I had finally given up on losing weight, so I did something very stupid, I got rid of a bunch of my clothes, including two new sport’s suits that I had only worn once each. I should know better every time I do something like that I end up regreting it. Of course soon afterwards due to health reasons I decided to go ahead with the surgery.
To begin with, this surgery is not something to be taken lightly. It involves a total change of lifestyle. By agreeing to do it, you are commiting yourself to not only all the preparation work but the post-op work and a lifestyle change that is for the rest of your life. If you can’t make that commitment then you are not ready for the procedure. It is kind of like being an alcoholic in denial. You can’t make the commitment to quit drinking because you really don’t think you have a problem. Unfortunately that means your condition will have to get worse before you are willing to make it. I did not wait as long as some people did. I was far from the worse patient that had the surgery on the week that I did it. I did not need a truck to run over me before I made up my mind. This, of course, all depends on you. Nobody can do the work for you. If you fail, you are the one that will pay the price.
I already covered the different types of gastric surgery that there is in Chapter 15. In this chapter I will cover how I decided on the type of surgery I wanted. They all had their upsides and downsides. Even though the gastric sleeve procedure is not reversible, it is still the easiest full surgery available. It is also a laproscopic procedure which cuts down on the recovery time. When they did my pre-op procedures they found that I had a hiatal hernia. They were able to repair that at no extra charge. Unfortuately, my health insurance doesn’t cover the gastric surgery.
Since the facility that I had it done at required the full amount of money up front, I had to take a personal loan out for the full amount. Even though the facility did a wonderful job with the procedure, I am not happy with the billing process, so I am not going to name who did my procedure. I don’t believe what they did was fair but since they were the one I wanted I had no choice but to go along with it. The procedure is over and it went off without a hitch so that is all that matters. If I wanted cheap, I could have went to Mexico. I wanted quality, so I paid the price.
After I decided on the type of procedure I wanted, I contacted the surgery center. I had to complete an online questionnaire to see if I met the criteria. Thankfully, I did. Their criteria is based on the National Institutes of Health (NIH) criteria:
- For insurance clients: BMI greater than 35
- For personal investment or financing clients BMI greater than 30
- For Gastric Balloon clients: BMI greater than 27
My BMI was 39.5, so I met even the insurance criteria. However, that was not an issue because I was self pay.
Besides the BMI data that was requested, there was a general questionaire that I had to complete before I was accepted. They asked questions like have I had any previous weight loss surgeries, could I walk 200 feet without becoming short of breath or experiencing chest pain, did I have a history of heart disease, stroke, kidney failure, and did I smoke? I am sure this is basic for all surgery centers.
The only good thing about self pay, I did not have to deal with all of the insurance issues that you have afterwards. I now know how it feels to have money. It must be nice to just go in and have something done without worrying if it is covered or not. The downside is that I will be paying for this surgery for several years to come.
In Chapter 15, I briefly discussed each procudure. In this chapter, I will discuss my procedure in greater detail.
Sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a surgical weight-loss procedure. This procedure is typically performed laparoscopically, which involves inserting small instruments through multiple small incisions in the upper abdomen. During sleeve gastrectomy, about 80% of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana.
Limiting the size of your stomach restricts the amount of food you are able to consume. In addition, the procedure prompts hormonal changes that assist with weight loss. These same hormonal changes also help relieve conditions associated with being overweight, such as high blood pressure or heart disease.
Why it’s done
Sleeve gastrectomy is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including:
- Heart disease
- High blood pressure
- High cholesterol
- Obstructive sleep apnea
- Type 2 diabetes
Sleeve gastrectomy is typically done only after you’ve tried to lose weight by improving your diet and exercise habits.
In general, sleeve gastrectomy surgery could be an option for you if:
- Your body mass index (BMI) is 40 or higher (extreme obesity).
- Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.
You must also be willing to make permanent changes to lead a healthier lifestyle. You may be required to participate in long-term follow-up plans that include monitoring your nutrition, your lifestyle and behavior, and your medical conditions.
Check with your health insurance plan or your regional Medicare or Medicaid office to find out if your policy covers weight-loss surgery.
As with any major surgery, sleeve gastrectomy poses potential health risks, both in the short term and long term.
Risks associated with sleeve gastrectomy can include:
- Excessive bleeding
- Adverse reactions to anesthesia
- Blood clots
- Lung or breathing problems
- Leaks from the cut edge of the stomach
Longer term risks and complications of sleeve gastrectomy surgery can include:
- Gastrointestinal obstruction
- Gastroesophageal reflux
- Low blood sugar (hypoglycemia)
Very rarely, complications of sleeve gastrectomy can be fatal.
How you prepare
In the weeks leading up to your surgery, you may be required to start a physical activity program and to stop any tobacco use.
Right before your procedure, you may have restrictions on eating and drinking and which medications you can take.
Now is a good time to plan ahead for your recovery after surgery. For instance, arrange for help at home if you think you’ll need it.
What you can expect
Sleeve gastrectomy is done in the hospital. Depending on your recovery, your hospital stay may last one to two nights.
During the procedure
The specifics of your surgery depend on your individual situation and the hospital’s or doctor’s practices. Some sleeve gastrectomies are done with traditional large (open) incisions in the abdomen. But sleeve gastrectomy is typically performed laparoscopically, which involves inserting small instruments through multiple small incisions in the upper abdomen.
You are given general anesthesia before your surgery begins. Anesthesia is medicine that keeps you asleep and comfortable during surgery.
To perform a sleeve gastrectomy, the surgeon creates a narrow sleeve by stapling the stomach vertically and removing the larger, curved part of the stomach.
Surgery usually takes one to two hours. After surgery, you awaken in a recovery room, where medical staff monitors you for any complications.
After the procedure
After sleeve gastrectomy, your diet begins with sugar-free, noncarbonated liquids for the first seven days, then progresses to pureed foods for three weeks, and finally to regular foods approximately four weeks after your surgery. You will be required to take a multivitamin twice a day, a calcium supplement once a day, and a vitamin B-12 injection once a month for life.
You’ll have frequent medical checkups to monitor your health in the first several months after weight-loss surgery. You may need laboratory testing, bloodwork and various exams.
You may experience changes as your body reacts to the rapid weight loss in the first three to six months after sleeve gastrectomy, including:
- Body aches
- Feeling tired, as if you have the flu
- Feeling cold
- Dry skin
- Hair thinning and hair loss
- Mood changes
Sleeve gastrectomy can provide long-term weight loss. The amount of weight you lose depends on your change in lifestyle habits. It is possible to lose approximately 60%, or even more, of your excess weight within two years.
In addition to weight loss, sleeve gastrectomy may improve or resolve conditions related to being overweight, including:
- Heart disease
- High blood pressure
- High cholesterol
- Obstructive sleep apnea
- Type 2 diabetes
Sleeve gastrectomy surgery can also improve your ability to perform routine daily activities, and can help improve your quality of life.
When weight-loss surgery doesn’t work
It’s possible to not lose enough weight or to regain weight after weight-loss surgery. This weight gain can happen if you don’t follow the recommended lifestyle changes. If you frequently snack on high-calorie foods, for instance, you may have inadequate weight loss. To help avoid regaining weight, you must make permanent healthy changes in your diet and get regular physical activity and exercise.
It’s important to keep all of your scheduled follow-up appointments after weight-loss surgery so that your doctor can monitor your progress. If you notice that you aren’t losing weight or you develop complications after your surgery, see your doctor immediately.
In the next chapter I will discuss my pre-op prep.
mayoclinic.org, “sleeve gastrectomy.”;