Weight Loss Surgery - 18 Years Ago

                                             
                                 
A gastric bypass...or stomach reduction, is exactly that.
18 years ago, when I chose to take this option, it was still considered experimental
and there were only a couple of doctors in California performing it.
I was required to travel to San Diego, which is 6 hr drive from my home, for that surgery,
and stay at a hotel there for at least 10 days immediately following my hospital release
with another person.  My husband accompanied me.

In my case, over 18 years ago, this was before laser surgery was common,
and my body was cut open vertically from chest to stomach...somewhere around 12+ inches.
My stomach was then cut apart into 2 pieces.
The top piece being a relatively small pouch,
and the bottom being the majority of the stomach.
At the place of division, the bottom part of the stomach was closed off and stapled shut.

As Food intake comes in through the top of the stomach,
and leaves though the bottom of the stomach,
the intestine connected to the bottom part of the stomach was cut away,
then brought up to the bottom of the small top part of the stomach and attached there.
The bottom part of the stomach remained inside the body, unattached to anything,
while the small top part of the stomach became the functioning body part.

In some of these surgeries, ....but not in my case......,
the intestine is shortened before it is reattached to the smaller, top portion of the stomach.
This interferes with the natural digestion process, so that ALL of one's food
...both calories and nutrients....are not absorbed but therefore pass through the body more quickly.
HOWEVER, in my case, all calories and nutrients in food are still absorbed.

A gastric bypass is, of course, major surgery,
although now laser surgery is commonly done,
which avoids the long vertical cut through the body.

It is painful, but my San Diego gastric bypass surgeon felt
that potential complications from pain medication outweighed the benefits.
So he did not routinely prescribe it.
In fact, a day or two after my hospital release,  I lay on my hotel bed in such pain,
that my husband phoned the doctors office for a pain prescription and was given one.
My husband returned from the pharmacy with TWO pills....TWO single pills.
That was the only pain medication I received after leaving the hospital.

 As my stomach healed, for several days I could only tolerate small sips of water.
Then I added jello and broth for several days.
On about day 8 or so, I was able to eat 1/2 a poached egg and a couple of bites of toast.
Eating more was physically impossible.

In those days, bariatric surgery was uncommon, and there were no large clinics
with nutritionists giving pre-surgery diet requirements or even post-surgery diets.
My only contact was with my surgeon...who like many doctors skilled in surgery...
lacked a pleasing "bedside manner".

My surgery was the Monday after Thanksgiving Day, and my pre-operation diet requirement
was not to "stuff myself" the week before surgery, as this might make surgery more difficult.

Regarding my post-surgery diet, after the first 10 days,
I was told that I should eat three meals a day, with only water in between;
that each of  those meals should be one-half protein:
and within those restrictions I could choose to eat whatever my body would tolerate.

 In fact, my surgeon's words to me were:

"You really only need the protein,
but I let people eat other thing too, just to make them feel good"

All carbonated beverages were strictly forbidden,
Sugar, fruit juice, and starches were discouraged
on the basis that they activated Dumping Syndrome..
....and they did...
It wasn't willpower that kept me away from sweets and starches.
It was the pain of "Dumping Syndrome" that ingesting these foods
generated inside my body which caused me to avoid them.
Protein shakes were not required or recommended.
My only additional medication was one daily multivitamin and an additional B-12 vitamin.

For the next six months, my body would only eat small amounts of food at a time,
and the amounts I could tolerate varied depending on what food I was eating,
and what food I had eaten within the 24 hours previously.

By small amounts of food, I mean, for example, during the first several months.
a maximum of perhaps between 1/3 of a small container of yogurt up to 1 egg and 1/2 piece of toast
...or perhaps 1/2 of a small sandwich, even sometimes a small lean cuisine dinner.

When I say tolerate...I mean that at the end of eating that amount,
I would feel stuffed like I had just overeaten a large Thanksgiving dinner,
and could not take another bite...
sometimes I had to lie on the bed in pain for 1/2 hour or so until some of the food digested.

People lose weight after a gastric bypass because they physically cannot overeat,
in fact at first, they can barely eat.
The first 6 months or so my daily calorie intake was between 300 and 600 calories a day
...and I felt stuffed and ill much of the time.

After 6 months, my food tolerance level grew and 2 or 3 years later it  sort of "topped out".
WLS made me lactose intolerant which has continued even now.
Sugar-free yogart and hard cheese has never been a problem,
but I still cannot drink milk nor eat more than 1/2 cup of ice-cream.

For example, now I can eat a 10 inch plate of food and feel full, but not stuffed---
depending on the type of food...and how empty my stomach was before eating.
This difference is not based on fat or calorie content, but is based on volume inside the stomach.
I still cannot physically eat large amounts of food at one time..
That is why, for me, seconds is not a problem.
However, snacking is a very large problem,
because after the surgery, nibbling and grazing was the most comfortable way to eat,
and after a few years, this became a firmly entrenched habit.

At present I can physically take in a great deal of food, by eating small amounts of food at a time
....like, for example, a couple of 100 calorie bags of snack food, or 2 or 3 cookies,
or a candy bar, or a couple of ounces of cheese, a small bag of chips, 1/2 cup of nuts...every 1/2 hour or so.
...even after having 3 small meals the size of a lean cuisine and small dinner salad.

My body, with an hour of daily low-impact exercise, burns less than 1200 calories a day.
My maximum physical calorie tolerance limit in one 24 hour period now is around 3500 calories,
where before my surgery there were days when I could take in over 10,000 calories.
I was a binge eater, and did not purge.

Prior to surgery I was aware of the process, the risks, and the after-effects.
It was a decision I did not make lightly, and in fact, a year before I had it,
my therapist and I together decided on taking that option in one year's time,
if I was unable to get back on some food plan that would drop some weight
or at least stop my weight from climbing further within that time limit.

I was around 47 years old at the time, and in good health
...except that I was 5'0" tall weighing 271 lbs....
after having lost over 100 lbs three separate times in my life,
and each time regaining that weight and more.
I had undergone many years of therapy on that issue (as well as others).
I had exhausted every effort, and I was ready for that step.

About 9 months after my surgery I weighed 160 lbs
and during that time I ate everything my body would tolerate without restriction.
ALTHOUGH, my doctor's instructions were to "eat 3 meals a day
...no snacking...with 1/2 of each meal protein."
I found myself unable to follow those instructions.

My weight stabilized in the 160s for several years,
and then as my tolerance for food grew, weight began to creep back on,
and I had to AGAIN, begin making effort to watch what I ate.
So, sometimes dieting and sometimes not,
in September 2004, my weight was 190 lbs....and climbing.
It was at that point I discovered the software program, Diet Power, 
and I began using it daily, writing down every bit of food that I ate,
and working to eat around 1000 to 1200 calories daily.
I had extensive food knowledge from my life of dieting.
I had been successful by counting calories in the past,
but it had proved too hard to keep up long-term
while using a pen and paper and a calorie dictionary.

The computer food journal was an answer to my prayers.
I found it easy to develop habitual use, and as of today,
I've recorded all my food every day in Diet Power for 2379 consecutive days...
I know that, because it says so right in my Diet Power history journal.

 So, now I've been working on maintaining my goal weight of 115 lbs for more than 5 years.
I do all kinds of different diets and food plans,
and learning about them and experimenting with them is part of my Dieting Hobby. 
The one consistent factor since September 2004 and 190 lbs
has been that I've logged all of my daily food intake into Diet Power.

Okay, so.......here's the thing...
I've described the Gastric bypass surgery, and its after effects.
Since my surgery, bariatric surgery, has gotten better
and some of the side effects I suffered aren't as much of an issue.
After my surgery, my adult daughter, my sister, and my adult nephew
.....as well as numerous friends....
have also chosen to have gastric bypass surgery with great success.
A negative is that my first cousin had the surgery, and died one week later from complications.

In the entire almost 18 years since that time, I have seldom regretted having the surgery,
and I would make the same decision again, if I were given the chance to relive the past 18 years.

What many "normal" people don't understand
is that, for many people,
the physical sensation of being empty or full
is not the real problem that causes overeating.

For some people, eating food is a successful device for handling uncomfortable emotions,
and there are also some people who simply enjoy the sensation of taste,
and the pleasant side-effects of eating far more than other people.

Personally, I've spent a great deal of my life feeling actual hunger,
and a great deal of my life feeling uncomfortable from being too full.
I find the physical sensation of hunger by far the most acceptable of those two feelings.

I hate being Fat.
I've been Fat, and I've been Thin.
Thin is better.

So as an intelligent being,
why would I choose to engage in behavior that makes me fat?
I've found I couldn't FIX that in myself... 

• through a lifetime of dieting;
  
• by my major surgery; or
  
• by more than 20 years of therapy.

So what I've learned to do is ACCEPT
that the desire to overeat is a problem for me that isn't ever going away
...and since I want to be thin...,
I just have to deal with it every single day...one-day-at-a-time.

When I'm in a public place and I see an obese woman
eating a really high-calorie treat
.....I DON'T think...."oh, dear...they shouldn't be doing that".
What I intensely know from my own personal experience
is the HIGH PRICE they have chosen to pay for that food,
and therefore how valuable and desirable it is to them.

I say :

"Go Girl, you enjoy that food,
because you've paid a high price for it,
and you deserve to enjoy it
far more than those people who are naturally thin."