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Diary Health

My weight loss surgery experience

On September 26, 2011, I had weight loss surgery.

Here I am right before the procedure. That day I weighed in at 257 pounds. I wore a size 26W (4X).

And here I am being released from the hospital a few days later, at 253 pounds.

After three months, I was already below 200 pounds. Here I am in November:

Over the next 15 months, my weight dropped precipitously, bottoming out at 127 in December of 2012. I was able to fit a size 6 at that time.

Around two years out from surgery, my weight stabilized in the 140 to 145 range. It’s stayed there ever since, and I now wear around a size 10.

I had struggled with obesity since I was a teenager. The most I’d ever been able to lose on my own was 50 pounds. I started investigating weight loss surgery in 2009 after recovering from congestive heart failure, but it took another health crisis to convince me to finally do it. In August of 2011 I was told, point-blank, that if I didn’t lose weight, I would go blind in my left eye. A buildup of fluid was pressing on my optic nerve and would soon block out my sight. I posted on Facebook:

Even though I knew it already, the doctor felt the need to repeat “IF YOU DON’T LOSE WEIGHT, YOU’LL GO BLIND” until I started crying.

Things were bad at that time. We had moved to Atlanta for Sean’s new job just months before, but he’d been shifted into contractor status, so he wasn’t guaranteed regular pay or health insurance. Meanwhile, I hadn’t yet found employment. I posted in a comment on the above status,

I am looking for a job and trying to eat healthier and work out more, but if being terrified into losing weight worked permanently, it would have happened back when I had congestive heart failure.

The health insurance we’d had through Sean’s job would expire in a month, and that insurance flatly refused to cover any form of bariatric surgery for any reason. I could prove it was a medical necessity, but they didn’t care. I felt so, so stupid for letting pride keep me from pursuing weight loss surgery back when I had insurance that would have covered it.

In this time of despair and desperation, extraordinarily generous family members came to my rescue. I’m not sure I can ever repay them.

I had the duodenal switch procedure done at Pacific Laparoscopy (PacLap) in San Francisco. Due to my circumstances, I was able to go through the approval process fairly quickly. I had to fill out a lengthy health and weight history questionnaire; undergo new tests (blood tests, chest X-ray, EKG, echocardiogram); have my GP, my neurologist, and my cardiologist sign off on the surgery; and have a psychological evaluation. We started the process on August 31 and managed to get everything done by September 14. Mom and I flew in on September 21, the pre-op appointment was September 23, and the surgery happened on September 26.

My relationship with food

Immediately post-op, I could only take in three sips or bites of clear liquid at a time. That first day I had broth, jello, a popsicle, decaffeinated tea, and juice. The next day, soft foods like cream of wheat, applesauce, mashed potatoes and yogurt were added to my tiny meals. After that, I was able to eat more solid food. But it was very difficult for me to eat. I could barely take in two or three bites, and I didn’t enjoy eating. I had to force myself to eat, and I had to be careful not to have even one bite too many, as that would have caused me to throw up.

Those first few months, eating right wasn’t very difficult for me. I couldn’t eat much at a time, and I hated eating and never felt particularly hungry, so it didn’t really matter to me what I ate. I’d grill a chicken breast and just eat that. A few hours later I’d eat a bowl of plain Greek yogurt. Later, I’d have a bowl of peas. Small frozen dinners were a mainstay. I have many pictures from restaurants demonstrating how very little I was able to eat. In this picture from September 2011 I’m taking home a piece of quiche and three links of sausage from J. Christopher’s; I had managed a couple bites of quiche and one bite of sausage:

The next time I went to J. Christopher’s, in October, I simply ordered the three sausage links and nothing else. I made other allowances when eating out as well, such as eating the fish and leaving most of the rice when I ordered nigiri, turning down side salads, and skipping dinner bread. Food choices were relatively easy; I had to focus on getting protein. My next priority, if I had any room left, was vegetables, then whole grains. Simple carbs were something to be avoided, and in the beginning, it was fairly easy to do so.

Over time, though, I gradually became able to eat more and more. Most of my stomach is gone, so I will never be able to eat as much as I used to, but I can eat a decent meal in one sitting these days–the size meal health and diet experts usually say you should be eating. I have also regained my enjoyment of food. I remember in the beginning wondering why other weight loss surgery patients were eating food that was bad for them, when it was so easy not to. Around the two-year mark, I understood. Food was delicious again. It was no longer a simple matter to avoid bad foods. This is something I’m still struggling with. While it is likely impossible for me to ever be obese again, I can still make unhealthy food choices that have an impact on my health.

Along with only accepting decreased portion sizes, my body reacts a little differently to food now. I can’t usually handle having sugar in the morning. If I have it, I end up feeling awful for about two hours. If I have a dessert in the evening, I generally choose something far less rich than what the old me would have gone for, for similar reasons. Eating really rich desserts doesn’t give me the pleasure it used to. Sometimes even a simple ice cream cone is too much.

I also don’t enjoy eggs the way I used to. There was a time when I absolutely loved eggs over-easy. They are still delicious, but I feel strange while and after eating them. The effect is short-lived, but it’s odd enough to make me seriously consider whether or not I want eggs. This is kind of a shame, since eggs are such a good source of protein.

Of course, the most notorious food effect of the duodenal switch is gas due to malabsorption. This has been a struggle for me. According to PacLap, foods that cause gas include white flour, white rice, sugar, beans, vegetables, some fruits, milk and milk products, and processed foods. I can avoid white flour with minimal effort. White rice is more difficult for me, but I haven’t found it to be particularly gas-inducing. Sugar, of course, is a challenge. I should be avoiding it anyway, as my surgery doesn’t affect the absorption of sugar. It’s hard to know what vegetables and fruits to avoid; I haven’t really figured that out. As for milk, I love having a bowl of cereal every now and again, but it may not be so great to do so. The big one, processed foods, is difficult to avoid in our packaged-food culture. Now that I’m working full time, I rarely feel like cooking, so I’m sure I’m eating a lot of things I shouldn’t be.

Thanks to the surgery, I am realizing more clearly that I have a strange relationship with food. When I am at a restaurant I love, I feel bad that I can’t eat everything. I want to enjoy the different dishes all at once. It’s as though I believe each particular visit is my last chance. I’ve found it frustrating to have to choose, and also to have to eschew foods I used to really enjoy because they will have ill effects on my stomach.

At the other end of the spectrum, there was a time when I would eat and eat and eat out of boredom. I can now pretty easily tell when I’m doing this, because I’ll be full and still trying to eat. During these times, it used to not matter to me so much what I was eating. Now, if the food doesn’t have enough protein, or if it’s too carby, I’ll get irritated by it, which I consider a good thing–it’s like a knock upside the head telling me to make better choices.

Exercise

Immediately following the surgery, I was encouraged to walk as much as I could without over-fatiguing myself. I was also encouraged to walk up and down stairs. I did pretty well in both regards. While I do spend a lot of time at a desk or on a couch, I tend to get antsy if I’m in one place too long. I like to be up and moving.

At first it was very frustrating how quickly I would get tired. I also wasn’t allowed to reach over my head or lift heavy objects, which was quite annoying for someone as independent as me. Sean was a huge help during this time.

Recovery took about three months. At that point I was able to pretty much go back to normal. I remember the first time I did an exercise video after having surgery; I was shocked at how easy it was without all the extra pounds weighing me down.

During the rapid weight loss period, I kept walking, did workout videos at home, and joined a gym. Unfortunately, after awhile these efforts dropped off, especially after I started working full time again. Now, at nearly three years out from surgery, I’m not particularly active. I do try to take the stairs at work, at least in the parking garage, and I go on photo hikes on the weekends…but I really need to do more, for the sake of my cardiovascular system. I’m considering taking up running again, or trying to ride my bicycle to work.

I can say that thanks to the surgery, I have plenty of energy, and if I feel like spending an entire day walking around, I can do it with no problem. This is not something I could say before this dramatic weight loss.

Next steps

Weight loss surgery helped me with the hardest part: losing over 100 pounds. It’s up to me to take advantage of this opportunity, to make good choices for my health. It’s something I have to work on every day. My fight to eat better and be physically active will never end.

There is one other thing I might do to make my transformation complete, and that’s reconstructive surgery. After losing this much weight, there’s a lot of skin left over. While I’m not unhappy with the way I look, the skin can be irritating to deal with. I don’t feel comfortable wearing sleeveless shirts, for example, and certain articles of clothing don’t seem to fit right. Health insurance generally only covers this in cases of medical necessity, so I would have to pay for it out of pocket, which I’m not sure is going to happen. Still, it’s something I keep in the back of my mind.

Final thoughts

Simple pride kept me from seriously pursuing weight loss surgery until it was almost too late. I felt that I should be able to lose weight on my own, and that if I couldn’t, it just meant I was weak. In other words, I was too proud to accept help. Eventually it got to the point that I had to choose between being proud and blind, or humbling myself and keeping my sight. It seems like such an obvious choice in hindsight, but when I was going through it, it was a struggle.

The lesson I’ve learned from this is that accepting help does not make you less of a person. It doesn’t mean there’s something wrong with you. It just means you’re making smart choices.

Every day I look in the mirror and like what I see. Every day I pull on clothes I never thought I’d fit into. Every day I feel healthy and strong.

I am so happy that I had weight loss surgery.

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