Gastric Band Surgery Trims 156 Pounds from Reporter's Frame

I turned 40 Friday, July 11, and stand 156 pounds lighter than I was 22 months ago when I set out to celebrate my birthday by weighing 230 pounds - my high school graduation weight.

I didn't hit my goal, but I still had a decadent slice of chocolate cake to celebrate the healthiest birthday I've had in 15 years.

Despite falling short of my target 200 pound loss, I'm ecstatic. I got my life back. I wasn't diagnosed with cancer in September 2001 when I opted for a unique weight loss surgery, but I may as well have been given the limits on my life and body that went with weighing a physically and socially crippling 432 pounds.(See photos of David Kiley's progress)

A 'cinch'

In the spring of 2001, our first child was on the way. I had worsening insulin-dependent Type 2 Diabetes, sleep apnea, circulation problems and severe arthritis in my knees. I could barely squeeze into even a first class airplane seat. Forget about riding a bike. I got winded antique shopping.

Life sucked. For 20 years I failed at Weight Watchers, Nutri-System, Optifast, Slim-Fast, Lean-Line, hypnosis and The Diet Center. My doctor agreed surgery was next.
I looked at two procedures: the gastric bypass, made popular by singer Carnie Wilson and NBC weatherman Al Roker; and an operation called The Adjustable Gastric Band (AGB).
With bypass, the most popular choice in the U.S., a surgeon re-routes the intestines and creates a small pouch for food to collect. The small pouch fills up fast, making the patient feel full. Food travels through a shortened intestinal track, and limits absorption of calories and nutrition. I was put off by the idea of leaving yards of unused intestine in my gut.

The AGB, the most popular obesity surgery in Europe and Australia, but newer in the U.S., seemed like a more elegant solution. The AGB is a silicon device that works like a hollow belt implanted at the top of my stomach and just below the esophagus. The band restricts what I eat, and the small pouch created above the band quickly makes me feel full. My God-given intestinal design was unchanged. If a complication arises, it can be undone or fixed easily.

That little band cinches the top of my stomach like the middle of an hourglass, and my surgeon can make the passage for food narrower or wider by injecting or withdrawing saline with a needle from a "port" implanted just below the skin on my chest. The smaller the opening, the less food can pass through. But I absorb all the calories, fat, vitamins and minerals that I eat. I just eat a lot less.

No more sandwiches, steaks, burgers, barbecue, chicken, pasta, crusty bread, chips or fries. No wolfing food, ever.

I don't miss those things, except maybe barbecue. I almost fainted during a recent Food Network show on pulled pork.

My protein now comes from skim milk, lots of fish, eggs and cheese. I'm not sure I get all the vitamins I need from my new food life, so I pop a multi-vitamin a day. Eating is an adventure now, and I've tried everything from pigs knuckles to calves lungs seeking new tastes.

I dropped 18 pounds a month after surgery, and another 18 over two months after my first tightening. After my second adjustment, I dropped 45 pounds in two months. I was so tightly banded that all I ate during that time was cream soup and protein/vitamin milk shakes. Tough, yes, but short-term.

Menu makeover

As I lost weight, the band loosened as my whole body got smaller and my stomach adjusted. I found to my delight that I had to create a new food life to cope with the restriction. Nothing was off the table for experimentation, as long as it was "band friendly" - meaning that its texture would get through the opening within 10 minutes or so of swallowing. Unfriendly foods, or too much food, cause me to vomit. I learned quickly how to eat.

I try as many different fish (very band friendly) as I can. I recently delighted in a dinner of Oysters Rockefeller at New York City's Oyster Bar. I've tried more than 20 kinds of cheese, and the stinkier the better.

It's great fun. I don't care that I'll never eat another ho-hum steak or chicken breast.
No more foods I consider crimes against the stomach: frozen or shelf-stable food long on chemistry and short on nutrition; McFood of any kind; growth-hormone laden dairy. I've learned life is too short and precious to eat crap. Carbonated drinks irritate my stomach, save for a weekly beer or two.

Salads are tough, because leafy, crunchy vegetables take too long to go down my new pipe. I chop vegetables pretty fine. Except asparagus and broccoli, which I can eat with abandon, and don't know why. Each person's band behaves differently. I can't eat pasta, but I still love the sauce.

I never eat margarine, Nutrasweet or "lite" anything. The taste of a real Coke when you only have three or four a year is a wondrous thing.

The social dividend

Couldn't I just draw on my own discipline to eat less and exercise more? I don't know. There are many theories. My heavy relatives may indicate a genetic predisposition to obesity. What I know is that I failed at every diet attempt and gained 200 pounds in 20 years. The AGB works great for me.

I'm part of the majority of AGB patients who don't have any side effects or problems, and who lose more than 50% of their excess weight after surgery. And I can, and will, lose more.

No one suffering from obesity should be discriminated against, but we are all the time. Chairs in fast-food restaurants bolted to the tables; tiny coach airplane and bus seats; even too-small chairs at doctor's offices. Insults and name calling in childhood carries on into adulthood. Job interviewers regularly pass over fat people. I was told by a superior at an ad agency in a previous job that my responsibilities changed because the head of the company objected to my size. Parents of children who insulted me as an adult, were oddly silent in admonishing their children for being rude. My son will be taught better.
Weighing 400 pounds was embarrassing and isolating. The people who made me feel that way will always be wrong. But feeling like a side-show attraction is in my past.

The kindest cut

My surgery took place at Hamilton Medical Center in Dalton, Ga. I chose to go there because I liked the long track record of the surgeon, Jaime Ponce.

My insurance paid 80% of the bill, which cost about $14,000 two years ago. I had some pre-surgery tests done at home, and flew to Georgia the day before surgery for a few more tests. I spent one night in the hospital and one day in a hotel room before flying home.

I lost just about all of my 156 pounds in 15 months. I have plateaued at between 275-285 since last December.

Still too heavy? Probably. But my diabetes is gone. I can ride a new bike over hill and dale for 20 miles, and play basketball with men a decade younger. I romp and play with my 17-month old son, Henry, in ways I thought wouldn't be possible two years ago. My knees don't ache. I can play golf again and recently walked a hilly course. I am healthy and getting healthier.

I still have another 50 pounds I would like to lose. And in the fall, I plan on getting my AGB tightened.

Despite my success, I have two concerns. The first is that a later complication could set in, necessitating that the band be removed. But I am hopeful. The second is that people as sick as I was will read my story and rush to get the surgery.

The AGB is not a surgery for everyone suffering from obesity. Some people, I believe, are better off with the gastric bypass, others not getting surgery at all. Figuring out which course is best is a process that should include at least six months of investigation, research and soul searching. And even then, some people will bet wrong, and surgeons, some ill-prepared or ill-equipped themselves, will accept ill-prepared patients.

I bet right, and got my life back. Happy Birthday to me.

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