Puree – the daily grind

20 Dec

Now I know I shouldn’t complain. So far things have been relatively plain sailing. The pain of the op was over quickly, I’ve not had any reflux and my GP (primary care doc) has been very supportive, prescribing good vitamins and authorising time off work. I just got a little down yesterday (only a little) faced with another day of yummy purees and protein shakes while my work colleagues were out at the Christmas knees up – 3 course of Italian followed by copious amounts of alcohol. Now I know that’s exactly why I had surgery, so I couldn’t do 3 courses of Italian, but I still managed to feel a little sorry for myself.

I’m on my 6th day of mush and I’m finding it quite challenging. Towards the end of the liquid phase those shakes were sliding down good style and I thought something thicker would be no problem at all. Nope – some mashed root vegetables with a little cheese can sit in my chest like a stone. It’s hard to believe (although my WLS friends all tell me so) that in a few months I’ll be able to eat anything and look back fondly on the days when I struggled to get food in. Christmas day will be day 11 of mush and I’m going to attempt some mushed veg, potato and a tiny bit of cashew nut loaf (we do a veggie Christmas dinner). Maybe a couple of hours later I’ll have a little of the all natural no added sugar Christmas pudding (yes we are a family of cranks) and hope I don’t throw up or dump in front of 15 family members.

Back Home and Out of the Closet

2 Dec

So after all that agonising talking to my mum went pretty well. And she admitted she would have been anxious if she’d know what was really going on. Shame the reaction from Darling daughter was so negative – as if my surgery was a personal affront to her, but 24 hours later she’s come around. Teenagers just can’t help being the centre of the universe I guess.

Visited my GP today and he was really interested and curious, not having encountered VSG before. We were having such a good chat I left without asking for the paper to send to my employer to get time off, and had to phone back later.

I have four incisions – 2 are only single stitch, one with 2 stitches and the exit one has 3 stitches.Alison Forde's photo. This is the biggest incision.

I’m feeling pretty good, full really quickly, even on liquid but tire easily. Still feel a little spaced out for some reason – just a bit dippy, though I’ve not had any heavy meds for days. Hope my head clears soon.

VSG time in Turnov

28 Nov

So I got to airport at Prague and was picked up by the driver from the hospital for the 2 hour drive to Turnov. Somewhere in that journey panic got a hold of me and by the time I checked in at the hospital I was a quivering wreck. Thankfully another patient from the facebook patient group who was going home that day was there to calm me down and reassure me that she wasn’t suffering.

Monday was test day: chest xray, ecg, gastroscopy ( that sedative is good shit), spirometry.

Tuesday is surgery day and I managed to maintain my cool on the way in, no Jimmy Cagney scene. Waking up after the op was horrible. Back killing me and chest feeling like it had been crushed. Fortunately the nurses are right on the case with the pain meds. Wednesday wasn’t much fun. Had to get up and go to xray for the leak test. I was taken down by an extremely hot porter, which just made it worse when I turned into a groaning barfing wreck after drinking the dye stuff.

Thursday is not too bad at all! Drain out (owwwww), IV out and yogurt drinks in. They offer clear soup at lunch time but it looks more like something they cleaned the frying pan with, so no thanks.

All in all, not too bad. And thanks to Dr Martin Hruby and his magic Ethicon stapler!

The time has come at last!

23 Nov

So tomorrow I’m getting on a plane to the Czech Republic to have me sleeve surgery. I’m in a strange mental state. Calm at the moment, but worried that panic will surface at the last moment and I’ll find myself re-enacting Angels Dirty Faces: 

The last two weeks I’ve been on a pre-op diet of around 800 calories a day. Sure, I’ve lost 11 lb, but I woudn’t want to live like this. I’m hoping the surgery will let me continue to eat low calories, without feeling completely starving all the time.

Well, catch up with you all when I get to the hospital in Turnov – laters!

The condemned woman ate a hearty meal

8 Nov

Well more than one to be honest. My pre-op diet starts 2 days from now, which will be 2 weeks of a delicious assortment of synthetic foods, shakes and protein bars. I proposed a last Friday lunch outing to the local chip shop for macaroni cheese and chips followed by deep fried mars bar and icecream, with lunch conversation revolving around what I wont be eating from now on. To be honest, I never enjoy these lard fests as much as anticipated, but I’ve gotten it out of my system now, hopefully. Just 2 weeks of vlcd torment then I’m off to the Czech Republic.

To tell or not to tell…

16 Oct

One of things I’ve been dealing with deciding what to say to people about where I’m going and what I’m doing at the end of November. So far my husband, a couple of close friends and 3 friends at work know about my plans. My husband has been supportive (well he would be, he’s never liked me being fat, and while he would claim he’s concerned about my health, I know there’s a bit of criticism about my appearance or moralising about my overeating (and let’s face it there’s lots of social condemnation around eating more food than you use up, from the sin of gluttony to skinny fashion standards). My two closest friends were supportive and uncritical, if a bit surprised. The first two colleagues at work were also surprised and supportive, but the third was shocked and horrified. She didn’t say much in front of me, other than asking the first to colleagues “You knew about this and you didn’t try to talk her out of it”. She’s made it clear, and it got back to me, that she thinks its sad that someone with such an “attractive personality” feels the need to undergo surgery, for what she clearly believes are cosmetic reasons.

Now – I’m not kidding myself, I know appearance comes into it. I have long felt the condemnation of being an unacceptable size, but health also comes into it. We fatties are constantly being reminded of how unhealthy we are and how our health is at risk and how gluttony will be the death of us. And it’s not comfortable being this size. My feet hurt. I would like to be fit, but its hard work hulking 240+lb around, so I do feel a certain justification in seeing this as a medical procedure for my health.

The most difficult part is knowing what to do about telling my octogenarian parents and my teenage kids. I’ve decided, at my husbands request, not to tell the kids before hand, as he’ll be at home with them and doesn’t want to deal with any stress they have over it. I’ll lie and say I’m going to visit a friend in Italy for a week, then tell them when I get back. I don’t like being dishonest, and wouldn’t like my kids lying to me, but I’ll have to justify it as “protecting them” from unwelcome knowledge.

The elderly parents I know would be worried and possibly angry if they knew, but it’s going to have to come out after the surgery. I’ll just be moving from post-op liquid to mush diet at Christmas time, and that usually means big family dinners. I’ll need to let them know early December and hope the dust has settled by the time Christmas rolls around and I’m the one eating the puréed Brussels sprout.

VSG for me!

8 Oct

That’s it – my mind’s made up  and I’m definitely going for a VSG – vertical sleeve gastrectomy. I think I’ve know all along that what I wanted was the best chance of losing 100+ pounds, but I don’t want a bypass. I think gastric plication looks like a good option for some but I worry it just won’t be enough to restrict me. I also really want to maximise my chances of ridding myself of hunger, by removing the bit of my stomach that produces ghrelin.

The fear factor is what has stopped me from committing to the sleeve up till now. There’s a tiny bit of my mind that keeps saying, “but what if you get a leak?” It’s scary, but I know the chances are low and hopefully even if I was the 1 in less than a hundred to spring a leak it can be fixed, although obviously it would have serious health implications. I’m going to buy some insurance which claims to cover “life threatening complications” of elective bariatric surgery (I’m pretty sure a leak would be life threatening), to make sure the cost of extended hospital treatment for a leak would be covered.

The surgeon I’m going with has a great record with VSG, a low complication rate and has completed over 500 of these procedures, and now that I’ve committed to the sleeve I can stop worrying over which procedure to have.

Decisions Decisions – Part 2 – Choosing a Surgeon

2 Oct

Where I live, in Scotland, the chances of my accessing surgery via the National Health Service are next to zero, not because I’m not morbidly obese, which I am, not because my Primary Care GP doesn’t think it’s a reasonable idea, which he does, but because lack of resources mean that health care is rationed and in this health area they don’t choose to invest much in bariatric surgery. I’ve already been through the weight management service in my local NHS area, where you get nutritional support to lose  around 10% of your weight in a target time. This worked for me, but like all dietary interventions, only temporarily, and when the programme came to its end I regained this weight and more.

So – the only option for me it to pay privately to have the surgery. I started investigating the cost of surgery privately in the UK (very expensive, but perhaps not as much as in the USA) and then I discovered, through online WLS forums that here are many private providers in mainland Europe who are much cheaper. Don’t get me wrong, cost isn’t the only factor, but I wouldn’t even have gone any further in investigating if it wasn’t affordable. I looked at a few providers but the one I was attracted to, and finally signed up with was the one which provided very clear information on the surgeon who would do the operation, his CV (with lots of information about his training) statistics about how many VSG and Gastric Plication procedures he had performed and his complication rates. I was then able to look at these complication rates in comparison to average complication rates for these procedures, to see if his rates were good, making him someone I would trust to operate on me.

If you are looking for a surgeon or health care company to arrange bariatric surgery for you you need to ask the questions:

Who is the surgeon – get a name so you can investigate

How many procedures have they carried out?

Complication rates?

Support afterwards – is there a community of patients or other follow up support offered.

I haven’t bought any follow up care, nutritional or counselling, but if I have any specific problems I’m expecting that the NHS will help me – after all other lifestyle choices hare supported (treatment for smokers or sporting injuries). I’m not anticipating any problems, although vitamin deficiencies are a possibility. The majority of support will come form the online community of patients who have already had the procedure done by the surgeon I’m going with, Dr Martin Hruby, in Turnov, Czech Republic. Being in touch with this group for several months prior to surgery has given me time and space to find out the good, the bad and the ugly about others’ experiences and I’m satisfied that I’m doing the right thing, with the right surgeon.

Decisions decisions

30 Sep

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So having decided that life cannot continue in the same vein, we’re faced with

the choices between types of surgery or intervention. I’ve listed them here from the most drastic to the least:

Gastric Bypass

Gastric sleeve – a.k.a. Vertical Sleeve Gastrectomy

Gastric Plication

Gastric Banding

Endoscopic POSE procedure

Gastric Balloon

I discounted the bypass as just too drastic, with the certainty of nutritional deficiencies which would require B12 injections etc. To be honest I find the whole idea of cutting bits of intestine out and rejoining them somewhere else just too scary. Gastric banding I discounted as it required lots of follow up care to get it right. POSE and the balloon are attractive because they are endoscopic rather than surgical but I don’t think the evidence is there that they would work for someone at my weight. This leaves me a choice of two procedures – the Gastric Plication or the Sleeve Gastrectomy, and I’m still weighing them up. Any input from those who have had either would be most welcome!

Anyway – even though the date of surgery is booked, I still haven’t quite decided what way to go.

Gastric Plication 

Pros – cheaper, less invasive – no cutting of healthy tissue, less risk of leaks (a big plus!!) and I’ve spoken to lots of people who’ve done well with it.

Cons – still considered experimental due to lack of long term data, more nausea to start with, ghrelin producing bit of stomach not removed, may not lose as much as with a sleeve?

Gastric Sleeve

Pro’s – longer term data on weight loss, surgeon has more experience, removal of ghrelin producing bit of stomach, less nausea in recovery

Cons – cost is greater, more risky surgically

Just as well I don’t have to decide till November.

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Me at my heaviest

29 Sep

Me at my heaviest

Yes, all 18 st 3 lb, or 255 lb of me. This summer I decided that 36 years of dieting – from ages 10-46 – was enough and it was time to start something new. I dived into the world of weight loss forums to learn more about the various procedures on offer, the costs, not just financial and then I found what I was looking for. I’ve booked surgery with Dr Martin Hruby in Turnov, Czech Republic for 26.11.13