Wednesday, May 7, 2014

Pre-op class #16, weekly weigh-in and thrown for a loop

I have a deep suspicion this post is gonna be a long one - a lot has happened since my last post.

First off, thanks so much for your sweet messages from my last post.  Reflecting on my experience with cancer has really helped me actually be very centered for things that happened Monday and Tuesday.  Looking at my own scar from my back seems pretty surreal.  Most of the time, I forget the scar is there unless I'm having pain from the scar tissue, which tends to be on a regular basis, or I catch a glimpse of it.  Regardless, I'd rather have the scars than cancer.

On Monday was my regular pre-op bariatric class.  I was a tinge disappointed with my weigh-in results this week, having lost two pounds.  I have to keep reminding myself that all of the losses are adding up, so it does not have to be a gargantuan number.  In fact, even though our goal is to lose ten percent of our body weight before going in for the surgery, the doctor who approved me said I'm okay if I don't lose weight but I just shouldn't gain any.  Besides, these additional two pounds brings me down to 77 pounds from my heighest weight.  So, I'm reminded that the bigger picture is the most important piece of this.

We're done with week 16 now, which was about post-surgery exercise.  We have just eight weeks left.  Wow!  We discussed the things that we can start doing now to ensure as much success as possible after the surgery.  For this week's class, our regular facilitator wasn't there so our structure was a little different with a sub.  This class was particularly odd because a stranger just happened to walk into our room by accident.  The place where our class is situated is in a corner room, so most people don't come there unless they are specifically looking for it.  It turns out that she was looking for a person in one of the classes, but it was the wrong time.  This person, though, had bariatric surgery six months ago.  We took the opportunity to ask her questions while she was there.  It was pretty funny because she stood in front of our class for about 45 minutes and gave us an impromptu talk on her story.  She had gastric bypass surgery and we haven't had one of those speakers yet, so we threw a million questions at her.  She was a great sport, though, because she answered every single one and even ended up showing us her tummy to let us know what the incisions looked like.  Imagine that ... a complete stranger lifting her shirt and showing us her tummy.  I loved that!

Prior to her walking in the room, I was one hundred percent all about the sleeve.  I had my mind made up that it was going to be the surgery I would select when it was time to let the surgeon know my decision.  There was absolutely no question in my mind. Then she shared her experience and I sat there almost in stunned silence because I was seriously starting to question my decision.  I know that everybody has a different story.  Some people have a great surgical experience and some are not so great.  I know that deep down inside, especially with all the research I've done and talking to various people online.  I have a good friend that had the bypass as well and I will often throw random questions her way.  She very sweetly answers them every single time [thank you for that my love!].  With the telling of her story, the person who happened to walk into our class told us about the fact that she had no pain from the surgery, no side effects, being able to be more active with her kids and so much more.  She also talked about the difficult parts, like mourning over not being able to eat certain foods and having an episode of dumping.  Yet, she kept saying, "You guys will be fine, you'll be just fine."  No matter what difficulties came up, she reiterated that she had absolutely no doubts about her decision and wished she had done it sooner.  I listened to her story and I thought to myself, "Gosh, that doesn't sound bad at all."  I keep wondering what I was so afraid of with the bypass.  I listed to her, asked questions along with other people and left there feeling struck with a million more questions inside.

What have been my issues with the bypass?  Well, for one, the malabsorption that occurs is a concern.  I thought about the fact that I would have to take supplements for the rest of my life.  I never went to the place of consideration that I'm already taking medication, so what's the big leap?  If I don't take my insulin, for example, I'm pretty screwed.  Then the idea of having my intestines moved around scared me.  What if they surgeon makes a mistake?  What is my course of action at that point?  It's a permanent surgery and my system will be forever changed.  Okay, that's a valid concern.  I also had thought a lot about stories I have heard of people gaining the weight back and other possible complications.  I was forgetting that the sleeve comes with its own potential issues.  Yet, that stranger's talk was replaying in my head and I wondered if perhaps I was closing my mind to at least being open to looking at the other side more.

The next night, which was last night, I had the infomation session with a surgeon at Pacific Bariatric.  It is a requirement for us to go to at least one information session prior to being referred for surgery.  With the discussion from the previous night replaying in my head, I reminded myself that I needed to have an open mind and be as honest with myself as possible.  As I drove up to the hospital, was incredibly nervous.  As I looked at the buildings, I was hit with the realization that my life would be changing forever in one of those rooms in just a few months.  Holy crap!

Our session was in the auditorium of the hospital.  I chose a seat right in the front.  I work in education, so I always rationalize to myself that I'll learn better if I'm sitting in the front.  I sat literally in front of the doctor - no better seat than that as far as I'm concerned.  I must say that he was absolutely amazing and I hope I can choose him as my surgeon.  He had an incredible bedside manner.  He was personable, spoke concisely, educated us and made himself available for absolutely every question the audience threw at him.  His approach to the issue of surgery was to first help us understand about the nature of obesity.  He didn't just stand in front of us and tell us we were overweight because we ate too much.  He came right out and described how obesity is a disease.  He talked about the factors that go into it, such as genetic, environmental, psycho-social and more.  I wanted to get up and give him a big hug because I felt like he "got" it.  This isn't just about this particular surgeon, but the entire Pacific Bariatric practice.  The approach was much more than just about the surgery itself, reminding us that this is not a diet but a new lifestyle.  Many doctors do judge patients who are overweight.  Yes, they are quite caring, but I can't tell you how many times I have been looked over and judged by the medical community for my weight.  I didn't feel that at all last night.  I just can't express enough how absolutely impressed I was with the talk.

Because I had such a primo seat, I was able to really pay attention when he demonstrated how each of the surgeries work and what our bodies look like internally before and after.  I wanted to focus, so I didn't take any notes until I got home.  This is such an important decision in my life with such a major surgery.  It is going to affect the rest of my life, so I wanted to be present enough and open enough to hear everything.  In my mind, I was really starting to focus more on the bypass and less on the sleeve, just like I had in the impromptu talk the night before.  As a diabetic patient who has sleep apnea and other issues, I needed to know what was the right choice for me.  As if reading my mind, the discussion started going in that direction.  The doctor told us that, when we meet with a surgeon, we will talk about all the options and select the one that is going to serve us the best in terms of long-term success for our specific needs.  My surgeon will not be telling me which surgery to have, but he will be giving me his recommendation as we discuss my options together.  There were a couple of things that really stuck out for me:

  • If a person has a severe case of diabetes and is taking insulin, they recommend the bypass.  While it is possible to go into remission with the sleeve, the chances are much better with the bypass.  I knew this, but the doctor was pretty clear to say that those on insulin benefit much more with the bypass than those just taking oral medications.
  • If a person has more than 150 pounds to lose, they recommend the bypass.  While people can lose a lot on the sleeve, and many have, the chances for losing all my excess weight and getting into a healthy BMI range is great with the bypass.  The very idea of being in a healthy weight range brings tears to my eyes. 
  • The rate of complications is very low with the bypass.  Their statistic is that one patient in every two thousand, or .28 percent, may have a complication.  In the over 16,000 bariatric surgeries they have performed, only four had to go in for revision surgery because of a complication.  They have only had one death and that was not related to the surgery, but it did happen a month after it was performed.  In fact, they are a center of excellence and have the best morbidity rate in the nation.  In the nation.  
  • There is thirty years of data that backs up the success of the bypass versus no long-term data for the sleeve since it has only been around for nine years.  This does not mean the sleeve is not a great surgery, but there just simply is a lot of history with the bypass.
If you haven't figured it out already, I am seriously considering the bypass again after the talks on both Monday and last night.  I believe in my heart, stronger than I can ever express in words, that it was God's hand at work that our visitor appeared in class on Monday.  Had she not come in, my heart would not have been as open to the possibility of the bypass in yesterday's information session.  His hand was at work as well last night with such an impressive surgeon.  I am praying that I continue having an open heart and a willingness to search my soul for the truth of what is going to be the right decision for me.  At the end of the day, the decision is going to be mine and mine alone.  Clearly I am going to take everything into consideration, but I also know that I have to be honest with myself.  Don't I want to give myself the best opportunity for long-term success and  the possibility of a healthy, long life?  Of course.  


Caitlin R said...

I think being open to all the options is wonderful. It's great to hear you weighing everything up so constructively. It's a big decision, and you deserve to have ALL the information at your disposal.

Congrats on the 2 pound loss. That really is a good loss, by ANYONE'S standards. And 77 pounds... fantastic, girl! You're a star.

Kathy said...

Thank you Caitlin! I'm really trying hard to be open and celebrate my losses each week.

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