Gastric By-Pass (Stomach Stapling): a Personal Experience.

March 17th, 2004 St. Patrick’s Day, was my lucky day – though I’m nowhere near Irish. On that day I checked into the Minimally Invasive Surgery Unit of Cedars-Sinai Hospital in Los Angeles for a "Rouen-Y Gastric By-Pass" – commonly known as "stomach stapling." I was a morbidly obese (more than 100 lbs. overweight) 64-year old woman, with Type-II diabetes, and a profound loss of mobility and energy. I had lost hundreds of pounds by repeated dieting, lost weight with each new diet (including liquid fasting for 10 months) and inevitably gained back every ounce – with interest. I could no longer walk for more than a block, took medication for my diabetes, and was finding it increasingly difficult to do the activities of everyday life. When my internist mentioned this procedure, I thought he was kidding. It seemed akin to that chubby mother and daughter who had had their teeth wired together so they couldn’t chew; it was an extreme, faddish measure that educated, sensible people like me would never submit to. "No", said my doctor. "It really works and makes good sense." He handed me a file folder full of articles about the procedure and offered me a referral to the Unit at Cedars-Sinai.

The surgery itself was laparoscopic: 5 small incisions across my upper abdomen enabled the surgeons, using micro TV cameras and instruments, to rearrange my stomach and part of my small intestine to create a new stomach "pouch" (about the size of a thumb, when empty; the normal stomach is about the size of a fist) with a new connection to my intestine. This is designed to fill and empty quickly, leading to a feeling of fullness after not much food intake, and for some malabsorption to occur, meaning that not every calorie that is eaten is utilized. (My husband says that the surgeons have designed a better digestive system for me than God did…) In the two days in the hospital following the surgery, I felt NO pain from the small incisions, and went home with instructions for gradually increasing the amounts and types of food I was to eat for the next several weeks. After about a month, I was (and am) eating whatever I want to. As of this week I have lost 92 pounds and I feel great!

I do understand that there are some cases that don’t have the amazingly positive results that I have had. How much of that is due to people not following medical instructions, or psychological factors overriding physiological demands, or surgeons screwing up – I’m not sure. I do know that techniques have vastly improved over the years, and that the patients of surgeons who have done thousands of these procedures are having more and more success. There are risks in any surgery; I will be forever grateful that I chose to accept the risks of this one.

I have been at least somewhat overweight for most of my life, and obese for the past 20 years or so (except for a short time after one diet or another.) I never considered myself an excessive eater: I have never eaten a whole pie or a pint of ice cream at one sitting. I just wanted everything that "normal" people eat: good meals, all courses including dessert, snacks and nibbles whenever I wanted them. Wasn’t I as good as anybody else? Why should I be deprived? I’ve been a good girl… Now, I do get to eat whatever I want – but my little stomach tells me when to stop: "You’re full!" it says, "No need to have any more… You can leave half of that sandwich and most of that pie." I now eat just about half of what I ate before – and who cares about eating a lot, if you get full eating whatever you want? (I do try eating a balanced diet – but I don’t begrudge myself that piece of bread and butter along with my salad.) I have always enjoyed cooking for company (as opposed to the day-to-day drudgery of feeding a family) and I’m still doing that. I’ve bought a new oven and new cookbooks and I’m having a ball!

When I was planning the surgery, I swore that I would not get caught in the "appearance trap". I considered my excess weight a medical, not a "beauty" problem. I planned to buy a belt to hold up my slacks if they got too big around the waist. I was not going to get into styles and clothes! Well, needless to say, the belt got ridiculous; I had to constantly buy new clothes, trying to shop the sales and get big bargains, and giving my old (really nice, good, large-size) clothes to Catholic Charities (feeling good about providing nice outfits to poor people). I had to buy clothes in constantly decreasing sizes; my husband said that when I bought clothes, by the time I got them home, they were too big! I’m still far from a "clothes horse", but I must admit that I enjoy seeing something in a store, and knowing that they are likely to have it in my size, and that it will fit and look and feel good and comfortable.

Why I am telling you all this? This is not a medical journal, and I am not trying to create business for the surgeons at Cedar-Sinai. I simply want to share (with the whole world, if I could!) the profound effect that this surgery and weight loss have had on my life. I have not had a "total make-over". I am still an old woman (now 65 years old) with gray hair and a wrinkled face; my hands can no longer grip a jar top very well, and I must use various tools to open a pickle jar; I still tend to get sleepy during the late news, and I still forget all kinds of names. Nevertheless, when I look at my face in the mirror and an old lady looks back at me, I say, "Who is that?" I feel at least 20 years younger than I did before. I have new energy for the tasks of daily life – and last week I found myself running for three blocks because I was late for a movie. I exercise three times a week – which I did before as well – but now it is almost effortless and exhilarating, instead of excruciatingly exhausting. I look for excuses to walk the mile from my house to the downtown shops and offices because it feels so good. Oh, and my blood sugar was within normal range two days after my surgery, and I no longer take diabetes medication.

This feeling of youth and vibrancy is something I haven’t experienced since – well, since I was young and vibrant. Friends say that even my old wrinkled face seems to have a new glow (and, no, I’m mot pregnant!) The new light-weight feels strong, flexible and invincible. After rains turned the curbsides of our city’s streets into small rivers, I found myself not searching for a dry spot to cross the street, but leaping over the rivers. "…tall buildings at a single bound!", is what I feel I can do We recently traveled in Europe, where we walked endlessly in those marvelous old cities, visited museums and sampled the various local cuisines. Last year, this trip would have been impossible for me; I used to need to sit down after 10 minutes in a museum, and couldn’t walk a hill or more than a block or two without resting. During these two wonderful weeks, we walked so much that I lost 4 pounds!

Mostly, I feel normal, with no need for special provisions (seat belt extensions on the airplane, for instance), not on a diet but being able to taste and eat a little of everything – feeling sated and satisfied with life…

(Editors note: This article was written as an op-ed piece. The author, who  wishes to remain anonymous, gave us permission to print the article. We edited out the last sentence)



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