PAUL McDONALD

Hi, I’m Paul McDonald and I am a 39 year old Morbidly Obese male! 'Morbidly Obese' - it sounds terrible doesn't it! However in reality it is simply a medical disease like any other (cancer, heart disease etc). The reason it sounds bad is because of the stigma society attaches to the disease. Many people consider the obese person to be ugly and dumb. This is total nonsense. In my case I have a University degree and I'm also quite good looking. Well meaning friends and family try to tell you that what you need to do to lose the weight is go on a diet and exercise and show some willpower. Unfortunately though, for the long term obese, studies have shown that treatment without surgery has only around a 5% long term success rate. It is important to note here that overeating has not caused my disease, but rather that my disease causes me to overeat.

This has ultimately resulted in my obesity as well as high blood pressure, high cholesterol, gastric reflux, sleep apnoea and sore knees. I have been fighting this disease for 27 years and in the end I said enough is enough which is why I chose to have lap band surgery. This wasn't a decision I made easily. I researched all the alternatives but none of them could offer the long term improvement in my health that the lap band could.

At first I tried to get the operation through the public health system. However, the waiting list for this surgery is so long that I may not have been around by the time I got to the top of the list. In the end I found myself in a position where I could have the surgery and I have now joined the lap band club.

Prior to Surgery

Prior to the surgery with Doctor Layani, I needed to have consultations with the nurse who explained the procedure for the surgery, asked me about my health, checked my height and weight and measured my waist, hips etc. This might sound daunting but Carol made it easy and treated me with respect (unlike many GP's over the years). I also met with Amanda the dietitian, Jenne the psychologist as well as Doctor Layani himself. Doctor Layani also ordered some blood tests to check my general health and suitability for the surgery.

It is important to note that ongoing consultations with this team at the Gold Coast Obesity Surgery Centre are essential for the best long term health results. In my case even though my disease started out as a physiological hunger, years of dealing with the unfair treatment that society places on the obese person have resulted in some psychological scars that would benefit from treatment. I have also come to think of food as a comfort from society and will need to find alternative ways of feeling good about myself. I also look forward to working with Amanda, the Dietitian, of finding ways to enjoy vegetables!

The Surgery

On the day of the surgery I arrived at the John Flynn Hospital at 8.00am and was immediately taken to my room. The room was awesome - almost like a motel! The anaesthetist arrived to explain his part of the procedure and to make sure it was safe to put me under anaesthetic. He also told me to put on a rather attractive blue gown! A nurse arrived, shaved my stomach and gave me a tablet for my gastric reflux. I was then wheeled to the preoperative area and given a relaxant.

I was then wheeled into the operating theatre still a bit nervous but with a nurse holding my hand which was great. Everyone was friendly and professional which put me at ease. After a little while I was given an injection and don't remember anything until I came out. Waking up I was in some pain and was given an injection for the pain which soon went away. I had no problems with the keyhole surgery and was allowed straight back to the hospital ward where nurses checked my blood pressure etc every 20 minutes or so. I slept a lot and watched television. The next day I was well enough to go home.

Three days later I am a little tender in the stomach area and have shoulder tip pain (common with lap band surgery) but other than that feel fine, have no problem with the temporary fluid diet and am looking forward to reclaiming my health as well as looking better in shorts! I also have a long term goal which is to run a full Marathon, something I couldn't do previously because of my weight.

One Week Post Surgery

It is now 7 days since I had my lapband inserted and for the last 4 days I haven't felt the slightest bit of pain. I have already lost 5kg and have dropped down in shorts size from 135cm to 130cm! Having said that, I've also decided I'm not a 'liquid' kind of guy and, while I never in my life thought I would say this, I find myself actually counting down the sleeps until I'm off the liquid meal replacements and can have pureed vegetables!

One thing the Psychologist, Jenne told me is that the lapband is not the be all and cure all for weight loss. Instead it is better to think of it as a valuable aid in achieving a healthy body weight. For optimal results I must also take part in some form of physical activity most days and make better food choices than the rubbish I used to eat. This isn't to say I can't enjoy the occasional takeaway, but instead of needing 1-2 large pizzas to fill me, it will be 1-2 slices that will do the trick.

In my opinion what the lapband has given me is the same opportunity as those lucky people who never had to suffer from constant hunger. What this means is that, for the first time in 27 years, I have the control. My destiny is in my own hands and that is a very exciting proposition indeed! I have already started walking for 6 minutes a day Monday to Friday.

Two Weeks Post Surgery

This second week of fluids has been tough and I’ve felt quite hungry at times. However, knowing that the fluid phase is to help ensure the lapband stays where it’s supposed to, I stuck to it with only minor indiscretions. This included a cappuccino (made me feel normal again) and a cup of pumpkin soup.

Today I had my first pureed meal, a half cup of pureed baked beans, which tasted absolutely awesome – go figure. Of course human nature being what it is, after a few days I’ll probably feel ‘deprived’ and count the sleeps until I can have solids.

I’ve now lost a total of 9kg since the lapband was put in. By sticking to the eating (drinking) plan the dietician placed me on, this weight loss has been fat and excess water with no loss of muscle. In fact, Amanda tells me I’ve added 1kg of muscle which is great.

My double chin has all but gone. I’m also built the walking up to 10 minutes a day and apart from a chest cold I’m coping well and am on track to be under 150kg by Christmas. My motivation for getting down to 150kg? – this is the most my bathroom scales go up to.

Choosing to have the lapband has been the best decision of my life.

Three Weeks Post Surgery

I have been on thick pureed food for one week now and, for the first time in my life, I have not felt the slightest bit hungry. A couple of times yesterday I actually had to remember to eat! I’ve also increased my walking to 12 minutes a day and already feel I’ve got more ‘get up and go.’ Previously my ‘get up and go’ often ‘got up and went!’

While I don’t have any physical hunger, I am craving spaghetti and cheese on toast as my first ‘real’ meal. However instead of 4 slices of toast and cheese plus a large tin of spaghetti, I’m going to try one quarter of that amount (and the cheese will be reduced fat).

I’m never going to be one of those people who say that food no longer interests them. I unashamedly love food and will continue to love food. The only difference is that I will be eating much smaller amounts and by losing weight I will be able to enjoy other things in my life as well!

One Month Post Surgery

I don't know if anybody reads these journal entries, but if you are reading them, then I hope you are getting something out of it. It is now one month since I had my lapband inserted and so far I have lost over 10kg. I am off both my gastric reflux and cholesterol tablets and have got my walking up to 14 minutes a day 5 days a week. I'm starting to feel more energetic and just better in general.

I'm eating normal food again (yippee!) but only about a third of what I consumed previously. I feel like a food critic now. I chew food for a long time and notice all the different textures and temperatures. It's quite fun tasting all the foods I eat. Previously I inhaled them.

I am a tad concerned about my first adjustment in a weeks time. After all, it involves a needle being inserted into my portal and saline injected. However, I figure thousands of people have had lapbands now, they got through it ok and so can I!

Six Weeks Post Surgery

It is now six weeks since my lapband surgery. I have lost a total of 12 kg and my walking has tripled from six minutes to 18 minutes a day. I am also going to the dry cleaners tomorrow to put a shirt in for alteration (taking in of course)!

This week I had my first band adjustment. To be honest, I was a little nervous but needn't have been. Doctor Layani poking and prodding to locate the portal caused some discomfort however the needle and injection themselves were totally painless. I then stayed at the centre for half an hour and drank a cup of water to make sure the band wasn't too tight.

After the adjustment, I had to go on fluids and then pureed food for a total of three to four days. This was a pain, but having gone back onto solids again, I realise again it was all worth it. Prior to the adjustment I would still get the occasional feeling of hunger. Now, provided I eat every three hours, I find myself in a satisfied state all day long. I am not hungry and I am eating six meals a day. What could be better than that!

The only annoyance I have is mild gastric reflux (I had super major gastric reflux prior to the surgery). I have been told that there is a good chance this will go away once I've lost some more weight. However, even if it doesn't go away, I will be happy being a normal sized man living a normal, happy and healthy life even if I do have to take one tiny tablet a day!

Two Months Post Surgery

A lot has happened in the two months since I had my lapband inserted. I have lost 14kg, gone off practically all my medications and I'm walking 20 minutes a day now.

I've also been offered a position at a Mobil Service Station in the Northern Territory which I have accepted. Previously I would not have considered this position as I was physically not up to it. Now I am!

Christmas has been good. For breakfast I had a little egg, ham, toast and tomato (little being the operating word) which I enjoyed immensely. Lunch was at a retirement home with my grandparents (again a small amount of ham, turkey and roast vegetables). I put the plum pudding into a doggy bag and had it later in the afternoon. Dinner was three skewered king prawns in chilli and garlic and I finished off with a mince pie later in the evening. I also enjoyed a few glasses of 20 year old port (thanks Dad) during the day. So, if anyone says you can't enjoy food after lapband let me assure you, they don't have a clue what they are talking about!

Tomorrow I relax and then fly to Uluru on Monday. As I write more and more of these journal entries, I find myself wanting to quote inspirational sayings. This month is 'if it is to be - it's up to me!' This is quite apt because all the lapband does is stop me feeling hungry. It is then my choice what type of food enters my mouth and what type of activities I do.

Ten Weeks Post Surgery (Letter to all State Health Ministers)

Good Afternoon,

This email is being sent to all State Health Ministers to beg you to include weight loss surgery in the list of procedures that are readily available through your public health system.

As a morbidly obese person I tried to get this life saving surgery through the NT and Qld public health systems but was told this wasn't possible and that I would have to find the $16,000 (or likely die in 3-4 years).

With no other choice, I was forced to go on National television (Today Tonight) in the hope that somebody would see sense or show some compassion and offer me the surgery I so desperately needed.

A surgeon on the Gold Coast (Dr Layani) saw the story and provided me with the surgery for free. I now have a life.

When I first appeared on Today Tonight I weighed around 170kg. I quickly lost around 5kg myself in the three weeks prior to the sugery (even though I have great willpower I could not have lasted much longer as the hunger was horrible) and since the surgery have easily lost another 16kg. I am currently losing 1kg every week and, provided I do what Dr Layanis office told me to, I do not feel the slightest bit hungry.

Prior to the surgery I was on medication for hypertension, hypercholesterol and gastric reflux. I also had sleep apnea (I was looking at getting a breathing machine) and sore knees. 21kg lighter my blood pressure and cholesterol (without medication) are in the normal range, I slept a full 8 hours the other night and my knees are no longer sore. I am still on gastric reflux medication but have been told this is most likely to stop once I have lost another 15-30kg.

Now, I am not asking you to believe that morbid obesity is a disease (it is actually). I'm also not asking you to believe it is not due to a weakness or lack of willpower (it isn't - the obese person usually has more willpower than other people).

What I am doing however is asking you to look at the cost to the health system of a 'one off' payment for surgery versus decades of cost to the government for medications in an attempt to manage the disease.

Morbid obesity is a disease not a weakness. I ask you to treat it as such and make lapband surgery readily available through your health system.

I now have a chance at a long and happy life. There are many like me who currently do not have this chance.

Give them this chance!
Regards,

Paul McDonald (149.5kg as of 18-01-05)

NOVEMBER 2005 - 52 Weeks Older - 52 Kilograms Lighter

Friday marked the 12 month anniversary of my Lapband surgery and on Sunday I was part of a triathlon team representing the Gold Coast Obesity Surgery Centre!

Review of the last 12 months:

• • Total weight loss of 52 kg in 52 weeks;
• • Cholesterol levels have gone from high to excellent;
• • Resting blood pressure has reduced from 160/100 to 120/80;
• • Gastric reflux is totally gone;
• • I can sleep the entire night now;
• • I no longer have knee pain;
• • I can now walk/run 10 kilometres;
• • Trouser size has reduced from 142cm to 102cm;
• • I can comfortably sit in movie theatres;
• • I fit into economy plane seats and don’t need an extension for the seat belt;
• • I am not stared at when going to the shops;
• • I look a million bucks;
• • People treat me as ‘normal’

The Noosa Triathlon – the lead up

Three months ago I received an email from Felicity asking if I would like to do the run leg of the 2005 Noosa Triathlon along with two other lap banders from the Gold Coast Obesity Surgery Centre. At first I was reluctant because I had not started jogging yet and from previous experience I knew that three months was not near long enough to build up to 10km. However, after thinking more about it I figured it would be the perfect excuse to begin my marathon training and, if the team did manage to finish the event, we would prove to others and ourselves that our previous obesity was NOT due to a lack of will power. The following day I got serious about my training and, with the help of a personal training friend, devised a program. The first day I barely managed to jog 5 minutes before collapsing in a heap. But surprisingly I felt great afterwards and by the 5th week of training, I was up to running 20 minutes. It was at this time I contacted the other two competitors (Julia the cyclist and Jeremy the swimmer). Each of us had our own story of success and each of us was determined not to let the side down.

With 4 weeks remaining, I was feeling very confident. I felt fine increasing my distances and was really enjoying the feeling of freedom that comes with running.

The Noosa Triathlon – The Big Day Arrives

Woken by my alarm at 3am, I groggily arose from a fitful sleep, had a coffee, a light breakfast and left home at 4am to meet my fellow team mates in Noosa.

We registered in the main tent and waited for a couple of hours before the start of the teams division. It was good to hear about the others success stories following Lapband surgery. All throughout the day a film crew from Today Tonight followed our athletic endeavours so this gave us even more incentive to put our all into it! Our first team member Jeremy thought he would swim the 1.5km distance in 45 minutes. He did the team proud by coming in under 30 minutes which was an awesome achievement! He then changed over to our cycling guru, Julia who in an effort to find out how long it would take her to cycle 40km, did it the previous day in 2 hours. Then, while waiting for Julia, the heavens opened and all the runners including myself got absolutely saturated. Finally the rain stopped, the sun came out (at around 30 degrees mind you) and Julia returned some half an hour earlier than expected.

The Noosa Triathlon – My Finest Hour

My saturated clothes tugged at me and felt confining as I started running through the muddy puddles and grass. Presently I made it to the road and the course proper.

Within a couple of minutes I thought ‘oh, oh, I’m in trouble here’. I was used to running 3-4 km in a cool dry climate and here I was attempting 10km in high heat and humidity. After about 10 minutes I was exhausted and waiting for the 1km mark where my friend Nina had agreed to meet me – she was in Noosa that day just to help me get through this race

By about 4km every other runner had passed me or pulled out of the race and I was not feeling well at all. I continued to the 6km mark feeling very ill indeed. At one point I remember yelling out aloud ‘just bloody finish Paul’. Spectators and the Marshals on the course were constantly giving me encouragement which was great. At the 7-8km mark I was physically ill and dizzy and Nina had to tell me to slow down my breathing and try to relax more. She also forced me to take a teaspoon of a gel energy replacement which seemed to help but tasted bloody awful! At least I kept it down and the dizzy feeling went away.

At about 9km we could see the finish line and I tried to run again but soon stopped feeling quite dizzy. I thought of stopping but quickly corrected myself by remembering what we had all been through just to get here and if the rest of my team could make it then so bloody well could I. Fellow competitors including the all time champion Pat Carroll cheered me on as if I was the first placed runner.

At about 500 metres I once again tried to run home but the dizziness came back so I started walking. Finally with about 100 metres remaining Nina said ‘go for it Paul’ and I raised a final effort to make it to the finish line. The last 30 metres or so I ‘sprinted’ with a chorus of applause seeming to surround me. I made it to the finish line amidst simultaneous feelings of pride, satisfaction and pain. I felt faint as was sat down and given some cold water. The medical people made sure I didn’t have any chest pain.

We had dedicated our ‘WIN’ to all the obese people who feel there is no hope and that they are doomed to less than a good life because of their weight. We proved that with Lapband and some common sense eating and exercise miracles can happen! We also showed that our previous obesity was not due to a lack of willpower on our part but rather a terrible disease.

The Noosa Triathlon – Afterwards

After the race everything was a bit of a blur. Felicity, Nina and her sister Megan helped me back to the Sheraton for an orange juice, a shower and a change of clothes. The whole team then went to a restaurant with Doctor Layani, Felicity and David as well as the Today Tonight camera crew who took a few more shots of us toasting our win.

Three days later as I write this journal article I cannot believe how far I have come in twelve short months and how grateful I am to everyone associated with the Gold Coast Obesity Centre. I now have a life where before I simply ‘existed’. I now have hope where before there was none.