The Driver!

It is 6 o'clock in the evening the day before the the day of the operation. I was told i could eat whatever i want before the operation, but that i would only be allowed what i get from the hospital from the time i check in.

That was a pretty good deal i found, as i had heard about others having to diet for weeks or even months prior to the operation. As said previously, the only drawback of having the operation earlier meant that i was missing out on a weekend full of comfort food which i had planned, but at the end, that was a small thing to give up for the benefits i was going to receive by this operation.

I checked into the hotel, sorry, the hospital at around 4PM and, said goodbeys to wifey who departed on her transatlantic flight. Tried to get myself well installed by putting my stuff away in the locker cupboard and side table so i would be able to reach what i needed from bedside without having to move too much. Checked how far i could reach with the left arm and the right arm.  Was smart enough to bring my own extension cable to connect my Blackberry and new Ipad easily to the wall from bedside. Ha! Learned that from the last visit!

I did not carry any snacks for this overnight adventure, so i found myself traveling quite light this time. Had underwear, tshirts, socks, slippers, toilet bag and some other stuff maybe to, but only needed the last two as i was to be dressed in a hospital shirt (only) anyhow for the operation and days after it, so i was told. Talking about the hospital shirt... So here's me, not grossly over obese like some other people i have seen, checking in for a gastric bypass. Now, as a nurse you know you have two sizes of shirts, big and medium... Are you really going to ask me to pu on a medium? Thanks for the compliment, lol, but really....lol!  Now, note that all those shirts only close with one small button at the back, that is, if the two pieces at the back can reach each other, else guess who was mooning my sweet old man neighbor? Yes, so i asked for the bigger version of the shirt, wouldn't want my neighbor to suddenly get very talkative for the wrong reasons, now would i!

Hold on there, i forgot to introduce my "neighbor" in the room. Last time i was bedridden in this room i had a young fellow as a neighbor, not too talkative, he never got any visitors and had told me his wife was pregnant and he had a kid which was overactive. He was cool, even exchanged numbers when he left, but we never stayed in touch.

This time i appeared to have somebody in the room who was considerably older than me. He stayed quiet in his corner, the nurses told him he is getting a new neighbor as i walked into the room. All i got was half a smirk. Nevertheless , i pleasantly wished him a very good evening, he wished me back the same. It was clear that we were not going to become bosom friends or anything like that, but i didn't mind, as long as he stayed reasonably silent at night i would not have a problem.

Now for something else, check this...not only did my wife have to go traveling whilst i have the operation, she also had to leave me behind with the notion that one of the cuter nurses had recognized me from last year's operation.... hahaha, hum, ok, so that was not funny, strike the laughter from the notes, your honor! Feather in their hat though that they recognize people they have dealt with in the past. Some of the other nurses were unsure if they should recognize me or not, they thought they did, but maybe from the grocery, ballet class, the swimming pool maybe? Ok, scrap ballet class, i definitely do not look like a guy who visits ballet classes that often, but still, some looked at me with a "like i have to know you, but i don't know from where" look. Anyhow, was fun to see that some did remember me, my wife did not appreciate it as much as i did though.

Now i was starting to get hungry, but i am focused! I will NOT walk down to the cafeteria to snack on something. As those thoughts were going through my mind somebody knocked on the door, in came the kitchen people with my last meal. Hmmm, my "last meal" eh? No, i think not, i will accept it as the last one pre-operation, and i am sticking with that! So lets see what i got, potatoes with minced meat rolled into a sliver of veal and green string beans. It all tasted quite alright,  even got a small desert with it and washed it all down with a healthy glass of mineral water of an excellent year 2012!

I noticed my neighbor didn't get any food. Felt sorry for him and didn't dare to talk to him about the food because i did not know how he would react. We actually did not speak to each other for the rest of the evening, he stayed hidden behind the curtain that separated our two beds, but i did catch him peeping sometimes to my side of the room. We'll see, i thought, how it goes next days, i was pretty selfish at this time, just concentrating on eating my meal, making sure i don't overeat, over drink and that i chew everything plenty. Not that i had been told to do so, but it just made good sense to me. I was being at my best behavior and did not want anything to disturb this yoga type of mental state i had put myself into for the operation. I was focused, stress free and determined. I turned on the TV and the choices were french, italian, german, even arabic stations if i wanted, oh, yes, and also CNN and CNBC  in english, you know, those two stations with exhilarating programming which can keep you occupied for hours if need be, yeah right...lol

Aaaand here's my brother, he arrived. Flew in just to come and keep me company. The best brother in the world! Brought me greets and magz from back home. He was allowed to keep me company for a couple of hours, then i sent him home by me where i arranged some baby back ribs for him. Dare i say, slightly better menu than i got...hahaha

Anyhow, it was almost 9h30PM now. Again common sense prevailed, gotta go to sleep because i know they are waking me up the next morning at 5AM and maybe they will even come and disturb ole grumpy and me in the middle of the night for vitals of my dear neighbor. I was right. 2AM reaches way too quick to my liking, grumpy got his vitals taken, nurses back out, me back to sleep, yes!

Lights on, it's 5AM, wake up time in military school, in prisons and yes, for me in hospital as well! Nurse comes to my bedside to ask me if i want to go and shower as i am being picked up at 7AM for the operation. Ooooh, yes, that's what i am here for? An operation? Yeah, duh! Well, got myself up, proudly assembled everything i needed for shower and change. Remember? I had stowed away everything properly last night? Was as proud as Mr. Bean would have looked, with a big smile on my face, ready for that shower! Oh, let's first check what size shirt i got to change into, cause did not feel like getting out of the bathroom half naked to beg for a bigger shirt! Ok, shirt is good! Then nurse tells me i cannot use my own soap, have to use a special anti-bacterial soap from the hospital, no deodorants, no perfumes, but was allowed to brush my teeth! So there i was, all ready with my properly stuffed toilet bag and all i was allowed to use was my own toothbrush and toothpaste...oh, well!

Mr. Grumpy had not been asked to go and wash himself, i figured by then he had had his operation already, but what? I was in the visceral section of the hospital, i figured it wasnt the same as me, unless he lost 40 kgs in the last three days since his operation, which was extremely unlikely. I would, i figured, find out at some point what had happened to him.

Anyhow, back to me! Have showered, am clean, new shirt, so just went on the bed to wait now for the butchering hour. Minutes passed, plenty of them and then there was a next knock on the door. No kidding, i am in Geneva, it is 7 o'clock on the dot! These Suise don't make joke with heir timing! It was my "driver". This hospital is so big that they have a department of drivers who do nothing else but drive patients around the hospital on their beds. It is taken very serious, as these drivers actually have training and practical exams to do before they are allowed on the corridors with patients in those big beds. I can also see why, those beds are huge, wide and heavy. If you bounce anything, the patient will get whiplashed and the object hit would suffer too. As i was being "driven" to my operating room, i could not help but satisfy my inner curiosity by asking the fellow how long it takes an average person to learn the location of all the departments of the hospital, all the test rooms, all the lab rooms and investigation areas for patients. He told me about two months, just for this department of the hospital, but it can take up to a year to get to know the whole hospital. Wow! Had i had a drink available i would have called for a CHEERS with the glass up in the air hoping he brings me to the correct operating room so they don't bring me wrongly into a room where they try a cesarian on me trying to find a baby in my big belly!
Anyhow, it seems like i reached the anestethic's room, the one next to the operating room, this is it, so it seems, it's going to happen.

Prepping for the operation, it is serious business!

Less than a week before "D" day of my operation I get a call from my surgeon. He tells me:"I have good news for you!". Good news? What could possibly be "good news" from a person who is about to cut your insides to pieces and then puzzle it back together again? My brain quickly interprets that as it could be nothing else but: "You don't have to do the surgery again because we juuuuuust developed a pill yesterday evening which you could take for a couple of weeks and lose all the weight that way!"

Yeah, so no such thing. Instead it went more like this:"Well, usually, if I have to call patients it is to tell them that I have to postpone their operation. On your planned operation date of next week Monday I have had to reschedule my work and perform an urgent, very invasive cancer surgery, so I would not be able to do yours. But as I said, you are lucky, I can do yours earlier rather than later! How's this Friday? Can you can arrange your life around it?"
Gulp!
Me:"well, of course I understand that the cancer patient has all priority, and by all means, yes, please go ahead. I will have to talk to "The Boss" though regarding Friday as she will be traveling. I promise to call back within a half hour."
Gulp again! And there goes my last weekend of pigging out...hahaha, I thought! I had so planned to go and have a fondue here in Switzerland, and have a McDonalds or two before that is cut out of my menu for months to come!

But had to set priorities straight. I had not heard mentioning of any another definitive alternative date during my short conversation with the prof if I chose not to do it on the Friday. I rather had the impression it was more a "do it now.....or maybe some time in the future" choice. So my choice, personally, was made up immediately. Like Mae West said:"Those who hesitate come last". By the way, not that i am such a big fan of Mae West or anything, just noticed some poor twitter soul post that this morning and thought that would look cool on my blog right here! Admit it, before you read this explanation of why i inserted it, you were subconsciously admiring my ability to come up with a fitting quote, eh? Anyhow.....

Now it was time to break it gently to wifey. Poor thing has had a couple of career changes in last years, now again building a new career,with a  hubby who isn't doing much except for being in hospital and recuperating, she has a  big trip planned for work, and now I have to go and tell her that whilst she is on a transatlantic flight, I will be having a possibly five hour operation. Again... I was more concerned about her willingness to accept this now yet again, rather than being concerned about the operation itself. She has been a jewel, a diamond amongst women, and has after all made it possible for me to undergo this operation. For me, therefore, it was of the utmost importance that she felt somehow comfortable in this whole situation, in for her, most non-comforting circumstances. I think, yes, the usually cool me, would have gone bonkers,  if I would have had to go flying for work whilst my wife was having a quite invasive surgery.

There is a big difference though. In this case I have been contemplating such or likewise surgery for years really. I was so relaxed about this surgery, firstly because I was mentally ready for it and secondly because I was very confident in the surgeon and the nursing team. After all, I had experienced the whole team just last year when they removed my gall bladder whilst treating me for a pancreatitis, and trust me, if you ever do need to get operated on, this is the place you want to be!

So with all the sales skills I have, the diplomacy of a professional and with one of the hardest sells of my life, I was able to convince my wifey that doing it, that operation whilst she was traveling, was the best thing to do. I had a sell, I convinced her and I was happy!

Called the prof back and told him it was a go ahead! Date was set, would go in on Thursday evening, that is, wifey would drop me to the hospital on her way to the airport, virtually tuck me in, and then it was up to me.

I also knew I had Sarah I could count on, Mr. Dias who would do anything to help out and my wifes staff at work who could be a rescue team if need be. My wife also pleaded for my brother to come over just for the operation so there would be somebody who is at ease in the French language, family, just in case things would go wrong and any decisions would have to be made. And last but not least, my mummy would be there days after the operation for the extra tender loving care if need be. I was in good hands!
Knowing my brother would be there, knowing the good professional team was available, it set my wife's emotions just over the brink of leaving me in good hands whilst she travels. People have told me i am brave to willingly do this operation without having an acute need to do so, I say I was not the brave one, for me it was no more than logic, the brave ine was my wife, and hats off to her!

Checked in, got shown to my room and my bed. You would have noticed there wasn't that much funny about this process, as nothing really seemed funny, this was real, it was serious!

Only curious fact was that i happened to land in exactly the smae room and exactly the same bed as last year's operation, to me that was a good, comforting sign. I was ready now!

Tough goodbye's with wifey, lying alone now, on my hospital bed with my hospital shirt on, browsing what the TV could bring.... Yep, this was serious, no laughing matter at all!

The Dietician, the Bad or the Ugly

I guess, for most of my life, dieticians have not been my best friends. One could say for obvious reasons. So that makes that my visit to this dietician was met with some form of apprehension from my side, expecting this professional to come and lecture me  on what to do and what not to do to lose weight.

My experience with dieticians dates back to early school days when we had a compulsory day at the clinic, every two years i believe, where all kids six years and up would be checked from top to toe to see if everything is in good order. And so i as well, got regular check-ups up to the age of about twelve. Tests included body checks,  psychological tests and the usual talk with the dietician, which for me usually was the climax. Every time we went we got the same dietician and every time she would lecture me on calorie intakes, the necessity of physical exercise and the healthy foods to eat instead of the greasy, oily or sugar foods pushed by our commercial society. It was a very depressing talk, every time again, because it would mean to give up on all of the good stuff in life, just to get a bit thinner? My understanding of life at that point had other goals, i am afraid.

And with repeat lectures every time by the dietician, maybe some truths of life would have sunk in eventually, had it not been that the dietitian, a woman by the way, was getting, let's say " more bodily rounded" every time i saw her? Yes, you can stop smirking now, i was not allowed to smirk either when i was in her office. I was even self trained to keep a very serious face, evolving into an overall depressed look by the time i left her office quarters, you know, just as if to show that the lessons had sunk in deep. Her secretary, seated just outside her office, told me on my last visit not to take the dietician too seriously either, cause she had seen the dietician eat many unhealthy things for lunch and that her favorite snack was chocolate, if you could call it snacking still because she turned to her vice much more often than she would want the world to believe. Ha! Gotcha, Mrs. Dietician, betrayed by your own staff.

So as i got bigger over the years, what was i to do, go back to a dietician? There really was nothing a dietician could tell me that i didn't know myself already, eat less, eat healthier, do more sports.

And here i am, scheduled for the gastric bypass at age 46, and now having to meet a dietician again, you can imagine my apprehension and gumption to see this person. Anyhow, arrived at same hospital again and asked at the reception desk where i could find said dietician and they directed me to the third floor, yes, via the orange elevators (see my post on the psychologist) and to ask the reception there to guide me further. I arrived there and this next reception told me to go all the way to the end of the hallway, then take a left and you will see a secretary there. So did my long walk and found the secretary, but this secretary told me that yes, they do have dieticians there, but none by that name. I showed her the letter of invitation i got and she told me she would look it up in the hospital database. No such dietician on the database. The secretary then offered to call the number on the letter but got an answering machine instead, so no help there. I had no better idea than to go back to the bariatric department, to the people who wrote me the letter, for sure they would know where i can find this person? I figured if i go down this huge staircase two flights and then take similar long corridor backtracking what i did on the third floor, then i would land pretty close, at least. I was right, hadn't it been that there was a wall between me and where i wanted to reach, a pretty new wall too, freshly painted. Cuss, cuss, damn, damn, so figured i best backtrack the whole way now to the first receptionist, else i am going to get completely lost in this huge building.

On a separate note, when you are a patient, hospitalized and you are bedridden ,  there are "chauffeurs", drivers, who will push you from your room on your bed to your next appointment in a next department. I asked a couple of them how long it took them to know all the rooms, all the departments, all the technical rooms of the hospital. The answers varied from two to three months up to even a year for the specialist things. Just wanted you to get an idea of the size of this hospital!

So having backtracked my paces i found the secretariat who issued my invitation letter to see the dietician. To my surprise this secretary as well said she didn't know exactly where this dietician was located, so she called the head of the department who was so kind to come to the office and guide me to the dietician's quarters. This department head, professional as she is, and in line with good hospital practice  asked if i could do stairs instead of elevators. My macho reply....OF COURSE! Up four floors we went, eight staircases if one would want to count. By the time we arrived there, in another building, on another floor, i was sure i had lost half a kilo of body weight. Let this dietician tell me i need to do more physical exercise..HA!

I was put to wait outside the door of the dietician and it's kind of funny, because there were different services on both sides of the corridor, at least three or four different offices from different doctors, each with their speciality. That is when the eye game starts, i am sure you are familiar with it. One one hand you have the doctors who are waiting for patients who may be late and they are wondering if you are the person. On the other hand there is me, watching everybody in a white coat suspiciously to see if they would go into the office i am supposed to go into as that may be my dreaded dietician. Not to forget, there are the other patients, looking at each newcomer and staring them down with a look of:"And if you think that you are going to skip the line in front of me, you have another thing coming!". So there is a psychological war going on between all the eyes involved, nobody really knowing what the prize of winning will bring.

There comes the next white coat, a lady, a head smaller than me, blondish hair, skinny and she goes into the office of the dietician. I just sat there as she was obviously not as anxious as the other docs to get a patient into her quarters, i was still early after all. I like being early, it gives me the opportunity to scan areas and to learn from experiences. My brother always jokes at me being early and he wasn't even convinced about getting the worm if you're early. His philosophy is rather that one doesn't have to be early, but rather better to get the worm. He may have a point. But i am sure that if i ask the dietician about who gets the worm she would say that both my brother and i would be fine without the worm!

The skinny lady was then apparently my dietician, just my luck. I got up and presented myself and then we had a nice talk. To my surprise she told me absolutely nothing negative about my weight, she complimented me on the choice of doing the operation and gave me some info about what to expect after the operation and what my temporary diet would be like. She told me i would be drinking plenty juices, water and tea, most foods will be like baby foods for the first days and only later i can add some soft cereals to the mix. She was very helpful with any info i needed, or questions i had. She also explained this thing called the dumping effect. With the bypass surgery, an actual bypass is created from the stomach to the small intestines. The stomach itself, which would normally be one to even two liters content wise, would be made smaller to a maximum content of 33 centiliters, about the size of a coke can. What can happen though, is that if one eats too much food, or undigested sugars for example, the the food is pushed right through to the small intestines. These intestines then in turn make an alarm to the brain and asks it to redirect water from the whole body immediately to the small intestines, and that is a feeling over the whole body which apparently is not a nice one to come across.

But in how far dieticians go, this was actually a very pleasant, cordial visit, without misconceptions of life or unrealistic expectations of life changes needed.

Side note: Between finishing this post and today, i have already had the operation, and all went well. The prof called me that my operation was four days early due to circumstances. I will update you on the operation and days after as soon as i get more energy to write.

No Funeral House on the list!

So the magical day finally arrived, my first ever visit with a psychiatrist. For those who have not read my previous blog posts, no, i have not gone totally bonkers as yet, it was a visit in preparation of my gastric bypass operation. It was the second to last visit of specialists i had to go through and it was the objective that the psychiatrist would do an evaluation to see if i am not only physically, but foremost also mentally prepared for the operation and the years after.

I was undeniably a bit nervous for this "interview"' I will admit, and i think it was because i could "fail" it. Failing it would have meant that he would have thought that I would not be able to take on the stresses and the life changes that this operation would bring along. Nevertheless, that day, i woke up, had my shower, didn't brush my teeth any different from any other day and got a drop to the hospital.

Having arrived, i went to ask at the reception where the psychiatric ward was. I had an invitation letter in my hands, in a hospital envelope and suddenly saw the point of view of the receptionist with me asking that question. Here is this suspiciously smiling guy with an invitation letter asking for where the psychiatric ward may be.... How can i get him going in the right direction without making a commotion right here at the reception desk?

She smiled right back at me and told me to go to the second floor, following the blue line to the orange elevators. Heh, yeah, right, sure... The orange elevators, of course, why didn't i think of that one myself!

I was about 30 minutes early, nothing abnormal for me, I'm  usually early for any meeting and things would have had to go awkwardly wrong if i ever arrive late for a meeting. But having that extra half hour, i thought it would be a good idea to go and look for those orange elevators, and lets not forget the blue line!

Seemed the lady at the desk actually knew what she was talking about, the darling, the orange elevators actually existed, so i took them to the second floor. I came out and there was staring at me, the reception desk for the psychiatric department.

For some totally crazy reason, a weird please to go and announce your arrival. But hey, i still had twenty minutes left and i did have to go to the bathroom, so why not take advantage of the situation as there was a toilet area facing me just on the opposite side of the orange elevators. Good idea to go to the bathroom in a hospital? In a psychiatric department? Well, i was still in "neutral" area, so thought it couldn't be too bad an experience, and hey, at least it wasn't next to the cafeteria where absolutely everybody pays visits after downing all the coffees. It was after all also still early in the morning, so in I went.
Being a hotel management graduate, and an airport management specialist, I do have experience with frequently visited toilets, and proper precautions dictate that wiping the seat is the minimum one can do before taking seat. Placing paper on the seat is a second precautionary step, so i also did that and took place on my throne away from home. Then, suddenly somebody switched off all the lights, yes, ALL the lights, pitch dark it was! I could have sworn that i was the only person in the toilet?
Recap time, i am just outside the psychiatric area, in a bathroom with toilet paper in my hands as last defense for anything that could happen. There was audibly nobody else in the gents bathroom, but maybe they were "testing" me to see if i could hold things up when stressed or if i would run out screaming and get an "F" on my report one time? Then i heard some slight chatter in the room next door, presumably the ladies room, and then a "click" and the lights went back on. Good try ladies, but it will take more than that to woosh me of my throne of bravery. Now, seriously, of all the times for this to happen to me, just outside of a psychiatric area opposite the orange elevators? A master switch for all the lights in the women's bathroom? Oh come on!

So with that bathroom episode behind me, i went in line to announce my arrival to the department, yep, in line.... So that means, behind others, other what? I can only suppose. Waited in line for some minutes before it was my turn, and when the next friendly receptionist (hey, hold on, did she turn off my lights earlier? Eh?) took time to address my needs i was simply told i didn't have to register, just to go to the end of the corridor, turn left and see the secretary there. So said, so done, and when i found that secretary she smiled at me again, i guess she was also taking the safe approach to this new individual coming into her office, cant blame her...hahaha, poor woman didn't know about my bathroom experience.
After some admin matters, she asked me to take place in the little waiting area outside in the corridor. I am easy, so I complied, still was ten minutes early by that time. In the same waiting area was a young woman, also waiting as a patient, I supposed, she was patiently waiting...yeah, ok, lets not go there. I was kind of relieved of all the previous stress there, i was willing to let the cards fall whichever way they did, nothing could bring me out of my concentration for the interview at that point. Now, i wouldn't make note of that if nothing was less true there, now would I ?

This young lady sitting, waiting there, yes, patiently, reading a hospital magazine with the utmost interest, so deeply entranced (should i use that word for anything on that hospital floor?) didn't even see it fit to answer my hello, but i really wasn't going to insist, not on that floor! She did although suddenly jump up, throw the magazine on the table and rush to another corridor, as if she suddenly was late for an appointment, yes, and then returned to read her magazine. She did that a couple of times. After a while she was invited by four doctors to come along, and honestly, it looked to me as if she was applying for a job or something, well, lol, she would fit right in!

There was also the other secretary, a second one in another office, with open doors,  who passed both of us straight when going to the bathroom without saying hello, nor hello again when she came back.
With all these unfriendly people around, i couldn't blame my co-patient/interviewee for delving into her magazine, as i found myself staring down my blackberry, hoping for something fun to read.

And the suddenly:"HHHHaatsheeewww!!!!!!" ... From the corner of the unfriendly secretary's office, a sneeze, so loud that I think even three corridors further echoes of it would have been heard. My co-patient and i both looked up and saw the secretary on all fours, on the floor, between her chair and her desk, looking at us both as we said, in a cool way, both together:"Bless You!".....

Recap II : She had obviously dropped something on the floor and whilst trying to find it got dust in her nose and was caught on her hands and knees by possibly psychiatric patients...poor girl i thought.... I also thought, nice try, i am not going to get distracted from my interview... I am all concentration!

And then the moment came, the psychiatrists door opened, the previous patient came out, looking left and right, i don't know if she was expecting a car in the corridor or something, good grief, anyway, it was my turn now! I am prepared, nothing can blow me from my pedestal!

Yeah, so how do you like a psychiatrist in a wheelchair for a change? Yes, My psychiatrist came rolling out of his office to come and greet me.... Honestly, never wanted to smile so hard in my life and still managed to keep it in...hahaha, the things they try!

Anyhow, psychiatrist was a very nice older fellow, just had a chat with me to verify and make sure that i understand what this operation will do to me physically, that i agree to it and to check if i have family support. Also to see if i think i will able to cope with then resulting changes after the operation, how my diet will change, how my body will change, and how i will need to find other things to preoccupy myself in different ways instead of eating or snacking.

I passed the test with flying colors and he told me he would write my prof a positive recommendation for me to go forward with the operation.

I will tell you, all kidding aside, that i do feel very comfortable with the operating team, all the specialists I have met during the pre-operative interviews and it is good to know that there is a team ready for me, whatever happens along the line. Also good news, they did not add gravediggers or funeral arrangers to the list of people i have to meet before then operation, and that has settled a lot of my nerves as well.

Off to the dietician next!

Psychology 101

Today I am 23 days away from my operation. Thought it would be a good time to start the countdown :-)

From what I have already learned is that the weeks and months post operation are not exactly days and nights to look forward to. But then again, no post operation is exactly a fun time for anybody, so that didn't come as a surprise. In fact, there have been little or no surprises in my online research thus far, except then maybe the pre- and post operation pictures of people who have gone through the procedure. Some are truly not recognizable, very strange how much weight some have lost.

Again although no surprise, the diet after the operation is quite strict, no sugar, plenty protein, daily vitamins to take as extras for the body as the digestive tract has less possibilities to extract the necessary vitamins in the natural way. Apparently a lot of drinking will be needed as well, just like have seen some people do at Carnival, but in my case it will only be water, decaffeinated tea and that will be about it from what I understand so far.

One thing I have been told to watch out for is something called "gastric dumping". As the operation actually makes the stomach smaller, it can of course contain less food than before. If one eats too much, and the food doesn't fit in the pouch anymore, then the food gets pushed through into the intestines, but undigested of course....and that is a very painful experience apparently with stomach cramps.

I am sure that during the days immediately after my operation, I will care little for what, when and how much I get to eat, the weeks afterwards will be the challenge though. Apparently, that is one of the reasons why they employ the services of a psychologist on the team, to guide the patients through the period of behavioral change. People who are obese like me frequently would turn to food or sugars when they are happy or sad, when they want to party or rather cool down, when they are in company or when they want to be by themselves. It really is no different in my opinion to the person who smokes cigarettes or even worse, or the people who drink beers and stronger, or the people who become violent because they have no other exhaust for their energy or loneliness.

The psychologist comes in to make sure I can find other ways than food to deal with all of the above, but not including any other unhealthy vices as replacements of course. And that is important, because when I stopped smoking, that is when I gained weight after months. and continuing for years because I snacked instead of smoking. A positive note, is that they do some handholding to make sure the operation of this gastric bypass is not just the cutting and healing, but a process which is managed years after as well.

In fact, when speaking to the prof he told me already that I am due back in the hospital for check-ups on a very regular base after the operation, not just to check the physical healing, but also the emotional handling of it all. It starts two weeks post operation, then every month for the next six, then 6 months later again, then yearly for the next 5 years post operation. He told me though that most appointments are made way ahead of time, and in years 3,4, and 5 it is not uncommon that people don't show up or call in much later with much apologies, but they just forgot they ever had the operation, their new life is by then felt as "a completely normal life", just to show that normal life will return, but weighing less.

Do some people put back on weight? I have heard some do, but do not have any examples or references to fall back on at this time. I have heard of friends of peeps who have gone through the procedure that they were glad that their friends had put on a little bit of weight again, just to fill the deep pockets in the face as they looked like deflated balloons...lol...I am sure it will not go that far with me.

Ok, having shared that with you all, I am ready for the psychologist next week Friday, bring him on...lol ! You can post in the comments how many rounds you think this encounter will take and who will win...hahaha, wohoho...weeeee....YO... wow! Yipieee! ;-)

The Carnival experience

On a slightly lighter note, just to go off topic for a little while :

I cannot have a blog online, no matter of the main subject, and not talk about Carnival in Trinidad and Tobago.

This country "lives" for Carnival. It is THE main yearly EVENT that absolutely everybody looks forward to, but not all for the same reasons. I will explain.

Carnival is a mixture of different side events, starting no later than the day after Christmas, December  26th. Many will dispute the "start" of the Carnival event as such. Some claim it starts in August with the first presentations of the new carnival costumes for the coming year, others claim no Carnival should be mentioned until after the end of year festivities, others again claim Carnival starts with the first Carnival "fête" (which is the local word for a Carnival party)', whenever that happens. Technically though, Carnival is dependent on the Catholic religion, and tied to whenever Easter falls. I am not going to elaborate there though as it is better explained elsewhere on the net as soon as you google Carnival.

In my own opinion, here in Trinidad and Tobago, it starts on Boxing Day, the day after Christmas, for the simple reason that radio's seem to keep the new Carnival tunes on a low simmering fire and finally burst loose as soon as the last drops of Christmas liquor have been consumed, the last bits of Christmas turkey and ham have been cut, the last carols have been sung and the last gifts have been exchanged. On Boxing Day the new tunes hit the waves and Christmas is immediately been put on the back burner till next year. The temptation is big though to start playing the new tunes of Carnival of Barbados for example of the previous summer, and for the last couple of years i have noticed that the radio jocks seem to disregard that unwritten Boxing Day rule more and more, that is how hot this country is for Carnival!

Now, Carnival itself, again, technically is only two days, a Carnival Monday and a Carnival Tuesday, but the Carnival season may take months, weeks depending on when Easter falls. During that period, between Boxing Day and the actual Carnival days, numerous Carnival fetes are being held at all kinds of venues, all catering to different types of Carnival enthusiasts. All fetes will have music by local deejays, pushing the local music, some will have live performances of which some are more the playback type with live singing and then some show up with a complete band, brass, strings, drums included. Some fetes cater for the "oldies" crowds, some for the teenage groups and some are just a nice mix. Some have Soca music, others more of the Calypso kind, Bollywood style Chutney music is a newer show stealer and this year I even saw a stage with more Euro style Techno music. So there is really something for everybody.

Then there are the "all inclusive fetes" which is exactly as it says, it includes everything, the door entry price, the music, the foods as much as you fan eat (and are willing to stand in line for) and yes, all and any drinks. For the drinkers, this is heaven on earth as you will be able to sample (or drink yourself Lazarus, remember, it is as much as you want) local spirits and beers, rums, but also most of the popular international spirits, whiskies, vodkas, wines, champagnes and cognacs, you name it. Oh yes, and you can get water too, but I think most of Trinidadian Carnival Runners would agree totally with my old great-aunt's statement that water is for the ducks! Having said all of that, not everybody is a drinker, there are people who roam through all the parties high on fruit juices, elegant waters and soft drinks, but would be the exception to the general rule. In fact, there are very religious people who love Carnival, including some of my in-laws who totally enjoy Carnival without any alcoholic drinks whatsoever, no spirits, only spiritual entertainment!

These all-inclusive events are not cheap, but to international standards certainly not expensive, and if you do enjoy your drinks, they are definitely worthwhile, price-wise. There are also eents though where you just pay the cover price to get into the fête and then they have chit-systems where you buy chits and then use them to order drinks and/or foods as you wish.

Talking about foods, you will find all the local specialties, doubles, boiled corn, blue foods, wild meats, Arabic dishes, Chinese dishes, Indian dishes, Italian and Mexican specialties and the rare European dish or the American barbecue style dishes. In other words, unless you have problems standing in line, or if you can not eat standing up or if music and drinks have influenced you more than the smells of the dishes presented, it is hard to walk away from an all-inclusive event hungry. Generally it is not allowed to Cary foods outside the event area, else people would buy just one ticket and carry foods for the whole set of 20 friends outside of the event, but by the end of the party, you would still see the odd person with doubles or pies walking out with amounts which will either feed himself/herself for a whole week or make all the neighbors happy.

Besides the fetes, there are also other side events, there are musical shows, theatre, comedy shows and then there is the pan-playing competition which almost totally separately from the rest is held every year at Carnival to see which group is the champion for the year. There are small bands, medium bands and large bands, of which the latter, on stage, is actually quite impressive and I have not heard any recording, digital or otherwise, which even comes close to how that symphony of notes, beats and differently tuned pan instruments sound in a live performance. If you ever make it here, do not miss out on that! Also, these pan groups hold many training sessions in their own "pan yards", their home bases, where during weeks, many evenings before the competition, you can go and enjoy the pan music, just a bit different from the rest of the instruments, and take in surprisingly melodious tones when it all comes together in a perfect way!

Also not to miss, in my opinion, and I know many local Carnival enthusiasts would disagree with me if I see the poor attendance it gets, is the Carnival Queen and King competition. This is the part where small individual, medium and very large, mostly moving, sometimes lit up, costumes compete for the biggest, most enticing and impressive presence on stage. To me now, the preliminary rounds are the most fun, as just like with ice-skating, it is nice to see all the competitors, it is even better to see an aw-inspiring performance, but admit it, it is also kind of like "fun" to see one fail. And when I say "fun", I mean not if it hurts somebody, but it is just the aaaaahhhh and oooohhh effect from the audience which brings many back the next years.  

Before "The greatest show on earth", as they self proclaimed their Carnival, takes place, there is a mini version, yes, literally a mini version, with and for kids. In the category "cute" definitely the winner of the season. It is like a. Growing grounds for future Carnival players, with kids in all colors masks, made up faces, with special characters of Trinidad traditional mass like sailor's mass, devils, but also from "Pretty mass", pompously clad 19th century ladies.

And then, ladies and gentlemen, come the two high days of Carnival, Carnival Monday and Carnival Tuesday.
Monday morning, early o'clock, Carnival officially starts with "J'Ouvert", which is "opening" in French. This part of mass includes Juve players to assemble before the sun comes up and play dirty Mass, with mud, paint, liquid chocolate, you name it. Don't wear anything you treasure, cause afterwards, all you can do wth your clothing is frame it.

Later on Monday it is almost alike a general rehearsal for the next day. People go clothed in colors of the band they signed up with, sometimes in themed T-shirts and parade the streets in group, drinking, dancing, having fun, still passing the judging points where both the band and the chosen songs are noted and scored.
On Carnival Tuesday, the last day and the pinnacle of Carnival, everybody who signed up with a band comes on the streets, par ding in full ornate in front of the judges. They do this with a mix of sense of duty for the band to portray their characters well, but mostly with an all-out fun attitude, showing off the revelry they have been planning to the stage  to bring for the whole past year.

You would have noticed that in the beginning of this article, I did mention that EVERYBODY looks out for Carnival! Not everybody loves Carnival though, and I can imagine if I would be living along the official route of Carnival, or close to one of the most frequented Carnival fête grounds, then maybe I would dislike it as much as some do now. But, having said that,everybody seems to look forward to the Carnival time, wether it is to play in a band, just to watch as a bystander, wether it is to sell as a supplier or as a foods or drinks vendor, wether it is to make extra money in over hours as police or other agencies, or wether it is to take advantage and go away for a couple of days, off the island to a quiet place to recuperate from all the complaining about Carnival of the last year.

For me, honestly, I did not captivate Carnival at all when I was first confronted with it some 15 years ago, but over the years, under the expert guidance of my wife and her friends, I have started to appreciate one part of Carnival at a time. Now I would have to say that I am still not a fan of Carnival as in that I wouldn't really come back for it every year if it were only for me, but as you noticed, I do believe it is a worthwhile event for anybody to experience at least once in your lifetime, cause else you actually would have missed out on something grand in your life!

My 2nd life, thank you very much!

The whole idea of this intervention I am going to be going through is to start my second life.

I was actually quite fascinated by what my professor told me during my interview and questions and answers session with him. He explained thAt at one point in my life I would have deviated from my normal life expectancy in years as I grew bigger and fatter and more obese. For instance, if I had never become obese, suppose my life expectancy in "normal" circumstances would have been 80 years, then now after being obese it might have been diminished quite a bit, to let's say 70 or maybe even less years.
By doing this gastric bypass surgery, and by then losing most of the excess weight in the months and years following, I would actually return to my original life expectancy, as if I had never been obese or overweight in my life. In my example that would mean I can expect to become 80 again.
It means, and he clarified, that there is actually no "penalty" for having been obese or for having eaten improperly in previous years.
Today is Ash-Wednesday in the Catholic religion, as I am writing this article. And I  can't help but think of the forgiveness part in this religion. You know what I mean... if you have behaved bad in the past, although maybe not always completely  through your own fault, you can be forgiven if you decide to confess. I kind of feel a bit the same way now, I have confessed that I am overweight, that I have not been eating correctly, that I have splurged when I probably shouldn't have, but at the same time it was also my body type that played a role as well. And now that I have confessed, I kind of get forgiveness from my own body, and it will sustain me till the day I was originally destined to die. Kind of neat, if you come to think of it!
But what kind of a life will I be going back to? From what I understand, those first days, weeks, if not months after the operation are not exactly times to look forward to. Painful days ahead, learning a new diet, teaching myself new habits, physical pain. But I have been through al of that already once before, although not all together. Stopping smoking has been an episode of new habits, new ways of looking at life after the cancer sticks in the hand to rely on. Having had the gal bladder removed last year also gave me an idea of the physical pain to be endured, and it is honestly all manageable, or should I call it tolerable?
I have found some nice people Twitter and other websites who have been giving me some previews of what to expect, 1 month post operation and 3.5 months post operation. Nothing again really to look forward to, except then what I keep seeing on the other websites, the before and after pics of people who went through the procedure. Wow if you see those results! It is even a bit of a scary thought seeing myself as a new me after this procedure. One year from now I think that some people who may know me very well may not even recognize me if I change like the people I saw on some of those websites.
So what am I looking forward to then? I am looking forward to move around like any other average person my age, do sports and maybe even excel in one or two again. I look forward to going into stores and buy clothing from the rack, knowing my own new size and them actually having it in stock! I am looking forward to buying a suit without major modifications. I look forward to being less tired, with more energy, although I understand that in the weeks and months post operation it may be even a big challenge to find any energy at all.
In other words, I feel like I am now prepping for a second life in some form, I am being offered a chance to change another one of my bad habits, I just hope I take full advantage of it, that my character proves to hold up just like when I quit my nicotine habit 13 years ago.
Wish me luck :-)

New places where the sun don't shine.

In preparation of this upcoming surgery I have to meet a number of professionals in the medical field for them to assess my complete program, my operation, healing process and guidance after.

I have already had blood tests doe, another day at the bloodsuckers department of the hospital...lol, recall, I was just in there last year and they pricked me so many times in arms and hands that they had no other options left anymore than to stick me in the feet. All my veins were already damaged in the arms and hands. So wasn't looking too much forward to this time, but all went fine, a little more painful than usual, but they hit then source with the first needle prick, which was good news in itself.

Then I had to get my lungs tested, had to go and blow in a machine which tested my lung capacity, and passed that with flying colors. The machine reminded me of an alcohol test (which they might have tested as well without telling me, lol...), but have never done such an alcohol test on the road, only seen it on TV, but that's okay, don't need the experience again, hospital version was quite satisfactory and I will count it as enough experience for now, thank you very much!

After that I had an appointment in the plastic surgeon' office. Was really wondering a bit what they would be doing there with me. I had concluded that as I would be losing a significant amount of weight over only one year, I would probably have an excess of skin which might need treatment of a plastic surgeon, I didn't know, so was kind of curious.
Turned out they just wanted to take pictures of me, hey (!) my very first "professional" photo shoot! I felt I was going places! So first a full frontal, then a profile, which I thought probably would be the less flattering of the two as my belly does reach beyond my belt buckle.
And then naked... What? Yep, well, almost then.... First time a woman other than my wife asked me to strip in front of her, I was alone in the room with her. Apparently I was smiling at the situation, cause she started smiling as well and asked me why I was smiling. She probably also noticed my face getting as red as her hair as I now stood in front of her, with only my boxer shorts.
She sat in front of me, on a barstool kind of chair, the swiveling kind, and suddenly reached forward to pull my boxers down. Yes, she did...ok, so not all the way down you perverts, she stopped under the curly hairline, but above the firehouse by means of a speaking...she said she wanted to see as much as possible on the picture. I though, yeah, if the roles had been the other way around I probably would have used the same excuse, professionally speaking of course!
After she had taken the pics, I dressed and le the room. They were doing some renovations on that floor and those guys saw this redhead nurse leave the room first, me minutes after with a red head and shirt probably still hanging out a bit.... I just saw their thoughts in their eyes!
Mind you, the red headed lady wasn't exactly miss universe 2012 eh... Well, like I am not mr. Universe either, you know! In this hospital the best looking women walking around (whenever my wife is not around, that speaks for itself!) seem to be the female doctors. The nurses are almost all extremely friendly, very helpful, most are very good at their jobs but not the soap series lookers of a nurse...

Last step for me that day was the anesthesiologist (thank god for spell checkers). Waited in the hallway for a good 40 minutes, thought after a while the doc had maybe turned the wrong valve in the office and gotten himself to fall asleep. But finally a door opened and another patient came out, door stayed open, and I was called in. Ok, so here's my luck, the first more than average good looking person I get the deal with and it's my anesthesiologist ...just my luck... Next times I am going to interact with her i will be sleeping away the hours, much to the joy and delight of my wife of course.
Got some good news and some bad news from her. Good news was that she had gotten results dorm my earlier tests that day and that all seems to be very a-ok! We are set to GO for the operation. Then she explained the procedure of the anesthesiology, what they will do to me during the operation, what tubes they will insert where etc.... And what to expect when I wake up, like the tube in my penis !!! Hello? Yes, what? Keeping my cool,she explains she, or rather her "team", which I now envision as a big tall hairy guy in my nightmares, or even two of them, will insert a tube into my penis so I don't have to get up to pee immediately after the operation. I nod with probably a clowneske expression on my face as to say:"but of course!"'.... Any other questions? I quickly said no and left the office before she comes with ideas where to put even more tubes yes! I am now expecting my wife having called that doc before my visit to scare the well, "P" out of me... I also looked for the candid camera and was ready to sign the re
Lease document for them to show my clip....but nothing of the sort...a tube it will be!

So that was my adventure at the hospital, the day before we left on holidays. Yes, I am with my wife in the Caribbean for the moment, but days after I get back, I still have appointment for a gastroscopy, oh I am so looking forward to that...NOT! Also scheduled to meet a psychologist, the bets are now on to see who leaves that office in a better mental state after our meeting. I have an insider tip for you if you are a betting person!
And then, my favorite people in the world, I am also due to meet with a dietician. Oh my God, have I had fun with those people in my younger years. In school we had a yearly visit to a doctor and a talk with a dietician was on my schedule eve time. The funniest part was to see the dietician fatter and fatter every year, and her admin people always winked at me as if to say "you survived her nonsense for another year?".

So stick around, fun times ahead, will keep you up to date!    

I didn't say it - read it yourself

Real or Urban Myth? The Gastric Bypass Ripple Effect
one welcome 'side effect' of gastric bypass surgery: friends and family of the patient usually lose weight too!

More than 350,000 people have had LAP-BAND surgery. Another ~200,000 have gastric bypass each year. Vertical sleeve gastrectomy is the fastest growing obesity surgery, and the new gastric plication, or "pleat" - an evolution of reflux surgery that accomplishes stomach restriction without device implantation or resection - is being hailed as the future gold standard king of the weight loss surgeries. Is this too many people having surgery instead of losing it by less drastic and invasive means (that are not without significant risk).

In Prevention Magazine (August 2011) Dr. Oz focused on weight loss, physical activity, and better sex and overall health. And while some might guess that a physician would be against surgical intervention for weight loss except in extreme cases, that is not the case with Dr. Oz, who says that "we are probably only performing about 1% of the gastric bypass surgeries that we should".

Dr. Oz calls himself an advocate for gastric bypass surgery in reducing the national BMI and stemming the devastating tide of maladies associated with "diabesity", saying he thinks that obesity surgeries will play a major role in people gaining control of their diets and lives.

He points out that a 50-year-old who is ~100lbs overweight has the same mortality rate "as if you have a solid cancer'" (that sounds pretty horrible, doesn' tit? I know, I paused when I read that too - ugh). Dr. Oz points out that in the case of the cancer patient, no one would hesitate to operate...so why hesitate on the obese patient, whose at just as much if not more risk of premature death.

In the world of Oz, if a person cannot lose the weigh on their own, that person should have a weight loss surgery. Do it with counseling and a complete clarity of understanding regarding the permanent changes in your eating and even lifestyle, but do it because "if you get people to start losing 5% of their excess body weight, you're really taking a big whack out of the two-thirds of Americans."

Allow me to expand that tot non-Americans as well - my own note

Source : http://www.squidoo.com/Stopping-diabetes-before-it-stops-you

Other considerations - the genes factor

Other considerations -the Genes thing

There have been some other considerations in coming to the conclusion that gastric bypass may be the solution to my current and possible, or rather probable future problems. When my father read my first blog post he said that I should mention him as well, in fact he wrote me:"You can, you know!".

Physically, body-wise, I am almost a copy of my father, and don't understand me wrong, I am proud of it. In fact, we both are in some ways copies of his father too, my grandfather. We are not too tall, but not exactly short, broad shoulders, wide hands, short fingers, with a waist and middle of the body which expands further than most. We look big, but not morbidly obese like some of the people who are seen on those shows.
This body type though brings a number of problems with it, exactly those which I mentioned that my prof warned me for.... Diabetes at later age, blood pressure problems and with those two as a nice base, a whole list of other problems tend to emerge.

My dad has worked hard his whole life, spent many hours at work every day and now that he is at an age where he should be able to profit from those years of work, his body gave up on him, step by step, with diabetes and blood pressure being the major players. He now has to spend half a day a week just preparing his pills for the week to come, one pill sometimes to negate the negative effects of the previous one. He sits at the table, with lists and boxes of pills and fills plastic containers with his morning, lunch and evening pills for the week to come. He in fact takes pills five times a day, try to beat that!
On top of all of the problems he has, he also has been suffering from sleep apnea for the last two decades. In fact, he was one of the people in the early batches treated by professors for this disease. When he was diagnosed, sleep apnea was not as commonly know as it is today. It basically means he has to sleep with a machine next to his bed which forces wind through the windpipe, as he would not be able to breathe by himself whilst asleep and probably suffocate in his sleep. And here we go withe the genes again, apparently my great grandmother was diabetic as well, as is my father's sister, as was my cousin.
My father also has to take pills which he has adopted as his P-pills, which have him urinating frequently during most of the day with only like ten minute breaks in-between toilet visits. He has to take those P-pills two days out of three. That makes that he now has to plan his week accordingly for anything else he wants to do, including shopping, doctors visits, visiting friends or even have friends visiting him. He now has one grandson, and he and my mother have the grandson at home for one day a week, but even that he he has to plan ahead of time, it really isn't all that easy.
And then there is his heart, had problems since birth with taht one, but also suffered from irregulat heart beats and high bloodpressure at times.
I totally admire how he keeps this life going, and I realize very well that if it were just for himself he may have given up already, but the fighter he has always been, and the provider for the family he has been, he doesn't give up that easily. He wants to be there for all of us, including his only grandchild, grandson. We all love him dearly and hope he sticks around for many more.

But emotions aside, what I see in my dad now, will probably not be far from my reality unless I change things for myself. So now I have some choices, some options presented to me.

To the contrary of popular belief, I do not eat big heaps of food, in fact, I eat very little and may even skip meals from time to time if I am not hungry. I will wholeheartedly admit I eat "wrong" though, I eat what isn't the healthiest of foods and I am also a sugar junkie, carbonated rinks, candy, chocolate and the finer combinations of all as well. So obviously, option number one is to cut all of that and then I will lose the weight. Easier said than done, and probably impossible if "we" are totally honest about that. Have done it in the past, but gradually all comes back, after months or even years.

Do more sports, people tell me. Yes, an option, but not easy either as doing sports with my body isn't that easy to start with, and injuries would become plenty as I am quite competitive when I do sport. And sport makes me hungry, so vicious circle if you ask me, and not my solution.

But to be honest, in cutting all the good stuff out of my life and adding plenty sports, eating only what is healthy, I think i probably could ( ok, let's be honest, I KNOW I could) achieve the same results over time as the gastric bypass surgery could bring me.

Two things though:

1) I know somebody who lives that way and although he seems happy with it, I really don't think I could be, the way he lives.

2) One of the profs told me that I have now passed an age barrier where the above solution would very very hard to achieve, as when we get older it gets harder to maintain the sports level, and our metabolism also naturally slow down as well...so even harder to achieve, He claims that if i were to lose all the wieght at this age, i would probably have everything back by the time i turn 60.

So taking all of the above into consideration, I think I am making the best decision, with the gastric bypass solution.

Oh, I had spoken to the profs as well about possible other operations, similar to gastric bypass, like for instance the gastric band, a rubber band which is placed around the stomach. There are even newer and even less invasive techniques as well popping up. Prof said that the gastric bypass is now a thirty year old technique, improved with better technology over the years, but there is no other technique which delivers the same amount of history to build on. In other words, we now have people who have had this surgery thirty years ago and we know that they are still fine today, so it is a proven technique, there are little or no surprises left.
That is also why the prof said that, listen, this operation is a major operation, and it carries risks like any other major operation, but if you weigh these against future health risks, well, basically, he can't tell me what to do, but those are the facts.

And again, with the knowledge of all the above, what do you think? Am I not making the correct choice?

Today I am one month pre-operation.... In one month time it is my turn, a scary thought now, but hopefully I will be able to laugh it away at the next Christmas dinner :-)