Today’s post starts a little like Bridget Jones’ Diary. My life has become a series of statistics and medications. It sucks, but it is what it is.
Weight: 128.4 kg
BMI: 48 (morbidly obese)
BGL: 15.4 mmol/L (target 6-8 mmol/L*)
Yesterday was a massive wake up call.
I visited my endocrinologist for my quarterly check up. I had a feeling my levels would be elevated, but not that bad!
I have become seriously lax when it comes to managing my diabetes. Thanks to an ongoing kitchen renovation (and laziness), we’ve been eating so poorly. Loads of takeaway and ready meals…resulting in dangerously high blood glucose levels (BGL). My fasting BGL was 17.9 mmol/L!! I burst into tears knowing that it meant I’d have to start insulin injections. My cholesterol levels were also elevated, so another tablet was added to my day. Am I starting to rattle when I move? So now my day looks a little like this…
– Checking my blood glucose levels before every meal and before I head to bed
– Injecting myself with NovoRapid before I eat breakfast, lunch, and dinner
– Injecting myself with Lantus prior to going to bed
– Swallowing a tonne of tablets for diabetes, cholesterol, and depression
(no shit I’m depressed)
– Recording everything in my diabetes record book for my endocrinologist, diabetes nurse, and gp to review
I’ll admit, I’m feeling pretty overwhelmed this morning. Thank goodness I took notes when my endo was filling me in on my new regime. I think I’ll need to create a check list for everything I need to take and do throughout the day so I don’t forget anything.
My escalating diabetes issues further confirms to me that having weightloss surgery pronto is the best way to go. Looking thinner would be a bonus, but reducing my blood glucose levels to “normal” is the ultimate goal.
Time to pull my head out of the sand and get real. Wish me luck!
*mmol/L = millimoles per litre
I recently joined a few Facebook support groups for people who have had or are considering having gastric sleeve surgery. I’m one of those people who likes to be informed before making a decision…I need to know all the ins and outs, the benefits, the side effects, and most importantly the experiences of others. Every day since then I’ve been inspired by so many people who have taken the brave step to improve their health and to live their best life possible. They make me believe that I can do this. I can lose weight. I can be healthy again. Once such person is Nichole. I was really inspired by her, and asked if she’d share her story.
I’m 32 years old and have battled with my weight my whole life…it’s been a constant up and down on the scales. After have my kids I struggled with PND and weight started piling on faster than ever, however I always told myself I didn’t care how big I was it didn’t matter to me.
The tipping point…I went on an amazing holiday overseas and it was this trip that made me realize how unhappy I was. It made me notice how much my weight was affecting my life, my ability to do things, and to participate. Instead of wanting to go walking and explore the beautiful cities, I opted to stay in our hotel.
When we arrived home, my husband mentioned the idea of surgery and asked if I had considered it. I hadn’t because I was under the view I wouldn’t be supported.
The first step…After many conversations, and lots of research, I decided I want to have gastric sleeve surgery. I went to my GP and got a referral to my surgeon at Greenslopes Private. My first appointment was on 30 September 2014. He went through the pros and cons, and answered the questions I had. I decided that I wanted to proceed with the surgery, and was given an operation date of 23 October 2014…less than 1 month away!
I was advised to call my private health insurer, and let them know my plans. I also made an appointment with the dietitian to talk about the pre-operation diet I would need to go on to reduce the size of my liver ready for surgery.
The next day I rang my private health insurer to get the paperwork rolling. It was at this time I was advised I wasn’t actually covered due to a change in coverage! I burst into tears and rang my hubby who suggested I ring back and fight, as the coverage change happened days before and we had not been advised. I followed his advice and asked for previous calls to be listened to, and requested that my cover be upgraded to cover surgery without having to redo the waiting period. After a stressful 24 hours, my private health insurer decided they would accommodate my request and cover my surgery!
Before surgery…I met with the dietitian, who advised that I would need to complete two weeks of an Optifast VLCD diet. The dietician also provided me with a list of fruit and vegetables I was able to have and the amounts I could eat. The first three days of the Optifast diet was hard. I was starving the whole time! It was the hardest thing I’d ever done. By the third day, it got a lot easier as my stomach had shrunk and I was in Ketosis* 😀. Over the Optifast period, I lost approximately 5-6 kgs (11-13 lbs).
The beginning of the new me…Surgery day arrived and I was first up on the listI arrived at the hospital at 6:30am. My husband stayed with me while I checked in, spoke to the surgeon and anesthetist, and waited to be taken into surgery. At approximately 8:30am, I was taken from my room to theatre, said goodbye to my husband, and the old unhappy sad me.
I remember going into the operating room and that’s it. Next thing I was awake in horrible pain (I’m a sook and don’t have a great pain tolerance). The nurses quickly showed me how to work my self-medicating pain killers and that’s pretty much all I remember that day.
I’m proud of how far I have come. I’m almost at my goal weight and can’t wait for that day to arrive!
Thank you for sharing your story Nichole! I’m sure a lot of us can sympathise with not wanting to participate in certain activities, and being held back by our weight. It’s fantastic to see your progress.
If you’d like to share your story, drop me an email.
*Ketosis is a process whereby your body breaks down fat to use for energy.
I had always dismissed weightloss surgery, despite the fact that several doctors have recommended it to me over the years. The first time it was mentioned was nine years ago. Imagine how different my life could have been if I’d just listened. At the time, my only health issue was my weight and I thought that if I just gave a diet a red hot go, that I could do it myself. Since then I tried every diet known to man. I successfully lost weight, and then successfully put it all back on…and then some.
I recently joined a couple of facebook support groups for people that have sought to improve their health via gastric sleeve surgery. The number of people seeking permanent weightloss solutions is very eye-opening. It’s so easy to be so consumed with your own issues and to feel alone in your struggle. The reality is, you aren’t alone, and everyone’s struggles are very very real. Choosing to have gastric sleeve surgery, or any kind of weightloss surgery for that matter, is usually the last resort and the act of someone who is desperate to regain their health and their life. It is not a decision that is taken lightly, nor the easy way out.
I asked a few friends why they chose gastric sleeve surgery…
The deciding factor for me was the embarrassment of flying for work and having to ask the airline for a spare seat beside me. Just the looks of others as I was walking down the aisle made me want to jump right off the plane. When I got to Malaysia I also didn’t do everything I wanted to because I knew I wouldn’t be able to walk for too long…. Definitely knew it was time to do something. – Michelle A.
I realized that the children I spent the last ten years trying to have, carrying and breastfeeding wouldn’t have me around if I didn’t do something, and that I wanted to see my grandchildren. – Anon
I was very overweight, but had no co-morbidities… that wasn’t going to go on forever. I wanted to live my live, not just survive it. I wanted to continue my adventures with my new husband and not sit back as a spectator wishing I could do that. – Michelle T.
I did it to stop the battle in my head over whether today a would be a good eating day or a bad one….I did it to stop feeling overwhelming regret and guilt on a constant basis. It was never about health or weightloss. It was about the constant self hatred. – Suzy
I was much like Suzi above, it was somewhat about health, but more about each day of self loathing due to 40 years of being obese and trying each day to “diet” without much success. At the age of 67 there is finally a tool that has helped me lose and I feel it is a workable solution for me. – Anon
I did it to save my life. At my heaviest I weighed 139kg. I didn’t stay at that weight for long but took too long losing it. As a result I was an overweight smoker for about 20 years. As a result I developed Diabetes Type II which went undiagnosed for many years. I was finally diagnosed when at 39 yrs of age and 100kg I had a massive heart attack. My body later rejected the 3 stents which had been implanted and I ended up having an emergency quintupple bypass. I developed endometrial cancer and required a radical hysterectomy with removal of 22 lymph nodes. As a result of missing lymph nodes I have developed lymphodema in both feet. As a result of clogged arteries I required an endartectomy where my neck was cut open and the carotid artery cleaned out. I have small blockages in my calves which make walking up an incline impossible and currently I have 3 fractures and 2 dislocations in my right foot and 1 fracture in my left. I now have a charcot right foot which may never regain normal shape. All of this has been a result of having undiagnosed diabetes as an obese smoker. I am 4 days post op, having had my surgery on my 42nd birthday at 101kg. Until my heart attack it was rare for me to have a sick day. Now I have a disability pension and a mobility scooter. I hope through my sleeve surgery to lose the excess weight, have full control of the diabetes and get rid of lots of medications. And I hope I have saved my life. – Melinda
My parents both struggled with their weight, and one week they had 7 doctor/specialist appointments between them. A week later I was told by a doctor that I needed to get my weight under control before I ended up down the same path as my parents. As I have a child with a rare medical condition, I was scared that I wasn’t going to be around in the future to help him and my other two children. I never want to have to tell my children I can’t help them because I’m too sick myself. – Tan
Every single person that chooses weightloss surgery has a very valid reason for doing so, and I can relate to every single one.
So, why am I heading down this path?
I have been overweight, and now morbidly obese, my entire adult life. A couple of years ago my wrist was aching terribly all the time. It was absolutely debilitating, so I sort medical help. I was diagnosed with carpal tunnel syndrome…which can be caused by obesity and diabetes. My doctor sent me for some blood tests to see if there were any other issues. Yep, you guessed it…type 2 diabetes. It was a shock, but not unexpected given my weight and family medical history. When I was first diagnosed, I could manage my diabetes with diet and exercise. I am now on oral medication. Unfortunately my diabetes is progressively getting worse. I was incredibly ill recently and my blood glucose levels sky rocketed into the 20’s, and I was very close to being admitted to hospital. I was so scared! Scared that I would have to be put on insulin, and scared of what will happen to my body if this continues…loss of eye sight, the possibility of losing my feet (just like my grandfather), and dying at an early age. Worst case scenario stuff, but it plagues my mind. The very next appointment I had with my endocrinologist, I asked for a referral for gastric sleeve surgery. I have been thinking about surgery for two years, but it wasn’t until recently that I made up my mind.
I have had friends who have had either the gastric balloon inserted, gastric band surgery or gastric sleeve surgery. I have been watching their progress closely and have decided that gastric sleeve surgery seems like the best fit for me. I needed it to be extreme and the assurance of permanency. I am confident it will work for me, and I am finally in a really good head space to undergo the procedure. From the very first moment I spoke with my surgeon, I felt a sense of calm. I know this is the right step for me.
Have you had weightloss surgery? What lead you to that decision?
There are a number of options available to you should you wish to have weightloss surgery. The type of surgery you have will depend on a number of factors such as your BMI, pre-existing medical conditions that may be life-threatening, and the results you are trying to achieve. The first step is to speak to your doctor and ask for a referral to a specialist surgeon. The surgeon will discuss the options available to you and make recommendations.
1. Gastric balloon insertion
The gastric balloon is probably the least invasive weight loss surgery you can experience. The procedure involves inserting a deflated balloon into the stomach via the mouth or nose (no surgery required). Once in place, it is filled with sterile saline through a catheter attached to the balloon. Once filled, the catheter is removed, and the balloon remains floating in your stomach.
The gastric balloon is temporary and can only be left in the stomach for a maximum of 6 months.
The gastric balloon should give you a “full” feeling, which helps you to eat less and to lose weight. It trains your stomach to expect less food and to shrink. It is hoped that while the balloon is in place, you will have adjusted your eating habits enough so you will be able to maintain a smaller volume of food intake once the balloon is removed.
2. Gastric band surgery
Gastric (lap) band surgery is performed via key hole surgery whilst under general anaesthetic. The surgeon will make a few small incisions in your abdomen, then fill the abdomen with carbon dioxide to inflate the area to give them room to operate. A laparoscopic camera is inserted into one of the holes so the surgeon can view the procedure on a monitor. The other key holes are for the surgeon’s operating tools. The surgeon places a saline-filled ring around the top of the stomach. This creates a new small stomach pouch above the band, with the remaining larger part of the stomach sitting below the band.
As you eat, the flow of food from the new upper stomach through to the lower stomach is restricted by the size of the ring. This makes you feel fuller sooner, and for longer periods, resulting in less food intake and weightloss.
Over time, the band/ring may need to be adjusted for comfort and effectiveness, and can be adjusted by your surgeon via a port under the skin. The surgeon will add or remove saline as required.
The gastric band is designed for long-term use, however it can be removed/reversed if needed.
3. Gastric sleeve surgery (Sleeve Gastrectomy)
Gastric sleeve surgery is generally performed via key hole surgery under general anaesthetic. Like gastric band surgery, a number of incisions are made in the abdomen, the area filled with carbon dioxide to create a space for the surgeon to work, and a camera and operating tools inserted through the incisions.
The surgeon will remove 2/3rds of the your stomach using a stapling device. The stapling tool staples and cuts the stomach into two pieces at the same time. This surgery basically leaves you with a stomach tube/sleeve instead of a stomach sack. It also removes the part of the stomach that produces the hormone that makes you feel hungry (ghrelin).
Once the stomach is separated, the surgeon will pump water into your abdomen to check that there aren’t any leaks in the stomach. The cut away part of the stomach is then removed via a tube inserted into one of the incisions.
This procedure is not reversible.
4. Gastric bypass surgery
This operation is performed laparoscopically under general anaesthetic, following the same procedure as lap band and gastric sleeve surgery above. This is the most difficult of the weightloss surgeries.
The surgeon will create a small thumb-sized pouch from the upper stomach using the stapling device mentioned above. The stomach may be partitioned or totally divided into two parts. The larger section of stomach separated away remains in the body. The small intestine is then attached to the base of the new small stomach, allowing food to bypass the stomach all together. This restricts the volume of food which can be eaten.
Gastric bypass surgery is not reversible.
Before deciding which path is right for you, please consult your doctor and seek a referral to a specialist surgeon. As with all medical procedures, please discuss the full procedure, risks and benefits with your preferred surgeon.
I’m back! Has it really been 8 months? A lot has been going on and I needed a little hiatus…okay, a long hiatus. I just haven’t felt like sitting at a computer at all in my spare time. Obviously I’m coming out of my funk. Why you ask?
I finally gained the courage to ask for a referral for weightloss surgery. I have tried every diet known to man, and have come to the realisation that something drastic has to happen. I know I can lose weight, but I need to lose it like yesterday! Over the past couple of years, I have lost 17kg and kept it off. That makes me super happy, however I have a long way to go. Unfortunately my blood glucose levels have been progressively getting worse. I’m sure I’ll be going onto insulin soon (I have my endocrinologist appointment in a couple of weeks) and I feel like crap. By having weightloss surgery, I will be able to improve my diabetes status and hopefully go into remission. This isn’t a decision I’ve taken lightly. I have been researching this for the past two years.
I met with a surgeon on Monday and he says I’m the perfect candidate. I felt so comfortable with him and I know I’m making the right decision. A feeling of inner peace has washed over me and I’m totally excited for the future.
Where to from here?
There’s some paper work that needs to be sorted before I see the surgeon again. All going well, I’ll start the pre-operation procedures in the next couple of months and then have surgery. I will be documenting the whole process, so if this is something you’ve considered yourself, you’ll know what’s involved.
In the meantime, I am going back to the gym. I have been paying for my membership without using it for the past 18 months. I’ve been asked a few times why haven’t I just cancelled it? Reality is, I know if I cancelled it, I would never go back. Stupid I know. I would rather waste the money, than cut off the possibility of return. I’ve set myself a goal of four times a week starting tomorrow night with a Body Combat class. I really love the exercise…it’s the getting there that’s the hardest part (damn you depression!). I figure by the time I go in for surgery, I’ll have the exercise routine down.
I know that surgery isn’t a miracle cure; it’s a tool…along with food, lifestyle and exercise.
I have joined a number of support groups online and I’m learning a lot from people who are experiencing the same journey I am. I have so many questions, and thankfully people have been generous sharing their knowledge and experience with me.
I feel good.
Yes I am aware of the risks, and I know this is not the easy way out.
This is just something I need to do. To live. I feel like I’m getting a second chance at life.
How good is that!
Diabetes can be so confusing, and many people don’t understand what this disease actually is…especially when you’re newly diagnosed. You are bombarded by a whole new world of regimes, terminology, and appointments with specialists; and you’ve got two choices…educate yourself and embrace it, or shorten your life span. It’s as simple as that.
Community awareness of the difference between type 1 and type 2 diabetes is still very limited. I am the first to admit, despite having family members who have type 2 diabetes (including my mum), I had never bothered to find out what it means…that is, until I was diagnosed myself. While some of the symptoms are very similar, the two diseases are quite different.
Type 1 diabetes affects around 10 to 15% of all people with diabetes. In individuals with this condition, the body is unable to produce the insulin required to stimulate glucose uptake from the blood into the body’s cells to be used as fuel. In type 1 diabetes insulin injections are required to control blood sugar levels.
The exact cause of type 1 diabetes is not yet known, however experts do know there is a strong genetic link, and it cannot be prevented. Experts also know that it has nothing to do with lifestyle. Maintaining a healthy lifestyle is incredibly important in helping to manage type 1 diabetes. Unfortunately, there is nothing that can be done to prevent or cure it at this stage.
Type 2 diabetes affects around 85 to 90% of people with diabetes. It is more common, and very different to type 1 diabetes. People with type 2 diabetes produce insulin, but the body is ineffective at stimulating glucose uptake from the blood into the cells of the body, due to insulin resistance. In some cases of type 2 diabetes, the body doesn’t produce enough insulin to keep the blood glucose levels under control. Although type 2 diabetes can often initially be treated with diet and exercise, many people also require medications to stimulate insulin release and improve insulin sensitivity.
Type 2 diabetes can be caused by a combination of genetic and environmental factors. Genetics play a strong part, however the risk is greatly increased in individuals who have high blood pressure, are overweight or obese, are physically inactive, maintain a poor diet, and/or have the classic ‘apple shape’ body where extra weight is carried around the waist. Let be know though…not all obese people will be diagnosed with type 2 diabetes, and just because you’re thin, you’re not immune!
For more information, please visit Diabetes Australia, or consult your doctor.
Hi all, and welcome. First things first…who am I?
Here’s the deal. I turned 40 this year, and I thought by now I’d be feeling great and living life to the fullest. Sadly, that’s not happening. I’m just going through the motions, and I’m fed up.
For most of my life, I have been battling my weight. I have tried nearly every “diet” ever invented…losing weight, never getting to my goal, and then putting on more. It’s an incredibly vicious cycle.
My most “successful” weight loss occurred in 2006-7, where I lost 40 kg. I was starting to feel really good, and shopping in the “regular” clothes stores was the perfect reward.
It was during this time that I started having major gallstone attacks (it’s worse than child birth, trust me). In March 2007 I had lost enough weight so that I was no longer considered a “high risk” patient, and could be admitted as a normal patient to have my gall bladder removed. Afterwards, the surgeon told me that my gall bladder had deteriorated terribly, and they stopped counting stones at 20. It’s no wonder I was in pain. The first thing I wanted to eat as soon as I got home was grilled chicken, green beans, and mashed potato. I hadn’t eaten a potato in months and it was delicious!
Shortly after surgery, I became incredibly depressed and started to stack on the weight again. Only this time it didn’t take years; it was only a matter of months before I’d added 50 kg to my frame. This only served to make my depression worse. I didn’t want to leave the house, didn’t want to be seen in public, and basically wanted to hibernate. I was prescribed anti-depressants, and after adjusting brands and doses, I’m on medication that is helping.
Fast forward to March 2013. Almost overnight I had lost feeling my right hand, and no matter what I did, I couldn’t get it back. It was incredibly painful and I had no strength in my hand whatsoever. I went along to the doctors to see what was going on, and was diagnosed with carpal tunnel syndrome. A nerve conduction study and bone scan confirmed this, and I was referred for surgery.
“Let’s do some blood tests to see what else is going on.”
This is when I was diagnosed with type 2 diabetes. I cried.
At first I was able to manage my diabetes through diet alone, and I was able to lose 15 kg by eating well and exercising my arse off. I also managed to regain feeling in my hand, and have avoided surgery (for now).
I haven’t been as diligent the past few months, however I’ve managed to keep the weight off. Phew! Unfortunately, my blood glucose levels have risen, and I’m now on medication. I’m hoping to avoid insulin injections in the future, but I need to learn to manage what I eat so that my blood glucose levels reduce.
As at today, I weigh 132.2 kg, with a BMI of 50.
My healthy weight range is 49-66 kg.
Essentially I have to lose a whole adult to get to my healthy weight range. Scary stuff!
So, I’m morbidly obese, a type 2 diabetic, and suffer from depression. Just thinking about my battle ahead makes me want to cry, but that’s not going to get me anywhere.
Thanks for joining me on my journey.