Grant Helsel was terrified to walk into the office of the bariatric surgeon at Evangelical Community Hospital.
“I had a mental melt down from the car to the sidewalk,” Helsel said.
That was in 2014. His sleeve gastrectomy surgery was Jan. 27, 2015. His wife, Stephanie, had the same surgery March 7, 2017.
Today, the couple looks back at Grant’s anxiety realizing it was minimal compared to the success they have experienced.
Grant, who now participates in triathlons has lost a total of 200 pounds, the first 100 of those pounds in the first 100 days. Stephanie has lost 115 pounds and is an active swimmer.
There are many questions that need answered when considering a bariatric surgery as to how this procedure impacts you.
Right for surgery?
Christopher Motto, MD, FACS, Medical Director of the Bariatric Center at Evangelical performed the Helsels’ surgeries and said the right person for these procedures must be highly motivated.
“They must be willing to make a lifestyle and behavior changes. Patients who are solely relying on the surgery to do all the weight loss for them will not see results.”
Medically there must be a body mass index of greater than 40, and there must be a health issue due to obesity such as diabetes, high cholesterol and so forth.
Motto said some insurances allow patients with a BMI of 35 and above to participate in the surgery if they have diabetes and/or hypertension.
Most programs allow for appointments with nutritionists and counselors as long as six months before the surgery takes place.
At Evangelical, Motto also requires a 10 percent weight loss prior to the surgery.
Grant Helsel needed eight months of preparation for his surgery.
Stephanie Helsel attended support groups with her husband prior to his surgery. She said she felt like she went through the preparation process twice and was confident when her time came for surgery.
Kim Peterman, of Montoursville, leads a Geisinger-based support group for bariatric surgery patients. Those who have had the surgery as well as those who have considered the surgery attend the meetings.
Some insurance programs require patients to attend two such meetings before surgery.
The bariatric surgery recovery group meets the second and fourth Tuesdays. Each meeting has a topic for discussion. Some examples include why drinking water after surgery is important, what vitamins and minerals are necessary.
Peterman said sometimes it is better to hear about the experience from the patients who have gone through it than from medical professionals.
Sometimes the patients return to the meetings years after surgery because they need encouragement.
“Post-ops come back seeking more information and sometimes they just need to feel rejuvenated.”
Some patients will return to the group after gaining 10-15 pounds back after a major weight loss. They may just need to be reminded how to have portion control and how to avoid the emotional “grazing,” Peterman said.
Grant said waking up in recovery was a realization that 80 percent of his stomach had been taken out. He experienced some nausea and a small amount of gas pain from the surgery.
Motto said nausea and gas pain is a normal part of recovery in the first 24 hours.
“After 48 hours most patients have no need for pain meds other than Tylenol,” Motto said.
Using less pain medications, said Dr. Anthony Petrick, bariatric surgeon at Geisinger, had a large impact on cutting down nausea complaints. In the past opioids were used for pain after surgery.
“We have dramatically decreased using opioids across the country for these surgeries,” Petrick said.
Something that has helped decrease the pain medications is the fact that almost all bariatric surgeries are done laparoscopically, which creates little pain after surgery, Petrick said.
Following bariatric surgery, parents will remain in the hospital one to one half days, going home the day after the procedure.
Within three days Grant was walking six miles, he said. He also pointed out he was not a “normal patient.” Grant’s recovery and weight loss far extends normal standards.
Patients should notice their appetite changes immediately, said Petrick.
“It’s amazing,” Motto said, “How many patients report back they do not experience hunger. Even when they are on the low calorie diet of 800 calories, there are no hunger pains.”
Motto said the “head hunger” goes away for most patients. He explained that when someone is hungry it is because the brain uses glucose as fuel.
“When the blood sugar drops, you start opening cupboards,” Motto said.
The diet after bariatric surgery is as follows: Stage One is a low calories, clear liquid diet for 12 to 24 hours. Stage Two is a four-week diet of protein drinks and softer foods rich in protein such as scrambled eggs. Stage Three is a soft diet that consists of mashed cooked vegetables for four weeks. Stage Four is a normal healthy diet of high fiber foods, fruits and vegetables.
“We’re basically never hungry,” Stephanie Helsel said, “Grant always says we have to eat, though, because food is fuel.”