Tuesday, November 29, 2005

Gastric Bypass Surgery

I had gastric bypass surgery on February 22. In nine months I've lost 106 pounds, and I feel great.

First off, knowing what I know now, I would do it over again in a second. I was drowning from congestive heart failure, and I could barely move around with the combination of psoriatic arthritis and diabetes-related nerve damage I suffer from. If we went to a museum I had to be pushed around in a wheelchair, but they never had one big enough to accomodate my gigantic fat ass, so it was almost as painful to squeeze in as it would have been to try to walk around. But the surgery has totally resolved the heart failure, my diabetes is under control, and even when my arthritis flares up, since there is no longer the added pain of almost 400 pounds bearing down on my legs and feet, I'm functional.

I had one of the top surgeons in the country at Rush University, and there was absolutely not even one hint of a complication. It was a huge adjustment, and the recovery was long and painful, but everything went just like it was supposed to. I was in the operation for 7 1/2 hours, and my wife told me after it was all over that when she pressed the surgeon to quantify what he described as a heightened risk of severe complications or death due to my co-morbid conditions, he nodded his head, with eyes cast down, when she worked up to 50-50. I'm glad I didn't know that going in.

My first thought about all this is that it's downright obscene that I got myself to a state where the only thing that could save me from the life-threatening effects of decades of overindulgence was a $90,000 surgery resulting in radical mutilation of my digestive system. As part of the workup I had a visual examination of my stomach by scope, and everything was pristine and perfect. The stomach doctor urged me to reconsider the surgery and try once more to lose weight the "normal" way. But anyone who is 200 pounds overweight knows, it is not that simple. Years of living at that size causes profound hormonal changes and disrupts the receptors for hormones that regulate food intake. It's not just a matter of eating less and exercising. Invariably any weight you lose that way will sneak back in time. The advantage of the surgery is that it reverses the hormonal changes and allows the weight to stay off permanently. It actually "cures" (as more than one reputable article on the subject has said) type-II diabetes. And then there's the congestive heart failure. I'm lucky. Mine was the result of a grossly enlarged heart (called "cardiomyopathy"), which was needed to pump all the blood through my body. It was relatively mild and had not yet led to permanent damage, so with weight loss it was reversible. Had it progressed much further, the only treatment would have been a heart transplant.

Even so, it's a shame that my nice, healthy, natural stomach has been physically severed and replaced by an egg-sized pouch reconstructed from a corner of it. I call it "radical mutilation therapy" and it strikes me as a perfect symbol of our sickeningly overindulgent culture. At a time when both food and medical resources are in dangerously limited supply in most of the world, it's shameful that so much of each has been spent on my personal self-destructive impulses, and the heroic measures needed to pull me back from the edge of a consequent annihilation.

But I'm not complaining. The gods have given me one more second chance. I've had a hefty share of those in my time, and I'm grateful. I hope I can make the best of it.

So I still do this joke, but hopefully I won't be able to use it much longer: "Say, does this shirt make me look fat? Or do you think it's the massive deposits of subcutaneous fatty tissue doing it?"

Feel free to use it as needed.