The sleeve gastrectomy surgery (TMI)

I want to talk to you all about the sleeve gastrectomy surgery. This post, almost in it’s entirety is TMI (too much information). I wanted share this because people need to see what it’s like going through a weight loss surgery.

The decision to have bariatric surgery is not to be taken lightly. Aside from the dangers of the surgery itself (.08 mortality rate), there are also complications (although relatively minor for sleeve gastrectomy). There is also the exponential amount of behavioral change that is extremely hard to cope with. You still have to make the mental and behavioral changes needed to make a long term change. This isn’t a shortcut to success. It’s just a jumping off point. In fact the behavioral change has been extremely hard to do. There is pain associated with swallowing, awful gas, bad breath, and little desire to eat.

The desire to eat is psychological as well as chemical. Eating releases dopamine, a neurotransmitter that essentially makes you feel good. Eating is addicting.

Like many pleasurable behaviors — including sex and drug use — eating can trigger the release of dopamine, a feel-good neurotransmitter in the brain. — Article in Scientific American

I like to rail against the blogs and personal trainers out there giving out advice about diet and exercise. The information and techniques are inconsistent. The diet industry is a sham. Recently there was a study done of weight loss programs showing that almost none of them were effective.

Of the 11 weight-loss programs with eligible RCTs that researchers reviewed, all emphasized nutrition and behavioral counseling or social support components with or without physical activity. Those programs were Weight Watchers, Jenny Craig, Nutrisystem, Health Management Resources, Medifast, OPTIFAST, Atkins, The Biggest Loser Club, eDiets, Lose It! and SlimFast.
Only Jenny Craig and Weight Watchers showed evidence of helping people lose weight and keep it off for 12 months or longer, said the authors. — Article on AAFP.org

STOP filling people who need your help with nonsense! STOP trying to get them to do the next fad diet or next technique. People need hope, and they need something that is effective!

I’m not saying that everyone needs surgery. This surgery is for people that are severely or morbidly obese (BMI > 40). I’m sure that some people can effectively get the weight off by making lifestyle changes. But a 3 year study (and there is a 15 year one somewhere as well, my surgeon showed us), showed that even intensive medical therapy is less effective in the fight against diabetes than bariatric surgery. Meaning obesity, which leads to Type 2 diabetes, is just as susceptible to the weaknesses of medical therapy as diabetes. Let’s not even go into non-medical therapy for obesity.

Here’s a link to the article in the New England Journal of Medicine.

Surgery was intense. The two weeks of liquid and vegetable diet was hard. But the post surgery has been the hardest part of the process so far. I’ve certainly had my second thoughts, wondering if I would ever have the happiness of eating a meal again.

This isn’t a trivial decision. It isn’t about looks or about “will power.” It’s about drastically altering a person’s mindset and physically limiting access to food. It adds a penalty for eating.

The surgery only took a couple of hours. My doctor generally uses a sophisticated robot to do the surgery. He didn’t use it for my surgery, but he does use it for gastric bypass surgeries since there is a lot more sowing involved.

To achieve behavioral change there has to be a negative associated with eating. Well, cutting out your stomach and parts of the esophagus will definitely add some pain to swallowing, gas, and uncomfortability after eating.

After the surgery, I slept for several hours, and woke up next to my wife, Rebecca. It was a great feeling having her there. I did not remember anything about the surgery, or even going into the room to be honest.

Me sleeping after the surgery

My first memory is getting knocked around in the elevator on the way to my hospital room.

F.A.Q.

How long before you were able to work again?

I was able to go back to work after three weeks. The first two weeks I was sapped for energy and I was able to work from home the third week. Thank goodness I work for a great company that cares. It’s my fourth week and I still find myself tired throughout the day.

How does your diet change after the surgery?

Everything tastes different. Almost everything tastes rich, too rich. Sweets taste awful. I’m told this will change as my body slows down the weight loss and my stomach heals. I’m still in the soft foods phase, so I can eat some “normal” foods, which is nice, but not everything. Generally I have to stay away from breads, rice, extremely tough or chewy foods, and I have to eat extremely slow.

I’m really not hungry actually. It’s hard to get the 70 grams of protein in a day, but I make myself so that I can heal. Water tastes glorious! That’s a big change from my previous feelings on water.

What do people say when you tell them you had surgery? Does it feel like cheating?

I’ve gotten nothing but positive support. Sure a couple of people expressed doubts about needing a surgery, but not many. People have outpoured their support on Periscope, here, and Facebook. And I appreciate it so much! It really helps to have people behind you.

Let me tell you, if this is cheating, I don’t want any part of that shortcut. This is not EASY and do not let anyone tell you it is. In fact it might be the hardest thing I’ve ever done, but I continue to think about Rebecca, Hannah and Violet and their future if I’m not there or unhealthy.

How fast have you lost weight?

I’ve lost 46 pounds since the start of the diet for surgery prep. Down from 353 pounds to 307 this morning. At this point, the speed of my weight loss is the LEAST of my concerns. I’m much more concerned with changing my mindset and my habits so that I can sustain the weight loss. Most people that I know have gained a small amount back after a year (give or take). I’m not too concerned about a small gain since I’m sure it will take a while to stabilize, but I don’t want my old habits back.

I do want to shift my happiness to my family and friends, and away from food.

Have you had any complications?

I haven’t had any medical complications as far as leakage, but I did have a sub-cutaneous blood clot and extreme constipation. I had to visit the ER because my constipation got so bad (I strongly recommend Miralax). My blood clot was drained by my surgeon in the clinic. It caused a large bruise around my belly button incision. Like everyone else who has had the surgery I’ve also had nausea, but no vomiting.

Progress in Pictures

Before surgery, after 2 weeks of surgery prep diet, 2 weeks after surgery, 3 weeks after surgery

Thank you all for your support!