A BARIATRIC SURGEON SPEAKS OUT - NOT THE EASY WAY OUT

I just read this great article written by a Bariatric Surgeon.  He is tired of people commenting about his profession - that he is an "enabler" for lazy, unmotivated fat people taking the "easy way" out of obesity.

He lists not only the difficulties of losing weight and maintaining that loss, the hoops people have to jump through to even get surgery and the fact that the AMA this year has declared obesity a disease and not just the cause of other diseases.

As a life long exerciser, a healthy eater and someone with knowledge of nutrition and of my own psychological issues - I can attest that it is not just a matter of eating less and exercising more.  Yes, for many people there is an issue with eating poorly and not exercising.  For many more of us it is far beyond that simple formula.  No one can really explain all the factors involved but the medical researchers are gaining awareness of the multiplicity of factors which affect different people.

Just as some people can smoke cigarettes all their lives and not get lung cancer, some people live long lives on a high fat diet and others drop dead in their 30's following a spartan diet and running marathons.  None of it is simple.

I had wanted to try weight loss surgery for over 10 years before I was given the opportunity.  As soon as I was aware of the Duodenal Switch I knew it was the solution for me.  I have never been a volume eater.  I have generally been a healthy eater - yes I have binged like pretty much anyone, for the most part I have been eating a high protein, low carb diet for 15 years so I knew I could maintain the dietary requirements.  When people "fail" following weight loss surgery and gain weight, it is probably because they didn't learn enough or know themselves well enough to commit to what it takes to be successful.

The surgery is a tool, not the final solution to the problem.  After all, we still have to eat!

3 MONTHS POST OP WEIGHT LOSS SURGERY

I finally hit the 3 months mark this week.  I don't know why it feels like such a milestone, but it does.  I guess it is the point where most post-op's feel more settled in, get the labs done and the mystery of how the body is handling things is illuminated.

I feel settled in some ways, but my bowels are still a daily question.  I have been trying to decide if I am lactose intolerant and can't determine an answer.  I have yet to determine the issues behind the days I am in the bathroom repeatedly vs. the more normal days.

I managed to eat two bites of beef stew meat* but then last night some roasted chicken upset my stomach.  I can only eat a couple of bites of egg and many foods still set off my gag reflex.  One day I can eat smoked salmon with a little cream cheese and the next day I can't.  I did have a couple of salads this week - it was so great to have that fresh, clean crunch again.  The salads may have been behind the gastric distress - but they were worth it! So each day is still an adventure.

The small amounts I can eat also pose issues.  I made a batch of "protein pancakes" on Sunday.  The entire  batch is a serving - 6 little pancakes.  I could eat 2.  So the breakfast I had hoped would be 19 grams of protein was only 6.

I finally got my special order potassium supplement from the pharmacy and started it on Friday.  It is just awful stuff.  "Fruit flavored" stuff to mix into water or whatever and it is sour and gross.  I experimented with adding it to different things this weekend with little success.  It is going to be a hard thing to take every single day...

But I am focused on the pleasures.  My grapefruit, more salads, a little pile of sunflower seeds I munch at my desk.  Not to mention that I am down 78 pounds.  My closet is pretty empty and I can't even believe the stuff in there fits me - it all looks so small!



* I make all kinds of things for my husband's dinner, including beef which is not yet advised post-op.  I tasted a couple of bites for tenderness...

LABS ARE BACK!

I got my labs back already and all but one thing is in the normal range. My potassium is very low and he doc has prescribed an additional supplement for me.

So what does it mean to have a potassium deficiency or Hypokalemia?  I looked it up:

 A medical condition in which our body fails to retain the amount of potassium required for its day-to-day functioning is called potassium deficiency or hypokalemia. This deficiency of potassium in body can be fatal considering it has a crucial role to play in various body functions - all of which are bound to be affected by the lack of this mineral in the body.

Fortunately my levels, while low, have not persisted long enough for me to have most of the possible symptoms or side-effects, which include:

• Myalgia (muscle pain), muscular weakness and cramps.
• Cardiac arrhythmia i.e. abnormal rate of muscle contractions in the heart.
• Unexplained fatigue and weakness
• Hyponatremia, which may or may not be accompanied by anxiety.
• Impairs nerve transmission and deteriorated nervous system, which, in turn, results in confusion and delirium.
• Skin related problems such as blistering, skin eruptions, dryness of skin, acne, etc.
• Temporary memory loss or other problems like weak memory, difficulty in concentration, etc.
• Sleeplessness and irritability
• Intestinal or lung paralysis
• Heart related problems, such as heart deterioration.
• Increase the risk of high blood pressure
• Ringing noise in the ear at times

I have had very dry skin since the surgery, other than that, some sleepless nights and irritability but nothing I haven't experienced before!  No unusual muscle pain but I do think I have been slow to recover from my new work-outs. I am off BP meds but my blood pressure is down to the high/normal range.  So this should protect my heart health, too.

 One of the great fears of making this great change to my physiology has been that I would loose not only weight but my health. I am thrilled that all the other areas tested were in normal ranges and that an additional supplement will help with this issue.