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Surgeon TestimonialPaul Cirangle (COE)My first impression of Dr Cirangle was that he was a super intelligent, straight to the point kind of guy. He knows what heís doing, and he can give you documentation as to why he does things a certain way. However he was a bit standoffish upon our first phone consult, and i don't think he paid much attention to my details. AFTER I'd gotten a surgery date with his office, he was a different person! All attune to detail and very nice. Hmm!rnrnThey have a very structured after care program, so far! They try to act like they do, we'll see *lol*rnrnHis office staff is absolutely sweet, but a little disorganized. A few who've had it together are, Erica who sets your surgery date, Marsha and Marilyn, who deal with the insurance. Marilyn has really been super awesome trying to get things in order for me, and Marsha has been helpful figuring things out for me after no one told me all the additional fees I'd be facing. Be sure to ask specifici questions, because this office seems to think you know things already...as if we go through bariatric surgery all the time!!rnrnI feel that surgical competence, is the most important factor in a surgery like this. Bedside manner is a plus, but I want someone experienced, and knowledgeable about the procedure I want. Also, Dr Cirangle worked with my insurance! His office is a center of excellence, for those who need it.rn** As of 2 days before my surgery, I've actually found that getting paperwork ready, sent to me, dates and PRICES correct, has been a full time job. His office has a left hand that doesn't now what it's right hand is doing. Funny how first impressions are!rn
- Travel - My husband and I love to travel.
- Fish - We have sooo many fish, tropical and Saltwater. My husband's fault!!
- Dogs - We have an adorable beagle named Daisy! And a kitty named Nermal!
- Writing - I aspire to publish, someday!
- Pottery - I love ceramics, it's so relaxing!
- Dancing - I used to dance all the time...I hope to be able to again!
- Photography - I'm getting better at it!
- Outdoor - I love the woods. Camping, fishing, and doing it with family.
- Video Game Systems - We also love to play video games and try to beat each other!
- Reading - My husband and I met through an online Book Club, essentially. We like to read!
This is a great info post on the surgeries on June 27, 2008 11:22 pm
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A post I made on the board on May 23, 2008 8:46 pm
(All information has been gleaned from websites and medical texts. Please feel free to look up terms and other info for verification and your own knowledge!)
Being overweight and obesity are becoming endemic, particularly because of increasing nourishment and a decrease in physical exercise. Insulin resistance, type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, certain forms of cancer, steatosis hepatis, gastroesophageal reflux, obstructive sleep apnea, degenerative joint disease, gout, lower back pain, and polycystic ovary syndrome are all associated with overweight and obesity. The endemic extent of overweight and obesity with its associated comorbidities has led to the development of therapies aimed at weight loss. The long-term effects of diet, exercise, and medical therapy on weight are relatively poor. With respect to durable weight reduction, bariatric surgery is the most effective long-term treatment for obesity with the greatest chances for amelioration and even resolution of obesity-associated complications. Recent evidence shows that bariatric surgery for severe obesity is associated with decreased overall mortality.
What Is Ghrelin?
Ghrelin, discovered as the hormone that stimulates growth hormone release from the pituitary gland, has been determined, along with several other hormones, to have significant effects on appetite and energy balance. The main source of ghrelin is the epithelial cells in the stomach.
What Does Ghrelin Do?
Stimulation of secretion of growth hormone.
Regulation of energy balance: In humans (and rodents), ghrelin functions to increase hunger through its action on the brain. Humans injected with ghrelin experienced sensations of intense hunger. Unexpectedly (because growth hormone has the OPPOSITE effect), ghrelin seems to suppress fat utilization in adipose tissue. Ghrelin is indicated as one of a few hormonal signals that convey to the brain the status of energy balance in the body. Ghrelin's other purposes range from stimulating gastric emptying, which occurs about half an hour after eating, to a variety of positive effects on the cardiovascular system. These positive effects, such as an increase in cardiac output, may be caused directly by ghrelin or may be the indirect effect of ghrelin's ability to stimulate secretion of growth hormone.
Blood ghrelin concentration is at its lowest right after eating a meal, but rises during the fast right before the next meal. Figure 1 (right), adapted from Cummings, et al. Diabetes
50:1714, 2001, shows this pattern and is based on plasma ghrelin assays in ten people over the course of a day (indicated by the blue line)
In bypass surgery patients (indicated by the red line), ghrelin blood concentration remains suppressed.
: (a) Jejunoileal bypass; (b) biliopancreatic diversion; (c) biliopancreatic diversion with duodenal switch; (d) vertical banded gastroplasty; (e) laparoscopic adjustable gastric band; and (f) Roux-en-Y gastric bypass.
a link to a website about why the DS may cure diabetes instantly after surgery.
Precent excess weight loss after surgery with Duodenal Switch:
* Average excess weight loss at 3 months is 29%.
* Average excess weight loss at 6 months is 51%.
* Average excess weight loss at 24 months is 91%.
Resolved Medical Co-Morbidities
* 97% diabetes resolved
* 96% high cholesterol resolved
* 90% sleep apnea resolved
* 85% hypertension resolved
* 60% asthma resolved
* 47% arthritis resolved
Some interesting websites with history and statistics.
This website discusses RNY surgery and polycystic ovarian syndrome (
PCOS). However the conculsions show that it is the weight loss itself, and the continued maintenance that give results. Thusly, it cannot be concluded that other surgeries will also benefits PCOS, if a large amount of weight is lost, and kept off.
Taken from the site:
"PCOS is a complex endocrine disorder that is associated with, and aggravated by, obesity. Weight loss has been demonstrated to decrease insulin and androgen levels, as well as to improve the clinical manifestations of PCOS. Our data support the hypothesis that weight loss results in resolution of the symptoms associated with PCOS. This weight loss, induced by surgical means, was followed by significant improvements in menstrual dysfunction and hirsutism.
Our 75% rate of moderate to complete resolution of hirsutism is superior to that of alternate methods of treatment described in the literature . In addition, marked improvement has been achieved in the treatment of comorbid conditions commonly associated with PCOS, including type II diabetes mellitus, hypertension, and dyslipidemia."
A document on 10 year study of Duodenal Switch
And this on long-term results
I decided I did an okay summary of some stuff, so here it is reposted:
People say there is a large "open wound" area for the DS, meaning the removal of the stomach (of course open wound on the outside could be done laproscopically). That might be true, but the part of your stomach that is removed is just the outer curvature that holds the hormone Ghrelin, which tells your mind "Hey, I'm hungry down here!" so the more you remove, the easier it is to keep your mind thinking it's full...when it is! With the RNY they actually remove (though still kept in the body) the lower portion of your stomach, which includes the pyloric valve, the exit of your stomach. That's why some people have issues with dumping, and with ulcers. The pyloric valve is a midway point from your stomach to your intestine, and some of the harsh stomach juices that normally get diluted in the pyloric valve, can cause sores on the newly attached intestine. Both the RNY and the DS have similar intestinal rearranging...usually the RNY has a longer "common channel" (about 250 centimeters or more) so you still absorb fats, and protein pretty much normally. With the DS they make the channel shorter (from 50-150cms...usually 10% of your intestinal length) so that you mal-absorb fats, and most everything else. For both surgeries this part is reversible. People with the DS usually get their stomach size from 1.5 ounces to 8...and then their stomach stretches from there. ( So that excuse that "oh no, that part is irreversable" is true...yet not true since the stomach does stretch back out.)
For some, the channel length is what they believe helps them maintain the weight loss, after their stomach stretches out from the 1.5-8 ounces. Usually people who've had more of the ghrelin holding portion of their stomach removed, feel fuller longer, and attribute that to their weight loss (this is also true for the VGS), whereas others think it is their channel length...the shorter channel length, the more carbs they seem to be able to eat without gaining weight...the longer the channel, the less the have problems with vitamin absorption. It's a give and take, and usually you and your surgeon can decide what is best for you and your body. Usually people give their specs, expectations, and eating habits to their doc and they decide what lengths and ounces and stuff would be best for the patient. Regardless, it is successful.
Some people think that doctors push the RNY more than the other surgeries, because they may get paid more from insurance for that procedure. This is actually true that -they get paid more for their time-, since the DS is harder to perform, and takes more training, but if you are informed about what procedure you want your surgeon should have no problem doing it for you, or referring you to someone who can. (It's always all about the money...)
Lastly, and what helped me decide, was the Long Term Statistics on all the surgeries. RNY and LAP have the highest percentage of revisions...failures or issues with the stomach.
RNY, VGS and DS have some of the highest percentage of people who have seen a lot of weight loss, and improvement in co-morbidities...but the DS has the best results for super weight loss, and long term maintenance of that weight loss. But of course it all depends on you, your wants, and your eating habits. There are people who have had the RNY for years and kept the wait off, and there are people who've had the DS and only lost 80% of their expected weight, and kept it off!
One last thing, people think that with the DS there is a more 'stinky' bowel because of the type of surgery it is...this is false. The cause of smelly bowl in ANY person, is the level of bad bacteria in their intestine. Simply by taking probiotics (the active live cultures found in yogurt) you can fix this problem (google it!). This myth has been associated more with the DS surgery because sometimes people have a shorter common channel, and it is more noticeable...however it is found in 'regular' people, RNY, Lap and just about anyone who has an imbalance of bacteria in their intestine.
Polycystic ovarian syndrome and the Duodenal Switch
I was talking to my doctor, and we were discussing PCOS. She was saying that certain hormones, such as estrogen, are drawn to, and stored in fat cells. That is why losing the weight will help get rid of PCOS symptoms. Your good hormones are stored continuously, making it seem as though you have excess testosterone and cortisol, some of the main reasons people have PCOS symtoms, when maybe their levels are normal. The release of all that stored estrogen stimulates your body to and you will see an instant decrease in PCOS symptoms, in fact throwing you in the opposite direction! After things settle, it's as if you've had an increase estrogen production. So, that is why some people who've had other weight loss surgeries experience a period of time when their symptoms go into remission. However, the regaining of any extra weight will cause the symptoms to start up again. PCOS is a genetic thing, and can never be cured...but it can be set into permanent remission by keeping weight off and losing fat!
Just keep researching, you'll find your way and what's right for you!!
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Information for all! on April 26, 2008 12:27 pm
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Insulin is an animal hormone with extensive effects on both metabolism and several other body systems (eg, vascular compliance). When present, it causes most of the body's cells to take up glucose from the blood (includingliver, muscle and fat tissue cells), storing it as glycogen in the liver and muscle, and stops use of fat as an energy source.
Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics
Hirsutism is defined as excessive and increased hair growth in women in locations where the occurrence of terminal hair normally is minimal or absent.
Hypertension, most commonly referred to as "high blood pressure", is a medical condition in which the blood pressure is chronically elevated. It was previously referred to as arterial hypertension.
Dyslipidemia is a disruption in the amount of lipids in the blood. The prolonged elevation of insulin levels can lead to dyslipidemia.
Ghrelin:Appetite-stimulating hormone produced by cells lining the stomach, specifically the fundus (As the rounded part of the upper stomach, it allows for an accumulation of gases produced by chemical digestion. It will also store undigested food for up to 1 hour.) of the human stomach and epsilon cells of the pancreas that stimulates appitite. Ghrelin levels increase before meals and decrease after meals.
Gastric Inhibitory Peptide: Polypeptide that stimulates insulin secretion in response to a high concentration of blood sugar, and inhibits absorption of water and electrolytes in thesmall intestine
Galanin: Neurotransmitter that helps to regulate contraction of gastrointestinal muscle and inhibition of insulin, and is associated with the urge to eat fatty foods
Bombesin: Polypeptide that inhibits intestinal motility and causes secretion of substances such as gastrin (which induces secretion of gastric juice)
Glucagon: Protein hormone that promotes an increase in the sugar content of the blood by increasing the rate of breakdown of glycogen in the liver
Pyy3-36: Peptide that has an inhibitory effect on gastric-acid secretion, gastric emptying, digestive-enzyme secretion by the pancreas and gut motility
Glucagon-Like Peptide 1: An incretin hormone that stimulates insulin secretion, inhibits gastrointestinal secretions and motility, and increases satiety in response to eating
Oxyntomodulin: Peptide that is released from the gut during digestion and is considered a putative physiologic regulator of gastric-acid secretion
Urocortins: Peptides of the corticotropinreleasing factor family with roles in gastric-emptying inhibition and distal colonic motor-function stimulation
Cholecystokinin: Peptide that stimulates delivery of digestive enzymes into the small intestine of the pancreas and bile from the gallbladder
Roux-En-Y Gastric Bypass (RYGB): A tiny stomach pouch iscreated and a portion of the digestive tract is rerouted to reduce absorption of food in the intestine
Gastric Banding: A band is placed around thestomach near its upper end to create a small pouch and a narrow passage into the remainder of the stomach
Vertical Banded Gastroplasty: Both a band and staples are used to create a small stomach pouch
Biliopancreatic Diversion: Portions of the stomach are removed and a small remaining pouch is connected directly to the small intestine, bypassing the duodenum and jejunum
Duodenal Switch: Biliopancreatic diversion that keeps the pyloric valve intact, retaining a portion of the duodenum in the food stream
Info that's been gathered on Sugeries! on April 20, 2008 11:20 pm
I stole this from hayley_hayley.
RNY compared to the DS
RNY – expected weight loss
DS – expected weight loss
- 50-65% expected excess weight loss (percentage varies in opinion – this is the most commonly seen estimate)
- Possible regain: more prevalent after 5 years
- 50-100% regain of weight has been recorded
- Results may vary
- Must follow “pouch rules” in an attempt to not regain
†RNY – have a stoma (stomach made into a pouch – size of an egg)
- 85% expected excess weight loss
- Studies show little to no regain (20 pounds recorded)
- Results may vary
- Highest success rate over 10 year study (78% avg. Excess Weight Loss – EWL)
†DS – whole stomach (size of banana)
- Size: 2 oz
- Stretch to average size of 6 oz in 2 years† (possible to stretch up to 9-10 oz)
- You can eat more as time goes by
- Average after 1 year is 1-1.5 cups of food
- No Endoscopes on blind stomach/remnant stomach that is bypassed
- Doctor evaluation: cannot use an endoscope (to find ulcers and tumors)
- RYGBP construction makes the large bypassed distal stomach inaccessible to standard non-invasive diagnostic modalities. Neither x-ray contrast studies nor endoscopy can assess this potentially important but hidden area.
- Stoma: pouch
- Should not take Nonsteroidal Anti-Inflammatory drugs (NSAID).
- NSAIDs are: Advil, Alka Seltzer, Aleve, Anacin, Ascription, Aspirin, Bufferin, Coricidin, Cortisone, Dolobid, Empirin, Excedrin, Feldene, Fiorinol, Ibuprofen, Meclomen, Motrin, Nalfon, Naprosyn, Norgesic, Tolectin, Vanquish
- NSAIDs are used for arthritis, bursitis, tendonitis, back pain, headaches, and general aches and pains.
- Taking NSAIDs could develop into a bleeding ulcer and interfere with kidney function.
- Possible Problems
- Ulcers (Some doctors recommend taking prilosec for 6 months to 1/2 years in an attempt to prevent the ulcers)
- Possibility of a staple line failure
- Noncompliance: simply do not lose enough (even with following the rules)
- Vitamin Deficiencies
- Narrowing/blockage of the stoma
- Vomiting if food is not properly chewed or if food is eaten to quickly
- Dumping syndrome, NIPHS, Hypoglycemia
- No Valve (pyloric valve that opens and closes to let food enter intestines is bypassed) which means food empties directly into the small intestines and causes dumping and/or can cause NIPHS or Hypoglycemia
- Dumping: food (most commonly sugar but not necessarily “just” sugar) enters/dumps directly into small intestines and causes physical pain (some people believe this pain enforces good eating habits)
- Dumping varies in degree of occurrence and discomfort
- Dumping symptoms:
- Bloated stomach
- Excessive sweating
- Increased bowel sounds
- “Emotional” reactions
- NIPHS (insulin over production): “the body overproduces insulin in response to food entering the intestines at a point where food would normally be more digested already - this part of the intestine is not used to coping with metabolizing glucose in the condition it arrives after RNY, and it is suspected that the intestine signals the pancreas for more insulin to aid digestion, causing a MASSIVE overproduction.† The change occurs on a cellular level, hard to diagnose.† Treatment: Removal of half the pancreas.”
- RNY stoma that is created allows food to go straight through the stomach into the small intestine unrestricted so it does not control the flow.† Because of that the body reads that it needs more insulin because the food is moving through so quickly and it thinks there's going to be a lot more food.††With the DS, the normal peristalsis works because the pyloric valve is in place and can control the movement of food into the small intestines.††
- NIPHS, Hypoglycemia is deadly if not corrected
†RNY – Eating
- “Whole working stomach” - meaning the stomach’s outer curvature is removed as opposed to making a pouch/stoma.
- Part of the stomach removed is where most of the hormone called Grehlin is produced.
- Grehlin gives the sensation of hunger so by removing most of that section of the stomach a DSer is not as hungry as before.
- Whole working stomach: no blind stomach.† Endoscope can be used.
- Can take NSAIDs
- Do not need to take Prilosec to prevent ulcers.
- Valves are in tack: no Dumping Syndrome or NIPHS
- Eat protein first
- Recommended to chew food to liquid consistency (pureed, soft, thoroughly chewed)
- This is more important for people early out (new pouch stomach will stretch out with time).
- Food is thoroughly chewed to prevent blockage (the hole/path leaving the stomach and into the intestine is roughly the size of a dime).
- To get food unstuck, patients drink meat tenderizer mixed with water.
- Low carbohydrates
- Carbohydrates can slow weight loss and lead to possible regain
- Avoid sugars in particular (to prevent dumping syndrome)
- Low fat
- Foods high in fat may cause Dumping Syndrome
- Fatty foods can lead to slow weight loss or possible regain
- 64 oz of water
- Stop drinking within 15-30 minutes of a meal
- Do not begin drinking after a meal for 1-1.5 hours
- Some doctors do not encourage the use of a straw (pushes food too quickly through the stomach and can cause gas/discomfort)
- Water Loading
- 15 minutes before the next meal, drink as much as possible as fast as possible.†
- Water loading will not work if you haven’t been drinking over the last few hours.
- You can water load at any time 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness.
- Disclaimer: this is a practice some people use to feel “full” and lose weight. Not a requirement.
DS – Eating
- Eat protein first
- 80-100g of protein
- DS patients can on average eat more food than any other type of weight loss surgery.
- Low carbohydrates
- Carbohydrates can slow the weight loss and lead to possible regain
- No dumping syndrome from eating sugar (or fat)
- Eat high in fat
- DS only absorb 20% of fat (do not need to eat low fat)
- If a taco has 20g of fat, a DSer only absorbs 4g while a person without surgery or RNY absorbs ALL 20g. (this is just an example, measuring absorption is not an exact science)
- When experiencing a “stall” (slowed weight loss/plateau) a DS patient commonly increases fat consumption to resolve
- 64 oz of water
- Can drink with meals
- Can use a straw
RNY – Possible Issues
†DS – Possible Issues
- Vitamin deficiencies: Must follow a vitamin regime for the rest of your life
- Common vitamin deficiencies found in vitamins B12, iron, and zinc
- Calcium must be supplemented for the rest of your life
- Bathroom issues
- Dumping in the form of loose stools
- Reversible procedure (Reversals of any surgery is very complicated)
- Revision often performed instead of reversal
- Revising to a different type of surgery is possible.
- Vitamin deficiencies: Must follow a vitamin regime for the rest of your life
- Common vitamin deficiencies found in vitamins A, D, and iron
- “Water soluble”/ “water miscible” / “dry” vitamins absorb best (in other words get vitamins that are not fat/oil based)
- Calcium must be supplemented for the rest of your life
- Bathroom issues
- Loose stool (Most common in the first few weeks of surgery. Generally food related)
- Reversible procedure
- The intestinal bypass is reversible for those having absorption complications
- revision: lengthening common channel (to stop losing weight and/or to absorb vitamins)
- Stomach is obviously not reversible (part of stomach was removed)
RNY - Diabetes
†DS – Diabetes
- 85% cure rate
- RNY can put diabetes in remission.
- Diabetes may come back in two or three years--even if the
patient maintains most of their weight loss.
- Even a small amount of weight gain, long-term, can cause a diabetes
- 98 % cure rate for type II diabetes.
DS – Myth or Fact
The DS is only recommended for the super morbid obese (BMI over 60) = Myth / Not True
The DS is “experimental and investigational” = Myth / Not True
- To be eligble for ANY type of weight loss surgery, a person has to be 100 lbs. over weight or have a body mass index (BMI) of 40 or more.
- BMI’s under 40 have also been approved (usually require a comorbidy/health problem - an example is sleep apnea).
DSer will have a problem when they become old = Not True
- Medicare approves the DS
- Many insurance companies are starting to cover the DS.
- DS has been performed since the 1970s
DSer’s gas stink = true
- We wont need to eat as much when we are older b/c our bodies will adapt
- The little hair-like villa located in the intestines grows longer to adjust to the new digestive system (grows longer to increase absorbtion).
DSers may need to wear a diaper = Myth / Not True
Skin color turns yellow or pallor = Myth / Not True
- The gas does smell. (This is true for the DS and RNY)
- There are products called air fresheners that a person can use.
- May take Flagyl or fish zole
DSers will have a heart attack from all the fatty food they eat = Myth / Not True
- Patients who follow their regular vitamin regime (keep up with blood work) do not turn pallor
- If someone looks pallor, they could have a vitamin deficiency.† This applies to any type of weight loss surgery. For both RNY and the DS.
- Vitamins and blood work must be monitored for life. For both RNY and the DS.
Dsers don’t need to exercise = Myth / Not true
- Cholesterol levels lower after having the DS.†
- 80% of the fatty food is not absorbed – the fatty food is healthier to eat as a DSer than a person without surgery.
- If a taco has 20g of fat, a DSer only absorbs 4g while a person without surgery or a person with the RNY will absorb ALL 20g.† Good meal for the DSer. (this is just an example, measuring absorption is not an exact science)
- DSer’s are aware of the benefits of exercise (body and soul).
- Exercise helps in losing weight and maintaining goal weight†
†*Some practices may not be used by all patients. Some recommendations will differ depending on a person’s surgeon.† Possible issues are just that, “possible,” and may or may not occur.††
Not every surgery will be right for everyone. Not every surgery will be covered by insurance. Good luck to everyone and thank you for reading†Hayley F.'s†comparison chart!
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Well, what can I say? Iíve always, always been overweight. I was a pretty active kid, I rode my bike everywhere, and was the fastest kid on the block! I would always reach the top of our big hill before everyone else. Was still fat though! I think there were bouts in my life where I felt sorry for myself, and hated the way I looked...but somewhere along the way, I just got to where I didnít care so much. Oh I still cared, but I wasnít going to let being fat stop me! I went to the water park in jr high for the class trip, and I went down the water-slides, and had fun! I remember there being a girl who went with us.... who went...but wouldnít get into her suit and get in the water. I just remember wanting to get her to understand that it didnít matter what everyone else thought. It was probably harder for her though, because she was bigger than me. And, Iím pretty hard-headed. SO, if someone made fun of me, Iíd just make fun back, and then ignore them *lol* I know that it did truly hurt me though, but it was easy to ignore because I had a supportive family, and some good friends.
Still at age 16 I went on the Fen-phen diet. I got down to the lowest weight Iíve been in my adult life.. 190lbs. I got a little attention from the guys at that point, but didnít get a boyfriend yet!! But I got to see how people treated me differently. That hurt my self-confidence a bit once I gained the weight back. By graduation I must have been about 240. After that, I think I went as high as 260-265. I began to have problems with my feet, when I would stand for long hours at work. After a year, I started college, and began to eat a tiny bit healthier...and I started to work out! That was cut short right away when I suddenly injured my knee. I hurt it three times! After the second time, a physical therapist said I would need surgery on it. Well, I never did get that. After four years I gained mobility, and continued to exercise, take martial arts, and even teach a dance class! I was still about 230lbs. Eventually it crept up on me again to about 250+ depending on the day!
Well, during my first year of college I met my husband. We had a long distance relationship for 4.5 years, before we finally got married May 25th, 2005. I went on an 8 month (we had planned for November, but then moved the date closer) crash diet where I worked out, calorie counted, and finally took phentramine. I managed to lose about 50-55lbs.
I lost it so fast! I hated my body when it was all over with. Loose skin!! That was an eye opener.Maybe if Iíd managed to keep losing, it would have worked out, but instead I kept my weight at about 215 for almost 2 years after the wedding, and now itís of course, gone back up. So then I got all the benefits of having hanging skin spots, that then semi-filled out again...to become...Hanging fat rolls!!! *lol* So, for someone whoís always been pretty confident, I was probably at my lowest level of confidence when I had surgery. Still, my main reason for getting surgery is my health. Old knee injury, fallen arches, plantar fasciitis, heel spurs, arthritis, and the joy of trying to sleep on fat rolls. Not to mention I also have polycystic ovarian syndrome, which leads me to have a slow metabolism, and many other problems! The last kicker was Iíve always been fairly healthy, but when last year a blood test showed that my cholesterol was up...not high, but up..and so I went on a low cholesterol diet. My family has an extensive history of diabetes, heart disease, high blood pressure, you name it! So, I knew I was heading down that road. At the time before my surgery, I was just so, so, SO tired of being in pain. Everything always hurts. And I was only 27!
Well, as it stands now, I know somewhere inside me thereís that "skinny girl" whoís always wondered what it would be like to come out and fit into a nice pair of jeans...and shop at a cutsie little store, and NOT pay Lane Bryant prices. Hopefully, within the surgery, Iíll be able to meet her!!
Got the surgery, June 3, 2008!!! SO! This update finds me at about three months out after my surgery. It took me about six weeks to finally regain some energy, and start eating a little more normally. At three months I find I can pretty much eat anything, but that pasta gives me a bit of gas...and that sugar will make me feel a bit ill. I actually find that I'm one of those people that has to force myself to eat. Getting in all of the protein and water has been really, really hard for me. I'm just not thirsty, and I'm not hungry. Even "junk" food or ANYthing...I don't want to eat! Protein drinks are diiiiisgusting! I gag each time I have them, so that's a shame because it would be so easy to get things in if I could just drink them.
Since the surgery I've passed four kidney stones, and, obviously, I think I was overdoing my calcium a bit, and not drinking enough water. I'm trying to do better there! I haven't noticed any hair loss yet..knock on wood! But I may not, since I lost my initial 20lbs the first month, and then it's gone very slowly for me after that. I was working out about 45 minutes a day right after surgery...but was so fatigued, that I had to quit. I'm just now getting back up to working out a few times a week. It kind of feels good to work out, but I'm still overweight enough that my knee and foot give me some trouble if I do too much. Every day seems to revolve around my surgery...eat, drink, poo, eat, drink, poo...but at least things are evening out finally. I'm such a slow healer! Initially I suffered some really bad depression, but I am doing a lot better with that now. I'd heard there was a mourning period for your old life, old eating habits, etc. But as long as I remember to eat slowly, I do well, now. So far, that's how things have been!!
This post finds me at about 9+ months out. March 20th, 2009. I kind of went off the internet for a while. It continued to be a huge struggle for me to get in any food, or water. I really went through some buyerís remorse! Man-o-man did I. I got so bitter reading everyoneís ďI love my DS postsĒ and wondering when I would get there! Having such a small stomach was such a struggle, that I could only find people to relate to on the Vertical Gastric Sleeve board! And their tummyís are TINY! About January I went shopping for the first time for some new clothes..that felt really great, because I was in a size Iíve never in my life worn before....a 12! It was a tight 12, but it was a 12! That got me kind of excited about my surgery, but it passed, and I was still bitter. I really wound up eating carbs a LOT around the end of November and up until the beginning of this month, March. Carbs made me happy! Protein, and surgery, did not. I was STILL mourning my old lifestyle. I stayed at about 182lbs and stalled for a few months. My fault. *shrug* Well, about a month ago I did the unthinkable and got really resentful of my stupid small stomach that I was forced into.....(my doc talked me into a longer channel and a smaller tummy) and ate Dry Top Ramen until I stretched the darn thing out!!! Yeah, Iím evil, but Iím finally HAPPY. It started off at just a quarter of a bag, and ended up to where I can eat a whole bag now. And you know what? I donít care, because Iím finally happy *lol*
NO more pain in my throat or chest, and Iíve been getting in my full 64oz of fluid EVERY DAY which is amazing for me. I struggled to get in only about 42 this whole time! Iím actually getting in Protein and water!!!!!! And no more discomfort! It has really lifted my spirits. So, I finally felt like getting back on the bandwagon. I came back on line, went to the DS board and got energized to finish this journey. Iíve been eating 40-50 carbs or less a day, getting in all my water and protein, and am now at 176 pounds!!!! NOW Iím excited. NOW Iím getting kind of happy that I had surgery. I still find it hard to be without my loving carbs, but Iíve gone online and actually spent some money trying alllll kinds of low carb foods, and found some things that I can snack on and that taste okay. NOW I feel like Iím not depriving myself, and NOW I feel like I can finish this trip to my skinny self.
I truly never realized how much of a mental struggle this would be. I went into this thinking it would be easy, and seeing all these people around me struggle though pain and complications, but NEVER having trouble eating or drinking, and I felt so depressed and sorry for myself. Maybe Iím a spoiled brat...Iíll not argue with it or make excuses for it...but at least now Iím happy and feeling like maybe I really did do the right thing after all ... : )