1 YEAR SURGIVERSARY

A year ago today I was in Mexicali, Mexico.  I was spending the night in a hotel after finishing some tests  Dr. Alberto Aceves was my surgeon.  He and all of his staff are very thorough, helpful and accessible.  The care I received was excellent and I would recommend the option of undergoing bariatric surgery with him in Mexico to anyone.
and interviews with the Bariatric surgeons at the Hospital Almater.

My experience with weight loss surgery has been chronicled here in the past year.  I did great in the hospital but after a week or or at home I started having some problems with tolerating foods.  I went as slowly as I could introducing different soft foods and then more options into my diet to meet my nutrition and protein needs - I had a difficult time for about 3 months but slowly found the foods and vitamins that worked for me.  There was, and in some ways still is, a certain sameness to what I eat each day.  I remained as patient as I could and put up with bouts of nausea and gastric distress when I strayed from what my body could handle. Having those outcomes in mind makes it a lot easier to stay on the straight and narrow - believe me!

My weight loss has been quite swift and I suppose to people around me, pretty shocking. My kids never knew me at the size I am now - for my husband it was a distant memory!

 It may seem like fast = easy.  In some ways I guess it has been.  When you have a physical barrier to overeating it does make it "easier."  Though I've worked  hard to do it right:  get my vitamins, protein, liquids and exercise - just like all the other times I have "dieted."  Except now this is my life and not a diet I can safely stray away from on a whim.  To maintain lifelong health - I have to stick with these requirements.

I am proud that I have done so well in this first year and I believe I can safely maintain my new found healthy weight and lifestyle.

I want to thank my good friend Christina for making this possible and all my friends and family who have been cheering me on!

MEDICAL STUFF



13 of these!

 My company switched back to Kaiser insurance and I signed up for a new doctor.  I couldn't believe my luck that among the 5 or 6 doctors taking new patients there was Dr. Vij - who specializes in obesity and nutrition!  I had my first appointment with him to see if he would do my periodic labs (every 3 months the first year for post -op weight loss surgery patients who have done the malabsorptive component.) I am 3 months post-op as of Wednesday!

He was great.  Understanding, knowledgeable and helpful.  He understood about the labs and was just wondering why I had gone to Mexico for Bariatric Surgery when Kaiser does it.  What?  I had been told for years by 2 different doctors that Kaiser didn't do weight loss surgery only "patient education" and liquid diet plans that aren't covered by any plans.  He was amazed and looked to see who my previous docs were - wonder if he will say something to them?

Anyway, had my blood drawn this morning - 13 vials of it. I had a student doing the draw.  He got quite a work out!  Results soon - looking forward to seeing if I am holding my own, nutrition wise.

DAY FOUR AFTER SURGERY

Today I had my barium leak test and x-ray.  I got to see each swallow go down and move through my stomach and down into my new intestinal tract.  Kind of looked like jelly fish billowing around down there.  Lot's of activity going on.  My docs are happy with all my otherwise socially unacceptable activities - burping and passing gas.

I am planning to take another shower after they take out the IV cath.  I have only had pain meds twice in the last 24 hours and took them sublingually - so no need for the catheter. 

I have still been sipping, walking and resting.  My bottom hurts from all the resting.  I have been working on my needlepoint and trying to find something to watch on tv since Netflix on my Nook hasn't come through for me.
So that's it for today.  Tomorrow is my last day here - it went so fast!

DAY THREE- POST-OP

I am on day 3 of my new tummy and switch.  I'm feeling good.  Got to shower and I have been sipping juice and Gatorade and walking around the hospital and sometimes just around my room. I am a little butt sore - more than anything else my bottom hurts from being on it so much!

I have not had any pain meds since this morning and except for achiness in my stomach and a little in my back, the pain is mild. I drank blue juice this morning to check to see if I was leaking - no leaks.  Tomorrow I will do a barium test and have an x-ray to see of my new plumbing.

Just got off the phone with my son.  He was asking me about my new tummy and what food it can tolerate and when.  The process is slow; building from liquids to soft food to mushy foods, etc.  The plus is that I don't feel hungry.  An improvement over the last month of dieting.

So I am watching the Giants winning with the sound off - Spanish announcers! and working on my needlepoint and keeping busy.  Home in 3 days!

HOLA!

I am here in Mexicali Mexico, sitting in a very nice hotel room with CNN on the TV so I can watch the debate!

I flew to San Diego this morning from San Francisco - it was pouring rain, the first of the season.  It created some challenges, but I made it to the flight on time.  I was worried that things were off to a bad start when my credit card was turned down at the check-in counter.  (Of course I only brought one with me so I am going to have to call the bank when I have cell service,)  I got on board and found the flight full except for the seat next to me - hurrah.  I could put the divider up and be comfy without upsetting someone with taking up more than my fair share of space...

I had my pre-op tests at the hospital, met the 2 surgeons and got the news that I could eat dinner.  I was shocked!  They seemed a bit surprised I was sent a liquid diet to follow this week.  Oh, well.

So I had 1/2 a very tasty hamburger with mushrooms and 4 french fries.  Whoo hoo.

These are some photos of the hotel:

 Pretty tile in the bathroom.

 This is what they brought for turndown!

I will probably be out of it for a day or two before I report in from the hospital, and I promise not to take pictures of my incisions!!

PASSPORT? CHECK!

Since I am traveling to Mexico for my weight loss surgery, I had to get a passport.  Gone are the days of my San Diego State youth when we took trips across the border to see the Jai Alai games or to buy cheap jewelry (I was not one to go down there to party - really, I wasn't) and then sit in line to get back across the border by showing our driver's license.

My first attempt to get the passport was denied because they didn't accept my birth certificate copy.  Back when I got a passport in the late 80's it was fine, but not anymore. So I had to get a new copy from Moscow Idaho were I was born, and start the process all over.  By then I was worried about the timing so I ended up spending even more money to expedite the order. 

It arrived yesterday.  Like everyone else, I hate my photo on it.  It is most unflattering. Even at my current weight I can take a better photo.  Oh, well.  Soon enough I won't look like the picture any more!

COUNTING DOWN THE DAYS

In twenty days I will be having my weight loss surgery.  Sometimes I feel so elated that I am surprised to hear others on the forums expressing their fears.  I know it is going to be painful and hard while recovering and I know it is going to be life changing but I feel as if I am being given a second chance.

This made me laugh.

My husband and I talked about it the other night.  He has now had time to absorb the idea and do a little of his own research.  We talked about some of the restrictions - beyond the pre-op diet I am currently following - he was pouting a bit about my not having cocktails when we were out.  We talked about how some people go through weight loss surgery and then don't change their habits or pay attention to the restrictions, which confounds me.  He said that in the 30 years he's known me I am such a healthy eater that he didn't think I will have a problem. Isn't it nice that he sees me that way? 

Many people assume if you are really big, like me, you must eat entire pizzas or order for 2 in the drive-thru and then eat it all. I have never been able to eat a lot at a sitting. Buffets are wasted on me. Plus, I hate to feel full.  I know I eat more than I should - even healthy foods have calories and they can add up.  I snack and nibble too much between meals.  I go on the occasional candy or baked goods bender.  But my new "plumbing" will prefer small meals through the day and the candy or whatever simple carbs I might want will give me gastric distress.  Good incentive to avoid them!

The duodenal switch surgery is the best for long term "getting back to normal" eating.  From what I can tell, the amounts remain small for life, the need to fill protein needs and take vitamins are first priority and the rest is pretty individual.  Some people can't tolerate dairy, some can, same with sweets and alcohol.  Some people even say their taste buds are different.  Foods they loved  don't taste good anymore.  Interesting how tied in all of our organs are!

So, 20 days to go.  I am down 7 of the 20 the surgeon wants me to lose, but I admit I am going to take a few days off from the protein drinks this weekend while we go to Yosemite for our 28th anniversary!

A BIG DECISION - A LONG POST

In the weeks prior to our high school reunion, I was e-mailing back and forth with my good friend.  I was talking her into coming to the event (she has been my date for all the previous reunions) plus it is pretty much the only time I get to set eyes on her.

 Suddenly the topic changed and she asked me if I had ever considered weight loss surgery.  I told her I had gone pretty deep into the pre-op planning about 8 years ago before we lost our coverage - why?  Well, turns out she would like to help me pay for it.  It was one of those "life turns on a dime" moments.  I said I would look into it and we would talk.

Turns out my insurance company not only doesn't cover it - they won't cover anything at all related to it, ever.  They were very emphatic!  Wow.  I got the feeling they had put me on a watch list just by inquiring!

So then I looked into the options.

Eight years ago I had planned on  the Duodenal Switch which is a reduction of the size of the stomach itself and then a re-routing of the intestines which creates a "malabsorption" effect.  It is considered the riskiest, most complicated surgery but the life long weight loss, maintenance and reduction of other weight related problems is the best. It is the only surgery which allows, over time, for me to eat somewhat normally, drink alcohol and take Nsaids. Considering my arthritis - I need that! There is a significant vitamin regimen and certain foods will likely cause distress - like refined carbs and sugar. But apparently it is different from person to person.

They also offer the "Sleeve" which is just the reduction of the stomach size but leaving the pyloric valve, which some of the other surgeries, like the popular Roux en Y, removes.  The new popular one is the Lap Band which is an inflatable band positioned at a spot around the upper stomach.  It can be inflated or deflated to alter the size of the pouch for food to be digested and slipped through into the rest of the stomach.  It is the easiest and least expensive surgery but there are lots of issues with the way you can eat and what you can eat and it requires frequent adjustments (ongoing costs).  There also seem to be a lot of ways to circumvent its effectiveness - not that I would set out to do that...

Anyway, I researched and went on weight loss forums and blogs and learned more than I wanted to know about the different types and how they have affected people and I came back around to the DS.  The DS costs between $30,000. - $40,000. Hard to pin down  (and why the range?), but that is the way our health care works in this country.

My friend and I talked and the amount of money she is offering is not going to cover my surgery of choice.

More research, and the answer has been found. They call it "Medical Tourism."  Going out of the country for medical care which is priced much higher here. 

I am communicating with two surgeons in Mexico and the cost for the same surgery plus a longer hospital stay is  $11,000 and $13,000.  Both are highly rated, very experienced surgeons working out of hospitals.  I have communicated with a dozen of their previous patients and read, probably 50 testimonials and blogs and other writings about them. Can't find anything bad about them - no complaints; more than I can say about some of the US surgeons and hospitals.

Plus, by circumventing all the BS that the US docs do (which runs up the costs) I can get a surgery date in weeks instead of 6-12+ months.

I also discovered a number of post-op people who have taken to YouTube to chronicle their experiences.  YouTube seems to attract a certain kind of person, at least on this subject.  Let's just say they like to hear themselves talk.  There are glimmers of good info, but for the most part - not so much.

However, the benefit of YouTube is the visual. For the topic which concerns most of us very large women it is:  what happens after the weight is lost?  What remains?  Answer:  Lots of skin.  The women brave enough to show it prove that it is not pretty.  In fact, it gave me great pause.  The likelihood of being able to afford plastic surgery is slim to none. 

That shut me down for a couple of days.  No - in truth, I went on a bit of a binge.  After all, when stressed - eat.  How crazy is that?

And yes, I know that having this surgery will mean big changes to that particular issue of mine.  I have given a great deal of thought to it and also read a lot about it.  I know that there are people like Carney Wilson who managed to circumvent the surgery and gain weight back and I don't want to be one of those people.  This is my opportunity to make the changes that need to be made.  Like one guy said on a forum: "I went into surgery a fat guy and I came out as a skinny guy.  I decided to live that way the rest of my life." 

The surgeon required a low carb, low fat diet for at least the week or so before surgery.  I had pasta for dinner tonight and that is going to be the last time for a long time.  Maybe forever.  It will be worth it.