Wednesday, May 25, 2011

Things Randal Hall Learned Before and After Bariatric Surgery







Randal Hall is an engineer who spoke at a recent seminar. He had a gastric bypass operation 10 months ago has lost a total of 200 lbs so far. He did a terrific job sharing many things he learned while proceeding through the process of bariatric surgery and printed his thoughts for us. I think you will enjoy reading them:






Things I Regret:
a.) Nothing!

Three things I wish I would have done differently:
I wish I would have taken more and better pictures and monitored my weight/size loss better.
I wish I would/could have done it sooner
I wish I would have started exercising sooner and stuck with the program better.

Things I didn't expect:
a.) I could have comprehended just how different my life could have been.
b.) My weight loss was very rapid.
c.) My size loss was not as rapid but much more steady than the weight loss.
d.) “Plateaus” are very frustrating but when they end the changes are dramatic.
e.) I became lactose intolerant, no big deal, I hate milk anyway.
f.) Reaction to the new “Me” varies greatly from awkward avoidance to wanting to know every detail.
g.) Size loss does not equal weight loss.

Things I am still learning:
a.) When I look in the mirror, sometimes I still see the “Old Me”, it is kind of weird.
b.) My eyes have not adjusted to my new reality. I see myself as the old size/lifestyle.
c.) Portion selection is still very difficult. I look at a very small portion and think that will never be enough and then I can only eat less than half of that.
d.) Buying clothes is difficult for a few reasons, self awareness of actual size and what fits today may not fit tomorrow.
e.) Chewing is critical, seriously! Few things are worse than getting food backed up, I learned fast to avoid this.

Things that worked out fantastic:
a.) Total lack of hunger (good and bad but the bad is manageable)
b.) Very small portions of food satisfy.
c.) Fluid consumption is not a problem, I can drink water/sports drinks normally as I use to.
d.) I don't notice increased energy levels, just increased endurance.

Things that disappointed me about the process:
a.) Sugar doesn't give me symptoms.
b.) Fats seem to cause mild dumping.
c.) High protein intake means you need to consume some sort of fiber trust me...
d.) While I don't get hungry, I get a feeling like low blood sugar when I need to eat, I try to avoid that.

Things I do different now:
a.) When I eat, I eat quality not quantity.
b.) I don't worry about a clean plate anymore, as a matter of fact, I don't know the last time I cleaned a plate. Wasting food is not good but it doesn't end up on my waist.
c.) I don't take elevators anymore; I don't get winded on the stairs now.
d.) I don't park close to the doors; I walk from the back of the lot now.
e.) I run, I just ran the Komen 5K in 41:00 and I run 4 miles 3-4 times a week.
f.) I can fly coach comfortably now. (This was a primary goal)
g.) I can buy clothes at department stores, non-Big & Tall stores. (This was a primary goal)
h.) I eat slowly, it is not a race and it makes me sick to eat fast now.

Things I recommend doing prior to surgery:
a.) Exercise
b.) Reduce portions
c.) Get use to eating small portions 6-8 times a day, this is critical practice.
d.) Do research. Research your surgeon, hospital, surgery method and every aspect of what you are about to do. I particularly recommend Dr. Myers and Fresh Start, they were absolutely fantastic to me.
e.) Once you start the program take pictures, weighing yourself can cause frustrations but pictures really lets you see your progress.
f.) Develop your story, you will be asked a lot of questions, if there are things you do not want to disclose, formulate your avoidance answers, you will be asked a lot of questions. Prepare for people to say rude things and ask inappropriate questions.
g.) Realize that this is not the easy way out, this is not easy at all. Your life will not be the same after the surgery.
h.) Prepare for post surgery. Have your foods ready and test them prior to make sure what you like, experimenting post surgery can be quite interesting.

Warnings From My Personal Experience:
a.) DO NOT proceed with the program unless you are 100% ready and confident with your choice!
b.) DO NOT think that the surgery is MAGIC!
c.) DO NOT think that you will be happier post surgery!
d.) DO NOT think people will stop judging you post surgery!
e.) DO NOT think that all of your eating troubles will go away post surgery!
f.) DO NOT think that this is the easy way out, while I didn’t find this to be difficult, if this is the easy way the hard way is to do nothing!
g.) DO NOT think the Fresh Start Staff is kidding when they tell you that you have to meet your weight goals before being released for surgery, they are not kidding!
h.) DO NOT think that if you really want to do this, that you CAN’T, you most certainly can!
i.) DO NOT think that my experience will be the same as yours!

Questions you may not be comfortable to ask me:
How much did I weigh before the program?
464lbs was my max weight.
424lbs was my surgery weight.
268 is my weight today.
200-225 is my goal weight.
Max Waist Pant Size: 52” current Pant Size: 38” and shrinking.

Do I have trouble eating anything?
Breads and stringy meats (chicken breast and roast beef) cause me the most issues but if you chew properly and eat slowly they are quite manageable.

Is sex better?
Yes! Very much so.

Do I consider what I did hard?
No, I think in the grand scheme it was pretty easy but there were points where I did ask myself what the heck I had done to myself. If I can do it anyone can do it.

What was the worst part of the whole surgery?
There were two particularly bad points. The first period was the three week period post-op. I was very sore and then one day I woke up and it was totally gone, like magic.
The second period was about 6 weeks out, I had to go back to thin liquids because I couldn't get or keep much down, that lasted for about 2-3 weeks and Dr. Meyers refers to this as the "Misery Window" and he is not joking. Since that period, I have felt fantastic. Other than being sore, I have never felt bad.

Do people treat me different now?
Some do, some don't. I don't let what people think of me effect how I think of me.

Do I tell everyone what I did?
No, not at first, not anymore. I did for a while and the reactions were mixed. I have adopted the "Less History More Mystery" model and it really reduces the drama. It is not that I am ashamed, it is that I prefer people get to know me now before I tell them about my history to avoid the prejudice.

What am I the most proud of?
I started running on October 1st of 2010 at 320lbs. I had not voluntarily run more than a few steps in 20 years. I started a Couch-to-5K program and by March 30th I had ran my first continuous 5 kilometers. I was able to run the Komen race without stopping in 41:00. I am very proud of this.

Can I go out to eat at restaruants?
Of course I do, I just choose much better than I use to but I still enjoy the experience just as much.



Thanks so much for sharing so much of your life with us. I know everyone will really appreciate this.I am also very proud of you. Not only for completing the 5K run but for all the work you are putting into getting your best result!

Best wishes for your ongoing sucess,

Dr. Myers

Friday, May 13, 2011

Blood Clot Prevention before Bariatric Surgery



Martha Pettit explains how the preoperative placement of an Inferior Vena Cava Filter the day before her bariatric operation prevented the development of a pulmonary embolus. Martha was determined to have a high risk of developing deep vein thrombosis and/or pulmonary embolus. She was advised to have the filter placed before surgery and now she is glad she did.

Sunday, May 8, 2011

Bowel Habits After Bariatric Surgery



While seeing patients in my office I often hear concerns about constipation. This is a frequent complaint in the early days or weeks after the three most frequently performed bariatric operations; gastric bypass, gastric sleeve, and adjustable gastric band.

Although after surgery patients may be using narcotic pain medicines that slow the intestine that may result in constipation, usually the problem is the lack of fiber in the diet. Since patients are only taking liquids for a time after the operation it is very difficult to consume adequate fiber.

I make the following 4 suggestions to my patients:

1). Stop the use of narcotic pain medicines.

2). Add 25 grams of Benefiber everyday to your drinks or meals. Most fiber products become thick and are difficult for bariatric surgery patients to tolerate. Benefiber disolves in liquids, is tasteless, colorless and is not gritty.

3). Use Miralax as necessary if you have not had a bowel movement for several days.

4). Censider using Colase twice daily until the fiber therapy results in soft bowel movements.

Fiber therapy is not an instant cure for constipation but over a week or so bowel movements will become softer and should stay that way as long a the patient is taking enough fiber. As fiber is added to the diet in other ways the amount of supplemental fiber can be reduced.

Monday, May 2, 2011



Recently I saw Angela McCaulley in my office. When I sat down across from Angella I first told Her,"I might see your name on this chart but I really do not know who you are!" Angela had her laparoscopic Roux en-Y gastric bypass performed by me nearly 18 months ago. She has had an amazing result as you can see.

She now walks or runs everywhere.

To remove some of the extra skin she had a "belt lipectomy" romoving skin from all around her waist about 6 months ago.

I did not feel so badly for not recognizing her after Angela told me even her grandmother did not recognize her!

Congradulations Angela, the great result you have obtained is the result of your exceptional efforts over the last 18 months.