Awesomely uneventful 2 years

[dbfn 67]

Hi, I'm a newbie here from the other land Down Under (New Zealand).

I had roux en y gastric bypass two years ago and while the lead-up to my surgery wasn't without its hassles, my recovery and life since has been almost boringly easy. Touch wood!

I've been overweight nearly all my life: I arrived kicking and screaming into this world weighing a healthy 9 pounds and was pretty much "normal" weight until I hit my early teen years. It was then the weight just piled on, and stayed there.

I managed to lose a decent chunk of weight a couple of times through old-fashioned healthy eating and exercise, once in my late teens and then again in my mid-30s. But as we all know, losing it and keeping it off are two entirely different things and as much as those who have never struggled with their weight like to insist it's simply a matter of eating less and doing more, that is so much easier said than done. And let's face it, if it was really as easy as all that, there wouldn't be a multi-billion dollar industry built around weight loss.

We have free major medical care here, which is funded by our taxes, but because demand far outstrips availability of surgical care, there are waiting lists for pretty much everything and even if someone has been scheduled for a particular surgery, they can still be bumped from their spot by emergency procedures (accidental injuries etc). Aside from that, some of us do have private medical insurance, often subsidised by our employers. However, our major insurers have weight-loss surgery listed as one of their exclusions. I was fortunate enough to have chosen an insurer that does fund it with some qualifications (basically at the recommendation of your primary doctor). There are a very small number of procedures done on the public health dollar (in my region, with a population of around 50,000 people, I believe about a dozen cases are funded per year). Most people I know who have had the surgery have actually self-funded via personal loans or extending their mortgages.

About 8 years ago, I developed gallstones and had my gallbladder removed. While organising the claim with my insurer for that hospital stay, I noticed a one-line mention of weight-loss surgery in my policy and phoned the company to ask about it. I was told I didn't qualify because I needed to have at least one co-morbidity. I was still recovering from my emergency gallbladder surgery and was also probably a little naive, so I didn't question their response.

Then, about three years ago, I was looking over my policy again and decided I should go back to my insurer and question them further ... demand some answers and justifications on why the co-morbidity was needed when it wasn't actually mentioned in the policy. Interestingly, the person I dealt with immediately agreed that yes, they would generally fund the surgery if a bariatric surgeon recommended it.

At that point, there was no bariatric surgeon in my home city so I booked an appointment with one a two-hour plane trip away and started counting down to my initial consultation.

During that time, I'd been feeling a bit unwell and things got a lot worse very quickly: I became incredibly short of breath and tired and just felt terrible. As it turned out, I'd developed dilated cardiomyopathy with a bundle branch blockage, incredibly high blood pressure and type 2 diabetes for good measure! Yep, I felt like death warmed up: heart failure will do that for you! That meant the surgery was, of course, put on hold. My cardiologist reckons the cardiomyopathy was probably caused by a virus and that the heart condition was likely what caused the diabetes because I'd been tested just a few months earlier and had been fine (family history ... mother was type 1, father type 2) so I'd gone from healthy blood sugar to HbA1c of 85 in just 4 months.

The next year was spent dealing with the heart problem and I have to admit, I was a bit stunned by the whole situation: I really just wanted to survive at that point, to get well enough to have the heart surgery my cardiologist said I needed (an implanted cardioverter defibrillator) but was at that stage too sick to have done. A year later I'd had quite a remarkable turnaround, still in heart failure of course, but my heart had reduced in size and everything was looking a lot brighter. Bright enough, in fact, for my cardiologist to decided I perhaps didn't need the defibrillator surgery after all.

I was about then I decided to push ahead with the bariatric surgery. I'd lost quite a bit of weight when first diagnosed with the heart condition but had come to a screaming halt, I just couldn't shift another pound. I had to get a cardiac clearance from the anaesthesiologist, which he was happy to do (said my blood pressure, blood sugars and cholesterol were better than those of his marathon-running, vegan wife!) Meanwhile, a New Zealand surgeon who has spent several years working in America as a bariatric surgeon had returned to NZ and set up shop in my home town, so I was able to have my surgery much closer to home. I got had my consult, phoned my insurer, got approval that same day and was booked in for three weeks later. It all happened so fast my head was spinning!

The surgery itself had one little hiccup: my heart went out of rhythm and gave them all quite a fright. However, they phoned my cardiologist and she told them that so long as it went back into rhythm on its own, they were good to go ahead (I knew nothing of any of this until after the surgery of course, I was already knocked out).

Aside from being incredibly tired when I woke up, and for the next day (they reckon because of the heart rhythm thing), being left with a lineup of fist-sized bruises across my ample tummy from the blood thinning injections, topping off those bruises with some impressive red welts after a cracking delayed reaction to those same injections on day 4, and developing a weird all-over itch for just one day a week after surgery that we never found a cause for, my recovery was pretty good!

I wasn't able to sleep in my own bed for about three weeks because our bed is quite high (I'm 5ft 4 and it's hip height on me), so I have to climb on to it. However, I just slept on a recliner chair and it was all good.

Oh good lord, and sorry for what turned to be something of a novel!

Edited July 27, 2015 by dbfn

[The Candidate 3,215]

Welcome my New Zealand friend, on behalf of America! ????

You have had quite the journey on the way to surgery and a healthier life. It shows just how committed you are, to have to go through all those trial and tribulations along the way. Just the amount of time you had to wait humbles me, as I thought my year would never come to an end (having surgery on the 29th).

How have things been for you these past two years? Any reoccurrence of the heart issue?

You are an incredible example of perseverance and hope. Thanks for sharing your incredible story!

Edited July 27, 2015 by The Candidate

[dbfn 67]

I've had a pretty easy recovery from the surgery ... the only food I've had an issue with is chicken breast (early on) that felt like it was stuck, and the only time I've dumped was with pineapple juice. I'd been having it mixed with cold Water every now and then for a change from plain old Water and couldn't understand why all of a sudden my heart was racing and I felt so ill. I initially thought it was my dodgy heart doing its thing, took me a while to click that it was dumping. I checked the label and sure enough, they'd changed that particular brand of pineapple juice: it used to be pure juice, but they'd started adding sugar to it. That one's now off the menu!

Aside from that, I've been really good and am eating pretty much normally, just in small quantities. My blood sugar numbers were pretty good before the surgery and my surgeon took me off metformin the day before my op, and I haven't been back on it since. I've been testing in the comfortably non-diabetic range since then with no medication.

The bundle branch blockage, which had been quite a worry when I first go sick, is now intermittent and in fact hasn't shown up at all in my past two ECGs. My heart has gone from being twice normal size, to totally normal in size, my ejection fraction (how much of the blood is pumped from the left ventricle when it contracts) went from a worrying low 20 percent to a now quite normal 65 percent.

When I was first diagnosed, my cardiologist said I needed the implanted defibrillator but that she wasn't sure it would stop the damage, instead of just slow it an that I might be looking at a transplant in a few years. Now, while I'm still technically in heart failure, she's a lot more positive and doesn't think I'll be needing any sort of surgery. She says I'll need to stay on the medication for the rest of my life but that my heart function is now looking as good as someone without a damaged heart, and that most of the damage appears to have reversed.

The anaesthesiologist who checked me before the surgery was fascinated by my progress and wondered whether the heart failure itself was a symptom of a virus, rather than simply being caused by one because I'd had such a rapid and unexpected turnabout in health after going on to medication.

And not long till your surgery! That's exciting ... I know how much I was buzzing two days out. There were some nerves, of course, but more excitement than anything else. You'll be itching to just get it over and done with now I suppose!

[The Candidate 3,215]

That is simply amazing to go from the prospect of a possible heart transplant to where you are now. It sounds like in your case getting the surgery was the equivalent of saving your life, quite literally. That's an incredible turnaround!

Yes, I'm definitely ready to go. Excited and oddly, remarkably calm. Hope that lasts up to the point where I'm being wheeled in! Can't wait to join you on the loser's bench!