Okay, so in true Kate fashion, it's now 9 weeks since my previous post, surgery is on Monday....in FIVE DAYS - and I haven't even told you what type of surgery I'm getting. (Let alone anything else, but let's focus on one topic at a time).😅
EDIT - I started writing this in September and never finished it. I only had a little bit more to write; it was practically done. It's now January and 'Kate fashion' needs to be entered into a dictionary to describe the most annoying term of not getting things done because I'm actually ridiculous. I'll fill you in when I can but let me just finish and publish this blog post first! (I'm now currently 4 months post op).
Before I delve into the details on any part of this, can I please just say for the record that I feel a bit weird sharing info about any part of this process. Why? Because it really feels like everyone who's battled their weight has already had weight loss surgery (WLS). I feel like I'm the only one who's never looked into this prior to now, and I'm finally jumping onboard with what everyone else has already done, and thus is all over.
I know that it's not entirely correct, and maybe I just happen to know of a LOT of people who have had it done. But I still feel really late to the party. I'll share anyway because when do I not Hahaa, but also it's possible that there's someone out there who is struggling, is contemplating this path or is just interested.
I guess what I'm saying is my apologies to those readers who have gone before me. And for everyone else, please remember that I am in no way an expert, this is just my own experiences. I've had to educate myself very quickly about how this all works.
SO! My usual disclaimer is now done haha.
I really wanted to tell my story consecutively, so that it organically make sense. But...if it's taken me 9 weeks (EDIT: + 4 months!) to get around to my first real insight, then let's just let that idea go and get my stories out there, in whatever order!
Because of this there's going to be things that don't make sense until I get to explain them, such as the fact that 3 weeks into pre-op, I decided to change surgeons. I'll share why in another post, but to help me tell stories such as this one, for now I'll call them Original Surgeon and Actual Surgeon.
So I went into this with the idea that I wanted to have 'the sleeve' (Vertical Sleeve Gastrectomy (VSG)). Because I never thought WLS was for me, I was very uneducated about the entire process. I really knew very little, including the types of WLS's available.
My old boss had had lap band surgery many years ago, and I was vaguely aware that that wasn't really done anymore. I'd heard of the term 'mini bypass' but the method that I'd heard used the most was the sleeve. #GastricSleeve and #vsg were the only hashtags I ever noticed.
I knew what the sleeve was, and it sounded like it was the new 'go to' WLS option. The current gold standard. So, before I did any research, I was confident that that's what I would want. With some things in life, I just like to go with the majority. It's going to sound like this regardless of how I attempt to explain it I think, but it's really not at all like me being a sheep or a follower. But instead, for many things, I like to do the average thing: take the safest route.
Such as with WLS, if 80% (I made that figure up just now) of WLS patients have the sleeve, then I'm not going to be inclined in the slightest to want to do some other method that's less well known. I am very strong minded and research and educate myself fully about things so that I can make informed choices. But I'm also going to be very influenced by the figures. There's a reason most people do the sleeve!
Okay, I still totally sound like a sheep, I know. But I'm really not! 😂
Anyway, so that thought process was the first line of influence for me, and I started getting ready to do my own research.
Once I made the decision to do (some type of) surgery, I was full pelt into it. I don't ever do things by halves. lol, case in point:
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| Why have 1 baby when you can have 2? |
The very first time I saw my GP after I made the decision, we only had 2 minutes to chat, so it was a very rushed mention. She was so supportive and encouraging about it, and I said that I'd come back the following week after I'd done a bit of research, to talk properly about it and to get a referral.
As I was walking out of the door, I remember her saying that different WLS methods are good for different types of people, and that she wasn't too sure herself, but she thought that bypass surgery was the one that would probably suit me better?
I was so surprised, because as I said I'd already assumed I'd be 'normal' and be on track for the sleeve! She said again that she wasn't too across the different methods and maybe she was wrong and had it mixed up?
I briefly looked up what the bypass was, and I was like yeah, nah, just the usual sleeve still, thanks!
You can google yourself all of the different weight loss options, but if I had to explain this to someone unfamiliar sitting in front of me right now, this is how I would describe them (and how I did, each time I discussed the options with family and friends while I was deciding).😆
(Again, these are my (VERY non-medical, VERY non-technical) words! Just trying to get the idea across: please don't take my layman's terms as anything other than what they are.😂)
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Lap band: where they put a 'rubber' band around your stomach so you can't eat as much. Not often performed any more.
Sleeve: where they cut 80% of your stomach and remove it from the body. This causes restriction as to how much you can eat. Not reversible.
Mini gastric bypass: where they cut your stomach and make a little pouch (but leave the remaining stomach inside you), and reroute your intestines so that food 'bypasses' some of the digestive track. So that you have a smaller stomach but also less chance for calories (and nutrients!) to get absorbed. So this results in weight loss via restriction like the above, as well as malabsorption. Reversible.
Roux-En-Y gastric bypass: same as the mini bypass but there's more rerouting of your intestinal tract. (Two joins rather than the one that the 'mini' bypass has). Reversible.
SADI: a combination of the sleeve and bypass.
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There are other types and I think there's different names for some, but these were the ones I started learning about. I'd obviously crossed the lap band off my list, and I crossed the SADI off my list too. One surgeon told me something along the line of that the SADI used to be called something else, and it had poor outcomes or something bad happened, and they renamed it...yeah that was enough for me to cross that one right off my list! 🙅
Here's a diagram of the main ones I was looking at; sleeve vs one of the bypasses:
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| Sleeve vs bypass |
Anyway I started to do my research and everything supported my desire to choose the sleeve. I went back to my GP and got referrals to weight loss surgeons.
I had initial consultations with two different surgeons to compare (Original Surgeon and Actual Surgeon).
My first appointment ironically was with my current surgeon (Actual Surgeon). Still very new to this whole thing, I rattled off that I would be looking at the sleeve but would be guided by him as the expert. I asked what he would suggest for me, and he said, and I'll always remember this: "If I had to bet my own life on giving you the right surgery, I'd do a bypass on you today."
What?
Another professional saying bypass...
This surgeon is very renowned and an expert in his field. I'd first saw him on TV actually, on an expert panel. So while I remembered what he said, I still was stuck on the majority, and was hoping I could convince myself that this expert didn't know what was best for me.😂
The following week I went to meet the Original Surgeon for the first time. Similar conversation, but less strong wording on his behalf. I told him I was looking at the sleeve, and what would he suggest. He said it was up to me (as did the other surgeon), but if he had to suggest something, he'd suggest one of the bypasses.
Damn.
So, as I thrust myself forward into choosing a surgeon, starting preparation and then pre-op, and getting everything organised, I continued my quest to prove to myself that the sleeve was the better choice for me.
I'd chosen the second surgeon I'd met with ('Original Surgeon') as my surgeon to go with. I started meeting with his dietician and psychologist, and they too were both gently leaning toward a bypass within conversations.
I didn't have to decide until I signed the consent forms a couple of weeks out from surgery, so there was no imminent rush to choose. But it was still hanging over my head. I felt exactly like it was when I was trying to decide on birth options for my twins: attempt to deliver naturally, or choose a caesarean? Everyone (medical professionals) were recommending a caesarean, and deep down I knew that was what I should do, but I really wanted to attempt a natural delivery. (I ended up choosing the caesarean, which I think I already knew that I should*, but it took months of pondering for me to finally be able to make that decision).
*Should = do what was best for my babies and me.
(A C section ended up being the safest thing for us 3).
Anyway, that was pregnancy, this is weight loss surgery!
I first met with the surgeons in May. My surgery was planned for early August. Late July it was time for my consent paperwork to be signed. And I still couldn't make up my mind. I rang the surgeon's office and asked if I could meet with the surgeon one more time to discuss the different surgeries before signing on the dotted line.
(This will have been only the second appointment with him, its not like I'd been to see him 7 times and kept going over the same stuff).
They said they could make that 'consent appointment' actually a discussion appointment, and I could always come back the following week to sign the paperwork. I knew that I would, because there was no way that I would have wanted to go in and discuss alternate options and then sign immediately after!
However, ironically, that's actually what I ended up doing...
I went along and met with him. I asked him to be specific as to why he suggested a bypass for me. In a nutshell, the reason this was everyone's suggestion, was that a gastric bypass was proven to be better for long term weight loss, especially when you have a lot to lose, like I did.
I also remember my Actual Surgeon telling me that it was very common for patients to get the sleeve, but then end up coming back 1-2 years later and requesting a revision surgery from sleeve to bypass, because the sleeve was no longer working for them. He said let's not waste my time and an enormous amount of money twice over, and just get the right* surgery first up.
(*Right surgery for me).
So, back to the Original Surgeon 'consent appointment' that was now a 'discussion appointment'...
After he discussed the different surgery options, he then said that they had had some results come back for me. This surgeon had required me to do 101 tests prior to surgery 😳
One of those was a gastroscopy (endoscopy) (where they shove a camera down your throat and check the upper part of your digestive system).
I'd had all of the required tests and as far as I knew, had gotten all of the results back from each one, including the gastroscopy, and everything was fine and in order. (?)
He proceeded to tell me that they'd discovered that I had something called 'Barrett's Oesophagus'.
I had no idea what that was, and to be honest, still am not very confident in my education of it. In my own words to sum up the brief overview that he gave me in the room that day, Barrett's Oesophagus is damage to the oesophagus: Apparently the cells in our stomach wall are tough and 'hardened', so to withstand all of the stomach acids that we have. The cells of the wall of our oesophagus, however, are 'not tough'.
Over time though, if people have a lot of reflux (stomach acid coming up into the oesophagus), the cells in the oesophagus can change, and harden, to mimic the type of cells that are in the stomach. (To handle the acid).
And then over time, with the cell changes, they can change even more and become cancerous.
Whoah. I was just expecting to have a chat about which type of surgery was best to fix my weight problem. I was so blindsided from this diagnosis; I wasn't expecting to have any results given to me this day.
That's pretty much all he told me, and all I was able to ask was "so it's not cancer though, is it?" Because hearing the words 'cell changes' is pretty frigging scary. As is asking that question...
He said no, not currently, but I would need to have a gastroscopy every year to monitor it, and that this diagnosis would be another reason to support me having the bypass done.
Sold.
That was the defining moment that made me finally make a decision. I specifically remember saying to him "ok, well I'm not going to muck around with that, bypass it is then."
(Apparently bypasses are better for reflux because physically it's harder for the stomach acid to come back up due to the rerouting of your digestive tract; whereas with a sleeve it can come straight back up just like it used to).
I'm still surprised by this diagnosis, because as far as I knew, I've never really had a reflux 'problem'. I had really bad reflux during the second half of pregnancy, but surely that wouldn't be enough to cause this, having been from such a concentrated period of time? I've experienced reflux other times for sure, often when I've eaten a lot of high sugar foods. But not often! Maybe pregnancy tipped me over the edge from the little I already had?
Anyway, I dunno. I already have to have annual colonoscopies, so it'll be easy to add in the endoscopy and do both ends at once. I'll have a chat to my specialist and doctors one day and try and get a bit more understanding surrounding it.
Anyway, so I signed the consent form right then and there, and never looked back! (Never looked back at the surgery type I chose, I mean). I looked back many times and as mentioned ended up changing surgeons the week after this appointment! Which I will explain. But that's how I came to decide what surgery type was best for me.
I remember being told that it will also depend on the day when they open you up, as to whether they can even go ahead with your chosen type of surgery. I was told that even if I chose a bypass, I would be consenting to both a bypass and a sleeve. Because if for some reason anatomically they couldn't perform a bypass, they would change to a sleeve on the day, while you're opened up! I don't know in what circumstances this would happen, I imagine it could be an issue if they couldn't reach certain organs, especially if your liver was too big, which is the point of pre-op, to shrink your liver for surgery.
I remember my Actual Surgeon also mentioning at one point that unless he told me, I would have no idea of knowing what surgery he performed, once he'd closed me back up. (Btw it's keyhole surgery, so technically you're not actually 'opened up'.😅). But he was just saying this to hint at the point that when all is said and done, all weight loss surgeries basically work in a similar way, so not to get *overly* caught up in which is best. They're all weight loss surgeries and you still have to work at each and every one.
On the day of my surgery they were able to perform the bypass, so that's what I have had done!
A Roux-en-Y Gastric Bypass.😊
And because I posted my first 'before and after' photo on my Instagram just this morning; here it is here, too. My first one that I've shared in 9 years.💗
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