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Thursday, April 30, 2009

First Office Visit

Today marks the completion of 7 full days of healing from plastic surgery. I drove over to the doctor's office for my appointment and the receptionist said "wow. did you drive yourself over?" When I said "yes" she looked amazed and said "well your color looks really well."

As I talked to the doctor I got the impression that the extent of what I did was even more than I thought. No wonder I'm having a hard time with the length of recovery. I'm suffering here. I honestly don't know how I'm going to get back to work next week but we'll cross that bridge when we come to it.

The initial results look good. As expected though because of how much skin I had around my middle, there is some stretching there. We'll see how it looks when all the swelling goes down but I might have a minor revision there. If so, the doctor believes we can do it in his office. That would be nice. $250/hr. I asked him if it would hurt as bad and what he said was candy to my ears. "We don't have anymore muscle work to do so nothing else will hurt this bad." Yay!!

Now if I could get those abdominal muscles of mine to heal. Heal dammit!!! lol

Tuesday, April 28, 2009

Recovery Update

Hahahahaha. 5.2 lbs below my goal weight. I just went under 220 lbs. Who would have thought? Anyway, yay!! and with all the swelling going on, how well I'm doing with the diet plan and my water, I expect I will be down at least another 4-5 lbs when it's all said and done. Too cool!

Anyway, day 5 after surgery. Recovery does better day by day but it's still too slow for my tastes. I know I'm looking at basically 2 weeks for the incisions to heal then another 4 weeks before I can start being really active and even 12-18 months for total recovery. I'm willing to put in the time with the exception of the first two weeks. Can someone just fast forward the clock? I'm BORED!!!! I've read a ton, watched tv and movies, listened to music, even brought out the laptop and worked. But I'm bored.

One other thing that I'll say. I'm tired of being in the lazy boy. I've been here for 5 days because you can't straighten up. This allows me to be bent. And no, you can't just sleep on you side in your bed. Why? Because the drains on either side of your abdomen come out there (one on each side). However, I did get tired of lack of sleep (no pun intended) last night so I rigged my bed and actually got some good sleep on it. But that's not to say that I didn't create a great deal of intense pain in my abdomen trying to get into bed but let's not talk about that.

I was able to truly shower today. I showered on Sunday as well but that was more let the water wash me. This time was more actual washing. I feel tons better. I need to go and get some new gauze wrap so I can redo my dressings. Also some antibiotic ointment - thought I had some but I guess not.

Now it's all about trying to have a bowel movement. Sorry for the gross-ness here but it's relevant. I tried to clear everything out for surgery but I was a little concerned that I hadn't had one in 5 days. I could feel the beginnings forming yesterday. I am worried because of all the percocet and the length of time. Thank god I've recovered as well as I have. Some came this morning (I can tell more will later). Since Sunday I've been taking a child's portion of Milk of Magnesia. Today I took an adult dose. We'll see. With any luck, that will pass without too much of a problem and provide additional weight loss *laugh*

Anyway, I'll update later one. Take care.

Sean

Sunday, April 26, 2009

4/23/09: Plastic Surgery

Okay, so now to catch everyone up on what you've been waiting for. Plastic Surgery. After losing 250 lbs, I had a lot of loose skin. My abdomen was where I wanted help the most. After that my inner thighs, upper arms, upper torso and back.

On Thursday morning, 4/23/09, I went into the Utah Surgical Center to have Dr. Scott Haupt do my abdomen, upper arms and inner thighs. 7 hours later I walked out (very gingerly) and began the recovery process. The first two days were torture. Day 3 (Sunday) hasn't been all that great either but it has been much more tolerable than the first 2. Thank god for my brother. If he hadn't been willing to help me out those first two days, I would have been sunk.

The pain is unreal. Percocet is your friend. Then on Saturday, I was asked to go into Dr. Haupt's office. I had no idea how that was going to happen. It was hard. You are so hunched over that it hurts your back to walk for very long.

I will tell you, however, that I'm pleased with what I've seen of my upper arms so far. I believe once the swelling goes down I'll be saying the same thing about my inner thighs. Time will tell in regards to my abdomen but I'm hopeful. Dr. Haupt told me that he cut an incision along my bikini line and then another about an inch above my bellybutton. He cut out everything in between those two lines and pulled them together. That's a lot of excess skin.

I expect that I won't be able to stand up straight for a few more days. I had the drains on my upper arms and thighs removed on Saturday and the ones on my abdomen should come out within the next week. I don't have to be back to work until May 7, 2009. That should be long enough for me to get things back together. And if I need a couple of extra days, my work doesn't mind. They are very supportive.

I did stumble onto the scale in the bathroom and even with all the gauze dressing and swelling, I'm at 225 lbs. So in essence I lost the 7 lbs that I had gained in the few weeks prior. Also, because of the tightening of the abdominal muscles, I don't have much of an appetite so I'm sure I'll lose a few additional lbs that way as well. Though amazingly enough it's been easy to keep up with my water.

Words of advice: when you're on percocet and your abdominal muscles are this sore, the last thing you want is a bowel movement. So clear them out before surgery. After surgery you also don't want to be constipated and percocet brings that on so it's important to keep up with your water and to take a little bit of milk of magnesia daily.

I'll try to get some before and after pictures posted eventually and I'll update you throughout the process.

Plastic Surgery

So on Thursday, 4/23/09, two years and 16 days after I had gastric bypass, I underwent plastic surgery. The surgery was 7 hours long and dealt wiht my abdominal region as well as my inner thighs and upper arms It all went well but the first day (really two) was mega-PAINFUL. But survive I have and even though I still can't stand upright and I still need some help, I've seen the light at the end of the tunnel and it's exciting to be so close to it.

Monday, April 20, 2009

How Did I Eat So Much

So today at lunch I went to Legers to get a sandwich. I bought a half roll with turkey and cheese (just light mayo) and a little lettuce. I took it back to the office and at the turkey and cheese. After that I was on the phone and I started eating a little of the roll (kind of absentmindedly). Before I knew it, I had eaten the entire half roll.

To say I'm shocked doesn't even begin to describe it. How did that entire thing fit inside my little pouch? guess it's not so little anymore. Scary, scary!!!

But it goes to show how easy it is to get off track and to go back to the old eating ways if you don't stay vigilant. Learning how to eat right is of utmost importance during your initial journey (which is 24 months -- even if you lose all the weight before then). Right around that point, you get to where you can eat most anything and if you still have the same bad eating habits (grazing, sweets, etc) then you're going to struggle. Hell, you'll struggle anyway but it'll be even more difficult if you don't get into some good habits now.

Just remember, what they said is true. The gastric bypass is a tool. A tool by which we can control our eating for life. But the work still has to come from you. Don't be fooled by the fact that the first bit as you recover from the surgery is so easy. The weight flies off and you can't eat much. It's easy to think it will always be that way but it won't. Learn!!! Practice!!! Change your life!!!

Sean

Tuesday, April 14, 2009

Protein Bars/Shakes

Just a short little post. There was a discussion (debate if you will) recently on the use of protein bars and shakes. RMAP will tell you not to use them. I have been highly successful using them. However, this does not mean that I think RMAP is wrong. So let me put it in perspective:

(1) It is ALWAYS better to eat real food as opposed to protein bars and/or shakes much like it is always better to have fresh food as opposed to prepared and pre-packaged foods.

(2) If you are not going to spend the time preparing your foods (my opinion) and you are often on the go, it is preferrable to take something quick and easy that's good for you rather than find yourself going out to eat where you have a high probability of going off the eating plan or end up finding yourself grazing.

Those really are the two mantras that I run with. As far as an explanation, I'll say that I do a lot of protein bars/shakes for breakfast and lunch but almost always eat real food for dinner. Why? Because I am always running out the door in the morning and I rarely take enough time at lunch to heat something up and I hate wandering into the break room anyway.

My Story
I lived on protein bars from the 3 month mark (once I could eat nuts I started with the high protein slimfast bars) through my year mark. I lost 188 lbs with that approach. From the year mark through the 18 month mark, I moved (85%) of my bars to Atkins Advantage (the bars with 20g carbs, 10g dietary fiber, 11g protein (the Double Chocolate Crunch was my favorite). After that (I'm currently a little over 24 months out), I've graduated to the Premier Nutrition protein bars from either Sam's Club or Costco (Sam's Club is cheaper). Recently I started using the EAS (Sam's Club) and Premier Nutrition (Costco) protein shakes. But again, this is because I'm always on the go for the first chunk of the day and these work for me.

Making my eating routine and easy was the key for me. Is it for you? Maybe. My eating is pretty boring but I like it that way because it takes away a ton of the cravings and makes the entire process easier for me. Many that I know don't like to do it this way. They want to have variety in their diet. If that's you, this approach certainly isn't for you.

Summary
All in all it comes down to what works for you. However, like I've said in previous posts, your first 18-24 months is all about learning how to eat while your pouch is small and you can't eat much. You will soon get to a point where you will be able to eat anything. Once you get to that point, the lessons you've learned over the first 18-24 months will save you so when you hit your 5 year mark you'll still be lean. Learn now what works for you and realize that what you are learning will help you lose the weight now but will also be how you will be eating for the rest of your life. You can't just eat one way for the first 24 months and then suddenly change and not expect something to happen. This is a lifetime approach. I've chosen to be with protein bars/shakes as well as beef jerky and (from Smith's) Kroger's Carb Master yogurt for life. Keep that in mind before you ever make a move towards such products.

Sean

Friday, April 10, 2009

Stress Eating

Okay, today was a stress day and with sugar around EVERYWHERE at work, I found myself grazing way too much. So here is where my biggest battle is. Learning how to not graze when I'm stressed to the max at work. Let me know how you're dealing with this battle. I want to hear from you.

The good news is that I am able to leave the stress behind once I leave work. Tonight I'm spending the first of 10 nights in a row with my daughter. Got to love spring break. So I'll leave you now so we can get back to our music appreciation night. YAY iTUNES!!!

Sunday, April 5, 2009

After 24 Months

I'm finding it more difficult to eat right and keep my portion sizes where they need to be now that I'm two years away from surgery. Yes, this is scary. I can see how easy it would be to let my guard down and regain the weight. I don't think it would be possible to gain all my weight back but I can see how easy it would be to gain back a lot of it.

Calories mount so quickly and easily during the day. Before when I couldn't eat a lot and not a lot settled well in my stomach so it was easy. But that has passed and now it's having conscious thought of everything I eat that is required.

I bring this up for those of you on the journey right now. Those first 18-24 months are where you set your behavior. Where you learn how to eat right. Where you learn to become conscious of the calories (and nutritional value) of the food you eat every day. It's where you learn how to drink enough water and to exercise. If you learn those lessons, they will serve you well when you get to where you're eating like a normal person again (and you will get there).

Case in point: When I was in Chicago, I went out to a business dinner. I ordered off the menu (a chicken curry dish) and ate a little more than half. Afterwards we were talking and the topic of weight loss came up. When they found out how much weight I lost, they were amazed. The one comment that stands out in my mind is when one of my colleagues said he couldn't tell I was on a diet or eating differently from how I ate. At first that scared me but then I realized that's what this is all about. Recovery from the surgery is when you lose your weight and learn how to correctly eat. After your complete recovery, then you have control to eat like all those skinny people you have known for your entire life.

So learn what you need to for your first 24 months. Don't waste it and don't make excuses. What you learn there will mostly determine the long term success of your weight loss. And remember that it will not always be so easy. There will come a time when you will have to monitor your weight closely and adjust your caloric intake and exercise level when needed if you start going up. It will be a lifetime fight but one you can easily continue to win. You can't allow emotions to control your eating habits anymore. You have to decide to be in control and to always remain vigilant... no matter what.

Friday, April 3, 2009

Protein Shakes/Bars

Oh yeah. I forgot to tell you that I'm now supplementing my protein bar craziness with EAS protein shakes. Can you believe? Love Sam's Club... get them at a good price. I'll let you know how that ends up working but I have found that I'm less hungry after drinking those than when I eat a bar. I find that interesting. Anyway, stay tuned.....

A Big Hello

So many things have been going through my mind lately that I haven't been sure what to write. So rather than avoid my blog like I have been, I'm going to give you a bunch of random ramblings.

1. I love my job. I absolutely love the travel. I wish I could do more. Unbelievable being able to go to Chicago (expense-free) for pretty much two weeks. It's all I could ask for in a job and more. I enjoy what I do, who I work with, and the unlimited potential. Why do I bring this up? Because it's only possible because of the weight I lost.

2. My daughter's mother. After two and a half years of divorce, the limited amount of communication we have is finally starting to be normal. For those of you in the know about this, I'm still in shock and feel like I'm going to wake up from a dream anytime now. It's nice though. What's funny is that if we'd communicated like this during the marriage (as much my fault as hers), we'd probably still be together. Though I don't know whether that would be a good thing or not. I bring this up because... well, again for those of you in the know, you understand.

3. Dating. I find dating to be a lot harder now than it used to be. I have a lot more opportunity to date now (for obvious reasons) but I find it more difficult to get into relationships now. That's mostly because I don't roll over and take shit like I used to. I used to get walked over all the time. Now I'm just me and if it's not fitting, I don't try to force it. Big difference from before but that has a lot to do with the increase in self-esteem and confidence.

4. Weight. Still frustrated with the fluctuations. Honestly? They downright piss me off. I got back from Chicago on Wed night late. I weighed at 230 lbs on Thur morning (down 1 lb from the morning before I left). Weighed again today and I was at 232 lbs. WTF? Really! Oh well, all I can do is continue to work at eating right, drinking and trying to get as much exercise in as possible.

5. Speaking of exercise... I was going to run a 3k (or really walk it) next month but as I told my daughter that we could do it together, I realized that I'm having plastic surgery at the end of this month and won't be in any shape to do something that strenuous that soon. Here's hoping I recover from plastic surgery as quickly and as well as I did from gastric bypass.

Alright. It's time for me to get sleep. Big day tomorrow. Keep dropping me emails, I love hearing from you.

Take care.

Sean

Monday, March 30, 2009

YOWZA!!

I was scrolling down on my blog and happened to look on the right side at my pictures. WOW!!! It's amazing to think how large I was not overly long ago. I owe everything to Dr. Smith for performing my surgery and the person who invented Roux-en Y. I'll say it again... WOW!!! A brand new life. The life I always wanted. I just wish it could have come 20 years before it did. Oh well, I will enjoy it now for the rest of my life.

How people look at me differently
The choices in life that are now available to me
The things I always wanted to do that I can do now
Etc., etc., etc.

So amazing. I would love to hear from all of you. How blown is your mind with what is or has happened to you because of WLS?

Saturday, March 28, 2009

Random Blogging

Have you ever been the first one you know to start listening to a band and then have someone you don't really like get into them and it kind of ruins it a bit? Yes, I'm being a little vague but that just happened to me with The Veronicas. I've been listening to them FOREVER but recently the luster was taken off just a little. Oh well, it couldn't last forever.

Anyway, I'm getting ready to head out to Chicago again; however, I wanted to leave you a little bit of advice. As you know (by my previous post), I went above my scary weight (all the way to 231 lbs). However, when I weighed this morning, I was at 227.8 lbs. Wow, right?! How did it happen? It's all about the water. I started drinking a ton of water and released all the water I was retaining. Now if I can just hold on through this next trip.

Faithy-Bears birthday is on Monday and I'll be in Chicago. It's a little sad but I don't have her on her birthday this year anyway. I do, however, get to celebrate her birthday tomorrow (Sunday). I have her most of the day. We'll go hang out at the movies and do a family dinner. It's probably going to be sucky weather or else we'd probably go out for a bike ride too. She's such an amazing girl -- a fact I tell her all the time. She's brilliant, beautiful, and so funny. You might think that I'm a little bias (and perhaps I am) but these three facts are repeated by anyone who meets her.

Anyway everyone, I'll try to blog while I'm in Chicago (I'm out to take a picture of the front of Wrigley this time and hopefully make it to the art museum). Take care and keep working hard. Remember that the journey is a lifetime so don't beat yourself up over a mistake here and there, just try hard to do better the next time. And if you get too down, listen to the song "Move, Shake, Drop." It always pumps me up.

Sean

Friday, March 27, 2009

My trip and weight gain

I just got back from my weeklong business trip to Chicago. I barely have a chance to breathe and I'm out again (Monday morning) headed back to Chi-town. I love Chicago and I love that I get to travel for my job. However, there is one thing I hate. Everytime I travel, I gain weight. Oh I tried really really hard this last trip to eat decent. I think I did a good job. And I walked everywhere so I got a lot of exercise. But yet I'm now up to 231 lbs. 1 lb over my scary weight. Dammit!

I know I'll get back down but it's always frustrating. But I realize that I have to be forever vigilant and always readjust my water and food intake as well as my exercise type and level in order to maintain my goal weight. It's not always easy but I've been on the extreme upper end. I know how I felt then compared to how I feel now. I know how happy I was when I got down to 225 lbs for the first time. It's all worth it and it's worth it to continue working on my diet and exercise to keep myself here.

It's all worth it!!!!!

Monday, March 23, 2009

Chicago: Weight loss/gain on trips out of town

I love business trips for everything other than weight maintenance. I'm in Chicago, easily the coolest city I've ever been to, and I'm struggling to eat right. Grrrr! I was up to 229 lbs the morning before I left (3/22/09), let's see what I can do over the next three days so on Friday (first morning back) if I can't say I lose (or at least maintained). Wish me luck.

I'll get back down to 225 lbs but I have to say that I didn't think it would be so hard to maintain my weight once I got down here. The biggest problem is that I can eat so much more and I can eat anything I want. That means that I need to use all the skills and new eating habits I learned during the weight loss phase and be like all those skinny people I've been around my entire life. I can do it, just need to always stay vigilent. Can't afford to stop paying attention to what I eat, how I exercise and how I control my caloric intake.

Anyway, I'm off to run around Chicago for a bit. I'll try to write more later on in the week.

Sean

Friday, March 20, 2009

Sam's Club / Stress Eating

So today I visited Sam's Club. OMG! I love Sam's Club. 3 boxes of my protein bars (Premier Nutrition - 30 grams of protein each). 15 bars per box for just over $14. Also purchased (for the first time), the EAS protein shakes. 18 count, almost $25. Also found some trail mix that isn't too bad at all -- really just the fat content but I'm not worried about that... especially if I keep it under control (how much of it I eat). I'll take a bunch with me to Chicago next week.

Anyway, so today's update is about stress. I've been MEGA (yes I repeat MEGA) stressed for the entire month of March. Work has been insane. But I'm finally almost at the light at the end of the tunnel. April 6th is the day when I think I'll be through everything with work and my life that has me running non-stop.

What I've noticed is a HUGE tendency to cheat with simple carbs (especially sugar -- candies). Soooo bad. It's almost a subconscious thing. It hasn't hit me too hard (hopefully that's because I've been fighting the good fight and not because it will hit me later) in the weight department. I need to watch the stress eating. Such a bad area for me. Definitely needs work.

Anyway, I'm sure I'll be posting from Chicago to let you know how the food and give you some highlights from Chi-town. This is the first of two trips over the next two weeks and in between is my beautiful daughter's birthday.

Enjoy the weather, my friends!! My daughter, Faith, and I will be enjoying our mountain bikes a lot this weekend. She's all psyched to go out. We fixed her bike up last night (brakes needed some tweaking and new pads had to be installed). So if you see us out on the road, try not to hit us but honk and give us a wave.

Sean

Wednesday, March 18, 2009

Current Dilemma

Okay, so I got back down to 225 lbs and then for some reason I fell off the wagon and now I'm back up 4 lbs. Grrrr. So I'm too close to my scary weight for comfort. Today I reaffirmed my committment to not cheat on my eating. I certainly wasn't perfect but I did do better. But now I'm going through carbohydrate withdrawal. I hate that! I will never know why I continue to fall into this trap but yet I do. The good part is that I know I can drop the weight again and get back to where I want to be. The bad part is that this shows me how easy it would be for me to gain weight and go back up again. Eeek! I don't want that. Five years from now I want to be at 225 lbs still. Even lighter depending on how much weight comes off when I have plastic surgery.

Anyway. I realized today that you can adjust your preferences on blogspot.com if you're a registered user and follow my blog. Several people do that already (as I found out the other day) and so they get automatic updates.

Which reminds me. I really want to hear your stories. Email them to me. Please.

Sean

Sunday, March 15, 2009

MUSIC!!!!

Okay everyone, I need your help. I've added a sampling of my musical tastes to my blog. If you add to it the hiphop song "Move, Shake, Drop" you really have a good idea of what my daughter and I listen to. With that said, I need your help to identify more music that I'll like. So please!!!! Take a moment and listen to the music here on my blog and if you have similar type music that you listen to, please email me a list of your musical suggestions.

Thanks.

Keeping Busy

You know, it's funny. When I'm busy I don't have as much of a time staying on the diet but I have a much more difficult time getting my water in. When I'm not busy, the reverse is true (obviously). I decided yesterday that the solution here is to stay busy but run around with an IV in so I can continually hydrate myself without thinking about it. *laughs*

My plastic surgeon (surgery in just over a month) has me taking a multi-vitamin twice a day to get my skin as healthy as possible before the surgery. I've upped my B12 supplement as well to make sure that nothing dips down below where it should be prior to the experience. I guess I should invest in a B-complex to make sure the other B vitamins (specifically B1 or Thiamine) doesn't get low.

I'm excited about having a lot of my excess fat/skin removed especially in the abdomen area though I'm not really looking forward to the recovery time. Recovery from gastric bypass, while not super long, cured me of any desire to go through a recovery period on anything. But I expect to have two plastic surgeries, at the end of which (once recovery is done) my total weight loss adventure will be over and the rest of my life will be enjoyment of being where I've always wanted to be and working to stay there. So..... I'm excited.

I would love to hear from more of you ... your stories, how all of this has affected you, and what you enjoy the most or are looking forward to the most. My email address is in my profile which you can access by clicking on the link over by my profile picture.

Sean

What? Me Exercise?

So yesterday I had worked on putting together the elliptical machine delivered on Thursday by NordicTrack. Hours later when it was basically put together, the last thing I wanted to do was try it out. It was a workout putting the thing together. And guess what? It takes two people so I had to work with my brother to get it. One of the screws at the base wouldn't go in the right way because the hole they had drilled in the two metal pieces didn't align correctly. Fortunately I'm good at puzzles so we put it in backwards and it worked well that way. Definitely one of the most frustrating pieces of equipment I've ever had the *cough* pleasure to put together. I seriously am tempted to call NordicTrack and give them a piece of my mind. Anyway, so a new era starts. I have an elliptical, new cross trainer (hiking/walking) shoes, and a mountain bike. That should keep me plenty busy through the summer and beyond. I'm kind of excited. I've drug my daughter into the fray. She has her own mountain bike and new shoes and together we've already started having fun. She loves going biking with her dad and is always asking me if we can go and disappointed when it ends.

One thing that I've heard about from a lot of you is that you hate exercise. Well... I'm right there with you. I bought a Gold's Gym membership but absolutely hated it. Let's face it, I'm not going to be a gym rat. But I needed to find something and this has me on the right track. As I get going, I know I'm going to augment my equipment with some dumbbells and at least a padded mat for crunches (if not a core ball). But all in its own time. I have found a few things that I will do, in places that I will do them. Stay tune. I'll keep you updated as to how it ends up working out but so far it's looking good.

Sean

And I'm Back....

For those of you who haven't discovered it yet, Ray Wilde, the office manager over at Rocky Mountain Associated Physicians and I had a phone conversation a couple of weeks back. Being able to have a frank discussion about what actually happened on the board brought a quick resolution and Ray has reinstated me to the RMAP message board. I don't know if it will ever truly be the same (do wounds ever heal 100%?) but I've started messaging there again.

I hope you'll continue to follow my blog as there will be more personal experiences here but I invite you to also join me on the RMAP board if you are so inclined.

Thursday, March 12, 2009

Update

Okay for those of you who have been asking me what's going on with everything, here's a big update:

1. No, I still haven't heard back from Ray Wilde, the office manager over at Rocky Mountain Associated Physicians. I haven't lost hope yet but at this point we are a couple days past when I was supposed to hear from him.

2. My plastic surgery is coming up in about 5 weeks. I'm a little nervous about it only because I keep thinking... what if I made a mistake with the surgeon I chose? I don't think I did ... I'm thinking it's just normal jitters.

3. I had my back molar worked on back on Tuesday and I'm wearing a temporary crown for the next 3 weeks. This means I can't eat anything hard to chew (i.e., beef jerky, nuts) or anything sticky (i.e., gum, chewy candy). So far this has proven to be a bonus. Who knows, in 3 weeks, I could lose another 5 or so pounds. *lol*

4. I bought a mountain bike from REI. As a REI member, I was able to use my 20% off dividend (only for the Navarro bikes) and get one for a really good price. I've been out biking with my daughter a few times already and I'm hoping the weather will hurry up and warm up so we can go more often. It's amazing how much I like going out in public now. I don't feel all self-conscious biking along the edge of the road now whereas before I hated even walking on the side of the road because I could have sworn everyone looked at me because of my size.

Other than that, all is well. Life continues to progress and get better with every day. Thank you everyone for keeping in touch and being such a great support system for me. I appreciate every one of you.

Sean

Wednesday, March 11, 2009

RMAP: Ray Wilde

I meant to post this earlier but I haven't had time yet. Last week I talked to Ray Wilde, the office manager for Rocky Mountain Associated Physicians about the issue that occurred between Carly and myself. I'm pretty sure I already posted about it. At the end part of the week, I followed that up with an email to him (per his request) outlining my perspective on the entire situation. He was supposed to get back to me by yesterday and I haven't heard from him yet but I am still hopeful. I would like to continue working with RMAP and I remain in disbelief that by relating what I thought was a small negative experience snowballed into me being banned from the message boards and into something that now involves Meredith and Ray. I never thought telling a story could have such an impact.

Anyway, two days ago a friend of mine (RMAP patient) started experiencing strong pain in her rib area. Yesterday she called RMAP and talked to Carly. Carly contacted Dr. Smith and Dr. Smith talked to her and she ended up going to the hospital where they operated and fixed the problem (I won't get too detailed because that's her story to tell). Anyway, as she related this story to me, I thought about what I would do if in the same position. Due to this situation, I don't know whereas I would be comfortable calling RMAP which irritates me. It irritates me because I had no malicious intent at relating my negative experience. I didn't even think it was that much of a negative experience. It was just relevant to the conversation going on in the forum at the time and fit the topic of the post which was saying that the one area RMAP could improve in was customer service. I stated in that post, however, how great I think RMAP is.

Oh well. Hopefully I'll hear from Ray and this issue can become a thing of the past. It would be nice to feel again like if something were to go wrong I could feel comfortable in calling RMAP.

Sean

Plastic Surgery

I'm getting excited about my upcoming plastic surgery with Dr. Scott Haupt. I'm going to have to stage this into two separate operations but the first is going to be the most extensive and do, in a way, the more exciting of the two. This first one will remove the excess skin from my upper arms, thighs and abdomen. Yay!!!!

I'm so excited that I can't even explain it. I can't wait until I can come back and leave a post tell you all about it and how I feel about having a flat stomach (without excess skin) for the first time ever).

Stay tuned!

Tuesday, March 3, 2009

Food Labels

So here's something new I recently learned:

Because I have made a conscious decision to learn how many carbs, proteins, sugars, fats, calories and dietary fiber is in everything I eat, looking at labels now helps me get past cravings. For example, the other day I was at the store. Before check out, I noticed I was hungry. In fact, I was starving. At the check stand I almost bought potato chips or some candy. It was obvious to me that my blood sugar level was low. I almost bought several different things. Why didn't I? I'd like to say it's because my will power is so strong but that's not it.

I didn't buy them because after each one I picked up, I read the label. When I realized the serving size and how many calories, carbs, sugars, fat were in them, I found myself thinking that if I ate that one thing, it would throw my entire day off. That thought process had me putting the items back and instead thinking of what I could eat -- and it ended up being a lot better for me.

So don't buy into it when you hear people tell you that they don't want or need to pay that close attention to those things. It does help. Perhaps not today but you never know when down the road it will help. A mental food journal or a written one. If you don't do it already, start today.

Sean

Meredith's Phone Call

Meredith called me this afternoon. We had an interesting phone conversation. Meredith is nice but nothing has changed in her stance or the stance of Rocky Mountain Associated Physician. A quick review:

RMAP believes that I slandered Carly. They state that it is okay to have freedom of expression on their board but apparently when you have that freedom of expression and actually name one of their employees, that's not okay. Nevermind that the post was not a personal attack, but rather me just relating an example where I was frustrated with the customer service of RMAP (like those who had been talking in the forum). I specifically stated in that post (at the end) that I thought highly of RMAP but hoped they would get better at customer service. There was no slander about it. As stated before, here's the definition of slander:

"a malicious, false, and defamatory statement or report: a slander against his good name."

The key here is "false." To be slander, it has to be false. I posted a true story and related my feelings to what happened. Meredith believes that could have been handled behind the scenes. Could it have been? I don't know. Who would I have talked to about it. I can't talk about it now as everyone at RMAP believes Carly's version of the story and certainly don't appear to give any weight to my version. To this date I have never heard one person say "I understand that you just wanted to know if Dr. Smith needed to see you based on his statement 'check back with me in six months.' I understand that you didn't need or really want an appointment unless Dr. Smith determined he really wanted to see you. I apologize that Dr. Smith wasn't consulted as to whether he needed to see you." No. All I continue to get is "Carly was just trying to tell you that you needed to make an appointment to see Dr. Smith." I know. That wasn't what I was asking her then and it's still not what I'm asking (nor is it the story I continue to tell). *sigh*

Anyway, Meredith believes in the above. That's fine. I believe things should be taken in proper context and this totally wasn't. Anyway, Meredith states that an email was sent to me saying that to be reinstated to the board, I would have to write a letter of apology to the surgeons. You have got to be kidding me!! An apology for what? For relating a true happening and openly hoping that it wouldn't happen again?

Okay. So I told Meredith that if she wanted a letter of apology that I would be willing to write one BUT Carly needed to provide me with one as well. Well, let's just say that's not going to happen. Meredith wants RMAP's apology for the incident to be her phone call to me. Okay, well then my apology should be able to be had over the phone as well. You want it in writing, I want one in writing. After all, I didn't create this situation myself -- in fact, I was trying to help when I wrote my post. I certainly didn't expect someone to decide it was a personal attack.

It became obvious on the phone call that Meredith and I weren't going to cover any ground that we hadn't already covered in email. Meredith and RMAP are unwilling to admit that they did anything wrong in regards to this incident. Meredith said that she did not call me evil. This is true. She didn't. But she and Carly make me feel like a criminal and she is trying to mete out some type of punishment in order to make it all better.

So what it comes down to is this: I basically admit that the entire incident is my fault and write a letter of apology to the RMAP surgeons and I can be reinstated to the message boards. Ummm... am I the only one who sees a problem here? By the way, I still find the whole issue of "resolution" to be interesting. So in our email exchanges before, I was told that Meredith's offer to resolve the situation was that I stop posting negative things about Carly. I have NOTHING against Carly. I never did. I actually think Carly is nice though I wish she had taken the time to listen to what I was saying. But how is it a resolution, as Meredith stated on the phone, that if I stop saying negative things about Carly that RMAP will move on and forget the incident? Hmmm. I don't know about you but to me resolution means that when I carry out my side, then the ban is removed. At least that was the assumption I made.

And I thought I was clear but apparently I wasn't. My entire reason for contacting Meredith was to rectify this situation and get things back to where they were. Why? Because of all the wonderful RMAP patients who reached out to me via email and my blog. Those who reached out to me on obesityhelp.com, those who have my cell phone and call me for advice. And those who have formed a help group on Facebook. I love being able to help all of them with personal experiences, things I've learned, etc. RMAP's message board was an easy way to do that. Why else would I reach out?

Anyway, like I said, I believe Meredith's goal was admirable but if RMAP isn't willing to admit to any kind of wrong doing here, then I'm not interested. If Carly wants to deliver a personal apology to me, I am more than willing to deliver a personal apology to everyone within RMAP. If they want me to stop writing about the incident and let bygones be bygones and put things back how they were before the incident, I'm good with that too. But to ask me to say I was the only person who did anything wrong is ridiculous and it isn't going to happen. Because it's not true. My intent with the offending post was not malicious, it was not slanderous, and it was not even detrimental to RMAP. What has been done to me, however...

Anyway, Meredith stated that Ray, the office manager will call me since her and I can't seem to find middle ground. I hope he does but somehow I think he won't. We'll see. Stay tuned. I would like to work this out but I'm not willing to sell my soul for it.

Sean

Monday, March 2, 2009

My Response to Meredith

Meredith.

I was unable to respond to your call/voicemail today because I am out of the state on business. In fact, I just got back to the hotel room. But from the sounds of your email it doesn't sound like I need to call you tomorrow. Like your other emails, it appears you're being very biased on this subject and though you're being relatively nice in your emails, I fail to see where you're offering any type of resolution.

What I would like to point out is that this isn't about me, it isn't about Carly. It's about RMAP. My post that I got banned for wasn't about me, it wasn't about Carly. It was a request for RMAP to get better in a certain area. This is a complaint brought up by many patients and has been sooooo evident. The post was left out of a desire for RMAP to get better and to be the best. Carly took it personal and there was no reason to. But that's not how you choose to see it though many many patients read that and agree with that.

However, I'm glad you have a flood of anger and are upset by my words. Perhaps that finally gives you insight into my situation. Here for over 18 months I spent my free time to give back to RMAP, to be there for their patients, to give back because of this gift I was given. I defended the RMAP surgeons when they were attacked by patients on the message boards, I soothed things over when former patients complained about how horrible gastric bypass surgery was to them or when they complained about the educational program, how they felt the $500 educational fee was a waste or how unresponsive they felt the office was. I have carried the RMAP flag higher than was ever expected of me and drove as many patients to RMAP as possible.

Then I had a negative experience with Carly. I didn't say anything for a long time then it became relevant in a post. The whole point of the post was not to degrade Carly. You never read the post. If you had, you would have seen that I merely suggested that RMAP could improve on the customer service side. Yes if I was Carly that would have been hard to take but I would never have banned anyone for relaying a negative experience and their perception. I wouldn't try to call it slander when it doesn't come close to the definition of the word. I would have taken a hard look at the experience, perhaps talked to the person if necessary, maybe even addressed it. I wouldn't have run from it. But that's just me.

You never, in any of your emails to me stated that RMAP wanted a letter of apology. And honestly Meredith, the situation between Carly and I was the banning from the boards. You offered a resolution to that. Offering a resolution means that if one side follows through on their side of things, the other side does as well. So please... don't say that you followed through on yours. I made it clear in my initial email that I was addressing the ban from the message boards. You offered a resolution that I accepted. You reneged. It's as simple as that. If you want to talk about slander, how about the slander that RMAP has thrown my way? You accepting Carly's version of what happened without reading the emails other patients have left about it stating quite the opposite or even reading the post in and of itself. And did you expect that by telling me that Carly is the victim and I'm some hate mongering individual who is into slander was not going to offend me? Much like you, I've tried to keep the anger out of it.
I reached out to you in hopes that this situation could be resolved. Your proposed resolution was fine. I wanted to just let bygones be bygones and go back to flying the RMAP colors. But I guess that isnt' good enough. Now you want to exact a piece of flesh. I'm sorry but I've given up the days of when I was willing to let people walk over me. I am owed a written apology from Carly that specifically lets me know she understands what she is apologizing for. If I get that, I would be more than willing to provide a written apology to the surgeons and Carly herself and spend my days praising everyone at RMAP. But since that isn't going to happen, I don't have to worry about that, do I? Right. Because neither you nor Carly believe there is any wrongdoing on your part.

You are always welcome to call me. If I am able to answer, I'm always willing to talk. But if this is just going to spin wheels, then I'm not interested. I am active in the legislature and the medical community with gastric bypass and trying to get more insurances to pay for it (through passed bills, etc). I actively offer support of past patients and love it. If it's not going to be through the RMAP board, it will be somewhere.

I do not feel it is appropriate to ask a patient to apologize for relaying a true story and voicing his/her frustrations. It also isn't appropriate to label that patient as a slanderer. It's obvious how RMAP has positioned themselves. If I felt that it would do any good to talk to you about this on the phone, I would. But at this point I don't see how the two sides are able reconcile. Your resolution was for me not to say anything negative about Carly anymore. I agreed. The fact that you offered a "resolution" to the situation implies that any punishment would be rescinded. It was not. It is obvious that you feel that I owe an apology. I personally believe that I have been unjustly vilified and that I am owed an apology for having been put in this position and being slandered myself (and in this case the word fits).

I am sad to see RMAP take this position. I was certainly willing to work with RMAP and try to make some good will out of this. I am a big believer in the gastric bypass surgery and I am a huge advocate in the legislative sessions as we try to pass bills that will cause the insurance companies to pay for this surgery whenever medically necessary and I also, through my mother's past connections as well as my own, work within the medical community. I am reaching out to more and more obese people and past patients every day and I do give recommends. I would have always preferred those recommends be to RMAP but I cannot in good conscience continue to recommend anyone to a practice that condones this type of action. A practice should not fear its shortcomings but rather should realize that all practices have flaws and that bringing those flaws into light allow that practice to grow and become greater and stronger than before. If RMAP is not willing to do that, if they seek to always hide anything negative, no matter how true it might be, then it is not the practice that I thought it was.

Take care Meredith. Contrary to what you might believe, I harbor no ill will. It was my hope that you would come into this situation unbiased and allow a peaceful compromise take place between myself and Carly that would allow me to continue to help RMAP patients as I have tried to do for well over a year. I am somewhat dismayed that my efforts will need to take a different direction now. Please let your surgeons know that I will always speak very highly of them but that this situation makes it impossible for me to recommend their practice.

Thanks.
Sean

New Email from Meredith

Meredith called and left me a voicemail today. I was unable to take the call or return her call today because of work but after her email (see below), I don't see any reason for making that call. I'll post my reply after this but it's obvious that this is going nowhere. It's sad. It would have been nice to have resolved this and let bygones be bygones but oh well. (btw, let me ask you, when the "banning" is the issue and someone offers a resolution, wouldn't you think that implies a reversal of the banning? As you read Meredith's email, ask yourself that question).

Sean,

I called you and left a voicemail today wanting to speak with you regarding our current miscommunications. I would prefer to speak over the phone or in our office; however, it appears e-mail is your correspondence medium of choice.

First of all, I really appreciate the second follow-up e-mail to your previous one this morning. I feel I must speak honestly and I need to let you know I was quite offended by your words. I feel I have been trying my absolute hardest to appease the situation and keep anger at bay. I hope you can recognize that.

Second of all, it appears some mind-reading has been occurring on both of our parts. In my resolution with Carley, nowhere did I state part of the deal was to reinstate you to the boards. I apologize if you ever felt differently. When you offered your help to current and future RMAP patients, I assumed you meant in a different educational capacity, i.e. support group. It appears when you offered your services to us, you meant to be reinstated to the boards. This is a miscommunication that I do hope we can resolve.

In your previous contact with RMAP, we made it clear to you that in order for forum reinstatement to occur, a letter of apology addressed to the surgeons would be necessary. Because that has not happened, we must still stand by our decision to not allow you to post on our forums. I know this is difficult for you, and is not the resolution you were hoping for; please know I understand that.

I feel I have very much so stood by my word, as RMAP has moved on from the situation. I do not see where we have fallen short of that promise. I also do not see how I have pushed you away, as I gladly accepted your offer to help RMAP patients in the future in my very first e-mail to you. Again, I apologize for that miscommunication.

We have support group every month and I do not see a better place to start helping RMAP patients than our support group. Your $500 fee for education goes to support group; it is up to you whether or not you utilize the resource.

Due to our history of misunderstanding one another through e-mail, I recommend that we either speak over the phone or in person to further resolve the issue, if you would like.

Thank you,

Meredith, RN
Education Director

Email (Meredith from RMAP)

Aha! So I was able to retrieve the email Meredith at Rocky Mountain Associated Physicians sent me. It is a rather nice email but I would like to point out for those of you who have read all the emails, the resolution was aimed at getting me back on the RMAP message board. RMAP did move on but they did not hold up their end of the resolution. I am still effectively banned from their message board. I'm not a big fan of those who do not hold up to their word.

Sean,

Thank you for your e-mail. It appears some miscommunication has occurred between our correspondences. First of all, I appreciate your willingness to accept my proposed resolution offer; furthermore, I have appreciated your efforts in following through with the aforementioned resolution with Carley and RMAP. However, I felt your e-mails in response to my initial e-mail carried a feeling of aggression and argument. I did not feel a response from me would prove productive, as one or the other, would find fault and/or offense would be taken. Hence, RMAP has done our part in accepting and following through on our end of the deal. We have, in fact, moved on.

I apologize if you felt we did not appreciate your offer to help current and future RMAP patients; I currently did not have immediate need to implement you into our educational system. I currently have several patients who are involved with support for our patients; however, that certainly did not mean I would never have need of you. I lament your decision to hastily offer your services to Dr. Cottam, as I had been brainstorming how to best utilize your experiences and I was looking forward to using you this summer in our support groups. Nonetheless, I wish you best of luck with sharing your experiences to the rest of the world. Whether it is through RMAP, Salt Lake Regional, or any other weight loss medium, you, along with many other successful weight loss surgery patients, possess a unique perspective and I am happy you are so willing to share it.

I do hope your efforts in reaching out to Dr. Cottam will not inhibit your follow-up care with us here at RMAP. We want to ensure your optimum health through yearly visits and annual blood work. Please do not hesitate to contact us with any further questions.

Wishing you all the best,
Meredith, RN
Education Director

Review: Rocky Mountain Associated Physicians and Surgical Weight Loss Center of Utah

Okay, so as stated before, I wrote Meredith to ask what the deal was with Rocky Mountain Associated Physicians (RMAP). I was going to post her response on here but it went to my spam folder and for some reason yahoo deleted it. I can't find it any longer. However, it basically stated that my response to her was aggressive and confrontational and so RMAP decided not to respond to me and to move on.

I posted the entire email exchange here in my blog. As you have read, all I did was to express my disappointment in her bias and to express my perspective since I was basically being told that I was this horrid person. I stated in that same email, over and over again, that I held no negative feelings towards RMAP or Carly and expressed my desire to resolve the situation.

Apparently, Meredith didn't like me giving my perspective. So it's okay for them to tell me how evil and inappropriate I am but I'm not allowed to have my own views. I'm supposed to let them tell me every little thing they don't like about me but I'm not afforded the same freedom -- lest I be banned. Hmmmmm. Well, I'm sorry. I made the effort to make nice with RMAP but this is indicitive of what they do. This is why their surgeons are great but the rest of their practice sucks.

So I'll say it here. I won't recommend RMAP to anyone. The surgeons are top notch but the $500 educational fee is a joke, the education part of their practice is a joke and the fact that they ban patients rather than deal with someone like Carly (I've heard from 12 of you to date -- thank you for relaying your negative experiences with her) they turn a blind eye.

I don't ever regret the surgery. I never will. But if I had to do it again, even knowing Dr. Smith the way I do, I would be hard pressed wanting to have the surgery with RMAP. Especially knowing that Dr. Cottam and his group is a Center of Excellence that is actually thought of in a better light than RMAP.

So if you're thinking of bariatric surgery, my recommendation is to go to the Surgical Weight Loss Center of Utah. Dr. Cottam and his group will treat you much better than RMAP and the surgeons there are also top notch. The number to the Surgical Weight Loss Center of Utah is 801.746.2885. Trust me, the surgeons there are the equal of those at Rocky Mountain Associated Physicians but the overall customer care experience is much greater at Surgical Weight Loss Center of Utah and you'll want that. I promise.

Email me if you have any questions.

Sean

Sunday, March 1, 2009

Music

BTW, (off the WLS subject for a second), samples of my music are here on my blog. I'm always looking for new music so if you like the music you hear here, please let me know what other types of songs in this vein that you are listening to. You can find my email address by accessing my profile.

And, just so you know, I never, ever get tired of hearing "Supermassive Black Hole" by Muse.

Sean

Email to Meredith at RMAP

Just wanted to share the email I sent to Meredith this morning:

Meredith.

I appreciate the time you took to respond initially to me on February 6, 2009. I also appreciate the offer of resolving the minor issue that existed between myself and Carly. As stated, I have nothing against Carly or RMAP. However, though I accepted your offer and have done my part (not saying anything that could be considered even slightly negative regarding Carly or RMAP), it appears the issue has not been resolved (or let go) from the RMAP side.

I have a big need to give back and share my 250 lbs loss with others who are contemplating or just beginning the journey. My blog, the RMAP facebook group and obesityhelp.com has allowed me to reach out to many former RMAP patients who were negatively affected by my ban from the RMAP board and a few others but my intention at reaching out to you initially (as I stated) was to increase my ability to give back, to share with others everything I have learned and help them be as successful as I have been. Since RMAP has made it obvious they have no need/desire to make use of me and my experiences to help their current and future patients, I have reached out to Dr. Cottam and his weight loss group.

As the other center of excellence here in Utah, I will be able to give back to their large patient group. This was a hard decision for me as my mother has a huge connection to RMAP surgeons (Dr. Smith, Dr. Halverson) as well as with Paula. I will always hold a soft spot for RMAP but life's too short to push for something RMAP obviously doesn't want.

Thanks for your time. And I do wish you and RMAP all the best.

Sean

The Effects of Weight Loss

I was just about to log off my blog when something popped into my head that I wanted to share. What are the biggest changes in my life due to my weight loss? I mean surely weight loss alone can't make my life different, can it? I wanted to take a moment to explore that in my mind and as I do so, I want to capture my thoughts on it for you. Yes, I'm just going to ramble. So consider yourself forewarned *smiles*

1. Movement. I always knew that I'd be able to move better if I lost weight. It wouldn't be as hard to get up off the couch and I wouldn't have to fight to maintain my balance or to push up each stair as I go up them. But I NEVER anticipated the change here. I exalt in the feeling of my muscles now as I move. I want to get out and move. I run up stairs now not for exercise but because I can and it feels GOOD to do so. I park way out in the parking lot at stores because I LOVE to feel my thigh muscles as I stretch them out and walk. This summer will see me at the local high school stadium a lot stretching out and yes, even running. HUGE difference.

2. Reactions. As much as I always wanted to believe there were people out there who treated me as a person despite my weight, I now know for sure what I always suspected... that's not true. Even my best friends treat me different now than they used to -- though they do argue that's not the case. It's even a bigger change with those who are somewhat biased against large people (whether they know it or not). I was almost invisible to them and treated much like you would treat garbage (if you treated garbage in a certain way). Suddenly I am the focus of attention just by walking down the hall at work or the grocery store and flirtations come my way almost every day from all ages. It's fun but it has really surprised me.

3. Past Relationships. I'll be the first one to admit that running across my ex-mother-in-law for Halloween 2007 (six months after surgery), when I was walking to my daughter's Halloween parade at her school was one of my best post-surgery moments. She stopped to cross the street, looked back at me and when she noticed how much weight I'd lost, her jaw literally dropped open. That image is burned on my brain. And now this last weekend when my daughter asked me if coffee causes you to gain weight -- I had to chuckle when she told me my ex-wife is really affected by the 50 lbs she has gained (she used to be super thin). I'm sure it doesn't help whenever she has to see me and the 250 lbs I've now lost. While it ultimately doesn't matter to me these days, it is a bit of a delicious delight.

4. Behavioral Control. There isn't a lot we control in this life other than our behaviors and reactions. Not having control over what I ate, or rather having my body win the battle over my mind in regards to eating and not being able to change that no matter how hard I fought, was one of the most frustrating aspects of my life. That has all changed now. Recently I gained 9 lbs (from 223 lbs to 232 lbs). 230 is my scary weight -- when I start getting concerned. No problem!! I just focused on my water and everything I was eating. I wasn't perfect but I improved a lot and now I'm back to 224 lbs. Yay! Pre-surgery, no way that happens. Post-surgery? Easy!

5. Size does Matter. Oh yes it does. Now I can go to Ballet West, the Capitol Theater, Lagoon, Disneyland, Kingsbury Hall, Energy Solutions Arena, the Venue, etc. because I FIT IN THE SEATS!!!!!!! This also holds true for airplanes (my new job allows me to travel -- I wouldn't have been able to take it before as I couldn't have flown). I've been able to share a lot of things with my daughter, make plans with my daughter, and travel like I've always wanted to -- all because my size is now normal and not 2-3 times bigger.

Oh. And one last thing. Ask yourself this. What was your reason for taking control of your life, having the surgery, and losing the weight? Keep that reason in your head at all times!!!! It's important. It's easy to say you did it for yourself. That's the politically correct thing to say. But let's be honest, that's not the only reason you did it. Here are my reasons:

(1) Because I wanted to improve my health, be happier, and have the life I always dreamed about;
(2) Because I wanted to be the kind of dad for my daughter that I couldn't be with an extra 250 lbs packed onto my body;
(3) Because my failed marriage taught me that I was never going to have the type of relationship I wanted unless I did something.

And now that I've done it. Now that I've lost 250 lbs, you might ask how has that changed how I view those three things.

(1) My blood pressure is better than anyone else at my work. Well within the normal range. My cholesterol is a beautiful thing. I'm healthy, healthy, healthy. And I can feel it. My life is quickly becoming everything I always wanted it to be. I just wish I had done this a long time before I did. At least 8 years before I did. Actually I think if I would have had the surgery 19 years before I did, my life would most certainly have spun off in a different direction. Who knows though if that would have been better or not. I can't know so I just enjoy where I am now. But that would have been interesting, for sure.

(2) I love being able to take my daughter to plays, to amusement parks, hiking/camping, and planning trips with her. I can now be the type of dad I have always wanted to be. It does suck a bit that I only get her 40-45% of the time. I miss her sounds and presence when she's not around. I love hearing her singing and dancing in her room, the "thumps" from upstairs, or the "daddy?!" when she has questions. But that's always the downside to divorce. At least my time with her now is of a high quality. We're always out doing something. This summer I'm going to get her into exercise and that will be yet another thing we can share.

(3) Ah, this is a big one. My ex-wife has a lot of qualities that I still admire to this day but how she was when we met... I never would have had a relationship with her if I'd been healthy. I didn't feel I was going to meet anyone better where I was weight-wise and so I ignored a lot of red flags. Now that I'm dating, I'm finding that I have the ability to make wise choices that aren't based around "what if I never find someone else?" This area is one of the more exciting to me. My self-esteem and self-confidence levels are at an all time high and continuing to increase with every day.

I'm absolutely giddy about where things are headed. I love my job, I'm highly thought of by the C level management at my company, the dating pool is amazingly large, I'm able to enjoy every minute of time with my daughter... things are good. So assuming I don't get hit by a bus tomorrow, I'm looking forward to every minute of every day for the next few decades. So all in all, the weight loss has exceeded every dream that I had of how it would be like if I lost the weight.

Plastic Surgery

Again I have to apologize for taking time away from updates. I've been under the weather. Before surgery I never used to get sick. I have to think that was due to one (or all) of three things: (1) My body had a lot more food to use to keep my body healthy; (2) the extra food and the lack of malabsorption helped my body be able to fend off illness; (3) I was too heavy to do much so I didn't get out and around people who were sick much.

I know it wasn't JUST (3) because I caught my daughter's illness this time and I've always been around her when she was sick (before and after surgery). But the first two times I EVER got a bad case of the flu have been post-surgery. All I can say is "ick!" I feel icky.

Anyway, today I wanted to talk about where I am on this journey. I currently weight 224 lbs. I still can't believe that I'm 250 lbs lighter than I was on April 11, 2007. I still double take whenever I see myself in the mirror. I went in to see the plastic surgeon this past week to discuss removal of my excess skin from my thighs, abdomen, upper arms, back and chest. I've scheduled (within the next couple of months) the first surgery for this. It will include the upper arms, the thighs, and the abdomen. I'm both excited and a bit anxious about this surgery. With any luck by June I'll be loving life.

But here's what I wanted to talk about in regards to that surgery. The timeline for this type of plastic surgery is much the same as it was for gastric bypass. You have to walk a lot after the surgery to avoid blood clots, 5-6 weeks and your surgeon's clearance before you start heavy exercise, and overall it takes about 18 months for 100% recovery -- scars looking their best, skin reattached perfectly, nerves regenerated, etc. So I'm going into it looking at it like 2009 is my plastic surgery year and 2011 is the year when my entire journey will be completely, 100% behind me. I'll be living my life long before 2011 (I already am) but I'm looking forward to the little improvements this is going to make for me with my exercise, etc.

By the way, if you want a plastic surgeon reference, try Dr. Scott Haupt. You can google him. I think he's amazing -- he spends an inordinate amount of time (both he and his patient coordinator Sheri) answering your questions and making sure that you have all your questions answered. If you elect to see him for a free consultation, please let him know you were referred by me.

Anyway, wish me luck.

Sean

Sunday, February 22, 2009

Weight Loss / Inches

For those of you who have followed my blog and are familiar with my journey, you know that I got down as low as 223 lbs but have fluctuated in the months since between 225 lbs and 232 lbs. It's been a little frustrating but I owe it to my diet and lack of water on a daily basis.

I really haven't had much weight change since December 2008. However, I did my measurements (waist, thighs, upper arms, neck, chest) in December and measured again just today. I've lost 2 inches in my waist alone. So while the weight hasn't gone down, the inches are still down. And inches are where it's at.

So keep this in mind anytime you hit a plateau. Sometimes the weight stabilizes but the inches continue to drop. Inches are better than weight.

How Others See Us / How We See Ourselves

How We See Ourselves
How many of you have lost a ton of weight but your mental image of yourself is still as an overweight person? I know it's still hard for me to wrap my mind around. I find myself still acting (in some ways) lke I did when I was overweight and sometimes thinking others view me as that overweight person.

How Others See Us
Isn't it amazing how others now see/treat us? Now that the weight is gone, suddenly we are more human, we aren't considered the invisibles. Opportunities in all areas of life are not available to us -- opportunities that were not available before. In all the years leading up to this moment, not once did anyone tell me that they thought I was good-looking. Not even when I was married. But since I dropped below the 250 lbs barrier I have had several comments. Wow. How much of a difference that makes. It's much like never being touched by another human being for 10-15 years and then all of a sudden getting a big hug.

Time and new experiences are what will ultimately change our perceptions of ourselves. I've noticed my perception of myself slowly changing over time. It's almost as wonderful as the weight loss journey itself.

Yay!

Update: Weight

For those of you who have been reading my blog on a regular basis, I altered my diet slightly over the past few days. I got away from eating so much beef jerky and I was really good with my water intake. The result has been shedding the water (finally) that I've been retaining. On the bad side was I was having to visit the restroom every hour for a day but the good news is that I lose 2.2 lbs just yesterday. Yes that means I weighed in at 227 lbs this morning. Yay! Below my scary weight. The funny thing was how all this affected the fitting of my pinkie ring that my daughter gave to me. Whereas it was perfectly snug before, now it's a little big.

I love the control that I have now. I eat like a normal person, can eat pretty much what I want... but now I eat the same portions as everyone else. I now can have conversations with others about how I'm eating and because I no longer have the large amounts of weight, I don't feel self-conscious about having the conversation. Yes, it's all good!

Saturday, February 21, 2009

New Update

Sorry for the absence but life gets hectic sometimes. I haven't been doing very good on my pledge to stay true to the diet plan. I actually went up to 232 lbs. Started freaking out. 230 is my scary weight so it's been nerve racking to say the least. However, I had two really perfect days (today wasn't but the two days before that) and I weighed yesterday morning at 229 so at least I'm headed in the right direction.

NEW FOODS
Protein Bar. I have a new protein bar. It's a bar put out by Premier Nutrition called "Protein: High Protein Bar" I found it first at Costco for about $1.62 a bar (12 pack). But recently I discovered it at Sam's Club for about $0.94 a bar (15 pack). The bar is bigger (which is good for me because I can eat a lot more now than in the past) but the bar packs 30grams of protein. So I bought four boxes (should keep me for like a month), along with a block of cheese, a lot of beef jerky (peppered) and a bunch of my new yogurt (see below). That plus some veggies should pretty much keep me for a long time. I know, I know. I'm not very creative when it comes to food but the regimen is what works for me.

Yogurt. At first I was in to the Yoplait Light (Thick & Creamy because it has Sucralose instead of Aspartame) but then I discovered Weight Watchers (better tasting, uses Sucralose, and has a bit more protein). However, recently I've moved to Kroger's (only available at Smith's). It's called Carb Master. Stupid name but amazing yogurt. Only 4 grams of carbohydrates and more protein than any other yogurt I've found (and only 1 gram of sugar). It's not as sweet or yummy tasting as those other ones but now I don't cringe when I eat yogurt.

Okay.. there you have it. My update. More later. Thanks to everyone who has written me to let me know how they are doing. I appreciate it. Also I haven't heard from Meredith at RMAP since I accepted her resolution to my situation with Carly. I have nothing against anyone at RMAP, I really wish they could say the same.

Sunday, February 15, 2009

When Weight Loss Ends

I've recently found that my weight loss has stalled. I got down to 223 lbs (which was 2 lbs under my goal weight) but more recently I'm up to 230 where I have settled. I'm perfectly happy at this weight. Other than my excess skin which I'm hoping to have removed as soon as I can afford it, I'm very happy and feel great. But I've wondered why the stall. I've only lost 85-90% of my excess weight. (keep in mind I'm not quibbling about it, just wondering)

So I started taking a micro look at the calories I ingest every day. I am prone to eat simple carbs here and there throughout the day. Especially at work. Not a ton, mind you, but a few little cheats here and there. As I analyzed it, I realized how many calories I am letting into my diet without even really knowing it. One piece of bread is like 100 calories. All in all, I think that's how anyone eventually gains some of the weight back. It gets to where you can eat normally and so you do. You can't eat as much but you get into this false sense of security because of how easy it was to lose the weight. Now you have to pay attention.

This is why I've advocated a food journal though most people (myself included) don't do this. But with the success I had using a food journal and turning it in daily to a friend (having a competition with her for best journal really helped too), I think I'm going to go back to that, see if I can get back to 223 again.Wish me luck.

Saturday, February 14, 2009

Changes in Libido

One other thing that they don't tell you is that your libido will be affected. I've heard a few say that their libido decreased. I'm not sure if that's because of everything you suddenly have in your life that wasn't there before or what but for most of us our libido will increase.

Yes, INCREASE! It's kind of scary in a way. But it can also be a wonderful thing.

I haven't had a libido like this since I was 18. It has to be because my body is truly healthy. Healthier than it's been in a really, really long time.Anyway, the reason I bring this up is because you really need to keep this in mind and be ready to deal with it otherwise you might end up making decisions that aren't good for you.

Friday, February 13, 2009

My Tailbone

Sorry I've been so neglectful with my blog lately. Life has been hectic. My work sent me out to Boston. I flew out to Baltimore and then took a connecting flight to Boston. On the way back, I flew from Boston to Atlanta and then to Salt Lake City.

One thing they don't tell you going into this surgery is that when you lose your weight, you feel your tailbone a lot more. I'm always finding I'm sore there. And the flight from Atlanta to Salt Lake City was no different. I thought I was going to die it hurt so bad.

But there is always a bright side. In this case it's that I fit in the seat without a problem. Even on the Baltimore to Atlanta flight when I was in the middle. It's so awesome sitting in a seat without overflowing. Yay!

I hope you all are finding little things like this on your journey. Revel in each and every little wonderful thing that happens to you. It's a great ride.

Sean

Tuesday, February 10, 2009

Beef Jerky/Sodium

If you eat a lot of beef jerky, you might notice your weight loss slowing down. If you're eating the appropriate amounts, at the appropriate times, and not deviating much for your diet, then the problem most likely is the high sodium content in the beef jerky.

I LOVE beef jerky and eat a ton of it every week. It's and easy food (already prepared), tasty, and it has a ton of protein. However, it does have a tendency to cause water retention. So you can still be losing fat (your body still has to eat) but the scale might not reflect as much because of the water retention.

There are two ways I've found to fight this. (1) Up your water content. As long as you flush your body with a ton of water, it has a hard time retaining water. I usually find if I'm retaining water (even with the beef jerky) it's because I'm not drinking enough. (2) Every so often I go off beef jerky and focus on other things (and stay super close to the eating plan including my water level). This really gives your body a flush and if you've been retaining water you usually notice a huge drop in weight (though I'll warn you if you're retaining water you'll be visiting the little boys/girls room a lot over the course of the next couple of days).

I hope that helps.
Sean

Sunday, February 8, 2009

Yogurt

Over the past year or so, I've had numerous conversations with WLS patients about yogurt. Some like it, some don't. Some believe you should eat it, some don't. It's been referred to as a "slider" food (a food that doesn't have enough consistency to stay in your pouch for long).

For what it's worth, here's my take on yogurt.

UP UNTIL NOW:
My body seems to crave yogurt. For a long time I believed it was because of the calcium. While that might be the case, I'm not of the belief that's because of its sweetness. Most yogurts are insanely sweet. Case in point, Kroger's regular yogurt has 43 grams of sugar.

I personally prefer yogurts without Aspartame in them (the light thick & creamy by yoplait or the Weight Watchers). Each of these yogurts (6 ounces) are 100 calories and are sweetened by sucralose (splenda). While both taste great (I think the Weight Watchers is better), both of them are also sweet tasting. I believe that makes it easier to eat more and have it curb your appetite for less time. Weight Watchers has 6 grams of protein, 3 grams dietary fiber, 17 grams of carbohydrates (12 grams of sugar) -- and it's the better of these two (by a slight margin).

CURRENTLY
Recently, a dear friend of mine put me onto a new type of yogurt. Kroger's (available at Smith's only) has a yogurt called "Carb Master." Yes, it actually says Carb Master on the label. It only has 4 grams of carbohydrates (3 grams sugar) and 1 gram of dietary fiber but get this, it has 10-12 grams of protein. The result is a yogurt that isn't as good tasting (since it's not as sweet) but I've found that it's way more filling and curbs your hunger for longer than those other brands. And it only has 80 calories (6 ounces). I highly recommend it.

As I've always maintained, the more simple carbs you eat (and sugars count here), the more you trigger your hunger. Your body burns off simple carbs FAST and it raises your blood sugar level quickly. Once they've been burned off you have a crash and your blood sugar level drops and your body suddenly wants more. It's like a drug. That's why things like nuts, beef jerky and other meats stay with you longer.

Friday, February 6, 2009

Conversation with Meredith (part 4)

There you have it. What happens from here on out is up to Meredith and RMAP. Thanks to everyone who urged me to write a letter to RMAP about what was going on between me and Carly. If not for the 20 plus emails that I received regarding that, I don't think I would have reached out to Meredith. I'm glad I did, regardless of what she decides to do.

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Meredith.

Sorry about the long reply email before. Look. This has been a very intriguing but unbelievable issue between Carly and myself. She was certainly welcome to reach out to me and let me know that she felt I was personally attacking her as that was never my intent. Your offer for resolution is fine as I have never thought negatively about Carly. My only desire through it all has been to give back to RMAP and I have done a lot of work in that area towards supporting the patients and giving glowing recommendations of RMAP as well as Doctors Smith, McKinley and Simper (especially Dr. Smith). Those recommendations have come from my mother's conversations with various nurses at St. Mark's and LDS hospital (she worked as an anesthesiologist for many many years and keeps in touch with many within the medical community) and her personal knowledge of working with Dr. Smith at the SL Surgical Center as well as the former RMAP I know and those in the medical community I work with since I'm in the field of healthcare.

As stated, I contacted you in order to try and continue to give back to RMAP. That offer still stands. I believe in RMAP and have always felt that to give back is the least I can do for what I was able to accomplish with their help.

Sean

Conversation with Meredith (part 3)

This is my reply to Meredith. I was astounded by the information that she sent in her email which confirmed my suspicious that she would get and take Carly's side. I'll admit that in reading the first part of her email my defenses went up and that's where this response came from. While this response is true in everything, it was merely me getting defensive. I completely missed the part of her email wherein she offered a resolution. Once I read her email a second time and caught that part, I sent a second follow up email (see part 4)

--------------------------------------------

Meredith.

My email in no way was an attempt to have anything done to Carly. I have never harbored ill will of Carly. Period. However, I will point out that despite the fact that you and Carly both have the best interests of RMAP in mind, not thinking there is room for improvement is not the best place to start. No one on this planet (myself included) is infallible or error free. There have been many complaints about customer service with RMAP -- including complaints against Carly. NO ONE (especially myself) has ever slandered Carly or anyone at RMAP for these failings but merely have brought them to light in hopes that RMAP will continue to improve (as they improved in order to become a center of excellence). The complaints seen on the board include not being responsive to calls, unnecessary delays in paperwork, perceived rudeness (at times - no one is saying all the time) from nurses or even perceived poor bedside manner by certain surgeons. Case in point, there are multiple posts on the message board talking about Dr. Smith's perceived lack of caring and poor bedside manner (an opinion not shared by me -- in fact I vehemently countered these claims by my own personal knowledge of Dr. Smith) but yet no one was ever banned for their perceptions.

However, I do take issue with your definition of slander. The dictionary (and the legal world) define slander as a malicious, false, and defamatory statement or report (i.e., a slander against his/her good name). If a comment is true, if it is not malicious, and if it is not defamatory, it cannot be slander. I have never written a post that could be classified as slander (as I have never posted anything that wasn't (a) true; (b) defamatory; or (c) malicious).

I can guarantee that you never read the post in question. I actually have a copy of it. If you had, you would have read my accounting of my phone call with Carly that day. It did not say she was unable to do her job, it did not say anything bad about her at all. It stated that I hoped that RMAP had room for improvement in the customer service area and I hoped that they would continue to improve there. It was not a personal attack on Carly a fact that everyone on the board (other than Carly) who read it shares. As for the phone call between Carly and myself, there was no courtesy involved. I did not ask for Dr. Smith's time. I told Carly that I did not "need" an appointment with Dr. Smith as everything was fine but since he had "asked" me to check in with him after 6 months about where my weight was, I wanted to know if he really needed to see me. Though I rephrased this question three separate times, Carly completely ignored the request and merely repeated that if I came in I would have to pay for the visit. There was no attempt to set up a block of time. My post reflected that and also made the jump in logic that it would have been nice if she would have just asked Dr. Smith if he wanted to see me due to this or if we were good. Now, since I know you are obviously going to lean towards the side of your colleague (why wouldn't you, you don't know me but you work with her) I know you'll dismiss my statements. That's fine. However, since the incident, I have had several (unsolicited) people contact me and leave me comments about Carly. Every single one of them have brought up her need to improve on her courtesy and customer service skills. None of them (mine included) have said she is a bad person. There has been no slander. And to ban people who point out flaws in the hope for improvement is merely to turn a blind eye to an area that can make RMAP (as a whole) better.

Anyway... the only reason I related that to you was to let you know why I am no longer providing support for RMAP patients via the message board. It wasn't to argue my side or to convince you that I should be reinstated. I was on the board as a way to give back to RMAP. It certainly took a great deal of my time but it was something I felt I owed. After all, my mother worked directly with Paula, Dr. Halverson and Dr. Smith which is why I went with RMAP in the first place. I have posted in several forums my direct knowledge of Dr. Smith's excellence as a surgeon (based not just on my experience but from my knowledge captured from may places).

My reason for contacting you was to offer my help (if ever needed). It was yet another attempt on my part to give back to RMAP. However, if it's not wanted or needed, that's fine. One day I hope Carly will recognize that I never harbored any ill will towards her and that the only malicious thing that happened on the message board was her banning me for leaving a post that she took personal but was actually not personal.

Anyway, enjoy your weekend.

Sean

Conversation with Meredith (part 2)

Apparently Meredith spoke with Carly after reading my email and she then sent this reply. It's about what I expected. I find it interesting that she thought I was trying to get Carly fired. Was there ANYTHING in my first email that would give ANYONE that thought? Can you say paranoia? By the way, the definition of "slander" (keep this in mind as you read it) is making a false, malicious, defamatory statement against someone's good name.
_________________________________

Sean,

I appreciate the time you spent to contact me. First things first: Congratulations on such an INCREDIBLE journey to find the new you- inside and out! The task you undertook (and will continue to undertake) was certainly far from easy and I am sure it was bathed with bumps along the way. Dr. Smith, the blessed man that he is, did provide the means to change your life, but ultimately, it was you who changed your own life. And in that you should take great pride.

I am aware of the recent forum situation and would like to shed some light on it for you, if I may. Not only is Freedom of Speech permissible on our RMAP forums, but it is a right provided to us in this country. But just like the God-given right to speak freely, there are respectful limitations. None of us are perfect, and that definitely includes us at RMAP and our interactions with our patients. I fully recognize that you felt you were not given appropriate customer service during a conversation with Carley, and that always feels frustrating, no matter the situation. However, I would hope you can put yourself in her shoes and try to understand the demands of a medical practice. Unfortunately, for all involved, our doctors live hectic lives and lead very busy schedules, which puts a damper on the amount of time they can spend with patients. From what I understand, Carley simply wanted to set a block of time, just for you, to meet with Dr. Smith. It appears this courtesy may not have been received properly, and for that we do apologize.

I do feel it necessary to share with you that in the short time I have been with RMAP (4 months in the summer, and now since middle of January upon graduation), RMAP needs Carley. She has bright ideas for improvement and has the fortitude and determination to promote and execute change. She and I have very similar goals for RMAP, as we look to the future as a big picture, and we are constantly looking for improvement. I am not sure if you are trying to have us let her go, or not; but I must tell you, she will be the last person to be let go. Again, RMAP needs her. The difficulty found in voicing your opinion about one of OUR employees in a negative light on OUR forum, is the setting. Just like you have seen, people feed off of one another on the message boards and will only add fuel to the fire (good and bad). Hence, when stating your disappointment in one interaction with Carley on a public forum, is slanderous. Put yourself in Carley’s shoes, would you want to be a moderator of a forum to only find hate messages posted about you? From patients you care about deeply? It comes across as backstabbing. Of course, all of us can improve our customer service skills, but if presented in a constructive critique. Your approach did not appear to be a constructive critique.

And I do know, that it only makes it more difficult for us to feel that your criticism was constructive when you currently still permit other patients to degrade Carley on your blog. Do not get me wrong, blogs are personal and they are for your own particular use. I have a blog- and what I choose to write about it is my own business. However, frequently adding more anti-Carley posts is degrading, hurtful and malicious in nature. I do hope you can appreciate that and, again, see it from her perspective.

In terms of your thoughts regarding the $500 education fee, that truly did not play a role in the removal of your membership from the forums. We were already aware of the problem in the education department; hence, I was brought on. Just as much as I hope you take great pride in your weight loss journey, I take great pride in improving our education program. My priority is to provide various useful resources for our patients, and to be utilized as a resource for knowledge, a listening ear, and to offer advice when needed. Support group has become my “baby,” and do hope you can find a way to attend. I am excited with the direction it is going and am always looking for ways to improve it. Please do not hesitate to flood me with ideas, questions and concerns to help better RMAP. I so value patient input, as their satisfaction means my satisfaction. But I do hope that such input will be directed toward a single entity, like myself, and can be addressed in a constructive way.

I want to acknowledge and extend my gratitude for the many good works you have done for RMAP and our patients. It sounds like you are a great asset for those patients who know you and look up to you. And my hope for a resolution in this matter is as follows: No more negative posts about Carley, as we clearly have witnessed both negative and positive testimonials pertaining to her; all of us are striving to be better. And I hope to maintain your trust in RMAP. We are on your side, we are your allies and we want to help you succeed in any useful manner possible. We choose to do what we do, here at RMAP, because we find joy in serving you. Your experiences will be of great use to me- I hope you didn’t bite off more than you could chew when you offered your services!

Meredith, RN
Education Director
1160 East 3900 South STE 4100
Salt Lake City, UT 84124
Phone: (801) 268-3800 Fax: (801) 268-3997

Conversation with Meredith (part I)

I reached out to Meredith (the new Director of Education) today. My reason for reaching out to her was to offer her my help if it was ever deemed that it would be beneficial to RMAP. In whatever capacity. I don't have the ability (time) to go to support groups so in the past I have tried giving back by being active on the support board. Obviously since the ban by Carly, I haven't been able to do that. I gave Meredith a little background on the ban. Here's the email I sent:
________________________

Meredith.

I apologize for not being able to speak with you yesterday. Work has been crazy as of late. I just wanted to introduce myself. I had gastric bypass with Dr. Smith on April 11, 2007. My weight at the time was 474.1 lbs. As of today, my weight is at 223.2 lbs (which is 2 lbs below the goal I set for myself). The journey has been amazing and I have learned a lot about myself and how to keep myself situated on this end of the spectrum for the rest of my life.

Anyway, after surgery I spent a great deal of time on the RMAP message support board and several of the old timers helped me out a great deal. As I got further along in the journey, I found myself giving back the support I had received. There came a point where I stopped frequenting the message board and only responded when I received private messages from other patients. Over the next couple of months I had so many RMAP patients emailing me asking for me to come back to the message board that I did. However, I apparently offended Carly when I relayed a frustrating experience at my 18 month mark. The experience I related spoke about how at my year mark Dr. Smith told me to check back with him in six months just to see where I was with my weight. That conversation happened only because I told Dr. Smith I wanted to go beyond the 250 lbs mark that he had set for me. I didn't need an appointment with him but called RMAP only because he told me to check with him in 6 months regarding my weight. Anyway, Carly informed me that I'd have to pay for an appointment if I wanted to see Dr. Smith. I asked her to just ask him what he wanted because I didn't necessarily need an appointment but he had told me to check with him about my weight. If he wanted me to just stop by so he could see where I was at, great. If not, fine. Anyway, long story short... it just wasn't the most ideal customer service moment. The other portion of that email was stripping down the $500 educational fee that some of the members were complaining about. In my message, I broke down what the fee was really for -- which is the pre- and post- surgery educational component and stated that if you take advantage of that component, it's worthwhile otherwise it's not. I also stated that RMAP believes that the educational component is necessary for long-term success and require it for their patients. The result of this email was a ban from the message forum.

It doesn't really bother me that I am banned from the message board. I've completed my journey. However, after the ban many RMAP patients continue to email me to ask me questions about my journey and to get my support during theirs. I offer them my (as needed) support through a personal blog and email. One RMAP patient created a Facebook group for everyone.

Sorry for the really long email. Where I'm going with this is that I have had an amazing journey. I believe in giving back in life which is why I was on the message board to begin with. Patients do need their doctors and nurses to provide them with medical help and advice but they also need the support and help of those who have gone before. If you read through the messages left by Michelle Christensen from the start of her journey to today you will clearly see what I'm talking about. Anyway... for what it's worth, I have been and am still willing to be there for RMAP patients. I do not usually have the time to go to the support meeting each month which is why I was on the message board. But if you ever need assistance from someone who has lost 250 lbs and understands the journey (from a personal level -- not a medical level), let me know.

Also, would you please let Dr. Smith know how much he has changed my life? I owe him a lot. Losing this weight has been everything I ever dreamed and more. I've attached a few pictures so you can see the transformation.

Thanks.

Sean Joyce

Basic Gastric Bypass Information

Nutritional effects
After surgery, patients feel fullness after ingesting only a small volume of food, followed soon thereafter by a sense of satiety and loss of appetite. Total food intake is markedly reduced. Due to the reduced size of the newly created stomach pouch, and reduced food intake, adequate nutrition demands that the patient follow the surgeon's instructions for food consumption, including the number of meals to be taken daily, adequate protein intake, and the use of vitamin and mineral supplements.

Protein nutrition
Proteins are essential food substances, contained in foods such as meat, fish and poultry, dairy products, soy, nuts, and eggs. With reduced ability to eat a large volume of food, gastric bypass patients must focus on eating their protein requirements first, and with each meal. Proximal GBP rarely leads to protein deficiency if this simple precaution is followed. Distal GBP is more likely to lead to protein deficiency, particularly if fat intake is excessive, and the position of the Y-connection is farther downstream. In some cases, surgeons may recommend use of a liquid protein supplement.

Calorie nutrition
The profound weight loss which occurs after bariatric surgery is due to taking in much less energy (calories) than the body needs to use every day. Fat tissue must be burned, to offset the deficit, and weight loss results. Eventually, as the body becomes smaller, its energy requirements are decreased, while the patient simultaneously finds it possible to eat somewhat more food. When the energy consumed is equal to the calories eaten, weight loss will stop. Proximal GBP typically results in loss of 60 to 80% of excess body weight, and very rarely leads to excessive weight loss. The risk of excessive weight loss is slightly greater with Distal GBP.

Vitamins
Vitamins are normally contained in the foods we eat, as well as any supplements we may choose to take. The amount of food which will be eaten after GBP is severely reduced, and vitamin content is correspondingly reduced. Supplements should therefore be taken, to completely cover minimum daily requirements of all vitamins and minerals. Absorption of most vitamins is not seriously affected after proximal GBP, although vitamin B12 may not be well-absorbed in some persons. Sublingual preparations of B12 will usually provide adequate absorption. After the distal GBP, fat-soluble vitamins A, D and E may not be well-absorbed, particularly if fat intake is large. Water-dispersed forms of these vitamins may be indicated, on specific physician recommendation.

Minerals
All versions of the GBP bypass the duodenum, which is the primary site of absorption of both iron and calcium. Iron replacement is essential in menstruating females, and supplementation of iron and calcium is preferable in all patients. Ferrous sulfate is poorly tolerated. Alternative forms of iron (fumarate, gluconate, chelates) are less irritating and probably better absorbed. Calcium carbonate preparations should also be avoided; calcium as citrate or gluconate, 1200 mg as calcium, has greater bioavailability independent of acid in the stomach, and will likely be better absorbed.