Weightloss Surgery

My weightloss journey… Part 1: Before surgery

My weightloss journey… Part 1: Before surgery

I originally started Less Lisa. More Life. as a way to document my weightloss journey. Life got busy (as it does), and all of the posts I had planned, fell by the wayside. It’s an important part of my story, and I want to share all the highs and lows of weightloss surgery. Here goes…Part 1 Before surgery.

Backstory

During 2015, I was completely miserable. I was at my heaviest of 147.5kg! It seems unfathomable that  I let myself get to that point, but that was my reality. I had tried every single diet know to man and had never successfully kept the weight off. Back in 2008-09, I lost 40kg and got down to 91kg. I was feeling pretty good about myself…but then I bounced. I put all the weight back on and more in a very short period of time! Being a depression sufferer, this only made my condition worse. I started avoiding social situations, and not participating in life at all. I was becoming the person who sits on the sideline, rather than participate. It’s funny though, the bigger you are, the more invisible you become.

By this time, I was also diagnosed with Type 2 Diabetes, and had become insulin dependent. Giving myself a needle several times a day, and swallowing loads of tablets made me feel completely miserable. I couldn’t sleep well, because I was constantly getting up to pee, or I felt like I was choking from the fat on my chest and throat (undiagnosed sleep apnoea perhaps?). I had no energy at all to exercise, or play with the kids, or do the day to day things that needed to happen. I just didn’t want to live life like this any more. Something drastic had to happen.

Less Lisa More Life…the before photos…at my heaviest of 147.5kg

Late 2015, I made the life changing decision to have gastric sleeve surgery. I consulted my local bariatric surgeon, and was confident he was the person for the job. Not being in a health fund, the cost of surgery was very expensive, so I applied to have a portion of my superannuation released to cover it. This was not an easy task. Loads of forms and waiting, but thankfully it was approved. I’ll write another post on that process. Essentially, as it was deemed surgery for a life threatening illness (morbid obesity and diabetes), it was agreed that the money should be released.

Getting ready for surgery

My surgery was scheduled for 20 January 2016, and my pre-op preparation began on 1 January 2016. Talk about kicking off the new year with a bang! I gave up my 3L/day Pepsi Max habit cold turkey, and committed to 20 days of Optifast shakes and vegetables (list provided by surgeon’s dietitian). This is the only time I have ever followed a diet 100%!

My pre-op diet consisted of the following:

  • Breakfast – an Optifast shake
  • Lunch – an Optifast shake and 1 cup of allowable veggies
  • Dinner – an Optifast bar and 1 cup of allowable veggies
  • Loads of water

That was it. It was tough the first few days. I suffered from migraines and vomiting from the Pepsi Max withdrawals. I wasn’t particularly hungry, but it was definitely strange to eat such a restrictive diet. No meat, no dairy, no carbs, no soft drink, and no treats. I’m actually shocked that I did so well! I was so committed to having the surgery, that I didn’t even doubt it. The real challenge was keeping the food interesting, and I will share some recipe ideas in a future post for others that are on the pre-op diet. Thankfully I could add in herbs and spices. I did cry one night when my plate broke as I was carrying it to the table, and my precious vegetables fell on the floor!

The reason you must follow this diet prior to surgery is to prepare your body; to reduce size of the liver and the amount of fat surrounding it, and to reduce the risk during surgery. There is the real possibility that you could be on the operating table, and the surgeon isn’t able to perform the surgery. There was no way I was going to risk that happening!! I get so cranky when I read other pre-op patients asking whether they can have a cheat meal prior to surgery, or if it’s okay if they don’t follow the pre-op diet 100%. To me it’s a no brainer. Just do it! It’s for such a short period of time, and the benefits will outweigh what you’re missing out on in the short term.

I’ll end this post with a before photo…stay tuned for Part 2 Surgery

Less Lisa More Life…the before photos…at my heaviest of 147.5kg

 


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Why am I choosing to have gastric sleeve surgery?

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.

less Lisa more life | why I chose to have gastric sleeve surgery

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?


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What are your weightloss surgery options?

less Lisa more life | weightloss surgery options

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

less Lisa more life | weightloss surgery options

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

less Lisa more life | weightloss surgery options

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)

less Lisa more life | weightloss surgery options

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

less Lisa more life | weightloss surgery options

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.

[Image credit]


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The one where you feel positively calm…

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.

less Lisa more life - 21/07/15

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.

Collective Hub quote

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!


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