Thursday, April 4, 2013

It has been ten years. . .

. . . since I had Open-Roux-en-Y Gastric Bypass Surgery. While I was sitting in a fancy restaurant last week, it occurred to me that exactly ten years ago, I was in the hospital.  This ten-year anniversary crept up on me, and I want to take this opportunity to share my journey with you. This post is a little more personal and the tone more emotional than is usual for this blog. If that makes you uncomfortable, feel free to skip this post. More cute pictures and tales of my mischievous sons will appear this weekend. Today, I'm celebrating one of my proudest accomplishments (other than my children, of course).

This is me in 2002, right before I started looking into surgeons.

Most people, in their 30s look back on pictures of their younger self with longing glances at the youthful figure and face they used to have. Not me. I've somehow managed to "lose" most photographs of myself between 1998 and 2003.

I was never really a thin person, but my weight was pretty healthy until I went away to college. A perfect storm of medical conditions resulted in a 100+ pound weight gain. I have asthma, and I kept getting bronchitis--sometimes four or five times each year. A diagnosis of bronchitis brought a prescription for Prednisone, an oral steroid. Each round of Prednisone led to weight gain, usually about 20 pounds. This made my asthma worse, increasing the likelihood that I'd get bronchitis again. Can you see how 100 pounds can creep on?

Though I wasn't diagnosed until after college, I have something called PCOS--Polycystic Ovarian Syndrome. Among other things, it causes adult acne, weight gain, and major fertility problems.
As to the root cause of this weight gain, I started suspecting I had thyroid disease right around the time I turned 19. It runs in my family, and I asked my doctor (at the NIU health center) to run blood tests multiple times. They kept coming up negative until my senior year, when I finally visited an endocrinologist and had them run a full battery of tests. Lo and behold, turns out I had pretty significant thyroid disease.

Complicating things was my college lifestyle. Living in a dormitory sometimes results in the Freshman 15, due to late night pizza, Lucky Charms for breakfast on a daily basis, and way you can choose to eat pasta with butter and cheese on top for dinner. Honestly, I don't feel that I ate much more (in quantity) or worse (in quality) than most people I knew. That still means my diet was very poor. While I walked to classes pretty often, my busy lifestyle probably didn't help me focus on my health. I took course overloads every semester I was an undergrad, and I ended up graduating in four years with over 170 credit hours. Working a minimum of 30 hours every week while taking 21 credit hours of classes led to some stress eating, I'm sure.

Christmas of 2002. By this time my surgery was scheduled for March 2003.

I decided to seek out a bariatric surgeon at one of my lowest points. At 24 years old and a little under 5'4" tall, I weighed 285 pounds and wore a size 3x or a 26/28 in the Plus-Size women's department. I taught 6th grade on the third floor of an elementary building, and I couldn't walk up even one flight of stairs without wheezing. My self-confidence was at an all-time low, and I was involved in an abusive relationship that I was too afraid to escape.

My doctor told me I was pre-diabetic, and would most likely be on insulin before I was 25. I had knee problems serious enough that my doctor was already leaning towards a knee replacement. The PCOS gave me really painful acne, as well as the knowledge that having children might not be in the cards for me. I had sleep apnea, which meant I had to sleep with a mask like this one every night. It was noisy and I certainly didn't look as cute as the model wearing one in this picture.

This surgery is only recommended for people who will likely die because of their obesity without such a drastic measure. As low as my self-esteem got, I didn't want to die. I wanted to play kickball with my students, sit comfortably in a restaurant booth, and feel comfortable in my own skin. I started the process, which took about six months and involved meetings with psychologists, heart doctors, nutritionists, pulmonologists, endocrinologists, and many other doctors. I attended support group meetings and was given endless paperwork to read and sign. Numerous people in my life, both family and friends, expressed concern that I was making a dangerous decision. I was also told more than once that I was taking the easy way out.  I can be stubborn, and this is one time in my life when I am glad I went for what I wanted, regardless of the opinions of others.

I chose the most radical operation, where my stomach and 150-200 c.m. of intestine would be bypassed. I also chose to have the procedure done "open" instead of laparoscopically. I had my procedure done at Central DuPage Hospital, and my doctor didn't have as much experience with the laproscopic method. I knew I'd be in the hospital for 4-5 days, and I arranged to have two weeks off from my teaching job, plus an additional week for spring break. I didn't hide the surgery I was having from any of my colleagues or friends, though I just told my students I was having stomach surgery.

I don't have many conscious memories of my time in the hospital. I can remember crying and having my father make the doctors switch my pain medication. I do remember having to do a barium swallow, where you swallow a solution while having an X-Ray to make sure your new stomach is working correctly. I had trouble keeping even a tiny bit of the solution down, so I had to do it over and over. I had a vertical incision down my belly that was 11 inches long, sealed with actual metal staples.

It didn't get easier when I went home. Due to the nature of the surgery, I had to give myself shots in the abdomen for ten days after surgery. I took special pills to make sure my gall bladder wouldn't fail (severe weight loss is hard on the gall bladder) in addition to many, many liquid vitamin supplements. I was on a high-protein, very low carbohydrate diet for three months. That's probably why I look so ill in the first picture here. I'd lost 30 pounds in less than three weeks. I ate pureed tuna, fat-free, sugar-free pudding, and special sugar-free protein shakes. About two weeks after I left the hospital, I developed something called a stricture. Basically, the stitches holding my stomach pouch to my intestine healed shut, and I went three days without being able to hold down any liquids at all. Another hospital stay and a balloon endoscopy fixed both the dehydration and the stricture.

My mom took the pictures of me as I lost weight, and she called this picture "Melissa-morphosis." In a way, she was right. I was like a butterfly coming out of a cocoon, and I don't just mean physically. My self-confidence, mood, and even my smile changed. I started standing up straighter, on legs that didn't hurt. I began walking and swimming regularly. By the time I was able to incorporate solids slowly into my diet, I could walk up that flight of stairs without any discomfort.

 I don't want to make it sound like this wasn't difficult. It was harder than I'd ever thought it would be. If I took even one bite too much of food, or if I swallowed a bite that was too big, I'd spend 30 minutes vomiting. I had to watch my protein and carbohydrate ratios all the time.  I developed a side-effect that sometimes happens with bariatric surgery patients: post-prandial hypoglycemia. I have sudden blood sugar drops that are hard to control. Exercising hurt, and I never did learn to like it, only to hate it less.

Sugar was another issue entirely. RNY patients get something called "dumping syndrome" which happens when foods high in sugar or carbohydrates move from the stomach to the intestine. Usually, there is a part of the intestine called the duodenum that allows insulin to slowly be released as you absorb the food. For me, my blood sugar could go from 80 to 130 in five minutes, resulting in chills, nausea, sharp pains, and other icky symptoms that I won't go into here. Let me just say that dumping syndrome does indeed work as a deterrent. You know the kind of taste aversion that you get when you spend an evening drinking screwdrivers and eating egg rolls, get sick, and never want to touch those foods again? Same principle.

I went down in size so quickly that I never did wear a size 16. By January of 2004, 9 months after my surgery, I weighed 162 pounds and wore a size ten. My doctors told me that without skin removal surgery, I'd probably always have at least 15 pounds of extra skin on my body, so that put me in the "normal" range for weight.

For me, the emotional changes were harder to deal with than the physical ones. It is exciting and really fun to move down a size every month or two. I even went down a shoe size--who knew your feet could gain weight? But I didn't know who I was anymore, and it took probably two years before I really felt comfortable in my own skin. I ended the abusive relationship and started enjoying my life. I figured out that I love being outside, and I went out with friends more often. I learned to like new foods, and to define myself differently. I had guys flirt with me for the first time ever, and I did not know how to handle it. Not at all.

I went to a hairdresser and figured out that I had curly hair. No, I had never known this before. When you are not comfortable in your own skin, you start caring less and less about how you look. Once I started liking what I saw in the mirror, I started liking the person inside the body as well. I do wish I had learned to love myself in the body I had before surgery. Medically, it was a sick body, but I would have felt better emotionally had I respected myself more.

I noticed within a few months of my surgery how differently people treated me. I was first surprised at how nice everyone in the world suddenly seemed to be. Then the realization hit me: people treated me better because I looked better. This actually still makes me angry. Overweight people are discriminated against, ignored by salespeople, and snickered at constantly.There are plenty of people in the world who are overweight, healthy, and happy. I don't want anyone to feel that being thin is the be-all-and-end-all of life. It isn't. I just wish people could be treated kindly regardless of weight.

Things are different today. . . 

Greg and me in Louisville on the 10 year anniversary of my surgery.

. . . but I still deal with the results of bariatric surgery every day. I have to take lots of vitamin supplements, and I have frequent low-blood sugar episodes. I have episodes of dizziness and fainting, and I have to carry food everywhere I go and snack frequently.  Every once in awhile, I take too big of a bite and end up spending an evening face down in the toilet. I still have to carefully monitor what I eat. Medications affect me differently, and sometimes cause severe side effects. I have the alcohol tolerance of a ten-year-old, leading to many giggling incidents.

Both of my pregnancies had complications: after about the sixth month, my body had trouble nourishing the babies and I became severely anemic. Nick was growth-restricted and there are long-term implications from that. With Henry, I had six weeks of intravenous iron. I still have a huge scar, though it's been joined by my two happy c-section scars. The recovery from those c-sections was nothing compared to my RNY surgery, and I've been told I am a fast healer. I smile whenever I think that without the vertical incision, the two horizontal ones (representing my children) wouldn't have been possible.

My vertical scar is no longer 11 inches, though, since I have shrunk. It took me a year after having Henry to get back down to my pre-baby weight, but I don't feel that my self-esteem changed when I was a little heavier. I now weigh the same size as I did when I met my husband Greg in 2005.

The weight, however, is less important than the health implications. My school recently required us to undergo a wellness screening, with blood tests and multiple kinds of health analysis. I came up as a level 1, which is the healthiest level, and higher than my husband, who scored a level 2. Since having surgery, my resting heart rate went from 93 to 64, I no longer have knee pain, and I can run after my little boys. My blood sugar is in the healthy range, and my blood pressure is on the low end of normal. My sleep apnea disappeared the same time I said goodbye to the 200s (lbs.), and my asthma is far milder than it used to be.

Ten years out, I regret nothing. The incredible challenges I've dealt with helped to make me who I am, and I genuinely like the person I have become. I feel much healthier and happier at 34 than I did at 24, and honestly, I am very proud of myself today.


  1. Your story is extremely motivating, you give hope to those who are weight strugglers that there is a light at the end of the tunnel. Kudos on your decision and kudos on sharing your journey with us!!

    1. Thanks, Rosie! That light at the end of the tunnel? For me, it was the first time I went through a whole day without thinking about weight loss surgery, diet, or health. Good luck with your journey. :)