Thursday, March 16, 2006

Reverse Q&A

Lindsey and I were on the phone for 4 hours last night, (totally cutting into my Gilmore Girl Tivo'd marathon by the way), and we were discussing the possibility, as best buddies, to get gastric bypass together.

Lindsey is all about it. I'm, on the other hand, really nervous and unsure. I mean, it's a big deal. And the thought of becoming less fat, is really scary to me. Being fat is safe. It's also an excuse to not live the life I would be living if I were thinner. I'm all about comfort and boy, being fat is certainly a comfortable state to be in psychologically.

"But", I asked Lindsey, "exactly how do we go about getting the surgery with insurance and all?"

She didn't know the answer and thus, I'm writing this to all of you, our readers, who have had gastric bypass or the lap band to chime and let us know what the hell is up with it. I mean, before we go to the Dr. and ask, we thought we'd go to you.

Questions we have:

What's the first step in getting GBP/LB?
What about insurance?
What about recovery...how long does it take to feel better?
How much is it?
What about the after effects, is it dangerous?
What's your eating routine afterwards?
We have a relationship with food, what happens when that relationship is severed?
And anything else you think we should know...

Curious minds want to know...cough it up!

34 comments:

Stephanie said...

Hey girls. A friend of mine from school had the surgery in December. I think she first talked to her Dr about whether she was a good candidate, because once your Dr says it is, then you start the insurance thing. My friend had the surgery over Christmas break, that's a 4 week break, and she was back to school right away. I know that she has definitely had a struggle with the food, beacuse it goes from all to nothing (more or less). Know that is not much help, but thought I'd give you what I had! Good luck with your decision!

fluffy said...

Hi! I had lapband surgery in November. My blog chronicles (for the most part) my journey. The first thing I did was check to see if my insurance policy covered WLS (I already knew I was fat). Many have exclusions. Mine did, but it also had caveats that if you had co-morbidites (e.g., high blood pressure, sleep apnea) it could be covered. Unfortunately for me, I was 'just fat'. I ended up self-pay (which varies) and paid $16K--had the surgery here in Texas. Many go to Mexico for half the price and have excellent experiences. Some people find their insurance will cover the surgery after being on a 6-month doctor supervised diet - or if you can prove this with prior medical records. I cannot stress enough that researching both procedures is your best first step- especially people that have had them as you will get the 'real scoop'-- I found people that had the procedures to be the best source of information. There are many groups on Yahoo for lapband and are a good source of information as well. On my blog you will find links to other blogs for both RNY and lapband. There are pros and cons to both surgeries - ultimately it is a personal choice. (I of course prefer lapband over RNY for many reasons that I won't post here.) I didn't cover all your questions, but am happy to answer those or any other questions you have --- just post on my blog. Good luck on whatever you decide.
Fluffy

cherree said...

http://onefatbitchypoo.com/
she just had it, you might want to ask her/ read her blog

mainja said...

i will start this with the comment that i know nothing about it. but, i will say that i think you should do some serious research on it before you decide, since i have heard that it can be horribly dangerous.

i could be wrong, like i said, i don't really know anything about it, but i would say research heavily.

Bronwyn said...

Of course you risk death with any surgery under general anaesthetic, as I expect you already know.

I have read a magazine article about a man from my area who had either the surgery you mention or stomach stapling, not sure which. He vomited so much after surgery that he lost his front teeth. His before photo showed a young looking fat man. His after photo was of a slimmer man who had aged considerably - presumably through lack of nutrients. If you can only eat tiny portions after the surgery, to avoide pain & vomiting, are you going to be eating small pieces of a vegetable - or something you enjoy eating more?

A friend of mine had the surgery. She didn't lose weight!

I believe some people are less hungry after this surgery - but some are just as hungry! How cruel to be permanently hungry, & not to be able to satisfy your hunger, even if you tried to!

Anonymous said...

I got the surgery in 1999, and have maintained a 110 pound loss. It was truly the best thing I ever did for myself. If you are over 100 pounds, insurance will usually cover it. Search on yahoo groups for OSSG (obesity surgery support group). (http://health.groups.yahoo.com/group/OSSG/) and you'll find help near you.

Lisa

Dani said...

Please, also check out duodenalswitch.com. This is the surgery I had, and girls, I live a normal life. If you didn't know I had surgery, you'd NEVER guess it. I eat nearly as much as a normal person, and I have NO restrictions on what I eat, I just need to get in enough protein. I've lost 130 in the last year. I watched my dad live with an RNY and I know that I could never do it.

The RNY and the band DO work for people, but there has been a lot of new reseach on regain after surgery, and the DS is showing to have the least regain of any of the surgeries.

In the scheme of things, as long as you research and make sure the surgery you choose is right for you (i.e. fits with HOW you eat incorrectly), all the surgeries have positives and negatives.

I'm really proud of you guys for thinking about this. I wasted SO much of my life being fat.

Beth said...

I am not a big fan of WLS, and have become less so since hearing that the average patient regains half the weight they lose over the longer term.

If you do decide to go through with it, I'd advise you to research multiple places and find one with the lowest complication rate. My sister-in-law's sister had WLS in early August in a rural hospital and wound up in the hospital for something like three months, much of that time in a coma. She is still dealing with major complications.

Eve said...

http://www.obesityhelp.com
http://community.livejournal.com/wls/

I have been reading the lj community for a while and they are a really helpful there. They would all answer your questions if you posted them and they do these weekly pros and cons which give a lot of good information.

Anonymous said...

I am biased, but I think ou should find another way besides this surgery, which has a high death rate. My step mother had it, and a year later spends most of her time ill. She has lost a hundred pounds, and has aged a lot in the year since she had (the band) done. There were horrible complicatons and she had to have a second surgery.

I have lost 140lbs in the last two years with no surgury at all, just tweaked the diet a little and exercised. You will HAVE to do those things to maintain weightloss even if you do have the surgery or you will gain it back, so why not just do it and skip the painful dibilitating surgery?

I weighed 355 and I have\have a real problem controlling how much I eat-love dessert, love fat, yet I have figured out how to lose weight in a healthy way and not feel deprived. If I can, anyone can. Everyone is different and so you have to do what is best for you both, but in my opinion there is a healthier way (albeit slower)to do it.

Good luck , whichever method you pick.

Tara
(tarahj65@yahoo.com)

Dani said...

This surgery does not have a high death rate. It it comparable to ALL abdominal surgeries. Also, if you research the people that ARE dying, it is the super morbidly obese who are at a high risk of dying in the first place.

Do not spread FUD unless you have read a large amount of medical journals, NOT media reports. The media sensationalizes anything they get their hands on. The death rate for ALL WLS combined in .5%. You're more likely to die in an auto wreck.

As for regain, it happens. That is why you MUST make sure you choose a surgery that addresses your specific food demons. For me it was the DS, because of the high rate of malabsorbtion. It CURED my high blood sugar, my PCOS, my heart issues, etc. I would take the .5% risk again any day.

Also, girls, I want to point out the obesityhelp.com is ridiculously biased towards the RNY. Make sure you do your OWN research, reading medical journals, or atleast NOT relying on media reports when you make your decision.

sharon said...

I'm 4 years post op from the DS. It was the BEST thing I ever did. I've maintained my 140 lb weight loss and I eat NORMAL!! You'd never be able to tell that I had WLS. No tiny pouch, no stuck foods, no vomiting. No restrictions. I have to take vitamins for the rest of my life. Big Deal. I was also a self pay and went to Spain to Dr. Baltasar. I paid $15K total, travel and everything. Then wrote it off my taxes. Next...to Brazil for plastic surgery and get my flat tummy!! Yihaa baby! Also. I'm newly married to a wonderful man. If you do this...research. I know too many people that have gained weight after their WLS or never lost all the weight to begin with.
Look through your insurance papers and look for exclusions. Mine excluded any form of surgical WLS. Good Luck !!!!

Anonymous said...

I have several friends and acquaintances who have had the lap band surgery and LOVE it. One friend in particular found it to be a wonderful tool in her weight loss journey.

You still have to exercise and eat a healthy diet, but it keeps you from getting off track. I know that I can do a "diet" or eating plan, but when something happens in my life that throws it for a loop, bye bye eating plan. The band keeps you from getting off track.

That's my surgery of choice. It seems to be the least invasive and can be easily reversed. Unfortunately, it is harder to get it covered by insurance in Canada, so I have to wait until I save up enough.

Just make sure you research what the best surgery for YOU is. Also, I would recommend seeing a therapist to talk about the emotional and mental implications.

Good luck!

Anonymous said...

http://www.flickr.com/photos/cunisdiabolis/112872217/

randomfatgirl said...

Hey ladies. Well, I haven't had the surgery myself but I know several people who have and I have attended the seminar given by WLS doctors with a cousin of mine. The main thing that they tried to drive home is that YES you will lose weight with the surgery, that's a guarantee. The problem is that it can only be a jumping off point for an entire lifestyle change of eating right and exercising. That's why so many people gain the weight back...they haven't been able to change their brains...their inability to fight cravings, their tendencies to get take-out for $5 instead of grilling a piece of chicken and adding a side of broccoli or carrots at home, their addiction or overeating disorder, their tendencies to watch 5 hours of TV instead of 4 hours with an hour of exercise, etc. Whether or not you chose WLS you WILL have to do it the hard way eventually...you can't start packing that little pouch full of cheeseburger and expect to never gain the weight back you know? So, you have to master the MENTAL part of it anyway and completely change your lifestyle...and if you do that anyway then you're going to lose weight. Diet + Exercise = Weight Loss. Period. The doctors said WLS is basically a really good jump start for the severely overweight...and especialy for those with co-morbidities...who can also make the commitment to change their entire lives for the rest of their lives. Don't know if this helps or not, but this is what I came away with from the doctors!! Now, I know all this, I just gotta get my ass in gear and put it into effect for myself...lol.

aztigger09 said...

A close friend of mine had WLS about a year ago, she looks incredible. But I just thought I would mention that most insurance companies will have you go through an extensive psychological evaluation before they will agree to the surgery.

randomfatgirl said...

OK I just wrote this big long response and my fucking computer ate it. :( So, let me try again...

I haven't had the surgery, but I know several people who have, and even went to a seminar giving by WLS doctors with my cousin. What they had to say was pretty much that if you get the WLS surgery you WILL lose weight...guaranteed. BUT, it is just a jumping off point...you MUST combine the surgery with a complete and total lifestyle change. The reason most people gain the weight back is that they don't change their BRAINS...they continue to give into cravings, get fast food instead of going home and grilling up a piece of chicken and some veggies, watch 5 hours of TV a night instead of 4 hours with an hour of exercise, etc. So their point was, if you're able to master the MENTAL part of it then you are also guaranteed to lose weight... Diet + Exercise = Weight Loss. Period. WLS surgery is just a really wonderful tool for those that are severely overweight or have co-morbidities to help them get started...those people also have to be able to make the commitment to change their lives for the REST OF THEIR LIVES...otherwise they're wasting money. So, if you have a food addition, or if you're an overeater and can't overcome it, or anything to that effect...you also have to get THAT fixed. And if you're not all that overweight and you can get THAT fixed then you should be good to go anyway...the doctors were basically trying to discourage folks who were there thinking WLS would be just a quick and permanent fix. Cuz if you're like me, you're too messed up in the head about food for it to do much good...lol. Hope this helps! :)

Eve said...

Hey just thought I would mention that I can't seem to get access to your main page.

GoBetty said...

I want the surgery but I don't want to change anything else, except to win the lottery. Did that make sense?

Joi said...
This comment has been removed by a blog administrator.
Joi said...

Read accurate, truthful information on this and other topics at www.bigfatblog.com, www.bigfatfacts.com, and http://fattypatties.blogspot.com

I was under the mistaken impression that this blog was about fat/body/size acceptance. I am truly disappointed to learn that it is not.

Stephanie said...

Interesting that "accurate, truthful information" is interpreted as size acceptance! I remember reading exactly the fact that this blog has nothing to do with body acceptance at all. This blog is about how life is as a fat woman (or something like that but said more eloquantly). It is not a weight loss blog but it is not a size acceptance blog either and if you had read the whole blog you'd know that.

I think it's TRULY judgemental to say you are disappointed because these girls are thinking about surgery!

Dani said...

I honestly think that the size acceptance movement is bull. I KNOW what it is like to be 5'6" 310 pounds, and no arguments in the world are going to convince me that being as big as I was was healthy for me. I had MY surgery so I could live my life happily, and not worry about the fact that if I didn't lose the weight I'd need a cane, and that I couldn't walk to the stairs up to my condo w/o being so out of breath I had to sit for 10 minutes. SURE, you MAY be fat and healthy, but it WILL catch up with you. The human body is NOT meant to carry around 100 extra pounds.

I agree that people who are large should be able to live their lives free of discrimination. I ALSO believe that those of us who were sick of walking the thin line between life and death get slated as traitors. That we did this because we want to conform to soceity's ideals. I want to live my life. Really live it. Not worry about if my ass is going to fit into a chair, or if I am going to be able to fit into that booth, or if I will be able to keep up with my nieces. Being fat was absolutely stopping me from living.

Starla said...

I have to say that I lean more towards fat acceptance and don't see it as bull or anything.

But that's not to say that I am necessarily opposed to WLS. I don't promote it (just like I don't promote cosmetic plastic surgery) but ultimately it is up to the individual.

I would just seriously look into the possible negatives, especially deaths that could be associated with this type of surgery before doing it.

What ever decision you make, it will be the right one for you.

Anonymous said...

I think the most important thing to do is to work out the psychological issues before you decide whether to have the surgery. It's absolutely the right decision for some people, but if some important part of you still needs what being fat gives you, you'll regain the weight, and you will have done all that for nothing. Work out the issues first, then maybe see if changing your diet does the trick once you really want to be smaller; if it doesn't, think about surgery then.

Anonymous said...

I would suggest looking into medical journals to get the official statistics on mortality rates and moderate to serious post-op complications. I have an acquaintance who is a doctor and he says he finds the post-op complication rates to still be unacceptable -- both in frequency and seriousness. He says he sees frightening post-op infections come through the ER that cause permanent scarring, dangerous scar tissue, and sometimes health problems for months on end that prevent people from going back to work for weeks or months. He feels anyone wanting the surgery should wait at least another 5 years until the industry gets a better handle on these issues. He compared it to laser eye surgery, saying that they now operate differently than they used to and have far fewer complications and poor outcomes as they did previously.

Personally, I vowed to myself to never have it done after I saw a special that featured people who had suffered complications. Yes, these shows are a dime a dozen but one guy said something that has stuck with me to this day. He had had the surgery about 2 years before the show aired and his doctor had given him approximately 18 months to live because the complications were so severe (vomiting, constant infections). He looked so terribly sad and depressed and when asked what he'd like to say to people watching the show he said, "If I could go back to struggling with diet and exercise, I would do it in a heartbeat. My life is ruined and I'm going to die. All I can say to people is to just keep trying. Find another way."

So, I just keep trying to find another way. I don't think the surgery would fix the thought patterns and habits in my head. I think I need something else. But good luck to you guys, whatever you decide!

littlem said...

What you're NOT looking to hear, I'm sure, but one of those things Docs don't mention (like if we put you on Prozac because you're depressed about your weight, the Prozac will make you gain ADDITIONAL weight you won't be able to take off - Doh!) --

Some people have the surgery and then, gradually, over time, regain all the weight they lost.

They didn't have these stats before b/c the procedure was so new, and the Docs won't share unless you ask.

Yes, they generally hate to see me coming. At least the men Docs who aren't used to having their omniscient authority questioned by a mere patient. :D

Peggy Nature said...

It's up to you, of course, but I generally think of surgery (any major surgery) as a last resort. Before you go to the last resort, it might be wise to get some nutrition counselling. Maybe you've done this in the past, but there is a difference between the kind of counselling I'm thinking of and the usual.

Some dietitians won't promote weight loss. But they will promote a good relationship with food and your body, and if you happen to lose weight in the process, then good. If not, you're still healthier and likely a lot happier with yourself, so also good.

http://www.ellynsatter.com

Email them for a referral to a dietitian in your area. I'm not sure if I've left this information on your blog before (if so, apologies), but I went through this sort of nutrition counselling last summer and I feel much more competent about my eating. I think it helped me strike a middle-ground between total rebellion (overeating for the heck of it) and dysfunctional behaviour (strict dieting and fanatical exercise.)

SharonC said...

The risk of dying from WLS is not low. The 0.5% quoted by a previous commented is rather optimistic; I've heard stats up to 2% risk in the general population.

That's a 1 in 50 chance of being dead within a year.

There was also a recent Medicare study that looked at WLS in older patients and the death rate within a year was really horrendous, approx 50% (can't remember the exact statistic).

I would agree with other commenters who said to check out the stats from medical journals. That's the only place you'll find the information. You won't get it from the WL surgeons, and whilst people's anecdotes give you an idea of the sort of thing that can happen, they don't give you any real idea of the risks either.

NancyKay Shapiro said...

I had a laproscopic roux-en-y gastric bypass in Dec 04 when I was 43 years old and in pretty good general health, and have since lost 97 lbs so far. (See my before & after pics.)

To answer your question:
1. My health insurance paid, which was great because otherwise I wouldn't have been able to afford the surgery. And surprising, because I belong to an HMO (HIP in New York City) and was pessimistic about their coverage.

2. It IS very radical surgery, and things can go wrong. I had a post-op complication--I didn't pass the swallow test after the surgery, and had to stay in the hospital for 10 days and then was on tube-feeding (directly into my belly through a surgical incision) for 2 weeks after that. It was an ordeal. However, all healed well and I've never regretted it. Even in the midst of the hoo-hah I had no regrets.

3. I have a compulsive relationship with sugary food and with eating in general, and I still have days when I overeat and when I eat sugar. That'll always be my struggle in life. But it's much easier to eat well now. I'm much more mindful. My capacity to eat is way smaller. I'm highly motivated to nourish myself and care for myself. I'm satisfied with much smaller portions and don't need to be hungry (I eat when I'm hungry.)

4. I was @ 150 lbs "overweight" and though not really sick, I was being treated pharmaceutically for high blood pressure and cholesterol, and felt I was on the slippery slope towards other problems, including perhaps diabetes. (Both drugs were withdrawn at surgery and I haven't needed them since--my numbers are great now.) I also had trouble walking and suffered from low energy in general--both problems having since cleared up. I'm now able to exercise and while I don't LOVE exercising, I do it and am glad to see my endurance and flexibility so improved. I've gone from a size 30-32 to a 16W or misses 18. I love clothes so am really enjoying the chance to dress exactly how I like, not just in what fits.

5. I take special vitamins designed for gastric bypass patients, and drink protein shakes to supplement what I eat, but I find that now I'm healed I can go anywhere and eat pretty much anything (altho' this varies for people, and I know I tend to eat stuff other bypass patients wisely never go back to). The amounts I can eat at a meal are roughly half of a normal restaurant portion.

I'm delighted that I took this step and feel it saved my life--and gave me a quality of life I haven't had since I was a teen. Having said that, I wouldn't encourage every fat person to do this--it's a serious decision and should be taken after getting a lot of information.

As for finding a surgeon, I did that pretty randomly as it happens, but I had the surgery at a reputable hospital near my home in Manhattan, and felt I got very good care. I'd recommend googling around, calling your local hospitals, and trying to meet people in your city or town who've had the surgery and will recommend (or not) a surgeon they felt comfortable with (or would avoid again).

Good luck.

NancyKay Shapiro said...

BTW, I see you're in NYC, so if you'd like to talk about this or ask additional questions, get in touch with me. As I said, I'm not just blindly cheerleading for WLS--I don't know what my long-term results will be, and I still struggle with my eating habits. But real life is real life, and my real life now is a thousand percent better than it was in 2004. My email is on my blog.

ivy said...

My mom had gastric bypass. She recovered fairly quickly and lost a lot of weight and felt great as long as she took a bunch of vitamins. When she didn't, her hair started falling out. Also she's now got these strange discolored spots all over her body. It looks really bad. They were not there before the surgery. I think it has something to do with nutritional deficiencies. She also ended-up gaining a lot of weight back. The difference with gastric bypass is that when she decided to go on a diet, she lost the weight again rather quickly and could stick to it. Moderation is not soimething she did well pre-gastric bypass.

According to her doctor, it is a dangerous surgery. I remember it used to be a lot less common because it was considered a last resort.

As far as the relationship with food, my mother- a life long very, veeeery light drinker (maybe a glass of wine every now and then) started drinking. Because of the surgey, she didn't actually have to drink a lot to get drunk. So now she goes to AA and Weight Watchers. She told me food is what she used to calm herself and when she couldn't have it anymore, alcohol started looking really good.

I have another friend who lost weight from gastric bypass but then gained a most of it back. Both my mom and my friend had obesity related health problems that made them choose the surgery. My mother feels the thinning hair and spots are worth it because now her knees don't hurt and she feels so much better and dieting works for her now. My friend felt it was worth it because it greatly improved her quality of life and also she got pregnant- which she had not been able to do before.

I'd have to have some pretty serious obesity related health problems before I would do it. I know not everybody gets the thinning hair spotty skin thing- but I don't want to chance it. I'd rather be fat.

btw-hi! I like your blog. I came over from fatshadow.

uberfrau said...

Regardless of pros and cons(I think surgery is awful at best, a form of self mutiliation at worst). What I don't understand is why you feel as though you're not living your life because you are fat. Why is that? Having your intentines removed or your stomach stapled, doesn't change who you are. Everything will be the same, except that you could shop in the misses section of department stores, instead of lame giant.
Being fat, there are some downsides sure-like having your skinny friends ask you if they look fat or being the suki or whatever, but there'd also be downsides to be bald, short, tall, disabled or whatever. Yet no short-tall-bald-ugly-whatever person, would ever say that they are not living their lives.

Ampersand said...

For whoever said .5% was a low mortality rate - what? That's 1 in 200. That's a very high mortality rate - and far higher than the chance of being in a fatal car accident.