Sleep apnea...

[sleuth]

Until my gastric bypass surgery, I had it pretty bad, too. Wore the mask every night. Highly recommend looking into masks that you're comfortable with, because a few nights with the mask, I had a big ol' welt on my forehead. We told everyone it was JUST A COIINCIDENCE that the mark on my forehead was exactly the shape of my wife's wedding ring.

Three months after surgery, I stopped the CPAP - didn't need it. BEFORE surgery, I had like 120 incidents an hour. TWICE every minute, I stopped breathing. No wonder I was tired when I woke up.

Sam, how was your recovery from gastric bypass?

I'm still trying to control my weight with diet. I have some success but always seem to fall back into old habits. I've been watching a lot of Discovery Channel specials on the procedure and it's scary.

Still, for many who do it it's either die within a couple years from their weight problems or die from the surgery. At least with the surgery they seem to have a better chance.

 

[vraiblonde]

Sleuth, I don't think you're big enough to qualify for gastric bypass. Shoot, I'm surprised that Sam was - last time I saw him, he'd qualify as a "big guy" but not morbidly obese by any stretch.

 

[Larry Gude]

Why warn 'em?

Did you warn them beforehand that your version of PJ's is an SOMD Forum Junkie thong and fuzzy slippers?

...and kill half the fun?

 

[Larry Gude]

Dur ha he ha ha...

OMG! On this other site there's this really funny video for sale.

...dur ha...dur ha de ha....ha.


Ha.

 

[SamSpade]

Sleuth, I don't think you're big enough to qualify for gastric bypass. Shoot, I'm surprised that Sam was - last time I saw him, he'd qualify as a "big guy" but not morbidly obese by any stretch.

Generally speaking - insurance will not cover anyone who is less than 35 BMI.

From 35-40, most insurance companies require a health reason - documentation of "co-morbidities", of which sleep apnea is usually the clincher. Others are things like diabetes, high blood pressure, heart disease, etc.. There has to be compelling need to go through with it.

Above BMI 40, it's pretty much a done deal.

I was at *48*. 6'2" and 375.

Gastric bypass is not really "cosmetic" surgery, and I would never have done it for cosmetic reasons. With all that has been discussed on here about the travails of losing weight, you'll just have to trust me on the fact that being 375 pounds every day and night was *painful*. I could give you a laundry list of everything that was nauseating or painful - from heel spurs, intense headaches, painful digestion (after a NORMAL meal), acid reflux, elimination. It just goes on and on.

However -

I DO know of people who have had it done for cosmetic reasons, and there ARE doctors who will do it for this reason - but you'll be paying for it. To go this route, you'd be better off with the lap-band. It's an expensive out-patient procedure, but it's not invasive - an adjustable band constricts the entrance to the stomach.

MOST doctors won't do it at all without a compelling need - but some will.

The "failure rate" - the rate at which some patients die due to WLS - is around 1 in 300, nationally. My doctor has never lost a patient - but he is also far more demanding in what he requires prior to surgery. (For example, he requires a three-week liquid protein diet prior to surgery - if you don't complete it, he will cancel the surgery outright. In addition, some insurance companies require a six-month doctor-supervised diet, fully documented). Most of the deaths you read about - and I know of at least one whom I knew online - had *very* serious problems going IN to surgery - even more than your average WLS candidate.

In any event - to answer your first question -

I had it done about a year ago - and the first couple of days were the worst. Never really had HORRIBLE pain - just persistent pain - the kind if you don't move much, you can easily tolerate. If you've ever had your gall-bladder removed, it was a lot like that. (However, IMMEDIATELY after surgery, they had considerable difficulty removing a catheter from - you know. THAT was the worst. Anyone who tells you this surgery is for wimps has never had someone yanking a wire out of your penis).

Most of the ensuing weeks, I was just tired all the time. I had to use this spirometer to practice deep breathing every hour. I couldn't eat anything but broth for like three weeks. But - I was at the Redskins game the Sunday after my surgery. In about three weeks, with the exception of fatigue and the twice daily blood thinner shots in the belly - I was pretty much normal.

 

[sleuth]

Generally speaking - insurance will not cover anyone who is less than 35 BMI.

From 35-40, most insurance companies require a health reason - documentation of "co-morbidities", of which sleep apnea is usually the clincher. Others are things like diabetes, high blood pressure, heart disease, etc.. There has to be compelling need to go through with it.

Above BMI 40, it's pretty much a done deal.

I was at *48*. 6'2" and 375.

I'm 6'3", 320 lb. That puts me right at a BMI of 40.
I was 337 lb. at my peak.
I'm trying to get down to 260 lb. by my wedding day (in May).

I'm only 28 years old. So far, I don't have anything like diabetes, high blood pressure, or heart disease, but there is a history of heart disease in my family. I don't know if I have sleep apnea, but I snore.

My triglycerides are high, my cholesterol is borderline. I want to get my triglycerides and cholesterol down via diet and weight loss before I start taking medication for it.

I usually have no trouble losing weight *IF* I stick to a weight loss plan. The problem is that after a few weeks of dieting, I get bored with my food, and then binge, get depressed or pissed off at myself, and then fall off the plan, and then gain most of what I lost. Just last week I fell off the plan early in the week (Thanksgiving, my birthday, and travelling didn't help, but that's just an excuse, ya know?). I gained 4 pounds in a week. So now I have to lose that again.

I've probably lost a thousand pounds in my lifetime. Now if I'd just quit gaining it back.

I'm *hoping* that since I'm getting married to someone that likes to cook and experiment, that it will help 'cure' the problems of getting bored with dieting. Everyone says that married men are generally healthier than unmarried men. I don't know if that has anything to do with it, but certainly eating at home where I can control portions easier and also know what goes into the food can't hurt.

One thing I've considered is doing something like weight watchers for a month, atkins for a month, south beach for a month, etc. and trying to mix it up.

WLS would help me control my appetite. But quite frankly I don't know if I could handle all the problems with recovery and the special diets for the few weeks after. Not to mention I don't think I could get enough time off to do the recovery.

 

[sleuth]

Sleuth, I don't think you're big enough to qualify for gastric bypass. Shoot, I'm surprised that Sam was - last time I saw him, he'd qualify as a "big guy" but not morbidly obese by any stretch.

I wish you were right.
But by medical definitions, I'm a hurtin'.

 

[vraiblonde]

I was at *48*. 6'2" and 375.

See, I would have pegged you at maybe 240. But I haven't seen you in a long time, either (hint hint).

 

[SamSpade]

I'm 6'3", 320 lb. That puts me right at a BMI of 40.
I was 337 lb. at my peak.
I'm trying to get down to 260 lb. by my wedding day (in May).

I'm only 28 years old. So far, I don't have anything like diabetes, high blood pressure, or heart disease, but there is a history of heart disease in my family. I don't know if I have sleep apnea, but I snore.

Most overweight people have some sleep apnea - it's why it's so crucial to WLS approval. I used to think - what's the big deal? I never heard of someone dying of sleep apnea. That's because they DON'T - they die of a heart attack in their sleep - brought ON by sleep apnea.

Two things cinched the deal for me - because, quite frankly - I did NOT want to do this. My wife can vouch for this - I left the first doctor's office like a bat out of hell. No - friggin' - way.

The first was the agony at watching m cousin wail over his father's coffin just as they were lowering it into the ground. My Uncle Bill was only 55, greatly overweight. He'd lost both feet to diabetes and had been deteriorating for years. You can't imagine hearing a grown man the size of Arnold Scwarzenneger wail and scream over the father he loved so much and not be moved by it. I can never forget his crying "daddy! oh my daddy, oh my daddy!" and pounding on the lid as they pulled him back from the grave.

That would NEVER be me. I'm going to die, yes - but not if I can do something about it now. Geez, he was only ten years older than me.

The second - SEVERAL doctors - and myself confirming the data separately while assisting my wife on a paper on obesity in American - that over 95% of people who lose weight - and we're talking significant amounts, not the cosmetic 5-10 pounds - over 95% of THOSE WHO *SUCCEED* will gain all of it back.

So the odds were against me. Biochemically, I had a battle at least as difficult as bucking a drug habit but with one caveat - you don't NEED drugs. You *have* to eat, to live. No one I know could shake a drug habit IF they had to continue taking tiny amounts of it all the time. Statistically, I knew that EVEN IF I lost 100 pounds - there was a 95% chance I'd regain it all. I knew this from even my own experience - I'd lost it before.

So I had to ask myself two questions.

Was I willing to pay the consequences of weight loss surgery (such as - pretty much can't drink soda, can't drink alcohol - much - can't have carbs, candies, pasta, or for that matter, ANYTHING in all that great a quantity - have to take six or seven vitamins a day for life - B-12 injections, for life - and so on)?

And - am I really willing to endure another 10-20 years of misery just to prove to myself that I can lose the weight "conventionally"?

Or just do it now, and live my life without all the pain?

Getting married, for me, was part of the impetus to getting it started. Sounds like you'd be a good candidate. IM me if you want to talk about it.

 

[SamSpade]

See, I would have pegged you at maybe 240. But I haven't seen you in a long time, either (hint hint).

Ran into Christy at Nook and Monk's though - after the tree lighting thing.

What's funny is, I weigh about 240 *NOW*. She can tell you, I look a lot different.

Since I'm not likely to EVER go to Frederick - you're gonna have to give me lead time the next time you come down this way. Seems like I always find out after I have the whole weekend planned from Friday to Sunday night.

 

[kwillia]

I usually have no trouble losing weight *IF* I stick to a weight loss plan. The problem is that after a few weeks of dieting, I get bored with my food, and then binge, get depressed or pissed off at myself, and then fall off the plan, and then gain most of what I lost. Just last week I fell off the plan early in the week (Thanksgiving, my birthday, and travelling didn't help, but that's just an excuse, ya know?). I gained 4 pounds in a week. So now I have to lose that again.

GASTRIC BYPASS: NOT ALWAYS A PERMINANT SOLUTION

One major factor in weight gain following gastric bypass surgery is the status of the pouch. If the pouch does not remain anatomically intact, the stomach will take longer to fill up and thus appetite will increase. What causes the pouch to come apart? Often times, it is due to overeating on the part of the patient, or it could be the body is rejecting the staples and attempting to destroy them. It is also essential that an individual who has undergone such weight reduction surgery return to his or her doctor for important instructions on how properly live with and utilize the gastric pouch created by the surgery. Remember that certain food types will be off limits, and all food intake will have to be limited in order to maintain the pouch.

What is the best type of diet to maintain following gastric bypass surgery? Doctors recommend three meals per day of about 10-12 ounces in size, spaced about five hours apart. Protein and vegetable intake is essential, and some experts stress that the meat should be cut into tiny pieces and that the vegetables should be raw or only slightly cooked. Doctors advise against drinking any liquids for up to two hours following a meal, and then drinking a considerable amount of water starting roughly two hours before the next scheduled meal. This is called fluid loading, or rehydration, and is done to help prevent in-between meal snacking.

 

[sleuth]

Sam, did you look at other options besides gastric bypass?
Such as the surgery where they put a band around your stomach, or stomach stapling, etc.?

Or are all those the same thing? :goesofftolookitup:

 

[Katie]

Sam, glad you are doing well post surgery.

I could have had it done, but I didn't. I did the diet and exercise root. I am right now currently 30 lbs from my goal weight. Which is still chubby by most people's standards, but it is TONS less then I was. My starting BMI was: 45 now it is 29. Not bad....

Sleuth, I know you can lose weight, your problem is portion control, and gastric bypass will not fix that. It might fix it temporiarly, but unless you learn portion control, you can stretch your stomach back out again post-surgery. My SIL had it done, and guess what, she is gaining weight back because she didn't learn the portion control. The stop eating when you are satisfied, not full or stuffed, but when the hunger goes away.

 

[SamSpade]

Far be it from me to tout it as a cure all. To me, it's not like people who get Lasik and declare it's the greatest thing since sliced bread. But in the year since surgery - and the two prior - I've gotten to know about a hundred people who have had the surgery, including four co-workers, two neighbors, a former girlfriend and two relatives.

That article seems to have made a couple presumptions.

One is what it states - do NOT have this surgery for vanity's sake. Do consider it if you think it is medically necessary. For all of the dangers they mention on these articles - SEVERAL of those I know would absolutely have died without it. One friend is a retired schoolteacher my wife and I know and love. No doubt - without the surgery - she WOULD HAVE died. Had she died due to WLS complications, no doubt *someone* would have made the point that the surgery was too dangerous.

Bull. Nationally, the figure is about 1 in 300. Or about 0.3%.

Obesity *untreated* - will kill you for certain. Oh you'll live - not entirely happily - for a few years. And then you'll die.

The other is that, that article presumes a specific procedure. It SOUNDS a lot like Vertical Banded Gastroplasty, which is almost never done anymore. In VBG, they do actually staple part of the stomach down without removing it. There's more risk in this procedure, and it's not as effective.

There are at least a half dozen common Gastric Bypass procedures that are used, none of which would be described by this article.

The MOST common is the Roux-En-Y (or RNY), which is the one I had done. In that, the "pouch" (the name they give to the new, smaller stomach) is made entirely of the tough tissue of the top part of the stomach. Many studies have shown that, despite what is said in the press - it doesn't "stretch" - much. If it were easy to stretch, people would eat themselves to death. When it IS stretched, the brain receives signals of satiety. You're full. And without a pyloric valve to ease the flow of food into the intestines - if you overeat, you will be in a LOT of pain. I know this from experience.

And there are others - the Micro-RNY - the the LapBand - the Duodenal Switch. And there are good reasons to consider any one of them. One of the reasons I chose the RNY is, people have been doing them for 35 years. There's a huge amount of data on it.

I don't get the part of the article bemoaning staple rejection. Staples are used in LOTS of procedures that have nothing to do with WLS. There are staples in my body from my gall bladder surgery eight years ago.

 

[vraiblonde]

My SIL had it done, and guess what, she is gaining weight back because she didn't learn the portion control.

My aunt had it done a year and a half ago and my Mom says she's gaining all her weight back, too.

 

[Katie]

The MOST common is the Roux-En-Y (or RNY), which is the one I had done. In that, the "pouch" (the name they give to the new, smaller stomach) is made entirely of the tough tissue of the top part of the stomach. Many studies have shown that, despite what is said in the press - it doesn't "stretch" - much. If it were easy to stretch, people would eat themselves to death. When it IS stretched, the brain receives signals of satiety. You're full. And without a pyloric valve to ease the flow of food into the intestines - if you overeat, you will be in a LOT of pain. I know this from experience.

Not everyone will listern to that *I'm Full" signal from the brain. It is possible to gain weight back also, I have seen it happen to more then one person.

That is unless you learn portion control, and listerning to your body. When your body says "I am full" stop eating. Sounds easy, but there are people that never hear that signal, and will contine to eat.

 

[Pete]

Not everyone will listern to that *I'm Full" signal from the brain. It is possible to gain weight back also, I have seen it happen to more then one person.

That is unless you learn portion control, and listerning to your body. When your body says "I am full" stop eating. Sounds easy, but there are people that never hear that signal, and will contine to eat.

Thats me. I eat to much because I like eating.

 

[SamSpade]

Sam, did you look at other options besides gastric bypass?
Such as the surgery where they put a band around your stomach, or stomach stapling, etc.?

Or are all those the same thing? :goesofftolookitup:

I went to one doctor who showed me the lap band (the stricture around the top of the stomach). However - he wasn't totally honest about the costs. BC/BS will NOT cover it - and he told me they would (there is no way he did not know this). My cardiologist, who originally recommended this surgeon, changed his mind about him. So I went hunting for the *best* doctor I could find. At this point, I didn't give a crap how close the drive was.

Originally, I wanted the lap band - and a lot of people I know, do want this. It has the allure of being non-invasive - and totally reversible. You lose the weight, and they either completely drain the band or remove it.

It relies completely on one of the two major "legs" of WLS - restriction.

Same thing with "stomach stapling" (honestly? an outdated procedure which is slowly becoming obsolete). It's purely restrictive. You can easily break this procedure by eating too much, over time.

The Duodenal Switch is almost entirely malabsorptive - your body simply doesn't absorb the food. Since there are sometimes unpleasant side effects - REALLY FOUL BM's for example - it used to be done only for people who were really super obese. But it's gaining popularity as the procedure is improved.

The RNY is BOTH retrictive and malabsorptive. You "gain" the side effect of "dumping syndrome". Despite its name, it has nothing to do with "taking a dump". It refers to the rush of fluids into your intestines should you consume too many carbs - pasta, rice, bread, candy, cakes etc. It's painful. Not OH MY GOD painful, but bad enough that you won't try it too often. Eat a Halloween size candy bar, you'll just feel a little nausea. Eat two large ones, or a milkshake, and you might wish you had died instead. I don't get it as bad as some people - but it's unpleasant. It's also harder to throw up, since you hardly have a stomach anymore - but your body will WANT to throw up.

The consequence of the RNY is - you will be full sooner - and no matter how I try, I'm always leaving food on my plate - and if you eat too much of the wrong thing, your body will reward you with pain. (You'll also learn to CHEW YOUR FOOD more - because if you don't, you will hurt a lot).

It also means - a one way trip. I guess I wanted to be sure it wasn't coming back.

 

[SamSpade]

My aunt had it done a year and a half ago and my Mom says she's gaining all her weight back, too.

I guess, since not a single person I know is doing that - especially in such a very short time - I have to wonder what procedure she chose. (I suspect, LapBand or VBG, as these have no malabsorptive component). It's pretty hard to gain ALL of it back with the RNY. You'd have to do nothing but eat most of the time.

 

[Katie]

You'd have to do nothing but eat most of the time.

AND that is what some people do. I could gain the weight back in a heartbeat, all I would need to do is start eating the cr@p again.