I must apologize for the delay in continuing this story. I wrote my last post the night before I was to undergo the most complex form of bariatric surgery (on April 30th), known as the duodenal switch (“DS”). I vastly underestimated how much this event was going to put me out of commission, both in terms of the surgery itself, and the impact of all the changes involved.

I fought for this surgery for five years because it offers benefits that the much more well known gastric bypass cannot meet. Such as:

• My stomach is made much smaller (about 4oz) but it is a fully functioning stomach retaining the pyloric valve, which allows me to take NSAIDS such as Ibuprofen safely. NSAIDS are banned for life with the gastric bypass.
• The intestines are reconfigured differently than the gastric bypass, resulting in far more malabsorption (and requires much more diligence with supplements). This is what helps DS patients maintain the weight loss down the road.
• The DS has a documented cure rate of 98% of Type 2 diabetes. I’ve had diabetes for more than 20 years, which lowers the odds of me being in the 98%, but I’m watching my blood sugars settle lower the last few weeks. This, only on a small dose of insulin, where before I took insulin and two oral meds. I am hopeful.
• With the DS, 80% of any kind of fat eaten is malabsorbed. I will never again eat “low fat” anything. In fact, I need to eat more fat to come up with what the minimum RDA for good health requires. After a lifetime of conditioning, this one is hard to get my mind around, but I like it.

In a state like Massachusetts, which is a hotbed for medical research and innovation, there is not a single surgeon who does the duodenal switch. This, despite the fact that Blue Cross of Massachusetts covers it. Go figure.

The closest verified DS surgeons are in New York City. After being pretty much housebound with a bone-on-bone knee and severe back spasms for five years, it took pure force of will — and a combination of muscle relaxers and pain meds — for me to get to New York. My husband Dan made it all possible. He took time off from work for numerous test appointments the year before surgery; he drove us to and from New York; and was with me every step of the way, both in the hospital, and at the hotel afterwards. We were in New York for 10 days.

Then the overwhelm truly ensued. It’s vital to drink enough water, which is a minimum of 64oz a day. Do the math! I have a 4oz stomach! I am fortunate in that I was able to drink water easily, which many people cannot, and wind up in the ER getting IV fluids a couple weeks out from surgery. Plus I have to eat frequent, very small meals. Like one scrambled egg. Or 3oz of pureed soup.

As I add new foods, the focus is always protein. The goal is 30 grams of protein a day by the 30th day (60 by the 60th, 90 by the 90th). The stomach is swollen and not fully healed for a month. It’s hard for me now to imagine eating 90 grams ever, but it will happen.

Plus, I must begin a schedule for adding large quantities of Vitamin D, Calcium, Iron, and other trace minerals that are now not absorbed well. The consequences of not doing so are very serious: osteoporosis, iron deficiency anemia, neurological problems. I’m not going there.

All of this is a huge undertaking, and requires a pretty sharp mind at a time when I’m told the anesthesia is still messing with it. So the days went by without any word from me, and I’m sorry it’s been so long.

But you know what my overriding feelings are about all of this now that it’s done? I feel hopeful for the first time in eight years. Hopeful that I will no longer be imprisoned by my body, and that I will be able to leave my house for things that are purely fun. Hopeful that I am on my way to good health, including resolution of diabetes. Hopeful that my life is beginning again, right here, right now.

What seemed impossible and pointless to even fantasize about for eight years now seems very possible. I’m excited about my future! It’s precious, and I am nurturing it with all I’ve got.

Stay tuned!