I haven’t had time to upkeep my sharing lately but finally, here’s a summarised WLS update! (That was meant to be a 'brief' Instagram post update but my understanding of 'brief' is somewhat skewed and I thought it would be best fit into a blog post). So there you go; my first blog post in a little while, too. 😉
So I had the RNY Gastric Bypass in September 2022. I lost 70kg by May 2023. And it was about that time that my restriction (surgically restricted exit from my smaller stomach) relaxed…a lot. Meaning it wasn’t as physically tight as when the surgery was first done. Soon after having WLS, my surgeon warned me that this is normal and is likely to happen 6-12 months post surgery. The nerves at the exit point heal, and over time, relax, and therefore become flexible, allowing stretching, 
-80kg
which allows more food to get through. He emphasised that when this happens it wouldn’t be my fault or his fault, it’s just how our bodies naturally adjust.
To be honest I didn’t realise or understand this properly, and when I finally did, it was a bit of a hard pill to swallow (still is). I thought (unless I got it reversed), that this was permanent! Yes, I knew you could overeat and stretch it that way, but for the nerves to naturally relax over time??
So from May-August 2023 my scale weight plateaued. I believe the ‘bypass’ component of the gastric bypass is what saved me from putting on weight, as I found myself naturally being able to eat more and more quantities. And because I could, I did.
In August I started on Ozempic. After a month I started feeling it working, and I lost about 10kg from September-December. I've hovered around the same couple of kg’s since. I've been within 1kg of losing 80kg for a few months; I just hadn't quite reached it yet: Until this morning when I did my usual Monday weigh in and I've finally lost 80kg! (Which is pure coincidence that I hit it the same day as posting this update!)
The restriction however kept loosening and it’s gotten to the point I sometimes feel I have no restriction left. It depends on what food I’m eating, so I clearly have some restriction. But for the most part, the quantity I can consume is hard to accept, knowing how much I paid for this surgery and more importantly, why I want and need it to continue working!
Just to reiterate, this has been a natural relaxation of the nerves - not me overeating to stretch! #PleaseSaveAnyJudgementalComments
The bypass component of my surgery hasn’t changed - food exits my smaller stomach and
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| My surgeon's sketch |
travels along the rerouted route of my intestines that my surgeon created. So food that I eat ‘bypasses’ a lot of my intestines; so that I have less opportunity to absorb as many calories as I would otherwise.
So the gastric bypass sort of has two components -
1) the smaller stomach and exit point to reduce what you can intake - and then
2) the bypassing / rerouting of where it goes once it exits the stomach).
The intestinal rerouting is absolutely what has saved me from putting on any weight since I’ve been able to fit in more and my eating choices have become poorer. I’ve basically ‘hovered’ since the 70kg in May 2023, and then ‘hovered again’ since the 10kg from the Ozempic. (Until today 😅) Usually plateaus and maintained weight would be awesome! But not quite yet for me, who still has a LOT of weight to still get rid of.
Concurrently though, mid 2023 I started actioning something that could help. There’s something called an ‘APC’ - which stands for Argon Plasma Coagulation. I’ve included a screenshot of what it’s about, and if you’re interested in the correct medical terminology, definitely Google it.
When you burn skin, it ‘shrivels’, and the scar tissue that is created from that is something that can give you more restriction back; to a similar point to when I first had the big surgery.
It’s basically reducing the relaxed / stretchy opening between the stomach and the small intestine, and ‘tightening’ it up.
In June 2023 I met with the surgeon who performs APC’s, and via an endoscopy, he measured my exit point, to see where we were at. He told me that when the initial surgery is done, the exit point is approx. 8-10mm in diameter.
In June, mine was 12-13mm. You wouldn’t think that a few extra millimetres would make much difference, but, look at my dinner plate one night: it does.😳
He agreed I’d be a candidate for an APC, and put me on the books to have a consult with him to discuss. (Although referred from and partially managed through my initial WLS private surgeon, the APC process has been through the public system here in Queensland, Australia).
I had the appointment in November 2023, he was thorough in his explanation, I agreed and signed the consent form to have it done. I was marked as a ‘Category 2’, and they said it would be about a 3 month wait to get a spot. I was craving it get it done so much! My Ozempic wasn’t working as effectively (it still worked and I would still take it, but this seemed like a better way for me to go, (especially with the current shortage).
Anyway, a few days ago, I got it done! It went really well, but we won’t know for a few weeks yet whether it’s been successful. There’s no way of pre-telling how each body will react. While they aim to ‘tighten’ it back down to 8-10mm; some people restrict too much, to the point they can only intake fluids, and would therefore need a dilation.
Likewise some people might not have much of a change in restriction at all, and therefore would need a further APC (or multiple). My surgeon told me that APC’s can be done almost as often as you need, and that many people have them done ongoing, following WLS. I found it interesting when he said that he sees the way of the future of WLS patients maintaining their surgery being managed by a combination of APC's and Ozempic (or something similar).
I haven't had any side effects or issues (within the last few days anyway), other than a tiny bit of reflux on the day of the procedure.
The thing that sux the most (right now) is that following an APC you need to go back and do the same post-op diet that immediately follows the initial big WLS. Which is 6 weeks of slowly reintroducing food textures into your stomach, so that the exit point has a chance to heal properly. You have to be on clear fluids only while in hospital. And then the diet is predominantly:
- 2 weeks of fluids only
- 2 weeks of puréed foods
- 2 weeks of soft foods
While I get it and accept it and know that I’ve managed it before; right now, a few days into the fluid only diet, it frigging SUX. Especially as I don’t feel any new possible restriction just yet. (That should 🤞 come when I start on soft foods). I can have soups, smoothies and yoghurt, and those things are keeping me somewhat sane. But for the most part I’m hangry and grumpy and I hate it. 😭😭
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| Grateful for snow cones at the school picnic |
Anyway, I’m hoping this will be a successful venture, and that it will kickstart me into the next phase of this huge journey. (Surely the stupid post-op diet should skim off a few kg’s in itself, seeing as I’m not eating anythingggg right now). 😩
So just a reminder that when you tune into any stories I manage to post over the next few weeks, that they’re coming from a place of hanger and headaches and that I’m not happy about it!! (I know that it’s worth it…just not right now while I drink a protein shake as I prepare, handle, smell and cook food for my kids).
Well done to you
ReplyDeleteDid you have to do a pre diet at all leading up to the procedure.