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July 18, 2004

Lack of energy

Amanda you look great.  I am 3 1/2 months out and I am finally feeling pretty good.  I still have a hard time eating.  I try to eat stuff I know will settle pretty good.  I don't eat much during the day because I just don't feel hungry.  My question to you is now that you are 3 years out how do you feel?  How is your energy?  Sorry to ask this question but did you have Plastic Surgery or were you able to tighten it up yourself?  I think my legs and arms are going to be my biggest problem.  I started out at 356.5 and I am now at 274.5.  I have a hard time to keep my energy up.  I can't drink Gatorade because it make me sick after about 3 sips so I don't bother.  I do try to get in as much salt on my fruits and veggies as possible.  Right after I had the surgery on April Fools Day I was like "What did I do to myself?" and for about the 1st month I craved food very badly. I am over that now and accept what I can and can not eat.  Well, sorry for talking your hear off.  I would like to hear back from you. Thanks and hope to hear from you soon.

It's been long enough, that I don't remember specific problems that were faced in the beginning.  As people ask questions things come to mind.  For example puking was a problem because I failed to chew my food enough or ate too much.   Saltines, tuna, and yogurt comprised my diet for the first few months.   Quick was the lesson that pasta, rice, and bread couldn't be handled.   Protein was what I craved.    Steak became a regular part of my diet.    It took a long time to learn to recognize hunger and to learn to listen to my body.  Diligence was necessary to remember to eat during the day.  It's still a problem even today.  Listen to your body.  Eat when your hungry.  Stop when you feel satiated.

 
At 3 years I feel pretty good.  Low blood pressure has been a problem.  It's improved over time.  On Monday it was 120/60.  In the past it was so low that often times I passed out, especially after hot showers or standing up too fast.   It became to be a real concern when it started happening more frequently.  My PCP warned that eventually medication might be necessary. 
 
Low and/or lack of energy was a problem in the beginning.  The first suggestion is usually to up your salt intake.  Also take a look at what you're eating.   Sometimes I still feel tired.  The reason that I can't eat rice and pasta is that it puts me to sleep.   Adding protein shakes, if you aren't already may help.  Try using non-fat milk, or Silk instead of water to improve the taste and texture.   I'm sure that you're taking your vitamins.  At one time, I was taking sublingual vitamin B.  I'd also go into my Dr.'s office for a vitamin B shot.  Perhaps your Dr. would be willing to do the same for you.

 
I haven't had plastic surgery yet.  My arms and legs are quite flabby.  I haven't had the money, time, or resources to invest into it.  I have an appointment next Monday with a plastic surgeon in Florida.  It is my hope that I'll be able to get insurance to cover my stomach and breasts.  Honestly, I need an entire body lift :)

Posted by Manda at 07:25 AM | Comments (1)

July 17, 2004

Craving's after surgery

I am also wondering about how and what, if anything, you did specifically in those first several months after surgery in regards to your separation from food? Did you do anything specifically to combat those cravings or desires for pizza or soda, etc.? Did you cry and have breakdowns or come up with a way to deal with them.....or simply just wait them out? This is a big concern of mine, but it will not stop me from going through with this. I am ready to break away from food, I just wonder how it will be for me. This is a major issue with my mother....she constantly asks me what am I going to do...and all I can tell her is "I don't know until I get there". I try to tell her about other people's experiences, but those are relative and personal to them, so I can't rely on those situations as hard facts. This is basically my major question, besides the typical things included in the contact letter.

The craving for food didn't start for me until a couple of weeks after I had surgery.  In the beginning, food just didn't appeal to me.  I spent so much time finding things I could eat, that I really didn't worry about pizza and soda.   Then I began to mourn food.  And yes I did cry.  About a week after surgery, a friend of mine from Alabama had sent me a case of vinegar and salt potato chips.  It was a brand that you can only get in the South.  I had mentioned before that it was one of the things that I missed about home, so she had a case delivered to me.  I gave most of them away, but a few weeks from then, I was standing at my kitchen sink, licking off the vinegar and salt.

 
Some cravings can be waited out, others you cry, and others you give into and end up sick.  The separation from food isn't forever.  You don't have to eat soup and yogurt for the rest of your life.  One day, you will be able to have a piece of pizza.  You will feel liberated and normal when you only eat one piece and have no desire to finish off the entire pizza.    In the beginning, I was too obsessed about not losing weight to give into a lot of the cravings.  Weight came off very slowly for me, about 10 lbs a month.  I wish now that I could be as diligent now as I was then.  I've never eaten more healthy in my life.  I exercise daily.  Over time, I've lapsed and don't make the best eating decisions.  I just see myself as a normal person now.  Normal people have a piece of birthday cake at a party.  Normal people have a piece of pizza at the office party.  I relish my normality.  If I don't watch what I eat, I gain weight.  I crave sugar now.  As a pre-op, I ate a lot of potato chips and fried foods.  Sugar wasn't a problem.  I crave it now.  When my pants start to get a little tight, I elminate all sugar from my diet and drink a few protein shakes.

 
Having surgery is a life long decision.  You will need to take vitamins for the rest of your life, and you won't be able to have the entire pizza.  As time passes you will learn what you can and can't have.  Life won't always be like it is in the beginning.   One day you'll have the chance to be normal.

 

Posted by Manda at 07:29 AM

July 16, 2004

In the beginning

I realize that many people who are researching weight loss surgery have questions about life in the few months after surgery, and then a few years after surgery.  As best as I can remember, I'll try to talk about my first experiences. 

I started a post very early this morning.  I had planned on writing about what my life was like in the first few weeks after surgery.  After an hour of writing, I realized that I hadn't even begun to make a dent.  So, rather than tackle it all in one post, I start from the beginning. 

Waking in recovery:

I was in no pain and I panicked. I had heard stories about surgeries that were stopped due to some problem: liver too fatty, something to do with the pancreas, years of diabetes had made one woman's stomach too hard to penetrate.  I was certain I had just become one of those stories.  I searched my stomach for the staples that should be covering my incision.  There were none because they were also bandaged.   Then I had a heart attack.  I don't mean to make light of it, but I truly believed that I was having a heart attack in the recovery room.  The nurse wasn't as nice as she could have been to someone convinced she was dying, but it turns out that I wasn't.  During a laparoscopic procedure, air is pumped into your body to inflate you.  I had air trapped in my chest and it was excruciating.   I asked about my surgery, and was assured that it went fine.  The only other memory I had was that of another patient that went before me.   She moaned the entire time.  She was in much more pain that I.  She used 2 pain pumps of medicine during our 1 day stay. After recovery I  was up and walking withing a few hours.   That night, I slept on my stomach.  Actually, I awoke entangled in my IV.  I didn't use any of the pain pump that had been given to me. 

Why? Besides having a high tolerance for pain, there are few pain receptors on the stomach.  From what I understand, the intense pain from a gastric bypass comes from the splicing, rebuilding, and then attaching the intestine(Roux-en y) .  The mini gastric bypass uses the Billroth II procedure, and since there was no division, there was less pain.   My procedure was also performed laparoscopically. Even today, many surgeons chose to do an open procedure.  I didn't have a slice through my body to recuperate from.

I didn't want to eat the first night, but the nurses made me.  And what would you guess they gave me?  Fruit juice and jello, and not the sugar free kind.  I had learned enough from other patients to know better than to try to eat anything with sugar in it for a while.  Fortunately, a friend dropped by the hospital with some yogurt.  I consumed so much yogurt the 3 months following surgery that I can no longer eat it.   I can't stand the thought of eating it.  But it was a life saver in the beginning.

I left the hospital the morning after my surgery.  I was tired.  We went back to the hotel and rested.  My mother tried to force food on me.  The last thing I wanted to do was eat.  I sent my dad out for yogurt, he came back with TCBY, sugar free of course.  He rocks.  So I lived off of yogurt and saltines.   I had some nausea in the first few days, but nothing extreme.  I learned soon to stop eating when I felt full.  I puked a lot, because I was over eating.  Each time I over ate, my mouth began to fill with saliva and I knew to get to the bathroom, or nearest trash can quick.  It still happens, only much less frequently.  I learned in the early days to chew EVERYTHING for a long time.  Remember, I was only eating saltines.  Even they needed to be chewed carefully.  I slept, did a little walking, went to a few stores, but took it easy.  I was lucky to have an uneventful surgery.  My new life had just begun.  I was reborn.  I still insist on celebrating my re-birthday every year on March 12th. 

I'm often asked if I made the right decision.  absolutely.  Do I regret it?  absolutely not.  Would I do it again? each and every year for the rest of my life if need be.

 

 

Posted by Manda at 09:53 AM

Obesity in the News

Medicare to fund obesity treatment
 
I said in my post yesterday that Medicare paid for surgery.  It seems that statement may or may not have been true yesterday.  I knew a woman 3 years ago that had the MGB paid for by medicare, or perhaps it was Medicaid.  She had an extreme amount of comorbitities, so perhaps that's why she wasn't denied coverage. Either way, the good news is that this morning, Medicare announced that obesity is indeed a disease.  This means that millions of obese Americans will now find it easier to have weight loss surgery covered.

Posted by Manda at 06:55 AM

July 15, 2004

Answers to questions:

Excerpt from an email I received today...

I would like to have a procedure like this done, but I have no insurance sooooo I can't. But I would still like for you to tell me what it was like and how much I would have to save to have it done! THANK YOU for taking the time to read this! You look beautiful and congrats!

Not many people know that Medicare will pay for weight loss surgery. So if you don't have insurance, and are eligible, please consider applying.

As far as cost, I've been unable to find anything definite online. Many people without insurance choose to have the laproscopic mini gastric bypass because it is so affordable. When I had my procedure over three years ago, Dr Rutledge accepted insurance. He no longer does. I believe that it runs about $18,000, and that includes everything.

I have heard that an RNY runs about $40,000. I can't be certain what that includes. It would be more if a longer hospital stay was necessary.

I don't know how much a lap band costs, but perhaps it's less because it is less invasive and the hospital stay isn't as long. My advice would to be call surgeons and ask. I don't know if anyone out there finances for WLS, but I'm sure that one day, someone will.

Posted by Manda at 01:15 PM

July 14, 2004

Questions from you, answers from me

Weight gain will always be a constant concern for me. I went to the Dr.'s office yesterday and was not surprised to see that I now weigh 150 lbs. My comfort weight is about 144. It may seem like a little, especially to the morbidly obese. What's just a few lbs? I'm convinced that's how I got morbidly obese. So, over the next few weeks, I'll put some extra effort into losing the extra lbs I gained on vacation last week.

I get a lot of emails concerning my weight loss surgery. I'm going to address the questions that I receive here.

Hi Amanda, My Name is removed for privacy and I'm from somewhere in the US. Tomorrow night I am going to an open forum for bariatric surgery with a co-worker that has had the surgery and is doing real well. I am going so I can learn more about it and make up my mind once and for all If this is what I want to do. I am 42, 5'2 and weigh 230 lbs. I have been over weight my whole life. It has only been the last 15 years of my life that I have been above 190. But I can feel the numbers climbing as I sit here and write to you because I just had a major pig out and I feel so miserable. I am so sick of wearing comfortable loose clothes or clothes that cover too much of me when it is hot outside. I want to wear nice clothes and in the summer time I want to wear shorts and a tank top like every one else as opposed to Capri's and a long baggy t-shirt. I want so badly to be able to cross my legs or sit in a folding chair with out cringing that the person behind me is looking at my body ooze over the seat. I have a supporting husband, of course he's one of those thin men that eats whatever he wants. His first reaction was that he thought this was awful drastic just to loose weight but I reminded him of how many times I have tried and failed and how upsetting it is to me. I also have two daughters age 21 and 22, both have great figures. although the weight creeps up on them every now and then and I encourage them to loose those 10 before it becomes 20,30 or more. And they do. One daughter told me, "Mom if you do this surgery and loose all that weight you will be so beautiful I will be so happy for you I'll cry." She's engaged and I'm sure she'd like a slim mother at her wedding next year. So would I. Well Amanda, now that you know my history I will tell you that as bad as I want this surgery is as nervous as I am to do it. I have had surgeries before, gallbladder, back surgery, appendix, etc. so I'm not afraid of the procedure. I am scared of the things that may go wrong. I'm so scared that I could die from this. One in every 200 ya know? that one could be me, it has to be someone. All though I am obese I am relatively healthy. My blood tests are great. Cholesterol, triglicerides etc. are all better than normal. I have border-line high blood pressure. My mother has been on meds for it for the past 10 years; her mother and grandmother both died from high pressure, one of a stroke and one a heart attack. I have had two back surgeries for a herniated disc ( the awful thing is that I got it from struggling to get off the floor, trying to convince myself I was in shape enough to sit on the floor, huh, wrong . It's embarrassing when the docs say, oh herniated disc, were you in a car accident........) so I know loosing this weight is going to change my whole life and I am so excited for that. I hate being fat !! I'm sick of overeating, but I can't seem to stop myself. So I know this procedure is right for me. I'm just so scared. Please tell me your thoughts. We're you afraid? How uncomfortable were you and for how long afterwards? How did you tolerate food at first and how are you tolerating it now? Do you know anyone who has had a bad experience from this? Thank you for being available for questions. I will write again and let you know my final decision after I meet with the doctor at the open forum tomorrow night.

I was afraid, actually, terrified would more accurately describe my feelings. Before I went into surgery I wrote letters to everyone that I loved and made plans "just in case". As afraid that I was of death, I was afraid of losing my relationship with food. It was where I turned whenever I needed someone. Making the decision to have a gastric bypass requires that you are willing to give up food. The hardest part of the surgery wasn't the surgery part. It was the weeks and months immediately following when I wanted to eat a piece of pizza, or a hamburger, and just couldn't. I was limited to soft foods and yogurt, and I was miserable. The mental part of it was much more difficult than the surgical aspect. I had discomfort in eating some foods for a long time. I still can't handle most breads. I have to take the crusts off of everything I eat. If I eat too much bread, it lays like a brick in my stomach. Pasta's and rice make me very tired. I was unable to eat any kind of sugar for a long time. I can tolerate sugar now, but still have some minor dumping from time to time. I began to become more selective about the foods that I ate, and actually enjoyed sitting down to a meal. I began to eat foods that I wouldn't have eaten before. I now love eating vegetables. I love to cook now. I love to make difficult recipes that require a lot of ingredients and patience. I have a more healthy relationship with food now. If I had known that I would, I wouldn't have feared the loss of my relationship with food.

Also, I don't want to disqualify any information about the mortality rates of this surgery, because I haven't done any research, and I do not know. But I find it hard to believe that 1 in 200 people die from this surgery. Perhaps it is accurate. In the past 2 years, since the surgery has become more popular, more doctors have been doing surgeries. Doctors who may or may not be specifically trained in surgery, much less gastric bypasses. My number one information to people considering surgeons is to do your homework. For example, I knew my surgeon had had 1 death in 1200 patients. His complication rate was also very low. I don't know why 1 in 200 deaths seems to be the accepted norm. I've met hundreds of people in all stages of the process, pre-op, post-op, old post-ops. I don't know a single person who has died from it. I know only a few people who have had serious complications, and even then, it was "a friend of a friend" of someone I knew. For me, the choice was easy. I chose to take the slim chance of death and improve my life, versus continuing to be fat and die anyway of one of the many diseases I was bound to get from being so obese. I was miserable. There really was no choice. But I was still scared.

If you have a question that you'd like answered, email it to me: eskieluvr@hotmail.com

Posted by Manda at 09:42 AM