My Gastric Sleeve

Three Hundred Dollars, Two Endoscopies, and a Partridge in a Pear Tree

On the first day of Christmas, my bariatric surgeon gave to me...okay, enough with the cutesy Christmas carol stuff. Suffice it to say that the month of December was memorable because I had not one but two upper endoscopies.

As I mentioned in a previous post, scar tissue can form after weight loss surgery and cause a narrowing in the stomach or the esophagus. This stricture makes it very difficult to eat solid foods, so patients tend to gravitate to "sliders," foods that go down easily. Unfortunately, many sliders, like ice cream, are high in calories and fat.

This means that a stricture can actually lead to weight gain because people edge away from their bariatric diet of solid proteins. Luckily, the stricture can be fixed with an upper endoscopy or EGD. This involves the surgeon passing a tube down your throat and into your stomach. He or she can then dilate, or widen, the narrowing with a use of a small, inflatable balloon. Sometimes, as in my case, the procedure has to be repeated to fully open the blocked area.

Getting an Upper GI

I've found a new favorite drink - thin liquid barium! Yummy! And on an unrelated note, if you believe that, I've got some lovely beach-front property on sale in central Kansas.

Anyway, it all started in August when I was about six months out from my gastric sleeve. I found myself craving sweet, cold foods like ice cream, foods that were easy to swallow. At the same time, I could not force myself to eat solid proteins. When I did eat them...well, let's just say it wasn't pretty.

I was sure that this ice cream binge was just another manifestation of my superior ability for getting in my own way. My bariatric surgeon, however, thought it might be a physical problem. Because I trust her completely, I allowed her to schedule an appointment for me to get a series of x-rays known as an upper GI.

Not a happy camper, I reported to the outpatient radiology department on Wednesday. I changed clothes, pleased to note that a single patient gown could cover my new, thinner body. Then I positioned myself on a table that tilted back and forth like a misplaced funhouse ride. Every now and again, a radiology tech held a straw up to my mouth and instructed me to drink more barium.

Suddenly, I heard the radiologist say, "That's it. That's why she's having a hard time with solids."

A (Relatively) Long, Hot Walk

The picture I'm using for my post today was taken about two weeks ago. It shows my mom standing beside a sign posted on Main Street of a small Kansas town. The sign reads: "Satan Called. He wants his weather back."

Ain't it the truth? For the last two weeks the temperature has registered 90 degrees or more by ten o'clock in the morning. We've had maybe three drops of rain during that time period, and all the local weather forecaster has to promise is more of the same.

This kind of summer heat wave is miserable for anybody, but when you're overweight, it's agony. Last summer when the weather heated up, I could only bear to walk about ten steps at a time before I had to pause and rest. Sweat soaked my clothes, ran down my face, and stung my eyes. By breath came in painful gasps, and my heart pounded so hard I actually worried it might just stop altogether.

What is Zofran or Ondansetron?

 
When you have more than 70% of your stomach removed and then try to force the little bit that is left to accept food, there will be times when you have a stomach that is...let's just say less than happy.

Before my gastric sleeve, I was almost never troubled by nausea. If I came down with one case of the stomach flu every five years or so, it was unusual.

Since the surgery, however, nausea and I have become dear friends. No matter how little I try to eat or how slowly I try to eat it, I find myself dealing with nausea several times a week. Not all of these episodes are severe, of course. Most are like a mild twinge, the body's way of saying, "Watch it!"

Then there are the more severe episodes, the ones when everything in my stomach seems to throw itself into reverse. My eyes water, my nose runs, and my mouth fills with saliva. It seems only a matter of time before the only option left is a mad scramble for the toilet. These are the times when I am so grateful for  Zofran.

MILESTONE: 50-Pound Weight Loss (& a Lecture on Protein)

 
I saw my bariatric surgeon today, and she told me I had officially hit the 50-pound mark. We talked about how my clothes felt and looked better and how I didn't become so horribly short of breath with exertion anymore. She was very pleased with the results of the surgery.

Just one thing concerned her. Since the surgery, I've been suffering waves of overwhelming fatigue. Sometimes I can scarcely keep my head up and my eyes open. I've been known to arrive home from work, fall directly into bed, and not stir until the next morning.

My doctor reminded me that I'm only three months out from major surgery and that my body is still probably doing some healing. She also, however, expressed concern that I'm not getting enough protein. Protein, she explained to me, is the second most abundant substance in the human body (water is first) and "the most important nutrient in a bariatric diet."

Coping with the Flu

 
Well, I've officially weathered my first case of the flu since my gastric sleeve. Actually, it's unusual for me to contract a stomach virus. I can't remember when I had my last one. I don't know whether the surgery made me more vulnerable or whether I just happened to stumble across a vicious bug, but I spent most of the weekend sticking very close to the bathroom.

Learning to Listen to Your Body

 
I tried to take it easy back at work. I really did. But I ended up going home and sleeping at least an hour after work each night before I dragged myself to my computer and started my freelance assignments. By the time Friday morning rolled around, getting out of bed was not an option. I called in sick, slept until 1:00 PM, woke up to eat something, went back to bed, and slept until evening.

I woke up today feeling better, if somewhat chastened. If I had just paid attention to the signals my body was sending me, I would have known that even the modest schedule I was pursuing was too much and arranged to spend more time in the office.

Weight Loss Surgery - A Cosmetic Procedure?

 
I made it through the rest of the work week, but I was definitely dragging come Friday afternoon. I got home, fell into bed, and slept like a baby. Today, Saturday, I'm taking it easy, doing a little writing, paying bills, but most of all just resting.

Speaking of paying bills, my health insurance company refused to pay one single cent towards the cost of my gastric sleeve. When I called them to ask why, they informed me that weight loss surgery was considered a cosmetic procedure.

Taking It Easy - Theoretically

 
Overall, this has been a really good week. I got out on Thursday to do another set of errands and stopped by my workplace to visit my co-workers. It was good to see all of them again--it seemed like it had been much longer than two weeks. On the way home, I stopped at the grocery store to pick up--DON'T laugh!--a few cans of baby food. That will be about the only texture I can swallow for the next week or so.

As the woman at the cash register was ringing me up, she saw the baby food and smiled. "How old is the baby?" she cooed.

"Forty-three," I said sourly, as I gathered my purchases.

History of Weight Gain - Bipolar Disorder

 
In my last post, I mentioned taking medications for bipolar disorder. Since they have to do with my weight gain, I wanted to elaborate on that a little bit more. First of all, what is bipolar disorder? It is a mood disorder, and sometimes a psychotic disorder, that affects about 2.9% of the population in the United States. It is marked by periods of mania, or hyper-awareness and hyper-activity, followed by episodes of deep depression. It used to be called manic-depressive disorder.

Bipolar disorder affects different people in different ways. Some of them have wild, extended manic episodes and only brief depressions. For others, it's the other way around. Some people may stay on an even keel for weeks or even months between episodes, while others cycle rapidly back and forth between mania and depression.