I am having a hard time comprehending the fact that I am now six months out from Gastric Bypass surgery (RNY)!! When I think about how far I’ve come and how many things have changed, I can “feel” that passage of time. But, in my mind, I just got off pureed foods a few weeks ago.
To say these past six months have been some of the hardest in my life would be unfair, because I have had a few times in my life that were unbelievably hard. But I can accurately say that these months since surgery have been life-altering…exciting, yet hard, at the same time. I have experienced physical changes and non-scale victories that I would have never imagined. In addition, I have learned so much about myself, physically and emotionally. This journey has definitely been a mental transformation as much as a physical one, and maybe more.
Let’s jump right into all the information from my six month follow-up appointment. This appointment was the first big “how are you REALLY doing” appointment since I started this journey. Up until now, I have only had appointments with my surgeon to ensure that I am healed well and that my weight loss is progressing as it should be up to this point. However, my most recent appointment was actually with the weight loss clinic where I started this journey in August 2021. I had been anxiously awaiting this appointment for several reasons, but mainly to see if I was on track with protein/vitamins absorption. Many vials of blood were taken for all the lab tests to be performed. I had to keep a written food journal for a week in order to show the dietician what I was eating. A new BodPod scan was planned as well in order to compare the new scan to my pre-surgery scan to see if I was experiencing any muscle wasting. (The BodPod is this cool egg-shaped machine which uses air pressure to measure how much of my body is muscle and how much fat.) I was informed that the machine was currently not working and my scan would have to be performed at a later date. Prior to surgery, I was literally half fat. Seriously…50% muscle and 50% fat. I’ll definitely look forward to seeing those new numbers in the future.
WEIGHT LOSS: Most observers concentrate on the amount of weight loss following bariatric surgery, but there is so much more that goes into determining how healthy a person is following WLS. Surprisingly, weight loss was not the most important indicator of health for this follow up appointment, so I will just give those numbers and then move onto the important stuff. I haven’t taken new body measurements in awhile, but plan to do that soon. My clothing sizes have changed quite a bit, so I know measurements will be very different.
Highest weight = 285 lbs
Surgery weight = 272 lbs (4/18/22)
Current weight = 209 lbs (10/14/22)
BLOODWORK: As an initial summary, all my bloodwork came back great. Yay!! I can’t begin to explain how huge this was for me. So many bariatric post-op patients have problems getting in enough protein or absorbing all the necessary vitamins and minerals needed to supplement what is no longer being taken in through food. Continuing down the road of malnutrition or vitamin deficiency can lead to significant physical problems such as hair loss, eye/skin lesions, bruising, bleeding gums and mouth sores, chipping teeth, muscle weakness, confusion, vision changes, and fatigue. Well, I certainly didn’t want any of that, so I have been determined to get all my supplements in each day. I also continue to count my protein and macronutrients daily in hopes of reducing muscle wasting as much as possible. There are a few numbers that I want to highlight in order to show some fairly significant improvements following my surgery. I apologize if this gets a little analytical for a minute, but this is WHY I went through this surgery (“the proof is in the pudding” as we Southerners like to say).
- Protein – my new bloodwork shows a current level of 7.2g/dL with a preferred range of 6.3-8.2g/dL. Now I know definitively that I am taking in enough protein and that my body is absorbing it correctly. CHECK!!
- Iron – Iron deficiency is a common side effect following WLS due to the physical changes made during the gastric bypass. Most of the iron from food is absorbed in the first part of the small intestine. But after a RNY procedure, food bypasses the first part of the small intestine which can lead to iron deficiency and other nutrition problems. The amount of iron in a standard multivitamin (18mg) may not be enough to prevent anemia following RNY, and therefore, most bariatric clinics suggest/require patients to take a multivitamin containing 45mg Iron. I have had a problem taking iron in the past, and I had a hysterectomy many years ago. Therefore, since my body did not require as much Iron prior to surgery, I wanted to try the bariatric multivitamin with the lower 18mg Iron in hopes that would be enough to provide the amount my body needed post op. My Iron tested at a level of 69ng/mL with a preferred range of 5-204mg/mL. Thankfully, I am able to make do with taking my current bariatric multivitamin. CHECK!!
- Calcium – People who have undergone bariatric surgery are at a greater risk for becoming calcium-deficient because it becomes virtually impossible to get adequate amounts of calcium through diet alone. This can lead to a higher risk of developing osteoporosis at which point the softening of the bones makes a person susceptible to fractures of the spine, wrists, hip and pelvic bones. Therefore, daily calcium supplements of 1500mg per day are required after weight loss surgery. My Calcium tested at a level of 10.7mg/dL with a preferred range of 8.7-10.5mg/dL. Now I will continue taking my five calcium tablets per day. CHECK!!
- Cholesterol – People who are obese are naturally at greater risk of developing high cholesterol, regardless of the cause for the obesity. Prior to my RNY surgery, high cholesterol levels had not been a big problem for me. Regardless of my weight, my cholesterol had always been within normal ranges, or at least not high enough to warrant medication. However, my pre-op lipid numbers were higher than I expected based on my previous tests. My pre-op numbers were as follows:
CHOL/HDL ratio=5.1 (normal 0.0-4.4)
Cholesterol=185mg/dL (normal <200)
HDL=36mg/dL (normal >40)
LDL=126mg/dL (normal <130)
Non-HDL Cholesterol = 149mg/dL (normal<130).
Bariatric surgery specifically affects cholesterol levels due to decreased food absorption, independent of weight loss and independent of glucose metabolism and insulin resistance. I was excited to have the post-op fasting labs done so that I could see how this area had changed over the past six months. My post op numbers are as follows:
CHOL/HDL ratio=4.0 (normal 0.0-4.4)
Cholesterol=157mg/dL (normal <200)
HDL=39mg/dL (normal >40)
LDL=96mg/dL (normal <130)
Non-HDL Cholesterol=118mg/dL (normal<130).
All numbers have improved. CHECK!!
- Glucose – Prior to my weight loss surgery, I was labeled as “pre-diabetic” due to my glucose levels being higher than normal. Fortunately, my glucose tests had not been high enough for multiple consecutive tests to officially diagnose diabetes. I only needed one more high glucose test and I would have been officially diagnosed as diabetic and possibly put on medication. Bariatric surgery results in significant weight loss and full remission of diabetes in most patients. After surgery, glycemic control is restored through calorie restriction, better insulin sensitivity, and increased insulin secretion. My pre-op glucose was 134.1mg/dL (normal 70-99) and my new post-op glucose has dropped to 106mg/dL!! Even though this is still slightly outside of the normal range, my glucose has dropped significantly and my clinic considers it normal. I’m NO LONGER pre-diabetic!! CHECK!!
MUSCLE WASTING ESTIMATE: Even though the Bod Pod was not available for a scan, the clinic was able to do another test to indicate whether I have had any muscle wasting since my RNY. Through the use of a specific type of grip test, they were able to determine that I have NOT lost muscle mass since my surgery. Actually, my grip test showed an improvement since before surgery. The BodPod scan will be more accurate and will provide specific fat/muscle percentages at a later date.
As you can see from the numbers, my overall health has improved dramatically over the past six months. I anticipate all these areas to continue improving over the next months and am already looking forward to my one year follow up appointment where all these tests will be repeated. I am excited to see what high blood pressure medicine I am able to eliminate in the future as my blood pressure continues to decrease as my health improves. I have not seen my general practitioner since he gave me surgery clearance in March, and he is the doctor that will start modifying/eliminating medications as I see long term consistent blood pressure drops. Oh, how I look forward to a day in the future where I may be free of prescription medications.
I apologize if this update got too technical and wordy, but I hope I was able to convey how excited I am and how blessed I feel to have been able to have this surgery. I feel like I have been given a chance to change my life and my future. That feeling is indescribable. Thank you for sharing in this journey with me.
