Revision from LGB to RNY - I begin again!

Dec 07, 2021

So, here I am again.  14 years after my first bariatric surgery, 40 years since my mom put me on my first diet as a teenager.

 

I realized 2 years ago (pre-pandemic) that I wasn't able to make progress and maintain without more help.  I had exhausted every option I could try using my lap band and different eating plans, fitness plans, etc.

- fitness challenges and personal trainer workouts

- post-op diet (basically low-cal, low-carb)

- tracking on this app

- keto

- paleo

- moderate cardio and resistance training

- "bio-hacking" with a coach -  keto with moderate cardio and resistance training, an asthma med and a steroid (which I had to buy using shady payment processes and receive by mail).  I wound up with mild palpatations during cardio and very little improvements to show for it. I love the trainer and consider him a dear friend, but the approach wasn't for me.

- medical weight loss - contrave and phentermine with low cal/carb diet and vitamin injections. I lost weight quickly (similar to immediate post-op), but had severe memory loss, anxiety and turned into a stressed-out idiot. My mental state cost me a contract job I was working. I was a cloudy-headed freak!

- noom - cheesy silliness and no new knowledge or health improvement to show for the money  

Every time, I burned out, and my setpoint came back with a vengeance and I turned into an unholy bitch/unruly mental teenager. 

Meanwhile, perimenopause kicked in and made me even crazier, and now my metabolism has slowed down even further than all the dieting had triggered already. 

Eventually I just threw in the towel and realized I needed a serious break from the madness.  I spent a few years having whatever I want and just gave myself a break from worrying about it. It just wasn't worth the stress and unhappiness.

While it was really good for me mentally to have a break from worrying about everything and driving myself constantly, I regained all that I had lost, plus about 20 lbs.  I'm now at my heighest weight, but I'm mentally in a MUCH better place.

I got a referral and scheduled an appointment with a Bariatrician. He reassured me that I'm far from alone with my experience.  By choosing a gastric band instead of a malabsorptive surgery option, I had not chosen a powerful enough tool (as he said, I was "using a ball peen hammer but needed a sledgehammer").  I needed that extra edge of malabsorption to help me with maintenance. 

In the 14 years since my surgery, weight loss science has progressed, and bariatricians have almost entirely stopped using gastric banding. It also turns out that up to 50% of patients with bands wind up having a revision to remove the band entirely or replace it with another technique, either because the device had physically failed, they had complications, or they couldn't lose the weight.

That's FIFTY, yes FIFTY percent! I also found out that it usually happens before 10 years, and I was at 14 years. It was a real relief to hear I wasn't alone in this.

So, I started my journey of preapprovals for surgery, following the same steps first timers have to take.  Aetna has the most complicated requirements of all insurers, so it would take a minimum of 10 months to get through it all. i started scheduling my appointments.

I went to orientation and started monthly appointments with a medical weight loss doctor who had me try Ozempic.  Weekly injections into my belly that caused gas, stomach cramps and left me generally crappy feeling, with no impact to my weight or appetite.  I stopped taking it. 

.... and then Covid happened. 

The offices closed indefinitely, so  appointments paused. Turned out they had reopened but nobody notified me (another several months' delay) until I  contacted them to see what's up and they sounded surprised I didn't know. Whoops on their part...

I ramped back up, got the remaining appointments out of the way via zoom, and FINALLY got to submit my insurance preapproval, and it came back in 2 weeks! Imagine that! I started talking with the coordinator about scheduling my surgery in the new year (post-holidays, refreshed FSA, etc).

... and then my employer announced we were switching insurance providers Jan 1 to UHG. $%^&**!!!!

I immediately started plan research and contacted their help line to find out if I even had coverage (turned out ONE of the 3 offered does cover it).

That said, after all the hoops Aetna had me jump, I thought it made the most sense to go forward with surgery before the end of the year, especially since I was already approved.  I got everything scheduled for surgery Dec 21. 

There's a 50% chance I'll need a second surgery for the RNY, depending on scar tissue or any complications he finds. If that happens, I'll use the new insurance and the approval steps I already took should cover the requirements for submission.  Let's just hope it's a once and done surgery this time!

SO, now I'm 2 weeks out from surgery. I had one last wild meal last night with Sacha (which wasn't THAT wild, in hindsight) and started my pre-op diet this morning (basically low-carb, under 1000 cal/day) so I can shrink my liver.  I  have my pre-op physical Friday, covid test 2 days before a liquid fast the day before, and then I head to the hospital.

I begin today, and hope for the best, trusting that the changes will happen for me again, and that my confidence in the process will come with it.  I'll have a different tool, one that shows much more promise for success, and will learn what life will be like with it (my food tolerances and reactions will change with it).I'll go in a little wiser than last time too.

I'll take Dory's advice and "just keep swimming..."  Wish me luck!

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