Thursday, January 31, 2013

Fat Faqs: Why Have VSG?

When I updated my Facebook status last week with the news of my surgery approval, over 50 people "liked" my post and my wall was flooded with comments in support of my decision.  My cell phone lit up with texts from friends who knew I was waiting for this moment.  I'd been "vaguebooking" about it up to that point; I was occasionally dropping hints that something very important was brewing, but only a handful of people actually knew what I was referring to prior to the official announcement. 

Despite this outpouring of support, there are still some people who don't understand what I'm having done and why, or are worried that I'm putting myself in harm's way.  In my previous post I provided some links to information on the procedure, which explain the "what" portion of the question.  Now I get to address the "why" part.  

Why weight loss surgery in the first place?  Why not just do Weight Watchers or Jenny Craig or Nutri/system or Atkins or South Beach or...

...or yet another diet that will only put me right back in this same spot two years from now?

Here's the ugly truth: For 30 years I have struggled with my weight and battled to keep it stable.  All other efforts have proven fruitless in a long-term capacity.  I can lose weight on just about any program.  And I have. However at this point, keeping it off has become the issue.  I think VSG will be the tool I need to resolve my weight issues - and all their related manifestations - in the long-term.   It's not an "easy way out," by any means.  I have a SHIT TON of work ahead of me.  I still have to maintain a healthy diet and exercise regimen. VSG is not a quick fix or a miracle panacea.  But it IS a powerful tool, and any job is made easier and more effective by having the right tools.  

The root cause of my weight issue is that I'm a compulsive overeater.  VSG will not change that.  But what it will do is make it so that I CAN NOT overeat or eat extremely rich foods without getting quite sick.  Drastic?  Yeah.  But it's kind of my last hope.  

But aren't there complications?  What are the risks?  Is it dangerous?

No more dangerous, complicated, or risky than where I'm at right now.  

At nearly 42 years old, the physical effects of my excess weight are more than should be for someone my age. I have poorly controlled asthma, unexplained edema in my extremities, sleep problems, migraines, joint pain, and foot pain.   Carrying 250 pounds on my 5’5” frame, I am winded from the smallest exertion.  Just putting on socks is a monumental effort.   Tying my shoes is exhausting.  I haven’t had a full night’s sleep in years.  Anyone who has ever shared space with me overnight can tell you my snoring can be heard two rooms over.  I suffer from excessive daytime sleepiness, and I have often wondered if my attention deficit disorder is directly related to this.  And this is just the tip of the iceberg.  Let's not even go into the stress that yo-yo dieting puts on the heart and other vital organs.

While the physical issues are plenty, the emotional issues abound as well.  I try not to let my weight hold me back from enjoying the things that I love, but my social life has begun to suffer.  Even my closest friends barely see me these days.  I work a gazillion hours a week, and that's my excuse for never going out anymore, but the hard truth is that I do that on purpose as a way to avoid the real issue, which is that I feel like shit.

I have tried everything else, and I have put forth a sincere effort in every attempt, but yet another diet would only become another cog in the wheel of my never ending struggle to maintain weight loss.  VSG is my last hope, and at my age I don’t have time to keep playing this game.  It’s time for me to get on with my life and regain control of my health already.

That's my answer, and I'm stickin' to it.

Wednesday, January 30, 2013

Tripping Over the Stumbling Blocks

In early August I was running errands and realized I was going to be just about a block away from Synergy Bariatrics.  I had just gotten my registration packet from them, and in it there was a note about the various support group meetings that they hold.  This particular night was post-op support, so I decided to stop in and check it out.   I figured it would be good to get some perspective "from the ground" in addition to all the stuff I'd found online.

There were about two dozen people at this meeting, and mostly everyone there had had gastric bypass.  There were a few sleeved folks there, and a few pre-ops including one lady was going in for her sleeve the following morning.  She was there with her husband who was 5 weeks post-op gastric bypass.

I listened to the stories and I studied the faces as they talked about their journeys.  I saw "before" photos as they got passed around.  I became momentarily stressed out when a woman began screeching about her incorrect bipolar med adjustment after her 150-pound weight loss, but most of the stories I heard were triumphant stories of newfound joy in life,  renewed confidence, and restored health.   I started to cry a number of times, not just at the success stories of these people who were now so happy to be alive, but at the thought that I, too, could be one of them.

Before I knew what was happening, my registration packet had been submitted and I was sucked into a vortex of doctor appointments, consultations, blood work, paperwork, classes,  counseling, evaluations, food journals, and so on.  By the end of August I'd gotten all my paperwork in, had my consultation with the surgeon, and had a full blood panel drawn.  By the end of September I'd taken a nutrition seminar and scheduled my psych evaluation.  In October I was given psychiatric clearance and started the mind-body workshop with the counselor.

On October 25th, my world was temporarily shattered by the notification that Premera had denied my authorization.  Not to be sidelined so easily, I threw myself into action.  I gathered support letters from my sister and two of my best friends.  My doctor wrote a letter of support.  I wrote a four-page letter appealing the decision.  And just for good measure, I included an 8-page photo essay that chronicled my weight fluctuations over a 30-year span.

It worked.  The second time around they approved me, and I'm scheduled for my surgery on April 10th.  I have a million things to do before then - more bloodwork, pre-admission appointments, pre-op diet, medical clearance exams...and that's just the medical side of things.  I also need to make sure that I'm set up to take the time off from work, make sure I have my support team assembled, get the house organized so that said support team can find their way around and have a place to sit when they come over to hang out during my recovery, and I need to ensure that I have enough juice, broth, and water to get me through the first week so I don't have to worry about leaving the house.  It's a lot to think about, even more than two months out.

It seems so far away, but it's closer than I think.  Holy crap.

Fat Faqs: What IS Vertical Sleeve Gastrectomy, anyway?

I asked myself the same question when I first heard it mentioned.

So I did what any reasonable person would do, and I started researching it.  I found a number of web-based support groups, and a shit ton of blogs, YouTube videos, and sites created by and for VSG patients.   I was astounded at how much information is out there, and the more I learned about it the more comfortable I became with having it done.

Vertical Sleeve Gastrectomy is, in a nutshell, a procedure wherein approximately 80% of a patient's stomach is removed, leaving a tube - or "sleeve" - shaped stomach.  The capacity of the stomach is significantly reduced, and the section that is removed contains the hormone that regulates appetite, so hunger is suppressed as well.  It was originally performed as a preceding step to gastric bypass in extremely obese patients who were not physically sound enough to undergo the quite drastic bypass procedure.  However, patients started reporting great success with just the one surgery, so it became a mainstream bariatric procedure.

By virtue of reading this blog, you're already familiar with the internet and are perfectly capable of gathering your own information.  However, to make it slightly easier on you, here are a couple of helpful links to satisfy your curiosity:

Here's the Wikipedia entry, which explains it pretty well

This is from the "A Lighter Me" website, and also explains the procedure in detail.

This video explains the procedure

This video shows an actual surgery being performed (warning: this is quite graphic)

I kind of hate that they call it "The Sleeve," because it's misleading.  To me, it sounds like they put some kind of thing around your stomach, like a sleeve on a cup at Starbucks.  To others, they hear "sleeve" and think I'm talking about tattoos.  Or shirts.  "Sleeve" in this context really only refers to the new shape of the stomach.

So yeah.  That's what I'm having done. :-)

Tuesday, January 29, 2013

The Moment of Truth and the First Step

In late July of 2012, I got on the scale at my monthly doctor's appointment and watched as the PA pushed the big slider to the 200 notch.  That was nothing - I'd been stuck on that notch for the better part of the last 10 years.  But then I watched as she slid the little slider up past 10...past 20...past 30...past 40...and came to rest on 49.

I'd gained back two-thirds of the 75 pounds I'd lost since 2010 (aside from the 25 pounds I'd lost and regained in 2012), and for the god-knows-how-many-th time,  the yo-yo was on its way up again.  It'd become my modus operandi for the last 30 years: lose, gain, lose, gain, lose, gain, lather, rinse, repeat.

When my doctor (here on in referred to as Dr. H) came in to the examining room he went through the usual motions, writing scrips and listening to my lungs, and then he said, "anything else?"

I took a deep breath and said, " a matter of fact, I need to ask you something.  I'm gaining again.  What do you think about weight loss surgery?"

He cocked an eyebrow at me and I thought I was going to get the same speech my last doctor had given me, about how I should try Weight Watchers - again - and blah blah blah.  Instead, Dr. H let out a low whistle, clicked his tongue, and said, "I think it's a good idea and you'd benefit from it.  It's worth looking into, in my opinion."

Later that week I got up the nerve to make the call and found myself on the phone with Missy, a patient rep at Synergy Bariatrics.  She and I discussed the various available procedures, and I told her that while I had considered Lap-Band in the past, I was thinking that this time I might have to go whole-hog and do the Gastric Bypass.  She said, "what about the sleeve?"

I'd heard of "the sleeve" before, but as far as I knew it was still considered experimental and therefore not covered by most insurance.  Missy assured me that it had emerged from its previous experimental status and was now recognized as a common procedure.  She invited me to a support group for pre-and post-op patients, and told me she'd send out a registration packet the following day.

I had absolutely no idea what this "sleeve" business was about, so when I got home I started my research.  And this, dear readers, is where it all began...