Saturday June 17, 2006

It’s been nearly nine months since I had the surgery and many new people have started reading the blog. I also wanted to have a blog entry to point people to in efforts to describe the surgery.

I have to admit, I’m going to take the easy way out on this one. I’ve copied and pasted in the text from my surgeon’s Web site. I think it explains it in pretty plain English and I know it is accurate. I’m also going to do some of my own explaining later on in this post. I know this will get long but it’s pretty easy to skim and I’ll try to do subheads so you can skip sections if you want to. Anything that is my words will be in this type of typeface.

 

Here’s the surgery I had and how it works:
“Roux-en-y Gastric Bypass – RNY

According to the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass is the current gold standard procedure for weight loss surgery. It is one of the most frequently performed weight loss procedures in the United States. In this procedure, stapling creates a small (15 to 20cc) stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus bypassing calorie absorption. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch. The other end is connected into the side of the Roux limb of the intestine creating the “Y” shape that gives the technique its name. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.

Advantages

• The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with purely restrictive procedures.
• One year after surgery, weight loss can average 77% of excess body weight.
  Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained by some patients.
• A 2000 study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved.

Risks

• Because the duodenum is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss.
• Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.
• A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
• A condition known as “dumping syndrome ” can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating. Some patients are unable to eat any form of sweets after surgery.
• In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15-30cc.
• The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.”

OK, My words again…

WHEW! That was a lot, wasn’t it? But seriously, this surgery has changed a lot over the years and while there were risks of possible bad things to happen, I knew there were far worse things that WOULD happen if I didn’t take control again.

Basically, the surgery works for two reasons:

-The pouch greatly reduces the amount of food I am able to eat. I used to be able to eat a full value meal plus dessert and/or a salad. Now I can barely down a regular hamburger without the bun.

-Malabsorption happens from everything I eat. I don’t get all the calories from what I do eat. The malabsorption also causes the dumping syndrome and that sucks! I either get varying levels of extreme tiredness for about 30 minutes or I get sudden and bad diahrea (sp?).

The post-op patient goes through lots of phases after surgery in all aspects of life. The first six months or so is when the patient loses weight pretty fast with a few plateaus (stopping of weightloss) intermixed. I was exactly this way except I was lucky, I didn’t stop losing weight until my eighth month. That month I actually gained about four pounds and although I knew it was normal and even my surgeon told me to not worry, I panicked. I then lost that four pounds and then seven more for a total 5-week weight loss of 11 pounds.

That won’t be the norm from now on, however. I’m at the stage after surgery where the body has basically figured out what happened to it so it isn’t dropping the weight as fast. I’m losing almost at the same rate as someone who hasn’t had the surgery. As I get closer and closer to goal weight, the weight loss will be increasingly more difficult.

Even though it will slow down greatly from here, I have already done well. I’ve lost just more than 100 pounds. I have about 130 more pounds to lose but my doctor said that is probably about 20 pounds or so of loose skin that will have to be removed when I get closer to goal weight. I am already having the irritating effects of loose skin and it isn’t fun!

But, as you can see in the pictures below, there is already a big difference…..

     

August 2005                                               June 2006

For more weight-loss photos: http://www.geocities.com/newslady72712/weightlossphotos.html?1132297911883