My experience with Bariatric Surgery
The skinny on weight-loss surgery, Part Two
At birth, I weighed 10 pounds and nine ounces. Since then, I've struggled with my weight. I have tried diets and assisted weight loss programs.
While genetics played a role in my morbid obesity, overeating was also responsible. Food was my drug of choice for coping with life.
My weight affected everything. Simple things, like walking short distances, were tiring. Going to amusements parks was an ordeal. There were rides I couldn't ride because the seat handle couldn't close. I had sleep apnea, bronchitis and borderline diabetes.
In 2004, my primary physician at Rancho Family Practice Associates in Rancho Cucamonga, Calif., recommended bariatric surgery. I was fearful because my grand-aunt died during bariatric surgery. However, at 24, I was ready for a drastic lifestyle change.
I was referred to Cedar Sinai Medical Center Bariatric Unit in Los Angeles. At my consultation, I weighed 434 pounds with a body mass index (BMI) of 75.0. I was 5 feet 3 inches tall.
The consultation preceded support groups, informational seminars, and intensive psychological, nutritional and physical evaluations. I was required to lose weight because my BMI needed to be at least 70.0.
After meeting pre-surgery requirements, my date was set. Two weeks before my surgery, AETNA, my insurance carrier, denied further treatment at Cedar Sinai. Instead, they transferred me to St. Bernadine Medical Center in San Bernardino, Calif.
I was uncomfortable with the surgeon from my first visit. There was never an uplifting session, just scolding.
Still, I underwent gastric-bypass on Feb. 18, 2005.
My surgeon chose to do open surgery instead of laparoscopy. The surgery went well; it was less complicated because my fat was outside the stomach lining. My gallbladder was removed to prevent infection.
I spent 10 days in the hospital following my surgery, then went back for weekly follow-ups.
Less than a month later, I started vomiting every time I ate, drank or smelled certain foods. The surgeon advised me to force myself to keep my nutrients down and to accept eating less food.
However, my health steadily declined. I developed memory loss and massive hair loss.
The surgeon continued to lecture me. He didn't listen, and said I was causing my health problems because I wasn't disciplined enough to do what was needed to lose the weight.
In April of 2005, I woke up to go to my bathroom, but fell and couldn't get up. My feet were paralyzed.
At the hospital, my test results showed severe dehydration, malnutrition and a deadly potassium level of 1.1. A normal potassium level is 3.6. An IV was inserted, to pump nutrients into my body.
After four days, my surgeon said I was in stable condition and I was discharged. Within two weeks, I was re-hospitalized with heart palpitations and hypertension.
A staff doctor at San Antonio Community Hospital ordered radiography with contrast, which showed stricture in the passageway of my pouch. He performed an endoscopic balloon dilatation to expand the passageway.
I could drink and eat again, but it took six months for this diagnosis. I required in-home medical care.
Before my discharge, a PICC line was implanted into my right arm. A PICC (peripherally inserted central catheter) is used for giving medications and intravenous fluids. My mom was taught how to flush and inject my medications into my IV and how to care for my PICC line.
Many times I felt like I was dying.
One morning, I woke up with leg and back pain. I was confused when my mom smiled.
"You can feel pain in your lower extremities," she said.
It took me a few minutes to understand what she meant.
Shortly after that day, I started in-home physical therapy to regain muscle mass and relearn to walk. However, my therapy abruptly stopped as I started to make progress.
I should have foreseen this after my last visit with my primary physician. She kept my mom out of the exam room, and told me I needed to tell myself to walk and I would. She said I seemed lethargic and depressed. She prescribed an anti-depressant and wanted to place me in a home for long-term care.
I told her it was frustration, not depression. She wasn't listening, so I left her office and never returned. I also stopped seeing my surgeon.
My mom and I later learned that my primary physician and surgeon were the reasons my insurance halted my physical therapy. My caseworker told us that they said I didn't need it, despite needing it during my hospitalizations.
Without physical therapy, I regressed, so I requested a new primary physician.
I was referred to a new doctor and within a week he referred me to an occupational center. He authorized as many physical therapy sessions as I needed. He also prescribed pain medication and had me do routine blood tests to check my potassium and vitamin levels.
My health improved because he listened. He didn't make me feel as though it was my fault or try to null my symptoms with anti-depressants. He informed me that I was one of many post-surgery gastric bypass patients with similar symptoms.
Today, I still cannot kneel. I have memory loss, cognitive limitations, sporadic frustration, a stomach ulcer and chronic headaches and back pain from osteoarthritis. All are post-surgery complications.
But today, with a cane and two legs, I can walk. I weigh 215 pounds and remain committed to losing more weight. Occasionally, it frustrates me that I'm not yet at my target weight of 140 pounds, but I remind myself that it is not because of laziness. I watch what I eat and I exercise regularly. Although there were setbacks, I know that I am healthier than I was at 434 pounds. I don't get tired as easily when walking. I also went from a clothing size of 32/34 to a size 14/16.
After I have reached my ideal weight, I hope to take the final step in my gastric bypass journey by having my excess skin removed.
Despite all that I have been through, having gastric bypass surgery has been one of the best things that happened to me. Though some of the complications I had are known side effects, the extent to which I got sick and the length of my sicknesses were because of the lack of proper aftercare from my former doctors.
Gastric bypass should be the last resort to losing weight. It requires a lifetime commitment of behavioral changes. It is a risky, painful procedure with a mortality rate of one out of 50 within the first 30 days. That risk can increase depending on the overall health of the patient and the experience of the surgeon.
My experience showed me the importance of maintaining a good patient-physician relationship where the patient is confident in a doctor's competence and there is mutual respect. Additionally, I think it is vital that those considering gastric bypass have a strong support system in place before, during, and after surgery.
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