2012 - I had Vertical Sleeve Gastric Surgery in October 2012, and this is my journey to push the fat girl aside and start living life without fear of lawn chairs, the middle seat, clothing shops and high heels. Among other things.

2017 - I'm preop for the Duodenal Switch procedure for my sleeve to help me get to goal weight....and to fix another hiatal hernia.


Tuesday, September 12, 2017

I am a terrible failure at weight loss


I am a terrible failure at weight loss.

I have been my whole life and so why would that change in my 40’s?  In letting go of trying to be “good at this” and accepting that I need more help (revision), I am doing myself a favor.   

 

I have already talked about how I don’t like to “blame” me for failing the sleeve, but the truth is that I did a lot of things wrong.  Stuff that I knew I shouldn’t be doing, but it was easy, familiar and comfortable.  I did a lot of good things, and I changed significantly, however, I want to take time to look at what I want to do now that I have more information and experience.

 

I have been seeing a lot of newly sleeved people doing things (that I also did) that lead to decreased weight loss. Specifically - Eating small quantities of shit food, and saying things to justify them. IAMGUILTY TOO....I used to say all of these things to make myself feel better about eating bagels, ice cream, chips, cookies, candy, etc. etc. 

  • It’s just a little
  • I still have to enjoy myself or what's the point
  • I can’t eat anything else
  • I can’t tolerate anything but carbs today
  • Sugar is fine
  • I’ll never have a life without being able to eat X (insert whatever food is your poison of choice)

 

These shitty foods feel good to MY brain, and in so…. I was willing to overeat more of those foods and damage my results because the BRAIN GOOD overrode the STOMACH BAD feelings. Overeating, overeating, overeating.  

 

The reward was worth the agony, and that agony lead me here.
- I can eat 3+ cups of food in a sitting.
- I can easily eat 3,000cal a day

I have learned a lot of things about the sleeve and bariatric surgery through trial and error, as many of us do.  I am one of many that has become obsessed with food in a completely different way from when I was super obese.

 

In the last few months while thinking about getting a revision, getting my consultation, check-ups, and now waiting on an approval and date for surgery - I have been introspectively looking at my behaviors and thinking about the corrections that I want to make this time with my revision:

 
1. Eat more “whole foods” in the puréed, mushy and beyond stages
- Eat less pre-packaged bars, cups of pudding or jello, easy soft carbs like oats and grits mixed with protein powder.
- I bought a blender to purée my own meats, I make my own soups now, and I’ll have a LOT more eggs in all its variety of forms. 


2. Stay off the Gawd Damn carbs.
- I went straight to bread as soon as humanly possible, but I had been eating oats, grits, and soft carbs like that for my soft and purred stages.


3. Better hydration. End of statement. 


4. Stop thinking of my new stomach size as a challenge.
- I used the sleeve as a challenge instead of a tool. How much can I get in there, instead of how much should/can I put in there.
Be more mindful.


5. Eat slower. I'm still a wolfer instead of a chewer.



6. Take full advantage of the honeymoon period.
- Last time I thought the easy & fast weight loss would continue for(ever) or at least a year or more. It came to a quick halt after about 4 months.  Then I had another 8 months of slow losses, and then… stopped.


7. Exercise.
- I didn't do anything at all the first time. I bought a treadmill for this time around, walking more will happen and does happen now.



8. Forget what others think.
- First time around I worried about what people would think about my food portions so I was always trying to eat more to appear "normal".  
- Avoid eating out with co-workers, that is a big one.  Everyone wanted to eat with me and talk about my weight loss… ironic!  I spent entire meals trying to look “normal”, this is no longer a concern for me.  I’m busy and I bring my lunch.


9. Better meal planning.
- I was always good about getting in my protein, keep at it.

- Keep packing my lunches. Make more meals at home.


10. Set better goals!
- I was so excited to have lost even 30lbs that I didn't care if I ever lost another pound again. That changed!!


11. Stay away from dessert longer.
- I always followed up meals with a spoonful of whatever was for dessert, and stating that “one spoonful can’t hurt, look at how good I’m doing etc”.
- Food will always be there – so no need to eat dessert every night. 


Tuesday, August 29, 2017

VSG Failure? depends on your perspective.

So I've had a lot of time to think about what a revision to my original WLS, vertical sleeve gastrectomy (VSG), means to me.  The word failure comes into mind a lot, and I try and fight that off, since I don't actually see the original VSG as a failure.

If you start looking around at information on VSG failure/regain you will see very quickly that the community really beats up on the person that is not successfully keeping weight off.  Its a pretty depressing situation, and actually, it kept me from seeking help a lot sooner as I did. I bought into the fact that it was me, my fault, my failure, my issues. 

However, when I evaluate the situation, it wasn't really a failure, in my perspective.

I did fail to make it to a normal BMI. 
I did fail to keep off all the weight I initially lost.

Based on those 2 things I am considered a medical failure, and I qualify for revision.

However, I don't see my journey as a failure and I don't see me as a failure.  The VSG has already done amazing things for me and my life.  I made massive changes to my eating habits, my portions, my choices.  100% good, no.  Better than they were before, yes.  

In 2012 I was on a slippery slope, 315lbs and gaining.  With the VSG I managed to get down to 230, and then springboard back into the 240-250lbs.  The surgery halted my upwards trajectory into the super-super morbid obesity and has made me a mostly normal looking, albeit hefty sized person. 

The "failure" comes into play for me in that I am still not a normal BMI, and I'm at least 50lbs heavier than I would like to be (my preference would be to be in the 190-200 range), and 86lbs heavier than a normal BMI for someone my size. 

Current BMI - 38, 250lbs
Normal BMI - 24.9, 164lbs




Hilariously, here I said that if I never lost another pound under 260lbs I would still be happy.  LOL perspective. That was 2 months post surgery in 2012.

I never made it to my goal weight of 190. Perhaps that is because I was comfortable? 

There are a lot of things that I am going to do differently this time as well.  I've been making a list of them and will make another post.  The main ones are that I ate too many carbs too soon, not enough water, and I didn't/don't exercise enough.

Regardless, there are also other things at play. My surgeon said that there are lots of people that VSG doesn't work for, those with metabolic concerns.  My fundus (stomach) is dilated. My normal anatomy might let food pass more quickly through then normal.

I can also say that my mom put me on my first diet when I was 5 years old, and basically I've been chubby ever since. I have lots of food anxiety, stress, and secret eating.  These are things that I have been working on.  I did a great emotional eating class earlier this year that help solidify my position that I should seek to see if there is another surgery/re-sleeve option for me.

So, I'm positive feeling about the upcoming duodenal switch. I am so excited to think about being a normal sized person for the first time ever in my adult life. 

For those that find their way here and are thinking about a revision for lack of weight loss, or regain, I'm with you.

Here is another great article on revisions to the VSG, a very easy to follow along power point from Duke University.

This is a long one, but if you are interested in this material, then you might find it worth reading.  The conclusion is one that is not very comforting, but pretty realistic. 

In summary, SG as a stand-alone operation is gaining popularity among both bariatric surgeons and patients. This enthusiasm, however, has to be balanced against a paucity of data in regards to potential long-term failure rates. Similar to other bariatric surgery procedures, SG failure is likely to be multifactorial and related to a combination of technical, physiological, and psychological parameters. When discussing SG, bariatric surgeons must review these unknowns with their patients to ensure they will make informed, long-term, surgical decisions based on all available information.

Friday, August 25, 2017

Duodenal Switch confirmed!

I originally had my follow up appointment with the surgeon for this coming Monday, however the hurricane in the gulf right now is going to circle around all weekend and make Monday appointments impossible.  I gave the office a quick call and they actually squeezed me in today, Friday, for an appointment before the weather turns for the worst.

My surgeon reviewed the results of the endoscopy and the result of the upper G.I. His recommendation is that I convert to the Duodenal Switch as well as fix the sliding hiatal hernia and perhaps some trimming of my current sleeve.

The upper GI showed that I have a giant sliding hiatal hernia  that is obstructing the esophagus from working properly. I'm mildly embarrassed by my own lack of body awareness, I guess I feel like weird feelings in my stomach and throat are just "normal for me ".  He  reassured me that this is in fact not normal.

The only good thing about the hiatal hernia is that my insurance will definitely cover the repair to that and I know that my insurance does definitely not include  any weight-loss surgery.

This means that a good portion of my surgery will be covered and I will only have to pay for the time it takes to complete the duodenal switch. A significant savings, and my work will allow me to go on short term disability to recover. Which is even better, so I don't have to use all my vacation time for recovery and possibly have to return to work sooner than I should.

I actually didn't really know anything about the duodenal switch until my first consult where he told me about it.  I've been reading a lot.  The conversion from a vertical sleeve gastrectomy to the duodenal switch means that I'm halfway done the surgery, all I require is the detouring of the small intestines.  Although he did say there might be some revision to the fundus, stomach, as mine is quite distended.  However he didn't recommend a re-sleeve by itself because they are not quite as successful and just revising the stomach tissue has a higher risk of leakage.

Because I have so much arthritis in my neck, I require ibuprofen on a pretty regular basis.  The other option of a gastric bypass is definitely off the table,  as that surgery is very intolerant too ibuprofen. The good news is that I regularly take ibuprofen and I don't have any stomach ulcers currently, so that is a positive indicator that this will continue to work well for me.

What I'm really happy about  is that all the waiting and wondering about what might happen, what's the recommendation,  which revision is going to be best for me  .... etc etc is over.  Knowing is just so much better, now I can rest easy and do research on my upcoming surgery.

Phew! So happy that I know the next steps.

His office is submitting to my insurance for the hernia fix and is going to get in touch with me with a quote for the remaining surgery that will happen at the same time. Then we can plan a date for the revision - which will have to be in October, I have too much going on work wise in Sept.  I'm hoping for  October 2,  first Monday of the month and almost exactly 5 years to the day (oct15,2012) from my initial VSG.  That will be a good date as well, so I can take almost that whole month off  to recover.

Happy Dance!!

Monday, August 21, 2017

The Waiting Game

It's so hard to wait now that I have all the tests done. I'm impatient and there are so many scenarios that this could play out to, so I keep over thinking what might happen.

The one thing that I need to get done is a check in with a regular GP to have my vitamin levels tested. Putting that on my to do list. I also need to scroll back in my calendar and review all the pre surgery steps that happened and in what order.

I'm struggling with the up down on the scale, as I always do. Weight down = flying high and feeling good. Weight up = angry frustratinion

I wish that I had a better relationship with my weight.  Guess I can file that under things to work on.

I've been doing better at lunch with bringing my pre-made good for me food. We are doing better at night with making dinners and not eating out, which is a huge downfall.

At this point it's just one day at a time and one snack at a time!

Thursday, August 17, 2017

Endoscopy done

You know what doctors of anesthesia don't appreciate, jokes about Michael Jackson when they're going to use propofol on you for your procedure!! Oops!!

All went well for my procedure. I read the report they give after but am trying to not read too much into it, since I don't want to think one thing and be told another when I have the consultation.

I've started prepping people at work that I am going to need some substantial time off for recover from hernia surgery. I did this the first time as well- I am a "secret sleever". I don't want to tell many people about my WLS so I just don't. Especially at the office.

I'm actually feeling very restless and impatient. I have 10 days until my consultation about the tests and then September is a terrible month for work for me, so I'm going to have to schedule the revision surgery for October. Which feels like forever from here.

But I'm sure that it will go by quick!

Tuesday, August 15, 2017

Another Hiatal Hernia... Good News, Bad New

Bad news, I have another hiatal hernia... Good new, that means that my insurance will cover the part of the surgery to fix that. 


Side note... barium is about as yucky as I expected.  When you have not had anything to drink in 10+ hours you would think that drinking anything would be awesome... yeah, no.






The curious part of me is wondering why I have one again.  I imagine that its a combination of genetically having a big hiatal hole (hahaha!), and being overweight with the majority of my weight being carried in the front of my abdomen. This creates more pressure on the organs and could be forcing the stomach up. 


Anyway... all problems that can be sorted out.


Onwards to tomorrows 5am wake up call.  At 6am I have my endoscopy to have a look see the inside and I'm guessing I have ulcers again. 


Regardless, it will be a day off after conscious sedation, so I'm going to turn my work phone off and rewatch Game of Thrones last season and this season (if I can stay awake), and snooze with the dog.


I'm super curious to see what the doctor has to say about my sleeve and how it looks and his opinions on how to move forward from here.  

Monday, August 14, 2017

Upper GI X-rays Tomorrow

Tonight at 10pm, nothing more by mouth for my upper GI tomorrow morning.

I've only had barium once before, post first VSG, to make sure there were no leaks. Or, at least I think it was barium... pain meds make things fuzzy.

Very excited to kick this off again. I've also started an instagram account: TammyTake_2 if you want to link up where the "kids hang out"!!

This morning I was down on the scales again, which is great! But then I get wracked with guilt... am I just not trying hard enough? Can I do this without another surgery!? Ug, such ugly feelings. I have worked hard and I never came close to my goal weight, so I know that this is the right decision. I have to keep reminding myself that.

I've struggled for three years and done nothing but creep ever upwards. This is the right decision.

I found my 1 year pictures from 2013 and I'm excited to see the next phase of progress!