Fw: Dying To Be Thin: Journal Repost

[Guest guest]

Pam in NC

Pre-Op Wt 318 @ 5 ft. 5

MGB Surg.= 1/4/99

Lowest Wt.= 143 10/99

Reversal of MGB= 10/24

Current Wt= 165-175, Holding healthy and happy

Re: Dying To Be Thin: Journal Repost

>Dear Tammy and Gang

>

>Here you go.....This post is very long and includes my answers to some of

>the FAQs which have been posted over and over. If after reading the

" novel "

>you still have questions, e-mail me your concerns, questions and I'll do my

>best to answer them or direct you to someone who can.

>

>---Original Message-----

>

>Dear Gang,

>

>I've been away from the computer and group for so long that I hardly know

>where to begin. What I am attempting to do in this message is detail my

>experience with MGB surgery, how my life has changed because of it and

where

>I am now.

>

>Before I get into details let me say unevquivocally that I feel Dr. R is a

>top notch surgeon who will do everything in his power to see that things go

>smoothly and any problems which do arise are handled expediently.

>

>None of the problems I have/had since my surgery are the result of poor

>medical care by Dr. R or Durham Regional. I apparently am in that 3% of

>patients who have been through this surgery and developed serious

>complications that were not easily or quickly manageable.

>

>My surgery date was Jan 4, 1999. I weighed 318 pounds pre-op. My hospital

>stay was only 2 days and I had relatively little pain after the first day

or

>two. My at home recovery seemed to be going well too. The juice and

> " liquid portion " of my diet were not difficult to maintain (But then I've

>always been a juice drinker). By the end of the first month I was able

(Dr.

>R quit reading here.....) to eat a few bites of (ground) of turkey and

>steak. The second month I started adding additional foods a few at a time.

>Everything seemed to be going well, except that I was disappointed with my

>rate of weight loss. It seemed like everbody else was losing faster. I had

>to keep reminding myself that everyone's metabolism has its own natural

>pace: some lose 2-3 pounds in a day or two and then don't lose for another

>week; some lose steadily at about 1/2 to 3/4 pound a day.

>

>I really didn't notice much visual change or clothes size changes until the

>end of the 2 - 3 month. After that initial period I averaged 1-2 dress

>sizes per month. This was with almost no exercise other than walking and

>occasionally water aerobics. ***No-No # 1: Don't sabotage your progress

by

>skipping exercise. Even if it's only walking down your block or back and

>forth around your neighborhood, DO SOMETHING. This is one of those don't

do

>as I do, Do as I say.... Now my weight loss is stabilized but the rapid

>weight loss without a regular exercise routine caused me to lose not only

>fat but muscle.

>

>February 1999: By the end of Feb. I was having a lot of stomach

>discomfort/pain and was getting nauseous. Dr. R and my family Dr.

conferred

>and I started on Reglan, Propulsid, Prilosec, Zantac, Actigall....you get

>the picture.....if there was a " stomach " medicine out there I tried it.

>During this month the only things I could eat were Frozen Lemon Slushes and

>Dill pickles.

>

>March 1999: Nausea and constipation continue. Began a series of tests,

>Edoscopy, ERCP, Flex. Sigmoidoscopy etc. They found no leaks but did find

a

> " marginal " ulcer had formed at the edge of the new stapled stomach where it

>was joined with the new small bowel connection. The excess bile " pools " in

>the indention between this area and erodes the stomach lining.

>

>Treatment of this ulcer which was not responding to conventional

medications

>resulted in a cauterizing of the bleeding ulcer during an endoscopy with

>biopsy.

>

>April 1999: Ulcer somewhat improved. Still a lot of foods I can't eat,

>some because they make me sick to my stomach and some that have just lost

>their taste. I was a meat and potatoes girl before surgery (and in our

>house gravy was a " beverage " ). Since this surgery (up to this point) many

>of the foods I loved before are no longer palatable to me: Potatoes

>(Mashed, Stewed, (months later, fried), Catsup (which I ate with almost

>every dish) would sit and go bad before I could finish the bottle.

>

>May 1999: Staying fatigued, noticed some weakness in my left arm and leg,

>couldn't sleep, depression returning because I was sick and tired of being

>sick and tired. Dr. R told me to use the " nibble & graze " eating

>method----meaning 6, 8, 10 small meals/snacks a day instead of 1 or 2 big

>meals.

>

>June 1999: Epigastric pain gone; severe constipation set in requiring

>frequent enemas and Citrucel and stool sofetener. (See Nov/Dec for details

>for more information on bowel habits)

>

>July 1999: Getting ready to start back to work in our local school system

>after a two year absence; excited about going to summer conference. Felt

>great, was able to eat small portions (2-3 bites). Got to summer

conference

>and had to introduce myself to people who hadn't

>seen me for a while. Heck, I didn't even recognize myself when I'd glance

>in those floor to ceiling mirrors along the halls.....But, boy did I look

>good! Talk about an instant ego boost.....the looks from people who knew

me

>(and especially from those who didn't know me before the MGB) were a

>trip......It really added to my confidence level. About 80 lbs lost.

>

>I hit the sales racks and went clothes crazy.....By this time I was down to

>a size 20/22 and sometimes an 18. ***NO-NO # 2: Buy only a few essential

>items a month. I now have a closet full of " professional " type clothing,

>most of which have never been worn in sizes ranging from 22-12.

>

>August 1999: School began on August 1 for teachers (I was a vocational

>guidance counselor). The first couple of weeks went well, but I found I

was

>once again not able to eat. Everything made me feel like I was going to

>throw up and I literally could not stand the thought of any type of " real "

>food. I did manage dry Mixed Baby cereal (box), applesauce, popcorn with

no

>butter. Bread was extremely difficult to digest and didn't really taste

>well either and the fresher the bread the worse the wadding up like paste

in

>your mouth. I was lucky to be able to eat 300 calories a day.

>

>September 1999: Problems increasing. Totally fatigued, mental clarity

>fading fast, increased migraine HA. We went home for my Brother-in-Law's

>funeral and family members were so shocked at my appearance that they

called

>my husband Bobby aside and asked him what was going on.....I looked so out

>of it to them that they thought intervention was necessary.

>

>I had to go into the hospital for 3 units of blood because I was so

severely

>anemic, all my electrolytes were out of whack, my protein levels were in

the

>pits, my potassium was off the bottom scale, etc. I litterally did not

>have enough strength to walk by myself to the car from the Dr.'s office.

>When I got to the car and got the door open I had to use the steering wheel

>to help pull me into the car and then reach over with my right arm and lift

>my left leg into the car.

>

>October: This is the month where it all reached a boiling point and

>something had to be done or my doctors tell me I wouldn't have made it

>another week or two.

>

>I was hospitalized at the first of October for more tests and to try to

>build up my potassium via IVs since my body was not absorbing any

>protein....even from the vitamins. *No-No # 3: Do Not Forget to take

your

>Vitamins DAILY!!!!!!

>

>During this hospital stay the results of an upper GI with Small Bowel

follow

>through showed that my stomach was not emptying. What food I could choke

>down just sat in my stomach. The Gastroenterologist who saw me said I had

> " stomach paresis " which means basically that my stomach wasn't getting

>signals to move the food on.

>

>By October 22 when I went back to see my Family Doctor the results of my

>Chem-7, Smack 20 and whatever other hundred things they tested for showed

>drastically low numbers in all categories, especially, protein, potassium.

>

>Dr. Bowen (PCP) was so concerned that he called Dr. R on Saturday and Dr. R

>arranged for me to have my surgery reversed on Oct 24. We drove straight

to

>Durham Regional Hospital and within an hour I was prepped and ready for

>surgery. The revision went smoothly and I was home 2 days later.

Everything

>seemed to be going fine. I still have to take 3 phenergren a day along

with

>Zantac and Prilosec if my stomach is acting up.

>I still could not eat....even the thought of food made me want to

>gag....forget Ensure, Boost etc...they were so rich I couldn't tolerate

them

>either.

>

>During my DRH stay I had to recieve 4 more units of blood. I lost 80 pounds

>between late August and October when they un-did my bypass.

>

>Everyone asks if I would do it all over again given the

>problems/complications that have arisen. My answer is that if this surgery

>only affected me and it came to a point where I wanted it done or re-done

as

>the case may be I would still be in favor of the procedure.

>

>However, my husband feels differently. He is now vehemently opposed to the

>procedure...He says he would rather have a healthy 300 + wife than an

>anorexic skeleton or someone whose 158 pound weight loss left no quality of

>life to be able to enjoy the " new " me.

>

>Our daughter who at age 17 also had the surgery performed ( June 1,

>1999) She has had excellent weight loss results (100 lbs) and now wears an

>11-12 jeans, and a medium/large shirt. She has had a great deal of

residual

>pain, feels generally yucky, has had an appendectomy and gall bladder

>surgery since her June operation.

>

>September and October were my worst months...I was literally a walking

>skeleton with just barely enough strength to " shuffle " across a floor. I

>had to hold on to someone or something to step up on a curb going into a

>store etc. The only thing that didn't happen was that my depression was

>relatively moderate considering the fact that my life and health were

>(again, literally, and without trying to sound overly dramatic) hanging in

>the balance. My family physician, during October told me he didn't think

I

>realized just how sick I was. I guess he was right. It wasn't until late

>December, after my revision and when I was once again healthy enough to

>begin to understand the gravity of the situation necessitating the reversal

>surgery that he confided that he really thought I might not survive if

>something weren't done immediately. Feeding tubes were discussed (even

>after the surgery...see paragraph below) but on Saturday, October 23, after

>reviewing my latest lab (Chem 7, and 14 dozen (so it seemed) tests HE

phoned

>Dr. R and aprised him of the situation. Dr. R immediately called me and we

>determined that I would be driven to Durham early Sunday morning and would

>have reversal surgery that same day upon arrival.

>

>At my lowest weight prior to the revision I had lost down to 143 lbs. Now

I

>am holding steady between 170-175. I can eat again thanks to Remeron (an

>antidepressant which also stimulates appetite ..considered a bad side

effect

>for most people, but was part of what I needed to stimulate my appetite)

and

>erythromycin (an old-time antibiotic which has as one of its " side effects "

>stomach cramping). That's what I need to get the food moving. The

>combination of the two have really helped. I can now eat pretty much any

>thing I want, but just in small portions. Dr. R's " nibble and graze "

>philosophy has served both and I well since my revision.

>

>November and December were spent trying to regain enough strength to lead a

>normal life instead of having to hang on to something to step up 2 very

>short steps, up on a curb etc....I literally did not have the strength to

>lift my legs. I could not pick up or hold anything with my left hand and

>arm because they were so weak. It took all the energy I had just to walk

>from my bedroom to the living/dining/kitchen.

>

>Since Jan. I have been improving. I am much more stable on my feet now,

but

>still have to be careful about tripping or falling. My sense of

equilibrium

>is still a little " iffy " at times, especially on downhill slopes and uneven

>ground. It has been (and continues to be) a slow process but I am hopeful

I

>won't regain all my weight.

>

>Here are a few more general observations and recommendations from me to

>everyone having this surgery.

>

> ****Read everything you can (good, bad, indifferent). Realize that the

>disclaimers on the website about MGB being major surgery with the potential

>for life threatening complications, some of which can be anticipated and

>some of which may not have been enumerated is true and be prepared for all

>contingencies. The human body and medical science (even in the most

skilled

>hands of surgeons like Dr. R are a crap shoot at times.

>

>*****Don't assume that because the first month or two go smoothly that the

>battle is won. Maintain a vigilant " follow up " plan with Dr. R and your

>primary care physician. Make your family and immediate support group aware

>of the danger signals in the event they " sneak up " on you like they did me.

>

>What I am going to say next will sound melodramatic to most and

>hypochondriacal to others, but it is what I believe with all my heart (hind

>sight being 20/20 as they say): HAD IT NOT BEEN FOR MY MONTHLY, and

>sometimes bi-monthly, VISITS WITH MY FAMILY DOCTOR I MIGHT NOT BE ALIVE TO

>BE TYPING THIS JOURNAL.

>

>*****Don't " beat yourself up " if your weight loss doesn't seem to be going

>as fast as others who are posting their results. The " old hands " will tell

>you we have all had to fight the comparison/envy game. Everyone's body

>responds differently. Some lose 1/2 to 3/4 pound daily month after month.

>Others may not lose for a week and then suddenly realize they have lost 3-4

>pounds.

>

>*****Take pictures at least every 3 months. You will be amazed at the

>difference and the progress you are making will be more obvious to you in a

>photo than by looking in the same mirror every day.

>

>*****Do not be afraid to query Dr. R about any problems you are having. If

>something can be done to fix them, he will know what that is. It may take

>several tries of different options but he will be with you every step of

the

>way IF YOU STAY IN CONTACT. This is another one of my don't do as I do, Do

>as I say edicts.

>

>*****Take advantage of the support group of pre- and post-op patients.

>We've been there and done that, and we may have insights which can help you

>over the rough spots. Even those of us who have moved on with our lives

and

>may not spend as much time on line or answer every query will help if asked

>directly. Sometimes the sheer number of e-mails if you are an active

member

>of onelist are so daunting (especially to those who may not be feeling

well)

>that it's too overwhelming even to begin to answer them. Those of us

>old-timers though can usually point you to one or two others who are or

have

>experienced the same things you may be facing and you can write them

>directly. Personally, I will always take time to talk to someone if they

>phone me or even if they call and leave a message if I am not home, I will

>return the call within a day or two.

>

>Below are a few of the questions which have been e-mailed to (my

>daughter, age 18 as of 4-3-00) and myself. My answers will be OUR

>experiences and may or may not happen the same way with you:

>

>Q. How long had I been thinking about having this operation?

>

>A. I was familiar with the " old " Roux-en-Y (? sp.) operation and began

>looking into possibilities other than diets, meds, nutritionists etc in

>early August of 1988 shortly after my mother died of a pulmonary embolism

>after years of hypertension, phlebitis, congestive heart failure and even

>sudden cardiac death experiences. My father died at the age of 52 of a

>heart attack. As my daughter is fond of remarking " Our gene pool sucks! "

>and I knew I had to do something. Since I was already on disability leave

>from work I thought this would be a good time to explore possibilities.

>

>Q. How did you hear about Dr. R and the MGB

>

>A. I looked up Bariatric Physicians on the Web and began scanning the info

>about each and the " programs " they advocated. I wanted a physician

>relatively close to home and found 2 in Charlotte and Dr. R in Durham. I

>actually had an initial visit with the surgeon in Charlotte, but he only

>performed gastroplasty (stomach stapling) and did not advocate " by-pass "

>surgery at all. Even he wasn't aware of Dr. R's procedure until I told

him.

>Next I read and re-read everything I could that Dr. R had on his web site.

>Then I called his office and lo-and-behold the great man himself answered

>the phone (he even postponed temporarily leaving the office to go by a

chain

>saw in preparation for a hurricane that was approaching). We talked about

>30 minutes and I decided I definitely wanted a face-to-face appointment.

The

>rest, as they say, is history.

>

>Q. Was it extremely hard to do the juice thing for the first month or so.

>

>A. Nope. This was the easy part for me but then I've always loved juice

so

>this wasn't a real hardship. I did miss the " chewing " aspect of eating and

>when I started dreaming about Banana Nut Muffins I decided to " go off the

>wagon " and eat one. It tasted every bit as good as I expected but it took

>me 4 days to finish one muffin.

>

>Q. Do I miss eating any foods? Have your tastes changed?

>

>A. During the several month period when I couldn't eat because of the

ulcer

>and later on the severe malnutrition and nausea I really missed enjoying

>food (any food) period. I guess it was at this point that I realized just

>how much of my life and itenirary revolved around meals, food, and snacks.

>Now that I can eat again without pain and limited nausea (controlled) I am

>once again getting pleasure and appreciation from food.

>

> My tastes have changed drastically. For the first time in my life

that

>I can remember a bottle of Ketchup had to be thrown away because it spoiled

>before I could finish it. My husband (once I was better) joked that they

>probably should have just hooked me up to a ketchup IV since I used to have

>a little food with my ketchup instead of the other way around. I was a

meat

>and potatoes girl....it is just within the last couple of weeks that I have

>been able to eat baked potatoes...in fact the more bland the food, the

>harder time I have eating it....go figure! I tend to go on binges of

eating

>primarily one thing until I'm tired of it and then I move on to a new food

> " addiction " . Right now, I'm ending my Waldorf salad fixation period and am

>into steak (3 oz. size) (with BBQ sauce instead of Ketchup) and salad with

>Country French dressing. It is only within the last month that I have been

>able to eat ground beef. For months I couldn't tolerate meat (or

vegetables

>for that matter) of any kind. I lived (if you can call it that) on dry

>Mixed baby cereal, dill pickles and an occasional bite or two of raisin

bran

>or corn flakes....complete with protein powder as a condiment on all the

>above. My craving for sweets diminished, but I couldn't get enough salty

>foods. I don't know that there is any medical significance to that (other

>than the obvious fact that protein was obviously lacking), but that's the

>way it was.

>

>Q. Did you have any side effects and how long has it been since your

>operation.

>

>A. The side effects I experienced you've already read provided you've

>stuck with this " War and Peace " version of my life since MGB surgery. My

>surgery was on Jan. 4, 1999. My pre-op weight was 318 pounds at 5'5 " . My

>short term goal was to get below 250. My mid-range goal was to get below

>200. My long term goal was to be able to wear a size 16 or less. 's

>long range goal was to be a size 11-12 or 9-10. She had surgery on June 1,

>1999. Her pre-op weight was 252 at 5'7 " . She now wears a size

Medium/Large

>shirt and size 10-12 shorts, jeans (depending on the make). Her new

>swimsuit is a size 12 and her dad may not let her out in public because she

>is a " killer " in the looks department now. She was always pretty, but now

>heads turn when she walks into a room. I'll try to get her to scan in a

>picture from her prom in April of 1999 and a current picture soon.

>

>Q. How has it changed your life.

>

>A. The most drastic changes other than health wise which you've already

>read about involve my relationship with food. I don't spend 3/4 of my time

>figuring out where and what I'm going to eat next. I have had to develop

>new interests. Until the health problems cropped up, I enjoyed being able

>to do things that " normal " size people think nothing of: Going to

Carowinds

>or a fair and actually being able to fit into a ride; shopping in clothing

>departments I haven't visited since high school; being able to leaf through

>a Roaman's or Lane catalog and then chunk it in the garbage can,

>because I can buy clothes in almost any store now; fitting into a booth in

a

>restaurant; being able to go through a turnstile at a concert hall or

>amusement park without " lifting and throwing " my stomach over the bar and

>hoping it would turn!

>

> It has also been a blast seeing the reactions of co-workers or

>others (including family) who haven't seen me in several months. They are

>literally speechless and most don't recognize me until I speak to them or

>re-introduce myself.

>

> Less positive changes include major hair loss (I look like a chemo

>patient), the slow recovery from my anorexic weight loss and protein

>deprivation resulting in severe anemia. I also think that I look 10 years

>older than I did when I weighed 300+. My face is thin now but it seems to

>have lost its youthful appearance. I look 46 now but then, I am 46 so

maybe

>my age has just finally caught up with me. It's also time to consider a

>panniculectomy to get rid of the excess stomach pouch....I only look 3-4

>months pregnant now instead of 12!!!! I look pretty good with clothes on,

>but the " saggy, baggy elephant " look is obvious when the clothes come

>off....One more reason to make sure you establish SOME TYPE of EXERCISE

>PROGRAM for post-surgery.

>

> My body thermostat seems to be out of whack too. I stay cold, chill

>easily and dress in 4 layers of clothes. There have only been two days

this

>spring that I have worn a short sleeve shirt. Oh well, maybe my air

>conditioning bill will be considerably lower this year......I'll keep you

>posted.

>

>Q. Would you do it again knowing what you know now?

>

>A. If I were single yes, but I couldn't put my family through what they

>have had to deal with over the last year ever again if I have any control

>over the situation. My husband (for whom my weight has never been an issue

>in his love for or attraction to me) says he would rather have a 300+ pound

>wife who had some quality of life, than a " skeletal...or worse " mate.

>

> says she would not recommend the procedure although all her labs look

>great, she has not experienced hair loss and can eat anything she wants.

>Her current problems are more the result of her appendectomy and gall

>bladder surgery than the MGB.

>

>Q. Have the health problems you were experiencing prior to the surgery

been

>resolved?

>

>A. Initially, my blood pressure was well within normal ranges without BP

>medicines. However, in the last 3 months my hypertension has returned and

I

>am once again having to take medication. I also have experienced severe

>edema in my legs, ankles and feet. At one point for over a month my legs

>looked like gourds which were about to split open and my ankles swelled

over

>my shoes. Aldactone (a diuretic which depletes potassium less than others)

>has helped as have Ted support hose. Most of my irritable bowel symptoms

>have subsided and I've not experienced any " dumping " since the surgery or

>reversal.

>

>Q. How much and how fast did you lose weight.

>

>A. My weight loss averaged about 1/2 pound a day and I didn't hit a

plateau

>until about the 2nd month for a week or so. on the other hand lost

>much more slowly at first, would go for almost a week without losing any

and

>then show a weight loss of 3-4 pounds. PLEASE DON'T GET HUNG UP ON THE

> " POUNDS LOST MERRY-GO-ROUND.) Consider instead or at least in addition the

>loss of inches and clothes size.

>

>The moral of this whole dissertation is that no one knows what is right for

>you but you. Only you can decide if the advantages outweigh the risks.

>Those of you who are now in the pre-op phase have the advantage of having

>100 or so people who are 6 mos. to a year post-op who can detail their

>first-hand experiences for you.

>

>The sample patient letter on Dr. R's web site was written by me, so I can't

>say I didn't know what I was letting myself in for, but I honestly did not

>expect to have the severity of problems that I did. Fortunately for most

of

>you who will choose to have this procedure you will be in the 93 - 95% of

>patients who have few side effects or relatively minor complications which

>can be readily solved. Just be aware that the other 7% of us are out here

>and that you may fall victim to complications you never expected.

>

>For those of you who are out-of-state especially.....It is ESSENTIAL that

>you maintain frequent contact with both Dr. R and your Primary Care

>Physician!!!!! Make sure your personal support group knows the danger

>signs. Call Dr. R with any questions (no matter how trivial they seem). I

>don't know when the man sleeps but he ALWAYS answers his pages and e-mails.

>

>If I can be of further assistance I am more than happy to oblige. My phone

>number should be listed in his patient manual. If not please e-mail me and

>I will give it to you. You can also reach me by e-mail psgreer@...

>

>Good luck. I believe in Dr. R and his procedure! Nothing that happened to

>me is the result of anything he did wrong, or sloppily or a reflection on

>his surgical skill and his dedication to those of us the rest of the world,

>including many in the medical profession have " written off " as hopeless.

>Above all else, he wants prospective patients to have a complete, unbiased

>picture of what lies ahead......Good luck to you all.

>

>NOTE: MAY 2000 UPDATE:

>

>My strength is much better. The last time all my blood levels were checked

>they were fine too. My weight is creeping back up so I'm trying to be

>careful not to undo all the progress made so far. My headaches are

>worsening (not MGB related) and my blood pressure is staying elevated (but

>not as drastically as before the surgery and wt. loss). The biggest

problem

>I am having now is fighting depression. Given a choice I would just stay

in

>bed all day. I can't seem to get motivated to do anything. I really need

>to go back to work for financial reasons but don't think I could keep a job

>with all these health problems still unresolved.

>

>

>Pam in NC

>Pre-Op Wt 318 @ 5 ft. 5

>MGB Surg.= 1/4/99

>Lowest Wt.= 143 10/99

>Reversal of MGB= 10/24

>Current Wt= 165-175, Holding healthy and happy

>