That's the trouble with fear...

It always gets you when you least expect it. You’re cruising right along, doing your thing, and then something happens and that fight or flight reaction stops you in your tracks. Humans have fear to keep themselves safe. The fear of the unknown has kept us safe for thousands of years; we do what is most comfortable, hardly venturing out into the great unknown without a reasonable reason for doing so. In cases of elective surgery, it’s a tricky thing because as in the case of bariatric surgery, no one is saying to you something like, “Your appendix has ruptured and we have to remove it”, or “Your heart has a blockage and we must do a bypass or you’ll die”. It’s tricky because without bariatric surgery, oftentimes it’s only a matter of time until it kills us. Although in many cases it’s probably not in the immediate future, but definitely not a long way away, either. Or, maybe your health is pretty good like in my case. I don’t have heart problems, diabetes or high blood pressure, but rather my weight has robbed me of my quality of life. With degenerative arthritis in my back, the pain from the weight has taken away a lot of my joy. So, when I say that it’s only a matter of time until it kills us, it could be in the physical or emotional sense of the word.

I’m amazed at the change in emotion as I go through this process and it gets closer and closer to my surgery date. I’m still vacillating between excitement and fear, and I presume that’s going to be the case until I’m on the operating table on December 18^th. However, I no longer fear the procedure itself. I have the utmost confidence in my surgeon. Now, I am more apt to be fearful of the recovery itself, and occasionally the years ahead of me as I age. Since there is no long-term data specifically on my surgery type, the future is uncertain even though people have had portions of their stomachs removed due to various reasons including cancer. There are thousands upon thousands though, that have had successful surgeries and recovery times, and the number of those with life altering complications are slim. But, it does happen and I have to be educated and aware that the possibility exists. Nonetheless, the fear is an ever-constant subtlety that will likely remain. That’s the trouble with fear; it’s not something that is easily controlled.

There are only two kinds of days.

Ambivalence is defined as the state of having mixed feelings or contradictory ideas about something. On this particular journey in my life I've decided that I have but only two kinds of days. The only way I can refer to them is as positive days and negative days. The two never seem to cross paths, and each morning promises one of the two. A new friend of mine that I have begun to get to know through bariatricpal.com, the website that I'm admittedly an addict of, said it best; "It's almost like a strange retake on Groundhog's Day, where we've somehow got caught up in this (seemingly) never ending loop." That's exactly how I feel. I fall asleep at night thinking one of two things, either worry about the surgery and/or post op, or feeling excited about the surgery and/or post op success. I wake up feeling either anxious about how many days are left until surgery or hopeful about how positive my life will change for the better. I'm not quite sure why I keep vacillating so much between these two outlooks. The good thing about the website mentioned before is that you can read all sorts of varying experiences from literally thousands and thousands of people. The bad thing about it is the exact same thing. It's the epitome of a catch 22. Sometimes when I read horror stories that people have gone through or turmoil that people going through right now as a result of surgery, its sets my nerves on overdrive. One side of me says, "that won't happen to me", and the other side says, "the risk here is real, even the risk of death". Those two extremes are just that. Extreme. Granted, I'm relatively healthy other than morbid obesity, degenerative arthritis and fibromyalgia. I don't have blood pressure problems or heart issues. But, the clock is ticking. I am getting no younger and no thinner being incapable of exercise in this state that I'm in. I know that I've made the right choice and I know that the more positive I remain, the better I will do. If I don't go through this surgery, one thing is for sure, I will get sicker, I will get heavier, and I will face more health challenges. My mind is made up, I just wish I could stop this cycle.

Questions you should ask your gastric sleeve surgeon...

When I started this process I was just so excited to find out that my insurance covered bariatric surgery after researching the process for over a year, that I left out an important piece to the process. It was all kind-of a whirlwind though, when I got my consultation appointment literally for the next morning after trying to get in to see the surgeon that I was set on using. Once that appointment opened up at the last minute, there were so many emotions going on and so much excitement that the ball was FINALLY rolling, I neglected to make a list of questions to take with me to my consult. Now, to be clear, I had been researching this procedure and my surgeon and his center of excellence for a very long time, so I was already very much aware of the process and most of the national statistics, but I didn't make a list and that was a bad idea. Fortunately, the nurses and staff have been great about replying to my questions as I have them, but I wish I had been armed with them so that I could have spent more time with my surgeon in the beginning. If I had it to do over again, this is the one thing I would have changed. So, I have made a list of questions for you, the reader, to use for your consult. You may already have a list, and if so, just take a look at these and see if there is anything you missed. The more information you have in your arsenal the better prepared you will be and the more likely you will be to succeed post op!

How many years have you been performing bariatric surgery?
Do you perform other surgeries or only bariatric surgery?

What type of training have you had in bariatric surgery?

Are you board certified?

Are you FACS? (Fellow, American College of Surgeons)
Do you also do body reconstruction? (loose skin, breast augmentation)

Do you use staples, sutures, or both?

After the stapling of my sleeve, will you over-sew the staples?
Do you use a tissue sealant in addition to staples and/or sutures?

What is your complication rate?

What is your mortality rate?

More specifically, what is your sleeve leak rate?

How many trocars will be used for my surgery?

I have read that most leaks happen at the top, or at the bottom; are there any extra measures taken to protect against this happening?

Will you leave in a drain that will need to be removed a few days later?

Will you put me on Lovenox, Heparin, or other blood thinners after surgery?

What type of compression devices will you use on my legs to prevent blood clots?

If I have a hernia will you repair it at the same time?

Do you remove the gallbladder during surgery?

What size bougie will you use?

Is your center or your hospital a center of excellence?

Are you a member of ASBS? (American Society of Bariatric Surgery)

How many sleeve surgeries have you performed?

How many do you typically do each year?

How many nights will I be in the hospital?

Does your facility offer support after surgery?

When will be my first post op appointment and how often will I check in at the office after that?

Does your bariatric center offer a clothing exchange among other patients?

These are the most important questions that I think need to be asked. Feel free to add your own! Make sure you take a good pen and leave room to write in all your answers.