The Consultation

If you’ve been keeping up with the blog lately, you know that I had a consultation with a bariatric surgeon yesterday…something I never thought I would do if you’d asked me ten years ago.

True to my word, I intend to write about the entire experience today – so this is quite a long post. I also asked my readers on Facebook whether you wanted me to talk about anything in particular, and many of you spoke up with questions, so you’ll see me bring those up along the way as well. Let’s get started…

I actually met with this same surgeon two years ago to discuss Lap Band surgery. Although I was approved for it, I never got it done. The main reasons were because I learned that ice cream (my major downfall) slips right past the band…and also because I had an epiphany of sorts that made me want to try and sort this out on my own. As a result, I lost 45 pounds.

Then I gained it back. Then I lost some of it. Then I gained that back. Then I lost some…you get the picture. I’ve been perpetually dieting, losing, and gaining it back (plus more) since I was 13 years old and the Evil Dance Teacher told my Mom to put me on the Scarsdale Diet.

Back to the consultation…

The office is run in a way that makes patients feel like people, not numbers, right down to the extra large chairs in the waiting room. I’ve never been comfortable cramming my four asses in most waiting room chairs, but here they acknowledge the reason their patients are here and they make an effort to make them comfortable. The office staff was friendly and kind and the only thing I can even think to complain about was the fact that they were playing one of those daytime “baby mama” talk shows on the waiting room tv.

When I booked the appointment last week, I received an email confirmation and a bunch of documents with tons of information and instructions. I was to visit their online patient portal to complete my paperwork and then follow all the new patient instructions.

As a result, by the time I opened their front door yesterday afternoon, I’d already taken an online webinar about the dietary requirements before, during, and after surgery, taken a quiz about dietary requirements after surgery, and read the entire patient education handbook that explained everything that would happen from the consultation to fulfilling my insurance requirements to pre-op tests, the surgery, and after care – including what I would be required to eat and do before and after surgery. It also listed the online support groups they offer. (Crystal M. from Facebook asked whether there would be classes or consultations about the major changes after the surgery…and I had all that information before I even set foot in their office, with the opportunity for support groups if I want it.)

Phew!!! These guys are thorough, I’ll give them that. Their mission is to educate and inform about every detail of the surgery experience and that was obvious from the moment I scheduled my appointment.

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Within a few minutes, I was taken to an exam room and the nurse took my blood pressure (high…I was excited and nervous all day leading up to this). She also took my picture to help document my progress for my patient file. Then she had me start on paperwork for my psych evaluation while I waited for the doctor to come in.

On Facebook, Kelly G. asked me to talk about the moment before the doctor walked in. I had a notebook on the exam table, flipped open to a page titled “Questions for Doctor”. The other pages behind it contained “Questions for Nutritionist” and “Questions for Finance Chick”. As I sat there waiting, I read over my questions and pulled a pen out of my handbag to write the answers down. I was very focused and very much on a mission to get the information I needed to make an informed decision about my next steps. I felt equally apprehensive about wanting to have surgery and not wanting to have surgery…and I just prayed that my choice would become clear to me before all of this was through. The right path usually opens for me if I just shut up and pay attention.

Before I knew it, the doc comes knocking at the door. He is a tall, gentle mannered man with a kind smile and a good sense of humor…just like I remembered from two years ago. He sits facing me and looks me in the eyes as I speak. He seems to have no schedule or concern that I’m rambling on a little nervously. He smiles at my stupid jokes. He lets me ask questions. He asks me questions. When I tell him I saw him 2 years ago for lap band but decided against it, he says “I’m glad.”

What? I asked him what he meant.

He says that he usually recommends gastric sleeve surgery for patients my age in my weight range who have no other physical/medical problems. He usually recommends gastric bypass for diabetics and other medically compromised patients…but I’m healthy other than my weight. He told me that fewer and fewer patients are asking for lap band surgery now since they don’t lose that much weight with it and it’s much easier to manipulate than a sleeve or a bypass.

He cautions me that I must follow the guidelines in the patient handbook to the letter or I’ll cause myself serious harm. I explain that I’m fairly anal about following doctor’s orders – especially if it involves vomiting or internal bleeding. He tells me of a 24 year old female patient he had who ate a ham sandwich the first week she was allowed solid food and ruptured part of her new stomach. (The patient handbook clearly and emphatically explains what’s allowed during every stage of recovery…ham sandwich is nowhere on the list, peeps.) Then he tells me of a male patient who ate a brisket sandwich 2 days after leaving the hospital and blew his stomach out.

Jesus…I’m grateful for my own flaws after hearing about these poor souls.

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As we discuss things further, I feel good about turning this corner. Not because he’s giving me a sales pitch, but because he seems naturally kind. When he asks me questions, he looks at me when I speak and pays attention only to me. He doesn’t fidget with my chart or stare at the floor and nod condescendingly. When he asks me how much I want to weigh and I say “I don’t care what the scale says. I want to be healthy, feel confident in my appearance, and go rollerblading”…he smiles with understanding.

I ask him how many gastric sleeve surgeries he’s performed. This is important to me because I want someone who’s experienced. The answer is over 1,200 gastric sleeve surgeries and I feel good about that number. He explains something I already know: the surgery will not lose all my weight for me. I have about 220 pounds to lose, depending on what day I get on the scale. The charts all say that the average weight for a woman my height is 155-170. He says that the surgery will get me to about 200 pounds. (Not a guarantee, just a ballpark idea.)

200 pounds. I can barely even remember the day that the scale hit 201 for the first time, it was that long ago. If I had to guess, I’d say 1990. I remember holding at 195 forever and fighting like hell to get that number down because I knew I would just die of horror if the scale ever read 200. Then it hit 201 and in the blink of an eye I was looking at 295 and praying to God I never hit 300.

200 pounds sounds fucking awesome to me. And it doesn’t happen with just surgery. I still have to eat right. I still have to work out – in fact, my patient handbook tells me to start working out immediately if I’m not already. (More on that later.) All the surgery does is remove the opportunity for over-indulging. That’s the biggest advantage. If I want ice cream, I can’t eat a pint of it. Not even close.

I’ve gone on and on in this post and I’m over a thousand words already – and although none of you seems to mind when I get long winded, I do apologize for being such a wordy bitch today. These words are necessary, though, and I don’t plan to pare much of it down.

After the doctor, I met with the patient coordinator (insurance/financial stuff) and the nutritionist (diet stuff). Here’s the scoop on the pre and post surgery diet, especially for Marcia S. who asked on Facebook:

First, to answer one of Marcia’s questions, there is no medication that I have to take for life because of this surgery. I do have to take a bunch of vitamins…some are recommended for life and some are for the first 6 months. I’ll list those out in another post I plan to write very soon, I promise.

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Second, the only “problem” I’ll have absorbing nutrients with a gastric sleeve is due to the fact that my new stomach will only hold about 1/8 of a cup of food. My body will absorb all the nutrients in the food I’m able to eat, unlike gastric bypass patients who’s bodies no longer absorb many nutrients in the food they eat. Gastric bypass patients have their intestines re-routed. Gastric sleeve patients only have their stomach operated on. No one’s touching my intestines or re-routing my digestive system. Now on to the food plan:

Two weeks before surgery I need to be on a 1,200 calorie a day high protein, low carb diet of my choosing (but they offered a butt load of suggestions). This is to help me adjust to a lower calorie life so that life after surgery won’t be so shocking.

One week before surgery, I’ll be on liquids only. Protein shakes, broth, sugar free jello, sugar free popsicles. Clear soups and juices. Vitamin water zero. This is to reduce the amount of fat in my liver. The liver sits on top of the stomach…and it’s easier to lift my liver off my stomach if it’s not loaded with crap.

I can expect to be in the hospital for 1 – 2 days. In the hospital, I’ll be on clear liquids only and that will continue after I’m discharged for a week after surgery.

The second week after surgery I’ll be on a liquid diet. Back to protein shakes, etc.

The third week after surgery, I’ll be on a soft diet. Baked fish, dark meat chicken, cottage cheese, etc.

If I tolerate all that well, I can switch to solid food on week four.

And right now? I’m to workout as much as I can handle right now. They want me to be able to do 30 minutes of cardio every day by the time I have surgery. The patient handbook goes on in detail about how important it is to get that going immediately – and how much it helps with recovery after surgery, as well as with the continuation of exercise as I lose weight.

They want me on all the vitamins now. They want me eliminating unhealthy fats and carbs now. Basically, I’m to continue fighting like I have…and take some extra vitamins.

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As you can probably surmise by now, I’ve decided to move forward with the surgery. There could be something that happens between now and the actual surgery that changes my mind, but as of right now I am sure that this is the right decision for me.

It hasn’t been easy. Someone very close to me has told me that they disagree with my decision and that they don’t think I’m being honest with myself. This is more a reflection on the fact that this person doesn’t know me as well as they think they do. Regardless, it still hurt a little to hear. It didn’t change my mind.

Many others are encouraging and supporting me. My boss and co-workers are amazing. HMH sat me down and said “You know you don’t have to do this…right?”

Yes, I know. But the fact is…I want to. In my heart, I feel this is the right thing to do for me.

Do you know that epic battle scene at the end of Lord of the Rings: Return of the King? The good guys are surrounded by thousands of screaming orcs and goblins and trolls and they’re fighting like hell to keep them back. I feel like I’ve been in that battle for 20 years – but instead of a big, badass sword I have a tiny little spoon as my only weapon. That’s fucked up, yo.

I have so much more to say on this and you probably have many questions – but I’m going over 2,000 words now and this is just ridonkulous. Once you get done with the novel I’ve just written here, let me know if you have questions and I’ll answer them. I promise.

I want to thank you all for the positive, encouraging messages you’ve posted and sent. They mean the world to me. This decision is mine to make alone and I feel that I’m making the best decision for me. I hope you understand that and continue to support me. I will continue to write about it and answer any questions I can. If you’re not comfortable commenting “in public” feel free to email me or contact me on Facebook. I’m happy to help.

I imagine that it will always be part of my life’s work to help lead the charge in helping obese and overweight people feel that there is hope…that not all is lost…that there are solutions out there that will work for all of us. The war on obesity should not be a war against the obese – and whether you choose a more natural method, surgery, or something in between, you have to find what works for you.

For the first time in a long time, I feel hope in my heart. Real, true hope. I drove home with a huge smile on my face, not fearing surgery but feeling the most uplifting joy at the thought of buying smaller clothes…fitting into an airplane seat without worry…dancing with my husband…and rollerblading down the concrete path through the woods behind our house.

The last thing I did before I went to sleep last night wasn’t to think about all the foods I was going to miss or planning one last dinner at Razzoo’s. I window shopped online. For rollerblades.

Got questions? I’m an open book. Let’s hear ’em.

24 thoughts on “The Consultation

  1. Oh, girl! I’m so excited/happy/nervous for you. You don’t let anybody push you around. You do what’s right for you. We will all be here for you.

  2. How exciting for you! I can’t imagine the excitement you are enjoying right now, I’ve thought about the procedure before and it always made me nervous, but sometimes you have to face your fears! I love reading all your endeavors and can’t wait for this one! Good luck and I can’t wait til you’re on your rollerblades kickin some ass!!!

  3. I can easily tell you are going to do it. You’ve been down the path so many times…go with it. I think you will be happy. I can easily tell you I would do it, but don’t have the means at this point in my life. But if I’m still this weight and the time is right, it’s a no-brainer. I’m proud of you. Please keep us posted on the journey!

  4. Everyone is going to have their own opinion- and here’s mine :). I think you are going into this with your eyes wide open- you know the surgery isn’t a ‘fix all’ or a miracle or that it will be smooth sailing and you’ll never be tempted again. You’re using it for what it’s worth- a tool to help you achieve your goal. Can’t wait to watch the process and your success!

  5. what an awesome blog!! like everyone else I am SO happy for you! Not that my opinion matters, but I think you are making the right decision, because it’s for the right reasons. You said it yourself – you feel it in your heart. So often we are faced with difficult decisions that we *know* we *should do* …sometimes we go along with it, and sometimes we don’t, but either way there’s always that little something in the back of our minds that says, “something isn’t right here.” But when you know in your heart that it’s the right thing to do, when you’ve come to terms with it in your own time, a weight is lifted off your shoulders (no pun intended) and you almost feel ‘at peace’ with your life and with yourself. I am guessing that’s how you are feeling right now. Nervous, anxious, and excited at the countless possibilities that lie before you. I look forward to sharing this journey with you!! XOXOXO

  6. I’m so excited/happy/nervous for you also! I am so glad that you are at peace with your decision. I do not think the length of your post was ridonkulous at all. I loved reading every word and wanted more! I can’t wait to read your updates and appreciate that you are willing to share this with all of us. Huge hugs!!

    1. Melissa, you must be a glutton for punishment! LOL. Thanks for not thinking my post was too long. ♥

  7. By the time I got to the end of this epic post, there were tears in my eyes. You are so fucking brave! You are taking charge of your body and your life and are doing what it takes to make a positive change. Maybe someday I’ll find that courage but, for now, I’m happy to cheer you on. You rock Lady!

    1. Kat, thank you SO much. Sometimes it doesn’t feel brave…but I know I need to do what’s right for me.

  8. I’m excited to go on this journey with you. I’m over 300 lbs right now and I’ve been chronicling my weight loss weekly on my blog. Even though I’m down almost 25 lbs, I’m still considering surgery at some point. I know I can do a lot with this diet plan, but I also know that I’ve done it before and it didn’t “stick”. I’m looking forward to your updates so I can decide when the time is right for me. I’m here to support you and am proud of what you are doing!

    1. Janet, that’s exactly what got me thinking…how long am I going to fight this battle with just a fucking plastic spoon. LOL. I need a WEAPON…and this is it. I know you’ll make the right choices for you, whatever those may be. Only you can decide what those are…but I support you! ♥

  9. I’m in tears right now because I am so happy for you and proud of you. It’s been a long time since I’ve heard you sound this positive about your battle. I want you to know that. I am here if you need support, a hug, bullshitting, or a baby cuddle! I will drive all the way down there just for any of that! <3 you, girl!

    1. Thank you so much, Jaime. 🙂 Big hugs to you, girl. I may miss your housewarming because I’m sucking down ice chips…but I know you understand. LOL.

  10. Congratulations on making a decision that is right for YOU. I have been reading your blog for almost 6 months now and I wanted to tell you how much inspiration and comfort it has given me – reading your honest reflections on this battle that so many of us fight while pretending we’re fine. I appreciate your honesty and willingness to let us all into your life.

    I have a few questions about the surgery – did they tell you to expect any excess skin as a result of the weight loss and surgery (I’m picturing Biggest Loser contestants who lose a lot of weight quickly and then have this extra skin they need to remove)? What kind of scarring can you expect with your surgery? And lastly, did they give you any idea of what a typical meal would look like (once you’re back on solids completely) after surgery?

    Again, thank you so much for your honesty and for continuing to let us share this journey with you. I cannot express how much it has meant to me. Again, congratulations on finding a solution that works for you and best of luck – I’ll be reading!

    1. Hi Cara –

      Thank you so much for reading and being here. ♥

      You know…they didn’t say anything about excess skin specifically, but I’m guessing that’s because everyone’s body is different. I know people who had almost no hanging skin issues and some that had it terribly (both cases were gastric bypass patients). I’m prepared for it if it happens, but of course I hope that’s not something I have to deal with. In my forties, though, I imagine I will. Stupid mother nature.

      As for scarring, this surgery will be done laparoscopically – and I actually had my appendix removed about 6 years ago (laparoscopically), so I already have those scars. I have 4 scars on my abdominal area, each about 1.25 inches long. That’s what I’ll have this time as well. Good question! I plan to ask my surgeon if he’s going to try and use the same places or if he has to give me 4 or 5 fresh ones. LOL. Honestly, I don’t care either way. I don’t plan on running around town in a tube top and daisy duke shorts…I can handle a few tiny scars. 🙂

      Lastly, they did indeed go over all the food plans for the entire stretch of this experience. My next blog post, which I hope to publish by Sunday, will go into greater detail on that subject – but I can tell you that the nutritionist’s orders are that I should eat protein first. It’s a MUST. After that, I can eat veggies. After that, fats. I can’t drink anything 15 minutes before I eat or 30 minutes after. I’ll go into much greater detail on all of this on my next post…promise!

  11. Glad you are on the road to surgery. I was where you were last year. I was sleeved on May 1 I am down a little more then 100 lbs. you will be glad to have this tool. I am now only 4 pounds away from being under 200 lbs. I haven’t been there in more then 20 years. It is great and I am feeling great and eating anything I want just a lot less of it. I had second thoughts up until I was getting on the OR table so don’t be surprised if you do too, most people do. After the first 4 weeks you will feel back to yourself. There is some pain because it is surgery. Make sure that they give you a binder in the hospital, it helps a lot the first month. If they don’t ask your doctor for a script for it so you can get it at a medical supply store. Hang in there you will hate liquids by the time you get to your surgery day but learn to love them after.

  12. Love your blog! We had both commented on a post over on the Vertical Sleeve Talk, so I thought that I’d check you out. I am heading down the same path as you are with my mind 99% made up! My case goes before the review comittee in November and then I can be scheduled! yippeee! I am scared, excited, nervous, apprehensive and also in a bit of awe. I can’t believe that I had the guts to go ahead with this. I’d been toying with the idea for two years and something just clicked this year…maybe my “straw” finally broke the camel’s back, I don’t know. I just know that to NOT do it is crazyiness personified! Take care and see you around 🙂

    VSKitty

    1. Hi Kitty!!!

      It’s so good to see you here. 🙂 I hope you’ll stop by often. Maybe we’ll be November sleevy sisters. LOL

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