PART VIII - 9 Month Follow-Up Visit Text

September 22, 2011

OBGYN.net Broadcasting present Part VIII of a series on Weight Loss Surgery. This series is unique in that we follow the patient from pre-op to one year post-op.

 

Roberta Speyer: Professor Weiner, hello. How are you?

Professor Weiner: Hello, You look good.

Roberta Speyer: You think?

Professor Weiner: Yes.

Roberta Speyer: How did I turn out?

Professor Weiner: Very nice.

Roberta Speyer: I’m Professor Weiner’s, Frankenstein, he created me. It’s been wonderful, it’s really changed my life, and I really want to talk to you.

Professor Weiner: You look very well, very well.

Roberta Speyer: See I turned out good, I kept e-mailing him and telling him there was really a good looking woman under all that fat, and I had to come back to Frankfurt and show him.

Professor Weiner: Very good.

Roberta Speyer: So we’re going to do a film today.

Professor Weiner: Yes.

Roberta Speyer: That’s great. Hi, this is Roberta Speyer; I’m President of MediSpecialty and home of OBGYN.net. This is another series in our follow-up of my surgery. I had the lap band surgery at the end of December of 1999 and now it’s the middle of or close to the end of August so it’s been about eight months since I had the surgery, and a lot has happened since then. I’m back in Frankfurt, and I’m going to have a fill procedure that’s going to help me lose the final amount of weight that I want to lose. I’m here with Professor Rudolf Weiner who performed the surgery and who is one of the innovators of this procedure. We’re going to talk a little bit about what’s been going on since then. How have you been doing? Have you been doing more procedures since me?

Professor Weiner: Yes, there are lots - everyday.

Roberta Speyer: Everyday, everyday another fat girl. Is it mostly women that have the surgery?

Professor Weiner: Yes, more than 80% are women and 15% are men but mostly between the ages of 20-40 years.

Roberta Speyer: Twenty and forty years, wow, I was a little bit old then for the procedure but I’ve certainly been happy with the results. You can see the difference, yes?

Professor Weiner: Yes.

Roberta Speyer: I lost seventy pounds.

Professor Weiner: Seventy - that is very good results.

Roberta Speyer: I lost twenty-five pounds in the first month and a half. I wasn’t eating very much at all and then I started to be able to eat more but continued to lose weight, and then I felt like I was eating perhaps too much and stabilized at about two and a half months in the middle of March. At that point, you exchanged some e-mails with a radiologist in Austin. We had our Publisher, Dr. Marshall Smith, looking for someone and we found someone and you all got connected. He was willing to try it and I went in. It was interesting when he put the needle in, all the fluid blew out in his face and he didn’t realize that it was under pressure apparently but you had suggested at that time that they put in 3 cc’s. They had me swallow afterwards and the fluid was stacking in the esophagus, and he suggested especially because I was leaving the very next day for a week for a business trip that I didn’t want to be in a position where I was out of town so he would only do two and if that didn’t work I could come back. What actually happened was after I had the fill with just the 2 cc’s - it was perfect. I have had a few instances maybe in the last five and a half months probably ten times where I’ve eaten something, and maybe I was talking or I swallowed too quickly, and I’d feel like it was stuck. Then if I ate something else before I realized that, I would end up going to the ladies room and throwing up but not very much because you know it’s really just what’s stuck there at that point. But that’s really not bad, I mean I don’t find that difficult.

Professor Weiner: If you have a band, you have to learn to eat slowly and…

Roberta Speyer: And chew, chew, chew.

Professor Weiner: Yes, chew, chew, chew.

Roberta Speyer: I’m in good but you know I’m in sales, Professor Weiner, and sometimes I’m there closing someone over a business dinner and all I’m thinking about is the sale, I’m not thinking about the band and that’s when it happens.

Professor Weiner: In the first six months you’re losing most of the weight and then it slows down but you have time - two years.

Roberta Speyer: Two years?

Professor Weiner: To find out what your optimal weight is.

Roberta Speyer: I have hit a plateau with my weight; I weigh about 202 pounds. What would 200 pounds be in European weight?

Professor Weiner: That’s not too much, 200 would be 110 kilograms. A lot of our patients have more than 150 kilograms so normally more than 150 for 300 pounds or more.

Roberta Speyer: But I weigh 115 kilograms now. I’m not sure how much I weighed, about 270 pounds, so that would be how many kilograms? I was right on the borderline for the procedure.

Professor Weiner: You have to divide with two.

Roberta Speyer: I’ve lost the 70 pounds but now it’s started to plateau. It’s very frustrating to me because it’s 202 pounds, and I just want to get it below 200. I just want that big thing on the scale not to have to get moved over, it would make me very happy. So I really think at this point my idea is, and I want to discuss it and see if you think it makes sense, I think when we do this fill that we’re going to do today, it’s going to be very restrictive for me. I’m probably not going to eat normal food, and right now I eat normal food.

Professor Weiner: But food or the energy is one problem but when you lose a lot of body weight you are able to have more movement so it is necessary to have sports or physical activities.

Roberta Speyer: Yes, I dance.

Professor Weiner: A lot of activities.

Roberta Speyer: I dance and have sex. So it’s sports for the sex...

Professor Weiner: Don’t use elevators.

Roberta Speyer: He’s not going to answer me.

Professor Weiner: Walk everywhere and don’t use elevators, this is very important.

Roberta Speyer: I do, I get much more physical activity - bicycling, walking, and dancing. I dance in my office at home to music; I don’t like doing exercises but I like dancing so I play music and I dance very strenuously. I find my energy level is so much higher and, also, I don’t sleep as much. I have much more energy during the day and I only sleep five hours a night instead of seven now. I was never a person who required a lot of sleep now I require practically none. I think the fill is going to be very restrictive but I think it may work and I want your advice if I do this. I would like to lose 40 more pounds, and I’d like to weigh about 160.

Professor Weiner: No problem, what you need is some time, maybe it’s better to lose this forty pounds in six or nine months and not too fast.

Roberta Speyer: Why is that? Because I like to do things fast so why do I not want to do this fast?

Professor Weiner: If you have a fast weight loss, you can have some other problems.

Roberta Speyer: Like what?

Professor Weiner: If you lose body weight fast, you can have problems with your heart function, maybe problems with liver function, and you’ll have cosmetic problems of the skin. If you have a slower decreasing of your body weight, plastic surgery might not be necessary because the skin can move.

Roberta Speyer: I was going to ask you about that, I do have this loose skin on my arms.

Professor Weiner: That is a problem area.

Roberta Speyer: And on the side right there, I’m wondering is this ever going to go away or am I going to have to have an operation and have that tucked, what do you think, or is there an exercise I can do? What’s the story with the bat wing?

Professor Weiner: Exercise is not necessary, you have to use creams on your skin and you have swimming and other things but the decision for plastic surgery we can have two years after the procedure. If you are stable, we can look at what is necessary.

Roberta Speyer: God, you just keep making me more and more beautiful. It will be frightening, I’ll be so good looking by then I’ll be ready to be fifty years old and it will all fall apart anyway. But you think that losing this next forty pounds I shouldn’t try to lose it too quickly, that would not be a good idea?

Professor Weiner: You have enough time, it is better to have a long stable period and then you can find your best optimal weight. Don’t look to the scale, look at what your body type is, don’t try to be like Twiggy.

Roberta Speyer: I don’t think I could be a Twiggy. I don’t think I’m the Twiggy type but I think from my experiences in my life when I was younger, I think 160-165 pounds even though that is fairly heavy for a woman that’s about 5’5. I think it would be good for me for several reasons, one - I have very large bones, I have size 10 feet, and I have a large head. I’m not a small petite built person. Also, I’m afraid that if I did lose too much weight then I would have the problem with me looking more wrinkly so I’d rather leave a little adipose tissue in there so we don’t have to see how old I really am. With the next weight loss, after I have this, is there a possibility that I might then take back some of the fluid back out or will I always leave it at whatever I am at?

Professor Weiner: Normally, the patient has one or two fillings when we still want less body weight, and after the stabilizing no change is necessary and no filling and…

Roberta Speyer: Removing.

Professor Weiner: Removing, but if you have a situation like a pregnancy, it is necessary to remove it.

Roberta Speyer: Oh, my God, let’s hope we’re not removing it because the President has become pregnant. I think that’s hardly likely but what if someone has a fill and it’s too restrictive, they’re vomiting a lot, and they’re hardly able to eat? They’ll certainly lose weight quickly but…

Professor Weiner: This is a reason, yes. If you are vomiting, you need instruction on how to eat, this is necessary.

Roberta Speyer: Right now I can eat almost anything, I just eat very small amounts of it. I can eat meat and I can eat asparagus.

Professor Weiner: But you have no hunger feeling?

Roberta Speyer: No hunger feeling and I also have no desire for sweets. For some reason I’ve lost any interest, I don’t even eat ice cream anymore.

Professor Weiner: That’s good, because if you have a lap band, you can have an increase of your body weight with using soft drinks which is a danger.

Roberta Speyer: I find sometimes that carbonated beverages, especially if I’m having food, do not agree with me. Beer - I used to love to drink beer but I don’t drink beer anymore, of course, a nice vodka gimlet straight up with Stolichnaya vodka nearby goes down very well still. So now we’re going to go in and we’re going to do some filming of the actual procedure. 

Professor Weiner: Yes, we can do it.

Roberta Speyer: All right, I’m in for the fill. They told me to get up on the table and lay down and promised they’re not going to hurt me but we’ll see, it’s all going to be filmed if they’re lying.

Professor Weiner: Dr. Foley.

Roberta Speyer: Say hi to the camera, Dr. Foley.

Dr. Foley: Hi, you can open your gown.

Roberta Speyer: Oh, my goodness, all my fans on OBGYN.net she opens the gown. At least she’s not as fat as she was the last time. Professor, I have the film of when I was being wheeled into the operating room, it looked like the Queen Mary pulling into the port. So what am I seeing up here? Is that my band?

Dr. Foley: You can see your band.

Roberta Speyer: And that’s my back bone?

Dr. Foley: This is your back bone, this is the lower part of the lung, your heart, and this is the band and now you take a drink.

Roberta Speyer: Do I sit up for this?

Dr. Foley: No, only a mouth full and don’t swallow. Now please swallow it down and we can see the contrast media on the screen.

Roberta Speyer: That stuff tastes terrible. We have much better tasting barium in the United States.

Dr. Foley: It’s not barium.

Roberta Speyer: What is it?

Dr. Foley: This is pure dye. Stand on your feet please. Take another.

Roberta Speyer Is it going through?

Dr. Foley: Only a little bit, and take another.

Roberta Speyer: This stuff is just so good I just can’t quit. Can I have all of this?

Dr. Foley: No problem.

Roberta Speyer: Quick, some lime. So what are we looking at here, what’s happening, is it going anywhere?

Dr. Foley: It’s just going through the band into your stomach.

Roberta Speyer: Slowly enough or not slowly enough?

Dr. Foley: I think it’s slow enough, this is the part before the band and this is the part after the band and I think it’s not too much.

Professor Weiner: In my opinion, the size of the stoma is correct.

Roberta Speyer: So you think I shouldn’t get a fill. I should just not be so eager to lose the weight quite so fast again? 

Professor Weiner: Yes, slowly in this period for your weight loss. We sometimes have a period of three or four weeks where your stable and you don’t lose weight, it’s because you’re moving more and you have more muscle.

Roberta Speyer: I’m happy, I can eat. I eat very little and I have up until a few weeks ago been losing weight. I don’t vomit which I don’t want to because that’s not something that anyone would want and if you think that I will continue to lose weight especially if I perhaps stayed away from fried foods which I do like.

Professor Weiner: No, sometimes there’s a period of one month, for example, after you’re losing your weight again because you are able to have more movement and you’re walking so you actually have more muscles. You’re losing fat but you’re getting more muscles.

Roberta Speyer: Interestingly to what you’re saying, in the last month I haven’t lost any weight, but I’ve changed my clothing size because you think the shifting around, I guess, and it’s more muscle.

Dr. Foley: The best thing if you are changing your body composition, nutrition, and your movement behavior is you should measure the composition of your body. In Germany we now have the possibility to buy body fat monitors because it is a scale or a little device to put between your fingers and this machine measures by sending some electricity through your body. It measures the composition - if it’s too much fat, too much liquid, or how much muscle is in the composition of the body. So you can track the alterations of your body composition and so you have control. If your weight is stable it might be that you built up more muscle and use that anyway. If you only go on the scale everyday or every week, it’s not enough.

Professor Weiner: I think with the increasing lean body mass and the fat mass is decreasing, we have a change and sometimes we have a stable body weight but you have a loss of body fat. But this stable body weight is caused by an increase of lean body mass, muscles, for example. You’re able to have sporting activities and, in fact, there’s the filling of the band. To summarize, it’s correctly at the very nice small pouch and you have good transportation and I’m sure you’ll be able to lose weight next month.

Roberta Speyer: Do you think it’s realistic for me to expect in the next year to lose this other forty pounds? Do you think that will happen?

Professor Weiner: Yes.

Roberta Speyer: What recommendations do you have for me to help make that be the best possible way for losing it? Are there certain foods I should be trying to avoid? Is there activities that I should be increasing like my cardiovascular activity?

Professor Weiner: There are two points - no fats in your meals because that’s your high energy of fat, the other point is to increase the sporting activities. You’ll have more energy for your muscles and you take up a lower rate of energy.

Roberta Speyer: I was thinking of taking up tennis, would that be a good activity?

Professor Weiner: You can do anything in sports. You have no problem with the band or with ??? you can go swimming - you can do everything.

Dr. Foley: Keep in mind that tennis is not ideal for the joints and for the bones. Sports like bicycling, swimming, and maybe even moderate jogging is better. With tennis, you accelerate the body and stop and you accelerate and stop and this is a high-low ???

Roberta Speyer: What about dancing, I like to dance to rock and roll music about once a week and dance my little night away.

Dr. Foley: This is better if you avoid pulling up loads because of your backbone, it doesn’t like to pull loads up but the girls of rock ‘n roll dancing they don’t have to do it but if you were a man you would and it would be a problem.

Roberta Speyer: A girl, did you hear that? He called me a girl, if he’d seen me eight months ago he would have called me a cow.

Professor Weiner: But if you’re overweight, first start with walking before you start jogging.

Roberta Speyer: With my job alone and traveling as much as I do...

Professor Weiner: You can walk in a small group for your health conditions and to increase your sporting activities.

Roberta Speyer: I want to just tell you a little bit about how my life has changed if you’d like me to share some of that with you since the surgery. Besides having more energy, I’m feeling better and not having aches and pains in my knees and ankles that I used to have, not sleeping as much, and just generally feeling better and being able to do activities like dancing and bicycling and things that were impossible when I weighed 270 pounds. Also, there’s been a big psychological change and some of that has been all for the good but some of it’s been a little difficult to go through. I want to tell you what I’m talking about to see if other people have shared this experience. I feel like I’m a teenager again and everyone, my husband, my sister, and the office, in fact, they call me the teenager. ‘Oh, the teenager’s at work again’ because I’ve done things like bought jewelry, Barb bought clothes because none of my clothes fit anymore, and I bought a new sports car. I think it’s almost like I feel not just 70 pounds lighter but I feel 20 years younger. It’s like being let out of a prison.

Professor Weiner: That’s a dangerous combination.

Roberta Speyer: Oh, dangerous, a dangerous combination. What do other people tell you? Do they have this resurgence of feeling young again and some of these lifestyle changes? I used to me more interested in cooking and decorating my house.

Professor Weiner: For most of the women it changes their life and the family also has changes, your husband, yes, some men like to have their women obese.

Roberta Speyer: I think they’re easier to control.

Dr. Foley: I find it ... but you shouldn’t have this problem.

Roberta Speyer: I think my husband has done an admirable job with all the changes that I have been going through and trying to be very understanding but I think it is difficult because I think before this happened, I focused more on my home and family, and I think in the months since I’ve lost this weight, I’ve been very focused on myself. I’ve been focused on me and I think before I didn’t want to look at me because I didn’t like me and so everything I tried to project my joy onto other things.

Professor Weiner: Lots of changes of life, things are very different between wife and… 

Roberta Speyer: And a person. I was always a pretty outgoing person and a pretty confident person, and that’s not easy to be when you weight 270 pounds. Obviously, I’m a President of a large company, I have employees, I travel, and I’m in sales so I already had a very outgoing persona but now I feel I guess euphoric most of the time. I don’t think there’s a single sales call that I won’t be a success on and this feeling of self-confidence that I have it makes you be more successful. When you project in your job, in your career, and in your life a positive attitude, people pick up on that and you are perceived in a better way and, therefore, you become more successful so it’s actually snowballed. Also, I find that I’m nicer to my employees, I’m sure they’ll all be disagreeing when they see this tape, and my family in that I’m not as angry with myself and then taking that anger, I think, out on other people. I’m happier; I go around the office and I’m singing, I’m laughing, and I’m enjoying myself. I just can’t tell you but being fat was the one terrible thing in my life, I had a good life but that was the blemish, and it was a big blemish. It was a blemish that people walked into a room and they immediately saw. You couldn’t hide it; you know with bulimia and anorexia you can hide them, but this you can’t hide.

Professor Weiner: That’s very good results.

Roberta Speyer: It is.

Professor Weiner: Congratulations.

Roberta Speyer: Thank you so much.

return to video

At this time, three years post-op, Roberta is satisfied with the outcome of her surgery and hopes you have found her story helpful in your search for answers. Please direct any questions about LAP BAND surgery to your personal physician, or email the product makers directly at: http://www.inamed.com/contact/bio_patient.cgi.  Due to time restraints Roberta Speyer and the OBGYN.net team cannot respond to personal emails. See Professor Rudolf Weiner's website about Weight Loss Surgery to see if this option is right for you. Visit www.profweiner.com.