Waking Up to a New Life

One of my biggest fears before surgery had been the fear of having to have a regular incision. I preferred the thought of laproscopic surgery which would mean a shorter recovery time. Morbid obesity causes a condition that enlarges the liver. An enlarged liver can increase the chances of a traditional incision as it lays right over the stomach. To combat this, gastric bypass patients are placed on a pre-operative diet that resembles a "Slim Fast" diet. All refined sugar has to go. Drop two meals and substitute them with high protein drinks. One protein bar is also encouraged. Then one sensible meal is allowed. During our training session, we (weight loss surgery candidates) were given very specific guidelines as to how much protein everything should have as well as caloric intake. This meal plan is designed to shrink the liver and enable laproscopic weight loss surgery. It also helps jump start good habits to keep post-op. I tried to stick to these guidelines. I did pretty well, but I wasn't perfect. I was very good about my sugar intake, but I wasn't so great with my shakes. The night before surgery, my family took me out to an Italian restaurant (my favorite type of food), but I worried about the incision. I allowed myself one last over-the-top meal and hoped for the best.

So when I woke up in the recovery room at the hospital, I tried to talk. The nurse warned me that they had encountered trouble getting the tube to help me breathe during surgery so I shouldn't try to hard to talk yet. My first thought was, "Yay! I lived!" My next thought was, "What kind of incision was used?" When a nurse caught my eye, I moved my fingers like a pair of scissors. She laughed at me and said, "Don't worry. The doctor was able to perform the surgery laproscopically." I heaved a sigh of relief.

Now, I wondered how much pain I would be in. Still dopey from the surgery and comfortable, I wanted to see my family as soon as possible. Before I knew it, I was being wheeled up to my room for the next few days. My family was already there. Everyone commented on how good I looked. I was hooked up to an IV with fluids and a pain pump with morphine. I could push a button and administer the medication whenever I needed with an unknown-to-me limit for safety. My comfort level was decent so I visited with everyone for a while. The minute I complained of discomfort, everyone encouraged me to push the button on the pain pump before the pain got really bad. I did this throughout the day. Probably the most difficult part of the first day, though, was being unable to even drink anything. I could have nothing by mouth for a full 24 hours. At that time, I would have to have a scan done using a barium drink to see if my new pouch leaked at all. If it did, I would need to have more surgery. If not, I would begin drinking 2 ounces of fluid every hour. In the meantime, I was given flavored swabs to wipe in my mouth and suck to combat the dryness. By the end of the day, I was exhausted and nauseated. To avoid blood clots, I had to walk around the ward at least once that day. Twice was better. I am still fuzzy on some of the details of that day, but I think I walked twice. I had worked with a woman who had gastric bypass surgery and died from a blood clot. I knew I couldn't completely prevent it, but walking would help. The day was a blur of visitors and nurses and medication. The more nauseated I felt, the more I pushed the button for the morphine pump.

By the next morning, my nausea was out of control. The nurse gave me an anti-nausea medication via my IV, and I felt better very quickly. Fairly early that same morning, I was whisked down to radiology to check my pouch. I didn't have as much trouble as I anticipated drinking the barium. The surgery was a success, and there were no leaks. I was cleared to start drinking. To my horror, everything I drank made me sick. Of course, the choices were limited to water and protein drinks. But both were maddeningly painful to swallow. And now my stomach was really hurting - with nausea. The worse I felt, the more I pushed the pain pump button. By the evening, I was really miserable. The nurse gave me a short of anti-nausea medicine, but she pushed it into the IV without diluting it or slowing the push. The pain in my arm was excrutiating. The nausea also did not abate. I passed a painful, sick night.

In the morning, I got up and vomitted in the bathroom. The vomit was almost entirely blood. The doctor came to check on me with the intention of discharging me. He looked at me and asked how I felt. I burst into tears and told him about the vomitting. "I don't think you'll be going home today," he told me. Obviously smarter than me, he immediately took me off the pain pump and ordered normal pain meds for me. The difference was apparent within a couple of hours. Evidently, morphine can make you very sick. I rebounded very quickly once I stopped taking it. Everything still hurt my stomach, but at least the nausea improved. Before I knew it, it was time to go home. Panic struck again. I had not really been able to do the water or protein drinks and now time to go home. Would I be able to stand the pain without medical staff? Only time would tell.

Plotting the Course

So I made up my mind to have the surgery. Now a lot of people think that what follows is for people who are too lazy to lose weight the old fashioned way and that people who have weight loss surgery just sit back and take it easy. Look, we have all heard the stories about people who have had gastric bypass surgery (or some other form of weight loss surgery) but put the weight back on. Herein lies the quandary. Weight loss surgery is not for the feint of heart. It is a terrifying ordeal meant to help someone who faces losing years from their life without it. It is NOT a cosmetic measure. And it is NOT pleasant. Once I made the decision to pursue the surgery, my ordeal/new life/adventure began. I met with a very talented surgeon who answered my questions, explained the risks, and asked about the sordid details of my weight gain and eating habits. Answering his questions was necessary though excruciating. But the fun would not stop there. To make sure I was a viable candidate for this surgery, I would need to undergo many tests. I had to go to a cardiologist, a pulmonary specialist, and a sleep center. It had to be determined if my body could withstand this procedure. Did I mention this is not for the feint of heart?

Fear already plagued me, but the tests fed the fear. However, once I made up my mind, I really felt it best to stay the course. The cardiologist's office put me through a stress test. The pulmonary specialist put me through breathing tests I didn't even know existed. And the always fun sleep study ("We're going to hook you up to ten thousand wires...now sleep! But only on your back! Go!"). Sure. And blood work...oh the blood work. For someone like me (notoriously bad veins - deep and roll), blood work can be like some weird form of torture

After all these tests, I had to undergo a psychological exam to make sure I understood the risks and could handle the emotional aspect of the surgery. About five questions into the exam, the psychologist deemed me mentally healthy (poor, deluded woman) and decided to then just give me some coping strategies and a pep talk. Something she said really stuck with me, though. "This is the absolutely hardest way to lose weight, and don't ever let anyone convince you otherwise." I thought she needed more psychological help than I did. I mean, wasn't that the point of the surgery to make it easier? The next couple of steps convinced me that she was right.

Tests completed, training came next. A one on one session with the surgical office's nutritionist helped me to understand what my new dietary needs would be. That was an eye opener. See, someone who has gastric bypass surgery suddenly has a tiny stomach pouch and issues with absorbing all the nutrients they eat. The human body's main fuel (though not the only fuel for sure) is protein. Body builders use protein bars and shakes to build muscle and burn fat. Bariatric patients use it for the same reason, but it's more important to their health. We cannot eat enough protein with meat or normal means, but must supplement our meals with protein rich snacks (bars and shakes). Luckily, the surgical group offered some protein products at cost as a convenience and had some suggestions for other good sources. I started looking at some options in grocery stores and vitamin/health food stores. I was pleasantly surprised by the options until I started actually trying to eat them. While addicted to sugary, fried, and super fatty foods, my body did not want these options - or at least, my tastebuds didn't want them.

Next came the extended group session for training. A nurse and gastric bypass patient led us through the gory details of what would be done to our bodies and what we could expect. She carefully explained what the first six weeks would require - pain and a liquid diet. The liquid diet would start with clear liquids like thin protein drinks, broth, and water. We could then move to full liquids like soup and thicker protein drinks. After that, the gastric bypass patient may begin to eat mushy, runny solid foods like oatmeal and thin instant mashed potatoes. No problem, I thought. I probably won't feel like eating anyway with the trauma to my stomach from being cut in half and sewn/stapled back together. Check out this video: http://www.mayoclinic.com/health/gastric-bypass/MM00703. I had the Roux-En-Y method. If you can't view the video, the transcript is listed below the video. Anyway, I just knew the post op diet wouldn't be too bad. And I can be a sissy about some things, but plain old pain, I can handle. I'll describe the post-operative period in another post. It deserves it own attention.

After the training and my own research, I had nothing left to do but wait. I made the decision to have the surgery in January, 2008. In June, 2008, I found myself in the waiting room of the hospital to have a filter placed to help prevent blood clots. One month later, I sat at my desk at work and cried almost all day. I have never been so scared in all my life. Whitewater rafting, bungee jumping, hundreds of rollercoaster rides...nothing could compare. What if I stopped breathing during the surgery? What if my heart stopped? What if I developed a blood clot? What if the stomach pouch leaked or my intestines exploded? Every worst case scenario played out in my head. My co-workers and family members and friends were a true blessing that day. They all showed great patience and kindness to me. Finally, all the waiting was over. July 1st, 2008, I was plunked in a hospital bed, wrapped in a gown, and waited for my IV to be placed. I shivered uncontrollably the entire time. After six failed attempts to start an IV, the anesthesiologist finally got a small IV started. He promised to place an improved IV once I was unconscious. That is pretty much the last thing I remember from that morning. I don't remember being wheeled into the operating room the way I had remembered it from other procedures. I don't remember saying goodbye to my mom or other family and friends. I just remember being stuck 6 times to start an IV and then nothing until after the surgery.

The Decision

When a close family member of mine told me she had decided to undergo gastric bypass surgery, I panicked. I had heard so many horror stories. I feared for her life and quality of life. But her mind was made up. In the end, I chose to support her as well I could. I began learning about the surgery, it's complications, and how it worked. But I didn't spend too much time on it. She had her surgery June, 2006. She did not die. In fact, her surgery has been quite successful. Despite some complications, her quality of life has greatly improved.

In October of 2007, I weighed in at 330 pounds. My life was in a state of disarray. At 31 years old and morbidly obese in a job I really detested, my husband declared he no longer thought our marriage was working. We separated. I thought all my dreams and hopes were done - shattered. But something funny happened. When I was at my lowest point, I began to believe God had more in store for my life. And then I realized that while some dreams were done, a whole new set of dreams could happen for me. And while I had been kicking the idea of weight loss surgery around, I had not considered it a viable option as my husband was so opposed. But since we had separated, I no longer needed his approval. I had tried dieting for years, but my weight had steadily increased. I felt I had let my life spiral out of control. The time had come to make a difficult decision. With much prayer and thought, I went to the free informative seminar at a local center for bariatric excellence. I felt able to make an informed decision at that point. I weighed the consequences of not having the surgery. I was diabetic. My feet were constantly swollen. I suffered from sleep apnea. I had constant joint pain in my hips, knees, and ankles. I could only buy clothes at specific plus size stores that carried a size 30 in pants. I had not been able to buy regular-sized clothes since my first two years of high school. And I was now facing starting over alone after a divorce. I wanted to start over with a fresh start. I needed my health. I decided to have the surgery.