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First off, I am considered a 'low BMI' patient and recall asking my doc over a decade ago about GB with insurance paying for it. She laughed and told me I'd qualify if I gained 40 pounds, kept it on for 2+ years while trying to lose weight, and developed co-morbidities. I was fairly trim until my 30s but have 2 problems contributing to consistent weight gain. First, I have really big boobs, and if that sounds silly try exercising with them. Second, I can eat the same amount as everyone around me but I gain weight while they lose or stay the same. I had anecdotally seen this for years when I discovered 'myfitnesspal' about 6 years ago and began tracking. I discovered I have to stay below 1000 calories per day not to gain weight, and drop to below 800 to lose. That is simply unsustainable. 5 years ago I went on phentermine and lost 35 pounds. While that was great, like most dieters I cannot sustain the weight loss. I stumble home exhausted, with no energy, and at night begin to crave food. That pretty much goes along with the research on those who have lost weight but not been able to keep it off; reduced metabolism by about 50% and the necessity to eat 500 fewer calories than a 'normal' weight person in order to sustain the weight loss. My weight has been climbing steadily for the past 3 years, and as I've gotten close to my highest weight my energy has returned and my weight leveled off. Still, though, I am frustrated at not being able to keep it off.

After reading the latest articles on the inability of 99% of weight losers to successfully keep weight off, I began to think about bariatric surgery. I was considering India for its low cost, but English friends told me a lot of Brits have serious problems with their surgeries there. I have a cousin in Belgium, though, an American who married a Belgian man, and she has glowing things to say about medicine in Belgium. In looking around I discovered Dr. Bruno Dillemans and the International Surgery Group ('ISG' based in Ireland) and contacted them. Dr. Dillemans reviewed my information online and suggested a standard Rouen Y gastric bypass. He told me that in his experience this is the gold standard and patients who demand other surgeries such as the sleeve, which many of his international patients request, end up coming back for the full bypass. He asked several questions via email and the ISG. For reasons of cost and convenience I elected to have my pre-op tests and consult done the morning of my surgery. I know some people have an aversion to this, but I did my research, knew my general health was quite good, and didn't see much reason to have a consult one day and operation the next, as my mind was made up.

My surgery was 3 days ago, June 21st - hard to believe it's been just about 70 hours! I checked in at 7:30 AM with clear and good instructions from ISG. First up was a series of 3 tests; bloodwork, lung xray, and EKG. As has been my experience in another European hospital the results were processed right away and the doctor had them by the time I met with him at noon. In my room as I waited for them to take me to surgery I thought to myself, "Why am I doing this to a perfectly healthy body?!" But I am a professor and researcher and have read all the literature and the reality is our chance of losing weight on our own is almost non-existent. Once one has gained weight the body will fight forever to return to that weight. We should tell every young person this basic fact and try to prevent them from gaining weight in the first place. When they came to roll me from my room to the surgical suite I said to the orderly, "oh now I am really nervous," and she smiled kindly and said, "Everyone is at this point, everyone, and some are quite terrified." That, plus the surgeon's record, were quite reassuring.

The process itself was smooth and I remember little. I was interested in the side by side metallic operating room doors which opened as people went in and out - I could see another laparoscopic operation going on in mine. I was in a little bay outside the operating room and the anesthesiologist and a tech went over everything thoroughly. Interestingly, on the ceiling was a security camera dome - apparently they film everything that's going on so can review the tapes if there is a future problem. The very kind tech held a mask near my face and asked me to breathe deeply. I recall going under and saying, "Here I go, I'll see you on the other side..." I recall only a bit of the recovery room and asking several times if I could turn on my side as it hurt to breathe, but they would not let me. Finally I was taken back to my room and the Dr. and his resident came to check on me. My drain was bleeding a lot and they examined it. Dr. Dillemans explained that he had stretched the incision with the equipment and the edge was bleeding so they would need to put 2 more stitches in, which they did. The Resident commented that I was the "Stoic American" and, thank heavens, told me that I could (finally) roll onto my right side, I slept most of the rest of that day. I recall asking if I could get up and walk to the bathroom but the nurses wouldn't let me, saying it was too soon after surgery (I think in the US they try to get you up asap, so this was different). I finally called for a bedpan and that nurse was a bit short with me - I asked her to close the window blinds and she said "we will do it when we come in to check you," and I realized they were in the middle of rounds so simply told her, "Thank you, but I have no way of knowing that" and she seemed a bit chagrined. I only called for a nurse one other time and both times the response was within 2 minutes.

Overall I am thus far happy that I went ahead with this. At least now I have 'a chance' where before I feeling pretty hopeless about sustaining weight loss. The Belgian hospital and procedures were stellar, super clean (they tested me for MERSA as well as 2 other common bacterial infections), cleaned my room 2x per day, were state of the art and efficient. I don't like nurses hovering around me and they didn't, but checked up on me every hour or so and came immediately when I called. Total cost of the medical portion was $9,981. Since I was already coming to Europe anyway there was no added expense other than the hotel, which I split with my cousin since she wanted to visit friends in Brugge.

I weighed today, expecting my weight would be the same since I don't feel any smaller and they stuffed me full of IV drugs, but I've already lost nearly 10 pounds. I recommend this to anyone going through the same struggles and frustration with weight. I'm happy to share info or insights with anyone thinking of this route.

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