Not Penny's Boat

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Your mileage can and will vary, but here's how life is going for me (keeping in mind I'm not a dumper and I don't have issues with food getting stuck):

Beginning stats:  
Start: 440
Starting clothes size:
Tops - 4x
Bottoms - 5 or 6x depending on what it was
(Could not walk into Lane Bryant at that point and buy something off the rack)
Co-morbids:  asthma, GERD and esophageal stricture, sleep apnea (Bi-Pap pressures of 22/15), high blood pressure, edema, stress incontinence
How I got around:  I didn't...store shopping and errands were avoided, I wheezed constantly even just walking from parking lot to work space, was approaching point where it was a struggle to get up from desk and walk to deliver paperwork - but even through all that I still stubbornly thought I was "happy"

Now:
Current: 258
Initial Goal (the point at which I'll be looking into plastics if needed): 185
"Chart" Goal (the point at which BMI is 25 or less): 165

Co-morbids:  still have sleep apnea, no longer on coritcosteroid asthma inhalers - only the albuterol that I use 1x a week, if at all, no BP meds, no edema, no GERD since day of surgery

Clothing sizes:
Top:  18 - can wear an XL from a NON plus-size store :)
Bottoms:  20/22 depending on the cut and fabric - jeans are 20's, tailored slacks are 22's

How I get around:  how do I 'not' would produce the shorter response - this past summer I bike commuted (18 miles one way to get there), completed 4 5K races, can leg press 220 lbs, handle 15-lb dumbells as my "normal" workout default, snowshoed and sledded for the first time - find myself making excuses to walk and window shop.  The only way I "don't" get around is on skateboard and jet ski.  :)

My current typical day's menu:

AM
- decaff coffee with 2%, occasionally real cream if I'm watching for carb bloat
- ff yogurt or Fiber One bar

LUNCH
- One Lean-Cuisine-type meal with a single-serve Steam Fresh veggie bag (and I usually end up tossing 1/4 of it all)
OR
- salad with chicken strips or beef, cheese, full-fat or no-fat dressing again depending on my mood, sunflower seeds or cashews for crunch

SNACK
- beef jerky stick or serving of cashews or yogurt if I skipped it at breakfast

DINNER
- varies, anything from a roast beef sandwich w/cheese, mayo, veggies and high-fiber bread to simple meat and veggies, to a serving of pasta with sauce and cheese - it all depends on my mood, what's at the house to fix, and if I've kept up with my exercise (I'd go all-protein if it wasn't an exercise day)

When I bother to journal specific nutrition values - I find I average anywhere from 1,400 - 1,700 calories - more if I've had a workout that lasted more than an hour, which happens 1-2x a week.  No more than 2,200 calories even on a "big" day.

I rarely eat fast food - I can count on one hand the number of times a month I go through a drive-through for ANYTHING - even coffee.  I eat at restaurants like Applebee's, Ruby Tuesday, and Olive Garden a few times a month as well - my fave meal is combo fajitas.  Love, love, love grilled steak and chicken :).

What I had for Christmas Eve/New Year's Buffet (keeping in mind these are celebration days:

A normal breakfast, an abbreviate lunch of protein (cheese cubes, yogurt, whatever was around)

Dinner:  
Sliced deli meats
Cubed, aged cheese
Shrimp and cocktail sauce
Deviled egg
Chocolate chip oatmeal raisin cookies (3 total before and after main meal)
Rotel cheese dip and 7 dorito chips
Small slice of lemon cake w/icing
ginger ale with a cherry in the bottom - our version of a "mocktail"

Not a typical day - but not a day that had me wanting more or feeling like i missed out on anything.  I was even down a pound this past week.  Passed on the crackers and spray cheese.  Just not tasty enough to bother with :).

Commonly hawked misconceptions about RnY that you'll see posted as a reason to "avoid" it by people hawking other procedures:

1.  RnY lifestyle is inferior.  A.K.A. the "RnYers can't eat this, that, the other thing" song and dance.

Truth is - during the first year - some people may have a harder time with denser foods as the pouch heals - but a good majority of people don't find much to be off-limits after that first year.  RnYers CAN eat just about anything they could prior to surgery - the point is that they don't WANT to eat the old junk anymore and they reach satiety more quickly than a DSer does so they're not left CRAVING more food.  Talk about freedom!  RnYers aren't hungry - they need less to feel full.  Saves a bit of money on grocery bills over time as well.

2.  RnY life is constant dumping and/or foamies.  

Truth - only 40% percent of post-ops experience even ONE episode of dumping in the first year - and the % of people who may experience it after that diminishes over time.  Personally, I'm in that 50-60% who has never dumped.  If you talk to people who have experienced it - it's something you do once and you don't repeat it.  People who tell you they or someone else is dumping repeatedly being a long-term post-op is describing an inability to control their own behavior - not a mechanical problem with their surgical choice.  

Not only have I not experienced dumping, I have not even been able to vomit since surgery.  For me, that's a plus, because I battled GERD and esophageal stricture as a pre-op.  To have the acid gone and unable to come back up again has made a big difference in my quality of life.

3.  People who choose RnY after researching DS are only doing so because their insurance doesn't cover the DS procedure.

True and false. Was NOT the case for me - DS was recommended to me as being the procedure that would require less "effort" in getting to goal, but was contra-indicated for me because of malabsorption concerns (that are real and legitimate - if someone tells you they're the same as they are with proximal RnY - they're trying to sell you something).  I was fortunate that I had a choice - if I decided DS was the procedure I wanted, all the surgeon had to do was say so - I was not going to have a difficult time petitioning insurance while my co-morbids continued to spiral my quality of life downhill.

Other people DO have this obstacle, because RnY has a decades-long track record of being effective in a majority of cases at getting people out of that "super-d-duper mobidly obese" category, in a population of hundreds of thousands of people who've had it in its various incarnations.  DS simply does not have the numbers behind it yet to get most insurances on board - and that doesn't mean that it NEVER will - it just means that there are still concerns about it being a solution for everyone who simply "wants" it.  If DS were a panacea for everyone's obesity - the surgeons who routinely perform it well would not still be running into issues.  It is a longer surgery to perform, and when it's done on people who are already ill with co-morbids - you're ratcheting up the risk factor in the O.R. a bit more than the typical RnY.  Doesn't mean it's not worth the risk - but people don't tend to emphasize that or acknowledge that it's a concern.  If you look at archives for the DS board, you'll notice a number of post-ops who experienced complications that required weeks of further hospital care after surgery – happens with RnY too – but it’s a bit more alarming when you consider that LESS people have DS, and MORE people posting there have these kinds of things happening.  It's not a deal-breaker - but it's not something to be completely dismissed or equivocated, either.

 

So the question for many people becomes – “How long do I want to keep seeing my health suffer?”  For some who decided DS was the only thing that was for them, they had to take out long-term loans, travel to a foreign country, or spend months and years haggling with insurance to get it approved or done.  And if they’re comfortable with that and have those means – more power to them!  But it’s not something the average person has the ability to finagle – especially those who are disabled by their obesity.  RnY doesn’t typically involve such a fight – though there ARE people who also had to fight and take out loans and travel out of state to even have access to RnY.  People who made the choice to have RnY for this reason aren’t “settling” for an inferior surgery – they’re being proactive about their own health.  Some people’s obesity isn’t so severe - they have the fortune of being capable of toughing it out.  But don’t let them tell you people who can’t or don’t are doomed to failure or needing a revision down the road, because the stats don’t bear that out – no matter how many posts you might be directed to on the revision board.  Consider the source, there.

 

 

4.  RnY is more restrictive, therefore not “fun” or somehow makes people cranky.

LOL at this one – the most ridiculous one I’ve seen people invent yet.  Yes, it’s more restrictive – but that’s precisely the point!  To feel fullness on a smaller amount of delicious food!  Not to choose the most bland, cardboard-tasting “diet” food you can find simply because the label numbers look decent.  This is such an individual thing – the people who make it a “surgery choice” blanket argument are showing their own ignorance.  Even people with DS differ over the type and quantity of food they consume.  RnYers are no different – there are people who choose to eat what others would view as “diet food,” there are people who choose to have indulgences here and there, and there are plenty of people who go back and forth between the two.  The initial stages of healing for people of BOTH surgery types are learning curves, and people post about frustrations with having to adjust to new norms.  But if you look at RnYers who are more than 6 months out – many of them are enjoying their food just as much as they did pre-op, they simply have a new psychological relationship with the QUANTITY of what they eat – people with DS, having less restriction, might feel like things are more liberating for them in that they “get away with” eating more – but liberation means different things to different people.  Happiness is found on both sides of the WLS fence.  So, for people to say they have the “market” cornered on happiness is a tell-tale sign that they’re pushing an agenda more than really touting what’s “great” about their own choice.

5.  RnY is inferior in curing diabetes and reactive hypoglycemia is “prevalent” after RnY.

False.

I’m fortunate in the fact that there is no history of diabetes in my family and I’ve never experienced it.  Yes, reactive hypoglycemia can occur after RnY, it can occur after ANY surgery that alters the digestive mechanisms in such a way.  But it’s not something that every RnYer will ever go through – and certainly not in numbers that non-Rnyers would suggest.  If you’re a person who has a family history or has highs and lows prior to surgery – it’s worth a discussion with your doc.

In fact, RnY and DS have similar diabetes cure rates when adjusted for the numbers of people who’ve had both surgeries.  Stat freaks will point to the 10% difference between them as though one is better than the other – but a simple Google search will point out to the average concerned individual that the odds are pretty darn good no matter which route you choose!  If diabetes is a concern for you – ask post-op RnYers about their experiences – many people have left the hospital no longer needing their meds.  Pretty darn miraculous.  And not in small percentages either.

6.  GERD and the two surgeries – one is better than the other.

Another case of BOTH surgeries having an equal success rate.  And as I stated in an early point, this is something I have experience with, because I had GERD so severe prior to surgery, I had developed an esophageal stricture.  I had troubling sleeping at night because I’d wake up with the burning throat, it was affecting my asthma, the whole nine yards.  Had surgery, and it’s completely gone.  Disappeared. Kaput.  No further issues – and I’m about 16 months out at this point.  Many other people report similar success after DS, and people in both camps sometimes see it reoccur, but the stats on both procedures are excellent.  Do a Google search, and you’ll find the relevant info.

7.   RnY fails more often.

False, when adjusted for reality.

When you consider that the surgery has been in common practice for more than several decades, on hundreds of thousands of people, with several SIGNIFICANT shifts in technology and technique happening over time – the most important having happened in the last 5 years with transection of the pouch becoming standard vs. stapling off – this doesn’t ring true.   Any time ANY surgical procedure gets done on an ever-increasing number of human beings from different health backgrounds – failure will happen.  It already is happening with some DS procedures – but the numbers are still low in comparison because it is still not performed in nearly the same numbers on a wider range of patients.  Human beings can out-eat any surgery if they’re determined to find a way to do so.  The number of TRUE mechanical failures is still low with RnY – and getting lower as less people are being stapled vs. transected, and lapro becoming the common approach.  You have to consider the DATE of people’s surgeries when they talk about being an RnY failure – if it was any later than 5 years out, you’re likely comparing apples and oranges.

 

There will always be different and more interesting attempts to sway minds by stating RnY or DS is this, that, or the other thing.  The overall point of what I’m trying to say in this blog is that BOTH procedures are effective – they each have different concerns.  People who try to say one is “better” than the other are naïve, ignorant, and trying to “convert” people – so you have to take those types of posts with a grain of salt.

RnY worked and continues to work for me, complication-free.  But would I tell YOU that it’s what YOU should do?  Heck no.  You are the only person who knows what’s ultimately going to work better for you – whether it’s RnY, LapBand, DS, or the sleeve by itself – it’s YOUR business, YOUR life.  This is just an attempt to shed a little light on some muck that tends to be slung around about TWO of a NUMBER of viable surgery options.