Tag Archives: bariatric surgery

My Tummy is Officially Tiny Now

17 Sunday Jun 2018

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For those of you just joining: I am a 55-year-old ciswoman of mixed racial heritage who started this journey with a BMI of 49, cardiac artery disease, type 2 diabetes, high blood pressure, and high cholesterol. My knee muscles never bounced back all the way after their replacement surgery a couple of years ago–although the titanium parts work fine, at 285 lbs they had too much to haul around. So my mobility has been limited for the last two years and I need a cane on stairs. I had a minor heart attack two years ago, and when they went to place a stent, my right coronary artery was 95% occluded–as the OR nurse said, I was one cheeseburger away from The Big One.

Being fat runs in my family, and although I whimpered in the back of my throat when I hit size 26, I actually have a healthy ego and have been a fat activist. I still support anybody’s body, although if you’re as unhealthy as I was, I suggest you . . . think things over. I will never proselytize, and there are other modalities of getting your body healthier besides the one I chose.

But then came the day my very nice, non-fat-bashy cardiologist turned to me and asked, “Have you ever considered bariatric surgery?”

Tl, dr: I’m not a skinnyism fascist, and I didn’t do this to become gorgeous, because I started that way. My kids need me, and I can’t afford to die yet.

The Surgery: After looking at the options for bariatric surgery, I chose the sleeve over the bypass for two reasons: The “connect piece A to piece Q” part of the bypass creeped me out and . . . damn it, I wanted to be able to cheat a little without an unpleasant physical reaction to simple carbs called dumping syndrome. (I was gambling, because some people dump with the sleeve anyway.)

I ended up losing 25 pounds to slim down my fatty liver, which was in the way, and every so often I would think, “Well, you’re losing weight . . .” (And then I reminded myself that we’d been to that rodeo before and it had all come back, as it does for 95% of the dieting population. True, there’s only a 56% success rate at five years with the surgery, but I know how to succeed and have been given the tools.)

For the last two weeks I was a ball of nerves, but despite an administrative glitch that postponed me a week, I showed up at Boston Medical Center last Wednesday, and the deed was done. Every single staff member (except maybe one nurse who was a tad brisk) was a complete honey and I am proud they are my co-workers.

It was rough. Probably because my surgeon had just reshaped my normal footballish tum into a small banana holding maybe 5 or 6 ounces max, I had horrible post-op nausea and retching, and the anesthesia took a long time to shake. (I’ve been induced with propofol a lot, and it never did this before.) Thus, Wednesday night flashed me back to hyperemesis with my daughter (18 weeks of non-stop “morning” sickness with 7 hospitalizations) because I haven’t had an experience like that in 30 years.

Pain, on the other hand, has been almost non-existent. I’m just on tylenol. Liquid tylenol, which isn’t as yummy as Robitussin but a lot better than the liquid bactrim I’m on as prophylaxis against my kidney stone, which of course picked this week to give me a UTI. What I am mostly is exhausted. I feel like I’ve walked through fire.

Probably the worst part is that all my meds have to be powdered. Imitrex? Kinda nasty. Metoprolol? REALLY nasty. Ranitidine? Worst of all. I know there are those of you out there who chew all your pills, and I think you’re freaks. Brave, wonderful freaks. How the hell do you do this?

I will be on a liquid diet for the next 2–3 weeks, and then graduate to very soft food. Most of my hunger-making hormones were secreted by the part of the stomach they excised, so I will have no appetite for the next half year. Right now, that’s just ducky.  It’s all I can do to stay hydrated right now–that’s the first goal; the second is high protein intake to reduce muscle wasting.

I’ve already lost 5 pounds from my pre-surgery weight. But the big news is that my diabetes has somehow gone into remission: No more insulin (I was on a high dose, too) and not even oral meds, thank all the gods, because those pills are huge and I’m sure taste awful.

So far, no regrets, other than some purely post-surgical self-pity. We’ll see how this goes. I’ll keep you posted.

 

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That Bariatric Thang

20 Sunday May 2018

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My cat knows it’s Sunday, and that hence our household runs an hour early. I am trying to let my son (the cat valet) sleep in for fifteen minutes. So Zoe is biting my legs–with great affection, I hasten to add. Unbidden, I get this flash of a post-surgical nibble. Maybe the fat helps insulate the nerves, and now it will hurt more. Maybe it would startle me into acting out on Zoe. And then maybe–

(You’ll have to excuse me. I think the most horrible things. Not just sometimes, but consistently. I suspect that this is part of why we writers are often a dour race.)

After attending group info sessions (three), visiting the dietitian (a couple of times), a shrink-person (who then needed documentation), a nutrition doctor (who put me on vitamins), my cardiologist (something of a character) and consuming hundreds of protein shakes, I was given my surgery date for my gastric sleeve this week. It is now less than three weeks away. Yipe!

I only lost ten of the sixteenish pounds I had to lose pre-surgery, so in a few days I start the no-kidding diet, which I’ll be on for the two weeks before the operation: shakes for both breakfast and lunch, and *gulp* a LeanCuisine dinner. “Couldn’t I just have another shake?” I asked the PA.

Nope, and “you’ll be hungry,” he warned. However, two weeks of this should take about eight pounds off. This is so all the instrumentation can fit around my corpulent little liver–thank mercy it’s laparoscopic “bandaid” surgery. (Yes! You too can have your stomach essentially removed through a two-inch incision!)

I don’t mind admitting that I’m freaking out. There are like all these voices in my head screaming, “What are you DOING???? Aieeee!!!” But then there are things like the looks of relief and satisfaction on the faces of all my medical personnel: When I started this project, I had a BMI of about 50; the ten pounds hasn’t done much to that. I also have “the trifecta” of diabetes, high blood pressure, and cardiac artery disease.

Plus high cholesterol, sleep apnea, and needing help to get things off the floor, not to mention not being able to easily take care of my feet–my tummy is in my way. So losing a bunch of this is only a good thing. But it’s still scary. I’m also afraid of the loose skin making me look like a shar-pei. We will have to see.

 

The Adventure Continues

02 Saturday Dec 2017

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Sorry to have been AWOL for so long, but between Inktober (which I didn’t do very well on) and NaNoWriMo (squeaked by), my creative energies have been sucked dry. In fact, in the interest of full disclosure, I’m making this post because all I need to do is tell what happened, not pull it Athena-like out of my forehead.

Last post: I finally decided to go for bariatric surgery, and joined the program at Beth Israel, where I had my knees replaced last year. I ended with being about to join the new patient group.

Well, no, bunkies. That didn’t happen.

Instead, I got a call a couple of days beforehand from a social worker who wanted me to come in to talk about my *chord of ominous music* Mental Health. So I get there, and am told that my diagnosis of Dissociative Identity Disorder scared the bejeebers out of their staff. My favorite line from this interview was the lady saying, “As it is, we have patients say they feel like an entirely different person afterwards.” (This sort of thing has nothing whatsoever to do with the alters experienced in DID.) In vain did I try to educate her, both about DID in general (spectrum disorder; not often as dramatic as Sybil) and my case in particular (well-controlled thanks to excellent therapy; don’t dissociate anymore). She managed somehow to combine “Sympathetic and on your side” with “Boy howdy, ain’t you the freak!” She claimed they’d never had a DID patient. (Well, if you don’t let them into your program . . .)

They kicked me out of the program. She told me (with the tiniest sneer) that there were over 30 programs in the city. I said, “Yeah, but my insurance sent me here.” She gave a cryptic little smile and suggested I call them back. Sheep you, honey.

Happily, said insurance covered the programs at the other huge local hospitals, so I steeled myself for a round of phone calls. I started out with Boston Medical Center, because I happen to work for them. I am a Certified Peer Specialist, which means I’m professionally qualified to deal with my fellow mentally ill and to be a Shining Example of Recovery. In other words, they hired me because I’m crazy, so I figured they’d have their nerve turning me down for the same reason, right?

I call and get the coordinator. I gave her the two sentence version of the BI story and said, “So BI thinks I’m too crazy to cut. What about you guys?” In an impassive voice, she replied, “We take everybody. Come on in and talk to the surgeon.”

Well now! I watch what by now is the third informational video, and pick the surgeon who seems most sympatico. I went in and talked to this very nice man, who has operated on people who were unrecovered schizophrenics. (Even really crazy people deserve medical care, folks.) The worst news I got from him is that my GERD means he sorta leans toward the RNY gastric bypass instead of the gastric sleeve, which is the procedure I want.

He had heard my story about Beth Israel and their weirdly creepy head surgeon before.

So why did this happen? Because what BI’s bariatric program is doing is called cherry-picking their data. This means that by refusing to treat people they fear may have less than picture-perfect outcomes, their end data looks amazing. They claim they’re the best program in the area, when all they are is a pack of hyenas who share the same level of accreditation with hospitals which actually (be still my overweight heart) heal the sick.

 

 

A New Adventure Begins

22 Friday Sep 2017

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Discerning readers will vaguely recall that I had my first heart attack the day before last New Year’s Eve. This surprised absolutely nobody, as my BMI is pushing 50 the way those guys on the Tokyo subways cram in the commuters. It wasn’t a BIG heart attack, feeling more like recalcitrant indigestion, but when they got inside with the widdy-bitty camera, my right coronary artery was 95% blocked. A little bit of titanium fixed that mo-fo, but in the recovery room, a nurse shared that they called situations like mine “One cheeseburger away.” (Hear that, Elizabeth? I’m comin’ to join ya, honey!)

Since then I have been on three new meds and had the dosage cranked on the Lipitor. And I’ve felt fine, except for a rather Victorian over-attention to my heart. I went in to see the cardiologist for the six-ish month check-in this Monday expecting only to possibly be released from a pill or two.

Instead, he scolded me for letting the baby aspirin lapse, and told me I was taking it for the rest of my life. And while he was on the topic of “the rest of my life,” he in so many words intimated that it would be a short story unless . . .

“Have you ever thought of bariatric surgery?”

Now, every fat person in the Western world has at least thought about it, so I parried by sharing my PCP’s aversion to the practice. (Malabsorption issues.) The cardiologist pooh-poohed this; said they had that under control, and went down the list: Diabetes, high blood pressure, high cholesterol, and the ever-looming sin of having a heart-attack at only 54.

Now, I am something of a fat activist. People were saying stupid stuff to me about my weight back when I was only 170, which is a hundred pounds or so ago. *I* was saying stupid stuff to myself back when I was in high school, at 129. I got tired of it after I had the kids and found that the baby weight had come to stay. So I left myself alone about it–started buying jeans that actually fit instead of jamming myself into a number that I thought was more reasonable than reality. I started being nicer to myself, which was groovy, seeing as sporadic attempts to Do Something about it kept putting another several pounds on, topped with the five I picked up from being sidelined by the double knee replacement last year.

I now weigh 274; been told I carry it well, but apparently my coronary artery wasn’t listening to the compliments.

The cardiologist, a former Marine, doesn’t do bullshit, but he doesn’t do fat-bashing, either. He was just laying out the facts, and this week I heard him. (It didn’t hurt that the podiatrist told me last week that my clumsy attempt to continue cutting my own toenails wasn’t gonna fly and I had to leave it to the professionals, ’cause I can’t really reach them anymore.)

I got referred to Local Hospital, which my insurance told me was out of network, and then went to (sigh) Beth Israel, where I had my knees done, so at least I know them there.

I discovered that the road to bariatric weight loss is long and dotted with hurdles: Mandatory info sessions. Psychologists. Social workers. And of course nutritionists and exercise physiologists and about a billion nurses. I need to have tried (failed) at least two formal attempts to lose weight. This is a bit of a sticking point for me, as I’ve never done Weight Watchers or fen-phen or any other fad, because I already knew what the surgery people posted in their PowerPoint: Only 5% of the people who do them succeed. At least I had a little time with a personal trainer. Sigh.

I don’t know how this story ends, but that’s the sitch whenever I begin a new book, so I guess we’ll have to wait and see. A big part of me wants to hide under the covers and pretend it’s not happening, but I know I need to be really social about this and have support. (Besides, it’s a Rule of the Blogosphere.)

Next stop for Beth Israel: I join a “new patient group.” Next stop for me: I tell my PCP on Monday. Yeep.