More and More Details

Tonight was my first meeting in awhile regarding the WLS. It was a group intro session… they had a staff person from Unity talk… and she is 7 years post-op herself. BTW, I realize these posts are getting long and maybe boring… but what do you want me to do? I’ll try to start finding some sort of inspirational or maybe at least humorous images to go along with these posts in the future.

I got there just in time for the meeting. I don’t think all the people there were possible patients… folks are encouraged to bring a support person with them. There were maybe 9-10 guys out of the over 50 there… including myself. The presenter mentioned knowing what it was like to be “here”, to be sitting in this room, all nervous. I’m not though.

I think I’ve learned a lot about this whole deal, but I started getting more details I haven’t found elsewhere… gonna run through them here… now, if you are reading this cause you are looking in to this, one thing I should mention that I discovered tonight - different hospitals will do things slightly different. What I list here may not be how the hospital you check out does certain things.

At the beginning, after by-pass surgery, the “pouch” or your “new stomach” holds bout 1/2oz. It will stretch a bit, slowly, until after a year or so you’ll be eating about 3/4-1 cup of food per meal.

A difference here than with the lap-band, with lap-band you start out fairly normal after surgery recovery and work your way down to smaller and smaller meals as they tighten, or fill the band.

After the surgery, you’ll be downing nothing but clear liquids for a period of one to three weeks, then you start on puree’d foods, and by about week five you should be back to eating “real food”. Just a heck of a lot less. But even then, avoid bread, rice, and pasta for the first few months until you can see how your body will handle them. Soft breads especially, as they are hard to chew. Oh, and ground meats too. After WLS you need to chew and chew and chew your food until it’s the consistency of apple sauce. You need to do this beause the opening from your esapaugus to your new stomach is only about the size of a drinking straw… if you don’t chew… well… ever had a bannana shake and had a chunk of bannana clog the straw? You don’t want that to happen.

And the big thing - no drinking while eating, or bout 30 min after. WLS as a tool works because it’s about getting your body to feel full, and stay full. If you drink, you’ll empty out your stomach too fast, get hungry again, and eat more. Think of it this way… pour some actual apple sauce into a funnel and let it drip through. It should sorta dribble through. Now add a couple tablespoons of water to that sauce… it runs through a lot faster, right?

And of course besides sticking to the 3-meal-a-day deal, getting 30min of exercise a day is huge. Even right away… even if you have to break it up in to five or ten minute blocks. Beside burning calories it can help with your skin and energy levels and other stuff.

Things aren’t gonna be all sunshine and roses even after you lose the weight, there are some general changes that it seems just about everyone goes through…. like they become much more cold-sensitive. Now as a guy that sweats when it gets above 35, right now that don’t sound too bad. But I suppose, like I joke about when I play paintball in 40 degree weather in a t-shirt, I am well insulated. Who knows how I’ll feel once I lose that insulation.

Course there’s the risk of loose skin. Keeping hydrated, making sure you get enough protien, not smoking and exercising can all help minimize the problem as you lose weight, but the risk is there. Sure, if you can afford it, cosmetic surgery will take care of that. But even if you can’t… what’s worse? a bit of loose skin, or an extra 150pounds?

The hair loss thing I’ve mentioned before - no biggie for me. The presenter and a couple other women that have had lap-band all said they lost hair, but also most of it did come back. Heck maybe I’ll get lucky and end up with more than I’m starting out with now?

Then there’s “dumping”. I’d heard it talked about a lot… but never in much detail. Basially, it is mostly for those who go through by-pass. Since you are by-passing the bulk of your stomach, certain foods that are normally broken down there end up right in the intestines… and when it comes to sugary or greasy foods… that’s not usually a good thing. With a lot of people, ya eat too much and it’s gonna cause all sorts of issues… usually not serious, but likely rather uncomfortable or maybe a bit embarassing if you’re in public. They suggest being at home when you try reintroducing such foods back in to your diet.

Also, there is “psychological maladjustments”. This covers a rather broad area, that I’m not sure I can touch on just yet. But they did go into common emotional changes. You may end up asking yourself “did I make the right decision?”, or mourning loss of food in general. Relationships can, and likely will change… but on the plus side you may also end up more outgoing, getting more socially involved.

Now when you compare bypass to lap-band (I’m leaning toward bypass at this point), the advantages it has are a more rapid weight loss and the total weight loss tends to be higher. And like lap-band, there is a minimally invasive option available. Lap-band work by restricting the amount of food you can eat, but after that everything that happens to the food is like normal. Bypass on the other hand is a “mal-absorptive” procedure. Basically means since you’re skipping over the bulk of the stomach, you skip absorbing some some of the “bad” stuff like fat and sugar.

And there are other things that pretty much become a non-factor after surgery. I can elimate acid reflux, type 2 diabeties, and in some cases high blood pressure almost immediately. Others are gonna be helped by the fact your losing weight, light the blood pressure, cholesterol, sleep apnea. And if they’re not eliminated, they can be severely reduced. I’ve got three of those issue and at risk for the other two… so… this just about seems like a no-brainer for me.

Oh, along with the skipping of sugars and such, you also end up skipping the absorption of some of the good stuff, so you need to take supplements the REST OF YOUR LIFE. I emphasized that because this is … forever. Lap-band, worst case, can be removed. Bypass, you can’t undo. So from then on, yer doing vitamins, calcium and b12… at the least.

And other than the supplements, you’ll need to watch over what other meds you take. Make sure they’re not too bid… or that they can at least be dissolved in water, or crushed or chewed, or maybe they come in a liquid form.

Generally, pre-op, you are going to need to lose about 10% of excess weight. Probably looking at 15+ pounds in my case. I’ve read on other sites that this is mostly done right before surgery when they put you on a liquid diet for 2-3 weeks. Unity doesn’t do that. You still need to lose the weight though, it help clean up the liver and make it easier for the surgeon to get in there and do what they need to do.

Speaking of which, the operation will likely take anywhere from 45min to four hours. Most insurance companies require an overnight stay, and they get you up and walking around hours afterwards. Never too early to start exercising. They said here you wake up with an IV, but no other tubes. And depending the the kind of work you do, you’ll likely be out for one to six weeks… mostly depends on if you need to be able to do any lifting and such that might effect your incisions.

Speaking of incisions… this is surgery. Pretty major surgery at that. There can be complications… from bleeding, infections, blood clots to leakage. They said if that happens, you will get sick very quickly and to notify the surgeon ASAP. At Unity, you end up with the pager number of your surgeon, and they (or someone working for them I figure?) is available to you 24/7/365. Period.

Now worst case, yea… you can die from this surgery… or bout any other. National average is 1 in 200. Unity though, their average is about 1 in 3000. That’s kinda nice to know. After the bypass surgery, there are a number of follow ups. 1 week, 5week, 3month, 6month, 12month, and every year after that. But Unity balances it out and seems to offer a number of free services as well, such as support groups and fitness/diet consultation and such.

I’ve already taken the next few steps… I have my nurce clinician appointment next week as well as my psyc evaluation. Week after that I meet with a dietician. I’ve been checking with my insurance company and think I’m pretty well covered there. Which I hope so, because if I were to have to pay.. I’d be looking at $15-20,000.

So that’s where I’m at right now. By the way… PLEASE realize that none of the above is actual medical advice. I don’t guarantee any of it to be accurate. This is what I took away from the meetings… don’t be stupid and take my word for it. If you have questions, talk to YOUR doctor. K? K.

Oh, and if you want to see a lap-band surgery, the surgeon at Unity did one a couple weeks back and they broadcast it live. You can still catch it at or-live.com