Update on my stomach issues from last week

My previous post discussed how severe abdominal pain ruined my last week with Flaminia ("Fla") and nearly prevented me from seeing my trainer at all before she moved to New York.  Vilma luck struck with a vengeance!

As of today, almost two weeks later, I still don't know what is going on with my stomach as I await the results of a CT scan I had a few days ago.  My doctor thinks that the culprit could be scar tissue from prior stomach surgeries I had years ago that is causing a blockage in my stomach, but nothing will be known for certain until the CT scan results come in.  Now I have to wait until next week to find out what's going on and what the next step is.

 

The one thing I've experienced when you're sick is that it's all about waiting.  You wait for doctor appointments, you wait for procedures to be scheduled, you wait for insurance approval, you wait for the day of the actual procedure, you wait for test results, you wait to hear what the next step is, you wait to feel better, and finally you wait to recuperate so you can get back to your normal routine.  You spend your life waiting when you're sick.  I hate waiting.  My life is in limbo because I can't make plans or return to my normal routine until it's all said and done.  Right now I'm taking it one day at a time because I don't know how I'll feel tomorrow.  But, thankfully, so far so good.

Last week I was in agony and couldn't consume liquids or food for several days, but since my doctor prescribed medication last Thursday, any issues I've experienced since have been minor.  Thankfully, I'm no longer in pain and any cramping I feel is temporary.  The doctor put me on what I call an 80-year-old-man's diet:  mashed potatoes, soup/broth, and bananas as well as Gatorade and Pedialyte to replenish my electrolytes since I was severely dehydrated and after a few days of eating like an old man, I started to feel much better.  The only bonus to this whole ordeal is that I lost more weight although now that I'm back to eating normal foods, I'm gaining it all back.  That scale is going to torment me for the rest of my life through health and sickness!

In prior posts I broached the subject of having experienced medical issues starting about 18 years ago when my weight was getting out of control.  My biggest medical problem to surface first was issues with my stomach.  What I'm experiencing now is a consequence of those stomach issues which my obesity most likely created in the first place.  Who's to say that if I had been thin my entire life I wouldn't have experienced the same medical issues, but I know that the obesity didn't help anything and it put me at higher risk of getting sick. 

When you're obese, if you have to see a doctor for any ailment, they will usually attribute what's wrong with you as a result of your weight issues even before any tests have been performed.  As soon as they see you, they visually decide that's why you're sick.  Hang nail?  Well, you got that because you're obese.  Painful knee?  Well, that's because you're obese.  Stomach problems?  Of course, it's because you're obese.  Of course, it is!  What else could it be?  I've had doctors diagnose me this way visually for some ailment only to find out later that test results proved that whatever my ailment was at that particular time had nothing to do with being obese.  I thought it was a catch-all phrase:  whatever is wrong with you is because you're obese.

I used to think, "So the only people who ever get sick are fat people?  There are NO skinny, fit people who have medical issues?  How lucky skinny and fit people are!  Not only do they not have to deal with the humiliation of being obese but they never have to worry about getting sick either!  Lucky people indeed!"  Of course, that's completely ridiculous.  Anyone can get sick.   

What I realize now, however, is that weight raises your risk by a huge percentage to get sick.  There's a long list of potential medical problems obese people might experience.  At the very least, we end up taking several medications to fix problems caused, or aggravated, by our weight.  Not only does your body and joints work a lot harder to carry the extra weight around on a daily basis, but your organs are trying to process unhealthy foods (which caused the obesity) that leave problematic residue which will most likely cause disease in the future, too.  Regardless of whether an obese person is medically healthy, there's also the drain on that person's emotional and spiritual well being.  Eventually the weight does start affecting people medically as they get older, too.  There's absolutely no benefit to being overweight other than maybe less wrinkles because your face is bloated like a balloon.

In 1998, I weighed about 230 lbs. and I was doing pretty well.  I was determined to lose weight so I joined Total Woman ("TW"), the gym I subsequently joined again in late 2014 where I met Fla, I started to cook my meals, and I started to work out regularly.  I even had a trainer at the time, although she and I never remotely connected the way I eventually did with Fla.  The irony that is always Vilma luck is that this other trainer is still working at TW today, all these years later, while my Fla, one of the most important people in my life, has moved away to New York.  In any case, back in 1998 I lost some weight and I was feeling terrific being in the 230s.  Then Vilma luck struck and I started experiencing issues with my stomach I had never had before and everything went out the window.  I kept asking myself, "Now that I'm finally doing something about my weight, surely now I'm not going to have stomach problems, right?"  But, of course, I did.   

In my case, my blood work and other medical statistics always came back normal.  My blood pressure was always perfect, my cholesterol stayed within 150-190 at my heaviest while thinner friends' were in the mid 200s, and my glucose levels never showed I was remotely close to getting diabetes.  I was lucky.  

Then stomach issues arose in 1998.  All of a sudden, out of nowhere, I couldn't keep food down, I was constantly regurgitating bile into my mouth especially while I was sleeping, and I would gag easily particularly after eating.  I became bloated and my stomach felt hard as a rock to the touch.  At the time, GERD (i.e., acid reflux) wasn't as commonly discussed as it is now and I underwent several awful tests.  Initially, I was told it could be anything from my esophagus was spasming to I probably had stomach cancer.  Ultimately, tests didn't show much of anything wrong.  I was given several medications, told to change a few things in my diet - primarily to add fiber, and told to start exercising.  My gastroenterologist told me to walk every day because it would help my present issues.  Of course, I didn't listen.  I changed things as my doctor prescribed for the short term, but then I stopped soon enough.  Eventually the symptoms went away and I went back to my normal habits of eating badly and my sedentary life.  By the time it was all said and done several months later, I had already given up on my new weight-loss efforts, I cancelled my gym membership, and I didn't contact the trainer again.  The result was I gained whatever I lost back soon enough plus more.  A lot more.  

I felt defeated.  Here I was FINALLY trying to improve my lifestyle and medical issues I had no control over ruined it for me and threw me off my new path.  I was doing so well and here was the universe once again working against me as it always did.  Instead of getting back on that health-kick plan, I gave up, and eventually ended up in the 300s.  I often wonder where I would be today if I had felt then the same motivation and the same "never give up" attitude I adopted during this recent weight-loss journey.  In any case, I wasn't ready to start listening and applying what was in front of me all along until now.

About five years later, in 2003, the symptoms returned unexpectedly with a fury.  By then, I weighed close to 300 lbs.  My stomach issues got so bad that I couldn't talk, especially when I ate with friends, because at any moment I could vomit.  The oxygen we swallow normally as we eat and talk would build up in my esophagus along with the food and it felt like a bottle being filled up until it overflowed.  I never knew when I'd vomit.  I could be perfectly fine one second, bend over to pick up something I dropped on the floor, and suddenly I was vomiting.  I had absolutely no control over it.  I was afraid to leave the house.   

At the time I had to give several presentations for work in front of large audiences (50 to 150 people) and I was petrified of embarrassing myself, as if it wasn't stressful enough to speak in front of a large audience already?  I forced myself to fast beforehand for more than 12 hours to reduce the risk of having anything in my stomach that would cause me to vomit in front of people during my presentations.  Regardless of how hungry I was, I just couldn't take the chance.  Thankfully, I never embarrassed myself although the stress of worrying about what could happen caused me to gag and dry heave for at least an hour before each presentation even started.  

All my friends knew what was happening to me so they thought nothing of it when we'd go out and I suddenly stopped talking nor when I suddenly ran away from them without an explanation.  They knew I was getting sick and was running to find a bathroom.
       

During these episodes, I attended the Lilith Fair with friends and I fasted for 24 hours before the fair because I knew I'd be in a very crowded situation and I didn't know if I'd have access to a bathroom at a moment's notice.  I still had vomiting episodes during the concert but since I had no food in my stomach, I was able to control it enough until I could find a bathroom.  Eventually my symptoms got so bad that I stopped leaving my house unless I absolutely had to.  I turned down any speaking opportunities at work and in general I stopped talking as much as I could.  I stopped going out with friends.

What was incredibly frustrating to boot was that I wasn't losing weight even though I wasn't eating much.  Instead, I gained over 10 lbs. in less than a month.  It wasn't a real weight gain though, it was mostly being bloated.  I jokingly told the doctor back then that I wouldn't complain if at least I was losing weight!

The most amazing thing about humans is that we tend to adapt to our situation, whatever that is, and we find ways to "get around" whatever ailment we have to continue living our lives as normal as possible.  Although this is a great attribute, the problem is we adapt too easily to having to take medications or undergoing medical procedures instead of tackling our weight problems when we should.  Why do we resign ourselves to being a slave to numerous daily medications which are necessary because of ailments caused, or aggravated, by our weight issues?  Wouldn't it be easier to lose the weight and be done with the medications?  Wouldn't it be easier to lose weight than wait until our bodies start falling apart and we need surgery to repair it?  You'd think so.  But, of course, it's not.  Addiction usually wins.  It's easier to pop pills every day and go from one medical test to another rather than fight obesity day in and day out.

At the time I was experiencing these episodes again for a second time in late 2003, I went back to my gastroenterologist and he sent me to the hospital to have some intrusive tests, one worse than the last.  This time I was diagnosed with a hiatal hernia, it was revealed that my lower sphincter was not working at all, and I had severe acid reflux.  By this time, GERD was common.  

A hiatal hernia is when part of the stomach bulges up into the chest through the hiatus, an opening in the diaphragm.  The causes of this are unknown, but obesity has been linked to it.  Acid reflux and hiatal hernias are not a cause or effect of each other either.  A person can have a hiatal hernia without acid reflux and vice versa.  In my case, I hit the jackpot and got both.

The lower sphincter is a muscular ring where the esophagus attaches to the stomach.  It's supposed to remain tight to keep stomach acid from going back up into the esophagus.  In my case, my lower sphincter remained wide open 24/7 so I was experiencing "tremendous acid reflux," as one doctor put it, all day long.  One horrible test I had to undergo showed I was having over 200 episodes of acid reflux in 24 hours.  I think they told me the normal was no more than 35 episodes a day.

One of the coolest tests I ever had was to stand in front of a huge X-ray machine that had a monitor attached to it.  When the machine was on, I could see my skeleton and insides on the monitor in live action.  It wasn't an X-ray picture, it was a live TV X-ray image!  It was like something out of a horror movie.  (I love horror movies, by the way.)  While I watched this skeleton next to me, they had me drink barium, a special thick mixture they give you for such tests.  As I swallowed, I watched the skeleton on the monitor open its jaw, swallow, and I saw its upper sphincter (a little trap door located at the throat) open and close to allow the barium to slide down its esophagus to the stomach.  The test was completely painless and other than the barium being a disgusting mixture to drink (it has since been improved in texture and taste), I thought it was so cool that I could see my insides and skeleton on this monitor in live action. 

After I was diagnosed, I was referred to a specialist and the suggested course of action was fundoplication surgery.  With fundoplication surgery, they wrap the esophagus around the top of the stomach, sew it in place, and this tightens the opening to create/fix the lower sphincter.  This surgery prevents or reduces the episodes of acid reflux.  

I was petrified because other than having my tonsils removed as a child, I had never had surgery before and I had never spent the night in the hospital.  It didn't help my fear any when the surgeon told me that because of my obesity, they couldn't perform the surgery laparoscopically (a less intrusive procedure) so they'd have to open me up as if I was having open-heart surgery.  This would mean staying in the hospital longer, it meant a lot more pain for a longer period of time, and it would add several weeks to my recuperation, not to mention my scars from the surgery would be huge.

The alternative to surgery was to take medications to control the condition for the rest of my life, but there was no guarantee the medications would work for long.  Additionally, the problem with GERD is that as the stomach acid continues to go into the esophagus, eventually the esophagus will try to protect itself by creating special tissue to coat itself.  This special tissue is known to turn cancerous in the future.  I met a patient whose esophagus had been removed.  I was so freaked out that I never found out what they used to replace it.  All I knew is that I did not want to end up like that.

After many sleepless nights and complete uncertainty about what I should do, I opted for the surgery.  Thankfully, on the day of the surgery in early 2004, the surgeon and his team decided they would try performing the surgery laparoscopically after all.  

The surgery itself was not pleasant and recuperation took many weeks.  For several months afterwards I could only eat mushy foods and, frankly, I had no desire to eat at all.  I dropped 20 lbs. in less than two months which I should have seen as a starting point to losing the rest of my weight, but that was not to happen.  I was not in the right mindset at the time so I gained it all back and more in no time.  In the end, I'm very glad I had the surgery.

One of the side effects of fundoplication surgery though is that my stomach now faces the "wrong" way, meaning my anatomy is different now, and I have to be careful about what medications I consume.  I will always have a higher risk of getting ulcers or stomach bleeding from certain medications.  The seriousness of ignoring this almost killed me in 2008 because of a doctor's negligence.

In early 2008, almost to the day since the fundoplication surgery years before, I had knee surgery on my bad (left) knee to repair a meniscus tear.  My sedentary life and obesity were definitely the culprits to having a bad knee.  Of this I have no doubt.  Prior to knee surgery, I included my entire medical history in paperwork the doctor asked me to fill out, but I guess he either didn’t read it or didn't understand it because he prescribed anti-inflammatory pills that I was to take after the knee surgery, the absolute worst thing he could have given me.  I've come to realize since that we, as patients, need to be advocates for ourselves because doctors don't know everything and there's negligence and incompetence in that field, too.  Within 24 hours after knee surgery, this medication pierced my stomach and I was in agony for about 12 hours before I had someone take me to the hospital.  I have never experienced pain like that before and I hope to never again.  I literally couldn't move, but I finally found the strength to reach for the phone and call my friend who took me to the ER.  I have a high pain tolerance, but that day I wanted to die because the pain was unbearable.  They always ask you what your pain level is from 0 to 10, with 10 being the worst.  That day, my pain was a 15.

After the ER staff conducted several tests, they could see "free air" inside my torso which meant I had a hole in my stomach.  While they wheeled me into the operating room for emergency exploratory surgery, I found out later that the doctors told my mother I probably wouldn't survive the surgery because of my obesity.  I was 300 lbs. at the time.  Not only that, it's not great to have two surgeries within 48 hours because now you're dealing with the aftermath of too much anesthesia.  My friend told the doctors that they didn't know me, that I was a fighter, and I would survive it.  Thankfully, she was right.

The surgery itself took over 3 hours before they were able to find the hole and repair it.  They saved my life, but they gutted me like a pig.  I am reminded of this emergency event every single day of my life because it left me with an 8-inch vertical scar from my lower chest to my belly button and I can still see where the 30+ staples were that sealed me up and where the various tubes (drainage and feeding) were surgically implanted in me because these also left scars.  The vertical scar is hideous and it looks like a big, ugly, built-in zipper:  a long, thick line with little holes on either side where the staples once were.  If people were to see the scar now, they'd naturally assume I had gastric bypass surgery.  But the surgery I had that day was to save my life as a result of a negligent doctor who ignored my medical history and it had nothing to do with losing weight.

This particular surgery was the worst thing I have ever experienced.  I was in the hospital for two weeks!  I had tubes coming out everywhere and I had several complications, too.   But survive it I did.  The recuperation took a very, very long time.  Once again I lost a ton of weight in a short time but I eventually returned to my old habits and gained it all back in no time.  Thankfully, this time, however, I didn't gain more than where I was before the surgery.

Because of these two surgeries, my stomach will never be normal and will always be more sensitive than it used to be.  After this horrible emergency experience, I ALWAYS contact my gastroenterologist first when another doctor prescribes anything new to make sure the medication is okay for me to consume.  I won't even take vitamins or supplements unless I check with him first. 

I haven't had any major stomach problems for the last several years, but now it appears there may be residual aftermath from these surgeries all these years later.  It makes me sad (and angry) that I finally got my act together, am eating better than ever before, I'm healthier than I have been in decades, and that now, once again, I'm experiencing health issues with my stomach.  At this point I don't know what the true problem is or if I’m going to need surgery again so I'm just in limbo waiting to hear what the CT scan results are and what my doctor has to say.  I'll get through it like I have gotten through everything else, but it's yet another setback because the universe has once again thrown a wrench in my life.

Should I need surgery now, however, at least no one will tell my mother that I won't survive it because I'm too obese.  

This is exactly why I always urge people who are obese and haven't had any medical issues to do something about their weight now, while they're still in good health.  This is the time to get your health under control before anything bad happens that will affect you the rest of your life.  And if you are already experiencing health issues, you have no choice, do something about your obesity now before things get worse.  I didn't listen back then and I paid for it and am still paying for it.