003 Surgery booked 17 July 2013

I had my consultation with Dr Kuzinkovas and decided to book in with him. I appreciated his direct manner and feel he is the right man for the job, he also has a good handshake (a silly thing I know but I hate dead fish handshakes, it feels half hearted). Another reason I chose him was that he was the only one of the three surgeons to give me a phone call. His manner was a little abrupt and basically told me not to self diagnose and that I should take the surgeons advice rather than selecting the type of surgery myself. In my initial email to the doctors I was asking about whether they provided Mini Gastric Bypass. The other two said we can do that. Dr K said let the surgeon decide what is appropriate.

I weighed in at 120.8kgs with a height of 178cm gives me a BMI of  38.1 which rates me as having Class II Obesity, just short of morbidly obese, scary.

I don't like being told off but I'd rather have a professional tell me like it is instead of supporting me in a wrong choice. Before I went for my consult I had gone past the Mini Gastric Bypass and was thinking more of the Gastric Sleeve. Dr K told me this was what he recommended for me. To be fair Dr Loi also said this at the information session and did email me personally, so I would equally respect his guidance. In short Dr K works out marginally cheaper and was able to book me in in just two weeks time, whereas I would have delayed a week before seeing Dr Loi and then have no idea when he could book the surgery in. A bird in the hand for Dr K. The reason for my rush as previously stated is to do with work pressures and timelines, I need to be well before Term 4, October.

My Monday consult was followed by a visit to the discount chemist to pick up the OptiFast VLCD (Very Low Calorie Diet) supplies for the next two weeks before surgery. This is required to shrink the liver before surgery. I did have a celebratory final meal on Monday night before starting the Optifast on Tuesday. I had a delicious Pan fried Salmon steak on a bed of raw chinese cabbage and shallots with an avocado. Along with a beer and a Cornetto for a treat, I never normally do sweets.

I am hungry on the OptiFast diet, no surprise there. I am sticking to the rules though, just having the shake for breaky, a bar for lunch and a soup for dinner with some fresh green veggies. Trying to drink more water but this is a struggle. I've told my work about the need for time off and have put my Youtube vids out to my Facebook page. Basically it would be really embarrassing to pull out now that everyone knows.

Pretty sure I'll lose a fair amount of weight before the surgery on this preparation diet. The only difference is this time I should be able to keep the weight off, yay!!!

002 The Information Session

Over the past few days I've been continuing my research. Looking at all the surgery options and have changed my mind about which option I believe will best suit my needs. I viewed many testimonials and doctors explanations about the VSG (Vertical Sleeve Gastrectomy) and believe this will provide the best results with the least complications, maintenance or side effects.

Fortunately my visit to Dr Ken Loi's information session at St George Private Hospital here in Sydney confirmed my selection as being a solid choice. There were no real surprises for me as I had learnt nearly everything I needed to know from Youtube. I was a little surprised at the ignorance of some of the people attending the information session as to the options and their implications. Which just goes to show you need to prepare yourself with the knowledge to make the right choices along the way.

Dr Ken explained that I should get my GP to prepare a Medicare Care Plan in addition to the referral I already have. This will give me five free consultations with the dietician. One pre-op and 4 post-op. I will need to do a special diet in preparation which I believe is a liquid meal replacement. This is to shrink the liver before surgery.

I have decided to keep my appointment with Dr Kuzinkovas next Monday to hear him out. Though I'm fairly convinced that I will proceed with Dr Loi. Doesn't hurt to get more options. I'm hoping that my surgery can take place in about 3-4 weeks time. My main reason for the hurry is that the next 8 weeks or so is a slightly quieter time for me at work. I work in a school and term 4 is normally a very busy and stressful time, I'd like to be recovered before that hits.

001 Being proactive about obesity related illness 06 July 2013

Blogging my journey from fat to fantastic begins here.

My current situation is this:

• 120kgs
• 48 years old
• Insulin Resistance (Metformin)
• Sleep Apnea (CPAP Machine 9 years)
• Depression (Zoloft)
• High blood pressure (Micardis)

My future with these stats is bleak to say the least. I am a sitting duck for diabetes, heart disease and cancer. I also have a family history for each of these.

Diet and exercise
Back in 2004 I won the Australian Men's Body for Life championship for my 12 week challenge. I went from 116.5kg down to 96.5kg and looked great. This I achieved with sweat, grit and determination. Since then the weight has crept back onto my bones such that I am now heavier than when I started. I mention this so that critics of weight loss surgery will realise that dealing with obesity is more than just hard work and will power. The only way with some people's genetic makeup to stay healthy is to live life like a nazi religiously and forever. Eating low carb and exercising 5+ times a week is not something I can maintain long term. This is also not a balanced diet and I started getting some gastrintestinal problems, the flatulence was wicked.

Thermodynamics
I read a book called "Why we get fat? And what to do about it", by Gary Taubes. He argues that it is not just the laws of thermodynamics (calories in vs calories burnt) at work in the case with obese people and weight loss. You don't need to be a genius to see the obese people eat too much and exercise too little. Does that mean they have lower willpower than other people that are slim? I know this is not true.
This is a simplistic and unscientific explanation that should be de-throned. Genetics is an obvious part of the equation but how does thermodynamics cater for genetics? it doesn't!

Environment
There are environment issues that make obesity a bigger problem in todays society. Our modern diet with the easy and cheap availability of processed foods, the advent of the motor car and the computer. All these makes sitting down and eating more, normal. My wife and children are slim, however my mother and brother are overweight, I haven't lived with my mother or brother for 30+ years so that is not my environment. I live with a slim family and have a healthy diet at home. I over eat at work and whenever I am not being watched. I have a supportive environment that I circumvent in order to consume more calories. Why do I do this?

Genetics
I inherited genes from my mother and father that give me my physical characteristics as well as some of my personality. In everyone's body are different sized organs, horse breeders apparently like horses with large hearts, because they can run faster longer. There is a region on the stomach that produces the hormone Grehlin. Some people have a larger or more active production of this hormone. This hormone regulates appetite. It is a little unfair to criticise someone's self control when you are not challenged with the same hormone levels.

Weight loss surgery
Some would argue that I am not fat enough to justify weight loss surgery. My argument is that I have lost and regained weight so many times through great effort that I have come to a point where I feel life should not be so hard if it is not so absolutely necessary. I view the weight loss surgery as a tool to help me reduce the amount of Grehlin in my system and thereby assist me to maintain the weightloss I achieve.

Several of my health concerns are potentially life limiting and all are certainly quality of life lowering. If I can afford surgical intervention to reduce those risk factors I feel I am obligated to do so for my family's sake at least. Even more so for my own enjoyment of my life.

I am seeing a few surgeons in the next week or so to gather information on which to make my decision. At this stage I feel gastric bypass surgery is the most suitable for my goals.

Thanks for joining me.

My most horrible fat photo, this is the shot that made me face the truth about my future.