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Surgeon: Dr. Aniceto Baltasar, Alcoy, Spain Latest update: July 2005 by Dina: Monday, April 22, 2002 Dear Friends and Family;
Now, after that mysterious beginning, let me start. As any of you will undoubtedly know, I have struggled with my weight since I was a girl. I perceived myself – from age 6 to be very much overweight. I often heard the comments of adults who remarked about my size – and believed myself to be gargantuan. And of course, I also heard unending comment from my peers – who also believed me to be fat. Those in my family will tell you that I started out very much “normal” – as this picture will show you. This is me with my Grandfather White, Christmas 1964 – almost 1 year old.
As most of you will know – I have lived a very active life. I’ve been so fortunate to travel a great deal of the United States and some in Mexico and Canada. I had the privilege of being in full-time ministry for a number of years. I also enjoyed sailing, water skiing, swimming, walking, and bike riding to name a few. One of my favorite things – even still – is riding roller coaster rides. Not far behind that – white water rafting! How I love the outdoors! I have such great memories of camping out under the stars in Central Washington with a bunch of teenagers and cooking over the fire, taking long walks through the beautiful meadows, and lying out at night watching shooting stars.
Some time in late 1999 I began to have problems with insomnia. As a matter of fact – it became severe. By spring of 2000 it was so bad that I would nod off at the drop of a hat. In fact, one day I followed John in his car to some errand or the other. I had a car full of children. We were slowing for a stoplight. I remember applying pressure to the brakes. Then I nodded off – I actually fell asleep. I actually rear-ended John! It was frightening – however I must confess that this was not the first time that I had nodded off behind the wheel. I had to fight to stay conscious all the time. During the summer months that year it was put to me that I might have sleep apnea, and I should probably follow it up with my doctor. In September I did, and I was referred for a sleep study. It was quite an experience – and what I would give now to have a picture of me then! I’m sure I looked something like the Borg Queen. It was wild – but also very revealing. It was learned that I have severe obstructive sleep apnea. When I fall asleep my airways close – and then I awaken with a start and rush of adrenaline – fighting for breath. I was immediately fitted for a CPAP (continuous positive air pressure) machine. I had tried a similar machine during my sleep study – and the lab technician confided in me that the CPAP didn’t help me much anyway – I continued to stop breathing even with the CPAP running. I tried, however, to use the machine – but largely without success. To this day, I continue to struggle to get enough sleep – being continually awakened from my sleep by the cessation of my breathing. It can be extremely frightening. It also brings on high blood pressure, and can also eventually bring on congestive heart failure.
At the end of April I saw my OB/GYN for my yearly exam. She has been my doctor since William was born, and she has always been very supportive of me – yet honest with me as well. After my exam she sat down and talked with me as sincerely and earnestly as anyone ever has. She said, “Dina – I am really concerned for your life. Your weight has continued to escalate – even though you eat a healthy diet and exercise. And to be honest with you – even if you dieted and had great results – you could not lose the kind of weight necessary to head off the kinds of health problems that will be yours if you do not lose this weight.
Standards Committee: American Society of Obesity Surgery; Obes. Surg. Dec.1997; 7:523
My co-morbidities are:
By the time mid-June rolled around, I was finally beginning to feel as if my knees would possibly heal. They were still painful and I was still having great difficulty walking because of the knee pain, however, I finally felt as if there were some hope. On June 18th, 2001 shortly after John returned home from work, I stood up out of one of our kitchen chairs. In an instant my right knee just buckled and it felt that everything inside my knee had had a collision of the worst kind. The wind was sucked out of me and the pain was immediate, extreme, and I was completely unable to walk. Within minutes my knee was swollen to twice it’s normal size, and the swelling was continuing down my leg. Within 30 minutes I phoned my physician, and I was referred to the urgent care clinic. I was seen right away and an x-ray was taken. It was confirmed that there was no broken bone of any type, but the physician told me that she wouldn’t be surprised if I had a meniscus tear or some other sort of tear in there. She told me to follow up with my own physician in two days and gave me some pain medication and anti-inflammatory – telling me to keep the knee elevated above my heart and packed in ice. When I returned to see the doctor 2 days later things were not much improved. I actually saw a colleague of my own doctor – since Dr. Foley was on vacation – and this doctor informed me that even if there were something wrong with the inside of my knee, it was doubtful whether anyone would do anything about it anyway – given my weight. She told me that I would likely just have to deal with the pain the best I could – and sent me home with lots of samples of Vioxx. Needless to say, this was disheartening. I tried returning to aqua aerobics – but the pain was simply too unbearable. When Dr. Foley returned from vacation I told her my saga and she disagreed. She felt it was reasonable to refer me to an orthopedic surgeon for evaluation, and so she sent me to Dr. A. Brooke Benz, where I was evaluated. At Dr. Benz’s office, I was evaluated by his associate John Voss (a PA). I went through a thorough exam and had quite a number of x-rays taken to evaluate. They were unable to determine from x-ray whether or not there was a meniscus tear, but were able to see that I have severe mal- alignment of the knees – due to my weight – and there is substantial damage done as a result. They referred me for aqua therapy for 6 weeks and told me to return for re-evaluation. So, I went to aqua therapy and did okay – but frankly, was experiencing substantial pain. On my return appointment I expressed my pain issues, and it was then that they agreed I needed an MRI. I was referred, and the next morning I went for the MRI. First of all, the place that did the MRI was in a building that was just recently completed in our area, and so of course, I’d never been in it. I parked in my handicap accessible space and once inside this very large building (that curves around 3 corners of a very large block) learned that the office that I had to visit was clear at the extreme end of the building. It is very difficult for me to walk any distance, so needless to say – I was in substantial pain by the time I got there. After filling out the multiple pages of information I was taken back to the MRI room. The tech had me climb on the table, positioned my knees (which was painful) and I mentioned that my lower back was very painful. She said it wouldn’t take too long, and could I tough it out? I said, of course I could. She then proceeded to advance me into the MRI machine. I had told them coming in what my weight was, but apparently they hadn’t paid much attention – because it soon became obvious that I didn’t fit into the MRI tube. She kept advancing and telling me to hold my breath – suck in – and hold my stomach down as hard as I could. We made it to my rib cage – where I had to gasp to get a breath. She asked if I thought I could stand it long enough to run the test image. I agreed that I’d do what I could. So, she left and began the test. A number of minutes she returned and told me that it was working, and could I stand it a little longer? I said yes. Well, 6 – 4 minute passes later I was done. I’ve never been so relieved in my life. She took me out of the tube, and then told me I could get up. The only problem was by that time, my lower back was in so much pain and so cramped up that I simply could not do it. It took assistance for me to be able to sit, and even more assistance to be able to stand. I was in so much pain that I had tears running down my face. I asked if there were any way that they could take me to my car with a wheelchair. She looked at me and said, “Oh – sorry, we don’t have any.” So, after waiting a while and trying to get a handle on the pain – I very slowly made my way back to my car. I cried the whole way. I finally made it back to my Mom’s house – where the kids had stayed during my appointment. My Mom kept the kids and sent me home to take pain meds and rest. It took several days to get over it. However, it only took 24 hours for Dr. Benz’s office to call and confirm that I had a severe medial meniscus tear and needed surgery as soon as it could be scheduled. The scheduler called and notified me that my surgery would be September 17th at St. Vincent’s Hospital. Several days later the scheduler called back – apparently my insurance would not cover at St. Vincent’s, so I had to change the date to the 20th of September at Tuality Hospital. This was August 17th, 2001. I should back up a bit and say that during all of this time that I was dealing with the knee(s), I was also having my various appointments in order to satisfy Dr. Patterson’s requirements. All agreed that weight loss surgery was what I needed to pursue. We were so thrilled, as well, to find that our insurance was paying for all of these visits – leading us further to believe that they would pay for the surgery. On August 21st I had the most interesting phone call. It was Sandy, from Dr. Patterson’s office. She’d just learned that there was a cancellation in the schedule, and Dr. Patterson could see me on the 28th, if I was interested in coming in earlier. Of course I was! John and I arrived at the surgical consult with Dr. Patterson and spent the next 2 hours going over all sorts of information with her assistant, and then eventually Dr. Patterson. I had done a tremendous amount of research and really believed that the BPD/DS was the right surgery for me. I knew from various on-line email groups, etc. that Dr. Patterson did the BPD/DS, the RNY, and the Lap Band (or AGB). When we finally saw her she informed me that I was too heavy to have the BPD/DS done, and the only surgery she would consent to performing on me was the Lap Band. I was so disappointed. I knew that people who had the Lap Band didn’t lose the weight like the other surgeries, and that the potential for complications was high. But she said if she did the Lap Band on me, then maybe I’d lose a certain percentage of my weight, and then be a candidate for another surgery later down the road. I found that incredibly discouraging, but I was willing to do anything by this point in time. So she put me on a pre-operative diet (high protein, low or no carb or fat) and told me if I gained a single pound I would be excluded from the program. I was notified that once all of my paperwork was in to her office, my case would be submitted to insurance for pre-approval for surgery. She told me that letters of medical necessity from my PCP, OB/GYN, and pulmonologist would be a real plus, and encouraged me to ask those doctors if they would write those letters for me. They were gracious enough to do that. By October 5th, they had everything together and submitted to insurance at 9:00 a.m. that morning. By 5:00 p.m. we had an answer – unequivocally – NO. Our insurance, we learned, has an airtight exclusion for the treatment of any weight-related condition. In other words, I could be dying of anorexia and they wouldn’t cover treatment, either. Shortly thereafter I learned some things about Dr. Patterson and her practice that were disturbing. I began to question whether or not the Lap Band was the correct choice for me – and whether Dr. Patterson had been completely honest and up front with me – and wondered was it worth the risk to do, and so I began my research all over again. I read many medical papers on the outcomes of the various surgeries. I talked to hundreds of patients. I emailed scores of Bariatric surgeons and asked their opinion about the changes that Dr. Patterson was making and whether or not they agreed that the BPD/DS was too invasive a surgery for a person over a certain weight. During this time we also contacted Walter Lindstrom – an attorney who specializes in fighting insurance companies to get coverage for people to have weight loss surgery. He had had much experience with our insurance company and assured us that their exclusion for coverage was airtight, and a fight in court would be a loss of money that we could save for a self-pay surgery. We did also write a letter to John’s employer asking them if they would please change the insurance product that they purchased so that it would include coverage for weight loss surgery. They told us that they were not interested in doing so. All of my renewed research and gained information from interviewing so many post-operative patients, surgeons, and their family members led me to an important conclusion. The Lap Band was not the right choice for me. I am highly prone to allergies – and because of this, chances are high that my body would reject the band and port that would be implanted in my body. The Lap Band also has the highest rate of reoperation due to complications. And – the Lap Band is the only weight loss surgery that does not “cure” diabetes, does not help bring an end to sleep apena, and has the lowest success rate for amount of weight lost. The surgery that is most often performed is the Roux-en Y (referred to by the WLS community as the RNY) – this surgery entails making a 1-ounce pouch by removing the lower portion of the stomach and the pyloric valve (the valve the regulates the release of digested food from your stomach to your intestine). A “stoma” is created by sewing the intestine to the bottom of the new pouch. While the results of the RNY are really great for some people – people who are heavier – or super morbidly obese, tend to end up still in the “obese” category. RNY patients also experience a syndrome called “dumping” that is caused when foods that are fatty or have a certain amount of sugar in them are consumed. Here’s a description that I felt gives good facts: DUMPING SYMDROME: Dumping symdrome occurs when partially digested food rapidly enters the jejunum, and is quickly digested creating a concentrated mass. This concentrated mass pulls fluid into this concentrated mass (due to diffusion) from the intestinal capillaries out of the main blood stream. Results of this sudden fluid transfer will be diminshed blood volume from loss of fluid from the blood stream and stimulated peristalsis from the sudden increase in volume inside the intestines. END RESULT: Cold sweats, nausea, weakness,chills, cramps, low blood pressure, diarrhea, over all flu like symptoms that come on quick and may last 30 minutes or so. Other discouraging statistics include: the number of people who end up with complications and reoperation, the number of people who learn to “out eat” their surgery and regain their weight, and the need to continue to “diet” with the surgery. I know MANY people who have had this surgery and are very happy with it. However, after my research, and speaking with my PCP, we agree it’s not the surgery for me. So, the surgery that we have agreed is for me, is the BPD/DS, or “DS.” The DS is the most invasive of the surgeries. It is recommended for patients with a BMI of 50 or higher. The pyloric valve is kept intact, so no dumping syndrome. Weight loss is a great percentage – I know many who have had the DS who have lost 100% of their excess weight and kept it off for several years now. And because of the combined restrictive and malabsorptive qualities of the surgery, weight comes off faster. Most of the patients that I have spoken with who have had the DS and are my size lose their first 100 lbs the by six months after surgery, and are generally “at goal” by 18 months following surgery. So, now that decision is made – the question is which surgeon? There is a web site that has a listing of the DS surgeons in the world, actually. (www.duodenalswitch.com) So I started emailing them and asking “how much” – because cost is going to be a significant factor for us – and whether or not this can actually happen before my health brings an end to my life. Pricing came in as low as $35,000 and as high as $120,000. John and I carefully analyzed our income, obligations, and budget and knew instantly – we just can’t afford that. About this same time I started running into people online who had gone to a clinic in Alcoy, Spain and a surgeon named Dr. Aniceto Baltasar. (http://www.drbaltasar.com/i_default.html) There were a number of things that were very impressive about Dr. Baltasar:
I have had the opportunity to email with Dr. Baltasar a number of times now. I have given him my health history, etc., and he has acknowledged that he will accept me as a patient whenever I am ready to go. I have discussed this at great length with my PCP – who has done her own research on the surgery and Dr. Baltasar. She agrees it is the right course to take – although she would much prefer I were closer by so that she could be involved in my immediate post-operative care – but gives me her blessing nonetheless. She feels the sooner I have this surgery, the better – my health will only continue to deteriorate with the lapse of time. So after all of that info, I feel like I should “recap” so there’s a little more concise accounting:
a. Diabetes (I take 5 pills a day to try to keep it in line – because I am insulin resistant, however, dosages change frequently). a. My diabetes will go away. A recent article published by the American Diabetes Association states that weight loss surgery (specifically the RNY and BPD/DS) are nearly 100% guarantee of elimination of diabetes in the morbidly obese. It would be best if I had surgery soon since I am losing my ability to walk – and walking is a major component of healing in major abdominal surgeries – it speeds healing so significantly and helps to avoid potential blood clots. That, and the fact that the sooner I have surgery, the sooner the other health concerns stop advancing – and in fact – begin to retreat entirely. One other thing that I would also ask you to pray about is the heredity factor that is involved with morbid obesity. This is very much a factor in my own case – my maternal grandfather and many generations back on his side of the family were morbidly obese. There are those on both sides of my family who are morbidly obese, actually. And we are beginning to see the signs of it in William – who at age 5 weighs 69 pounds – the same as his 9 ½ year old sister. He will be seeing an endochronologist May 16th because of suspicions of possible low thyroid and potential Type II diabetes. If his weight escalates at the rate that it has been he will be facing the same health concerns that I am. A frightening legacy to hand down. So that’s the scoop. We come to you to join us to come before the throne of the Father to pray for provision of this surgery so that healing can take place - from these diseases, and for an end to the constant pain. Will you also be praying for John? My lack of mobility and physical limitations have left him with such a heavy burden. He awakens early each morning to do housework before he leaves the house at 6:00 a.m. for work. He returns home from work at about 5:30 p.m. only to have to prepare the evening meal and do more housework – there seem to be endless dishes, laundry, and bathrooms to be cleaned, and floors to be scrubbed. I am so humbled by his incredible servant heart and loving kindness to me. God has blessed me so richly with such an incredible husband. Thank you for being there to share this with. You are a blessing to me. Love, Addendum: On Monday evening April 22nd I finished writing the preceding pages. I had just come from the doctor’s office for a check-up and to discuss my referral to the spine specialist. My doctor once again asked – “When are you going to Spain? You’ve got to have this surgery!” I told her that I really didn’t know – but I thought it wouldn’t be anytime soon – I wasn’t going to hold my breath – but that I did believe that God knew our need, and would provide at the right time. She said something about now being a fine time, and she hoped it would happen sooner, rather than later. That evening when I was praying I was telling the Lord how discouraged I felt about all of this. That if He chose that I should be in Heaven instead of here on earth, I was okay with it – that I’d try to use those days that I had left to His glory. I just felt so tired, and tired of not being well. Wednesday morning the 24th I was getting my desk all straightened up and getting ready to get back to work when I found the checkbook for my new surgery account checkbook. We’d set the account up on the 10th of April at the urging of our church, so that people who were interested in helping us out financially could. We finally had scraped together the $100 necessary to open the account, and were thankful that it was open, and there was a designated place for us to put our saved pennies, too. I thought I should call and check the balance, and so I called the automated banking system and entered the appropriate codes. The balance was given and I sucked my breath in sharply. “Oh no!” I thought, “I’ve accidentally gotten into someone else’s account.” There was a lot of money in that account – it couldn’t be mine. So I thought for a moment, my heart pounding, as I realized how many codes were required to get into personal account information and it would be nearly impossible to “miss-key” the codes. It couldn’t be my account! So I phoned John at work and asked him to call and check the balance. He did – and then had the foresight to speak to a human and confirm the balance, and inquire about the deposits made. The first $100 deposit that we’d made was there. And then on Monday, the 22nd, someone deposited $15,000.00. We don’t know who. We just know when and how much. WOW. To say that we are floored, in shock, totally amazed, grateful, completely caught by surprise… all gross understatements of gargantuan proportions. I’ve cried, I’ve laughed, and I’ve laughed and cried at the same time! I really thought it was going to be another couple of years before I would be able to go – and I wasn’t quite sure that my health would hold out that long. We are so blessed by this generosity. We are so amazed at this mark of obedience. We are once again finding ourselves amazed at God’s faithfulness to us, His loving kindness, and His delight in doing the impossible. What an incredible God we serve. What an honor to be called His child. Will there ever be adequate vocabulary to thank and praise Him enough? I’m not sure, but I’m going to try and see. So – here’s the plan. I have emailed Dr. Baltasar and am waiting to hear back from him on available dates in July. I know he still has dates in May, but there are too many complications and not enough time to take care of all of the details if I take one of the available May dates. (Like – we need passports!) Then doctor is going to be traveling outside of Spain during the month of June for various teaching conferences, etc. July works out well for us for a number of reasons. John’s workload will be most accommodating at that point in time. John has to be at work during the month of August because his boss will be on vacation during that time, leaving John to “manage” things. Also, my mother (sainted woman that she is) is taking our children on a cross-country road trip to visit my brother Joel and his family in Florida – they will be gone the majority of the month of August. This would give me a period of time to recuperate without the temptation of doing things kid-related that I ought not during the healing stages. Our wonderful friend Paul Eastman is an incredibly gifted travel agent. He is in the process of determining what the best dates for travel (price wise) are so that we have some options based on the surgical dates open. So, as soon as we have a date for surgery, we’ll purchase our airfare. We’d like to have some time with the kids between getting back from Spain and their departing for Florida, too. So. We still come and ask you to pray. For safety as we travel. For a smooth surgery and recuperation. For wisdom as we make decisions. For blessings to be heaped upon the heads of whomever it was who chose to gift us with this generous gift. For our children to feel settled and content in our absence. For God to be glorified in all that we do. We love you, Saturday, September 13, 2002
I had my first check up with my PCP on July 25th. I was off of all of my meds. My diabetes, hypertension, and sleep apnea were gone. And I was down 33 pounds already! On Friday, the 26th my drain from the seroma came out. Three days later – when the scab from the drain had finally formed – I was able to shower again for the first time since July 2nd! It was glorious. And wayyy better than any sponge bath!
Would I do this again? Without a doubt. Any regrets? Absolutely not. Every day I feel as if my life is restored a little more than the day before. I love sleeping all night long every night. I love not having to test my blood 5 times a day and taking handfuls of pills daily. I love being able to eat pretty much whatever I want – and still lose weight. I feel so incredibly wonderful. Here’s a picture of me today. I’ll also include a picture of my scar – cause everyone wants to know what it looks like. I think it looks great – it’s healed up very nicely.
First – my home church body – who supported me 100% in every way they could possibly think of – emotional, spiritual, practical (like coming to my house and cleaning floors and doing laundry for me), and financial. These people live out Jesus’ love in their lives every single day. To my pals at the OSSG-WLSChristian Yahoo group who prayed me through insurance woes, health crises, rejoiced with me when miracles happened, and continue to bless my life daily. And to the great folks at the DrBaltasar-DuodenalSwitch Yahoo group – they were so great. Each sharing their own experiences and helping me to know what to expect when traveling to Spain, going through surgery, and life as a post-op.
On the day of my surgery I weighed 365 pounds at 5 foot 3.75 inches tall, with a BMI of 64. My diabetes was out of control – I was on multiple medications in an attempt to rein it in. My fasting blood sugars on meds were generally in the high 200s and low 300s. My doctor felt I probably should have been on insulin, but knew that it would mean an almost automatic 50 lb weight gain – and she just didn’t think my heart could take that. My hypertension was stroke level. It’s embarrassing to admit – but even my 90-year-old grandmother’s hypertension was better controlled than mine! It wasn’t unusual for my blood pressure to be in the 185/110 range. Meds helped – but didn’t get anywhere near to normalize it. I had horrible severe obstructive sleep apnea. I would sleep anywhere between 45 minutes to 20 hours – in 10 to 15 minute snippets – each NIGHT. I couldn’t lay down to sleep – if I did – I couldn’t breathe. So I slept in the recliner in the front room. As much as I was able, anyway. I felt like the living dead. I was experiencing early stages of congestive heart failure. The swelling of my feet and ankles was simply amazing. I couldn’t imagine them getting any more swollen than they were – without popping! And I had horrible acid reflux day in and out. I suffered from stress incontinence. My asthma and allergies were constantly at severe levels. I struggled with yeast infections in the folds of skin on my abdomen, around my groin area, under my breasts, and arms. And I was – for the most part – confined to a wheelchair. I could stand for about 30 seconds before the pain would get the better of me. I did okay in the house just using a cane and holding onto furniture and the wall. I couldn’t stand to shower, and didn’t fit in a bathtub. So I used a handicap accessible shower bench – which had to be replaced frequently since they are not designed to hold 365 lbs on a daily basis. The degenerative joint disease in my back was to the point that my medical team was predicting that I had only a few months left of ability to walk. I also had severe degeneration (grade 4) of both of my knees. In fact, I’d had 2 knee surgeries just months before my DS – both of which my orthopedic surgeon refused to put me under for – I was just too bad a surgical risk. So I went through both with a spinal block – and was just amazed to be there – awake – watching the whole thing go on. (To be honest, I think it was as strange for him as it was for me to have me awake during the surgeries!) My orthopedic surgeon was saying that he thought it would be between 1 and 3 years before I would need bilateral knee replacement. Between the time that the money became available for me to go forward with my surgery (you can read about that incredible miracle below) and the time to leave for Spain, my doctor gave me very specific instructions: do not die of a heart attack this close to having hope. She carefully schooled me in the signs to watch for. She was very concerned that I wouldn’t live long enough to surgery. She had reason to be concerned. I’d been dying for quite some time. I knew without a doubt how terribly ill I was. I knew I wouldn’t be alive much longer if there weren’t drastic intervention. I don’t know that I can adequately describe the horrible pounding that went on in my chest. The incredible seizing pains that I experienced with them – and sometimes the radiating pain to my upper arm. I would get blinding headaches when my blood pressure was very high. I knew that by all rights I should have had a heart attack or stroke long before then. But God… I have to just stop and say this has got to be my number one favorite grouping of words in the world. “But God…” What an incredibly rich phrase. So, I’ll say it again… But God intervened. He provided the money miraculously for me to have the surgery. So let me share some milestones:
I’m often asked how the weight loss has progressed. To be honest, I spent most of my life on a plateau. Seriously. Then, one magical morning I wake up and weigh 5 lbs less than I did the day before, and that will happen a couple of days each month, and by the time it’s over with, I’ve lost on average, about 15 lbs a month. My weight loss milestones were like this: 1st month: 33 lbs I think I’ve finally learned not to stress it. It’s hard not to when you’ve spent your lifetime watching the scale go up! And I’ll admit it – I still stand with my mouth open (trying not to slobber) when the scale moves down again. It’s still thrilling. It’s still amazing. It’s still mind blowing. People always ask me, “What’s your quality of life like?” Can I just confess here I have a hard time knowing how to answer that? How can I adequately convey that my life has gone from a death sentence to more than just a little bit of freedom? How can I express appropriately the amazing feeling that comes from not being in horrible, debilitating chronic pain 24/7? How do I try to explain that I’ve never felt this good as an adult? How do I try to communicate what it’s like to be wearing a Size 18 or XL in clothing (with an occasional size L thrown in) when I’ve only ever worn clothing that is over a size 24 my entire adult life – in fact, before surgery I was wearing size 4X – a little too snugly. My dresses were size 34 if they were cut generously. I know a lot of them want to know, “Are you able to eat real food?” Gosh, yes, so much more so than ever before in my life. Before the DS I would fear the repercussions of food – and I was good! I followed the diabetic and heart-healthy diet to a ‘T’ – but I still experienced horrible repercussions! Now – if I want it, I eat it! I don’t count a single calorie. I don’t care a whit whether it has a lot of carbs versus so many grams of protein. If it sounds good – I eat it. Do I eat sweets? Oh yes. (I should get paid in dividends for keeping Costco’s chocolate covered almond stock flying off the shelves!) Do I eat good for me food? Actually prefer it. Couldn’t live without a good chef salad on a regular basis. Love steak. Love Italian food. Live for Mexican food. Adore Chinese food. In fact – I’ve never felt the freedom to say this before, but let me say it in caps to just get the feeling across: “I LOVE FOOD!” I’ve been afraid of it before this season of my life. I gotta tell you, loving it is way more fun. And I know that people are dying to ask me about my toileting habits – particularly if they’ve ever heard anything from the detractors of the DS. No – I don’t live my life on the toilet. No, I don’t have gas that could clear a major sports arena in seconds. And no, I don’t have uncontrollable diarrhea – if the truth be told, I’ve never had diarrhea since I had my DS. Loose stools, yes. Diarrhea, no. In fact, if the truth be known, I spend way less time on the toilet now as a post-op than I ever did as a pre-op. Do I stink so horribly that the paint peels off of the walls on a daily basis? Nope. Well and let’s get back to reality here folks. No one’s poop smells pretty. Mine is stinkier on days that I eat fattier foods or lots of gas producing foods (gotta love that cooked cabbage!). Do I let it determine what I eat? Nope. If I want a big old sauerkraut covered polish sausage – I have it for heaven’s sake. I just make sure to burn a candle in the bathroom, keep the bathroom fan on, and smile sweetly at my poor husband should the smell be worse than average. Honestly, I have friends and family members who are not DS or any other type of WLS post-ops who are stinkier than I am in the bathroom. Having had the DS has not had any negative toileting side-effects in my life at all. Now – I should tell you one side effect of having the weight loss that I have that I totally didn’t expect. I’ve had a hernia right under the belly button since a couple of months after my son was born by emergency c-section 6 years ago. It was a vertical incision for the c-section, and the hernia developed at the top of it. It had gotten worse over the years as my weight had climbed. But after my DS I thought, “Sigh, it’ll just stop being a problem now that I’m losing weight.” However, that was not the case. In fact, it got bigger and worse the more weight I lost. In December we moved into a 2 story house – my bedroom and office are both upstairs – and I run those stairs a good 50 times a day. And when I would do that – my panni would flap – loudly! – as I went. So the more active I was, the more exacerbated the hernia became. So much so, that it became obvious that I had to see a surgeon about it. So, on May 20th – just 6 weeks ago, I had hernia repair/abdominoplasty with Dr. John Zelko and Dr. H. Daniel Zegzula – the fabulous Drs. Z! They repaired the hernia, laid mesh side to side and top to bottom, and cut off 8 lbs of fat and skin, and I have a flat tummy now. I think the first time in my life to have a flat tummy, by the way. I will probably need another tummy tuck in future, I do still have 60 lbs left to lose, and they say those 60 lbs will have pretty dramatic effect on my state of sag! (Let’s not even talk about the batwings, okay?) Right now any more surgery does not sound fun, so I’ll just ignore it for a while and pretend I don’t have to anticipate it!
Today I opened my eyes, once again – like I did those 365 days prior to it and said, “Dear God, thank you for the gift of this life. What a treasure you have blessed me with! And please bless that soul that responded to you in obedience to bless me with the money to have my surgery.” I gotta tell you, God’s pretty cool. The DS isn’t so bad, either. Please feel free to email me. Blessings, Tuesday, July 20, 2004:
Two years ago I weighed 365 lbs at 5 foot 3 inches tall, with a BMI of 64. I was in a wheelchair. I had out of control diabetes, stroke level hypertension, severe obstructive sleep apnea, horrible GERD, stress incontinence, and was experiencing these horrible chest pains and shooting pains to the arm. I remember my PCP sitting me down and saying, "Don't die on me yet - you're so close to hope!" She gave me a little tutorial on how to recognize a heart attack and seek emergency help. She was very concerned I wouldn't live until surgery. A lot of people talk about their road to WLS - all of the pre-op tests, the support group meetings, and the like. For me it was an entirely different kind of journey. I was a self-pay patient. Starting out I didn't have dime one to go toward my surgical costs. At first I looked into surgeons based on the bargain shopping method. How dumb is that? It was my LIFE that was hanging in the balance. My medical team all insisted I needed to be under anesthesia for less than 2 hours - my orthopedic surgeon wouldn't even do my two knee surgeries in the months preceding my DS with general anesthesia - it was pretty trippy being alert during those two surgeries! So I started searching for a surgeon who was not only good - but who was great. Over and over again I ran into post-ops of a surgeon who by all accounts was kind, compassionate, caring, and committed to the morbidly obese getting more than a chance at hope. So, I contacted Dr. Baltasar - by email - and was floored when I had a response from him in less than 24 hours. Wow! And an actual email from the surgeon - how trippy was that? (I work in health care, not something I see in my day-to-day life!) He was kind, courteous, and happy to answer my long list of questions. He told me he believed I needed surgery soon. I couldn't agree more, but we had no money. So, we prayed. On April 22, 2002 someone anonymously donated $15,000 into my surgery account at my bank. Still don't know who it was, I'm pretty sure it was someone from church. But wow - what an amazing selfless gift. So, I got a date, and got stuff in order. I was going to Spain for surgery. So when you talk about WLS journey - I had not only a figurative one, I also had a literal journey. A journey - as a super super morbidly obese wheelchair-bound woman from Portland, Oregon to Alcoy, Spain. No, fitting into economy seats in a crowded airplane wasn't easy. No, getting around cobbled streets in Madrid wasn't a joy ride. BUT - it was a part of the journey I wouldn't trade for anything. Oh - the memories I have of my first trip to Spain! I remember checking into the Clinica. I remember meeting Dr. Baltasar for the first time face to face and realizing that for the first time in my life I was meeting a doctor who was thin - but GOT IT about what it was like to be SSMO, and living the pain, and agony that I lived with each day - and that he just plain old cared about me. It was something like meeting an old family friend - someone whom you deeply respect and care very much about how they think of you. I saw in his eyes an immediate acceptance of me, and a comprehension of the pain I was living in. What an amazing thing! And I remember the sweet nurses! The day of my surgery they lined up and kissed me on the cheek and wished me well, and two even serenaded me. I remember sitting on the balcony in the warm Spanish sunshine. I remember the beautiful hillside that I could see in the distance from my Clinica room. I remember climbing up onto the surgical table in the OR and having Dr. Baltasar there, and that he stroked my forehead and sang me a Spanish lullaby, prayed for me, and promised to take care of me just as if I were one of his daughters. I think one of the things that amazed me the most was the fact that compared to my c-section 5 years earlier; my open BPD/DS was a total walk in the park. I only needed one shot of morphine after surgery - and that was it for pain meds. I was on pain medication for 8 weeks after my c-section. After surgery, on days 2, 3, and 4 my blood sugars spiked up into the 600s and 700s and I was on insulin for the first time in my life. I was amazed that I could actually walk the halls a bit - even though before surgery I could only stand for about 30 seconds at a time. I was discharged from the Clinica on day 6 - I could have left on day 5, but my husband came down with a bad virus on day 4, and Dr. B wouldn't release me until John was well. We spent the week after leaving the Clinica in a lovely little town on the Costa Blanca called Villajoyosa. The houses that face the ocean are painted different brilliant jewel tone colors so that the fishermen know how to find home again from the sea. It was beautiful, restful, a perfect place to recuperate. One week out from surgery I walked 1/8th of a mile from our apartment down to the boardwalk along the beach. I hadn't walked that long in years. The next night I did it again - my motivation (besides just the fact that I COULD) was that I could get some of that wonderful Spanish ice cream at the little heladeria on the corner - deeply appreciated on those 90 plus degree days! Every night I walked down to the boardwalk. It was amazing. I thought - maybe - if I lost my weight, within a year I might be able to lose the wheelchair. You should have seen the happy dance I was doing at 6 weeks post-op when I sent that thing back to the medical supply company. Just a couple of weeks later I gave up my cane. I remember the absolute amazement and wonder that I felt at every doctor's appointment - seeing the number on the scale a smaller number than the visit before. Two years ago I had no way of knowing that two years from that day I'd be back in Spain - on my fourth trip to Spain, actually - sitting in my husband's hospital room - waiting for him to walk to surgery. He had his DS two years EXACTLY (same date, same time) from the time I had mine. Two years ago I had no way of knowing that my life would have been completely renewed. I hoped for an end to diabetes. I had no way of comprehending that it would be gone by the time I left the Clinica. I hoped for an end to hypertension - today, it's a thing of the past. I longed for a life not filled with chronic pain - today I am surprised when I experience pain after a day of long, intense labor.
Two years ago I had no way of comprehending what it would be like to weigh 210 pounds less than I weighed then. I had no way to fathom the challenges associated with being a "normal" sized person after being heavy my whole life. Like - the absolute wonder I still feel when I hold up my size 12 shorts that are too baggy for me and wondering, "How do I fit my butt in those?!" How can I possibly wear clothing THAT small? Or, feelings of wonder that still pass through my mind when I pass through a space that would previously have been impossible for my 365 pound body to fit through. And the slight holding of breath that I still go through when I sit in a booth at a restaurant, momentarily wondering, "Will I fit?" and then remembering, "Oh yes, not only do I fit, but I can sit here with lots of extra room." My life is so rich. I am so blessed. I'm floored by God's goodness and generosity to me. I'm so thankful that my husband is now post-op DS, too - and that his health is steadily improving! The gift of this surgery keeps me with a constant, breathless anticipation of the next wonderful surprise around the corner. What an amazing thing that these two years have gone by in just the blink of an eye!
So... Amazing - three years now since my DS with Dr. Baltasar. I have maintained my 210 lb weight loss. My life has seemingly gotten busier - okay - well, honestly, it has. LOL! So many more things get packed into my day because they can be. I don't have to worry about diabetes or any of the other many co-morbidities I once juggled, or scheduling taking the many prescriptions I was on previously, or dealing with a wheelchair, or making it to frequent doctor's appointments, or struggling to simply breathe and move. I walk effortlessly, I am healthy, I volunteer in my son's classroom at school, I volunteer at church, I live my life to the full, I love my life.
As far as supplements go - I'm actually getting better about taking all of them every day. Amazing how consistency helps with that! My labs are good - going for my 3-year lab draw day after tomorrow, but I am encouraged with the fact that everything has been trending in the right direction the last couple of rounds of labs. Food continues to be great fun! I'm not ashamed to say I love it! I love to cook. I love to experiment. I even love to eat. I know - shhhh! - those of us who are or have been MO are not supposed to admit that, but sorry, it's true - so I must. My real guidelines are these: Avoid artificial sweeteners like the plague.
I love the farmer's market, and New Season's Market (gotta love their meat department!), and I love growing lots of my own veggies. We've taken up going out to the local u-pick farms and picking fresh fruits and veggies and canning our own, even. It's been great fun! I love it that my children are learning that food isn't the enemy. I love that they are being given the opportunity to learn to love stuff that's good for them, and to learn that moderation is an okay thing. The overeating thing was a recent realization that I was consistently trying to eat too much when sitting down to the table. I don't know when it started, but it finally dawned on me a couple of months ago that I felt so much better if I didn't push it so much with food. It's a strange thing giving up that one last bite - it's a little bit of an emotional tug of war that goes on. BUT - I just feel so much better when I don't overfill my poor little tummy! It is so worth it to slow down again, to take my time eating, and to pay attention to the fact that I'm getting full, and that I don't have to clean my plate, and that I can be emotionally satisfied with a smaller portion consumed - in fact, more than satisfied! I haven't changed WHAT I eat at all, just HOW MUCH of what I eat at a sitting. Little things that have helped me to keep perspective have been things like cutting sandwiches and burgers in half, ordering smaller sized items as opposed to larger - and being okay with not being able to finish something off!, and paying less attention to the speed that other people at the table are consuming their food - it's not a race! It's okay if I'm slow! It's okay if I can't eat as much as they can! I CAN - and DO - enjoy every bite. I don't have to deny myself anything, so there's no sorrow or deprivation involved. Funny how the brain can subtly lull you into not paying attention to the details! It's been a GREAT year watching my husband shrink, I've got to say. He had his DS with Dr. Baltasar 2 years to the day and time after I had mine. He's lost 93 pounds, diabetes, hypertension, high cholesterol, high triglycerides, etc., etc. He's gone from 3X and 4X sized clothing to XL. He's shaved his bushy beard and got a very cute goatee now - looks awesome on him! He wears a smile a lot more nowadays, too... It was amazing what a huge and dramatic change there was as soon as the diabetes was gone - his stress level seemingly just vanished. I was blown away at how much that affected him that way! Being a DS couple has been fun date-wise, too. We get to go to restaurants that are maybe a little more expensive, and enjoy funner food - splitting a meal between us is more than enough. We've enjoyed several weekends away - where we can walk, and see the sights, etc... Of course, those are not the only benefits! :) LOL! So - here I am, 3 years later. Would I do it again? In a heartbeat! Am I still thrilled with Dr. Baltasar as my surgeon? More thrilled than I could have dreamed possible - he continues to be a wonderful friend, and caring participant in my life. Anything I would change? Can't think of a single thing - except maybe have done it sooner. So that's my recap in a nutshell. I'll try and do better with more frequent updates this year. If you want to chat, let me know - I'd love to email! And if you want to see our web site, check out www.bodybybaltasar.com. Blessings,
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I am writing to you to because John and I consider you a close friend or family member whom we love, and because we covet your prayers – now, as we have in years past. I am about to share some very personal information with you and ask you to join us as we come before the Lord, seeking His wisdom and provision. I want you to know that for many months now John and I have been seeking the Lord’s face in regard to these issues, and have made no decision lightly.
I could recount for you heart-rending tales of horrible things said to me about my weight, looks, etc. It took me many years to get to the place where I felt okay about being me. And I’m sad to say it was well out of high school. If only I’d been able to see myself with different eyes back then and realize that I wasn’t the “cow” that I was so often labeled. I just wasn’t fashion model proportioned. I’m happy to say that once I was happy with who I was before the Lord, I was able to begin to love myself and forgive any unkindness shown to me. It ceased to be a concern.
What most of you may not know at this point in time is how much my life has changed in the past few years. But before going into that more, I should say that my weight has gone up steadily since my late teens. I have tried Weight Watchers, over the counter diet drugs, vegetarianism, starvation; I worked with a registered dietician for 18 months at Kaiser, and tried virtually every other diet under the sun. In my mid-twenties I went to my primary care physician (who had been my doctor since I was 15 years old and I trust implicitly) and asked her about the Jenny Craig phenomenon. I had a friend who had lost a great deal of weight, and my own mother lost weight with that program. My doctor explained to me that she did not feel that this was the correct choice for me – that given my allergies (to medicines, environment, and foods) and her concerns about the end-result on heart and liver function, I should not proceed with this type of program. She urged me to follow a heart-healthy diet and to be more concerned about keeping my blood pressure and cholesterol in check, and to make sure that I continued to live an active lifestyle. So I did. A couple of years later, when the phen phen phenomenon hit, I again asked if it were something that I should pursue. Again, she felt that it was a poor choice, and urged me instead to eat a healthy diet and stay active. Again, I trusted her and followed her advice.
After John and I married we agreed that we’d like to have a baby, and began our quest to have one. Our first pregnancy – just a few weeks in length – ended in miscarriage. But shortly thereafter in June 1994 we learned that I was pregnant once again. I carried our baby Elizabeth until 23 weeks gestation, at which time she was born prematurely – weighing 1 pound 9 ounces, and was 12 inches long. She lived 4 minutes before returning to heaven. Since then we have experienced five more miscarriages, and of course, the birth of our son William – after 18 long weeks of bed rest. I am sure that the continual change and surge of hormones did nothing to improve my metabolism. My weight has gone up and down during these years. However, after William was born in February 1997 things did change. I actually lost 30 pounds when I was carrying William, and then after I lost even more weight. It was totally amazing. However, one of the things that I was aware of from the time he was born was the fact that “something” had happened to my back during that labor and subsequent c-section delivery. After William was born I found that simply walking through our home made my back feel as if it was on fire – it was searing pain – and at a given time I could hardly walk at all. It was then that I was referred to a chiropractor – who was able to manipulate my back and perform massage and apply heat packs. After several months of chiropractic care I was better – not quite where I had been before – but better, and this made all concerned happy. As time went on, though, my back would become more and more painful. It was a gradual thing. And with that pain came curtailed activity. It became very painful for me to walk any distance at all. And as a result, my weight began to climb again. It seemed ironic, really, because about the same time John and I vowed to give up nutra sweet (at my doctor’s urging) so we kicked our MAJOR Diet Coke habit. I thought – wow- we should lose weight now. Sadly, we learned to love regular coke and other sodas in its place.
In the spring of 2000 I was so fortunate to be referred to a wonderful new PCP – her name is Marnie Foley, and from the time I met her I liked her very much. Of course, by this time, my own dear wonderful Dr. Madill, who had been my doctor for literal decades had decided to retire.
In March of 2000 I also made another discovery – a lump in the back of my left wrist. It was tiny to begin with. But it continued to grow. And as it did, it pressed against the nerve bundle in my wrist, and brought on shooting pain, and eventual numbness of regions of my hand and arm. My doctor referred me for a nerve conduction study where I learned that I had several problems going on at the same time – there was some carpal tunnel syndrome in that wrist – but nothing glaringly horrible, I had some tendonitis in another portion of the wrist, and then I was beginning to experience permanent nerve damage from the pressure that the mass was exerting on that nerve bundle. I have up to 10% loss of function in portions of the hand, wrist, and arm. Dr. Foley referred me to an excellent hand surgeon who removed the mass November 20, 2000. It healed nicely, and the pain, tingling, and numbness that had been ever-present was gone.
February (2001) I had an appointment with Dr. Foley. When I arrived at the office the nurse took my blood pressure. It was astronomical – 184/118. Dr. Foley encouraged me to begin exercising right away if I preferred to stay off of blood pressure medication. She made an appointment for me to return in 2 weeks to be checked – and told me to get going with an exercise regimen. So I went back to the pool and began doing aqua aerobics 3 to 5 times a week. I loved it! I was so fortunate to have a friend who was able to join me for the same class and we had great fun.
However, while I enjoyed the aqua aerobics immensely, I was continuing to have debilitating back pain. When William turned 4 years old, I turned to John and said, “This has to change. My back is killing me – I can’t walk through the grocery store any more, it kills me to walk through church, I can hardly even make it to the mail box and back. I’ve got to speak to my doctor.” I spoke candidly to Dr. Foley about the fact that I was completely dissatisfied with the fact that my mobility was so severely limited by the back pain, and of course, the fact that I was now at my lifetime highest weight. She encouraged me to continue with my exercise, and she also referred me for physical therapy, feeling that it would teach me some strengthening exercises and that would help some healing to begin to take place. I had every intention of doing both right away, but somehow got distracted. I did, of course, continue on with the aqua aerobics – and was successful in lowering my blood pressure enough to hold off on beginning any medication to regulate it. But it wasn’t until April that I got around to arranging my first physical therapy appointment. When I went to physical therapy I was instructed how to do a number of exercises. I mentioned to the therapist a number of times that some of the things that he was having me do was causing some pretty significant pain in my knees. He told me not to worry about my knees – we were working on my back right now – and just to tough it out. After 6 weeks of physical therapy – I could hardly walk for my intense knee pain. My back was none the better, either. At one appointment the therapist actually threw my back out – after my repeated warnings that it would kill my back. It was significant enough that I wasn’t able to drive and John had to leave work to come and pick me up and drive me home. After a week and no resolution of the pain to my back and knees I returned to Dr. Foley and reported. She at once told me not to return to the physical therapist, and urged me to take Advil for the pain, and apply ice for any swelling.
It was during this time that a sermon was preached at church that had to do with healing. One of my favorite subjects – since I so wholeheartedly believe that God can and will heal according to His good pleasure. I know from personal experience that not only can He, but certainly – He does still heal today. It occurred to me in the car on the way home that I hadn’t asked God for healing for my back pain, the issues related to my weight, etc. And then, for the first time I sincerely prayed and asked God to bring physical healing to my life.
You need a drastic solution or you will lose your life. I want to encourage you to seriously research weight loss surgery, and once you have done that, please approach your primary care physician and ask what her opinion is. Frankly, I fear that your life will be severely shortened if something doesn’t happen soon.” To be honest, I’d never really heard about weight loss surgery – well, maybe in the back of my mind I’d heard horror stories about stomach stapling and people dying torturous deaths. But it was so remote and unclear in my memory, I determined to go home and begin hitting the Internet to research. John and I spent hours and hours researching. We learned that the stomach stapling of old was a trend long past. There were now Bariatric Surgeons world-side performing a number of surgeries that had been refined long-since – giving the morbidly obese a new chance at life. We learned that there are 3 main surgeries being done: The newly FDA-approved AGB (adjustable gastric band), the Roux-en-y (which is most popular and widely-known surgery), and the BPD/DS (biliopancreatic diversion/duodenal switch). There are a number of factors to consider when deciding which surgery is the right one for you, but a helpful tool is a BMI (body mass index) calculator. Here’s a chart that may be helpful:
My BMI at that time was 61.8 – putting me in the super/superobesity range. Another determining factor is what a person’s co-morbidities are. The National Institute of Health (
On May 8th, 2001 I met again with Dr. Foley – and I shared with her Dr. Darm’s concerns for me and her feeling that weight loss surgery (WLS) was what I needed. Going in I was a little concerned that she would react very negatively to this. One of the reasons that I like her so much is the fact that she is so conservative in her approach to medicine. But at the same time, she is also very pro-active. The other reason I wondered is because she probably weighs 95 pounds dripping wet – and this post-partum with 5 pounds to lose. I simply didn’t think she could relate. I was grossly wrong, however. She wholeheartedly supported my pursuit of WLS – and in fact confirmed that she believed if I continued on the path I am at currently – even with a sensible diet and an aggressive exercise program – I might have 5 years left to live. She was glad to research local surgeons performing the various weight loss surgeries, and assured me she would place a referral as soon possible. Within a week I had received that referral, and I called to schedule an appointment with Dr. Emma Patterson – the surgeon that Dr. Foley had found in her research.
Upon reaching Dr. Patterson’s office, however, I learned that it wouldn’t be as easy as making an appointment with the surgeon. I was told to leave my name and address, and I would receive information in return mail. Several days later I received a large packet and learned that I would have to recount my life history for this office. My information would be reviewed, and then, if they felt I was a candidate, I would be notified by return mail that I could then make an appointment. So – that very day I filled out all of the information and mailed it back before 5:00 p.m. A number of days later, I received notification that I was a candidate for the program, and I could proceed by calling to make an appointment with Dr. Patterson, and then I should also make appointments with an independent internist for a physical and blood draws, a psychiatrist for a psychiatric evaluation, and a dietician for analysis of my diet and explanation of what changes WLS would bring about. So I called to make my appointment. Keep in mind that this is the 3rd week of May. The soonest I could see Dr. Patterson would be September 25th, 2001. I was disappointed, but took the appointment. So I started scheduling the other appointments.
In early June I received in the mail a notification from our Insurance (Regence BC/BS, HMO Oregon) that my appointment with Dr. Foley on May 8th would not be covered. I of course phoned the insurance company and learned that because of the diagnostic code used, I was ineligible for coverage for that appointment. They urged me to phone Dr. Foley to learn what code she’d used and to ask if there were another she could use so that the visit would be covered. Suffice it to say that I learned that Dr. Foley was on vacation, no one wanted anything to do with breaching physician/patient confidentiality and reveal that code to me – even though I was the patient!, and I made approximately 30 phone calls before I finally reached someone who could help. The lady I reached was in the coding department of the clinic that I see my physician at. I gave her the details, and asked if there wasn’t some way – seeing that I was the patient and the payment for this visit was on the line – that I could learn what that code was. She agreed that it was reasonable that I be given the information and she did the appropriate research. The code used was for morbid obesity. I had been diagnosed as morbidly obese – and my insurance was saying that I wasn’t allowed to be that, or be treated for it. The coding lady agreed that was precisely what they were saying, and wished me luck. So I phoned the insurance company once again, and it was confirmed that indeed, I was not allowed to be morbidly obese, or be treated for it. In fact, I learned that they would not cover any thing related to morbid obesity at all – they had an air-tight written exclusion. So – needless to say, weight loss surgery would not be covered either. And I had just learned from someone on one of the e-groups that I was on that self-paying in the U.S. generally starts at $35,000 and goes up from there – I’ve heard of someone even having a $120,000 bill. I was depressed.
Amazingly just a few days later John learned that his insurance was being changed at work. There had been so many complaints about the service with BC/BS that they were changing to ODS Health Plans – and they said our coverage should be just about identical. I wasn’t sure what that meant, but I did hit a web site to research if anyone else with their coverage had ever been successful in getting coverage for WLS. I was encouraged to see several who had. So, the game plan was to wait until July 1st, have Dr. Foley re-write the various referrals, and start over again.
On Tuesday, July 2nd, 2002 at 3:00 p.m. I weighed 365 pounds at 5 foot 3.75 inches tall. I entered the operating room at the Clinica San Jorge in Alcoy, Spain. Dr. Baltasar held my hand and escorted me to the operating table, helped me climb onto the table, and get settled. He told me he’d take care of me like I was one of his own children, stroked my forehead, patted my head, and assured me that everything would be fine. I prayed for him, he prayed for me.
Eighty minutes later – with my appendix, gallbladder (and large gallstone!), liver biopsied, and guts majorly rearranged I remember being awakened by the anesthesiologist who was giving me puffs of albuterol and encouraging me to breathe deeply. It took me a while to remember that I was supposed to breathe, and after a number of puffs of albuterol was doing much better. I remember saying, “Ouch” as we went over the lip where the elevator and the floor don’t quite match up going back to my room. Within 3 hours I was up going potty on the toilet. For the majority of the night I was switching between the bed, my wheelchair (which I thought was more comfortable) and going potty. By the afternoon of the second day I was walking the halls.
On the second day Dr. B wanted to remove my stitches – but I didn’t want him to! With my C-section when they removed my staples my incision burst open! So he agreed to wait one more day. On the third day he took my stitches and drains out and taped me up with this great stretchy tape that made me feel very secure. On Sunday, the 7th of July we left the Clinica and went to a lovely little village on the Mediterranean called Villajoyosa where we had rented an apartment for a week. The ocean, town, everything – were just lovely. On Tuesday, the 9th I walked from our apartment to the waterfront – 1/8th of a mile – without my wheelchair! I was also sleeping in 6 hour stretches of time – simply amazing, and incredibly wonderful! By Thursday the 11th, I began running a low grade temperature and had an area of swelling on the right end of my incision. I wasn’t feeling so great – but still better than I had before surgery! John and I continued to make a goal of walking down to the waterfront every night (after the heat of the day had passed) and I would get a little bit of ice cream as my reward. On Sunday the 14th we left Villajoyosa for Madrid, stopping in Alcoy for my final check-up with Dr. Baltasar. He looked at the area that was so swollen and hot and said, “Yep – something’s there!” It was a seroma. He took a sharp pair of tweezers – poked the seroma and out all of the goo came. The smell was absolutely revolting! After it was drained he put in a 6” drain and took a stitch – all without anesthetic – but truly, the smell was the worst part!
We left Madrid the early morning hours of July 16th – and arrived back in Portland, Oregon by early evening the same day – go figure! It was an uneventful trip – and I actually slept a good deal of the flight between London and Seattle.
Today, I am 10 weeks 4 days post-op. Two weeks ago at my 8 week check-up with my PCP I was down 65 pounds total, and improving in every area of my health. A week ago yesterday I sent my wheelchair back – I hadn’t used it in 7 weeks. I am walking without a cane. I can even walk through the grocery store now!
I couldn’t finish this up without saying a special thanks to some very important people who supported me with wisdom, friendship, and hours and hours of prayer.
This is me just 12 months ago. It was 4 days post-op, actually. On the balcony of my room at the Clinica, the small private hospital that Dr. Baltasar uses for his bariatric patients.
So there are the gorey details. Here I sit… One year ago today I walked into the operating room at the Sanitorio San Jorge in Alcoy, Spain – was met by Dr. Aniceto Baltasar, sweetest of hearts among men to be sure (well, except my own wonderful husband, of course!), and went to sleep on that operating table knowing full well – I ought not to wake up. But God…
Where did the last 2 years go? And actually a little more than 2 years now - my anniversary was July 2nd. I find it nearly completely impossible to believe that 2 years have passed since I had my surgery.
A couple of weeks ago, when I was in Spain with my husband for his surgery I walked about 8 miles. There's a joke those of us who have been to Spain for surgery laugh about - ask a Spaniard if a destination is within walking distance, and pretty much they will always say, "Oh yes, it's within walking distance." I can walk and keep up with the Spaniards! I would never have believed that.
Can it really be true that a whole year has passed since I last updated here? How did the year go so quickly? Does time speed up somehow? Wow!
I've even - gasp! - taken up exercising in the past month or so. Funny how beneficial it's proven to be to my back pain issues! (While I've lost the many co-morbidities, I still have degenerative joint disease in my back, and bilateral grade 4 degeneration of my knees.) My husband, children, and my Mom and I all go to the high school track and walk each evening after dinner - a mile or two - and enjoy talking to one another while we walk. I'm amazed at how much it has helped my back pain.