For those of you who don't know, the hiatus is the opening in the diaphragm that allows the esophagus to pass out of the chest and attach to the stomach. A hiatal hernia occurs when a portion of the stomach is forced through the hiatus into the chest cavity. Remarkably (not) this can cause a great deal of pain as well as a whole host of other issues. The stomach can start to spasm and the resulting sensations feel (I'm told) quite similar to a major heart attack. For hours. Days even. (I will post more later about how doctors/hospitals respond to fat people in pain).
My hernia was severe and of a type that presented significant risk. The standard treatment for this condition is a surgery called a nissen fundoplication. Fancy name for semi-miraculous, snippy, wrappy, stitchy medical magic. Truly awesome stuff.
However.
"This surgery will not be approved due to your weight. Morbid obesity leads to surgery failure."
Thank you Kaiser.
Nevermind that research shows that obesity is not a contraindication for the surgery and that failure rates for the surgery are no different between those with a wide range of BMI (Journal of Gastroenterology, 2005). But hey, why do facts matter in medicine?
Anyhoo.
I was given three options -
a) wait it out and potentially face a medical emergency
b) lose 100 pounds and maintain the weight loss for a year (did you know: the only sure thing about dieting is that 95% of the time people regain the lost weight and then some?)
or c) gastric bypass.
Bariatric surgery was, of course, billed as essential for my overall health and well being. It would make me "happy and healthy" and clear up all of my on-going health problems (at the time, my only health concern was the hernia and GERD). It was promised to be the "magic pill" that would solve everything (and make me socially acceptable).
Here's another fun fact: Given surgeons with equal experience and past successes, gastric bypass is almost twice as likely to fail as a nissen procedure.
Doesn't add up, does it?
Once I was referred to the bariatric program - which I don't remember agreeing to, just that I would consider it - my referral to the GI doctor was closed. He would no longer see me or treat my condition. I was given no options for treating my reflux or hernia during the in-between-time for any of the three choices I was given.
Meanwhile, the pain increased, the reflux increased, the nausea, vomiting and swallowing difficulties increased. It's difficult to sleep when you can't lie down without aspirating stomach acid. It is difficult to exercise more when you can't bend over, twist, jostle your body, tighten your abdomen or freaking breathe because of a hernia. And despite popular belief about fat people, I actually like to move my body.
I spent a lot of money jumping through hoops for a surgery I didn't really want. I spent a lot of time trying to lose weight for this surgery I didn't really want - to "show that I'm serious about the program." Every hoop I jumped through led to a new one, and at the same time my life was ridiculously full with a challenging (but rewarding) full-time job, graduate school and raising four teenagers on my own.
I resisted, I delayed and I lived with the pain until I couldn't anymore. In October of 2017 I finally gave in and committed to the program, and in February of 2018 I had a roux-en-Y gastric bypass procedure.
I'm still waiting for the magic I was promised.
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