Sickness after surgery

If I can say anything consistent about being a post-op RNY patient, it's that there's always something new to contend with right around the corner. And since in life, timing is everything, this latest eye-opener came right on the heels of my exciting and reaffirming experience speaking at the Bariatric Conference.

I was looking forward to celebrating my one year surgiversary on December 7th, but the night before I got sick. After a long day at work, I went home and collapsed on the couch with extreme dizziness and a high fever, followed by vomiting. Now for those of you unfamiliar with the gastric bypass procedure, vomiting is a scary prospect. Not only is my stomach much smaller than the norm, thereby limiting my ability to take in an appropriate amount of nourishment to fight off whatever bug is causing it, but replenishing the fluids I've lost through vomiting is a huge issue. I can only take in about a cup of food or liquid at a time, and with rapid loss of fluid, dehydration is a potentially life-threatening risk. In fact, when completing the pre-op education classes necessary to have the surgery, I was warned again and again that if I vomited for more than a day, I needed to get to the clinic to preserve my health. There were stories of other post-op patient deaths that were a direct result of dehydration, and they didn't need to convince me how very important staying hydrated is to an RNY patient. 

So, the next day, off I went to my family doctor to get checked out. I have nothing but praise for my fantastic GP. Despite being new to gastric bypass, he's always well informed and listens to my concerns as they relate to my new lifestyle and eating abilities. He was equally as concerned about my fluid levels with vomiting as I was and he set to work to rule out his main concerns: bacterial meningitis, c-difficile and H1N-strains of the flu. He was able to positively diagnose a viral infection, and he explained to me that rest was my absolute best ally in the fight to get well.

Quite honestly, before surgery, the whole "rest and get well" thing kind of went in one ear and out the other with me, as I'm sure it does with most people. Yes, we get sick, but very often we still go to work, we still keep up with our daily lives, and we don't take enough time to give our bodies a chance to rest. As a result, it can take 2 to 3 times longer to recover from a common illness like a cold or the flu, and we tend to feel miserable (not to mention exhausted) for weeks.  But I'm glad that my doctor explained the difference for RNY patients. Without the stomach capacity or duodenum to adequately digest and absorb nutrients, our bodies' only defense is to rest. When rest can't keep up with illness and dehydration sets in, IV fluids are generally needed. This is no joke. And in the past year, if I've learned anything, it's that my health is paramount and I refuse to take it lightly.

That being said, the first week home was hard for me. Besides being a sitting duck for an infection that was ravaging my systems (I even developed infected gums and cuticles), I found it hard to sit still. Even as a sickie, my post-op energy was getting the best of me. After 6 days, Monday rolled around and I was chomping at the bit to get back to work. Bad idea. On my way out the door to go to work Monday morning, the dizziness and vomiting returned with a vengeance. No work for me, and a trip back to my doctor, who was not pleased that I had tried to rush the process. Now, I'm pretty thick-headed, but I think this one actually got through. Even with my new body, with all of its new abilities, I still can't cheat illness.

My doctor ordered me off work until next Tuesday, and I plan on taking his advice. My only trip out of the house was to Indigo to stock up on must-read new releases, and I'm expecting a visit from my wonderful sister this weekend (who has graciously volunteered to clean my house for the holidays - no doubt to put a stop to my whining about it, lol). I was also thrilled to get a visit from my friend and co-worker Jenn yesterday, who delivered a delicious batch of homemade chicken soup to my door, along with a group get well soon card from my team at work. Needless to say, I feel extremely lucky to have such caring people looking out for me.

So I leave you with this thought. Whether you're post-op patient, a pre-op patient, or just your average Joe, please take care of yourself this season. There's nothing heroic about going to work sick or exhausting yourself when you're feeling terrible. Be gentle with yourself and your body will thank you with good health all year.

My Speech at the Bariatric Education Conference

Today I had a full circle moment. I was lucky enough to speak at the 2nd annual Bariatric Education Conference at the University of Toronto's Faculty Club, and to share my weight loss surgery story with people in the business. It was an amazing feeling to stand in front of health care providers like nurses, dietitians, social-psychiatry staff, surgeons and folks from the Ministry of Health and detail my journey. I also got quite a few requests for my blog address so that it could be shared with patients going through the same thing. I'm humbled and honoured that they would think to share my experiences, and I aim to keep writing about my struggles so that others can benefit :). And so, below, you'll find my speech in its entirety. I want to thank my wonderful friend and surgery-sista, Heather Rosenthal, who also spoke at the conference today. As patient #1 in our program, she's always been and will always be my inspiration.


When I first heard about gastric bypass surgery, I was skeptical. I thought it was a crazy & dangerous procedure reserved for the rich and famous out in Hollywood, not for normal, everyday people like me. What I did know was that after 34 years of trying to control my weight through every way possible, and after failing miserably at it year after year, I was ready to try something new. Little did I know that this procedure, this tool, would change my life in ways I never thought possible.



My surgery date was almost a year ago today, December 7, 2009. The day I went in for surgery, I was 281 lbs on a 5 foot, 1 inch frame. My BMI was a whopping 51.1. I had been suffering from extreme hypertension for 10 years, had severe asthma that limited my activity level, was infertile thanks to polycystic ovarian syndrome, I was exhibiting symptoms of pre-diabetes, and I was exhausted. I couldn’t climb a flight of stairs without feeling faint and needing to sit down. And most importantly, my favourite expression was, “I can’t.” After so many years of being obese, I had gotten used to giving up before even trying so many things because I knew that I physically couldn’t do it. Activities like skiing, running & rock climbing were out of reach for me. I would avoid public places like restaurants in case I couldn’t physically fit in their seats or booths. Then there was the emotional tole. I shied away from social gatherings and any situations at work where I would have to be front and centre. I didn’t want anyone looking at me or scrutinizing me because years of being the target of ridicule over my weight. I have to say, the social stigma and resulting self esteem issues that come from being obese should never be discounted when treating patients.


So, when I went into surgery, I was as hopeful as could be without actually believing that it would work. After failing at something for so long, it was difficult to believe that this tool could really help me. I wasn’t convinced that I would be successful. It was scary at times and definitely difficult. While the physical recovery only took a matter of weeks, the emotional healing after years of using food as a coping mechanism was incredibly difficult. In particular, I credit the counseling and dietary staff at Toronto Western Hospital for helping me through all of the trials and tribulations I faced. They kept me on track with exercise, helped me to learn to eat properly, and guided me through the various stages of vitamin intake to stay nourished throughout the process. They had warned me ahead of time that the emotional and mental effects of this procedure far outweigh the physical ones, and they were right. I feel like I’m well on my way to conquering food issues, but it’s a work in progress that will likely take the rest of my life.


Physically, I still have difficulty recognizing this new woman in the mirror – she’s so different than the one that lives inside my head! One of the most surprising things for me is that it’s a bit of a struggle to shop in regular sized clothing stores – there’s so much available when you’re not in a plus size! I still gravitate towards the extra large clothing on the racks, only to go back for a medium once I realize I’m swimming in them. I’m not sure how long it will take to get used to this new body, but it’s not a task I’ll complain about!


In terms of physical healing, I’m shocked that my once-barely-mobile body has been able to accomplish so much. My energy level, in particular, is amazing. I feel like I can get so much done during a day now, because I’m not exhausted anymore. Exercise is a daily ritual for me, and I can’t believe that I’m enjoying it. That alone – the mind shift required to now think of myself as a person capable of physical activity – is an amazing accomplishment in and of itself.


I think one of the most difficult aspects of this procedure is dealing with the often prevalent public perception that bariatric surgery is a quick fix or the easy way out. It is a frustrating misnomer for those of us who have had the surgery. This journey through gastric bypass surgery has been the most difficult challenge of my life, but also the most rewarding. As a writer, I’ve made the decision to share my journey with the public both through my blog and in the form of a memoir which I hope to have published, but it still never fails to surprise me when people I don’t even know boldly tell me that my weight loss doesn’t count or I could have done the same thing without surgery. I think that everyone in this room has their work cut out for them in convincing the public that obesity is a disease, and it’s a wonderful advance in modern medicine to finally have a treatment that yields the kind of results gastric bypass does. I am a healthier and happier person now, and it’s due to this procedure. I’d highly recommend it to other patients seeking a tool to help them conquer obesity.


As for my personal results, I’m ecstatic. Today, my total weight loss is 120 lbs, only 30 lbs away from my goal weight. I no longer take any medications. I don’t have hypertension, my lung function is normal, and I’m happy to report that the effects of polycystic ovaries have been reversed. I’m excited at the prospect of having my own family in the future! I am active and love to try new things, including running. When I recently had a fitness assessment, I was shocked to find that my fitness level actually fell into the “good” range. I have so much energy, some days I just don’t know what to do with myself. I’ve dropped 10 sizes in less than a year, and I feel like the world is my oyster. I’ve also gained confidence I never knew I had, and it has truly changed the direction of my life. I credit all of these things to this procedure. This tool was exactly what I needed to finally gain control of my life and to live it to the fullest.


In closing, to those of you in the room who treat and work with bariatric patients, I will say this: you change lives every single day, whether you realize it or not. It is your work that gives obese patients the strength, the knowledge, and the tools they need to finally break free from their personal prisons and live the healthy lives they’ve always wanted. Your compassion, your dedication to helping others and your willingness to keep learning by attending events like this one are exactly what are needed to fight the obesity epidemic, and I applaud your efforts.


Thank you for listening to my story today. It’s not finished yet, but I feel like this happy new beginning I’ve been given will lead me to a happy ending!




My story in pictures...the night before surgery, my princess costume from Halloween, and me on the beach in N.B.



A truly thankful Thanksgiving

As a post-op weight loss surgery patient, nothing strikes fear in my heart more than the prospect of a celebratory meal. So I approached Thanksgiving this year with some trepidation. In years past, before this massive change in my life, I would have approached the meal like any other - it was all about the delectable dishes being served, and about showing how you feel by putting all of your love and concern for family into the dining experience. Given that, I was concerned that major holidays like Thanksgiving would be lost on me, since I can't indulge with seconds (or thirds!) like I used to. And so, as the many counselling sessions I've had pre-and-post-op have taught me, a change in my thinking was in order.

This Thanksgiving marked a lot of firsts for me...and lots to be thankful for. It was my first major holiday with my new boyfriend, and we were invited to share in a meal with his extended family. It was my first major holiday post-op where I was in a position to actually eat solid food. It was my first holiday in a new city, and after starting my new job. And it marked my first Thanksgiving in Ontario that I didn't spend with my sister. In the past, any one of those stresses would have sent me into eating overtime under that guise that I was celebrating while I was really dealing with anxious feelings by stuffing them down with food. So I knew going into it that this year, this glorious year, had to be different.

The day was a wonderful inauguration for me. I spent the afternoon catching up with new friends, sharing stories, holding babies and babying pets (all 5 of them!). The food was plentiful and delicious, but I used my coping mechanisms - small serving sizes, eating slowly and not depriving myself. I had about 2 bites of everything, including a lovely strawberry pie for dessert, and felt so good to finally be in control after all these years. That point, in and of itself, is my most significant reason to be thankful this year.

Now that the first food-centric holiday is under my belt, I think the upcoming Christmas holiday should be a little easier. Although I think it will take some time for my brain and habits to catch up with my body and lifestyle, I know that it's possible to make this life change. And I'm not afraid, just happy to have so many caring people around me who are supporting my efforts. My new reality - that food is not the centre of my world anymore - is going to take some time to adjust to, but I'm up for it. I have to say, this mind shift is the hardest part of weight loss surgery. Thirty-five years of gorging at holiday functions is a tough habit to shed - I might venture to say, even harder to shed than the 115 lbs I've lost so far. In fact, when I signed up for the program, they warned me that the mind issues would be far more difficult than the physical issues. They were right.

And so I close this post on a positive, thankful note. I'm lucky to have had the opportunity to get this surgery, to change my life, to have caring, supportive people around me and to finally have my health in hand. All very good reasons to celebrate indeed.

To Be Or Not To Be

Sometimes, people define themselves by what they're not. For my single girlfriends, it's "I'm not married", "I'm not attached", or "I'm not a mom". Or maybe it's how you define your moral high ground. "I'm not a dishonest person", or "I'm not someone who does that sort of thing". But for me, recently, it's been a labour to find the words to express what I'm not anymore. By the BMI scale, I'm not obese. By association, you might say I'm not the object of ridicule or scorn. I'm not a freak show. Or by other's (albeit, unfair) standards, from the outside I look like I am not out of control, I am not obsessed with food and I am not a hazard to the health care system. But do these things really define me?

But now the more difficult question looms. What am I? Who am I? I thought I knew the answers to these questions, but the farther along on this weight loss journey I go, the less certain I am. I'm finding that defining myself, my likes and dislikes and even my wants and needs is not only tricky, but limiting. Saying I dislike something might close a door leading to further exploration. And saying "I'm not" limits my ability to say "I am". If I'm certain of anything these days, I know that possibilities are endless and embracing new experiences is one of the joys in life. So let this be my cautionary tale. The only "I'm not" you'll hear from me these days is that I'm not going to define myself that way. These days, I prefer to let my actions speak for themselves because they surprise me every day. This week, I am a runner (30 minutes on intervals on the treadmill, thank you!), I am a girl who wears high heels, I am a good friend, I am a writer. And I am excited to see what else I can be in the future.

A Comment On Energy

If anyone out there has ever lost a significant amount of weight, you probably already know this. You end up with energy to spare. As someone who previously had minimal energy and trouble getting through the day, this was a huge surprise to me! Yeah, I had lost some weight in the past...20, 30, 40 lbs at a time..and promptly gained it plus 10 back ;) I never kept it off for more than a few months, and often didn't even notice any extra energy I had - I was too busy "white knuckling" it, hanging on for dear life as I starved myself silly or worked myself to the bone at the gym to force my body into submission. But now, that's all changed.

It started at about one month post-surgery, when I had lost about 30 lbs. I was shocked to find that I had bursts of restlessness (despite the doctor's warnings to take it easy for about 6 weeks), and I had this innate desire to get up and MOVE! I was limited to 15 minutes at a time on my exercycle and a few arm-toning weight exercises, but I was itching to go. After the 6-week embargo on exercise, I was cleared for takeoff and joined the YMCA for aquafit. It was just what I needed - classes with cheerful members, all the dance-beat versions of Britney and Lady Gaga a girl could handle, and a well-toned male instructor with a cute-as-a-button bum in a speedo (Hey! I go to the Metro Y in the gaybourhood, so I'm totally allowed to look, lol!). But as I continued on with my progress, I was very surprised to find that even regular exercise, noontime power walks around the office and walks on the weekend weren't enough. This week, I made the transition from my beloved aquafit classes (that no longer make me short of breath or even a little winded) to straight-up lap swimming. Wow! 30 minutes of intermediate laps and I'm spent, and it feels soooo good.

I think the most surprising thing for me is that I can get through my day and actually feel like doing something after work. For all of you out there who struggle with weight, you know what I mean. If your idea of "relaxing after work" involves collapsing on the couch or having a 3-hour "power nap", your energy is just like mine used to be. Take it from me, there's a whole life waiting to be lived once you move beyond the fatigue. I'm so happy I stumbled across it while on my epic journey!

As for me, it's 7:15 on a Wednesday night, and now that the rain has stopped, my feet are craving a powerwalk around the 'hood. And I'm so thankful for that!

Perception Is Everything

I really can't believe how my own perception has changed since the surgery. I used to think that how people reacted to me, whether good or bad, was a direct result of what kind of biases they held and misjudgments they made about me. How wrong I was! Since losing the equivalent of a 13 year old supermodel (they don't weigh more than 80 lbs or so, do they?), I've noticed a marked difference in how people treat me. People I know, people I kind of know, even perfect strangers...they all seem to have a different perception of me now that I'm no longer morbidly obese. They seem to be more accepting, friendlier, they smile and make eye contact more, offer their assistance more readily - all the way around, I seem to be more "accepted" in society with my new appearance, and I've chalked it up to society's bias against folks of size. But I've been reading up a lot on this, as well as chatting with some of my surgery sisters (the go-to gals I meet up with about once a month to discuss our trials and tribulations), and I'm starting to realize that it has precious little to do with how I look or how much I weigh. It just dawned on me that I'm different on the inside. This weight loss has freed me of some of my own hang-ups, like shyness, insecurity and a lack of energy that bordered on apathy. I'm the one who has changed how I interact with people, and their reactions mirror it. For example, I make eye contact where I never did before. I smile more (and mean it!). I'm more open to communication, whatever the form, because I'm not expecting rude comments about my weight. And now I'm reaping the rewards. I can't believe that all this time, I thought it was them. It was me all along.

Now, that's not to say that when you're fat you don't get way more negative reactions and harassment. I'd be a fool to assume that fat-bias is a myth now that I'm leaning towards lean. But I am saying that if I had behaved differently at the size I used to be, maybe I would have had an easier time. What's that quote? "Insanity is doing the same thing over and over, and expecting a different result.." Hmmm...food for thought ;)

And the truth shall set you free....

Well Happy 2010 everyone, and thanks for your patience over the first quarter of it while I let the blog slide :) I'm happy to be back, and have missed writing about the big and the minute things that make me wonder on a daily basis!

So, I have to say, this blog entry is late for one really big reason - I was deciding if this would be a forum for me to come clean on something. I've been running through things in my mind, wondering if I should or I shouldn't tackle this topic. After much contemplation, I finally decided to go for it! Honestly, I think what I'm going to tell you about has become a part of who I am, so it would be difficult, if not impossible, for me to ignore it. So here it goes...

As most of you probably noticed from some of my previous posts, weight issues have plagued me for my entire life. The topics of weight discrimination and in particular, fat biases, in our society have always been of interest to me because I've lived it every day. That, coupled with the health issues surrounding obesity, made me consider every option available to me to finally kick my obesity issues for good. It took me about 5 years of researching, a move to another province, and 14 months of waiting on a veeerrrry long waiting list, but I finally got to the bottom of (or, rather, on top of) my problem. And the results have been stunning.

On December 7, 2009, I had Roux-en-Y Gastric Bypass Surgery at Toronto Western Hospital. Now, most people probably have little to no understanding of what this surgery entails, so let me enlighten you. Basically, my very qualified surgeon took my extremely over-sized stomach and cut it down to size (figuratively speaking, of course) by sectioning off a very small portion of it to create a pouch. The two parts of my stomach are separated by staples, with the largest section being the portion that produces the hormone ghrelin, which is responsible for physical cravings for food. With the ghrelin contained and a much smaller receptacle for incoming food, I don't crave anything anymore, and I can only eat about a cup of food at any given time (and to be honest, it's usually less than that). That's the restrictive part of the operation. The other half is called malabsorptive, because my intestine was cut so that food being digested would bypass my duodenum, the portion of my intestine that's responsible for absorbing calories and nutrients. I had a new portion of my intestine attached to a new "out port" in my new pouch, so most of the food I eat doesn't get absorbed completely. Combining both of these methods (restrictive and malabsorbtive) helps me to control what I eat and how my body digests it. And to be perfectly honest, although it sounds extreme and a little kooky to someone unfamiliar with it, my RNY was the best decision I've ever made. But for you to understand what drove me to such an extreme, you first have to understand the kind of day-to-day difficulties I endured by being morbidly obese.

A slug. That’s what I would have called myself a year ago, with my lack of energy, motivation and drive. I sat. A lot. With my heaviest weight of 281 lbs oppressively smothering my 5’1” frame, it’s no wonder I couldn’t move without pain, couldn’t sleep without severe sleep apnea, and couldn’t fathom another day trapped in my own personal fat hell. I had high blood pressure, asthma, circulation issues and couldn't walk up a flight of stairs without almost passing out. And I knew that at 34years old, it was only going to get worse if I didn’t do something drastic. But after years and years of failed diet attempts, gym memberships, personal consultations, pills, potions and prayers, I did what Jenny Craig, Nutrisystem, Weight Watchers, Slim Fast, and Bob & Jillian couldn’t. I asked my doctor for a referral to a weight loss surgery clinic. Thus began my journey towards health, wellness and living (for the first time in my life!) as a “normal” person, free from the bonds of obesity.

That first appointment I had at the Toronto Western clinic was exhilarating and terrifying all at the same time. Somehow I managed the courage to continue through a rigourous screening process that involved a nutritional team, social worker, psychiatrist, nurse practitioner, surgical team and now, a support group. I found out all of the info, weighed my options carefully, and went for it. And at this point, 4 months later, I couldn't be happier.

I've lost 79 lbs (and counting - on average about 5 lbs a week!), I no longer take any medications at all. My lung function is normal, no need for asthma puffers. My high blood pressure has disappeared. I no longer suffer from sleep apnea. My joints don't hurt anymore. I walk everywhere (and fast, too!), climb stairs at every opportunity, don't obsess over food, and I go to the gym as much as possible. And I've shrunk a whopping 5 dress sizes, which allows me to shop on the large or extra large rack of any regular-sized store in the city (Sorry Lane Bryant and Penningtons, you won't be hearing from me again!) All this at 4 months out, and I'm not done yet. I'm actually giddy with anticipation for what the future holds.

In the coming weeks, I'm going to delve into what an emotional and psychological journey this has been for me so far, in particular in relation to how I was an emotional eater who used food as a crutch in my daily life. I'm also going to go into detail about the struggles (and there are many!) a post-op patient goes through, because believe me, this was no "easy way out"!! But for now, I'm content to finally let this cat out of the bag. It's one more weight lifted from my shoulders, and I have to say it...I feel as light as a feather.