Two-Weeks Post-Op

 It's hard to believe that it has been two weeks since my surgery. I am feeling better than I have in a long time. I don't have the fatigue or nausea many people have, which is great! I have even been hitting the gym on a regular basis to do 30 minutes of cardio and some light weights. All in all, definitely no regrets afterwards. 

Otherwise, things are going well. Nothing too interesting is going on in my life, so this is a short post. I will have some more things to cover in other posts, but since this is more about a health update I will just leave it at that.

Adjusting to the new lifestyle

 One of the biggest things about being sleeved is that it requires a lot of adjustments to how you approach food. The average adult stomach can expand to accommodate about one quart, or four cups, of food. Some have stomachs that can expand more or less (I firmly believe mine was on the more side) but a quart is average. After the gastric sleeve the stomach capacity eventually becomes about one cup, how it starts off, however, is about two ounces. 

In the immediate aftermath of the surgery is the healing process. The body's natural processes cause inflammation/swelling which further decreases the capacity making it difficult to get just about anything down. Ingesting too much too fast will inevitably result in a rapid upward evacuation. 

This is one of the main reasons for the progressive diet that you go through post-surgery. Clear liquids, full liquids, pureed foods, soft solids, and eventually regular food. You have to stretch out the sleeve a little bit by bit and give the stomach time to heal and adjust. I just hit purees this morning, and might have overdone it a little with my eggs. I didn't go too far, but I am a bit uncomfortable at the moment. 

Slow eating, small bites, putting the utensil down between bites, chewing 15-20 times (hard to do with purees), and no drinking while eating are all methods we are taught as we prep for life after surgery. I used to constantly drink water. I could go out to a Chinese buffet here in town, eat two plates and finish two glasses of water along with them. I had serious doubts about the ability to not drink while eating and waiting at least 30 minutes after. Here I am almost an hour after finishing my eggs and I haven't touched my water. Not just because I know what could happen, but because I don't feel thirsty. The lower blood sugars help with that. 

Weight loss surgery is a tool. It isn't a miracle cure. If you do not maintain your new eating habits the effects of the surgery can be reduced and/or reversed. It requires changing your interaction with food and for those of us that have struggled with weight issues all of our lives it can be a real challenge. The gastric sleeve surgery makes it easier by not just restricting the size of your stomach, but removing the portion of your stomach that "growls." There are hormones released that cause the hunger sensations we all know. Those hormones are produced in the part of the stomach that is removed thus reducing those sensations. What you have to then overcome is the mental hunger. The part of your brain that just wants to eat for the sake of eating. No surgery can fix that, it takes willpower. 

But this feeling from eating too much of my breakfast sure helps the conditioning process. 

First Post-Op Update

 My surgery was on Wednesday, 16 November. My arrival time was 8:20 am and my scheduled time to be in the OR was 9:50. I arrived, got checked in, and did all the pre-op stuff. Changed into the gown, had my vitals taken, an IV started, the whole nine yards. This gown was interesting as there was a port in it for a hose that could either heat or cool you to your liking. It felt weird, to say the least. 

After the requisite waiting around they wheeled me back and my wife was left to fend for herself with my belongings in the waiting room. I am not sure how long I was in surgery or the recovery room, all I remember is slightly coming to in my room. The rest of that day would be marked by me slipping in and out of consciousness and trying to drink water whenever possible. It wasn't until much later in the evening that I did really wake up. 

I received some rounds of pain meds and nausea meds, but was unable to touch anything on the tray that dining brought to me that first evening. All night it was in and out of sleep, vitals being checked, meds being given, all that fun. But, in the morning, they unhooked me from most of the things and I was free to move around. I wandered around in my room and landed in the chair in the corner. Sitting upright to "eat" my clear liquid breakfast and drink my water while catching up on email and everything that had gone on the previous day. 

The day passed slowly with several check-ins by various members of the healthcare team. I then got the greenlight to go home and was out of there as quick as I could. My wife picked me up and I wasted almost no time hitting the sack because it was exhausting. 

The next couple of days have been plagued by hypoglycemic events at night and difficulties getting in all of my needed protein and hydration, but today has been a good one. I exceeded my protein goal and am feeling pretty good. The swelling seems to have subsided enough where my stomach has a better capacity and I can take in more liquids. 

Now I am just waiting for Wednesday when I can start the pureed foods diet. Would anyone think they were excited about pureed foods? If you had asked me a year ago, that would never have been me. But today that is where I am. 

Pre-op Update

 I am currently in the middle of the liquid diet that is required prior to the operation. This is required to jump start the weight loss but also to shrink the liver, making it easier to operate. From Monday to today, I have lost 7.5 pounds. The diet requires only full or clear liquids and keeps you to around 1,000 kcal a day. 

I have been having two protein shakes and soup as my three meals. I will supplement with bone broth, popsicles, gelatin, and other things to fill in the gaps as the shakes and soup come out to less than 600 kcal. I may have cheated, today, and had a pickle. Because the calories are so low and there is no fat or cholesterol, I felt safe and it made me feel a little more human than I had been. 

The most difficult thing is the lower energy. I know that will take some time to adjust to the caloric intake. With four full days between now and the surgery, the nervousness is becoming more real. On Wednesday, because of the issues with the liquid diet, I decided to start my time off the next day. It's been tough, but not as bad as I thought it would be. 

The most difficult moments come when making food for my father-in-law who lives with us, or when smelling the food that him and my wife are eating. It could definitely be worse. I just can't stop thinking about how much different it will be after Wednesday. 

In the meantime, tomorrow is the pick-up day for Scouting for Food, the annual food drive that we take part in. We collect mountains of food for the Blue Ridge Area Food Bank and other food banks in the area during a time when need is high. I am looking forward to seeing the Scouts engaged in this service. 

Feeling my age

 Yesterday was our council's annual auction to benefit Scouting. Because of a number of things going on causing us to be short handed. So, I volunteered to lend a hand. This resulted in me spending 12 hours at the event. Setting up, tearing down, and of course attending. It was a long day and I am certainly feeling it. 

The event was a great time, though. We didn't have a huge turnout, but we raised over $8,000 for the council which is always good. I got to see some wonderful people and have some good discussions about what has been going on in our Scouting community. This is just a short little post as a placeholder so that I have written something for today. Hopefully I will have more, soon. 

What is Gastric Sleeve Surgery?

 So, most people have heard of bariatric surgery and are probably familiar with at least one of the different forms that it takes. Gastric bypass, Lap Band, gastric sleeve, all of these are types of bariatric surgery procedures that are used as tools for weight loss. Please note, I am not a doctor so look to more authoritative resources if you want to learn about these in depth. I am just writing this in the context of showing the difference between the procedures and which one I am going through. 

Gastric bypass, or Roux-en-Y, is probably the most common one and the most commonly referenced. It creates a pouch in the stomach that is then connected to the intestines, bypassing the majority of the stomach and the duodenum, or where the small intestine attaches to the stomach. That all still remains in place, but is just bypassed. 

Lap Band, or any gastric band, is a temporary, adjustable procedure that places a physical band around a portion of the stomach. This reduces the amount of food you consume by making you feel fuller sooner. It has had its ups and downs as far as image is concerned but is still a tool used. 

The last one is the gastric sleeve, or sleeve gastrectomy. In this case, about 80% of the stomach is removed during the procedure, leaving behind something that is about the size of a banana and will hold about one cup of food or liquid.  

I didn't specifically seek out the sleeve surgery; that is just what the local hospital performs for their bariatric procedures. That being said, it is the one that is most appealing to me. The parts that are removed include a portion of the stomach that makes you feel that "growl" when you are hungry. It can alter the way certain chemicals in your body are released reducing insulin resistance. It seems like the best option.

The intention is for the procedure to be done laparoscopically. It can be done in open surgery if there are complications, but obviously that involves more invasive methods and a longer recovery time. 

For any of these methods, it is intended for use after diet and exercise have been tried already with little to no success. It is for those with a BMI over 40 (or for those with a BMI of 35-39.9 if there are other significant health concerns that could be mitigated by weight loss). I'm over 40 with my BMI and I have significant health concerns. So it's a two-fer for me. 

To say I am excited is an understatement, but I am still nervous. This is my first surgery. Sure, I had my wisdom teeth out, but this is a little more involved. Any surgery has risks and I am aware of that. This also isn't going to be just a walk in the park. I have mentioned that this isn't easy and referred to it as a tool. This is for good reason. 

A lifetime of overeating is a hard habit to break. Overeating after this surgery is not a pretty thing. Think about how sick you feel when overeating at a buffet with a full size stomach and then imagine only one cup of food filling your entire stomach. Drinking any liquid while eating a meal is something to be avoided and you should wait 30 minutes after finishing before drinking again. Carbonation is out the window. Sugary foods can induce what is called "dumping," which isn't explained very well in many places, but the term alone can give you a good picture. 

Then, you can stretch it back out. That is a very real possibility if you don't keep up with things. You can also put weight back on if you do not follow the guidelines. Including exercise in your routine is important. You also have to utilize vitamin supplements for the rest of your life because you will not be able to take them in through your food consumption. You are ingesting roughly one-third or fewer calories than that of a normal person which will cause you to lack energy while your metabolism changes and you adjust. 

These are the things you often don't hear about with these surgeries. I don't know if I will be successful; not everyone is. I am going to try my best at it, though, to be a healthier person for myself, my family, and my Scouts. To be able to do the things I want to do with them. 

Anyway, that's enough for now. Off to enjoy a fundraising event for Scouting. It has good timing being the Friday before my pre-surgery liquid diet starts.

My Final Roundtable...

At least for Massanutten District. The night before last we held our November Roundtable and it was all about charter renewal. It was a good turnout and we had some good discussion. As we move forward towards 2023 we will be merging districts and my district will be no more. 

There have been a lot of changes to Scouting in recent years. Most of them for the better. However, there have been many challenges and Scouting is on the decline. Membership is down, donations are harder to come by, volunteers are stretched thin. These aren't unique to Scouting. Many non-profits will tell you they are seeing similar patterns, and especially civic organizations. Elks, Moose, Masons, all of them are experiencing declining memberships and reduced income. 

This isn't all just the pattern we have seen with these organizations, though. COVID and the recent bankruptcy/lawsuit with the BSA has played a major role. I grew up in the Massanutten District, and membership when I was a youth in the district is what our entire council has right now after the slide during the pandemic. But we are still here. We aren't giving up on this program because there is a value. I will be continuing on, right now it is likely that I will be the District Commissioner for the new district. I am looking forward to the challenge but also nervous about it. Hopefully it will turn out well. 

I am keeping this post short as I don't have a ton of thoughts going on right now. I had intended to write more, but life happened and now it is almost 24 hours from when I started this post. So I will post what I have and move on to the next. 

Two Weeks Out - How I got here

 Two weeks from today is my surgery date. I don't know what time, yet, but I know that on November 16th I will be going in for a sleeve gastrectomy, or gastric sleeve surgery. It is going to change a ton about my life and I am nervously looking forward to it. 

I have spent nearly my entire life overweight. I started putting on the pounds when I was four years old. I know full well that genetics and lifestyle play a big part in my weight, but there was a kicking off point that was environmental. I was prescribed a drug called Hismanal (generic: astemizole) for allergies at this time. I was on it for several years. The drug was pulled from the US market for a number of reasons, but one of the most common side effects was weight gain. My weight gain correlated with me taking this medication. From there it just snowballed. 

I was never thin after that point. It wasn't that I wasn't active. I wasn't a sit-at-home kid. I played outside a lot, spent time outdoors, played little league. I just think that the medication affected my metabolism and made it difficult for me to really lose weight when I was younger, and by my teenage years I just stopped trying as much. I was still active in many ways, but it was easier for me to be more sedentary with increased school work and some extra-curricular activities we won't get into. This is where those lifestyle choices really come into play. By this point, I was heavy enough that it was difficult for me to do many of the things that others my age could do. 

I hit 300 pounds in high school. I tried playing football, but it was too physically demanding for me and, quite honestly, I was losing interest in a lot of things. I was dealing with depression and self-medicating in some ways. The former honor roll student failed a couple of classes because of disinterest in school. I graduated and went on with life, not really getting it together for another ten years or so. When they say the male brain doesn't fully develop until your mid-twenties, that's the truth. At least it was for me. 

Throughout all of this, I was in Scouting. I enjoyed it tremendously and it was one of the things that probably kept me from making decisions that would push me even further astray. I signed up for Cub Scouts in first grade as a Tiger with Pack 42 at the Harrisonburg Baptist Church. Tigers were new at this time and weren't fully integrated into the Cub Scout program. It was much like Lions are today. I stuck with it and went all through Cubs. We had two awesome Den Leaders who put a ton of time into the program for us. In the end, a handful of us crossed over into what was then Boy Scouts, now called Scouts BSA, with Troop 42 at the same church. Only three of us really held on for any amount of time. Then two, then it was just me. But there were other troop members and we had an active, thriving troop. 

We again had some outstanding adults who really put a lot of effort into the program and we had some great youth, as well. I was often the odd one out, being that I was usually the only one my age and also being as heavy as I was. I never let it keep me down, though. I stayed active. I worked three summers at Camp Shenandoah, I held several lodge offices in Shenandoah Lodge for the Order of the Arrow. I went to two NOACs and a National Jamboree. I was always too heavy to go to any of the high adventure bases, though. I knew that from the start. 

As I was working on my Eagle and getting close to aging out, the new Scoutmaster and I did not get along very well. I wasn't keen on his leadership and he didn't like the OA, of which I was a prominent member. I ended up joining Venture Crew 124 in Tenth Legion and finished my Eagle with them. That Crew no longer exists and it is probably my biggest regret in Scouting that my Eagle certificate does not say Troop 42 on it. But I digress. 

As an adult, my lifestyle choices weren't getting any better and when I turned 21 I took a hard look at myself and decided that I did not need to be an adult in the program. I was not a person for our youth to look up to. So with that, I left. I stayed up on the program, following the news, watching videos from Jamborees and NOAC, keeping up with people I knew from the "good ol' days." I graduated college, got on a career path. Got married. Got laid off. Got on a new career path. Started college again (because for-profit higher education is a scam, people). Then, as I am nearing the completion of my second undergraduate degree and my wife and I are house hunting, I decide to get involved in Scouting again.

During this time period I had reached a high point on my weight of 395 pounds. I ended up being diagnosed with diabetes. I quit smoking and worked on my health enough to get the diabetes under control, but I still had many other concerns. My weight went up and down but lately has settled right around 300 pounds, where I was in high school.  

I don't have any kids, so I wasn't looking to join a unit. I had spent some time on the District Committee briefly years ago and so decided that would be a good way to get back into it. I reached out to people in the district (because I still kept up on things and knew how it worked) and turned in my application. Well, it took all of one meeting for me to get roped into Commissioner work, which I honestly enjoy tremendously. I was made the Assistant District Commissioner almost immediately because of my knowledge and enthusiasm for the program. Then COVID hit, and my District Commissioner was a doctor. We did not (and at this point still haven't) seen him back involved in the program since. I was made District Commissioner and have been since. 

During this time I have been highly involved and one of extra things I did was a training to become an NRA rifle/shotgun instructor. During this training, one of the other participants and I were talking about his experiences with bariatric surgery. I had heard of it and honestly had a negative view of it to that point. My discussion with him changed my mind, though. I decided then and there to investigate. Within two months I had my first consult and began the one-year coaching from my insurance. 

At one point they asked me a goal weight, and this wasn't something I had thought about. I just wanted to be able to be more active, do more things, and maybe not shop at a big and tall store. But one day I was filling out the health form for Scouting and noticed the height/weight chart at the bottom for high adventure activities. For my height of 5'8" the max weight was 214 pounds. That became my new goal. To be able to go to the high adventure bases was always a dream of mine. To possibly get the triple crown or maybe even the grand slam would be tremendous! I became more excited than ever to begin this journey. 

Scouting has continued on as has my surgery prep, but so has COVID. There became a backlog of patients and a personnel change at the hospital resulting in a delay. My year was up in June and my original surgery estimation of August became November 2nd. Today. Then it got pushed back two more weeks because of the surgeon's schedule. Honestly, I am happy about that. I have to run a Roundtable tonight and march in a parade on Sunday, so surgery would have put a damper on all of that. But I started thinking about everything this morning and realized I would like to document this journey.

I now know five other Scouters in my circle that have had bariatric surgery. We tend to be our own little community. With everything we do in Scouting I had many questions about food while camping, keeping up nutrition on the trail, etc. So, I just decided I am going to blog about it. Not every post will be specifically about the way things are going with the bariatric surgery. I will probably talk about Scouting in general a lot. Maybe it will alleviate some of the Scouting talk my wife gets to hear. I've tried many blogs in the past, but none have stuck. Hopefully this one will.