Why Choose Bariatric Surgery & Risk Analysis

Q. Forgive me if I'm confused...I have a few friends who got gastric bypass. One lost 80 lbs before the surgery, she was around my current weight when she got it. (I'm 255, she was around there somewhere.) The other lost 60 lbs before the surgery,she was probably in the 270's or so. Anyhow...I was 299 at my high weight and I feel SO much better at 255, I feel more hopeful, more like 'I can do this' now that I have a little success built up...I'm confused, why go to all the trouble, the possible complications (my two friends, the one had to go back in three times to fix problems the surgery caused, the other had to go back in twice)...the risk of regain WITH a stapled stomach which seems so much worse than regain without it, the side effects, malnourisment, possible addictions in the future... If you have done it, why not keep at it? This isn't a value judgement, it is I swear...total bewilderment. Or, maybe I'm a wimp and surgery is scary. lol.   

A.  I explained some of my personal reasons in my introduction. I can't tell you everyone's reasons, but I can give you some generalities. Some people, such as myself, can make short term succeses by ourselves. We can take off 10, 20, 30, etc. pounds - however, we don't have the capability for one reason or another (whatever this reason is, is a big factor into why we would qualify to receive the surgery) to take off the full amount of our excess weight or can't keep the weight off ourselves.

Many people lose some of the weight before the surgery like your friends did because - well - sometimes if you DON'T lose weight before it (and prove that you will really try to AFTER it) the surgeon will refuse to perform the surgery on you. To someone who thinks the surgery is their last chance, they'll do pretty much anything not to screw it up. 

Yes, as we all know, bariatric surgery is only a tool in the end. You have to change your lifestyle either way. The surgery can make it easier to do because you can eat much less food and still feel full. Personally, I know I won't be able to do it myself (sometimes I swear I can eat an entire cow without feeling full). I know I won't be able to do it myself because I have tried over and over and failed. I know the way my brain works, and besides the fact that I will feel full much sooner, I know the surgery and the risk of all the complications if I do go off track - those will keep me in line. It will give me enough incentive to keep going.

My BMI is 57.4- far over the morbidly obese line, no matter who you're talking to. I'm pre-diabetic, and can barely get out of my house without being in pain. For me, WLS will give me my life back and the capability to actually help myself. WLS will make me lose enough weight initially where I CAN get up and exercise and be about; and therefore really able to aid myself in losing the weight. I'm really looking forward to going on long walks with my husband.

You should feel fantastic that you got yourself as far as you have. You should be proud that you can do it yourself. You're doing something great for yourself. However, without sounding snotty (because that really is not my intent), people like me who have been honest with themselves, and admit that we need help, are doing just as well for ourselves. If we use our method correctly, just as you use yours correctly too, we will all succeed.

Of course people want to talk about all of the horror stories. 

 First, we'll examine those who gain back the weight. This is rare, but it does happen. Some people just won't stick to the plan. It's sad, but it is possible to fail. No method of losing weight is 100% effective - and no matter what, people will have to change their lifestyles to succeed. Some people just will not do this, and no matter what their method - whether it be calorie counting, weight watchers, atkins, any other food plans, or bariatric surgery - those people will not succeed.

Next, of course, there are complications of WLS as with any surgery. We'll talk about this in terms of people who follow the plan post-op. These people will have lost or be losing the weight, and the risk factors associated with obesity. We'll also discuss this in terms of people who cannot lose the weight themselves. We'll assume that the person would not be considering bariatric surgery if that was an option in the first place. This becomes an internal debate anyone considering WLS must have. Two different people can look at the same list and choose different options. The options are to remain obese, and have the risk factors of obesity:

Increased Risk of Premature Death

Increased Risk of Heart Disease

Increased Risk of Stroke

Increased Risk of Type 2 Diabetes

Increased Risk of Cancers

Increased Risk of Fatty Liver Disease

Increased Risk of Gallbladder Disease

Increased Risk of Breathing Problems

Increased Risk of  Arthritis

Increased Risk for Expectant Mothers and their Babies

also, there are Psychological and Social Effects of Obesity  

 or to have Bariatric Surgery and you may experience some of the complications of bariatric surgery:

Dumping Syndrome

Blood Clots occur in about 0.2% of Roux-en-Y patients

Leakage approximately 1% of patients will experience leakage

Bowel Obstruction occurs in 1%-3% of patients

Ulcer occurs in about 2% of patients

Gallstones about 7% of WLS patients have to have their Gallbladders removed later on

Infections

(There are also more complications that can occur in peple with heart conditions, sleep apnea, and other specific conditions, but I stuck to general complications).

The question is: Which list is scarier to you? Both are a result of your own actions (unless there's a medical problem obviously); you just have to choose which one you can live with.

To me, the first list is much scarier.

I will risk the complications also because I truly believe that I will never lose the weight by myself, and my life will be stuck with that first risk list. At least the surgery gives me a really good chance of succeeding. 

This is probably way longer of a response than you expected, but I felt the need to put this all up because I know more people than just you wonder the same thing. 

Links: Obesity Risks WLS Risks

       

My Medications

For kick and giggles, here's a list of prescriptions and OTC drug as recommended by my doc I am on:

Propranolol 120mg/ day - This is to prevent my migraines and cluster headaches, but also helps lower blood pressure.

Imitrex 100mg as needed - If I do happen to get a migraine even though the above should work, I take this.

B12 500mcg/day - OTC but doctor recommended because my count is low.

D (?) - I have a prescription of a stronger vitamin D I am taking once a week for a month then I will go to the dosage below:

D 2000 IU/day

Gummy Multivitamin 


Ibuprofen as needed for back pain (and usually needed)

Vitamins take up the most of that, but I figure I had better get used to taking them now anyway. After the surgery I will have to take many different vitamins for the rest of my life because of malabsorption (as a result of bypassing the part of the intestines that absorb the most nutrients).

Off Topic P.S.

I did get my lip re-pierced on Tuesday, and I love it! Here's a random crappy picture I took on my iPod touch:

Oh, it also shows of my new awesome glasses. They're friggin' sweet.

X-Ray, PFT Follow Up, and More

Today I had yet another doctor's appointment, and this time I got some answers (sorta).

First, we discussed the results of my x-ray. She went down the list and told me how many things look beautiful in my back. Then she scooted over the real information I was looking for. She (again sorta, vaguely) told me the cause of my back pain. It results from a couple spots where my discs didn't have much space, and the added weight I have is pressing on them.

I was (and still am) kinda confused, but happy to hear both that a. nothing extremely serious is going on, and b. she knows why it is happening. She asked me about what I take for it usually (~600-800mg of Ibuprofen a dose, and different frequencies of dosages depending on how much I'm upright). I also told her that the ibuprofen does nothing to help my pain; I barely see a difference. The ibuprofen only helps the dull ache that I have when I'm resting, but not the extreme pain when I'm walking that makes me have to sit and rest frequently. Annnnnddd, she just moved on to the next thing and didn't say more about it. I didn't think about this until later and was like wait, she didn't recommend any suggestions to do anything about this...

Except to lose weight.

Well, duh.

Then we went on to talk about the results of my PFT. The results came out good for this as the NP had suspected from the previous day. So, I have no major respiratory problems, at least during the day.


Now, she has prescribed me to go for both an Overnight Oximetry and a Sleep Study. The Oximetry is easy because someone drops the machine off at my house. I attach the thing to my finger and go to bed. Simple enough. This only tests my oxygen levels while I'm sleeping (and if they get low - that's bad).

The sleep study is more in depth. I have to spend the night in a lab designed specifically for this purpose. They hook you up to and test many different things at the same time. They even video monitor you (kinda creepy).  I forgot all of her specific reasonings she wanted me to go for this. I do, however, remember her telling me that sometimes when you're not getting a good nights sleep the brain senses that you need more energy and triggers you to eat more (which can lead to obesity). This is obviously a stupid reaction for the body to have because its just masking the original problem (and creating more if it does lead to obesity).

Because the body can get confused in this way and lead to obesity, she wants to rule out (hopefully) sleep apnea and other respiratory disorders as a cause (or helping hand at least) to my weight. In her words

"I want to test you for everything so those people (a.k.a. my insurance company and the bariatric surgeon) have no reason to deny you."

I totally inserted an evil laugh in my head after that statement. I like to think of it as a battle of us against them right now (and I think we might be winning).

We also talked about diet and exercise of course. She wants to set me up (doesn't that sound like a date?) with a dietitian to go over things I could be doing. Also, we talked about exercises I can do that won't hurt my back as much. Mainly exercises that can be done sitting or lying down. I got some 5lb hand weights, and she recommended I lay on my back and do leg lifts.
If you have some ideas of easy home exercises that can be done sitting or laying down, I would love to hear about them!  
I also have an exercise ball and a yoga mat/blocks (but no video) to give you what I have at home.

Also, I'm still waiting to hear from Upstate Medical University (the bariatric surgeon) about my first appointment. The doctor is trying to get in touch with them again, and in a few days, if I don't hear anything, I'm going to start calling them myself.

Doctor's Apppointments Galore

So this week I finally got my back x-ray done and my Pulmonary Function Test (PFT).

I wasn't too fond of the x-ray for the simple point that I have to strip to my undies. Sometimes they're nice enough to give me two gowns (and this time the woman did thankfully) because one just doesn't cover me. There is something awkward about lying on a cold table basically naked and being positioned around by a stranger. Oh, and they never even hint at what the x-ray shows.

I'm nervous about these results. In one aspect, it would be nice to have the results tell me that there are no additional problems than just my weight...
However, some part of me wants there to be some other problem that the doctor can solve now. I've spent a lot of my time in the past few days in tears because of the pain. A short walk may seem like no big deal to some people, but I can barely walk from one building to another on campus (even if they're next to each other) without excruciating back pain. I want something that will help me NOW because I can barely get to my classes at all.


Talk about education being painful...



Then today, I had to go to another doctor's appointment for the PFT. I tried to get it rescheduled so I didn't have to miss the same class again, but apparently they will only do them on Thursdays, and the next chance is over a month from now. Balls. I guess I have no choice but to go right?

So, grudgingly, I walk into the quiet office, and wait to be called.

Part 1 - They clip something to my finger and tell me its 97/100. Okay sounds good. - part one complete.

Part 2 - They give me the little tube thing to blow into. You have to take a deep breath and blow in it as fast and hard as you can. It goes something like this wait... wait... wait... OKAY TAKE A DEEP BREATH... AND BLOOOWWWWWWW as you desperately try to inhale and blow really fast. Okay, maybe she wasn't so dramatic, but the anticipation of waiting for the cue made it seem that way.  I blew about a 3. I'm told the magic number to beat here is a 3, so I shouldn't worry.

Part 3 - here comes that little finger clip attached to the box with the magic numbers again. This time I have to wear it while I walk up and down the hallway a few times. The number goes down to 92/100. She says the magic number that means bad is 90 or under, so I guess I'm still good.

Part 4 - Now I go into another room to inhale and exhale through the nebulizer for a few minutes. The thing is loaded with albuterol, so we can see if it changes anything when we repeat Part 2 again.  Trying to minimize my drool the entire time (and failing) I try to breath as normal as possible through it until its done. By the time she tells me I can stop I feel woozy/jittery as she called the feeling. I would also call it feeling a bit high.

Part 5 - Back into the other room we go to blow into the tube again. So I blow as hard as I can. The graph looked like I went longer this time, but I didn't get to see the number.

Then the NP gets an oh shit look on her face. Her printout is telling her, that the stats cannot be read. Something is wrong, obviously, but she doesn't know what the computer wants her to do. She makes a call, and we decide to re-do part 5.

Part 5.5 - Same results as Part 5, even the weird readout is the same.

My guess is that instead of the computer having to interpret the results, the doctor is gonna have to do it herself. Hopefully that's the only problem.



Any interpretation of results is only my or the NP's reaction to the tests. I have yet another doctor's appointment tomorrow to see the actual doctor and learn the results of this week's tests.

A Voluntary Hole in the Face Approaching

Disclaimer: This blog will be primarily about weight loss related stuff, but, I don't want it to get monotonous and boring, so I'll put other stuff about my life in here too.

So, with my journey to feel me like me again, the hubby suggested a perfect (early) Valentine's Day gift... to get my lip repierced! Triple woot!

I never wanted to take out my beautiful little lip piercing first place; it was a fluke when it fell out and closed up. I can remember that dramatic moment of being at work and desperately trying to find the fallen ball to no avail. It was so depressing! I've felt sad about it being gone everyday since, although I saw it as fate making my mother's wish of a lip piercing free wedding come true (that lucky lucky woman). So, I sucked it up and celebrated my wedding without it. The moment the wedding was over I couldn't stop thinking about it. My tattoo kept the urge for a new (old) body modification at bay... but anyone who likes piercings and tattoos knows that the little devil rises his awesomely pierced head not before long.

The people who know me know that I'm not a wild and crazy person. You'll almost never find me out at the bar or a club partying. I'm not the typical 21 year old in anyone's head. I'm mean, first of all I'm married (and not because I got knocked up). Unless I married a party animal (and anyone who knows my geek of a husband will laugh hysterically at the notion) there's very little chance of that happening. Yet, I have my vices. I love body modifications. There are many I love that I would never get, and admire from afar; there are also the ones that I can't seem to live without. My lip piercing is one of them.

I mean, even on a lazy yoga pant and hoodie day, you at least carry with you SOME semblance of style.

So, as with other things recently ;), I'm going to stop moping around and being all Eeyore about it. Thanks to the hubby I'm going to do something about it.

My face will feel like me again with a little extra hole. I made my appointment for next Tuesday at 5:00.  This time, I hope they will have my proper hypo-allergenic jewelry all ordered and prepared. What happened last time will not happen again. This time I will be pierced with jewelry that won't give me an allergic reaction because I'm too impatient to wait for proper jewelry. Oh impatient me. I will beat you out of me one day!
 Fun picture:
A pretty b/w of the day I got my lip done the first time:

Be Careful What You Say

I don't have any specific new updates for you today, but I do have some old thoughts to share.

And the motto is:

Be Careful What You Say

A "Compliment" Can Turn Bad

Before I get into this, I want to say - the person really did mean well, and I love them still. 

So, I remember the first time I got up the nerve to show "Before and Progress" Pictures to a friend. I had lost about 25-30 pounds at that point from what was my highest weight... then anyway. I showed the two pictures, and for a moment the person was stunned. Then they stated something along the lines of this:

"Wow, you're looking good. I just can't believe you really looked like that before."

Thanks... really. I totally understand you mean well and are excited about my progress. Yet, did you really hear what just gushed out of your mouth? That person was still me. I was still the friend you liked. Were you lying back then any time you complimented me on "how I looked today". 

But then I think whatever, its not like I'm going to be that anymore anyway - so I don't have to worry about it. But then comes the kicker... I gain back the weight...

and more.

Oh crap. Now, I have stuck in my head, "Well, if they thought I was hideous x amount of pounds ago, I wonder what they really think of me now."

Now, being a rational person, I know that my friends love me and they really don't care about my weight. That's why they're my friends. So, I don't really worry about my friend's judgement.

It just makes me think of strangers reactions. The ones that couldn't give a flying hippopotamus about me. They look at me in disgust, and believe me, I know this by catching some of them. My mind goes straight back to that little truth my friend let slip (because I'm not going to be dense enough to ignore the reality). Yet, sometimes, reality sucks...

                            and that compliment becomes a nagging bother in the back of my head. It will probably always be there until I get under that number that got deemed bad and ugly.

Weight is a touchy subject; Especially with women, with our hormones and all. So the moral of the story is, as I said above, be careful what you're really saying. It may have more and a different effect than what you and the person receiving it actually wanted it to be.

Losing My Worst Half Introduction

A big hello and welcome to my readers.
In this blog you are going to read about the struggle of one woman to lose approximately 175 pounds.

That is an insane amount of weight.


This blog will be an interesting journey because to do it right I have to be completely honest and open... and frankly - that scares the living bejesus out of me. I can be honest and open to strangers that don't know me, but being honest and open about this one thing to people I know is going to be hard - and embarassing. I still haven't decided if I will share this blog with those I know right away or sometime else along this journey, but the plan is to include them.

So who am I? And how did I get to where I am today?
I am a college student, and not necessarily a hard working one recently. I study Psychology, and I am currently in my senior year, and I just see that BA in the distance. What am I going to do after that beautiful little document with my name on it reaches my hand? I haven't exactly planned that far yet.

My rock standing behind me is my husband. He is the one person in the world that can tell me I look beautiful who I actually believe. He has seen me struggle with my weight since the moment he met me. The spectacular part of it all is that even though I've gained somewhere in the vicinity of 80-100 pounds since we met, he has never loved me less or ever said a vulgar word about my weight or how I look. Quite the opposite is true. He embraces who I am and how I look no matter my weight.

I love this dude.

However, no matter how much my husband embraces who I am, we both would like to see a big change. Sure, the looks may be part of it (more in my perspective than his) but the biggest part of this journey for me will be mobility and activity. Right now those two things are at zero in my life. As a result of my weight, I have acquired a most unpleasant symptom - always present excruciating back pain. My weight is literally crushing my spine. The ability to move around more than doing small things is almost non existent. I can't stand in my kitchen long enough to do the dishes or even make a meal without pain. The result is using a desk chair to sit in my kitchen.
When I go shopping, I end up using those motorized carts because I can't get through the store without my back pain flaring up. This is one of the most embarrassing things because its so public. I dread seeing people I know because they always ask why I'm in the chair. I usually come up with some excuse or blatant lie that makes me look like less of a fata**. Of course, there are also the looks from strangers screaming "stupid disgusting fat person, learn to walk you lazy bum". Meanwhile through all of this, I'm crying inside. So, I've stopped going out very often.
Don't even get me started about seat belts *grumble grumble*. Lets just say when I do get them on, its a strenuous activity that leaves one very frustrated.

Although I have pretty much always been overweight/obese for my age/height, it has not always stopped me from being active. The truth is, I LOVE sports. Mainly baseball or softball. I played for awhile when I was younger, and I wasn't half bad! I also played soccer and volleyball.  Putting aside how good or bad I really am at all these sports, the important point is how much I enjoy getting up and being active with my friends. I also love the outdoors in general. I would love to just get out and go on a long walk on a nature trail, or by the lake I live by.  I want to lose weight to get all this back. Inside, I'm not this person who can't move.

In fact, I HATE this person who can't move.

In the past I have tried many many many times to lose the weight. I have tried so many different methods. The one that worked the best for awhile was the combination of vegetarianism and calorie counting. I have calorie counted on its own for awhile, and its a great method, but in the end, after a few months I fall off the wagon. I was vegetarian for a year and a half, and I lost around 40 pounds. In the end, the truth is I gave it up because I like the taste of meat. My family members are basically carnivores (not literally, but you get the point). It just wasn't a lifestyle I could keep up my entire life. My problem is that I lose motivation. I have tried many many different ways of keeping myself motivated throughout the years, and failed miserably. The truth is, I have to have a kick in my butt. For example, if there is something I have to do where OTHERS are counting on me, well, you can be 99.99999% sure it will get done, and be fantastic at that. Now, I have always let myself slack off on my duties when it comes to myself (which you can definitely tell by looking at me). So after thinking long and hard (and I mean years of research and contemplation) I finally reached an answer.
What other better kick in the butt than surgical intervention. A surgical procedure that literally makes you physically ill if you don't follow the rules, and change your lifestyle. Well my dears, that's a kick in the butt I can be sure to believe in.

And one I'm 99.9% positive will help me learn my lesson and change my life.

After a few doctor's appointments, I have a referral to a bariatric surgeon waiting for me, and I couldn't be more excited about it.

I know a lot of people out there aren't going to be happy with my decision. I have one thing (or maybe more, we'll see) to say and its not going to be nice. Shut the f*ck up. Seriously. I have done so much research, that there is not one thing you can say to "scare" me away from it. I can also almost guarantee I know way more about it than you do. I know exactly what I'm getting myself into the good, and the possible complications.

I know how nasty you can be because at one time, I was one of you. I thought I knew all about it, but I was focusing on all the negative parts and not seeing the big picture.

And to my mother in law - I'm genuinely sorry about that. Maybe this will help our relationship and bond.

So you probably want to know how much I weigh, or what my body measurements are?

 Well, you're not getting that today. Those are some things I'll just have to work myself up to.