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Answer 49 Pregnancy After Weight Loss Surgery There is a research article that deals with this subject that I discuss in my book, Weight Loss Surgery, Finding the Thin Person Hiding Inside You. The research article, “Pregnancy Following Gastric Bypass for Morbid Obesity,” appeared in the August 1998 issue of Obesity Surgery, Vol. 8 (4) p 461-4. Dr. Alan Wittgrove reported on a study he conducted that followed 41 of his own gastric bypass patients who had become pregnant. The pregnancies and deliveries of each of these patients were without complications. There is an online bulletin board that deals with the subject of pregnancy and weight loss surgery. It is OSSG-pregnant and has 338 members. Join http://groups.yahoo.com and sign up for the pregnancy group. For a testimonial, I felt there was no one better to ask than Denise Rasley. Denise is very well known on the OSSG Bulletin Board (http://groups.yahoo.com/group/OSSG). OSSG (Obesity Surgery Support Group) is the main group of weight loss surgery groups with a membership of 4,068. Denise had surgery in October of 1998 and continues to provide support to those seeking information on weight loss surgery. The issue of pregnancy after surgery remains a subject near and dear to her heart. Denise was recently one of those featured on the MSNBC news report on Weight Loss Surgery in May called The Last Chance. She is also very active working with the Ohio legislature to ensure that weight loss surgery is not an excluded benefit in health insurance.Click here for her story...
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Answer 48 Hunger Pains What a great question! The lower stomach that is left in tact after the RNY surgery, still produces gastric juice, but since there is no food going into it, it "goes to sleep." It doesn't atrophy, but it also doesn't cause you hunger pangs. It is just not part of your truly active digestive system anymore, other than producing a small amount of gastric juice. The functioning pouch is what controls your hunger after the surgery. I always had a huge appetite. Prior to my surgery, I would eat a full meal and an hour later I could eat another one. I never knew what it was to be satisfied until after this surgery. One things that helps is concentrating on protein. Protein is a natural appetite suppressant, while carbohydrates stimulate your appetite. Yes, those hunger pains will go away after your surgery. But you also need to keep in mind that the hunger pains don't go away
forever. In the beginning, your pouch is small and swollen and after
the initial "head hunger" when your body gives you some false
feelings of hunger, you are rarely hungry for a couple of months.
But when the swelling is long gone and your pouch stretches a bit and you
are able to tolerate a wider variety of food, your hunger starts to
return. But I have found that it returns only a fraction of what it
was before. And I find that when I am hungry, I eat a small amount
and the hunger is gone. That very small stoma (the opening between
the pouch and the small intestines) holds the food in the pouch for a
longer period of time and the feeling of being full and satisfied lasts
longer. Hunger is now controllable for me. But I do have to
exercise some control and some good eating habits. To be truly
successful, you will have to do that also.
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Answer 47 Is this elective surgery? Would it be elective for someone to have a disease that will kill them if not treated? No. They did not choose to have the disease and the treatment would be considered to be medically required. Morbid obesity is a disease that must be corrected or it will surely kill as well. Gastric bypass surgery isn't elective surgery. It is a procedure that is recognized by the National Institutes of Health as a proper method of treatment for morbid obesity. If you have over 100 pounds to lose, and are gaining more weight every year, it is only a matter of time before the co-morbidities caused by the weight will kill you. And consider the quality of life you will have in the meantime. Yes, people die from this surgery, but so many more are saved by it! Is it elective? Definitely not!! |
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Answer 46 Questions about the Surgery I hear the desperation and fear in your words and WOW do you sound like me in October of 1999. It is very normal to think that this is scary, so please know that what you are feeling now, we have all felt! If you weren't concerned, then it would probably indicate that you don't really understand that this is major surgery that has risks and don't understand that this is a life altering procedure. But it is important to learn the benefits of a happier and healthier life that are derived from this surgery and compare with the risks. Also research the very high risk of impaired quality of life and early death by doing nothing at all and continue gaining more weight. It is difficult to say how much pain there is because people react differently. Some say they feel like they were hit by a truck and are just very tired. Others say they had a lot of pain. I am in the latter category. I had a lot of pain. However, I had a complication. I had a tiny leak with my surgery which sealed itself immediately. However, my surgeon didn't want me to have anything by mouth for a week and have a retest a week later just to be absolutely sure that the leak had sealed. So I went home from the hospital with an IV and just wiped by mouth out with ice chips for a week. However, this also meant that I couldn't take my liquid Roxicet. That impacted the pain I felt. I had morphine suppositories which just didn't relieve the pain sufficiently. But even with that, the pain was certainly bearable. And I'm such a woos! It was more a dull pain like I had had the biggest workout of my life. Initially you will probably throw up because you haven't yet learned what is going on. Try to keep the "baby" thought in your head. Does a baby throw up? Sure! Is it a big deal? No. You will have the system of an infant for the first month or two until the swelling goes down and your body adjusts. I have only met two people who told me that they have never thrown up. Maybe you will be the third person! Later on, say after two months, If you are very careful, you really shouldn't throw up. Every time I have thrown up it was my own fault. I am terrible about eating too fast and not chewing enough. I am 16 months post-op and I threw up 2 days ago. I was in my office on the phone with my husband, talking and trying to eat lunch. When you eat and talk you have a tendency to swallow food so that you can say something. That's what I did. My food wasn't chewed well enough. I got a pain right between my breasts (that's my signal), and up the food came. I just swiveled in my chair and leaned over my trash can (I have a private office). It was not a huge amount because I can't eat huge amounts. There is no bad taste because you are not throwing up any bile. And I didn't feel awful after that. What I have noticed is that after I throw up, my pouch seems to be irritated a little for the rest of the day and I need to eat easy foods, something like scrambled eggs, cottage cheese, or soup. The process is a learning one. And the payoff is absolutely
fantastic. I am soooo happy. I wish you the very best!
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Answer 45 Will I survive the surgery? The mortality rate is less than 1%, which is about the same as if you were having any other surgery. A question you must ask yourself is, if you don't have the surgery, how long are you going to live being morbidly obese?. An ongoing study in Sweden is following 2 groups of morbidly obese people. One group had surgery and the second group did not have surgery, but dieted. Since the beginning of the study, there have been 3 deaths with the surgery group and 27 deaths with the diet group. The results of the study indicate that you have a 9 times more likelihood of dying sooner if you don't have the surgery. You also need to consider your quality of life. I can't say if you will survive the surgery. Only God knows that.
But you have a better chance of survival over the next few years if you do
have the surgery. But you must decide for yourself. Research,
think about it, and know what you are getting into. Being scared,
though, is very natural. I was terrified!
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Answer 44 What about a psych Evaluation? A psych evaluation is something that my surgeon requires of all his patients, although some surgeon's don't bother with it. It is to determine if you have any unrealistic expectations from the surgery, eg. your life is now miserable and after surgery you will become magically happy. One very positive thing that it does do is to put you in touch with a psychologist who is accustomed to working with morbidly obese patients. There are many psychological issues to be dealt with after the surgery, and at least you have had an appointment with someone that you might want to call upon for counseling. An example of the emotional issues include your relationships with others during a time when you are changing so rapidly. Some marriages cannot survive this. It seems that weight loss surgery makes good marriages better and bad marriages worse. We are also accustomed to using food to relieve stress. When we no longer have that crutch, it can be very difficult to cope. Another area in which people run into trouble involves the fact that many use their weight to ward off attention. When you lose that layer of fat, some people feel very vulnerable and don't know how to deal with attention. These are just some of the psychological issues that can come up.
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Answer 43 Confused about Terminology Bariatric surgery has been done in the United States for the last 20 years. The word bariatric is from the Greek word "baros" meaning weight and the Greek word "iatrike" meaning treatment. In other words, bariatric surgery is any surgery for the treatment of weight. There are many types of bariatric or weight loss surgeries. One is the Roux en-Y (RNY) gastric bypass surgery which is what I had. This surgery is considered the "gold standard" of weight loss surgeries. It is performed on 80% of patients and has been endorsed by the National Institutes of Health. Other bariatric surgeries are the Vertical Banded Gastroplasty and the Duodenal Switch. I hope this clears up your confusion.
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Answer 42 Fearing the Surgery Weight loss surgery is a very frightening thing. It is major surgery and is life altering as well. The mortality rate is less than one percent which is the same as for any surgery. But remember that those people who are in the pool with you in gauging that mortality rate are many patients who have extremely serious health problems because of their morbid obesity. You are fortunate that you are having your surgery now while you are still healthy. If you cancel your surgery, you will just reschedule later and your health might not be as good then. You should do this while you are still healthy. Instead of focusing on being the one person in
more than 100 who dies during surgery, focus on what your life will be
like after the surgery. Every time you start to get those scared feelings,
write down on a piece of paper your wish list; things like being
able to walk up stairs without being out of breath, fitting in a bathtub
with room to spare, being able to comfortably paint your toenails, going
to an amusement park and fitting in a seat with the bar going down, etc.
Make your own list. When fear strikes, either write your list or
read it and imagine how wonderful these things will feel.
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Answer 41 Lap vs. Open If the only way you can have the RNY surgery is with the open procedure, then I would suggest to have it done open. The surgery itself is exactly the same. The only difference is that with an open, the surgeon performs the surgery through one long incision that goes from your breast bone to your navel and with the lap, the surgeon works through five very small incisions (each less that one inch) in your abdominal area. In my own situation, I had the option to choose either procedure, so I chose the lap. But if I didn't have that choice, I would have had it done as an open. There are several additional problems that are associated with the open
procedure such as increased chance of infection, longer healing time and
more pain. These problems are not very appealing, but consider the alternative
which is no change from what your life is now. In a decision between
staying morbidly obese for the rest of your life and having the procedure
done open, you must determine your priorities.
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Answer 40 The Heartbeat "Thing" Great question. Maybe we use that expression because we thought about having the surgery for such a long time. Debated it, wondered if we could survive it both physically and emotionally and then struggled with insurance companies and worked to get a surgery date after having all of the pre-op testing done. It was just a very long process. So maybe the "heartbeat" thing comes from not having to even consider it now. But more than likely, it is just something that someone started and it stuck, and is now a cliché It's like "the other side" saying. When I first heard people saying, "Welcome to the other side," or "I can't wait to join you on the other side," I thought it sounded bizarre. It sort of sounded like dying. After I had the surgery though, I understood. It is like a whole new life. And I also would do it again in a heartbeat!
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