Friday, September 17, 2010

5-Months Post-Op Update

Hi Everyone:

So, I am five months post-op and doing really well.  I am now 215 lbs., my BMI is 32 and I am now a 38 waist (and wearing slim jeans)!  I wear M-L shirts and feel great about it!

Eating has been easier for me, so long as I take my time.  I am able to eat some more things and I haven't had any problems since the procedure back in June (knock on wood).

I am 30 lbs. from my goal weight.  I started running again and I am back up to 1.25 miles every other day.  Laila and I run and she really loves it!

I feel good...I look good and healthy.  Life is great. 

Be good - I'll check in next month!

Friday, August 13, 2010

Four Months Post-Op - and 110 lbs. lighter

Hello Everyone:

It has been a little while since I posted (about two months), but it has been a busy two months!  I became employed with a job that has kept me busy as a bee for 60 hours a week.  Finally off the unemployment roles and back into the workforce.

So, four months in - here's my update.  As of today (August 13, 2010) I am 220 lbs.  I have lost 110 lbs (which is 1/2 of my current weight, 76% of my total weight loss goal and 33.3% of my total body mass).  My BMI is now a 33.4, down from 50.2.  I now wear L shirts (and even got into a M and looked pretty good), which is significantly smaller than the XXXL I was wearing.  My pants size is now a 40 waist down from a 54-56. 

Prior to me starting work at the end of June, I was running 1.25 miles a day and had started P90X.  Unfortunately, my schedule at work has prevented me from continuing the rigorous schedule of P90X, however, I have cut back my hours and will be starting back up again.  I also plan on re-starting my running schedule this Sunday.

I am doing better with eating - I still have to be very careful about what I eat, as I still will vomit if I don't eat the right foods and eat slowly.  However, since I have identified eating out as a major obstacle, we have just eliminated it all together.  Even foods that you would think would be OK to eat just don't sit right...even grilled chicken out doesn't sit well with me.  So, why waste money - I can eat my own food and it is cheaper.

I feel great and really think I look pretty good.  I am still burning through clothes faster than I can replace them since I am still losing weight.  I just got all 42 waist pants a couple of weeks ago and they are already getting too big - the belt only works for so long - then the pants just don't sit right.

So, here is a current picture - it was taken about 2 weeks ago at my mother-in-laws 50th b-day.  You can judge for yourself.



Thanks for reading!  Enjoy life...I know I am!

Monday, June 21, 2010

Day 68 - Feeling Amazing (and looking pretty good, too)!

Hi Everyone:

So, it is day 68 post-op...I have begun training and I feel great.  I started P90X yesterday with Chest & Back.  Today was Plyometrics (jumping)...it's all sorts of squats, jumps and cardio.  It was really hard but you feel so good afterwards.  I then took Laila on a 1-mile run (yeah, I said run).  So, I'm feelin' pretty wiped right now but I feel great at the same time. 

My weight is 248 and I am a 44" waist.  Pre-surgery...330 and a 54"/56" waist.  Oh, and those 44" pants/shorts are starting to get loose.  As I do P90X, they are going to get very loose very quickly.  I don't mind...I don't have a lot of money to replace clothes, but the smaller they are for men, the cheaper they are - so bring it on!

So, all in all, life is great.  Here is a picture I took on Saturday.  There are some positive things happening on the job front as well...let's hope...next time we talk I will definitely be in better shape and I may be employed :-D

Thanks for reading...talk to you next time! 

Wednesday, June 9, 2010

June 10, 2010 - Almost 2 months Post-Op and feeling great!

Well, I can tell you that the procedure seems to have been a success.  Eating is much easier now and I feel fantastic. 

Yesterday, I weighed myself and I was down to 252 lbs.  So, I am down almost 80 lbs. since the the onset and nearly 55 lbs. since the surgery.  I truly feel wonderful.  I am walking 1.5 - 2 miles per day, I am working out in the yard and I am starting PX90 next week.

So, what else is there to say?  I'll post a new picture soon...I want to be in the 240's before I post a picture, which should be next week.  I'll also be taking my pre-PX90 photos for comparison, so I'll find some shots to post. 

Talk to you soon - thanks for your support!

Friday, June 4, 2010

Status Update - June 4, 2010 (My B-Day)

Hi Everyone:

So, let's start with a photo. 

It has been seven weeks and two days since my surgery.  I am down to 260 lbs., which is 70 lbs. lighter than my original weight of 330 lbs. and I am 45 lbs. lighter since the surgery.  My cholesterol (specifically, my triglycerides) are down 120 pts. since my surgery.  I now walk 1.5 miles a day and I am starting a more rigorous exercise routine next week that will include cardio, weight lifting, core training, etc.   I am feeling great and getting past the issues that have plagued me for a few weeks now.  Speaking of which, let me take a moment to go through that.

Since my hospital visit, I was put in contact with a fantastic gastro doctor in Denville (Dr. Emiliani from Morris County Gastro Associates) who ran blood tests and today dilitated my anastamosis.  The anastamosis is the connection between the new stomach and the by-passed intestines.  Due to my severe acid reflux, which didn't totally subside after the surgery, the connection became ulcerated and strictured (constricted) to 1/2 the size it needed to be.  As a result, I couldn't eat solid food as it would immediately come back up because it had no where to go...the hole was too small.  Today, they did an endoscopy and placed a catheter with a balloon down my throat and into my stomach and expanded the anastamosis to the proper size.  It was a procedure that lasted about 15 minutes and I was able to eat by 9:00 AM this morning, which I did with much ease.  The procedure, so far, has proven successful.  There is a possibility that the stricture may return to some extent, but that is normal.  It sometimes take 2 or 3 dilitations before the problem is resolved.  However, for now, I am able to eat and that is a wonderful B-Day present!  I had a slice of pizza tonight...yeah...only 1...but that is all I can eat...however, I was able to actually eat it without throwing up.  Huge success.

I also have diverticulitis, however, for the moment, it has calmed itself.  If I stay hydrated, I am hoping to avoid another flare up until I lose all my weight and they can operate to remove the section of damaged colon. 

So, the process can continue.  I am feeling much better and I have reduced my body weight by over 20% so far.  There have been some bumps, but the process is proving to be a positive change overall.  Nothing comes easy and nothing comes without a price.  However, the health benefits outweigh the risks and so far, nothing too terribly serious has come down the pike.  So, onward and upward.

I will talk to you all soon!  Thanks for the support and enjoy the weather!

Tuesday, May 18, 2010

Surgery has it's risks - a week in the hospital supported that reality

On Sunday, May 9th, I wasn't feeling all that great in the morning.  I had trouble using the bathroom all morning (from like 4am on) and had stomach pain.  I figured...not enough fiber.  So, Nicole and I were going to take her mother to breakfast for Mother's Day and then out for dinner later that afternoon.  So, I told Nicole to go without me for breakfast and I would go to dinner.  I figured a couple hours in bed would help. 

So, 4:00 PM rolls around and Nicole gets back from hanging out with her Mom and sister, so I get up, get ready and off we go to her mother's favorite place - the Cracker Barrel.  My side hurt, but I pushed on...it was Mother's Day...I wasn't going to ruin that.  Not for a little stomach pain.

So, we get to Cracker Barrel and I feel like crap, but I just try to keep it to myself.  We finally get seated (place was packed - very popular on the holidays and weekends) and I, being on a limited diet anyway, order the children's grilled chicken fingers with some pinto beans. 

So, I eat about 1/2 my food and I tell Nicole quietly, I think I may need to go to the hospital after we finish up here...my stomach is really starting to hurt and it is getting hard to walk.  Of course, everyone heard me...I just dismissed it as no big thing...just enjoy dinner.  So, after dinner, we stopped at Dairy Queen for some ice cream.  I didn't have any, but everyone else enjoyed it.  We left, and since we were driving, we headed back home.

So, once everyone was dropped off, I told Nicole we needed to go to the hospital, but I wanted to go to Monmouth Medical, not the crappy hospitals down here because Monmouth had one of the State's best bariatric surgeons on staff and if something was wrong, I wanted to have access to him.  The hospital I had my surgery was too far away for an ER visit, so this was the best alternative.

So, when I get there, it is about 9:45 PM.  We check in and they see me almost immediately.  They draw blood, run an IV and give me a large dose of morphine for the pain.  That helped some.  Then, about an hour or so later, they have me drink a litre of contrast solution in water (tasted like water...not too bad).  That took about 45 minutes.  I had to then wait another 1.5 hours before they could do the test.  So, they do a CT Scan of my abdomen to see what was wribg,  I thought the whole time my gallbladder was the problem, since gall stones is a huge problem for bariatric patients because of how quickly weight is lost.  An hour later, they come back and tell me that my ascending illium section of the colon by the secum was inflamed.  They hang some antibiotics and want to send me home. 

The morphine brought my pain from a strong 6 to a strong 3...so it was manageable.  They also gave me some antinaseau medication that was awesome...took away any naseau within seconds after being administered via the IV.  So, at 5:00 AM (yeah, 7 hours later) the doctor was ready to discharge me.  He drew up all the paperwork, gave me my prescriptions and said have a great night, follow up with your doctor for follow up CT Scans once I finished the antibiotics.  They also said that I had a mass in my abdomen the size of a racquetball, but it wasn't something to be concerned about at the moment - they could check that out when they did the follow-up CT Scan.  So, the nurse came in, removed my IV.  She left, I sat up to get my clothes on and immediately my pain went back up and past the 6 on its way to 8 and I started vomiting profusely (well, it was dry heaving...I hadn't had anything in my stomach for over 12 hours).  The nurse came back and gave me a dose of that anti-naseau medication to put under my tongue, which helped stop the vomiting.  Everyone thought...he still has contrast solution in him...it has a tendency to make you nauseous.  So, as I am leaving, the doctor crosses my path in the hallway, so he asks how I am feeling.  I said, well, my pain is through the roof and I was just vomiting profusely...given the discharge papers say either of those symptoms warrant a return visit to the hospital and I haven't even left yet, I'd say not good.

Needless to say, he agreed and said I need to be admitted.  So, it took another 3 hours to get me a bed.  Finally, I am moved upstairs to a room and that's that.  Over the next week, I saw 30 doctors a day and was stuck more times than a pin cushion at Vera Wang's house.

The initial diagnosis was accute Diverticulitis, which is when a section of the colon develops pockets (like when your tire bubbles when you hit a bad pothole).  This weakens the lining of the colon and also traps food, which then becomes infected.  If not treated, this can lead to a perforation of the bowel and well...let's just say I may not be speaking to you now if that happened.

So, I was getting lots of antibiotics and basically just sitting in my room.  I was NPO (Nils Per Os, or Nothing By Mouth), so I wasn't eating or drinking.  So basically, I watched TV and slept when I could.  They came in to stick me every morning at 4:30 AM, the first doctor showed up at 5:30 AM and every 1/2 hour after that more doctors would stream in. 

On Wednesday, the GI doctor came in and said he was reviewing my CT Scan from the ER and noticed the mass in my abdomen.  He wasn't sure if it was fluid or solid and wanted to investigate to make sure it wasn't something serious.  It was on the remnant stomach (the part of the stomach that is no longer used), so they were almost positive it was fluid, but they didn't want to take any chances.  If they didn't investigate it and it turned out to be cancer, that would be a big problem. 

So, on Friday, they took me in for an Endoscopic Ultrasound.  Basically, this procedure is much like an Endoscopy, where they feed a long tube down your throat with a camera at the end, only this instrument had an ultrasound attachment.  This allows them to ultrasound internal organs not accessible with great ease from the surface.  I was knocked out and was told it was about an 1hr. long procedure.  When I wake up, I look at the clock and not even 1/2 hour went by.  The doctor came out a little later and said they couldn't finish the procedure because the anastimosis (the connection between the new stomach and the by-passed intestines) was about 1/2 the size it was supposed to be and the scope didn't fit.  The whole area was raw and there was stricture.  Coincidentally, this explains why I spent the prior week throwing up my food...apparently it wasn't that I was eating the wrong things, but because of this.  So, the doctor put me on a quadruple dose of Nexium and stated I needed to have a repeat of this procedure in 3 weeks to a month to see what is going on and whether it can be stretched to normal size or if I am going to need more surgery.

This is considered a complication of surgery, so that's why the title of my blog is "Surgery has it's risks - a week in the hospital supported that reality".  The Diverticulosis was not, however,  I apparently had this for at least 2 years, but less than 3 years, since it didn't show up on my colonoscopy in 2007.  It decided to flare up now for who knows what reason. 

So, to cure Diverticulosis, they will need to remove the section of the colon that is diseased.  As for the anastamosis issue, well, time will tell whether another surgery will be needed. 

So, on Friday, after the procedure, I spoke to my doctor (the one overseeing my whole case) and she said I could leave Saturday, since there wasn't much more the hospital could do for me.  I could take antibiotics at home, so there was no reason to stay.  She said I could leave tomorrow (Saturday) and she would be in early to discharge me.  She knew I was singing Saturday and Sunday and that if I could get out of there early enough Saturday, I could make it to NYC. 

So, Saturday comes around and no doctor.  9AM, 10AM, 11AM, 12PM...I start to get a little miffed.  I spoke to my nurse (by the way, every Nurse, PCA and Tech on that floor was amazing all week...such nice people) to try and find out what was going on.  Nicole had come up to pick me up and run me around to get my music, pick up my tux, etc. and when the doctor still wasn't there...she was not happy either.  1PM, 2PM, 3PM no doctor.  She decided not to come to the hospital that day.  So my nurse started hounding her resident to get up there to discharge me.  That finally happened at 4:30 PM.  Now in the meantime, since we saw the time ticking away, Nicole ran home, got my toiletry bag and undergarments, got my music, picked up my tux and came back to the hospital.  I showered at the hospital and walked out in a Tuxedo (that was fun).  I got to NYC at 8:10 PM...they choirs actually rearranged the program to give me time to park. 

So, I performed, but not without cost.  Sunday night I couldn't finish the performance...I ran out of gas during the last movement of the last piece and had to sit it out.  Luckily that was the only problem.  Sunday, I got through the whole performance but nearly blacked out on the subway platform at 68th St. because all the walking drained my energy and my BP tanked.  So, that was a fiasco. 

So, the moral of the story...everything has benefits and risks.  I weighed them and made a decision...do I regret it...not yet.  I hope I don't ever.  I am down almost 70lbs.  So, I can't say it isn't working.  However, if these other issues can't be resolved...it makes the whole process somewhat a wash in the health benefiting department.  If I fix my weight issue but have intestinal issues for the rest of my life...well, that doesn't really make the surgery worth it.  I am hoping that these issues will resolve themselves and I can move on.  I am looking forward to restarting my 2 mile walks, working out and getting in shape.  I can't start until this stuff is resolved, however.

The journey is never easy, the road is never straight and the path is not always clear.  Determination, perserverence and faith will guide you to your destination, whatever it may be.  That's not a quote...that's mine.  I believe this to be true. 

Friday, April 30, 2010

2 Weeks Post-Op and Feeling Great!

Two weeks and two days since my surgery and this past week has been fantastic.  Let me give some highlights.

1.)  On Monday, I met with my surgeon and he took out my staples.  He informed me that I am healing exactly as I should, I have lost 50lbs. total since I started the whole thing and except for the little "incident" last week, I am the model patient and he asked me to come talk at his seminars.

2.)  In addition, he told me to progress "as I am comfortable" to real food.  I am taking that slow, but last night I had real chicken and broccoli with cheese for dinner.  Very excited about that. 

3.)  I started walking this week...I walk with my puppy and with my wife, so I actually and taking two walks a day.  I feel great and find that I am walking with a little more "pep in my step".  I guess being 50lbs. lighter will do that.

4.)  I am feeling great as far as the surgery itself.  I can move pretty freely now without any pain.  Bending over is not a problem any more and the only time I am a little uncomfortable is if I roll over weird in bed...sometimes it causes a little pulling (I still have a belly).  Other than that, I can sleep on my stomach again, so sleeping is becoming a much more comfortable situation.  Of course, my puppy sleeps between my wife and I, so the bed is getting a little crowded.  She even shares pillows now...funny, yet sad all at the same time.  I move her when she is dead asleep and she somehow works her way back up to our pillows. 

So, life is returning back to normal.  Since having major abdominal surgery, the recovery period has been progressing quickly.  I have already been to two rehearsals in NYC for a group I am singing with and have been able to sing without any major problems.  My breathing is still not perfect, but it's not horrible either.  The whole recovery process is going much quicker than I anticipated.  I have to be careful though, as I know I will push myself too far if I don't feel any pain to slow me down.  I am trying to watch myself and not over do it...

It has been a great journey so far.  As of today, according to my Wii, I weigh:  278.5.  I started at 330.  Not too shabby.  I have 94.5 lbs. left to reach my goal.  I have lost 51.5 lbs. since January 2010.  I have lost 26.5lbs. since the surgery on 4/14/10.  Happy happy joy joy!

Saturday, April 24, 2010

Big Scare for a Small Problem

This past Wednesday was the one week anniversary post-op, as most of you know.  Well, per the doctors orders, I was permitted to take a shower and trust me - I was going to enjoy it.

So, I took off the large bandage that was placed over the drain site, which was now safe for open exposure and showers, I got in and started to wash up.

Well, about 3/4 of the way through my shower, I started to feel a little dizzy.  Then, my head started to feel like it was being crushed in a vice.  About 5 seconds after that started, it started to get very white.  I called for my wife and just as she came into the bathroom, I collapsed and passed out, hitting the back of my head on the tub.

After about 15 seconds, I started to come to, my wife screaming.  I was very nauseous and weak.  I started to regain my strength and after my wife finished rinsing me off (I still had soap all over), with her help, I got out of the tub and sat on the toilet.  I started to dry off and all the sudden, the process started over again.  I told my wife to call 911 and I nearly passed out again, though my wife was there to catch me that time.  The 911 operator told her to help me to the ground and to lay on my side.  Within minutes, police, EMT and Paramedics were at my house. 

So, besides the fact that I was completely naked with half of Barnegat looking on (my wife provided me with a towel to cover up), my blood pressure was low. 

Off to the ER I went.  When I got there and after being stuck 4 times by a nurse who definitely needs to take a refresher course in phlebotomy, they took blood and x-rays.  It turns out I had what's called a "Vagal Response".  I was on the same dose of blood pressure medication as I was when I was 330lbs, only now I am 280, I had surgery only a week ago and I took a warm shower.  The vaso-dilator along with the warm water (also dilates veins) caused my blood pressure to fall rapidly, causing my body to trigger this response...it forces the body into a horizontal position to save the brain from lack of blood due the drop in blood pressure.

So, after receiving a full liter of saline, I was tested and released.  I am now no longer on blood pressure meds and hopefully this won't happen again.  I truly thought I was having a stroke and even had my wife ask me questions and go through the standard stroke response to ensure I didn't have one.  It was extremely scary, but turned out to be a minor thing. 

Luckily, when I passed out, I fell in such a way that didn't rip out any stitches or staples and because we have a soft fiberglass tub, it gave enough when I hit it that I didn't have a concussion.  Luck all around...thank God.

So, I am down 50 lbs. since I started this exciting journey and I am just getting started.  Keep me in your prayers and I'll be back soon to provide more updates.

Wednesday, April 21, 2010

One Week Post-Op - The Journey has Begun!

Today is Wednesday, which is one week Post-Op.  The first few days for me were filled with a mix of anxiety, pain and optimism for what had just happened and what was going to happen.

The day of surgery, I was asked to be at the hospital at 9:45 AM for an 11:30 AM procedure.  My father, bless his heart, worked the night before and still brought me to the hospital, waited during the procedure and met me afterwards (as much as I remember, anyway).  We got to St. Clare's Hospital in Dover at 9:50 (hit a little traffic) and I checked in and was almost immediately brought back to the surgical prep area.  The nurses were all lovely and, after I derobed and put on the 1/2 gown that allegedly ties in the back (nobody ever found the ties), walked me through all the paperwork and formalities and hooked me up to my IV's.  My Dad came back after all this to wish me luck and then I was quickly ushered down a hallway into the pre-surgical waiting area. 

A short note:  As they were wheeling me down the corridor, for about 5-10 seconds, it seemed like there were no lights on in the hallway...it was like I was being wheeled into the "closed wing" of a hospital for an experimental procedure.  I actually cracked a joke about it and the nurse who was pushing my bed chuckled and said that they joke about that, too.  Don't know if I was relieved or more scared when I heard that.

Anyway, so another few minutes goes by and I meet with the anesthesiologist, who was really odd who gave me his 30-second schpiel and then my surgeon came up to me.  He goes, "are you ready?" and I was like...no...I actually like the anticipation so much I want to wait like 10 minutes.  He laughed and informed me that we were 30-minutes ahead of schedule.  So, off we went.  I get into the operating room and they ask me to move over to the operating table.  They situate me and give me the first of two drugs, which made me woozy but didn't knock me out.  As I was used to getting one shot and "night night", I inquired as to whether it was normal that I just felt a little woozy and not asleep...the anesthesiologist said yes and that he hadn't administered the other drug yet that would put me out.  They did some more prep stuff as I got "comfortable" and then he said...ok, ready to sleep.  I said yes, he injected me and I had just enough time to tell the staff in the OR "thank you in advance" and off to sleep I went.

When I woke up, I was being wheeled into my room.  The surgery had gone about 1hr 45min and I was out for an additional 2 hours, so by the time I got to my room, it was about 2:30 PM (as best I can recall).  I was groggy and somewhat out of it, but I know my father was there and I think my surgeon came in, but I can't be sure.  I was told about the morphine pump that I was hooked up to for pain and how it worked.  After that, I think I dosed myself once and went to sleep.  My father left right before I passed out, as I told him I wasn't going to me much used to him any more and he had to go back to work soon anyway.  I then passed out and woke up several hours later (Criminal Minds was already on, so it had to be like 8:30 PM or so).  I was in a tremendous amount of pain, so I pressed the morphine button and it quickly dulled out everything, but really kept me sleepy.

During the surgery, they put CO2 gas in your abdominal cavity to create room to work.  The procedure consists of first dissecting the stomach into two pieces, the part that you will use, which is about the size of an egg, and the rest, which is not to be used anymore.  Then, a part of the intestines is re-routed and connected to the new "stoma" or pouch and that section by-passes a section of the colon that is responsible for the absorbtion of fats and nutrients (your body can still absorb some through another section lower in the colon, but the main absorber is by-passed, thus giving the surgery its name.  Anyway, the gas doesn't just disappear after surgery.  Your body has to absorb it and then pass it, which is a painful process.  Some equate the pains to thinking they are having a heart attack.  When it shoots up to your shoulder, you can think that.  However, I felt more like I had a large hunting knife jabbed into me and twisted in several different places, so the pain is real.  When I first got to my room, by blood pressure was 250/180 from the pain...it calmed down once I took the morphine and they gave me an injection of blood pressure meds (HCTZ). 

Also, I had a drain after surgery to remove blood from my abdomen.  At first, it was supposed to come out Friday before discharge, but on Friday, the doctor came in and said there was still too much drainage, so I had to keep it until the following Monday. 

During the first 24 hours, you are not permitted to eat or drink.  Considering how dry my hospital room was and how dry my mouth was, that was difficult.  From the second day until Sunday, I was on a clear-liquid diet consisting of broths, teas, jello and sorbet.  Yum! On Sunday, I started a full liquid diet, which included dairy products.

So, on Friday, I was still in pain but the surgeon sent me home with Percocet and well wishes and I was to come back on Monday to have the drain removed.  My brother picked me up at the hospital and off we went back to my Dad's house.  Since I live in South Jersey, it made sense to stay up North since I had a doctor's appointment Monday.  My wife had to work, so it was just easier to stay up North where there is always someone home.

Over the next two days, I was still in a tremendous amount of pain.  On Sunday, I actually thought I had torn muscles in my stomach because of the sharp burning pains I had.  Come to find out that the Percocet was actually causing more problems than good.  Percocet is a narcotic downer.  It dulls pain, but also slows muscle movement and was actually slowing down my body's ability to expel the gas, so every time I took one, the pain would go away for a few hours, but when it wore off, I was in even more pain because the gas had pooled up in an area and was creating a tremendous amount of pressure and pain.  So, at that point, I switched to Tylenol Extra Strength.  Funny, Tylenol has a massive recall in process making finding Tylenol very difficult.  Figures.

So, Monday, I saw the surgeon and told him about my pain.  He looked me over, removed the drain and informed me that the pain was normal.  First, he used a long-acting Lanocane which takes 48 hours or so to wear off...so that was masking some pain initially.  In addition, the drain creates additional irritation which can increase pain and bruising around the incision sites, which is normal, also causes additional pain.  Everything was normal.  I was informed to keep doing what I was doing, I could take a shower after Tuesday and I could start eating soft foods on Thursday or Friday. 

So, today is Wednesday and I am feeling much better.  I have a large hematoma on my stomach above my navel which is creating some pressure and pain, but slowly I am recovering.  I am on full liquids including cream soups and so far it has been uneventful. 

I was never big on sweets, so eating puddings and jell-o and the like has not sat well with me.  I couldn't even eat pudding...it turned my stomach.  Eating strained cream soups has been just wonderful I can enjoy real food flavors instead of just sweets.  You have to try new things...if you don't like something, move on.  Your tastes definitely change some after surgery, so it will take a little bit of trial and error.  Things you could tolerate before surgery may not be tolerable after.

I am down to 289 lbs.  I was 304 before surgery, so I have lost a total of 15 lbs. in a week.  I'll be able to drive soon and get back to singing next Monday and I also have an appointment on Monday to have my staples removed (they are holding my skin together while the incision sites heal. 

It's a process.  Most important for me to remember was that this was MAJOR ABDOMINAL SURGERY!  Just because the incisions are small, the changes inside were huge.  It takes time to heal and I have to give my body time to heal.  It's a struggle at times, but I am really excited and already seeing changes is really awesome!  My legs, arms and face are already thinner.  In two weeks, I will be 275.  It's been a long time since I saw that number.  The whole process is very exciting.

So, I will be back next week to give you an update.  Thanks for reading.

18 Hours to Surgery - An Intro to My New Best Friend

Doctor's orders: Drink 8-10 oz of Magnesium Citrate (a strong laxative) when you wake up and immediately follow with water. Continue drinking water throughout the day. Stop all fluids after midnight.

Question: How does one successfully continually hydrate if said person cannot stay out of the bathroom long enough to make it to the kitchen?

So, with that being said, I would like to introduce you to my new best friend,the porcelein throne itself, John L. Crapper.

I have a strong feeling in my gut(something like an alien about to pop out and start singing at a diner counter) that a majority of the next 18 hours will be spent with my friend, pondering life and the human digestive system.

The Klumps talked about a colon cleansing...I'm pretty sure they meant systematic colon erradication.  I highly doubt there will be anything left. My body doesn't seem to want it anymore. Given the current state of things, I don't blame it.

Sunday, April 11, 2010

36 Hours to Surgery - The Countdown Has Started

When I started this journey back in September 2009, I thought it would take forever to get to this point.  When I found out that it would take six (6) months of pre-surgical testing, dieting, exercise, insurance approvals, etc. etc. etc., then actually scheduling the surgery...I figured it would be forever before I actually saw the operating room.  Well, it has now been eight (8) months and here I am...36 hours before surgery and I am running around completing last minute errands.  All the planning, waiting and anticipation is nearly over...

So today, Nicole and I went shopping.  I started my liquid diet today so that my liver would shrink before my surgery.  This apparently helps the surgeon when he gets in there.  So, soups, broths, pudding, jell-o, whipped cottage cheese and protein shakes.  On Tuesday, it's clear liquids only until midnight, then nada.

After the surgery, I will be on a clear liquid diet for at least a week.  Once the doctor approves it, I will transition to a full liquid diet, which includes dairy and anything that can be diluted enough to fit through a funnel (warm cereals like Cream of Wheat, etc.).  I'll be on that for a few weeks.

So, today we bought all sorts of drinks, pudding, yogurt, broth, etc.  Our fridge now looks like a drink cooler at the local convenience store.  No solid foods, just yogurt, cottage cheese and all sorts of drinks.  Oh yeah, and ricotta cheese.

So, the whole thing is for real.  On Wednesday, I will arrive at the hospital, get prepped and then in I will go.  Laproscopic surgery, so I will not be cut open, but instead have a few holes.  The surgery takes about 1hr 15min and that's it.  The new life begins.

Support has been great...my family and friends have been supporting me the whole way.  All that support got me here and will keep me going after the surgery.  Everybody has been asking me, "Are you scared?" and my answer has been, "No...excited as hell!".  That is the truth - I can't wait to begin this chapter of my life where  I can take control of my life and do the things I have always wanted to do...like become a police officer.  I have very clearly defined goals.  I will be able to run 5 miles.  I will qualify and become a NJ State Trooper (if the State doesn't fire everybody first), I will be in fantastic shape and have the body I have always wanted.  I will live a healthier life and enjoy time with my children (when we have them next summer, hopefully).  So, this is such a monumental step for me.

I will have my wife's phone while I am in the hospital, so I will be able to blog...I'll be able to give you real-time updates of how I feel, what is going on and my overall impressions of how it goes.  This is going to be great!

Stay tuned, I'm just getting started!

Thursday, March 11, 2010

Surgery Date - April 14, 2010...the beginning of my new life!

The date is confirmed - April 14, 2010.  This is NL-DAY...no, not National League Day...but New Life Day.  This is the day that begins my new life. 

Imagine spending your whole life with a dream of doing something but knowing that you will never be able to do it because some obstacle stands in your way.  You do everything in your power to overcome this obstacle, but you go backwards instead of forwards.  Next, consider how you may feel if you have to decide to abandon that dream and follow another path...one that you are good at but doesn't bring you any satisfaction. 

That's me.  My entire life, I have wanted to be in law enforcement.  From a little kid, I wanted to provide a service to the community, uphold the law and provide protection for those who cannot protect themselves.  However, when my weight would never go down despite eating right and playing sports, it became more and more difficult to achieve my dream.  So instead, I went to college to get a degree in business...went to grad school to get a degree in business...worked in a business field.  I wasn't happy, but I tried to convince myself that this is what I was supposed to do. 

When I was laid off back in March 2009, I was able to take stock of my life.  When I saw my doctor for routine check-ups, he noted that my blood pressure was right on target for the first time since I became his patient...the stress my job created in my life was actually affecting my health.  I realized at that point that I needed to make some changes.  Weight loss surgery wasn't well known when I started college.  I didn't really understand the whole process until I met my wife.  When I was laid off, it provided me with an opportunity to gain my life back...to be able to make a change and actually be able to pursue my dreams once again.  The feeling of optimism for the future is overwhelming.  I giggle every day when I think that I am one day closer to a better life. 

Do you have a dream?  More importantly, do you have a dream you feel you'll never achieve?  What is the one thing that would have to change for you to be able to pursue your dream again?  It can be anything...

Now...if someone told you that you could have the tool to make that change...wouldn't you grab it with both hands?  It's been 16 years for me...but I am 34 days from reaching NL-DAY.  It can't come soon enough.

Friday, March 5, 2010

Surgery Approved

When someone says that today is a defining moment in their life, I think they may mean that today is the day that removes all excuses, reasons, hurdles and doubts from taking the necessary steps to change their life forever.  Today is that day for me. 

I contacted my insurance company today as I have every day to get a status update on my pre-authorization for surgery.  All week I've been getting the same response - "It hasn't posted yet, so it is still pending...give it 24-48 hours and we should have an answer for you."  Ok...so I am a persistent pain in the rump, so I called back every day.  This was just too big to let go because I didn't make a phone call.  So, today, I called, half excited because it would be the end of the 48 hours, but half expecting to be let down and having to start asking for supervisors and getting huffy.  The lady I spoke to on the phone was very polite and said that it still hadn't posted, but she would call over to the pre-authorization office and see if they had any status that wasn't put on the computer.  So, I gladly waited on hold and listened to some Sade...yeah...they play Sade for hold music...a little odd, yet very relaxing.  When she came back, she said it was approved and gave me the authorization code. 

So, after I did a little happy dance, I realized that today is the defining moment.  The day that the hurdle has been lifted...the obstacle has been tackled...no more doubts or excuses...just a doorway to a new beginning - and I was given the key to unlock the door and walk through. 

So, now's when the fun begins.  The tentative date for my surgery is April 7th...I am just waiting for a callback from my doctor to confirm.  It's all very exciting.  Interestingly enough, April 7th is my Mom's birthday...I figure she'll be right there with me the whole time, just like she always was whenever anyone in our family was in the hospital.  At least now, she won't have to sleep or eat...not that she ever did...it just won't take a toll on her now...she'll just be ever-present to make sure the procedure goes according to plan. 

Tuesday, February 23, 2010

The Insurance Battle

Anybody who knows me knows I am pretty persistent.  I usually don't let things go for very long without follow-up, it's just who I am.  So, today, I contacted my surgeon's office to see what progress was made on the submission of my file to XYZ Insurance Company (the name's have been changed to protect the guilty).  The response I received was less than optimal...

"Hi, this is Chris Nicosia and I was calling to check on the status of my insurance approval."  "Ok, let me transfer you to L. (name deleted to protect the innocent)...she was working on that for you."

"Thank you." 

"Hi Chris, this is L.  We ran into a bit of a problem.  When I called XYZ Insurance Company, they said that Dr. G (surgeon's name deleted to protect the innocent) was not an approved provider.  I told the guy I spoke to that he needed to check is computer again or look at a different screen because I submit these every day and I work with XYZ Insurance Company every day and never have a problem."

Insurance rep: "Well, I'm sorry, but he is not on the list, so your claim has been rejected."

L: "Don't worry, Chris.  This was not the case and I know that XYZ Insurance accepts Dr. Garrison.  I forwarded this over to M. (name omitted to protect the innocent) who deals with insurance issues.  Let me call over there and see what progress she has made to straightening out that darn insurance company and I'll call you back."

Me:  "Thanks, L.  I'll talk to you shortly."

A few minutes later, she called me back.  L: "Ok, I spoke to M. and she said it was a simple problem...the guy who I talked to apparently didn't scroll to the third page...which coincidentally is where all the updated information is posted in their system.  Of course they found Dr. Garrison.  She told me to just inform whoever I speak to when I call back that he is on the 3rd page of their system and it will not be a problem.  Since I have your file in front of me and we are talking about it, let me call over there right now and I'll call you right back."

Me:  "You have got to love these darling insurance companies.  Thank you for your help, I'll talk to you soon."

A few more minutes go by, I start writing this blog and post on Facebook that I hate insurance companies.  As I start typing this up, L. calls me back.

L: "Ok, everything is submitted...it is in their system and hopefully we will know something by Friday.  Feel free to give me a call back on Friday, don't think you will be buggin' me or anything...we'll talk then and see what is going on."

Me:  "Thanks so much for all your help.  Dr. G. said everything submitted by all my doctors was sufficient and he signed off on it?"

L:  "Yes, he reivewed it and said it was ready for submission, so it is good to go."

Me:  "Thanks again, I'll speak to you Friday."

I give a transcript because it takes all of this extra work because  somebody at the insurance company doesn't know how to properly search for a provider in their computer system.  This same person is informing policy holders every day who they can and cannot see for treatment.  My frustration level goes up every time I have to interact with them.  Thank goodness for my surgeon's team in his office...they take some of the stress off me.

Ok, so it is submitted.  I may be able to get a surgery date as early as Friday when I call L. back.  I am really pushing for the Thursday before Good Friday...we can hope, right? 

Oh, and I am so happy because I broke the 300 lbs. barrier yesterday...I was 297.5...the lowest I have been in about 6 years.  So, it was a good day...I am having a good day again.  Talk to you all Friday!

Saturday, February 20, 2010

The beginning...well...we'll start at the six-month mark

The beginning of my blog doesn't start at the beginning of my journey...it starts a lifetime later.  I have battled with my weight since I was 11 years old.  Ever since then, it has been a constant struggle that I have lost time and time again.  A battle to lose weight, get healthy and live an active, normal life.

Unfortunately for me, as time goes on, the damage to the body becomes more and more difficult to repair.  I was born with a slight hip rotation that makes exercising somewhat difficult, especially when carrying a lot of extra weight.  My liver is packed full of cholesterol - I have the liver of a 50+ year old.  This condition, known as hepatosteatosis, or fatty liver, occurs when excess fat builds up in the liver.  This condition can later lead to cirrhosis of the liver, which can lead to liver failure and death.

So, as time goes on, the condition worsens despite medication.  Given traditional methods of weight loss have been less than successful, my doctor strongly urged me to consider weight loss surgery.  I had been thinking about the surgery for some time and when he recommended it, I was already in the mindset to get it done.

On top of the fatty liver, I also have very high cholesterol, mild/moderate sleep apnea and hypertension with edema.  I take 9 pills a day to try to control the different issues I have.  At 28, I know that I can't live like this.  Without a permanent fix, the road ahead only goes down.


In September 2009, I chose a surgeon to perform Roux-en-y gastric by-pass surgery.  In order to receive insurance approval for the surgery, I had to undergo 6-months of pre-operative, medically supervised diet and exercise programs, receive a nutritional evaluation, a psychiatric evaluation and visit with my primary-care physician monthly for regular check-ups.  In addition, all the doctors had to write reports on my behalf with recommendations, evaluations, test results and analysis.  The pre-approval requirements have all been met...the insurance company is now reviewing my file and I should know in the next two weeks when my surgery will be scheduled.


That is the background, in a nutshell.  Over the past six months, I have been on an exercise and diet regimen that has prepared me for the weight loss surgery.  I slowly reduced my calorie intake from over 4,000 calories a day to less than 1,800 calories per day.  I exercise in different forms several days a week.  In the past month or so, my weight has dropped 31.5 lbs.  It took a while for results because I slowly reduced my calorie intake so my body didn't go into shock...that would have lead to binge eating, which would not have been good.  My calorie intake is between 1550-1800 calories a day, depending on the day.  After my surgery, I will only be able to eat 2 oz. per meal, three times a day.  My calorie intake will be around 800-1000/day total.


Now a little about me as a person.  I am 28 years old.  I am married to my beautiful wife Nicole.  I am an ex-executive that led a very active and stressful career managing condominium and townhouse communities in some of NJ's most well-to-do neighborhoods.  I am also a classically-trained singer who performs throughout the NY/NJ/PA tri-state area.  I have recently performed with the NJ State Opera, Coro Lirico and multiple other groups, taking me to prestigious venues like Lincoln Center's Avery Fisher Hall, Carnegie Hall and the Academy of the Arts in Philadelphia.  I am currently the tenor section leader of the Russian Chamber Chorus of NY and will be performing with the group at Madison Avenue Pres. in NYC in May.  I am also a pretty good amateur chef and love working in the kitchen.  The reason I tell you all of this is I have tried not to allow my weight to interfere with my life.  However, property management was never my career goal.  I am happy with other parts of my life...but my career has been a disappointment to me for a long time.

I have always wanted to be in law enforcement.  Eventually, I want to be in the FBI, but my main goal (5-year plan, you could call it) is to lose the weight and become a NJ State Trooper.  Law enforcement sort of runs in my blood...many of my family members are police/FBI/military and I have always been drawn to the calling of helping people, enforcing the law and providing a service to my community.  I am limited now in how much I can do because of my weight, but that changes when the weight is lost.

So, over the next year, I plan on writing this blog to document my journey.  I will post once a week...I will post pictures as I go, so you can see how I change.  This is my journey to a new and healthier life...I hope you will come along for the ride.