Surgery Seminar

Deciding to get more information about bariatric surgery, I picked up the phone and arranged to go to a seminar that the surgeon has monthly. My wife and I ended up going to the seminar in November of last year (2010). The surgeon himself seemed slightly awkward. He appeared uncomfortable with public speaking, but once he got going, he seemed to relax a bit. He explained that there are three different types of bariatric procedures.

1. Gastric Bypass- This is where the esophagus is cut away from the stomach, leaving a small "pouch" that eventually becomes your new "stomach." This pouch is then attached to your small intestine just below your actual stomach, which remains in your abdomen. This procedure is highly used, highly successful, and also reversible, because the stomach is not removed.

2. Bariatric Sleeve- This is where approximately 75% of the stomach is cut away and removed from the body. What is left of the stomach is closed up, and will now hold only 2-3 ounces of food or fluid. With both procedures, you will need to take certain medications for the rest of your life because you are not injesting through food all the nutrients you once did. With the Bariatric Sleeve, because you have a more complete stomach (just a smaller version) than the Gastric Bypass, you do not need to take as many medications because you are able to absorb more nutrients. This procedure is relatively newer, and is increasing in it's usage, and is also quite successful. But because the stomach is removed from the body, it is not reversible.

3. Gastric Band- This procedure is where a silicon band is placed partway down your stomach, in effect, "hugging" your stomach and limiting the amount it will hold before you feel full. The surgeon stated that he does not prefer this procedure, and doesn't perform it very often. It is my understanding that this procedure has the most complications, basically stemming from the band itself. I've heard that the band needs adjustment every six weeks, and that it can slip up or down the stomach. This procedure is also reversible.

Before leaving the seminar, I was handed a packet to fill out. It was 10-12 pages, and it reminded me of a massive job application. But in a way, I think that's exactly what it was. It asked about medical history, health insurance, diets that I've tried, and it left a full page for a small essay for me to write on why I want the surgery. I think part of the reason the packet is as big as it is, is because it is the first step a person has to take toward having surgery. It's their first test. If someone doesn't have the desire or dedication to answer a bunch of questions in a packet, then how are they going to go through everything involved with surgery?

Taking this information home, I had a lot to think about and discuss with my wife. I still had no idea if this was something that I wanted to pursue, but at least I was more informed. The surgeon had an amazing track record, and performs several hundred procedures each year. Complications from the procedures performed by this surgeon were measured in the tenths of a percent. Since I tend to be rather pessimistic about things, I was paying close attention to his statistics. After all, the percentage of people that have my heart condition is only about 2%.

Surgery?

Several years ago, I applied, and was hired, at the local fire department. It's a small department, with only a few full-time fire fighters, and the rest are paid volunteers. Working for the fire department was something I had wanted to do since I was a teenager. While getting my employment physical, the doctor detected a heart murmur. This lead to further testing, and the discovery of a heart abnormality that I was born with, and never detected until now. The deformation was severe enough, that I had to resign from the fire department.

This new development caused me to start thinking about the direction that my health was headed. My parents had been urging me for a few years to get checked for sleep apnea, and my wife thought it was a good idea too. I'd snored for years, and had even been told that I stopped breathing in my sleep for short periods of time. Deciding that it was time to get checked out, I participated in a sleep study. The results of that study were clear: I had sleep apnea. I came from from that test with a c-pap machine. A c-pap means Continuous Positive Airway Pressure, which means that the owner wears a mask to sleep, and the mask is attached to the c-pap with a flexible air tube. Humidified air is pushed from the machine through the tube and mask and into the mouth and/or nose. It sounds horrible, but it actually looks and sounds worse than it is. The machine is actually extremely quiet, and as long as the owner chooses a mask that is comfortable, it's quite tolerable. My initial downfall was that the mask I chose wasn't as comfortable as I thought it would be, and it caused my nose to break out. I actually had painful sores just below my nose. Because of my discomfort, I stopped wearing my mask.

Here, I must apologize. I cannot remember why, but about six months later, I decided to give the c-pap another chance. This time, I chose a different mask, and it was great. I've used it every night since. However, although the c-pap allowed me to get a restful night's sleep, and put less stress on my heart, my increasing weight made up the difference.

About a year and half ago, I began talking to my boss and my dispatcher about the success they had had with weight loss. They both had had bariatric surgery through the same doctor, and between the two of them, they lost well over 200 pounds. They began telling me about their experience with the surgery, and how much their lives had changed for the better after the surgery. They had nothing bad to say about it, and strongly encouraged me to go to one of the doctor's seminars, and learn more about the different bariatric procedures.

I wasn't ready to go to a seminar yet, but I asked my boss and dispatcher everything I could think of: What are the procedures, and how are they different? How much weight can you lose with each procedure? How safe are the procedures? What is the doctor's track record? What is the surgery like? What can I eat after the surgery? How much can I eat after the surgery? How long would I be off work? Can I put weight back on? What kind of food can't I have after surgery?

They were extremely patient with my questions, and answered everything. But no matter how much they told me, I just couldn't see myself getting surgery. I knew I was a big guy, but was I really so big that I needed surgery? I'd seen people much larger than me, and they weren't getting surgery. So did I really need it? And was I even big enough to qualify for the surgery?

Thinking about surgery brought another internal struggle. Is this even something that I want to do? What will people think of me? Will my family support me? Can I do this? These were all things that I began to think about.

After thinking about it for several months, I picked up the phone and called the doctor's office.

My Inner Struggle

For those who have never struggled with weight issues, I have to tell you, it's a very unique problem. My wife described it perfectly. She said that EVERYONE struggles with something. Everyone has some kind of internal conflict. For some, it's mental illness. Others, it's alcoholism. And others may struggle with infertility, or with a mid-life crisis. But the one thing in common with all these people, is that you'd never know by looking at them that they're struggling with anything. They just appear "normal." But for the growing population of overweight people, you're wearing your struggle for EVERYONE to see. As soon as people see you, they already know what your personal struggle is. And this doesn't make them sympathetic. In fact, it's quite possible that many people judge you the instant they see you.

You see, there are no politically correct ways to describe someone who is overweight. If you're arrogant, you could be described as over confident. Confident still being a positive word, a word that people like and want to be. If you're lazy, you could be described as laid back, or take it as it comes. But when you're over weight, there's no way to sugar coat that. There are no positive words to describe that. You're fat, obese, and chubby. Women have tried to smooth it over, calling us guys "teddy bears." I don't want to be a teddy bear. Don't call me "stocky" or "husky." A husky is a dog. Even fat people have tried to cover up their problem with a cute way of saying it. "Fluffy," or "festively plump." And even "more cushion for the pushin'." Ew.

I don't really know what my point is, but I feel that quite often, I am judged by my looks before ever saying a word to someone. As I stated in my previous blog, I work on the Security department of a major hospital, and I encounter scores of people everyday. And many times, I am tasked with the challenge with solving their problems. From lost property, to family disputes, I have to step in, take charge, and as quickly as I can, make decisions that can affect not only the people involved, but the hospital as well. And I need the staff and customers involved to feel comfortable with me the instant I arrive. I need them to see me and be relieved that I'm there to help them. And as my weight has increased, the confidence that I have in my appearance has decreased. I walk the hallways, and as I look at people, I can almost hear them judging me. I can hear their thoughts. "Ugh!" "Look at that guy!" "I hope I don't need him for anything, it'll take him 3 years to get there!" "Man, if I need help, he'll be out of breath before he gets here!" I even think that the people who don't look at me, are avoiding eye contact with me because they don't want to see the fat guy.

Of course, I can't really hear their thoughts, but this is what plagues my mind when I'm at work. I think about it more than people realize, and probably more than some people would believe. It burdens my mind as much as it burdens my bones. This is my personal struggle. It's not just the physical weight, but the mental weight as well. I don't tell people these things because for me, it's become part of my life. Looking at people and judging them, because I believe they are judging me.

What's ironic is that when people do say something about my weight, it's not the rude comments from belligerent drunks that hurt me. I know that they are just trying to elicit a response from me, and it's nothing personal. It's the "helpful" comments and suggestions from people that I know that hurt me the most. I am well aware of my weight issue, and I am well aware of what I need to do to correct it. I don't need suggestions. I've been overweight for years, and if I didn't take your suggestions then, I'm not going to now. Stop trying to "help." I know these people don't mean anything by it, and that they are just showing concern, but it's doing me more damage than good. These comments generally come from people who have never experienced weight issues. This is what it is like to be me, concerning my struggle with weight.

Gaining Weight

My challenge with weight loss has been ongoing for some years now. While I was in the Navy (98-02), I was at what I deemed an acceptable weight, being around 200 pounds. The Navy thought differently, and I failed Physical Readiness Tests before even taking them simply because of my weight.

After my Honorable Discharge, I returned home to Michigan and after working for 9 months at a small juvenile detention facility, I was hired at a major hospital, initially as a clerk in the Emergency Room (ER). I don't remember paying much attention to my weight at this time, but I loved living alone in my apartment, and relished being able to eat whatever I wanted. I think my weight around this time was somewhere around 230 pounds.

I clerked in the ER for about 3 years, and grew tired of it. The Security department appeared to be more fun, and so I applied and was hired. I was already living with my girlfriend (who would eventually become my wife), and together, we both gained weight. Eating was something we could do together, and it was something we both enjoyed, and so we packed on the pounds. We were both very self-conscious about our weight, and our looks, and so we started thinking about a weight loss program. My wife's sister and brother-in-law were both losing weight through L.A. Weight Loss, and they recommended we try it.

The LAWL center was in a small plaza, and right away we noticed that the girls working there were all skinny and attractive, and it was very apparent that they had never struggled with being overweight, or the struggles that go with it. Through no fault of their own, it immediately set a level is distrust. How are we supposed to believe and trust these girls who have never done what we're attempting? We still put 100% into the diet, which consisted of measuring all your food, and accounting for it in a food journal. We also had to go to the LAWL center three times a week to weigh-in, and have them inspect our food journals. We noticed right away that it took much longer to prepare our meals because we had to measure and weigh everything, and check our journals to see how much of each food we still had to consume for the day. In addition, we had to go to the grocery store more frequently to buy fresh produce, which got annoying.

We both began to lose weight on this new diet, and we were excited about it. I lost weight slightly faster, but we were both seeing results. We did occasionally hit a short plateau, but each time, we'd break through and keep losing.

After several months though, we both began to get frustrated. Not so much with the diet, but with LAWL itself. They were adamant that we come in three times a week for weighing in and to have our journals checked, and it proved very difficult. We lived about 20 minutes from the center, and so three times a week we were spending at least 40 minutes just in driving time to go weigh in. Also, we never saw the same girl twice at the center. Every time we went there, it was a different girl telling us how to eat. And they were never consistent with their instructions. They would tell you one week not to eat a certain food that you were eating a week ago, and they never said anything about it then. And lastly, they insisted that you buy their snack bars. They came in a box of 14, at $10 per box. So one person goes through a box in a week. But there were TWO of us eating them. So we were spending $20 a week just on the snack bars, not to mention the money we paid up front for the weight we were SUPPOSED to lose.

We were both getting fed up with LAWL and their prissy staff. When they told us that they were soon closing the local LAWL center, and that we would have to drive to another center 60 minutes away, we stopped going entirely and dodged their phone calls. We just cut our losses and moved on. We tried to follow the diet we had been on for six months, but we slowly fell back to our old habits, and back to putting on the weight we had tried so hard to lose.