Bariatric Diaries 3: First Weekend Home

What a rollercoaster.

I got released on Thursday afternoon from the hospital and left pretty sore but looking forward to recuperating in my own bed. Friday I was home alone so that my wife could go back to work. I relied on the pain medication to help me make it through the day and slept most of the day between HBO movies. Saturday, I got to see my son for the first time since the surgery. In the most innocent 6 year old voice he immediately said ”Wow you look like you lost some weight already Dad.” Even though I knew he was trying to make me feel better, I played along. I also got out and did some walking with my wife while she ran some errands. She must be a saint, because she has been so supportive and waited on me hand and foot this week.

The pain has not been too bad so far. My surgery was laparoscopic, so I have 6 small incisions forming a rectangle on my stomach. I would offer to show a picture, but trust me when I say you don’t want to see that. The incision on the upper left side is by far the most painful. Dr. Douglas Lorimer, who did the surgery, explained that is the “port” where they insert the stapler and so it will generally be the worst pain wise. So as of Sunday evening, I am for the most part pain meds free (5 days post op). I have made it to the evening without taking any pain meds, which depending on how much I am moving around, makes me question myself. Overall the pain is about a 1 or 2 on the infamous pain scale you will experience at the hospital.

Ok, so I know you are probably telling yourself that there has to be something that isn’t going so well. A couple things!! I am having issues with nothing tasting good to me anymore. Things I fell in love with preparing for the surgery taste like awful. Even my fall back plan of fat free pudding that I have eaten most of life tastes bad. I unfortunately had to pay another trip to Vitamin Shop today because the one protein I really liked before surgery tasted and smelled so bad that I started to gag from drinking it. Oh yeah, the vitamins aren’t so bad, but I have found myself brushing my teeth more because they make my breath smell horrible. Not sure what is causing this problem; I have to figure something out QUICKLY!!

Overall, I give 2 thumbs up with my surgery experience. I will make it through the couple bad things and I will be a better human because of it. Life is too short to let small issues like those get in my way. I go back to my follow up appointment with Dr. Lorimer next Wednesday morning. I am sure he will have some answers to my issues and more importantly he is planning on taking out the stitches. I forgot how much they can start to itch after a few days. Be very careful with your wounds, the last thing you want is an infection or something to happen to those stitches.
Also, I want to take a quick moment to thank some very special people at Texas Health Fort Worth. Dr. Lorimer and Dr. Castaneda, you guys did a great job and I really appreciated the kind words from both of you after I got to my room. I could not have asked for a better team of surgeons to work on me. The nurses and patient care techs on the 3rd floor are amazing. They can be tough on you when it matters most, but they are always there. I can now confirm that in any state of medication I will forever be able to provide my full name and date of birth. J I have worked with nurses for several years through my job and I have never seen such a professional and caring group of nurses in one place at any given time. The “Lovely Ladies of Bariatrics”, Tiffany Norris and Jaime Bass, are again awesome. They both came and checked on me daily and helped make the stay just a little easier. Carey in the chaplain’s office also came by to see me every day. He prayed with me and my wife pre surgery and really made me feel so much calmer and always had some kind words to share when I was stuck in the hospital bed. Finally, thank you to Whitney Jodry in marketing who braved the early morning hours to tweet about my surgery to promote obesity awareness. It is a huge problem (no pun intended) and people should know their options. My family is extremely appreciative of the work that the entire team of Texas Health Fort Worth put forward to make our experience that much better.
Since surgery, I have lost about 10 lbs. bringing my total loss since January to approximately 46 lbs.

The journey continues…..

Full coverage of the Casey James Visit!

Casey James' visit to Texas Health Fort Worth was nothing short of amazing! I have documented his entire visits with the highlights pictured below. I also want to mention that his visit has been well documented on People.com, MTV.com as well as on Fox 4 last Friday. We also have been told that the segment from his visit will air on Wednesday night on American Idol. Please tune in...

Texas Health Fort Worth surgery nurses made their own posters and came to catch a glimpse of Casey!
Hundreds of fans waited in anticipation of his arrival!
The police motorcade that escorted Casey all over the metroplex!
He finally arrived! And in style...
Fans first glimpse of Casey!

Casey took time to stop, sign autographs and take pictures with his fans! He was so gracious!
This precious boy brought his guitar for Casey to sign!
Casey and his mama seeing Dr. Cory Collinge, orthopedic surgeon at Texas Health Fort Worth, for the first time.
Casey presented Dr. Collinge with one of his guitars that said "To the good people that saved my life, I love you!" This was a very touching moment!
From left to right: Lillie Biggins, senior vice president of operations at Texas Health Fort Worth, Dr. Cory Collinge, orthopedic surgeon, Casey James and his mama!
Dr. Collinge and Casey James with two of our excellent clinical staff in Trauma ICU!
Dr. Collinge and Casey!
Casey doing an interview with the local Fox affiliate about his accident and what the staff at Texas Health Fort Worth mean to him!
Casey even made time to stop and visit with a patient, Dalton Williams, who recently was in a motor vehicle accident and was thrilled to have the opportunity to meet Casey!

Casey gave one last hug and picture to the PR girls at Texas Health Fort Worth!

I have to say after working at this wonderful hospital for six years, this media event goes down in the books as one of the most memorable and most touching! I am proud every day to work with such incredible physicians, nurses, administrators, volunteers and professional staff who make it their goal to improve the health of the community!

Thank you, Casey, and American Idol for stopping to pay it forward to our clinical staff! This day was truly one we will all remember for the rest of our lives!

- Whitney Jodry

Texas Health Fort Worth spokeswoman

Bariatric Diaries 2: Getting closer

I woke up early today to visit Texas Health Harris Methodist Fort Worth to have my pre op testing done for surgery day. You can schedule your pre op tests up to 5 days out from the date of the surgery. The tests were pretty straight forward. They did blood work, an EKG, a couple chest x- rays, and of course a weigh in. Also, be prepared to give your life history. I am almost positive they asked me over 1000 questions. Ok, maybe it was more like 40 or 50. Before all the testing I paid a visit to a friendly admissions counselor who verified all my information and collected my deposit for the surgery. I was in and out in less than an hour.
So now I am preparing for my last weekend before surgery. A friend asked me earlier today what I had planned for the weekend, and I could hear in their voice they were waiting for this great lineup of events. No, I am not going to go slay a dragon, or go bungee jumping, or anything crazy. It’s just another weekend like all the others. I am going to relax with my wife and son while trying to get some things done around the house since I will be out of commission for a week or two. If it doesn’t rain too much, I will be coaching t-ball on Saturday morning. I will probably slip away to do a little shopping for chewable vitamins, protein, and all the other supplements that I will begin taking once I am home from the hospital. Other than that, I plan on spending most of the weekend at home.
Oh yeah, I almost forgot to mention how the weigh in went this morning. Drum Roll Please………. I have lost 23 lbs since my last weigh in a month ago. Great way to start the morning!
Have a good weekend everybody!! The journey continues….

- Casey Armstrong

All about Casey James today!

What a day we have had at Texas Health Fort Worth! So glad to have former patient Casey James and top 3 American Idol contestant in the house! Here are a few pics from his visit...

Casey exiting the limo to hundreds of fans!

Casey was so generous and signed this little boys guitar! He probably made his year! He also took pictures and signed autographs with hundreds of fans!
From Left to Right: Lillie Biggins, senior vice president of operations at Texas Health Fort Worth; Dr. Cory Collinge, orthopedic surgeon at Texas Health Fort Worth and Casey's doctor; Casey James and his mama!
Casey presented the hospital and Dr. Collinge with one of his guitars signed "To the good people who saved my life. I love you." Signed Casey James.

What a priceless gift!

Dr. Collinge is quite the miracle worker. I love the beaming look on his face after receiving one of Casey's very own guitars - signed!!!
Casey also went and visited one of our trauma patients, who is also a musician and loves to play the guitar! Glad we could have you participate today, Dalton!

These fans made today even more special! Thanks to the community for coming and showing your support!

I will be posting more pictures as I get them, so make sure you check back! What an incredible day we have had and can't wait to share more photos and video with you!

- Whitney Jodry

Texas Health Fort Worth Spokeswoman

Guess who is coming to Texas Health Fort Worth Today??? Casey James!!!

If you want to catch a glimpse of Casey today, be here at 11:45 a.m.

Texas Health Harris Methodist Hospital Fort Worth
1301 Pennsylvania Avenue
Fort Worth, TX

Fans will be welcome to line the streets of W. Cannon Street!

Hope to see you there!

Bariatric Diaries 1: A Perspective from Casey Armstrong

My name is Casey Armstrong. I am a fat guy.
I have been an obese person since the day I was born. It all began August 18, 1979 when my parents gave birth to a strapping 10 lb baby boy whom the doctor proclaimed needed to be playing for the Cowboys. Growing up I was always active in sports and other activities and I always made a mental note of the fact that I was always the biggest kid in the group. That might have bothered some people, but I was lucky to have been taught that I shouldn’t let people’s words bother me. By junior high I was already hovering around the 200lb range and by high school I was nearing 275. After high school I went on to college at SMU in Dallas and after tearing my ACL and becoming less active, I was quickly over 300 lbs. I am now 30 years old and at the beginning of the year I was close to 350 lbs. All these years I would make excuses as to why I didn’t need to diet, I was in denial.

This year has brought lots of twists and turns to my already jammed packed life. Back in January I got some bad news, my mom was very sick from complications of congestive heart failure. Not long after that, I found out that an old friend had passed away at just 37 years of age. My mind raced with the idea of death, illness, and my family. Life is short, and the fact that I have a family history of medical issues a mile long and the fact that I was overweight didn’t help my cause much. Later that night, I stood in the kitchen with my wife and we talked about death, our family, and the fact that I needed to do something to change my life because I didn’t want to die. We decided that I should call to get more information on weight loss surgery. At that moment, I knew my life was about to change.
I contacted Dr. Lorimer at Texas Health Harris Methodist Hospital in Fort Worth and scheduled an appointment. My wife went with me to find out what my options were. I was nervous to the point that I was sweating and almost couldn’t think straight. After talking to Dr. Lorimer, I knew what I had started down a path of no return and now I had to finish it. I began all of the prerequisites set out for me by my insurance company so that they would help pay for the procedure. A pulmonologist visit, then a psychiatry visit (I now have proof I am not crazy), a monthly trip to see the “Lovely Ladies of Bariatrics” at the hospital, and finally attending a monthly support group (yes men go to support groups too) for weight loss surgery patients. After 5 months of appointments and mentally and physically preparing myself I am scheduled to have gastric bypass surgery on May 18, 2010.

I get asked a lot of questions lately, so I thought I would get those answered one more time for anybody out there reading this. Here we go…

Why am I doing this?
That’s easy. Although I don’t have any major health problems, my family does. I am married and have a 6 year old son, and I want to watch my marriage grow and be there for my son as he moves on in his life. Most importantly, I am doing this for ME!! I am smart enough to know that if I don’t change the way I live, I will most likely miss out on things in life. I am not one to miss the party, and I plan on being here for many more years.

What do I look forward to the most with losing the excess weight?
I can finally walk into any store and buy clothes off the shelf rather than paying more money to buy big and tall clothes. My wife always reminds me how good it will feel to lose the weight when I get discouraged or try to venture off my plan.
What is the worst part of getting to surgery day?
Two words, CHICKEN BROTH!! You will have to go to a liquid diet 2 weeks before surgery and Chicken broth cannot be altered enough ways to make it appetizing. Also note that once you put no sugar into your body for a few days and then you accidentally eat something sweet, WOW you will get a rush. I experienced this at the hands of a cherry Popsicle. I bounced off the walls for hours. It sounds horrible to go to a liquid diet, but it becomes easier the further you go. On top of that I have lost over 20 lbs after my first 8 days on the diet.

What is my goal?
My goal is to lose approximately 120 lbs. That would put me close to 200lbs for the first time since junior high. Also I have made it a mission to compete in some type of endurance race with a few of my friends within a year of my surgery.

How long will I be away from work?
I have been told 2 weeks. I am stubborn and want to go back sooner, but I am playing it safe and doing as I am told. I hope to be fully recovered within a month.

What does everyone think about this?
I have some of the most supportive people on the planet in my corner. My family and friends are rooting for me the whole way and have already told me that I will be under watchful eye. Your support group is probably one of the most important elements in this process. This is not a quick fix, it is a lifestyle change.
I go in tomorrow morning for my preop testing; I am nervous and excited all at the same time.

I am having surgery in 6 days. Now more than ever, my life is changing. The journey has just begun! Keep you posted!

- Casey Armstrong

Nutritional Facts - Coming to a Restaurant Near You

There’s a lot of talk about menu-labeling laws requiring restaurants to post exactly how many calories, fat grams, sodium, etc. are in that quick lunch you eat on your way to your next meeting or your daughter’s soccer practice. Americans are spending almost half of their food dollars on food outside of the home, specifically at fast food restaurant and food-service vendors. And most don’t know exactly what they are eating.

The nutritional facts are available for most of these restaurants and have been for years, but research from the American Journal of Public Health show that most don’t look. Researchers observed 4,311 patrons of several very popular fast food restaurants to see if they accessed in-store nutrition data. The info was not on the menu board but in a pamphlet, on a wall poster or an on-site computer. Only six, or 0.1%, of the patrons looked at the numbers.

Some will argue that consumers don’t care or won’t change their selections based on nutritional information, but does that mean we shouldn’t have this information readily available. Would you choose to super size your order, knowing it adds 220 calories and 6 grams of fat? Maybe, but it would be an informed choice.

We cannot argue that obesity, heart disease and diabetes are growing rapidly. If laws require us to know what our clothes are made of and how to properly launder them, shouldn’t the same be said of our food?

- Tiffany Norris
Bariatric Nurse Coordinator

Knowing Your Rights

If you are admitted to our hospital or come to our Emergency Department, you’re given a small stack of papers to sign. While it’s tempting to quickly sign the forms and feel that you’re done, these forms are provided for your protection to empower you while you’re in the hospital. It’s more than okay to read the forms and ask questions before you sign them.

One form you or your loved one will receive is titled “Patient Rights and Responsibilities.” It lists numerous patient rights which are based on the inherent values of dignity, respect, and consideration. Some of the patient rights on this form involve important topics such as privacy, freedom of choice, and obtaining information from the medical record.

I think many people underestimate their influence over their own health care decisions. For example, you could be going into a state of the art operating room with the best physician in the country with our amazing nurses ready to help …but it still comes down to you consenting to have the surgery done. The surgery starts with you and ends with you.

Just as looking at your favorite restaurant’s menu is the best way to see what to order and what to expect, reading the “Patient Rights and Responsibilities” form at the start of your hospital stay is the best way to prepare for a very satisfied experience.

Craig Pomykal
Patient Advocate

Boat Safety and Summer...

It looks like spring has officially arrived here in North Texas. The skies are clear, school is nearly out and the bluebonnets are everywhere, making even traffic jams tolerable with their incredible beauty. There is just something about spring that brings a new found energy and beginning.
Folks spend more time outside this time of year. In Texas, that also means on the lake. We have more square miles of inland water than any other state. I have lots of memories being pulled behind a boat trying to get up on water skis. Thank goodness that was before personal video cameras. Remember those big orange life-jackets?
Speaking of life jackets, it is a law that anyone younger the age of 13 must be wearing one. Nearly 85% of all boating fatalities were not wearing a life jacket. Of course they don’t have to be the orange ones, just one that are coast guard approved, and they have come a long way baby. In fact, life jackets are a requirement for personal water crafts.
Be the “designated driver “and avoid alcoholic beverages while boating. Alcohol plays a role in 50% of all boating accidents. Boating while intoxicated carries penalties similar to driving while intoxicated.
It’s also a great idea to take a boater education class. They will tell you to maintain a 50 foot distance from other boats, personal water crafts and swimmers unless operating at an idle speed. They will also let you know that weekends between noon and 7PM are the busiest times on the lake, so operate your vessel at safe speeds, especially in crowded areas. Information can be found at the Texas Parks and Wildlife web pages.
Both of my sons love the lake. They spend hours perfecting their wake boarding flips including “front roll, back roll and half-cabs”. They post their pictures on various social networks. It’s an enormous workout. I know my heart rate increases when I see the photos! But most of all they have a great time with friends and family. That’s what spring and outdoors is about.
Until next time keep it safe and shipshape!

--Mary Ann
Injury Prevention Coordinator

Buying medications online

Internet pharmacies have increased in popularity over the last few years. Although pharmacies provide customers with a convenient, private, and affordable way to buy prescription medications, the use of online pharmacies can be a safety concern, particularly when unapproved drugs are dispensed.

The National Association of Boards of Pharmacy (NABP) conducted a review of over 5,000 internet pharmacies and found that 96% of online pharmacies are not in compliance with the laws and regulations set forth by the Food and Drug Administration (FDA). Medications dispensed by these non-compliant pharmacies may be unapproved by the FDA and contain the wrong ingredients, too much or too little of an active ingredient, or even dangerous substances. For example, recently the FDA purchased and analyzed several products claiming to be Tamiflu, a medication commonly used to treat flu. When analyzed, some of the products did not even contain the active ingredient found in Tamiflu, but instead contained a common over-the-counter pain reliever, acetaminophen (Tylenol).

In order to protect the public from the dangers of illegal online pharmacies, the NABP has set forth guidelines to help identify websites from which prescription drugs may be safely ordered. Signs of a trustworthy website include a valid physical address in the United States, a license by the State Board of Pharmacy where the website is in service, and a licensed pharmacist available to answer your questions. Prior to dispensing the medication, internet pharmacies should require a valid prescription from a physician who has physically examined the patient and determined the prescribed medication to be an appropriate treatment. Some illegal online pharmacies issue a prescription without a physical medical examination, which may result in an incorrect diagnosis and/or treatment.

The NABP has also developed a program, Verified Internet Pharmacy Practice Sites (VIPPS), to help reduce confusion and ensure customer safety. This program places a hyperlink seal on a pharmacy website (image shown below). When a customer clicks on this seal, they should be linked to the VIPPS website which contains information about the particular pharmacy website they are visiting. The VIPPS seal verifies that the pharmacy has met state licensure requirements as well as the NABP criteria for a valid pharmacy practice. An additional tool for consumers to use when considering an online pharmacy is a list of approved online sites provided by the NABP. (www.nabp.net/vipps/consumer/listall.asp).

Online pharmacies can provide benefits for patients and their healthcare as long as precautions are taken to ensure their privacy and safety. The NABP is continuing to research internet pharmacies in order to help educate the public on the dangers of buying prescriptions online. With a little research and the use of the VIPPS seal, consumers can help ensure the safety of their health and privacy information.

Nicole Day, PharmD