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Surgeon: Dr. Clifford Deveney, Portland, OR DS Revision Surgeon: Dr. Kenneth Welker, Eugene, OR
by Joy:
When I went away to college, I discovered the joys of an unlimited portions meal plan at the dining hall. During my Freshman year I gained 25 lbs. So, once again, I went on a diet; this time I tried to go on a starvation diet but after a week of this, I was too weak and shaky to even walk across campus to my classes, so I had to revise my diet a bit! Again I was able to lose the 25 extra pounds in time for summer. I maintained my weight loss all summer by swimming for exercise and continuing to eat modest portions of healthy non-fattening food. I was diagnosed in the summer between my Freshman and Sophomore years with Hypoglycemia, and I learned about the hypoglycemia diet, which I adopted and I did feel better and managed to keep my excess weight off throughout the remainder of my college years. I did periodically have to go on diets during this time; I mostly used high protein-low carbohydrate diets. The original Atkins diet was popular at this time, and it suited my needs well when I needed to lose a few pounds quickly. Throughout my first marriage, I struggled with the weight, gaining and losing again with different diets combined with exercise. After a period of slipping up on my diet, I didn’t have too many problems getting the weight back down again until I got pregnant. I couldn’t do a strict weight loss diet while I was pregnant, but I was concerned with eating healthily, because I wanted a healthy child. So I read Adelle Davis and followed her suggestions for healthy eating. After the first 2½ months of almost non-stop nausea and vomiting, I developed a mighty appetite and ate lots of healthy food. I was about 20 lbs over my ideal weight when I got pregnant and ended up gaining an additional 40 lbs. Getting the extra weight off after the birth of my son was extremely difficult. I was tired all the time, and didn’t want to exercise. I wasn’t getting enough sleep and was eating to try to give myself the extra energy that I needed. But my mother gave me a present of an enrollment in a Jazzercise class, and I faithfully went and did manage to diet and lose weight again with the exercise. It was at this time that I was diagnosed with a low Thyroid and began on Thyroid supplements. I didn’t get back down to my ideal weight again, but I did lose some of the extra weight I had put on while pregnant. After my second divorce, I entered college again to get a degree I could use; my first degree was in Psychology -- not too useful in the job market. I also took the opportunity to go on a total self-improvement program and began a new diet of my own design. I called it my "life-time" diet and it consisted of a balanced, healthy diet with low carbohydrates and no refined sugars and no fried or hi-fat foods. I counted portions of carbohydrates, but that was all I needed to count. I lost 55 lbs on this diet down to 120 lbs, only 5 lbs over my ideal weight. While in school, I began dating the guy who would become my 3rd husband, and I began to eat "treats" with him. I was still only 10 lbs over my ideal weight when I married him. After my marriage, I slowly put all my weight back on, plus a lot more. Over a 7 year period I gained 95 additional lbs, a total of 105 lbs over my goal weight! It was a difficult marriage, with the extra stress of trying to finish a Master’s degree and working part-time through a lot of my schooling. When I finally graduated and began my career, I once again found that I had the emotional energy to begin another self-improvement overhaul. I went back to the "life-time" diet that had worked so well when I first started graduate school when my son was small. I also joined Overeaters Anonymous at this time. Over a period of 1 year, I lost 82 lbs on my life-time diet and went through another divorce. I met Joe at an Overeaters Anonymous meeting after I had transferred back to Texas. Joe had just gotten out of an in-patient treatment program for obesity, which stressed O.A. meetings after he was out of the treatment center setting. At first we did really well with our food, going to meetings together and writing all our portions down after each meal and tallying them up at the end of the day. (We weren't comparing what we each ate with what the other one ate; we were doing this only as an aid to ourselves to keep to our own food plan.) When we were married, I was 138 lbs, 23 lbs over my ideal weight. I once again started to get lax with my food portions. I also tore the cartilage in one of my knees doing the twist at a party, and then about 8 months after we were married, I tore the cartilage in the other knee, just walking across a dry, level parking lot. Well, this was a more serious tear, and I had to get off the knee for a few weeks. The few weeks turned into a few months as I had to have arthroscopic surgery on it, and from this time forward, it was too painful for me to do brisk walking, my favorite form of exercise at the time I met Joe. Without the walking, and with me being lax on my "life-time diet", I managed to slowly gain an additional 130 lbs over the course of 6½ years. In the fall of 1996, I weighed 275 lbs -- my maximum weight. Walking was absolutely agonizing, and I decided I really had to do something about my weight again. I went to my Dr. and got a prescription for Redux. It had absolutely no effect at all on my appetite. But I was determined to lose my excess weight, so I put all my willpower and energy into going back on a diet. After 7 months of obsessively writing down everything I put in my mouth, I had successfully lost 55 lbs. But, I needed to lose 160 lbs! I was far short of my goal. I tried two other diets in 1997 and 1998, in the hopes that they would be the answer I was searching for. One was The Zone, and the other was The Carbohydrate Addicts Diet. Neither one was the "magic diet" that I was looking for: they weren't easier to follow and I didn't lose any faster on them than on my own portion control diet, so I went back to it. It took a HUGE amount of emotional energy to deny myself day after day, and not eat everything I wanted to; I just couldn't keep it up. When my Dad got cancer and Joe and I went to help my Mom care for him during his last couple of months in the late summer and early fall of 1998, my resolve and determination to lose just weren't enough. I began eating more than I should, gradually at first, but it wasn't long before the pounds began to come back. Since that time, the best I have been able to do is to just not binge uncontrollably. I haven't gained all my weight back yet, but without surgical help, I know it is just a matter of time until I will gain it all back and more as well. I have finally had to admit that dieting doesn't work for me long-term. Joe and I began to look for answers on the Internet. I had vaguely heard that Carnie Wilson was having weight loss surgery but hadn't really investigated it further. I was really turned off by the idea of getting my insides cut up and re-arranged. It seemed so drastic, and I was skeptical. I was also concerned about the possible complications and wondered if it was just exchanging one set of problems for another, and if it was healthy medically, especially over the long term. I had heard about the terrible problems with the old Illeo-Jejunal bypass, and I also had heard about disastrous complications from the old stomach stapling operations. I wanted to have nothing to do with those! I did a search on Alta Vista, using the term "weight loss surgery", and the first web site that caught my eye in the list that came up, was Heidi's website. So that was the first weight loss site that I read about on the Internet. Joe also did a search on weight loss surgery, and found the site of a local San Antonio surgeon who only did the RNY procedure, and that was the first site about weight loss surgery that he read about. So Joe and I knew from the very beginning that there were TWO effective and safe weight loss surgical options that we needed to investigate. After reading more on both procedures and reading the posts on the DS Yahoo Groups list, we both came to the decision to have the DS surgery. We both really like the long-term weight loss maintenance that this surgery offers, as well as the better and more normal quality of eating that it affords. Update 2-1-01 Update 2-25-01 I didn't have any nausea or vomiting, either in the hospital or in my first few days home. I was able to sip water and Gatorade with no problems, and I had no trouble handling liquids and soft foods. At 15 days post-op, I did develop an alarming pain in my right shoulder and severe nausea, which did lead to vomiting. But the vomiting only lasted a few hours and the aching and nausea only lasted about two days. I spoke with my surgeon and he thought from my symptoms that I was having a virus. I believe that it was a virus, since the symptoms cleared up after a couple of days. My only problems now are severe fatigue that comes on suddenly without much warning and I have to go to bed and rest, and frequent spells of chills, which I believe will eventually go away. I am eating a variety of soft foods and trying to get lots of protein in. I am 2- 1/2 weeks post-op and have lost 11 lbs. Update 5-6-01: My weight loss has been slow compared to many others who had surgery at the same time as I did. I still have lots of pain from my osteoarthritis and Fibromyalgia so I haven't been exercising as much as many folks do after weight loss surgery. Another reason for my slow weight loss may be that I was a small eater as a pre-op, and I am now eating about 2/3 of what I ate as a pre-op at a sitting. I had some problems with depression after my surgery, some of which were related to my not completely absorbing one of my Estrogen pills, but that has been remedied, and I do feel better. As long as my weight loss continues as it has, I will be satisfied with it. Update 9-10-01: For my original DS surgery, I did not get to have Dr. Welker, the surgeon that I had consulted with and had chosen. Due to hospital politics, the hospital switched surgeons on me and I found out about it only two days before my surgery date. Because I was having almost constant severe gall bladder pain, I could not wait to have the gall bladder removal surgery. Since I didn't have too many co-morbidities and the diseased gall bladder was one of them, I was worried about getting insurance approval if I waited to have the weight loss part of my surgery, so I chose to go on with my DS surgery with the substituted surgeon instead of only doing the gall bladder and waiting to have my DS surgery at a later time. The surgeon that was substituted had very little experience as a bariatric surgeon and gave me an extremely conservative weight loss surgery-- much too conservative to be effective. At my 6 months follow-up visit Dr. Welker agreed with me that I was having inadequate malabsorption and weight loss. In addition, my stomach had stretched out to hold 10 oz by 4½ months and 10½ oz by six months. So on Aug 28th, 2001, I had a revision of my DS surgery. Although my initial operative report said that my common channel was made 100cm, when Dr. Welker opened me up and measured my common channel, he found that it was 225cm long! Some of that could have been re-growth and lengthening that often happens after DS surgery, but the majority of it was probably inaccurate measuring by the surgeon who did my original DS. So it was reduced to 100cm, what it was supposed to have been originally. He also reduced my stomach to approx. 5 oz. The recovery from my revision has been similar in many ways to my initial surgery, but it has been easier and less painful. I have had better mobility, strength, and stamina after the revision than I did recovering from the original DS surgery. At 13 days post-op, I had a follow-up appointment with Dr. Welker. I got weighed at his office and I had lost 5 lbs at that time. In order to make my stomach 5 oz, Dr. Welker has had to make it very narrow, especially in the middle of it. This has made my swallowing more difficult than during my first DS recovery. It has also given me a significant amount of discomfort after swallowing, even when my smaller stomach isn't full. At times, the very first swallow is extremely uncomfortable. And I have to eat so much more slowly than I had to even as a brand-new DS post-op last time. But, if I lie down on my left side for a bit, the discomfort usually subsides pretty quickly. Why this helps is a complete mystery to me! I am hoping that with time, the narrow place will get a bit wider and I won't have these symptoms. In the meanwhile, my smaller stomach has greatly reduced the amount I can eat at a sitting! Update 10-23-01: I don't mind this at all, since I really wanted my stomach capacity reduced somewhat anyway. I have lost a total of 14 lbs since my revision. I am not dieting anymore, other than to always eat protein first and not to overdo the sugars and simple carbs. My weight loss is going very slowly still, but at least the scale is moving the right way most of the time! The Tanita scale seems to hover around 45-46% body fat, which is down somewhat from 47.5-49%, the range it stayed at the whole time after my first DS surgery. I am now below 200 lbs, a real milestone for me! And I am finally too small to be able to wear my pre-op clothes! My pre-op BMI at the time of my original DS was 47, and now it is 36.
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I was not always overweight. I was not an overweight child. I was not an overweight teen-ager. I did gain 15 extra pounds as a Senior in High School. So I went on my first diet. I lost 5 lbs a week, and at the end of 3 weeks, I had lost the entire 15 lbs and was successful in keeping it off by riding my bicycle and jogging and eating modest portions of healthy food for the rest of the school year and the summer. Of course, in the summer, there was swimming, which has always been my favorite form of exercise, as well as the extra incentive not to gain the weight back so I’d look good in a swim suit.