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Pre-Ops and Post-Ops may find some interesting information
here.
My
Personal Pledge To Success
Life
Long Battle With Weight
The Start Of My Journey To A Healthier Me
Dr. Barry L. Fisher's
Seminar
Intake
Packet - Tests - Insurance
My
First Office Consultation
Demons, YES They Are Real!
I Am
Approved For Surgery
Coping With Food Related Issues
Pre-Op: My surgery Date July 16th. 2001
Post-Op: In UMC After
Surgery
Journaling: Reflections Of The Morbidly Obese
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My
Personal Pledge To Success
I will
constantly work to achieve my
goals. I am intelligent and know I
will do whatever it takes to totally succeed in
my weight loss quest.
I will go to support groups, and
follow the suggestions that will lead to success.
I know this will take work, effort, dedication and
PRIORITY! I know following Dr. Fisher's nine rules
I will achieve optimal results. I will succeed!
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| Life Long
Battle With Weight
 | My childhood and bad habits have shaped my
adult eating habits.
I fought the weight battle with my mother (who is overweight, hell my whole family
is over weight) during my pre pubescent and on into my teen
years. One diet that sticks out in
my mind was the "Liquid Protein Diet". My mother had great short-term
success with this one. I was either to young for the diet or there were insufficient funds
for me. I can't imagine that at the age of 12 years old that I was wearing a size 40
in men's pants (I was wide as I was tall) and by 20 years old I was back into a 38 inch
pant waist. In my late teens my weight seemed to stabilize for four or five years
due to entering the work force and enjoying weekends. My size has always been very
large for my age. Twenty-one is where I peaked in height at six foot-three inches
and about 280 pounds. From that point forward I gained and lost hundreds of pounds
with every kind of DIET you could think of.
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At the age of 30 I looked up a weight
control Doctor
my mother used to see, but he had
retired. Another Doctor took over his practice so I went under his care. My weight was
around 345 pounds. I was very tired all of the time and my other half complained about my
snoring. I would also wake up gasping for air, sweating profusely and even choking
on my own stomach juices (that burned and was tough to cough up out of you lungs).
He ordered a sleep study and within a couple of weeks BAM....
I had my C-PAP machine. The Doctor
had prescribed to me
"Adipex-appetite suppressant". In the beginning few years I did great, I
was going to the gym while taking this medication and lost 75 pounds. Here
is a picture of my success. After a while the
drug lost its good effect and
I was experiencing weird side effects like tunnel vision, paranoia and
losing my short term memory. I felt better not taking the medication and I
was out of control. My appetite was ravenous. I was taking
Adipex for about five years when I gave up in this
medication. I kept my C-PAP machine even though I was not under any Doctors care until
2000. I had found an
internal medicine Doctor that I
felt comfortable with as my primary care physician; he was
also concerned about my
health (what a concept). I went to him because I was feeling tired, joint pain in my legs, shortness
of breath, and pounding of my heart. My weight had blossomed to 430 pounds. I
had to use the scale at work to weigh myself as I could not find a scale that would handle
my weight. He ran some blood tests and found that I was borderline diabetic (that
was scary for me). We also discussed my sleep apnea condition. I had told him that I
was not under anyone's care and it had been eight years since my last sleep study
in 1992.
He order a sleep study and the results were my C-PAP pressure went up two points. We
also discussed weight control medication. I told him about Adipex and he mentioned
Meridia and or Xenical
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The start of my journey to a
healthier me
| This journey started out with my weight up to 438 lbs.
The
heaviest I have ever been! I thought about Weight Loss Surgery for a few years
before checking into it further. My health was deteriorating everyday and even my
primary care
physician suggested that I lose the weight now before more damage is done to
my body. So I was going to try Xenical first. I was told the side effects were
different than most other medication and your body
will adjust over time. I was using it for about two weeks and
noticed the normal side effects but I was very embarrassed when I stood up
from my office chair and there was this God-awful large
wet spot on the seat of my chair. I rubbed it, smelled
it, and noticed the orange color; it was oil
from something I ate earlier. I didn't
know what to do as I share this chair with a co-worker on another
shift. I went to the restroom and checked my
underwear and sure enough I was dammed. Needless to say that
ended my evening at the office and home I went to clean up. I
wonder if they noticed THIS LARGE ORANGE OIL SPOT ON MY HINNIE? I
stopped taking Xenical and made an appointment to my
primary care
physician to try the Meridia. This drug
helps people lose weight primarily by
enhancing satiety. It acts by changing
brain signals somehow that affect eating.
I took this drug so I would not feel like
eating as much. The side effects felt were
constipation, dry mouth, and insomnia. My
success was not that great on this drug maybe because of the tolerance I
had built up by using Adipex I don't know. I did continue on this
medication for 6 months until my gastric-bypass.
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Dr. Barry
L. Fisher's Seminar
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My PCP gave me the name of the surgeon and asked if I would
call and make an appointment. I called and found out that I needed to
attend a mandatory seminar and
could not get an
appointment with the Doctor until I attended. I thought to my-self
"Who does this SOB think he is? I need help and need it now!" Well
little did I know what I was getting into?
I received the information I needed with the dates for the next
couple of seminars and I searched the Internet and found the
Surgical Weight Control Center
web site for Dr. Fisher. A date was picked and I took time off from
work to attend his seminar. I went to my first Seminar in January 2001. When
I arrived I met two girls from work, one of whom works in my department. I
said Hi and we continued to listen. Dr Fisher told the group that one
of the rules if you underwent this surgery was NO MORE DRINKING SODA or any
CARBONATED beverages.
In my observation people were turned off by Doctor Fisher’s comment and a
few left, including my friends from work (they were obviously not
motivated).
Doctor also mentioned that he
would not do the surgery on a person that smoked. I was in trouble, being a
two-pack a day smoker for twenty-six years. I was either going to have
to quit or not have this surgery. I sat in the
audience and listened to Dr. Fisher's lecture for two-hours. I was mesmerized by him, what he said made perfect sense to me.
Someone who explained that my weight problem was not my fault and the
pit falls I was experiencing while dieting. I found a profound person
who
didn't judge us because we were fat; he looked into the audience and saw
people, people who were at the end of the road. He gave me hope that
maybe I could be a normal person.
I waited until
the end of the night and talked to DJ and received my intake packet. I
would need this information in order to make an
intake appointment.
Doctor Fisher was answering questions and I listened in. Meeting him I
shook his hand and introduced myself, he did something wonderful for me that
day. When I reached my car I felt like crying, I must stop smoking. I
threw that pack of cigarettes out and stopped cold turkey!!! I am
getting ahead of myself a bit, I met some of Dr. Fisher's Post-Op patients,
and one who stands out in my mind was Sue B. She had a big impact on me....
she weighed 500 lbs. and now standing in front of me was this normal size
woman. I met a few others but don't remember them. I was determined to
educate myself about Weight Loss Surgery and did so by reading about it in
the Internet.
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My Soul Search
Questions I had to ask myself:
Are You A Ready for WLS?
(Saturday, April 28, 2001
Vincent Williams)
This series of
questions may help you determine if you are ready for Weight Loss Surgery. Some
WLS patients have found that they have answered yes to many of these questions.
- Do you eat when you're not hungry?
- Do you go on eating binges for no apparent reason?
- Do you have feelings of guilt and remorse after
overeating?
- Do you give too much time and thought to food?
- Do you look forward with pleasure and anticipation to
the time when you can eat alone?
- Do you plan these secret binges ahead of time?
- Do you eat sensibly before others and make up for it
alone?
- Is your weight affecting the way you live your life?
- Have you tried to diet for a week (or longer), only to
fall short of your goal?
- Do you resent others telling you to "use a little
willpower" to stop overeating?
- Despite evidence to the contrary, have you continued to
assert that you can diet "on your own" whenever you wish?
- Do you crave to eat at a definite time, day or night,
other than mealtime?
- Do you eat to escape from worries or trouble?
- Have you ever been treated for obesity or a food-related
condition?
- Does your eating behavior make you or others unhappy?
Is WLS For You?
Only you can decide that
question...no one else can make this decision for you. We who are now WLS
recipients have found a new way of life. This tool enables us to live without
the need for excess food, but battles rages on if you’re not in control. We
believe that overeating is a progressive illness...one that is like many
addictions. Remember, there is no shame in admitting you have a problem; the
most important thing is to do something about it.
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Intake Packet - Tests - Insurance
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I feel
compelled to say this was probably the hardest time for me dealing with a
single person that was uncompassionate, uncomforting, harsh with brightly
colored eye lids, loud scrubs, loud mouth, obnoxious and thought she was
running the whole show with an IRON fist and with the will of a dictator.
She was down right repugnant. I will not mention any names, but she is no
longer affiliated with this particular
organization and I will refer to her as Miss X. Since Miss X is now gone I
have had nothing but GOOD experiences in the office. Doc hired a gal who was
a patient so she knows first hand how to deal with his patients!
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My First Office Consultation
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I was sent away after my first office
consultation. There was a question of my commitment to lifestyle and
the bad habits that got me to this point. I needed to research more
and do some soul searching. Being sent away hurt but I was determined to
learn and grow from this little bump in the road. I had to get a
Psycho evaluation before moving on.
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Dealing With Insurance
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Getting Approved
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May 1, 2001
Dear Dr.
Getting the
surgery in the State of Nevada is very important to me, probably one of
the biggest and most important major events in my life. I need your help
and support that only you and your staff can provide me. The desire runs
deep for this surgery and the magnitude of this life changing surgery
has my full attention. I have been heavy my whole life, please help; you
have the power to make this come true for me. Here are the details.
I have talked to
the insurance company (claims supervisor; Ann , Southwest
Administrators) and they are willing to pay for this procedure. Ann
shows bariatric surgery (gastric bypass) is a covered procedure, it only
needs to be submitted by your office to Sierra Health Options for prior
authorization. My insurance has already paid for all tests without
question. They have shown me their commitment. I believe we have to go
through SHO (Sierra Health Options); I am calling them to find out what
hoops I need to jump through. The phone number for SHO managed health
utilization resource is 242-XXXX. SHO is
waiting for the paperwork to be submitted by your office and will
respond within 72 hours with an approval, I
hope.
It does not make
sense for me to travel to California when we have a good and caring
physician here in Las Vegas. I could not get the quality care from you
and your office, nor would I have the benefit of the support group if I
had to go out of state.
Dr. , UMC is a
provider under my insurance, the anesthesiologist is a provider under my
insurance, however your office is not a provider under my insurance.
Could you please submit this for me as a non-provider? I will pay your
fees before the surgery. I will sign a personal guarantee that you will
get your money. I am pleading for your help.
I have spent many
mornings calling the insurance company. Everyone I have talked to has
been great; the only place I seem to be running into trouble is your
office. DJ asked you on my behalf about
submitting this to SHO, and your answer was
you don't take insurance if you’re not under contract. Well Doc, I am
the patient and I want a life long contract with you!!!! I will give
you cash (Ben Franklins), please submit the paperwork to SHO, prior
authorization (242-XXXX). SHO main number is
242-XXXX. My certificate holder, Southwest
Administrators 1-800-942-XXXX.
Sincerely,
Vincent T.
Williams (your humble patient)
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Demons, YES They Are Real!
Physiological Evaluation
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de·mon (d  m n)
n.
- A persistently tormenting person, force, or passion: the
demon of food addiction.
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I
Am Approved For Surgery
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Hi Doc,
This is a
good day. I received a call from DJ this morning showing that SHO approved my
gastric bypass procedure. I am so grateful to you and your staff for submitting
this request. I am very anxious to get going on my way to a new me. If I had
been able to keep my original surgery date it would have been June 18, 2001. I
would like to get the very next possible date for surgery, as I am ready to go!
(Of course I would have to coordinate the date with work but I do not see ANY
complications.) I remain committed and dedicated to obtain a better body size,
healthy life and quality lifestyle. I will be available on my cell phone if you
could call me (283-xxxx) as I have a few small
questions to ask you regarding all of this.
Sincerely,
Vincent T. Williams
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Coping With Food Related Issues
I
have joined Overeaters Anonymous and watching those people suffer and beat
them selves up over their battle with weight loss is unfair.
Long Term
Habits of Successful Gastric Bypass Patients
edited by Albert Wetter, M.D.
The first
postoperative year is a critical time that must be dedicated to changing old
behavior and forming new, lifelong habits.
The success of weight loss
surgical procedures is most commonly defined by the total weight loss during
the initial weight loss phase. However, foremost in the minds of patients
undergoing surgery for morbid obesity are the questions "Will this be a
long-term permanent solution?" and "What can I do to insure my lifelong
success?" In other words, how can I maintain at least 74% of your initial
weight loss after your successful gastric bypass? The following are findings
from a survey of patients habits following Roux-en-Y Gastric Bypass.
Eating: Successful patients
ate three well-balanced meals and snacks maximum twice daily. Daily servings
for each of the food groups included three servings of protein, three
servings of vegetables, one serving of fruit, two servings of
bread/starches, and two servings of sweets.
Drinking: Successful
patients drank water and did not drink carbonated beverages. On the average,
patients drank 40-64 oz of water per day: 58% of patients did not drink
carbonated beverages of any kind; 55% did not drink juices or sweetened
beverages; 53% did not drink caffeinated beverages; and 74% did not drink
alcoholic beverages.
Carbonated beverages may be
detrimental to the long-term success of gastric bypass for the following
reasons:
Carbonation: When the cold
beverage is consumed, it warms and releases gases, distending the stomach
pouch I he stretching of the stomach then creates undue stress and
subsequently causes stretching of the anastomosis.
Caloric intake: Many
carbonated beverages are high in calories, are low in nutritional value, and
contain simple sugars. Not only do they add additional calories with low
nutritional value, but they are absorbed quickly into the blood stream,
causing a rapid rise in blood sugar, elevated insulin levels, and increased
hunger.
Caffeine: Many carbonated
beverages contain caffeine, an appetite stimulant, which is detrimental to
initial weight loss and long-term weight control.
Vitamins and Supplements:
Successful patients took daily multiple vitamins, calcium, and iron if
needed; 92% of patients took a daily multiple vitamin, 68% took supplemental
calcium, primarily in the form of Tums, and 40% continued to take
supplemental iron, such as Trinsicon or Chromagen.
Exercising: Successful
patients exercised regularly to maintain their weight; 77% of patients
exercised. The average was four times per week for at least 40 min. Patients
reported exercise as a key factor in their ability to maintain their weight.
Exercise helps you to keep your weight in check and keeps you in control.
Sleeping: Successful patients slept 7 hours per night on the average, and 76%
of patients rated their personal energy as being average or high.
Personal Responsibility: Successful patients took personal responsibility for
staying in control. Of the patients, 70% weighed themselves at least weekly.
They were found to have a general feeling that maintaining their weight was
indeed their own responsibility and that the surgery was a tool that they used
to reach and maintain a healthy weight. By weighing often and allowing
themselves only a few kilograms of leeway, patients stayed in control.
Patients NOT successful lacked at least one or more of the six success habits.
The most common were lack of exercise, poorly balanced meals, constant grazing
and snacking, and drinking carbonated beverages.
Conclusion: The first postoperative year is a critical time that must be
dedicated to changing old behavior and forming new, lifelong habits.
To
be successful after a gastric bypass, you must eat three well-balanced meals
and maximum of two snacks daily; drink water and avoid carbonated beverages of
any kind. Remember to take your multiple vitamins, iron, and calcium
regularly. You must sleep at least 7 hours per night. Regular exercise is
imperative and above all, weight control is your own personal responsibility.
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Pre-Op: My surgery date July 16th. 2001
| I eventually ended up at 450 before going under the care of
my surgeon
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Post-Op: In UMC after Surgery
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Journaling: Reflections of
the Morbidly Obese
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6/24/2001
The date is Sunday. Twenty-two day until my surgery. I am
starting a journal about my road to a new me. Scott and I have talked about
taking pictures of my body but still have not. I am sure we will rush to take
these photos. We had dinner at Jerry’s Nugget last night, the best place in
town to have prime rib. I have thought about WLS for a few years now. My first
seminar was back in January 2001. I am wondering what I will look like twelve
months from now. One of my biggest personal accomplishments was to quit
smoking. I was listening to Dr. Fisher in a seminar and he said he would not
operate on someone who smoked cigarettes. Dam, I was a two pack a day smoker
since the age of fourteen (twenty-four years). A few days later I made the
commitment to stop. I tried the nicotine patch, gum in the past with no
success. After being inspired from Dr. Fisher I quit cold turkey. I have not
smoked since. Reading other peoples experiences will help me in dealing with
what I will go though. I know I will be successful on my way to a new me, the
goal I have set for myself is to weigh 230lbs. and be a healthy person for the
rest of my life.
People would love to go to lunch with me just to see what I
would eat. "Is that all you're having?" I heard that a lot. I pretty much
stuck with soup or yogurt at work because I was afraid of getting sick.
Certainly there were times that I would, and my coworkers got used to that too.
I am
ready to give up all carbonated beverages like beer and soda. I want to keep
the above segment on what not to eat because the last thing I want is to put my
staple line in jeopardy or cause myself pain. This will be a lifetime
commitment.
She is picking on a male,
I wonder if she has issues with the male species? She mentioned some trouble
with her father figure.
Dr. Fisher once asked me a
question and the question still burns in my memory. It is, “ Vince, will you be
happy a 325 lbs?” I was not sure of the question or how I should answer it. He
asked me this under my OC visit and to evaluate me as a candidate for
surgery. My answer was, any improvement would be acceptable. Now after
thinking about it a good while ( two months ), HELL NO, 325 lbs is not
acceptable for me to settle for. I want to be 230 and I will work to obtain
that weight.
I have a few questions and would like them answered before
my surgery. So here is goes.
- What should I do to prepare for the surgery?
- Do I have to do anything special the day(s) before
surgery?
- I have sleep apnea, should I bring my CPAP machine with
me before surgery? Who will hook me up to my mask?
- Will I have a drainage tube in my incision and or
stomach?
- What about pain medication, will I have a morphine pump?
- How soon do you allow water, juice, broth, etc., after
the surgery?
- Will you visit with my family after the surgery to let
them know how the surgery went?
- What about any medicines I already take, do I bring them
to the hospital?
- Will I have a private room or will I share?
- Can my support person stay with me at the hospital?
- Do I have a limit on how much I can carry or lift? For
how long?
- What is your after surgery diet?
6/24/2001 4:02 PM
Well, I am getting some question and starting to do a check
list of what I think is important. Thanks to Sue Bees web page, her page will
help me prepare for WLS.
Don't be afraid to talk
to your surgeon after surgery and
let them know exactly how you feel. If you hurt tell them. If something doesn't
feel right tell them. Also, if you don't feel "right" let the nurses and doctors
know until they do something about it. Discomfort is normal. Pain is normal. Not
being able to keep ANYTHING including water down is not normal.
THIS SURGERY IS A TOOL!
A TOOL! You need to make it work.
Not exercising, not drinking water, eating whatever you want, you aren't working
with the tool. You are setting yourself up to fail. Maybe that is what you want
to do. Yes you have arthritis but get to your doctor and see about getting some
medication or physical therapy to help you. Hell the physical therapy will count
as exercise. As for losing forty pounds, good for you. That is a good amount.
But if you are going to graze and eat high calorie food and not exercise and not
drink your water.
If you expect someone to
tell you it is going to be all right and a miracle I think you are asking for
far too much. You know what you have to do. So do it. Drink the
bloomin' water and do some movement. get physical therapy prescribed. And don't
think I don't sympathize with weight gain because I have gained four pounds in
the past two weeks due to stress. But I also know what
I have to do to take them off and that is what I am working on. If you are
looking for a miracle answer you are not going to find it. And realize the
realistic expectations of this surgery. 60 to 80% of your EXCESS weight LOST in
12 to 18 months! That is realistic. What are you expecting??? Don't blame the
doctor for making your stomach too big when you are eating candy bars. As for
taco salad -- lettuce, tomato and hard shells go down easily and you can eat
quite a bit of it. Are you going to lose more? I don't know. But I do know if
you want an excuse for why you are not losing, don't use the doctor or the
surgery. Look in the mirror. You are responsible. You need to do things.
Get physical therapy. Try exercising in the pool. Ask your doctor for
suggestions or medication to ease the pain so you can move. Drink your water.
Take your vitamins. Get with it!
RULES FOR THE USE OF YOUR NEW
TOOL
1. THREE MEALS PER DAY
(not FIVE, not TWO.....THREE!)
2. DO NOT EXCEED FOUR
OUNCES PER MEAL.
(Two to two and one
half should be enough....if in doubt, weigh your meals before serving.)
3. SOLID FOODS ("Chew
foods") NOT SOFT OR LIQUID FOODS (not "slidey, slippery" foods)
4. NO CARBONATED
BEVERAGES (Not even diet sodas!)
(Don't pop your
staples or stretch your pouch!)
5. AT LEAST 30 MINUTES
PER MEAL. (Don't INHALE your food.)
6. DON'T EAT WHILE DOING
ANYTHING ELSE.
(No distractions, be
aware of what is passing through your lips at all times.)
7. LIQUIDS
FIRST...PAUSE...THEN SOLID FOODS.
(Don't mix; as space
is limited, since liquids empty more rapidly than solids, drink first, then
eat. Allow 30-45 minutes after solids to take more liquids.)
8. YOU ARE IN
CONTROL OF YOUR WEIGHT CHOOSE FOODS WISELY;
SPACE IS
LIMITED
9. RENEW YOUR COMMITMENT
EVERY DAY!!!
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One Month After Surgery
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Two Months Out
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Today is Monday
September 3rd; this entry is about getting sick (throwing-up, vomiting
what ever you call it!). Last night it was one Shrimp, this morning it
was two segments of Tangerine and lunch it was Panda Express - Mandarin
Chicken Bowl with out sweet sauce. To sum it up, I have not eaten much
the last couple of days. I am seven weeks out from surgery
yesterday. Liquid and chewable vitamins don’t give my any problems just
solid food. It seems that my new tool (stomach) is even more sensitive to
food than week’s prior. I have been doing the solid food thing for about
three weeks now and the past few days have been HELL. It's all about
making the right food choice and I am having a little trouble here...LOL.
Doctor Fisher's support group meets tonight and I will get advise from WLS
veterans about my problem.
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Update: March 11, 2002
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Ok,
This is going to be short. I'll add more soon.
I
haven't hit the hard plateau but I can see it. I am just sitting here
thinking about WLS patients and wondering how you all are coming along.
If you feel up to it, drop me e-mail. My weight loss is slowing and it’s
because of my food choices and me. Commitment to losing weight starts
with me, Doc fisher said it's about 7 to 10 months and the honeymoon is
over. I am here to tell yooooooou he is right!!!!
Oh yea, the best
news is I am down 170 Whopping pounds...Woooo Hoooo!!
As of March 18, 2002
I am down 175 pounds....Oh yea!!!
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