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a personal story: Second in a series
Feeling smaller every day
Star reporter Dan McFeely sheds 58 pounds since bariatric surgery.
December 21, 2003
It's a cold operating room, and the table is way too thin for a fat man. Side-arm tables appear to my left and right, and I am strapped down, as if crucified for the sin of morbid obesity. The lights go out. The Mozart goes up. And Dr. RoseMarie Jones steps toward me, ready to conduct a bariatric symphony inside my body -- which is quickly rising while being inflated with carbon dioxide gas. TV monitors flicker on. Dr. Jones reaches for her laparoscopic tools -- including a tiny camera that will be inserted into my belly button -- and begins a 55-minute Roux-en-Y gastric bypass. Of course, I see none of this. I am out cold. The last thing I remember is giving Indianapolis Star photographer Frank Espich a "thumbs-up" before drifting off to la-la-land. A few hours later, I wake up in recovery, with an extremely dry mouth and a foggy head. That day was Nov. 3. I would eat nothing but ice chips the rest of the day. Six weeks later, I am more than 50 pounds lighter, I have tossed away medicines for blood pressure, blood sugar and cholesterol, and I am walking about three miles a day. The real Dan McFeely is starting to emerge from the pounds of fat I had accumulated during a lifetime's struggle with overeating and a fast-food lifestyle. Like an estimated 103,000 morbidly obese Americans this year, I turned to bariatric surgery as a last-chance solution for life. It hasn't been an easy journey, and it is far from over. But so far, it's working. Memories of my first 24 hours after surgery remain blurry. Family and friends have filled in the details of how I complained about dry mouth, begged for water and repeatedly apologized to my granddaughters for being so sleepy. I do recall the nurses at St. Vincent Carmel Hospital pulling me out of my hospital bed and launching me into my first post-op walk on the "loop" -- a circular hall that wraps around the Bariatrics Unit. It's like a racetrack, constantly busy with big rigs (weight-loss patients) who have to keep active to promote digestion of their minimal meals in their newly stapled stomachs and to prevent blood clots, a key concern for any surgical patient. I was handicapped on my first walk. First, I was still tired and very sore. I had a gown with no back, a Velcro-strapped stomach wrap and hospital booties that kept slipping out of place. I also had to push an IV cart. I did not get far. But after repeated attempts (just about every two hours), I made my first complete lap around the loop and got the privilege of putting my name on a "lap chart." The more laps you did, the more gold stars you got. And there were always nurses cheering me on. Medically speaking, I was doing fine. I could not drink or eat, so I was nourished by an IV drip. Nurses came every hour to check my vitals and prick my fingers to monitor blood sugar. By the next day, I was able to eat for the first time. My first meal: mashed potatoes and sugar-free vanilla pudding -- 1 ounce of each. I also began to drink liquids, including water and Crystal Light. With my stomach now reduced to about the size of an egg, these meals filled me up like a Thanksgiving dinner. In fact, I have yet to experience the kind of hunger that used to drive me to the nearest pizza place. By the end of the second day, I had passed an X-ray test (to make sure my new stomach was still air-tight, and my vital signs were excellent. I anticipated staying another day or two at the hospital. But my doctor surprised me with a phone call at 6:30 p.m. I was going home less than 48 hours after surgery. Four to five a day Dr. Jones performs her first surgery of the day at 7 a.m. She does four to five a day (except on Tuesdays and Wednesdays) and averages up to 10 a week. Each operation is set into motion when a stereo's volume button is cranked up. A Mozart Adagio is her favorite. "Not everybody believes it, but studies have shown that background music can improve the activity of the brain. They call it the Mozart effect," she said. "I also think it's nice for the patient." But Dr. Jones, who calls herself "Rosie," is not a classical fanatic. By midday, she is dabbling in some easy-listening tunes. And by the end of the day, she is cranking The Beatles. Born in Chicago and raised in northwestern Indiana, Dr. Jones came to Central Indiana in 1980 as a student at the Indiana University Medical School. She began doing general surgery at Winona Hospital in Indianapolis. In 1995, she did her first bariatric procedure at Winona. Three years later, she left for St. Vincent Carmel and became one of the founding surgeons for its new bariatrics unit. As a whole, the hospital has done about 4,500 weight-loss surgeries in the past five years. At age 45, Dr. Jones has done nearly 2,000. My procedure, the Roux-en-Y, was done without a conventional cut into my chest. Instead, four incision points were made (two on each side of my stomach) through which the doctors would maneuver their tools, including "graspers" and a stapler. Another small incision was made so that a "liver retractor" could be put into place and keep my liver steady during surgery. A camera line was shoved through my belly button, a tracheal tube was inserted into my lungs (to keep anesthesia flowing), and lastly, a tube was inserted down my throat to pump air and water into my new stomach, making sure the new line of staples is water-tight. Once the operation began, Dr. Jones said, the first task was to staple off a small pouch at the top of my stomach and then divide it from my larger stomach (which will continue to produce necessary chemicals but will no longer digest food). Next came the creation of the Roux limb (taken from the small intestine) and finally the attachment of this "bypass" limb from my lower intestine to my new stapled pouch. This is where my food would travel from now on. The advantage of a bypass is twofold, Dr. Jones said. My body does not absorb as many calories as it would without the bypass, and if I consume a high dose of sugar, I will experience "dumping syndrome" when my body responds by producing a high amount of insulin. In other words, it's a surgical way to keep me from cheating on my new diet. There are potential post-surgery complications: peritonitis (inflammation or infection of the abdominal cavity), small bowel obstruction, malnutrition due to malabsorption, constipation and hair loss. Thankfully, I have had none of that. The most common complication found in Dr. Jones' patients has been food intolerance, where patients make mistakes and consume something they should not. "That's why our dietitians spend so much time instructing patients how to eat right and avoid that problem," Dr. Jones said. Twenty years ago, she said, patients were not usually educated as well on how to eat after surgery. That's why a growing number of her new patients are asking for "revisionist surgery" after experiencing failure from a previous stomach stapling. "Those people not only did not get down to a good weight, often times, they added weight," Dr. Jones said. Success is reached if a patient can lose 60 percent to 65 percent of his excess weight. Most do. But Dr. Jones said those who are vigilant about sticking to their diet plan and exercise can lose 75 percent or more of their excess weight. First day at home I will never forget my first day at home. I was so paranoid that something would go wrong. It was nice to sleep in my own bed, but I woke up at 5:30 in the morning and thought I would really mess things up if I didn't take an immediate walk. In the rain. Didn't matter. I grabbed my umbrella and walked about a half-block. I also worried about blood clots. Got to keep moving, I told myself. For the next five days, I had to jab a needle into my stomach to help prevent those blood clots. I also swallowed various medicines to heal my stomach. I was given a giant bottle of codeine-laced pain-killer. And I was put on an anti-depressant in case I could not handle the fact that I could no longer eat "normal" or drink a Coke. I healed well and never did experience any real physical pain. The anti-depressant, however, was another story. It seemed to turn on an internal fog machine and cloud my head, making it difficult to concentrate on anything but television. No books, no newspapers. Hour upon hour, day after day, I sat in my living room with my remote control, sleeping on and off, watching endless hours of mush on TV. For a while, I thought this was a natural component of healing. Eventually, as I stopped taking other meds, I traced it to the anti-depressant. Thankfully, my doctor said I could stop taking it as long as I felt I didn't need it. After that, I felt like I had more control over my mind, and I began to read. Can you imagine waking up on Thanksgiving Day with no warm smell of turkey in the oven? No pumpkin pies cooling on the counter? That's the way it was in my house. My wife canceled plans to host a family dinner. Instead, we spent the morning on a nice, long walk through the neighborhood. Later, we had dinner at my mom's house -- I enjoyed an ounce of mashed potatoes with tiny bits of chopped turkey and some sugar-free pumpkin pie. Then I dragged my brother and sister outside for a one-mile walk. Eating right has been a challenge. For my first six weeks, I was on a "full liquid" diet, which meant I could have cream soups, mashed potatoes, puddings -- almost anything without sugar, easy to chew and easy to digest. Unfortunately, these things did not always have a lot of taste. I have become a big fan of pepper. And then there were those days when no matter what I ate, it wanted to leave my body in quite a hurry. I still have nightmares about the day some "cream of mushroom" attacked. Even today, those kinds of episodes can strike without warning. I try not to walk too far away from home or, when I am at work, the nearest plumbing facilities. The biggest challenge, however, was a little friend who hung out of the left side of my stomach. I nicknamed him "Dwain." He was a tube designed to suck fluids from my stomach. He had to be drained several times a day. The worst part about Dwain was the shower. Without my stomach wrap, he simply hung around, swinging like a pocket watch -- pulling and tugging with each motion. A week after surgery, Dr. Jones removed Dwain from my side. I don't miss him. Most of my days of recovery were great. I bought some new walking shoes and started a routine of walking at least three times a day. Soon I was up to a mile a day, then a mile per walk (three miles a day). One week after my surgery, I weighed in at 28 pounds less than my pre-surgery weight. That was an incredible day. And since that time, I've averaged a loss of about 5 pounds per week. My shirts are getting loose; my pants are baggy. And I continue to astound waiters who can't believe it when I order one scrambled egg with cheese, rather than the six-item breakfast platter. Last week, at my six-week check-up, I graduated from 2-ounce meals to 3-ounce meals. And my "full liquid" diet has given way to more solid offerings such as beans, chicken, pork, fish, vegetables and fruit. My restrictions on bread, red meat, corn and high-sugar foods and drinks remain in place. Before this is all over, my 2-ounce stomach will eventually expand to about 8 ounces. Sometime in the next year, I will be back to eating just about anything I want, only in much smaller portions than I used to consume. My exercise routine will gradually increase from walking to swimming, bike riding and lifting weights. My body will continue to shrink, forcing me to buy new clothes. And my life will get much better, God willing. Call Star reporter Dan McFeely at 1-317-444-6230.
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