July 6, 2010 Adventure starts BEFORE the birthday!

The day started very early. I had no food or water since 10pm Sunday night to prepare for my ultrasound. I got to Methodist extremely early and checked in and made it to Radiology. My technician's name Was Bart...could that be more perfect. There was mood lighting...is that right, mood lighting?Then he told me to remove my shirt. After he came to and accepted my apology for the black eye, we started my ultrasound.

The gel was very warm, unexpected , as was the touch of an ultrasound tech voice at 7:45am. For 20 minutes, Bart calmly told me to breathe in and breathe out. We finished and he pushed me out the door towards fate. My anticipation was jamming blood through my veins faster than my wife can smoke a cigarette outside in a blizzard. I coursed my way through the hospital maze to make it to the Bariatric Center at Methodist. Everyone is so helpful and welcoming, like a secret club. I was checked in and ended up being so incredibly early that I waited over an hour to see the Surgeon.

Dr. Thomas Jones is an unassuming man at first glance. Shorter than his name suggested, made up on experience and demeanor. He made me completely calm from the very first words, "Let's fix you". He sat down and got to know me and asked me questions rather than see me as a spot on a meat packing line. Dr. Jones joked and laughed, got serious when needed, and finally; after two plus years and especially the last 7 months it all came down to; "So, when do you wanna do this?" I didn't respond at first. Yesterday was all that was in my mind. Yesterday, I was just Christopher Seiple, the prisoner in his own body. Now someone was holding my key to the rest of my life and I locked up. Finally, after what seemed like a lifetime, I said "As soon as possible Doc, as soon as your schedule allows".

I have my day. I know the roadmap for the next few month. I meet with my Boss at work to discuss the 3 weeks I will need off on Wednesday. Tonight, Lisa and I will discuss with the kids what to expect. In between all those hours, I will contemplate the change I'm about to go through. I will dream of better days when my image in my head will match what my eyes see. I can't wait to be the man I know is inside. And I will be out of the hospital in time for my birthday!

My life through John Goodman's eyes.

I just saw photos of and read an article about John Goodman shedding over 100 pounds recently. They had attached photos of him from 2008 & 2009. I was so proud, looking at those photos. The article quipped that he looked younger and healthier than he had in years.

I only bring this up because I used to think of myself as a sort of poor man's Dan Conner (his role on Rosanne). And then I started to think of how I looked at some of my Hollywood heros, like Jim Belushi and Chris Farley and people like Kevin James or to a lesser extent, Meatloaf. Did I find solace in the fact that these portly entertainers had success despite their waistlines? Was I comforted to see someone represent me on the big and small screens that raised me? A few comedies even seemed to pattern after what my life was like, fat guy and skinny, hot wife (King of Queens and Still Standing, the latter which was almost exactly like my life). I looked at these and didn't see a problem, not until Dr. P stepped into my life.

Dr. James Parnell, our family's general practitioner and all around guru is a straight shooter. He tells it like it is and never beats around the bush about anything and everything. He looked at me one day and said, "Chris, if you don't change your ways, you'll be dead by 50." Let that sink in. That's scarier than Jason, Freddy, Michael or the Exorcist combined. I had been on the fence about doing something about my weight. I've had more gym memberships than 1 person needs in a lifetime but the other side of that coin is there is no one better than me to justify why NOT to go and work out. Thank you Dr. Parnell for finally having the balls to say what needed to be said, for shocking me into the reality of my life, for putting it into the ultimate perspective. I will forever be in your debt.

So, it's the Saturday before my appointment with my Surgeon on Monday. I am nervous and excited. I think, weirdly, I'm more excited to get an ultrasound on my gall bladder and stuff. I love procedures and how the body works. I should've been a doctor; but I gave that dream to my ex-wife. I can't wait to have a focal point in my life. That will come with the surgery date. I have a nice, long couple of shifts ahead of me to help the time move faster. I can't wait to be able to satisfy the inquisitors when I'm asked "when". I can't wait!

There is not much on my mind today. I can't get past the eagerness of anticipation. Thankfully, I have a lot of work ahead for the weekend to make the time lapse faster. Thanks for checking in with me. I'm sure I won't be able to sleep on Sunday and Monday with provide a plethora of information highs and lows.

Long weekend.

Sorry, it's been a few days. It is a very busy season out on the lake and this weekend was packed with long shifts and lots of customers. I am losing a step on these busy weekends. I can tell how the weight has effected my work life. I used to love going in on busy nights and chatting with guests and relishing in the spirit of a great, fast-paced night. Now, I'm so self consciences about my weight, self consciences of the way my clothes fit me and how I am being perceived that I'm panic stricken when I have to go in for a closing shift that I find any excuse to no chat up tables, even if they know me. It's stupid, I know and it is what I'm building up in my own brain; but, knowing that makes it all the more easy to get caught up in a spiral downward.

Does this surgery make me a better manager? I hope so. Does this surgery allow me to do my job better? I believe so. Does this new lease on life change the way I am perceived? Absolutely. I have not been able to find a negative for doing this surgery. The closest negative is that I didn't decide to do this 2 years ago, or that I will be away from work for 2-3 weeks. That's sad. I hope anyone who reads this and is trying to wrestle with their addiction will take away the fact that there is nothing but good that can come from this procedure. Make up your mind for your life. For all the superfluous reasons I can come up with for doing this for my wife and kids, for my job, for my friends etc., I understand that I'm doing this for me-selfishly.

It's one week. One week until I sit down face to face with my doctor and shake the hand of the man who will change my life. I'm very emotional right now about it. This week is going to be hard to concentrate on anything else. I can only hope that the week goes fast.

And the days just go on forever...

I am not a very patient person. Ask anyone who knows me. Actually, the only place I have patience is in a restaurant or bar. Why?!? I work in them and have for 20+ years in some form or another. This is the biggest Achilles heal I will have to deal with in the next few decades. There is a veritable buffet available to me and I now have to control my addiction.

I have talked about control before; but, I feel it is almost Zen-like when it comes to how I am approaching this life altering decision. I know I have support.

So, back to patience. I can't wait to have my pre-op with my Doctor. Why can't it be now?!? I have so many questions and want to know everything that is going to happen. I wonder if I can get a DVD of the surgery. Is that gross, is that too much? I'm going to have an ultrasound on my Gall Bladder. Will they take it out? Everyone I've talked to that has had the procedure has said they just remove it. Don't I need it? Doesn't it produce the bile by which I digest? Here is what I found:

The adult human gallbladder stores about 50 millilitres (1.8 imp fl oz; 1.7 US fl oz) of bile, which is released when food containing fat enters the digestive tract, stimulating the secretion of cholecystokinin(CCK). The bile, produced in the liver, emulsifies fats in partly digested food.

After being stored in the gallbladder, the bile becomes more concentrated than when it left the liver, increasing its potency and intensifying its effect on fats.

Bile secretion and gallbladder function

1. Composition and function of bile Bile contains bile salts, phospholipids, cholesterol, and bile pigments(bilirubin).

a) Bile salts: are amphipathic molecules because they have both hydrophilic and hydrophobic portions. In aqueous solution, bile salts orient themselves around droplets of lipid and keep the lipid droplets dispersed (emulsified), aid in the intestinal digestion and absorption of lipids by emulsifying and solubilizing them in micelles.

b) Micelles Above a critical micellar concentration, bile salts form micelles. Bile salts are positioned on the outside of the micelle, with their hydrophilic portions dissolved in the aqueous solution of the intestinal lumen and their hydrophobic portions dissolved in the micelle interior. Free fatty acids and monoglycerides are present in the inside of the micelle, essentially "solubilized" for subsequent absorption.

2. Formation of bile Bile is produced continuously by hepatocytes. Bile drains into the hepatic ducts and is stored in the gallbladder for subsequent release. Choleretic agents increase the formation of bile.

Bile is formed by the following process:

a. Primary bile acids (cholic acid and chenodeoxycholic acid) are synthesized from cholesterol by hepatocytes. In the intestine, bacteria convert a portion of each of the primary bile acids to secondary bile acids (deoxycholic acid and lithocholic acid). Synthesis of new bile acids occurs, as needed, to replace bile acids that are excreted in the feces.

b. The bile acids are conjugated with glycine or taurine to form their respective bile salts, which are named for the parent bile acid (e.g., taurocholic acid is cholic acid conjugated with taurine).

c. Electrolytes and H20 are added to the bile.

d. During the interdigestive period, the gallbladder is relaxed, the sphinc- ter of Oddi is closed, and the gallbladder fills with bile.

e. Bile is concentrated in the gallbladder as a result of isosmotic reab- sorption of solutes and H20.

3. Contraction of the gallbladder

a. CCK: is released in response to small peptides and fatty acids in the duodenum. tells the gallbladder that bile is needed to emulsify and absorb lipids in the duodenum. causes contraction of the gallbladder and relaxation of the sphincter of Oddi.

b. ACh: causes contraction of the gallbladder.

4. Recirculation of bile acids to the liver.

The terminal ileum contains a Na+-bile acid cotransporter, which is a secondary active transporter that recirculates bile acids to the liver. Because bile acids are not recirculated to the liver until they reach the terminal ileum, bile acids are present for maximal absorption of lipids throughout the upper small intestine. After ileal resection, bile acids are not recirculated to the liver, but are excreted in feces. The bile acid pool is thereby depleted and fat absorption is impaired, resulting in steatorrhea.

Neat. I will wait to hear what the Doc has to say. Yet, I can't wait. For those who don't understand what I am having done, here it is:

How is the Roux-en-Y gastric bypass performed?

In Roux-en-Y, the stomach is divided, and a small pouch, which limits calories that can be taken in on a daily basis to less than 1,000, is formed as simultaneously the majority of the stomach is sealed off. A portion of the small intestine is then divided and sewn to the newly created small stomach pouch. This process limits the body’s ability to absorb calories. This procedure can be performed as a standard open surgery, or as a laparoscopic surgery.

How is a laparoscopic procedure performed?

Laparoscopic (minimally invasive) surgery involves several very small incisions rather than open surgery, which uses one large incision. Once the patient, who has been given general anesthesia, is asleep, a harmless gas is introduced into the abdomen to move the organs so that the surgeon can work in increased space and can see more when a tiny camera (a laparoscope) is inserted into one incision through a narrow hollow tube (a trocar).

This technique allows the surgeon to view images of the surgery site on a video screen. Then through other trocars inserted into the remaining small incisions, the surgeons introduce and manipulate long narrow surgical instruments that allow performance of the same procedures that take place in traditional open surgeries.

What are the advantages of the laparoscopic approach?

At the University of Maryland Medical Center, we only use the laparoscopic approach for Roux-en-Y because of the many advantages, including quicker recovery and shorter hospital stays, as well as a significantly reduced risk of wound infection. Patients also report less pain and quicker return to normal activity.

Thanks for reading. More soon.

Hesitation and anticipation

So, there are butterflies where I thought courage would be. My Doctor, Dr. Thomas Jones, MD, is an artist of sorts and supposedly has a complication rate of 1/2000 Gastric Bypass procedures performed. I have a hard time dealing with something when I am not in control. No, I don't want to wait until I pass 7 years of Medical School, residency and the like to perform the procedure myself. Ask my wife how long it took me to get over my fear of flying (which is actually a great story-thanks to Old Chicago...). My point is that although I trust that my doctor will have my best interest in mind and hands and that thousands of these procedures are completed every year, I still have some trepidation due to the fact I'm not in control.

Look at where I got with being in control of my eating so far. My addiction has won and now I am going to get the help I need. I love the absolute that this surgery will give me. Sure, for all intense and purposes, nothing is 100%. I feel my strong will, coupled with the surgery, will prove the proper defense. If I'm told I can only eat 3oz. of food at each meal, must take a multivitamin and other substances for the rest of my life, can't drink liquid with my meal or have any of my wife's sweets anymore...yeah, I'll be depressed for a bit, but that's the addiction talking. Once food is removed as the addiction, life can progress as it should have.

I can't wait to see the new me develop. I can't wait to shop at Target again or wear a suit or tie my shoes without falling short of breath. I want to not be an embarrassment at the pool for my Daughter. I want to look good for my sexy wife. I want to wear sexy striped shirts and take my wife places only pretty people go. Mostly, I want to be around for grandchildren and great grandchildren and become the person I have always felt inside that I can become. Through all the layers of fat and depression and anger and pain, there is a Chris Seiple just waiting to get out.

I didn't receive a call from Methodist today like I thought I would. I will call and check in tomorrow morning, as I am anxious to get the ball rolling and get this body into the shape it needs to be in for the rest of my life.

I credit a regular at my place of employment, Jay Sutherland, as the one who really made the decision easy to make. Jay had gone through the bypass experience. He was at 415lbs at his heaviest and regrets only that he didn't have the surgery sooner. His tale and insight has been inspirational ever since he made me understand that I have an addiction to food. That explains why I sneak food, even to this day. I've gotten very good at covering up my traces of gluttony. It was like hearing my own life when Jay described the food addiction as bad as heroin, alcohol or cigarettes. People who don't have that problem have no understanding. When you're an addict, you eat when you're hungry, when you're not hungry, when you're bored, when you're sad, when you're happy, depressed or exhilarated. It happens for any reason and at any time. I'm so glad that Jay, this unassuming person, that I would have never imagined in a million years, would be the one who took the time to help. Thanks Jay.

So, that's it for today. It's raining out and just got done with helping with my daughter's homework.

So, when I started this entry, I had not heard from Methodist. I decided to call them and guess what!?! I got my Pre Opt Dietician appointment scheduled, I got my Surgeon Consultation scheduled with my Dr. and I'm having a Gal Bladder Ultrasound. I'm still hoping that I can have this done before my birthday in July; but, I understand I am but one in a sea of thousands looking for the same "cure". Yes, I know this isn't a cure; but, for those who know me, you will certainly think once I set my mind to something, I accomplish the feat with great intensity. Through the dark clouds today, I'm still walking on Sunshine!