Monday, November 7, 2011
Taking care of ourselves in the gastric bypass world
The first real person I knew who had gastric bypass surgery was my friend, Melissa Donald. This was almost 10 years ago. Lately, she's been facing some issues and I have asked her to write a guest blog about them as a reminder that, as gastric bypass patients, we always need to remember that we've been altered:
I was always the chubbiest kid in school. It didn’t really bother me because I was also usually the smartest. The kids might not want me on their kickball team, but everyone wanted to sit next to me in the classroom.
It was a system that worked for me.
By 2000, I was in my early 30’s, happily married with a great career. I also weighed about 500lbs. I did not really have any co-morbidities – no diabetes, no high blood pressure and I had not blown out a knee or my back.
In July 2002, I started preparing for surgery in earnest. I switched to a post surgery diet and started losing weight. I also got my first Cane Corso mastiff as a walking companion. My first walk with him was to the end of my front lawn before I was out of breath and sore. I weighed somewhere north of 525lbs.
In January 2003, I had RNY gastric bypass surgery. I was a poster child for the surgery. I was ostensibly healthy, I had no side effects, I became obsessed with walking my dog and going to the gym. I lost 39lbs in the first 13 days after surgery and continued to lose at a great clip for six months.
My body just stopped losing weight at 6 months, even though I continued to shed inches as I exercised more. My lowest recorded weight was 299.5 lbs. Given where I had started, I was very pleased with the result.
I never found a supplement/vitamin regime that I could stomach (literally and figuratively). Pills of any sort make me sick. Always. I also didn’t worry about it because my lab work was always well within normal range.
I maintained my weight loss until 2008, when my mom died. Slowly, my weight crept up – a pound here, a pound there. In 2009, my 18 year marriage ended and in early 2011, I had to put my dog (exercise companion, best friend) down.
For the first part of 2011, I thought I was in a funk. I was exhausted, sore, unmotivated, and the weight kept creeping up. I had gained close to 50 lbs and I did not have the gumption to do anything about it.
In July I finally went in for a routine physical and asked my PCP to call in lab work ahead of time so we could talk about the results at my appointment. The day I did the lab work, I started getting frantic calls from the lab asking me if I was OK and if I needed an ambulance. It turns out that my blood count was so low (5.9, when low-normal is 11.5) they were sure I was not standing upright. I spent the next day in the ER getting blood transfusions while everyone fussed around me, determined that I was bleeding internally. I however, spent my time in the ER with my phone googling reasons for low blood counts. The light bulb went on that this was all related to my surgery and malabsorption.
I spent the next several months arguing and fighting with doctors who wanted to perform every invasive test possible. Even though I told the doctors that pills of any sort make me sick, their “answer” to my problem was to take toxic levels of iron and feel nauseous all the time) I finally went outside my insurance and paid out of pocket for a holistic doctor who took one look at my test results and said “They did not test for the right things…why is there no test for B-12 or vitamin D?”.
End result…I am severely B-12 and D deficient. Ironically, this is one of the most common health issues for women in their 40’s AND gastric bypass patients. It maddens me that given the fact that I am a female gastric bypass patient in my 40’s and it took my diligence (and frankly, fear of needles since they next invasive test scheduled was a bone marrow biopsy), to get to the root of the problem.
I spent three months feeling nauseous and not getting well because the doctors would not listen to me. Once I was properly diagnosed, I was able to start getting well.
In the last two months, I have had 7 iron infusions and have started a regimen of liquid supplements that 1) taste good and 2) don’t make me sick. I have gone back to the gym (first time back to the gym I lasted for 7 minutes – I am now up to almost an hour of cardio). I have lost 14 lbs, the dizzy spells have passed and my blood work is “almost” normal.
So, what is my point, you ask? Well, whether you have “side effects” while you are still in the hospital or it takes 8 years for them to show up, the health issues WILL present at some time and we must be ready for them. And, no one can advocate for us better than we can. If I had not done my own research, gone outside my insurance, and advocated for what I KNEW the problem was, they would have continued to poke me with needles and do a bunch of testing and I would not be well on my way to good health.
I will never regret having the surgery. It quite literally saved my life. I will also never again be in a situation where I expect some medical book to know more about me than I know myself. And… if anyone reading this gets their Vitamin D and B-12 checked and can avoid what I have dealt with, it will be worth it.