Sonya (srb) wrote,

Why I hate the Lap-Band

I don't think anything I'm going to say here will be new information to anybody who has been present when I've been eating over the past 9 years, but I think it all should be in one place.  I probably won't even think of everything tonight, so I may come back to update this over time.  

The first year was pretty good.  I lost about 50 pounds.  I had a few issues, but nothing major and overall I felt great.  I was losing weight slowly, with minimal frustration, and basking in the compliments and goodwill of people who were trying to be supportive.  

The second year was not great.  I plateaued for several months, then went in to get my band tightened, but it tightened so much that I couldn't swallow my own spit and I had to go get it untightened in the ER in the middle of the night.  It was downhill from there.  I never found the sweet spot between feeling satiated on smaller amounts of food but not throwing up constantly.  Some people with the band do, but long term statistics indicate that the number of people who do is closer to 10 percent of all the people who have the surgery.  

"Success" is something everyone should be aware when it comes to weight loss, and weight loss surgeries.  For the marketing collateral they claim 60-80% "success" - but depending on what you're reading they will define it as some small percent of body mass lost and/or limit the time to a couple of years.  There aren't a lot of ten year follow ups, and they never do the math to include the people who died from the surgeries in their failures either. 

So.  No happy middle ground with the band for me.  In years two and three the weight started coming back, even though I was following all the rules, getting my band adjusted, and exercising as regularly as I could.  For the past six years or so I have weighed exactly what I did when I had the surgery.  

The day to day reality of living with this is that I eat in a completely disordered way, I eat much less healthy, fresh food than I would like (or ever did pre-op), I'm tired all the time, I'm cold all the time, I vomit several times a day most days, and I get horrible reflux if I try to sleep on my back or my stomach or my left side.  In the last few months there has been blood present a few times when I was vomiting, which finally vaulted the need to have this thing out from elective to emergency as far as the insurance company is concerned.  That change means that instead of paying $30,000 out of pocket, I'll pay a $100 copay.  

Here's a breakdown of the negatives I listed above -

disordered - I can't eat when other people do, or on any fixed schedule, because I don't know when my stomach will decide to accept something.  

lack of fresh food - I can't eat anything high in fiber - I tried a few times with each of these, but I have not digested a raw carrot, celery, broccoli, asparagus, bell pepper, orange, apple, you get the idea, since the surgery.  Small bites here and there, but never anything that could be considered a serving.  No sushi.  No steak.  (Yes, I know steak is not high in fiber.  It's high in connective tissue.  Same problem.)

tired all the time - I think this is metabolic nonsense.  My body wants to be heavier than I wanted it to be, so it fights for every calorie I eat, and doesn't make a lot of energy available.  I exercise most days (brisk 30-45 minute walk on the beach, or a hike in the hills, plus yard work and gardening when it's not rainy or cold) but I'm consistently more tired than I used to be.  It's definitely not thyroid, and I don't think it's age related.  On the days I manage to eat a reasonable breakfast I do better than days that I don't.  I try every day - if I don't succeed it's because I keep barfing it up.  

cold all the time - same deal - I never used to be cold.  Not thyroid.  Not Reynauds.  Just cold hands and feet. 

vomit several times a day - it is worst in the morning.  Things seem to loosen up as the day progresses, but even at the end of the day I can't take a pill larger than a birth control pill or an ambien because it won't fit through the band.  Breakfast is often leftovers from the night before or steel cut oatmeal, or grits. A small bowl of oatmeal on a good day takes me about 90 minutes to eat, in bites no bigger than a teaspoon at a time, with long waits between bites to see if it's going to clear or get stuck.  When I go out to eat with Cait on Saturday mornings I order an English muffin, one egg over easy, and we split a side of bacon.  I smash up the egg and tear up the bacon to make two little open faced sandwiches.  I always get a box to go for at least the second half, but usually I only manage half of the first half.  And I usually get up and barf at least twice.  So maybe an 8th of an English muffin and egg, and an inch or two of bacon?  I'll eat the rest for a snack and lunch.  Or lately I'll bring it home to Bob.  It's not that I'm not hungry.  It's that I can't physically get it into my body.  Things that made me throw up in the last two days include spanish rice, refried beans, baked potato soup, kettle corn, and butter pecan ice cream.  I'm sure there are more, but that's all I can think of at the moment.  The rice was this morning, and I remember barfing at least three times over two hours.  Could have been more - it all fades after a while.  This has been a pretty normal day for me.  

I'm not diabetic, but I do have issues with blood sugar that I never had before.  Since mornings are so hard, I often can't get enough food in to keep it stable. I'm always within an hour of a crash and end up grazing through most days.  On days when I can't do that, a blood sugar crash, complete panic attack and then even more difficulty eating is a regular result.  I haven't really kept track of this, but I'd bet it's averaged out to once a week.  There are days when I just can't get anything even semi-solid down.  I drink a lot of milk for protein on those days.  Sometimes if it's late afternoon and I haven't been able to keep anything down I'll stop trying for a couple of hours and then get a milkshake.  A small McDs milkshake can take me about an hour to drink.  

I used to skip the milkshake and just go to bed hungry.  Yes, I lost weight.  If you starve a fat person you get a thinner one.  You also get a depressed, food obsessed, mentally impaired person.  Obviously, I'm taking in enough calories to maintain my weight.  I think a lot of people don't understand how few calories that actually is.  Despite what weight watchers and the diet industry want you to believe, our bodies are not bunsen burners.  3600 extra calories does not equal one pound of fat.  (Read Rethinking Thin by Gina Kolata for some really interesting and accessible science on that topic.)

reflux when I lay down -  I cannot lay down within two hours of eating anything without having reflux, and this definitely contributes to my sleep issues.  Flat on front or back is reflux, pretty much instantly.  Even on an empty stomach.  So I flip back and forth between right and left sides, waking up every time I need to turn over.  Right side - sleep for a while until a hip starts to bug, flip to left and sleep for a while until reflux becomes intolerable.  Lather, rinse, repeat.  I can't take any of the acid reducers (tried that once and the acid rebound nearly killed me, literally) so I crunch a lot of tums.  They help for an hour or two.  Sometimes.  

blood in vomit - somewhere along the way my esophogus or stomach lining are giving out.  This has been really minor, and honestly, I'm surprised that it took this long for it to happen.  Just traces of red that I know had nothing to do with food - like when you nick your gum while brushing your teeth?  If it was ever seriously bloody I would have gone straight to the ER with it.  And honestly, I have hoped for that for years, just to get this damned thing out.  

Other random things -

Because of serious risks of ulcers (and then death) I can't take NSAIDS for pain relief. No Aleve, no Ibuprofen, no aspirin.  Just tylenol.  And we all know tylenol doesn't do shit, right?  And narcotics.  Those are fine.  Cramps?  Vicodin.  Headache?  Vicodin.  Sprained ankle?  Vicodin.  I don't take a lot of it even though I have it, because I am scared of how much I like it.  I love the cozy warm drift-off-to-peaceful-sleepiness I get from it.  And I hate being constipated more than I hate being in pain.  I could easily see a life of a vicodin at bed time and an ex-lax for breakfast if I let myself go down that road.  I have never taken anything stronger and I kind of hope I don't ever need to, for this reason.  

I haven't eaten a full meal sitting at a table in years.  I sit through the meal when dining out and then take my box of food home where I can walk around while I eat it, or else nibble very slowly on the couch or in my office while I watch TV or surf the web.  Bob and I have never eaten a meal together at the table in our house.  I've watched him eat, and then moved to the couch to finish mine an hour later.  We did that a couple of times and then agreed it was creepy and started just eating on the couch while watching TV.  I realize that this is the norm for a lot of people now, but I kind of hate that.  And I would like to have the option to sit at the table comfortably, at least. 

The weirdest thing that I gave up for this is my sewing.  I used to do needlework - tatting, cross stich, hardanger, crewel embroidery.  I used to do this while watching TV at night.  For a long time I was feeling guilty because I felt like I had replaced that habit with web surfing, but when I tried to break that I realized that it's not about the web, it's about food.  It takes me at least two or more hours to eat dinner every night, and I don't want to sew while I'm eating.  So I don't sew, ever.  I miss it.  It was relaxing and engaging in a quiet way.  I wonder sometimes if not having that kind of habit in the evenings anymore also contributes to my sleep issues. 

Despite the general boringness of my current day to day existence, I've lived a pretty full and adventurous life.  Getting this thing put in my body nine years ago is the only thing I truly regret.  

One week from tonight, it will be gone.  Best hundred bucks I ever spent. 
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