Third time lucky from Queanbeyan

Here's a bit of an update.

I'm still 2.5 weeks pre-op.  My weight is going in the right direction, but this last week has either been the mother of all stalls, or there has been some muscle gain that is throwing off the figures.  It feels like I have nothing to show for an awful lot of effort.

Usual weight: 185kg
Last Sunday (8 nights ago): 172.6kg
Last Monday (7 nights ago): 172.2kg
Tonight: 172.0kg

In that time I worked out Sunday, Monday, Tuesday, Thursday and Monday, typically 20(25) minutes on the Elliptical machine.  I have a spinal injury and my balance is shot, so I don't dare use the other cardio machines.  I'm also not doing any weights just now.

I'm having an Optifast for Breakfast (on its own), another Optifast and some veggies with a can of sardines (or similar) for Dinner and Weekend lunch, and my weekday Lunch is lentil stews and veg with a little chicken.  I've been wearing down my supply of snacks prior to the final two weeks, so I also had most of my remaining nuts last weekend as snacks, and I had the last of my frozen yoghurt last week too.

I used a test strip tonight to check my urine.  There's no glucose and a low level of ketones.  Of course, I could have just gone off the bad breath and saved $8.40 from Chemist Warehouse on the canister of Keto Strips.  I just wanted to be sure.

After the stellar weight loss in the last few months, 200 grams in a week is a bit of a disappointment.  Though maybe it shouldn't be so unexpected given the frozen yoghurt and the nuts.

Peter - Thanks for your honesty, I'm so sorry that the health system has let you down so badly, but sadly I have had similar experiences myself (of course not as bad as yours) and being an obese spinal patient is really the pits, especially the way some nurses treat them, I have been on the receiving end in Royal North Shore Hospital in Sydney. I was only there for less than 48 hours and it was my own personal horror story.

Thanks so much for your account of your experiences of spinal surgery etc., I really don't know how to put into words my gratitude. You have really been through a lot for someone who is only 33 years old. I am really hoping to avoid spinal surgery, I think for me the biggest worry it is the fear of incontinence for me, I value my independence in that area like everyone else I guess. I was terrified to have the sleeve surgery but I made myself do that hoping that with the weight loss I may get a reprieve from the spinal problems. I also am very cynical towards our health system in general, I attended a pain clinic before my injury became obvious, as in CT scans proved I wasn't lying or exaggerating the pain that I was in and that there was an actual injury in the spine. The pain clinic told me some crappola about the body feels pain to protect me from some perceived injury but as there is nothing actually wrong with me I should simply 'work through' my pain. So I kept pushing myself, kept working full time until I finally 'broke' my back! Of course work didn't want to know about me and I have felt great hostility towards that pain clinic to this day.

The political garbage that different states go on about, won't lend a NSW patient equip from ACT hospital, what nonsense, my husband and I went through a similar type of thing with him stuck in a hospital in far North Qld and me at home 2000 kms away in NSW a few years ago, they wouldn't transfer him closer to home because of the different health laws between the states??? Last time I looked we all belong to the same country!

My husband has had the sleeve surgery on March 25th this year, his BMI was around 57 and he was 175 kilos, he is currently BMI 49 and weighs 147.7 kilos, he isn't keeping a diary on here though, he tends to just follow me, he calls me 'the trailblazer' as I was the one who researched and went ahead with the surgery last October. I am happy to ask him any questions you might want to know, he probably would be happy to answer you directly if you would like to 'talk' to him maybe through email?.

Wow!  What an ordeal you have been through at such a young age!

I just wanted to offer some advice though as I think you have been through enough at this point.  Choose your surgeon wisely, even if it means you have to go to another state.  I had many complications after my surgery and dealt with a few crappy hospitals and surgeons until I found a great one now.

There used to be a gentleman on here who I haven't seen for a long time and I think his starting weight was also 190kg.  He was told he would need a revision down the track as the initial surgery will only get him so far.  Last I heard he had the 2nd revision, weight loss going great and was next looking into plastics.

Note also, any referral you get from the GP, doesn't have to be for that surgeon.  Any surgeon will accept it as it's a referral for WLS.

Be prepared to ask your surgeon loads of questions and if you feel he can't answer them properly or you don't feel comfortable, see another one.  It is important as you need the very best of care with someone who knows what they are doing - you don't need any more dramas in your life!

All the very best and good luck :-)

TeaBreeze wrote:

Gosh Peter, it sounds like you've certainly been through the ringer with your health and some of the institutions here around Qbyn and Canberra.

Thanks.  It's disturbing that I feel this wholehearted revulsion for our health system at only 33 years of age. 

TCH has things growing in and on the building.  Spend enough time looking out the grotty window onto the grotty brick wall outside and you wonder when all that growth will achieve sentience.  On the plus side, TCH has lots of equipment.  On the minus side, they won't loan any rehab equipment to NSW residents.

QDH has amazing new facilities, but next to no diagnostic equipment, very few doctors, very few specialist services, no CT scanner, no MRI scanner, and no bariatric beds or rehab equipment.

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I'm in Qbyn also and went through Canberra Bariatric for my surgery almost two months ago (8 weeks post-op on Tuesday!). I can't comment on Siva, as I had Charlie as my surgeon, but they're lovely people and if you do decide definitively to go down the sleeve route, I can't recommend them highly enough. They are based in John James though and it's their preferred base for surgeries, but I'm sure there's no harm in requesting a secular hospital anyway!

I really am not looking forward to any of my money enriching the little company of mary/the catholic church (non-capitalization intended).  I've been seriously contemplating getting my sleeve done in Sydney so that I can avoid the ethical dilemma of my money funding an order of an evil religion that has hurt and killed so many people throughout history.  Even in my immediate family there are three cases of forced adoptions that come to mind, which are unforgivable crimes.

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I hope everything goes well for you and you end up on the sleeved side, it's a nice place to be ;)

Thanks!  I just read your 8 page chunky thread, and a few others.  All the info I can get is helpful, and appreciated, though I'm still hoping to find a tad more from the male perspective, or the 190kg / 52.4 BMI perspective, or the spinal injury perspective.  I'll keep looking.

Gosh Peter, it sounds like you've certainly been through the ringer with your health and some of the institutions here around Qbyn and Canberra. 

I'm in Qbyn also and went through Canberra Bariatric for my surgery almost two months ago (8 weeks post-op on Tuesday!). I can't comment on Siva, as I had Charlie as my surgeon, but they're lovely people and if you do decide definitively to go down the sleeve route, I can't recommend them highly enough. They are based in John James though and it's their preferred base for surgeries, but I'm sure there's no harm in requesting a secular hospital anyway!

I hope everything goes well for you and you end up on the sleeved side, it's a nice place to be ;)

Vikki28 wrote:

Hi Peter - Thanks for that information, I may have to have spinal surgery in the future, I have seen a specialist about it but at the time he decided that I was too fat to operate on (benefits vs risk). Yes the whole thought of spinal surgery terrifies me and the possible consequences of it.

Spinal surgery is a disaster waiting to happen.  I don't blame surgeons wanting to use any excuse under the sun to not perform it, outside of an emergency.  No matter how skilled the neurosurgeon is, the prognosis is bad, and I imagine they would be exposing themselves to too many lawsuits.

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I've been trained as a nurse so I probably think too much about the negative stuff. I agree with you that the wheelchair option is a last resort, sometimes I want to give up and sit down at least if you are in a wheelchair people don't expect you to be 'normal' and keep going

Being obese and in a wheelchair invites even more scorn IMHO.  Doubly so if it's a motorised wheelchair.

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Funny thing the doctor has now put me onto a stronger pain killer as I wasn't sleeping very well at night due to pain, but of course a side effect of the drug is constipation! I think I'll become a laxative expert if nothing else!

I'm a huge fan of Osmolax.  It doesn't have the disgusting aftertaste of Movicol and it's almost as effective.

Having said that, when you have lost sphincter control, laxatives are a worse option than enemas.  Laxatives plus no sphincter control means regular messes, which pretty much rules out maintaining a job, a livable income, and any sort of dignity.

Reader discretion advised here: At least if you have the sort of shower fittings that gay men use before bottoming (which can be bought online very cheaply!) you can make sure you never have an accident, by every 2nd day setting aside two hours to make sure there's absolutely nothing left in there to come out.  So long as you supplement with probiotics, get your technique right, and have backup plans for holidays and any other travel, you can bypass the laxatives.  I am a huge fan of the 12" rubber attachment that can bypass the rectum entirely.

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Anyhoo......at least I am getting lighter and that does make everyday movement and getting around easier.

Congrats!  I hope to do the same later this year..

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When you lose the weight I'm sure that you'll find it much easier to do things too. The great thing about the sleeve is that you don't have to exercise like a demon, to lose weight, I know it is better if you can but.........

That's one thing I wonder about.  Doesn't your body end up in starvation mode?  Surely exercise (like a demon or otherwise) after a sleeve or band is tempting fate...

I had some success with exercise a few years ago, and now I'm right back where I started.

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Would you mind if I were to ask you questions about your spinal surgery?

Not at all.  Here's how it went.

On a Friday afternoon I was sitting down at a cafe in Canberra with work colleagues, then I stood up, when I felt something pop and suddenly I started going numb while also starting to feel some excruciating pain.

The excruciating pain kept getting worse.  I have had back issues for years and I find that sleeping in a hammock helps, so I ended up in the hammock.  It was the middle of winter and thankfully I have strategies for using a hammock without freezing.  On the Saturday night I ordered pizza but forgot to unlock the front door during the few minutes I was able to move that afternoon.  The delivery guy was really unnerved by all the screaming as I dragged myself across the floor to get back to the door.  On the Sunday I had to get my neighbours to break into my flat, and the ambos and a few firies helped drag me out to the side balcony where I could collapse onto their trolley.

At Queanbeyan Hospital they kept talking about discharging me.  "Oh, it's just sciatica, we'll send you home with some pain meds and you can come back for some outpatient physio".  Meanwhile I had real grief passing urine and couldn't pass a bowel movement at all.  Eventually the VMO in the emergency department started thinking it's not sciatica, but they don't even have a CT scanner at Queanbeyan Hospital.  The CT scan was done on the Monday (at a small radiology practice around the corner), and it was inconclusive.  The MRI got bumped from Tuesday, to Wednesday morning, then to Wednesday afternoon.  It involved a long agonising drive from Queanbeyan hospital to a radiology practice in Garran, then a long agonising drive back.  On the Thursday morning the report came back and they transferred me over to Canberra hospital (also at Garran) in an even less comfortable ambulance bed (something I thought was impossible but there I was!), followed by a long wait in the corridor outside the emergency department.  I couldn't lay on my back without maximising the agony, and the trolley was too small to do anything but that.

The VMO at Queanbeyan told me to make sure I ask for non-surgical options, if any exist.  The specialist at Canberra said point blank that I had no options left if I ever wanted to get out of that hospital bed.  I was on the operating table a couple of hours later.

I came out of the surgery on my back, thinking "hold on, I'm on my back, I can't be on my back without agony, do I need to move?" but then I found I was feeling nothing and had real difficulty moving anyway.

The next day the physio tried to get me mobilising on crutches.  Insane!  Timber! (Well, almost!  The physio probably needed physio after that episode)

I was really struggling at Canberra Hospital.  It was a six bed ward with an old man that snored badly in the next bed.  I snore badly too but at least I had a CPAP machine to manage it.  He eventually got moved out and they managed to fill that bed with chatty young girl with more chatty friends.  Also the nurses at TCH are a real mixed bag and I had one who insisted I stand up before even moving the catheter bag off the hook behind the toilet and onto the forearm support frame.  Also the patient call system at TCH is not very effective.  I refused to be a patient that would sing out "NURSE" so I pushed the button occasionally, as required, and just waited.  And waited.  My mother drove from near Sutton to Queanbeyan's outskirts while en route from Sydney in the time it took a nurse to respond to my call one evening. 

I gradually lost it at TCH over the course of a week, and I demanded to be transferred back to Queanbeyan Hospital.  The VMO at Queanbeyan really didn't want to treat me again unless I could empty my bladder without a catheter.  The instructions didn't specify that I had to do it the normal way instead of stressing and straining right before they gave it an ultrasound showing I did actually get it empty.  The specialist offered to treat me at John James instead, but I really dislike catholic hospitals/institutions with a passion (and I'll be asking if my sleeve can be done at a secular hospital if at all possible).  Since Queanbeyan was almost an option (and it was at least a nice environment) I parted ways with the specialist and got myself transferred back to the care of a less qualified VMO back near home.  Fortunately from that point on it was mostly just a stay of convalescence, so the doctor's skillset didn't really matter.

So all up I spent a week at Queanbeyan, a week at TCH, and then another two weeks at Queanbeyan.  None of the rehab equipment at Queanbeyan could support my weight, except for one forearm support frame, but that was fine, since as a NSW resident I was barred from borrowing rehab equipment from TCH, thus I was equally screwed by the state border.  I found a forearm support walker (on wheels, with brakes, instead of the hospital style ones with plastic skids only) online, and I got it couriered to the hospital.  Several hundred dollars later, and after some assembly (from my hospital couch), I was up and about as often as I could (despite usually leaving trails behind me that required a cleaner with a mop).  Eventually I met their criteria for discharge, back to the comfort of my own damned home, despite the mould and the freezing cold, and the stairs on entry, and having to do my own cooking and cleaning etc.  It was a small price to pay to get into my own damned hammock and out of the hospital beds.

Hi Peter - Thanks for that information, I may have to have spinal surgery in the future, I have seen a specialist about it but at the time he decided that I was too fat to operate on (benefits vs risk). Yes the whole thought of spinal surgery terrifies me and the possible consequences of it. I've been trained as a nurse so I probably think too much about the negative stuff. I agree with you that the wheelchair option is a last resort, sometimes I want to give up and sit down at least if you are in a wheelchair people don't expect you to be 'normal' and keep going, being in constant pain and obese of course, it seems to make me physically tired. Funny thing the doctor has now put me onto a stronger pain killer as I wasn't sleeping very well at night due to pain, but of course a side effect of the drug is constipation! I think I'll become a laxative expert if nothing else! 

Anyhoo......at least I am getting lighter and that does make everyday movement and getting around easier. 

When you lose the weight I'm sure that you'll find it much easier to do things too. The great thing about the sleeve is that you don't have to exercise like a demon, to lose weight, I know it is better if you can but.........

Would you mind if I were to ask you questions about your spinal surgery?

Vikki28 wrote:

I have L4/L5 and L5/S1 protruding disks and suffer with chronic pain and mobility issues because of it, I can't imagine being a partial quadriplegic but the scare of possibly ending up in a wheelchair did motivate me towards having sleeve surgery and making it easier for me to get around without the excess weight.

I'm sorry to hear that Vikki.  I might be lucky in that regard.  I had the L4/L5 Laminectomy and Discectomy as emergency surgery in July 2011.  There's now no longer a disc left to protrude and cause grief.

Partial paraplegia is annoying but better than actual paraplegia.  I lost the nerves that transmit sensation from substantial parts of my legs and feet, as well as a few nerves that control legs, feet, bladder, bowels etc.  They are gradually coming back, but not in their entirety it seems.  Apparently what comes back after 2-3 years is what you can expect to get back, and what I've got back isn't much.

I started out with a forearm support walker and gradually learned how to walk again after a couple of months, though I still stumble from time to time.  A wheelchair would only make things worse IMHO.  I could barely move myself in the hospital issue wheelchair and mobility is just the tip of the iceberg when it comes to spinal issues.

Best of luck with your struggles!


-Peter

Hey Queanbeyan,

Constipation seems to be a common side effect for sleevers. I have been constipated all of my life, I have low thyroid function so I am prone to it anyway. But with the sleeve you can't eat the same amount of bulk in your food, so a lot of people do have constipation after surgery. I would doubt if many people have diarrhoea after surgery but you never know I guess, of course you'll need to address this question to your surgeon for a better informed answer.

I have L4/L5 and L5/S1 protruding disks and suffer with chronic pain and mobility issues because of it, I can't imagine being a partial quadriplegic but the scare of possibly ending up in a wheelchair did motivate me towards having sleeve surgery and making it easier for me to get around without the excess weight.

All the best with your upcoming surgery and I hope it helps to make life better for you.

Hi All,

Next month will be the third time I've seriously contemplated bariatric surgery.  This time I expect I'll actually go through with it.

I've been obese since fifth or sixth grade.  Back then I'd make four strawberry jam sandwiches each morning and have half or one for breakfast and the rest across morning tea and lunch.  Dinner was a $1 bag of hot chips from the local take-away (because that was all Mum could afford).  My diet changed quite a lot as the years passed, but I never shook off the spare tyre(s) I got while in fifth and sixth grade.

Three years ago I was 30 and a congenital spinal defect turned acute prematurely (chances are it would have always gone acute but probably not until old age if I didn't have all the extra weight).  That left me a partial paraplegic (Cauda Equina Syndrome - or an L4/5 large paracentral disc protrusion with left lateral stenosis - basically a disc started to bulge and started rubbing against (and damaging and triggering) the nerves that control most of the lower half of my body).  I've been using catheters for my bladder and various methods to deal with constipation.  The spinal issue itself was a week of complete and utter agony, followed by emergency surgery once the issue was identified, followed by a whole lot of nothing.  It's hard for people to understand that you can still have a major back problem but feel no pain whatsoever.  The thought of spinal problems being partially fixed by surgery and not hurting, but remaining a problem, just doesn't compute for most. 

Fortunately for me I'm moving around a lot better now, albeit with a lot of stumbling and the occasional fall.  I refuse to use a cane though, except when I know in advance that I'll be walking on unstable surfaces.  The cane stays in the car the rest of the time.  I'm only 33, and an occasional fall seems preferable to the indignity of using a cane at this age.  Besides, if I have the cane in my hand, I end up using it, even when I don't need it, and that will only cause dependence issues.

Anyway, the food at Queanbeyan and Canberra hospitals caused me to lose about 5kg (185 to 180) over four weeks.  After my discharge I got tired of paying a physio top dollar for really short consultations, way more than I'd pay a Personal Trainer to do much the same thing and actually coach me through the activities (rather than telling me to go off elsewhere and do them in my own time).  I found an excellent PT in Queanbeyan and she got me down into the mid 150s after a couple of months.  She also set me off on protein shakes, and later a wheat-free diet, and I was feeling way better as a result.  I decided to cancel my appointment with Dr Gananadha.  I felt empowered.  Then I stopped going to the PT because I thought I was able to maintain the healthy eating habit and do my exercise in my own time.  I kept the wheat-free diet but dropped the protein shakes, and as time went on, it was easy to occasionally (and not-so-occasionally) indulge in sugary rubbish.

Then a year ago I was starting to get up into the high 160s and I decided to contemplate banding or sleeve again, but with the constant cuts in the APS I had serious plans to move to Brisbane (or maybe Sydney, but Brisbane almost firmed up).  The thought of getting banded in Canberra where it's expensive and then having to pay another specialist again for fills in a new town didn't appeal.  I wasn't sure about sleeves at the time, and even if I did choose a sleeve back then, it just didn't make sense to lose the option of follow-ups with Canberra Bariatric/Dr Gananadha if anything went wrong, so I cancelled the appointment.

Suffice it to say I never left town.  The job up there fell through, the job down here firmed up, and a much nicer flat opened up in the same complex here in Queanbeyan, so I moved.  However, since then I've gradually crept back up to 184kg.  I just looked at the scales at the gym in horror last week.  It's time to bite the bullet and get the sleeve done.

I have appointments at Canberra Bariatric on 14/7 and 17/7 after which I'll need to get my superannuation paperwork in order.  If all goes well I might end up with the sleeve done in August, but September seems more likely.

I guess the big question I have is whether anything the surgeon does can make diarrhea more likely than constipation.  I have been reading side effects and both are listed.  If he can err on the side of the former, I'll be quite happy to kill two birds with one stone!