| Regrets ??? |
| Recently the question was posed on one of my favorite Yahoo support groups about whether any of us regretted our gastric bypass surgery. I ended up writing a lengthy reply to the question because I felt that the person who was considering this life-altering surgery had the right to more than a simple yes or no answer. Below is my answer: Do I have any regrets about choosing WLS as a way to deal wtih my morbid obesity: That is a HUGE question that I cannot just give a simple yes or no to. My response is rather lengthy, but I feel compelled to at least point out what I feel the shortcomings are in the gastric bypass industry. I could probably write much more than I have written here, but at least this will give you an idea of what to expect once you have had your surgery. I decided to have Roux-en-Y gastric bypass surgery because my quality of life was miserable. I weighed 303 at my highest recorded weight and 290 on surgery day. I was in chronic pain when I walked and doing anything around the house was a miserable experience. If I had tasks to accomplish it was a MAJOR effort on my part to succeed and I had to force my way through terrible pain. I also had Type II Diabetes, hypertension, fibromyalgia, severe sleep apnea, irritable bowel syndrome, high cholesterol and triglycerides, and a number of other issues that made the quality of my life not good and future bleak. I was looking into the future with the hard, cold fact facing me that I would end up in a wheel chair and most likely a nursing home to end out my life. How soon all that would happen I did not know. I did not know how long I could continue forcing my body to carry me around and if I were to have a serious accident how would I be able to survive and take care of myself. It was all very daunting. I did a lot of research online and by reading books on the topic. I carefully researched my surgeon and clinic of choice so that I would feel comfortable with the expertise taking me into surgery. I knew about the risks of surgery and knew that vitamin and minerals deficiencies could indeed be part of the package. I knew I would have to take supplements the rest of my life. What I did not known was how inconsistent the whole gastric bypass industry is when it comes to what they recommend for us post-op. I did not realize that there was a discrepancy between surgeons and clinics when it came to what lab tests were ordered. I did not realize how very important it would become to network via the various yahoo groups so that I could begin a long process of learning about vitamins, minerals, protein, and lab tests. I did not realize that I would have to question the labs that my surgeon ordered and that I would have to find a cooperative primary care physician to actually order those necessary tests that my surgeon did not find appropriate. I did not anticipate that I would actually have to begin the process of educating my PCP about what the needs of a post-op gastric bypass patient were. Post-op, I certainly learned very quickly to research via the yahoo groups and googling all sorts of things on the Internet. I made the correct decision with my choice of surgeons, but at the time I forgot that I was selecting him for one skill -- his surgical abilities. I did not select him because he was well versed in dietary needs, nutritional needs, or the complex mechancis of how our bodies assimilate vitamins, minerals and protein. I chose a clinic that had a good reputation, great staff, and a clean environment. I naively thought that their after care program would be very comprehensive and learned that it was really geared for the initial stage of recovery. I believe this to be the case for most programs that are available because there is no big profit in our after WLS care. The disadvantage of a program that is nationwide is that they have more of a corporate mentality and thus are quite inflexible when it comes to identifying and adapting to the needs of a specific person. The advantage of the corporate program is the continuity of their program from clinic to clinic. I believe that most of us are encouraged to go back to our PCPs for our "issues" and we have to know what we are asking for in order to successfully manage our health. I am a quick learner though and identified rather quickly that I needed to be proactive in my post-op care in order to have a successful and healthy recovery and life. My physical recovery from surgery was smooth. I did not have any issues with nausea, eating or drinking. I followed the post-op instructions faithfully for the six weeks that I was restricted and am very happy that I did so. I did develop a hernia along my incision line and just above my navel that will require surgery to correct. My worst time as a post-op began at about 8 weeks out when I had many unexplained symptoms including: increased heart palpitations, rapid pulse rate, my blood pressure was not coming down even with meds, heightened anxiety, and finally at three months full blown panic attacks. My three month labs showed my magnesium level was low and I was not advised to do anything about it. I discovered via a yahoo group a reference to magnesium (thank you, Julia Ziobro) and began my research and discovered my symptoms were compatible with a diagnosis of magnesium deficiency. I pursued this with my bariatric MD and he concurred (this is not my surgeon) and I began magnesium injections and oral magnesium. My symptoms began improving shortly thereafter. Next, I noticed that my pre-admission tests had my ferritin level at 13.3 and that it was low (bottom level on that lab was 14) and yet this was not flagged for follow up. I finally was able to get a new ferritin test at five months post-op (after my magnesium were under control and I was able to shift focus) and found that my ferritin level had dropped to 12 (bottom of the range for the lab). My PCP immediately put me on iron supplements. When I questioned my surgeon he said that my iron labs were fine and no reason to test ferritin. FYI: Ferritin is the stores that your iron numbers draw from and should be included as a very important part of watching your iron levels. Then, when I had my surgeon evaluate my hernia, I asked when I would be having my Vitamin A, D, and B1 (Thiamin) tested. I was advised that there was NO need because they had not done anything to me to affect those numbers if I was doing my multi-vitamin regimen (not only was I doing 2 centrums a day, but I was also doing Glacial Milk multi along with many other vitamins and minerals). I had my PCP order the requested labs and my Vitamin A came back 10 points below range and I had to add Vitamin A in the form of retinol to my daily supplements. All of this convinced me that it was indeed in my best interest to continue challenging, researching and being my own best advocate. I chose my surgeon because of his surgical skills! He is a very skilled and intelligent man, but he is not perfect AND I will not allow him or any other doctor to send me blindly down the primrose path. At this point I am finally beginning to see the light at the end of the ever-changing tunnel and I believe that I would indeed have this surgery again. It has been a long eight months since surgery and battling deficiencies that I had to pursue diagnosis of via extra lab work. I discovered about the lab work that I specifically needed via the yahoo group OSSG-Protein and have since reworked their suggested lab work sheet to include Homocysteine as part of testing the B12 levels. Currently, my blood pressure is on the low side of normal, my blood sugars are coming down, my cholesterol and triglycerides are completely in the normal range, I can walk much further without all that pain (I still have my higher pain days with the humidiity, but am much improved), I am sleeping better at night but do need the apnea reevaluated, my irritable bowel problem has actually improved, and I am feeling much better because of the proactive work on my deficiencies. I have not had any "food" issues because I made peace with that part of the decision before I had the surgery. I gave up sugar and the artificial low carb sweets the day I was rolled into the operating room. I have not looked back on that decision because I know that these are my triggers to failure. Yesterday, my gastric MD said that I was the healthiest that he had ever seen me and it felt good to hear that. Much work is ahead to make my tool work to the best of its capability for me, but I am on my way and finally see the light at the end of the tunnel. I am totally convinced that comprehensive blood work will have to be done on a regular basis (3-6 months) for the rest of my life if I wish to keep on top of any changes that the malabsorption process creates. It is totally unwise to ever think I will be NORMAL. I will not be normal. My body was broken before surgery and it will remain broken, but I can have a direct affect on keeping it as healthy as possible by focusing on the proper supplements and the proper lab work done at frequent regular intervals. I have decided that I will tell people about my experience and lessons because this problem exists across the gastric bypass world. We are being recruited into surgery because of the insurance dollars available. We cannot give up control over our lives by blindly trusting any single person to order all the proper labs and provide the correct supplement information. Networking is the best way that we have to learn right now. Groups like this one [the yahoo group I was responding to] are a big step in the correct direction for us while the gastric bypass profession gets it's collective butt in gear on the post-op needs (assuming it does). Feeling great is not an idicator about what is currently happening on the inside of your body and you need to know this. I, personally, see a class action law suit in the future from all the poor souls who do not have adequate access to information via groups like this and who have had their bones ruined because of the wrong calcium instructions, their brains damaged because of incorrect testing for Vitamin B1, the many anemia's associated with iron and B12, amongst many other things. Education has become my mission in life and what I tell people is that I am not saying for them to do it my way or no way, but I am saying that I will provide information that I learn and you decide for yourself. Am I passionate, you bet!!! We make such a huge decision that has so many possibilities in how it can affect our life and we can only attempt to do the right thing if we know that a specific program may not have all the answers needed. In fact, they may be seriously deficient in the answers that they have. Sandra Arizona August 4, 2004 At eight months out I am down 71 pounds from my surgery date and 83 pounds from myhigh weight. I am doing my journey "MY WAY" |
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