Bariatric Surgery, Anyone?

Continuing our saga of life through August 09....let's see....I forgot to mention that my temporary promotion to Ecosystem Management and Planning staff officer began in July and continutes til the end of October. It means that I must attend Forest Leadership Team meetings, representing EMP, and am the approval point for our group for purchases, training, and all supervisory matters...our supervisor will be resuming her duties in November after she has completed a "detail" to another program.

In August, about the only newsworthy item to report is our trip to San Diego over the weekend of August 15th. The trip was conceived after I acted upon a suggestion from my endocrinologist (at Scripps Clinic in La Jolla) during my late June visit to investigate the possibility of surgery to improve or resolve my diabetic condition. His comments were precipitated by his concern that, with my declining pancreatic function and aging, collateral health issues, such as high blood pressure, would soon be on my horizon.

With this in mind, I phoned the Wittgrove Bariatric Center in La Jolla to request a consultation with Dr. Alan Wittgrove, a renowned bariatric surgeon. An appt was scheduled for August 17th to screen both me and Vern for our Body Mass Index and discuss our options for weight loss and improvement/resolution of my type 2 diabetes and Vern's cardiovascular diseases and sleep apnea.

Upon screening, we learned that I was at the cusp in BMI for morbid obesity and Vern was about 5 points above me, well into morbid obesity. That alone indicated that we were tentative candidates for bariatric surgery. We then met with Dr. Wittgrove to discuss our options. He asked us about our past success with diets, our current eating issues, and other variables that would affect our BMI. One of those is sedentary activity, such as Vern's passion for the TV. We explained that both of us swam laps regularly, and that I was successful in losing over 30 lb with Jenny Craig foods. (Vern lost 10 lb over a year...cheating.) Further, I had gained 15 of that loss back in 18 months. I continued to describe our ventures with Weight Watchers, loss of weight, regain, and my experiences with Optifast, Medifast, and a Dr-supervised high protein program where I lost 20 lb in a month.

Dr. Wittgrove described the types of surgery that he performed, the risks and benefits associated with each, the post-surgery expectations and more. I learned that over 40 years of bypass surgery, statistics indicated that type 2 diabetes was reversed or markedly improved in 90% of patients who had diabetes for 8 years or less. (I have had it 12+ years.) This reversal/improvement occurs LONG BEFORE an individual loses excess weight!

Scientists subsequently hypothesized that the rearrangement of the small intestine during the bypass surgery was the key to diabetes resolution. They subsequently researched the intricacies of the first length of small intestine, called the duodenum, using diabetic rats to try to pinpoint the characteristic(s) of duodenal tissue that causes glucose metabolism to malfunction. Experiments concluded that there is some factor(s) (enzyme? hormone?) in the lining of the duodenum that does(do) not function properly to regulate glucose metabolism. Bypassing that part of the small intestine results in food not coming in contact with the duodenal lining, and hence, there is no adverse effect on glucose metabolism.

With the bypass surgery, the duodenum is disconnected from the distal end of the stomach, where partially digested food empties into it. The next lower segment of small intestine is then reconnected to the stomach and things continue as normal, without food passing thru the duodenal lining. Of course, the bypass surgery also restricts the size of the stomach, which fosters significant weight loss over time in the patient.

We had a lot to digest (no pun intended) after the consultation. I read every article I could find about "duodenum/diabetes". I learned that several medical centers of excellence had been established across the U.S. to make the bypass surgery available to diabetics under the designation as "metabolic" or "diabetic" surgery. Dr. Wittgrove's center is one of them. Cornell University's Medical School at Columbia in NYC is another.

I was stoked that this surgery could improve or resolve my status as a diabetic. I followed up with the doctor's office to learn what I needed to do to be considered a candidate. Vern followed my lead. Weight loss for him is the key to resolving his cardio issues and sleep apnea, over time.

We had the necessary blood tests, a psychological evaluation to screen for any potential mental health concerns post-surgery, and Vern had to obtain clearance from his cardiologist. Doctor's office submitted to BC/BS for approval, which was quickly approved for me. Vern's primary insurance, United Health Care, denies bariatric surgery coverage, so he had an extra hoop to jump thru. After his denial, my BC/BS approved him for surgery.

That about sums up our August and September adventures. I was advised in mid-Sept of a surgery date on October 6 at Scripps Memorial Hospital in La Jolla. Vern was assigned a date in November, but after my rough post-surgical ride, we rescheduled him for January. He continues to eat like it's his last meal, and has GAINED weight since our first visit to Wittgrove. He is swimming regularly, but our pool temperature has dropped from 96 to 84 due to cold nights. Don't know how long he'll be able to tough it out.

I will write about my surgery in an October update in a day or so.
Please pray for my continued recovery.
Peace and good health,
a