Robin Ayala - foothills sept2015She never liked having pictures made, but after losing 279 pounds via gastric bypass, Robin Ayala of Cleveland, Tenn., might want to reconsider that one photo she loathes most: the one on her driver’s license.

“I’ve had to show people my driver’s license and they won’t accept it!” Ayala said recently. “They don’t believe it’s me. I ask them, ‘Why would I show you that ugly picture if it’s not me?!’ I have changed a lot.”

Indeed. Not only has her shoulder-length hair been traded for a short ‘n’ sassy cut, but the 45-year-old mother of four is noticeably thinner – in her face, stomach, arms, legs and even her feet. So much so that friends do a “double take” when they see her.

What made the difference? The Rouxen Y gastric bypass surgery performed by Dr. Jonathan Ray, a surgeon at the Fort Sanders Center for Bariatric Surgery and Foothills Weight Loss Specialists in Knoxville.

Roux-en Y gastric bypass is the current gold standard for weight loss surgery. The stomach is reduced in size by stapling a smaller stomach pouch. The outlet from this new pouch empties directly into the lower portion of the small intestines, “bypassing” calorie absorption.

The key to successful weight loss via the Roux-en Y gastric bypass is the early sense of fullness and satisfaction that results when the mixing of food with bile and pancreatic juices that aid in the absorption of nutrients is delayed.
Robin has seen a dramatic change since undergoing Gastric Bypass surgery.

Robin has seen a dramatic change since undergoing Gastric Bypass surgery.

Ayala, who had packed on most of her pounds during her four pregnancies and was suffering from diabetes and high blood pressure, was referred to Dr. Ray by her primary care provider in Cleveland who had told her that she “wouldn’t be around for her kids” if she didn’t do something soon.

She searched the Internet and found a schedule for Dr. Ray’s evening bariatric surgery seminars held at various locations throughout Covenant Health. There, she found not only the  answers she needed, but the doctor she wanted as well.

“The seminars were very informative,” she said. “There was a slideshow, and he would point out things and tell you exactly what was what. Instead of just telling you, ‘You need to get it done’ and that’s it, he tells exactly what you need to hear. I like to be informed. Listening to him and talking to him one-on-one really helped, because I like a doctor who will talk to you and has a good bedside manner.”

For Ayala, the January 2013 surgery marked a turning point in her life, helping her not only lose weight, but realize the seriousness of her health risks. “I knew I was big. I knew I was very big, but I couldn’t be weighed because there wasn’t anything to weigh me on,” said Ayala.

So when the scales at Dr. Ray’s office rocketed to 477 pounds,  even Ayala couldn’t believe it. “When they weighed me I just cried,” said Ayala. “I just couldn’t believe I was almost 500 pounds! I thought maybe I weighed 400 because 400 is big, but I didn’t know I was almost 500! I just didn’t see it. I told Dr. Ray, ‘There is something wrong with your scales!’ I didn’t believe it. My husband didn’t believe it either. I guess him seeing me every day he didn’t think I gained that much.”

Even more devastating was that Ayala’s Body Mass Index, the most common weight-to-height metric for identifying obesity, measured 79.5 – more than double the morbid obesity marker of 35-plus. That meant she couldn’t qualify for the surgery unless she first lost 50 to 55 pounds. It seemed an almost impossible task.  Yet, she knew something had to be done.

“I was 477 pounds and almost immobile,” Ayala said. “I had diabetes, high blood pressure and sleep apnea. I could hardly walk and I wasn’t getting any smaller. I kept getting heavier and heavier and heavier, and I felt I had to do something and it had to be something drastic.”

“I didn’t really have a life,” she added. “I’d drive the kids to school and come back and sit on the couch and fall asleep. I’d just conk out. I had to sleep on the couch, too, because my back hurt and my knees killed me. I had to sit in a chair to load the dishwasher because my legs couldn’t support me. Taking a shower wore me out – I would be more wet from sweating than from the shower. Even hygiene-wise – you can’t be as clean because you can’t reach areas as well. My feet were as high as they were wide and ached so bad that I would literally wait until it was almost too late before I would go to the bathroom. It hurt that much to walk.”

So, Ayala decided to follow Dr. Ray’s instructions, attending four required nutrition classes to help her shed the needed pounds to qualify for the surgery. “If you don’t go to the classes, you don’t have your surgery – period,” she said.

By the day of her surgery, Ayala had lost 77 pounds. When she was discharged two days later, she began life anew.

“Your stomach is just like a baby, a newborn – it’s been ‘reborn,’” she said. “The first two weeks, it’s liquids only. And you don’t even want the liquids because you’re not even hungry. You’ve got to force yourself to do that but you’ve got to have it or you will starve to death.”

The pounds began falling off quickly. Although she began to reach a plateau at nine months, she shed 155 pounds by the 10-month mark. Then, over the next few months, she shed another 65.

Today, the 5-foot-6 Ayala weighs 204, and hopes to lose about 30 more. “I’ve almost been at a standstill for about 15 months, but I can lose more if I just do better,” she said. “I would love to be 170. I wouldn’t mind being at 180. I never wanted to be tiny – I think it’s better to be 10 over than 10 under, but I’ll be a decent size anyway. I’m pretty happy where I am now if it was just firm.”

But the loss has also been accompanied by gain: more energy,  better sleep, fewer body aches, “great” blood pressure and best of all, a new life.

“My worst days now are what I thought were my best days before,” she said. “I still love food. I think it tastes good. That’s why I eat it! But now I love yard sales – that’s my addiction now. I can wear my friends out shopping now. They’ll be ready to quit and I’m saying, ‘C’mon! I’m bigger than you! C’mon, let’s go!’”

She doesn’t mind getting her picture taken anymore either. But when she looks at her “before” pictures, Ayala says, “I think, ‘Lord have mercy! How did I ever let myself get like that?’ It’s not because I was in a car accident and was bedridden and I couldn’t get around. It’s because I kept putting that food in my mouth and I didn’t stop. I really do recommend that surgery. It’s not an easy way out, but for some of us, it’s the only way out.”

To learn more about bariatric surgery, register for an informational seminar conducted by Dr. Mark Colquitt and Dr. Jonathan Ray from the Fort Sanders Regional Center for Bariatric Surgery.  Call 865-541-BAR1 (2271) or click here to register.

Seminars will be held at Fort Sanders Regional Medical Center in Knoxville these Thursday evenings throughout the remainder of 2015:

  • October 22, 7:00 p.m.
  • November 12, 6:00 p.m.
  • December 10, 7:00 p.m.

Other Seminar Dates and Locations:

  • October 15, 7:00 p.m. – Parkwest Medical Center, Knoxville
  • November 17, 7:00p.m. – Claiborne Medical Center, Tazwell