Tuesday, October 20, 2015

The Decision

"Would you... consider... bariatric surgery?"

Wait... I don't know...
Like... SURGERY, surgery?
Am I... big enough for that?

I, much like most people that struggle with their weight, feel like I've done EEEVVVVEEERRRRYYYYTTTTHHHIINNNNGGGGGGG to try to lose weight.  

Weight watchers?




Diet and Exercise?

Personal Trainers?

And all of this started when I was maybe 12 years old?  I always felt big.  When I look back at pictures from high school, I don't think I look big at all, but I was bigger than the other girls and that's all that mattered.  So I started dieting early in life.  My weight was always on my mind.  I went to Weight Watchers for the first time when I was 15.  And it has never. freaking. ended.

I was mildly successful using several of these tactics.  Weight watchers helped me lose 40, then gain back all of it.  Then I lost 18, then I gained back all and more.  Most recently I gained 10 pounds over a 3 month attempt (screw you, Jennifer Hudson.)  (No I like you, I'm sorry.  Just... WHAT DID I DO WRONG?!).

I had an awesome trainer that got me nice and tight and fit and lookin good... but I didn't lose an ounce by working out.  I lost everything while I was doing HCG.  I lost 60 pounds.



And then I gained - like... 90 back.

I had a nutritionist put me on an all egg diet for 2 weeks.  

1) don't do this.  Cholesterol is not to be messed with.  

2) I lost like, 3 pounds  because do you know how nasty it is to eat eggs all day every day?  Gross.

I've subscribed to the EAT LESS YOU'LL LOSE WEIGHT mantra.  I've subscribed to the YOU CAN'T LOSE WEIGHT IF YOU'RE HUNGRY ALL THE TIME mantra.  I've subscribed to the 6 SMALL MEALS A DAY matra.

And cue - I've now destroyed my metabolism.  I'm burning like, 800 calories a day when the average person burns like 1500 a day.  Just.  Humaning.  Just living and breathing.  Not even working out.  Just for sitting in a chair and breathing, they burn almost double what I now burn.  



But it's the reality I am now faced with.

At my highest, I currently weigh 272 pounds.  

I can't even believe that's real.  Like.  Seriously.  

Something I should mention - I don't carry my weight the way most people my weight carry it.  I consider myself lucky that I carry it in my hips and boobs, but also just kind of all over.  Don't get me wrong - I look big.  I am big.  I am a big girl.  But I wear between a size 14 and a size 16.  I can shop at stores that sell "average" sized clothing (I just can't bring myself to say normal sized because... ugh... what does that even MEAN?!).

So before I decided to have this surgery, I obviously had a loooooot of trouble losing weight.  I convinced myself that I had a thyroid issue.  What else could it possibly be?!  I've done EVERYTHING.  

So I made an appointment with a Gastroenterologist and had her do a bunch of tests.  

Yeah, apparently I'm the most healthy human on the planet.

All of my labs came back normal.  Not just normal, but they each hit directly in the center of the range that they should have been in for my demographic.  So... not my thyroid... 

I tried Victoza for 6 weeks.  I lost zero pounds. 

So that's when the opening conversation happened with my doctor...

"Would you... consider... bariatric surgery?"

So I did some research.  I attended the seminar at NYU to learn about the options - Lap Band, Gastric Bypass, Vertical Gastric Sleeve.

I had myself completely convinced that I should be doing the Lap Band.  My Gastroenterologist said she thought I needed something more drastic.  But what did she know?!  I wanted the least invasive, easiest to recover from, most impermanent option around.  

And then this weird thing happened.  The more I researched, the more I read, the more people I heard from, the more I changed my mind.  For starters...

"Let's talk about which would fit best into your life"

Wait.  What?

Which would fit best into MY life?  I get a say?  I'm not trying to conform to the solution for weigh loss?  We're trying to consider my human component?  

There is a LOT of guilt and shame associated with being overweight.  You may not even realize how much you feel.  I didn't.  But there's a lot of pressure to make yourself conform.  And when you don't - when the weight loss program doesn't work, or you gain weight back, or you start having to shop at the big girl stores, or whatever - you feel bad.  You feel ashamed that you couldn't do it.  Because when thin people need to lose a couple pounds to look good in that bikini for the summer, they try for like 2 weeks and they're good to go.  You try for two weeks and it's like "WHAT?!  I GAINED 3 pounds?!  How?!"  And you know all of that "water weight" "eat less salt" "muscle weighs more than fat" crap does NOT resonate at a time like that.  

So the idea that I was making a decision that would both help me lose weight, but that was meant to work with me as the person that I am was... liberating!  Freeing! Shocking!  Emotional! Cray-cray!

A little (more) background on me - I'm an event planner.  I travel.  I eat.  I drink.  All for my job.  I'm paid to do these things.  Which adds to the struggle of losing weight.  Because nothing says "I'm not eating right" like 10 days straight on airport/hotel/restaurant food paid for by the company...

So I discovered that the lap band had some draw-backs for people like me.

1) the band can tighten due to air pressure when you fly
2) Just because something digests without issue today, does not mean that it will work as well next week... or tomorrow...
3) "band sick" is real, and could have me running to the bathroom a lot because something isn't staying down.

Basically, the band wasn't going to work with my LIFESTYLE (it's crazy how crazy of a concept that is to me, but... I digress).

I decided on the VGS pretty quickly after that.  It was between the bypass and the sleeve, but the sleeve is less invasive, but still would change the hormones and way that I digest food.  it would limit my portion sizes (a huge plus for me, as I tend to eat pretty healthy, just too much for my sad little metabolism).  But I can eat most normal foods, which works for my job.  I just... won't be able to eat very much of them.  Which I am just fine with!

So... the process of setting up surgery.  After attending the seminar in June/July, I left with a lot of information, and a long list of things I needed to compile before meeting with the surgeon for the first time.  I made my first (and I think only... so far...) mistake by not booking with the surgeon while I worked on compiling everything.  It can take a month or more to get an appointment - they are very busy and important.  So by August I had all of my past medical records compiled, but then had to wait until September to meet with the surgeon.

My first trip to the surgeon went quickly.  I spoke to a nurse about my process to that point, and what I was thinking.  He basically told me that I would be a good candidate for any of the procedures because I am young (awww... blushing... I'm 31.  I'm not that young.) and healthy (meaning I don't have any blood pressure, diabetes, etc. issues due to the weight and I'm not on any medication.)  Then I met with the surgeon. 

I love her.

I told her all about my struggle with my weight and weight loss.  I told her about my lifestyle.  She agreed that surgery was a good option for me.  But she didn't know which she wanted to recommend.  So she asked me to come back in a month.  I very much appreciated that she wasn't in a rush.  That she wanted to take the time to think this through and decide what was best for me (again, a foreign concept.)

Then I met with her surgical coordinator.  She gave me a whole list of things i needed to compile for her:
  • Blood work-up from my panel done at the Gastroenterologist's office
  • Letter of recommendation from my PCP
  • A few more notes from my medically supervised weigh loss attempts*
  • Psych Evaluation
  • Nutritional Evaluation
*For my insurance, I was required to prove 7 consecutive months of medically supervised weigh loss attempts.  I had, like, 2 years worth.  So I was covered.  Insurance companies and practices differ, so just make sure you follow whatever they need.  I had a relatively easy time getting everything together because I basically had everything done already.  Unfortunately, some have a harder time, or have to go through 7 months of the medically supervised weigh loss attempt before they can schedule surgery.  Just make sure you are asking questions and staying on top of what you need.

So I took the next month.  I did some more research.  I got all of the above together. And I came back.


I did NOT see this happening so fast.  

I went in expecting to talk to the surgeon about my decision.  Figure out next steps.  HOPEFULLY schedule surgery before the end of the year.



I told her what I was thinking.  She agreed.  She sent me to the surgical coordinator to give her the rest of the stuff that I had compiled.  And do you know what that lovely surgical coordinator said to me?

"Ok, so let's get this on the calendar.  How does.... November 3rd look to you?  I have the 3rd or the 5th."

(My face)

That was a full 18 days from Friday.  18 days?!?!?!

So I said ok, let's do it.  I need to get a pre-op authorization from my PCP and an agency within the hospital.  I need to have an endoscopy to make sure my stomach is healthy enough to heal from the surgery.  And that's like... it.

Oh wait. 


That's not it.

Today I start a 2 week liquid only diet - and no, I can't have booze.  Which is like... my favorite thing.

So I can still have coffee (thank. God.)  I need to drink 5 or 6 protein shakes a day (less than 35 grams of fat per day, around 1000 calories per day, and at least 50 grams of protein per day).  I can eat some vegetables and chicken broth (hellooooo dinner!  ugh.)

This is so the liver is less fatty for the surgery and makes the stomach easier to see, get to... whatever it is they need during surgery.  

So I think this brings us current.  My plans is to use this blog to track my thoughts, experiences, feelings, things I learn along the way... etc.

I'll also post before and after pictures.  

Like this!

Here's my starting picture...

It's me!

This picture makes me sad.  Because I think I look cute, and I think if I saw me on the street I would think I looked cute.  But I also think I would think "that poor girl... I bet she just wants to lose weight so bad".  I could be projecting.  So this will be the picture I use to compare to pictures as I progress.

Ok.  Here we go!

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