Wendell saw the PCP Monday.. he's down another pound. This is a good thing. One month to go..

1st surgical appointment bariatric

I believe the first thing we need to do here is thank John and Amanda for taking the time to take Wendell and me to Wendell's first appointment with the bariatric surgeon in Pgh.
Lots of paperwork had to be filled out.. and then back to the exam room to wait for 40 minutes for the PA to give us information and a quick physical exam. She went over everything that was expected of us as far as testing goes. The psychiatric exam and nutritionist have to be from their department, but otherwise he can have all his testing done locally.
The doctor came in for about 10 minutes and gave him a lecture on being willing to change lifestyles that have been engrained for years. It's that, or no surgery- it would be a waste of time. I like this surgeon. He doesn't mince words- says what has to be said and gives the ultimatum. Wendell finally said 'yes, I can comply'.. we are off to the races!!!
Labs, chest xray, ekg, pfts, and other tests to be completed as soon as he can get them scheduled.
This doctor reminded us that the surgery is a tool, not a cure. We can use this tool effectively or not. Wendell told him he wanted the gastric bypass. The doctor said okay.. start the exercise program now and let the lifestyle changes begin.. that includes decaf coffee if he wants coffee.
We came home with 2 booklets and a pile of papers to be completed as soon as we can do so.
Provided all this can be done in another couple months, I think we may be looking at September possibly for the surgery.. I'm just guessing. The surgeon never discussed a timetable.. just get the paperwork done with labs and doctor checklists.. and then give them a call when it's done. Then we talk schedule.
The prep for this surgery is a bit different. Although the bowel is involved, there is no real 'bowel prep' pre op. It's a full liquid diet for a week prior to the surgery and then meds get eliminated including his regular dose of insulin. He'll be on a sliding scale from that point on, and hopefully that will be the end of insulin for him. Amen.
More later if I missed anything.. and updates as they happen.

9# loss

I'm so proud of Wendell. Today was weigh in day at the PCPs office.. He's lost 9 more pounds!!!! Atta boy Wendell
This week he sees the bariatric surgeon. I'll fill you all in on the next step when we get back.

We got the call !!!

Happiness is hearing from the bariatric surgeon that you are a candidate! Wendell got the call tonite and is walking on air! ME TOO!! I'm so happy for him.. His first appointment with the surgeon pre op is July 2nd. John and Mandy have kindly agreed to take him since the initial visits are all on Thursdays and that's office day for me. I'm going to check the schedule to see if we can switch some people around so I can go too.
Now, 1st step is the education session last week where the surgeon describes the surgeries available and initial paperwork is filed with his office indicating a desire to have one of the procedures done.
2nd step is being called to inform you that you are a candidate and set an appointment with the surgeon. Most people don't realize that insurance companies require the patient to follow a supervised diet with their PCP or the hospital's group weight loss clinic for 6 months before the bariatric procedures will be covered by insurance. So if you are considering this surgery, get going with a program with your PCP. Wendell was fortunate in that his PCP's nurse just had her procedure done a few months ago and she knows the ropes. She started Wendell on his diet and supervised weigh ins in March this year.
Next will come the scripts for psychological evaluations and the nutrition evals and education.
This is a whole new world of weight loss.
Wendell is hoping for the bypass surgery. It's a bit more complicated and requires a 2 day 2 night stay in the hospital. He's good with that.
Pray all will fall into place easily.. that this is God's will for his life.

Wendell and I went to an education session given by Magee Hospital Bariatric surgeons last evening. It was a 2 hour experience where the doctor explained the 2 most commonly performed bariatric procedures. One is lap banding and the other is gastric bypass or Roux en Y.

We both went in thinking that the banding would be better for him, but when we came out, we were both convinced that the gastric bypass is really the better choice for life.

You have to meet certain criteria in order to be a candidate for this surgery. The BMI has to be at least 35 or more with associated medical conditions like diabetes...... or a BMI over 40.

You also have to fail the supervised diet for 6 months. That is, you have to follow the plan for 6 months without gaining, but without exceptional losses too.

It involves life style changes in exercise and diet and requires life long follow-up.

The doctor described the risks and the benefits of each procedure. He mentioned that with the bypass, 85-90% of type 2 diabetics are not any more. That is exciting news. He also said that men do better with the bypass and the loss is generally more rapid in the first year than the banding. 70% of excess weight is lost that first year. The weight loss with banding is at a much slower rate, but also sounded to us like the complications could be a problem.. like the band slipping..

One thing I thought was interesting was that he said you can't eat concentrated sugars after the bypass.. you might try, but you won't do it twice. Also, you say goodbye to red meats and bread.

There is a malabsorption risk with the bypass, so one must be on vitamins and minerals daily for life afterward.

We learned that eating habits at the table would change dramatically. He described it as taking a very small bite of food, purposefully placing the fork by the plate, and chewing at least 20 times before swallowing. No drinks with meals either. No more fast foods.. meals will take 40 minutes or more to complete.

There is a psych evaluation, nutrition eval, and then labs and testing as needed prior to surgery. Wendell has 3 months of supervised diet therapy already, and the final testing and instructions are due the last 2 months.

We may hear by the end of this week whether he's a candidate, or perhaps early next week. I'm praying he will be chosen.

After he gets settled and is doing well with this, I'm going to apply myself. I asked about blood thinners and having the surgery, and he said it can be done with injections in the belly (Lovenox) and perhaps an IVC filter to catch the clots if any form.

Weigh in with the PCP this past week for Wendell. They say he has NOT lost a pound though our scales say he has. I'll be calling the bariatric surgeon this week.. hopefully

5 more pounds gone for Wendell..

I am at the same weight.. gotta quit cheating on the diet..

Wendell had a weigh in with his cardiologist today.. YIPPEE !!!! Down 3 more pounds for a grand total of 8 # lost !!! Atta boy Wendell!!!!!!

Today was the official 1 month weigh in for Wendell at the doctors office. Not good news, I'm afraid. No loss at all after following the 1200 cal diet.. and though the doc says to look on the bright side because he didn't gain either, it wasn't very encouraging. I'm feeling badly for him, but we shall go on.. and try again..

The weigh in was yesterday, and the word was good.
Wendell is down 5# more.. He still struggles with being hungry between meals..

I am down 1#. I tend to cheat now and again..

Here's the score for the day.. ambiguous..
I try to catch Wendell before he's dressed, but didn't .. so I put him on the scales anyway just for a check.. and he's gained a pound... BOOOOOOO!!!! The thing is, I think he has at least a pound of loss because of his clothes and shoes especially.
I'll recheck him in a day or so.
Blood sugars have been stable in a normal range aside from the past few days when he was 111 and 115.. hmmmm he's also been feeling ill. I would think the BS is elevated for that reason.. today he is back to 96.. and normal.

As for myself, I stayed the same.. and I was dressed too.. but not with the heavy clothes that Wendell had on. I should probably go to the 1200 cals.. but I'll try one more week of 1500, and then move if I need to.

Pray for our success!! We can do this..

Happy Day!!! It was weigh in day for Wendell and me..
Drum roll please........rrrrrrrrrrrrrrrrrrrrdrdrdrdrdrdrdrdrdrd
In one week, he has lost 3 pounds! Atta boy , Wendell !!!!!
As for me, I am another pound down.. -7 for me.

Here we go...!!! Wendell weighed in at home this morning, so I'll be keeping track of his losses here in the next months. He had been using a 1600 ADA diet, but the doctor decided to eliminate 400 calories more, and he's now on 1200 calories. He can do this.

I have joined him on the diet.. I also started at 1600 calories, but now am seeing some results with 1500, as of Monday. It's Wednesday. As of March 21st, I've lost 6#, and it hasn't been too difficult to stay with the program.

Exercise: we are heading to the pool today for an hour or so walking.
I have walked around the yard and have done very little, but some yardwork, and I feel that's why I've lost so quickly.

Tomorrow I will post some of his meal plans. They are filling despite the lesser calories. It helped to limit to 1600 calories for a week before going to the 1200. He is adjusting.

1200 calories

Wendell went to see his PCP today. He got his diet and instructions. The surgery he desires is not done at Butler and the alternative is not covered by Medicare. Pray we can find a surgeon closer than Pittsburgh for his lap banding.
Today, so far, so good. We are adjusting well to the program. More later..