Meetings with consultant, nurse, dietitian and anesthetist

Well, where to start?

I am very grateful to my best friend for driving me up to Taunton and to be my rock whilst going to see the consultant, nurse, dietitian and anesthetist.

This week, I have been thinking over what type of surgery I may go for if I am given the chance.  I was under the impression, following the educational session last week, that the mortality odds were 1 in 1000 for all the bariatric surgery, but in the leaflet I was given it stated that the bypass only offered odds of 1 in 200, which I couldn't take that risk, so I changed my mind and decided to ask if it was possible for me to have a gastric band instead.  Also, my husband is not happy with the odds and didn't want to loose me and would prefer me to have the band if I had to have surgery at all.

Firstly, I saw the dietitian and was explained a little more about the pre-op liver shrinking diet, and the post op diets etc, and she discussed what surgery I was hoping to go for etc, and she was happy that I go for the band.

Secondly, I went off to have a load of blood taken to do various tests.

Thirdly, I saw the nurse who explained a little more to me about the band operation etc, and also explained more about the odds, which had now gone up as Mr Mahon (my consultant) is actually building a database on the odds so that it is all up-to-date.  The band has a 1 in 1000 rate and the bypass has a 2 in 1000 rate.  This did make me think more but I am still convinced that I will be doing the right thing if I go for the gastric band.

Next I went to have an ECG to assess whether my heart is up for the surgery, which it was absolutely fine and also an MRSA swab.

Next I had to see the anesthetist, who was very nice and congratulated me on my weight loss to date.  He discussed all the things that would be happening on the day of surgery and the chance that I may go to HDU following surgery - unlikely but a possibility.

Last but not least I saw Mr Mahon.  What a lovely man!  He prodded me around a bit to check if my body was up for the surgery - and he was also happy for me to go for the band as I was worried about the stats which were in the leaflet.  He did say that he and his team have done just over 1000 bypass ops in Taunton hospital and have only lost 1 person who was severely overweight to the point that they were not mobile at all, and also had type 2 diabeties, and other health problems, but that he knew that in other hospitals the mortality rate is 2 in 1000, but as I stated earlier I am still going to go for the band.

They reckon we will probably be looking at March time for the op so going to knuckle down and try to lose more weight before then as:
a) it will be easier for them to do the op
b) it will be better for me when they do the op

Just have to keep my fingers crossed that I get a date earlier than that :)

For anyone who doesn't know here is a few images of, hopefully, what I will be getting:

Was up bright and early this morning as I had to travel to Taunton for my Educational Session.  Left nice and early to avoid traffic, but didn’t hit any so we were there early – typical!!!

Well, I walked in and there were a few people there already, all had brought a friend/relative with them so my husband didn’t feel out of place.  I was quite astonished at the range of people there as one of them only looked like a size 16 compared to me and a couple of others she did look out of place there.  The nurse who was running the session greeted us and she seems like a lovely lady.

So, we had approx a 40 minute powerpoint slide show and speech about the various types of surgery available to us, then we took a 5 minute break and then we had another powepoint slide show and speech from the dietician on the team.  My husband had just finished nights this morning so was absolutely tired so only sat through the first slide show – but wish he hadn’t (will come to why in a minute), and then he couldn’t be bothered listening to the dietician part so went out to the car for a snooze.

We were shown the pros and cons of all the surgeries offered and deep down I feel that if I am going for surgery I think that the bypass is the best option for me – and the consultant that I saw at NDDH also felt that that would be the one most suitable for me.  They also explained all the pre-diet stuff we would need to do and also what our diets would be like after the ops – for each one they are slightly different.  We were also given some reading material to help us make the decision, however, at the end of the day, the consultant will say what he thinks is best for us anyway.

So, back to my husband!  He isn’t happy about me going for surgery, but if I have to have a surgery he would be happy about the gastric band but not at all happy about me having a gastric bypass.  How can I make him see that it is my body and it is my life that hangs in the thread of the “morbid obesity” label.  If I stay the way I am at the moment I could get bigger, and already my hips/knees/back hurt and I can’t walk very far without being in pain and could end up in an early grave.  So I really need help, and if that means that – ok I might have to change the way I eat for the rest of my life then surely he should support me and want me to live longer – even if I do nag him lol, but I do love him….

In case you don’t know the difference between the gastric band and gastric bypass I will try to describe briefly the difference.

Gastric Band – With this procedure, the surgeon implants a soft, low-pressure band around the upper part of the stomach, giving it an hourglass shape.  A small passage between the small, upper pouch (approx 30ml) and the rest of the stomach allows food and fluid to pass through.  When you eat, the food quickly accumulates in the small, upper pouch and slowly passes down to the lower part of the stomach.  It only takes a little bit of food to fill the little stomach pouch.  The upper part of the stomach sends a signal to the brain as if the entire stomach were full.  This causes you to feel full more quickly and for a longer period of time while at the same time eating less. 

Your anatomy is not changed by this operation; it is completely reversible.  The band can be removed.  In addition, the digestion and absorption processes in the digestive tract remains unchanged.

The inner part of the band is inflatable and contains a saline fluid.  The size of the passage through the stomach depends on how much fluid is in the band.

Gastric Bypass – With a gastric bypass, the surgeon creates a small stomach pouch (approx 30ml).  The pouch is connected right to the middle portion of the small intestine.  When you eat, the food quickly accumulates in the pouch, but as only a small amount of food is required to fill the pouch, the upper part of the stomach signals the brain early that it is full – as if the entire stomach were full.  Your appetite also decreases since, in contrast to the normal process, the contents of the stomach pouch empty directly into the small intestine.

Since the food bypasses the first part of the small intestine, the body absorbs fewer nutrients and calories.  Because the stage at which the food is mixed with gastric juices, bile and pancreatic juices is delayed, the food is digested at a later stage than during the normal digestion process.  Because your body is not absorbing as many nutrients etc you need to take multivitamins and calcium and vitamin d tablets for the rest of your life.  You also have to have a vitamin b12 injection every 3 months for life.  Also, if you are a menstruating woman, you may need to take iron tablets as well until you no longer have your monthly period.

As you can see, neither of these options is the “easy way out” that many people consider bariatric surgery to be.

Friday 11th November 2011

Today I had a phone call from the appointments team at Musgrove Park, offering me a cancellation appoint next Wednesday at 9.30am with a group of likeminded people who are in the same situation as me, as an educational session, which we would have to undertake before we would be able to see the consultant.  I was also offered another appointment the following Wednesday to see the consultant – argggghhhh things are moving quite quickly and I need to work things through quicker in my head …..

Feeling very nervous about this but know that it is something that I have to do if I want to take the surgery route, but still know that I have plenty of time to change my mind if I want to.

Tuesday 18^th October 2011

Received a letter from Mr Watt, my consultant at NDDH, which was addressed to the bariatric consultant at Musgrove Park Hospital in Taunton, and was cc’d to me.  It stated that I had received the funding to go ahead with bariatric surgery and asking for him to see me with regards to taking the next step.

I had very mixed feelings when I received the letter as I have now got to the stage in my life with my weight that I really do need help.  I have lost approx 15kg since I started my diet back at the end of February this year, most of which I attribute to walking more with the dog and also by eating better – the truth is that the only way to lose weight is DIET & EXERCISE – sad as it is :(

I do know that probably surgery is the best option for me now and I am in the best place, as far as my head goes, to know that now and realise that it is a major lifestyle change which is a permanent change of my life, however I also wonder if I am able to cope with that change – how will I cope with that change also?  Lots of thinking to do, and convincing my husband that I am really wanting this surgery now and that I need it for me…..

So, what next? Well I have to wait to hear from the bariatric team for an appointment.