Weight loss surgery is not an easy way out and it requires a lifelong commitment to eating right,exercising, and taking multiple types of vitamins daily since you can't absorb enough vitamins from food anymore. It still takes hard work to lose the weight and keep it off once you have the surgery.

I have put a lot of thought into having weight loss surgery. I have researched all of my options in depth and have made the choice I feel is the best for me. I am not having this surgery for my dad. I am doing this for me. I want to be able to get this weight off and keep it off because I want to get healthy and I can't do that at this weight. No matter how many times I explain it to him he doesn't seem to understand that the surgery is a tool to help me lose the weight and get healthy. I don't want to die young like my mom did. Most of her health problems were due to her weight.Most of my health problems are due to my weight. All of my doctors have told me that if I lose the weight that the weight related health problems will improve or totally go away and that I will also be able to get off about half or more of the medications that I take on a daily basis. I have had 2 doctors tell me that I need the surgery(the liver specialist and the surgeon) and all of the doctors I see(primary, pain management, neurologist, allergy, and liver doctors) have all told me that I need to lose weight and my health will improve. I discussed it with both the liver doctor and the surgeon and they both agree that the sleeve is the right choice for me. My liver doctor told me that if I don't lose weight that I could easily be dead by the time I am 35 because of all of my health problems.

Almost all of the information that I will discuss below is easily found online although some of it is specific from my surgeon.

A gastric bypass surgery is where part of the stomach is stapled off but it is left in place. The intestines are rerouted and attached to the new stapled off portion of the stomach. It comes  with a high risk of dumping. THIS IS NOT THE SURGERY I AM HAVING.

The lap band surgery involves palcing a band around part of the stomach so that food intake is restricted allowing you to feel full sooner with less food. The weight loss is slower when compared to the gastric bypass and the Vertical Sleeve Gastrectomy. Less weight is usually lost as well. This surgery is not an option for me because after careful research I decided I didn't want to deal with the potential complications. When I first saw the bariatric surgeon he stated that he no longer performs this surgery because the complication rate is too high and most people end up having them removed due to the complications or because of not losing enough weight.

The surgery I will be having is called a Vertical Sleeve Gastrectomy (VSG). It is also called a gastric sleeve. It is a weight loss surgery where they totally remove approximately 75% to 85% of your stomach and create a new banana shaped sleeve out of your remaining stomach. The amount of the stomach that is removed depends on the individual surgeon. Mine said he removes about 85% of it. The intestines are not rerouted like they are in the gastric bypass and the risk of dumping is very low. The part of the stomach they remove is responsible for producing a hormone called Gherelin. It is a hormone that stimulates hunger. Since this hormone is no longer produced in the usual quantities there is a reduction in appetite after the surgery. The feelings of hunger do return later but they are not as intense as before the surgery. I eat when I get bored,stressed or depressed. Some days I eat constantly because it seems like I can never get full. I need the level of restriction that a gastric sleeve provides to keep me from eating too much. I need to be able to feel full without feeling deprived. A smaller stomach means that you get full on less food. In general the surgery requires a 2 to 3 day hospital stay, however some surgeons do this as an outpatient surgery. My surgeon does this as an inpatient surgery so I will have a hospital stay. According to my surgeon, the sleeve is safer than a gastric bypass and has lower complication rates with a similar rate of weight loss.

Currently I am 5'1” and 235 pounds. I have always been heavy even as a child. The surgeon has set a goal weight for me of 105 pounds post-surgery. However, my personal goal is 125, so if I can achieve that I will be very happy. If I attain my personal goal weight I will still have a normal BMI of This surgeon's goal weight requires me to lose a total of 130 pounds which he said is doable after surgery. He said most people have a weight loss of at least 100 pounds after surgery. The weight comes off quickly after surgery and you will lose most of it within the first 18 months after surgery. You have to eat right and exercise as well or it is pointless to have the surgery.

Starting out after surgery you can consume 1-2 ounces of food at a time and over time you can generally consume 3-4 ounces of food at a time. 3 small meals and 3 snacks spaced evenly out the day are necessary. It is very important to get lots of protein after the surgery because protein will help you to feel full longer and will also help you to lose weight. The goal is to aim for 75-100 grams of protein per a day. This will have to include protein shakes and protein powders as it will be hard to get all of the necessary protein from food especially in the beginning stages. A lack of protein after surgery can cause you to not lose weight, cause low energy, and cause your hair to fall out. A minimum of 64 ounces of fluid is required each day. For 10 days prior to surgery, I will have to be on clear liquids and protein shakes only. This is done to help shrink the liver before surgery because the liver can be in the way of the surgery if it is too large. The pre-op diet varies by the surgeon. I will start on a clear liquid diet for 48 hours post-op. Then I will be moved to full liquids for 2 weeks. If tolerating full liquids well at the end of the 2 weeks I will be able to progress to pureed food for 3 weeks and then from 5 weeks to 6 months post-op I will be able to progress to mechanicallychopped foods. I won't be able to eat high fat foods, sweets or foods with a high calorie content. I am not allowed anything carbonated. I am also not allowed caffeine (for 6 weeks pre-op and 6 months post-op). Once I am totally healed, I will be able to eat normal food again but in much smaller quantities. I will eventually have a daily caloric intake of 800-1200 calories per a day and will have to make sure I get enough protein daily for the rest of my life by supplementing with protein shakes and powders. You are also not allowed to drink liquids with meals and are required to stop eating and drinking for 30 minutes to an hour before and after eating in order to avoid washing food out of the new stomach pouch.

Medications must be in liquid or chewable form or be crushed after surgery until given clearance by the surgeon to take whole pills. In addition to my normal medications, I will be required to take 4 chewable Bariatric Fusion multivitamins per a day (2 in a.m., 2 in p.m.)  and 4 chewable Celebrate Calcium Plus tablets 2 times a day(2 in a.m. 2 in p.m.).  Bariatric patients must take Calcium Citrate instead of Calcium Carbonate. Calcium Citrate is easier to digest and absorb for bariatric patients. The Calcium can not be taken at the same time as the multivitamin if the multivitamin contains iron. If it contain iron then they must be taken 2 to 3 hours apart from each other because the iron will cause the calcium not to be absorbed properly. I will also need to take 10,000 units of Biotin a day (to hep prevent hair loss) and any other vitamins that the doctor deems necessary based on blood work which will have to be repeated at 6 weeks intervals for the first year and then every 3-6 months to check for vitamin deficiencies . For the first year after surgery, I will have to see the surgeon and dietitian every 6 weeks and then on a yearly basis after that for life. I am not allowed to take NSAIDs (Ibuprofen, Aleve, Excedrin. Aspirin, etc.) for 6 weeks prior to surgery or 6 weeks post surgery because they increase the risk for bleeding which means I will have to stop my arthritis medications during this time which means my pain levels will increase. Some surgeons will not allow any sleeve patients to ever take NSAIDs again. However, mine allows them if they are absolutely necessary as long as they are taken with a medication like Nexium.

My surgeon equires a psychological evaluation with a psychiatrist (as do most health insurances). I have  already completed and passed this. He also requires an Upper GI barium swallow test and a complete abdominal ultrasound. The barium swallow and abdominal ultrasound are done to determine if there are any abnormalities and also to check for a hiatal hernia and to check for gallstones. These two tests are already scheduled for February for me. The surgeon has stated that if a hiatal hernia is detected during the testing that he will repair it during surgery and that if gallstones are detected that the gallbladder will be removed during the surgery.

So after reading all of this about what the process will be like before and after surgery for me, why would I willingly subject myself to something like this unless it is absolutely necessary? My health is important and matters to me. I want to be healthy. I want to live a long full healthy life. I don't want to die young. As far as weight related health issues goes I have hypertension, hyperlipidemia, obstructive sleep apnea, Gastroesophageal Reflux Disease(GERD), and NASH. . I take 2 different blood pressure medications. One of them is twice a day and the other one is once a day. I have taken multiple medications for my high cholesterol and we have not been able to get the numbers down to acceptable levels. There is a very high risk of heart attacks and strokes in my family on both sides too. Both parents have had heart attacks. My dad has also had a stroke. I have multiple aunts and uncles that have had heart attacks and/or strokes as well.  Having Obstructive Sleep Apnea increases the risk of heart attacks and strokes. All of the extra weight I have contributes to the pain I have from my Degenerative Disc Disease (osteoarthritis in the spine). I have this in my lumbar and cervical spine. Less weight =less stress and pressure on the joints. I also have depression and anxiety issues, asthma, allergies, hypothyroidism, migraine headaches and insomnia.  I don't want to have to take tons of prescription medications the rest of my life. I would rather take daily vitamins than all kinds of other medications for conditions that I can get rid of by losing weight. My doctor has told me that if I lose enough weight that most of my health related issues will resolve and I will be able to stop taking  between 1/2 to 3/4 of my current medication. I take on average about 20 medications a day currently. This includes all of the supplements and prescription medications I take.

In writing this I hope you have a better understanding of why I have chosen to have this surgery and why I am willing to make the necessary lifestyle changes that I will need to make.