Saturday, July 08, 2006

why oh why

I have been battling the bulge my entire life. For a treat, I would get a bag of Doritoes and a 6 pack of Dr. Pepper. From the time I was in high school, when I thought that little pouch on my belly was something. In 1984, I was 5ft 7in and 150 lbs, just 10 lbs overweight. I gained 60 lbs with my twins, and then lost almost all of it immediately (within 5 days) after they were born. Just 10 more lbs kept hanging on. While my eating habits were poorly based on McDonald's, I did exercise a tremendous amount, so I didn't suffer a lot of retaliation from fast food. YET. Once I started college (in 1987) when they were 15 months old, I started some additional bad habits, not only was dinner fast food, but now breakfast was from the snack machine, a package of Grandma's Cookies and a can of Coke each day on my way to lecture. As my class load increased, so did my waist. By the time I was a Junior in 1990 I had gained yet another 20 lbs, and then I had my third child, and gained another 30 lbs, after she was born, I could never get below 200 lbs, I took tons of nutrition classes, special classes on weight management at the hospital, paid tons of money to learn to eat healthy. All efforts would have a small success and then a larger failure. By 1995 I had gained another 25 lbs, in 1998, I gained 10 lbs over the holidays, and then I got pregnant again, ballooning up to 265 lbs. It took 12 months to take it all off, and then I was pregnant again, and gained again, this time up to 285 lbs.

During the last month of my pregnancy, my husband's office colleague died 14 days after having gastric bypass surgery. While I had toyed with the idea of surgery, this situation terrified me and completely turned me off the idea of having surgery. I tried unsuccessfully to loose weight on my own. I tried for four years with minimal success. Eventually I got down to 242, but then a combination of rheumatoid arthritis medication and anti-inflammation medication, and stress, I started gaining like crazy, from 242 to 275 in a matter of weeks, I started to get some other issues affecting my health. Mostly irregular heart rhythms and decreased energy and just general poor health. I made the rounds of doctors to find out what was wrong and all signs pointed to my obesity and arthritis so I asked the doctor if she would recommend weight loss surgery and much to my surprise, she did recommend it as well as a referral.

The first place I started in was and I did a lot of reading and research, finding out who in my area was the most successful surgeon, what methods had the best success rate. Talking to other people that have had the surgery and who has been able to 'live' with the change. The doctor referral that I was initially referred only does Lap RNY, so several resources all pointed in the same direction.

I was able to get it to see the doctor for the initial consultation within 5 days of seeing my primary care provider. To be 'approved' for surgery, I had to have an initial BMI of 35 plus co-morbitities or 40+, mine was 42.1.

I was put on a strict diet (to accommodate my body to the primary food sources post surgery) while waiting for Insurance Approval (that took 28 days) and through preliminary testing (blood work, the EKG, the Gall Bladder Ultra Sound, the Upper GI, the physical exam, and medical clearance), that took another 3 weeks, eventually I got on the schedule for surgery. So my total preparation time was 90 days. It was an emotional roller coaster of dealing with when I eat, why I eat, all kinds of things.

The surgery it self was over so quickly, in at 7 am, in recovery by noon, home by 3 pm the next day, the learning to cope with the new tummy pouch, that has taken MUCH longer to get used too. What I can and can not eat, how much, how often when to drink, how to survive one sip at a time. That has been the challenge.

While on the restrictive diet the first 90 days, I was eating just lean meats and green leafy vegetables, it took some time to get used to but the weight loss was substantial. 10 lbs a month. I seriously considered continuing with that alone and not following through with the surgery. But as time went on it was harder and harder not to go back to old habits of eating food that was high carbohydrates. I felt myself back under the control of the carbohydrate monster and the cravings were driving me to consume them anyways. So I went ahead with the surgery as scheduled.

The surgery has a couple of benefits. One, you are FULL after consuming 1 oz of food. That limits your day to 3 oz of food or about 100 calories, which is highly effective in weight loss. The second is that the food you do eat is not fully optimized, and you miss most of the nutrients. The third is that you develop an intolerance for certain foods like sweets and oils. If I consume sugary sodas (with or without carbonation) I get nauseated and diarrhea, same with oily food. Even well cooked high fat meats that have been rinsed and drained can still make me heave, thus training me that those foods that are not good for me, make me sick.

One of the things that I am having difficulty with this month is that I am not able to be exercise as much as I was able to before the surgery. I have a harder time getting enough fluids to keep hydrated when it is hot and I am perspiring. I do not have the energy that I had (I used to be able to walk 8 – 10 miles) now I can barely go 5-6 miles.

Hope that helps answer your questions.