Operation Weight Loss: Inch by Inch on the road to success
By DAVID PERRY, Sun Staff, May 6, 2003
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"I threw up for the first time last night," Kym Pizzano says.
No one enjoys vomiting, but for Kym it's harrowing. A choice between throwing up and jumping in front of a rolling bus and Kym would ask, "Where's the bus?"
She closes her eyes and plugs her ears. She nearly gags just talking about it.
"Oh, God, I hate it," she says.
She worried the stitches holding her new stomach together would rip loose as she yielded the morning's Cream of Wheat.
"I tried a protein shake with lactaid milk and ... the minute it hit my throat, it came right back up."
Ingesting protein is her largest problem. She hates the taste the smell, even of the powdered protein supplements she takes. Anticipating her new diet, she bought six boxes of Carnation Instant Breakfast: Chocolate, vanilla, vanilla cream. Two days after the surgery, she couldn't be in the same room with the stuff.
Three weeks after undergoing gastric bypass surgery, Kym, 35, is struggling.
At 281 pounds, Kym was the first person to undergo a gastric bypass at Saints Memorial Medical Center's new Center for Surgical Weight Management. Surgeon Michael Jiser reduced the size of her stomach from about 40 ounces to a one-ounce pouch.
Kym has lost 17 pounds since the Feb. 5 procedure. The last time she weighed 264 pounds was in 1992, she says.
The surgery, performed laproscopically by Jiser, was the "easiest" part for Kym.
She wilts from exhaustion, as her body adjusts to its new stomach. The previous day, she had returned to work, as a reading facilitator at The Arlington Elementary School in Lawrence.
She lasted two hours.
The principal told her, "Hey, you've been through major surgery."
And now, Kym's complexion is pallid, her eyelids droopy, her skin dry.
"I'm definitely low on protein," she says. "They called in a prescription for iron. I'll have that today."
Her new stomach growled for the first time this week.
Kym is personable, with a good sense of humor. She knows she's acted differently lately.
Her sister Lyn's 8-year-old son asked, "Why is she so crabby?"
"That says a lot," Kim says. "I'm never crabby."
She gets up, eats breakfast, then goes back to bed.
"Three hours later, I get up, then lie down. And I'm up three hours later again."
Some days later, Kym stares down on her plate: Two ounces of turkey; a tablespoon of applesauce, a tablespoon of baked beans.
"It looks like a lot to me," she says. Too much to finish, usually.
Her stomach aches. "I don't know if I feel hungry or full. But the last thing I want to do with a stomach ache is eat."
Two weeks into a diet that includes solid foods, there isn't much she likes.
She's sick of chicken, and eggs. Hates the whole bird.
Her mother, Sandra, frets.
"She said, 'I'll make anything you want. I'll go to the store.' Yeah, Mom, sure. If I make myself sick, I can end up in the hospital."
There was a family party the Saturday before.
"I wasn't even tempted to eat a cheese curl," she boasts.
"The surgery really is the easy part. This is the worst. Maybe when I step on the scale, it won't seem as rough."
On March 7, Kym is back on the fourth floor at Saints Memorial Medical Center in the surgical weight management clinic.
"I'm starting to feel like myself again," she tells Christine LaBrecque, the gastric surgery program's coordinator. "My energy level has jumped from 20 percent to 80 percent."
Still, the school where she works in Lawrence has brought in a day bed so she call sprawl during down time.
She's not taking in much, but her body continues to burn calories. She can taste it. It's called ketosis.
It's as if her stomach is a stove, burning fuel, and her mouth is the chimney.
It "leaves an awful taste in my mouth," Kym says. "It's my tongue. I was dry-heaving in the elevator just thinking about it. I literally peel it off the roof of my mouth in the morning."
She sets her alarm for 3 a.m., to brush her teeth so she won't wake up with the taste. Three hours later, she sprints to the bathroom to brush again.
Christine takes her hand.
"You're also a little dehydrated. You feel a little dry."
"I know," Kim says. "I feel scaly."
She has found some foods she likes: Pineapple and orange juices. Cheese. And pears. They go down well.
Water is her constant companion. She drinks eight ounces per hour.
"If you have a bad day," Christine counsels, "just go back to clear liquids."
It is time to weigh Kym. It's the first time she has looked forward to stepping on a scale.
The red digital numbers pop up. She weighs 249.6 pounds. She has lost 32 pounds.
She smiles.
"Now, for the first time in my life, I weigh less than my sister."
She smiles, savoring the thought for a moment.
Then, it occurs to her: "If I lose that much in a month, how far will I be down in four months?"
Kym skipped the recent support group meeting.
"I didn't want to go to support group after the first week," Kym tells Christine. "I'd give them a terrible picture. I felt like crap."
"Don't worry about that," Christine says. "They need to know this isn't a walk in the park."
On March 18, Kym tells the gastric bypass support group her surgery is six weeks behind her. Twenty-one people are gathered in a conference room at Saints Memorial Medical Center. By now, another woman besides Kym has had the surgery. The rest await dates.
Lyn, who plans to have the surgery in June, sits next to her. The sisters are a gastric "tag-team," Lynn says. "I've watched what she's gone through."
"I've had my ups and downs," Kym tells the group, "but I'm so glad I did it."
"Weeks three and four were awful," Kym says. "I had a little problem with protein."
"A huge problem," Christine notes.
"Today and yesterday have been my best days."
She tells them about the ketosis.
"It leaves the loveliest taste in my mouth," she says, rolling her eyes. "I was dry heaving for 11 days every morning. I have the most incredible six-pack after all that heaving."
She just discovered a sugar-free breath mint.
"I live on those."
She tells the group she toasted a piece of Syrian bread, spread peanut butter on top, "and it was the best thing I've ever eaten in life."
Her mother told her, "You should see the smile on your face," like it was the rapture of Chinese food.
"It's not an easy time, girls and guys," Christine tells the group.
"It's not fun for anyone," Christine says later. "There's an overwhelming fatigue if you're not getting enough protein. You can sustain yourself longer with fluid, and in her case it worked. There's been a definite improvement."
The surgery presents emotional trauma, too.
"It can be overwhelming. You're physically changed for the rest of your life. But people are looking for this. Obesity is the second leading cause of death, behind cigarette smoking, in the U.S."
But it's not a quick fix.
"It's a life commitment," Christine says.
Kym's sister, Lyn, knows this.
"Every person's different," says Lyn, who is scheduled to have the surgery June 30. "I'm going in with a positive attitude. I know it's a big move."
Lyn's husband asked Kym about the risks. Well, Kym told him, one in 200 people die.
He doesn't favor the surgery, says Lyn, a first-grade teacher in Lawrence.
"I'm very stubborn. If I want to do something, I do it come hell or high water. And this is time for me. I'm so tired of doing everything for everyone else. It's me time."
She thinks about her youngest sister, Gayl, the slender blond.
"You know, I was like that," Lyn says. "I gave her my old clothes. Now Kym asks me, 'You want my old clothes?' I'm like, 'Are you kidding me?"
Eighteen years ago, she met her husband. She was 125 pounds. She roller-skated, went to the gym. With marriage, she grew sedentary.
"It just crept up on me. The wedding pictures look great and then, ppfffft."
"Listen" she says. "I know I can't get younger, but I can be healthier."
It's now the beginning of May, and Dr. Jiser has performed the operation 16 times since Kym's surgery,
He says Kym could be down to 150 pounds, maybe less, after the first 18 months, the period the majority of the weight is lost.
As might be expected, the surgery is becoming easier for him with each patient. The surgeries usually take about two and a half hours now. The ninth one he performed clocked in at just under two hours.
Kym is long past the worst part, that sickening taste in her mouth and the dry-heaving. It left an impression, though. ("It lasted 12 days," she says. "Twelve days.")
She's chipper again, enjoying work. She walks around the block.
Two weeks ago, Kym spent four days with other reading professionals on a trip to New York, for a conference. The bus stopped at McDonald's; she munched on peanuts. At other restaurants, when the menus came, she ordered appetizers. She had originally feared there wouldn't be anything she could eat.
"Now, I want to go back this summer."
She has tossed aside two tops that don't fit anymore. She hasn't stepped on a scale in nearly two months; there's not a scale she trusts at home. Besides, she wants to see big results when she weighs in again this Friday.
But she knows she's winning the losing battle. People are noticing.
One day recently, a woman who helps out at school pulled Kym aside. "Don't take offense to this," she told Kym, "but your (butt) is getting smaller."
She was not the least bit offended.
David Perry's e-mail is here.
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