1/10/01. I just returned from my physical with my primary care doctor. He suggested I check into surgical weight loss. I was shocked!
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Surgeon: Emma Patterson, M.D.
I am 58 years old, medically retired from USWest. I have diabetes, hypertension and now high cholesterol. I am also a chronic pain patient from back injuries. I am a vegetarian and have lost and regained almost 70 lbs in the past 4 years on a vegetarian diet. My doc feels the yo-yo dieting is very unhealthy for me. I have gained almost 100 lbs in the past 20+ years. Prior to that I was of normal weight and size but a divorce in 1980 really set me for a loop. I had poor self esteem and a real fear of interacting with men. I went through emotional eating therapy in the late 80s and came to grips with the whys and wherefores of my over eating. I practiced fat acceptance, demanding that my doctor treat the body I came in with not the body he wanted me to have. 5 years ago I developed Type 2 diabetes, which I controlled with low fat vegetarian eating, gradual weight loss and exercise for several years. After another back injury dieting and exercising took second place to pain control.
My primary care doc feels I will be able to control diabetes, hypertension and high cholesterol as well as lessen the back pain if I lose about 100 lbs. I think that is probably true but I am cautious about making a commitment to do this. Having had several surgeries I'm a bit surgery shy! I have decided to explore the options.
I called Dr Welkers office and he is not taking any more patients right now. The earliest appointment with DR. McConnell is in September 01 so I made that appt. I'll continue to diet my low fat vegetarian way and see if I can be more focused this time.
2/10/01 Just returned from vacation in Mexico where I ate in a healthy vegetarian manner and walked daily. I managed to lose 4 lbs on vacation which is a real treat. At my doctors follow up visit this week he encouraged me to check out other doctors in Portland, especially at Legacy Health Care, where they perform the surgeries laproscopically. Still quite unsure if I want to do this.
2/20/01 I called and asked for information from Dr. Patterson, rec's her packet 2 days later and have scheduled appt's with Diabetes Dietitian and the psychologist as required. My appointment with Dr. Patterson is April 6 2001
3/13/01. Last week I had the nutritinal appointment at Good Sam Hospital in Portland. I'm a vegetarian so we spent quite a bit of time talking about protein. It appears I will need to alter my vegetarian stance for this surgery. I would need to have, at least, fish in order to get the required protein. This gives me great cause to consider if I want to have the surgery, however I am going ahead with my appointments, which are already scheduled.
3/15/01 Today I had the meeting with Dr. Poole, the 'shrink' who gives Dr. Patterson the psychological assessment. I had never had the MMPI before and it was a real kick! Some of the questions were wild.
The results were pretty much in keeping with what I know about myself already. The test showed that I resent authority (ok - we'll just call that part of growing up during the 1960s), that I am depressed (ok - thats why I take Paxil), that I like to do things my own way and will continue doing something even though others might give up )ok - hubby calls that my Irish stubornness).
The doc encouraged hubby and I to do something every week that does not involve food, as we usually go out to dinner at least once a week. He also encouraged us to seek marriage therapy even prior to surgery because this can change relationships a great deal. Hubby has agreed to do both whenever I want to.
I am getting more enthsiastic about this option for weight loss. I have spent a lot of time reading the plethora of information on the web about it.
5/8/01 I have seen DR. Patterson (4/5/01) and she has agreed that a Lap D/S is appropriate for me. I have a BMI of 37.5 and she has said a 85lb weight loss would bring me into a better range. Since I am not going to be as concerned with pounds as with my co-morbs, I am going to judge my final goal by that. When I weighed 170 in the past, I was still on high blood pressure medication. My personal goal is to get off of insulin for diabetes, of the 5 high blood pressure meds I am on, of the cholesterol lowering med I am on and have a good blood workup of low cholesterol and triglicerides.
Dr Patterson is insisting I have a sleep study done, although I have no real sleep apnea symptoms. Since my husband DOES have sleep apnea, and sleeps with a C-PAP, I am bery aware of the symptoms. However this is just one of the steps I must climb prior to surgery. This study will be done on June 14 so I'll check in after that.
I HAVE been in contact with my insurance, UHC Select Plus POS and the Lap DS is an approved surgery if the BMI and co-morbs are in line to suggest it. They are for me.
6/12/01 Sleep study done - what an interesting experience! I felt like a Borg from Star Trek! I had requested a firm mattress when I originally signed up for the study but was called early so I got a typical soft hospital bed. I was very uncomfortable, had back pain all night and did show a bit of sleep apnea at the very end of the study. that qualified me for a CPAP and another co-morbidity.
6/14 - Amber from the doctors office submitted my information to UHC last night at 5PM and rec'd approval this morning - she called me at 9:30am with the news....less that 1 day approval is wonderful.
I am also going to have a July 30 surgery date instead of Aug 20 - and decided to go for it instead of waiting. I'm tired of waiting for things. 6 weeks before surgery and I am really really excited - who woulda thought. Reading my initial story I remember how I felt about WLS in January and how education has changed my mind. I thought I was coping out - not trying hard enough - giving up on something I "should' be able to do. Well I have dieted myself to 255 lbs and serious medical issues and something obviously isn't working. Perhaps it's the dieting .
I am mentally ready for WLS.
6/18 - I am getting ready physically for the surgery. Today I walked about a mile on the Nike World HQ track, which is about 1/4 mile from my home. My goal is to be able to run the track by surgery time. I am also working out by moving great quantities of dirt delivered to make new gardens this summer. the fir4st day I moved 5 wheelbarrows full, today it was 15 and I'm not so sore in the shoulder muscles as I have been.
I am going to a chiropractor on Wednesday and Thursday having a massage. I spoke to my daughter avout healing massage post surgery and she is up for it. We are going to work on it ahead of time though.I am ready I will succeed.
7/27 - Just 3 more days....I am nervous and excited. I have been wearing a nasal gastric tube for the past day. It measures the pH level in the esophagus and tells the doc if I have reflux...I don't think I do.
Been doing pre op dieting and have lost qyite a bit if weight following a diet of 3-4 six oz protein shakes a day and one vegetarian meal.
Sunday next is the bowel prep and Monday am bright and early is surgery. Wish me luck!
8/12 - I'm almost 2 weeks post op and doing very well. I spent just 48 hours in the hospital following a 3.5 hour surgery 2 hr recovery room time. My hospital time was fine and nursing care was excellent for the most part. I came home to my comfortable guest room and care from DH, who took several days + the weekend off work. My first at home recovery time was primarily spent sleeping and sipping water and protein powder drinks, with occasional small servings of cottage cheese and applesauce or bland soup. My surgeon insists on pureed foods the first 3 weeks and I have found that very easy to follow as my tummy is not interested in anything strong flavored or crunchy right now.
The 2nd week I was on my own except for occasional visits from my grown children or friends and I again rested, took short walks and read a lot! I am listening to my bodys needs and find I have more energy in the morning so I do some light chores then, rest in the PM when it's hot....and it's hot even in Oregon right now.
I have had very small amounts of nausea when I tried a too spicy soup, no BM troubles, little gas and light heartburn which TUMS cures. I am working on hydrating and protein powder shakes.
9/17 - 7 weeks post op today and things are almost back to normal, except that I eat **far less** food. I was on vacation last week, for a few days and was able to eat my meals in restaurants. With the exception of very spicy crab cakes I did just fine. Restaurants are very helpful and DH and I have split some meals.
I also ordered off the kids menu for smaller portions and hit up the store for soy cheese and fruit to have in the car for snacks. I eat about 4 small meals a day and make sure I have a snack before bedtime so I don't wake up at 4AM starving. If I do get hungry at night, some hummus on a rice cake is a good snack. I have been able to maintain a vegetarian diet except that I have added some fish in my meals, especially when we were at the coast.
I only weight myself once a month, at the doctors office because I am scale-o-phobic. However my size 22 pants are now falling off me, some size 20 jeans I thought I'd be able to wear most of the fall are too big and I am in some size 18 shorts right now...depending on the brand of course.
I am giving all my 22's to a WLS friend for her trip to Mexico in a couple of weeks-I need to clear out the closet.
10/20 - 12 weeks post op and doing better every day. I have learned that if something does not agree with me, try it again in a few weeks. I am doing lunches with friends and going to dinner parties, preparing for a wonderful, slimmer holiday season in a sexy new dress...of size 16!
I am between a 18 and 16 in size right now and have a pretty empty closet, having given many of my clothes to pre ops and recent surgery patients and sold some to the resale shop. Since my personal goal was a size 16 I am now rethinking my goals and believe that a 14 is more realistic. I have lost 47.8 lbs and am 7.2 lbs from the 200 lb mark, which I haven't seen in about 20 years. I know I am reaching the end of my quick loss period (the first 3 months) so I am putting on extra effort to exercise and control fat intake a bit more to see if I can break that 200 lb mark by the end of the month. It seems like that light at the end of the tunnel isnt a train after all!
I am totally pleased with my surgery choice, the BPD/DS. It has enabled me to take control of my food intake in a healthy manner and not forced me to give up token sweets that I love and would miss terribly if I were to have had the RNY.
10/30 - exactly 3 months out and below 200 lbs for the first time since 1968 and pregnancy with my 32 year old son! What a joy! I have had minimal negative side effects from surgery and truly believe that following a lower fat vegetarian diet has been part of that. I have heard eating fat causes diarreah and I have not experienced any of that, nor has the fact that the majority of my calories come from carbohydrates slowed my weight loss when compared to others who have had the same surgery.
I have increased my activity level but still tire easily...I think this surgery is a bit harder for ~mature~people (ok I'm 58) to recover from. I am noticing some pretty bad skin texture..that crepy old persons skin that I think has come from quick weight loss. I saw my dermatologist and she said that exercise, good hydration and time can change things but older patients are pretty much going to have crepe type skin no matter what. For the first time I have started using a skin firming moistureizer on my face as wrinkles (formerly plumped out with fat) are starting to show. Not bad but more than before. I guess that comes with age anyhow and there is always plastic surgery if I just hate it (NOT).
Speaking of plastic surgery I am hoping and working on trying to avoid having a tummy tuck. I don't have the "batwing" problem as I had muscular arms and working out has done a nice job of giving me muscular arms back. My apron is going away pretty quick and the lose skin is not bad. My major problem is abdomen skin that is flabby so I am doing ab exercises to build up muscles and try and tone that part of my body.
Have not had the 3 month blood work, but thats due now and will report back on it.
I am very happy with my decision still.
12/01/01 Thanksgiving post. I had to write a note and tell my journal about all the things I am Thankful for this year.
WLS has made such a big change in my life. I spent the weekend at my brothers house and ate anything and everything I wanted to eat. It was a great get together and my brother, who is an excellent candidate for WLS himself, was amazed at the way I looked, my energy and health and the way that I can eat what ever I want. His biggest fear was being deprived of food-and I'm sure not deprived!
01/09/02 Five months post op and 190 lbs. Although I had a slow weight loss the past 2 months I am still pleased because it was over the holidays and I did not edit my eating much at all, attended parties every weekend wearing a great size Large velvet dress and got heaps of compliments about how I looked.
At my yearly physical last week my doc, who suggested that I investigate WLS a year ago, was as excited about my loss as I was. When we got the bloodwork back, he was even more excited.
Cholesterol down 100 points
Diabetes (HbA1c) was 5.5 which is normal. My fasting blood test was 100, excellent considering I was using insulin 5 months ago.
My blood pressure was 138/78 and last year it was about 150/95. I'm on half the medications I was last year and hope to be able to cut back even more as I continue to loose weight.
Protein was excellent and on a vegetarian food plan that was a consideration for my surgeon.
I have had some side efects...I've been VERY cold this winter, needing to layer sweat shirts over t-shirts and wear socks to bed. I bought some mew pj's to replace the too big nightgowns and added another quilt to my side of our bed. This is typical for WLS patients and I hope it goes away! I have a fire burning almost every day these days!
I've also had several colds since surgery, none of them major but much more than ever before. I expect I'm not fighting off illness as well as previously. I also have had significant reactions to pain medications...needing to halt their use because of nausea,headache and other unwanted side effects. This has mde pain control difficult but I am hoping still that more weight loss will eventually help with chronic back pain.
My size 16 jeans are now slightly baggy in the hips and I expect another 10 -15 lbs will but me into a 14.
The goal set for me by my surgeon was 180 and I'm 10 lbs from there now. My personal goal is 160 and I expect to be there by late summer now that I'm back to eating in a more healthy manner and not going to parties every weekend .
My only New Years resolution was to increase exercise and to that end I have resumed walking every other day. I have also bought an AbDoer abdominal muscle exerciser that has helped with waistline and ab strenghtening, as I can't do crunches or sit ups. Eventually I hope to rejoin a gym. I have some saggy skin in the tummy but my apron is not significant enough for me to consider plastic surgery as a necessary option. There is also some saggy thigh skin that walking will help. I don't have 'bat-wings' but the loss of my double chins has left me with old ladychin wrinkles but it looks better every week.
I have no regrets that I chose WLS and specifically the BPD/DS for my lifestyle. I would encourage anyone to investigate this surgery as a viable option~
03/13/02 just about seven and a half months after surgery. My weigh in last week was 175 and at my surgeon visit in Feb. I had lost 85% of my excess body weight and surpassed the goal originally given to me by the surgeon. I am 15 lbs from ~~MY~~ goal weight of 160, wearing a (baggy) size 14 jeans and size L or XL tops. I have lost most of my weight in the tummy and hips and but managed to keep my bust line, though things are a bit saggy. I credit an upper body exercise that I've done for 40 years with the bust line stuff, and my "AB-doer" with the amazing lack of apron that I am fortunate enough to not have. I'm basically a pretty lucky old broad!
The tiny bits of negative issues are continued fatigue and some nausea. I have had a difficult winter with illness and blame that on the fatigue - as for nausea, I haven't a clue whats causing it, but I have, again, resorted to post op foods of cottage cheese and applesauce, soups and crackers. This isn't a real big issue for me as my appetie has gone away, the urge to snack has gone away and controlling food intake is so simple since surgery that I never have to think about it.
My average meal is around 5 oz of food still. I think I got a smaller than usual tummy because at dinners with other Ds patients, they are able to eat far more than I am...but all the blood work is good so who cares.
Blood presure has really gotten in control and in June I think my PCP will pull me off of all but 1 medication. Sadly I have had no decrease in back pain following the 80 lb weight loss but still have hopes that another 15 lbs will make a difference. Presently I am on OxyContin for pain relief, Paxil for depression, Dynacirc and Zestril for hypertension, Ambien for sleeplesness. Plus of course all the supps the doc prescribed for post op health. I use Isopure for protein and buy the multi-flavored box about once a month. I am still primarily eating vegetarian with fish eaten a couple of times a week and occasionally chicken. I'm looking forward to planting a big vegetable garden this spring and being able to pull my food fresh out of my own yard.
11/11/01 - Dr Emma Patterson no longer does a BPD/DS after 6 successful surgeries in Portland OR. She has decided to do the old Scoparino version of the DS and now removes the pylorus in her surgeries.
I can no longer recommend her for DS surgeries...and am very frustrated about this decision, which was "sprung" on both her pre op patients and post op patients with no reasonable fore warning.
She still does the RNY and a Lap Adjustable Band.
6/1/01 I was originally dissatisfied with the office but they have grown, the staff has become more efficient and they have worked thru the original growing pains of a new surgeon coming into an existing small office.
Dr Patterson is a thoughtful person and in a recent conversation described her position as a bariatric surgeon.
She said "I love this surgery and the people who come here for help. With a few hours of surgery I can help them change their life and manage their health. I find my patients to be the most educated, the most willing to co operate with the pre op requirements and I love being able to help them."
I am impressed with this young woman and would encourage others to choose her for their surgeon.
She fully covers the surgical risks.
The aftercare program is a monthly group meeting and members are encouraged to comtact each other for support.
Her patients have formed a tightly knit community on Yahoo at
United Health Care, POS select
5 STARS for United Health Care ***** - less than 1 day authorization
6/14/01 Amber from the doctors office. She had called United Health Care west coast surgery auth yesterday afternoon, spoke with Patrick a nurse coordinator and got a fax number. My info was faxed at 5PM on 6/13. Amber called me this morning at 9:30AM and said I had been authorized for surgery - a real record setting less than one day. What is significant is that my fairly low BMI (37) was not even considered a deterant. The co-morbs were sufficinet to warrant WLS. Nor was there a question about the BPD/DS as others have experienced.
Dr Patterson is not in the United Health Care system. UHC pays 80% after a $300 deductable per year. Dr. Pazttersons office has said they are willing to accept what UHC paid. This is called a Preferred Rate Match according to Dr. Pattersons office.
UHC seems very easy to deal with so long as my PCP approves.
5/8/01 - Further conversation with UHC Medical Managment. I am asking for a lap DS and wondered if this is an approved surgery, if BMI and co-morbs indicate it, as they do in my case. I have gotten names of everyone at UHC that I have spoken to just in case.
So far they are not resistant, of course the final authorization will tell the tale.