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Friday, July 26, 2013

Back To Square One ~No Sleeve For Me

I thought I was so sure.... I made all my plans for the surgery, my daughter is coming to help me for a week and then POW!  It all started Wednesday when I attended a four hour mandatory class prior to the Gastric Sleeve procedure that was scheduled for August 5th. The nurse went into detail on the surgery , aftercare and the possible complications. Of course any surgery carries the possibility of complications that can lead to serious illness or death. We all know that. I managed pretty well for the first hour or so. The chatter was light and I was in a room full of all women, mostly middle aged,excited about starting a new chapter in their life. I was the only one who had already had a previous bariatric procedure so I wasn't quite as giddy as they were. I knew all too well the reality of vomiting and terrible nutrition absorption following my lap-band in 2004. I am very versed in the fact that a quick fix carries dire consequences sometimes. I have had a failed piece of silcon/plastic in my stomach since January 2012. I have lived with pain, nausea,vomiting, severe acid reflux and the re-gaining of approx 40 pounds that I had finally shed.  Soon the discussion of the surgery procedure was explained. The surgeon would cut away approx. 70-80% of your stomach, leaving you a small banana shaped new stomach. Your new and permanent stomach will hold less than what your mouth will hold...that is why you must chew your food till it is mush and not over eat.
  The liver must be lifted out of the way for the surgery, so you will be on a liquid diet for up to two weeks before the surgery to reduce liver fat. I was still doing o.k. until the dietician took center stage to tell us how and what we should eat following the surgery and then after six months when you go to a "regular" diet. The thought of the reduced food volume didn't bother me at all, but when we discussed dehydration is when my antennae went up. She kept stressing  how important it was to keep your water intake high. This is not news to me since I battle dehydration everyday of my life as a sufferer of HPOTS. I am always in a level of mild dehydration even after drinking 60-70 oz's  a day.  And then she said the words that changed everything "the first few days after surgery, you can only drink 1oz of water every 15 minutes and you will break that into two small sips about 7 minutes apart, anymore and you will vomit". Oh Snap... that will not work for me. When I wake each morning I have a bottle of water ready to drink before I even get out of bed. One thing us Potsy folks know is that when you are feeling like you are about to drop over or faint, you have to guzzle water ASAP, lots of water,with a side of salt.   The extremely small sips is the first few days, but then she added " you will never guzzle big swallows of water again or you will be sick".  I knew at that moment I had a big problem that would probably keep me from having this procedure.
I went on to get my labs drawn and tried to keep a positive spin on the procedure. The other ladies were all very excited and I knew that first of all, none of them would have a clue what Postural Orthostatic Tachycardia was and I didn't have the energy or desire to try to explain it once again. I know that this surgery has been very successful for many people and I don't want to discourage anyone from considering it, but it is a huge life commitment. It is not reversible and if you continue to overeat you will stretch the small stomach to a larger one and you are right back to square one. You have to take Prilosec everyday of your life and if you smoke (i don't ) you run a risk of getting ulcers that will never heal. I really appreciated the honesty of the staff for telling us the bad along with the good. Another big "oh hell no" was when the nurse said some women who have stopped having periods will start them again after this procedure. She said women of child bearing years must use two forms of birth control for a year after the surgery. Not that that is an issue with me, since I am a born again Virgin. I was so bummed and confused on the long drive home. I cannot do anything to put myself in a state of dehydration.  On Thursday, I emailed the doctor at Vanderbilt to see if he had an opinion or any guidelines on the subject. Within an hour he had answered me and said he had little experience with POTS and gastric surgeries.Apparently most people who have POTS are not overweight.
He did say that anything that restricted my intake of water was not good, and that if it was a serious complication for me, they would have to put in a port and administer IV fluids to keep my body at a level to keep me from having runs of Tachycardia. Obviously, this is a no brainer. I have about 40 pounds to lose, I  will not take such a risk for minimal weight loss. I might feel different if I had 100+ pounds to shed. But I doubt it. One other thing that bothered me was that most of  the women in the class were much smaller than I expected. I would estimate that all but two were only 20-40 pounds over their goal weight. I just expected to see much heavier people. I started to wonder if this is yet another fad. But, to each his own and we all know our own bodies and I know I can't take the chance of being unable to guzzle my H20. I called the office and cancelled the revision today.I will just have the lap-band removed and come home the same day if all goes well.
I am both disappointed and relieved. I have been on the pre-op diet for a couple days and really feel good getting the high protein diet. I have not had any sugar or sweets of any type since last weekend and I sure can feel the difference in my energy level and in the clarity of my thoughts. Even if I had went through with the sleeve, I could still eat sugar filled ice cream,cookies, candies, demon is sweets and I know the answer is a change in my overall eating habits. I am going to have to break up once and for all with my evil lover. It is an abusive relationship, but yet I stay.  My brain knows how bad I feel after the sugar high fades, but this is an addiction like any other.  I hope to continue this pre-op diet even after Gary is removed. I was talking to my sister and If I could incorporate the low cal/high protein diet into my eating habits I think it would be helpful. Maybe two days a week and then the remaining days eat a healthy diet sans sugar/junk food.
I know I have made the right decision for me to cancel because of the possible POTS complications. Hopefully, If I can stay away from the sweets and try to find another way to self sooth I can someday feel better.
Life is all about our daily choices and what makes each of  us happy...well, I should say content or resigned to life  in my case.
 Happy was one of Snow Whites Dwarfs.....