Writer begins weight-loss journey after stomach-band surgery
'I did this for me'
EDITOR'S NOTE: Over the next few months, Staff Writer Debbie Legare will share her journey after undergoing weight loss surgery on June 12.
There is the adage that every journey starts with one step.
At 42 years old, I have taken many first steps only to feel like I quickly fall miles behind.
Before 1988, my weight was steady around 130 pounds. Life was good and I was physically comfortable. But after the birth of my daughter and the loss of my 80-pound pregnancy weight gain, I just started what eventually would be a 20-year-long weight gain. The medical consensus was: "It's normal, you're depressed."
OK, but was it normal to diet and still gain? Over the years I tried NutriSystem, Weight Watchers and Jenny Craig. I read books like "Atkins Diet" and "South Beach Diet," and then turned to doctors who prescribed Phen/fen and Ritalin. I followed Oprah's example with Medifast and Optifast.
By 1996, the doctors finally diagnosed me with hypothyroid, took out my gallbladder and weighed me at 250 pounds. In 2003, I tipped the scales at 311 and was diagnosed with insulin resistance, sleep apnea and polycystic ovary syndrome.
Add some clinical depression to the mix and I had all the things that would make losing weight a nightmare. Even with medications, I would lose but then gain more back. Nothing lasted long-term.
Recent aches and pains caused me enough concern that I went for a physical. Earlier this year, I was informed that my right thighbone was bowing from my hipbone. If my weight didn't dramatically change, I would end up in a wheelchair.
"Imagine a pick-up truck carrying an 18-wheeler load. That's your legs," my doctor said.
Scary stuff.
In April, after many nights of tears and with the support of family and friends, I decided to begin another journey, one that I have started many times. This time my decision to lose weight is taking me in a whole new direction - bariatric surgery, also known as weight-loss surgery.
I searched the Internet for the best in the area for surgery and found Dr. Andrew Averbach, a bariatric and oncology surgeon with 28 years of experience at St. Agnes Hospital in Baltimore.
He has 950 surgeries to his credit with low complications and no deaths. This impressed me enough to make the appointment and at least get information.
Dr. Averbach was cordial, listened to my concerns and offered me the options he thought would help.
Gastric bypass would create a smaller stomach pouch by cutting the stomach off and attaching a Y-shaped section of the small intestine directly to the new pouch.
Sleeve gastrectomy would create a small, banana-shaped stomach by cutting off the right half of the stomach. Some call this stomach stapling.
A gastric adjustable band would attach a vinyl band around the top of the stomach to create an hourglass shape. All could be done in a less invasive, laproscopic surgery.
Dr. Averbach was very clear about the complications. There was a risk of punctured of organs, infections, abcesses, nutrient deficiencies, hernias, vomiting, dizziness and diarrhea after eating, future surgeries and even death.
No matter which I chose, he promised to help me through all of the transitions. Just what I needed. I have had doctors make promises only to retire or move on.
We decided that if I went forward, the gastric adjustable lapband was the right way to go. It promised a short hospital stay and little time off work, but food blockages in the band, requiring a possible emergency room visit, are a complication reality.
Basically, everything I ever learned about eating had to change. I would have to start eating like a toddler; food the size of an pencil eraser, no fluids while eating and eating very slow.
Dr. Averbach warned me my weight would not "just fall off" like some of the other options. It would be a slower, more healthy way to lose.
"Weight loss is determined by a strict protein diet, exercise and the right restriction," he said.
The right restriction is "the sweet spot" or "green zone," adjusting the band so not much more than a half-cup of food is taken in at a time. This means the need for follow-up appointments to fill the band and adjust food intake.
Making a decision
All of the information was a lot to take in. I wanted to cry. I thought I knew what I wanted. I felt the pressure to make a decision right away.
No matter what the complication, I knew being obese was going to kill me.
So I went in search of others who have had the surgery and found a great Web site, www.lapbandtalk.com, and a local support group sponsored by www.ObesityHelp.com in Glen Burnie. The responses were mostly positive about the surgery and the results.
I made the mistake of asking for other people's opinions.
"Just try one more diet."
"Be patient, it will happen when it is supposed."
"You're a strong women just use will power."
It was my husband, Dick, who with his calmness and logic helped me understand this was for me, not for anyone else: "You always put everyone else before yourself. You need to put yourself first for a change."
I went the next step and scheduled surgery for June 12, talked to the nutritionist and did the psychological evaluation and pre-operation tests.
The day started for me at 4:30 a.m. in the shower with a bar of antibacterial soap and hot water. I was tired but excited.
My scheduled arrival at St. Agnes was 5:45 a.m., with surgery at 7:45 a.m. I spent the car ride telling myself that I was going to be fine.
I checked in and went to the waiting room. It wasn't long and I was being walked back to my awaiting room, leaving my husband behind. The closer I got to my room, the higher my blood pressure was getting. I was getting scared. Was I doing the right thing?
For 90 minutes, a steady stream of nurses and doctors came in to talk to me and get me ready. My husband arrived, then the anesthesiologist, surgical nurses and then Dr. Averbach.
He explained that surgery would be at most 90 minutes and then I would be taken to my room for recovery. At 7:45 a.m. on the nose, I was rolled back and told the anesthesia was being put in. I was expecting to have to count down backward but as soon as the thought occurred to me, I was out. I felt nothing, saw nothing and heard nothing.
The next thing I remember was being touched by the nurse trying to wake me up. It startled me and I couldn't breathe. My throat felt tight but I was told my pulse oxygen was good so I ended up having a mini panic attack, grabbing my chest, trying to sit up but being kept down. Within a few minutes I was calm and breathing again but had a sore throat. I was checked on by Dr. Averbach and then rolled up to my room.
My husband was waiting for me with a smile. He told me the surgeon said it all went fine, no problems, just some old scare tissue that had to be removed. I sighed in relief. I raised my gown to look and see what was just done to me. Five little incisions covered by tape. Wow. It was done. My new life was now starting.
The next step
It is now a month later. I have five little incisions, one of which pulled a lot and had to be closed again, but healing is good. I am back in the middle of my chaotic life and 10 pounds lighter.
I have just finished two weeks of liquids and two weeks of pureed foods. I never thought I would look forward to mushed food. I can have an estimated 1,000 calories a day with the focus on 60 grams of protein.
My first fill at the six-week mark is July 30.
A friend of mine told me she thought I would have trouble psychologically. She said I like to think too much and second guess. I have spent way too much time since the surgery reading Web sites on this procedure, putting me on a yo-yo of inspiration and fear.
I have done much harder diets, like those six months of liquid protein. This time I had someone open my body up and insert a foreign object over my stomach.
When in doubt, I turn to my husband. He always knows how to bring me back from the edge.
I did this for me. I have made this commitment and have gone though with the surgery. It is my hope that this piece of vinyl will be what it takes to keep me on target and away from a wheelchair.
By DEBBIE LEGARE
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