In August 2011 I signed up to attend a free Bariatric Center information session at a nationally respected local teaching hospital. My husband came with me so he could learn more about the procedures and what my lifestyle would require post surgery.
First impression: Wow, I think I might be in the best shape of all the people here. At a BMI of 41, I was not expecting that. Several are having labored breathing just walking to the conference hall. Everyone is very welcoming and warm. The center's coordinator starts things off and then hands the mike to the director (one of two surgeons for the center). She's also very gentle and supportive- congratulating us all for having come to the session and knowing that we've all been through a lot to decide this is necessary to consider. She details the three types of surgery they perform (gastric bypass, lap-band, and gastric sleeve) and their risks and average outcomes. I quickly decide that I will be considering the gastric bypass when she says that they recommend it for type II diabetics, and that clinical trials show it "cures" most type II diabetics by making their pancreas start producing more insulin again, even before any weight is lost.
The pre-surgical prep is extensive. At least three months of medically supervised dieting checking in monthly at the center. Meetings with the surgeon, nutritionist, psychologists, sleep studies, ekgs, labwork, x-rays. I'm a bit surprised by the sleep study, as I rarely wake up during the night unless one of my kids is calling for me. I ask if it's necessary, and they respond that over 85% of the patients they refer are diagnosed with sleep apnea. Being a sound stomach sleeper and thinking of the mask and wires, I have reservations, especially thinking that this will be one more night/ morning that my hubby will have to handle the kids on his own. He later tells me not to worry about it.
Another person from the bariatric center talks to us about the financial process, and everybody hangs on her every word. The surgeries range "from $20,000 to $30,000" and are "more expensive at the main location, less expensive here" (in the suburban center). Ouch. Still, I've already spoken to my insurance company and they say that they have a $15,000 lifetime cap, but at least it is a benefit. Some insurance companies still don't cover it. Having a BMI over 40, I qualify. Having a co-morbidity of diabetes mean I would qualify even if my BMI was 35-40. This is good news, because with the pre-surgical diet, I might go down to 40.
After surgery I will be in the hospital for 2-3 nights. Initially I'll be on clear liquids, then full liquids, then soft foods. By 6-8 weeks however, they need you to be eating regular food. Since my stomach will now be the size of an egg, I will eat VERY LITTLE and feel full. That's great, because I'm a volume eater. I'll choose to eat 6 cups of popcorn than 16 pieces of skittles because I need to feel the fullness to be satisfied. I will also have to learn not to drink while eating - I simply won't have room for the nutrients I need and liquid. Also, the liquid could wash some of the food out of my stomach prematurely. I'll need to sip water frequently through the day to stay hydrated. Your food needs to be chewed 30 times before swallowing because it won't be in your stomach as long to be digested. I try this later at home and find it's kind of gross feeling liquified food swishing around in your mouth, but I'll get used to it. Here's one I didn't know about ahead of time. No more soda-pop. Really, not even diet? I'm a lifetime diet pop drinker, and a caffeine addict in the morning (but I don't like coffee or tea). Apparently carbonation is VERY uncomfortable in your new small stomach and they chuckle saying "everybody tries drinking it ONCE, but then swear never again". Bummer. Add weaning myself off caffeine to the pre-surgical list. People who have the traditional gastric bypass are also prone to "dumping syndrome". That means that most of us will be unable to eat sweet creamy temptations like ice cream or fudge without experiencing cramping, discomfort and diarrhea. Yuck. However, I agree with the surgeon - this is a positive behavior reinforcer. I shouldn't be eating that stuff anyway in my new stomach. It reminds me of the medicine that alcoholics can take to make them sick if they have alcohol.
I will need to exercise regularly and I'm actually looking forward to that. I already walk 1-2 miles a day with my dog (usually the one to be honest), but if I have more energy then I can do more exercise. Swimming laps used to be so relaxing, but now after 6 laps I'm too tired. To be able to have the energy to bike when the kids ask me... and being a good role model for my kids means a lot. They've inherited the low tone chunky body type, but that doesn't mean they have to become obese like me.
The average patient loses 60 - 80% of their excess weight after 12 months, and at 5 years, 85% have kept it off. LOVE THAT. While curing my diabetes is my first goal, I would love to be a healthier weight, have more energy, fit into non-plus size clothes. When I was a teenager I dieted (and eventually starved myself) until I got to 112 pounds. Unfortunately, my naturally endowed bust didn't shrink at all, and I felt I ended up looking a stripper with breast implants. Even though I wore a size 8 in pants, I wore a 14-16 top. I stopped starving myself and kept eating healthy for a couple years and settled into a weight between 125-135. That felt ideal. At this point, I would be really happy to get down to 160. When I was 26 I was swimming with a master's club twice a week and was a strong 160.
My husband's impression: This is more about the work you do after the surgery than the surgery. Yup. He thinks it sound like something I could really do well at, and so do I.
I'll have monthly support meetings and checkups at 1, 3, and 6 weeks, 3 months, 6 months, and 12 months. I'm excited!
*A word about dieting. Other than the crazy cut-out-everything-with-sugar-and-fat I did as a teenager, I have dieted with weight watchers and nutrisystem. Nutrisystem helped me lose over 30 pounds (15% of my body weight) which felt great, but as a vegetarian after 6 months of eating the same food EVERY DAY and not losing any more weight it just didn't seem worth it. Weight Watchers was better for me in many ways, but I lost 23 pounds after 9 months, and was exercising a lot just to earn points so I could eat enough food to feel full. Sounds good, but unless you plan on biking 6 miles a day for the rest of your life, it isn't sustainable. When winter hit and biking was out, I had to cut my points/ food back and still wasn't losing any more weight. So the idea of feeling hungry, eating a restrictive diet and STILL being morbidly obese just didn't feel worth it either. The idea of not being hungry, not being diabetic, and not being obese but with a very restrictive diet seems TOTALLY worth it.