You may remember (if you’ve been following) that I had gastric bypass surgery about 10 months back.  Mostly, things have been pretty status quo for a while — so while it continues to be something I deal with every day, I really haven’t had much to say about it for a while.

But I heard last night about another guy who had the same surgery, and had pretty much the same complications I’ve had (ulcers, difficulty eating protein, throwing up food), only his ulcer(s), the root problem, caused by the surgery, have not healed.  So at some point this week he’s going to have another surgery — maybe with a full, traditional, surgical cut — to try to fix the problem.

I expect he will, ultimately, be ok (and happy he had the surgery).  But I know this will not necessarily be the case.  Every surgery has risks.  Most of us who have this surgery are happy with our decision five years down the road.  But not all of us are — and some of us don’t make it five years down the road.  So this is a serious decision.

I’ve pretty much stopped losing weight.  Twice in about the last two months I have been above and twice in the same period I have been below the 155-160 range (first thing in the morning on my way to the shower).  I started out around an even 300 and, by my scale, weighed an even 263 the morning of my surgery.  I had to lose weight for six straight months before my insurance would cover the surgery — and in my mind that’s a pretty good rule.  This is a last resort treatment.  It is not magic.  And those who approach the surgery as though it was magic, and those who snack all day or drink their calories throughout the day, are among those who are less likely to have good results (from what I see and hear).

Typically people lose and keep off between 60 and 80 percent of their excess weight about five years down the road from the surgery.  So, with few exceptions, we don’t get thin.  But a vast majority of us get a lot healthier longterm.  I really was expecting to end up somewhere between 200 and 230 long term, and hoping for somewhere between 190 and 215 five years down the road — and that’s still very possible as a result.  My understanding is that almost all of us lose more weight than we will keep off, and it will be at least 18 to 24 months before I have any idea of where my weight might stabilize.  I have to admit I’m hoping for better these days.  But I know only time (and the ongoing work I put into this) will tell.

So I’m pretty worried about a young man I know who is scheduled for the surgery early next year.  Last I heard (and from what I can see) he’s continued to gain weight this past year as he moved towards the surgery.  And my impression is that he sees the surgery as a magical cure (and my current status as validation of this expectation).

I’m off of most, but not all, of my medications (from before surgery).  But it’s still not completely settled that this will be permanent.  My weight is in a good place in my mind today.  But I have to tell you that at a gathering of my peers recently, a lot of folk thought I was dying of cancer, and folks in my own congregation have been a little worried that I may have lost too much weight.  And what I think I know is that I have just reached the point where the real challenge begins — and although I am more active than I was, I don’t really have an exercise plan up and running in place.

And there are many changes.  I have a much better idea these days how much I can comfortably eat.  But that amount still changes, meal to meal, in ways it didn’t pre surgery.  I have vitamins I really have to take multiple times every day — they pretty much are the replacements of the medications I’m not currently taking.  I’m wearing medium shirts these days (instead of 3x).  My internal thermostat has changed.  I used to always be the hottest (i.e. sweatiest) person in any given room (regardless of my weight).  Today I’m usually wearing an extra layer (or two) of clothing, inside or outside, and I’m using roughly 3 times the covers at night.  I’ve largely switched, at least for now, from being a red wine drinker to being a white wine drinker.  My taste may have changed a bit — but I still like red wines in my mouth.  But more often than not even smooth red wines don’t agree very well with my stomach.  I can’t drink anything with carbonation (and I miss a nice glass of beer).  Eggs (my old daily breakfast) seem to only sometimes agree with me (and a restaurant omelet is probably four meals for me today — I haven’t kept the leftovers long enough to get past 2 or 3 meals to date).

I remain happy with my decision.  And since reining in my diabetes (which I’m pretty sure is happening) was my decisive motivator (and although not sexy, I thought even 230 was a good deal healthier than 300, and I’m really expecting to do better than that today), I would have to say that I’m meeting my goals — exceeding them so far.  But it’s early.  I’m still a work in progress.  I need to keep watching what (and now, also, how much) I’m eating.  I need to keep up with the support group.  I have to make adjustments as needed.

For me, this has been, and at this point I think will continue to be, a good decision.  I believe that something like 90% plus of people who have these types of surgery would say the same five years down the road.  But that still leaves a number of people for whom having the surgery was not a good decision (and some of them die).  And we don’t really have good data (from what I can tell) for 10 or 20 years down the road.  This is definitely not magic — except that in a lot of cases (but not all) gastric bypass surgery (specifically — not the related surgeries) has near magical results with diabetes.  (The longer you’ve had the diabetes, the less likely this is.)

I decided to blog about this because deciding to have the surgery was a very difficult decision for me.  And I thought it might be for others, too.  And this is not a one size fits all decision.  You have to do this, from all I see and hear, for yourself (not someone else) because you’ve thought it through and are prepared and ready to pay the prices (and take the chances) involved.  There are a lot of changes, and they are different for everyone.  There are a lot of risks — and they can be very serious, even deadly.  There is a big payoff too.  For most of us.  If we’ve thought it through, and prepared ourselves, and we pay the price.

At least, that’s what I think I know ten months down the road from surgery.

Remember, this is forever.

And I see folk in the support group still working through stuff five years down the road and counting.

I also see folk beginning to be able to drink from their Camelbacks again by say year three.

From all I can see, this is an ongoing process.  I’m really used to things having clear beginnings, middles and ends.  But as near as I can tell, this is going to be an ongoing, continued process.

Then again, I’m realizing more and more, so is life.

As what’s his name (who used to coach the Yankees) said, “It ain’t over til it’s over!”