In which I tell you how to ginsu your guts

“Which weight loss surgery is right for me?”

Also don’t let me fix your tablet, either.

Great question! You should probably ask a real doctor, not an information security guy.

Since I’ve already had a weight-loss surgery I’m going to spoil the end of the article for you: I went with the gastric sleeve.

Based on the propaganda supplied by my glorious surgeon and a little bit of googling, there’s three main types of bariatric surgery. There’s the bypass, the sleeve, and the band.

There’s 3 ways I weigh the different procedures. The first is the amount of weight lost (and kept off). The second are the health effects of the surgery. Finally, I consider the dietary requirements.

Gastric Bypass (Roux-en-Y Gastric Bypass)

This is the old fashioned standard bariatric surgery. It’s been around the longest so there’s the most studies for its effectiveness. I’ll explain the pros and cons, but first here’s a technical description of the procedure:

  1. The doctor cuts you open and starts cutting your organs out.
  2. Eventually the doctor gets tired, or a hand cramp or something, and stops removing vital organs.
  3. In a rushed panic reminiscent of a 6th-grade science fair the doctor hastily plugs whatever’s left of your intestines into the bottom of your throat.Et viola! Really, though, wikipedia has a good description.

The gastric bypass is the older of the three surgeries so there’s been more time for studies showing how well it works. Turns out, it works the best for long-term weight loss. Wikipedia says a loss of 65–80% of excess weight is typical. I didn’t bother to see if that’s backed up at all because, man, I just love rolling the wikipedia dice.

You’ll have to deal with the fallout of bypassing more of your GI tract for absorbing vitamins and minerals by battling deficiencies for the rest of your life. Not an awesome Braveheart-style historically inaccurate battle; the kind of battle where you eat tons of chewable multivitamins forever and ever. Oh, yeah, you can’t ever have a regular pill again ever.

After surgery the diet restrictions are intolerance to red meat, milk, sugar, and starches. Essentially, anything worth eating. There’s also our old friend dumping syndrome, too.

Gastric bypass is sorta reversible. They can re-re-plumb your insides, but I don’t know how to do it. So do yourself a favor and don’t call my office to book your appointment.

Gastric Sleeve (Sleeve Gastrectomy)

This is the one I’m having. Read my expanded post on what this entails. I wanted to make an entrails joke here, but I am too serious a dude to make those jokes. Stay with me, people!

According to a study of a bunch of Poles, the sleeve and bypass have about the same long-term weight loss. Maaaybe you can lose a little more with the bypass, but it isn’t much if any.

There’s three ways bariatric surgery works. First, there’s restrictive. That’s simple; you’re restricted from shoveling so damn much Americone Dream into your face-hole. Second, there’s malabsorption. Malabsorption means that you don’t absorb as many nutrients (protein, carbs, etc.) from your food as you normally could. Third (and in terms of writing a 3-part paper, what a cop-out) is a combination of the two.

The gastric sleeve is a restrictive approach (as opposed to the gastric bypass’s combination approach). The downside to this is that you may not lose as much weight. The upside is that you avoid all of the vitamin and mineral deficiencies. You also miss out on most of the dumping syndrome.

As for the long-term changes to diet, there aren’t really any. Well, aside from the obvious change where I won’t eat so damn much. Remember above where I said gastric bypass patients are intolerant to “red meat, milk, sugar, and starches”? With the gastric sleeve I can still eat sensibly-small portions of all of those.

It’s a little bit safer than the bypass since there’s no rerouting of the intestines (yeah, I wasn’t kidding about that part). There’s lower risk of infection because of that as well. Since part of the stomach is removed the procedure is irreversible.

Adjustable Gastric Banding

In a typical “here’s three alternatives, and this one is the best” article you’ll see the best one last. I’m super great at this sort of thing so I’m not following that rule. A friend asked why I chose the sleeve instead of a Lap-band in a comment on my previous post. And he’s right to ask; the adjustable band seems to be the perfect solution; all the weight loss and it’s reversible. So here’s why.

First, here’s what an adjustable gastric band is. Instead of rerouting your intestines or tossing most of the glorious stomach you’ve worked so hard on into the trash, the band just inserts a little loop around the inlet to your stomach. It’s like a surgically implanted Verne Troyer choking the shit out of your stomach 24×7. The awesome part is that it’s inflatable like a water wing, so the doctor can inflate (or deflate) your band as needed to allow you to lose the weight at a good rate.

You don’t lose weight as well as the other surgeries. That might not be as big a deal for my minimally-morbidly obese (is there such a thing?) friends, but it’s a thing. If you have the band adjusted to be wider, you can eat more so you won’t lose as much weight. If you have it adjusted tighter, then you weren’t losing as much weight as you could have been prior to the adjustment. I know I would have kept a get-out-of-jail-free card in the form of “Eh, I’ll just go have it adjusted.” It would have spelled doom. Doooooooooooooooom.

Oh, once the band is removed there’s nothing to stop you from just eating your way back to the top of fatass mountain. If I had that sort of self discipline to stop that amount of weight gain in the first place, I wouldn’t have needed surgery. So the outlook isn’t so good.

Gastric bands are restrictive so you aren’t going to have the same issues as with a gastric bypass. Instead, you get a whole bunch of other ones! Remember how I said the band chokes off the inlet of your stomach? Because of that you can’t have regular pills, you have to chew/puree everything you eat like crazy, and you have your own list of food intolerances: Red Meat, bread, pasta, rice, nuts, seeds, the skins of fruits and vegetables, and the membranes of citrus fruits.

Oh dear sweet baby Jesus H. Christ! Not the membranes of citrus fruits! Oh no!

But really, that’s a hell of a list of food intolerances.

Adjustable banding gets off kinda easy in the long-term comparison since it’s reversible. I have a couple of things here, though. First, remember what I said about just being able to yo-yo back up again. For me it was a real concern, and I imagine it may be for you too. Second, the adjustable band requires regular visits to your surgeon to have it adjusted.

So you get the hassle of going back often to have it adjusted. And while you’re at it, you have to worry about infections at the site of your port. Sure, you and the doctor probably view that port as place to import/export saline to inflate/deflate the gastric band. But nefarious germs will view that port as an easy way to import undeclared fruits and vegetables, illegal firearms, giant bales of marijuana, oh and MRSA right to your abdominal cavity.

Hey, at least it’s reversible.

My Verdict

Diet and exercise is the winner!

Just kidding. That’s ridiculous. And I’m not kidding about it being ridiculous. I’ll explain more in an upcoming post.

SurgeryWeight LossHealth ConsequencesDietary Boo-Hoo-HooSuperpowers ConferredArbitrary Grade
Roux-En-Y Gastric BypassBestLifelong nutrition deficienciesred meat, milk, sugar, and starchesnoneC
Sleeve GastrectomyAlmost bestMinimal impactHave to cut down on portionsnoneA
Adjustable Gastric BandBetter than nothin! (maybe)High impact while it's in, zero otherwiseRed Meat, bread, pasta, rice, nuts, seeds, fruit skins, vegetable skins, citrus membranesnoneF-

I got a sleeve gastrectomy. I really do think it was the best of the three options for me. It may be for you as well, but you’ve got to do your own homework.

I must confess I had a big help that didn’t really factor into the comparisons above. My sister had a gastric sleeve 8 months before I had mine. I was able to see first-hand all the problems and success she’s had. When I went in to the informational seminar I had a feeling I would end up with the sleeve. They presented all three types of surgeries and gave the same basic reasons I have here as to why they do mostly sleeves.

They didn’t mention Verne Troyer, though.

That was all me.

Going home today

The doctor came by and said I’m cleared to leave after lunch!

I’m feeling alright. My abs feel like I’ve been doing crunches all day (and yesterday (and the day before) )

The chicken broth here is delicious. Seriously.

This morning for breakfast I had beef broth and orange jello. I was so excited to try the beef broth that I ate too quickly. So now I have that thanksgiving stuffed feeling. From 1/2 cup of broth and a couple spoonfuls of jello.

Anyhow, can’t wait to get home.

Check-In Time

My surgery is tomorrow. My check-in time is 8:30am.

The early check-in is welcome; since I can’t eat after midnight (doctor’s orders — I’ll turn into a gremlin). The sooner I am into surgery the less time i’ll spend being hungry.

Sorry to be morose, but there is a tiny sliver of a chance that I’ll die during the surgery. So, just to rub it in, here’s a list of the titles of upcoming posts you’ll miss out on:

  • In which I tell you how to ginsu your guts
  • Suddenly, everyone is a dietitian and personal trainer
  • No, you go fuck yourself, Guy Behind the Counter at Krispy Kreme
  • My family loves me
  • Some books to read

The 8:30 check-in gives us enough time to get all the kids off to school, assuming it isn’t cancelled. For the historians visiting from the future, there’s a winter storm going on right now so it’s possible that school will be cancelled tomorrow. If so, that’ll suck for my lovely wife who will have to deal with all the kids while I’m relaxing in bed and high as a kite on drugs.

Still doesn’t seem real.

My Weight Loss Surgery

On January 6th 2015 I will undergo bariatric surgery.

A portion of my stomach will be removed, the rest formed into a new smaller stomach.

I will then rapidly lose between 80 – 120 pounds, eventually settling close to my goal weight of 180 pounds.

I will then live a long and healthy life; for me, but more importantly for my wife and children.

Continue reading My Weight Loss Surgery

Transformers Generations Legends Cosmos legs fix

I recently purchased a Transformers Generations Legends-class Autobot Cosmos & Payload figure from the local store. I love this little guy but had problems transforming it into UFO mode and getting it to stand in robot mode.

I did some googling and so far haven’t seen anyone else describing this problem. I have, however, found some people complaining that the panels don’t line up correctly in UFO mode. Perhaps they have the same problem I do. I’m getting ahead of myself.

Symptoms:

  1. In robot mode it’s nearly impossible to get Cosmos to stand up without support. I simply could not get his feet situated in any sort of stable pose. I didn’t take any pictures of him fallen over because there’s simply no reason to post such an embarrassing photo of a brave Autobot warrior.
  2. In UFO mode the front of the disk dips down at an angle compared to the back of the toy. There’s also a gap between the top of the front of the disk and the central portion of the UFO. Both issues are shown here:
Cosmos figure in UFO mode side view showing angle and gap
Mis-assembled Cosmos side view.
Front view of Cosmos in UFO mode. This shows the gap between the outer disk and center portion.
Mis-assembled Cosmos front view.

Determining the problem

I examined as many pictures and reviews of Transformers Universe Legends Autobot Cosmos & Payload as I could find and soon discovered a discrepancy between the working toys in the reviews and mine.

His feet are on the wrong legs!

In other words, his left foot is on his right leg and his right foot is on his left leg. The bottoms of the feet aren’t flat; they’re at an angle to make the transformation work and allow him to stand. So being on the wrong legs means the angles won’t line up properly.

Is your Cosmos mis-assembled?

Transform Cosmos into UFO mode and examine the top and bottom of the front corners (these are his feet).

Look at the top. Look at the fin on the outside. Is it scooped out like this picture? If so, your Autobot Cosmos has this problem.

If mis-assembled, the fin on the edge will be scooped out on top and near the center portion of the UFO there will be two slots.
Detail of mis-assembled Cosmos figure.

Look at the bottom. Look at the fin on the outside. Is it scooped out like this picture? If so, your Autobot Cosmos is fixed. Also you can check the slots near the central hole on the bottom. There will be two slots as shown in this picture.

Underside of Cosmos in UFO mode. The fin is scooped out on the bottom and there are two slots near the central hole.
Underside detail of correctly assembled Cosmos

The fix

Swap his feet.

At first, I tried swapping the legs at the hips but it doesn’t work quite right. Swapping at the hips will put the blasters on top of the UFO disk and the transformation won’t be quite right because there’s supposed to be a cut-out on the bottom of the disk to allow for his crotch.

So, swap his feet. I used a pin punch to tap the pins holding his feet on out. There’s plenty of guides online for how to remove the pins so I suggest looking at a few (including Youtube demonstrations) before trying.

Cosmos in robot mode, standing easily. His feet have been swapped. This image also has arrows pointing to the locations of the pins to remove to swap the feet.
Cosmos with fixed legs

I have a watch repair kit with pin punches small enough for these pins, so I used that. The pins used are knurled and slightly larger at one end and smooth at the other. So you identify which end is knurled and then tap the pin out from the other end.

Then I swapped his feet to the other legs and reinstalled the pins. I tapped them in (smooth end first, the opposite of when I removed them) and it was all good.

Side view of fixed Cosmos in UFO mode. There is no gap between the disk and central portion at the front.
Side view of fixed Cosmos.

Here’s a final vanity shot of my repaired Legends-class Cosmos:

Cosmos displayed in UFO mode demonstrating the overall look of the repaired figure.
Vanity shot: Cosmos in UFO mode

 

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