CarolineAnnMartin

BMI 20.6
RNY on 05/02/03

Obesity & Me

Describe your behavioral and emotional battle with weight control before learning about bariatric surgery.

Shortly before moving out of my parent's house at the age of 18 1/2, I started gaining a lot of weight. In a short year, I went from 135 to 210 lbs. I continued to gain weight over the next several years going up to 330 lbs. In February 1997, I started Phen/Fen and never felt better about my relationship with food. I lost about 70 lbs without hardly trying and was being very physically active. But Phen/Fen was taken off the market in September 1997, and it was only a short time before I started gaining all the weight back plus some. In January 2000, at 357 lbs, I started an all liquid diet/fast through Health Management Resources. By September 2000, I'd lost a wonderful 125 lbs, but the depression accompanying the weight loss was awesome and many abuse memories from my childhood began surfacing. I started binging and was so scared to gain the weight back that I wound up suffering from a short stint of bulemia. In October 2000, I wound up in the hospital because of the depression, and was not allowed to continue the fasting program. Even though I felt very strong in my physical activity and as though I would never gain the weight back, I did. By the time another year passed, I'd gained ALL of the 125 lbs back minus a measely 2 lbs. In January 2002, I decided to try the fasting program again and even managed to lose 45 lbs in a fast 2 months, but my confidence in my ability to keep the weight off was seriously in question given my inability to maintain my 125 lb weight loss. Also, at this time, I was attending a group for women with eating disorders through Manhattan Beach Health Center called "Food and Feelings". This program emphasized intuitive eating - a great concept but it was hard to put into action when one's intuition is to eat everything. I finally gave up on dieting in September 2002, and quickly gained my weight back. I seemed settled around 340 until I suffered a bout of bronchitis in Dec 2002, and in January 2003 I was given prednisone (a steriod). It didn't help with the bronchitis but did further increase my appetite such that I was back up to 360 lbs in no time flat. I attribute my weight problem to compulsive overeating that most probably relates to an abusive childhood and a need to "stuff" and hide from my feelings. But obesity does run in my family and the Phen/Fen was like a light switch being turned on in my head allowing me a healthy relationship with food, so I really think that there is a genetic/brain chemistry factor as well.

What was (is) the worst thing about being overweight?

While there are MANY hardships associated with being morbidly obese, the worst one is not being able to do the things "normal" people my age do. My husband, whose always been very active, is always asking me if I want to go out for a hike, go to the gym to workout, etc. And my answer has always been no (except for when I was losing weight). But it's not that I don't want to be active - actually I am eager to get out and partake in life - but my body is not up to it. My weight severely limits what I can and can't do - from walking up a flight of stairs without gasping for breath, to going for a hike here in the CA foothills on a beautiful day.

If you have had weight loss surgery already, what things do you most enjoy doing now that you weren't able to do before?

Hmmmmm... So far it is being more active - swimming, walking, hiking, etc. I so look forward to more and more weight coming off so that I can become even more active. I can't wait for the day that I can go rollerblading, cross county skiing and snowshoeing, and horseback riding. And let's not forget my hubby and me biking on our tandem bike!

How did you first find out about bariatric surgery and what were your initial impressions of it?

I first heard of bariatric surgery when I was in the HMR fasting program the second time (a year ago). I was losing hope and fast that I'd ever get control over my eating and weight, and while I was doing very well losing weight (even though at a slow pace as I wasn't keeping to the fast as prescribed), the doctor supervising the fast labeled me a failure. At my last meeting with him, he told me that there was a surgeon with UCI (where I was going to for the HMR fasting program) who was now performing bariatric surgeries via laproscopic techniques. I expressed interest right then and there but was quickly told that it "wasn't for me" because of my problem with compulsive overeating.

Describe your experience with getting insurance approval for surgery. What advice, if any, do you have for other people in this stage?

My primary insurance is through my husband's work which is First Health. Although a PPO, any "weight loss treatment" is excluded from the policy. Fortunately, I also have Medicare as I am on Social Security Disability and my surgeon's office accepts Medicare payment as payment in full.

What was your first visit with your surgeon like? How can people get the most out of this meeting?

Well, my first and only visit before surgery with my surgeon was somewhat brief, and I didn't really get any questions answered that I didn't already know the answers to given I was very "read up on" about the surgery with the help of ObesityHelp.com and the center's support group meeting held weekly. I would recommend that anyone seeking this surgery attend a support group meeting for bariatric surgery patients while in the learning stages of the surgery.

What made you finally decide to have the surgery?

Once I started learning about the surgery, I knew that this was my last hope. Sure, I could try a diet again, but I had no reason to believe I could maintain any weight lost as I was never successful before despite losing a lot of weight many times. I would have liked to believe that a "cure" will be found sometime in the future (and I'm sure there will be one someday possibly in the next several years), but being age 34 and having already watched my entire adulthood being "lost" to my weight, I didn't want to prolong the new beginning for my life. The benefits outweighed the risk...

How did you decide which proceedure to have?

It is what was recommended by my surgeon. Although I do wonder if I'd have been better off with the Distal RNY. I wasn't interested in the lap band as even though there are less risks, the weight loss isn't a great.

What fears did you have about having complications or even dying from from the surgery, and what would you tell other people having the same fears now?

I was absolutely TERRIFIED of the pain I thought would accompany the surgery, and I was certain that if anyone would have complications, it would be me - afterall, there have been very few experiences in my life where there wasn't "some catch". Since coming out of the anesthesia, I've been "waiting for the other shoe to drop". For, it's been too easy with hardly any pain (just some mild soreness). But perhaps life isn't meant to be one struggle after another, and perhaps God is watching over me afterall.

How did your family and friends react to your decision? Would you have communicated anything differently if you could now? How supportive were they after your surgery?

My husband was 100% supportive. He has been witness to the problems I've faced as a result of my weight for the past 7 years including all the times I lost massive amounts of weight only to quickly regain it back. He's excited for me and for us, and it's wonderful thinking of all we will be able to do as a physically healthy, married couple. My friends, while supportive, have expressed concern as they were scared of what could go wrong with the surgery, but they've been there for me supporting my informed decision. My therapist who I've been speaking about the surgery since I started learning of it (in January 2002), has also been very supportive of my decision once we ensured it was an informed decision :)

How did your employer/supervisor react to your decision? What did you tell him/her? How long were you out of work?

Fortunately I am on Social Security Disability, so this wasn't an issue for me. In the past when I was working and fasting, while my coworkers were supportive of my weight loss, my supervisor was indifferent and even attempted to sabatoge me at times.

What was your stay in the hospital like? How long where you there? What things are most important to bring?

My stay was absolutely uneventful. I went in for surgery at 5:30 a.m. Friday morning (surgery was at 7:30 a.m.) and was discharged Monday at about 3 p.m. I was in ICU the first two days given I have asthma and there was concern I'd have breathing problems. I would recommend bringing a stuffed animal (preferably one large enough to put over your belly when you have to cough), chapstick (boy was my mouth and lips ever dry!), one's own pillow from home if one doesn't like the hospital's, baby wipes to wash off with as it's hard to shower, and a bottle to squirt water from as it is near impossible to wipe one's self. (this was the worst part of the hospital stay I think - talk about indignity....)

Did you have any complications from the surgery? If so, how did you deal with them?

Fortunately I had no complications. My drain was getting pretty sore about 6 days out, but I was able to go to the surgeon's center early and the drain was removed a couple of days early.

In the weeks after you got your surgery date, how did you feel? How did you cope with any anxiety you might have felt?

Well, I went into see my surgeon on 4/29/03, and got a date for only 2 1/2 days later, so there wasn't much time for me to panic. But I do remember being very scared - so much to the point that I considered canceling (or at least postponing) the surgery the morning of surgery...

Describe your first few weeks home from the hospital. What should people expect from this period?

I had some minor soreness where the drain was and was very tired and fatiqued. I remembered hearing so many people talking about how much energy they had and I couldn't figure out why I had none. I also had a very hard time sticking to the 4 weeks of shakes only given that they reminded me all too much of the diets that I'd been previously without success. Also, while most people report not being able to eat much and having no physical desire for food, I was just the opposite. I COULD eat if I wanted to (although not a tremendous amount - about 1/2 cup of food at a time) and I felt physically hungry most of the time. This did eventually subside.

How far did you travel to have your surgery? (If far, how did this affect your aftercare?)

I only had to travel about 25 miles from home and the drive is a quick 1/2 hour drive without traffic. But my friend who was staying with me (my hubby was out of town on work) is allergic to my kitties, so we rented a hotel room nearby the hospital.

What vitamins and/or dietary supplements have you taken since your surgery?

HMR 70 Plus for the first 4 weeks - shakes for food replacements I initially started with: Micro K (Potasium), Trinsicon (Iron, B12, & Intrinsic Factor), and Multi-vitamins (I was using Centrum Chewables). Beginning in early August '03, I started taking Bariatric Advantage's vitamins. I take the chewable multi-vitamin, chewable chocolate calcium citrate (with Vit D), sublingual B-12 (with magnesium), and iron citrate. I LOVE the Bariatric Advantage vitamins as taking my vitamins is no longer a chore. In fact, I look forward to taking them now as they are a "treat" LOL

What side effects (nausea, vomiting, sleep disturbace, dumping, hair loss etc.) were worse for you? For how long after surgery did they persist? How did you cope with them?

At 3 1/2 months post-op I think the vomiting and dumping have been the worst. I completely avoid sugars, refined carbohydrates, too large of portions or big bites, etc., and this seems to help so far.

What was the worst part about the entire bariatric surgery process?

So far, the worst has been dealing with plateaus (that started only 2 weeks post-op), and also the fact that my periods are now back to being as painful as they were when I was a teenager. Ow!

What aftercare support group/program do you have? How helpful/important is this?

I attend the Coastal Center for Obesity's weekly support group meeting (Mondays from 6 - 7:30pm at Western Medical Center in Santa Ana, CA). Everyone there is so supportive, and it really helps to get others' feedback to know that I am pretty much "on target" with my weight loss, eating, ability to tolerate certain foods, etc. For my day to day support, I am extremely active in several Yahoo!Groups including the GastricBypass-PostOp group found at http://groups.yahoo.com/group/gastricbypass-postop .

What is your scar like? Is this what you expected?

I have 5 of them and all but the one from the drain site are very tiny. And I'm finding that as I lose weight, they are shrinking even more. 4 of them are about 1/4 to 1/2 inch long, and the one from the drain site is about 2 inches long. Honestly, I am proud of them :)

Please describe any plateau experiences you have had since surgery.

Gosh... where do I start LOL Well, my first was for 2 1/2 weeks that started only 2 weeks after surgery. Then, every time I've gotten my period, my weight loss came to a halt immediately following the start of my period and lasting about 2 weeks. I seem to be losing weight in "chunks". Most weeks I lose only about 2 lbs a week. But then the week to week-and-a-half before my period starts, I may lose a lb a day. I am learning that I have to be patient and trust in the process - that the surgery (and my efforts) WILL be a success.

Do you notice people treating you any differently now?

Absolutely - no more gawking, people seem to approach me more, I am sometimes mistaken as pregnant instead of as just fat, etc. Most of all, I find that I, myself, am taking better care of me in all aspects of my life.

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Before & After
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