Something I'm working on...

This is something I'm working on, its long but meaningful to me. Would like opinions. This is a rough draft. The Easy Way Comments on Weight Loss Surgery I joined one of the most interesting and healthy "fads" of the 21st century this past September. On the 19th of that month, I allowed the good Dr. Facundus of Alabama Surgical Associates to perform an operation known as Laparoscopic Roux-en-Y surgery, more commonly known as "Gastric Bypass." I made this decision because I needed help. Food had become my enemy to the point I had ballooned to over 450 pounds. As the result of the blubber on my 6'4" frame, I had developed a number of complications, including diabetes, high blood pressure, high cholesterol, sleep apnea and depression. In my heart of hearts, I knew that if I didn't lose the weight, I would die. I thought I knew that I was "morbidly obese," a condition that by its very name indicates death. I was wrong. I was "super obese," a classification even worse that morbidly obese. At least I was super at something! But all that changed in the days, weeks and months following the surgery. Prior to surgery, I struggled to get my weight down to 427 pounds. My first weigh in after the surgery was 397. Thirty pounds gone in a week and the 400 mark broken. Since that time, I've lost an average of around 6 pounds a week. As I write this, 17 weeks out from surgery, I've lost a total of 110 pounds from surgery and 133 pounds from my highest recorded weight of 450, although that weight was taken after a couple of weeks of dieting. I'm a happier healthy man today. I'm wearing clothes that haven't fit since I got married i***** I'm creeping down to being simply overweight instead of obese. I'm no longer classified as Super Obese or Morbidly Obese. Far too many people look at what I've done over the past 17 weeks and classify it as easy. I suppose it is simple to assume so, after all I've lost more weight in those seemingly short 17 weeks than I did in 11 years. More than most people lose on any diet they may try. Dieters often assume I "cheated" in some way. The attitude of friends toward me and my actions have changed dramatically. This "cure" for obesity, especially in the honeymoon period shortly following surgery, may seem easy. Patients may lost 15-50 pounds in that first week following the operation. But as with any weight loss program, the heady quick lost of the first few weeks quickly slows down and the doubts and questions most obese people have about themselves rear up their heads and make you question the success of the surgery. I belong to an online support group and regularly interact with just shy of 100 people who all had their surgeries in the month of September. I wanted to know how I was doing compared to these other surgical candidates and with their permission I started compiling a weight loss comparison about our mutual trip toward a normal weight. In doing so I learned just how "easy" this process is. (You can find our data at http://homepage.mac.com/totalriot13/SeptemberAverages.htm) I learned a lot about myself doing this, and about how we all judge our own weight issues while we are trying to loose. Without an exception, the members of this little group have at some point truly believed that they would be one of the ones who fail at the surgery. Failure does happen, the surgery isn't a magic pill for weight loss, a patient can eat around the surgery and lose very little weight. Grazers, as they are often call, eat the smaller portions that the surgery force the patient to eat but they don't stop eating and consume nearly as many calories post surgery as they did before. So the surgery alone doesn't make you lose weight. There is a very strict diet that accompanies the surgery, and if you don't follow this strict diet you will have all sorts of problems. Grazing is just one. Malnutrition is another, and many patients have problems with proper nutrition. Myself, I couldn't absorb Vitamin B12 successfully and now have to get B12 shots. On the other hand, I don't take calcium supplements like many patients because I can not only tolerate milk (lactose intolerance is common among WLS patients) but I find it one of my favorite post-op drinks. Another reason to follow this strict diet is dumping. Dumping occurs when either what you eat or how you eat irritates the new stomach pouch, causing the patient to feel sick. Often dumping includes fever, sweats, pain and a dumping of the stomach contents (hence the name) through either vomiting or diarrhea; and sometimes both. In the "what you eat" category are foods that the patient will have to avoid forever, such as sugars, fats and other tasty food. In the how you eat, not only is portion size important (eating to much will cause dumping) but bite size is too. A single oversized bite can lead to an episode of dumping. So I hope you can see that just the act of eating is harder post op than it was for the patient prior to surgery. The simple act of eating is a new hardship for the WLS patient. The very act that so many obese people took comfort in it, and caused their health problems, now makes them sick. The emotional upheaval this change causes is massive, but the daily upheaval to the normal living of life is even larger. Every meal is scrutinized, every bite taken with care as the WLS patient learns the rules of their new stomach. And the rules may change, what tastes good today may make one sick tomorrow. There is nothing "easy" about eating post surgery. Then there is the "miraculous" weight loss. It may sound grand to loss 30 pounds in a week (and in fairness, that number is not normal, I had an exceptionally large weight loss that first week) but the reality isn't so pretty. When fat is burned, a number of hormones, primarily estrogen, is dumped into the body. Burning a large quantity of fat in such a short amount of time and all sorts of effects can be felt on the body. Depression, sexual dysfunction, mood swings, and other hormonal surges can erupt. The rapid weight loss can cause other problems as well. The liver is taxed due to the state of ketosis the body enters while the gall bladder may act up and have to be removed. At around 3-6 months out from surgery, hair may start falling out at a rapid pace. These are just some of the stresses that the body endures following surgery. And these aren't even the complications that may arise from the surgery itself. In addition to the stresses the rapid weight loss puts onto the body, the stress the fat has put on the skin is often irreversible. The skin becomes inelastic and does not shrink around the body as it grows smaller. The resulting saggy skin, mocked in the last Austin Powers movie, has medical complications of its own. The Pannus, or stomach area of the skin, can droop. Men particularly and many larger woman may have a pannus that is so large that after weight loss, the skin literally sags to cover the genitals. Additional sagging is common along the arms, thighs and neck. The folds of this loose skin can harbor bacteria and heat, allowing horrible skin infections to grow. The solution to this problem is the removal of the excess skin, a surgery that for most WLS patients is actually harder to endure than the original gastric bypass. In addition to the medical side effects of the surgery and the requirement to follow a strict diet, the WLS patient must also exercise to achieve their weight loss goal. Without exercise, the patient may lose a significant amount of weight, but will fail to attain their goal weight or reach a normal weight status. Even with exercise, success isn't assured. With all this said, I hope it is becoming clearer that there is no "easy way" to loose weight. WLS patients have challenges and troubles that are insignificantly different than a normal person trying to lose weight. I've in no way gone into the very real emotional aspects following WLS and rapid weight loss, a field of study we are just beginning to understand and appreciate. WLS isn't a magic bullet, or an easy method of weight loss. It is a difficult road to walk in ways just as challenging as a "normal" diet. The surgery is a tool, just like a food log or an exercise log. It helps the obese maintain a weight loss program, but it isn't a end solution. And it isn't easy.

Michael, I think that what you wrote is AWESOME!!! You said everything so right on! I feel the same way, that people think that I took the easy way out, but in no way is this easy!!As a matter of fact this week 2 of my friends said that I was lucky because the surgery is so easy. I had to let them know that its not easy, you still have to chose to eat the right things, you still have to excercise, and all the other stuff that comes along with this surgery! Keep up the good work! Nicole.

That is just great, Micheal. I am curious where you are going to submit it though, perhaps your local newspaper? Very good, very informative & very inspiring! Makes us sound like some tough cookies, huh! I hate people thinking this is the "easy" way out, although, I must admit, in 2000 when my sis had hers, I said the SAME thing! :blush: Just jealous, I suppose. By the way, not to rush you or anything...is there a current chart for us? My weight still says 265 and I'm 256. Sorry, I know you've been busy, just curious. I really appreciate your hard work. Kelly

I just haven't been able to post it. It's done, as off last night anyway, just not posted. At the top of the page is a "Snapshot date" which is when it was created. You can look at that and see if it is "recent."

Other than my own journal, I hadn't really though about where to submit it. Ideas would be great.

Michael, I think what you wrote is exceptional. There is something very cathartic about it. I can honesty say, I relate to everything you've written about. I sense the happiness the miracle the surgery has brought you, and the reality of what you are having to endure "re-learning" how to deal with food and the world after surgery. I hope that you're planning on publishing it somewhere. Kaye Bailey is always looking for material for her newsletter, and web site. I would contact her if you were interested. Here's her web site: http://www.livingafterwls.com/ There's a woman in my support group who has done extremely well with lap-band. She's lost over 200 pounds, and is an inspiration to everyone. She makes sure she goes to the monthly info session our surgeon holds to talk to people who are considering surgery. She calls it "paying it forward". Below is something she wrote when she was about at the 4 month mark too. As always, Thanks for the inspiration, Linda R The Easy Way Out "Well, you've lost 69 pounds. How do you feel?" I must have looked at the doctor like he was speaking Swahili. How do I feel ? Lighter. Overjoyed. Smaller. Happy. Healthy. Exhilarated. Terrified. Doubting. Is weigh loss surgery a "cheat"? Is it "the easy way out?" That, unfortunately, seems to be the opinion of a lot of people, probably more than anyone realizes, since most people with that opinion seem to be smart enough to keep their mouths shut. "Hell, if you had any balls, you'd lose weight the old-fashioned way!" "The rest of us are toughing it out with exercise and the ability to push ourselves away from the table!" "If you had any willpower, any self-restraint, you wouldn't be fat!" "Jeez, try a salad once in a while!" "All you had to do was get some doctor to staple your stomach a little and, voila! Instant thin person! Anyone can that! " I can't imagine that two dieters would say to each other, "You're doing low-carb? You're taking the easy way out!" "Oh! Weigh****chers - that's taking the easy way out!" "Jenny Craig? Hell, you don't even have to COOK! That's the easy way out!" But what damn difference does it make HOW anyone loses weight, as long as the result is the same: better health and a better quality of living. "The Easy Way Out." I wish I could have been reminded that I am taking the easy way out five minutes ago when I was throwing up my dinner. Again. You know what I ate? Two baby shrimp and two strips of chicken that, together, were the size of my little finger. Folks, this IS the hard way. It means that I've tried a lifetime of diets: Slim Fast, rice diet, high-carb/low fat, high-fat/low carb, cabbage soup. Hell, I even tried those diet candies called "Aids". Remember those? Yeesh. What a publicity nightmare that product name turned out to be after about 1985! But they sure were tasty! The diets never worked or, rather, they worked for a while, then they didn't. I lost weight, and gained it back. Lost weight, gained it back. It's like the instructions on a shampoo bottle: lather, rinse, repeat. Diet, gain, repeat. And those returning pounds never came alone; they always brought a bunch of friends with them to take up residence in my ass. To make the decision to have weight loss surgery is to face the realization that this is it: the end. I've heard people call it "the last house on the block." Your options are gone. You're never going to get any thinner. You're certainly not getting any younger. Those knees, hips and ankles are going to need replacing sooner rather than later. And chances are, you might not live much longer. The short time you have is going to be filled with can'ts and don'ts and never agains. Stares, giggles, comments. "We don't have anything in YOUR size here." "Wideload." "Fatass." "Orca." The short time will be full of big things like diabetes and high blood pressure, of osteoarthritis and edema and congestive heart failure. Of annoying things like recurring yeast infections and skin ulcers. Of little things, like not being able to cut your own toenails or wipe your own ass. Then, finally, it's resignation; it's just giving up. You reach the point of living the rest of your increasingly short life in discomfort, pain, illness and depression, or reaching out and praying that there is one last hope. It's reaching the point of being willing to subject yourself to dangerous surgery, pain, and possibly even death. It should be given a scenic kind of name, like "Desperation Point". They could sell postcards: "GREETINGS FROM DESPERATION POINT!" This IS the hard way. Every meal has to be as carefully and scrupulous studied as if you are on a diet: because you are. Not for a month, or until your vacation, or until the wedding. For the rest of your life. But it is so much more than just a diet. There is the missing element of eating as pleasurable as it once was. Instead, there's constant worry. Is that food, which you always loved, going to "agree with you" still, or will it make you sick? Have a couple of bites of your half-cup sized dinner before your last meal has cleared your new stomach, and it's coming back up. Have one tiny, pencil-eraser sized bite of food too many and it's coming back up. One chew too few and it's coming back up. Too much fat or sugar and you'll get "dumping syndrome". Not enough protein and your hair will fall out. Not enough iron and you're anemic. Not enough potassium, and your heart will stop. This IS the hard way. It's living with the terror of gaining the weight back and knowing that there will be NOwhere else to go. There are NO other answers. This is it: the last house on the block. It's there, every minute of everyday. And it's not "the easy way out". This is the toughest thing I've ever had to do. THIS is the hard way. And is it worth it? Hell yes. The joy is overwhelming. To be able to buy clothes in a regular store. To tie my shoes. To be able to walk even a block again. To lose the painful edema in my feet. To sit comfortably in an armchair. To wear my cowboy boots again. To know that my blood sugar levels are down and that I don't need to take as many meds. To know that I'll be able to spend even a few extra years with the husband I adore. Worth it? Oh, yes, yes . . . YES!

They are both eye opening ! Sandy

Michael, Once again, great job! You approached every difficult subject that we go through. Thank you again for your eloquence. I hope you will submit it to an editorial section in a newspaper....I'd love to hear the response of a general population. ~~em

Micheal, I want to thank you once again for doing something for this group that is so meaningful. I know that there are alot of us in this group that are not as eloquent with words as you are, and it is very nice of you to put into words what some of us are feeling. I don't want to speak for everyone because I don't know what they are thinking, but you have nailed this to a tee for me. Christine

Very well said, Michael! I've been worried about people telling me that I took the easy way out. I've told very, very few people that I had surgery. I used to work at my kids school. I see some former coworkers and friends occasionally when I go pick them up. One lady, who has lost about 200 pounds through extreme diet and even more extreme exercise, asked me how I'm doing it. I just laughed and said, "Oh, you know!" My Mom once told me that she'd better not ever hear anybody saying I took the easy way! Yeah, like she's so tough! If somebody says something to me, I'm going to direct them to your letter and tell them to bite me! Thanks! Jenn