Game Day

This is it.  The day I have been worked so hard to prepare for.  I'm not anxious or nervous, just ready for this part to be over.  I'll post some surgery day before pics later. 

Getting a massage before my 11:30am check-in and 1:30pm date with Dr. Khalil.

Toodle-oo for now.

ONE More Day

One full day and counting.  Any other time, the weekend would fly by.  This weekend, noooooo.  Heaven forbid.  I feel every lingering second, as though time is actually fighting its natural pattern.  One more day, until I get over the biggest hurdle.  One more day of being grumpy and malnourished.  One more day, until the arguably most important day of my life.  I'm ready for this ... 

All Clear Liquid

I have been on an all liquid diet since Sunday, September 27 (13 days).  My doctor wants me on an all clear liquid diet two days pre-op, figured I'd start a day early, like I did with the all liquid diet.  I'm also supposed to take 3T Milk of Magnesium on Sunday at noon.  Figured I'd take a 2T today and tomorrow to get things moving (every pun intended).  Sunday, it's fair to say, I will be chained to a bathroom.  My all liquid diet consists of organic chick stock, low sodium beef stock, bone broth, sugar free Jello (great sale at Safeway - 86 cents for 4 pre-made containers).  Looks like the next few days will be full of small walks, reading, Netflix and Hulu queues.  This is the final trek. 

Last night, I literally had an emotional breakdown while unloading the dishwasher.  More than anything, I think it's just nerves and anxiety, along with some mild work stress.  Plus, there's this stupid boy and well, boys are stupid.  End of story :-)

Looking forward to Monday morning.  I think I am more anxious than a kid on Christmas morning.

5 Days Pre-Op

Yesterday was the very first time I had any sort of cold feet.  I felt icky - heachache, backache, hangry (hungry and angry) and miserable in every sense of the word.  For a split moment, I questioned my decision to have the surgery.  The "what-ifs" fluttered my brain - What if it wasn't successful?  What if I self sabotage?  What if there is a major complication?  What if they have to open me up?  What if, what if, what if?  Just as soon as those thoughts raced through my mind, most rationality returned and I determined my lack of solid food (11 days ago) and carbs caused these racing thoughts.  Now 12 days into my all liquid diet, I am confident in my decision.  I have a solid support system.  I am nervous - sure, but I know this is the decision for me.  I have worked so hard to make sure that I have set myself up for success.  I have been so strong during this all liquid diet, I know I can conquer the entire journey.  I have faith in me.  That's all that matters.

One Week Pre-Op

It's almost here - the date I have been anxiously awaiting for MONTHS.  I am so ready for the surgical portion of this journey to be over, so I can start sculpting my new body.  The mind had been shaped, the body just has to catch up.  

This is going to be a busy week between tying up loose ends at work, a couple interviews, and preparing my house for this big change.  I almost feel like I am nesting; being completely anal about having things clean, easy to access for when my mom comes to help me post-surgery.  

This surgery is more than a new lease on life, it's a new beginning, a new journey, a new way.  I have literally been talking to just about anyone who will listen.  I am proud of the decision I have made for myself and my life.  I know there are a lot of "haters" out there who say some pretty mean things about deciding to have weight loss surgery.  What many don't understand is that surgery is not a cure all.  You don't wake up 100+ pounds light without putting the work in.  Bariatric surgery is a tool.  If you choose not the use the tool properly, it's not going to help you, right?  People who are not fully on board with making lifestyle changes, putting down the ice cream and picking up some fat free greek yogurt or chowing down on french fries instead of some lean protein are NOT going to see any improvements in their health.

Many people can tell you of horror stories about people they know who have had weight loss surgery that didn't turn out well.  Sure, they might have lost the weight initially, but down the road they gained the weight back plus some.  I think in part this is an old way of thought.  Doctors and insurance companies now make patients jump through hoops - labs, nutrition classes, psych evals, support groups and pre-op weight loss to prove they're making a lifetime commitment to the surgery and lifestyle change.  How could you go through all these classes and work so hard, just to throw it all away?  I know I can't.  Will I have birthday cake - damn right I will, but it will be small and I won't eat all the frosting.  Will I have a glass of wine on occasion, sure.  I feel that I am strong enough to have some "cheat" foods here and there without launching myself back to the mess where I started.  

Well folks, this will be an interesting week.  The count down has officially started.  7 days and counting.

Support - On and Offline

I am loving the online and offline communities for those on their bariatric surgery journey.  Lately I have really taken to blogging (obviously), Bariatric Pal, and Pinterest as my main go-tos.  

Bariatric Pal offers a global online community for bariatric patients who are both pre and post op.  It has been great collecting information from all different kinds of folks, with different reasons for taking on this massive journey.  

Pinterest is great.  It's also very torturous when you've been on a restrictive all liquid diet for over a week.  However, I am finding it to be a wonderful resource for finding post-op recipes - cupcake pans will be your best friend.  It's perfect for portion control.  Also, there are some fabulous people who have gone great lengths to make some awesome recipes which are bariatric friendly.  Post surgery, this blog will follow my progress, but I will also share a lot of my favorite foods.  

I found this great visual of the benefits (mostly for females).  Of these different ailments, I am hoping for the following to be eliminated post surgery.

• Metabolic Syndrome
• excess belly fat
• elevated cholesterol
• Polycystic Ovarian Syndrome
• hirsutism
• menstrual dysfunction
• Non-Alcoholic Fatty Liver Disease
• I don't have Fatty Liver disease, but have fatty liver 
• Venous Statis
• varicose veins

Before Pics

I wanted to post a couple of my before pictures so that there is some visual documentation from a start to finish.  I will post some full body on the day of surgery.  Stay tuned sleevers.

3 weeks Pre-Op
September 2015

MKTO Concert
Summer 2014

Wine Tasting
February 2014

Vitamins

Vitamins are important for anyone, but are absolutely crucial after bariatric surgery.  There are plenty of brands including Bariatric Advantage and Opurtity that cater to the bariatric community.  I, however, prefer the Wellesse brand.  I purchase my vitamins through Amazon - I find this particularly convenient, especially with Prime.

Wellesse Multivitamin + B-Complex                         Wellesse Calcium + D3
     16 servings                                                                16 servings
      2 pk - $15.98                                                             2 pk - $13.58
                                             

Wellesse Iron                                                               Wellesse D3
     16 servings                                                                  16 servings
      2 pk - $20.49                                                               3 pk - $17.97
                                                         

Trace Minerals Magnesium 
     32 servings
     $15.45                                                                                                                                          

Pre- Op Liquid Diet - Week One

I started my liquid diet a day early to get a jump on it.  Plus, I didn't want to start on a Monday, I felt that would be too overwhelming.  The first four days were the most difficult.  Thursday was definitely easier and it's progressively becoming less torturous to be around food.  I know that I am more grumpy towards the end of the day (2pm on).  I have little to no energy right now, my doctor says that will change after the surgery.  I went out last night with friends for dinner.  I had water and they ate actual food.  It wasn't nearly as miserable as I thought it might be.  Looking forward to Thanksgiving - that's when I should be able to start eating real food again.

Main stables for my all liquid diet...

• Water ... lots of water  
• I also use the Crystal Light water flavors (sugar free of course)
• Imagine Brand (Safeway)
• Tomato
• Tomato and Red Pepper
• Cream of Broccoli
• Cream of Chicken (strained)
• Cream of Mushroom
• Anderson Split Pea Soup (without ham)
• Dr. McDougall's Right Foods Vegan Split Pea Soup (Amazon)
• Premier Protein Drinks
• Chocolate
• Strawberry Cream
• Sugar free Jell-o and Pudding
• Sugar free Ice Pops

Difference in Inches

I started my journey the end of May 2105.  I decided to take measurements from my start date and then four months later.  Here are my results.

	May-15	Sep-15	Difference in Inches
Neck	15 3/5	15 3/5	-0.9
Chest	47 7/8	45 3/5	-2.275
Lt. Arm	13 1/3	14 1/3	1
Rt. Arm	13 1/4	14 1/2	1.25
Hips	52 1/4	49 1/2	-2.75
Waist	50 1/2	47 1/2	-3
Lt. Leg	29	28 1/5	-1.8
Rt. Leg	27	25 3/5	-1.4

Pre-Op with PCP, Nutritionist, Hospital and Surgeon

On Monday (3 weeks pre-op), I had my Pre-Op appointment with my PCP.  I was recovering from a minor cold, but she expressed no concern.  She checked my vitals (BP, HR and Temp) and also conducted an EKG.  My PCP was EXTREMELY thorough with my medical history to ensure that I was clear for surgery and that my surgical team had the best possible information to ensure my safety before, during and after my VSG.

On Tuesday, I had my Pre-Op appointment with my Nutritionist.  I have been seeing her since May, so we had already discussed the aspects of my nutrition and activity post surgery.  We went over best practices and my vitamin (all liquid) schedule post surgery.  It was a relatively productive appointment and scheduled my post-op nutrition appointment for 4 weeks post surgery.

On Thursday, I had my Pre-Op appointment at El Camino Hospital.  This was a two hour appointment.  It included submitting my admission papers (saves time the day of my surgery) and received information regarding an Advanced Healthcare Directive.  Once all the boring paperwork was complete we went through the check-in process for the day of surgery, discussed expectations post surgery (peeing, walking and drinking fluids).  It was very comforting to go through the steps before and after surgery.  I was surprised to learn that the procedure is only 60-90 minutes.  Then 90-120 minutes in recovery and an overnight stay in a private room.  

Today, I received my pre-op packet from Dr. Khalil.  It included pre and post op instructions and a special bar of soap to ensure that the surgical area and areas surrounding are extremely clean.  

I have to check into the hospital at 11:30a on Monday, Oct. 12.  Surgery is scheduled for 1:30p.  

I have scheduled a massage for the morning of my surgery to relax my body and muscles before heading to the hospital.  

I had my pre-op with Dr. Khalil 13 days before surgery.  He was VERY please with my weight loss thus far (17.1 lbs).  We discussed incision placement - 5 in total.  One at the apex of the bottom of the ribcage and then two on each side below the ribs.  I have stayed well educated regarding my surgery - during and after.

And so the count down begins ....  

Protein -- Can't get enough!

I have never been much of a chocolate fan, but it seems that all the decent protein shakes are chocolate.  I have yet to find a non-dominant chocolate shake that I enjoy.  

Costco has been my go to for all protein.  Remember the rules of thumb for protein

• Under 220 calories in total (this includes the liquid you're using for shakes other than water)
• Double digit protein (10g or more)
• Single digit carb/sugar (9g or less)

Some great brands I have found that I thoroughly.  I always use a blender bottle with coil ball and extremely cold liquid (water, coconut water, sugar free coconut milk) 

Calories:  140 (1 rounded scoop)
Carbs:  3g
Protein:  30g
Texture: Rich and creamy
Taste:  Very rich and chocolatey 

Calories:  140 (1 rounded scoop)

Carbs:  5g
Protein:  25g
Texture: Rich and creamy
Taste:  Very sweet 

Anthem Blue Cross of California - VSG Requirements

At the advisement of my doctor's office, I contacted my insurance company, Anthem Blue Cross of California (Prudent Buyer Plan) to make sure that I had all my ducks in a row.  Here are their requirements.

• BMI of 40 or higher 

          OR 

• BMI of 35 with a pre-existing condition such as high blood pressure, Type II Diabetes, PCOS, etc.

• 6 months of a doc. supervised diet (Weight Watchers, Atkins, calorie and carb reduction, etc)
• Pre and post-op nutrition classes (I am doing 3 pre-op)
• Psychological evaluation
• Blood test
• EKG
• Barium test 

My doctor, who is with Palo Alto Medical Foundation (PAMF), a Sutter affiliate also requires that I attend two surgery orientations.  PAMF also offers an array of support groups for pre and post op patients.  I love these groups.

The Beginning of the Rest of My Life

My name is Ali.  I am a 25 year old (will be 26 in August), software sales professional.  I have struggled with my weight my entire life.  I decided to make the leap to VSG after years (12+) of unsuccessful "dieting".  I am young enough to heal easily and tired of after every "diet", I end up gaining the weight back plus some.   

I began my official journey with preparing for VSG on May 26th, 2015.  I have completed all lab work (blood draws), chest x-ray, and Upper GI test with barium.  I have also completed my first of two nutrition appointments with ease.  My last nutrition appointment is the first week of July, as is my "psych" eval - more to insure that I am mentally, physically and emotionally prepared for a drastic life changing procedure.

My initial appointment with Dr. Beeman Khalil was AWESOME.  He had a such a great personality that was welcoming.  It made me feel like an active participant in my health.  Since meeting with Dr. Khalil and my nutritionist, Darcie, I have rid my house of all items that I won't be able to eat post surgery - why not start now, right?  I have began eating two protein shakes and one square meal a day.  I have have two dogs, so I am already relatively active and walk for about an hour a day.  I have eliminated alcohol completely, along with sodas and carbonated beverages.  Obesity runs heavily (no pun intended) on both sides of my family.  I am looking for an opportunity to wipe my slate clean and be able to determine my health and future through a lifestyle that is more healthy.

This blog will act as a live journal and documentary for my journey to health and success with VSG.   

 

   Here are some pics from the nasty Barium test.  This is how the doctor can see the shape of the esophagus and stomach for the VSG procedure.  After evaluatiing my images, my doctor found that I have a minor hiatal hernia; which can be fixed with a few stitched when I have the VSG procedure.