15Aug/17

How Much Did The Surgery Cost?

One of the first questions I get asked when people find out out I have had Bariatric Surgery is… “How much did it cost?”

Firstly, let me say that if you are seriously thinking about this surgery, then either get your private medical insurance increased to the top cover or take out private medical insurance with the top cover. Its not a cheap process even with insurance, however, without insurance it would be beyond most people’s budget without taking out finance or accessing other forms of funding like superannuation, re-draw facilities etc.

If you decide to increase your private health fund to the top level or take out a new policy, most providers have at least a 12 month waiting period until this surgery is covered. The main cost is not actually for the professional costs of the surgery itself, but more so for that of the private hospital where the surgery will be performed. Currently in Australia there is very limited opportunity for this surgery to be performed in a public hospital and on the rare occasions it is, it is on patients that are deemed to need it the most more so than a “first come – first serve” basis.

So here are the costs Ive incurred so far…

Surgeon

Initial Consultation:         $160.00                Medicare: $72.75         Bupa: $0

Second Consult:                 $88.00                  Medicare: $36.85         Bupa: $0

Surgical Fee:                      $4503.50              Medicare: $703.60       Bupa: $234.50

Anaethetist

Initial Consultation:         $300.00                 Medicare: $106.40       Bupa: $0

Surgical Fee:                      $1900.00               Medicare: $685.65        Bupa: $228.55

Private Hospital

Fees:                                     $9782.00              Medicare: $0                Bupa: $9282.00

Pathology

Blood Tests (Pre-Op):        $151.00                Medicare: $39.95          Bupa: $0

Dietitian

Initial Consultation:            $99.00                Medicare: $0                 Bupa: $45.00

Subsequent Consults:       $65.00                  Medicare: $0                 Bupa: $27.00

 

06Jul/17

Week 7 Post Surgery – Normal Eating Has Resumed

Ok so I survived the staged eating plan of Fluids, Puree and Minced foods. I have to say that although it sounds quite ordinary, there are lots of good food options when you apply some thinking to it.

However, I must say that it is finally good to commence eating normally again.

Unfortunately for me, just as I commenced the “Normal Eating” mark, I was required to go away for 2 weeks on business, so normal eating revolved around restaurants and take-away. It also involved the temptation of have a few “Happy Hours” along the way as well.

Firstly, the food. Eating the right portion size was the most difficult thing. I basically had to rely on when I felt full. As time went along, you do seem to know when to stop eating before you feel “too full”. There were a few uncomfortable experiences early on when I had that one spoon full too much…but you quickly learn you are far better putting the spoon down than going for that one more mouth full and feeling like you just ate christmas dinner. I usually relied on the entree menu in restaurants and would eat half of what I ordered for lunch, usually eating the other half the following day. For snacks I’d usually have a small can of tuna in the afternoon and a coffee in the morning.

So for the beer drinkers out there…Ive proven one thing, its ok to have a beer again…but do so at your own peril. Without getting melodramatic, I resumed having a beer at the end of the day with my work colleagues. The only way you can do this is before you eat. As soon as you eat, there is no room in your stomach for any liquids at all. Recommendation is that you don’t drink anything 30 mins prior to and after you eat to allow your food to digest at normal speed. The grog does have a more accelerated effect on your than you would normally expect…in other words…you feel pissed a lot quicker than you normally would.

When I got home from the business trip I jumped on the scales and saw very little movement in weight. I obviously put this down to the lack of structure around what I was eating and also my consumption of alcohol, albeit limited.

Once at home I was able to concentrate on putting together sensible meals. I purchased a special kit designed for bariatric patients, “Portion Perfection”. I have found this kit extremely useful. It comes with a book that explains the importance of portion sizes and includes recipes designed for small serves. It also has a plate and bowl that has the portion sizes clearly printed on it so that you can visualise your portions of food and ensure you have the right size serving. There is also a  Menu Plan and a handy guide for snacks.

One ting I learned from reading this material is that my success in losing weight is going to be reliant on sticking to a proper eating plan…much like any diet. My surgery will assist in allowing me to eat smaller meals and not feel hungry. While I can quite easily have a beer if I want to…the calories will counteract the good work I’m achieving through my diet.

Basically in round figures, I am now eating 6 meals a day which equates to 4200 Kilojules or 1050 calories.

Breakfast, Lunch and Dinner – 250 calories each

Snacks – 100 calories each.

The Portion Perfection Kit has lots of good ideas and suggestions about foods that fit the desired calorie limits. It is easily explained and is written by an Australian dietitian who refers to products you’ll find on an Australian supermarket shelf.

In addition to the above, i am using an App called CalorieKing which keeps a record of your meals, calories, kilojoules, weight etc. It is similar to the Weight Watchers Tracking App (for those that have used it). It also takes into consideration any exercise you may undertake. I have found this very helpful as well.

 

07Jun/17

Day 14 – Finish Fluids – Start Puree

Day 14 and 2 weeks post surgery. I’ve finished the Fluid Stage today and had a visit to the Dietitian to discuss the Puree Stage.

I must say the Fluid Stage sounded worse than it actually was although I was glad to start broadening the culinary horizons, albeit of the pureed variety. The results so far have been quite significant – 7.5kg in weight loss as well as reductions in all the other measurements. (See updated Weight Loss Record post)

The new diet for the Puree Stage includes a range of foods with a slight consistency…. “You must be able to drink it through a straw”. A typical day during this stage is:

Breakfast: 1 Weetbix with soggy milk

Morning Tea:  Small Skim Latte

Lunch:  1/2 Cup of Soup – preferably vegetable

Afternoon Tea:  Yoghurt or Fruit Smoothie

Dinner:  Soup or blended meal of meat and vegetables

Supper: Pureed Fruit, smoothie, yogurt or trim custard.

In addition to the above its recommended to drink 2 litres of water (which Im finding difficulty with). Vegetable Juice and vitamins.

Some other suggested foods during this stage is: blended meats into the meals, eggs blended into smoothies, blended pasta, blended vegetables, thin custards, yoghurts and jelly.

I didn’t get too adventurous and stuck with the suggested daily menu above. Mainly soups for lunch and dinner. I did have a meal out at an Indian Restaurant one night and enjoyed a bowl of Dahl (of which I took most home in a container and had the following day). I also had a take-away Thai Soup one night, Tom Ka Gai, and put it all in the blender. It tasted ok but Im glad I didn’t pursue other recipes with blended meat – not a fan at all.

Suggested serving size during this stage is 1/2 cup (125ml). If this isn’t sufficient to get you through to the next meal its suggested you try a serving with more consistency, its suggested to increase more 1/2 cup meals ie 8 per day instead of 6. I found that I actually did both… I slightly increased the meal sizes of some meals, increased the consistency in others and added a small serve here and there. I found that when I ate dinner around 6pm, I felt hungry again at around 7pm and so had a yoghurt or Skinny Cow ice cream (allowed by Dietitian). I also had a snack of yogurt again before bed, anytime from 8pm-10pm. Yesterday I tried Rice Paper Rolls for lunch and it was fine, you just need to chew it well before swallowing.

After the change in diet from Fluids to Puree I noticed the weight loss slowed for a few days and on one day even increased. This was explained by the dietitian in that the change of diet usually involves foods that have salt added and as such the body will retain fluid. Weight loss resumed after a couple of days, however at a more steady pace than what was experienced in the Fluid Stage. Of course the dietitian warned me of the dangers of getting on the scales every day to check progress as weight will fluctuate for a lot of reasons. But if you’re like me and spent the best part of the last 30 years watching your weight increase every time you jump on the scales, the temptation to weigh in every morning to check the progress is overwhelming. The best advice I can give is if you see a slight increase, it will no doubt be for the reasons I stated above… You only need concentrate on your weekly results, not what happens daily.

Exercise.

Bruce

I’ve been doing my best to walk 10,000 steps per day. My Apple Watch tells me I stick to this most days. I also commenced back at the gym this week doing some light workouts on weights. Without a doubt I am noticing even with the small weight loss so far that my energy levels are returning. I try to replace a drive with a walk where possible and my best mate “Bruce” the Airedale Terrier is loving the daily walks he’s been getting as well.

Im glad to say that my clothes are also starting to feel more comfortable.

Tomorrow marks Day 23 post surgery and back to the Dietitian to discuss the final eating stage, The Minced Stage.

 

26May/17

Weight Loss Record

DATE          WEIGHT (Kg)    BMI      Vis Fat    Body Fat %   + / – (Kg)

4/4/17          130.0                  38.8     395.6       46.4                 – – –

15/5/17        129.2                  38.6     375.7       44.9                – 0.8

23/5/17        124.9                  37.3     347.8       44.5                – 5.1

30/5/17        122.5                  36.6     337.9       44.5                – 7.5

8/6/17          121.7                  36.3     330.9       43.0                – 8.3

17/6/17        119.2                  35.6     319.4       42.5                – 10.8

6/7/17          116.3                  34.7     321.5       42.0                – 13.7

7/8/17          113.9                  34.0     287.6        39.6                – 16.1

 

 

26May/17

Day 10 Post Surgery – 5kg down

Frontal view of incisions. Note the larger of the 5 incisions on left, small incision above sternum, one near navel, one above right of naval and one just visible on far right of photo.

I am now at Day 10 post surgery and feeling good. From Day 5 I continued to experience abdominal pain albeit reducing by the day. The pain was probably most uncomfortable under the right side incision which is the largest of the incisions. This is because a rather large internal stitch is inserted under this point. In saying that, I found I have been comfortable enough throughout the day, it is only while sleeping that I required pain relief. I continually reduced the pain relief to 1 x 5 mg Endone with 2 x Panadol which I would take before going to bed usually around 10pm. I would also take a Tramadol around 7pm prior to that. I am currently taking 2 x Panadol in the morning and at night as required and completely off the Tramadol and  Endone.

As per doctors orders I commenced walking the day after I arrived home from hospital (Day 3). I took a slow walk around the block (approx 10 mins) twice a day. Then on Day I was starting to feel better and ventured a bit further. I have been averaging about 10,000 steps of easy paced walking every day since. I recommend either a Fitbit or pedometer to keep track of your steps, even if it is just to slowly increase your walking each day.

The Weight So Far….

Well Ive heard all the stories about it falling off.. and it does. The first day or so after surgery there was not much change from the pre-surgery weight but as I became more active the scales started to move. I’m glad to say they have moved downwards every day Ive got on them. Very encouraging. The official weigh in was with my Dietitian on Day 7 and I had lost 5kg. Already I’m noticing clothes are fitting better and energy levels are increasing.

Sometimes the smallest wins are the most memorable. I actually put my wedding ring back on yesterday that I had to take off 18 months ago because it was too tight.

The Food So Far….

So Ive been strictly following the recommendations of the Dietitian. My daily food intake is as follows;

3 x Up and Go Protein Drinks (150ml) per serve.

1 x Optifast Shake or Soup. I have opted for the soup which I have for dinner.

1 x Berocca Tablet in 150ml water

1 x Unsweetened fruit juice 150ml

1 x Vegetable Juice (V8) 150ml

20 ml of Liquid Multivitamins – although I have now switched to a tablet recommended by the doctor – called “Nutri Chew” 1 morning and night. These tablets have to be ordered on line and are designed especially for people that have had bariatric surgery.

1 x Liquid Yoghurt – I went for the Chobani screw top sachet which taste great.

Basically you consume the above throughout the day as you feel like it. I have also been enjoying a skim latte for morning tea.

In addition to the above I sip water throughout the day.

The Fluid Phase finishes on Day 14. I then commence the Puree Stage.

 

19May/17

Day 4 – Start the Fluid Stage

Still not a great night but again better than the last. First night without drips and machines hooked up which was a bonus. I was up multiple times through the night as world war 3 was going on in my guts…but still no shots fired. I took a number of Tramadol and a few Endone throughout the night to improve my sleep as well as two more Coloxil for the constipation. I am limiting the Endone until the constipation is rectified.

Breakfast was a “Sanitarium Up and Go” as per the directions from the Dietitian. Also on the shopping list today is small portions of fruit juice, liquid multi vitamins, vegetable juice, Berocca, another 2 serves of Up and Go and an Optifast shake. This is to be consumed through out the day and is designed specifically to provide the right amounts of protein and vitamins.

The pain has eased today which Im happy about as such Ive backed off the Endone. Then at about 11am after another dose of Lactulose – my prayers were answered… Operation Evacuation was underway… Obviously bringing with it an extreme amount of relief.

Ive been for a couple of walks around the block today and I can feel the pain in my abdomen starting to reduce. I will try to restrict the medication to Tramadol tonight and stay away from Endone..for all the reasons previously mentioned.

I can expect to remain on this “Fluid Phase” for the next 2 weeks.

19May/17

Day 3 – Going Home

I had another restless night although it was better than the first….at least I wasn’t dealing with the arm amputating blood pressure thing. I did still have the drip on which is a pain in the arse as you have to wheel it with you everywhere you go, including short trips to the brasco. The pain in my abdomen is still present and is managed pretty well between the Endone and Tramadol. For those that have used it, Endone is a great pain reliever but the down side is it causes chronic constipation. No different for me and with the constipation building it was also causing discomfort in the abdominal area. So Ive taken a few Coloxil tonight which will hopefully have some effect in the morning. Ive been for a few walks down the corridor today as per doctors instructions and also had regular sessions on the inhaler to restore breathing function. Meals today have been the Sustagen Protein Drinks for Breakfast, Lunch and Dinner. They are also allowing me a cup of coffee. Sipping water and ice happens through out the day as well. I haven’t had any hunger sensations around a meal time, in fact you eat because your told it’s time to eat.

A visit from the surgeon this morning and he’s happy with the progress so Im right to go home. The nurse is instructed to change my dressings which gives me my first look at the aftermath of the surgery. Basically I have 5 laparoscopic insertion points around my abdomen, all of which are the same in size with the exception of the one on my right side. This one was made larger due to this being the point that the stomach was removed. The reason for these ports was for the insertion of various surgical tools required for the procedure. It is around these points that I am the most tender, in particular the one on the right. Any movement of your abdomen causes a level of pain, especially when laying down or sleeping.

So I was collected around 11am by Rachael and Samantha, signed the paperwork and discharged. I left with prescriptions for Endone and Tramadol as well as some other reading material of do’s and don’ts. Still no action on the bowel movement which by now is getting pretty uncomfortable. I took a dose of Lactulose at the hospital which hasn’t done anything. Although leaving until the very last option, I even resorted to a suppository…still no action. Although Im up an about, I still feel pretty washed out and weak.

17May/17

The Big Day….and the day after that

Ok so Im back in the land of the living….sort of.

Day 1 (Yesterday)

Started about 7.30am when I got dropped off at the hospital. I checked in and waited until the nurse came around about 9am. I went through and answered the standard clarification questions before changing into my gown. The nurse then put me into a bed and I was wheeled down to the pre-op area. About 10am the anaesthetist came along and put the canulas in. I had a brief visit from the surgeon and then about 30 mins later I was wheeled into the theatre. The anaesthetist then did his thing and I was out….

The next thing I remember was coming around in Recovery. Obviously pretty drowsy for a while then as I brightened up I was transferred to the High Dependancy Unit (one step below Intensive Care). By this time it was about 3.30pm so Im guessing the  surgery took around 3 hours. The nursing staff kept me topped up with Endone which has kept me quite comfortable. I spent most of the rest of Day 1 asleep except from the visit I had from my lovely wife. The only thing I was given to eat was a cup of crushed ice. The recommended intake is 30ml of water every hour. I didn’t have a great sleep, mainly because i was hooked up to a drip in my left arm and the automatic blood pressure machine on the other which automatically attempted to take my arm off every 30 minutes. Not great for a good nights sleep. Not to mention the selfish old bag in the bed next to me who decided she wanted to watch TV at 10pm last night… Suffice to say, she didn’t get to watch TV. My sensational nurse Niki looked after me very well throughout the night making sure I got the Endone when required. Im on 3 tabs (15mg) every 4 hours. I find that the pain starts creeping in about 30 mins before the dosage is due. Once medicated, i remain quite comfortable.

Day 2

I woke up about 6.30am (not that I really got to sleep). Breakfast today was more crushed ice. I had a very careful shower which was great. Then a visit from the physio who got me up for a walk. Although a bit tender, no problems with that. A quick visit from the surgeon and shortly after I was transferred to the ward. Must say I am feeling ok as long as Ive got the pain killers on board. Just feeling a bit washed out today which is expected, but still comfortable. For lunch today I had a 250ml Sustagen Dutch Chocolate protein drink and a cup of coffee. I don’t have any sensation of feeling hungry, so pretty much eating by the clock. I am maintaining the nibbles of crushed ice throughout the day. Dinner tonight will be another Sustagen drink with a coffee. I have been given a little thingo that I have to suck on and get the little balls to fly in the air. This is to build normality back into my breathing function. The surgeon has also directed me to go for a couple of walks. Ive been for two so far and feeling comfortable.

 

15May/17

Tomorrow’s the day….

So tomorrow is the big day. The first day of the rest of my life.

I had my last weigh in with my dietitian today..129.2 kg.

I was hoping to have lost a bit more weight prior to the operation. From my first visit to the dietitian Ive lost 2.6% body fat but increased my muscle mass percentage due to increasing my exercise (30 minute morning walk)… So the scales didn’t move much.

For the 2 weeks prior to the surgery, I was placed on a Very Low Calorie Diet (VLCD) which comes in the form of the Nestle product “Optifast”. Optifast is a range of products including shakes, bars, soups and mousse deserts.

The purpose for this VLCD is to lose as much weight as possible before the operation and reduce the size of the liver prior to surgery. The liver sits just above the stomach and it greatly assists the surgeon to perform the procedure more safely if the liver size is reduced.

Having tried every shake diet under the sun, I reckon I’m well placed to make comment on “Optifast”. I was not looking forward to the prospect of drinking shakes and soup for 2 weeks, but I must say, they weren’t too bad. I found them quite palatable and easily modified so you could vary the taste.

For example, the shakes came in Chocolate, Vanilla, Strawberry and Banana. I preferred the chocolate and vanilla flavours. With the vanilla flavour, you could add a teaspoon of coffee and it tasted like iced coffee. I definitely recommend you add ice to the shakes and use a blender. The result is that the shakes taste like smoothies and are easy to drink.

The soups come in two flavours, Tomato and Chicken. On their own, the soups don’t taste great, however, I threw in some low fat extras to make them taste better. With the Tomato soup I added a couple of tablespoons of tomato puree, garlic, herbs and spices. With the chicken I added garlic, herbs and even curry powder. I found the pre-packaged herbs you get in the small tubes in the fruit and veg section of Woolies were ideal. Especially the “Garden Gourmet” Thai Herbs, Moroccan Spice, Basil and Coriander. These stir in flavours greatly assisted these otherwise rather bland soups taste better.

 

For those that have a sweet tooth after dinner, the Optifast Deserts came in lemon and chocolate flavour. I liked both of these products without doing anything to them. I am a bit of a sucker for something sweet after dinner so found these very good. In addition to these they also do Carob bars in a few different flavours. These bars are pretty rich but again are not too bad.

Its recommended that you consume 3 Optifast products per day, 3 litres of water and your evening meal should be a small serve of protein, meat chicken or fish with vegetables. Fruit is also OK throughout the day, as is tea, coffee and diet soft drinks. A more complete list of do’s and don’ts come with the products themselves.

All in all, I didn’t find the Optifast VLCD too cumbersome and when you get creative with how you prepare it, it is quite palatable as well.

I got a run down today from the dietitian of what my diet will look like over the post operative period…

Weeks 1-2 will basically be fluids. Your diet increases in texture from liquid to solid over the next 2 weeks until your stomach has healed to the point where normal food can be resumed. I will talk more about the post operative diet more in the weeks to come.

 

14May/17

Which Weight Loss Surgical Procedure to Have?

The first decision I had to make was what procedure I was going to have. Obviously I did the research, mostly on line. I also was able to discuss this subject with my surgeon during my first visit.

Basically the three most common procedures are:

  1. Gastirc Banding
  2. Sleeve Gastrectomy
  3. Gastric Bypass

I’ll briefly outline the pros and cons I found in my research of these procedures.

1. Gastric Banding

Laparoscopic Swedish Adjustable Gastric Band Surgery is a procedure where a curved adjustable gastric band is placed around the stomach using keyhole surgery, dividing the stomach into two parts. The section of the stomach sitting above the band can only hold a small amount of food (approximately half a cup). This helps you feel full sooner and for longer than usual. As your eating patterns change and you become accustomed to eating less, you can achieve sustainable weight loss, which in turn will lead to a healthier lifestyle with less risk of obesity related health problems.

Advantages:

  • Limits the amount of food that can be eaten at a meal.
  • The surgery is reversible.
  • No part of the stomach is stapled, cut or removed. Your normal anatomy has not been altered and food is absorbed by your body exactly as it was before the surgery.
  • Statistics show that in a clinical trial, Gastric Banding patients lost an average of 38% of excess weight at 1 year and nearly 43% at 3 years.

2. Sleeve Gastrectomy

The Sleeve Gastrectomy is a restrictive procedure that limits the amount of food you can eat by reducing the size of your stomach. During this procedure a thin vertical sleeve of stomach is created using a surgical stapling device via keyhole surgery. This sleeve will typically hold between 50-150 mls which equates to about the size of a banana. The rest of the stomach is removed. The newly created gastric sleeve is able to hold approximately 1/10th of what the stomach was able to hold before. The stomach sleeve restricts the amount of food you can eat before feeling full. As you eat less food your body stops storing excess calories and starts using it’s fat supplies. As with the Gastric Banding procedure, many health problems i.e. back pain, sleep apnoea, high blood pressure, diabetes and depression may improve or be resolved following surgery.

Advantages:

  • Limits the amount of food that can be eaten at a meal.
  • Food passes through the digestive tract in the usual manner, allowing vitamins and nutrients to be fully absorbed into the body.
  • No post-operative adjustments are required. In clinical studies patients lost an average of 55% of their excess weight.

3. Gastric By-Pass

Gastric By-Pass Roux-en-Y (GBRNY) is what is known as a combined restrictive and malabsorptive procedure. By adding malabsorption, food is delayed in mixing with bile and pancreatic juices that aid in the absorption of nutrients. The result can be an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat. The GBRNY is an increasingly performed weight loss surgery option. In this procedure, stapling creates a small 15-20ml stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the lower stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus by-passing calorie absorption in the duodenum. This is done by dividing the small intestine just beyond the duodenum and constructing a connection with the new, smaller stomach pouch. The length of either segment of the intestine can be increased to produce lower of higher levels of malabsorption.

Advantage:

  • The average excess weight loss is generally higher than the restrictive procedures above.
  • Restricts the amount of food that can be eaten in a meal.

Disadvantages:

  • Because the duodenum is by-passed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anaemia.
  • By-passing the duodenum has caused metabolic bone disease in some people resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. These deficiencies mentioned can be managed through proper diet and vitamin supplements.
  • Chronic anaemia due to vitamin B12 deficiency can occur.
  • A condition known as “Dumping Syndrome” can occur as the result of rapid emptying of the stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious health risk, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and on occasion, diarrhoea.
  • In some cases the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15-30 ml.
  • Re-routing of bile, pancreatic and other digestive juices beyond the stomach can cause intestinal irritation and ulcers.
  • The lower stomach pouch and segments of the small intestine cannot easily be visualised using x-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.

Resource: “The Facts About Weight Loss Surgery – A Guide to Your Treatment Options”. Johnson & Johnson Medical.

So what did I decide?

In addition to what I read and what I discussed with my surgeon, I decided on the Sleeve Gastrectomy.

I initially was keen on having the Gastric Banding due to the procedure being “reversible”. I was also not that keen on having my stomach stapled, parts removed and plumbing re-routed. The whole idea of this was not appealing… however..

I have known a couple of people who have had the Gastric Band. In addition to this, there are plenty of stories on line. Despite the statistics mentioned in the reference above, my research has indicated the procedure does not produce a huge amount of success stories. All those that I have spoke to who have had this procedure initially lost weight, however, all eventually experienced problems which led to weight gain. Most re-gaining all the weigh plus more. Apart from the obvious disappointment of regaining weight, the people I have spoken to were faced with additional medical bills to have the band removed. Some had the additional expense of then having the Sleeve Gastrectomy performed. One lady I spoke to could not afford to have the Sleeve surgery after exhausting her finances on the band…so she’s back to square 1.

I know a guy who had the By-Pass surgery around the same age as I am now. I can say the procedure has been very successful for him. He, like me, was always a big guy, loved a drink and his food. He embraced the surgery and the lifestyle changes required post surgery. He has kept the weight off and still enjoys a beer and food in moderation. All that said, my opinion is that this procedure is too invasive and I just wasn’t comfortable with the nature of what would be done.

And so for me its the Sleeve Gastrectomy. I have an old mate who, again like me, has always been a big chap, who I spoke to recently. He had the sleeve procedure done just before christmas last year (2016). He is now about 6 months post op. His weight has dropped from 145kg to 109kg and continues to fall. He is extremely happy with the results and how things are going for him. He told me that there are obviously a lot of changes needed to be made to your diet (no surprises there) but the benefits far outweigh the negatives. He is only part way through his journey but is extremely happy with his decision. He is now at the stage where he is eating normally, only in significantly smaller portions. He still enjoys a drink with the boys…although avoids beer and aerated drinks due to the resulting flatulence. He, like the surgeon and dietitian have told me, the first days and weeks after the operations are difficult due to the nature of food you need to consume as the stomach is repairing post surgery. But once past this early stage…life gets a lot better.