The kind I'm scheduled for is called Roux-en-Y. Ironically I knew what roux was...basically fat and flour used as a base for certain recipes as a sauce. In this case it is a procedure named after the first surgeon to describe this type of operation. There are several variations of the procedure but for the most part if you diagram the end results your stomach and intestine are rerouted into a "Y" shape.
More drastic than the common gastric banding, Roux-en-Y combines calorie restriction - your stomach pouch is made smaller so it holds less food and makes you feel full sooner - with malnutrition; your intestine is shortened so it can't absorb as much nutrients (and calories) into your system.
The technicalities and all the pretty diagrams and pictures are readily available on the webbertubes via Google. If you're reading this because you're interested in the topic you no doubt already saw material describing the procedures; I started this to describe less about the technical aspects and more about expressing the emotional impacts and ramifications of the surgery.
In my research on the Internet I've run across references to people thinking that this surgery is a magic bullet fix. It's really not. Over and over it's reiterated: this is a tool to help you lose weight. It alters the way the brain perceives fullness. It alters your absorbtion of food. It punishes you if you "cheat" unless you stretch the pouch or start eating foods that are high calorie and slip readily through the pouch (milkshake, anyone?) (If you want to know about punishment, look up "dumping syndrome" related to gastric bypass surgery).
There are actually people that find ways to "cheat" their bypass surgery and there are a significant number of people who fail to lose weight after the honeymoon period following the procedure. Perhaps they just expect this to be a magic fix and ignore anything told to them to the contrary. Maybe they failed to address the underlying reason they overeat in the first place. I'm sure I'll have more thoughts on this after the surgery as I experience the emotions that follow the knife.
The underlying reason for overeating is a big problem, however. In my case I most likely eat because in part it is a comfort, an emotional hat rack on which to hang my problems. A very common response to the surgery is depression. Depression because of a variety of pressures but also because the primary emotional friend...the cheeseburger, the cupcake, the block of cheese...is no longer there to comfort the patient. The perception others have that this is an easy way out is yet another bit of baggage to lug around. It increases the self-perception that I'm a failure, that I wasn't "strong" enough to do this on my own.
I don't expect to change people's minds about this. They'll think what they will. But my reaction to other people's perceptions is something I do have some degree of control over. I've spent a lot of time thinking about the ramifications of what I'm about to do; if the things I will be facing post-operatively are considered the easy way out, then I guess they're right.
- I'll never be able to eat sugary foods unless I want to drown in nausea and diarrhea.
- I'll never be able to drink while eating.
- I'll never be able to drink alcoholic beverages. Okay, this isn't a biggie for me.
- I'll most likely be facing depression that may require treatment professionally.
- I'll have at least a month of enduring a "clear diet". Broth. Jello. More broth.
- I'll have to face my own fears of waking with tubes sticking out of my gut for several days. And a catheter. I'm squeamish about this.
- I'll have to change my routine and habits. If you don't understand Asperger's, you can't comprehend how difficult this is for me.
- I'll have to face the fear of food becoming "stuck". If I don't thoroughly...completely...chew food until it would fit into the pouch and through the opening into the intestines, let's just say what I've found isn't pleasant. At best I'll vomit. Next best I can try eating meat tenderizer. Worst case...surgery. Because of a stray bit of oversized chicken.
- I'll be on a permanent regimen of mutivitamins and probably calcium every day.
- I'll probably lose hair. Temporary, again not a biggie since I'm warned about it.
- I'll have to re-learn how to eat. Foods that "normals" take for granted can induce a dumping attack because of an aquired sensitivity to sugar. Something as innocuous as salad dressing at a restaurant could reduce me to a sweaty shivering heap on the floor. On the plus side I hear there's some people that experience a kind of delirium in the process so I guess that's a silver lining.
- I'll have to face psychological issues...ranging from the previously mentioned change in routine to depression to mood swings to coping with other people's reactions to my own fears about tubes in my gut and leaks where the surgeons reattach my innards and fears that a sneeze will forcefully expel my intestines from the front of my abdomen through the stitches like a birthday blowout party favor, only instead of making an annoying twitter of noise, I don't want to think about what flies out in this case.
- I'll have to survive the slim, but not nonexistent, chance that I won't be leaving that hospital if things turn for the worse. And the risk doesn't end there. The chance of dying from complications reduce as I'll heal, but that doesn't happen overnight. I'll be on embolism watch for at least a month.
In other words a few hours one day will forever change my life, gambling that the benefits will outweigh the drawbacks. I don't think this is the definition of an easy way out. Some other people might.
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