The Journey to becoming a Pre-Op
From 1/2001 until my surgery on 7/17/2002, I was in the hospital about every three months for cellulitis in my left leg. The swelling in my leg (a combination of lymphedema & chronic venous insufficiency) caused the skin to be stretched so far that it would begin to lose integrity and I'd have open sores and the lymph fluid-enriched tissue provided a perfect growth medium for all sorts of nasty bacteria - including a rather nasty one called MRSA (methacillin-resistant staph aureus) to grow. It was a rather predictable cycle - go in the hospital for a week of bedrest, IV antibiotics and IV Lasix, go home for a couple of months as the leg started to get worse and worse and then by the 3rd month, it'd be bad enough for my PCP to put me back in the hospital.
I was working from home, being able to travel little to none in a position that required it and my career was suffering as a result with impacts to my bonuses and my salary. My non-work activities were little to none as a combination of the super morbid obesity and the lymphedema and I was basically an invalid. I was angry at God and at life - I had been saved from dying from the non-Hodgkins' lymphoma back in 1995, but for what? This was living??? No - it was dying. I knew that unless I did something, I was not going to live long enough to see my kids grow up.
The first time that my wife Geri suggested WLS, I was highly resistant to the idea. Then my PCP, my vascular doctor and a plastic surgeon I consulted about a possible debulking operation on my leg all suggested the surgery. I was still resistant to the thought of gastric bypass surgery. Then my vascular surgeon during one of my hospitalization in 2001 said to me "John, if these recurrent infections and lymphedema and circulatory problems continue with your left leg, you stand a real chance of losing that leg."
That was a shocker. There was no way that I was going to be able to function at 425-450 pounds with a prosthetic left leg - no way... Therefore, I had the possibility of whatever time I had left on this earth being spent confined to a wheelchair. I still wasn't ready to commit to having this surgery but the possibility of having it was crossing my mind. During the same timeframe, my wife took care of a post-WLS patient at Riddle (she had had the surgery elsewhere and this hospitalization was non-WLS related) and was talking to her about me. This patient - who didn't know me from Adam - was kind enough to loan me a copy of Barb Thompson's book Weight Loss Surgery - Finding the Thin Person Hiding Inside You
Pre-Op to Surgery Day
Well, reading Barbara's book was the clinching blow. I started researching this surgery extensively. The plastics guy had suggested Dr. Raper at HUP and I decided in mid-October 2001 to make an appointment with him and was given a date of April 2002. I asked what the waiting time was for Dr. Williams and found it was even longer. So I decided to spend the time until my appointment continuing to research the surgery. I continued to have health problems from the leg though. I was hospitalized in early January 2002 with cellulitis and then two weeks later was hospitalized with pulmonary emboli in both lungs - probably from a blood clot in this left leg that had gone unnoticed with the other problems that I had with it. I ended up going back in shortly after my initial consult in late April for another hospitalization due to the cellulitis.
Well, July 2002 came and it was a race to see whether I was going to be in the hospital first for another leg infection or for the weight-loss surgery. My leg had "sprung a leak" - I was leaking clear serous fluid which was not stopping. I'd bandage it at night and the bandage would be soaked through by morning. Well, I decided to tough it out until the surgery date. If I was hospitalized for the leg first, then my surgery would end up being delayed for goodness knows how long and I couldn't afford for that to happen.
The morning of my surgery, as I was laying on the table in the pre-op area and saw Dr. Raper, I decided to tell him that my leg had started leaking that morning. I figured that this would minimize the impact of this disclosure and avoid cancellation of my surgery (and I was right...phew!). Well, believe it or not, after the surgery, that leg never leaked again.
The past year
I got out of HUP after 5 days of being in there and less than a week later, I was in the hospital at Riddle - for the leg. That was the last time. Between continuing to work from home and keeping my leg elevated in a reclining chair all day and the weight loss that followed the surgery, the leg has remained pretty much at normal size. The leg is permanently discolored from the lymphedema and its effects, but it's otherwise a healthy functional leg and one that I can keep.
I went in for my first post-op visit at 3 weeks and had lost 37 pounds. Shortly after that, I went to my first support group meeting as a post-op and had lost another 37 pounds. 74 pounds gone in less than two months!! I was able to go to the Jersey shore) around the two-month mark and walked a total of 8 blocks with no problems.
I had a little setback in my walking program (I was doing 1/2 to 1 mile almost every day) when I was in a class in Columbia, MD in October when I had severe right knee pain upon standing and my initial few steps. It felt better the more I walked, but I didn't want to aggravate anything by walking at this point. I made an appointment with Dr. Kain (ortho) and he basically prescribed rest. I stayed off the walking program for a week and took some Ascriptin (Maalox-coated aspirin) as recommended by Dr. Raper and I've done OK with it from that point on. I just modified my walking and added some other exercise like bike riding. When the knee acts up, I take a day or two off from exercising.
About 5 months out, I was down to 301 and got the picture done that is up at the top left of this page.
In December, I spent 7 days with Geri, David & Rebecca down at Walt Disney World. I had no problems doing all of the walking that is a part of such a venture *G*. Walking through the airports without the need of an electric cart and not needing a "seat belt extender" were additional joys. I fit on all of the rides that I wanted to go on - including Splash Mountain and Space Mountain.
My 6-month check up saw me at 288 - that's 159 pounds down. I had a repeat sleep study in March and unfortunately, I still have sleep apnea - although I am down to an average of 8 episodes an hour (vs many, many more before) - a level of "mild sleep apnea". I went back on 3/27 for another sleep study to titrate my new level - down to 7 lbs pressure instead of 11, so we are getting there. Got Aetna to foot the bill to lease me a new CPAP machine. The sneezing and dry mouth has stopped with the decreased pressure.
Now
Well, it's July 17, 2003 and I am one year out. I've got my life back. I have a much more active lifestyle - I walk and bike for exercise and I've joined the Y. I've got some shoulder problems that are preventing me from doing a bit right now, but I'm taking physical therapy for that. I walk through the store instead of waiting in the car...I enjoy walking through the stores and the mall (especially in the summertime).
My weight - although it's remained steady the past month - is much much better than it was a year ago. I was 427at the time of my surgery and am 247 a year later - a 180 pound loss. My leg has been well and I had enough health to get out of my old System Engineer position at Siemens to take a new position in the same company. I'm sure that the weight loss also gave me more confidence during the interview process as well.
Where do I go from here??? Well, I want to get down to 213 pounds (which will mean a total of 214 pounds lost). I had hoped to be there by my one-year anniversary, but that didn't happen. So, I'm shooting for Christmas as my new time limit to reach that goal. I've gone from wearing size 64/6X clothes to wearing 46-48's and XL-2X clothes. And while there is always the possibility of getting hit by a bus tomorrow, I'm not staring death or permanent disability in the face like I was a year ago.
Thanks to everyone who made this last year possible
Geez, I hate doing these "thank you's" because there is always someone that you will forget and feel bad about it afterwards... Let me apologize in advance.
First and foremost, thanks to my wife Geri and my kids David and Rebecca for being with me every step of the way. I love you all more than words can say. Thanks to all of the people on the UPENN-WLS list that helped me and were there for me before and after my surgery - Don, Dave & Marybeth, Ellyn, Dan, Phyllis, both Chrises, Mags, Barry, Stacy, Patti-Pat, Kathie, Val, Laurie, both Charlenes, Dorothy W., Joe, Ken, Maryann, Mariann, Marianne, (geez, I hope I got all of the MA's *G*), Kathleen (aka CatQ), Steve, Brian, Alicia, Angela & everyone else who I have forgotten to mention... If some of you are saying "well, I never helped JR - he was the one who was there for me"; well, being able to share my experiences and help you through your journeys has allowed me to "pay it forward" If it wasn't for a previous postie paying it forward and loaning Geri her copy of Barb Thompson's book for me to read, I may not have had this surgery yet. As I said before, this lady didn't know me from Adam - she could have simply given Geri the title and author of the book, but she felt it important enough to lend a perfect stranger her own personal copy.
And a big thank you to the medical professionals who helped along the way...to my primary doctor, Dr. Daniel Soffer...to my vascular surgeon, Dr. Robert DiGiovanni...to the staff at HUP...Susan, Rachel, Wanda, Dr. Sarwer (who unknowningly gave me the challenge that spurred me to the 180 pound weight loss to date)...and finally and especially to the surgeon who saved my life - Dr. Steven Raper.
I love you all...
JR