SpartanMaker's Long and Winding Road

[SpartanMaker 767]

I’m not sure why since I’m a pretty private person, but for some reason I want to share my story here. Honestly even if no one reads this, I think just writing it will help me feel better?

This first thing people should know is that weight loss surgery has saved my life and I have not even had surgery yet! How? Well it’s a long and winding story. Grab a Protein Shake and settle in…

In January 2020 (you know, back in ancient history pre-covid), my insurance changed and started covering bariatric surgery. I had thought about surgery before, but my wife was set against it and especially considering the out of pocket cost, had decided it wasn’t for me. With the change, I decided to investigate it more.

In February of that year, I booked an info session at the biggest bariatric center in the state. They let me know all the things I’d need to do before I’d be approved, so I started the dietitian visits, started booking appointments with all my various doctors, and just generally trying to be as prepared as I could.

Among the approvals I’d need from my various doctors, one was with my cardiologist. I was born with a bicuspid aortic valve, which can mean nothing, or can very serious. The biggest challenge is that over time, the valve can become calcified, causing an already reduced blood flow to become much worse. Since we knew it was potentially dangerous for me, my surgeon insisted we get full approval before proceeding.

At the cardiologist appointment, he decided further testing was needed. By early April 2020, I had some CT procedures to get a better idea how badly the valve was blocked. Things were not looking good, so I was scheduled to undergo a cardiac catheterization procedure to see if I was a candidate for valve replacement via cath.

Here’s where things take a turn for the worse. During the cath procedure, the doctor noted that my left anterior descending artery was 90% blocked. In the medical world this artery is known as the “widow maker” because blockage will cause a heart attack and the survival rate for widow maker heart attacks is only about 12%.

I’ll stop here for today. (Yes it’s a cliff hanger, but spoiler alert, I’m still alive!)

I think you can see how I can rightfully say bariatric surgery saved my life, even though I have not even had surgery yet. Had I not decided to have the surgery, I probably would never have had that cardiology visit, meaning I would not have known about the blocked artery.

Edited August 3, 2022 by SpartanMaker

[SpartanMaker 767]

We ended with me lying on the table in the cath lab being told that I am in danger of imminent death.

Now before I go on, I should explain something else about me. I’m severely hearing impaired. This is important here, because you have to picture me on that table, feeling pretty good (I think they gave me a Valium), and then waking up to find everyone in the room desperately trying to get my attention.

I finally come around from my stupor enough to explain to them that I’m hearing impaired, so I don’t understand what’s going on. I’m pretty good at lip reading, but we’re in basically an operating room and everyone is gowned up and has masks on!

Finally I explain that I have partial hearing in my left ear, so if they come around there and speak slowly and close to me I will probably be able to understand. It took a few tries, but I finally gather I really am in imminent danger and they were recommending that they put a stent in me RIGHT NOW.

Doing so might seem like a no-brainer, but like lot’s of important decisions, there are always trade-offs. I didn’t feel alert enough, nor did I feel like I understood the options I had, so I told them no. Bottom line, they patched me up and took me out to recovery. (I’m sure they were all thinking I was an idiot and that they’d never see me again.)

While in recovery, I asked them if someone could explain my options better. Fortuitously one of the heart surgeons had just finished up a procedure and he came by to discuss my options with me (with my wife present as well). After some soul searching and after better understanding the tradeoffs, I actually opted for open heart surgery. The reason is that if they had done the valve replacement via catheter (something called TAVR), I likely would not have been able to have a second one that way in the future. That would have meant that in 10-12 years, I would have needed another valve replacement and they would have had no option but to do it via an open heart procedure. I figured it’s better to get the open heart procedure done while I’m younger and save TAVR for later when I’m likely less able to tolerate major surgery.

Yea, we get it dude, but what does this have to do with WLS?

It means that in less than 2 months, I went from being excited to be having weight loss surgery, to knowing I’m living on borrowed time. I’m also realizing at about that time that my dreams of weight loss surgery have been dashed, or so I thought. Instead (assuming I make it to my heart surgery date), I was facing the reality of having one of the most major surgical procedures one can have. Oh yea, and I'd get to do it during peak COVID. How fun!

We’ll stop there today, but in case you’re still in suspense, I still survived!

[SpartanMaker 767]

Did I mention that having surgery in peak COVID sucks? It does. Now open heart surgery is hard enough, but I was in the hospital a 7 days and was not allowed any visitors the entire time.

I think that was actually harder on my wife through. Especially the first few days. I had some complications, was in a lot of pain and was highly medicated, so I was unable to talk to her. My nurse was supposed to give her regular updates, but like most nurses, she was overworked and wasn't able to call regularly. Imagine a loved one in the hospital after major surgery, but you can’t see them, can’t talk to them, and have no idea what’s going on other than they are having “complications”.

Now maybe I should explain these “complications” a bit. Basically I was having trouble breathing on my own and they thought they would have to reintubate me. For those not familiar with the term, it means they would have had to put me back on a breathing machine. They didn’t want that and though I didn’t know it at the time, I didn’t want that either.

Some studies suggest the mortality rate of cardiac patients that are reintubated is over 40%. Not good odds. Thankfully they didn’t have to go there and I was finally able to make the staff understand that one of the drains in my chest was causing the breathing issues. They removed that drain and I was immediately able to take a nice big breath.

Crisis averted.

Once I went home, the story honestly gets pretty boring. The surgical recovery period was hard, but being a big fat dude made it harder. The important takeaway here is that my cardiologist said I’d need at least a year to recover from the heart surgery before he would even consider signing off on the weight loss surgery. So my hopes for WLS in 2020 were dashed, but at least there was hope for 2021!

Those of you that realize it’s now 2022 (I know, with COVID, I lose track too), will also realize I’m still waiting for my weight loss surgery. Why I’m still waiting well over a year later is a tale for next time!

[Tomo 1,191]

Wow, what a story. So glad that you made it through okay. Thank you for sharing this. I used to complain about all those hoops for WLS but this time around I was actually glad. It was reassuring after a nuclear stress test that my ekg was off, for example.

We will be looking forward to your full recovery and then your WLS journey.

[SpartanMaker 767]

1 minute ago, Tomo said:

Wow, what a story. So glad that you made it through okay. Thank you for sharing this. I used to complain about all those hoops for WLS but this time around I was actually glad. It was reassuring after a nuclear stress test that my ekg was off, for example.

We will be looking forward to your full recovery and then your WLS journey.

Thank you!!! I know everyone get's really anxious before WLS, but after so long waiting, I'm just about beside myself! As a guy, I'm not good with the whole emotions thing, but I do know there are lots of different feels going on!

[SpartanMaker 767]

So it may be time to take a little break from the ongoing saga of why it’s taken me over two and a half years to get to surgery and instead talk about how I got to the point of wanting to have bariatric surgery in the first place.

My lightest weight as an adult was while I was in the Army. Just sheer physical activity and regular PT had me lean down to around 175 from maybe 185 when I graduated high school. Unfortunately I was severely injured in a training accident while in the service and left the military with a bad limp and a knee brace as a constant reminder.

Weight wise, things went downhill from there.

Being somewhat disabled made it hard to exercise, but meanwhile I was still eating like I did when I was in the service. (Lots of food, very quickly.) This was obviously not a good combination.

Several other health scares and life events later, I shot up to around 240. I managed to stabilize things at this point and was even able to get into strength training pretty seriously for a while. Most cardio was still out, though.

Life went on for several years, until I got a new job that paid me very well, but also took it’s toll on me physically and mentally. Within 3 years in the new job, I was up to 285 or so and climbing. I knew I needed help, so my wife and I tried just about every possible diet program imaginable.

Interestingly, I’ve kept logs of every one of those diets. For at least the past 15 years, the typical pattern was for me to be somewhere between 285 and 300 pounds lose 30-80 pounds, then yo yo right back to my starting weight and then some.

In about 2017, I finally asked my Doctor for help. We did all the things you’re supposed to do: talk to dietitians, try medications of various kinds, and even do physician monitored diets. None of that worked any better.

The problem was, they just assumed like everyone does that I was weak-willed or to stupid to know how to eat properly. That’s never been my problem. I actually eat pretty well overall, with lots of fresh veggies, and plenty of lean Protein.

The problem is, in addition to all the good food, I’m also an emotional eater that soothes with sweets. I knew I’d reached rock-bottom when I started hiding food from my wife. As an example, I might buy a box of donuts and plow through it in a matter of minutes. Or buy the boxes of chocolate intended for Valentines day and devour them all in a morning. No box or bag of candy or pastries ever had the dust settle on it around me!

About this time, I got up to 330 (my highest weight), and knew I needed to take a different road or I would never live to see my grandchildren. (I may never actually have any grandchildren, but that’s a story for a different day!)

This takes us to late 2019 when I discovered, quite by accident, that my new insurance plan starting in Jan 2020 would finally cover bariatric surgery. After about a millisecond of research (okay, maybe a little longer), I decided this might be the thing for me. I think you already know what happened in my saga in 2020, so we’ll stop there for now and start back up next time in the summer of 2021, when I finally got the cardiac clearance I needed to get WLS.

[SpartanMaker 767]

So, we’re jumping forward to May 2021. Picture this: I’m about to talk to my cardiologist at my 1 year surgery follow-up and am getting nervous. Mentally I’m going through all the things I’m going to say to convince him I’m fine, and that he should definitely approve me for WLS.

Turns out, I was worried about nothing.

He went through the standard checkup stuff and at just about the point that I was ready to go into my well rehearsed sales pitch, he actually asked me if I was still considering bariatric surgery. Imagine my surprise at that one! When I said yes, he didn’t hesitate to say he was fine with it and didn’t see the heart surgery as an issue at all.

He just became my new favorite doctor. I walked out of his office ecstatic and ready to call the bariatric center to get the weight loss surgery scheduled right then. I mean if they would have taken me in tomorrow, I was READY. It was late in the day though, so I decided to wait.

Turns out waiting was a bad choice. I woke up the next day with horrible back pain. I’d had back issues for many years, but it had been mostly stable for a while. Now I was experiencing a bout of sciatica that was so bad, I had little to no muscle control in my legs.

Great, more health issues to deal width and once again bariatric surgery would have to wait.

Let me jump forward a bit here. It took a few months, some new meds, some injections, and some aquatic therapy, but the back was feeling tolerable, at least. I was finally ready to call the bariatric surgeon’s office.

Remember me saying I should have called sooner? It turns out they had a 2 month backlog for “new” patients. You see, because I had been out of the program for almost 18 months at that point, I basically had to start over.

Fast forward to September 2021 and I finally get to meet with a PA and start the “intake” process. I then did the standard psych evaluation and 6 months of dietitian visits required by my insurance company. The surgeon also decided that I needed to do an abdominal CT scan with contrast. Not sure if this was typical, or something “special” just for me.

Unfortunately, once again something wasn’t right. This meant the surgeon wanted a closer look, which meant more testing.

Pro tip, if you ever get told you need to do a fluoroscopic swallowing exam, see if you can get out of it. Seriously. This was probably one of the top 5 worst exams I've done. I went in thinking it would be no big deal and was much more worried about the endoscopy they also were planning. Turns out, I had it completely backward. I slept through the endoscopy, but the swallow study just was miserable.

After a few tense days of waiting for results, my surgeon’s office said they found a couple of issues, including a hiatal hernia, but I was okay to proceed to surgery! Now it became a waiting game for insurance approval and surgical scheduling. (Apparently they are still way behind and not able to accommodate a full surgical schedule due to a COVID-19 induced backlog.)

After an eternity waiting, I finally, finally got scheduled for September 20^th. I just thought I was anxious before. Now the waiting really begins!

[Voogs 41]

As another Nebraskan, I wish you good luck. I just finished all my hoops and an waiting for approval/scheduling.

Your story and perseverance are truly inspiring.

[ShoppGirl 4,785]

Wow. It’s so weird how things work out sometimes. So glad you were required to do that test, and at that time!! Also, Congratulations on your surgery date.