Tips on air travel if you're MO or SMO - pre- or post-op

Apr 01, 2008

Flying home after surgery is ROUGH.  I did it at 8 days out, but mine was only from SF to LA.  Over the few years pre-op, flying became more and more difficult for me, not just because of my size, but also because of arthritis in my knees and feet, that made it painful for me to walk more than short distances.  But I learned a lot about how to make flying a bit more manageable when you're MO or SMO, and I want to pass that on. 
First, the dreaded seat belt extender, which many of us find so embarrassing, even shameful.  I'd required one for years before surgery, and I discovered that, to the flight attendants, it's no big deal.  (Makes sense since the percentage of adults who are obese, MO and SMO  has been increasing.)  I've never gotten a rude or critical response from them.  TIP:  Try to board early, and ask a flight attendant for the extender very soon after you board - it makes it easier for her/him to take care of it before all the aisles are crammed with passengers.  
Second, plan ahead to get your best shot at comfort/not getting squashed.  When you're planning your trip, check the seating plans for the flights you're considering, and try to go with the one that has the most open seats.  You can also choose your own seat on line, and change it as often as you want.  I would check the seating on my flight every couple of days, and switch if there was a less crowded spot available.  TIP:  If you're traveling alone, your odds of having an empty seat next to you are best if you choose an aisle seat in the middle section (where there are 3 seats), towards the back of the plane.  ADVANCED TIP:  I used to think it was best to choose a row where both of the other seats were empty.  Then a savvy reservations person clued me in that I might end up with a couple taking those 2 seats.  So the best option is a row where the other aisle seat is also taken, leaving only the one in the middle, which never gets taken unless the plane is near-full. 
Third, when you fly, DEFINITELY get wheelchair assistance (especially on the way home), even if you never use one in your day-to-day life.  Not only will it save you the long walk to and from the gate, but the attendants will help you with LOTS of other things.  They will wait while you use the restroom or the ATM, go into a shop to pick up a bottle of water for you, stay with you at baggage claim, pull your bags off the carousel for you, and get you and your bags out to the taxi or pick-up zone.  Have lots of small bills with you and tip generously for good assistance.  (Try to check your bags curbside and tip well there - a skycap can often get you into a wheelchair much faster than you could get one otherwise.)
Fourth, when you are in a wheelchair, you skip the line at security because they screen you separately.  The screeners I dealt with over the years were mostly very considerate - they helped me get my shoes on and off, made sure I didn't have to stand for more than a few minutes, etc.  
Fifth, before you pack, check the TSA website for the most up-to-date guidelines on what you can/can't carry on the plane and put in your checked luggage.  The rules change frequently depending on the current security concerns. http://www.tsa.gov/travelers/index.shtm 
They also have a section for travelers with disabilities:
http://www.tsa.gov/travelers/airtravel/specialneeds/index.sh tm
And don't hesitate to ask for help wherever you need it, from whoever is around.  I found that a lot of people would help me with things if I asked, and mentioned that I'd just had surgery.  Part of what was hard for me, psychologically, was feeling so weak and vulnerable right after surgery, and embarrassed that I had to ask for help.  And I think our obesity only adds to that.  (I felt compelled to explain to every wheelchair attendant that I had weight loss surgery, like I had to apologize for being obese, and show that I was doing something about it.)  
And, finally, I've NEVER been asked to buy a second seat, even at 336 lbs. and a BMI=56, when I could barely squoosh myself into the seat, and my size/thighs clearly intruded on any poor person sitting next to me.  Not saying it doesn't happen, but my impression is that it's not as common as we fear. 
For all of you flying off to get switched, I hope this helps!

Thinking of WLS? People telling you to just go to the gym?

Feb 03, 2008

So many of us have been through this.  After years of fighting obesity, we finally decide to have WLS, and people around us tell us that we don't need it.  We just need to go to the gym more, or eat more fruits and veggies, or do Atkins and don't eat fruits and veggies.
They are all WRONG!  Dieting is a $60 billion a year industry that makes book authors rich by pushing the myth that obesity can be effectively treated by diet and exercise.  IMHO, it's the 2nd most fraudulent industry in this country.  The only reason it's not 1st is because you just can't beat the tobacco folks when it comes to lying!
Sky rocketing rates of obesity are the result of a body type that has been highly adaptive for most of human existence colliding with societal developments that now make that same physiology work against us.
Think about it:
What are our bodies really good at?  
1)  Converting food calories into fat.
2)  Lowering our metabolism in response to decreased caloric intake.  And
3)  Getting fat back into the fat cells when food becomes available again.
Regardless of whether you believe in creationism or evolution, all of these things were a huge survival advantage for 99% of human existence, when food supplies were erratic and periods of famine were common.  Our bodies are extremely well-designed to deal with that environment.  But now, the environment has changed so that food is always available, and the physical activity required in our day-to-day lives is greatly reduced.  Admittedly, the trend toward relying on fast/processed foods adds into this as well.  Our bodies are not well-designed for this environment.  And so, obesity rates go up and up.
Scientists are finally beginning to understand the complex system of "gut hormones" and neural pathways that govern  eating, food intake, and weight.  These systems are so complex, they now conclude that there is basically a "second brain" in the gut.
Does this mean we have no responsibility for the choices we make?  OF COURSE NOT!  It does help us understand why every treatment for obesity, except WLS, has been a complete and utter failure!  And why most obese can't lose weight through diet/exercise alone.  And why, of those of us who can lose the weight, at least 95% gain it all back (and often more) within a few years.
And most important of all, it explains why the people who tell us we don't need WLS, and we just need to go to the gym more,  are full of s**t!  Especially if they have an M.D. after their names.  (There should be a special place in hell for them!)  How would they feel if they had a life-threatening illness, and a doctor told them they should go with a treatment that has a 95% (or higher) failure rate instead of a treatment that has an 80% success rate?  If you find yourself in the unfortunate position of having one of these jerks as your doc, why don't you ask him/her that question?  Then head out the door and find yourself a new one!
IT'S YOUR BODY.  IT'S YOUR LIFE.  NO ONE ELSE GETS A VOTE.

I'm in One-derland! (aka 9-month update)

Dec 23, 2007

What a wild and wonderful ride this is!  I'm 9 months out, down 133 lbs. since surgery, and solidly in One-derland!
I can hardly believe it - I've been keeping track of my weightloss total all along, but suddenly I'm looking at it, and the changes in me, and I'm kind of in shock (a happy shock though).  I had never expected it would happen this fast, or go so well.   My goal is within sight!
When I went into surgery, I put down 175 as my goal because well, I couldn't do a ticker without a number.  But really, I didn't have a number in mind back then.  My true goal, my only goal, was to reach a point where I had enough energy to get through the day, my knees and feet weren't screaming in pain all the time, and I could keep the weight off without having to deprive myself.  If that point had been at 220 lbs., that would have been OK with me - anything below that would be a bonus.  I revised my goal to 170 a while back, and now I feel like I might even get down below that!  
My doctors are amazed, not only at the weight loss, but also by my overall health and well-being.  None of them had ever had a DSer before me, but they are all converts now!  My GERD (which had been a problem at weights even lower than where I am now) is gone!  Haven't been retested for sleep apnea, but I no longer feel like crap the next day when I fall asleep without my C-PAP.  My BP, though never worse than borderline high, is now low-normal.  My feet no longer scream in pain.  (My right knee is a different story, as some of you know.)  
The list of things I'm grateful for could go on for miles.  I can tie my sneakers without getting winded, and get in and out of the car without feeling exhausted.  When I go out in the world, I feel like a normal person again!  Even though my BMI still has me "obese", I no longer worry that the first (and maybe only thing) people notice about me is how fat I am.  My latest fav is realizing that I now approach armchairs without even thinking whether I will fit in them.  
I'm so thankful for the wonderful and supportive community I've become a part of here.  And most of all, I'm grateful to the people whose posts led me to the DS board, and saved me from the RNY I'd never wanted.  (I wish I could remember just who it was.)  If it wasn't for your courage and persistence in "invading" other boards, I wouldn't be where I am today, which is a totally ecstatic DSer!
                                    
I have some new pics on my profile, and you can see my "transformation" at:
http://s225.photobucket.com/albums/dd190/StefanieLA/My%20DS% 20Weight%20Loss%20Journey/?action=view¤t=70fce859.pbw? nocache=955
HW 336/ SW 326/ CW 193/ GW 170

Diana's wise words for pre-ops

Dec 18, 2007

Those of us who are happily living our post-op lives - loving our DSs - sometimes forget how important it is for pre-ops to realize there are real risks associated with this surgery, and real problems you may have to deal with post-op.  I was incredibly fortunate to have zero complications and a very easy recovery.  BUT there was no way to know that ahead of time, and I went into surgery with my eyes wide open about the possibility that there could be problems, whether big ones (like leaks) that keep you in the hospital, or little ones (like frequent nausea or diarrhea) that just make your first few weeks more miserable.
And every pre-op needs to have that same awareness.
So I'm happy to reprint something that the very wise Diana Cox posted tonight, as a good reminder to us all:

Reality check for Newbies

There have been people who have had severe and life-threatening complications.  People have died.  People have had issues with eating and food that have lasted beyond the expected few weeks.  People have become malnourished.  People have had problems with gas and loose stools and incontinence that have made them homebound.  People have not lost nearly enough weight and/or regained.  People have lost weight and become severely depressed and have even commited suicide when their lives didn't improve the way they thought they should have.

There, we've put it on the table.  The DS isn't a panacea for all that ails you.

Having said that, the above issues are rare and/or mostly easily manageable:

* All surgeries, especially those on MOs and SMOs, have a non-trivial rate of complications and dying.  You can minimize that by (1) going to the BEST DS-experienced surgeon you can find, with no fewer than 100 DSs under his/her belt; (2) performed in a facility that is beyond reproach; and (3) get yourself in condition for surgery as best as you can: quit smoking, start walking, start taking vitamins; use an inspiration spirometer or blow up balloons pre-op; get your ass out of bed ASAP after surgery and WALK; don't worry about protein the first month or two, but DO worry about fluids.  And taking your supplements, and following up with your surgeon and doing all your blood work REGULARLY. 

* The surgery has a long term weight loss statistic of 75% of excess weight lost.  That isn't 100%.  It is a bell curve that means that there are 50% who do better and 50% who do worse.  Be prepared to deal with that statistic.  By the way, it ALSO has a long term weight loss statistic of 94% "success rate," by which is meant, that 94% of all patients kept off at least 50% of EWL.  Yes, the measure of success is only 50% EWL.  But that statistic in particular beats the hell out of the long term RNY statistics.

* If you are in danger of losing too much weight, there are strategies for coping and adapting short of revision surgery.  Eat more is an enjoyable one.  Take fistfuls of pancreatic enzymes with each of several meals a day is less appealing, but should only be necessary for a few months until your body adapts.  Only about 3% of patients need revisions to their DS, usually to lengthen the common channel when these methods fail, which is a relatively easy lap surgery.

* Stinky gas and loose poops usually can be treated.  For some of us, that's as easy as taking probiotics and TiVo'ing our white flour or other carb food choices to more convenient times (i.e., only eat them at dinner or on the weekends so you can fart to your heart's content in the privacy of your home).  For others, it can be more of a struggle, but still manageable -- taking Flagyl prophylactically, avoiding trigger foods, using medications to ameliorate smell or absorb bile acids.  It is quite rare that this is an intractible problem, and even then, revision is an option.  More commonly, people who have the DS and then lose touch with their support community and surgeon support think nothing can be done and give up trying -- THAT is almost always wrong.  There are LOTS of strategies that can be tried and usually one or more will help.

* Some people can sabotage even the DS and not lose enough.  The DS is not a free ride in particular for sugar and alcohol.  There are one or two surgeons who have or have had a reputation for having way more than the average number of patients who fail to lose enough -- my understanding is that asking whether your surgeon uses the Hess method of measuring the intestines is critical to reducing the likelihood of this problem.

* If you are depressed before surgery, you will likely be depressed afterwards.  Get treatment.  Psychological treatment is a good adjunct to a post-surgery program, especially if you suffered from mood disorders, addictions, sexual abuse, eating disorders, a marriage that was sucky before surgery, etc.  Weight loss isn't going to cure the problems in your life, and in fact may bring even more of them to the surface if you buried them in food and fat.

If you want to avoid regrets, learn everything you can, with an open mind, before you chose a surgery and before you commit to a surgical program.  This includes reading here, on your surgeon's chat site, and at:
http://health.groups.yahoo.com/group/DS_PostOp_Problems/
http://health.groups.yahoo.com/group/duodenalswitch/
http://www.duodenalswitch.com/forum/forumdisplay.php?f=25

But for me, the almost effortless weight loss, ease of maintenance of that loss, quality of life, my ability to feel SATIATED for the first time, ablity to eat pretty much what I want, including fat and protein to my heart's content, is beyond worth the risk I took to have this surgery in the first place, and is all the impetus I need to do the modest amount of work that it takes to stay healthy (eat protein, take my supplements, go to the doctor once a year or when I need it).  It is my gift to myself.

Good luck, and work hard at preparing and informing yourself fully.

Thanks to Diana for writing this, and allowing me to post it here.

The Question was - Did you have WLS for health or a rockin' bod

Jun 30, 2007

Health - hands down.  Or, really, life. 
At 56, and 150 lbs. overweight, my body was crumbling - horrible pain in my knees and feet.  I was terrified I would just keep gaining, and I could see that in a few years, I would need a "Hoveround" or one of those Scooter Store chairs just to get around.  
I was also really debilitated by the lack of energy - I'm single, with a mortgage to pay, and it was getting more and more difficult to keep working.  It took all the energy I could muster to drag myself from one end of the day to the other.  Forget about doing anything for fun.  Even going out to eat with friends seemed like too much of an effort.  And the movies?  I stopped going, because I could no longer fit in the seats.
Longevity runs in my family.  My mom is 89, and her mother lived to be 99!  I was very lucky that I hadn't developed diabetes, or hypertension, or heart disease - yet.  I could see that I might have a lot of years in front of me, but I couldn't see a life.
Don't get me wrong - I enjoy all the compliments, and I love being able to wear clothes that I haven't fit into in a few years.  But if the price of the DS had included walking around in a burlap sack for the rest of my life, I still would have said "Yes"!  Provided the sack would cover up my thighs and my batwings!
As for the rockin' bod, I'd have to win the lottery to afford that much plastic surgery!

Coping with Pills Post-op

Jun 30, 2007

Pills were the worst thing for me the first few weeks - the one thing most likely to make me gag and feel like I was going to vomit.
If you're taking vitamins, calcium, etc, they should be in chewable or liquid form at this point.  Don't try to swallow ANY large pills whole.
As for prescription meds, I cut mine into very small pieces, and spread them out throughout the day - a couple of pieces here, a couple an hour later, and so on.  You can also crush them, if they don't taste too nasty, and mix them into a little apple sauce. 
CAUTION - If you have timed-release meds, or anything that says "don't break or crush" on it, CHECK with you pharmacist FIRST!  You can find pill-splitters and crushers at any drug store.
Other options are to ask your doctor if you can get the same dose in smaller pills, or seeing if there's a "compounding pharmacy" near you - they can convert your meds into liquid preparations.
Be patient - it will get easier.  Right now you have totally remodeled insides, and a body that's recovering from the trauma of surgery.  It takes some time to learn what your new tummy will handle and what it won't.  Just take it slow, and you'll be fine!


My Blog that Isn't [really a Blog]

Jun 30, 2007

I've never been much for keeping a diary/journal of ANY kind, even when I was in high school, and all my friends would pour their hearts out in writing.  (In those ancient times, the 1960's, we had diaries - usually pink, with a flower or a cute teenaged girl on the cover.  No one "journaled" in those days!)
Instead, I'm going to start using this space to post things that come up a lot on the board.  I love being active on the board, but at 3 months out, life is taking up more and more of my time, leaving less time to post.  As I respond to questions that come up over and over, I'll post my answers here, as well.
I'm hoping that will leave me more time to respond to other posts.

About Me
Los Angeles, CA
Location
54.1
BMI
DS
Surgery
03/20/2007
Surgery Date
Jul 29, 2006
Member Since

Friends 81

Latest Blog 7
Tips on air travel if you're MO or SMO - pre- or post-op
Thinking of WLS? People telling you to just go to the gym?
I'm in One-derland! (aka 9-month update)
Diana's wise words for pre-ops
The Question was - Did you have WLS for health or a rockin' bod
Coping with Pills Post-op
My Blog that Isn't [really a Blog]

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