Weight Loss Surgery

My insurance now covers the Roux En Y Gastric Bypass surgery. There are about six months of hoops to jump through before the surgery actually takes place. That is six months from the first appointment with the nutritionist. I meet with the nutritionist November 13th, which means I would be clear mid-May. I will just wait until school is out and use my summer break. I submitted my 17 page application in September and met with the surgeon today.

Meeting with the surgeon and the other people in the office today was overwhelming. I was with the surgeon for about an hour; she was very nice and thorough. She was also very clear about all of the risks involved in the surgery, which are especially high for me with a BMI of 62. Today, at the doctor's office I weighed 417.1 lb (I was had been fasting for 13 hours before the appointment). Each BMI point above 50 significantly raises your risks of complications and death. That was very sobering.

To help offset the risks of blood clots I will be on a blood thinner, have compression stockings and need to have a mesh basket inserted through my neck one week before surgery. It will be inserted in my neck and then guided down to the largest vein in my body to "catch" any blood clots. It will remain in place for one month after surgery. Talk about freaking me out! At that point I started hyperventilating and felt like I was going to pass out. I had a difficult time grasping everything the surgeon said from that point on; I was beginning to wish I had asked my mom to come back to the office with me. Clots are a possibility up to three months after surgery.

There is also the risk of leaking, which would be devastating. At least I think that is the 'D' word she used. After she used the 'D' word three times, it dawned on me that she was using that in place of 'death'. To confirm I said "do you mean death", she said "yes that would be devastating.

The doctor said that because of having my gallbladder out the old fashion way there would be a lot of scar tissue which would complicate the procedure, increasing the time from two hours to probably at least three hours.

If my liver were a duck's liver, I would be ready to be served as foie gras, my liver is so fatty it would make excellent pate'. An excellent pate’ it would make, but not excellent for surgery. Right now my liver is covering all of my stomach. There is no way she would be able to operate as is, my liver is blocking everything. Even if she were to open me up and use liver retractors it would most likely be unsuccessful as well as cutting into my liver causing me to bleed and a host of complications that could be devastating. Apparently my liver is so fatty it would just slide around and a retractor would just slice through it like a hot knife through butter. Luckily, the first place a person gains weight is their liver, and the first place a person loses weight is their liver. Here I’ve always thought my face is where I lose and gain weight first.

The doctor asked me if I thought I could lose 30 pounds. I said sure, losing 30 pounds will be no problem at all. Keeping it off might prove challenging, but I have always been able to lose weight quickly when I work at it.

Random stuff…I have 268 lbs of excess fat that I need to lose. One week before surgery I have to turn my CPap level from 13.5 to 10; apparently anything over 10 blows too hard and can fill my pouch with air, causing too much pressure, causing leaks, which could be devastating.
I need to have a chemical stress test to make sure my heart is good. It has to be chemical because I can’t go fast enough on the treadmill to truly test my heart. I will need to have an upper endoscopy to make sure everything looks good. Both of those procedures mean an IV, which freaks me out!!!
My surgery will be done by a robot. My doctor is able to do it herself, but says she prefers doing it robotically. With so much fat in the stomach there is a lot of pressure on the instruments while she is trying to do tiny movements, using the robot eliminates this problem. She will be 4 feet away at the controls.

This is all so intense and overwhelming. I haven’t even gotten to the part about after care for the rest of your life. That will be another post. I know that having the surgery you are committing to walking at least an hour a day afterward (or the equivalent) forever. Well I know just because I have surgery doesn’t mean I am going to instantly be 50 lbs thinner and feel great wanting to just hop out there and start walking for one hour a day. No, I would think I will still be moving slow, shuffling along, and hurting like nobody’s business; at least until I get some weight off and my body gets used to exercising. So, if that is the case, shouldn’t I be moving slow, shuffling along and working through the pain now? I remember when I spent the summer with my Dad and Step-Mom, we walked the dogs every evening. The first night I had to stop at every high curb, bench and light post to rest. The first night I was out of breath and done before we even left the driveway. I didn’t want to walk every night, I was in pain, I didn’t like it, it wasn’t fun, it wasn’t comfortable. But, by the time I left three weeks or so later, having walked every night but 2 or 3, I was walking much further than when I started, I only needed to rest once, I made great strides. I noticed that the walking, arm exercises and squats not only made it easier to walk, but I felt better all the time, I was more mobile, little things were easier. Life was better. It is ironic that life on the whole was made better but I didn’t continue once I got home. I need to learn to be comfortable with being uncomfortable. I need to push, to break out of this small immobile cocoon I am in. I am in pain all of the time, even when I don’t move I am in pain. I need to move, if I move, I believe the pain will eventually dissipate.

I want to lose as much weight as I can. The more I lose the better my odds of coming through this all right. The idea of risking my life to lose weight scares me. On the flip side of that, I am courting death living as I currently am.  At this point I am going to go through all of the motions, get as healthy as I can, lose as much weight as I can and then see where I am in April or May when the time comes to schedule surgery. I don’t know if I am ready to do the surgery, luckily that is not something I need to decide for another six or seven months.