Pam M.
I did not have a weight problem as a child. It was not until puberty, age 12 or 13, that I started gaining weight. Even so, I was not terribly overweight, but I thought I was because my sister and my cousins were all thin. I was always just a little bit bigger than all my friends. I remember I weighed around 145 or so in junior high; all my friends weighed 115. And can someone please explain to me why they weighed us in PE? That is when the cycle of shame over my weight began.
I grew up in a household with no boundaries. Rather than share the details, I will say that it had a profound effect on my weight.
I remember when 9th grade started, I noticed that one of my friends had gotten really skinny over the summer. I wanted to know what she did, and one of her revelations was that she would just eat a piece of lettuce for lunch. That is when the vicious cycle of starvation dieting and gaining weight began. I look at high school pictures of myself, and now realize that I looked great. I was 5'7", around 150 pounds or so. I was a good student, I had a lot of friends, I was active and on the drill team. And I thought I was fat. I still have old high school diaries, and it is sad to read them. Literally every page has some reference to my next diet, or comments such as, "I must lose weight. I have to get to 135, but 130 would be great!" It is horrifying to read these diaries now.
Throughout college, I was in the mid 170 pound range, still not too bad for my height. It was in college that I met my now ex-husband. He was a big guy, 6'3" and about 205 pounds. Over the years, his weight has fluctuated from 205 to as high as 280. He was one of those guys who preferred girls with "meat on their bones." After college we got married, and all we did was eat out; pizza, Mexican food, buffets in Reno. We both gained weight together. When I got pregnant in 1988, I weighed 190 pounds, and reached 232 pounds on the day I delivered my son. I would not even tell my husband my weight. After delivery, I stopped losing baby weight at about 220 pounds. So I joined Nutri-System. And so the cycle continued. My husband hated my repeated weight loss attempts. He didn't care that I was heavier, he just hated how I always spent money and started on diets that I never finished. When we got divorced 2 years later, I was still at about 220. Who knows how much I had spent on diet programs at that point.
I stayed between 210 and 220 for the next 4 years, and then rapidly started gaining. I think I gained 80 pounds in about a year. It was so rapid it concerned my Mom. I didn't feel like I was eating any differently. And I was exhausted all the time. At my next doctor appointment, my doctor discovered that I had hypothyroidism. I'm not blaming my thyroid on the 80 pound weight gain, but combine a person who eats for comfort, when bored, when sad, when happy, any reason to eat, with slow thyroid, and you have an 80 pound weight gain. I stayed in the 290 - 310 weight range for the next 15 years. I do not even know how much money I have given to Weight Watchers and Jenny Craig. I had a personal trainer at one point, and she helped me get down to 269. That lasted for about 5 minutes, and I promptly went right back up to 306 pounds. Who has time to exercise 8 -12 hours a week, work full time, and be a single Mom?
Even though several of my friends resorted to weight loss surgery, I was "never" going to do that, because, (ha), "I could do it on my own!" So there! One of my friends went from 348 to 140 with RNY around 2001. She did wonderful. And yes, I struggled with envy. My other friend had some very serious complications that kept her in the hospital for quite some time. She has since recovered and looks awesome, but I was still so sure that I could "do it on my own." I was afraid of the complications. I also had this fear that people would think I was a failure if I could not do this the old fashioned way. I started to see a therapist who deals specifically with eating issues. It was with her help that I realized that having surgery is not poor reflection on my character or a moral failing.
I was seeing the therapist at about the same time a friend of mine got the lap-band, and that is when I started to consider the band. I believed that it was far less invasive. I also knew I would have an easier time convincing my family that the band was ok, that I was not having "the dangerous" surgery! So in discussions with my therapist, I started researching the band, and made the decision in 2008 that I was going to get the lap band.
Since I live in Renton, I went to the information center at Valley Medical Center. I went through the pre-op program, and on July 18th, I got my lapband. Three weeks later, Valley Medical Center closed their Bariatric Center without warning. I had not even had a fill yet. They were open long enough for me to get one fill, but then they closed for good, and I had no doctor. I looked online, and found Dr. Lauter. He is in Bellevue and performs surgery out of Overlake Hospital. I discovered that a friend's sister had her RNY with him, and she was very happy with him. That was enough for me, so I called his office and made an appointment. It is funny because when I first started researching lapband surgery, I had seen Dr. Lauter's profile online, but I just stuck with Valley Medical Center because it was closer to home. Not my wisest decision. I really wish I had found him to begin with, he is wonderful doctor. He was also happy to see me; some doctors in the area would not see me because someone else had performed my surgery. I immediately liked Dr. Lauter, and immediately trusted him.
About 2 months after switching to Dr. Lauter, I had a night where I could not keep any fluids down, and I was in severe pain. I called Dr. Lauter's office first thing in the morning, and he had me come in immediately for an unfill of my band. He was hoping the problem was as simple as some food getting stuck. I was able to drink some water in his office, so I thought it was fine. By 4pm, I started vomiting again, so I called his office. He told me to meet him at the emergency room. I was in so much pain in the emergency room, I could not even sit in the waiting area, I had to lie down on one of the sofas. Thankfully I did not have to wait long. Dr. Lauter was there, and he ordered somes tests, where he discovered that my band had slipped. He said to me, "You are having surgery tonight." He repaired the slipped band, but I was back at square one, with no fill.
I weighed 294 when I got my band in July, and had gotten down to 252 when my band slipped. With no fill, and because it was during the holidays when I had my emergency surgery, I put some weight back on. I had already started thinking of revision to RNY during that time, because I did not want to ever experience the pain of a slipped band again. In addition, when I was restricted enough to lose the weight, I experienced a lot of foaming/sliming/PB'ing. Eating was not a pleasant experience. I wasn't too eager to get a fill, because I did not want to go through that process of trying to find the"sweet spot" that they refer to. I was getting impatient. At my next appointment with Dr. Lauter (after the holidays), I mentioned revision. He very patiently explained the percentages of expected weight loss of both procedures. He also told me he would support whatever decision I made. He said he would start the paperwork for my insurance if I wanted a revision. I left his office with no fill, and told him I would be back in a month with my decision.
I did some research on obesityhelp on revision from band to RNY, and did not find one person who regretted their revision. Most wished they had not even bothered with the band at all. That was all I needed, that, and the knowledge that I had a very competent and capable surgeon who I trusted. I went back to him a month later and said, "Let's do it!" I sensed that he agreed that I had made the right decision. We agreed to not work the band, and to just wait to see if the RNY would be approved. Admittedly, I used that time to enjoy eating. I had no fill, and I knew that if the RNY was approved, my life was going to change dramatically in the near future. I ended up gaining back 19 pounds of the weight I had lost with my band. In April, I got a call from Kelli, who works in Dr. Lauter's office, telling me that my insurance had approved the revision. Kelli told me that he wrote a great letter, which is awesome. I cannot sing his praises enough, and would recommend him to anyone seeking a competent and compassionate doctor. He is the best!
I had my revision surgery on May 26th, 2009. The timeline is as follows:
1st appt. with lap-band surgeon - weight - 306
7/18/08 - Lap-band surgery - weight, 294 (from pre-op diet)
11/24/08 - emergency surgery to fix slipped band - weight 252 - back at square 1, with no fill.
5/26/09 - Revision to RNY - weight 271 - When I went to my 1st appt in January, after the holidays, I decided to not get a fill. I was going to take a month to decide on whether I wanted to pursue revision. In February I went back and told my doctor I wanted to pursue a revision. He gave me the choice of whether I wanted a fill or not, and I chose to not get one. If my insurance didn't approve the revision, I was going to work the band. In the mean time, I didn't want to diet, I wanted to eat normally. That was my choice, others would have made a different choice, I'm sure.
Other than the expected gas pain, I really didn't experience much pain. I was on liquid oxycodone for less than a week, and I felt fine. What I didn't expect was the fatigue, low energy, and nausea that I would experience. Looking back, I think I was dehydrated. Food tasted different, and for those first couple of months, I practically had to hold my nose to gag down my protein shakes and food. I also had one bout of horrible constipation at about a month out, something I hope to never experience again! I have since come up with a maintenance plan to prevent that kind of constipation.
In those first couple of months, I did have some feelings of regret, because it was so hard to get in my water and my protein. There were many days where I barely got 300 calories in. My doctor wanted me to aim for 750. Prior to surgery, I thought that would be easy. Afterwards, it became a huge chore to get down 750 calories.
I also did not expect the fatigue and weakness. There were times in the shower that I barely had the energy to lift my arms to wash my hair, and I'd have to lean against the shower stall wall. As soon as my shower ended, I would stumble to my bed to lay down; I didn't bother drying off, I didn't have the energy!
Fortunately, there are many wise and experienced veterans on the board who assured me that these difficulties I was having with nausea, fatigue, and low energy were only temporary. And they were correct. By about the third month, I gradually started feeling better. At 6 months out, I was back to my old self, going to the gym, and pretty much able to tolerate most foods. I still made mistakes and threw up a couple of times, but it is all a learning process. I definitely know the signal that tells me I shouldn't take another bite if I want it to stay down!
It took me about 8 months to lose 100 pounds, and I'm beginning to wonder if I'm going to have to work to not lose too much weight. And as horrible as I felt in those first 2 months, the further out I get, the more distant those unpleasant memories become. In the beginning I would ask myself, "What the hell have I done to myself?" But now, I am positively thrilled with my results. I feel great!
