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The Long-term Consequences of WLS - Rich & Heather's Story

My name is Rich, but I may be better known to some of you as richie79 of the UK who used to post prolifically here on Big Fat Blog and elsewhere in the Fatosphere for many years. Don't know if any of the old faces are still around but I wanted to share my wife Heather's story and felt this was maybe as good as any a place do it. If you believe otherwise, please let me know and I'll remove it.

In February 2005 a pretty girl with big brown eyes by the screen name of 'sweetheather86' sent me a 'smile' through a plus-size dating website of which we were both members. At the time I was at a low point following the failure of a previous long-term relationship. Heather and I hit it off almost immediately despite her being in the US and at 18, almost 7 years younger than I. Looking forward to daily emails from one another quickly progressed to a first nervous long-distance phonecall, nightly 4-hour chat sessions on MSN and before either of us knew it I'd booked a ticket to Boston. Two incredible weeks on from our first shy meeting at Logan Airport I knew this was the one person I wanted to spend the rest of my life with.

The only cloud on the horizon was the gastric bypass Heather underwent just two weeks after we first made contact. Even then I knew of the horrendous risks of these operations but although I had already fallen for her, didn't feel i knew her well enough to ask her to delay or reconsider it. She came from a long line of big women and had herself been fat throughout childhood, resulting in numerous failed diets and all the bullying and self-loathing that accompanies being a fat child / teen. At the time the media was full of stories of this 'magic bullet' and several of her family members had undergone the surgery with dramatic initial results. She told me that she wanted it done so that she could have all the things in life she had been convinced were not available to people of her size - someone to love her, a home and a family, access to nice clothes, and not to be abused and harassed in public. Tragically she later told me that she opted for the bypass as unlike the lap-band it was irreversible (the stomach is cut in two and 18" of small intestine removed and discarded) and therefore offered no opportunity to back out at a later stage.

Our relationship continued to blossom even as her health began to deteriorate. Each of us crossed the Atlantic to spend long periods together in one another's countries and during this time we crammed in as many activities, visits etc as many couples do in a lifetime. In September 2007 I proposed to her and she accepted tearfully and without hesitation; we were married two years later almost to the day and having obtained a spousal visa, in July 2010 she finally moved to Leeds in the UK to live with me full-time. By this point she had lost around 200lb and gained back almost 100lb of that. She was on a cocktail of drugs, could eat very little, suffered from constant dumping syndrome and was developing problems with joint pain, blood sugar and constant fatigue, all of which were exacerbated by a revision to the original surgery to repair the staples but which further reduced the range of foods she was able to eat.

In October 2010 Heather gave me the news that she was pregnant. Our joy at this was tempered only by concerns about her deteriorating health. Fortunately apart from having to be artificially rehydrated several times (she suffered from such debilitating nausea throughout the pregnancy that she was at times unable to keep down fluids) her pregnancy passed largely without serious incident. Our son Ben was born in June the following year; despite several attempts to induce her at term plus two weeks she never progressed to active labour and had to undergo an emergency Caesarean section on one of the hottest days of the year in an overwhelmed Leeds General Infirmary where she was treated like an inconvenience by several of the medical staff.

Her surgeon in the US had recommended a UK counterpart in our city who might have been able to help but NHS rules decreed she would first have to see a dietician. As was often the case I went along with her as she was rightly worried that this would be used as yet another opportunity to shame her about her weight; predictably the dietician told her that on her sub-1000 caloric intake it was 'impossible' for her to be maintaining at 320lb and that there must be something she wasn't telling her (because *everyone knows* that fat people always lie about their eating habits). This was followed up by a barium swallow which suggested she may be suffering from a stricture (narrowing) of the digestive tract and the prospect of further investigation, though subsequent events meant this never ultimately took place.

On the weekend of 8th February 2013 I went to visit friends in another city an hour away from home. Heather had encouraged this rare weekend away, as we took it in turns to give one another breaks from the stresses of young parenthood when possible. She waved me off at the train station with hugs and kisses and called to tell me goodnight later that evening. That would be the last time I ever heard from her. My attempts to contact via text and phone throughout Saturday went unanswered and, knowing how out of character this was, my friend drove me home. Unable to gain access to the house, which she'd locked from within the previous night, I frantically called the police, who broke in through our basement and found her collapsed in our bathroom. I was told that she'd been gone for some hours. Our little one was fortunately still upstairs in his crib and none the worse but for need of a clean diaper, a good feed and a cuddle.

Initially we thought the cause may have been related to a persistent headache she'd been complaining of but which her doctor had failed to take seriously. The results of the post-mortem however showed the truth to be far worse. Unbeknown to anyone she'd developed a fistula at the site of the gastric bypass surgery. This had suddenly ruptured causing, as the report put it 'destruction of chest cavity and diaphragm through discharge of gastric material'. I don't even want to imagine the discomfort my poor sweet girl likely suffered in her last hours, or to think that the surgery on which she'd once pinned her hopes of acceptance (and subsequently come to regret when she realised that her happiness was not weight-dependent) had been a ticking timebomb from the very outset of our relationship.

Heather was without a doubt one of the sweetest, kindest, most loving people I have ever had the privilege to know. In a world beset with so much cruelty and unpleasantness she was a revelation of tolerance and humanity. For the first time in my 33 years she made me comfortable in my own skin, gave me confidence to be myself and become a stronger person through my recent diagnosis with Asperger's Syndrome, a strength that only left me two Saturdays ago. Our long-distance relationship was forged in patience and anticipation of better days ahead, giving us a depth of connection that is all too rare and making us soul mates in every sense of the word. Heather loved me for my differences and quirks rather than despite them, as I loved hers and trusted her implicitly. In turn she told me that my unconditional love for her had finally given her the contentment and safety she craved when so much of her life had been marked by pain and unhappiness. She often said 'I'll always be your girl', over the years it became our little refrain that she would add to the bottom of cards and emails and tell me last thing at night. My life, Ben's life, those of all who knew her and the world at large will be all the poorer for her absence from them. Rest in peace forever sweetheart, know no more pain or torment, and I'll be counting the days till I'm back at your side.

(Cross-posted as 'Rich & Heather - Love Can Bridge an Ocean' to 'First Do No Harm' blog at www.fathealth.wordpress.com, WLS Uncensored Yahoo group and my personal FB page).

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