To surgery or not to surgery

Tonight, I’m going to talk about surgery. I have to lose weight and so far, it’s not going well. It’s never gone well. I’ve been on yo-yo diets, I’ve tried “mindful eating” and exercise. I’ve tried not eating (that works real well until you pass out from exhaustion and then gain it all back and then some). None of this works. I can’t just cut out things completely from my diet and honestly, that’s not a good idea anyway (this has been confirmed by at least 4 separate dieticians/nutritionists that I have personally talked to).

So, after talking things over with my colorectal surgeon, his office referred me to a weight loss clinic in Portland. I’m hoping to be accepted into a weight loss and bariatric surgery program. I had my welcome group visit today. It’s not going to be quick and I may not be accepted. Like always in my life, I’m too big for what I want but too skinny for those who like overweight LOL (and yes, this is basically how my dating life goes, I’m too fat for guys who like fit girls and too skinny for guys who like “fat chicks” but that’s another story). So, at this point, I’m still hoping I’ll still be accepted into the program.

Alright, so what am I looking at? Well, I’m looking either a gastric sleeve, or a gastric band. They both have their pluses and minuses. I’ll start with the sleeve.

Gastric Sleeve:

Most of the stomach is removed. A long tube-like stomach is left, that is about the size of a banana. It restricts how much you can eat at one time, so you feel full with less food and less grehlin (the hormone that causes hunger) is produced (I’ll come back to this hormone later). Average weight loss is about 50-55% of excess body weight. You’re less likely to have ulcers or blockages than the bypass and there is a lower risk of vitamin and mineral deficiencies.

The risks include heartburn, scarring, long-term weight loss is unknown (because it is a relatively new procedure compared to the bypass or band) and of course death. With any surgery death is a risk so that one is a given.

Results are usually seen within the first year. After that is just maintaining.

Adjustable Gastric Banding:

This is also know as the “lap band” surgery. It is just a band that goes around the top of the stomach, causing a small pouch about the size of a golf ball (imagine only being able to eat about the size of a golf ball) and the band can be loosened or tightened by adding saline through a small port that attached just under the skin and connected with a tube. It restricts how much food you can eat at one time (yeah, like a golf ball) and makes you feel full with less food (grehlin production doesn’t change). Average weight loss is about 40-50% of excess body weight and takes about 1.5-3 years to see results. However, no permanent changes are made to the stomach or intestines and most patients go home the same day of the surgery. And of course there is a lower risk of vitamin and mineral deficiencies.

The risks, however, are greater than with the sleeve and include heartburn, slippage of the band, blockages at the location of the band, erosion of the band, high maintenance, and of course death. Slippage of the band is where it slips down and suddenly that golf ball gets a bit bigger. Erosion of the band is where it erodes through and then into the stomach. High maintenance includes needing to go the doctor frequently to have the band adjusted, based on the results being seen.

 

So, there are my two options. I still need to talk with a surgeon and go through a bunch of stuff before I can even think of getting the surgery done, or even decide which one I’m going to get. I have four specialists I’m going to be seeing: Medical professional, Nutritionist/dietitian, Physical Therapist, and Psychologist (Behavioral Health). All of these specialists will be helping me prepare for the surgery and monitor me over the next six months. I have all of my initial visits scheduled for these guys and over the next month or two, I will be getting these things taken care of.

To finally have a light at the end of the tunnel with my struggle with weight loss and the potential for having my ostomy reversed, I feel a funny kind of anxiety and relief. I’ve always fought with that stupid hormone grehlin so if I can get the sleeve done, I can say goodbye to that running my eating habits. It is hard to explain to someone who doesn’t have to struggle with it. It’s normal to get the “Gee I’m really hungry right now” feeling. It’s quite another to have it pop up 5 min after eating (regardless of what was eaten, so please don’t try to tell me I just have to eat right, it doesn’t matter what I eat, this happens and I’ve eaten everything from candy bars to cauliflower).

Having a psychologist who specializes in this stuff is going to be awesome to help set me on the right path to getting my behavior changed. Let’s face it, exercise alone doesn’t always help and yes, I’ve tried. Diet alone doesn’t work and yes, I’ve tried. I’ve even tried combining the two. And while combining the two works for a little while, I’ll plateau and then dropping any more weight is impossible. It’s all so frustrating. And I’ve never been good with sticking to a plan for more than a 3 months (for all those who say, it only takes a month to establish a habit). I stick with something for a while, but then things change, something happens, and I fall off. And these guys are there to help keep me on.

Overall, I’m excited. This will definitely be an interesting journey.

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