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Well, after a VERY long trip down here, during which I didn't get one iota of sleep, we've finally arrived in Curitiba, Brazil.

The flights down were uncomfortable, but do-able. We got stuck on the ground for two hours in Columbus at the very beginning, so we missed the connecting flight in Atlanta, but they upgraded us to first class for the next plane out to Miami, and got to Miami with hours to spare. The international flight was unremarkable for the most part - the 90" or so of space between seats in business class was a welcome change from the cattle car of coach. The TSA agents were especially nazi-istic in Miami, yelling at us because we weren't moving fast enough.

We got to Brazil, and were surpised between the difference in customs/security here vs. in the good 'ole US. No shoe carnival, unloading every single thing you own, quart bags, etc. We were expecting to be fingerprinted/photographed but none of that happened. We filled out two customs forms, got waved through, passports stamped and that was that.

The airport in Sao Paulo was a bit intimidating, to say the least. Definitely not handicapped friendly. HUGE. The elevators weren't working, and there were about twice as many people waiting for flights as there were seats in the waiting area. There is no such thing as lines there - people pretty much push you along in a throng. There is especially no patience for the elderly/infirm/children, etc. If you're in their way, they'll literally push you aside or climb over you. Not fun. Especially when you don't know a lick of Portugese and can't understand what people are saying to you. Not that many people speak English here (not that I expect them to, mind you - no more than I would expect people in the US to be bi/tri/quadlingual to accomodate tourists). I'm picking up a bit of Portugese (i.e. obrigado "thank you", bom dias "good morning", desculpe "pardon me", etc. and I can understand a good deal of the written langauge but when people speak it to me, it's much more fast than I can process it. I guess that's true for many non-native speakers of a language.

The plane to Curitiba was...interesting. Think Skybus as far as boarding - you get bussed to the tarmac where you board on stairs. All of the announcements were in Portugese, but we've discovered that flights are pretty much universal in safety instructions, processes, etc. no matter where you go.

It is beautiful here in Curitiba. The man who picked up at the airport, Gilberto, speaks fluent English and has been invaluable thus far in getting us the stuff that we need. My throat was raw from the dry air, and the doctor prescribed benzocaine lozenges (over the counter here, vs. being a prescribed drug in the US, go figure) which have helped immensely.

The doctor is one of those rare people that make you feel completely at ease the moment you meet them. He comes across as very grandfatherly, and I can't imagine anyone I'd rather have elbows deep in my guts. On a serious note, I think we made the right decision in coming here to have surgery, no matter how ill-advised it sounded in theory.

The hotel room (it's more of a suite) will be just dandy for the three weeks we're here. Great water pressure, a little kitchen area, separate living and sleeping areas - it comes out to about $100US per night, but that also includes a pretty nice breakfast buffet in the morning at the attached restaurant.

The food here is...well, different. Not bad, just different than our American palates are used to. They season food much differently here. The thing that has been most agreeing with my stomach is salami/meat, cheese, and fruit. We got some beautiful strawberries at Super Walmart (yes, they have them here too) for like $1.25 US.

More later, we've got an appointment with the doctor in just a little while. Just wanted to post to let you all know we got here in one piece.
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Less than 3 full days before we begin our trip - wow, how time flies! There were a couple of scares in there. We were afraid our tourist visas wouldn't come back in time, fortunately they did :) And when I went to comfirm our flight details on Orbitz, they had unassigned our seats and had us stuck in the middle of two people on one flight (there is a reason why I bought two seats for myself, duh!), and had not enough seats for the seats they unassigned on the other. They have assured me that we will be accommodated properly on the flight, but I'm still a little bit nervous. All I know is that heads will roll if I get to the airport and there are issues.

I'm actually looking forward to the TAM portion of the flight. I've been looking around online, and trip reports like this one have shown me that I really have nothing to worry about.

It's been a bit nerve wracking trying to do all the last minute things and not forgetting anything (like going to the bank, stopping mail and paper, calling the alarm company to let them know what's going on, calling the credit card companies, taking the animals to the kennel, going to the doctor, packing, and so much more.) I went to the doc on Friday and she gave me 30-day supplies of all my meds and a pre-filled Lovenox syringe (for my Factor V Leiden, so I don't get DVT on the long flight) to give myself before I get on the plane. I'm planning on documenting the trip fully by taking pics, stay tuned. I'll have (from what I understand) internet access in both the airports and on the plane. so you'll be hearing from me soon. :)
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Barring unforseen complications, this is where I'll be in exactly two weeks:

It looks sort of like Chicago to me, for some reason. But contrary to popular belief (and the worries of friends and family), it's a thoroughly modern city, not a third world rural chop shop. ;)

So we finally got our plane tickets, and they cost a pretty penny - $8,500 for two tickets! Yowza. At least it wasn't the $14,500 it could have been if we didn't find the Brazilian ticket broker that meant we'd have to fly on TAM and have multiple connections. If it gets us there in one piece, I'm happy, even if it means a lot of layovers. $6,000 is a lot of money to save, and makes it worth the inconvenience of traveling 50+ hours to get to and from Brazil.

We're both having surgery on January 8th. First Paul, and then me a few hours later. My nerves are acting up, but on the bright side, because of those jitters I haven't had much of an appetite and am down to 389 lbs. Paul bought me a new toy for Christmas that will make posting from Brazil super simple.

More as we get closer to the date I'm leaving.
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On the bright side, after my trip to Florida, I'm hovering around 395-400ish. I always lose weight when I'm on vacation, for some reason. Probably because I only eat a few times a day, and just munch when I'm really hungry. Wish I could apply that to everyday life.

But we're getting all the paperwork together right now to send to Marchesini, so we can hopefully get a surgery date in January. I'll keep you all updated on what happens next. The sooner this surgery is done, the better. I feel like crap.

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A long while. 4 months. No more weight loss, I've been bouncing around 410ish because I haven't even really tried to lose weight either. I know where diets get me. I don't want to screw up my metabolism any more.

Paul and I have both decided to have revisions to our gastric bypass surgery. We're both getting revised to a duodenal switch in Brazil, hopefully in January or February. We've got our passports, hopefully the plans will go smoothly.

Having lots of problems with arthritis (knee and back), got a HUGE hernia (I call it the alien baby), plus mis-aligned vertebrae that make exercise painful if not impossible at the moment. The word miserable is an understatement. Right now, it's just a matter of biding my time until some of the weight is lost and the hernia is fixed.

So expect this to be less about dieting, and more about preparing for the weight loss revision surgery and the aftermath.

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Down another couple of pounds today, to 409. I'm a logical person - I know that it's water weight, and that it's virtually impossible to lose 12 pounds in one week otherwise without starving yourself. Believe me, I'm not starving myself. Small changes that are making a lot of difference, I guess.

I wish it weren't so friggin' cold out - the dogs can use some exercise, and so can I. My knee is still shot, but I really need to start using it more. I think my muscles have weakened from lack of use.

I'm looking forward to my trip to Philly/NJ in a few days. Keeping myself busy by trying to get everything I need loaded onto my laptop before I go. I'm going to pack tomorrow, so I don't forget to bring anything with me. I always lose weight on vacation, no matter what I eat, since I'm not grazing all day. Paul wants me to mail him a big box of Tastykakes when I get there, so he doesn't have to wait until I get back to eat them.

Fish tacos for dinner tonight. Yum. :)
Current Mood:
cheerful cheerful
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...I've lost 8 pounds this week, without even changing much yet - I've avoided fast food, and that's about it so far.

My mood has been up and down. Hopeful about getting healthier, cause I feel like crap 24/7 - frightened that I won't be able to do it - a bit of panic if I contemplate more restrictive "diets" like South Beach, Atkins, Weight Watchers, etc.

I think I just need to eat more like a normal person. A little bit of everything in moderation. Watching portions. Not eating mindlessly when stressed or bored. Not letting food replace sex, crying, laughing, etc. In a way, food numbs me. Fat is a great barrier from having to deal with people.

I think in response to a lot of bad treatment in the past, I've become a stone cold bitch. A whole lot less naive. Less willing to sit back and let people tell me what to do, who to be, etc. I think it will be difficult to let go enough to let the weight management program to work, I'm really friggin' hard headed.

I'm so guilty of putting my life on hold, especially right now. I want to change that, but don't know how. I want to learn how to stop pushing people away when they start getting close. I want to stop being so damned self-conscious. I've always been big, but there was a time where I was OK with it, comfortable in my skin. Comfortable enough to be intimate with people without regard to body image. If I don't think I'm sexy, how the hell can I expect my husband to? He's already expressed that his "ideal" body type is half my size. He loves me anyway and tells me he finds me attractive, but knowing his "ideal", how can I believe him? There's a big difference between curvy and voluptuous and fat. Not that fat is bad, mind you...Just that I think my husband wants a curvy girl instead of a fat girl.

I don't know. I'm confused.
Current Mood:
confused confused
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And here's what happened when I saw the surgeon yesterday for my follow-up visit, again summarized by what I posted to the WLS listserv:

"Thank you everyone for your input so far, it's been very helpful.

I went and saw the surgeon today as a follow up to my hospital stay
this past weekend. To say it was a waste of time is an
understatement. He refuses to consider *any* malabsorptive revision,
says he was talking about LapBand placement over existing pouch only.

I told him that I didn't believe that would work for me, that a
LapBand on a proximal RNY for someone who is SMO has just about 0%
chance of success, and that I was looking for a revision to a
malabsorptive procedure, either a DS or a very distal RNY if the DS
weren't a possibility due to pyloric atrophy. That I *know* that I
would need to work to lose the weight, but that I wanted a solution
that would be realistic for where I'm starting from and that would
ensure that I could keep off the weight once I've lost it.

And then he told me that I wasn't being realistic - that I would
(not might, would) get debilitating diarrhea 24/7 and would stink up
a storm, etc. I countered with "yeah, sure - initially until you
figure out ways to eat that won't make you gassy, it may be a
problem, but that's why there's Devrom and Ozium and fiber to bulk
you up, and if it means living longer and getting rid of my
comorbidities, that's a tradeoff I'm willing to make". I told him
that for someone my size, the DS is the ONLY logical choice, and has
a record of 80% EWL, compared to 40% of the Lap Band - and that
regain was minimal compared to my current surgery, which is said to
have an 80% failure rate in the long term. He told me that after "1
week of research on the internet, I don't know anything, and need to
more research" - I pointed out that I have SEVERAL years of research
under my belt, and have read all the studies for all types of

Needless to say, we're at a stalemate - I told him I was planning on
eating healthier/exercising to get some of the weight off anyway,
and was planning on enrolling in the weight management program at
McConnell Heart Health, which involves a nutritionist, exercise
physiologist, and is physician supervised. I figured in the year it
would take me to research my options, I could get myself down 75-100
lbs. on my own so I could have a lower BMI at surgery time and
increase my chances of hitting somewhere near goal. He told me that
wasn't a good idea, that was for people who only had a little weight
to lose, and that I should go see this doctor friend of his who
would "get the weight off quick through drugs and other drastic
measures". Sigh. I'm not looking for quick solutions, I'm looking
for a permanent one.

More and more, the DS is looking like what I want/need. And
insurance will pay for it too, but there's no OON benefits on my
plan and no INN doctors who do it (except for Maguire, and I don't
think he does RNY to DS revisions). So either way, I'll have an
insurance fight on my hands or will self pay if insurance still
denies. Can anyone point me to a list of doctors who will revise a
RNY to DS or a very distal RNY (w/ 50-75cm CC) if the DS revision
isn't possible?

Current Mood:
frustrated frustrated
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To bring everyone up to speed, here's what I posted to a WLS listserv, which basically tells most of the story of my experience so far:

"I'll admit it. I'm officially a failure.

When I had weight loss surgery nearly 6 years ago, I sang the
praises of the surgery, saying it was the best thing I have ever
done for myself.

In many ways, it was. It got me mobile again. It got me living life.
And even though I've managed to gain back half of the weight I've
lost, I'm still mostly mobile. And still living life.

But it's also given me a lot of things I didn't bargain for. Anemia
and B-12 deficiencies. CFS/Fibromyalgia. Some autoimmune crap we
haven't been able to diagnose yet. Some of this stuff is treatable,
but I'm taking more pills every day than my grandmom did when she
died at 86.

Over the past few years, I've stopped trying to make the surgery
work. Since the malabsorption was gone, and since I didn't have any
restriction, it was so very easy to go back to eating the way that
got me to 500 lbs. in the first place. I'll take my share of the
responsibility for that. If I had dieted my ass off, I may have even
eventually made it to the high 200's.

So let's get to this past weekend. Ate dinner as usual - a few hours
later I was doubled over in pain with waves of abdominal cramps and
major dry heaves. Paul took me to the ER, and they thought I may
have had a partial bowel obstruction. After some pain and anti-
nausea medication and a CAT scan, they decided to admit me. I saw
the surgeon there the next day.

While I do still take responsiblity for my part in it, he's taken a
huge weight off my shoulders. Told me that I was doomed to fail from
the beginning. Starting at 500 lbs, a proximal RNY was not what I
needed. He told me that no matter where you start, a realistic
expectation is to lose 150-200 lbs. total. So starting at 500 lbs.,
I would have still ended up obese. Which I did. If he had done my
original surgery, he would have put a lap band on me until I got to
350, and then done a distal RNY. Also made sure that I had addressed
the food addiction issues first.

He told me that there's still hope. That he wants me to do a
medically supervised diet to get me to 350 (I say 320, because
that's the point where insurance would cover it), and then put a Lap
Band over my RNY pouch and failed stoma. That we'd address the food
addiction issues as part of the process.

He also told me that the CT scan showed that I had a hernia. And
that I possibly have a gastro-gastric fistula, because there
was "communication" between my pouch and remnant stomach where there
shouldn't be. Which explains why I never felt full. Ever. So either
way, I need surgery to repair this stuff because both of those
things are bad mojo. The hernia was probably what caused my
intestines to get kinked. The issue resolved itself, but could have
ended up very badly.

Part of me agrees I should get a revision. But I'm not sure to what.
Will I have decent results with a Lap Band? Or do I need to go
straight to the big guns of the DS (which is also now covered by my
insurance)? Should I lose that 100 lbs. on my own first, so I have a
chance of approaching something nearing a healthy weight? Am I even
capable of losing it on my own? Should I get the Lap Band, lose some
weight on it, and then revise to a DS to get the rest off? Or should
I see if he'll fix my common channel (which is 375 cm) when he
places the lap band?"

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...for this site. For food blog entries, please visit http://www.columbusfoodie.com/

I'll now be using this as a blog to track my progress in losing weight and getting healthy. The entries that were here will eventually be deleted, as they are already mirrored on the new site.

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