Countdown to First Anniversary

Dec 17, 2011

With a week to go to the anniversary of my bariatric procedure, I have been reflecting quite a lot on what the past 52 weeks have meant to me. They will undoubtedly go down with many favourite cliches. "Got my life back," and, "Given a second chance," come to mind. Suffice it to say that there is no substitute for even improved health, let alone good health. A body that is malady-free after grand weightloss is quite simply a bonus.

52 weeks ago, exactly seven days before a Dec 23rd surgery last year, I was becoming increasingly anxious. It was the third day of a 10-day pre-op diet comprising protein shakes for breakfast and lunch, unlimited greens from lunchtime onward, and a piece of protein and sliver of carbohydrate for dinner. The diet had two purposes: one, to reduce the amount of fat in the liver which would induce a state of ketosis (in which the body seeks fat and protein stores for energy rather than glucose) and, two, to reduce the size of the liver in order to increase the amount of space available for the surgeon to do his work, thereby minimizing the risk of damage to the liver. I was just beginning to cope with the diet as the hunger pangs began to subside. The sensation was not new to me; I had been in similarly happy states of weightloss from countless diets before. This time, it was euphoria mixed with dread and a dose of anxiety. The euphoria was the usual glee that accompanies shedding a few pounds. Also, I was still in joyful disbelief at my good fortune for winning approval of funding for the surgery. At the same time, however, I was harsh on myself for letting myself deteriorate into a preventable condition of obesity that now required surgery to correct. As often as it flashed through my mind that I could do this without medical intervention, the counterarguments flooded my thinking of how many times I had failed at dieting and what enormous secondary benefits followed WLS. High blood pressure, Type II diabetes and sleep apnea are not conditions to be trifled with so their eradication after surgery was very appealing. Finally, who isn't terrified of dying during surgery? Even the statistics of stunning rates of success and almost negligible deaths on the operating table weren't enough to console my fears.

In the week to come I would conquer many psychological lapses. Right up to the point of being wheeled into surgery, I remember thinking that it wasn't too late, that I could cancel the whole show, hop off, go home and just lose the weight by myself. By far the hardest thing to let go of was an ego-driven resistance to submitting to a surgical solution to a mental condition. The reason that I ate and ate more was not because I was hungry but because I was greedy. My stomach could stretch without limit to accommodate my appetite so it had to be cut out. The VSG was the perfect solution: an irreversible procedure resulting in a small pouch that could never stretch. Well, it was either that or a lobotomy for I was surely losing my mind from the distress of not being able to control my eating. I used to have this irrational fear of being separated from food. I dared not take even an hour-long bus ride without carrying a snack for the road. What if the bus broke down on the freeway and it would be more than a few hours before my next meal? What if I was maimed in an accident in Winter and was too injured to eat. I might as well eat the cholocate bar at the start of the journey. I feared hunger more than being attacked by hooligans on the bus or freezing in the snow. With the ample availability of cheap food in North America, the fear of hunger is irrational indeed.

As the year progressed, so did my relationship with food. It was an education in restraint, patience and reassurance. Old habits die hard. Even post-op, food is of paramount importance in one's thinking. Both you and the doctors want you to eat. You want to eat because you're conditioned to want to eat. Then you learn restraint in a most painful way, when you overeat and discover the contraint of your pouch. It only takes a few istances of that gut-wrenching pain when you feel that you cannot breathe from having eaten one bite too many, that you quickly learn to confine your meals to very small portions. The surgeon on the other hand wants you to eat to avoid your body cannibalising itself. Very early in the weightloss experience, you become accustomed to a weekly dip in the scale that seems almost magical. A fair bit of that is fat, a lot of it is water, and a hefty chunk of it is muscle. To counter the latter two, the medical staff wants you to eat good protein, the very eggs, chicken and beef that you once thought was the sole cause of your weightgain. And you start to drink more water. Eventually, the weightloss slows down to a crawl and even reverses, much to your surprise. You wonder how it is possible for your clothing to continue to get loose yet you don't seem to be bothering the scale too much. The education in patience comes from realising that muscle weighs more than fat yet occupies less space. Eventually, some semblance of stomach capacity returns, you can eat a bite more and even drink an entire glass of water. It sometimes leads to panic that you may have stretched your pouch. It's reassuring however when you continue to shed pounds and go out to eat only to find that unless you order from the appetiser menu, you're taking the bulk of your food back home with you.

Such has been my year. The literature that convinces you to consider surgery sometimes promises loss of as much as 75% of excess weight within 6 months. Just before surgery, I weighed about 330 lb. I needed to lose at least 130 lb. At the 6-mth mark, I weighed 263 lb, so had lost 67 lb or, 52% of excess. A year on, I'm 245lb so have lost 85 lb or, 65% of what I needed to. To put things in slightly different perspective, I weighed around 350 lb when I met my surgeon, needed to lose 150 lb and have since shed 105 lb or, 70% of my excess. Although my personal experience has been far below the expectation created by the literature, I could not possibly be happier with where I currently am. I am confident in my skin and my clothes, step out without looking like a miserable slob and am fit beyond my wildest expectation.

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