Patient Articles - Lightness of Being
By Lorraine Ash -- Daily Record, Morris, New Jersey
Bariatric Surgery Helps Two Women Achieve Dramatic Weight Loss
Susan Davenport couldn't stop grinning at her eight-month checkup. The 46-year-old nurse had lost 69 pounds since she'd had an adjustable gastric band laparoscopically placed around the outside of her upper stomach last July.
The band created a 2-ounce pouch. When it fills, she feels sated and stops eating. She bounded into Dr. Alexander Abkin's Florham Park office at 186 pounds wearing a bright pink top and beige shorts. Her eyelids glistened with blue makeup and her long bangs, part of her new look, fell fashionably over her forehead.
"I just came back from a cruise," said the usually quiet Davenport, who lives in Dover. "I wore my bathing suit and it was too big. I can't remember the last time it fit me. We were in the Caribbean and did a lot of walking and I didn't have any aches or pains. My hips weren't killing me."The best part was on the plane. I could pul l out the seat belt, wrap it around me and there I was. It was wonderful."
Her blood pressure, which had been borderline hypertensive before the operation, was 110 over 70 that day.She went from wearing a 3X or 26-28 to buying large shirts and size 16-18 pants in Bloomingdale's. Recently she spoke in front of the congregation at her church, another accomplishment.
"Seventy pounds has made a difference in my self-confidence," she said.
Davenport and 19-year-old Holly Kapra l of Jefferson, who underwent gastric bypass surgery in July 2002, agreed to share their stories with Daily Record readers up to a year and a half after surgery. They hope their experiences will educate others about the realities of living as an obese person and the difference bariatric surgeries can make. For some of the 26 percent of Americans who qualify as obese because they carry at least 100 excess pounds, such surgeries are the only way to drop to a healthy weight and prolong their lives.
The same day, an effervescent Kapral, a graphics arts student at County College of Morris, discovered she weighed 234, a drop of 130 pounds since surgery. She spoke often of having "a new life."
Kapral, like Davenport, has energy to burn. She works out at a gym and buys clothes at Lane Bryant, which is more fun than the big and tall men's shirts she wore before surgery. Plus, she's enjoying meals, small as they are. "We went to Chinese buffet with my sister's family," she said. "If I get that sweet tooth I can have half a brownie or I can have a cookie. I can have some ice cream, just not as much as I would have before surgery." A little bit of food - 400 to 600 calories a day - makes gastric bypass patients feel satisfied. If they eat more than their 1-ounce pouch can hold, they experience "dumping syndrome," including nausea, stomach cramps and diarrhea.Kapral's Roux-en-Y gastric bypass operation, the gold standard in bariatric surgery, is more extensive than the procedure performed on Davenport. The 1-ounce pouch on top of a patient's stomach is separated from the rest of the 70-ounce organ using staples. A hole is then cut in the pouch and the small intestine is rerouted to it.
The new hookup lessens Kapral's ability to absorb some fat and calories, although there's a downside: It also lessens her ability to fully absorb vitamins, which is why she needs to have daily protein shakes and vitamin supplements."When I met with Dr. Abkin in November I had to start on an iron pill because my iron was a little low," Kapral said. "I'm thinking that's because I don't eat a lot of red meat now."
Her blood test results at last month's<March> checkup were better than they were in the fall because, Kapral said, she's being conscientious about taking her multivitamin and B12 every day.
"I'm just trying to get my protein in - my meats, my dairy,my beans, nuts," she added. "You get up in the morning and you have an egg. That's some protein. But it's hard to get 80 grams in when you can't eat a whole lot. But you have to do it. It's not hard to do. With a different stomach, though, it's a little more complicated."
Bariatric surgery patients experiment with protein shakes, bars and powders. Kapral says she can't finish a whole protein bar. Davenport shared her solution: Isopure from GNC. She tracks how much protein she eats in a day. If she hasn't had enough protein, at 8 p.m. she'll pour a scoop of the flavorless powder in yogurt, cottage cheese or soup.Abkin, of Advanced Laparoscopic Surgeons of Morris, said Davenport and Kapral are at "the top of the pack" for getting results, adding that any patient who follows instructions - takes the proper supplements, follows dietary guidelines and exercises - probably can expect the same. Six months out of surgery patients are experienced in all the things they need to do. It's then a matter of maintaining a good regimen.
Five hundred gastric bypass surgeries were done at the 4-year-old Morristown Memorial Hospital's Obesity Center, including Davenport's and Kapral's, according to Dawn Schu, hospital spokeswoman. More than 100,000 gastric bypasses were performed in the United States last year, Abkin said. "That's less than 1 percent of what needs to be done," Abkin said. "It's a drop in the ocean, but you've got to start somewhere. There are more than 10 million people in the U.S. who are morbidly obese."
Physically used to her new life, Kapral now is addressing shifts in her emotional relationships. Her eyes welled when she spoke about family members and friends who supported her before the operation and still do, including her mother, Debbie, who also has a gastric bypass. Kapral felt as strongly about newer friends at CCM.
"Just being my friend is support," she said.Ambivalence surfaced concerning people who didn't talk to her when she weighed 364 pounds but are willing to now.
"Al l of a sudden people are going to flock to me because I lost a little weight?" she said. "You didn't want to hang out with me before and I'm not going to hang out with you now. Before the operation I was still human, still a person."
Shifts in relationships are common after the effects of surgery start to show, according to Debra Freschl, new coordinator at Memorial's obesity center. A previously content spouse may become jealous or possessive of a mate with a slimmed down figure, for instance. Patients also let go of food as a crutch, which also affects how they conduct themselves emotionally.Kapral finds satisfaction in meeting other young women
contemplating gastric bypass at the obesity center's monthly support group gathering
"I went bowling with a gir l one day," she said. "She asked me a lot of questions, including if she could have ketchup after surgery. I said, 'Yeah, I think
so.'"
