I could make a long list of health-related problems that have either disappeared or been greatly reduced, but the best part about the weight loss has been the improvements to sleep. (Miraculously, I’m able to wake-up feeling like I’ve actually slept.) I rarely fall asleep during the day anymore! Words cannot describe how much better I feel due to the improved sleep alone.

My sleep apnea has not been “cured,” however. According to my BiPAP and oximetry data, I still do have notable episodes of apnea while I sleep. So I still need to use my BiPAP, and I’d say there’s still some room for improvement. True, I’m awake during the day, and not sleepy, but I don’t feel quite as alert and “on the ball” as I think I could be. So I’m still working with a sleep doctor and taking measures to reduce my apnea even further.

In short, my apnea has gone from out-of-control to manageable. My quality of life is remarkably better now for just that reason.

I don’t like to place too much emphasis on the exact weight lost; it was never about the number of pounds, but more about my health. But for general reference, I peaked at about 348 pounds in 2008. Let’s just say I’ve lost more than 90 pounds, and not yet 100. I updated my little graph… see for yourself.

The scars have healed quite nicely. I don’t even see them in the mirror unless I’m looking for them. (Having a little bit of belly hair has helped, too.)

Since the surgery, my taste in food has changed somewhat. I used to love fried food. One of my favorite things was a big ol’ cheeseburger with a giant pile of fries. But it just doesn’t have the same allure anymore… I don’t crave that kind of thing these days. I used to eat a lot of bread. Now I can only eat a little bit of bread. (No more bagels, thick sandwiches or buns). I thought I’d really miss it but it hasn’t been a problem at all.

Conversely, I didn’t used to have a sweet tooth… but I now have fairly regular cravings for chocolate. I’m told that after weight loss surgery, many people do experience a shift in their food preferences, but they vary by individual. I guess the important thing is to be aware of these kinds of shifts so you can make the best decisions.

There have been a few downsides. Ok, so I have some excess skin. I’m more gassy than I used to be. And I have to be careful not to eat too fast or too much or I’ll vomit. (Thankfully this has only happened to me twice… hopefully I’ve learned my lesson!)

All of this is a very small price to pay for the benefits. I’m not complaining in the slightest!

Now please allow me to celebrate some victories:

• Last week I fit into a front seat on the "Scream" coaster at Magic Mountain without even trying. (I didn’t even have to use the "big boy" seat. Just last year, I didn’t even fit on the ride at all.)
• I easily fit into my size 38 jeans again. (At my heaviest I wore a size 46.)
• My triglycerides and HDL have gotten a lot better. (They’re not perfect. But they are better.)
• I feel more upbeat these days. I think I’ve been smiling more.

By far the biggest benefit has been the improvements in sleep. Consider:

• Since the surgery I have missed zero work due to daytime sleepiness.
• On the Epworth Sleepiness Index, I jumped from a 14 to a 4.
• I’m sleeping 6, 7 even 8 hours straight through the night, with no tossing and turning.
• When I wake-up, I no longer feel like I’ve been hit by a truck. I feel like I’ve actually slept.
• I don’t get sleepy during the day anymore.

I still have sleep apnea but now it’s manageable. I may always need my CPAP. And you know what? I’m ok with that.

Contrast all this with where I was in 2008:

(For a little history, you can read my original lament here, or follow the whole, chronological tale here.)

I’m still paying the bill for the procedure. I’m on a monthly payment plan, and it’ll take another 2 years to pay it off. But it has been completely worth it. My only regret is not doing it sooner.

If you’re considering having weight loss surgery, definitely talk to a doctor. Find out if you’re a candidate. Learn more about it. Make sure you know what you’re getting into.

The lap-band surgery doesn’t always work for everyone:

• Some people don’t lose as much weight as they want to.
• Some people have vomiting problems.
• Some people gain the weight back. (There are ways to cheat the band.)

Some people say that before getting the surgery, you need to change your relationship with food. Others say that the surgery changes it for you. The truth is, it’s a little of both. (As the doctor said repeatedly: the lap-band is a tool, not a cure.)

Even with the lap-band, I still face daily choices about what I eat, and I must make time for physical activity. Not long ago, the mere thought of exercise made me cringe. But now I actually have the energy to do it. A 30-minute walk is now easy for me.

I’ll let you in on a little secret. Since the surgery I haven’t spent a single moment in a gym. Instead I’ve been doing other types of activity: walking, biking, even occasional yoga, kayaking or a volleyball game. (Of course, it helps that I live in a city where I can enjoy these things year-round.)

Whenever I can, I try to bike or walk with a purpose. Whether it’s a trip the grocery store, the dry cleaners, or a restaurant, it makes it feel less like a chore if I have a destination. (Also, thank goodness for iTunes.)

I look back and I’m amazed at the progress that I’ve made. I once wondered if I’d ever be able to escape the vicious cycle of weight loss (every time I lost weight, I’d gain it all back… and then some.) The surgery seems to have been the vital catalyst that allowed me to achieve escape velocity.

Miraculous? Yes. But the surgery is no magic bullet, and it’s not a free pass. It still requires work. I’m still learning every day.

And now comes the hard part (the Mormons like to call it "enduring to the end.") There’s still more work to be tackled, more choices to be made every day.

In the meantime, Mikey’s got his bounce back.

The scars from my surgery are healing-up quite nicely.

So here’s my little report card. It shows, at a glance, how I’m doing since having my lap-band surgery 6 months ago.

The biggest news here is my progress on the Epworth Sleepiness Index. This is a number that helps the doctor know the severity of daytime sleepiness. I leaped from a 14 to a 5… which is simply amazing… and much better than I’d hoped. I no longer require daytime naps… and I haven’t missed work due to tiredness.

Even though I didn’t meet my full goal for O2 desat levels, I’ve done really well! So exciting. I’d like to do a little better, but this is just awesome.

A new BiPAP mask (a full-face model that actually fits me, thank you!) has made a big difference for me as well. Hence the nearly perfect score for BiPAP leak rate.

My triglycerides and HDL have improved as well. As my friend Nick says, there’s only so much you can do about them. (Still, I’d like to improve my score a bit more.)

I wasn’t able to find numbers for blood pressure and neck size, but my blood pressure’s always been good. I think my neck size has gone from about 21-ish to 18-ish. (Reducing neck size is important because it correlates to a more open airway… allowing more oxygen to flow, and decreasing sleep apnea.)

I’ve taken all of my vitamins and supplements every day, and I have not had any caffeine or soda since the surgery. (At first I missed my Diet Pepsi, but I honestly don’t miss it anymore.)

My Apnea/Hypopnea Index (AHI) has improved significantly, which I’m happy about. The doctor says a number under 5 is considered normal… woah. But I want to do even better. I think that with a little work, and maybe some tweaking of my BiPAP settings, I can do it.

During all of this, I have not had a single complication. I’ve never vomited. I’ve had my lap-band filled twice without incident. I barely even know it’s in there.

Now comes the hard part… being persistent, and continuing to get at least 30 to 45 minutes of physical activity every day. (As you can see, my daily compliance was umm, pretty good, but not great. But I have plans up my sleeve!)

Overall, I’m VERY happy with my progress. I only wish I’d done it sooner!

I’m now past the 6-month mark since my lap-band surgery. Things are going really well!

This chart shows my weight. It doesn’t have any numbers on it because I don’t really give a fuck about how much I weigh. Suffice to say that in terms of weight lost, I’ve safely passed the 75lb mark, most of it in the first few months after surgery. (The notch mark for 2008 represents the middle of the year.)

I’m happy to report that my health is getting much, much better, and most importantly, my sleep apnea is becoming more and more manageable.

Have I “arrived?” Not yet. But I’ve made tremendous progress and I’m sooo happy with the results.

I feel a bit self-conscious doing this, but several folks asked me to post some recent “post-surgery” pictures.

I didn’t want to do anything cheesy and I really dislike the idea of a before/after thing. Just kinda lame.

Anyways, so above are some recent pics of me. (Taken by friends Rob, JP and Wayne.)

I dunno, I guess if you want to see a “before” shot, there’s one here.

In three and a half months I’ve dropped over 70 lbs, gone from a 4XL to a 2XL shirt, and from a size 44 (sometimes 46) pants to a size 40. (I can actually wear my 38 jeans but they fit very snugly.)

I’ve been walking or biking every day, and occasionally mixing-in other stuff. Over the next few weeks, it’ll include hiking, kayaking and volleyball.

The weight loss has leveled-off a bit, so now comes the next phase: the goal is to lose about 2-3 lbs a month for the next year.

Meanwhile, my sleep continues to improve, though perhaps more slowly than I’d hoped. I’m definitely over the first “hump” and able to sleep soundly throughout the night. I’m also happy to report that I am alert enough to work a full 40 hours per week at work again. WHEW. But oximeter readings indicate that my blood oxygen is still low and I’m still having some daytime sleepiness. This means I need to keep using my BiPAP*; and I’m working with a sleep specialist to keep finding ways to manage my apnea better.

Things took a giant leap forward when I started using a new BiPAP mask: the Respironics ComfortFull 2. It’s practically a perfect fit… my numbers indicate an amazingly low leak rate every single night since I got it. It’s comfortable, and I don’t get air blasting in my eyes. (This, after experimenting with at least a dozen different kinds of masks over the last few years. Yay!)

So that’s one problem solved. Now onto the next one: getting the right BiPAP pressure settings. I got a new BiPAP machine, it’s smaller and has some nifty electronic reporting features that should give us some clues. Right now the BiPAP pressure is set to 20/16. I told the doctor that I thought 16 was too high, because I couldn’t exhale completely before the BiPAP started making me breathe-in again. He looked at my last sleep study and agreed that my oxygen levels looked better at 20/14. So we’ve adjusted the machine, and we’re tinkering with a few other settings that it has (ramp, cycle, min/max breath time, etc.) to get things better.

So things are progressing!

*A BiPAP is just like a CPAP, only it has two levels of air pressure: one for inhalation, and another (lower one) for exhalation.

• I now have a bunch of clothes that are too big for me. Pants, shirts, belts. Yay!
• The incisions are healing faster than expected. (Pic coming soon.)
• I am getting a good seal on my new CPAP mask… last night I had one of the lowest leak rates yet.
• My energy level is climbing, slowly but surely.
• My feet always used to be kinda puffy. They’re not anymore.
• My left eye used to twitch a lot. The doctor says it was a side effect of the Provigil. I’m not taking it anymore, and the twitch is gone.
• Several folks have commented that my eyes don’t look as baggy anymore.
• I’ve been 100% compliant with my daily supplements, in attending the nutrition support group, and in getting 30 minutes of activity every single day. (Mostly walking, some biking.)
• Remember that sinus surgery I had last year? I actually have been reaping the benefits (finally!) over the last several months. I can breathe freely through my nose now. Not just sometimes, but every single day, and every single night. Which is making the CPAP therapy more effective.

I still have a long way to go, but things are improving even faster than I expected. Yay!

You may have noticed that I’ve not been focusing on my weight (as a number). I don’t think the number is a good way to measure one’s health. However, I suppose it would be good to give a rough idea of how much progress I’ve made; let’s just say I’ll easily surpass the 50lb mark by mid-June.

And I haven’t felt like I’ve been depriving myself of food at all. A small serving of food tames my tummy with no problem.

By the way, I finally did receive a letter from the insurance company, in which they let me know the denial was upheld. I’m not really surprised, and, as I’ve mentioned previously, I don’t blame them. (It was never a question as to whether the procedure was medically necessary; the fact is, the procedure is simply not available through my particular coverage plan.) Ah well, it was worth a shot.

Life = good.

I’m still having some daytime sleepiness. It’s hard to know if this is due to insufficient sleep, or insufficient calorie intake. The doctor warned that during the first month or two, there’s a chance of some lethargic tendencies, but this was normal and will eventually go away. In the meantime I just need to follow the prescribed eating plan and make sure I take the vitamins and supplements. Pretty easy.

For the first few weeks, I was only allowed to have a few types of food (water, Propel, broth, sugar-free jello, sugar-free Popsicles, etc.) Soon after, I worked my way up to soupy foods (Cream O’ Wheat, creamy soups etc.) and now I’m up to mushy foods (soft cheese, oatmeal, pureed meats and fruits.) Everything has to be moist and soft or mushy for now. Pretty-soon I’ll actually be able to eat things that can actually be chewed.

I’ve had my first post-operative follow-up and everything looks good. In about three more weeks I’ll have my first Lap-Band “fill.”

I’ve been cleared to drive, and given the green-light to ramp my physical activity back up. So I’m doing 30 minutes of activity every day again now. So far it’s been mostly walking. I’ll introduce biking again soon, then start going to a monthly exercise class, which the doctor requires us to attend. I have some ideas for other stuff, too.

I was just thinking about some of the pleasant “side effects” today:

• I’ll be able to buy clothes at regular clothing stores, instead of just Casual Male XL.
• I’ll be able to fit on some of the roller coasters that I couldn’t fit into before.
• Many asthma sufferers report improvement after weight-loss surgery, and I have mild asthma.
• This may sound weird, but I’m already spending a lot less time sitting on the toilet. (Sorry for the TMI.)
• I’m obviously spending a lot less money on food.

MANY thanks to everyone for your well-wishes. I am really trying to catch-up on all your e-mails… please be patient with me!

So far, things really haven’t been difficult at all. And finally I wake-up feeling like I actually slept (instead of feeling like I’ve been hit by a truck.) I still have a long way to go. But I’m seeing improvement already.

Monday

• Got a call from the hospital… they had a cancellation so they need to move my procedure 3 hours earlier. D’oh! That means getting-up early.
• Went to my nutrition support class.
• Shaved my beard
• Had no food or drink after 11pm.
• Took a Hibiclens shower. (I guess this is to minimize the chances of getting staph.)
• Went to sleep very late, perhaps 1:30am, because I had other stuff I needed to finish.
• Got-up at 6am. Had my second Hibiclens shower. Got dressed and Matt took me to the hospital.
• Checked-in and was brought to a room. Changed into my gown and waited. Watched TV, and actually surfed the ‘net for a bit, as I’d brought a laptop and the hospital had free WiFi.
• They tried to prep me for the IV. The nurse, who seemed to be new, poked me twice and was unsuccessful, so she told me the anesthesiologist would do it.
• Received word that our operating room needed to be used for an urgent trauma case, which meant we’d have to wait longer. (It ended-up being a 60-to-90 minute delay.) Matt took a nap:
• I occupied myself with my camera, and started playing with the macro feature:
  
  
• They took me in my bed to a pre-op holding room. Hung-out there for awhile. Boring.
• The doctor stopped-in to say hello, and ask if I had any last-minute questions. He said he’d submit doctor orders that would allow me to be discharged early the next morning; he wouldn’t even have to be there.
• Got called-in. They took me to the O/R, which was big and snazzy-looking. And freezing cold. They had me lay-down on the operating table and started to get me ready. I started to shiver a bit. They asked me what my favorite radio station was, they found it and cranked it.
• I observed the camera and the video monitor that they’d be using to do my (laparoscopic) procedure. Somebody had told me that when you’re doing (or observing) the surgery, you basically watch it on the television screen.
• The anesthesiologist came in and had to poke me three more times to get the IV done properly. Ouch! Meeting your anesthesiologist is a bit of a weird experience. Though you may be able to choose your surgeon, and you get to meet him/her beforehand, this is not the case with the anesthesiologist. They’re assigned to you, often at the last minute. So you basically get what you get. They walk into the room and introduce themselves and you basically think “wow, nice to meet you, here’s my life in your hands!”
• Still shivering, too. They put some blankets on me.
• The two assistants were young ladies who were very nice to me, tried to keep me calm and make me laugh a few times. They told me I wouldn’t need a catheter, yay. They attached the little stickers for the heart monitoring. Shaved my belly. Put those plastic leg cuffs on me, which inflate intermittently to prevent clots, neat!
• They turned-on the “drip” in my IV, and I drifted-off into unconsciousness listening to Linkin Park’s Shadow of the Day. (“And the sun… will set for you…”)
• I woke-up in a little bit of pain. They gave me morphine. (Thanks, morphine!) My memory from this part is a little fuzzy. I do remember them wheeling-me up to my room, number 711. I remained there for a time.
• I heard a couple people talking outside the room, then Matt came-in, yay.
• I got my own room. With a nice view, even. Matt and I watched Scrubs on little airline-style TV screens next to the beds. Got a dose of Pepcid and some more morphine.
• As it got later, Matt went home. I never got totally comfortable on the hospital bed, but somehow managed to sleep for a bit. I slept hard, but only for about 3 hours. Wide awake, I attempted to watch TV. Nothing but infomercials. Eventually I got back on my laptop.

Tuesday

• I tried to start arranging to be discharged, but the nurses insisted that I couldn’t leave until the doctor saw me. They couldn’t get a hold of him, but said he’d be making rounds at 9am.
• Around 9am, Matt came back with Rob (aka Roblet) in tow. No doctor. We waited. Over an hour. I called the nurse and asked her to check things out. No news, no doctor, nothing they could do.
• 11am rolls around. A nurse has discovered the doctor’s orders said I could check-out without being seen. *sigh*
• We check-out. I walk to the entrance with Matt, while Rob gets the car. Ride home. Lay-down on the couch. Watch TV. I take a little nap.
• I take vicodin (generic, in elixir/liquid form) for pain. I think it actually worked better than morphine for this particular kind of pain. Another Pepcid AC. (They want to make sure I don’t have much acid for now.) Three Flintstones Kid Complete multi-vitamins. A sugar-free Tums E-X.
• It’s no problem to drink the prescribed water, ice chips and Propel. No pain, no regurgitation, no difficulty or anything. Anxiously awaiting the day I can have more… broth, a (sugar-free) popsicle, etc. (You have to be very careful at first to promote healing.)

This is the vicious cycle that I was caught-up in. I firmly believe the weight-loss surgery is going to help me escape it.

I made this chart. Maybe it will be useful to someone who’s been caught in the same cycle.

When deciding whether to have weight-loss surgery (and if so, which surgery), I sat down and drew-up some “what-if” scenarios:

• What if I did nothing?
• What if I tried to lose the weight myself? (What if it all came back?)
• What if I had gastric bypass? Lap-band?

When I plotted everything out, they looked something like this.

(The black line on the left represents actual numbers. The other colored lines represent some possible paths.)

These are very rough numbers… just estimates. These are not goals, but more like educated guesses, based-on my history and what I think I’m capable of.

You’ll notice the chart kinda “flatlines” towards 2011 and beyond. I don’t think all the options would literally remain unchanged, but the chart gives a general idea of where I might expect to be.

In the end, I opted to go with Lap-band surgery for several reasons. I’ll expand more on that later.

I’m posting stuff like this because I’ve had a number of people ask me questions about weight loss and about the surgeries. Maybe this will be helpful to someone. I just thought the graph was useful in showing the options in a more visual way.

Again… these are just rough numbers and would vary.

A friend asked me how much weight I hope to lose after having the lap-band surgery. The truth is, I’m really not focusing on that. (I’ll still keep records of it, but my point is that it’s just a number.)

Instead, I have my eye on the goals written-out here. I believe these will give me a much better picture of my health and improvement.

Some of the items listed here may really be the means to accomplishing a goal. But I still list them here as goals because I want to monitor how well I do.

If I reach my goals at the 6-month mark, I’m going to treat myself to something suitably loverly… perhaps a next-generation iPhone or something.

There are five scars from the surgery. (Obviously they’ll heal much better than this, but some peeps had asked about them.)

I’m up and about a lot already, and even walked 5 blocks outside today.

Right now I’m on liquids only… mostly water, Propel and ice chips. Tomorrow I introduce broth, sugar-free Jello and sugar-free Popsicles. After that, other soft stuff like Cream O’ Wheat and strained soups. And we keep going up from there.

Tonight I sleep with my oximeter to get a reading for my blood oxygen saturation.

They also shaved my whole belly, and part of my wrist (where the IV goes.)

This is only the second time since 1995 that I’ve shaved my whole face.

I’d like to introduce you to a totally rad website called SparkPeople.com. I learned about it from my sister Suzanne awhile back.

SparkPeople helps you live a healthy lifestyle, even if your goal isn’t necessarily to lose weight. You can:

• Set health-related goals and track your progress.
• Use an instant search to get nutrition statistics about thousands of different foods, including fast food.
• Explore tips about nutrition and physical activity.
• Find, contribute, and rate food recipes.

You already know my beliefs about the rebound weight re-gain when you reduce food intake to lose weight. So I really like SparkPeople because the emphasis is placed on healthy living. You don’t need to focus on weight if you don’t want to.

Say for example, you just want to concentrate on your sodium consumption, or fiber, or you want to drink 8 glasses of water per day. Perhaps you want to reduce (or eliminate) alcohol or caffeine. Reduce your triglycerides. Eliminate high-fructose corn syrup. Maybe you want a way to track how much physical activity you’re getting every week. Whatever your goal, SparkPeople will help you track it. Here are some of my goals, for example:

(NOTE: The items listed above are based-on my doctor’s recommendation for lap-band patients. Your actual goals and numbers may be much different.)

What else do I like about SparkPeople?

• It’s totally and completely free.
• No junk mail, no obligations, and NO CATCH. Unsubscribe at any time.
• Well-designed, easy to navigate, useful.

I like receiving the “SparkPeople Food Showdown” e-mail newsletter. Every day they pit two foods against each other, then tell you which one is better for you. What’s great is that they pick foods that you’d probably actually eat… the Whopper vs. Big Mac, for example. Sometimes the results are obvious, and sometimes they’re surprising. And often they’ll throw in useful tidbits… like “hold the mayo and save another 120 calories.”

There are a number of other features, some of which are useful, others not. You might find the community features helpful, and you might even create your own SparkPage or gather friends into a SparkTeam. Or you may just want to join to get the e-mail newsletters and do nothing else. You can pretty much decide what level you want to participate at, then go with it.

No matter how big or small you are. No matter if you’ve had weight surgery or not. SparkPeople has something for everyone, and I highly recommend it.

I have five (relatively small) scars. I’m moving around on my own. Matt is taking good care of me. Just relaxing and doing some short walking trips.

Yesterday my buddy Rob (aka “Roblet”) stayed with me while Matt went to work. Last night JP brought over the film Shortbus on DVD, so we caught-up and watched that. After that I was pretty exhausted so I went to sleep. (The night after the surgery I slept perhaps 3 hours. But last night I slept nearly 6 hours, yay…)

Yesterday and today I’ve been having water, Propel, ice chips, and a few chewable supplements. It doesn’t hurt to drink or anything, which is nice.

THANK YOU for all your nice e-mails. I’m so amazed at how supportive y’all have been! It’s a great thing! Thank you!

I’ll probably post a “flashback” from surgery day soon.