Pragmatic 57: Lap Band Bypass Gastric Sleeve

15 February, 2015

CURRENT

My wife joins me as we discuss our recent experiences with being obese and undergoing weight-loss surgery. It’s extreme but it works though it’s not without serious risks.

Transcript available
Irregular. You did me you you okay you close right now that still finish holding development and 50 seconds to longish yes welcome to pragmatic pragmatic as a weekly discussion show conveying the practical application technology explainable will trade off to look at how great ideas are transformed into products and services can change our lives nothing is as simple as it seems this episode is sponsored by extrasensory devices and their amazing laxity for all an incident like me to attachment your smartphone or tablet visit ES devices.com/pragmatic for more information about the handy luxury for all no modern photographer should be without and take advantage of a special discount exclusively for pragmatic business as observers also sponsored by many tricks makers of helpful apps for the Mac visit many tricks or one word.com/pragmatic more information about their apps but the chemo leach desktop curtain time sink usher movement name angler as well as which anything visit that URL you can use the code pragmatic to find that pragmatic the word and to fibre numbers in the shopping can't save 25% on any many tricks product will talk more about them during the show on your host John Geagea and joined today by special guest host my wife Kirsten Geagea is reading has gone to apologise in advance if the whole sweaty and anything is sickening or armed yet just filter out to get used to using others names first names recent years mum or dad all sweaty and they say McCoy mum and you're not my dad never you say clarifying what there is a special reason I got your show Darling and its got to do with the procedure that we both been through a lot of vacuuming through three different procedures but they're all related to the same thing and that is yes right and that is weight loss surgery and this is something that I didn't have to do much research for the show 4 to be perfectly honest because we both researched this to death before we actually had done ourselves people of the following are the blog will not my blocked extortion will know that about nine months ago now thereabouts arm I posted an article is a link in the show notes feel free to read if you want and arm it was basically are entitled – how do I get here and see walks through all the stuff on a nominal cover somebody and the people that haven't read the article but I encourage you to read it the more background on my personal story but I asked around few people I also up an open question on Twitter and articles on Facebook asked a few other people personally though interested in coming on to talk about weight loss surgery with me and I was sort of surprised but not surprised too much the people I think find a very personal topic and I don't really want talk about it so it'll just let me disrupt some people arm very secret it's not something they discuss with work colleagues or friends arm some people even mention it in the family when they asked about weight loss may simply say diet and exercise and simply because there is still in some situations and circumstances there is still a stigma attached to weight loss surgery and we face experience that before our surgery but will will talk a little bit later on the right and I am grateful that you're prepared to come and talk about this because the show does have a reasonable number of listeners and it's not it's it's something that Ivory put out there on the Internet for me personally I know that you still have on Facebook and on and on lots of our though weight loss are forms I think on Facebook as well groups I guess you can groups technically are and I realise that some of your stories out there but there's a lot of people may not of her excitement I do appreciate your agreed to come on what I've achieved in the last 18 months since I had my surgery and if I can help one person to realise or help make that help clarify in their minds and make a decision either way then I theorise I have achieved something that's awesome so right before we get into any detail we have to start by arm several big disclaimers this is very important one we are not doctors are made bank accounts we no were not and finally enough when were in the hospital a few times and were asked who is your surgeon and done we said I was such and such and the like yeah yeah okay yet is doing well for himself so no we are not doctors were not surgeons from that we are also not nutritionists okay so arm yet again nutritional advice take with grains of salt multiple or a whole sort not too much stock between a physical point and how our service is not medical advice in any way and that you need to do your own investigation you need to speak to your own doctor medical practitioner soothsayer whatever you got are do not arm just listen listen and go do something extreme our story is is our situation and we are not where we are not saying go out and do this make a decision and is simply our story and experience take from it what you will already so why is this a problem why is there such a thing as weight loss surgery because prior to 1950 there was no such thing there is also the different surgeries but there was no weight loss surgery really did become regular practised until the 1960s and even then mainly in the states so why is this a problem are the world health health organisation are recently part updated that their website and so these figures are relatively recent worldwide obesity has more than doubled since 1980 and 2014 more than 1.9 billion adults 18 years and older were overweight of these over 600 million were obese 39% of animals aged 18 years and I and over are overweight in 2014 and 13% were obese and most of the population in countries were overweight and obesity kills more people are then underweight so 42 million children is another one for you under the age of five are overweight or obese in 2013 and their punchline in the article is a Lincoln assurance feel free to read if you would like to be freaked out arm is the quite rather rather obvious obesity is preventable how easily preventable is what we are adsorbed out so everyone goes on about your things were. Better procedures are first of all is body mass index something BMI is actually very interesting answer a program on TV supplements that discussed how arm that came up with the BMI and the limits which showed what was a normal weight what was overweight and obese and was was created by an insurance company in the United States here where trying to skew their figures and just decided that the bulk of majority of people who would this place would be considered a normal weight and a skin graft said they were thinking this they would then be considered overweight international premiums BMI thing I think is a crock and if you a lot of setting to deal with and I have overweight and obese patients they will agree someone out there who is set full of muscle and according the BMI they would be considered overweight and any any system that can classify someone like that as overweight the systems gotta be flawed say if you're looking BMI chart and thank God I'm overweight aromatase take it again with that the grain of salt and arm don't put too much stock in the problems is obviously that Edgar is a simple calculation of our of height to weight and and is difference are numbers whether you're male or female but the problem is of course that it doesn't take you people build some people are very skinny build other people are not and the others there's lots of other variables like you're saying is really about must muscle mass and everything like that so BMI is nothing more than a guide and they do that they do have hard colours but they do have the mainly because for the want of nothing better but ultimately the decision comes back to a doctor and a surgeon to make an assessment as to whether or not you really are at risk will not so arm user it was a red spin around is as a measure since the early to mid 1800s and it was during the 1970s insurance thing happen your mentioning so out of analogue in the article but that you're out more about the similes and assurance anyway so arm BMI is a first examining is dieting and the success of dieting and I call this thing the weight loss industry for a reason is that it's an industry that takes people in you you follow all rules and do all the now dieting fatty take the right pills whatever house down your head spin around three times all other rubbish you and what happens well you just end up on the way back on again within 1 to 5 years the Lee's way of often finds that once you start to either get an ideal way or you get you get over it and I'll have it start to slip back you start to put weight back on and start it normally again and the way goes back on simply because it is an industry and sure enough people legalities diets and enough done I've done all of the new name I've done it arm and at no point did I end up getting anywhere near a goal weight or a healthy weight and I usually end up heavier then I started say that's why liked likens that it's called an industry because they expect you to fail now expected to come back again finding is that sometimes the spider backs out tell you they want you to come back again because that's their business and in the same fashion which McDonald's wanted to come back to our deep more of their food the weight loss industry what you fail so you keep coming back year after year irrespective some are some recent studies in America suggested that as many as 95% of diets fail are am I so failed under the fail success criteria it varies from study to study but the idea is that the majority of the weight lost is regained within 51 to 5 years so some of the things with gaining ways that make its somewhat to arm the addition of weight makes it harder to still lose weight is that the extra weight you're carrying this makes it more difficult to stay fit Karen graduate does burn more calories but your body then tends to reach a new equilibrium really hard arm exercise when we reach certain weights arm the amount of pressure and stress you're putting on your joints and your body is actually doing a lot unharmed and people who are overweight will start running and find within a few weeks in these give out land shin splints because they are not designed to carry that much weight and run or do seriously physical exercise so it's a vicious cycle in that respect is that the bigger you get the less able you are to move and exercise sealing up putting more weight on say you find yourself Cortina in a catch 20 and the worst part is that once it affects your mobility to a point at which you can't move around you can't get out arm much if any exercise at all are then the solution in the last 1520 years seems to be getting mobility scooter which of course then makes a bad situation worse and with little or no energy then being burned all your weight skyrockets even more so it's it's of it becomes what you said vicious cycle and it's of a cycle is very difficult to break but it's not just because that it's also because our food has an addictive element to it and is is weird I was because people think a lesson like like an opiate like heroin or so my cocaine there is theirs and there is an addiction that because our you feel the need to continue taking Axa makes you feel really good but you could live without you could live without heroin you could live without cocaine we live without those those hard drugs but you can't live without food is that that the people get stuck on and I call we can't get addicted to something that you need to survive as cycle the problem is that once you take a nutritional aspect of food out and put to one side and say what I need the nutrition to survive I don't need the sugary fatty in no bad foods only those all those are the ones that are the problem those the ones that have the of the addictive nature to them the ones that that arm go stimulate the right pleasure centres in the brain and encourage the wrong behaviour will continue to keep taking them and then a low carb diet or make up giant arm which is patently his been overweight if tried at least once after two or three days of my calves you would kill an outline point I would have sold one of my children for a slice of bread I was craving carbohydrate and tries to tell you that that is not addictive ideal and talking about absolutely and I decide to add no children were sold in confining undertakings and metaphorically speaking we can offer today he offered to give us one of his other trade in Australia and again how right good lovely so arm you bad fruit examples are the ones become more popular recently the people banter as being horrible as high fructose corn syrup but now we was been told to years of carbohydrates out there that the greater Philly you know but no told that in the past that was bad that was the enemy and and sugar and carbohydrates carbohydrate of course is broken down into sugar in the body carbohydrates forests studies now finding that facts really that bad fully carbohydrates that are not good for us because we in such quantities and such highly processed carbohydrates are flower anything made with flower our past a potato bread rice anything pretty much that is why it is good for our bodies in quite large in in the quantities that have been recommended to us in the past never wholefood. The is the wrong way round dance round K it upside down again my opinion only nutritionist I'm not a nutritionist but this is just based on my research and my experience any other thing to keep in mind also is that it's also based on some of some of what we're saying is based on the result of our changed eating habits as a direct result of our surgeries which will get into in as we progress through the episode we are getting to our stories with their cricket they got a good starter beginnings assist away was actually so anyway all right so a few more little little details before we start on a different kinds of surgeries and the wine if you would choose to do it anyway next is the problem with arm the our bodies that we accumulate fat to store it for tough times rough time you know my caveman days when you hard to find and there were famines and yes exactly exactly there was never really meant for extremely long term storage the body simply not designed for that little touch neighbour forcefully when you talk about people joints and everything you even if you don't do much exercise any prior a lot of weight all that extra extra fat that your body is carrying will cause my physical damage will get arthritis you'll get arm yet you have problems so it's problems yet is the body simply not designed for that and the other thing is that continued stretching of the stomach for example if you continually stretch the stomach enough times are along a period of time, like skin once skin stretches as well it never truly retracts to its original state its original position is lean and you blown up in the area blown up again and let the error couple of times and nibbling back to the same size that it originally was in the stomach is much the same if you're constantly stretching and then arm emptying as it only time it stretches it is actually worse than a balloon because it was the weather weather balloon see our bodies are also making cells to fill in so as your skin stretches and so on your body actually to some extent fills in some of the gaps on and so on an empty can't restrict is that is a chemical star for an everlasting lesson less than the yes and it's just something people don't think about so the problem is that once you've then stretched your stomach it then makes it easier to overeat in the future so once you've done a few times it gets easy to keep doing it and and that's a big problem because it will totally reach the point where you are never full the problem I had is that I never felt full so here exactly and I imagine Adam in the article I wrote is that you are looking forward to feeling full again are which I now definitely fearful beneficial okay so arm the whole point of of of that is to understand that once you go down this path you've had too much over to longer period of time and then you go on a diet you lose like 20 kg audio 50 £60 order that works out to you ultimately you know it's still very easy to overeat from that point and you're not resetting your stomach at all by guiding you not so okay arm another things to think about before we dive in is i.e. eating is actually pretty disgusting case the hangar steps stay with me just think about okay takeaway taste take away that feeling of of of pleasure of feeling full arm of the open the desire for food you take that away think about you taking a foreign plant or animal matter you put in your mouth you've got a bit of saliva and now you chewing and grinding up into a pulp and any swallowing and then it sits in use inside the middle of your body for a while what your body tries to go pulling down nutrition out of it and we won't go past that point is as discussed I guess but anyhow bodily functions beyond so it is kinda disgusting but either evolutionarily speaking or arm you over religiously speaking the body has been designed or has evolved either which way you choose to believe that that needs to be a pleasurable experience so you have to enjoy eating you have to like the taste of certain foods in your taste of of different ways that are suitable to use a different taste to avoid are likewise the business is well something is taste right good chance that it's unpleasantness all off all arm isn't going to be good for me so that's why taste has developed things that taste nice arm are usually things that I'm not going to kill us in certain volumes have lots of energy typically as well so the other thing is arm the reason I bring this up is when a circle back to this later and that is a hormone that was discovered only in 1999 called Dag Llewellyn as the topic of a lot of discussion and now in obesity and weight loss circles and talk about ways and methods of reducing the production of gravel and as a because it is considered to be the trigger mechanism make a meal yet hung on the other it makes you feel hungry he can fossil our tablet. The production of drilling in the body you now swear if I knew how TI beyond that like a shot trying to invent something – giving away business strategy, was a long-term calcium long-term yes study chemistry and biology and invent run blocker is it convenient done yet with their already okay good back on track lovely it's anyway okay so sorry okay so arm several surgeries disrupt the function of this hormone and that's why I bring it up and will circle back that as we discuss them okay so before we dive into each of the individual kinds of surgeries that you can have a talk about reason why you may want to consider doing this but some let's start with the first basic this is none of the sub rental bar is free it all costs money some surgeries are covered by some health insurances by some countries it is so widely varied by country by even state within a country is so hard for me to even give you any kind of advice or suggestions but what I can tell you is that it's gonna cost you something you think some countries like the UK where they had their NHS arm you can get it on the NHS that you may have waiting periods et cetera and I know here in Australia we have the Medicare you can go on to a waitlist arm but in most states that waitlist is at least a year to try and get paid for by the government yourself to meet minimum criteria will absolutely my surgeons as well I might just specify most surgeons will have minimum criteria that you will have to meet if you want to have surgery absolutely light like BMIs like you have a habit of proving all kinds of teas such as high blood pressure high cholesterol type II diabetes and any kind will be ditties that go along with being overweight and obese satyr have a proven record that you've attempted our weight loss through alternative means in some cases well so that there is a strict regulation for that so if you assume that you may not meet some of those criteria or maybe should be considering weight loss surgery but then again of a minor arm yet well anyway are let's assume that you can't you don't have access to that sort of that healthcare of those waitlist options we don't qualify for whatever reason the cost can range based on my research between 10,000 to about $35,000 are yet let's just say US dollars dyspnoea because I know is roughly what what the greenback is worth roughly so the point is that that's can very also by hospital by a surgeon the type of surgeries logs each procedure is slightly different has different costs than you and it usually with the cost usually relates to how long the duration surgery are so short of surgeries and usually cheaper and of course how heavy you are as well to heavy the patient more difficult it is more dangerous it is to sedate them young so the energy needs assessment can't I if you are having something like gastric band you have to pay arm there will be an out-of-pocket cost for the cost of the band as well arm side that can be a contributing factor as well any hardware I think that they may be using in the operation when surgery will be arm neatly paid for as well so so yet is this quite a lot of variables there so first of all our I guess that the takeaway finales is probably gonna cost you a reasonable amount of money are it's not something that you know a lot and although thereafter as you said there are some places but will cover it most won't okay so let's start with the crazy ones that are no longer recommended showing justice for the sake of completeness the last year exactly last size is not a funny are right and never heard of this wiring someone's jaw shut I have actually I have they actually did that someone radiating down then I think you'll find a way around it take for example Hannah Simpson in his July shut down and put everything through a speedy arm say if we with a lot of things if you're really arm like any addicts you'll find a way round things which I will talk about a little bit later so anyway so your Georgia wiring arm because one pair of pliers and it's defeated arm's kinda considered to be a bit yet know so arm and obviously works by preventing food going and likely set access to good blender and straw and defeated anyway that must apply some psychos would have used open blowtorch okay stomach alone is not one actually has I've seen recently had quite good weight loss with that arm at something that sits instantly stops you eating as much arm and may fall and also slows down the digestion and quite effective but again if you've got quite large amounts of weight to lose arm it can be seen is short-term to get someone's weight down enough so that they can then qualify for this surgery here and that's exactly the point is that originally it was suggested as a long-term potential weight loss technique that it tended to only work for short periods of time like in terms of measured in months not years yet but which is now whites only really used exclusively to all my almost exclusively as a method of reducing your weight to make the actual surgery or getting safer to perform because obviously the lighter you are before surgery the safer the surgery is which may seem like a bit of a as a bit of irony then we've got to lose weight seeking have surgery exceedingly small weight but arm surgery has its own risks the heavier you are more complications and the more risk you are say if they can get you to leave a little bit of weight for surgery for arm having the full on procedure the full and weight loss surgery the safer the surgery will be surgeons that will say I will not do the surgery until you are less than this thing I like is just too dangerous because you realise put up their premiums and their health and if you do if you die in the table exactly a mere part of the fact that you'd like to think they will cows and only cared about the statistics which aren't sure some of the money for surgery in case you hearken on the table and Hayden and Sabrina yeah great okay cheers lovely okay and now you was lovely again are you telling me before you know you how to pronounce this word due Julie Julie Neil Julian Jenna G I write this this is a bypass thingy method thingy for the Jays and a doubling in the shadows anyway but it's it has pronounce that was Marco's suggestion I could pronounce you know the Arcana Janine earlier whatever bypass I can try mangling that it was actually the first kind of weight loss surgery performed are and it was done at the University of Minnesota actually during the 1950s and the idea is that you disconnect the outlet of the stomach are a reconnected with part of the intestines further down essentially it will hence what I call bypass the idea is that you essentially remove a section of the intestines from mind yet from from actually being our process are the food seek uninstalled anything you basically bypass arm a portion of the small intestines arm absorbs feed so therefore you buildings as like a good idea at the time are there seem ugly at the time et cetera little few complications first and obvious ones were diarrhoea arm via caused a lot of problems vitamin A deficiency and that leads to night blindness which is probably not good are also vitamin D deficiencies are lead to osteoporosis in quite a few cases are external a lot of people develop kidney stones after the operation but the big one the bad one was toxic overgrowth of bacteria in the bypassed section because of the lack of use of that section are which then of course could cause liver failure arthritis are skin problems and is essentially constant flulike symptoms so most patiently in you is not a good long as a panellist anyway so most patients require the reversal of that procedure is no longer recommended and is therefore really performed any more so they then refine that technique and involved that technique to what is now our become the Roux-en-Y gastric bypass summit is called the gastric bypass of which you have had and will get that little bit later on before we do was quickly to a benefit sponsor enacts extrasensory devices now exercise revises an innovative company based in Palo Alto California and they recently released their all-new luxury for all an incident like me to attachment your smart phone or tablet if you're a photographer like to take the best possible shot or even if you aspire to be a better photographer than precise control your exposure is critical and a figure that out you need a reliable accurate like mere SLI light metres can cost upwards of $100 they take up a lot of space in your camera bag or many other bag you may choose to using at any there are batteries and they can be a pain to use but the lucky flames to solve all these problems by utilising the front facing camera on your smartphone or your tablet then provides accurate readings using is freely available lacks the app from the App Store the Google play store lucky for all is easy and quick to calibrate on your first use in any sense 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and in the coupon code tech distortion and you'll get 15% off your luxury for all photographers always want take better pictures and taking better pictures start with your laxity thank you to extrasensory devices for sponsoring pragmatic okay a little of the history of Ron why but because of the order in which everything happens to you personally so you think we might would discover them quickly as in what they are and then will talk about what we have done okay lovely I cooked so I mentioned in the 1960s it started evolving and it we really sort of settled in its current form the Roux-en-Y gastric bypass in the 1980s the techniques incentive pretty stable and as a result yet the effect of the procedure is now very well understood is a lot large body of people that have had done and people know how you quite a long period of time they know what the long-term effects and implications of the surgery are exactly so is it is now the world's longest arm running bariatric are procedure what you're here Lloyd Moore was a bariatric is of course that means relating to the stomach and intestines and so on and so forth and eager arm okay so just a little bit quickly swing I would you like to describe what they do with the Ron why gastric bypass bypass years basically they create and then go in and they use state titanium staples create a small pouch that size of an egg and chicken egg and they all say bypass nanometre or so of small intestines say they leave arm everything stays where it is laid nothing gets pulled out so the rest of the stomach and neither of bypass will intestines stays in body they bring up their arms mind test and attach it to the new pouch say you not only are able to eat a lot less you also get what's called malabsorption so you have a knee have less arm nutrition unless things are like fat and sugar is going into your body and this can cause problems yet be very careful with malnutrition of set violins minerals so taking multi-line ends and having regular blood tests after surgery is very important to actually not deficient people have been known to die from not keeping an eye on it and from ending up malnourished from certain things that is true really sell another our rescue need to know the risks and you need to know that you if having this procedure would be a multi-vitamin C and regular blood tests further quite possibly rescue life is fine it is on that point to some people said arm because I talk to other people about it as well and you their response I couldn't I couldn't do that and the funny thing is that a lot of people already on multivitamins as it is and a lot of it was properly have our blood tests done to check if you have blood tests every 6 to 12 months just to check things like cholesterol and arm liver function and an L status for ornamental blank information and had blood tests regularly anyway a friend might work for example are always had our running nose and dad got a blood test done is years ago and a ferry was deficient in some environment likes to know what it was and I took supplements and edges cleared up some in some tidy and I'd sometimes you people got listings in the odours anaemia and also to the many iron tablets and so it that's not it's not as bad as it sounds but it's something that you have to go into your eyes open for not currently on the overtaking environments and stuff like that and once I scoff a little bit of that in any case Oracle select so discreetly the Roux-en-Y bypass the next one people or people heard of this one but it's actually not something that is done anymore and stomach stapling so sorry savings over briefly tried concept and it started in the 1970s and it uses a combination of stapling and fixed gastric banding as a create a small pouch like the Roux-en-Y pouch but Saeed maintains everything else is no hint interfering with the bowel or anything like that of the VX stomach anything like that are the long-term weight loss results however weren't as good and as a very high rate of erosion are of one of the younger fixed gastric band section of it and do as a result the procedures essentially as is no longer performed very rarely performed so people say I air your weightless your stomach stapling cycle notes are like mom though that's what they used to do and all these different terms might hear some of banding around I thought was worth mentioning that one because I've heard that use quite a lot in a few people's idea stomach stapling is no was 70s thing okay our rights so the next one it sort of the order of these two is little bits are bit fuzzy because one came after the other but the other came in terms of popularity after the other for them that's actually really confusing about confused me fantastic good as I'm going for it all right lovely art so let's cut okay let's start with the band the gastric band so Prof Dag Howell Burke in 1985 applied for a patent into an adjustable gastric band in Scandinavia but is was not actually the first work in the area and hear all those attributed with inventing the lap band as we know it today and it's a long time from that pattern to the first human trial so the first human trial was Ashley 1993 and up until that point and even Trident animals animals with late problems yeah yeah we seem strange but anyway right nevermind arm so yes it was approved by the FDA in America until 2001 so there's actually quite a large gap between when it was first suggested and panted that it was trying the person then it was essentially approved the use of the general populace so the lab enters as these are techniques go is relatively recent now because you had one of these daily maybe should explain how it works and laparoscopic band arm wrapped round the parts top portion of the stomach creating small pouch so that you can eat much if he eat to much year end up arm bringing up anything and bring up all spit up feed in the sink gets clogged up and that you say when you distinctly pull plug something in that it's too big to go down it locks up you think stomach that's my year have to chew your food very well have to have small pieces and feeds completely off the list arm so the do and adjustable side they can increase Howell much restriction or how big that plughole is basically an ever small port with a tube that they usually place sort of either above the Reds or in your abdominal wall and you have to go in for an adjustment which that weight they use a.m. meal and just insert fluid now and mouth and as little as eight of the meal which is rainy is enough to arm and pushed year either too restrictive where not eating his saliva goes down or no restriction when T-bone steak will go down so it can be very finicky trying to find what's called the sweet spot and that has led to problems which I'll talk about later so arm with the the needles again forward and outbid some not particularly asked the neither Nigel arm because that port is actually quite close to the surface and something that can be done in in the doctor's office in 30 seconds and it's just how much restriction it then provides like this in an eight mil is enough to be too much so there are cool okay so are the last one I talk about is the are the gastric sleeve sleep gastrectomy sleeve gastrectomy has a later point is it's nothing like a sleeve visitor thing when I first heard my colleague that they put like a sleeve around your stomach or something that is kind of cool. The stomach expanding and yeah much but never then of course. From the erosion in the again I write so arm know the reasons given that name I think predominate is because it makes your stomach look like it's a sleeve naysayer takes the stomach as you would ordinarily sit and again nestling sunshine interviewer check out the details of each of these individual procedures and it will show you far better pictures of the stomach than I can ever hope to describe the words you can see some pretty cool arm canteens and recreations arm on the gory stuff to grow 17 nascent company like watching and stuff to do and I don't know John can't stand watching it, things are not bass okay that's one engineer and Dr Casino for eccentric things year lineages at night I went I came combination was about safe place for me the door shut his headphones on page 1 of have things in my ears is perfectly normal under saying yes darling lovely moving on so gastric sleeve first try 1993 equation and arm okay first try 1993 arm so about the same sort times as the band was actually and it was by our Douglas Hess and PMR must so and date was originally intended to be the first stage of a two-stage weight loss procedure for extremely obese patients whose BMIs were greater than 58 where they has pretty extreme that is begging out where the risk of performing the role my bypass was considered to be far too great on the first attempt at surgery so the idea was you do the sleeve drop some weight and then convert this that sleeve into a bypass ruin my bypass which is there much safer before but by the time we got 2003 I done enough of these two-step procedures to realise that they in fact most people lost most of their ways just on the first procedure and wasn't actually required for the vast majority of people to go to the role my bypass and so they simply left alone as arcades work and we don't totally get why but it's work and so thumbs up will leave it alone you know what why risk additional surgery of its working so are anyway that the technicalities of this surgery this the idea is that you don't they have a stable line-up along the entire length of the stomach the inlet and outlet of the stomach are left untouched essentially and they they basically just remove 70 yes 75 to 80% depending upon which the witchdoctor you want talk would sign look at is roughly back on a range but let's just put this way most of it the bottom half of it the stomach bottom similar degree prefaces the beams they were doctors you'll see that they create like a sausage generously shape that yes indeed sleeve you cannot put your arm in your yeah okay loving on visual thoughts we welcome anytime okay good lovely so you and the whole stabling thing actually on the topic and there's another I've got no offence really great links to the stuff that there is a great article shows a PDF it's the science of stapling and leaks and it's all amounts stomach out like stapling procedures in a medicine going back to the 1800s and showing the evolution and all the different statistics behind that the tests are done between single line to line 3 line staples are our surgeon for example are darling goes for the other three rows approach although interestingly I read the article the days they said in the article that in their studies they found no specific improvement going from 2 to 3 improvement from want to but not 2 to 3 irrespective a lot of surgeons still insist on the third row because it's our name makes them feel better know in terms of they relate they swear by there is less risk of a leak because obviously leaks are the biggest risks in these surgeries are now part from the open in secondary infections on so are anyway right are the staples that they use are as you mention for titanium because titanium is nonferrous which means begotten arm out an MRI later on then can be ripped out of the body which would be generally an unpleasant thing having set of house where the guy had a bullet and it was a certain couple and is right there and when destroy the MRI out of them there in houses like laughing think it was most hilarious thing ever since staples are know so you not stainless steel anymore we go titanium any other benefit titanium course is its use widely entire inside the body. Things like pins as well because you doesn't get attacked by the immune system pre-much about it is a very very small percentage of people forges a problem but essentially it's practically zero close enough to very hard wearing two days you put in your good forever pre-much anyway well I said if I say forever forever being the standard lifetime of a person's is not really for archaic ice rider focus okay lovely so are we now reached the point arm and now comes the part where we talk about our specific little are procedures so are you first arm I hate typing late my whole life diagnosed tenderness and setting up from that point arm I tried everything Jenny Craig Weight Watchers optics lean in and I tried still still overweight still obese and I after we had our third child I decided I was going to have a look and put in I figured it was reversible and that life down tonight when it when I found my goal weight I third had fill out there was no accounting and there was no parts of my body being removed and so I am putting and over the course of about 12 months I lost about 40 to 45 kg I actually did that was in not ideal I would eat one day arm and would have no trouble eating the next day would get stuck and you'd be in pain and trying to drink soft drink to try and clear the blockage and like you the sinkhole would get locked in because information which meant that the blockage was cleared very good chance that you wouldn't be able to swallow your own saliva for a couple of days say denigration was very big risk especially in an Australian summer yet 40 to 45 kg and I say that's £100 by the way follows the big North America wave energy finance and dependency and so I hit about 85 kg and that others living on flavoured milk and The suit because that was all that I could get down and spit up comes MRI 88 when I had something and it would get stuck drink any lead come back up and I think up beside me rather large And I split up into the next half hour to an hour and occasionally forget that I had up there and's arm and he was basically not a pleasant experience it meant going out to eat was a horrible horrible experience and couldn't sit down any family because you have to concentrate so much on pursuing and taking small bites otherwise it gets dark qualitative distraction as I say because you when you were having a conversation it's like arm thought you think Kirsten and in that split second your site right that's it I'm going to have to respond to this person and you swallow that you haven't chewed enough and it gets stuck in the our crap and then you're in pain the next half hour in your arm your mouth is set you salivating basically trying to get rid of this blockage and was experience I think by the time I reached at 85 kg would have been considered as having an eating disorder staff knowing that it was gonna come back up again knowing it had no chance of going through and that I was hungry this is the problem I was still hungry I still needed to eat arm because that's the problem with the band as the band doesn't prevent hunger all the documents you need to actually stand when I went and saw him about a bite about my bypass he said he would not do a band anymore because it does not address that feeling of hunger he said he feels bad about arm howl what this is what the band did to people is it restricted what I could eat and how much they can eat but it didn't take away the hunger and eating you sort of think about arm when you get hungry that is your body's trigger to each and anyone who is overweight and obese when they get really hungry they will gorge metal beams met is the worst thing you can do and then transferred to A5 delays got there for about a month then we had a miscarriage and my head was not the right place and I for band and by eating stuff I knew I shouldn't have and bring it back up again and once as a result might then select and can actually be quite common with the band and is that either the stomach ends up going out through the ban or accept certain stitches in place sometimes implicit pressure on on it when you are throwing up bringing stuff up the band will slip and so for three weeks I was extremely uncomfortable I could barely eat or drink and I had acid reflux every night and is I went for my surgeon and he put me back in hospital and he repositioned the anyway within a month arm having been repositioned we feel pregnant again and when being pregnant under morning sickness so I never had any fill put back my bands as well as pregnant so because of the nine months I put all of my weight back on plus probably a little bit more so that by the time I had had the baby in September 2010 I was actually I was if not heavier anyway after we had about 80 diagnosed with postnatal depression announcement of stuff going on in my life that I like and intake and that I was others depressed and arm part of that depression was eating and is within a very very dark place and save 2011 2012 arm I tried to get at Weight Watchers again that I stated hit hundred and 40 something she lies and this Weight Watchers I'm actually separate delays that hundred and 36 delays and just couldn't the prospect of losing another 50 or 60 kg just through diet and exercise to scenes like an impossible task say arm January 2013 we went on a bush walk down at O'Reilly's dialectical death much of 2013 because it was it was horrible it nearly killed me I was it was downhill all the way which was fine coming back up to 10 steps I had to stop i.e. I could have killed John quite easily any point along that death marked, look to me like you can and I IN you can see in the photo that I am not a happy camper happy anyway I was 40 kg and calling around that much weight is hard point in June 2013 where John and I sat down and one of the things I will say is that most people who opt for weight loss surgery has a watershed moment or a low point and for me it was when John and I sat down one night and we sat down and ate a arm in a box from Akers designed for people we ate it between parents and men had deserted afterwards and I was thinking that I wake up the next morning and when I I was disgusted with myself I was horrified and I literally wake up next to John (amounts to say I wanted to get more for my band and I opened my mouth and out came I want to get a sleeve done a lot of gastric sleeve land back my mind for the last few weeks or months arm that subconsciously I had decided that the band was not going to work for me and I had written it off arm actually mentions there get some I discovered with the band that if you're taking your from class half an hour before you eat everything goes down there because it led the dwelling and actually mentioned that people discovered alcohol also have the same effect save people with the band where we are discovering that they were ending up with our problems as well aren't simply in an effort to try and eat in the not to mention the side-effects of you in Europe and a password and has to you're on your round delivering your kidneys as well I think it is a reasonable and SA do not take longer than three days in the box and you reach twice a day for a long period of time it is not good for you to seek any just so I could eat with the bank could see would not go down like ice cream and chocolate and chips went down trees arm salads and protein not a hike so that was another drawback to the band I guess was that good feed would not go down and anyone who experience this problem that turns of June 2013 I went I've gotta do something I'd reached highest recorded weight was hundred and 47 that was highest recorded weight to realise arm although I suspect I was heavier than that I was just in denial so I went back and saw my surgeon and said please help me I need to do something I want a sleeve he went to the bank probably wouldn't do a sleeve I do a bypass because my metabolism was so screwed up from having the bite the bands arm and being on smaller amounts anyway that my metabolism was messed up so he said a lot of people find that going from a band took bypass is usually better because you end up with that element of malabsorption arm and you not just relying on metabolism and smaller amounts of feet that's just me my personal opinion and what my surgeon suggested that every surgeon is different some people are going to bat from band to sleeve and had great success everybody is different so anyway I did the pre-op die that was the last weeks for leaks of Opti fast say the shakes three shakes again and kilograms of protein for four weeks oh my goodness you are you are easy-going I was not a pleasant person to be around and I apologise new times to John I'm sorry I'm sorry I'm sorry arm Mother's Day fill during a four week period even have their speech the actor's well-being and NDX in the cow which is like a state fair for those of you who are in America arm yeah I couldn't and I went to the accurately carrot sticks and kitchen and that is of course only Ltd that year all the fun veggies like corn and potatoes and peas when I had my surgery on 21 August I lost 8 kg with the arm pre-op die so gay surgery I weighed about 140 kg that was August 21, 2013 we seen but it's hard by Christmas of 2013 I hear about hundred and 1617 kg so a weight loss apparent arm 2324 kg in the space about three months which when you see wake of that quickly it's staggering I was having to buy new clothes every couple of weeks for much premarket share last 12 months so over 2014 my way continue to drop arm say that Christmas this year so I will say Christmas 2014 I was down to night actually goal my 40th birthday which was in August say 12 months after surgery I wanted to be back to 85 kg an hour before my birthday I checked that I had lost arm and now they are 30 kg in space of eight months and I was state that 85 miles an century I'd never set a goal weight I figured if I got to wait where I was happy and that I could maintain I would be thrilled here we are arm February 2015 I am sitting at 7677 kg for anyone who wants to put some weight and some stock in BMI I'm sitting at about 29.9 BMI hundred 58 cm tall and considered overweight legionella and they still will still look at me and gate wow she still overweight in our care happy where I am 7677 kg I started looking into plastic surgery because arm when you start at hundred and 40+ kilos have space skin it's it's skin doesn't stretch that far and then go back microsomal fluorite 76 and recently was happy here at hundred £65 by the way everyone is wondering what I beginning after the bypass I was very careful after surgery yesterday two weeks of liquids two weeks of purée is two weeks of mushy is to get everything a chance to heal arm because if you push it too early year 10 birthdays arm staple lines and that's when you end up with a lake and you can end up with a world of problems with leaks even if you did the right thing and follow all rules against applicant may severely arm but that's I was I was one of the lucky ones it didn't happen to me the current Jaguar Mia, a poster child actually because are posted to my surgery was went perfectly recovery with perfect weight loss is imperfect arm I do have some negatives I won't won't lie in that respect you can only send feeds the snowwhite then feeds the bishopric we should make huge amounts of anyway sugar and carbohydrates a kidney arm was brutal about dumping syndrome is jumping and basically because arm of the change to your arm how your body absorbs things basically got a metre less of absorption and also with the bypass valve is on this on your stomach and at the bottom of your stomach between the stomach and small intestine isn't there anymore it's in what's called the remnant stomach and as a result stuff passes can pass through your pouch very quickly so when something like sugar or carbohydrate it really hits you and Scott dumping because it counts a lot of sugar into your bloodstream very quickly and effects can range from arm at heart palpitations heart pounding right through to dizziness and feeling very very ill and nauseous and to the point that I've been named sort of had some orange cheese once I end up falling asleep in the corner literally passout out without going to Christ are really unconscious that very sleepy as your body tries to deal can't stay away excess sugar in your body can't will yourself to stay awake I and if he really tried arm that I tend to just go had a little nap now arm and is to think like you know arm deferred people in North America after Thanksgiving I see a lot of those I hear a lot of this after the big Thanksgiving dinner you got lots and lots of carbohydrates in the food you as like if you been lie down with Massimo carbohydrates and you can be affected by that that snooze NSW blood sugars ago and Natalie crazy but it doesn't take it anywhere near that quandary the same effect for us really can be as little as a slice of bread needles or table arm something got some sugar in it much food has sugar in it and you don't realise until you get one actual very well everything here is in everything outside arm I have lost my sweet care for small squares of chocolate or a small Mars bar or whatever and all I can eat sugar white because it makes me sick but the colours just physically cannot eat any more sugar than that if I eat too much fat in beginning or end up with quite quite severe diarrhoea from arm now too much fat just leave that horrible oily greasy feeling in my mouth is willing to talk about is that the surgery that we well that you had an iPad effects it seems crazy but it actually does affect the way you perceive certain tastes you and I've actually found my palate has changed significantly are since the surgery are you've seen this firsthand is that I've been having different foods are previously I would never touch and ones that I used to have our eye I can't take any more like I used to allow hot spicy you still love it and now he really usually ill then drowned a bit more and try a vindaloo or something from Indian that he is not putting chili everything arm say to change the biggest contributing factor to the weight loss besides not being able to eat as much and the and disincentive even crap feeds that make you feel sick because I don't feel hungry and it is such a liberating feeling after 30 something years of being at the mercy of your hunger to no longer feeling to no longer feel that it it's just the most mind blowing experience you get two or 3 o'clock in the afternoon and Gaia I haven't really anything today and eaten anything at all probably should eat something and then sign it you haven't eaten anything is the fact that you start to feel a bit and it shaking a bit woozy simply because your body has run out of arm easily digestive material and protein for the energy and it comes back to that hormone growl and later said arm play they think there's 100% sure what Grella nears or how it selected learning arm that it's something to do with the bypass and the fact that there Grella and is possibly produced in the remnant stomach arm the part that nylon has access to the sea and guesses been I guess the most contributing factor scares me to the weight loss is the lack of hunger because when you you are not obsessing about food and thinking about feed and wondering about what you can have what you can eat what you can and what you have for next meal easy seat simply does not become the focus that once was whereas before surgery extending frequently get a woman can have this so much to choose from I want all that I can't decide now standing for court Gaia year I'm not hungry but I am now I have to eat something and say you tend to make the Battersea choice which for someone with his had weightless surgery your first feed choice and third priority is protein and after protein if you've got room for veggies fantastic hydrates and even fruits fruit let's face it is a sugar arm is quite a long way down the list your top priority is protein however you can get back into your body you need to have that whether that's through adding protein powders to foods arm having slices of arm extra high-protein feeds arm Neil is entirely based on on protein that is your main priority after you have weightless surgery in the evening remember swinging is that because the size of the pouch is so small in relative terms then you have to prioritise what you so it's gotta be the proteins first resents that we can get the benefit to get the benefit from the car to get the benefit from the from the fruits order all the all not even the veggies to some extent you've got the vitamin D deficiency because of the malabsorption and you are compensating that already with the Vineland tablets and so on so it becomes all about the proteins so for example you know I could get my stuff and I guess but because the iodised to about my stuff so okay before we go on any further dialogue talk about a second sponsor for this episode and as many tricks now many tricks there are great software development company whose apps do like the name suggests many tricks and their apps include but like email each desktop curtain time sink usher move name angler and witch and a new one that they're working on will be released in coming months is a very very excited about safe as some are still back for each of their absolute focus on are four of them specifically and first of all we start with Usher Usher can access any video stored in iTunes aperture iPhoto on any connected hard drives on your Mac allowing you to easily group sought tag and organise them in one place if you still pairing off its makers need to convert anything into an iTunes format page 264 to watch it you can leave as native format so you got a video collection scattered across different programs and drives and she can help you strain it all out in one 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feature that when you automatically connect and disconnect out an external display in automatically reconfigure windows in the right places just we like them it's really awesome and it is for their great apps are still five more to check out so all these apps have free trials and you can download them all from many tricks all one word.com/pragmatic and try them out before you buy them there available to buy from the respective pages on that site or through the Mac App Store he preferred by them that way however if you visit that that URL and yes they keep extending it make them so that's awesome you can take advantage of a special discount off their very helpful apps exclusively for pragmatic listener simply use the code pragmatic 25 that's pragmatic the word into five numbers in the discount code box in the shopping cart and you receive 25% off this offer is only available pragmatic lessons from for a limited time it will eventually and I assure you so take advantage of it while you can thank you to many tricks for sponsoring pragmatic once again to enter the continued support of the show okay well darling I can say yes I'm looking at your notes here yes arm partly sex and alcohol all you are we haven't talked about Argyle great fun before surgery I was pretty drunk anyway arm it didn't take much yes that's right arm now yet to do much more than smell alcohol and I and tipsy you find the bypass and with the sleeve as well and alcohol hits you march much quicker because of the arm are malabsorption and the difference in inhaling way processes things that you are not quicker but it also wears off a lot quicker which is good and bad arm because it also means that the hits will not quicker as well are so alcohol you have to be very careful with arm there is still the jury is out and how it will affect you if you ever brutalised and say you you've gotta be careful in that respect all the rules go out the window so in Australia have this service system where you have a standard drink a while to stand during the first hour one standard drink every hour after that annually afternoon and for women is one standard drink per hour things are right here so the point is that if you follow those rules you'll always be under .05 which is the legal limit in Australia if you can open drivers licence our reality check once you have the surgery you cannot count on that you just can't so you far better off to employ the tried-and-true practice of if you drive just don't recall you meet your alcohol yes you don't drink anymore any liquids at all you'll die so we recommend liquids anyhow lovely again so my turn okay since you started at the beginning of you start at the beginning for me to add tea that my surgery I no longer have high blood pressure i.e. no longer take antidepressants and the only tablets I have to take our multivitamins by the incoming forms is a little early back so I'm often the medication because of the surgery as well is fantastic is fantastic and you obviously something you've been in so much more consistently happier as well which is just awesome so the kids and I have the right here that others can't be around when I was at my life and it's not real amend the stress okay headspace arm and we'll know you get into an endless cycle you depressed say really put the weight on yet more depressingly say something to break that cycle and I it was drastic but it had a virtue of working is drastic it is either I can't stress more anymore that this weight loss surgery is a last ditch access it is extreme and people who are seriously overweight and obese arm overweight and obese and like tea and the healthy fantastic that you know what is a lot of people out there who are overweight and obese and a miserable arm but I think like most things you have to reach that low point arm that watershed moment for you to really realise that you need to do something and you need to do something drastic that okay we will come back Elton John Sweeting will come back to that at the end of course because some that is a lot of the point of this so my journey well arm I'd always been little bits arm chopping when I was a teenager but never really overweight exactly are I guess technically they would arm. That night I I did have our weight problem are when I was at university though I ERI when an insane diet I refer to as the new life it was amazing it I loss and like 30 something kilos in a space about 34 weeks is you did yet under the gotta realise I was living in the tropics at the time and I was going universe is writing my ear my bike to and from university and I was driving at that point and you know when I was the one 11 fair afternoon I was riding home from uni and now as I was going up the first hill to get out of university campus arm the whole world every thing I saw when this very disturbing shade of yellow in North America or not in Australia arm the neutrals and is referring to artillery noodles or Ramen noodles all noodles here arms as a regionalised nutritional-out and I founded by the third week to make an even palatable are I had to add so much chili into them to make them actually that I can eat them all the point is arm that that's generally not healthy thing in the world looks yellow especially for not wearing yellow glasses so yeah and causal fable pinpoints of our of multicoloured light, like a been punched in the head so let's just suffice to say that it was bad at which point I ceased that night but I got down about 78 kg which are is still my ER lowest our weight as an adult John lies he was now that's just inevitably BMI and honour BMIs yes arm when I went over to North America the first time I didn't really have much of a weight issue I was staying on our residential campus with the University of Calgary with some mates so we would go jogging around the ER Olympic ice skating rink in the middle of winter which was an interesting experience argues your hot Sweeting step outside the -20 and that cycle brisk anyway our side and actually have a weight problem until after that and I sort of stopped moving and I started driving everywhere and then my weights have gradually increased and increased increased then IR then I met my lovely wife and that turns out she could cook and she introduced me to hold much food that I never tried before and they were really really good only like the fight is lasagne for example which is is kind of like it used to be considered to be heaven on a plate but never mind that the point is piano things change things have changed anyway so are the point is that arm we sort of both of our weight sort of spiral out of control together I like to think that we were as bad as each other arts with dinner wasn't he the yeah extended the year so long story short arm my way because I'm just under six for some 511 510 are similar and down so you anyway about some my way got up there to my BMI hits 140 I sorry my BMI 40, God hundred 4019 is clarified good are the point at which arm I started to develop problems though are it started with blood pressure so now it was my was in my early 30s and I found I was getting pounding the base of the back of my neck are sorted by base the skull meets that the top of the neck in particular closely side they are die in addiction and for the guy yeah which probably didn't help that you are cutting out the problem was when I cut out the Diet Coke as I went through. Why I cut out the coca door completely and I still cite the S&M in cocaine Coke full light. You know that's just there was to sweep even back then a searing cutout sweetness my coughing that another sidetrack anyhow by point was aware was already done and is done in the canon the baskets and okay lines anyhow lovely so are yet I ERI had the eye high blood pressure and I was on medication and it reduced my blood pressure and is okay that's fine you know I'm still in denial everything is all good early 30s right either visually 30s non-that's not normal that's not good so the next thing is that I gradually found that I was becoming constantly out of breath after if you're walking ice flat level ground it wasn't that noticeable but it said you had to go before flight of stairs or CJ to go up a gent even a slight incline you know you would notice that you were breathing heavily and incurs and often turn to me when were walking around so I say you're puffing an online I'm not because your brain tunes it out you don't realise you're doing it awesomeness pointed out to dislike you your your pure puffing over there and why I am not not and so you refer to denial my cat's okay all the so far your denial is in full swing on I'm not too concerned I go cholesterol is not necessarily related is more more genetics I've selected off the list because I still in here that John and I had his heart attack at 42 say there's definitely is family history data John of arm heart disease and that was always something was in the back of his mind was that he was going to die young like his father while the bottom line is that I I didn't really start to take things seriously enough until our the sleep apnoea and that was that was the beginning of this for me so by that time arm you have the sleeve done the band thank you until yes by the time you had abandoned and I was at work and are seven December our fourth child arm had been born was laudable little cute little cherub wake us up at all hours and I just blamed on that I was always tired tired tired all the time I couldn't concentrate at work and I was so I blamed it on me and my my newborn son keeping you up at all hours meeting be wrong he was but it turns out that no it wasn't actually that it was one thing not causing that it was the other thing which was a sleep apnoea anyway I got called into my manager's office at the time and I was told get your fatigue under control or we will get under control for you and dad that's code for if you get under control use sacked so basically I had no choice but to take it seriously and I snapped out of my denial I went to go and see a doctor I really seen a doctor and like Owen are ye almost a year maybe about nine months previously and he recommended a sleep study all this time I actually went to the sleep study I walked out wall rather stormed out I think it was a two in the morning when I could not sleep because of what your sleep is that if you don't know they'll attach a mask to your face are for a CPAP machine which stands for constant positive air pressure what does it forces and through the nose and the nasal passage are and there's a small flap of skin that start when you're more overweight is our it it basically ER allows it to completely block when you're overweight arm around your neck and when you sleep especially in the back puts pressure on to the airway which then obstructs your breathing when you're asleep and what this causes you to do then is when you stop breathing you get no oxygen to your brain what happens then is your heart starts racing like hell to try and pump whatever oxygen is left your brain to wake you up enough so that you can move to clear the obstruction so your body wakes up he moves slightly you get airway is a pathway conforms and then you essentially fall back to sleep again but you never wake up just enough to even realise it's happening to you and that's it they refer to as obstructive sleep apnoea was diagnosed slider next to John any hearings nor against breathing and snoring and it stop breathing the silent distance and then breathe out again snoring must know that I used to kick in and rough during the night and then roll over and pretend I was asleep you your likely extension of my brain time in a way that set the leisurely hiking and say rollover labour arm I will admit the snoring got got very bad arm especially when I was pregnant and wasn't sleeping well anyway so that put a lot of strain on us arm because he was tired I was tired for staff arm can touchy-feely this is the most touchy-feely episode of pragmatic and that have been made if you are getting touchy-feely with any of those other people a new noise go back and listen your regulars moving on answered on grounds that just lovely okay so let's just let's just pause the rest the discussion right there I was diagnosed with 19 I think it was memory serves our episodes every hour when I was in a deep sleep in my sleep study that's he was late without stopping breathing and waking up 19 times every hour they saw they called severe obstructive sleep apnoea not just like mild moderate severe so it was recommended that I get a CPAP machine immediately and I needed to use it every single night now the funny thing is I was difficult to embrace this boy I am using are all the mask off cursing and swearing arm even do it when he was asleep he pull the mask off and I wake up to snoring and I like kicking and packing put your mast back and put us back on yesterday asking nicely after our first few nights of John leaving and putting and leaving it on all night he would wake up and say I feel so much better within two or three nights of putting a CPAP leaving on all night arrived and saying what a difference it had made as a matter of retraining your brain to getting used to having this thing on and once you've done that once you cross that bridge and once you've suddenly that they talk about sleep debt you know but the truth is you can never recover lost sleep you really can't there is there is no bank account with withdrawals and state piano kitten how much are we lost the last 12 years in point is that it made out was a profound difference so once I'd reached that point I thought it's all good right it's organiser on back into denial again okay let's not think about what causes sleep apnoea let's just with retreating right so I'm tree my blood pressure arm onto my sleep apnoea sure I'm constantly out of breath whenever I go up on one micro fraction of a millimetre in height that's okay no problem still in denial still well overweight okay sentencing when I'd gone through with the band and how horrible that will increase war that he would never ever get weight loss surgery because he'd seen what I'd been three that was when the band then okay and now were roughly at the point where you had arm given up on the band due to all the complications and difficulties that and that came with it and had gone to the ER Ron my gastric bypass and I had seen the first few months of that and the absolute night and day difference in in in you because I had I been typing trained to associate weight loss surgery with the band and with that was constant frustration he still felt you were hungry and he still had to eat because there was no interruption to that to the hormonal balance and tell you that you're full so you're still starving you couldn't eat and that you're abusing Nurofen in order to be able to eat what was the end it was about you is the point the point was that it was not a good experience not for you not for any of us it was bad just bad but the wrong one was a complete polar opposite it once you got past that armed them and past mushy back on normal food again it was night and day it was a stumble I could not account express with words enough how different it was and suddenly I started nose around about that time a tingling in my feet and this is when I started to freak out now not can I say exactly why that was blessed to say that somebody that I knew was also having a lack of sensitivity in our in their extreme in in in certain extremities and that is of course those are not aware are so an early sign of our developing diabetes because of the circulation are because of the increased pressure on and the actuator came around are essentially a causes our lack of circulation eventually the lack of circulation can require the amputation of toes feet you know limbs it actually is really kinda serious and I want to keep all of my extremities I figured that they were now functional and now useful for the most part so young we we I don't want that kind of thing and is our it was just after Christmas arm of 2013 are that I had my moment and is our bottom line arm I okay came home with ADR box of crispy cream donuts as was one of my guilty pleasures of the time now before I had my surgery to the complainants and arm we have some of the kids and we we basically down a box of a dozen doughnuts between you between us arm but this point in my clinic you can either count and your sweet tooth like this before had gone as a result of the bypass you just had no interest in those sorts of foods and so what happens is your sitting Stena watching me sitting down eating these doughnuts and you making decent progress into them shall we say and you made an offhand remark that was that was disgusting and the funny thing was that at the time is wise comments that sort of made me stop and think after-the-fact by any hours that followed it sort of nagging away at me saying that it was disgusting and I had a look on my face know you said it needed the truth was though that it was disgusting sitting there shovelling these things into my mouth like there was no tomorrow after having just had like Christmas it just was not that far gone and we were still downing huge amounts of food and why I Was You Who You Are and I'd I'd Been Troubled by the Tingling in My Feet I Knew That That Was an Early Indicator of Diabetes I'd Seen Success That You Had with the Bypass and I I Was a CPAP Machine Is on Blood Pressure Medication I Felt Terrible I Got Wind Just I Got to That Point Where I Just Snapped and I Do Know What I Need to Consider This Seriously As an Option for John That Was That Was His There Was One Minor Point His Moment His Aha Moment Being in Our Care with the Alcohol People Have from the Alcohol Abuse They Yum They Go to a Backing Rock Bottom Right There That That That Was the Moment and Obviously Sounds Trivial to You or Ridiculous Stupid in the End It Was Mine and That's What Mattered to Me Anyway I Dwell on That Point Was That Our I Made an Appointment to See a Surgeon and We Started Talk about Options and They Recommend the Sleeve Now the Sleeve As a Said Came out Arrived like around at the Same Time As the Band That's the Timeline That Person May Have Glossed over a Little Bit Obvious That Consider That 2001 FDA Approves the Band and Then 2008 You're Not Sure of the Exact Date Is Subtly Practised in Australia but I Am I Believe It's within 2 to 3 Years of Ever Being Passed by the FDA and States That Was Performed Here so Let's Work with Five Years to 5 Years out and It Was Generally Considered to Be the Best Way to Go Least Intrusive Arm Fastest Recovery Time Fully Reversible in a Scene like a Godsend but Then the Problem Started Happening Discovering That Arm Bands Were Raiding into This Stunning Gate Has Arm Endoscopies When They Put the Camera down the Track Are to Check out What Was Going on in the Stomach and Find the Band That Had Been Placed on the outside Distantly Was Now on the inside of the Stomach out Exactly This Friction Write Anything That You Got a Fixed Are Affixed a Foreign Body and It's Basically Constantly As Your Body Flexes and Moves Most Food Goes in and out and As You Stretching and Whatever Else It Rubs Backing for Bank for Bangle Was Cohabiting a Rupture in Aware through Hence the Term Erosion Has a Life of 10 Years Anyway like Any Animal Implants into the Body like Breast Implants and Have a 10 Year Lifespan and Band Is the Same It Only Has a Lifespan of 10 Years and People Finding That They Were Having so Many Problems with the Bands and It Was Causing Devastating Long-Term Problems That's It It Just Became Not Practical Any More so and Then of Course When He Went Back into Thousand and 10 2000 and 9000 and 2013 It Then Reached the Point Where the Same Surgeon Was No Longer Recommending the Bad Soak in a Short Decade or Thereabouts It Went from Being a Godsend to Our Web Guy Probably Not Do That in the Same Time the Gastric's the Sleeve Gastrectomy Which Is What I Had Arm Had Only Gained Significantly in Popularity despite the Fact That You're Essentially Removing the Vast Majority Stomach You Got It's It's Intrusive Procedure You Can't Get over the Stomach Back Later If Your Book I Have My Stomach Back Please Know You Can't It's Gone Right Removed Gone Forever Bye-Bye You Know and the Staple Line Is and Is Is Is Quite Long Is Significant and If There Is a Leak Well You Know It's a Far Far More Statistically Probable Have a Leak the Longest That the Staple Line Is Therefore Its You Got Got High Complication Rates I Had Look into This and There Are Numerous Studies but Now You Look at about 3.2% Complication Rate We Had to Have Readmission to Hospital and a 0.19% Mortality Rate so Those Are the Figures I Found a Bunch of Different Studies and the Bottom Line Is That As Time Goes on the Statistics Will Improve Item Improve in Terms of Numbers in the Reliability and Accuracy of the Statistics That Said I Had Personally No Complications and I'm Still Talking Therefore I Was Not Mortality Statistics Quite Obviously Inherently Guessing Game Ended yet so Bottom Line Is Arm Yes so There You Go That's That's How I Reach the Decisions I Had My Surgery It's Getting Close to 10 Months Ago Now 26 2014 How Do You Remember That I Do and What You Have a Gift Understand Remembering Dates Me I Got a Calendar at That Year's Lovely Good and Have Bottom Line Is Our It's Been Unbelievably Successful so I've Now Lime Now down to 9092 Kg I Think I Am Are Which I Will Just Very Quickly Figure out for You Ears Are Just Almost Exactly £200 and I Started out and Are My Absolute Worst Record Weight Was Hundred and 45 Kg Which Is £320 so I've Lost A Lot and Is I Feel Absolutely Fantastic All the Odd Right CSM Offer Blood Pressure Medication Now I Haven't Gone off My CPAP Machine and What I Did Do As I Did Go in for Reassessment and the Reassessment in the Sleep Study Reassessment They'd Situate They Essentially Took My Dose My Depression "You Don't like Stockholder Dose Is an Air Pressure Right to the Air Pressure Required to Maintain an Open Airway Has Now Been Cut Essentially in Half and to Get the Same Effect so Honestly I'm at the Point Where I Could Probably Live without the CPAP Machine If I Can If I Lose Another 1015 Kg Which Is Still Quite within the Realm of Possible I Don't Know Was the Stress This Is That in the Doctor's Ostracism As Well Usually the Last 12 Months Is When the Most Weight Loss Will Happen When the Weight Loss Surgery Is at Its Arm Best and Say They Say Lose As Much Weight As You Can in the First 12 Months Because over Time of Course and the Pouch or the Sleeve Tends to Listen up There and You'll Be Able to Be Little Bit More Which Means That You Won't Lose Weight As Quickly and Any Won't Lose As Much Weight Say Arm This Is Why They Say You've Gotta Lose As Much As You Can in the First 12 Months People Still Want to Lose More after That 12 Months Are Still Lots More Are in in Their Then Six Months since I Had My out after My 12 Months and I Still a Small That Deadweight Loss Has Slowed Dramatically Which Is Fine That Doesn't Worry Me Arm but yet That That the First 12 Months Is Crucial Absolutely Right so Just to Talk a Little Bit More about Arm My Experience the Lead up to My Arm My Presurgery Our Diet Arm Which You Always Remind Me Is Only Half What You Have To Do Sign out Two Weeks and the Doctor Gave Me the Option Sighted Dr Surgeon Gave Me the Option He Said That My BMI Was That Rye Was One of the Lies Right on 40 and at That Point in Time and He Said That That Sort of Borderline We Probably Don't Need to Do It the Whole Idea of It Is That It Reduces the Amount of Fat in the Liver Which Means They Can Access the Stomach Area When Doing Surgery Then and Increases the Safety of It so I Basically Said I Put a Question to Warm Because While I'm Me Which Basically Went along Lines Will It Improve the Site That the the the Potential Outcome and Reduce the Risks of the Surgery Yes or No He Said Undeniably Unquestionably Yes Some Said While There Is No Question I'm Doing so Are We Went Away on a Holiday down the Gold Coast and I Was on My Diaper Gold Coast You Had Your Birthday in the Acker and I Had I Had the Holiday on the Gold Coast Where I Was on Arm Obviously Multi-Bar Things Which They Dare to Call Food and Are My Garden Out Of You Ever Tried and That She Anyway so Then As Those and of Course I Was Glad to Have Our Mushrooms Arm Set Vegetables Mushrooms Say Okay and I'll Be Honest Here You See a Talus Is Exactly What You like Vegetables a Please: Potato Mushrooms and Onions Well When You Eat Many Peas, Basically Living on the Shakes and Bars and Mushrooms and Onions Estate House and When We Were on Holidays We Go out and Go into a Coffee Shop or Restaurant and Hard Rock Cafe Plate of Sautéed Mushrooms and Onions Please Get to Say to Name Just Don't Mushrooms and Onions and to Say the Hard Rock Cafe Mushrooms Were Thinking They Were the Best Mushrooms I've Ever Had in Mind You I Was Starving at That Point Said That the Concrete Obtaining Grilled Styrofoam Would Have Done the Job Unlocks Styrofoam As Staff Discern Its Lightweight Anyhow Okay Good Lovely so the Bottom Line Is That Were Two Interesting Weeks of Which I Had a Blast the Ball Lies to Vegetables Mushrooms and Onions and Garlic in You Maybe Put so Much Curry Powder into a Remember Four Hours I Was Sitting across the Cow and His Stomach Was Making the Loudest Noise Ever Hair Pretty Sure St Another Side Effects of the Arm of the Weightless Surgery Is the Gurgling Noises from Something I've Heard of People Being in Meetings and the Cynics That's Giggling in the Meetings of Just Come to an Abrupt Halt Because the Gurgling from People's Stomachs As Loud As It Is Our Four Year Old Will Rest His Head on My Tummy When He Is so Having a Bit of Arresting Then Look up at Me and Look at My Tummy and Look at Mango Money Attorneys Making a List Yes I Nicely It Can Be Quite Embarrassing Arm but You Know What Is Just My Listings Okay Good Now Let's the Move on the Principle That More Than Enough American Arm Not yet I'm Sure We Can Do Better Okay That's Not Know That Was Not a Challenge Okay Good Are the Insights into Peoples Personalise He Would like Further Insight No You Cannot Not Email Are Not Given out Your Email Address of Acre Property Figured out How My Naming Method Is Pretty Simple Anyhow Good Lovely Moving on so Arm My Postop Diet Was Exactly the Same As Yours Which Is of Course Clear Liquid Signing Was Mostly the First Two Weeks the Listless Liquids and after That It Was Our Hero Purée Food and Then It Was My Seafood for Two Weeks after That so Six Weeks after All That I Can Actually Have Proper Food Again and of Course Due to Living in a What Out Of However the Other Side Effects That I Did Not Count on Our Previously I Had Never Really Had a Problem at All with Rep with Acid Reflux Y Had Acid Reflux from Hell after That Surgery and I Learn Very Quickly That You Do Not Because Previously Ice to Have My Arm Tablets Medicine before I Went to Bed like I'd Have a Glass of Yellow Glass of Water and I Would Have My My Arm My Blood Pressure Tablets Which Admittedly Looks Are and A Few Other Different Things and Danceable and I Have Them before I Went to Sleep and I Would Lie down Okay Big Mistake Can't Do That Anymore since the Surgery Because Otherwise If I Do That and I Lie down It Hasn't Gravity Helps It to Get through My Stomach Now Because the Valving in the Back Pressures and All That Stuff Is All Messed up Now Because of the That the Work That's Been Done to My Stomach so I Can't Do That Anymore Which Means I Now Get Reflux and Not Everybody Gets Reflux Know That Bracelets before Surgery They Will Often Recommend You Do Not Have the Sleeve Done Because It Can Be a Side Effect Yes and Is What This Is What the Surgeon Said to Me Afterwards That We Have Should've Told Me That If You Had Reflux of Wayne, I Didn't What You Did Gave Me to Me in Exactly so I Was I Was Less Cheerful about Than Him of the Pond Bottom Line Was That I Was on the Arm Medication to Reduce the Amount of Acid Produced in My Stomach for Our Several Months after the Operation and Then We Tried Going for a While Wasn't Quite Ready Went Back on for a Bit Longer and Then I Came off It I Haven't Had an Hour for Nearly 2 Months and I've Really Only Had One Bout of a Reflux in Two Months Now and It Was Because I Had a Drink Way Too Close Identify Those Rules Which Is a VR Drink or Eat Anything You Gotta Have It and Sit Upright and Make Sure It's Passed through before Our 30 Minutes before You Go and Lie down Horizontally I Suppose If I Were Sleep Sitting up That Would Be Finding This Property Had up with a with a Pillow or WP Live Rents Usually Reduces the Problem Anyway so That's Something to Be Aware of That I Had to Deal with That I Didn't Previously so the First Few Are the First Few Months Afterwards I Was Very Our Intolerance to Our Lactose so I Had A Lot Of Far Really Bad Arm Now Cramping and It Was Pretty Horrid Actually Very Painful Are Thankfully Though That's That Dissipated As I Discussed on the Yard the Coffee Episode Are Yes I Don't Do I Don't Have Any Problems of Having a Mate Right Now so That's All Good Thankfully Are Okay Right Good Lovely so Arm Honestly One of the Things You Notice and Kidney Stones before Arm When He Was at His Heaviest Hands in Order to Blast the Kidney Stones They Had to Wait until a Certain Machine Was Available That Could Handle Someone of John's Eyes When He Had to Be Sent Again Last August Because He Lost Had the Surgery and Lost so Much Weight It Was so Much Easier for Then to Get in and Deal with the Kidney Stones Arm Because He Was No Longer Carrying Extra Weight like Being Able to Get Yourself up off the Couch Easier Being Able to Cross Your Legs Arm It's the Things That You Don't Really Notice at the Time When You Heaviest That As You Start to Regain Them You Realise How Much You Miss Them Mean Silly Things to Me like Our Animations in the Article I Wrote Says Are Having to Tie My Shoelaces a Different Wake so I'd I Traditionally Have Leaned Forward in a Seated Position to Tie My Shoelaces Why Couldn't Do That Was My Heaviest and I Couldn't Estimate Belly in the Middle so I Had to Lift My My Legs up upon My Foot up on Something in Order Time a Shoelace Which You Looking Back Nothing Really Goes on but You Is like It's More of an Annoyance but You You Do Realise It and Once You Can Do It Again in Yates It's I Think As It Is Again Go but It's Not Just That the Thing That I Find Arm Frustrating and Horrible about about Humanity Is the Way That People Look at You Differently and yet That's Been the Biggest One of the Biggest Arm Underscores I Guess You'd Say That I've Experienced in Losing Less Weight so Quickly Is That in a Short Period of Time Are You We Tend Undiluted Things in over Long Periods of Time the Human Brain Which We Sort of Tended Memories Fade and Get Fuzzy and We Tend to Sort of Gloss over Certain Details When Things Happen over Short Periods of Time You Notice Them More and Just the Way That People Look at Me to Come up to Me to Strike up a Conversation and the Way That Arm That the Way That You Are Perceived in the Way That You Are Either Ignored or Paid Attention to It Varies in the Way That People Look at You and I Can See It in Their Eyes and It's Not a Paranoia It's a Fact Is That's the Way That People Are It's Terrible but You Know I Mean I Had All Sorts of Horrible Comments in Your Minute Time and We Were Walking and He Was Well out Walking Main Pram and to Will Describe Organs Either on the Sidewalk and Arm That Is Some You're Both Sort of Leaned out the Window and Yelled out Hey Fatties Given the Lamb and Went down the Barrel House You Miss like That Sort of Horrible BS Now That She Got Put up with Promises from from the Age of the Jackasses Okay Fine You Need Whatever They Were People Were Hours of People Would Ever Say Something like That but While We We Didn't Meet They Were Not the Mass of the Point Is That That's Assaulting a Deal with One Time Arm Was in a Meeting and Arm No IQ Consummate People in Suits My Listing Again Suits but the Point Is That You Know Okay so Sue Guy in a Sizes of the Food Was Served for Lunch We Had a Long Meeting You and the Food Player Came in and the a Psycho May Weigh John Yeo You Go First Go Sure You Hungry and a Psych Note That Wasn't As Exactly Your Fat Therefore You Got It First Because You Fat Comment It Was a Thinly Thinly Veiled in a Disrespectful Comments Now Work with That Same Individual Make the Same Comment to Me Now Know in Fact the Same Individual When He Said When He Saw Me Now Because I Still Work with This Individual Is He Has This Nervous Look on His Face and His Oysters Are You Looking Good and That's All He's Got in a Psych It's Just It's Sad to Me beyond the Health Benefits of Doing This Which Frankly I'm so Glad I Did Because of the Health and As I Feel Fantastic Life Ever Felt This Good in a Decade Really It's Really That Dramatic and I'm so Glad How Dunamis Forget the Fact That I I Do Get Not Quite As Badly As You Darling of Course I Do Still Get Mild Dumping Syndrome If I Have the Wrong Things Are Still Get Racing Heartbeat Is to Break and Cold Sweats I Still Feel the Effects of Alcohol Any Faster Not to the Same Extent As You but Still Relatively Significantly and Certainly A Lot More Than Proper Presurgery but the Net Benefits Is a Positive It's an Internet Is a Net Win and That's the Way I Choose to See It and That That the Underscore That That the Biggest Benefit I Would See If Educ the Thing That Drives a Home Is Standing in the Food Court Disorder Touched on This but Maybe Didn't Quite Say Just How Profound That Is Imagine Right Now That You Are at Your Favourite Shopping Mall That Is Assuming You Go to Shopping Malls but Anyhow Your Favourite Food Court in Your Favourite Shopping Mall They Got a Massive Variety of Foods from All around the World and They Are the Most Beautiful Foods That You Could Ever Imagine Tasting Now Imagine Standing There Salivating at the Options in Front of You Now Have the Surgery Imagine Standing in That Same Place the Same Spot and Feeling Nothing and Just Saying You Know What I Can Smell Food I Know I Have To Eat Something Agreed Something I Can Listing I Live out the More You'll Feel Body Rather Than Arm That the DDL and I Guess This Is Something That I've Come to Appreciate and Why I've Decided I'm Happy at the Way I Am Is Because I Have To Exercise for a Five Times A Week to Maintain This Way Have To Count Every Calorie That Goes into My Body Because You Can't Consume Much While I Call It If I Wanted to Really Graze All Day Knows I Could I Could Arm Eat Quite A Few Calories and Especially for Sort of Quite High Fat and High Carb As Well Relationship with Food Is A Lot Difference Arm If I'm Going to Eat Something I Would Go for Quality Rather Than Quantity I Will Go for Something Quality and Something I Had A Lot Of Trouble Getting My Head around and John Is Still Having Trouble Dealing with Is Linking Food on Your Plate Needing Something and I'm Not Enjoying It in a Tell I'm Not I'm Not Doing so Why Bother Eating It and Eat Something That I Ain't Enjoying Something That Tastes Good but You Know What I'm Running a Small Amount of It I Still Get Cravings I'm Human and Especially Sort of Round Certain Times and I Crave Chocolate and Arm You Know What I Give into That Craving and Made a Small Amounts and in the past by Crave Chocolate AT the Family Block of Chocolate and Now If I Crave Chocolate Is Much As I Want Which Is Quite Similar Elsewhere Three or Four Square P I'm Not Having to Count Every Calorie and Watch Every Bite I Don't Feel Guilty Anymore about Eating Something That Isn't Healthy or Is It Good for Me Because I Know That It's a Once off It Only Happens Very Rarely Do Make the Right Food Choices Because That's What My Body Wants It Wants the Good Feet It Wants the Protein Occasionally It Wants the Crap Food and the Bad Thing That's My Body and I Don't Feel Guilty about It Because You're Back in Control at the Point of Our Hunger and Desire Does Not Control My Life As the Final Point Is Where I Want to Wrap up on This Is That Weight Loss Surgery the Funny Thing Is It's about Losing Weight Loss Only Superficially Is Actually about the War Control the War on Hunger the War against Control of Your Hunger and Control of Your Relationship with Food and People Say Well You Not Your Usages Diet More You Know and I Got That Full Sorry Sweeting before His Surgery Some People Did Some People Quite Close Twisted Turn around and Say Well Why Don't You Just Die Stop Eating so Much and Exercise More out There He Is Grossly Overweight and Obese Will Know That It Is Only Skinny Person Would Make That Comment the Truth Is That We Are at War with Our Own Hunger and the Surgery Is a Rather Inelegant Solution to That Maybe Someday That We Are Better More Elegant Solution like They Can Control the Hormone Assignment with with a Certain Tablet or Something yet Matt Maybe I Don't Know Ultimately Though If You Don't Want to End up Having to Have the Surgery to Get That Control Back Visible Anything You Should Feel Ashamed about Theodore Taking Surgical Option to Get Control Back Especially If like Curson I Have Tried so Many Different Things and It's and You've Always Failed in Its It's the Admission to Me Was an Admission Yes Okay John You Know What You Tried You Tried and Failed You Know What Fine I Would Rather Try and Fail and Then Try This and Succeed Are and Then Have To Look to Have Three People in the Face the Don't Care and Don't Understand and They Say to Me Why You Should Have Died Harder Orson You Should Have Just Whatever You're Doing with Your Heart Not Good Hard so Well You Know What I'd Rather Look You Guys in the Face and Say You Know What That's Your Opinion Welcome to It Arm Because Now I Get to Live Longer Now I Get to Not Die of a and Have Diane Do Not Have Diabetes and Not Have High Blood Pressure I Succeeded through Means That You Use Some Divorces Copping out It's Not It's Not Easy This Is Not the Easy Part This Is the Hard Path This Is Not a Cop out in Any Way Surgery Is Just at School Is Not a Quick Fix Is Not the Arm Is Not the Easy Way out Is Still Have To Make the Right Food Choices the Weight Loss Surgery and Still Eat Crap for Constantly Eat the Crap Food and Eat All Day Stretching the Pouch out and Not Lose Any Weight It Is Only a Tool Some People Do That Any Other That Throwback Sometimes so I Yeah What Is a Statistical Chance It Is Not a Work While You Know the Statistical Chances Are of the Ones That Don't Work Because the Biology Doesn't Line the Biology Will Work It's Not the Biology It's What If You Listen to Your What Your Body Is Telling You after the Surgery You Won't Have a Problem You Will Lose Weight but If You Do like You Are Saying Sweetheart like You Just Graze Constantly in the Wrong Foods That Arm A Lot Of People Don't Realise Is That the Whole Eating When You're Not Hungry Eating and Finding out What Your Triggers Are and Whether It's Depression Whether It's the Weather Whether It's Stress It's Head Hunger Not Static and That It Had Hunger and A Lot Of Surgeons Will Recommend and Suggest That You See Someone about It to Deal with Your the Issues Are Either before or after You Have the Surgery to Help Ensure the Best Possible Outcome for Surgery before We Do Wrap up and We Direct Wrapper Sometime Is Some of What I Have Had a Note Here to Talk about and Only with Rashly Talked about and I Think We Can Talk about the Alcohol Side of Things That Arm Deals Wanted to Quickly Benediction Transfer Called Addiction Transfer to Our Overweight and Obese See When You Take Away That's Arm See You Can No Longer Be Addicted to Feed A Lot Of People Can Find That They Transfer Their Addiction to Other Things Some People Find a Map with Alcohol Issues or Gambling Shopping Is Another Big One Arm That You Can Become Addicted to Arm Some of Us Just Have Addictive Personalities and Will Be Coming into Things and Arm Addiction Transfer Is Is Definitely a Be Aware and Allowed the Reason the Trade-Off Is That You Mention the Psychological Component so That the Overhead Hunger Doing the Head Hunger It's like That's Not the Only Problem That Can Rises Some Psychological Had Problems Go along with That and Something That Bunch and I've Had to Face Is after the Surgery You Go through a Mourning Period Sounds Really Weird but You Mourn the Loss of Feed Seat Was All That the Fourth Century Feet Was Always a Comfort When You Are Stressed yet Eat When You Celebrate the Eat Feed Was Always That Constant Companion and after Weight Loss Surgery Thinking No Longer Be Facts That Friend That Crutch That Arm That Companion That It Once Was to Go through a Mourning Period Where You Really Nice We Really Miss That There Are Any Missed That Arm Comfort That Gave You and A Lot Of People Find That They Replace That Feed with Something Else and That's Why You Have To Be Very Careful Arm after Surgery with This Transfer Type Prefer to Think That Food Used to Be One of My Best Friends Food Is Now a Distant Acquaintance Seeing Arm through Food As Fuel Food Is Not You Know Your Best Friend, Best Friend Emma and That's a Ladies to Get a Car so I Have To Wrap This up with a Bow and Put a Pragmatic Spin All This What Is All This Mean and I Guess What It Means to Me Is If You Listening to This and It Overweight Problem Thumbs up Never Never Stop Worrying about It Be My Advice Keep on Top of It Do Not Let It Get Away from You Always Keep in Mind Because If You Do Let Things Go There Reaches a Point Where It Is Difficult to Come Back in the Further You Go the Harder It Is to Come Back and Once You Get onto the Rollercoasters Diet Rollercoasters the Conclusion Statistically Is That Ultimately You Can End up in a Bad Place so I Don't Know Whether or Not You Should Consider Weight Loss Surgery As a Saviour or As a Warning Either Way You Want to Take It I Really Don't Care You Need to Choose Make the Right Decisions in the Right Decision for You It Was the Right Decision to Curson and Me and Given the Alarming Number of People That Are Technically Now Obese in the World It's Can Become Far More Common and Scared Is Already More Common It Was Even As Recently As Five Years Ago and Is I Say Now I Had a Gastric Sleeve and the People Know Roughly What I'm Talking about You Go Back Five Years Ago despite the Fact That the Procedure Existed Most Will Give You a Blank Look It's Becoming More Prevalent It's Gonna Become Even More Prevalent People Are Going to Become More Accepting I Think I Hope Are of This People to Become More Aware of the Diets and the Problems of Carbohydrates and High Fructose Corn Syrup and Always Other Bad Things That Are That Are Driving along This in and Controlling out Sugar Is Going into Their Diets All of These Things It's Going to Increasingly Come to a Head and Governments Can Start Regulating Things in the Meantime My Advice to You Is Always Care about What's Coming in Your Mouth Think about It Try to Keep Your Weight under Control or You'll End up Where I Am and Frankly It's It Is an Option It's Not the Best Option Necessarily I Wish I Could Have Kept It under Control but I Chose a Far More How Should I Say Our Last Resort Measure but That Said As Last Resort to Go I Think It Is a Net Win in the End and You Are Ending and Unite and That's What You'd like to Talk More about This You Reach Me on Twitter at John Geagea and That My Site Take Distortion.com As Whether Podcasts Host along with My Writing and Other Stuff Done If You like This Any Feedback Please Use the Feedback from the Website As We Also Function As This Episode Casts Pragmatic Dignified Tram Pragmatic Show on Twitter at the Seashell Announcements and Other Related Stuff I'd like to Thank My Guest Host My Sweetheart Normally on Our Direct Peoples of the Year to Your Twitter Account Which You Want to Hear Any Check It like Never Checked It so Feel Free to Figure out What Her Curson's Twitter Account Is an Am Not As a Favour, the Website Anyway Lastly Okay I Once Again I Would like to Thank Extrasensory Devices and Their Laxity for All the Sponsoring Pragmatic Collective Rules Are Compact and Lightweight Incident like Me to Attachment Your Smartphone or Tablet Visit Here Is Devices.com/Pragmatic More Information about the Handy like Several Use a Coupon Code Take Distortion for 15% of Exclusively Pragmatic Was Taking Better Pictures Starts with Your Lungs I'd Also like to Thank Many Tricks the Continued Sponsoring Pragmatic If You're Looking for Some Mac Software That Can Do Many Tricks Many Many Tricks Remember to Specifically Visit This URL Many Tricks or One-Word.com/Pragmatic More Information about Their Amazingly Useful Apps and Is Discount Code Pragmatic 25 Pragmatic the Word into Five Numbers 25% of the Total Price of Your Hurry Is Only for a Limited Time and I Guarantee You Yes It Will Answer Getting What You Can Once Again Thank You Darling and Thanks Listening Everybody in the SBS BMI BMI Beep That This Is a Family Show on Enemy Families Listen to It Dear Listeners If You Are a Family Apologise Okay Lovely This Is about the Meaningless Bits about Me Thank You Yes Your Podcast Would Think That Wouldn't Keep Talking Okay Lovely We Focused Night Sky It Is Lately a Lady They Don't Know That They Were Losing This in the Mid Days of I Say Whatever Time No Date Is Here Relative to SA for Children Your Conclusions Makes You Indicates Late. It's All Right Visit I Never Regret It Later Thank You I Just the Place We Visit Here Is Devices.com Subsets When I Was Setting up This Episode My Son My Four-year-old Son Decided He'd Help Me out with a Little Sound Test This Is What Happened Are All and Known and Love You Too Thank You Sam Ame We Helped�
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People

Kirsten Chidgey

Kirsten Chidgey

Kirsten is my wonderful wife. She has a Twitter account but never uses it. She has no blog, but honestly I think she should.

John Chidgey

John Chidgey

John is an Electrical, Instrumentation and Control Systems Engineer, programmer, podcaster and runs TechDistortion and the Engineered Network. John has produced and appeared on many podcasts as well as Pragmatic.

What Happened to Mastodon? You can reach me on the Fediverse as explained here, just search for me on your instance of Mastodon, Misskey or Pleroma and you’ll be able to follow/remote follow me wherever you are!