Six Month Follow-Up Appointment: WIN

File under Things You Don’t Expect To Hear At Your Doctor’s Office:

(especially after stepping on the scale)

“Get you some!”

That’s how my appointment started, followed by a high five.

My surgeon’s currently out of town so one of his partners in the practice (Dr. Carlton) did my follow up appointment, and to say he was blown away by my progress to date would be an understatement.

If he could have been slack-jawed the entire time, I am sure he would have been.  As we went into the exam room, he said, “Well, you look good, you smell good (haha!  my perfume is pretty awesome if I do say so myself–thanks Jo Malone!), and I bet you feel good too!  You are kicking ass!  Man, 130 pounds!  I gotta text Nick (my surgeon) and tell him you are kicking ass!”

I laughed and said that yes, he did indeed need to tell Dr. Nicholson that I was kicking so much ass at this game.

Dr. Carlton then asked me a bunch of questions–how much protein was I getting daily, was I sticking to a certain amount of calories each day, was I drinking enough water, did I have any bowel movement issues, was I exercising, did I have any nausea or vomiting?  When I told him about my protein intake (80 grams minimum daily), his face lit up and he said, “That’s what I told the last lady that was in here–that she needed to be getting more than 60 grams!”  And then when I told him I was downing close to a gallon of water each day, he said, “I wish you could tell everybody that–they don’t understand how important water really is to this process.”

He gushed about my progress and success the entire time I was in the exam room with him.  I did show him the composite I made yesterday of me at my heaviest next to me now and his eyes got really big and he said, “Wow…you were really big.”  I nodded and said, “Yep, and now look!”  He said, “That is amazing!”

I asked him about Dr. Nicholson’s goal weight for me (220 pounds) and how I’m trying to get down to 170, because I felt that 220 wasn’t good enough for me.  He said, “Good for you.  I think if you can get between 170-180 that would be good for you.”  I explained that I don’t want to be at the upper end of my weight range to have what is considered a “normal” BMI because at that weight I am afraid I will look gaunt and sickly–what I always refer to as ‘heroin chic.’  I told him that was not the look I was going for, and he agreed that aiming for 150 would not be a good idea and that my goal was totally doable and reasonable.

To hear him say that made me feel good about my goal.  To have a doctor tell me that I could weigh 170-180 and be healthy made me feel really good about what I’ve done so far, and was very encouraging.  He then said,  “You know, you’re only like 90 pounds away from that range.  We’ll need to see you again in a few months, and then again at your 1-year, and then again at the 2-year mark.  You know, if you started at 400, and you’ve lost 200 pounds, you’re going to have a lot of excess skin that’s going to add weight.  We might need to talk about plastic surgery at that point to remove that skin so you can get rid of that weight.”

I was floored.  I didn’t think this conversation would happen so early on in this process, but clearly it was important enough to him to bring it up because perhaps I am closer to the end of this weight loss process than I think I am.  Or perhaps it is something he wants me to start thinking about as I inch closer and closer to my goal so that I can prepare for the possibility that I may have to have plastic surgery.  He did mention that things could be coded such that my having plastics would be a medical necessity and thus covered by insurance.

After I asked him some questions about the gurgling I was experiencing, he said, “Yeah, that’s reflux.  A lot of folks get it after they have this surgery.”  I told him that it didn’t burn or anything, and he said that the gurgling feeling in the back of my throat was the reflux manifesting itself and that I needed to take my Pepcid at night, every other night instead of twice a day like I currently do.  He also suggested Gas-X since there’s a fair bit of gas that accompanies the gurgling.

The appointment ended with another high-five, and encouragement to keep doing what I’ve been doing.  I told him that if they ever needed a patient to come to a seminar to show people what is possible that I’d be more than glad to do it, and he said, “That would be great.”  Then I scheduled my next appointment, which will be in April.

I’m curious to see how I will look 3 months from now.  I’m hopeful that I will be close to my surgeon’s goal by then.  At least I hope I will be.  It’s 42 pounds away.  I won’t be disappointed if I don’t hit it by then, but I’d like to see it by April 30 for sure.

I left the doctor’s office encouraged, validated, and happy.  Encouraged that Dr. Carlton felt like I could get to my goal, and that I could exceed Dr. Nicholson’s expectation for weight loss.  Dr. Carlton’s response to my success so far validated that what I’ve been doing so far is working.  Most of all, I was happy that I had a successful visit.  I hope my next visit is as successful and that at my next visit, I’ll actually get to see my surgeon and show him how I have put the tool he made for me to good use.  It’s like he told me, “I know you know how to lose weight; you have a hard time keeping it off.”  I want to show him that I can keep it off and that I can exceed his expectations for me.

And I will.  It’s like I told my therapist today, I have been given a second chance to have a healthy life and I am going to fight like hell to make sure I get that healthy life.

Today I ate a ton of seafood.  Thankfully I love seafood. 🙂  I got in 84 grams of protein, 40 grams of carbs and 31 grams of fat.  I ate a roll at Logan’s…so good, but probably the only Logan’s roll I will eat all year long.  You bet I savored that thing!

I am thankful that vacation is coming to a close for one reason only:  I’ll be cooking more to get ready for the grind of the work week.  When we are on break, we tend to eat out a lot, which isn’t a good thing.  Mind you, it costs us a lot less now than it did before, but in going out, you give up control of how things are prepared so calculating nutritional information is tougher.  I tend to overestimate calories when we go out just to be on the safe side.  I think next week I am going to aim for eating the majority of my meals from home rather than from restaurants.  Also, I’m ready to be back in a regular routine, eating, moving and sleepwise.  I’m going to give a Zumba class a try on Monday night since my gym offers them for free to members.  Wish me luck!


Today’s food choices, from upper right: leftover breakfast frittata; vitamin C and D supplements; multivitamin and calcium supplements x2, iron and B12 supplements; Logan’s roll with butter; Jack Link’s beef jerky; Swiss Miss diet hot chocolate; seafood stuffed flounder filet (took the other one home for breakfast tomorrow) and roast veggies; part of a dinner salad; grilled shrimp and vegetables.

2 responses to “Six Month Follow-Up Appointment: WIN

  1. First of all, congratulations on such a successful and positive doctor’s visit!!!

    I am intrigued that you drink about a gallon of water a day. One of the things I’m trying to do preop is to drink more as I’m not getting nearly enough. How soon were you able to drink such a high volume of fluid, since staying hydrated is such a challenge in the beginning? A gallon of water a day just seems “too much” for the sleeve, IMHO, since it’s so small. What’s your secret? 🙂

    • First, water and all fluids pass directly from the stomach into the intestines. The pyloric valve does not slam shut on them, so they are easily passed through. Here is a good primer on the function of the pyloric valve:

      Because water and other clear fluids like water can just pass through the pyloric valve, it is no trouble to get in so much fluid during the day. You just have to really like drinking water. 🙂

      I was not able to get in a gallon of fluid at first–no one can. The sleeve is too swollen for about the first 6 weeks for that to reasonably occur. What you must do is constantly sip on fluids in order to meet your fluid goals, which for most doctors is 64 ounces a day (half a gallon). I know I was not able to get up to a gallon until around 3 months, and even then, I had to take it slow, which meant drinking constantly. If I was not eating, then I was drinking (45-60 minutes after eating, of course).

      Now, at 6 months out, I can down water like nobody’s business. I have not had trouble drinking the amount of water I drink at all. Like I told my doctor, if I’m not eating, I’m drinking. When I am at school all day, I aim to get at least 64 ounces down before I leave for the day at 5. My students even remark about how much water I drink when I am in my classroom–I always have a drink either close by or in my hand. I generally drink from 1 liter bottles or 24-32 ounce cups so I always know how much I’m consuming.

      When I am at home, I aim for an additional 48-64 ounces. I like to strive for a minimum of 100 ounces total each day. Water is critically important to any weight loss process, especially ones that involve high protein diets since the metabolism of proteins is tough on the liver and kidneys–you gotta have that water to flush out all the urea and other metabolites produced as a byproduct.

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