49 Weeks – Feeling Fantastic

49 Weeks – Feeling Fantastic

Its been a little over 3 months since my last post… but how many times can you say “things are going great” ??

I’ve continued to lose weight and are now just over 90Kg…. That’s a total weight loss of 40Kg or nearly 1/3rd of my original body weight 🙂

Gym Junkie

I’ve continued going to the Gym… and am loving it…. In fact, for a while there I got a little obsessive and was going 8 or 9 times a week, but have scaled that back to just 5 or 6 … which I’ve found is actually more effective and efficient – my gym sessions are now longer and more powerful and my body is recovering better between sessions.

Since joining the gym – 7 months ago – I have lost an additional 10Kg in weight, which is pretty significant given that my muscle mass has also substantially increased.

Blood Results

I did a regular follow up with my nutritionist today… and all my blood tests are fantastic… except for Iron which is a bit low. This is completely normal (and expected) after a Gastric Bypass and I will continue to take Iron supplements (Maltofer) daily along with my multivitamins, although I can now stop taking Calcium supplements.

I am still not taking ANY diabetes (49 weeks since surgery), and my average blood sugar reading (HbA1c as per stats below) is continuing to drop.

Blood Sugar (HbA1c)

HbA1c is a blood test that is used to help diagnose and monitor people with diabetes. It is also sometimes called a haemoglobin A1c, glycated haemoglobin or glycosylated haemoglobin.  It shows the average level blood sugar levels over the past 2 to 3 months.

Target Weight ?

I can expect to continue losing weight for another 6 months or so… although the rate of weight loss will slow down.

I have already lost more than I had hoped for, but at 90Kg and 172cm… my BMI (31) still puts me at borderline Obese…. I am now hoping to lose another 5 or 10kg – with a provisional target weight between 80-85Kg… This would still mean I was considered Overweight…. but at 172cm, the suggested “healthy” weight is considered to be between 54 and 72 Kg… which to me seems absurdly “skinny”.

So far, even though the quantity of food I eat has significantly reduced (I just can’t physically eat anywhere near what I used to), I have to admit that I’ve not been particularly careful about the types of food I eat.

I have decided that once I get below 90Kg (which should be any week now) I will make a conscious effort to make smarter choices about the types of food I eat and this should help me get closer to that 80Kg target 🙂

Diabetes Free at last !!!

Diabetes Free at last !!!

Today I had my final (hopefully ever) trip to my Endocrinologist and have been declared “Diabetes Free” at last …

HbA1c

I have not been taking ANY diabetes medication since my surgery (35 weeks ago), an now (as per my HbA1c stats below) I am finally in the “non-diabetic” range

HbA1c is a blood test that is used to help diagnose and monitor people with diabetes. It is also sometimes called a haemoglobin A1c, glycated haemoglobin or glycosylated haemoglobin.  It shows the average level blood sugar levels over the past 2 to 3 months.

The graph above shows my HbA1c stats for the last 6 years or so – since I was diagnosed with Diabetes.  Soon after I was first diagnosed, I was able to control it pretty well with diet and exercise, but in 2015 it shot up and I started medication.  Over the subsequent years, despite increased medication it was never really well controlled… Since late 2017 it has gradually improved, but this was primarily as a result of increase medication (mainly mutliple daily insulin injections).  However, since my Gastric Bypass operation (35 weeks ago) I have been completely off all diabetes medication… and my blood sugar is finally back to “non-diabetic” levels.

This does not mean that I am “cured” – the underlying problems still exist, and I will need to keep an eye on it in years to come (diabetes has a tendency to worsen naturally with age)… but I am no longer conside4red “diabetic” and will not (as long as I stay diabetes free) be impacted by the many life shortening outcomes caused by diabetes.

In fact… not only is my HbA1c looking good, my cholesterol (which surprisingly was never that high) is down and everything else is looking great… except for slightly low Iron levels… sounds like a great excuse to eat a nice juicy eye fillet to me 🙂

Muscle is Denser than Fat … Apparently …

Muscle is Denser than Fat … Apparently …

As per my last post (Still Losing Weight & Getting Fit)… I started back at the Gym after reaching my 100 Kg Milestone… Without thinking too much about it, I had anticipated that this would give my weight loss a bit of a boost… I was WRONG !!!

In fact, rather than losing weight (I had pretty much consistently lost 1Kg per week since surgery), I actually started to put it on… and 2 weeks after joining the gym I was up by 1.5Kg…

Muscle vs Fat

I remember people saying “Muscle Weighs more than Fat“, so thought I’d do some research.

Of course 1Kg of Muscle weights exactly the same as 1Kg of fat… but Muscle is actually denser than fat, which means muscle occupies less space (volume) compared to fat.

Muscle has a leaner appearance due to its high density whereas fat occupies more space (volume) in the body. Two people could weight the same but could look very different depending on their body composition – a person with high body-fat percentage versus a person with high lean muscle percentage will probably be in two different sizes of clothes and health risk.

Muscles are made of long fibers tightly woven together. Fat, on the other hand, is composed of different sized droplets and some are more full than others. These droplets stick to each other but leave some empty space in between.

In the image above, one kg of muscle takes up less space than one kg of fat. This is why you might notice a slimmer waistline but no drastic change on the scale as you begin a new workout or meal plan regime – your body is burning light fat, but building heavier muscles.

Weight Loss Graph

Here is my weight loss graph since surgery… for the 1st 4 weeks at the gym (3 or 4 times a week – moderate intensity), I still had a net gain in weight of approx 1.5kgs… however, since then, my body seems to have figured out what’s going on, and my weight is (again) on a downwards path… In the last couple of weeks I have increased number of gym visits and intensity and seen a 3kg drop in just 2 weeks 🙂

Note: Even though I wasn’t actually losing “weight” during the 1st 4 weeks of gym, there was a noticeable change in body shape and toning.

5 Months after Surgery – Still Losing Weight & Getting Fit

5 Months after Surgery – Still Losing Weight & Getting Fit

5 Months now since my Gastric Bypass Operation and I have reached another Milestone.

I am finally down to 100Kg …
Losing now more than 30Kg

I have not been down to this weight since 2003 – more than 15 years ago !!!!

Time to hit the Gym….

I have been increasing daily exercise for a while… mostly walking… but I promised myself that once I had reached 100Kg I would join a gym and start building up my exercise regime.

I decided that I’d like to focus on boxing type exercises… but had visited a couple of local boxing gyms and they were pretty hard core… I was not that interested in actually hitting anyone (or getting hit for that matter), but I did like the types of exercises involved.

I wanted to primarily do some upper body toning and body core workouts… and thought that boxing/skipping exercises would be a good start.

12 Rounds Fitness

I checked around and discovered that my sister had (for months) been going to a gym called 12 Rounds Fitness. This is based around circuit training, with 12 different “stations” setup, each with 2 different exercises.

You arrive at whatever time you like, start at an available station of your choice, and spend 3 minutes exercise at each station, before moving onto the next. The types of exercises at each station change daily, and you are able to push it as hard as you like, or “tweak” the exercises to cater for specific exercise targets (or injuries).

I found that during the first session a pre-existing back injury flared up again, so I have been able to focus on low impact and upper body exercises… and my back seems to be improving…

Interestingly, despite (or perhaps because of) significantly increasing my exercise program (and as far as I am aware not changing my food intake much), instead of losing additional weight, in the 2 weeks since I started I have actually gained 1.2 Kg.

Blood Sugar & Diabetes

I also recently re-visited my endocrinologist – hopefully for the very last time… The previous visit my hbA1c reading (which measures the average blood sugar over a three month period) was just a smidgen above 6.0 (6.1 actually)… and I was hoping that this time it would be below 6.0 and in the “normal” range… However, it was back up to 6.4 – despite the fact that I had lost another 6Kg 🙁 …

So it seems that diabetes is still lurking around, so I still need to keep a close eye on it…

I suspect that despite eating much less than I used to (I reckon it is about 1/3rd) I am being less careful about the types of things I am eating. Although I am eating significantly less Carbs, I need to focus a bit better on less sugary foods (i.e. cut out soft drink and Fruit drinks, which I now realise I had started having more of)…

3 Months after Surgery – All Systems Go!!

3 Months after Surgery – All Systems Go!!

3 months since my Gastric Bypass Surgery and all system go !!!

I have just had my 3 month follow up with the Dietitian and Surgeon and 
have now lost almost 15Kg since surgery 3 months ago – which is apparently a little more than the surgeon expected. 🙂

ALL my blood results are looking fantastic (better than hoped in fact).. with Protein, Vitamins and Blood Sugar levels all doing very well. I am still off all Diabetes and Hypertension medications, and have even stopped precautionary meds for Gastric Reflux… so the only medications  I am taking are Vitamin and Calcium supplements 🙂

Must Eat Breakfast….

I have fallen into the (bad) habit of not eating breakfast (I rarely feel like eating at all until after midday), but the Dietitian suggested that I start trying to eat a small serving of Muesli/Yogurt for breakfast… and I did have some Bircher Muesli today… which was Yum !!

Weight Loss Plateau ??

I was a little concerned that my weight loss seems to be slowing down, however both the Dietitian and Surgeon assured me that I will continue to lose weight for the next 9-12 months, and that plateauing is normal at 3 months.

After about 12-18 months I can expect my weight loss to slow down and eventually stop… and then (which is normal) I am likely to put on another 10%.. so if I get down to 80Kg , then I can expect to put on another 8Kgs before it stabilises….

Mini Gastric Bypass Surgery – The Video

Mini Gastric Bypass Surgery – The Video

I have finally got my hands on the video of my Gastric Bypass Operation.

Despite researching Gastric Bypass a lot, I had never seen any video footage of the procedure, so I found this fascinating – particularly as it is my own surgery 🙂

It is much “cleaner” in there than I had thought it might be, and the video is not as gory or confronting as I thought it might be.

Saying that, if you are a bit squeemish, you may choose not to watch this :).  This video just shows the “highlights” – it runs for just over 6 minutes and the total procedure took closer to an hour.

Here are some timestamps and brief descriptions of what is going on :
(note these annotations are my own and not necessarily medically accurate)

  • 00:00  – fighting through abdominal fat to get to my stomach
  • 00:20 – removing fat from where stomach meets upper intestine
  • 00:52 – separating and stictching stomach to form new “mini” stomach
  • 01:37 – my new stomach
  • 01:46 – hauling in my intestine to find a suitable new “connect” point
  • 02:10 – attaching new stomach to lower intestine
  • 02:20 – cutting opening in new stomach
  • 02:40 – cutting new opening in intestine.
  • 03:00 – stitching up stomach/intestine join
  • 04:38 – final stitches
  • 05:42 – check stitchwork by inflating
  • 05:55 – cauterise
  • 06:05 – final rinse

 

10 Weeks after Surgery – Some Stats

10 Weeks after Surgery – Some Stats

10 weeks since my surgery and time for some Statistics

My weight continues to drop off… it has been a little erratic… losing a little each day for a week or so… putting on a kilo … and then having it drop off again.. but the overall trend is consistently down, and in the 10 weeks since surgery, I have lost  a total of 14KG… and little under 1.5Kg per week is pretty good  right ?:)

More remarkably, I am still completely medication free for my diabetes… my HbA1c Blood results have plummeted since surgery… and I am currently just a smidgeon above the “Non-Diabetic” range.

HbA1c

HbA1c is a blood test that is used to help diagnose and monitor people with diabetes. It is also sometimes called a haemoglobin A1c, glycated haemoglobin or glycosylated haemoglobin.  It shows the average level blood sugar levels over the past 2 to 3 months.

The graph below shows my HbA1c stats for the last 5 years or so – since I was diagnosed with Diabetes.  Soon after I was first diagnosed, I was able to control it pretty well with diet and exercise, but in 2015 it shot up and I started medication.  Over the subsequent years, despite increased medication it was never really well controlled… Since late 2017 it has gradually improved, but this was primarily as a result of increase medication (mainly mutliple daily insulin injections).  However, since my Gastric Bypass operation (just 10 weeks ago).. I have been complelety off all diabetes medication… and my blood sugar is almost back to “non-diabetic” levels.

This was not entirely unexpected (and was the primary aim for the operation)… However the results have been much more dramatic than I had expected.  Loss of weight in itself, is one of the most effective ways to reduce blood sugar… and I had already lost about 10Kg prior to the operation, and had seen a reduction in my medication… However weight loss is obviously a gradual thing , and the “overnight” impact on my blood sugar was a bit of a surprise… and seems to have been been as a direct result of the physiological impact of the Bariatric surgery.

Weigth Loss

The graph below shows (almost) daily weight data since my surgery10 weeks ago :

Unsurprisingly, the rate of weight loss is highest in the first week or two, but since then (apart from a few “hiccups”) has been fairly steady at about 1.5kg per week.  In th4 last 10 weeks I have lost 14Kg :).  The “trend” seems to be that iI lose a small, but steady daily amount (around 300g) for 7-10 days… then I put a Kg or two back on overnight, it rollercoasters for a few days… and then I start the gradual weight loss trend again.  Not sure if this is related to  hyydration… or diet.. or whether it is just a natural pattern.

I have not been down to this weight for about 10 years and I am “swimming” in my current wardrobe, but I am holding off getting any many new clothes until I lose a bit more 🙂

My next “major” goal is 100Kg… I will probably reward myself with some new clothes…and I have told myself that when I reach that I will start back at a gym and start to do more regular (and more “serious”) excercise.

What’s Brown and Sticky ??

What’s Brown and Sticky ??

The title of this post “What’s Brown and Sticky” is unfortunately the lead into one of the few jokes I seem to remember with any consistency…. It is my favourite “Dad” joke… and the answer is of course ….  A Stick !!!

It is curious, that even though we don’t usually like to talk about bodily functions (in “polite” conversation)… we do seem to have a fascination with Poo and Fart jokes… and they are not just for children. Even if you’re a full-grown adult, you are still going to end up laughing your ass off.   This post is primarily about Poop and Farts – in relation to Gastric Bypass Surgery, which is not quite as hilarious (but see the end of this post for some more Poop jokes).

Apparently, after gastric bypass surgery, many people experience some degree of diarrhea and smelly gas (malodorous flatulence). This is typically common during the first few months as the body adjusts and heals.

Since my Surgery (7 weeks ago), I have been Pooing much less – which is hardly surprising since I am actually eating less than half what I once would have.  I have experienced a little Diarrhea (but not as much as I had anticipated), but my stools are certainly softer than pre-surgery… are consistently a light brown (almost beige) in colour… and my gas is more often than not smellier than previously.

I have collated together below a range of information on some of the most common post-surgery effects on digestion :

Digestion After Surgery

Gastric bypass surgery helps you lose weight by altering the anatomy of your digestive system. Your stomach is smaller after the procedure and food passes more


Long-Term Dietary Considerations

quickly through your digestive system. As a result, your body absorbs fewer nutrients and your shortened bowel produces more gas and odors than before surgery.

Diarrhea and flatulence usually improve as your body adjusts after gastric bypass surgery. After the early postoperative period, you will begin to eat small amounts of high-protein, low-carbohydrate, low-fat foods that give you the nutrients you need while losing weight. However, certain foods — such as meat, beans, wheat, dairy products and vegetables — may cause flatulence and diarrhea long after your body has healed.

Dumping Syndrome

Dumping syndrome frequently occurs in gastric bypass patients when they eat foods containing a large amount of sugar. The bowel responds to the high concentration of sugar by moving extra fluid into the digestive system. As a result, diarrhea may occur within 30 to 60 minutes. Excess gas is also produced as bacteria feed on the sugar. Hormones are released during an occurrence of dumping syndrome, commonly resulting in dizziness, flushing, a drop in blood pressure and an increase in heart rate. Symptoms may range from mild to severe and generally last 1 to 2 hours.

Eating Habits

Certain eating habits can increase intestinal gas. Many surgeons advise patients to avoid activities such as drinking carbonated beverages, chewing gum or using a straw to prevent the introduction of excess air into the digestive system. Eating slowly and chewing your food thoroughly can improve digestion and may reduce excess intestinal gas.

Drinking liquids during meals can push foods through the digestive system too quickly. People who have undergone gastric bypass surgery are usually advised to stop all fluids before beginning to eat and to wait for roughly 30 minutes afterward before drinking again.

More Poop Jokes

And to finish off… here are a few more Poop jokes to put a “smile” on your face :

  • Did you know that diarrhea is hereditary?
    It runs in your genes.
  • Have you seen the movie Diarrhea?
    It leaked so they had to release it early.
  • Did you hear about the constipated accountant?
    He couldn’t budget.
  • Did you hear about the constipated mathematician?
    He worked it out with a pencil.
  • What’s brown and sounds like a bell?
    Dung.
  • What did one fly say to the other?
    Is this stool taken?
  • Do you want to hear a poop joke?
    Never mind it’s too corny.
  • What’s the true definition of bravery?
    Chancing a fart when you know you have diarrhea.
  • Did you know that when you say the word “poop”, your mouth does the same motion as your bum hole?
    The same is true for the phrase, “explosive diarrhea”.
  • Poop jokes aren’t my favorite jokes.
    But they’re a solid #2.
6 Weeks after Surgery – On Track !!!

6 Weeks after Surgery – On Track !!!

6 weeks since my surgery and I am still on track

My weight has been on a bit of a roller coaster over the last couple of weeks… going up and down a bit… I have more or less started eating “real food” so some weight gain is apparently not unusual… but overall there is still a good downward trend… and today I reached a bit of a weight milestone – under 110 Kg. I have not weighed this little for more that 5 years 🙂

My next “psychological” weight barrier is 100 KG… which I have not weighed for more than 12 years… and my target for this is Month 3…

I have been taking weekly photos, which I eventually intend collating into a timelapse…I have not noticed any dramatic changes in my body shape… although shirts are starting to feel a bit baggy…. and I will soon need to get some new undies, because my old ones are sometimes falling down when I walk 🙂

I certainly have more energy, and am building up my exercise.  I currently aim for at least 6000 steps (about 5 km) each day.

I am sleeping really well.. although have been waking up earlier and earlier (usually up by 0530 these days).

 

Although I am probably eating 1/3rd of what I used to, I am still not feeling hungry at all, and have to remind myself to eat.  As expected I can only manage small quantities of food at a time… A couple of poached eggs and 1 piece of toast or a muffin is too much for me to eat in one go…

I have also started to make up batches of fresh seasonal fruit salad (watermelon, rockmelon, pineapple, banana, strawberries, passionfruit, grapes at the moment)… and am enjoying eating this a couple of times a day as snacks.

 

 

 

 

About Liver Cirrhosis

About Liver Cirrhosis

I have been aware that I have had a fatty liver for some time…. Although my liver function is fine, ultrasounds over the last few years have shown that it is enlarged (which is not unusual with obesity) and a Fibroscan undertaken last year indicated that it was probably scarred (and potentially cirrhotic), but it was not until a liver biopsy was taken during my gastric bypass surgery, that Cirrhosis of the liver has been confirmed.

Cirrhosis is scarring of the liver caused by long-term liver damage. … Cirrhosis can eventually lead to liver failure, where your liver stops working, which can be fatal. But it usually takes years for the condition to reach this stage and treatment can help slow its progression.

Cirrhosis is a type of liver damage where healthy cells are replaced by scar tissue. The liver is unable to perform its vital functions of metabolism, production of proteins, including blood clotting factors, and filtering of drugs and toxins. A common misconception is that liver cirrhosis is caused by drinking excessive amounts of alcohol, but there are a number of other ways that the liver can be damaged and lead to cirrhosis.

Liver cirrhosis and fatty liver

Non-alcoholic fatty liver disease (NAFLD) is a condition where fat accumulates in the liver. It now affects about 20 per cent of Australians. It is becoming more common in children who are overweight or obese. Fatty liver does not usually cause pain or nausea. NAFLD is associated with conditions such as:

  • obesity – 20 per cent of people with obesity have fatty liver disease
  • high blood cholesterol and triglycerides
  • type 2 diabetes.

NAFLD can lead to inflammation of the liver and the formation of scar tissue, a condition called non-alcoholic steatohepatitis (NASH), which can then lead to cirrhosis of the liver. NASH usually occurs in people who are obese, have diabetes or have high blood cholesterol and triglycerides, so controlling these conditions is recommended.

Complications of liver cirrhosis

Without medical treatment, cirrhosis of the liver can lead to a range of potentially life-threatening complications including:

  • insulin resistance and type 2 diabetes – a poorly functioning liver stops the body from properly using insulin, the hormone that moves sugar from the blood into the cells
  • osteoporosis (brittle bones) caused by changes to metabolism of calcium and vitamin D
  • primary liver cancer – the most common type of cancer caused by cirrhosis is hepatocellular carcinoma
  • liver failure – scar tissue can impair the functioning of normal liver tissuebleeding from blood vessels in the oesophagus or upper stomach (oesophageal varices)
  • increased blood pressure in veins that take blood to the liver (portal hypertension)
  • build-up of fluid within the abdominal cavity (ascites)
  • infection of the fluid found within the abdominal cavity (spontaneous bacterial peritonitis)
  • damage to the brain and nervous system caused by toxins that the liver has failed to remove (hepatic encephalopathy).

Treatment of liver cirrhosis

Cirrhosis of the liver is incurable but, in some cases, treatment can help to reduce the likelihood that the condition will become worse. Options include:

  • treating the underlying cause of liver damage
  • making dietary and lifestyle changes – a nutritious low-fat diet, high-protein diet and exercise can help people to avoid malnutrition
  • avoiding alcohol – alcohol damages the liver and harms remaining healthy tissue
  • Taking certain medication – such as beta-blockers to reduce blood pressure and lower the risk of bleeding, diuretics to remove excess fluid
  • avoiding certain medication that can make the symptoms worse – such as non-steroidal anti-inflammatory drugs (NSAIDs), opiates or sedatives
  • having regular medical check-ups – including scans to check for liver cancer
  • having regular endoscopic procedures to check whether there are varicose veins within the oesophagus or stomach
  • having a liver transplant – an option that may be considered in severe cases.