Phentermine trial

So I met with my primary care doctor again today. On the protein regimen (>100g protein per day, <100g carbs per day) I lost about 10 pounds over 2-1/2 months, then started glucophage 100mg BID in addition to the protein regimen and I've been plateauing between 354-358 for the last 2 months or so.

Today, I again brought up the possibility of getting a sleeve gastrectomy, or at least starting the referral process so that in 6 months if I'm still not making decent headway with medical management I can go ahead and get the surgery. I made it clear that I would keep being committed to any recommendations he could add to the medical side of things, and that as long as I continued to lose weight with his regime (and at a rate that will get me where I want to be before I'm 40) that I would postpone surgery, even beyond the necessary 6 month preparatory period.

He agreed to that arrangement, and wrote orders for some pre-operative lab work, mammography, bone density scans, etc that I am supposed to get done as part of the referral process to the surgical program. He also prescribed phentermine 30mg once a day before breakfast, to try to get me off my current plateau. I picked it up from the pharmacy and took my first dose around noon today. Normally I would be concerned about taking it so late in the day, but I'm working night shift tomorrow night, so I need to stay up late tonight in preparation for that anyway. My other concern with phentermine is that my personality tends toward the anxious (not outwardly, according to my friends, but very much so on the inside) and I worry about the phentermine heightening my anxiety. Fingers crossed that it's just an extra boost of energy to get some school work and exercise done.

I did 2-3 hours of yard work the other day and my body really felt it the next day. My arms were as weak as cooked spaghetti. Felt good to do something physically demanding though.

I will continue to track and share my progress. Here's my current front and side view. About 357 pounds this morning.

Attended surgical weight loss seminar

Last night I went to a surgical weight loss seminar put on by a local bariatric surgeon and his team. The doctor said he doesn't perform lap band surgery anymore because it's not proven effective in the long term. Just a few years ago my mom was trying to talk me into having that surgery with her. She got it, herself. Got down to a healthy weight but then gained it all back again. Whenever I pictured getting that done I thought I'd feel like Ping the Duck, in a childhood story I read, with a ring around his neck that prevented him from swallowing his fishing catch.

One thing the doctor pointed out in the seminar that I didn't know is that if you need to take medications regularly, and have them absorb well, a gastric bypass is not the best option -- you not only have limitations on absorbing nutrients, but on medications as well. The gastric sleeve, which is what my friend had, doesn't do this. But sometimes people get really bad acid reflux after the sleeve and end up having to convert to the bypass (which corrects the reflux).

I gave them my information at the seminar with the thought of starting their process in case my current gung-ho efforts at weight loss through increased protein and decreased carbs doesn't turn my health around enough. If I'm going to move forward in their process (which would take at least 6 months before insurance would approve it, including nutritionist and psychiatrist appointments leading up to the surgery) the next step is to get a referral from my primary care doctor and have him send over my labs etc. My next follow up with my primary care doctor is in 2 weeks, so I'll talk with him about it then.