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R.R. - December 10th, 2009

I have struggled all my life with being heavy. I was always the heavy set comedic guy, fun to be around with. I think when you have played such a role for so long in life you think well that is the best it is going to get. Even though I was overweight I did play football in high school and other sports with friends. Well after high school and going to college I think that is when the majority of my weight came on. I was able to lose some of it but never able to keep all of it off and of course what I did lose came back and with some friends. Sure I would do the Weight Watchers program and have some success with it. In fact I even lost 86 lbs once. But sure enough it came back. I even did an all liquid diet and lost 85 lbs but once I got off it, I didn't have a good support system and yep you guessed I gained it back and more. That was the story of my life able to lose some weight, but never able to keep it off. So I would go on to the next diet. After college I was hospitalized once due to poor circulation in my lower extremities and was diagnosed with having Sleep Apnea while in the hospital. A few years later I had developed some issues with circulation in my legs due to the excessive weight and needed to get care at the wound treatment center at my local hospital, the Dr. tried to suggest that Gastric Bypass Surgery should be considered so I could get the weight off and help my circulation issues. Well at that time there was no way I was going to have anyone cut my stomach and get that surgery, too risky and not for me back then. I said to myself, "this time will be different...I will commit myself to losing the weight the old fashion way." Well that would work for about a month or so. My quality of life was not much better. So here I am in my mid to late 30's with Type 2 Diabetes, High Blood Pressure and Sleep Apnea and about 260 pounds overweight from a weight that I felt was ok.

I had an incident in July of 2007 in which I was experiencing lower back pains, had x-rays done and found out it was due to excess weight, not arthritis on the bone thankfully. My primary physician at that point really started pushing for me to have RNY; I again said well I will think about it. I developed another lower back pain in February 2008 which led to a slip disc and sciatica shooting down my right leg. It was at this point in my life where I knew I had to have the surgery and get back control. I had tried many times in the past to control the eating and lose the weight, it just wasn't happening. There comes a time in each one's life where you have to look yourself in the mirror and do what is right for you. It was the slipped disc in my back and losing a close friend of mine who was 40 that I finally came to realizing that I needed help and could not do this on my own.

I first felt guilt like that I was a failure that I could not control my weight issues and health issues on my own. Why couldn't I be like everyone else and do it that way? Why would I have such discipline for a few months and then let it get away from me? Well after talking to my primary while healing my slipped disc, I told him...I'm ready to go to the orientation for weight loss surgery! It was at this point that I realized something...I am not the only person in this world who is not able to control their weight and health issues by conventional ways. There are many before me who had the surgery and now on to a better quality of life. I felt like a failure at first because I could not maintain my weight on my own. Then after more research about WLS I started a new way of thinking. I'm not a failure if I need to have the surgery to help me turn my life around for the better, but not being able to recognize that I need the help and accepting it would make me a failure. Now I'm not saying that this applies to everyone, this how I felt inside and should be viewed as such.

So at the end of March 2008 I started the processing of this life changing event...I was home on Short Term Disability from work from slipping that disc in my back and attended a 3 hr orientation at Roger Williams Hospital. My PCP had been encouraging me to go to this orientation for almost a year at this point, but as he puts it I was in "denial" and I felt I could correct my weight issue on my own. Why I thought I could stay on a diet and keep off any weight I lost without surgery after all these years was beyond me, after all I had been heavy all my life and been through numerous different attempts at diets and trying to keep the weight off. But the slipped disc and losing a close friend of mine who was 40 years old at the time really hit home and was enough for me to realize that I did need surgery to help myself. My PCP stated that if I didn't make some serious life changes that I may not be around to see 50 yrs.

My first thought was ok I will get the Lap Band because there was no way that they were going to cut my stomach and re-work my plumbing no way no how!! I discussed this with my primary and he tried to explain it to me that the Lap Band would not help MY situation enough and that RNY is the better tool for me. But he was glad to hear that I was at least considering surgery. I went to the orientation and was thinking Band Band Band all the way...by the time I left that three hour session...it was like a some flicked a switch on my head and showed me the light that RNY was the better choice for me. The Band would not allow me to loose the weight that I needed to loose and help me rid myself of my co-morbidities (Type 2, HPB, Sleep Apnea) quick enough that my primary doctor felt was necessary. So from there I made my first appointment with Dr. Giovanni.

When I met with her we discussed my health issues and the plan of attack to get me ready for surgery while getting my tests done. Then she looked at me at a said that she needed me to lose 75 lbs for her to be comfortable to do surgery. I looked at her with an expression like are you serious?? I need to loose 75 lbs to have WLS...ok where is the camera hidden?? Her reasoning was it would make me change my lifestyle now, show a commitment to her that I am willing to change, and give her the room to do the procedure laparoscopic while reducing the size of my liver. At this point I new I had to get the weight off and be able to keep it off till surgery...so I chose a road that most don't travel as pre-op...I went for an ALL liquid program(Optifast) at a local hospital that is medically supervised. Yep once again back to all liquid, but this time with a support group and my eye on the bigger prize.surgery! I started the program on June 13th 2008 with having 6 shakes a day and nothing more. I continued to be on the all fasting program for 4 months straight...then I went to the modified program (4 shakes 1 meal) then (3 shakes 2 meals). I finished their program just before Thanksgiving and was down 120 lbs. at this point; mind you I only had to lose 75 lbs. From the time of Thanksgiving till December 28th 2008 I managed my own eating regiment and gained back only 10 lbs in this time period. Not bad in my opinion from going from a regiment eating plan to just making sound choices by myself and both holidays included. I started my two week pre-op diet on December 29th (3 protein shakes from surgeon office and 1 LC or WW meal) I lost 20 lbs in the two week pre-op period. When I saw my surgeon the morning of my surgery she looked at me and my Dad and said "Rob I only told you to lose 75 lbs and your down 130 lbs and I haven't even touched you yet" My thinking was as long as it gets off before or after surgery is fine by me. I told her I was keeping the deal that we had form our first meeting...she was going to give me the tool to help me keep my weight off and I was going to lose the required weight and then some...win/win in my mind!

My new birthday is January 13th 2009...the day that Dr Giovanni helped give me a new life. I have been doing well and the scale is moving along nicely. I attend multiple support meetings at the hospital I had my surgery, to the local hospitals and my nutrionist. My family and friends have supported me from day one and continue to do so. The friends that I have made in my support groups are like family to me now and we are there for each other. My total weight loss between pre and post op is 230 lbs, I would like to lose another 35 lbs. I am currently working with a trainer at my gym to achieve losing the rest. I am ten months out of surgery and feel that I have made the transition from honeymoon period to discipline. It is this period in which one must use the tool in order to lose the remaining weight, the way it should be.

I can't say that surgery is right for everyone...this is a very personal decision. I do know one thing, which is if I didn't make this change in my life that my quality of life would of not of been very good. I have no regrets as of right now, I can't say that I wished I did it earlier because I was not ready to make this major change in my life...only you can decide if it is the right choice.