I have struggled with obesity my whole life. I was born weighing nearly 11 pounds! Being overweight was just something I had gotten used to. If diets worked, the whole world would be thin. The problem with dieting is that once you've lost the weight you're trying to lose (or just get tired of the diet in general) you "reward" yourself for a job well done. How does one reward themselves, you ask? They allow themselves to eat everything they deprived themselves of during their diet…to excess.
I remember the day I realized that my weight was out of control and I desperately needed to do something. I wasn’t feeling well so I went to my family doctor. The nurse brought me back to take my blood pressure, weight, and temperature. I stepped on the scale and was not prepared for the numbers that popped up. Without realizing it, I had gained 10 pounds in just 1 month! It had officially gotten out of control.
I was dealing with depression, sleep apnea, high blood pressure, edema (swelling of the hands and feet), my migraines were becoming more frequent and more intense, I could barely walk across the room without getting winded, and was finding it more and more difficult to do my job. I had even become anemic due to “woman issues” that were hitting me full force for literally months at a time. My kidney (I only have 1 working kidney) was shutting down and passing too much protein as well. All of these things started happening with the gain of the last 10 pounds and my body was telling me that I had to do something immediately… or I wouldn’t be here much longer. I was going to die.
As I sat there and cried, my doctor brought up the gastric bypass. She told me that it was time to make a decision before it was too late. We talked for quite a while, despite the fact that there were other patients who also needed her attention. She gave me the number of a good surgeon and told me to think it over. A few days later, I was in such horrible pain that I could no longer move. My body was shutting down. I swallowed my pride and gave in. I called the gastric surgeon’s office and scheduled an appointment.
My husband, who has spent his whole life hating food and has problems gaining weight, was very unsupportive at first. It is not easy to get support to have weight loss surgery when the person you’re trying to get support from has never known what it was like to be overweight. I went to the consultation anyway, despite being told that all I needed to do was “just stop eating for a while”. I had suffered all of my life with this problem. I had done every diet known to man and I was obviously not able to do it on my own.
My first visit was more informative than I expected. The bariatric surgeon, Dr. Mirza, told me about all of the different types of procedures and how they worked.
The first procedure we talked about was the Gastric Bypass. Roux-en-Y gastric bypass surgery is the most popular bariatric surgery in the United States . This procedure sections off the top of the stomach to create an egg-sized pouch. A piece of the small intestine is connected to the pouch, which fills quickly with a small amount of food. A person feels full fast, and as a result, eats less. Food passes from the pouch directly through the small intestine, bypassing the rest of the stomach, which continues to produce digestive juices to help break down food in the small intestine. This new digestive route reduces the amount of calories the body absorbs, which promotes weight loss. For more information on the Gastric Bypass procedure, please visit this link.
The second procedure we discussed was the Sleeve Gastrectomy. During Sleeve Gastrectomy surgery, the surgeon removes the larger, rounded part of the stomach. The remaining stomach looks like a sleeve (or hose or tube) and holds about 15 percent as much food as the original stomach. This procedure is helpful for patients who wish to lose weight but have health conditions that make combined restrictive/malabsorptive surgery less safe at this point in time. These patients may want to consider a malabsorptive procedure like duodenal switch (DS) or gastric bypass later to lose more weight. The surgery cuts away the part of the stomach that produces grehlin, a stomach hormone that stimulates hunger. Though the stomach is smaller, the openings are left intact, so digestion can go on as normal, without any malabsorption.
Disclaimer: There are specific risks and possible complications associated with any bariatric procedure. If you have specific questions, arrange for a consult with your bariatric doctor.
For more information on the Sleeve Gastrectomy, please visit this link.
The third procedure we discussed was the Lap-Band. During the procedure, the surgeon uses laparoscopic techniques (making tiny incisions rather than a large incision and inserting long-shafted instruments through “ports”), to wrap the LAP-BAND® System around the patient’s stomach. A narrow camera is passed through a port so the surgeon can view the operative site on a nearby video monitor. Like a wristwatch, the band is fastened around the upper stomach to create the new stomach pouch that limits and controls the amount of food you eat. The band is then locked securely in a ring around the stomach.This creates a new, smaller stomach pouch that can hold only a small amount of food, so the food storage area in the stomach is reduced. The band also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach. When the stomach is smaller, you feel full faster, while the food moves more slowly between your upper and lower stomach as it is digested. As a result, you eat less and lose weight. Once placed around the stomach, tubing connects the LAP-BAND® to an access port fixed beneath the skin of your abdomen. This allows the surgeon to change the stoma (stomach outlet) size by adding or taking out saline, or salt water, inside the inner balloon through the access port.
Disclaimer: There are specific risks and possible complications associated with any bariatric procedure. If you have specific questions, arrange for a consult with your bariatric doctor.
For more information on the LapBand procedure, please visit this link.
For more information on the LapBand procedure, please visit this link.
*All information on these procedures was taken from www.drbrianmirza.com
After my consultation, I knew the sleeve was out. My choice was going to be between the bypass or the Lap-Band. My husband was still not on board with the idea whatsoever, so I finally got him to agree to go to my second consultation so he could talk directly with the doctor and get answers to any questions he might have had. Dr. Mirza was fantastic! He described everything for my husband. Exactly what the band was, how it worked, how it fit onto the stomach, how much food is allowed per meal...etc. He also explained the surgery, the requirements pre-surgery, the requirements post-surgery, exactly where the incisions would be, how big the incisions would be, how long it would take to recover, etc. He showed him the BMI chart and where most normal people are vs. where I was. (I was at a BMI of 65! yes, 65!)
I went back and forth on my decision between the bypass and the Lap-Band. I knew that bypass patients lost the weight faster but I also knew that they could stretch their stomachs back out over time. There was also the "dumping" syndrome that caused patients to be violently ill if they had even the smallest amount of sugar. Sweats, chills, monstrous diarrhea, vomiting, dizziness, and even passing out are some of the symptoms associated with “dumping” syndrome and I knew I didn't want to risk ever suffering those issues. The alternative choice being the Lap-Band, whose patients could eat very small portions of whatever they wanted without having to deal with the whole “dumping” syndrome. Their down side was that food could get stuck if they didn’t chew well enough. My deciding factor was that I didn’t want to mutilate my body any more than medically necessary in order to get my health back. Lap-Band was the only procedure that didn’t permanently alter my organs, so that was the path I needed to take.
I started this journey at the end of October, 2009. I spent the next 2 months getting the documentation and doctor clearance letters that my insurance company required for approval. My insurance finally approved me and my surgery was scheduled for December 29, 2009. I got to begin the pre-op diet of clear liquids and protein shakes 2 weeks prior to the surgery. My doctor recommended a minimum weight loss of 10 to 15 pounds. The key reason for the pre-op diet was to lower the fat content in my liver. Lowering the fat content in the liver and reducing fatty tissue around your stomach area prior to surgery greatly reduces the chances of excessive bleeding during surgery. While some bleeding is normal, a lower fat diet prior to surgery will minimize bleeding even further.
The surgery was a success and I was back home 2 days afterwards. Some people bounce right back and can even attend work the day following their procedure. I was not so lucky. It took me about 2 weeks before I could even stand up for any length of time. I was then put on the post-op diet that slowly introduced foods back to me in 2 week increments. It started off with 2 weeks of clear liquids, then it was soups and yogurts, next was anything pureed. The final month was 2 weeks of soft foods, then up to regular foods. From then on it has been touch and go.
I lost between 15 and 20 pounds in the first month after surgery. It took around 3 to 4 months after the surgery for the doctor to be able to access my port (which is under the skin and accessed via syringe and needle) to add saline to the band. (Most Lap-Banders call this procedure a “fill”). The first fill went great for the first month. I had restriction and was losing weight. The second month after my first fill was not so great. I was able to eat everything that wasn’t able to run away. I ended up gaining 4 pounds.
The 2 months following my second fill (4cc) were, let’s just say, unpleasant. I couldn’t keep any food down. I vomited every time I ate or drank anything. I believe I lost around 20 pounds in those 2 months and hope I never have to experience that again.
My next visit, he took out 1cc and that made a world of difference. I had very few vomiting episodes and was happy to be able to eat again. He saw me again after just 1 month and I hadn’t lost but a few pounds. He added 0.25cc to my band and that’s where I’ve stayed.
I still have the occasional day where nothing wants to go down and I end up losing everything I tried to eat. There are also some days where I can eat pretty heartily. Most of the time, it is just right. I am able to eat a little bit of something every couple of hours and I’m feeling really good. My total weight loss as of today is……drum roll please…. 92 pounds!!!! The following pictures are (from left to right) April, August, and December of 2010. Do you see a difference?
I am starting to feel so much better. I can walk without pain, clean without being out of breath, sleep without a CPAP machine, and I’m generally in a better mood. If you ask me if I think it’s worth it. My answer is not just “yes”, but “absolutely”! It takes a lot of adjusting to portions and learning your limits, but in the end, I’ve lost almost a whole person and am absolutely ecstatic with my progress. I highly recommend this procedure to anybody who is having to decide which procedure to have done.
If any of you have questions, please do not hesitate to ask. You can send inquiries to amal.cpht@yahoo.com and I will try to address them as quickly as possible.
Thanks for reading.
Disclaimer: There are specific risks and possible complications associated with any bariatric procedure. If you have specific questions, arrange for a consult with your bariatric doctor.
