Patient Perspective: Life After Gastric Bypass

In the early fall of 2002 Sally Long was sitting in a support group listening to horror stories about bariatric surgery. She heard statistics about complications, even death, suffered by patients who had their stomachs surgically reduced; statistics that she admits were "very scary." A short while later, on October 16th, she would undergo that same surgery. "The question is 'is it worth risking death,'" says Stacy of the operation that would change her life. "For me, yes."

A Heavy Decision

The type of procedure that Stacy had is called Roux-en-Y gastric bypass. During the operation a small pouch was created with a line of staples and connected to a loop of her small intestine, drastically limiting the amount of food she would be able to consume after surgery. She knew that her eating habits would change drastically, but what else could happen? As a part of those "very scary" statistics Stacy found out that an estimated 0.5% to 2% of patients die as a direct result of surgery, many suffer hernias afterwards, and others suffer complications including staple leakage that leaves them incapable of leading a normal life. But she was in relatively good health and was one hundred pounds overweight at her heaviest (not that bad compared to others who were having the surgery), wouldn't her chances of complications be smaller? No, not according to her surgeon Dr. Robert Marema, who told her of an instance of a similarly healthy firefighter who died as direct result of surgery.

Of course she tried all of the diets, even lost 70 pounds on Atkins, but no matter how strictly she stuck to them the weight kept coming back. As the excess weight she thought she had lost by swearing off carbs slowly found its way back to her waistline, Stacy felt dejected. She wasn't suicidal, it wasn't quite that, but with the excess weight acting like an anchor on her physical ability and self image she felt the pangs of mere existence without the excitement and substance in life that she was used to. Surgery was her only option, her decision had been made.

One Day of Surgery, A Lifetime of Changes

It's been over two years now. Two years of turning down French fires, being unable to enjoy a nice evening out to a restaurant with friends like she used to, avoiding sweets, concentrating on protein. Two years of weight loss and new found energy. This is the stuff that Stacy loves to talk about. The after surgery stuff. The new 135 pound Stacy who fits into a size six stuff. It's not all pain, complications (she suffered none after surgery by the way), and not eating what you want. Of course, it's not all easy either. She is grateful for the support group folks that didn't sugar coat the procedure at her pre-surgery meeting. "No one said you'll be fine," she says. So now when she talks to people who are considering surgery she never says they'll be fine. The surgery itself you have no control over, but you can control what happens after if you take care of yourself.

Part of the success that Stacy has had after surgery she attributes to how prepared she was going in. She knows people who were completely unprepared and didn't know how to react to the aftershock. "It blows my mind that a doctor would perform surgery without explaining what will happen afterwards," especially when so much weight loss comes from following what she calls "the rules."

Even with following "the rules" and doing everything that she is supposed to after surgery, it has been a rough road to where she is now. She spent the first two days in excruciating pain, and was pretty much miserable for the first month. She is self-employed and says she can't imagine being able to return to work within the two weeks that her doctor suggested might be possible. She also said that the loose, saggy skin that is still hanging around is a bit disappointing, but she isn't ready to turn to more surgery and is learning to live with it.

An Emotional Roller Coaster

Of course there's also the emotional changes. Since surgery she says she has been "wacky emotional." Not surprising: it's a wacky change. At one instance she says, "it makes me feel like a million bucks," she never thought she could feel or look this good, and of course she is much healthier. At the same time it is a strain; she misses the restaurants (a full meal with bread and dessert), misses late night cocktail parties with friends (she can't tolerate liquor like she used to), and when she's hungry, making sure she counts how many times she chews each bite before swallowing is no great joy. She says there are so many changes and you just have to learn to adapt as you go: she is still learning.

Stories of success and complications have been in the news for years. Most people have heard the high-profile cases of Al Roker, Roseanne Barr, and others, and have also probably heard stories of post-operative death. But even with the stories, no matter how prepared you are, life after surgery isn't going to be exactly what you expect.

Being a post-bariatric patient means having a special knowledge of life that people who have not yet had the surgery can't quite understand. It's exhilarating and frustrating. That's why there are support groups and educational classes. That's why Stacy can share so much with her friends that have had the surgery; the experience helps them pull each other through tough times.

The last two years for Stacy have been full of ups and downs, some gains and very important losses. So what is her one regret? "I wish I would have had it done twenty years ago."


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