Dragon64

I have not had any reflux since I started the CPAP machine. I hate being on the machine, but if it keeps the reflux demons away, then I am good with it. I've elected to not stress over the possibility of reflux coming back after the sleeve operation, but I do plan to work closely with my doctor, if he feels that I am at too high of a risk, then we can begin discussions of gastric bypass as an alternative.

The second list I received from my nutritionist deals strictly with behavior. We ALL have to make life-style changes, and to do that, we have to modify our behaviors. As recommended by my nutritionist, select one behavior to modify, and each month, incorporate a new behavior to modify. 1. Eat at the table instead of while watching TV or reading. 2. Pre-portion your food and put the box or package away. 3. Keep tempting foods out of house. 4. Don't go to the grocery store hungry. 5. Make a shopping list. 6. Use smaller plates and bowls. 7. Keep healthy foods available. 8. Focus on activities other than eating. 9 Brush your teeth, floss, and use mouthwash after meals or if feeling the desire to eat. 10, When you are at parties or buffets, be sure to eat sitting down and facing away from the buffet or food table. Allow some distance between you and the foods. Offer to bring a healthy food item to a party. 11. Park your car far away from your destination. 12. Take the stairs instead of the elevator. 13. Keep a food exercise diary. You will find that some of many of these modifications you are already practicing, so be sure to select one that you are not yet practicing, do not skip a month. Remember we are adding to, not changing out modifications in order to create these new life-style changes. Again, I hope you find this and the previous helpful, they have become my guidelines. My first month I selected #1. This month I selected #3.

My nutritionist gave me a large packet of very useful information, most of it had to do specifically with what to expect before and after surgery, and to to maintain a new and healthier life-style. But it was the lists that are helping me make the life-style changes that I have taken whole heartedly. I would like to share these with, in hopes that they can help you in the way they are helping me. Here is how it was explained to me; from the first list of 20 options choose 2 modifiers and start employing them into you life. Then, when you see your doctor in a month, choose two more. Don't just choose them, but add them to the previous months modifiers. Repeat this month after month. I call these modifiers, as that is essentially what you are doing, modifying what and how you eat. here is the first list: 1. Do not skip breakfast - eat three distinct meals per day. Avoid grazing. 2. Decrease portion sizes and stop eating when you are no longer hungry vs. when you are full/satisfied. 3. Limit eating out to once/twice per week; make better choices when eating out; ask questions about how the food is prepared. This might mean you cook more at home and meal prep. 4. Increase fruits and vegetables by including one or both at each meal. 5. Reduce desserts/candy/sweets to one time per week. 6. Reduce grab-n-go processed foods such as granola bars, chips, frozen meals, PB crackers etc. 7. Prepare meals with a half-plate portion of non-starchy veggie, a palm-sized portion of lean protein, and 1/3 - 1/2 cup of healthy carbs. 8. Avoid fried foods and begin choosing leaner meats (Leaner meats include the word round or loin such as sirloin, top rounds etc.) 9. Begin some sort of activity every day even if just for 5 minutes (walking, swimming, exercise videos etc) Reduce time sitting. 10. Decrease caffeinated, sweetened, and/or carbonated beverages with the goal of eliminating. 11. Start gradually increasing your water intake until you are up to at least 64oz per day. 12. Reduce alcohol with the goal of eliminating. 13. Begin a multivitamin daily (after surgery, you will switch to a quality bariatric vitamin). 14. Begin calcium citrate with vitamin D 500mg twice daily. 15. Practice taking bites the size the size of a thumbnail, eating more slowly, chewing more. 16. Practice SIPPING beverages---no longer "chugging" or gulping. 17. Practice NO LIQUIDS 30 MIN. BEFORE/DURING AND 30 MIN. AFTER MEALS. 18. Practice positive self-talk; weight loss isn't easy, so be nice to yourself! 19. Begin to reduce use of straws and gum. 20. Track calorie intake. The first month I chose #7 and #18. This month I chose #9 and #20 I hope this will be of some use to you who are just getting started, and to those of you already on the losers bench...

You brightened an otherwise dreary start to a day (work related dreariness). Thank you !

Well, I have been on multiple diets, the most damaging of which was the starvation diet (no breakfast or lunch, with huge supper). My metabolism rebelled against me so hard... it took months to get turned around, and yes, I gained back all the weight plus some on that self imposed diet. I'm working smarter this time, as I have a team of weight loss professionals on my side, surgery or no surgery, this is happening. I am very happy to share this with you all, cause going it alone just plain sux!

I'm just so tired of being unhealthy... I don't want to live forever, but I am striving to live longer. Thank you for the kind words!!

May 9, 2018 Update: I have mentioned some lists that I have been working from in the last month or so, lists that I received from my nutritionist. These lists, the behavioral list and the how to eat list, have been very beneficial to me on my journey. I will try to post the lists in another posting, as they benefit someone else just starting out. The deal is, from the how to eat list, I would select 2 changes (from 20), and from the behavioral mod list, I would select 1 (from 13). Then every time I visit my family doctor for a monthly weigh-in, I get to add 2-more and 1-more from each of the lists. Note here, you are not swapping out last months changes with this months changes... No, you are actually adding these new changes, in hopes of developing the life-style changes that we need in order to be successful with our surgery. This month I added in exercise from the list of 13, and using the My Fitness Pal app from the list of 20... more on this later when I post the lists. So I started exercising just this past Saturday, the day after my 3rd visit to my family doctor. It is a simple workout from the Power 90 series of videos put out by Beach Body. There are plenty of other options, but the exercise guru, Tony Horton, has some charisma, so I stick with him... My "man-crush" so to speak. So I start this on Saturday, and I gotta say, that I noticed a scale victory right off. I am losing a pound everytime I exercise. No crap, I weigh before I exercise, and then after, and I have lost a pound... Too bad I am maintaining at the moment (301 to 302 etc etc) I should mention here, that losing as much weight as possible prior to surgery was aggressively stressed to me by my surgeon. Dr Foreman stated that the more weight I can lose before surgery, the easier it will be to get to my goal weight... and my nutritionist stated I could also have a shorter pre-liquid diet (or no pre-liquid) if I can get as low as possible. ...and I have an admission to make here; My wife, who is my corner stone, my life and my god-send angel, has expressed that she does not want me to have surgery. She will support my decision to have surgery, and will be by my side through out no matter what. But she has issued me a challenge; that if I can get my weight down to the point that my BMI drops below insurance acceptance level of 35, that I will cancel the surgery and continue on my new life and course. As stated early on, I have been able to quit smoking pot, cigarettes, and I managed to quit drinking. She believes I have it in me to succeed at this endeavor as well. So what have I got to lose? By September 4 of this year I will either be canceling my surgery, having met my wife's challenge, or will be receiving my surgery date... both paths lead to a healthier me, and shame on me if I do not try! No doctor updates until June 6, so more when I know more... maybe when I drop below 300, as that would be huge for me at this stage of my life!

The visit went well Frustr8, the doctor was happy with my progress. I felt good and was in great spirits. Today I started my exercise routine... figured right away that I needed some clothing to left move freely... seams of the clothing tended to chafe me...

Thank you! I feel so good about the visit, I gave myself half the day off from work!

May 4, 2018 Family Doctor Visit (3 of 6) Stats: Weight: 306.4 BMI: 42.7 So, a net loss of 10.2lbs since my last visit to the family doctor. He was quite pleased with the progress. To recap from the last visit; I was concerned that I was not losing any weight. He asked that I get some blood work done to check my thyroid and insulin levels. As it turned out, my insulin levels were elevated, and my doctor started me on Metformin. That same week I started on metformin, I met with my nutritionist, who worked up a diet plan for me... It would seem the combination of the two have been a success! Just last week I gave away 4-pairs of pants to my mother so she can make a denim quilt, they ranged from size 50 to 54 (men's). I am now wearing size 48 comfortably. The hardest part of this journey is the 'life style' change that we all must change in order to make this journey work. I can honestly state that I have nixed "head hunger" That feeling you get when your head says you are hungry, but your stomach is mum on the subject... I no longer feed the head beast, that is a huge life style change for me. The next is pushing away when you are satisfied... That takes some getting used to, as I like to eat until my plate is clean! So going forward, I am starting an exercise routine, a routine I used to follow some 10-years ago; 6-days on and 1-day rest (Saturday-Thursday, off Friday) My favorite exercise video series that I can faithfully do at home is Power 90 from Beach Body. This series incorporates weights, cardio, resistance training and more, 30+/- minutes everyday. Feeling good here, better than I have felt in many years. My milestone is June 6, which will be my 4th of the required 7 visits to my family physician. The journey continues...

Yep, today, Star Wars day, is my next milestone in my journey, and much has changed; Since visiting my nutritionist, I have made and noticed some huge improvements in life style changes. These are forever changes too. As you may remember, the nutritionist gave me two lists; one was a list of 20 items on what & how to eat changes, and the other list was 13 items related to behavioral changes. From list 20 I elected to eat better using portion control by eating a healthy divided meal (i.e. 1/2 plate of non starchy veggies; 4-6oz lean protein; and 1/3 to 1/2 cup of healthy carbs) and to love myself... From the 13 list I chose to eat at the table, far removed from the TV. Believe it or not, these were not easy to change. But I have noted advancements, in that I am now unable to finish my meals anymore, so I need to further reduce my portions... and I watch TV less I should note here, that before I post my post my weigh-in update from the doctors office, that the weight posted will always differ than that which I post in my signature below. The weight posted below is a fist weight, from when I wake up in the morning. I am empty and nude. The doctors weight that I post at the top on my visiting days, is clothed and at least a serving of breakfast in me... this is also the recorded weight that the doctors will submit to the insurance company for approval. Regardless, both will show similar results in weightloss. So, the last time I visited my family doctor, his busted-arse scale weighed me in at 316.6lbs I believe... here's to seeing some lower numbers today!

Being perceived by others as weird only means that you are Truly Unique. My high school years were not memorable; did not date, was ridiculed as a "fatty" etc etc. I decided long ago that people just 'sucked' in general. I have since changed my attitude, to basically that I do not care much for what people think anymore, I am who I am... That worked until I realized that "I am who I am" is not what I thought I would become... It was when I started hating myself that the problems really began, and which led me to the state I am in now. If I do not love myself, then who will (?) My wife aside, as she will love me to the end of time, it seemed that no one else much cared for me, and that hurts,,, all the time. So here I am, turning things around. I had to love myself first to make this journey, otherwise I would not care whether I succeeded or not. Thank you for sharing, it really helps to know that many of us got here on similar journeys, and that we are not traveling alone anymore.

I am definitely enjoying this standing desk feature, the only issue is my weight impacting my knees, but a little music, and I can keep the knees moving. I was born in `64, the Chinese "Year of the Dragon" That is how I set my screen name. Dragons Rule!

That is pretty strict compliance... every doctor I have had the pleasure of giving a co-pay to has asked that I use My Fitness Pal. I have used it, even recently, but I end up getting tired of always inputting and tracking data. Glad you are working well with your dietician, case manager and nurse prac. It is best to make the life-style changes now, so as to breed success after surgery. You can never be too prepared for anything. Your class reunion is a good goal... heck about any goal is pretty good, especially once they are reached. I love a true sense of accomplishment. I graduated in 1982, and never returned. The shoulder ordeal sounds miserable. Nothing I hate more than being in pain and literally losing sleep over it. Your forum name suits you, your year seems quite frustrating... but from what you have posted, you have a plan to remove all frustrations from your life. Stay focused, as you are going to prevail... Thank you for sharing!

Ahh,Ms. Moore, for I watched her shows well. And you are right, we will make it after all. Do you have a surgery date yet? It seems the closer I get to knowing mine, the further away it seems to get. Yes, I suffer from instant gratification; like internet sales, I want my tracking number (surgery date) NOW!! So what, exactly am I doing? 1) Not watching TV when I eat 20 Cutting calories - although I am not counting them, I know that I am eating less by cutting out foods high in empty calories... walking a mile or so a day helps to burn the rest... 3) Cutting carbs back. Most of my carbs now come from healthy fruits like apples, strawberries, and grapes. As much as I love oranges, they are rich in sugar, so I must strictly moderate my intake of the juicy wedges. 4) knowing when I am hungry; stomach hungry (true hunger), and not head hungry. Head hunger stems from my food addiction, which I am refusing to feed anymore. used to smoke, so I know what it feels like when my head told I needed to smoke another ciggy. Food addiction brings on the same feeling.

Indeed, currently I am experiencing weight loss from either the Metformin I was prescribed for my elevated insulin levels, or from following the diet work-up set forth by my bariatric dietician... maybe a combination of both. As of this morning, I am sitting at 304lbs, down 21lbs since I started this journey. I am told that if I lose enough weight, I may not need to be on the pre-op liquid diet very long. It will be decided the closer I get to the end of "the 6 month march." Per insurance, I need 5-more visits with my doctor before Sept 4 (end of 180 day evaluation). My next scheduled visit is on Star Wars Day "May The 4th" Thank you so much for thinking of me and asking for an update, I appreciate you very much.

Thanks Frustr8... I don't know about growing in maturity, but there does seem to be some un-used cogs starting to break loose (gears are turning again).

Thank you Fluffy, the news definitely brightened my day!

Minor Update to my Weight Loss Journey: I met with my Hematologist today; this is the doctor who first recommended that I seek weight loss surgery. He gave me high praise for my continued success, because according to his records (& scale), I have lost 22lbs since our January appointment. I have actually lost 17lbs since January, but his assessment sounds much better I explained to him what has changed, and what I still have left to achieve, and that was pretty much it. He wants to see me again in August, to hopefully pull me off of the blood thinner, Xeralto.

A full up-front discussion with your surgeon is how this gets determined. Prepare to ask your surgeon lots of questions, be very upfront about your health and mind set, and you and your surgeon will define the correct path forward. I asked 28-specific questions, I expressed my concerns (while the doctor took detailed notes), and then WE both determined that the sleeve was the best course of action for me... now I only need to do my part to prepare. Knowing everything up front has really boosted my confidence that WE chose correctly.

April 11, 2018 1st Visit With Nutritionist Stats: Weight: 311.3lbs BMI: 43.4 **NEW STAT** PBF: 47.8% (PBF = Percentage Body Fat) The talk with the nutritionist was good, one might even go as far to say 'uplifting'. Uplifting because I felt really good after talking with "Tacey". We talked at length about where I am at in the weight loss process, and we talked goals. "we have 5-months to help you start a complete life-style change..." We talked my good and bad behaviors, and developed a plan on changing the bad ones for good ones. Specifically reversing some of my bad habits, two at a time over the course of a month. My choices were love myself; and eat a meal healthily divided on my plate (i.e. 1/2 plate of non starchy veggies; 4-6oz lean protein; and 1/3 to 1/2 cup of healthy carbs) The last items was a behavior change, and I have decided not to eat in the living room while watching TV. Next month I get to select two more food practices, and one more behavioral change. This visit started with two tests; the first was a breathing machine to help determine my resting caloric burn rate, and the second was to step on an InBody 520 machine, which determined fat, water, and muscle content of my body (way to many stats to post here). Note: I had to fast for the tests. The data is an interesting base line from which to see changes that I will be making to my body mind and soul over time. Next milestone is another doctors visit, slated for May the 4th (Be With You). Alos one edit: I mistakenly stated that I needed to visit my doctor 6-times in 180 days... that number is actually 7-visits in 180 days. I must watch and manage the schedule carefully, because if I do not meet the 180 time frame, I have start this process over from the very beginning...

An Update to my Weight Loss Surgery Journey... At my last doctors appointment, Friday April 5th; my doctor recommended that I get some lab work done to check my fasting insulin and thyroid condition. I had the lab work done yesterday, and my result were called back to me today: Thyroid is normal, however, my fasting insulin was high. Normal is 2.6 to 24.9 and I came in at 35.7. The doctors office stated that they want me to start taking Metformin to help manage the insulin levels. The analysis being that the higher insulin levels, could be the cause to my lack of weight loss. My next mile-stone on my weight loss journey is tomorrow when I meet with my nutritionist for the first time. Note; this visit is also a fasting visit. I plan to bring up the current diagnosis with her, so that she can correctly tailor a diet for me. Looks like my life-style changes are about to get real! More after tomorrows visit.

Awesome! Looking forward to reading up on your post op!

Exactly! Most recently I let a doctor convince me to take a pill for my Psoriasis. I started a regimen of Otesla, which for all intent and purpose, sent my Psoriasis into remission. However, the pill also made me feel bad all of the time, and gave me headaches. Seeing as I am still taking a blood thinner, I was not able to take any over the counter meds like aspirin or Ibuprofen, so I ended up taking acetaminophen (daily) to counter act the side effects of the Otesla... I do not wish to get into taking a pill to cure a pill that was used to cure a pill etc etc. I ultimately took myself off of Otesla, and the unfortunate side effect being, I now have full blown psoriasis...

In passing, I mentioned to a co-worker that I was looking at getting weight loss surgery in the next 4-months. Her reply was that "surgery is too invasive..." She recommended I "take pills" instead. Her thought was that medicine had advanced so much that obesity could be cured with a prescription. She did not know a specific brand or drug, but she remembered reading it somewhere... Our talk was not a heart-to-heart, as this is the first time I had talked to her in a long time, as she works in a different department now, so I just smiled and waved. I do not mind telling people about my journey; sometimes you meet an agreeable personality, and sometimes you do not... everyone want to mean well, but in the end, it is my journey to carry.