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Author Topic: Weight Loss Surgery  (Read 10144 times)
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BMadsen

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« on: Oct 31, 2016, 10:58AM »

Hey All,

So, in my years on the forum, I've seen the topic of weight loss discussed regularly, and I've also seen surgery mentioned a few times, but, as far as I can tell from searches, nobody here has had it. I thought I would share my experience, being I'm now approaching 2 weeks post-op, with it, my current thoughts, etc. I'm happy to answer questions (I don't get on here every day, but I will check this semi-regularly).

First, a little background about myself. I've been heavy since late elementary school. I finally got serious about losing weight in college, and lost 50+ lbs halfway through my 2nd year. I managed to keep that weight off through a 4 month cruise contract (not easy when you consider the food and binge drinking that happens, and being I was an irresponsible 20/21 year old - I turned 21 on the ship - quite impressive). That weight took about 6 - 7 years to come back. I then lost about 15 lbs of that regain, and then, because of multiple injuries, dieting issues, etc, I ended up at my peak in Dec of 2015. Luckily, I was healthy through all of it - no blood pressure issues, no cholesterol issues. My doctor said to me, if I was 100+ lbs lighter, she'd not even worry as everything is "pristine."

I've learned A LOT about weight loss over the years. It's not about "dieting," but lifestyle changes. And, every time I've seen a nutritionist, and bring a food diary (with pictures of what I ate, because if you are going to be honest, you want them to know what you are eating and if you are estimating portions correctly, and pictures go a long way when you don't have a scale to measure with you), they have made suggestions, but they are minor suggestions of changes to my diet - except that I eat too much. Too much meat, too many veggies, cut back on carbs a bit more than the rest, etc. I don't eat a ton of chips, sweets, etc. My drinking is less than one drink a day (and often one or so a week), etc. I generally eat well. Just too much. So, "dieting" for me means cutting calories.

My main issue with cutting calories started about 3 years ago. I've always suffered from migraines to a degree, but not often. As a side note, I'm going to put this out there now - if you've never experienced a migraine, it's not just a headache - mine would render me useless for anywhere from 4-72 hours. Luckily, if I got 4 a year, it was a bad year for migraines for me. Now, for those who don't know about migraines, they have triggers. Some people need one, some need two or more to set them off. I'm a two+ person. The more you suffer them, the easier it is to avoid triggers, and manage them. Since I rarely got them, and need a combination, it's very hard for me to figure mine out. I know high-stress times can feed into them. And, 3 years ago, I found hunger was another trigger. During a time I was cutting calories, I had 3 migraines in one week. Luckily, they were short (longest was 8 hours), so I was still able to work, but it's not a way to live. I also was able to connect it to hunger, rather than weight loss, because 2 years ago I was able to lose about 10 lbs in 3 months by working out a lot (1-2 hours a day for 5 days a week). I didn't eat any more than usual, but didn't experience hunger, and lost the weight. But, my schedule doesn't permit that kind of time normally, so I couldn't keep dropping that way (I did keep it off, however).

So, I was getting stuck. My diet was good, I was working out at least 3 times a week, and couldn't cut calories without significantly harming my quality of life and ability to work. So I made the decision to explore weight loss surgery.

Now, every insurance company is different, but most have some sort of basic requirements to pass before you qualify. Mine required that I went to a center with specific qualifications (only 2 near me), had 6 months of nutrition counseling, and a psychiatric evaluation. My surgeon also required a cardiologist, pulmonologist, and gastroenterologist to sign off on the surgery. So, when I started, I had to wait until September before I could have my surgery because of the requirements (I then chose late October because I'm not typically busy late-october and November, so I knew I wouldn't miss too many gigs if recovery took longer than expected).

I'm not going to go into details about all of those visits, except to say that there are things you expect to hear there (eat more veggies, avoid sugar, etc), that I was already doing, and surprising things because of the way your body works post-op (no carbonated beverages, no straws, because of the possibility of severe gas pain).

I started the pre-op diet October 12th. My surgeon required, based on your BMI, either a one or two week liver shrinking diet to make the surgery safer. I feel into the one week range, thank goodness. I lost a lot of weight then, but it's not a long-term diet solution - you aren't allowed any fat or carbs, which isn't healthy long-term. I didn't get any migraines, thankfully, but I wasn't terribly hungry on it until about 3 days pre-op, so it was manageable at that point.

There are 4 primary types of weight loss surgery. Gastric Band (aka LAP Band), sleeve gastrectomy, gastric bypass, and BPD/DS. Most people have Gastric band or sleeve gastrectomy. I had a sleeve gastrectomy. This entails permanently removing about 80% of your stomach, leaving you with a very small stomach. It stretches a bit after the surgery during recovery, but it will always be significantly smaller than if you didn't remove it. It also removes almost all of the part that produces the hunger hormone.

After surgery, you spend a couple days in the hospital, and start on a liquid diet the day after surgery. After about a week, I was cleared to start eating purees. The first week, I was unable to lift anything more than 5 lbs (I could, but had to avoid it) - I was also told not to play. I was cleared to start playing a week after surgery, and am cleared to lift 15-20 lbs now.

All in all, I'm very happy I did it. I'm down 30 lbs already, and expect to lose at least 60 more over the next year. I am already back on gigs, and only lost a week of income, actually (and only had students and three gigs that I missed, so not a huge amount compared to what it could have been). If you need it, and have been on the fence, I highly recommend it - it's a life changer!
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Bradley Madsen
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« Reply #1 on: Oct 31, 2016, 11:11AM »

Brad, are you required to eat 6 small meals a day?  Someone else I know had Lap Band and that's what they told her.

As a fat old geezer, my doctor was toying with the idea of surgery, but given my heart problems (coupled with diabetes) we aren't sure it's that good an idea at this point.
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BMadsen

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« Reply #2 on: Oct 31, 2016, 11:36AM »

Nope. Now that I can eat purees, I have 3 small meals and 3 protein shakes. Eventually, I'll eat "normally" - 3 small meals (bigger than what I'm eating right now - I literally only eat about 4-6 tablespoons of food), maybe a couple of snacks. Protein shakes will probably be in my rep for life, as they want me to consume 80-100 grams of protein a day, which is hard with such a limited diet.

I can't speak to your heart issues, but they find that many people (I think it was something like 75%) who have this surgery actually see their diabetes improve or go completely into remission. It didn't apply to me, as I never suffered from it, but it's worth knowing.
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« Reply #3 on: Oct 31, 2016, 11:40AM »

I am no expert on weight loss or this surgery, but I am decently fit and have pretty low body fat. First off, kudos for sharing the story. That takes a lot of guts to get that surgery and try to improve your life.

My thoughts probably mean nothing, but to me the big issue with weight gain comes down to sugar, refined carbs and other processed foods, and fake sugar, plain and simple.

Drinking a lot of juice, soda, diet soda, and beer/alcohol all but guarantees that someone will get fat, and it seems like the surgery wouldn't prevent these poisons from being consumed. Eating ANYTHING out of the frozen prepared foods section of the grocery, and nearly anything out of the main isles of the grocery store will make you fat. Adding sugar to any sauce or recipe will make you fat. The calorie in/out methodology is flawed. 100 calories of soda will always be more than 100 calories of banana or steak, because of what it takes to access those calories. 100 calories of white bread will never equal 100 calories of whole grain sourdough. I totally believe that the many health problems we face today would all but disappear if the central isles of the grocery were closed off and people could only buy raw food from the produce, butcher, staples (bulk rice, bean, flour, oil, spices, etc), and dairy sections (select items only). You could basically eat anything you wanted but you would have to cook or bake it yourself.

Hopefully this surgery does give you many extra decades of life playing the trombone and all is well. I'm kind of curious what limitations it puts on what you can eat. Any complications?
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« Reply #4 on: Oct 31, 2016, 11:57AM »

Maybe if grocery stores were built like IKEA stores you'd burn it all off by the time you reached the checkout.
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BMadsen

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« Reply #5 on: Oct 31, 2016, 12:05PM »

I am no expert on weight loss or this surgery, but I am decently fit and have pretty low body fat. First off, kudos for sharing the story. That takes a lot of guts to get that surgery and try to improve your life.

My thoughts probably mean nothing, but to me the big issue with weight gain comes down to sugar, refined carbs and other processed foods, and fake sugar, plain and simple.

Drinking a lot of juice, soda, diet soda, and beer/alcohol all but guarantees that someone will get fat, and it seems like the surgery wouldn't prevent these poisons from being consumed. Eating ANYTHING out of the frozen prepared foods section of the grocery, and nearly anything out of the main isles of the grocery store will make you fat. Adding sugar to any sauce or recipe will make you fat. The calorie in/out methodology is flawed. 100 calories of soda will always be more than 100 calories of banana or steak, because of what it takes to access those calories. 100 calories of white bread will never equal 100 calories of whole grain sourdough. I totally believe that the many health problems we face today would all but disappear if the central isles of the grocery were closed off and people could only buy raw food from the produce, butcher, staples (bulk rice, bean, flour, oil, spices, etc), and dairy sections (select items only). You could basically eat anything you wanted but you would have to cook or bake it yourself.

Hopefully this surgery does give you many extra decades of life playing the trombone and all is well. I'm kind of curious what limitations it puts on what you can eat. Any complications?

I'll admit to past sins of poor eating - especially in childhood through my teen years. As an adult, I eliminated regular soda from my diet about 15 years ago, and diet about 6 years ago. Before the surgery, I rarely ate white bread - always opting for whole grains. I make a lot of my own sauces with no sugar, cook fresh a lot (or from frozen veggies - which have nothing added to them). I started eating this well in college, when I became a vegetarian (except for drinking WAY too much), and got better and better as I got older. Even after reintroducing meat and fish, I still eat very well. As I stated in my first post, nutritionists had very little advice for me except calorie cutting and eating a few less carbs - not a ton less, however. About 20% less or so. And, by doing that, I lost about 1 lb.

I have to run out to teach, but at some point I will try to link to some of the more recent research on weight loss - you are right that it's more than just calories in and out, but it's so much more than that than you realize. Our biology makes it incredibly difficult to lose and MAINTAIN weight loss. It can be done, but, when I can get that done, you'll see that it takes a level of work that most everyone would feel is extraordinarily difficult for any working adult to do.
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Bradley Madsen
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« Reply #6 on: Oct 31, 2016, 12:48PM »

Thanks for sharing.

I lost 22 pounds this past year and got down to my goal weight(I've since crept up a bit, but I'm still maintaining a healthy weight.  So far.)

I did it on a wellness program we have at work, where they measure body composition and metabolism and give specific guidance. 

And like you, migraines that I'd pretty much got past, down to maybe one a year, came roaring back, daily.  They were milder and shorter, but still no fun, plus I get the optical part where I can't see to read or drive. 

They didn't last.  They were daily for a bit, then weekly, then tapered off. 

I read up on them again and some of the thinking has changed.  They are no longer thought to be vascular, but neurological.  And some of the triggers are not triggers, but symptoms - like that Hershey bar didn't cause it, you were already into prodromal and that included a craving for a Hershey bar.  (that's an example, I pretty much have a craving for a Hershey bar 24/7.)  My occasional extreme irritability is part of the migraine I'm going to get tomorrow.

Well, I've drifted off topic.  Congratulations on a healthier you. 
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Tim Richardson
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« Reply #7 on: Oct 31, 2016, 03:47PM »

I've actually found (60 lbs. down, eight years after losing it), that my life is much EASIER now that I spend, cook and eat less-- not harder.  I focus on food and fitness more than the average person, to be sure, but insofar as I believe that there is nothing more important on which to focus than maintaining one's quantity and quality of life, I don't consider it a hardship at all.  Quite the opposite actually.  PM me if you want some suggestions or a full program.  I have a half-dozen or so trombonist clients who have seen similar results to mine. No extreme dieting required. 
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« Reply #8 on: Oct 31, 2016, 04:09PM »

Thanks for sharing.

I lost 22 pounds this past year and got down to my goal weight(I've since crept up a bit, but I'm still maintaining a healthy weight.  So far.)

I did it on a wellness program we have at work, where they measure body composition and metabolism and give specific guidance. 

And like you, migraines that I'd pretty much got past, down to maybe one a year, came roaring back, daily.  They were milder and shorter, but still no fun, plus I get the optical part where I can't see to read or drive. 

They didn't last.  They were daily for a bit, then weekly, then tapered off. 

I read up on them again and some of the thinking has changed.  They are no longer thought to be vascular, but neurological.  And some of the triggers are not triggers, but symptoms - like that Hershey bar didn't cause it, you were already into prodromal and that included a craving for a Hershey bar.  (that's an example, I pretty much have a craving for a Hershey bar 24/7.)  My occasional extreme irritability is part of the migraine I'm going to get tomorrow.

Well, I've drifted off topic.  Congratulations on a healthier you. 

I wish that the migraines had decreased - the longer I went, the worse I got. Over 3 weeks of calorie cutting, I had 2 migraines the first two weeks, and 3 the 3rd week. I stopped after that because it was clear it was getting worse, because none of my other suspected triggers were present.

I didn't have cravings leading up to my migraines either - beyond desiring to eat more. But I would have been thrilled to have steamed chicken and vegetables at that point, and that desire existed all day at that point, rather than specifically before the migraine.

I've actually found (60 lbs. down, eight years after losing it), that my life is much EASIER now that I spend, cook and eat less-- not harder.  I focus on food and fitness more than the average person, to be sure, but insofar as I believe that there is nothing more important on which to focus than maintaining one's quantity and quality of life, I don't consider it a hardship at all.  Quite the opposite actually.  PM me if you want some suggestions or a full program.  I have a half-dozen or so trombonist clients who have seen similar results to mine. No extreme dieting required. 

I'm glad that your program is working for you. When I get the chance, I'll post the research I mentioned earlier. It's not that you CAN'T lose weight, but it requires a certain level of focus on this stuff that is rather difficult for most people to manage with work and family obligations. It sounds like you are able. I would probably be able to as well, if my migraines weren't such an issue.

As for a program, I'm personally set with a program - I have a pretty scripted diet with my recovery (it won't be until about 12/14 that I can eat anything with little risk), but even after, my nutritionist has already approved my previous diet, just in much smaller amounts (with a few modifications - for instance, I used to make this great black bean filling that I would have on a whole wheat tortilla, and instead I'll add chicken and cut the tortilla because the carbs in the black beans is more than enough to cover my carb needs). But, I'm sure anyone looking to lose weight would be interested, knowing you've lost so much and kept it off for 8 years.
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Bradley Madsen
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« Reply #9 on: Oct 31, 2016, 04:24PM »

I'll be interested to see that research. It's hard for me to ponder the idea that doing less would require additional focus in the long run.
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« Reply #10 on: Oct 31, 2016, 06:25PM »

Here's a starter: http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html

Almost all of the research I've seen since this article has basically deepened the basic ideas that this magazine article talks about. I'll continue pulling up more things I've read in coming days.
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« Reply #11 on: Oct 31, 2016, 07:10PM »

Interesting to read your story. The only other online personality that i've followed who has had weight loss surgery is TV writer Mark Evanier who occasionally writes about it.


Best wishes for your continued weight loss and improved health!



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« Reply #12 on: Nov 01, 2016, 06:34AM »

Here's a new story I just read that's exploring the link between poor memory and weight gain:

http://www.bbc.com/future/story/20161031-why-obesity-damages-your-mind-as-well-as-your-body

Nothing conclusive, yet - it's new - but it does raise interesting ideas and questions. One nutritionist I saw about 5 years ago told me to completely focus on my meal when I was eating, and I did for 2 weeks. I know I ate less, and lost 2 pounds, without changing what I was eating, but my wife wasn't happy that I was ignoring her during meals. When I tried to balance the need to focus on eating and on her, the weight loss stopped - and when I started focusing a lot more on her, I put those 2 lbs back on. Again - the kind of thing that seems to help, but for me, was unrealistic (and I doubt that my experience is unique).
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Bradley Madsen
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« Reply #13 on: Nov 03, 2016, 06:26AM »

More articles citing reliable research into losing weight:

http://www.cbc.ca/news/health/obesity-research-confirms-long-term-weight-loss-almost-impossible-1.2663585

http://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss-drugs/art-20044832?pg=2

https://www.hsph.harvard.edu/nutritionsource/best-diet-quality-counts/

http://ajcn.nutrition.org/content/82/1/222S.long

I post these not to discourage trying (some are rather negative on long-term success), but to educate. My feeling is, if you know what you are up against, you can set realistic expectations, and decide if more extreme interventions (such as my surgery) are necessary, based on your health and goals.

The Mayo Clinic's page about weight loss drugs is interesting because my doctor and I considered them, but her concern was long-term dependance on them to keep the weight off. I wanted to not be on medicines long-term if I could avoid it, especially if they could have serious side-effects (because the longer you use them, the better the chance you can develop them).
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Bradley Madsen
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« Reply #14 on: Nov 03, 2016, 06:29AM »

The very best weight-loss diet I ever saw advocated eating anything and everything you like - just smaller amounts. That is a whole lot more sustainable than crazy schemes. If it took 20 years to put the weight on, don't expect it to come off in weeks or months. Think long-term.

...Geezer
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« Reply #15 on: Nov 03, 2016, 06:32AM »

The very best weight-loss diet I ever saw advocated eating anything and everything you like - just smaller amounts. That is a whole lot more sustainable than crazy schemes. If it took 20 years to put the weight on, don't expect it to come off in weeks or months. Think long-term.

...Geezer

 Good!

Sustainability is everything.  It's science!

https://www.sciencedaily.com/releases/2005/01/050111122137.htm
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« Reply #16 on: Nov 03, 2016, 06:57AM »

Bradley, thanks for sharing your journey. No doubt it may help someone reading to make positive changes to their own life. You were right when you said lifestyle changes, and doing what works for you, within job and family obligations. Some people are truly lucky if their healthy lifestyle gives them ample time to invest in their wellness. The rest of us just have to make time, the best we can.

I would like to mention that for me, I always feel better when I exercise daily, and eat a good balance of fruit, vegetables, beans, and nuts and seeds. Plant-based meals are the simplest and work the best for me (and the world 🙂).

Best of all, the ability to continue making music is a gift that some with health problems don't get to continue.
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« Reply #17 on: Nov 03, 2016, 12:14PM »

That is a whole lot more sustainable than crazy schemes. If it took 20 years to put the weight on, don't expect it to come off in weeks or months. Think long-term.

...Geezer

Geezer, I'm not sure how to take this statement. If I take it at face value, then I have to assume you've completely ignored everything I've written and posted here, and believe that this choice I've made in consultation with my doctor over the course of years is a "crazy scheme." (To add to the background, my doctor started suggesting it for me in 2013, but I really didn't come around to the idea until Dec of 2015, and then by the time I got enrolled in the program and started working through the requirements, had to wait until October for everything to line up).

If I take it as a comment on weight loss in general, then you are also ignoring the articles posted. Even the article posted by TromboneMonkey admits to only modest losses, and doesn't look at regain issues. For long-term improvement in health, it's commonly accepted that (if you are overweight or obese) you need to lose at least 10% of your starting body weight and keep it off. Those diets, in the time frame indicated, actually had very few successfully losing at least 10% of the body weight in a year. There is also this caveat mentioned:

"… we found that a variety of popular diets can reduce weight and several cardiac risk factors under realistic clinical conditions, but only for the minority of individuals who can sustain a high dietary adherence level. Despite a substantial percentage of participants who could sustain meaningful adherence levels, no single diet produced satisfactory adherence rates and the progressively decreasing mean adherence scores were practically identical among the 4 diets. The higher discontinuation rates for the Atkins and Ornish diet groups suggest many individuals found these diets to be too extreme. To optimally manage a national epidemic of excess body weight and associated cardiac risk factors, practical techniques to increase dietary adherence rates are urgently needed," the authors write."

While the study admits that there may have been better long-term adherence if the participants got to choose their own diet, society is clear proof that long-term adherence is not actually possible with these diets, because outside of the study, we can all choose our way to weight loss, theoretically.  And, the transition back to regular eating, if you read the NY Times article, is particularly a problem, because our brains trick us into eating more without realizing it, and our bodies actually need significantly less than we realize because of the fact that a large amount of weight has been lost.

If these are wrong, please clarify. If one of these are correct, please take the time to read everything before commenting, so you add something to the discussion, rather than sounding like you are attacking what's being discussed. I intended this discussion to be a positive one, and educate the community on how having this surgery, should you deem it necessary, doesn't end your ability to play (as I remember was mentioned at one point in another thread).
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Bradley Madsen
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« Reply #18 on: Nov 03, 2016, 01:03PM »

It was just a general comment on dieting, etc.

...Geezer
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« Reply #19 on: Nov 03, 2016, 01:21PM »

On long car trips sometimes my wife listens to the radio talk show, Delilah.

Yeah this is a circuitous route but I might be able to connect it up.

The conversation is pretty much the same on every single call:
Caller:  I can't seem to stop nagging my husband, even though I know how much it bothers him.  I've been trying for years and failing, and I'm at my wits end.  I think my marriage is going to fail.  What shall I do?  (nb:  specific example chosen at random from multiple similar scenarios) 

Delilah:  Stop nagging him.

Caller:  Oh, thank you, thank you, you've saved my marriage and my life.  I'll always be grateful, and tell all my friends about you. 

The point is that some things are easy to know how, but hard or impossible to do.  Losing weight is one, quitting smoking is another.  The better studies say only about 5% of people actually succeed in quitting smoking.   
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« Reply #20 on: Nov 03, 2016, 03:38PM »

Geezer, there are some of us (and Brad is one) who seem to gain weight even eating moderate meals and doing reasonable exercise.  There has been some talk of a bacterium in our gut, or a gene, or who knows what.

I know of several people (including myself and my spouse) who have battled obesity for all our lives.  We can diet and lose weight, but as soon as we let up it comes right back.

I applaud Brad for doing what he did.  I hope it works out for him.
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« Reply #21 on: Nov 03, 2016, 03:55PM »

Geezer, there are some of us (and Brad is one) who seem to gain weight even eating moderate meals and doing reasonable exercise.  There has been some talk of a bacterium in our gut, or a gene, or who knows what.

I know of several people (including myself and my spouse) who have battled obesity for all our lives.  We can diet and lose weight, but as soon as we let up it comes right back.

I applaud Brad for doing what he did.  I hope it works out for him.

I do too! Don't take my general comments any other way.

Which actually supports my assertion that adherence to a proper diet should be a life-long endeavor. I don't have a "weight problem", but it has been a life-long practice for me to weigh myself every day at the same time and under the same conditions. If I gain a pound, I do whatever I need to do to lose that pound - that day - unless I specifically wish to gain some weight. I always felt that was down-to-earth and something I could live with all of my life, which I have. If someone can not adhere to that, they may be a candidate for a doctor's intervention.

OBTW Bruce: I hope you are fully recovered from your horrific automobile accident!

...Geezer
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« Reply #22 on: Nov 03, 2016, 05:41PM »

Geezer, there are some of us (and Brad is one) who seem to gain weight even eating moderate meals and doing reasonable exercise.  There has been some talk of a bacterium in our gut, or a gene, or who knows what.

I know of several people (including myself and my spouse) who have battled obesity for all our lives.  We can diet and lose weight, but as soon as we let up it comes right back.


I attribute it to prosperity and the bad food habits that enables.

There's a site called shorpy.com devoted to old photos from 1850 to 1950.

It is exceedingly rare to see an overweight person among those pictures. Most people are rail thin and not just the poor people. 

What happened? It's not like we are a different species than 100 years ago.

Food got cheaper. It got easier. It got mass produced. It got sweeter. And I suppose we have more time to eat now also.




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« Reply #23 on: Nov 05, 2016, 08:41AM »

Robcat is right.  Genetics and biochemistry alone are not sufficient to explain the weight shift in our society.  Also, regardless of how much one eats, if one eats less, weight loss will ensue.  I eat well below average for a male of my size to maintain my weight.  I find that it has the added benefit of saving me money and time.  However, the average person is eating well above what they need, almost double in fact.

http://static4.businessinsider.com/image/5232240a69bedded5396670c-960/markets_cotd-new.png





I always felt that was down-to-earth and something I could live with all of my life, which I have. If someone can not adhere to that, they may be a candidate for a doctor's intervention.

 

Indeed.
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« Reply #24 on: Nov 05, 2016, 08:47AM »

There's just so much food around. When in the history of our species has there been such abundance? And, over our evolution, gorging ourselves  when food was available because tomorrow it might not be was probably a good strategy. Pretty strong innate drives.
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« Reply #25 on: Nov 05, 2016, 09:30AM »

There's just so much food around. When in the history of our species has there been such abundance? And, over our evolution, gorging ourselves  when food was available because tomorrow it might not be was probably a good strategy. Pretty strong innate drives.

Agreed.  I think the ultimate solutions to the trends we're seeing will involve a massive environmental adjustment.  Right now we have government subsidizing the very things killing us.  That needs to stop.  We also need to create a social environment that encourages sustainable healthful habits.
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« Reply #26 on: Nov 05, 2016, 09:41AM »

But, at the end of the day, those innate drives will compel us (as individuals) to gorge ourselves on good-tasting food, even though on a nutritional level, the quantity and quality are killing us.
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« Reply #27 on: Nov 05, 2016, 09:44AM »

We're probably off on a tangent and the Tangent Cops will descend. However, until they do, if everyone would follow a vegan diet 90% of the time - as wife and I do - there would be enough food to go around for everyone on the planet with far fewer environmental consequences. At present world population levels, some scientists state that it is sustainable. Kinda uncommon - not unheard of - but kinda uncommon to see an overweight vegan.

...Geezer
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« Reply #28 on: Nov 05, 2016, 10:22AM »

You can eat all the french fries, cake, burgers, candy, mozzarella sticks, pizza, and nachos as you want, so long as you cook it yourself from ingredients that only have one ingredient listed on the packaging. Guess how often you'll be breading mozzarella to stick in your deep fryer.

This is why people were skinny in those old timey photos.
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« Reply #29 on: Nov 05, 2016, 11:41AM »

But, at the end of the day, those innate drives will compel us (as individuals) to gorge ourselves on good-tasting food, even though on a nutritional level, the quantity and quality are killing us.

Not necessarily. Choice DOES factor. I haven't eaten fast food in over five years, nor will I ever again.
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« Reply #30 on: Nov 05, 2016, 12:20PM »

None-the-less, I do want to wish BMadsen success with this new treatment.

When all the other tactics have been tried and have not succeeded then it is time to try something else.

I hope he will check in occasionally to let us know of his progress.
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« Reply #31 on: Nov 05, 2016, 01:29PM »

I Agree with Mr. Reed.  Buy your food from the fresh meat counter and the produce section.  IF it comes in a sealed package with a list of ingredients longer than 1, it's probably best to leave it in the store.

I reached a peak or 294 lbs. the beginning of this last May.  My doctor was worried about type II diabetes, and my cholesterol levels were getting in the 'orange' zone.  I did not want to resort to drugs for the diabetes and cholesterol control and really felt awful physically.  My doctor gave me some literature about averting type II diabetes and the net of what that said was what I said in my opening remarks.  The kicker is I knew all this before too, so I only have myself to blame for my weight issue.

Since then I prepare all our food from fresh ingredients.  I've personally cut out all starch and sugar sources and stick with fish, lean meats, eggs, vegetables that grow above ground (plus some onions and turnips) and fruit low in sugar (peppers, cucumbers, tomatoes, etc...).  Of course the beer is gone.  :cry:

It's made a huge difference.  Right away my blood sugar settled down, my cholesterol dropped, my frequent indigestion stopped, my energy level went up and I started to loose weight.  The weight loss has been slow, but very, very welcome.  I'm now down to under 265 and it's been falling at about a pound+ a week since the start.

It's not been a huge change for me to handle either.  The variety of food around here has not diminished, just changed, and I really like the benefits.  Oh, and our grocery spend is less too now. Good!  I've not yet felt the desire to quit this and go back to the old ways.  I don't think of it as a diet that will end some time.  This is now how I live.

I applaud anyone that takes some action to improve their lives.

Bruce bought up a god point, and it may be affecting most of us.  That is the bacteria theory.  There is more and more research coming out on this.  The point in time where obesity rates begin to climb correlates with the point in time when antibiotics came into use.  The latest research is not saying antibiotics should be avoided altogether, but they should not be unnecessarily prescribed and when they are prescribed, they need to be followed with a suitable pro-biotic therapy.

As to alcohol and weight loss, while alcohol itself cannot be turned into fat, it is more readily used by the body for energy than are sugars, triglycerides and ketones.  The net net of this is, if you wish to have a drink, it is best you don't drink anything with sugar in it, or beer, and do not drink within a couple of hours of eating.  Yeah, I know, nearly impossible, but it's better than giving it up altogether (at least for me).  Even then, drinking will slow your weight loss, so be moderate.
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« Reply #32 on: Nov 05, 2016, 02:53PM »

None-the-less, I do want to wish BMadsen success with this new treatment.

When all the other tactics have been tried and have not succeeded then it is time to try something else.

I hope he will check in occasionally to let us know of his progress.

Yes!
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« Reply #33 on: Nov 05, 2016, 10:14PM »

You can eat all the french fries, cake, burgers, candy, mozzarella sticks, pizza, and nachos as you want, so long as you cook it yourself from ingredients that only have one ingredient listed on the packaging. Guess how often you'll be breading mozzarella to stick in your deep fryer.

This is why people were skinny in those old timey photos.

That's a big part of it:  Cook things from scratch, and you know exactly what you are eating.
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« Reply #34 on: Nov 06, 2016, 07:06AM »

Thanks all for the support!

All in all, recovery is going great. I'm digging into practicing more again (was doing very light sessions to keep the chops up enough for the gigs I had, but now I know I'm good to really push myself), and am continuing to drop.

When it comes to food choices, it's definitely better to prep all your own food with fresh produce (or frozen, which can be healthier than fresh because it's frozen at it's peak which preserves the nutrients) and meat. And, I applaud anyone who has that kind of time. My wife and I don't - between her full-time job, my gigging, rehearsals, teaching, chart prep, booking gigs, running multiple groups, and our 2-year old daughter, it's a wonder we have time to cook (which I make a priority). That being said, I don't use foods that are heavily prepared. I use canned tomatoes as a short cut for sauces (basically just tomatoes in there), canned beans (low-sodium variety), etc. I avoid "boxed meals" like the Hamburger Helper and other stuff that line the shelves, we rarely eat pasta (if it was once a month it was a lot, and very little in a serving, and always whole wheat), only bought whole grain breads, etc.

We are all right in the sense that we are not a different species than a 100 years ago, but we are in a different environment. It's only been in the past 50-60 years that we've really seen the level of prosperity where we have abundance, all the time. We are programed to gain weight easily because of the feast and famine cycles we used to endure - now it's all feast. And, because of that, we are starting to see biological changes - the bacterium theory, the way our brains can be rewired (in an article I posted), etc. In addition, our lives have become busier, and it's harder to fit everything in, so more and more of us are turning to convenience foods and restaurants to eat, which is not necessarily a source of healthy food. Until our society values good health, we aren't going to see a lot of changes to support this.
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« Reply #35 on: Nov 07, 2016, 07:42AM »

Thanks all for the support!

All in all, recovery is going great. I'm digging into practicing more again (was doing very light sessions to keep the chops up enough for the gigs I had, but now I know I'm good to really push myself), and am continuing to drop.

When it comes to food choices, it's definitely better to prep all your own food with fresh produce (or frozen, which can be healthier than fresh because it's frozen at it's peak which preserves the nutrients) and meat. And, I applaud anyone who has that kind of time. My wife and I don't - between her full-time job, my gigging, rehearsals, teaching, chart prep, booking gigs, running multiple groups, and our 2-year old daughter, it's a wonder we have time to cook (which I make a priority). That being said, I don't use foods that are heavily prepared. I use canned tomatoes as a short cut for sauces (basically just tomatoes in there), canned beans (low-sodium variety), etc. I avoid "boxed meals" like the Hamburger Helper and other stuff that line the shelves, we rarely eat pasta (if it was once a month it was a lot, and very little in a serving, and always whole wheat), only bought whole grain breads, etc.

We are all right in the sense that we are not a different species than a 100 years ago, but we are in a different environment. It's only been in the past 50-60 years that we've really seen the level of prosperity where we have abundance, all the time. We are programed to gain weight easily because of the feast and famine cycles we used to endure - now it's all feast. And, because of that, we are starting to see biological changes - the bacterium theory, the way our brains can be rewired (in an article I posted), etc. In addition, our lives have become busier, and it's harder to fit everything in, so more and more of us are turning to convenience foods and restaurants to eat, which is not necessarily a source of healthy food. Until our society values good health, we aren't going to see a lot of changes to support this.

Advertising is also a significant problem.  One study showed that food adverts increased consumption in children by 45% (!).
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« Reply #36 on: Nov 17, 2016, 08:14AM »

Just an update. I'm now down 40 lbs ( Amazed ).

I can now eat a limited solid diet (no more purees, yea!!!!) Whole wheat crackers, veggies, and protein - protein is the primary focus, according to my nutritionist, with veggies and crackers being additional.

Feeling absolutely stellar - playing has been fine, can't wait to be able to play my tuba as well (I have a Wessex mini tuba in C that is under the weight limit, so that suffices, but I love playing my Sousa and my big tuba).

Still no real complications, other than needing to switch my multivitamin because it was making me ill. Very minor issue, new ones are great.
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« Reply #37 on: Nov 17, 2016, 08:29AM »

Wow, Brad.  Good going.  Good!  Keep us updated as major changes occur.
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« Reply #38 on: Nov 17, 2016, 08:33AM »

I have to wonder if you will experience any loss of high range. I did after a hospital stay with significant weight loss (for my frame). It came back as I gained my body weight and strength back.

...Geezer.
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« Reply #39 on: Nov 17, 2016, 11:11AM »

Haven't lost any high range yet.

Lost some endurance, but I didn't play much for over 2 weeks (started playing light, easy gigs after a week and a half, but waited until I started practicing with more intense sessions to determine how much I could push myself). It's coming back as I keep practicing and gigging.

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« Reply #40 on: Nov 17, 2016, 11:31AM »

Haven't lost any high range yet.

Lost some endurance, but I didn't play much for over 2 weeks (started playing light, easy gigs after a week and a half, but waited until I started practicing with more intense sessions to determine how much I could push myself). It's coming back as I keep practicing and gigging.


 Good!  I believe that speaks well for your technique. It takes strength to hit higher notes, but some have the advantage of better technique that seems to require less strength than others who might have to belt it out with brute strength.

I believe if you continue to keep your protein, vitamin and mineral intake up - as well as a modest amount of carbs from complex sources - you will not experience loss of strength to any great degree. I think hydration is important as well.

Take care...

...Geezer
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« Reply #41 on: Nov 18, 2016, 11:18AM »

Good!  I believe that speaks well for your technique. It takes strength to hit higher notes, but some have the advantage of better technique that seems to require less strength than others who might have to belt it out with brute strength.

I believe if you continue to keep your protein, vitamin and mineral intake up - as well as a modest amount of carbs from complex sources - you will not experience loss of strength to any great degree. I think hydration is important as well.

Take care...

...Geezer

This is certainly true - I'm taking in a MINIMUM of 60 grams of protein a day - most days 80+ - by order of the doctor. I also take a daily multivitamin, 2 doses of Calcium + Vit D (our bodies can't take in the amount I need daily in one does), and an iron+vitamin C supplement, all by order of the doctor.

I used to have bad technique - even after graduating from the New School. I chalk it up to being young and thick-headed - my teachers tried to set me on the right path, but I was hitting what I wanted to hit with enough consistency to be happy, so I didn't fix it. When I did some masters work and studied with Bruce Bonvissuto, that was the first thing he had me fix, and I was much more mature and open to doing the work. It's now something I pay careful attention to, because when my technique starts to falter, I IMMEDIATELY notice a problem.
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« Reply #42 on: Nov 18, 2016, 01:20PM »

The following is my opinion. I'm not certified (though some may say I'm certifiable) and it's been a while since I studied this personally, so I may be off the mark.

I'm glad you are doing this per a doctor's instructions. I think it could otherwise be dangerous. When someone over-enthusiastically follows a diet to the point where it becomes a crash diet and the dieter reduces carbs down to below a minimal amount they truly need in a day - it can throw the body into ketosis or even acidosis; due to fat metabolism, if I remember my nutrition courses correctly. I'm not stating that is what I think you are doing; I'm stating that it is something to guard against.

I have heard of dieters reducing carbs down to below 35 grams a day. They can maybe get away with it for a day or two before trouble sets in. I would hope your Doc has counselled you to keep a little supply of crackers or a small piece of fresh fruit or maybe even hard candy (not sure about that) with you and if you feel any slight bit of dizziness or light-headedness, to ingest some. And since you are metabolizing fat from the body, I think hydration is necessary to flush everything out. Some dieters get extreme to the point where they do not want to even drink water, because it can temporarily fill the stomach up and make them feel "fat".

I would avoid all carbonated beverages - even diet ones. I find that when I consume them, my stomach gets a little distended from the CO2 released and when the gas gets burped out, I feel hungry from an enlarged and empty stomach. If I'm trying to lose weight, the last thing I want is to feel hungry.

But don't take my word on anything above. Continue to follow your Doc's advice, or if I've raised some points - seek their counsel.

Best of luck and keep us informed!

...Geezer
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« Reply #43 on: Nov 23, 2016, 07:10AM »

The following is my opinion. I'm not certified (though some may say I'm certifiable) and it's been a while since I studied this personally, so I may be off the mark.

I'm glad you are doing this per a doctor's instructions. I think it could otherwise be dangerous. When someone over-enthusiastically follows a diet to the point where it becomes a crash diet and the dieter reduces carbs down to below a minimal amount they truly need in a day - it can throw the body into ketosis or even acidosis; due to fat metabolism, if I remember my nutrition courses correctly. I'm not stating that is what I think you are doing; I'm stating that it is something to guard against.

I have heard of dieters reducing carbs down to below 35 grams a day. They can maybe get away with it for a day or two before trouble sets in. I would hope your Doc has counselled you to keep a little supply of crackers or a small piece of fresh fruit or maybe even hard candy (not sure about that) with you and if you feel any slight bit of dizziness or light-headedness, to ingest some. And since you are metabolizing fat from the body, I think hydration is necessary to flush everything out. Some dieters get extreme to the point where they do not want to even drink water, because it can temporarily fill the stomach up and make them feel "fat".

I would avoid all carbonated beverages - even diet ones. I find that when I consume them, my stomach gets a little distended from the CO2 released and when the gas gets burped out, I feel hungry from an enlarged and empty stomach. If I'm trying to lose weight, the last thing I want is to feel hungry.

But don't take my word on anything above. Continue to follow your Doc's advice, or if I've raised some points - seek their counsel.

Best of luck and keep us informed!

...Geezer

Well, if someone wants to lose fat, some level of Ketosis is required - ketosis is how our bodies burn fat. But it needs to be controlled.

That being said, losing weight with surgery has very specific, unique circumstances that aren't true when you just diet and excercise.

For example, I have to be careful when I eat vs when I drink, otherwise the combination of liquids and solids in my stomach can cause issues. So, I stop drinking fluids 15 min before I eat, and start drinking again 30 minutes after I finish eating. No fluids during the meal, and I take 20 - 40 minutes to eat a meal. Stopping too often to eat would mean I risk dehydration, so I only eat 3 times a day.

I drink a minimum of 50 ounces of caffeine-free beverages a day. I can't drink anything carbonated anymore - the carbonation can stretch my stomach, and even if it doesn't do that, for the vast majority of people with this surgery, they find it gives them very, very severe gas pain.

There is a very specific diet you follow in recovery. Almost no raw fruit (skins and crunch are a problem, so ripe bananas are ok, for example), no candy, etc. Very, very low carbs (none at all for the first month beyond whatever is in your protein shakes and pureed veggies), mostly protein (to avoid muscle loss), etc. This has all been designed by nutritionists along with doctors, and perfected over a more than 10 years (I think more than 40, actually, since this is basically a modified gastric bypass without the bypass - so it almost eliminates the risk of nutritional deficiencies that can arise even when following doctors orders), so anyone doing this should follow their doctors advice, not anything anyone has posted here, including myself. Every doctor has adapted things for their patients so they know they work.

And, anyone doing this is going to eat very differently than what anyone else would expect, so it's even more important that you IGNORE the advice of anyone not tied directly to your healthcare team, especially those working with your surgeon, as not following the directions can last you in the hospital. I've already had a few people ask why I couldn't eat/drink something with them, and they tried to argue it would be fine, because it was "healthy" food (and, it was - bites of broccoli, a low-cal fruit smoothie, etc) - but, I know that what was in those foods would be problematic FOR ME because of the surgery, and had to be avoided, because of my situation.

The only people who tell me what I can and can't eat? My surgeon and the nutritionist working with them. They are the only people in the world who I trust to know what is going on with my body and offer advice. And, so far, they are right - I'm down 48 lbs now, with no issues beyond the multi-vitamin issue.
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« Reply #44 on: Nov 28, 2016, 01:17PM »

Well, if someone wants to lose fat, some level of Ketosis is required - ketosis is how our bodies burn fat. But it needs to be controlled.

That being said, losing weight with surgery has very specific, unique circumstances that aren't true when you just diet and excercise.

For example, I have to be careful when I eat vs when I drink, otherwise the combination of liquids and solids in my stomach can cause issues. So, I stop drinking fluids 15 min before I eat, and start drinking again 30 minutes after I finish eating. No fluids during the meal, and I take 20 - 40 minutes to eat a meal. Stopping too often to eat would mean I risk dehydration, so I only eat 3 times a day.

I drink a minimum of 50 ounces of caffeine-free beverages a day. I can't drink anything carbonated anymore - the carbonation can stretch my stomach, and even if it doesn't do that, for the vast majority of people with this surgery, they find it gives them very, very severe gas pain.

There is a very specific diet you follow in recovery. Almost no raw fruit (skins and crunch are a problem, so ripe bananas are ok, for example), no candy, etc. Very, very low carbs (none at all for the first month beyond whatever is in your protein shakes and pureed veggies), mostly protein (to avoid muscle loss), etc. This has all been designed by nutritionists along with doctors, and perfected over a more than 10 years (I think more than 40, actually, since this is basically a modified gastric bypass without the bypass - so it almost eliminates the risk of nutritional deficiencies that can arise even when following doctors orders), so anyone doing this should follow their doctors advice, not anything anyone has posted here, including myself. Every doctor has adapted things for their patients so they know they work.

And, anyone doing this is going to eat very differently than what anyone else would expect, so it's even more important that you IGNORE the advice of anyone not tied directly to your healthcare team, especially those working with your surgeon, as not following the directions can last you in the hospital. I've already had a few people ask why I couldn't eat/drink something with them, and they tried to argue it would be fine, because it was "healthy" food (and, it was - bites of broccoli, a low-cal fruit smoothie, etc) - but, I know that what was in those foods would be problematic FOR ME because of the surgery, and had to be avoided, because of my situation.

The only people who tell me what I can and can't eat? My surgeon and the nutritionist working with them. They are the only people in the world who I trust to know what is going on with my body and offer advice. And, so far, they are right - I'm down 48 lbs now, with no issues beyond the multi-vitamin issue.

You have gotten expert counsel and that's the way it should be. I imagine the toughest part of this past holiday week-end was saying "no" to all of the well-intentioned force-feeders you came in contact with. Everyone is a chef and a nutritionist.

But if you survived this past week-end, it's because of your determination!

One holiday down; one to go. You can do it!

...Geezer
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« Reply #45 on: Nov 29, 2016, 05:14AM »

Holidays are a little easier than you'd think for me - we don't have family nearby, so this year it was just my wife, daughter and myself. But, even if we did have family over (or go to see family), everyone knows about this and has been extremely supportive, so I'm not terribly worried.

And, trust me - I already had problems with eating a little too much once (my doctor was surprised it was only once - apparently multiple instances is so common they expect it as part of the relearning how much you can eat process) - it's not an experience I want to repeat, so it becomes really easy to say "no" to the large amounts of food! Even last nights gig, with copious amounts of delicious hors d'oeuvres floating around, was easy to turn down more than 3 items, which was about all I could handle.

Thanks! I will continue to keep everyone updated with my progress!
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« Reply #46 on: Dec 01, 2016, 09:02AM »

Another update.

Just got home from seeing my surgeon for a follow up.

I'm fully cleared to lift again - no weight restrictions, and can start going to the gym again.

I am also cleared to (slowly) introduce a more regular diet. Obviously, I still need to focus on protein, but at this point there are no restrictions on what I can eat. They recommend having one new food a day, to see how I tolerate it, and to avoid bread and rice for now because they can expand and fill the stomach very quickly, but I've been healing great.

On the healthfulness of my rapid loss, they say I'm doing fantastic. They project, for most patients, 10-12 lbs a month. I've lost 48 lbs in 7 weeks, if you include the pre-surgical period (38 lbs post-surgery, which is a 6 week period). They say as long as I'm feeling well (good energy levels, keeping food down, etc), the rapid loss is fine, and bodes well for long-term success at keeping it off, since it shows I'm willing to eat well long-term (which I already knew I was because I already had been).

Very happy I made this decision - the nutritionist expects I'll eventually make it down to 180-210 (hard to know exactly where in there I'll fall). I haven't been that weight since I was in middle school or early high school!
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« Reply #47 on: Dec 01, 2016, 09:34AM »

Another update.

Just got home from seeing my surgeon for a follow up.

I'm fully cleared to lift again - no weight restrictions, and can start going to the gym again.

I am also cleared to (slowly) introduce a more regular diet. Obviously, I still need to focus on protein, but at this point there are no restrictions on what I can eat. They recommend having one new food a day, to see how I tolerate it, and to avoid bread and rice for now because they can expand and fill the stomach very quickly, but I've been healing great.

On the healthfulness of my rapid loss, they say I'm doing fantastic. They project, for most patients, 10-12 lbs a month. I've lost 48 lbs in 7 weeks, if you include the pre-surgical period (38 lbs post-surgery, which is a 6 week period). They say as long as I'm feeling well (good energy levels, keeping food down, etc), the rapid loss is fine, and bodes well for long-term success at keeping it off, since it shows I'm willing to eat well long-term (which I already knew I was because I already had been).

Very happy I made this decision - the nutritionist expects I'll eventually make it down to 180-210 (hard to know exactly where in there I'll fall). I haven't been that weight since I was in middle school or early high school!

That's excellent news!

I wouldn't be surprised if your team decided to take your weight down a little further than your target goal, to give you some bounce-back cushion room.

 Good!

...Geezer
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« Reply #48 on: Dec 27, 2016, 08:50PM »

An update...

I'm now down 69 pounds since 10/12. That's an average of 27.6 pounds a month.

My weight loss is slowing, but is still continuing. This is expected, but, after seeing the weight just drop, a little disappointing (I know it will continue, but there is something about seeing that scale move that quickly that is very motivating).

I tolerate most foods well. Bread and pasta are a big problem for me, but crackers are fine. I have lots of protein, and then veggies - carbs are not as important to me.

My tastes haven't changed a lot, but considering that I craved veggies and salads before the surgery, it's no surprise.

Haven't been able to start working out again - I've been way too busy gigging. And, most of those gigs involve playing my mini tuba (wessex mighty gnome) for 4+ hours a night walking around on my feet, so, that counts as a workout, right?

Interestingly, the NY Times just put out an article about Gastric Bypass. For those of you following this thread and interested, I found it very good.

http://www.nytimes.com/2016/12/27/health/bariatric-surgery.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region&region=top-news&WT.nav=top-news
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« Reply #49 on: Dec 27, 2016, 09:45PM »

Wow, that is amazing progress!
I wonder how you can lose it that fast and still have stamina and chops to play lots of gigs.  I guess the simple fact that you're hauling less around gives you more energy.
Congratulations, it sounds like you're doing really well.
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« Reply #50 on: Dec 27, 2016, 10:37PM »

Nice work mate!

I wish you continued success with your health for the rest of your life!

Justin
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« Reply #51 on: Dec 28, 2016, 05:37AM »

AND on top of it all - the holiday season - where NO ONE loses weight!!!!!!! WOW!

...Geezer
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« Reply #52 on: Dec 28, 2016, 11:26AM »

Wow, that is amazing progress!
I wonder how you can lose it that fast and still have stamina and chops to play lots of gigs.  I guess the simple fact that you're hauling less around gives you more energy.
Congratulations, it sounds like you're doing really well.

My guess is that it has to do with the fact that fat is stored energy - so, since I'm eating so little, I'm burning up the fat.

I've definitely been busy - at least one job a day every day this month except 12/5, 12/25, and today (which I took for myself - I have a small strain in my back, and some bigger jobs the next few days, so my lower money gig got subbed out in favor of resting that back).

I have had enough energy - I'm worn out now, but I was at this point last year too (same deal then), so that just has to do with being on essentially non-stop for a month.

AND on top of it all - the holiday season - where NO ONE loses weight!!!!!!! WOW!

...Geezer

Pretty hard to NOT lose weight when you can't eat more than a few ounces at a time!

That being said, I've indulged in some treats that I normally don't have during the year - holiday cookies, for example. But, where I used to eat more of them, I am eating a lot less. That also might be why the weight loss slowed a bit (in fact, I'm sure of it) - we will see once we've finished the last of the holiday treats how the numbers start moving again.

Nice work mate!

I wish you continued success with your health for the rest of your life!

Justin

Thanks!
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« Reply #53 on: Jan 01, 2017, 10:38AM »

Stupendous!

Do you feel like you might have a new lease on your life? Losing that much must have given you a DECADE or even TWO to live beyond whatever you would have had without losing weight. Maybe even more! How great is that?!

Keep on trucking!
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« Reply #54 on: Jan 03, 2017, 05:57AM »

Stupendous!

Do you feel like you might have a new lease on your life? Losing that much must have given you a DECADE or even TWO to live beyond whatever you would have had without losing weight. Maybe even more! How great is that?!

Keep on trucking!

I'll be honest - I don't feel like I have a new lease on life, in terms of longevity. That may have to do with the fact that, except for sleep apnea (under control with a oral/dental device), and a knee that I've had 2 surgeries on, my health was, and continues to be, excellent (pristine bloodwork, except for a vitamin D deficiency which my doctor said nearly every American has now). As my doctor put it, if it weren't for my weight, I'd be one of her healthiest patients. Now, I have no disillusionment as to what might be coming my way had I not lost the weight - the risks for diabetes, heart disease, etc, were a lot higher, and I'm sure I would have faced SOMETHING at some point because of the weight. But, it's hard to feel like I've gained a longer life when I was feeling great already.

However, I do notice that things that used to wear me out, don't as much anymore. If I had to climb a lot of stairs (not my regular stairs in the house, but 3 or 4 stories or more), it would be tiring. Now, I can do that and not be as tired. My bad knee doesn't bother me as much. And, because I had to be acutely aware of how much I was carrying during recovery, I'm now aware of how much weight 20, 30, 40 lbs is when I'm carrying equipment now, and it shocks me to think I was carrying a lot MORE than that in excess weight.

I'm getting excited about another milestone I'm approaching. I'm about 13 pounds away from the lowest weight I've ever been as an adult. Once I hit that, I'll be in new territory - and I'm very curious and excited to see where that will take me.

As a another note, here's an interesting article published last week about gastric bypass surgery. Bypass is more drastic than what I had - they usually makes the stomach even smaller than what they do for gastric sleeve, and they reroute the intestines so your body bypasses some of the small intestine, making it harder to absorb as many calories. But, it's an interesting article because it does talk about how the entire system that regulates our weight changes when someone has the gastric sleeve or gastric bypass surgery.

http://www.nytimes.com/2016/12/27/health/bariatric-surgery.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=9&pgtype=sectionfront

And, the times also did an article earlier this year about the Biggest Loser contestants, and how their weight struggles (nearly all regain the weight, most regain most or all of what they lost) have shed a lot of new light on how our bodies regulate weight.

http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0

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« Reply #55 on: Feb 22, 2017, 05:15PM »

An update...

I'm now down 69 pounds since 10/12. That's an average of 27.6 pounds a month.

My weight loss is slowing, but is still continuing. This is expected, but, after seeing the weight just drop, a little disappointing (I know it will continue, but there is something about seeing that scale move that quickly that is very motivating).

So, the above was a mistype - and I didn't notice at the time. I do apologize. I'll attribute it to late December exhaustion, because the accompanying math was also based on the wrong data. It was actually 59 lbs, and 23.6 lbs a month.

I'm now down 75 lbs, averaging around 20 lbs a month. As you can see, the weight loss is slowing, as expected. I've also hit that milestone - I'm the same weight I was when I was 20 (last was this weight in May of 2003).

The doctor believes I'll settle anywhere between 100 - 130 lbs lost, all in all. They figure I'll hit that point in July. That would be 9 months, which is an average of 11-14 lbs a month at that point. Considering I have 25-55 lbs to go, that's 5 - 11 lbs a month.

At this point, the weight loss, while still something I'm watching and excited about, doesn't occupy a central role in my thinking. Most of the changes that I had to deal with regarding eating are now habits, and I don't even miss most of the old foods I used to eat and can't anymore.

I will say I am noticing some changes in my tastes. I used to have to be really careful with sweets, because while I wouldn't crave them, when I got started on them, it was hard to stop (so I mostly aimed to avoid them, and did so successfully most of the time). Now, I can enjoy a sweet from time to time without that drive to keep eating them - and it doesn't have to do with fullness. I CAN eat more than one of my wife's homemade chocolate chip cookies (they are small). I now find one is enough.

I am noticing a little bit of extra skin. That is normal, from what I understand - it can take up to 2 years for the skin to catch up to the weight loss because it happens so fast, so I'm not worried. But, it's enough that I'm one size of pants bigger than I was when I was last this weight.

I still, occasionally, eat too fast and have some issues. But, I'm getting very good at knowing what I can eat without any problems, and when I have to eat fast on a gig, always eat less than I probably could to ensure no issues.

All in all, I would highly recommend this to anyone considering it, who is willing to follow the recommendations for the diet, and can stick to the vitamin regimen. To say it's life-changing is an understatement - while I'm not skinny, I look trim now. I'm down 10.5 points on the BMI scale (an imperfect measure of health, but nice to know). And, believe it or not, I notice my car getting better gas mileage, by almost 1 mpg!
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« Reply #56 on: Feb 22, 2017, 05:44PM »

Thanks for the update, Brad.  This is really interesting.  I hope you check back in April to see how you are doing.  Meanwhile, keep helping us with our playing issues when you can.
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« Reply #57 on: Feb 22, 2017, 06:38PM »

I was wondering about you. You're doing amazing!

It's interesting how the tastes can change. Wife & I turned mostly vegan about 2 years ago and our tastes have definitely changed. It's all what you get used to.

Keep going strong!

...Geezer
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« Reply #58 on: Feb 22, 2017, 07:10PM »

This is amazing Brad.   Good!

I wish you the best on this voyage.  You're a real trooper!

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« Reply #59 on: Feb 23, 2017, 04:18PM »

Thanks for the update, Brad.  This is really interesting.  I hope you check back in April to see how you are doing.  Meanwhile, keep helping us with our playing issues when you can.

Will do. I've been slammed lately - had a record January, fantastic February, and just scored a great opportunity that will very likely be very lucrative, and fun. It means playing a different axe for that gig (non-low brass), but definitely worth it.

Been working a lot as a consequence (I'll share the whole story of that opportunity when I can go public with it), so I haven't had much time to chime in. I will when I can though!  Good!
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« Reply #60 on: Apr 18, 2017, 09:48AM »

As promised, I'm back.

I've been SUPER slammed as of late, so I'll have to re-acquaint myself with what's going on with the other boards, but my weight loss is progressing very well!

Back in February, I was down 59 lbs. I'm now down 91 lbs  Amazed. I think I mentioned before I will probably lose somewhere between 100 - 130, so I'm closing in on the low range of that. I also crossed another milestone - I'm now down over 100 lbs from my max weight ever.

To give you all a sense of the roller coaster ride I've been on, things have been good, for the most part, but I started having issues taking my multi-vitamins. If you've read up on this surgery, or any other weight loss surgery, you know that it's vitally important to take them. I had to work closely with my team to solve the issue, but it looks like I'm back on track there (was getting nervous - there are lots of stories out there of people not staying compliant with their vitamins and ending up in the hospital, so this was not something I took lightly).

I did develop some back issues because of the weight loss, believe it or not. I didn't realize I had developed poor posture because I was leaning on my weight as I played, so the muscles that would normally hurt with bad posture were not strained. I've found a great chiropractic and physical therapy practice, however, and they are setting me right.

Other than that, work just stays busy - this week is a little lighter, but then I have 2 shows, and then May and June are always slammed.
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« Reply #61 on: Apr 18, 2017, 11:09AM »

Wow!  Way to go  Good!
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« Reply #62 on: Apr 18, 2017, 01:11PM »

Congratulations!

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« Reply #63 on: Apr 22, 2017, 02:28AM »

Wow, I have to be better about reading my old posts. I wasn't down 59 in February - I was down 75 lbs, not 59. Either way, that's another 17 lbs.

The nice thing is that, except for the change in portion size due to the surgery, I haven't done much. Haven't made it to the gym because of the back issues, and I just broke my toe, so won't be back there for awhile. I plateaued for a bit, but that was on me - I was not eating as well as I should. But, to be able to say that I didn't gain during that time of not as healthy eating is awesome - and I'm back to eating well again, so it was just a short time.

As a side benefit, I think my migraines are, for the most part, completely resolved. I usually get 3-4 a year as a matter ofncourse. My last one was 2 months before the surgery. So, I'm at 8 months with no migraines. Very, very happy about that!  Good!
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« Reply #64 on: Apr 22, 2017, 11:05AM »


As a side benefit, I think my migraines are, for the most part, completely resolved. I usually get 3-4 a year as a matter ofncourse. My last one was 2 months before the surgery. So, I'm at 8 months with no migraines. Very, very happy about that!  Good!

Mine came back after weight loss.  Weird.  I'm up a few pounds from that and holding steady, and the migraines have abated again. 
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« Reply #65 on: Apr 22, 2017, 08:08PM »

Thanks to Brad and everyone participating in this thread.  I am going for my first consult this coming week to weigh the surgical options.  I am happy to know that the gap in playing is so short even though I am only a weekend warrior now days and rarely gig anymore.  The issue with back pain is interesting, I'll have to give some though to how I 'use' the lump of fat I carry above my belt when I play so I start correcting bad habits well in advance of it being a thing of the past!   
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« Reply #66 on: May 08, 2017, 07:35AM »

Thanks to Brad and everyone participating in this thread.  I am going for my first consult this coming week to weigh the surgical options.  I am happy to know that the gap in playing is so short even though I am only a weekend warrior now days and rarely gig anymore.  The issue with back pain is interesting, I'll have to give some though to how I 'use' the lump of fat I carry above my belt when I play so I start correcting bad habits well in advance of it being a thing of the past!  

Very excited for you! Definitely worth keeping an eye on your posture - you may not have that issue, but it came out of left field for me. I've basically resolved it, except when I'm in a bad chair (as I was last week for a run of Urinetown), and even then it's manageable.

Wish you all the best on your journey!
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« Reply #67 on: Jul 09, 2017, 06:39PM »

Updating this thread with my current experience.

I am surprised by the number of very comprehensive pre-surgical tests that have been needed.  The down side is the length of time these collectively take to get through and the up side is the depth to which I know in what areas of my physiology there are issues and not.

After meeting the nutritionist, I am starting to practice the type of diet that will be required for my long term post surgical life.  It was quite enlightening to really get down to the basic needs of my metabolism and the best ways to keep myself fueled without gaining weight or losing lean muscle mass in the process.  Even if you are never considering surgical intervention and struggle with weight, a nutritionist can be an amazing help.  I have already lost 20 lbs, in a short period and can predict with deadly accuracy whether or not I will be up or down on the scale in the AM based on what sins I may have or not committed in my eating over the prior day or two.  Knowledge is indeed powerful.

I am nearly complete with all my tests and am looking forward to getting my surgical date.  My surgeon has asked for 4 weeks off the horn to avoid herniating incisions (not worried about the actual surgical site).  I am going to petition for a shorter layoff ... but 4 weeks is not terrible considering I am not making a living on the horn.

Updates to come.
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« Reply #68 on: Jul 11, 2017, 06:19AM »

That's great to hear!

I only needed a week and a half off the horn, but my surgeon asked I be conservative in my return (started with very easy gigs, and built up as the weeks passed). But, most important thing is you heal well. And, you will have lifting restrictions, so you have to abide by those (I couldn't play my Sousa or big tuba for 6 weeks, but my mini tuba and all my other horns were in the clear the week and a half after.

I played for my surgeon so they could feel how my abdominal muscles were activated when playing - you may want to consider that so they can better assess how much time you'll need off.

I'm currently hanging out between 95 and 100 lbs lost. I'm finally back at the gym, and very grateful for that. I am very happy with the way I look, and I feel great (although I always did). I miss a few foods I can no longer eat or drink (missing my seltzer, for instance), but I'd rather have all this weight off, so it's a worthwhile trade off. And, staying compliant on my vitamins is easy.
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« Reply #69 on: Jul 11, 2017, 06:30AM »

I always look forward to seeing your updates.

My hat's off to you!

...Geezer
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robcat2075

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« Reply #70 on: Jul 11, 2017, 10:45AM »

... I miss a few foods I can no longer eat or drink (missing my seltzer, for instance)...



Why is Seltzer banned?
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« Reply #71 on: Jul 11, 2017, 10:54AM »


Why is Seltzer banned?
Because of the gas it produces, maybe?
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« Reply #72 on: Jul 11, 2017, 01:10PM »


Why is Seltzer banned?

High in sodium.
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Tim Richardson
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« Reply #73 on: Jul 11, 2017, 05:50PM »

Because of the gas it produces, maybe?

Correct - can stretch the stomach out in the worst case (long term drinking of it). Best case, it will just make you sick since the gas needs to go someplace, and since the stomach after surgery doesn't have much give, it comes back up and pushes out the liquid along with the gas.
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« Reply #74 on: Jul 25, 2017, 11:35PM »

Fantastic Brad, it's awesome to hear about your progress with your surgery from a perspective like yours.

Question for you: Did you pursue it because of the possible health risks from being overweight or a body image thing? Just curious what your motivation was.

I guess I can share my side of the coin:

I have a similar background where I have also been heavy since elementary/middle school, but for the most part, especially since high school, I have been very physically able, and I've also been very healthy as well. I've never broken anything, been to the hospital for anything and I've only ever taken antibiotics once for an ear infection.

At my worst, at the end of my first year of my undergrad here, I was at 265 lbs, and that was when I wasn't working out regularly and eating typical freshman dorm BS for a year. I started running 3 times a week, started just cutting down on portions and eating smarter and I went down to 208 by the opening of my Junior year here. I don't know what my weight was but in high school I did lifeguarding for a semester and with how that kicked me into shape I'd imagine my weight was around 208 as well at the time. My high school swim coach wanted me to be on the team even at my weight. On average right now, I run 2.5 to 3 miles about 3 times a week and my average pace is like 9 minutes (it was down near 8:30 for a while...)

I'm hovering around in the same range between 210 and 220 for the last year, and it seems like that whenever I miss a couple of workouts I immediately put the weight directly back on. I've had a blood test and I'm healthy except for one anomaly with my hematocrit which the doc wasnt terribly worried about especially because of my physical shape. I exercise and watch my portions decently well. The only thing that I can think of is that I have a bit of a a sweet tooth but I control it fairly well, just trying to have a small dessert at night...

I'm just curious as to what perspective you came from to help me think about it. I definitely have some body image issues which contribute  anxiety issues that stem from my rough upbringing, my minds tendency to run at 1000mph and my social anxiety.

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« Reply #75 on: Aug 07, 2017, 06:53AM »

Fantastic Brad, it's awesome to hear about your progress with your surgery from a perspective like yours.

Question for you: Did you pursue it because of the possible health risks from being overweight or a body image thing? Just curious what your motivation was.

I guess I can share my side of the coin:

I have a similar background where I have also been heavy since elementary/middle school, but for the most part, especially since high school, I have been very physically able, and I've also been very healthy as well. I've never broken anything, been to the hospital for anything and I've only ever taken antibiotics once for an ear infection.

At my worst, at the end of my first year of my undergrad here, I was at 265 lbs, and that was when I wasn't working out regularly and eating typical freshman dorm BS for a year. I started running 3 times a week, started just cutting down on portions and eating smarter and I went down to 208 by the opening of my Junior year here. I don't know what my weight was but in high school I did lifeguarding for a semester and with how that kicked me into shape I'd imagine my weight was around 208 as well at the time. My high school swim coach wanted me to be on the team even at my weight. On average right now, I run 2.5 to 3 miles about 3 times a week and my average pace is like 9 minutes (it was down near 8:30 for a while...)

I'm hovering around in the same range between 210 and 220 for the last year, and it seems like that whenever I miss a couple of workouts I immediately put the weight directly back on. I've had a blood test and I'm healthy except for one anomaly with my hematocrit which the doc wasnt terribly worried about especially because of my physical shape. I exercise and watch my portions decently well. The only thing that I can think of is that I have a bit of a a sweet tooth but I control it fairly well, just trying to have a small dessert at night...

I'm just curious as to what perspective you came from to help me think about it. I definitely have some body image issues which contribute  anxiety issues that stem from my rough upbringing, my minds tendency to run at 1000mph and my social anxiety.



Hey,

I was worried about long term health. My health before the surgery was excellent except for the weight. Great cholesterol, heart rate, ect. As my doctor put it, I was one of her healthiest patients except for the weight. But, I have a fair number of bigger friends and colleagues who are anywhere from 5 - 30 years older than myself. Some took good care of themselves, some didn't. All had some health issues related to their weight, and I didn't want to walk down that path if I could avoid it. After trying for two years to lose weight with diet and excercise (and failing due to my issues with migraines and hunger), I finally sought help.

There are some pretty strict requirements to qualify for the surgery (at least, for insurance purposes). Usually, a BMI of 35+ with two obesity related health issues, or 40+ with none is required to qualify. Some of the health issues that qualify are sleep apnea, heart disease, diabetes, etc, although every insurance carrier is different. I was at a BMI of 44. Then, even if you qualify, there are usually a lot of hoops to jump through to still qualify, including a meeting with a psycho therapist to ensure you are a good candidate mentally for it.

If you can keep the weight off without it, definitely don't have the surgery - unless you are really short, your BMI is probably not high enough, and it's not worth paying out of pocket for it. And there are other attendant things that come with the surgery - you can't eat certain foods anymore (well, some can, but it's not recommended as most can't tolerate them, and they can negate the surgery in the long term), and you have to take a lot of vitamins everyday for the rest of your life. Not worth it if you can manage it on your own. I tried for years with no success, so I knew I needed the help.
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« Reply #76 on: Oct 11, 2017, 01:09PM »

So, another update.

I'm now about a year in (a week out). I saw my doctor for my 1 year followup on Monday. According to their records, I'm down 104 lbs! (less by my count, but I'll take the higher number  :D)

I'm seeing the weight loss slow significantly at this point, but I'm still seeing body changes as I continue working out. I'm into a pretty solid program of 3-5 workouts a week (at least 2 weight training workouts, and at least 1 run).

It's amazing - I have been able to start running again, and it feels amazing. In 2 months, I've gotten myself to running over 3 miles per run, and at a pace of less than 10:00 min a mile! Even at my peak running days in college, I was hitting an 11 min mile for 5 miles.

For the first time ever as an adult, I have also hit some clothing sizes I never expected to hit (even after having the surgery). I was wearing XXL or XXXL, deeding on the brand before the surgery. I just bought new clothes for the fall/winter, and bought some M and some L shirts. I have been a L all summer, so having to buy M so they fit right was quite a nice feeling! As for pants, at my lowest weight, I could wear a 38 waist - I just bought new jeans that are a 36 waist!

Playing-wise, I can definitely say it's improved my playing. Not so much the actual playing, but the stamina needed for gigs. I play the San Gennaro feast in NYC every year, and usually by the end my back is destroyed - need a couple days of rest to recover. This year, no trouble whatsoever - finished the gigs, kept on working without a break! And, day by day, I was less tired, even on my long days with 2 or 3 gigs back to back.

I'll update as I have news, but will probably wait for major milestones at this point. My hope is this thread will help musicians decide if this surgery is right for them. I'm not perfect in what I'm eating by any means, but I'm pretty good - and I'm holding to the major things (no carbonated beverages, little to no bread/pasta, taking my vitamins, etc). If this thread can illustrate that it's possible to live a normal, happy life after the surgery, keep playing, and be at a healthy weight and not be deprived, then it's worth pursuing if other options have not worked out.
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« Reply #77 on: Oct 15, 2017, 08:44AM »

Congratulations on the good results!


I'll update as I have news, but will probably wait for major milestones at this point.

What would you say are the milestones still to be achieved?
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Robert Holmén

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« Reply #78 on: Oct 29, 2017, 07:31AM »

Congratulations on the good results!

What would you say are the milestones still to be achieved?

At this point, I've been holding pretty steady between 212-217. If I can get that below 210, then every 10 lbs below that. Or, if I find that my clothing sizes change significantly. Or if my weight holds, but my shape changes (going from the "dad bod" look to something more toned). Hard to know at this point - I feel like I'm pretty much where I will be, so I'm interested in what my efforts will bring as time goes on.
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Bradley Madsen
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