During my adult life, I had been struggling – suffering at times – with my weight issues. I weighed around 18st at that point, and was still trying to maintain some physical activity, but I had just moved from North Wales to London, and had very little money and knew hardly anyone. I made constant bad life choices when it came to food, and drink, and couldn’t find myself getting out of it. It was quite depressing. My job required me to travel the length and breadth of the UK and was stressful too. Couple that with my psoriasis – which I’d had since the age of around five – and it was a stressful time.
Things just never seemed to get any easier – the psoriasis stopped me exercising at times, and I just couldn’t seem to get out of a vicious cycle of putting weight on, which made my psoriasis harder to deal with, which was stressful and that made the psoriasis worse and thus I comfort ate. This went up and down for years.
I tried weight watchers, slimming world, going to the gym, seeing dieticians… a long list of different “techniques” to try and lose weight. I never tried anything drastic or went as far as having any eating disorders, but I just couldn’t get out of the cycle.
I got referred to see a dermatologist under the NHS, and whilst they tried hard to help through treatments (cyclosporine, methotrexate) these had their side effects, and the advice from the Dr was “you need to lose weight – move more”. I knew this.
This went on until the end of 2014, when my wife started looking into Bariatric surgery – originally for her – but after her initial consultation, we discussed that actually I should consider going to see Mr Goldie Khera. My wife was hesitant; I was an irritable person when it came to discussing my weight because I was embarrassed. But actually, when I looked into it myself, this seemed like worthwhile exploring, an option that could help me because I knew my problem was almost a bit of self-destruct mode and that I needed help mentally as well as physically to change my life, and live longer.
I met Mr Khera at the Montefiore Hospital in December 2014, and we discussed my background and why I wanted to get his help. I explained that I had two kids and wanted to see them grow up, but that I just couldn’t do this on my own. We discussed what was involved, and that it wasn’t an easy option by any means, but that I would be the right candidate to go through the process. The level of support that was going to be given to me filled me with confidence, and Mr Khera in particular helped me to realise some self worth again, all from the first meeting.
In early 2015, Mr Khera and I spoke and, after he had spoken to Mr Woodsford (anaesthetist) decided that we needed to put the process on hold as there were concerns that, due to my size (I was 23 stone or more by this point) I may have sleep apnoea. I was sad about this news, but Brighton Bariatrics and Mr Khera helped me understand how important this was. I undertook a sleep test via the NHS, and indeed I did suffer from slight sleep apnoea.
Over the following 10 weeks I slept with a CPAP machine, and started to feel significantly better – slept properly, no snoring – this was like a new lease of life! I also needed to lose around 5kg, which I started to do slowly but surely, with the support of the BB team. Then, in September 2015, I met with the BB Nurse and she fed back to Mr Khera that I had made a lot of progress with the apnoea, and had lost some weight. I got the call a week later that Mr Khera and the team were happy for me to proceed with the Gastric Sleeve operation if I still wanted to progress. I was booked in for a meeting with the Clynical Psychologist and the BB Dietician (Caroline Laidlaw) and finally with Mr Khera.
The Dietician explained how my life was going to change from a diet point of view, not just what I could eat and drink, and how I was going to recover, but also why I had to eat the right things and how they would be good for me. This was going to be a life-long change and with her support I knew I could do this.
The date was set for my operation – My birthday! At least I would never forget the date my life changed.
Pre-gastric sleeve surgery, I had to go on a strict milk only diet to try and shrink my liver size, so that the operation had more chance of success. This was tough for the first few days – no food for two weeks was as big a mental challenge as physical, as I was still at work and surrounded by people who now appeared to be constantly eating! But I got through it, I knew I needed to because the long term goals were so important.
On November 3rd I arrived at the hospital for my operation, having met the Matron the previous Friday who had explained the process, and for me to undertake the Pre-Op assessments. I was ready to go, nervous of course, but settled and confident that I was in the most amazing team that were going to take care of me.
We just had to wait for some blood tests to come back and we would be off… which unfortunately delayed the operation starting for a few hours. However, Mr Khera and the nurses, and Mr Woodford, kept a check on me and informed me of what was going to happen – everything to keep me from being too stressed.
Eventually, the test results arrived and I went into theatre. My psoriasis was quite bad at the time as I had been off all medication pre-operation too, so that my immune system could recover. Mr Woodford had to find other veins in the side of my hand to for the anaesthetics, as he couldn’t use the back of my hand. He did this, and the next thing I remember waking up in recovery. I only really recall seeing Mr Khera and Mr Woodford, and that there had been a bit of concern that the new stomach may not have sealed properly as my liver hadn’t quite shrunk enough. I don’t really recall the full conversation, other than I would be nil by mouth for probably a week, and would be in hospital longer than originally anticipated. My wife came to see me, but I don’t remember too much more.
The nurses looked after me in the HDU, and I went in and out of consciousness throughout the night – needing to urinate but couldn’t for a while. But I didn’t feel stressed – it is hard to put in words the confidence I had in the team, but I just trusted them.
The next morning I was taken back to my room, and slept a bit more, before getting up and moving around my room. Mr Khera came to see me, as did Mr Woodford and they explained every step of the way what was happening and kept a close eye on my medication and recovery. I was told that I would have an X-Ray hopefully at the end of the week, and should be able to go home the following week if all was well. The most difficult part was not being able to have a drink. I was on a drip for fluids and medication for a few days, but my mouth was very dry.
One thing that made life not so easy to cope with in the hospital was that each night the staff would come along and ask if I had filled out the food menu, and I would have to remind them that I was nil by mouth. For someone who had struggled with temptation for years, this was a test of wills – maybe that was the idea? I doubt it. I wish they’d told me that was where to order the newspaper though! Felt like such a big deal at the time, but in hindsight it was probably just to occupy my mind.
On Friday 6 November I had the X-Ray, and my first drink post operation was X-Ray fluid – nice! But I didn’t care because this was when we were going to find out it was all ok. I had the X-Ray and within an hour I got the news that all was clear!! Such great news, and I spoke to Mr Khera and he too was very pleased. I was able to have a drink and some jelly and yoghurt. It took a long time to eat, but I enjoyed it.
I was up and moving really well at this point – probably the most difficult thing was showering. Mr Khera came to see me on the Saturday and was happy with my progress. We removed my compression bandaging and the “wounds” were healing well already. Mr Khera asked if I wanted to go home because he was satisfied that I was coping really well – I didn’t need asking twice, as I was missing my wife and kids a lot by this point, and there is no place like home to recuperate.
Mr Khera kept in touch with me, and would text me regularly to see how I was progressing, and would call too. I feel like I owe him so much, and am grateful for how my life has changed.
Over the next few weeks, I kept strictly to the diet that I had been given – I became a master at making soups that is for sure! I took my vitamins every day, and still do.
I went back to see Caroline and Mr Khera on December 4th, and they were both very happy with how I was progressing. Caroline thought I had lost more weight than she would have liked, but when I explained that after the milk diet I also went four days nil-by-mouth, she said that this explained a lot, but I would have to put back moving to stage two by a week. We planned on how I would move forward and in particular how I would have to be strong and handle Christmas day.
Mr Khera was pleased with my progress and gave me some advice on what I needed to do to keep progressing.
Christmas wasn’t too bad – I even cooked the whole Christmas dinner! I had a glass of wine and spent some amazing time. I was starting to really see the benefits and feel much better, physically and mentally.
In the New Year I was now 20kgs lighter than I was 12 months earlier, leading a healthier life, and enjoying all element of life more. I was able to start moving better, and noticed that actually my psoriasis had made a significant improvement – so much so that it had pretty much gone! I never expected this, but it was so noticeable. I knew that I had to let Mr Khera know about this, because this could be something he could be very interested in.
I had an appointment with Mr Khera that following week, and I told him about my magical improvement in my psoriasis, as well as significant weight loss – I was not down to 123kg from originally being 153kg back in January 2015. He said that, coincidentally, he had just been to a bariatrics conference and this had been discussed, but that nobody truly new why psoriasis sufferers that had undergone bariatric treatment saw a significant improvement. Great news though.
I am still going through the programme, and I cannot stress how much the support of Mr Khera and the BB team has made this the most positive change in my life that anyone could wish for. The only negative that stuck out was the menus in the room! That’s a pretty good story so far I would think!
I continue to change and evolve how I lead my life, and with the support of BB I am sure that I will continue to get healthier and lead a longer happier life.
It’s Nov 18th & I’m sitting here exactly 1 month out from surgery.
I’m back at work & back at the gym (treadmill only – no weights, sit ups or plank!).
I start pilates again at the beginning of December.
I’m feeling happy, pain-free, energised and re-born.
Most importantly I’m 27 lbs down from my starting weight of 17 stone 11.5 lbs on Oct 3rd when I began the milk diet.
I can honestly say I’ve not regretted my decision once & have not felt low or depressed once.
I have not been sick or even felt nauseous once.
The 2 week milk diet was fine – I was still working (and really busy!) and attending my usual 2 pilates classes & 1 pure stretch class per week. I had stopped my gym workouts as I wondered if that would be too much given that they were largely weights/strength based.
The day of the surgery (Tues Oct 18th) arrived & I awoke feeling calm. On the journey to the hospital at 6.15am I felt a strange sort of calm excitement.
As soon as I got to the Montefiore I felt very settled. All of the staff were lovely, my room was beautiful & spotlessly clean. The next couple of hours flew by, blood pressure, temperature and pulse checks, some blood tests, getting changed into my operating gown & stockings. Meeting Mr Khera & Mr Westhead again confirmed the start of my new life. I was first on the list & very grateful for that.
I walked to the theatre & was handed over to Mr Westhead & the theatre nurse. I climbed onto the operating chair & the next few minutes were taken up with being positioned, having monitoring equipment placed on me & a canula in the back of my hand. I must have looked slightly nervous but Mr Westhead soon fixed that by placing his hand over mine and jokingly asked if I felt “over-medicalised”. He adjusted the theatre light & said that it would soon to be time to go off to sleep – I was relieved.
He placed a mask onto my face & asked me to take some deep breaths, he said that things would start to get a bit fuzzy – and they did as soon as he spoke – but fuzzy in a nice way. My last thought was how pretty the theatre light looked, white, blue & green lights.
I woke up in exactly the same place that I had gone to sleep in.
I was clearing my throat & was told by the theatre nurse that it was all over & everything had gone well. I was given very small sips of water to take – all was fine.
My pain was very well-controlled over the next couple of hours in the recovery room, I had some fentanyl which seemed to work immediately. Mr Westhead came to see me & said that all had gone very well.
I was wheeled back into my room.
The rest of that day & night I slept on & off.
Mr Khera & Mr Westhead both checked in on me with the good news that the operation only took an hour due to my strict adherence to the milk diet which shrunk my liver quite considerably.
The nursing was calm, efficient, professional & non-intrusive.
I was encouraged to take sips of water – all was fine – no pain. I took things very gently.
I needed the toilet early in the evening, the nurses wheeled in a commode but I didn’t want that – I asked if I could get up & use the proper en-suite toilet. It was good to move about.
I was attached to a fabulous pair of self-inflating stockings to help to avoid blood clots. I loved this – they gently squeezed my calves – like having a nice massage.
I progressed to apple juice that evening. The pain medication was dissolved in water.
The following morning (Weds 19th Oct) I was allowed to shower & change into my own clothes – much more comfortable. The day continued – I walked around the corridors a lot very slowly looking at the artwork. This made me feel loads better. I kept taking deep breaths & gently stretching everywhere – except my stomach. I felt that it was important to stand tall & not hunch over.
By the evening I had progressed to jelly & plain yogurt.
The following day (Thurs 20th Oct) I had a lovely cup of coffee, more yogurt & for lunch – tomato soup (my absolute favourite!). I had a cup of tea mid afternoon & was allowed to go home at 5pm.
I felt ready to go & confident that all would be well.
My recovery continued, I followed the diet plan to the letter & have not ever pushed it by over-eating – I am too scared to force it & frankly don’t want the associated pain & possible very serious consequences.
This is an honest reflection of my experience so I feel that I do need to give you the downsides.
The only 4 issues I had were:
1) Oral thrush, I think I had just got run down prior to surgery, eating the very low calorie milk diet whilst working a busy, stressful, job & getting everything sorted out beforehand (which included making sure that my 82 year old Mum who suffers from Alzheimer’s disease was going to be well cared for whilst I was unable to drive for 2 weeks). Nystatin oral solution & soluble co-codamol helped to quickly sort that out.
2) Pain whilst trying to get out of bed, I employed a log-roll technique & used my arms as much as possible but it still hurt. Any twisting or turning of my abdomen hurt. I did consider sleeping in my electric recliner chair for the first few days as I’m sure that this would have made things easier. I have only just progressed to sleeping on my left hand side.
3) Constipation, inevitable I suppose! The lactulose solution helped & as I have progressed to solid food which includes fruit & veg (but no skins yet) this has helped but my 1 tip would be to drink lots of water!
4) A slight mental detachment which has slowly cleared & was thought to be due to the anaesthetic & pain medication. Apparently this can take 3 months to completely disappear.
If you are reading this & wondering whether to go ahead with a vertical sleeve gastrectomy my advice would be to read as much as possible about the surgery, including other patients’ experiences on various forums.
I can only speak from my experience – which was totally positive and one of the best things I’ve ever done.