6/12/2010 Day 6

Weight: 271.8 lbs

6/11/2010 Day 5

Weight: 272.2 lbs

Notes:

Finally the rapid weight loss seems to be slowing down!

Awoke today flipping starving! On the way to work people starting to look like food to me :)

Ok, so I am allowed to have broth during this time period and to be honest it sounded gross! Today I walked to Au Bon Pain and grabbed some broth from the Chix soup and it was awesome!

I feel like I am a new man, eating yogurt, cottage cheese, and Atkins shakes is getting old and I am only 5 days into this thing! Uggh, I have a lifetime of battling ahead of me.

6/10/2010 Day 4

Weight: 272.8 lbs

Notes:

Sent a note off to my weight loss doc and my liver doc asking if this rapid weight loss is an issue for my liver and if I need to stop Vit E prior to my surgery.

The weight loss doc got back to me :

"As far as I am concerned no worries about the weight loss and yes stop the Vitamin E."

Still waiting on my liver guy. With that said I am having a ravenous day, I wish I could dive into mountain of hot wings :) My vice is spicy hot food.

With this food deprivation I am learning some things about me and my relationship to food. Every now and again I forget I am on a special liquid diet and when I feel the hunger pain coming on I think ".. I can't wait to tear into some good hearty food ..". During that thought I become euphoric but when I realize I can’t do that I become slightly depressed for a minute or so. How does one get around this pleasure/reward mechanism that appears to be quite powerful! Uggh! I have 40 years or so of conditioning that dictates that food takes all the stress away and makes things better. Perhaps I need to figure out a way to avoid having the need for the “fix”. They say that food is a drug and we all want to be high, right? Is work too stressful? Is the commute too stressful? It is probably wise to try to remove some of the stress in my life, this will most certainly elevate my mood and perhaps I won’t have to turn to food for relief. It is a well know fact, at least to me, that whenever I go away on a vacation (at least 1 week) I always lose weight. It isn’t much, about a pound or two, but I do lose. I know for fact that my mood is much better when away on vacay. These are good thoughts and they will come in handy when the honeymoon period with the LAP-BAND ends. And by honeymoon I mean the rapid weight loss period.

Good night. L

6/9/2010 Day 3

Weight: 275.2 lbs

Food:

My meals are going to be identical to the first two days so I won't bore you with redundancy.


Notes:

Overall today was a good day food wise. I am getting used to the halving of my daily caloric intake. I actually forgot to have my 3pm snack (remember I am trying to eat something every two hours) today, I worked right through it. I had my pre-operative visit at the hospital today, they asked a bunch of questions, weighed me, took blook pressure, I had blood drawn, and EKG done, and finally I met with the anesthesiologist. I am pretty much locked and loaded and ready to go. I just have wait unti next Thursday for my banding :)

Nighty night.

6/8/2010 Day 2

Weight: 277.2 lbs

Food:

4:40am - 4oz Orange Juice

6am - Atkins Shake

8am - Cottage Cheese

10am - Yogurt, 40z Orange Juice

12 pm - Atkins Shake

2 pm - Yogurt

4pm - Cottage Cheese, 4oz Orange Juice

6pm - Atkins Shake

7pm - Two "no sugar added" Fudgesicles

~1200 calories

Notes:

I actually awoke this morning at 4:30 starving and dizzy. I went and had about 4oz of orange juice and that helped. I felt weak and dizzy until 12 noon or so at which point those feeling went away and were replaced by a ravenous want of bad food. The entire afternoon was pretty much miserable for me, I did my best bury myself in my work. By the time I left work (4pm) and got on the train I was feeling numb. However, once I got home and had my last Atkin's shake I started to feel better. I actually felt pretty good. So, here I sit at 9:56pm and I am not sure how I feel, it could be that I am tired or it could be that my body wants solid food. One thing is for sure, I don't feel 100%. Tonight I am going to bring an orange juice/water mix to bed so that I can sip it during the night to stave off the morning dizzies. Anyhoo, I should be off to bed now. I am curious of my weight come tomorrow morning. Oh, I also have my pre-surgical visit tomorrow with the team. I believe they do an EKG, take blood, I meet the anesthesiologist, and the nurses.

Good Night.

6/7/2010 Day 1

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.