Saturday, February 03, 2007

Living with a defective digestive tract

I have GERD, (gastro-esophagal reflux disorder) as a result of a hiatal hernia which I was born with. From the lifetime of reflux, and adhesions from a medical procedure, I have developed a stricture of the esophagus which means there is a narrowing which doesn't stretch very well and can easily get plugged if I take too large a bite or eat too fast.

Most of the time I remember that and try to eat slowly, chew well and take small bites as well as staying away from foods like steak which don't easily liquify, but occasionally, I'm upset or anxious and I forget and take a couple of large bites and then, the trouble starts.

This morning as I was writing my other blog post, I committed the sin of biting 1/2 of a boiled egg, and not chewing well enough, something a normal person would toss down with no problem.

Said egg got stuck so I did my usual thing of gulping water to try and force it down. It stayed obstinately put and didn't move and I could feel that the water I drank was going to come up so I flew toward the bathroom and started to do with the adjustable lap band patients call, "PBing" i.e. "productive belching". In other words, I coughed to try and dislodge the stuck stuff. I finally, got enough up to make the rest of the stuck egg go down but it was a bad moment.

Because if I could not have gotten it down, I would have had to have an scope to push it down and would not have even been able to drink water until it was dislodged. That did happen to me once and it was so not fun.

I see people rushing to get weight loss surgery "done" - gastric bypass which is a permanent change to the digestive tract or even lap band which at least, can be reversed and adjusted. People whose digestive tracts work fine. Who can eat things I only dream about eating like steak, and toss it down with nary a thought. And I think about how they will feel after surgery when they have to wait for every little bite to go down, every time they eat.

When a gastric bypass patient gets something stuck in the opening between the pouch and the small bowel, they can suffer two hours of rather intense pain until it hopefully goes down.

And yet, this inconvenience which they will endure for the rest of their lives after their bypass is never even discussed at seminars or in weight loss surgery groups.

Having GERD as I do, my eating choices are limited (as are those for gastric bypass patients although few will admit this). And I go through this fight to swallow with every meal. Even with this stumbling block to eating, my "weight advantage" (how much less I weigh than if I didn't have this problem) is about 20 lbs. For 20 lbs, I'd druther be able to eat normally.

The quality of life index for a GERD patient has been said to be 2 out of a possible 10. And lately an article in a medical journal which will never hit the light of day in the mass media, observed that gastric bypass patients also experience a quality of life hit. A unpublished study, heralded in the mass media under the headline that gastric bypass patients live longer, also included a forgotten line... that deaths by accidents, and suicides were "significantly" higher among gastric bypass patients than among fat people.

When you decide on surgery that NO ONE guarantees, not even the AMA, remember that being slim if you are among the 7 percent who GET slim and can stay there, wears off but what you live with is fighting with a digestive tract which no longer works as it should, several times a day. (Surgeons state in the medical papers that they expect most patients will only keep off 50 percent of their excess weight and that about 30 percent will gain it all back).

Compliments are nice and so is wearing a smaller size but it's the moments day to day that you live with the most. Make sure there are no dealbreakers in those daily moments or MOST of your life (outside of the compliments occasionally) will have a poor quality.

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