Patient Y
(Preferred to remain anonymous)
My life before my operation was good – I was happy and successful. My size didn’t cause me much unhappiness, and had presented relatively little difficulty in terms of causing any other health problems. For me, my principle motivation for weight loss was my recent diagnosis with MS because if I was to fall over, I was going to have to be able to pick myself back up again. I was of course aware of the risks of being overweight, but had not yet felt the effects of them, and as I was happy I had little to motivate me. I first heard about weight loss surgery twenty years ago, when stomach stapling first started to get a lot of media coverage. Surgery had always been a possibility and when my MS was diagnosed weight loss became a necessity, which gave me the motivation I needed to take drastic measures. My neurologist had encouraged me to lose weight, and when I told him I had considered weight loss surgery, came up with a contact at St Anthony’s Hospital.
I had always been overweight. At 8 years old I weighed 8 stone, and I took on a stone for every year of my life so that by the time I was 19 I weighed 19 stone. I tried every diet imaginable but could not shift the weight – at one point I was consuming only 500 calories a day and was exercising 5 times a week at the gym. But nothing worked, which I found very demoralising. Although doctors did later attribute my chronic overweight to a medical condition, this did not change much and was not much of a ‘revelation’ – I still needed to lose weight! Surgery was something of a last resort.
Although my weight had never been an issue for my friends and family, I decided that I did not want to burden them, or have them try to dissuade me, so I would only tell one member of my family and one very close friend – they were both very supportive and respected my privacy.
Pre-surgery
I was given a pre-surgery diet of four cans of weight watchers soup, four low fat yogurts and half a pint of semi-skimmed milk a day. I had always had complete freedom of what I ate, but it was not difficult to reduce what I was eating – I was by habit a grazer, so had always eaten little and often. Indeed rather than finding the diet too difficult and restrictive, it made me more determined to succeed so I halved what I was taking in and also exercised. Once I had decided to have weight loss surgery, in my mind there was no going back, and I wanted to be in the best possible shape for the operation.
The risks of surgery were fully explained to me, but I felt very confident – I had decided on weight loss surgery, and I had decided I would make it work for me. I never had any doubts and found this positive mental attitude crucial to my weight loss.
I first met my surgeon, Mr Fiennes, in March, and the date of the operation was set for that September. For me, the choice of which operation to have was a simple one, and one my surgeon and I made together. I was not suitable for the band, as this is normally recommended for those with Binge Eating Disorder which I did not suffer from. I did not feel the band would be right for me as I did not feel happy with anything alien or external being placed in my body. My bypass operation went ahead in the September.
I spent the first day after my operation in bed, and on the second day I got out of bed for a walk around the ward. I do remember this as being uncomfortable, but I was not in any great pain. Whilst this was partly due to the operation (I had had five incisions), the discomfort was also due to my size and the various temporary lines and tubes I had had inserted in me.
When I returned home my diet still largely consisted of soup. I did experience some unpleasant side effects if, for example, I ate too quickly, which would produce a thick, bile-like saliva. But for me, these side-effects were overcome by a positive mental attitude – mind over matter!
The extent of post-operative care I received played a large part in my weight loss success. Whilst I did not feel the need for psychological or emotional support, I knew that the team were there for me should I have needed anything. I had attended a group therapy session before the operation, which was much like an extreme version of Weight Watchers, but I did not feel that this was for me. At the meeting I saw how this support could be hugely beneficial for many of the patients. The support, if you needed it, was fantastic, although in my case I felt I needed little more than the occasional consultation with my surgeon.
Things changed once I started to lose some weight. One of the impacts was that it made clothes shopping much more fun and rewarding – and much cheaper. Clothes had always been too small for me, but now clothes are very often too big! I came to realise that in the past my social life had wholly revolved around going out for supper, so I stopped doing this for a year and found new ways to socialise. My friends accepted that I was introducing changes into my life (although they did not know about the operation).
I would say that my diet has changed, in terms of what I eat as well as how much I eat. Interestingly I would say I eat less healthily now than I did beforehand. Before the operation when I had the freedom to eat as much as I wanted, of whatever I wanted, I made sure I consumed a variety of fruit and vegetables, and I rarely ate biscuits, bread or crisps because I would put on weight so easily. Now, although I am still careful, I do have more of the things I used to avoid, because I can. On reflection, you could say I have been liberated to be less strict, thanks to the surgery – and this is actually helping me to lose weight! I will be on vitamin and mineral supplements for the rest of my life. I have noticed that I tend to eat for fuel rather than for fun now, and eating often bores me – although I did always have the capacity to be bored by food before the weight loss surgery too. Now that I have reached my goal weight and do not need to lose anymore, I have had to change my eating habits again, to adapt to this. As I adapt back to normal eating habits, I am anxious that I may regain weight I have worked hard to lose, or that although I am exercising regularly, any weight I take on will go on as fat rather than muscle.
Overall, the total package that I got at St Anthony’s Hospital was second to none. I would not have had my weight loss surgery anywhere else, and I have in fact returned for subsequent plastic surgery procedures, to remove the excess skin. The care of the surgeons in both instances was phenomenal, even if at times care bordered on over-care! However, this was definitely preferable to the alternative; I have seen media coverage of the weight loss stories of patients from other clinics, and some that chose to go abroad. These patients did not receive anywhere near the same level of post operative support and as such have encountered problems and have not succeeded with their weight loss.
Weight loss surgery, and the subsequent weight loss, is very much a team effort – the surgical team, the nursing care, the psychiatrists and the nutritionists all work together. I attribute my success to a combination of their support, and the realisation this provoked in me of the need to be fully committed. As I saw it, there was no point in messing around. From my experience the less successful patients were the ones who had the wrong attitude or did not fully commit. For me surgery was the tool I needed to help me lose weight. When combined with my life experiences and the determination this had given me, surgery helped me lose weight rather than being the solution in its own right.
