I am looking for a better life with better health. I think the BPD/DS is the surgery for me. Why did I choose the DS over the RNY or Lap Band?
1. There is no dumping syndrome with the DS because of the working stomach.
2. The working parts of the stomach are maintained even though it is smaller (about 3 ozs.) and nutrients are better absorbed than with a pouch.
3. The restriction component of a smaller stomach is combined with a malabsorptive component to produce greater weightloss and a longer sustained weightloss over time.
4. The surgery can be performed and revised/reversed laproscopically. Once you have the RNY, you cannot reverse is without a major open operation.
5. I only have to return to my surgeon for follow-up. I do not have have "fills" in order to get my tool to work.
6. My post-op life will be filled with good food in fairly normal quantities. I choose not to live on protein shakes and avoid sugar the rest of my life.
7. I choose the DS because I have researched ALL forms of weightloss surgery and it is the best choice for me. I will not blindly choose whatever someone told me was good.
8. My surgeon is exceptionally skilled in performing the DS. I will not be a guinea pig for an inexperienced surgeon.
9. The DS requires lifetime follow-up which I am grateful for as way to maintain my health.
10. No other weightloss surgery provides the benefits of the DS.
I have embarked on a new venture this week. I started to research weight loss surgery. I have been researching the duodenal switch surgery. I have never considered it before because I thought the aftermath was a bit much to contend with.
The doudenal switch surgery is different from RNY or gastric bypass. Carnie Wilson and Al Roker had the RNY type surgery. DS patients tend to lose more weight and keep it off longer than other WLS surgery patients.
I sent a completed questionnaire to the doctor in my area who does this kind of surgery. It is complicated and only about 3 dozen surgeons do it. It is also expensive and only sometimes covered by insurance. I have taken a baby step towards this venture. It is not a done deal.
With my questionnaire, I did my diet history. It is pretty revolting. Fat all my freaking life. I am adding here for your perusal.
1981- First official diet. It was a low calorie eating plan with lots of vitamins to take. I went from 130 lbs to 115 lbs in the 8th grade
1986-1990 – Tried Weight Watchers 2 times with only 10 lb loss each time. Graduated College at 185lbs.
Summer of 1992- Did Optifast Liquid diet plan under medical supervision. 214 lb. start to 155. Lost 40 pounds on the fast and another 20 in Maintenance. The weight started to return immediately upon finishing maintenance.
Spring 1993- Weight creeping up after the fast, decided to do Jenny Craig. Weight is in 180’s. This only lasts about a month.
June 1994- Start first profession job and move to our first house in 1 month’s time. Gain 30 lbs that month. 255 lbs range.
Spring 1996- hire personal trainer at gym. Go 3-4 times per week, but only lose 3-5 lbs. to 249 lbs.
August, 1996- get pregnant with first son after 4 months of clomid for annovulatory cycles. I am 280 lbs when I deliver him by c-section. He is 8 lbs., 6 oz.
May, 1998- Down below 240 lbs due to increased metabolism from breast feeding. As soon as my son weans, the pounds pack on.
Nov, 1999- Conceive second son at 260 pounds after 8 months of clomid therapy.
May 2001- Down to 256 from breast feeding again. Once baby starts taking solids, metabolism decreases and weight comes back.
Aug., 2001- Start Michael Thurmond’s 6-week body makeover. In 6 weeks, I lose 30 pounds eating 6 mini meals of protein a day with only complex carbs and no sugar or flour products.
Jan, 2002- Start Dr. Atkins diet plan, lose about 15 pounds in a month.
Fall, 2003- Try to do 6 week body makeover again for a few weeks. I lose about 15-20 pounds; put it all back on over holidays
Jan, 2004- Start Atkins again. Find out I am 6 weeks pregnant. I stop dieting. I am very sick all the time, so I eat to combat the nausea.
June 2004- put on Metformin to regulate cycles, control cravings, and to try to halt weight gain. Went from 1000 mg/ day to 2000mg/day XR by January, 2000.
Jan, 2005- Trying again with high protein, complex carbs no sugar. Lose from 280 to 265.4. Stop clomid.
Feb., 2005- Gain 5 lbs back. Give up trying to conceive.
March, 2005- Lose 5lbs again. Knees hurt from standing for any length of time.
April 15, 2005
How Long Does It Take?
On March 24, 2005, I made the decision to pursue bariatric surgery-specifically the BPD/DS surgery. I sent my fully completed paperwork, copy of insurance card, diet history, beseeching cover letter, and coverage documents to my surgeon of choice that I had met the night before. I called the following Tuesday, March 29th, and the documents were in the office. I have called and called and called every couple of days. I even called from freakin' Disney World. It does not buy me any love in the surgeon's office. I called again today. Doctor Smith is at a conference and he has not given them back yet.
So, three weeks I am waiting for the magic words that say I can have a consult appointment with the surgeon. Who knows how long I will have to wait for the appointment once he gives the okie-dokie.
Once I have the consult, there are a myriad of other specialists to see to deem me fit for surgery. Once those are done, we can ask my insurance to approve it. Since insurance companies are so speedy when they have to pay money, I may be writing about this topic for a long time to come. My fervent hope is surgery in late June. The split in the middle is probably September. The last is, "Who the hell knows!"
I would have never considered doing this before. This procedure is different, and I think worthy of the hours I have put in studying it. I am not saying it is right for you, but it is giving me hope.
Here are some exciting updates on the new venture. I have a psychological evaluation on May 3rd. I have never had one these before. I can already tell that I do not care for the doctor. I will have refrain from arguing with her that I know more about the surgery than she does. It is silly really for me to try to educate her on something that she clearly is the expert and doesn't need any additional information from me- her morbidly obese referral. I am also seeing a pulmonologist on May 10th for lung function clearance. I am seeing a cardiologist on May 12th for clearance as well. I see my PCP for a letter of medical necessity on May 11th. Lastly, I have my first consult with Dr. Thin on May 20th at 8am. I hope to have all my ducks in the row before I see him on the 20th. Hopefully, I can get my pertinant paperwork off to the insurance by the end of May. Ha-Ha-Ha-Ha-Ha. I unrealistically optimistic with that timeline.
I weighed in today after a rather fun evening scrapbooking with friends and salty snacks. I am back up to 268.8. Blech.
May 7, 2005
Obesity is not a disease it is a character flaw.
I would like to get my feelings down about this psychological evaluation. As a start to our beautiful relationship, I was confronted on the phone making the appointment with this Phd. that she was not a big fan of the DS procedure. Her belittling of me and my concerns about the RNY over the phone only produced an delayed agitated response from me. I put that aside and went to the appt. I figured it was only one appointment.
When I arrived, it is apparent she does a thriving business with the bariatric consults. I took a 567 question true/false question on computer. I did a 40 or so questionionaire in pencil in the waiting room. I had to meet with her for an hour. We went over what you would expect the questions to be- first diet, psych history (none), insurance(?) etc. Then, I get what amounts to a lecture about how bad my chosen course of treatment in terms of side effects and the possibility of insurance coverage. Is this not my surgeon's job? After quite a bit of badgering, I told her how many countless hours of research went into this- how I am knowledgeable about both the good and bad results of this procedure. I am also familiar with the long term health maintainence required.
Why am I so annoyed by her behavior? She has never had either procedure. She has a weekly support group for failed RNYs. She said she would LOVE to have me in this group because of my knowledge. Why does she need to make up my mind for me? It was very controlling. If I needed an operation on my (whatever) to restore my health (but not because of weight) would I be getting a freakin' psychological evaluation? No, because I would NEED the operation to restore my health. Why is fat any different?
You see, I am just a vain pitiful fat girl who wants to be thin. Bullsh*t. I am a happy mother and wife who wants to live my life. I would prefer that life to be devoid of snap judgments about my size. Can I get that without jumping through more hoops than flipper? Apparently not.
May 12, 2005
The Cardiologist's scale is a liar!
I was 275!! on the cardiologist scale today! I weighed at home this morning at 271.0 thankyouverymuch. I am almost passed for cardio surgery clearance. EKG was good. I have to go have an echocardiagram tomorrow afternoon. It is an ultrasound of my heart. Do you think they will give me a little picture?
I passed with flying breaths the pulmonary clearance on Tuesday. Yesterday, I dropped a letter by my pcp in support of me having surgery. Hopefully, he has signed, and it is winging its way to me now. I want all these things arranged by the time I see Dr. Smith on the 20th. I would like for him to be able to send a nice clean packet to the insurance by say, June 1.
I now have made a 3 ring binder of all my information...with color coded tabs. How anal is that?
May 17, 2005
I am calling the psychologist today to see if her "findings" are in yet. I am also awaiting cardiac clearance for sugery. I had to have an echocardiogram last Friday. It has not been read yet. I have a clearance in hand from the pulmonologist. I want my file to be as close to complete as possible for the big consult on Friday. I have never had to see so many doctors at one time in my life.
Did I tell you I am, for the most part, a healthy fat person. It is what scares me. I think that I will not be able to have the surgery because I am not sick enough yet. My eating has been crazy with all the doctor appointments and the worry. I am think I am hovering in the low 270's.
I got my cardiac clearance today, and I am good to go for surgery. They are faxing it to Dr. Smith today. Also, I got my psychology report today. It was a tad embarassing with some of the personal details, but it said I was an "excellent candidate" for bariatric surgery. It also said I had no personality disorders. It said nothing about the duodenal switch however! Her office is faxing to Dr. Smith today as well. Tomorrow, I will call Dr. Smith's office to make sure all my clearances have arrived safely in his office. Any that have not, I will follow up on. I am getting excited about this consultation on Friday. Wish me luck.
May 20, 2005
I saw Dr. Smith today. He is very reassuring. He told me that I am a good candidate for the DS surgery. He and his assistant were very pleased that I had gotten my clearances in advance. The assistant was impressed with my tabbed notebook! LOL
On Monday, I will have blood labs drawn and an upper GI series of x-rays done. I have to have a nutritional consult with a dietician as well. I have that scheduled for next Friday.
The possibility of having this procedure seems so real to me now. It is tantalizing, but I am afraid it will now be jerked away from me. My dh's office is most likely changing insurance. It may not be an included benefit when that happens. It is dangerous to have something so close and lose it. I know we are all familiar with that.
All in all, today was a very good day. I am hopeful and optimistic. Today Rocked!
May 23, 2005
I did get some good news today. My letter of medical necessity is ready to go to the insurance company for the ds. I am asking them to send it tomorrow. I, also, got to have a barium breakfast this morning. A lovely upper GI series today produced rather milky results. I think this too shall "pass." Many, many vials of blood were drawn as pre-op labs. My nutrition consult is this Friday. Things are moving along with the assistance of my trusty tabbed notebook.
May 26, 2005
Here's the deal. I had blood work (bazillions of vials) drawn. I also had an Upper GI on Monday- the barium breakfast of champions. On Tuesday, I called Dr. Smith's office and talked to the sweetest girl-Danielle. She said they had everything to submit but my TSH (thyroid) results from the blood draw. She said those took a week to come in. I was disheartened. So, the very next day, I called the lab and inquired where the results might be. I found out the results had been faxed to the doc. I called the sweetest girl again. She found them on the fax. She said she would submit my packet to the insurance. So, I am hopefully in the insurance queue now.
I may call the insurance early next week to see if I am in their system. I have my nutritional consult on tomorrow as well. It is my last consult to get a surgical date.
May 28, 2005
The nutritional consult went well. It was mostly pre-op and post-op eating with a mix nutritional supplement information thrown in for good measure.
I will need to do one more 3 hour class right before surgery. Now, I am just waiting on approval to get my date.
June 4, 2005
Why Insurance Companies are Instruments of Torture
Called the insurance Tuesday morning 5/31/05, the rep says that they have not received the paperwork. She said it would take 30-60 days for pre-determination to make a decision. Needless to say, no help at all.
I hung up and called again and got a different rep. I told her when my documents were faxed again and asked her to research it. She transferred me to a nurse in the the pre-authorization department. She said she would send the gastric bypass team an email to check on it. She said I should hear something in 48 hours.
I did not hear anything the next day (Friday) until 4:07pm. The sweetest girl from my Doctor Smith's office called me. I was just starting to get excited that this was the approval call when she hit me with the bombshell. My insurance had called the Doctor and told them that I had no medical insurance AT ALL! Our contract had expired on 5/31/05!!!!
So, I immediately felt the urge to vomit. I was shaking all over when I told her I would call her back. I called the ins. company. The first rep I talked to said the same thing- no medical coverage. Remember, I had just called the day before and had coverage. She called the enrollment department and found out that yes, we had PPO coverage. I asked to speak to the person that had called my dr. She could not connect me.
I hung up and called the sweetest girl at my doctor's office back. She gave me more information about the insurance caller- her extension #. I called the ins. person back at her confidential voice mail and left a friendly but anxious message.
Next, her cubicle mate who had found out about my dilemma called me back. She said that she would make sure the original person had not thrown my documents away and to tell her I did in fact HAVE insurance. I was so very relieved. I no longer was shaking, but still felt like I had to hurl. I thanked her profusely for making a phone call that she did not have to make to salvage my weekend. My nerves were cracking and popping like being hit with static electricity.
I called my doctor's office back and told the sweetest girl what had transpired, and I should hear more on Monday. So, that's the torture story. It only took about 45 minutes, but it felt like hours.
June 6, 2005
What a Difference a Weekend Makes!
We had a fun weekend. Bicycle rally with the kids on Saturday with some swimming in the afternoon. Sunday we went to church and then slipped over for a late afternoon at the local water park. It is tough being in your bathing suit in front of hundreds of people. It was very difficult to climb all the steps. Some of the higher rides I just didn't even try. The kids loved and we were all exhausted at the end.
This morning I took my little one to swim team practice, there was NO message when I got home. I was just getting settled into my office when the phone rang. I was sure it was my husband calling to tell me how the drop off went at baseball camp. It was an out of state number. It was the nurse clinical whatever from my insurance company that had gone home on Friday after telling my dr. I had no insurance. I thought she was calling to tell me she was reviewing the paperwork now that it was confirmed I had coverage. No, she told me...
I AM APPROVED!!!!!
I will be having surgery in early July most likely. I will know more later this week. I am on cloud nine both nervous and excited!
June 12, 2005
One Month from Today
One month from today on July 12, 2005, I am scheduled for my duodenal switch surgery!!!! I am amazed with the speed of it all as I expected it to take months and months.
I received my official approval letter from the insurance company yesterday. It says I am approved for the "douenal switch." LOL I have quite a few pre-op appointments to do and I have to give a big load of money to the doc for our co-insurance payment.
After this week, I will start making lists of all the things I need to get together for the hospital and after. We cancelled our vacation for the last week of July :-< . It had to be done as there is no way I will be able to ride in the car for 6 hours that early after surgery.
I am been on a bit of a farewell tour of food. I have had sushi and mexican this week. My doc wants me to lose 10-15 pounds to shrink my liver a bit before surgery. I don't think it will be too difficult.
I cannot believe I am going to get to have the surgery that will make my body work correctly again!! I am excited and scared and worried. Of course, I worry about everything. There are some people we are not telling. I need to figure out a way to tell my in-laws. They will be helping us with the boys. How am I going to explain to the boys? They are so young, but old enough to know something is going on. (4 & 8).
One month from today!
July 1, 2005
Visa Card Burps
So, I have had to make a few purchases of late for my immediately pre and post operative period. I may even need a couple of things to take to the hospital with me.
Here's the list:
1. Unjury protein powder shakes- both chocolate and unflavored
2. Sugar free jello in numerous fruit flavors
3. Lots of broth both beef and chicken
4. Soy chips both revival and others
5. Tuna packed in water
6. Peppermint tea
7. Yo on the Go- a yogurt smoothie that does not have to be refrigerated
8. Calcium Citrate with Vit. D, Magnesium & Zinc
9. Proflex 20 protein bars
10. Cream of Wheat and Cream of Rice cereals
11. EAS Advantage French Vanilla Carb Control drinks
12. Various Protein shake samples from Vitalady
12. Davinci Sugar-free syrups in travel assortment
13. Calcium Citrate Lozenges (cinnamon) 400 mg. from Bariatric Advantage
14. Devrom- 100 count
15. Small fan for the hospital
16. Protein For Life protein shake powder in Cinnamon Toast
17. Pro-Stat64 protein drink with 15g in a single ounce (wild cherry and orange mist)
18. Pill Crusher
19. Weekly Pill Sorter
Still need to buy:
Mag. Citrate for Bowel Prep
I start my liquid diet on July 10th.
Only 11 days left!!
July 6, 2005
I have my nutrition class tonight that my surgeon requires. It is 3.5 hours with a test! The bariatric coordinator and dietician of the hospital do the class. I am looking forward to learning even more about my post surgery eating. It is starting to get a little nerve racking.
July 9, 2005
So, I had it. My final solid food meal for about the next 3.5 weeks or so or ever. My husband grilled steaks in a torrential downpour (some Hurricane Dennis clouds) and we had baked potatoes and corn. I had wanted shrimp, but he could not find the right kind at the grocery store so it was just steak. It was good. It seems weird.
I also got a little pedicure today and a bikini wax. I bought some light reading magazines for the hospital. I got some last little odds and ends.
Tomorrow I start liquids and then clear liquids on Monday.
Just 2 more days,
My Reasons For Surgery
1. My sons- they need me to care for them
2. My husband- he needs me too
3. My health- I need it
4. Life is harder when you are fat
5. To be "normal" sized
6. To fit in chairs, booths, & cars easily
7. To quit making jokes about my own weight
8. Better clothes for less money
9. Fashionable clothes
10.To be in control of my hunger
11.To play tennis
12.To dance all night
13.To go places without people staring
14.To go places and have people meet my gaze
15.To have a funky haircut
16.To sleep better
17.To wake-up without pain
18.To help my infertility
19.To be accepted
20.To fit in an airline seat-just mine
21.To fit in a movie seat or stadium seat with fixed armrests
24.To avoid confrontation because I can
I went in early Tuesday morning. Everything was hooked in through my pick line, so no new sticks. I walked myself to the operating room and made myself comfortable. I got some nice warm blankies because it was cold in there. Next, I wake up in recovery and it hurts. My husband and Mom are there in recovery with me (which I thought was odd) at about Noontime Apperently, with no room at the inn (hospital) they had to come see me in recovery. I was struggling and agitated with the pain. The nurse said, "Well, it is going to hurt." I got more agitated with her then. I was given something because it was better after that. I stayed in recovery because they could not find a bed on the floor my doc puts his patients in. I got to my room around 5pm. My mouth was so dry. I had these spongy swaps in ice water to swish around in my mouth. Had super nice nurses and techs once on the floor. They are very used to Dr. Smith's patients. I hung my legs off the side of the bed about 8:30pm. I did a couple of hall laps at about 10:30pm.
Here is what I had in: I had an med/saline iv pump and a pain med patient controlled pump (morphine-yeah) both in my one PICC line port. I had a cathereter? for urine. I had a jp drain out of my stomach for excess fluid (still have and it is coming out on Tuesday). Pain was well controlled with the morphine pump. My belly was sore. I was slipping in and out of sleep. I got the cath out the next day and was able to have clear liquids (Wednesday) only 50 cc an hour. Lots more laps and progressed to full liquids by the evening or next morning. Was only use morphine once an hour so he let me go to liquid lortab (not bad acting) Spiked a little fever in the night which was gone the next day.
Thursday doing well still. Doc comes in around 2pm and says if you keep your pureeds down then you could go home if you wanted. I said "WHOOO HOO" The nights were tough. I would fall asleep and think that I had slept for hours and it was only 45 minutes. I wanted to go home, so I did my pureeds and got home around 9pm Thursday night.
Here are the things that were helpful to me:
FAN- huge, nurses came in to stand in front of it.
Ponds Facial Wipe clothes
Lanyard to hold my drain while I was in the shower
Hair ponytail holders
Small travel pillow
Did not use:
Magazines- could not really focus to read
Robe and slippers- just used the gowns and footies there
chapstick- had those swaps which worked well
Journal- same as mags
Make-up- who cares
A Summary of My First Days Home from the Hospital
Wouldn't I just love to say that it has been a merry jaunt in the park? What follows is merely my early recollections preserved here before I forget.
My first full day home, Friday, was all about drinking and sleeping. (3 days postop) Since I was drinking my food, I was getting both nurishment and sustainance at once. I managed 12 laps inside my house. I ended up with about 60 oz of liquids and about 38 grams of protein for the day. I mostly had water cut with half gatorade. Plain water was hard on the stomach. I used carb control yogurt smoothie, pureed beef mushroom soup, the unflavored Unjury protein supplement and another protein sample for my protein for the day. I got my 2 chewable multivitamins in.I took 2 naps and had my pain meds about every 6 hours. I had my first bowel sounds this day.
Saturday at 4 days post-op. Woke up with crazy hot sweats for most of the morning. I had 1 nap in the morning. I am sleeping part of the night in my bed and part of it in an oversized chair with ottoman in our room. I am using Lactaid milk, pureed creamy chicken rice soup, egg drop soup, yogurt, and an Advantage EAS Chocolate Fudge Shake for protein. I get 67 oz. of fluid in and 45.7 grams of protein. We did not count the egg drop because it was difficut to get an idea of the protein amount. I had my first bowel this day. I proceeded to have 4 more. They are smelly- make no mistake. Oust seems to work well on them. I got in my multivitamins plus 2 calciums as well. I also took a shower today. I am walking hunched over- sometime I hold my middle for support. W took a short jaunt out for the new Harry Potter book today. It was very tiring, and so was the shower.
Sunday at 5 days post-op. I slept all night through in the big chair. I took my Lortab elixir once in the morning and once at bedtime. I also take 1 Nexium a day and an Ambien at night for sleep. These seem to be the standard scripts for Dr. Thin. I managed a great, restful 2.5 hour nap in the morning. Today we took a different tactic with food. I had lactaid milk again (lots of protein) I also had a SciFit Cookies & Cream shake sample that I mixed with some more lactaid milk. It was actually good and not so much liquid that you got tired of it before you were finished. It had a whooping 33 grams of protein plus 4g from the 4oz of milk. I also had pureed tuna and later cottage cheese to round out the protein for the day. I got try a small smattering of mashed potatoes mixed with milk which have been the best thing since I have been home. I reduction in liquid protein caused an overall reduction in fluids. I got 53 ozs of fluid and 69 grams of protein. My new drink is 7oz water with a small tsp of lemonade mix stirred in. It has just a hint of lemon, and I can get it down. I had made my protein, but missed my fluids. I managed my multis along with 4 calcium citrates so I am up to 800mg in extra calcium. I am walking upright with no assistance and little pain. I am doing less laps because I am moving all about the house even traversing the stairs (16) to upper floor several times. I had 4 bms today with one being a liquid accident that horrified me as I was home alone at the time. I cleaned it the bathroom and moved immediately to the shower.
Today at 6 days post-op. I did not sleep well because I spent most of my night in my own bed. I am still too sore for that. I have managed 4 oz cottage cheese for breakfast and 3 oz pureed chicken for lunch with a touch of mayo. Both of these take a looooong time to eat. As a result, I have 31 grams of protein in today already. I feel good. For the most part, if it is not going to give me protein, I am not eating it. I may have a little mashed pototoes again today though. They are delightfully tasty and have 1g with the milk I put in to water them down. I have had no pain meds today and no nap yet. We'll see how the day goes. I did finish Harry Potter today and it was a fantastic story!
My observations on my recovery: Thicker is better than watery. Warm is better than cold. Each day is much better than the last.
July 26, 2005
Two weeks ago today I had the Duodenal Switch surgery. Tonight for dinner I had 3 pieces of grilled filet mignon, 3 slices of sauteed mushroom and about a half a tablespoon of baked potato. Now that I am eating more solid food, water is more difficult to get in the quantities I need. I only drink water with a splash of either lemon or lime juice in it. Water is so heavy in my stomach. I am getting in the low 60's in ounces of water daily. All my incisions are healing nicely- one is itchy. My energy level is about 65% of normal. I would like that to improve.
Here are the stats. I will have dh take a pic and do my measurements tonight. I have lost 18 pounds as of this morning. It is still amazing to see the scale go down instead of up. Many have told me I need to concentrate on me and my recovery, but I am finding that difficult to do. Surgery seems like it was a long time ago now when in reality it was not.
It is an incredible journey so far, but still one I wish I had never needed to take.
3 Weeks today!
I am doing remarkably well. I practiced tennis with a team of women for 2 hours today! I felt kind of bad by the end of it though. I am down 21 pounds. My favorite protein is bacon. It is amazing.
August 12, 2005
It is 1 month today. I am not very hungry. My energy is returning. I am playing tennis once a week. I am down 25 pounds which was my realistic goal for this first month. Tonight, I will do my pictures and measurements.
August 20, 2005
Dr. Visit Yesterday
I went in to visit Dr. Smith yesterday. He was very pleased with my progress on his scale. I was down over 28 pounds which is 23% of my EW (excess weight). The average duodenal switch patient loses 85% of their excess weight. If I hit that goal, I would weigh 175 pounds. If I get to 100% ewl, I should weigh 159. We talked about the calculation of that. A BMI of 25 is considered the upper range of normal. Anything over 25 is considered overweight. So, 159lbs is a 25 BMI by his calculations. That is my doctor's goal weight. My personal goal weight is 150. I would not even mind dropping a bit lower than that to accomodate a small rebound which is common in ds patients.
150lbs, to me at this moment, seems to far-fetched to be possible. I cannot even fathom being below 200 pounds again- much less 150. Getting your head to the place it needs to be post-surgery is one of the toughest post-op conditions. There is no checklist- no test- not even a map to guide you there. I am trying to go with the flow to see where this takes and not get hung up on when I am going to be there.
Dr. Smith is very please with my protein intake. I enjoy getting my protein from food sources mostly. Sometimes, I still have to remember to eat. I have lost a total of 30.8 pounds on my scale today and as of last Friday 20 inches from various points on my body. My old clothes are loose, but I can still wear them.
I cannot say enough good things about my doctor. He is so knowledgeable and conscientious. It is all about his patients and their health and their continued improvement. I can very highly recommend him.
2 months today! I hopped on the scale this morning to see 239.2 come up. I was happy. I have lost 40lbs in 2 months. The scale will not move for a few days then it drops. It is maddening. All this scale business reminds me of the pregnancy test obsession I would have during my infertility days. I only get on once a day though. I also do not feel bad if the scale does not move. I am trying to stay confident that it WILL move.
10/12/05 3 MONTHS TODAY
Time is really starting to fly. I had surgery 3 months ago today. I was 56 pounds heavier. Today, I practiced with my tennis team for 2 hours easily in the warm sun. I have given away almost all of my 26/28 and 3x clothing. I exercise by playing tennis. I take my vitamins. I have lab work that I am waiting on. It is going well. I want to add some balance ball stuff to help with my droopy stomach. This really is an amazing surgery, and I am very grateful to have had it.
Finally a Progress Picture as Promised
Yes, I was late taking these. Please do not laugh at the outfit. We had a charity thing to go to this past month. I had to dress up. The top is an 18. Whoo Hoo! The skirt I had majorly taken in for the event. I am trying NOT to buy any new clothes. This is not the actual night. I thought I looked so festive that I put them on for progress pictures a few nights later.
Below the picture, is my before pics. There is a difference, but still such a long way to go. I am glad the sun I am getting playing tennis gives me a little color. To me, the back shot still looks just as wide! My measurement chart has me down 40 inches total the day these picture were taken.
Here is a weird thought. The boys in my house have all had a stomach virus with vomiting and fevers etc. Despite having tended to the them all, I have not been blessed with the virus as yet. Do you think my changed innards has any thing to do with that?
Since Thanksgiving, I had only lost .8 pounds. I was getting frustrated, but a similar thing happened last month too. Well, Saturday I went to put on a plaid wool skirt that my mom had given me. It has no elastic in the waist. As I was about to put it on, I looked at the tag. "Oh Crap, no way I am going to fit in a 16W." I thought all the items she had given me were 18s. I pulled it up expecting it to stop at the thighs. It went right on and wasn't even tight! WhOOO HOOO
I can still only wear 18s in jeans though.
As for the weight, I have been stalled above 200 for almost 2 weeks now. Yesterday morning, I hopped on the scale~ 199.8!! I was fired up, but I did not want to report it yesterday in case it popped back up. I thought it would be the same today and I could come tell you guys. Well, it was 198.2 this morning! I have lost 2.8 lbs in 2 days.
SO, I am now 198.2. I have lost 81.8 pound and I have reached ONEDERLAND for the first time in over 12 years. I know because I weighed 200 pounds the day I got married in October, 1993. I have not seen this number since 1993.
So, here I am 48.2 pounds to goal. 18.2 to the century club and darn thrilled to be here!!!
Five months have passed on this wild and crazy journey. I am very pleased with the weightloss and how I feel. I am down 87 pounds. I was a 26/28 on bottom. I can wear 16/18 now. I am a normal XL on top from a 2X-3X. I have one issue that I am currently getting reviewed. My iron stores are low. The test is for my ferritin. Technically, I am not anemic, but if the stores keep dropping I will be. My doc's office is pretty proactive, so I am going to see a hematologist in January. I am upping my Proferrin ES supplements to 3 a day. You know since I am not a big fan of flour based products anymore- I started looking. They are all fortified with iron! So, the plan is increased iron supplements with OJ, dark green leafy veggies and meat with OJ to help iron absorption. It absorbs better with Vitamin C!
If you have had any kind of wls, please make sure to check on your health with labwork. Don't be afraid of doing it so that you can make any changes early on!
The Easy Way Out
The easy way out. Lots of people would say that I took the easy way out by having surgery to cure my morbid obesity. I should have relied on the tried and true diet and exercise to acheive a normal weight. Until someone has been here, it is pretty impossible to change this opinion.
While I agree that it is possible for morbidly obese persons to lose weight by diet and exercise, it is not the same as it is for regular overweight people. When you are looking at losing say 15, 20, even 40 pounds, it is a measurable, conquerable goal. You can restrict your diet and exercise and maintain that long enough to acheive a reachable goal. For a MO person, we have done that so many times that are bodies are very resistant to releasing that fat. We can eat less and exercise more and still lose very, very slowly. The more drastic we go in calorie reduction- the more resistant our bodies become. The only counter to that resistance is exercise. Guess what? Exercising when you are more than 100lbs overweight is difficult, humiliating and sometimes very dangerous. So, what do you do? You break your weight into manageable chunks and keep working until you have it all gone, right? Every person has trouble maintaining a restrictive lifestyle for the long term. Life or other priorities get in the way. Lastly, once an MO has attained a weightloss, they only have a 5% chance of keeping it off for 5 years.
Have I done all the above. Yes, I have achieved weightloss and not been able to keep it off. Since I have had surgery, my body works more like a "regular" person. My body responds in a more normal way to diet and exercise. I can lose weight by diet and exercise. Yes, my diet has changed~ the surgery requires it. Do I exercise now? Yes, I love tennis. I can do so much more with almost 100lbs gone. I can maintain my focus longer because my body requires it rather than fights it.
I am using fitday again to track my protein grams. I am going to start listing how I eat, so that people who think major surgery is the easy way can learn that it is a medically necessary procedure to regain my health akin to knee replacement surgery or even cholestral lowering medication. My health is infinitely better than it was. My life is as well.
Here is the food for 1/2/06
Nectar Roadside Lemonade 23g protein, 0 carbs, 90 calories
Spring roll- veggie 3g protein, 10 carbs, 101 calories
Power Crunch Bar 14 g protein, 9carbs, 180 calories
Pan seared Tilapia w/ light butter caper sauce 4oz. 26g protein, 0 carbs, 127 calories
Mashed Potatoes 1/3 cup- 1g protein, 12 carbs, and 73 calories
Fried Calamari 1oz- 5g protein, 3 carbs, 55 calories
Can of V-8 3g protein, 14 carbs, 70 calories
Pork Rinds 9g protein, 0 g carbs, 82 calories
5 Rolo individual candies 1g protein, 10 carbs 71 calories
Totals for the day: 85g protein, 61 carbs, 29g fat and 861 calories
Today's weight 187- total lost since 1/2/05- 93 pounds
Obese NO More!!!
You heard it here first. I entered my weight (184.2) into my Fitday program today. Despite being notoriously stingy with the BMI rankings, I got a BMI of 29.73 wherein they proclaimed me only OVERWEIGHT. I have been hoping for this next milestone for the last few days as I crept ever closer. It was great to bust right through there today. After spending most of my adult life as an obese person (of course I never actually would say that until this blog), it is thrilling to be only considered overweight!
I am on my way to goal. I will get there. Will She lose it? is the tagline of this blog and has many meanings the weight, the struggle, the infertility. Don't you find that as people move closer to their goal that it then changes as the end nears. I am hopeful for 2006.
Food on Thursday was pretty good considering I spent 5 hours surrounded by fish. Took the boys to the aquarium yesterday. We are totally going for sushi tonight! Here it is by the numbers:
Iron with OJ 14c, 1g protein
Inside of cuban sandwich 1c, 28g protein
Double Nectar Roadside Lemonade 0c, 46g protein
Power Crunch Bar 9c, 14g protein
Edamame 1/4 cup 5c, 6g protein
Large Boiled Shrimp (8) 1c, 13g protein
Steak 3 oz. 0c, 24g protein
Totals: 1051 cals, 31 carbs, 130g protein
86 oz of water
6 Months Post-Op
6 months ago today I was being drugged by a morphine PCA pump. I had finished surgery at noon but did not get a regular room until about 5 pm. Those morphine pumps are crazy things. You push the button, go to sleep and wake feeling like you have slept hours. Unfortunately, only about 20 minutes went by. That went on for the next 2 days until I busted out of that hospital.
6 months ago, I had laporascopic Doudenal Switch surgery. You can read more about that kind of surgery at www.duodenalswitch.com. I was 280 lbs and today I weighed 182.4. I have lost 63 inches all over my body. I saw my surgeon, Dr. Smith, yesterday who was very pleased with my progress. I have lost, by his caluculations, 78% of my excess body weight. I am ahead of the curve. Is the surgery magic, it seems but I have also been exercising and have altered my diet as a result of the surgery. What the surgery has done is make diet and exercise finally work on my body. I have recovered very well from the surgery. I play tennis and exercise on my elliptical machine.
Today, I saw my OB-GYN who has not seen me for a year. He walked into the room and did a huge double take. He did not recognize me. He thought it was someone else with my name. He was thrilled and happy to hear that my cycle had returned with some regularity. It was great to see him at a loss for words because he is at a loss for words.
Here, is the picture comparison of my before and after. My clothing sizes have changed dramatically. In the top photos, I am a 2X/3X on top and 26/28 tight on the bottom. In today's photos, I have on 16 medium Dockers and Large shirt.
Do you want to know the downsides of my particular journey with this surgery? Well, my iron is low and may be forever. I am getting an infusion of iron (an iv) tomorrow. I will report if it makes a huge difference in how I feel. I feel pretty good. I am active and have a lot more stamina than before surgery. The second downside is realizing how much better people treat thinner people than obese people. It disgusts me.
Here is my last WOW moment for today. I noticed for the first time today that my legs do not rub together when I walk anymore. Amazing. Hubby says I look thinner than in the pictures here which he took- I think I will keep him.
Work gets in the way
Love my new job. After taking 8.5 years off to raise my sons, my job is very stimulating to me. I have gone from breastfeeding, cloth diapering and organic foods to back practicing law everyday. I do not regret being with my boys when they were smaller, but I am thrilled with the adult interaction and mental stimulation. Lunchables are still not an acceptable choice however.
Here is where the new job is causing problems though. My new post-op life. I am eating out more at lunch. I am very tired when I get home- too tired to exercise. Getting in my water (80oz) and supplements (many) is very hard with the crazy schedule I have during the day. I am still mostly eating protein, and I am drinking only water still. I am guessing that eventually I will get some type of pattern developed to get the supplements and water in. I hope to have the occasional adult beverage again someday.
You know what is the coolest? Only a couple of people who work at my office knew me from "before" and it had been several years since they had seen me. My new co-workers have no idea that I was ever fat. I have lovely new stylish clothes in misses sizes. It is a heady experience.
Tomorrow is my anniversary day of my surgery. It has been 7 months and a miraculous change. 108.4 pounds ago, I had duodenal switch weight loss surgery. My stomach was made smaller- to a 3oz size, but still fully functioning. The duodenum was separated after the stomach. The enzymes that break your food down are separated from the actual food I eat until 95 cm from the large intestine. The results are that I eat less (capacity) and I absorb less of the food I eat. My capacity has increased a good deal since surgery and probably my absorption too. I have some foods that make me feel bad or do not agree with me, but I can choose pretty much any types of food to eat.
Recently, I learned that I can eat ice cream with caramel sauce and whipped topping with little to no ill effects. Not a fantastic discovery as it once may have been. I have been craving chocolate more and more. The effects of the malabsorption are diverse. I have much more interesting bowel movements and habits. I also have some vitamin deficiencies. I am low on stored iron and apparently cannot process Vitamins A and D very well.
People who do not know that I have had surgery to help produce the weightloss want to know how much healthier I am now. I tell them that I have more medical issues now as a thinner person which is true. It is not the expected answer.
Are all my problems solved by my decidedly thinner frame? No way. It has created quite a few problems. The first is financial. Replacing ones entire wardrobe including shoes and undergarments is costly. The needed supplements along with better protein sources are is expensive. My new body has given me the self confidence to work outside my home for the first time in several years. Hopefully, that decision will result in increased funds. The excess skin is a weird compliment to the weight loss as well.
Some of you are finding me for the first time. You have to go in the archives to March, 2005 to find the true beginning of this journey. Here is the first surgery post.
Would I do it again- knowing what I know now? Resoundingly yes! I have been very complication free with a built in support contingent (my dh). I was able to recuperate without worrying about going back to work. My phenomenal weightloss shows that. Each person has to make the decision on their own. Here are changes you have to live with:
1. You will never be able to go on Survivor. Let's face it, that diet would most likely result in our deaths.
2. You will be eating a lot of protein for the rest of your life. If you are vegan, this is not for you.
3. You will have to give up some foods/beverages that are your constant companions for a long time and for health reasons maybe forever. This was not a deal breaker for me, but I was worried about it. If you cannot do with out Diet Coke, coffee, alcohol, little debbie snack cakes, or insert your craving here for a period of time, this is not for you. I will say though that some things you loved will not taste good or be wanted in the early months (makes it easier).
4. You will finally have to put yourself first. Many of us got this way by putting ourselves last forever. You have to take care of yourself.
5. You will need some type of exercise to achieve maximum weight loss.
6. You may never get the fat person out of your head.
7. People will treat you better as a thin person and it may piss you off.
8. Supplements will have to be taken for the REST of your LIFE.
9. It is a miracle, but it ain't easy.
My last comment is a shout out to my girl Ezpy who has reached Wonderland at 199 pounds! She was the initial contact/inspiration for my surgery. Her picture array says it all. Go congratulate her for the truly amazing progress she has made these last 11 months!! Look at that smile. It is hard to stop.
7 months have passed
Here is the comparison pics taken a little late. They can be accessed in the photo albums at right. I am so different looking in the pictures, but I did not think that I looked like my before picture when I looked in the mirror. I guess I still have a distorted view of myself. I think I look thinner than the pictures look. How's that for humble?
It is very strange to work where no one really realizes I was fat before. They just think I am on a diet all the time. People treat you differently no doubt about it.
Time to start working on the remaining pounds to lose. I lost 11 pounds last month, but the changes at work have made the weight loss slow. I have significant hanging skin. I give myself a standing ovation with the clapping of my flapping belly to my thighs. I am self-conscious about the skin- enough so that I do not particularly want to run outside in front of people. I think plastics are in my distant future.
I went to see my friend, JoAnn, last night at the hospital. She had ds surgery yesterday. She looks great. I helped her visualize what her next 2 years of loss would look like. She would like to f