KimD.

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Obesity & Me

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

I could never talk about my size. I never wanted anyone else to talk about it either. Once my brother said he could guess what I weighed within 10 pounds and I screamed at him to keep his mouth shut. He didn't get it and asked me,"Why, what's the big deal?" I totally lost control, yelling at him to shut-up and ran from his house and went home. It was a complete melt down that left me trembling and crying and afraid he said it after I left. I was so horrified about how I looked and I didn't want to know what anyone else thought of me. What if he thought I weighed more than I did? Then I would know I was even more hideous than I thought. Weight loss programs never worked and after I started diabetes meds I seemed to have an even worse problem getting it off. I had become resigned to the fact that I was a useless instrument in getting the weight off and I knew I was going to die, probably soon and probably of cardiac related disease.

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

Never fitting. Not in airplane seats or restraunt booths or turnstiles or bathroom stalls but even worse was not fitting on the inside. Being uncomfortable in groups where I was always the largest person and therefore in my mind less attractive. I never felt as graceful or feminine as the other ladies. I also felt that physical intimacy with my husband was restricted because of my impediments in mobility.

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

I can cross my legs and sit like a lady. To me this is huge as I feel more feminine than ever. I am also able to be less of a lady with my husband during intimate moments. (woohoo)

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

My first introduction to WLS was through a friend. She had lapband surgery and had paid for it herself at great personal cost. I had reached a point where I thought I was never going to lose the weight and would probably die prematurely because I was so overweight and now diabetic as well. I had decided to find financing to pay for the lapband surgery and contacted my friend who told me about R-N-Y surgery and how it was covered byt OHIP in and out of Canada. She put me in touch with a woman who belonged to a support group for WLS and I went to a meeting. The people there were so informative. Within 2 or 3 weeks I had my approval and shortly thereafter a date for my surgery. I was so impressed with the health and vitality of the people I had met at the group. Even with the malabsorptive problems these folks were saying they had more energy and enthusiasm for life than they could ever remember having as obese people. Their enthusiasm and information made the entire process a smooth sailing for me. No anxiety at all.

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

I am Canadian and therefore it was fully paid for by OHIP as I met the criteria for approval. However I was very careful to give them answers to any questions while I was applying. The people at the support group gave me pointers on what information to include and I did it ALL! Including sending a picture of myself from the neck down in my underwear.

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

I researched the surgery extensively before I had my consultation. I was able to ask very pointed questions. The initial seminar was in a group and the MD gave us a brief comparison between lapband and R-N-Y surgery. There was a question period and then each individual was given a basic physical exam by a nurse and then a short private meeting with the surgeon. It was informative if fast but I didn't really learn anything new that day because my research was thorough. I benefitted most by meeting the doctor and gaining confidence in him.

What made you finally decide to have the surgery?

To be completely honest I decided to have the surgery so that I could have a longer life to spend with my husband. We had only been married for 6 years and I felt like he was truly a gift from God that I was going to squander because I was so huge I was going to end up dead and lose the little peice of heaven I had right here on earth. I had the surgery so I could have more time to spend with him!

How did you decide which proceedure to have?

There was never really any question. I coudln't afford to pay for lapband and the one person I knew who had it was unhappy and applying for R-N-Y revision so I went with the RNY. It just seemed to have a better built in system for long term success.

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 well checked out. I had a cardiac work-up before I even applied and knew my heart was strong and healthy. I also had a pulmonary function test prior to my application so I knew that was not a concern. The hospital where I had my surgery (Barix) specializes in bariatric surgery so I had confidence in the surgeon and the staff as this is the only type of surgery they do so they had lots of experience. Also the follow-up care is really great with Barix so I felt that I would be well cared for after the surgery where I think the biggest risks are.

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?

Everyone was very supportive although concerned because of course statistics related to the surggery are not great. I explained that many people who woudl have the surgery could be extremely obese and have multiple comorbidities that would make it risky for them to have the surgery. Also there are many people having surgery by MD's who woudl not have had as much experience with this complicated surgery and after care considerations. I took my parents with me when I had my surgery and the hospital care I received and the hospital itself inspired confidence in them as well. Forrest Health Medical center (Barix) in Ypsilanti MI is without question the cleanest hospital I have ever seen. My mother is a nurse and she was completely impressed. She now refers people to me to get info on Barix. My entire family is so supportive that they have stocked their homes with things I can eat and drink for when I visit and I have talked to friends and family members of even my in-laws and have asssisted them to get the surgery approved as well.

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

My employer was very supportive. I am an RN and the hospital I work for is struggling to provide support for our bariatric patients. I was off work for 8 weeks and this was a problem with staffing to replace me but my general health was going to improve which would make me a more reliable and effective employee in the long run so they supported me and are currently in support of another nurse who is a friend of mine and is having her surgery next month. If my job was not so physical and I was not going to be changing my insulin requirments I may not have needed 8 weeks off. I felt so good while I was off but my PCP felt better be safe than sorry and kept me off the 8 weeks to allow for insulin adjusments etc. As it happened I had no insulin at all at 3 weeks after my surgery.

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

I lost a lot of blood during my surgery and had to stay in an extra day because my hemoglobin was quite low and they thought a blood transfusion may be necessary. There was a lot of blood left in my intestinal tract and it made me very ill feeling at first until it had all come out. It slowed down my recuperation at first because I was weaker with the blood loss but by the 2 nd post-op week I was feelign better and my hemoglobin was climbing so I had more energy.

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

No real anxiety but impatience was driving me crazy. I felt like I was on the edge of a precipice. My life was about to begin for real and I just wanted it to start. I know many people feel scared of the surgery but I felt like I was already dying and so if I died on the OR table it was inevitable that I was going to die anyway. No risk there at all I was just speeding things up in my mind.

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

I was completely swelled with the IV fluids I was given in the hospital. I did wonder is my surgeon was trying to drown me. Once the excess fluid was gone I felt remarkably good. Better than I expected. More energy than I expected and I overexerted myself once or twice. I also dehydrated so I think that people should really pay attention to their bodies and learn to tune into the signals their new body will give them. Really concentrate on themselves and make sure they follow doctors orders.

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

I had a 5 1/2 hour drive. I was supposed to stop every hour and walk to prevent blood clots. That was impossible as we were stuck in rush hour traffic on a major highway in the middle of Toronto. Also due to swelling my feet were as big as my head and I was very uncomfortable. I wish I could have lost the IV the day before I went home as my leg discomfort was the worst part of the tip and I coudln't get out and move around.

Please describe in detail what things you could and couldn't eat in the weeks and months following surgery. What foods have been off limits? Please explain how your dietary tolerance changed week-by-week, and then month-by-month since surgery.

Well the first two weeks were liquid only. Then pureed for 2 weeks. Honestly anything is pureed if you chew it enough but there are foods that DO NOT go down. At 3 1/2 months I still can't eat too many breads, especially soft breads. A thin peice of bread well toasted will go but nothing too doughy. Dry meats are also a no-no. Sugar doesn't work for me either. I have had a tiny peice of sweets over the holiday season and I ended up with a small taste of dumping syndrome I think. It was uncomfortable enough that I don't need to push that button again.

What was your actvity level in the days and weeks after surgery?

More energy than I knew what to do with. I felt better after the surgery with hardly any weight loss than I did before the surgery being allowed to eat whatever I wanted.

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

I take a chewable vitamin (flintstones) twice a day and most days I also have a Carnation Instant Breakfast with no added sugar. That is also full of vitamins and nutrients. In the beginning I also had protein supplements but I don't do that now. I do watch my protein intake through my diet and blood work has shown I am doing well except for a little iron and pottassium so I eat a banana daily and try to eat iron rich foods every day as well.

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

I belong to a local suport group that meets weekly and Barix has a great follow up program for nutritional studies. This is extremely important to me as malabsorption can cause huge problems. I do feel however that each individual also has to take responsibility for their follow up as well.

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

6 tiny scars, the largest is about 1 1/2 inches the smallest 1/2 an inch. Totally expected.

Please describe any plateau experiences you have had since surgery.

I stalled at 3 weeks and was very depressed about it. For 2 1/2 weeks the scale didn't move. I contemplated using it as a frisbee but my husband wouldn't let me. I was really upset and wondered if my doc had really done anything in there. I have never been completely happy with how much weight I have lost. Many people I have met have lost more weight than I have at this stage. I don't think sometimes that the doctor made this as malabsorptive as he could have.

Do you notice people treating you any differently now?

Definetly! Co-workers are always asking me questions and even the dietician I work with is using me as a tool for her learning. I am constantly talking/teaching about the malabsorptive process and how to ensure a good nutritional standing. My family is so excited for me that practically everyone is on a diet. Between my husband, 2 young adult daughter's and myself we have lost 130 pounds and even my brother, mother and father are on the bandwagon. To tell the truth I think my decision to do this has inspired people to respect me even more and it has changed my relationship with my father dramatically. He and I have a much deeper communication now than ever. I think this is because my weight has always been such a taboo subject around me and now although I still don't tell people how much I weight I will talk about how much I have lost. It seems a step toward being more open about something very personal to me.
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