoke to at the seminar had been sent to the CLOS centres in either Orlando, Florida or Las Vegas.
Henry Ford Macomb hospital has been designated as a "Centre of Excellence" by the Ontario Government. This hospital specializes in Bariatric Medicine and Gastric Bypass Surgery. That is what they do. As I see it, the Ontario Government was sending me to the best place for this surgery and my personal care.)
NOTE: In February 2009, the Ontario government announced that as part of Ontario's diabetes strategy, they would be investing $75 million to increase bariatric surgery capacity in four centres: St. Joseph's HealthCare in Hamilton; Humber River Regional Hospital (Toronto); Guelph General Hospital and the Ottawa Hospital. This will increase the number of surgeries from 244 a year to 1,470 by 2012. It's a good start - but expect a lengthy waiting list.
The OBESITY EPIDEMIC in North America
There is an ever-increasing (or to use a bad pun) ever-expanding "epidemic of obesity" in North America. Statistics show that not only young people are overweight (and grossly out-of-shape) but those adults in middle age are at a much greater risk of associated health problems due to increased weight in later years. These include Adult onset Type 2 Diabetes, Cardiovascular disease, Breast and Colon Cancer, Gall bladder problems, High Blood pressure, High cholesterol, etc. etc. Well, if you are in that age category, you are likely aware of most of them.
* In Canada alone (where this was written) approximately 6.8 Million Canadians adults, ages 20 to 64, were classified as overweight - and an additional 4.5 Million were Obese, according to the official report The Obesity Epidemic in Canada which was presented to Parliament in 2005.
The cost of this epidemic to the Canadian Health Care system alone, including related diseases, was approximately $5.3 BILLION dollars in 2004. That figure has increased substantially since that report.
(NOTE: OHIP is quite smart to approve this surgery. They realize that if I have the surgery now, I will likely save the Canadian Health Care system hundreds of thousands of dollars in the next decade or so. It will also likely save me the same amount in prescription medicine.)
In the United States, the medical community has declared a full-out war on Obesity. It is truly in epidemic proportions, so to speak, throughout the US. Statistics show that 26.6 per cent of the population fall into the Obese category. Not overweight. Obese.
The estimated economic cost is approximately $117 BILLION DOLLARS. $117,000,000,000! This includes both direct costs (preventative and treatment) as well as indirect costs such as absenteeism for work, etc. This exceeds the combined health care costs related to Smoking and Problem drinking.
* In the United States, the medical community estimates that some 400,000 deaths per year occur due to obesity-related disease.
The Centers for Disease Control and Prevention, based in Atlanta, GA, hosted its first inaugural conference - "Weight of the Nation" - dealing with Obesity Prevention and Control in July, 2009 in Washington, D.C. The CDCP is bringing its campaign to the nation in an attempt to publicize the dangers of some many health risks and diseases when people pack on the poundage and lug too much weight through their lives.
13355 East 10 Mile Road. Warren, Mi. TEL (586) 759-7443
The first person who contacted me was L'Nora Bieske who, as Patient Advocate, had Gastric Bypass surgery herself in February 2008. She had lost 197 pounds in one year. 197 LBS!!!!
We arranged for my first introductory session in two weeks time. (Two weeks!!!!).
The hospital is located in Warren, Michigan, a suburb of Detroit about 15 miles from the city. Since it was winter, I took VIA Rail to Windsor (always love taking VIA) and depended on taxis after that. Note: A cab from Windsor, across the border, and then up to Warren is about $80. There is no public transportation in Warren. This is Detroit, Home of "The Car", everyone drives everywhere. You have to depend on local cabs (Sterling seems to be the company) and you have to call in advance. There are no cabs trolling the highways of Warren - if one passes you by, it is on the way to pick up someone. They don't stop.
* A word about Warren -
As Dorothy Parker once said: “There is no there, there”
There is absolutely no core, no centre, and no downtown. It is all freeways and highways, small industry, little strip malls, fast food restaurants & bars, Walmart Supercentres and side streets of little homes. When I decided to go for a walk one night, I asked the night manager: “Is there anywhere to walk to? Any direction I should go?” The answer was: “No.” And she was correct.
But then, you are not there to party.
30180 North Center Blvd, off Van Dyke between Mile 12 & 13. TEL: (586) 558-7870

On the hospital's website they list several hotels for visitors. I chose the Hawthorn Suites because I had never stayed there plus they offered the best rate ($79). I checked their website and found they are located on the hard-to-find North Center Blvd. just off Van Dyke between 12 Mile Road and 13 Mile Road
The hotel is only minutes from the hospital - straight down Van Dyke to 10 Mile. Turn left (east) at 10 Mile and drive about four miles to the hospital. (Note: the highways and byways in Warren are very confusing. Van Dyke is the main highway you will be using.)
It turned out to be an excellent choice.
The suite was beautiful. Full kitchen facilities – stove, fridge, plates, cutlery, dishwasher, etc. Living room with huge TV screen & DVD player, big comfortable double bed (another TV in bedroom) spacious, complete bathroom. All amenities. Plus they feed you a hot breakfast – AND from Monday to Wednesday, they serve dinner! Also every afternoon until late evening, they put out beer on ice, and carafes of wine in the lobby for guests. Staff is young and friendly. (There is also a small Office Center with computer just off the lobby)
I would advise people to bring books, DVDs, their computer and just stay in the room – believe me, there is nothing outside of it!
Hawthorn Suites is in a little cul-de-sac street (North Civic Centre Blvd) off the main highway (Van Dyke) between 12 Mile and 13 Mile Roads. The best way to describe it to a taxi driver is that it is beside the Civic Centre. There are other hotel companies here – Marriott Residence Extended Stay, Holiday Inn, etc. yet you cannot see them from the highway and there are no signs stating they are there. Somewhat confusing - but worth the search.
Feb 19 & 20/09

Sally Green, RN, BSN, CBN
Coordinator of Henry Ford Macomb Bariatric program

Contact: (586) 759-7469 or e-mail at:

Sally Green, RN, is the Program Co-ordinator. She is terrific. We had an 8:30 am meeting on Thursday. She explained the program, the surgical procedure and the followup steps, etc. Sally spent 12 years on the non-surgical side of Bariatrics then switched when she saw the results and follow-up from surgical procedures.
* This is also a good time to stock up on the Bariatric products you will need following surgery.
These include:
1) HMR70 PLUS - protein shakes
2) Bariatric Advantage Chewable Vitamins
3) Calcium Citrate chewy Bite supplements
4) Iron pills (more common for women)
Sally and her team have all these items on hand. It is a good idea to get them in advance so they are handy and ready to use after your surgery. (Note: Keep in mind the only pills you will be able to take following surgery will be very tiny - Large pills will come right back up.)
Anyhow, after our 2-hour meeting, Sally told me there was an Information Session that was mandatory for everyone who was contemplating the surgery– and fortunately, there was one scheduled for the next morning.
* Then off to see a Doctor Carolann Kinner for my 1-½ hr physical – I had already filled out a 10-page information sheet on my medical history for Sally with copy to Dr. Kinner. Very pleasant young doctor, thorough and competent. (Note: her offices are offsite but easy to locate. 30050 Hoover Road in Warren. TEL (586) 558-4081).
* Next, yet another cab ride to see the psychiatrist Dr. Leslie Kaye. (again, very pleasant doctor). We talked for about an hour and then I sat at a computer and spent about 45 minutes answering a 368 question True/False Questionnaire.
NOTE: Some of the questions are real puzzlers. For example: "In every marriage, one person is always happier than the other."
How do you answer that? For one thing, how do you define 'happy'. And how do you measure the level of 'happiness'. They are tricky and often though provoking. Just answer the closest you can to a Yes or No.
Oh yes, a psych evaluation is essential for this surgery. And don't even try to fool her! (Note: again, her offices are offsite but very easily located at 26156 Van Dyke Avenue, north of 10 Mile and just south of the Hawthorn Suites. TEL (313) 978-7792). Yet another Note: this is the same location as the surgeon Dr. Carl Pesta. 26156 Van Dyke, Centerline, MI 48015.
(IMPORTANT: You still may not be approved for surgery. You could be turned down if you display other physical ailments that might conflict with this procedure or for reasons of mental/ emotional problems. You are actually going through a vetting process by the experts at Henry Ford Macomb.)
The next day was a four-hour Information Session led by Sally, at the Henry Ford Macomb, plus a tour of the Bariatric ward. There were about 60 people in attendance - both those who had applied for surgery and their spouses and/or supporters. My head was actually reeling from the amount of information and the binder of materials she gave us. (For people who are more local, the hospital provides weekly one-hour sessions for six weeks.)
There are three main types of Bariatric procedures; the LapBand, the Roux-en-Y, and the Mini Gastric Bypass (MGB). The procedures will not be discussed here. There are other professional medical sites to go for this information and this is something that should be discussed between you and your doctor/surgeon. I had the Roux-en-Y, which is the operation performed at Henry Ford Macomb. I know others who had the Mini Gastric Bypass and the LapBand. (although the LapBand is not being used as much anymore - people are opting for permanent surgery.) Everyone I have spoken to who has had any of these surgeries has lost huge amounts of weight, they have more energy and are much, much happier. The choice is yours.
(Note here: They are not there to 'sell' you on this procedure. Absolutely not. The goal is to give you the necessary information so the individual can make an informed decision. In fact, there was so much information, it was difficult to process all at once and I was feeling so overwhelmed that I thought maybe I would not go through with it. As it turns out, many people have this reaction. In the next few weeks, however, I calmed down and went over all the material in the binder a number of times. At that point I realized that this procedure - and the (Life) timing - was right for me.)
As you can see – they really do spend time with you. A lot of care, information and services. Absolutely no complaints or worries about that – they are extremely proficient and you soon feel very comfortable with the information and services you are receiving from caring people.
There were about 60 people at the Information Session and about half were from Canada – Chatham, Windsor, Woodstock. I was very lucky that the couple from Chatham (Randy & Robin) volunteered to drive me back to the train station in Windsor.
Physical & mental
Lots of reading and research. Also, talk to people who have had the surgery - I was fortunate in that Dr. Porter had a patient (Debbie) who was so generous with her time, via phone and email, to coach me through all the steps. If you don't know anyone who has been through this - it is still a relatively new procedure - ask Sally Green for some former patients. There are many people who are willing to spread the word about their new life.
You will be asked to start your new life by losing weight prior to your surgery. This is a basic 'weight watchers' diet. Losing weight will assist the surgeons with their job as well as proving that you are committed to this change. Switch to veggies and fruit as opposed to burgers and fries. Start walking more. (Note: Make sure you take some 'before' photos so you can compare them with the new you after six months.)
Whether you discuss this with friends and family is up to you. I decided that I would tell people just so that it wouldn't become 'a big thing' in my mind. And that worked for me. I know others who decided to say nothing and just let people comment that ' wow, you've lost a lot of weight'. Again, your choice.
First of all, Congratulations. You have started on a path toward a new Life. A New You. You've decided to shed all that excess poundage that has been clogging up your life and threatening to overwhelm the person inside. You have chosen a healthier lifestyle with more energy, better (no, make that) intelligent food choices, smaller clothing sizes that don't look like a tent and little things, like, oh say, not huffing and puffing over a simple task like tying your shoelaces.
And surely (surely!) all your friends and family will rally around and support your efforts. Right?
Unfortunately that is not necessarily so. In fact you may be shocked that your best buddy, your favorite sister, does not want you to lose weight. (Note: People on diets find that friends and family often try their best to sabatouge their efforts.)
Why? Why is this so? What wouldn't someone want you to improve your Quality of Life?
The first thing to keep in mind is that - to quote Author Edgar Allen Poe - "People are perverse".
You may have always been the "jolly fat friend" whenever the girls get together or the "fat cousin" at every family reunion.
People have come to define you by your weight.
But suddenly you are taking control of your Life, your future. There are people who are not comfortable with change; they want you to stay as you are. Maintain the status quo. Because by making these changes, you are changing the human dynamics of every relationship you have.
(i.e.The most common and stereotype example one hears - unfortunately true - is that some men do not want their wives to lose weight. These are very, very insecure people. They don't want their wives to look better because - who knows? - maybe some other man will be attracted to her....horrors!....and maybe she will leave him!
Sad, yes. Sick, definitely. True, unfortunately).
But there are all types of examples - the "good looking girl" in the group can't stand any competition and is afraid the "fat girl" may turn out to be a babe. The high school jock may lose the butt of all his cruel jokes when the 350 pound wimp slims down to 180 pounds and gets in shape enough to kick his butt around the football field.
Even more revealing - a close sibling doesn't want you to change in case you start getting more attention. You never know.
But you can expect your relationships will change because you have chosen to change the dynamics. You have chosen to change the course of your Life.
Be prepared for some shocks, some unpleasant, many unexpected. Yes, you may lose friends, but on the bright side, you will find others who like you for the person you have become.
NOTE: This is where the psychological assessment plays a major role in determining 'who' you are and whether you have what it takes to weather some of these changes. Again, I stress, do not try and fool the doctor and put on a happy face. Dr. Kaye knows...!

Dr. Carl Pesta, MD, D.O./Bariatric Surgeon
(26156 Van Dyke Avenue, Centerline, MI 48015
TEL: (586) 759-2005

I returned to Warren in May for a meeting with the surgeon (Dr. Carl Pesta) & the Anesthetist.
This time I drove. For those coming from Toronto, this is a simple drive. Point your car west, cross the border at Sarnia, turn left. Really, that is it. Highway 401 to #403 to Sarnia. Cross the border and turn onto 94 West. Drive about half an hour and this turns into Hwy 696. Take the 12 Mile turnoff, drive eight miles to Van Dyke. Turn right for the Hawthorn Suites, left for Henry Ford Macomb Hospital.
Dr. Pesta is a terrific young guy - his confidence is infectious (if I may use that expression about a doctor). He will explain the operation in detail and answer all your questions. By the time you leave, you feel as though you are in the best possible hands and no longer anxious about the surgery. (He told me that I could expect to lose anywhere from 90 to 100 pounds). And my surgery was scheduled for Friday May 29th. Note: The man is a sharp dresser. Make sure you check out his outfits. I want his tailor after I lose all my weight.
The final 'pig out'
I had three weeks to 'pig out'. Although I did try to get a Mandarin mega-Buffet in there once or twice, it never happened. My one and only did occur when my friends Don and Mado invited me for a perfect final feast, barbequed Lamb on the grill with some excellent side dishes (Risotto - so delicious) grilled asparagus and salads created by Mado. By my calculations, I ate at least two pounds plus of the 4 1/2 pound roast as well as the side dishes and salads. But other than that, I pretty much stayed on my diet for these three weeks and didn't get to any massive buffet spreads. I lost about seven pounds pre-op.
May 29/09
Let me state that I have never had a problem with the Ontario or OHIP system (in fact I still believe we should still be paying the premiums every three months to assist the financial stress on the Health Care system). I have always had excellent care. Much of that is due to my personal family physician Doctor Ron Porter – if I need to see a specialist, he picks up the phone and 15 minutes later I am having tests in the doctor’s office. An MRI – I go in for my appointment two days later. He is a miracle man in the health field.
I have had Oxford Knee Surgery replacement and spent four days in the Scarborough Grace Hospital. I had excellent care and service. (After Dr Jose Guera checked me out, he said “How about three weeks from now?” No waiting, no delays.
So all I will say for those of you from Canada who being introduced to the Henry Ford Macomb Hospital in Warren, Michigan for the first time is that you are about to experience the difference between the private health care system and a government facility.
The care and concern is unparalleled -
efficient, friendly, personable and professional.
This hospital specializes in Bariatric medicine. Not just the surgical aspects but they also provide non-surgical programs and seminars for patients who wish to learn more about losing weight through nutrition, diet and exercise. That is the raison d’ĂȘtre for the Henry Ford Macomb Hospital and everyone is well versed and focused on this mission.
* I arrived at the hospital on Friday about 11 am, several hours prior to surgery, and checked in with Patients Admitting. They brought me down to a spacious waiting room filled with natural light from floor-to-ceiling windows. I hardly had time to start reading a magazine when I was called into the ‘prep’ area. Again, this is a well-lit space with curtains closing off the various ‘bedroom’ areas. It is here you change into the hospital gown and pack off your belongings – which you will see again when you are wheeled into your room.
* You are then ‘prepped’ for surgery. All vital stats, blood pressure, etc. are taken and a needle with a slow sedative is injected in the back of your hand. (Note here: I’ve had this done before and don’t like the location of the needle; not much makes me squeamish but I don’t like to see the needle injected into the back of my hand. so I asked if they would move it to my arm. They did. No problem.)
* You are then left alone to relax and let the sedative take effect; it is very calming after a while. Then various nurses and doctors (Dr. Keith Marshall, another surgeon on the team, led the group of caregivers) gather around to see how you are and again, talk you through the procedure – what will happen, how you will feel when you wake up, etc. At this point it started to get a little fuzzy and relaxing for me.
* I was then wheeled into the operating room about 1 pm – all bright lights and sterile environment. Some doctors gathered round the table and started to talk to me when the mask went on and I went out.
(Note: For those who have never experienced this ‘sleep’ it is the deepest state of unconsciousness you will ever experience. No dreams, no thoughts, just out. And then suddenly you are awake; your eyes open and you have magically been whisked into the Recovery ward.
* From here you are soon taken to a private room for the rest of your stay – mine was a mere 1 ½ days.
* When you wake up you will likely be in some pain and discomfort – well, of course, you have just had major surgery. You are wired up, attached to monitors and two packs that move with you – the one is pain medication that is feed directly into your system through wires that are coiled and fastened to your stomach area while the other monitors your various vitals.
* I woke up about 6 pm and then tried to get comfortable (which was impossible) for the next six hours or so; there is no position that works when you are in this state. However it passes. In fact I took my first walk along the hospital hallways at 4 am.

A 4 am stroll down the hospital corridor
(Photo by: Nurse Tanisha Buckner)

* The next day, Saturday, was a daze of intermittent napping and having my vitals taken by numerous staff members. At my count, there were a basic minimum of at least three dozen people who checked on me during the day – the level of care was truly amazing. Six of these were actual doctors (remember, it was Saturday) and then teams of nurses, nursing assistants and various caregivers taking my temperature, checking my blood pressure, changing my various drip bags, etc. Even the food service personnel (the jello was great!) and maintenance staff were friendly and encouraging.

* Dr. Marshall dropped in to give me a session on what to expect in the week after I left the hospital – how I would feel, what to eat, what not to do (i.e. don’t lift anything over five pounds!) and various other practical information on starting my new life.
* I really cannot say enough about the care and concern on every level at the Henry Ford Macomb – from the first phone call you receive welcoming you to the program to the nurse who wheels you out on the day of your departure.
Your time in the hospital actually goes by in a daze because you are in one - a daze that is - and then suddenly you are home.

Relaxing in bed on a Saturday morning
(photo by: Lab Tech Karen Sholar)

Week One
Well, some people go home. I took a taxi (Sterling Cabs) to the Hawthorn Suites, my home away from home. I had arrived on Thursday night and brought supplies for the week - broth, soups, a case of bottled water, fruit juices, puddings, yogurt, cottage cheese, 1% milk to mix with the protein shakes (three per day for the next few months), jello, lots of jello and plenty of Gatorade. (I know, it tastes like nothing but you need the electrolytes, so get used to it. Note: I add some disolvable Vitamin C tablets as well; it does make it taste better).
* Now, as a Travel Writer, I have been hosted at some of the finest and more expensive hotels and villas throughout the world. But I can assure you, they can’t match the Hawthorn Suites. For those “staying local”, you need to feel comfortable and secure – your suite has all the comforts of home and this property has the staff that will make you feel secure.
This is the first time I have had to truly depend on the staff at any establishment. The Hawthorn personnel seem to be a revolving group of young employees (most work at other nearby properties under the Wyndham flag as well) but they were all well-versed on who I was and that I was recuperating at the hotel.
They all greeted me by name; everyone was cheerful, helpful and most attentive. For instance, Sales Manager Victoria drove me to the hospital on the day or my operation and Manager Tanya personally went on a ‘soup run’ for me when the chicken noodle was running dangerously low.
I received a phone call every morning about 11 am just to check on how I was feeling and asking if they could do anything for me. George, Lina, Ryan, Paul, Kevin, Mary, etc. were just terrific.
This was the best service I have ever received at any establishment and this 'group' truly made me feel safe and secure when I was at a very low energy level and needed assistance.
WEEK ONE - What to Expect
When I returned from the hospital to my suite I proceeded to sleep that afternoon – and actually most of the coming week. Had I been feeling better, this situation would have been almost decadent – lounging around a hotel room all week with nothing to do. But I didn't have enough energy to feel decadent. You really have no energy this first week – as I say, I slept at night but never straight through. I always got up for a few hours, watched some bad late night TV, napped for hours during the day, watched some summer re-run TV ( “The Food Network” * if you can believe it) and fortunately discovered a “Burn Notice” marathon (great little show) on the USA network.
* I forced myself to go out for walks, sit in the spacious Hawthorn lobby, and even tried to read beside the hotel’s pool area. (I found it difficult to read, as if I had no attention span). Suggestion: stock up or bring lots of DVDs
NOTE: * Speaking of The Food Network, check out their show "Dives, Diners and Drive-ins". I've always said that they really kill you with food in the United States - massive portions. Not that I have ever minded that - bring it on, I say. (Or said). Look at the size of the platter they serve one person - it could feed a family of four! And still take some home for 'the dog'. Huge portions, way out of control. Watch this show and you will understand why an Obesity Epidemic has been declared in the United States. The food always looks terrific, mind you - but about one-quarter of the platter should be sufficient for most human beings. And now, much less for me.

The well lived-in suite/home away from home

Note: I never slept through the night – even having taken a sleeping pill. Your body seems to naturally wake up when it needs you to move. Don’t fight it – don’t lie there, frustrated, or toss and turn (actually you will be turning very gently and definitely not tossing).
Get up! walk around, move, sit in the living room and watch late-night TV. You will likely be experiencing the “Burp, Belch and Fart” syndrome (sounds like a law firm, doesn’t it?). Your body needs you to move so it can expel the gas induced during surgery. Also your new system is just starting to function and seems to need the movement to establish itself. You won’t be missing any sleep because of your numerous naps during the day.
Note: If you are doing something – watching TV, reading, whatever – and you start to feel tired, don’t fight it. Just walk to the bed and crash. Your levels are so low that your body needs all the rest it can get to help restore your energy. And keep drinking that Gatorade.
For the first week your day will consist of getting up (eventually), sipping some water, eating some runny porridge, watching a little TV, having a three hour nap, get up, have some Gatorade, watch more TV, make a protein shake, (force yourself to) go out for a walk (take your time when walking – there is no rush – even though you might feel as if you are 89 years old), get back in time for another nap….and so on.
But remember, when you awaken during the night, enjoy the freedom – get up, walk around, burp and pass that gas, then watch some TV until you are sleepy. You don’t have to follow your typical 9 – 5 regimen.
* Take your Vitamins! Chew, chew and chew some more
* Drink your Protein Shakes. Three a day. Actually, SIP them. You won't be gulping anymore.
* You will have medications prescribed for the first week. Just follow the instructions. The blood thinner Lovenox may cause you pause - this is a self-injected shot (a syringe) that you give yourself in the stomach. The nurses will show you the procedure in the hospital and help you with your first shot. Surprise! It is totally painless. Just take a pinch of skin, inject the needle and slowly push the plunger. Absolutely no pain (really!) so don't worry about it.
* On Tuesday I removed the wires feeding the pain medication under my skin. The one bag you carry around pumps pain medication into you and eventually wears out - it looks like an apple core. You then (gently) remove the cellophane-looking bandages from your stomach and chest. The wires are coiled many times. You then (again, gently) pull the 'wires' from underneath your skin; they have been inserted about three inches under your upper chest area. I know, it sounds gross and painful - but it isn't. Well, OK, it is gross. But not painful in the least. It is just weird.
* Also, prepare yourself because your stomach and chest will be a lovely shade of purple. Don't freak out. Trust me, it will fade - after turning various hues of yellow around the edges.
Your energy levels will ebb and flow throughout the week but mine started to return (slightly) to a more even level by about Day Five.
* You usually see the surgeon after about 10 days following surgery but since I was from out of town, Dr. Pesta saw me on Thursday, one week after my surgery. Again I had all my vitals taken by the nursing staff and then the doctor checked me out. And he proclaimed me in good shape – almost a ‘poster boy’ for the surgery – and released me to return home.
* So on Friday – one week to the day after surgery – I drove back to Toronto. Yes, I drove myself. It’s rather funny – I couldn’t walk around a block but I could drive 400 KM. (And it’s true, I was fine to drive. No problem.)
WEEK TWO and beyond: Post-Surgery
The most important thing to remember is that you will have very low energy for the next few weeks – I started to feel better after Week Three. Don’t plan or schedule too much activity; you will be tired. Make sure you get plenty of sleep and plan on taking afternoon naps.
Again, stock up your fridge with broths and pureed soups, yogurt, porridge, bran flakes, jello, Gatorade and the various other “allowed” foods in your manual. Make sure you have your Protein Shakes - three per day. (Note: These shakes actually taste good and remember, you can also put them in the blender and add fruit - I use bananas, strawberries, sometimes mangos.)
* Sip water constantly. Sip. Gulping is now a thing of the past.
* This is IMPORTANT: Learn to chew slowly and thoroughly – masticate and masticate some more. Concentrate on completely shredding any solids in your mouth before it heads down your esophagus. Chew! Think of chewing as a Zen-like exercise. Concentrate on your food and chewing it down to nothing. You want it to be pureed as it heads down your gullet.

These are some of the products you will be using following surgery. A good Protein drink supplement (three per day), chewable Multi-Vitamins, Calcium Citrate (again, chewable) and some Nexium which you sprinkle on your morning cereal for the first month.
* Eventually you will find that something just doesn’t sit right – this happens to everyone who has had this surgery. Suddenly you will feel a lump just sitting in your chest. Hmmm, this is not something that can be cleared with a burp. So go the washroom and throw it up – clear out your system.
What a surprise! No gassy burning. No bile! You have just discovered what it is like to puke without being connected to your stomach. There is no longer any unpleasant or lingering aftertaste. It is quite a shock the first time. So when that lump appears again (it will as you start to experiment with various food) it is just a simple matter of clearing your system. No fuss, no muss.
NOTE: You will soon discover that one of the benefits of your surgery is that you no longer have any acid reflux. You won't burp and feel the burning of bile in your throat for the next half hour. Or eat rich foods that 'come back' on you. That is gone forever - you are no longer connected to your stomach so no acid can back up on you. It's great.
(NOTE: Bodily functions. Speaking of changes and adjusting, expect some changes in your bodily functions, such as "passing gas" and "bowel movements". You suddenly may think you are about to pass gas (expect to pass A LOT of it - stay in the fresh air! Keep your windows open!) but it turns out to be, well, something else. Yes, like a surprise bowel movement. Don't trust the 'gas' feeling. Head to the washroom just to make sure; after all, your body need to adjust to your new plumbing.)
* Remember I mentioned the puddings that I stocked up on? I have never touched them. Dr. Marshall told me after the operation that I will have now lost my cravings for sweets. It's true. The puddings seem too rich, too thick or something. Anyhow, I will have to give them away to my neighbours.
*** I am a coffee lover. My daily ritual is to put on a pot after getting out of bed. You are told before surgery to cut down on the caffeine and switch to de-caf. I did that. I found a great brand of De-caf beans ("Kicking Horse") and mixed half regular/half de-caf. Then I switched entirely to de-caf about two weeks before the operation. I love my coffee. However, as I write this, it has been five weeks since my surgery and I have not had any coffee. I haven't craved it, or even thought about it. I'm sure I will have a cup (de-caf, of course) sometime but I no longer think about it. And it is no problem. I don't feel that I am missing anything. I simply do not think about it anymore. To once again use that very technical medical phrase: That is weird.
When you are on a diet, there are things you cannot have anymore. Yet you still want them, crave them. You start to feel like a martyr - "I want this so much but no, no, I'll resist the temptation". After surgery, there is no temptation because your cravings have been curbed.
You are told that things will change - and they do. It's as if your body is trying to help you heal by ignoring your former cravings and weaknesses. Basically, it's weird.
*** WALK. Start to walk. You will not be able to do much exercise - remember, you can't lift anything over five pounds - but you can walk. If you aren't used to it, just give it five minutes a day to start. Walk around your block. Then after a week pick it up to 10 minutes, two blocks. Gradually increase your time and distance. Make a game of it - buy a little Pedometer at a sports store or drugstore. This way you can record the distance you walk every day. It will surprise you but eventually you will be up to one mile a day. Walk! Your body needs it; not only for the exercise to speed up your weight loss but to shake up those internal gases and get everything moving again.
Hand weights. Get some light (five pounds or under) free weights that you can use while sitting and watching TV. You will find your arms may appear 'flabby' from the sudden weight loss. Just as you are walking to keep the muscle tone in your legs and stomach, use the free weights for your arms. However, remain seating when you use the weights so you are not putting too much stress on your stomach muscles - concentrate on your arms. Remember you should not be lifting anything too heavy - think 'repetition' and not weight.
'Things' they don't tell you in the Information binder
You've all heard the expression that someone "thinks their sh*t don't stink". Well, that may be true for some people, but not after this operation. Your sh*t does indeed stink. Same as your urine and the gas you frequently pass. (Keep those windows open). The odour is now sharper, more pungent. And for those who check these things, your bowel movements have changed colour - more of a light, yellowish brown. Hey, don't look at me like that - I am simply reporting and passing along the information. Just be prepared for some changes, that's all.
I drove back to Warren, Mi. on Sunday June 28 and checked into the Hawthorn Suites - my home away from home. (How friendly are they? There was someone I hadn't yet met on the desk and he immediately knew who I was; asked about my health, how I was doing etc.). And my suite was like a second home. Very comfortable.
The next morning - one month to the day of my operation - I had my 10:20 am appointment with the excellent Dr. Pesta. All my vitals were checked, weight, etc and my blood pressure was an amazing 100/83 (my pressure is usually pretty good at 135/80 but this was a marked change. For the better, I might add). The doctor and I talked, he checked on my progress and took notes on everything I had been doing. Apparently I am ahead of the curve for both weight loss and recovery. So, off I go until my next checkup on August 10th.
(Note: Dr. Pesta also has a very efficient and friendly staff - they even called several days before to remind me of the appointment. Also, they are extremely helpful when you phone for assistance. Ask for Shelley.)
Just a few days later I received a package from Sally Green. It was a followup congratulations on having the surgery with a list of annual support seminars to be held at the hospital. There was also a photo album included to measure your ongoing weight-loss results. But the best item was an enclosed card, an official certificate from the Henry Ford Macomb, stating that " This person had bariatric surgery and is required by doctor's orders to restrict the quantity and type of food consumed. Please allow him/her to order a smaller portion or to make a selection from the children's menu. Thank you for your cooperation."
Man, (Woman - not to be sexist) I am just dying to use this card!
Don't think you have to avoid going out for dinner with friends. You'll discover it is not a problem; there is always something on the menu you will be able to eat. After about six months, of course, you will be able to eat just about anything you ate before. I’ve joined friends for restaurant meals, order soup ($4.95) and take half of it home with me for lunch the next day. The same with a grilled vegetable appetizer ($8.95) – if I eat half of it, I am stuffed. I’ve become one of the cheapest dinner dates in town. As well, since I am eating and chewing slower, taking smaller portions, I finish about the same time as my friends who ordered appetizers and an entree. (Everyone seems to skip dessert). Make sure you request your 'doggie bag' for your leftovers - I am actually thinking about bringing my own.
TIPS - for food and drink
* Protein shakes. They taste fairly good with just the powder mix and milk but feel free to experiment with them. Use your blender, of course. Add a banana or two. Through in an egg or two. This helps create a rich, thick drink that is both tasty and very filling. Get it good and thick so you can almost chew it. Make sure you sip it slowly, take your time. (Remember, no straws!)
Sprinkle cinnamon on top. An eight ounce glass of this can be a real meal and you will feel surprisingly full after.
* Since you cannot drink sodas or any carbonated beverages (soda water was always my drink of choice) you need to find substitutes. Make a jug of (decaf) Ice Tea and keep it in your fridge at all times. Also, cold water with lots of ice cubes. For something a little different, squeeze in some fresh lemon juice, either an actual lemon or Real Lemon juice from the bottle. This will help in quenching your thirst.
* The advance information warns you about eating in front of the TV. Especially if it is on. (nyuk, nyuk). It seems strange but you are actually learning how to eat all over again - chewing slowly and thoughtfully. If you are distracted by the TV, you tend to just shovel the food in and not think about it. And you won't - until suddenly there is a lump in your esophagus sitting just above your new pouch which will have you heading to the washroom. So if you do eat in front of the TV (I confess that I do), only take a few mouthfuls at a time and then set your plate aside for a few minutes. Just push it away. Then take a few more bites, small bites and chew A LOT. Don't worry about eating your food while it is hot - it should taste just as good cold. (For example, I prefer beans right out of the tin - well, OK, you can put them in a bowl - but they taste even better cold than hot. Try it, you'll see). If you are used to wolfing down a meal in front of the tube, learn to slow down. Use your fork three times and then push the plate aside for two minutes. You are learning new habits. After all, you have the challenge of learning to undo many years of improper eating patterns - and this takes time.
* PURGING - and you will. Quite suddenly you will feel this lump in your chest - and this cannot be cured with a simple burp. (Expect to burp quite a lot however). Head to the washroom and it will automatically come up once you get to the toilet bowl. You won't have to use your finger (i.e. bulimics) it will just come up quite naturally. But as i have mentioned, without the bile it is more like clearing your throat than, well, puking. Be warned however - sometimes this is so sudden you don't have time to move. I have had to use a nearby wastebasket and once a newspaper that was conveniently located beside me on the couch. Eat slowly. Chew. Chew. Chew some more. I cannot stress enough that everything has to be pureed before it leaves your throat on the journey to your pouch. Did I say - chew?

So, how'm I doing?
* After five weeks, I am down 38 pounds.
* I have lost almost five inches (5"!!!) off my waist and have moved to a smaller pant size.
* My face has obviously lost weight (friends tell me that I look younger).
* Taking that much weight off has helped my 'new' knee immeasurably - I can now walk without pain. In fact, I once again look forward to just getting out and walking.
* I sleep better, deeper - sometimes my body wants me to get up for awhile, move around. Other times I will sleep through the night.
* Although still recuperating (your body has been through the trauma of surgery) when I get a block of energy, I feel better than I felt prior to surgery at 294 pounds. However, remember you still aren't back to full levels and there is a daily ebb and flow of energy. When you are tired, rest, sleep. Don't fight it, go with it. And when you have the energy, don't go crazy - like weeding the garden or carrying out the trash bins. Use that time to go for walks, read, work on your computer.

Steve Veale/ April 2009
Steve Veale/ July 5, 2009

The author Steve Veale five weeks after Bypass surgery.
Down 38 pounds; lost five (5") inches off his waistline.
New jeans, already too big.
*Taken at Toronto's Distillery District
(Photo by Richard Greene)

The Tale of the Tape

Pre-Surgery / Six weeks later
Weight 294 Lbs / 252 Lbs - down 42 Lbs
* BMI 42.2 / 36.2 - down 6 points
* Neck 19 1/2" / 18 1/2" - down 1"
* Chest 49 1/2" / 47 1/2" - down 2"
* Waist 52 1/2" / 47" - down 5 1/2"
* Hips 49 1/2" / 43" - down 6 1/2 "
* Thigh 29" / 25" - down 4 "
I lost 42 pounds in the first six weeks. That is an average of one pound per day. I also whittled five-and-a-half inches off my waistline. The smaller sized pants I bought (just a touch snug) were starting to look baggy by the time I had them sized for length. That is not, I repeat, not a complaint by the way. Just an observation. NOTE: Stock up on clothes at your local thrift shop; you won't be wearing them for long. My email friend Debbie told me this - don't buy good clothes that you really "love" until you have lost the majority of your weight. This varies for everyone, of course, and your doctor and the hospital will give you a good idea of your ideal goal weight.
* I find I have much, much more energy than before. I can honestly say that I haven't had this much energy in years. I get out and walk; In fact I now look forward to walking since it no longer causes pain to my knee. It is easier just to move, walk upstairs and even bend down to pick up the papers on the floor of my messy domicile. I sleep better, deeper I think - the hospital told me that my Sleep Apnea will likely disappear within six months of surgery.
My weight today was 246 pounds. The weight loss, formerly a pound a day, is slowly coming down to a more reasonable and steady rate, about three pounds per week. The hospital cautions that you can expect to lose the poundage quickly at first and then it will level off; you will continue to lose slowly but surely as you reach your ideal weight.
Also, you are starting to eat more 'normally now (although your 'normal' has just changed forever) by adding more foods to your daily diet; broths have morphed into chunky soups and lean meats have replaced your cream of wheat.
As mentioned, the good doctor Keith Marshall told me after surgery that I would no longer crave sweets. All true. Those puddings I put in my fridge prior to surgery are all still there, untouched. They just seem to sweet, too thick. And who doesn't like pudding?
The same with coffee - I love my coffee. It's a daily routine. Or it was. I haven't had any, I don't miss it, I don't even think about it.
I don't salivate when I am out for a meal - picking at a small appetizer plate of fruit and veggies - while my friends are digging into a plateful of rare roast beef or bbq ribs or "the best pizza in town". The cravings are just not there anymore.
I don't know why this is so - I just know it works. (I don't believe the medical community has pinpointed the reason for this as yet). Possibly since you are no longer connected to your stomach, the mind doesn't receive those signals saying: "Feed Me! Feed Me!" Or perhaps the mind is helping the body repair itself and refusing to transmit those signals.
All I know is that these cravings disappear overnight. Or if they are not entirely gone, they have been reduced to a level where you can control them. It is such a relief - and quite a strange feeling - when the first bite of a favorite food doesn't trigger something in your brain that screams: "More! More!"
NOTE: My Cyberspace friend Debbie once told me she used to eat an entire bag of chocolates at her desk every day. Now she can nibble on half-a-chocolate per day. That is half of one chocolate! She has had the taste and she feels just fine with that.
It is difficult to imagine feeling full with this reduced amount - especially to anyone who has ever been on a diet. On a balanced diet, (i.e. Weight Watchers) you may be allowed 3 oz of meat (protein), a cup of veggies and perhaps a half a baked potato with no butter. That is your allotted meal. But let's face it - you are still hungry! Sometimes ravenously so. Eventually (unless you have superhuman willpower) you will break down and binge - ordering a tonne of Chinese food or a pile of pizzas at midnight.
* After surgery however, you will have your three ounces of meat, cup of veggies and half a baked potato (with butter!) and be completely stuffed. Totally satiated. That will be it. Well, perhaps like Debbie, you can still fit in half-a-chocolate for dessert.
Some surprising changes
Speaking with various people who have had the surgery, they are all surprised that their cravings for sweets and heavy, fried or fatty foods have been replaced with mental visions of fresh fruit and crisp green salads. As I enter Week Nine, I too find myself drawn to fruits and veggies as opposed to burgers and wings. Your taste buds are the same but your 'tastes' are changing. Again, I do not know if this is a psychological response or a physical reaction - perhaps a combination of both - but your former cravings are either gone or manageable while your food choices tend toward lighter dishes and lots of fruit and veggies. (I had lunch with a friend the other day - he ordered a toasted bagel with salmon and cream cheese. It looked good but I was drawn to the watermelon. Watermelon! How things have changed.....)
Oh, I still can see myself eating a burger (although not for a few months yet) but I have no desire to rush out and get one. Let me repeat: I do not feel that I am missing out on anything.
Did I mention - It's weird. All these changes are very sudden: literally overnight.
Problem Foods / "Trial & Error"
In the extensive binder (a.k.a. "Lifestyle Guide") from Henry Ford Macomb, you are warned about certain foods you will have to 'work up to' before you can eat them again. Specifically Pizza and Chinese food. How do you know when you are ready? You don't. As they tell you, it is all 'Trial and Error' at this point.
So I tried some Chinese food - Cantonese Chow Mein, Veggies & Almonds, Chicken Fried Rice. Not too bad, right? Nothing deep fried. I tried a few chopsticks of the first dish. Hmmmm, no. A visit to the bathroom to 'clear my throat'. Second dish - the same thing. And a further repeat for dish number three. Then a couple of more times just to clear my system. So I threw up about five or six times. (But remember - without the stomach bile and acids, it is just like clearing your throat.) I had a few sips of water, set my food aside and waited for 10 minutes. Then I concentrated solely on one dish, eating it slowly, making sure all the food was in a pureed state before it headed down my esophagus toward my pouch. That was fine. I could handle it. And the Cantonese Chow Mein tasted just as good as ever - except all I needed was about one-fifth of the dish and I was full. Completely satiated and happy to pack up the leftovers. (Note: I have never had so many plastic containers of left-over food packed into my fridge. Wow. I actually need to buy more of them.)
I did the same thing the next night with some fresh Swordfish (again, the lighter fish and seafood is suddenly more appealing than the heavy meats), one small boiled potato and half-cup of veggies. I threw it up. So, I had a few sips of water, let my meal sit for 10 minutes, then once again tackled the Swordfish only. (Take small bites, eats slowly and masticate. Then continue to masticate.) That was fine. It went down well and stayed there. The potato and veggies ended up in a left-over container.
Again, I am not sure if I perhaps ate too quickly, didn't chew well enough or maybe it was the combinations of the food groups. But if you slow down and just stick with one item, you should be fine.
After all, you have lived with your original system for XX years. You've only had your new one for a few months so give your body time to heal and adjust.
239 Pounds. This from my Weekly Friday morning Weigh-in. On May 1st, I weighed 294 Pounds. I lost about seven pounds while on my pre-surgery diet, so I have lost a total of 55 Pounds in Ten Weeks. That is 55 pounds that I am not carrying around with me anymore; 55 pounds that is no longer dragging me down.
Speaking of being "dragged down", I am finding that the more weight I lose, the lighter I feel. Well, of course, you say. But it isn't just the physical feeling of lightness, it is a lighter feeling both mentally and emotionally. I have always known that I am a 'depression' eater - the more depressed I get, worried, anxious, etc. the more I eat. Others do the opposite. But me - I bog myself down with food. Losing weight rapidly as I have been doing seems to have lightened my mood as well as my frame. It's that old familiar phrase: "Healthy Body, Healthy Mind".
Checkin/Checkup - Monday August 10/09
This was supposed to be my 10-week checkup with Dr Pesta back in Warren, Michigan but I had to cancel at the last minute. My family doctor (Dr Ron Porter) suggested he could do the checkup here and then I could send the results to Dr. Pesta.
I saw Doctor Porter Monday afternoon and we talked about my progress, various changes (I told him that I am still amazed that I don't crave burgers and wings but instead always have a bowl of fruit salad in my fridge. Mmmmmm, watermelons, apples, pineapple, orange melon.....) and he then gave me a quick physical. (My annual physical takes about two days with all the blood tests, x-rays, etc).
My blood pressure is 120 over 73 with a pulse rate of 60. ("That's the reading of a healthy teenager," said the doctor.) Lungs and chest were healthy, no swelling of the ankles (keep an eye on that after surgery), all bodily functions working normally.
I then went downstairs to the Lab for blood work - results to come.
WEEK 11 - Plateau!
Friday morning weigh-in. Check the scales. 239 Pounds. Re-check. 239 Pounds. Try again - 239 Pounds. Oh no! I haven't lost any weight this week! But I haven't eaten any differently! Nothing changed! Horrors!
Relax. I just reached my first "plateau". Anyone who has ever been on a diet knows that you lose weight steadily at first and then suddenly you plateau for awhile. You could eat nothing for a week, drink only water, and you still would not lose any weight. Your body is simply adjusting to the sudden changes; it has to re-align itself, to coordinate everything with this rather rapid loss of poundage. After steadily losing weight, it is a shock to see no weekly downward movement in the scale. You panic - "but I've stayed on my diet. I never cheated"! Your body simply needs to level out, to find a new "balance". It may take a week, it may take three, but once your system has self-adjusted, your weight loss will continue.
So I plan to keep walking and have started daily bike riding as well. I am introducing new foods into my diet; I bought some shrimp (seafood and fish are lighter than meats and both good sources of protein) which I steamed and ate slowly, oh so slowly, with my own special seafood sauce. Also I plan to try some thinly-sliced calf liver to add some meat protein. However, I will (alas) pass on the fried onions for now.
Note: The liver was good. Don't overcook it, leave it pink inside. Cut off small bites and keep chewing until it is pureed. It is a great source of protein.
Chicken also goes down well - but stick to the white meat. The dark meat is heavier and richer; it may not go down so well. It didn't for me and caused another trip to the washroom to 'clear my throat'.
Remember, Trial and Error. Try anything but eat it slowly and thoughtfully. If it isn't working for you, there will suddenly be that 'heavy' feeling in your chest. (Also, you may break out in a light sweat.) Think of this as the food sitting on top of your pouch, unable to sift itself through because the entrance is clogged up - because that is exactly what it is. Just a quick trip to the washroom, get rid of it, take a break, and then start again - slower and chew more.
Three months. My weekly weigh-in checked out at 236 - approximately a 58 pound loss in 12 weeks. This time it took two weeks to lose three pounds. That is actually good, slow and steady from now on. As well, I am adding 'heavier' foods to my diet all the time, more solids (i.e. chicken, fish, seafood, etc) instead of just yogurt and porridge. I have become a maniac for fruit though - especially water-based fruit such as melons, canteloupes, watermelons, and so on. (I am also constantly drinking - more like sipping - liquids all the time; water, ice tea, clear juices.)
Last night at Don & Mado's I tried pasta for the first time - one of Mado's excellent dishes mixing pasta, tomatoes, garlic and cheeses. I just had about a quarter of a bowl (instead of an overflowing one), ate slowly, chewed well and along with a few forkfuls of spinach and melon for dessert, I was satiated. Now I know I am good-to-go with pasta dishes.
Public Image / Self Image
People who I haven't seen for a few weeks, especially months, are astonished at the change in my appearance. "You've lost so much weight"! quickly followed by: "I can see it in your face - it's amazing, you look 10 years younger." (I actually get that a lot. Which is nice, I freely admit.)
Those looking at me see the changes.
I do not.
Oh, of course I know that I have lost weight. No question about that; my clothes are hanging off me and even the smaller sizes that I have stepped into are too big. But i really don't/can't see it. When I look in the mirror I still 'see' the same person who has looked back at me for so long.
My self-image has always been that of a 'big guy' (As mentioned earlier, I am known by one and all as "Big Mon" when I am in the Carib). I have always been big and heavy with legs that size that a professional football player would envy. Or my "Brontosaurus legs" as my friend Don would say.
One time when I started weight training, the instructor asked "It's tough getting back into it, isn't it?" I replied "No, it's tough starting". His astonished retort was "You mean you just look like that"? Man if I started like you I'd be world champion by now."
Big. I'm big. I've always been big.
But now that is changing and my 'image of self' also has to change. This is where the pre-surgical psychological assessment comes in: Can you handle the change?
That may seem ridiculous. After all I am/you are losing weight, becoming healthier, getting stronger and feeling better. Right? What's not to like? So why hasn't my mind - my inner eye - allowed me to see those changes?
I've been told this is very common phenomenon among people who change their appearance in some manner. It takes a long time to mentally adjust to your new existence from your long perceived self-image.
Because after all these years, if I am no longer "Big Mon" - Who Am I?
(NOTE to Self)
No more Chinese Food until I reach the six month mark. I tried some last night; chicken, shrimp and sauteed veggies. It did not stay down. In fact I had to make a number of visits to the washroom to repeatedly 'clear my throat'. It was not pretty. The literature does suggest you avoid Chinese Food and Pizza for at least six months. (Rice is especially bad for your new pouch). The literature is indeed correct. Back to my fruit salad and watermelon.
The scale sat at about 233 Pounds. I always try it three times just to make sure it is accurate. I lost another three pounds this week which bring my total to 61 Pounds.
Three pounds two weeks in a row, plus a plateau week. That is good. It means my body is slowly adjusting to this new regime and allowing me to lose weight at a much more measured pace. My waist is now down to 45 inches from an all-time high of 52 1/2.
(* Oh yes, and Cyberspace Debbie just broke the 100 Pound mark as she celebrated her one year anniversary. Surgical anniversary that is. Congratulations!)
Only a loss of one pound this week. And I could tell the scale wasn't going to budge that much; this time I could feel there wouldn't be much weight loss. No problem. It is still going down - that's the correct direction - and at this stage, slow is good. Gives my body time to adjust to my new weight and lifestyle. But check out the following photo - compare it to the one at the beginning. Same jeans, different body.

This photo was taken Sunday, September 06/09 at Toronto's Distillery District. The jeans I am holding are the ones I was wearing in the first photo of this journal. I am down at least 60 pounds and slightly more than seven inches off my waistline. And again, it is time for smaller size pants - or suspenders. (Photo by: George Shewchuk)


Another two LBS down at today's Weigh-in which puts me about 230 LBS.
TIP: A great 'snack' is Cheerios. Yup, good old-fashioned breakfast food Cheerios. Just pour in a bowl and eat them dry - no milk or sugar. The beauty of Cheerios is that after a few crunches they disappear in your mouth - just seem to melt. Therefore there seems to be almost nothing that heads down your windpipe. Plus they are healthy and good for you. Try the 'Honey & Nut' version for just a hint of sweetness.
Another two LBS as well at this week's Weigh-in. Slow but sure.
People always ask if I am hungry and/or tired. No to both. I have much more energy with every pound I shed. As for hungry, I can honestly say that I have never felt hungry. It's weird (have I used that expression before?) But for the first time in my Life, I am not hungry. In fact sometimes I realize that I haven't even had my minimum for the day (That is not good!) I always try to get three Protein shakes in during the day - add an egg to the milk in the blender, a couple of bananas or some other fruit, perhaps some vanilla yogurt, some flax and you have a very healthy and surprisingly filling meal. Drink it slowly, sipping occasionally, and you will feel very full by the time you are finished the glass. (Note: I always keep several mugs in the freezer so my drink will be nice and cold).
We have always heard that it takes 10 to 15 minutes for the brain to catch up with the stomach. So even when you are stuffed, you still feel hungry because your brain hasn't told you to stop. When you eat and drink slowly that gives the brain the proper time to coordinate with your stomach - or now your new pouch. You will suddenly feel full from one bite to another. That is when you stop eating and put your leftover food in one of the many new seal-tight plastic containers you now own.
Whoa! I've gone in reverse this week. According to my scales, I am actually UP a pound! 229 LBS
What????? Not to panic. Again, this happens - as anyone who has ever been on a diet knows. It's as if 'the fat' seems to know that you are trying to kill it - and it is determined to hang on. It just wants to cling to those bones. It is fighting back.
Plus I was fairly lazy this week and didn't get out walking every day.
This week I knew I had lost weight even before I stepped on the scale. My body felt like I had dropped a lot of weight. My clothes suddenly seemed baggy (and this is my smaller size) and I had to cinch my belt up tighter during the week. Actually I've been putting more holes in the belt because know even my belt is too small! Prior to my surgery, I was putting extra holes in my belt but in the opposite direction - I was letting it out.
So my Weigh-in was 224 LBS for a total loss of 70 LBS.
Seventy Pounds have disappeared since my surgery on May 29th.
How much is 70 Pounds? Go to the gym, put 70 pounds of weight on a bar, then lift it up. Hold it out straight in front of you. See how long you can hold it - if you can. And I've been lugging all that unnecessary weight around with me for years.......
** WEEK 26
Six Months since Surgery
"This was the best thing I could ever have done for myself" quote the author.
Weight: 214 Pounds (Formerly: 294 LBS. A loss of 80 pounds in Six Months)
Waist: 41 inches (Formerly: 52 1/2 inches. A loss of 11 1/2 inches in Six Months)
I haven't done much writing on this journal because there really haven't been any new discoveries to report. As a journalist, I give the story what it is worth - no padding. If there is nothing new to report, then don't bother.
But the changes have continued. I am now starting to look for my third set of smaller clothes since these ones are falling off me; I've been making new holes on my belt. I've done this before, of course, but now I am making them on the inside of the belt and not toward the tip.
I still do not feel hungry. I will suddenly realize it is 2:30 pm and I haven't eaten anything since my morning Gatorade and Protein shake. So perhaps I'll munch on a protein bar or make a sandwich - and still not finish it all.
Dinner used to be a major event of the day - a steak, perhaps a roasted chicken, roast beef or roast of pork on the weekends. Now, I heat up a bowl of soup (usually Campbell's Chunky something or other - I love the three bean Pork.) I will likely have half the tin and perhaps some cheese (extra old Cheddar) and crackers, Saltines or Triscuits. (Note: Check out Triscuits these days - they have many interesting flavours).
Although I don't get cravings anymore, I still may 'feel' like eating a certain type of food - Yah, I could eat a hamburger now, or Maybe some Thai food today. Just like normal. Except that when I order the meal, I find that I am satisfied after three or four mouthfuls. I've had the taste and that is enough to satisfy my desire. So I end up taking home my doggie bags.
The same with Take Out or Delivery - I will order a "2-4-1" Pizza on a Friday evening. For those who don't know, you actually do get two pizzas. Pre-surgery, I would sit in front of the TV and eat one entire pizza - and perhaps a couple of slices of the second. Now it is a major feat (and not recommended) if I eat two slices. This really is fine because I have food in the fridge for the entire weekend - just pop a slice in the microwave anytime I do feel a little peckish. Keep in mind that you better really like whatever you order because you will be eating it for several days to come.
* Also for the past month or so, I have been involved in moving and renovating. I found a new apartment but it required tremendous work and I only had a few weeks to get it cleaned up - just made it in time thanks to the help of Norman and Rodney. But during that time my routine was thrown off and I actually started drinking coffee again - regular at first and then I switched to decaf - and eating muffins and doughnuts in the morning and Subway sandwiches for lunch (which are actually pretty healthy) while I was working on the house. I was tired and exhausted and not really thinking about my food intake.
However now that I am (sort of) settled in, I am sitting here, writing this with my Gatorade at hand and my Protein shakes in the fridge, just ready for lunchtime.
Note: I have been steadily losing weight but at a much slowly and safer rate. During these renovations when I was active every day (the physical work, while exhausting, was actually good to get me moving) I didn't lose that much weight but I found that I 're-distributed' it. My waist actually became a distinct waist, my legs became more muscular as did my arms. People have commented that I have suddenly lost weight just because my shape has changed with my body taking on different proportions.
More changes: I have grown back my beard for the winter (it is now an annual event) and more people have commented that it looks good. It is the same beard as always but I think people are noticing because my face has changed shape; it is not more long and lean and opposed to Santa Claus chubby and the beard now highlights my face instead of making me look 'puffed out'.
* I also discovered there is a gym only three blocks from my new place and they are having a special introductory offering; sign up for a year @ $59 per month and get the first three months for a total of $39. Plus all the classes - yoga, pilates, spinning - are included. I think I should join. Being active during this renovation has made me realize that it is now time to help maintain and assist my weight loss with some formal exercise.
(Six months plus two weeks)
All that hard labour during the recent renos - moving, twisting, turning, lifting, etc - paid off.
Weight 210 LBS (down from: 294)
BMI: 29.7 (down from: 42.4)
Measurements (Today and pre-op)
Neck 17" (19 1/2")
Chest 44" (49 1/2")
Waist 41" (52 1/2")
Hips 41" (49 1/2")
Thigh 23 1/2" (29")
I cannot remember the last time I weighed 210 pounds - at least 20 years. The difference in how I feel physically is amazing. I get up and move faster, (actually, I get up and move!) walk faster, no longer get winded walking up stairs or even tying my shoe. But for me the major change is that I am no longer craving food. I still like the taste of food, of course, but as I have mentioned, just a little is fine. I got the taste of it and I was satisfied with that.
I never thought I would ever see 210 pounds again. I really do feel like a different person. Which makes sense because, having lost 84 pounds, I have almost lost a person. Yikes! Where did they go?
Friday January 1, 2010
Weight 210 Pounds
A New Year and a new weight to greet 2010.
In the past three weeks I have stabilized and maintained this weight. That is great. I expect that I may lose more weight in the next month or so but 210 is actually a good weight for me.
My sister was in town last week, organizing my apartment, and decided that I needed some personal organization so she took me to Value Village (the weight loser's best friend) and pick out some 'new' clothes for me; jeans, dress pants and two shirts. The jeans were size 38. Thirty eight. (Priot to surgery, my pants were a very tight size 46 and should have been 48 but I refused to buy that larger size so I sucked in my breath and put up with the 'too tight' feeling). I haven't been able to squeeze into that size for approx 25 years. They fit perfectly. I realized after wearing them for a few days that these are likely the first pair of pant that have actually fit me in years. Really. For the waist size to fit, the rest of the pants have to be baggy. (the crotch hangs down to my knees like some wannabe rapper. OK, that is a bit of an exaggeration but you get the picture.) But now size 38 fits me from the waist down and look good.
One reason I am pleased I maintained my weight is that I was home for five days at Christmas. Anyone who has ever been on a diet or weight loss program realizes that 'holidays at home' can be a dangerous dining time: Thanksgiving, Christmas, Easter etc are all triggers for 'pigging out' over the two or three days. These times are ingrained in us - this is the time when it is acceptable, indeed encouraged, to go back for third helpings. Also you must eat all the hors d'ouevres, snacks, double helpings of dessert and raid the fridge at midnight. It's tradition. Besides, you cannot resist my sister's Xmas Eve Tourtierre or Xmas Day Turkey, stuffing, mashed potatoes, gravy, apple and raison pies (a la mode, of course) etc etc. I was no exception and tried to stop before I did irreparable damage to my pouch.
Sine then I've gotten back to my protein shakes, Campbell Chunky soups and Gatorade. The fact I stayed steady at 210 is terrific.
Food Hints: Chocolate and Liqourice. These two items are very important and you should have some handy at all times. Every now and then you will eat too much, too quickly or perhaps discover that a certain food is too heavy or fatty for you. You will start to feel heavy or queasy - this may last for 20 minutes or so (at least it does for me). When you start to feel this way, eat a chunk or two of a chocolate bar or a few bites of liqourice. The feeling will disappear. I have no idea how this works biologically but it does. I discovered this during one of these queasy sessions when I suddenly felt like having a little chocolate. It worked. And then I found that liqourice had the same effect. Again, weird, but effective. Just a little, mind you. No pigging out.
Friday, April 2, 2010
(Good Friday)
Weight: 210
Neck: 17"
Chest 44"
Waist 40 1/4 "
Hips 40 1/2 "
Thigh 23 1/4 "
Obviously I have not written much for the past few months. As a journalist, I was always taught to "give the story what it is worth". so if there is nothing to report, report nothing. Wait until there is some news or changes.
Everything has been basically 'status quo' for the past three months. My weight has remained at 210 - some weeks it will read 212, others 208 - but always returns to 210.
* In January, I did appear on the CBC morning radio show "As It Happens" with Andy Barrie. The report finally came out about Canada's obesity problem reaching epidemic proportions. One of the researchers, Jason Osler, 'found' this blog, called me, and asked me to be on the show. Actually he interviewed me for almost 45 minutes. Good interviewer! He knew what he was looking for, what he wanted; I felt like I was back on the psychiatrist's couch.
Anyhow I took the early morning streetcar to the CBC building and appeared at 6:45 AM for about 10 minutes talking about my lifelong problems gaining and losing weight. Andy Barrie interviewed both myself and Health Guru Hal Johnson of the "Body Break" TV commercials. Hal was on via telephone and we had a good discussion. I remember saying the word "diet" should be banned from our vocabulary and the dictionary. Hal agreed. It is a "lifestyle change".
The Gym:  Just this week I finally (finally!) joined the gym. I have been noticing in the mirror that I look flabby. I am so used to being more bulky and fleshed out that I actually think - at 210 pounds - that I look gaunt. (As if...). So I walked by "Fitness System" (in Toronto at Queen & Eastern Avenue) and they were having a special - sign up for a year, get the first two months free (well....they did have this one-time signing fee that pretty much took care of those two months) but then monthly fees of only $60 won't start until June. Plus all your classes - yoga, pilates, etc - are included in that fee. Big, clean three-storey building right on the corner.
As a bonus for me, they are only a few blocks away and I can actually see them from my corner. so I have no excuse not to go. Have been several times so far - even had a physical assessment - and have been re-learning the machines and equipment. Feels good to get some exercise; as a mesomorph body type, I have always realized that my body craves exercise.
Clothes:  Clothes have become more important, actually more fun. For the first time in years, clothes actually fit me and - dare I say? - actually look good on me. They don't billow out: pants fit: shirts go straight down my stomach and don't balloon over my belt. So I have been having fun going to Value Village and spending some time looking for great deals. I have gotten some great-looking shirts ($5.99 each); a good (expensive!) new sports coat for $12.99; some very cool vests at $6.99 each (I am so glad to see that vests are coming back. I knew it every since "The Mentalist" appeared on TV last year; As soon as I saw Patrick Jane, played by Simon Baker, wearing vests, I knew they were making a return. Indeed, this year the lawyers on "Law & Order" are wearing three-piece, pin-striped suits. Hooray. I have always loved vests) and I've gone crazy buying real bright and gaudy Hawaiian shirts ($5.99), some short sleeves and a few truly wild and wonderful long-sleeved ones.
As I say, clothes are suddenly fun again. So I am having fun with them.
Food: At this point I can pretty much eat anything - although there are still things that I choose not to. I still do not have cravings for the fries, and burgers and wings. I still order salad and fruit - because I really do want salad and fruit. Oh, I will have a burger every now and then - but I take off the top bun (bread really does stuff up your pouch too quickly) and then only eat half of it. Same with the fries - I cannot finish a regular serving. I have three or four forkfuls and that is it. I've had the taste of it and feel full. It is so liberating not to be in the grip of Food.
I can eat pasta - but not spaghetti. That too also stuffs up the pouch. If I chop it up first, then chew it dozens of times, it is fine. But aren't you supposed to slurp down spaghetti? It just seems wrong to cut it up with your knife and fork before you eat it.
Ice tea is number one - I can easily go through two or three Arizona ice teas every day.
Coffee: I confess - I have started to drink coffee again. Six weeks ago, a new coffee shop opened up on the corner of my street, Queen & Ashdale. It's about 100 yards from my house. Sean and Julie are the owner/operators of Voulez-vous and I have taken to starting my day in one of their wingback chairs, reading the paper and drinking a coffee. However Julie also introduced me to their "tea lattes" - various types of tea with the steamed milk. And I even tried soya! Which I quite like (surprise, surprise). So while I will have a coffee or cappucinno every now and then, the Tea Lattes made with soya are quite good and (I can tell) much better for my new plumbing. (The coffee will occasionally produce gas whereas the teas do not have the same reaction - so I am much safer in public if I stick with the tea.)
WEEK 52 - One Year anniversary
Friday May 28, 2010 
Weight: 210 pounds   (296 lbs.)
BMI: 29.5  (42.4)
Blood pressure 122/72
Heart rate: 60 per minute
* Neck 17 "  (19 1/2")
* Chest 44"  (49 1/2")
* Waist 41"   (52 1/2")
* Hips 40 1/2" (49 1/2")
* Thigh 23 1/2"  (29")