Life before the Weight Loss Surgery

I thought I had better write about my issues prior to having Vertical Gasrectomy weight loss surgery.  In 2003 I was at my heaviest of 392 pounds. I normally don’t have a problem with my weight, but I started to grow concerned. I decided to diet, I had never wanted to diet but decided I better. I went on the Atkins low/no carb diet.  Over the course of 8 months I lost 71 pounds.  I was feeling better than 392 but still not right. Then I had an opportunity to move with the company and moved to Redding, CA.  I could never get back on track, I would say over the next 3-5 months I gained 30ish pounds back. Then July of 2004 I was diagnosed with cardiomyopathy/congestive heart failure (CHF).  I went on special care and medications.  Did okay under care but never again did I feel 100%.  I was fatigued a lot and my back and knees were killing me.  Joints hurting was nothing compared to cardiomyopothy and congestive heart failure. Then May 2005 I had a serious heart problem. Wound up in the hospital for 5 weeks. See August 7, 2005 blog entry for more details.

Lets list problems associated to weight.

Joints hurting and deteriorating
Major Heart issues – Cardiomyopothy and Congestive Heart Failure
Sleep Apnea
Always Fatigued
Kids embarrassed with size of Dad
Had to buy special clothes (5XL in shirts, 50+ in pants)
Well that is life before weight loss surgery. We will see what happens over the next few months.

12 days to Weight Loss Surgery

I am 12 days away from having Vertical Gastrectomy weight loss surgery. I have to go do pre-operation stuff 8 days from now. I am anxious to get this done, but not so anxious about the pre-operation stuff my cardiologist wants to do.

I am back to work I get real tired by the end of the day.

I switched our cell phone service from Nextel to Cingular.  I will try to give updates from the hospital using my Blackberry.  I want to try to keep my feelings and emotions in check and be able to recount my experiences during this new life changing event.

Weight Loss Surgery Update August 2005

Were do I begin since my last Blog.

February 28, 2005 was my last day at Ch2m Hill.  I went on to work for myself with one main contract in hand.  Things were going good and looking up as far as financial stability was going. The one thing that happened that was not good was I had to drop the family for medical insurance. I keep on with COBRA from Ch2m Hill.

May 3, 2005 – As I was typing an email to a client, I broke out in a cold clammy wet sweat from head to toe.  At that time I thought I had to go to the bathroom so I did and nothing but I felt really bad. So I got up and then went by the fan and told myself just  for a minute or two and cool off.  As I did that my chest started hurting. That is when I knew something was wrong. I was able to get up and grab my keys and head out for the house (stupid thing to do). I barely made it to the house when I told my wife something is wrong and to get me to the hospital. She wanted to call 911 but I told her to drive me to Mercy hospital. I arrived there at 11ish am and told the clerk I think I am having a heart attack. She told me to sign in about the time she looked up and saw me she said, wait come right back. She took my blood pressure and her eyes went wide and rushed me to the ER. That is when all the fun began, they did all kinds of things to me and stabilized me. My cardiologist Doctor Mendelhson had an EKG done on me before he got there. They decided to admit me and when I got up stairs to a room my cardiologist came in to talk to me. He basically told me that he would not be able to continue care for me.  That my heart condition has deteriorated tremendously. My Ejection Fraction was 10-15% and 2 months prior was at 30-35%.  He began to talk to me about seeing a specialist that deals in this kind of thing. I recall him saying heart transplant facility once but just thought it was a place that works on rehabilitating the heart.  Tammy and I said yes lets make the arrangements to go. I told him to talk to them and I would drive down in a day or two, well that is not what he had in mind.  At 7 pm that night I was life lighted down to San Francisco and taken to California Pacific Medical Center (CPMC). At 7 pm I was loaded up and flown to San Francisco and arrived in the hospital shortly after 9 pm. I was alone but in good hands. The nurses that flown down with me were extremely nice and supportive. Tammy was unable to fly down with me because of the kids. She in turn made arrangements for the kids and drive down the next day. My Dad and Uncle B drove down the next day as well.  So for the next 5 weeks I was in California Pacific Medical Center being worked up for a heart transplant and trying to rehabilitate my heart.

It was then recommended that I speak to a weight loss surgeon.  California Pacific Medical Center said that I needed to lose a 100 pounds to be a better candidate for a heart transplant.  They recommended and contacted Pacific Laparoscopy to come speak to me. They sent over a Physician Assistant to show me the different laparoscopic bariatric surgery.  Then Dr. Robert Rabkin came over to meet with me.  He then had his brother Dr. John Rabkin come in and speak to me and talk to me about what procedure they recommended for me. They want to do Vertical Gastrectomy see attached photo showing my surgery.  I agreed and they started the approval process with Blue Shield. During this time they sent Barbara Metcalf a very nice lady over to speak to me. She was so happy for me and looking forward to seeing my progress.  As you can imagine Blue Shield denied my life giving surgery.  Feeling down and out I told the cardiologist unless were doing some thing else it was time for me to leave. I would fight the insurance from home and not the hospital. They finally released me on June 7, 2005, just in time to see my daughter graduate from 8th grade the next night.

That brings us to the end of June. I filed an appeal with Blue Shield and for 30-days I called the case manager every day or every other day checking in and telling her this is medically needed.  I remember even crying on the phone a couple of times saying I did not want to die or have a heart transplant.  Then on July 22, 2005 I received a call from Blue Shield and I just knew they were denying me again.  The call was a great one… I WAS APPROVED!!!!!!! .

I went back to work with Ch2m Hill on July 25, 2005. I have done pretty well so far. I will have vertical sleeve gastrectomy surgery on August 30, 2005 down in San Francisco at California Pacific Medical Center with  Dr. John Rabkin doing the laparoscopic bariatric surgery.  I have to go in on the 29th to have some precautionary measures down before the surgery the next day.  For the next 3 weeks I will be working, yet taking it easy. I cannot have any issues before then.

Let me list a couple of Newsgroups that I have been turned on to by Pacific Laparoscopy.

PacLap – http://health.groups.yahoo.com/group/DS_PacificLaparoscopy/

VS newsgroup – http://health.groups.yahoo.com/group/sleevegastrectomy/

Some statistics before surgery.
Age: 35
Height: 6′
Weight: 325.5 Ibs
BMI 43.3

That will be it for now. I may or may not be back until after my weight loss surgery. Then I plan on keeping my Blog up-to-date with my progress.

Heart Attack or Not?

In 2004 I was diagnosed with a heart condition known as idiopathic dilated cardiomyopathy – A very weak and enlarged heart with no known cause.  I was under treatment taking heart medications and water pills (I call pee pills).  Then on May 3, 2005 As I was typing an email to a client, I broke out in a cold clammy wet sweat from head to toe.  At the same time I thought I had to go to the bathroom.  I went in and nothing happened but I sure felt I had to go.  I got up and went by the fan to cool down and decided at that time to lie down.  I told myself just for a minute and things would get better.  As I layed there my chest started hurting more and more like there was a 500 pound Monkey sitting on it. That is when I knew something was seriously wrong.  I was able to get up and grab my keys, lock to office door and head down a flight of stairs and get in my car and headed for the house (stupid thing to do).  I recall barely making it to the house and through the door when I told my wife something is wrong and to get me to the hospital.  She wanted to call 911 but I told her to drive me to Mercy hospital.  She frantically loaded me and the baby into the car and drive like a bat out of hell to get me there.  We arrived there at about 11 am and some how I was able to walk to the front counter as Tammy parked the car and grabbed our baby.  I told the clerk I think I am having a heart attack she told me to sign in and about that time she looked up and saw a young obese male pale white and sweating profusely hunched over the counter she said, wait come right back.  She took my blood pressure and her eyes went wide and rushed me to the back to the ER. That is when all the fun began, they did all kinds of things to me to stabilize me (I don’t recall much of it for some reason).

My cardiologist Dr. Mendelhson had an EKG done on me before he arrived. They decided to admit me and when I got up stairs to a room my cardiologist came in to talk to me. He basically told me that he would not be able to continue care for me.  That my heart condition has deteriorated tremendously. My Ejection Fraction was 10-15% and 2 months prior was 30-35%.  He began to talk to us about seeing a specialist that deals in this kind of thing.  I recall him saying heart transplant facility once but just thought it was a place that works on rehabilitating hearts.  So Tammy and I said yes lets make the arrangements to go and told him to talk to them and I would drive down in a day or two. Well that is not what he had in mind.

At 7 pm that night I was loaded into an airplane life flighted down to San Francisco and taken to California Pacific Medical Center (CPMC). I remember being alone and wheeled into only who knew at that time.  The nurses that flown down with me were extremely nice and supportive and thanks to that I did not worry to much. Tammy was unable to fly down with me because she needed to secure care for the kids. The next day she and her dad (Greg) drove down.  My Dad and Uncle B drove down the next day as well.  So for the next 5 weeks I was in California Pacific Medical Center being worked up for a heart transplant and trying to rehabilitate my heart.

It’s really hard for me to write about my 5 weeks.  They did so much testing on me that I honestly am not sure all of what they did.  I know I had three Pulmonary artery catheter, in medicine pulmonary artery catheterization is the insertion of a catheter into a pulmonary artery. Its purpose is diagnostic; it is used to detect heart failure or sepsis, monitor therapy, and evaluate the effects of drugs. The pulmonary artery catheter allows direct, simultaneous measurement of pressures in the right atrium, right ventricle, pulmonary artery, and the filling pressure (wedge” pressure) of the left atrium.  They made an incision in my neck and threaded a tube with a balloon on the end.  The insertion process was NO fun what so ever.  The first time did not go to bad it was scary but they got it in with little trouble.  Oh but the second time it took three doctors before I finally said enough was enough to either get someone that new what the *@#$%! was going on or forget it.  They called in the ICU doctor and he came over and wham bam it was done.  I was glad for that but ticked off it took that many people.  The only good thing about the Pulmonary artery catheter was that every morning at 5 am they could draw blood from it instead of poking me every time.  If your one to look on the bright side that is it.

I had a hiccup in insurance that first week so they just stabilized me while that was sorted out.  Probably a good thing cause who knows, they were going so fast that I may have had a transplant before any other test were done.  They talked about inserting a ventricular assist device (VAD) that would help my weak heartbeat.  Luckily one of the nurses in strict confidence told Tammy and I to try and not get that done without some more testing cause once you get a VAD it is a long straight shot to a heart transplant.

After about 2-3 weeks I was transferred to Ernie land (aka Transitional Cardiac Care Unit (TCCU)) this is special unit for those waiting for heart transplants.  This is were I was given a little more freedom for movement.  I was allowed to walk around the ward and down the hall while be attached to special heart monitors.  They started me on rehabilitation for things like getting out of bed, walking, showering, and getting dressed.  Surprisingly I had to relearn how to do these things and also learn new techniques to limit the stress on my heart.  They had a spot down the hall that was a roof garden.  This is a place that was outside that overlooked the city.  The nurses new how much I loved San Francisco and anytime I could be outside in the foggy city lifted my spirits.  Once a day they had one of the helpers walk out there with me.  Normally it was pretty cold out there and the nurses would bundle up but I would go out in my shorts, slippers, and hospital gown.  Those short few minutes allowed me to escape the hospital and reflect on life without heart monitors beeping at me.

The physical therapy depart that was teaching me a lot of the stuff we take for granted got wind that I loved the city and the Golden Gate Bridge.  They said if I started walking on a treadmill that they would take me to there department for a special treat.  They said that I would like there offer to see the city in more detail.  That sparked me to get up and walk the treadmill.  After about 2 days of walking Barry came and got me and walked me around the corner to there department.  There they had exercise equipment to help my rehabilitation.  There was two treadmills and they were facing the most beautiful site of all.  This corner of the hospital looked out at the Golden Gate Bridge.  I was in such amazement I wanted to stay there and just walk forever to see that.  They told me as long as someone was there I would be allowed to come down and do the treadmill.  Seeing the Golden Gate bridge daily was all I need to get me moving.  I wanted them to take the treadmill outside on there patio so that I could walk in the cool weather and feel like I was on the Golden Gate Bridge.  They could not do that but boy it would have been something.

I spent my 35th birthday in the TCCU I was extremely bummed about that.  The nurse were kind enough to wish me a happy birthday even though I did not want to be reminded.  One of the doctors brought me cupcakes for my birthday which was really nice since they had me on a strict diet.  I was allowed to have one and I shared the rest with the nurses that were on duty that day.

Overall my 5 weeks were intense, yet the staff was caring and since I made it out alive and without a heart transplant I would say it was a good experience.