Greetings, I wanted to share my experiences with the world so that others who share my condition can relate and take solace in the fact that they are not alone. First off let me apologize for any typos and/or errors in the mechanics of the English language as written here. Among many things I am very impatient and find it very difficult to go back and proof what has been written. So, moving forward I will follow the form of Mr. Kerouac and simply type the conscious stream.
I am a 43 year old male who has been overweight since age 5 or so. I am not sure how or why I became fat but one thing is for sure, it had something to do with all that bad food I put into my mouth.
It was my second year of high school when I decided to take on the bulge and thus began the see-saw of fat ebb and flow which has defined my adult life. My BMI is currently 36 and has been as high as 38. My weight has topped out at 298 and is currently 277. I have a wonderful wife and a beautiful son and it is in these facts that I have decided to opt for Bariatric surgery. My decision was not based on vanity, it was decided for me by a lurking monster that has been with me since 1989. While an undergrad in college I became ill at the end of fall semester, being young and foolish I decided to sweat it out. I sweated for 4 days and then finally went to the infirmary. They took blood as part of a standard workup and the results came back with wacky numbers for liver enzymes, lipids, and triglycerides. The conjectured that I had mono but they could not confirm that fact. Once fall term ended I came home for xmas break, I used this time to visit a gastroenterologist. To make a long story short I had a liver biopsy and it came back with simple fatty liver, nothing to worry about. My liver enzymes were still high and the triglycerides were high too but the doc said it was nothing to worry about. However, he did say that we would need to monitor the liver and ever since then my liver has been monitored religiously. Over the past 16 years I have watched my liver go from simple fatty liver disease to NAFDL (Non Alcoholic Fatty Liver Disease) to NASH (Non Alcoholic Steatohepatitis) with grade 1 fibrosis, to NASH with grade 2 fibrosis, to NASH with grade 3-4 fibrosis. Now for the uninitiated out there grade 3-4 fibrosis is also known as incipient cirrhosis which means I have to get my shit together quick or else I won't see my son go to high school. It is a simple truth that all overweight people have fatty liver which in and of itself is harmless. However, some folks such as myself have a genetic predisposition for advanced liver disease due to excessive weight. If I don't lose the excessive weight and keep it off my disease will most likely progress to cirrhosis which isn't always a death sentence but given my track record, well ..... If the cirrhosis does not end my stay on this planet the next step is liver cancer and we all know how that ends, barring a liver transplant it is not a desirable outcome.
That was all the bad news and now I have the good news. This monster, this NASH is purely metabolic which means if I lose the weight and keep it off the liver will start to heal itself. I have actually experienced this during a 1 year period where I had dropped about 50lbs and was biopsied soon after. I met with the pathologist myself and saw the slides with my own eyes. The fibrosis had started to reverse, the fatty buildup was cut by 50%. I felt great and was convinced my liver disease was going away, however time can be cruel in that it makes you forget why you lost the weight to begin with, you forget that your liver is sensitive to fluctuating weight gain, and before long 2 or 3 years have passed. Well in my case 2 or 3 years had passed and another biopsy was performed, also, all the weight had come back, and it was sorta shock, in hindsight not really, but my liver was more pissed than ever.
More good news, NASH has been getting more and more attention over the past 10-15 years and although there is no approved FDA drug (weight loss is the only recommendation) there are cocktails that have shown much promise for treating the fibrosis and fatty buildup. For the past 6 years I have been taking Ursodiol off label to help with the fibrosis, I can't say for sure if it helped or not but studies have shown it does help. Also, for the past year I have been taking Actos off label because it has shown great promise in treating the fibrosis. Finally, there has been a recent large double blind study that has shown that Vit E does a pretty good job at combating the fibrosis as well. I am taking all three drugs to treat my fatty liver disease.
With that said I understand that I have an eating disorder, why else would I not lose the weight given my illness. I know it sounds like an excuse but honestly folks I have tried repeatedly to lose the weight and I have been successful. However, it is the "keeping it off" part that I fail at every time.
So here I am today starring at bariatric surgery as my final life line. I understand that it is only one leg of a three legged stool but know that once I take off a good amount of weight(thank you LAP-BAND) and my liver biopsy comes back with good news I will be motivated to stay the course.
Where I stand right now is that I have to be on a 10 day liquid diet prior to my surgery. There are three reasons for this: 1.) Lose some weight, 2.) Shrink the liver, 3.) Demonstrate that I can follow the rules. Once the 10 day period ends I will get banded.
As I am typing this I am into day two of my 10 day liquid diet and I have to say it is not as easy I thought it would be. I had consumed approx 3000 cal/day and now I am at approx 1200 cal/day. Anyhow, I will present my daily log in template format, it is how I think so it makes sense to write this way as well. The template is:
Weight Information
Food Consumption For Day
Comments/Ideas/Thoughts
Weight: 279.4 lbs
Food:
6am - Atkins Shake
8am - Cottage Cheese
10am - Yogurt
12 pm - Atkins Shake
2 pm - Yogurt
4pm - Cottage Cheese
6pm - Atkins Shake
7pm - Two "no sugar added" Fudgesicles
~1200 calories
Notes:
Total caloric intake was approx 1200 for the day. My usual was about 3000/day so it is fair to say that I felt kinda weak all day but it was manageable at least up until 3pm. Around this time I started to feel my old daemons coming out and I wanted to eat something rich and salty. I was also feeling quite hungry at this point too, almost ravenous. I managed to make it through to dinner which was my last Atkins shake for the day and I felt better. That night (when I usually do most of my bad eating) things went well; I did not long for the bad stuff. The help I went to bed early (9:30pm) just in case the daemons popped up.
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