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Surgeon: Dr. Robert Rabkin, San Francisco, CA
Surgery date: July 13, 1999
Pre-op weight/BMI: 395

by Jessica:

When I was a child I was of normal weight. My dad told me I was fat all the time (which I took to heart), but when I look at pictures from those ages I see a normal weight child. I have shown them to my therapist for a reality check and he also says I was of normal weight.

When I went through puberty, my family started to go backpacking. We worked up to very long trips. With all this working out I not only blossomed but I also lost whatever baby fat I had on me. This was around 12-14 years old. I would have to say this was the best I felt in my body. I don’t know why.

When I was in my teens in high school I was very active in sports - track, long distance running, swimming. I was also a bit on the too thin side. I ate very little, if at all. I weighed between 112-125.

I was thin until I moved back to California from Oregon during my senior year in high school. I gained over 10 pounds and kept it on during the school year. I was not active in sports. I was about 135-140 pounds.

After high school I started to work out again in college (doing karate) and I lost the extra weight (I was at about 125 lbs). I had my body fat evaluated in college and I was below normal, I guess you would say. I had a lot of muscle and a low percentage of body fat.

When I was 21 I got married. I gained 10 pounds the first week during the honeymoon. I stopped working out because I was working full time. I gained weight steadily until I reached 170 when my son was conceived at age 24. I went on one diet during this time that I remember. It was Weight Watchers. I lost some weight. But as I seemed to always do I started the program before Thanksgiving and was brutal to myself during the holidays. I don’t remember what year this was. I was on this diet with my husband.

Anyway, I got pregnant and gained 60 pounds during the pregnancy. There were complications (with me, not the baby) and the pregnancy ended in a C-section (not fun). Obviously a lot of weight. My dad was dying at the time and I was stressed. I ate. When my son was born, I breast fed him for about 7 months and lost about 30 lbs. I then went on Nutrisystems. I lost the rest of the 60 pounds I had gained, going back to 170. I had wanted to lose more. It didn’t last long though. When my dad died I fell apart. I gained the weight back plus a lot more. My weight went up to about 250.

Move up to about 9 years ago. I got pregnant with my daughter. Things were much better in terms of environment. I weighed about 250 when I got pregnant. I changed the way I ate while I was pregnant (fruits, veggies, no dairy because I am allergic and eating only when I was hungry) I actually lost 10 pounds and stayed around 240 for the duration of the pregnancy. The baby was just fine and I had no complications. Unfortunately the eating habits changed back after she was born and I went back to 250.

When she was about 7 months I started another diet. This was a liquid, very low calorie diet. I lost 50 lbs. I got down to about 200 (which seems to be a difficult weight for me). Again this weight loss did not last very long. I soon regained the weight.

I was pretty steady at about 250 lbs until about 5 years ago. Things in my life crashed. I have gained 150 pounds in 4 years. I am at my highest weight ever (395). I tried another liquid diet last year. I was not able to tolerate it this time though. The combination of that with the meds I am on caused severe diarrhea and my system just kind of shut down. I didn’t lose weight and couldn’t afford to keep trying.

During all of these years I have been on countless other diets. I have been on the rice diet, high protein/low carbo diets, the Zone, a vegetarian diet (I still don’t eat red meat - one good thing from this), Overeaters Anonymous, and anything I could find that seemed even remotely promising. I had a few diets that caused minor weight loss but not for any length of time. And there were no plans that worked on the emotional issues. I couldn’t sustain any plan for more than 2 weeks. I felt totally defeated by the small amounts of weight I would lose. I stayed on the liquid diet for several months (the first one) only because of the rapid weight loss. I need the feedback that I am doing a good thing and losing the weight quickly. I always feel deprived on a diet though.

I guess I feel that making a change in my body, a drastic measure I am fully aware of, will cause quick weight loss no matter what I eat and will force some of the changes I have wanted to make for a long time anyway (more veggies, low sugar, no red meat). Maybe these expectations are unrealistic or too simplistic.

The only successful long term change I have made recently in my eating is to cut out red meat. Believe it or not that worked when everything else didn’t and I have no idea why. Too bad it doesn’t do anything for weight loss.

Eating Disorders...
Yes I have a history of eating disorders. I started out being anorexic when I was a young teen. I was so into being thin that I couldn’t deal with the normal weight gain that came with growing and with creating muscle from working out almost daily. That continued till I scared myself one day by getting really faint during swim practice. I hadn’t eaten anything all day. I decided that maybe I was getting too thin.

I was then ok till I was in my senior year in high school. I wanted to lose the weight I gained and I couldn’t do it. I started on a path of being bulimic. I would starve and then binge. I would try to purge. I tried throwing up but that just didn’t work for me. I tried laxatives, enemas, exercising. The only thing that seemed to stick with me was the pattern of starving and overeating or bingeing. I would not eat for the entire day and have very little for dinner. I was a very cheap date. The problem is that I then alternated that with just going for the binges and compulsive eating without the starving or purging. I would stop purging or starving for a while and start to gain weight rapidly. Most of the major weight gains I have had are from compulsive eating and bingeing. And most of the stable places in the history are during bulimic periods where I spent a lot of time not eating.

Surgery
The decision to have surgery came out of desperation I think. I didn’t know what to do with my weight. I knew I was at an all time high. And I couldn’t move. I couldn’t walk for any distance. I couldn’t stand. I couldn’t sit up for long periods of time. I have apnea. I have high blood pressure. All of those things were killing me and keeping me from being a mom and a wife. I needed to do something and it had to be drastic. I needed the feedback that comes from a surgical tool like WLS. I decided on the DS procedure from reading about it on ’Dr. Rabkins website and comparing it with other procedures available. I also asked around about the hospital where he performs the surgery in San Francisco and found that they have an excellent reputation. I went to see Dr. Rabkin and we talked about surgery. I was a good candidate.

I want to say that my journey through surgery was an easy one. It was not by a long shot. It took several weeks to get approval from the insurance company for the procedure. The reason they gave when they denied it the first time was that the procedure specified was experimental. I asked what the difference was in how this was specified and I found that the insurance person in the surgeon’s office used a new code. That new code was specifically excluded from my policy. They decided to change the code and try again.

In the mean time I was given a surgery date. I was anxious to get this going in a short time because my husband was in danger of losing his job in a reorg. I called the insurance company every few days. As my surgery date came close I was told that the insurance company was not going to rule on my case. I called the insurance company myself and found that that was not the case. They actually ruled in my favor. I was approved! What I didn’t know though is that I was taken off the surgery schedule by the coordinator. I found out when I came in for my preop appt. which was also canceled.

I was in tears. I got rescheduled for the following week. I went in for my preop testing. I was also told that the specialist clearance that I needed was not done. That was not true, but for some reason the notes from that appointment did not make it into my file. I saw yet another doctor to get my medical clearance the day before surgery.

That was a major mistake. I was exhausted by the time I got there. I had been walking all through the hospital for the preop testing. He decided that I was not a good risk for surgery and I should lose 50 lbs before surgery! I found out from Dr. Rabkin the night before surgery. I was furious. I was livid. I can’t describe the feelings I had in the days that followed. I was very clear with Dr. Rabkin about how I was being treated. I got some great apologies out of it. I was rescheduled for surgery for 2-1/2 months later.

I have to say that from here things almost didn’t happen. My husband did indeed lose his job. We had 60 days within which to have the surgery done. It would not cover the entire time I needed to be in the hospital. Not only that the change in plan did not even show up in their system for two months. My husband was able to get another job within the same company and reinstate his insurance but that took another few weeks. The surgeon’s office needed to know I was still covered before surgery could take place. I spent a lot of time on the phone making sure that that discussion happened and everyone’s computers matched.

I also did not want to see the same doctor for clearance that I saw before. I got a referral for someone else. I also made sure that I had the appointment well in advance of the surgery to deal with any problems. Make sure that you do not do things at the last minute.

The day before surgery I kept expecting the phone call to come canceling again. But it didn’t come. I had surgery on July 13, 1999. I have steadily lost weight since then. I with I could say that the recovery was easy. It isn’t. I was sick for a long time. It takes me time to figure out how much to eat and when. But it is doable. I can’t imagine how the other surgery would be.

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