Four Months

Heaviest weight: 296.5

Surgery weight: 274.5

Today's weight: 225.6
Total pounds lost: 70.9 lbs.

I continue to work out every day, alternating treadmill/arm weights with swimming/leg weights. I look forward to exercising and I love feeling my body change. One thing that is hard to describe is how it feels when your body is so heavy. I love losing weight when my body starts to feel more free. It's like I can breathe within my own skin. 

On Tuesday, I had my latest follow-up appointment. The nurse practitioner - Judy, who is the person I always see, says that I couldn't be doing better and that she is completely satisfied with my progress and attitude. Below are the numbers from my lab work from this visit.

Weight

• Before - 296.5
• This week - 225.6

BMI

• Before - 49 (Class III Morbidly Obese)
• This week - 38 (Class II Obese)

Blood Pressure

• Before - 146/74
• This week - 134/83 (High normal, have to stay on half dose of medication)

Blood Sugar

• Before - 135 
• This week - 88 (last labs - 97)

AST (liver)

• Before - 55 (101 in October 2013)
• This week - 29 (last labs - 34)

ALT (liver)

• Before - 95 (120 in October 2013)
• This week - 35 (last labs - 48)

Vitamin D

• Before - 95 (120 in October 2013)
• This week - 41.5

My blood count, platelets, oxygen, potassium, B12, protein, sodium, calcium and iron levels were normal.

Folate (folic acid) was high - could be a result of the change to my small intestine; creatinine was low - usually caused by loss of muscle mass, so this should come back up now that I'm lifting weights; chloride was high - not sure about this one; prealbumin was low - can be a result of hypothyroidism, which I have, or malnutrition; and red blood count was high, not sure about this one either.

I no longer have to take cholesterol medication. I never had high cholesterol, but because I was diabetic, I had to take the medication. Now that my blood sugar numbers are normal, I don't have to take it anymore.

Questions and answers from the visit

• Can I drink from a straw now? Yes. 
• Should I be adjusting my caloric intake when I exercise? Yes, but cautiously. I should still stay close to 1,000 calories a day, but can eat more when I exercise. I should be sure to focus on protein and avoid carbs.
• What should my target intake be for sodium? < 2,400 (This is much higher than the 1,000 I was aiming for previously. Since my blood pressure is still a little high, I'll continue to keep this as low as possible.)
• When I am lifting weights with my abdomen, is there any risk that I could damage my stomach or anything else related to the surgery? No, but I should still be careful to avoid a hernia.
• Can I take Excedrine Mild Headache medicine? No. No Excedrine products at all. (Fortunately, I haven't had a migraine since I had surgery.)
• Can I fast? Not yet. Maybe by next Spring.

Thanksgiving weekend I'm going to have another sleep study to see if I can stop sleeping with a CPap. That would be amazing!