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Surgeon: Dr. Ara Keshishian, Delano, California Latest update: 22 months post-op
by Nancy L.: The first time I became painfully aware of being fat I was eight years old. They’d ended the Brownies meeting with a game of “Pass It Along” and the secret, which eventually was whispered in my ear, was “Nancy is a Two-Ton Tessie.” I ran home in tears and told my mother what had happened. When she said, “What do you want them to do, lie to you?” I think I knew then that I was on my own. I’d started to gain weight after a traumatic tonsillectomy at the age of five. Food was a particular focus of my mother’s, who would encourage a binge one minute and the next was restrictive. Each week a big production was made of unpacking groceries and hiding the treats that I was not allowed to eat. I soon learned to sneak food and eat in secret. When I turned 12, my height shot up six inches to 5’10” in one season and suddenly I was tall and willowy. Oddly enough, that’s when my mother really pressured me to diet, saying that I could have a model’s figure if I only restrained myself with food. One plan I used in high school was the all-fruit diet that made my fingernails soft and my hair fall out. My father once paid me $20 to lose twenty pounds in a month and his favorite expression was to say he was calling Omar the Tentmaker if he thought I was eating too much at dinner. By the beginning of my senior year of college, I weighed 211 pounds and joined Weight Watchers for the first time. I lost forty pounds by graduation and thought I’d conquered my problem. During graduate school, the old habits of binging and sneaking food returned. By the time I began my first professional job, I was a veteran of three stints at Weight Watchers. Ironically, my career was flourishing, but the more I battled my weight, the worse it got. Three more attempts at Weight Watchers, Nutri-System, Jenny Craig, Herbalife, liquid “cherry” protein, Diet Center, “behavior modification” from a counselor (“Imagine maggots crawling through that hot fudge sundae you want!”), and dozens of diets from books and magazines followed. Needless to say, all these attempts failed and five years after graduate school I weighed 237 pounds. By 1988, I weighed 264 pounds and I participated in the Optifast program (even before Oprah! I felt so trendy!). I lost 75 pounds in three months. I was marvelous at starving myself and felt free of food preoccupations for the first time in memory. I gave away my expensive professional plus-sized wardrobe and bought all new gorgeous clothes and just knew I’d finally solved my problem. Then I regained. And gained and gained. I regained the 75 pounds I’d lost, plus another 120 pounds. I was so devastated by what I thought at the time was my failure, I committed myself to an in-patient eating disorders clinic. I lasted one week in this program, in which I was the only compulsive eater, surrounded by anorectics and bulimics. I then tried Optifast again, TwinFast, Medifast (twice), HMR (twice), and UltraFast. I became convinced I couldn’t lose weight unless I fasted. The psychotherapy I’d begun in 1985 had helped clarify all the emotional issues that had led me to my top weight of 385 pounds, but it did nothing to remove the weight. I tried to become reconciled to my weight, attending NAAFA meetings and Geneen Roth workshops. I now had mobility problems, especially at work, hypertension, sleep apnea, asthma and bronchitis, and depression and took a host of meds. I also tried Redux, but my blood pressure was too high to continue. In 1997 I married a wonderful man who fell in love with me when I was at my highest weight ever. He was and is completely nonjudgmental and accepting, but I resisted the idea of marrying him until I’d lost some weight, until one day I realized that he’d already SEEN me! In January of 2001, I read the People magazine article about Carnie Wilson and congratulated myself on avoiding surgery, the one weight loss method I thought caused permanent damage. But I couldn’t throw the issue away. I started to do research and went to a RNY orientation. By then I’d found Heidi’s marvelous web site, www.mywls.com, which introduced me to the duodenal switch. When I asked the RNY surgeons about this procedure they were either uninformed or dismissive. Further research led to www.duodenalswitch.com, where I read every single patient profile. I saved the ones that were similar to me and monitored their progress. When I realized that Dr. Ara Keshishian was only a few hours from my house and there was a local support group, I became cautiously optimistic. I sat in the car and cried after the first support group meeting because it seemed like there might be hope for me at last after 40 years of struggle and 30 years of dieting. I had a major phobia about needles, which I’d overcome with hypnosis, but I still was quite seriously terrified of surgery and hospitals. I continued my research, talked to post-ops at the local support group and had my first consult with Dr. K on April 18, 2001. I weighed 341 pounds at the consult, but before surgery I gained (the farewell food tour) to 355 pounds. I canceled my consults with the other surgeons in California because I was so impressed with Dr. K and his organized and effective office staff. I knew I didn’t want to be battling paperwork instead of getting well. I took aqua aerobics classes and short walks in the park to prepare for surgery. I was approved by Blue Cross in one week and on June 26, 2001, the day after my 47th birthday, I was switched. I remember being awakened in the operating room and being asked to help move myself to a new gurney and feeling a lot of pain very briefly. The next thing I remember is removing the oxygen mask to breathe more deeply in recovery. The nasogastric tube wasn’t draining properly and I remember throwing up blood on some poor nurse and discovering I’d been moved to my room. The tube was tweaked a bit and the problem was solved. I knew the “big walk” was coming and with the help of my husband and the fantastic nursing staff of DRMC, I made it down the corridor. I slept in the recliner after that, and I was fortunate enough to have had no complications, although my hands swelled enormously from the IVs infiltrating and I was very sensitive to noise. I spent four days in the hospital and three in a local motel. The whole time I had the incredible support of my husband. The day I was released to go home, I think I was the proudest and happiest I’ve ever been. I’d done something I was terrified of and survived! I spent five more weeks at home, recuperating and taking very slow walks in the park. I probably could have gone back to work after three weeks, but I decided to take my time. Although it didn’t seem like it at the time, post-op recovery went by quickly. The thing I missed most was sleeping flat and on my side or stomach. After seven weeks, I returned to the aqua aerobics classes I’d taken to prepare for the surgery. I ate incredibly small amounts of food and felt full for the first time in my life. Foods that worked well for me post-op were sharp cheddar cheese on crackers, scrambled eggs, and Luna bars. I didn’t bother with protein shakes and concentrated on water first, followed by protein. My surgeon took me off all meds, but at about two weeks post-op I resumed one of my antidepressants. In the first month, I lost 35 pounds. At three months, I’d lost 62 pounds and was able to walk two miles in the park. There were no foods that disagreed with me, but I found that bread filled me up too quickly. One night we went to the movies and I screamed when I realized I was sitting with my legs crossed for the first time in 13 years. Since we were seeing “Shrek,” the audience didn’t exactly appreciate my contribution! At my six-month anniversary, I’d lost 85 pounds and rejoiced in my new mobility, which included daily 2.5-mile walks in the park. Six months out from surgery, I started drinking Coke again, which led to eating more sugar than I wanted. After a few months, I realized how much it had slowed my weight loss, so I eliminated sodas. With the help of some of my switch sisters, I’ve regained my focus. I’ve thought a lot about the opportunity I’ve been given to have the DS. As of my nine-month anniversary, I’ve lost 105 pounds. I’m writing this on the anniversary of my surgery, which was 22 months ago. I appreciate all the comments I’ve gotten via e-mail and hope that this page continues to help people who are contemplating weight loss surgery. It’s really true that you get your life back after the DS—I didn’t realize how long it has been since I sent an update! I’ve lost 148 pounds so far, and my BMI has dropped from 52 to 29.7. I used to wear a size 58 (basically super-sized clothes) and now I’m an 18 on top and a 14/16 on the bottom. I had hoped to be less than 200 pounds by now, but I can’t complain because I am continuing to lose weight, even though I’m well past that optimum 18-month window. I’ve learned that my body does like to “pause,” usually at old set points that I had trouble getting below during all those frustrating years of fasting and dieting and restricting. These plateaus (some of mine have been so long that I call them tundras) aren’t fun, but I think the lesson that I’m still learning is to trust my body. It knows when the time is right to let those pounds come off. As for food, I can eat virtually anything and my bathroom issues are mostly a memory now. The only thing that still doesn’t seem that appealing is whole wheat bread—it just seems too heavy. I still have a sweet tooth and I have noticed once again that eating carbs makes me crave carbs. I do find that loading up on protein really helps keep cravings in check. We eat a lot more sushi, fish and shellfish these days (those George Foreman grills are great!) and I continue to eat the eggs and tuna and chicken that saw me through the first post-op year. (These foods all sound like cat food!) The other thing that’s really great is sugar-free chocolate pudding, but it has to be the cook-and-serve kind, as the instant is vile. I’ve gotten pretty bored with the aqua-aerobics classes that helped me get ready for surgery and that I attended religiously the first year and a half after the DS. These days I mostly swim laps (usually twice a week for a half-mile or mile each time) and walk in the park (about 2.3 miles) on the other days. I’ve tried spinning classes (thanks for the tip, Suzanne!), which used to intimidate me because I’d see the gym rats stagger out of that room. So far I’ve made it through three half-hour classes. I recently bought a mountain bike and am enjoying it tremendously. I look forward to taking yoga classes again, which I stopped after I sprouted a modest incisional hernia. I have found that when I don’t exercise, I don’t gain, but my weight loss stops. Sometimes it’s difficult when I see some of my switch sisters who had less to lose being at goal weight sooner, but I am confident that I can make it down to a BMI that’s normal, which is my lifetime goal. Right now I’m auditioning plastic surgeons for two sets of procedures: first an abdominoplasty and hernia repair, and then breast reduction and maybe a facelift to get rid of the wattle where my triple chin used to be! One piece of advice I have for pre-ops is to meet and stay in touch with others having the DS at the same time as you. I still think Dr. Keshishian and his staff provides incredible support, but it also has helped me tremendously to have the sounding board provided by my two switch sisters, Jacqui and Julie, who have been so wonderful. There are no words to describe all the physical and emotional changes that have come from this surgery. I sometimes forget that I don’t have to use the handicapped stall in bathrooms, or that I don’t have to fold my skirts at the waistband to get them to fit on a hangar, or that I can now walk across campus to meetings, or park in far-away parking lots, or shop in the regular sizes. It all seems pretty miraculous to me, after a lifetime of shame and struggle about my weight. My wish for all of you is the same fabulous result. |
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