Raze

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Yes, it's true. Not everyone will understand our choice to have WLS. Many will judge, some will scoff, and yet others will be resentful that we had our cake and ate it too, and took the easy way out in the end. We refused to pay for our "sins" into the grave, and would not accept our punishment for being all too human, and falling all too short of perfection. Somehow we deserved to be FAT, diabetic, outcast, and sexually undesirable. Somehow, unless we lost weight ourselves, we deserved to reap what we had sown, and could not make a change how we saw fit. We should suffer, we should pay, and why on earth could we "not do it ourselves."

So many times I heard that refrain. "Well,  can't you do it on your own? "Why do you need surgery?" "Are you that weak?" These questions used to shame me terribly. But now they are easy to answer. No. To lose weight. Yes, I am that weak. Anymore questions? I'll be glad to look you straight in your ignorant face and answer them. 

Because nothing speaks like success, and nearly eight years out of surgery my success at weight loss and changing myself and my life speaks far louder and truer than any of the haters. But most of the time nothing need to be said. I speak for myself very clearly just being myself, and no explanations for my weight or how I lost it is necessary. It just is what it is.

I post this mostly for the pre-ops and new post-ops. I have read their posts on the board and the fear, stigma, judgement, and doubts can be palpable. It's sobering to realize not long ago I was where they are today. Excited and fearful, uncertain but committed, looking forward to a future that is certainly uncertain. How much weight will they lose, how fast, how will their lives change. That is enough to deal with without having to deal with others who do not walk in their shoes judging them. So I want them to know it will be OK. Even if you don't lose all the weight you want, its slow, you have complications or otherwise, it will be okay.

The haters will come and go. You cannot tell everyone you had weight loss surgery. I once told a woman who was interested in me I had lost 200 pounds. Her eyes lit up, she thought I had some magic. When I told her I had surgery she was no longer interested in me. I guess that kind of magic was far too real for her. I have told other FAT people I have had surgery and they tell me they know people who have but "gained it all back" or died. They keep talking to me and others about how they want to lose weight, but NEVER ask me about my surgery. A couple of these people are now diabetic, one is using a mobility scooter to get around, and a couple others are facing knee replacement. They tell me and others they are lonely, can't find a good lover, work jobs they are unhappy with, and want to lose weight. They never ask me about surgery. I never mention it. Not anymore. It's too sad for me when I see that "look" of fear come across their faces. What fear? The fear of change. Real change, permanent change, no going back change. The change hopefully each and everyone who reads this is courageous enough to face and embrace and make real. And you're fuckin' awesome for that. Some of these people are haters, too. Trouble is they hate themselves, even if unaware of it. And I have come to have great compassion for them. After all I was once one of them. And of course not everyone wants to lose weight. Some don't, and seem perfectly happy. But regardless it's always "doctor says I have to lose weight" or "it sucks to have to take this medicine"  or "i am so embarrassed," and all the rest. And that doesn't sound very happy to me. But who am I to say? I love people and accept them as they are. But for me that only came after surgery and as I learned to love and accept myself. I have a smile for all I meet and truly wish them the best. Just don't cross me or those I love because I will bury you. But I'll do it with a smile on my face.

So not all will understand us or our choice to do this. Some of these people will be very close to us, some not so close, and yet others complete strangers. But we're not doing it for them. We're doing it for us, and its our life to live. Your success will speak for itself, and your life changes will speak louder than the haters and all their useless banter. They are of no consequence. When we allow someone to literally reach inside us and change us for good, for real, and forever...that is when all the haters can go to hell, and for good. They will never walk in our shoes, know our courage, or taste our success. And that success is not completed when you lose weight. That success is completed when you lay down on that operating table and say "I am ready. Let's do this." And that is when the hate stops, and the love begins. 

I wish you all my very best....

Hello All

Well my posting on the board tends to be long, so you can imagine my blog. But perhaps something I share will be useful to some or one. It seems to pre-ops and post -ops alike the type of surgery had is of some interest, and visiting the board just recently for the first time in forever has caused me to think about my own. 

I had the Fobi Pouch procedure completed almost eight years ago and am maintaining a 240 pound weight loss. Pretty darn good and about what I had hoped for going in. I did not choose this surgery so much as it chose me. Let's just say opportunity knocked, I got informed of the procedure, and went with it. I am not an advocate for the procedure or a fan of it in particular. We all choose our own surgery and path. It has been greatly effective for me concerning weight loss and even almost eight years out is significantly restrictive regarding the amount of certain foods I can eat. I consider it a great success in my case being the tremendous weight loss, zero complications, and no maintenance nutritional routine I follow. However I know that has something to do with the procedure and also a lot to do with me. So far, so good.

That said it is a typical RNY for all intent and purposes. The Fobi simply sews the pouch instead of stapling, and puts thin silastic places a thin silastic ring around the stoma to enhance restriction. It is not a too common procedure to this day as it takes more time to complete on the operating table making it costlier, and many doctors simply consider it unorthodox or unnecessary. Dr. Fobi liked to consider it an improved RNY, and I do believe he was one of the first surgeons to "detach" part of the stomach and develop a pouch in WLS rather then simply stapling a section off, making a smaller stomach. Which led to all kinds of complications considering staple line breakdown in "old fashioned" WLS days.

However if you read my posts on the board and see my pics in my profile do not take that as advocacy for this surgery. Indeed I would carefully consider having this surgery as Dr Fobi is now retired as are many of the doctors he trained and mentored in performing this procedure. I do not consider it riskier and indeed some of its potential complications such as ring erosion over the years are imo overstated and over emphasized as dangers. Statistics bear this out, and even in cases of ring erosion that is all there is to it, usually. The ring is simply gone with the stoma fixed in place. And a "new" ring has been used in recent years to help prevent this. Otherwise from pouch on  down this is a typical RNY but for the sewing instead of stapling. But  somewhat more restrictive RNY.

I am writing this blog post not to encourage people to the Fobi, but to actually have them turn away from it if not comfortable with the idea. I see posts in the Fobi Pouch forum both pro and con, but many con. Which is to be expected of any WLS type on WLS forums. Botched surgeries, "failed" surgeries, people with regrets and complaints of all things, about not being able to tolerate or eat certain foods. Of the Fobi one patient some years out and with good results now has complaints of not being able to tolerate eating meat, and throwing up. To which I think "they should have told you about that going in." That can be typical of the Fobi pouch, as it is highly restrictive. So know what you are signing up for and be prepared to roll with the changes whatever surgery you have. And know this...if you have not had surgery yet you will read pro, con, and folks screaming and complaining to high heaven all over WLS message boards about this, that, and the other. Some are frivolous, others legit, and many are highly subjective. For instance I cannot eat a steak or chicken breast. I don't care. Others might to a great degree and blame their surgery. Yet other more unfortunate patients will suffer greatly with medical complications, illness, and near death trauma. This can happen for a number of reasons but many blame the surgery type when in fact it's just having any weight loss surgery. Outside a completely botched procedure not all will respond the same to the same procedure and some will have a very hard go of it. To those I truly have compassion for, and commend them for there courage.

Which brings me back to the Fobi Pouch. For those considering WLS and if offered or recommended, I would say be quite wary of the Fobi as even the center where Dr Fobi performed thousands of the operations does not favor them. Some of that is cost, but it's also because Dr Fobi is retired and no longer there to supervise or mentor. Other WLS have come along since RNY, and those must be looked at, too. And while the Fobi is excellent for weight loss so are other procedures more commonly performed these days. IMO it is a somewhat specialized RNY and should not be performed by someone with little or no knowledge of exactly how to do it. I have read some offer it as a "Fobi" but use staples on the pouch, as well as overlooking other aspects Fobi included. In short simply tying a silastic ring around the stoma is not a Fobi Pouch. It is a variation, but a somewhat crude one. 

Below are the specific characteristics of the Fobi Pouch. If you are offered this surgery and these specifics are not in place be wary imo and know it is not the Fobi as Dr Fobi himself intended, suggested, or performed

1)Vertical 30 cc pouch - Easy to intubate, less distensible, provides early satiety.

2) Transected Pouch - Minimal mobilization, no problem with staple line breakdown, minimal occurrence of marginal ulcers

3) Banded pouch, longer band, 5.5 - 6.5 cm - Leaves a large stoma but limited in diameter, allows dumping  but not severe dumping 

4) Imbricated Gastrojejunostomy - The limb of the jejumun that is brought up to form the gastroenterostomy is also used to imbricate the transected edge of the proximal pouch thus diminishing the possibility of leaks and subphrenic abscess.

5) Large gastroenterostomy 1.5 - 2 cm long - Markedly decreased rate of gastric outlet stenosis

6) Decompressed distal gastric pouch with a gastrostomy - No incidence of acute gastric distension, decreased incidence of atelectasis, provides for temporary feeding and administration of medication if the need does arise.

7) Marked gastrostomy site - Provides easy access to study distal bypassed stomach radiologically and/or endoscopically, as needed, access for enteral feeding in the rare case of excessive weight loss.

Hi 

I am Raze. I have lost 240lbs through my RNY Fobi Pouch Surgery and some physical exercise. I don't like to call the exercise a "lifestyle" change because I don't workout much anymore, and it's just exercise, not an entire lifestyle or too big a change. But in conjunction with surgery it promoted weight loss whereas before it did not, much less "keeping it off." Which is one of the biggest benefits of having wls IMO, that keeping it off part. And of course the surgery has been the essential part of my weight loss as without it I'd still be as in my "before" pics, without a doubt. But after surgery for those who want to lose all or nearly all their excess weight and wls has brought you close to whatever goal you've set but hasn't quite put you over the hump, if physically capable a bit of exercise might get you there, one day at a time, and easy does it. WLS made the impossible, or at least highly improbable, a complete reality for me.  

Much luck to all

Raze