For nearly four years I’ve been on the NHS journey towards bariatric surgery for weight loss. The majority of that time was spent, as you can imagine, waiting. This week, after waiting 11 months at a stage that was supposed to last 6-8 months, I called the hospital for an update and found out that I was still up to a year away from my next consultation. After that, I could expect to wait at least another 6-8 months for surgery, and I’d heard that before.
Having spent the last few years clearing my debts and starting to build up a small emergency fund, I was incredibly reluctant to wipe out all my savings and then some paying for private surgery. For several years the NHS surgery has felt so close, and yet so perpetually out of reach. However, with the reality of potentially another two years in wait, enough was enough. Time to go private.
So, why the rush?
I have a somewhat unique set of circumstances that make this surgery so critical for me. I’m morbidly obese for sure, but also very limited in terms of what I can do about it, and in poor health to boot.
The most pressing of my co-morbidities is a malignant congenital heart defect called an Anomalous Right Coronary Artery Originating from the Opposite Sinus with an Interarterial Course (R-ACAOS with IAC). Instead of having a right coronary artery on the right and a left coronary artery on the left, both of my coronary arteries emerge from the left sinus. The “Interarterial Course” means that my left-situated right coronary artery runs between the aorta and the pulmonary artery which can compress against each other with high heart rate. This condition increases the risk of sudden cardiac death (SCD). In fact, it is one of the top causes of SCD in athletes and racehorses.
While my weight is so high, I’m too high risk for certain procedures, and so require regular stress echocardiograms to monitor my risk. When I lose weight, I can have more tests and, if needed, corrective heart surgery.
But why can’t I lose weight the old fashioned way?
For one thing, my heart condition and/or my weight and poor fitness cause severe chest pains on exertion. Combined with fibromyalgia and osteoarthritis in both knees, exercise of any kinds comes at a high pain cost. The best place for me to exercise is in water where I feel weightless and virtually pain-free, but then it becomes the chest pain and pressure that beats me quite quickly.
So diet then? Well, I’m certainly not going to pretend I couldn’t do better. I have a sweet tooth and a healthy (unhealthy?) appetite. However, again, I’m hindered by another medical condition; Polycystic Ovarian Syndrome (PCOS) with insulin resistance. This means that my body struggles to effectively metabolise even small quantities of simple carbohydrates such as sugar and white bread.
And for the cherry on top? Due to my weight, I can’t take a conventional medication for my PCOS and instead take a pretty disruptive and sometimes dangerous one called Cyproterone Acetate. Among it’s many undesirable side effects, one lesser known one that I have discovered is that it blocks or at least severely limits the ability to get into ketosis.
And why the bypass as opposed to a gastric band or sleeve?
After extensive research and recommendations from several of my medical specialists, the gastric bypass really is the only viable option for me.
The company I’m using, Healthier Weight, shared this video with me ahead of my initial consultation and the following comparison table:
While many of my conditions will improve or even resolve after significant weight loss, some may not. I need a permanent solution that puts me at minimal risk of significant future weight gain, where I will find myself in the same position. While the bypass has the most extreme and permanent impact on way of life, it also drives the highest rate of excess weight loss and is a permanent, irreversible solution.
So, what’s the plan?
Here’s the plan as I know it today:
- Initial consultation with my surgeon on Wednesday 16th April 2025
- Celebrating with a final Cosmo buffet dinner on Friday 30th May
- Cruising from Friday 6th June to Friday 20th June
- Starting a three week liver reduction diet on Friday 20th June
- Expected surgery date in mid-July 2025
In my upcoming posts, I’ll go into more detail about the various stages, from the liver reduction diet to post-surgery recovery diets and more permanent changes. I’ll also sound off about how I’m feeling, what my worries are, and, importantly, how I’m managing those concerns.
For now, it’s business as usual as I enjoy my last few weeks enjoying the finer foods in life!