Abilene Stars

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While Batman is an awesome guy, I have never aspired to be him.  Unfortunately, my body has other ideas.

My arms have always been large.  I used to have to buy a 30/32 shirt if it had sleeves, but I could fit into a 22/24 tank top.  From elbow to shoulder I'm just so out of proportion with the rest of myself.

Now that I'm down 110lbs I can't take it anymore.  I'm moving back home shortly and as soon as I get there I'm going to start looking for a plastic surgeon.  I just want to be able to look at a shirt or dress and know that it will fit my arms when I put it on.  I want to be able to buy dresses with sleeves.  I want to be able to wear a blouse without my torso swimming in it.  But, most importantly, I want to look in the mirror and LIKE what I see.  All this sagging skin, all the wrinkles and wobbly bits, they're awful and ugly and I just can't deal.

This post is long overdue.  I received my approval letter from my insurance company before I'd even completed my appointments with my doctor.  My insurance company wanted me to see a dietitian/nutritionist once a month for 6 months, have a psych evaluation done, see an exercise physiologist 3 times in 6 months, and see my surgeon (which ended up being his partner) once a month for 6 months.  A week before I went in for my last appointment with the dietitian and a week and a half before my last appointment with my surgeon, I had my approval letter.  They finally called me last week (after I'd had the approval letter for 3 weeks) to schedule surgery:  November 17.

On October 23rd I have my pre-op appointment where they'll go over my liquid liver-shrinking diet and everything I need to do before hand.  I'll actually meet with the nurses and staff that assist my surgeon.  I am not looking forward to being out of work for 2 solid weeks.  I'm really hoping I can convince the surgeon to make it just a week.  I can do my job sitting down.  Especially if I come back and it's the first week of class that I walk into.

My husband asked me today if I'm scared about the surgery, and I'm really not.  I trust the team of doctors that I've chosen.  They've done this surgery hundreds of times.  And I trust myself to be able to do what I need to do afterward.  I won't be able to overindulge anymore.  I'll have a few bites of a favorite food, and that will be it.  Thanksgiving this year is going to be baby food: turkey, sweet potato, green beans.  It'll be gross, but that's what I have to do.  By Christmas I should be able to enjoy a bite or two of something lovely.

What I don't want to do is tell everyone around me what's going on.  I've told my coworkers so that they are more gentle with me, because they see me every day.  But I haven't told my family.  My family lives 1500 miles away from me right now.  I just saw them this past week.  The next time I see them is going to be another year or (most likely) two down the road.  If it's two years from now I should be at goal by then and I will have the joy of FINALLY having that "OMG!" moment when they see me.  For THEM it will be like an instant change, but for me it won't be.  To add to that, my Facebook picture isn't a real picture of me. It's a cartoon version of me.... so that when I finally update over there, everyone will see the sudden change there, too.  I've always wanted that moment.  I know it's superficial of me, but I'm okay with that.  I'm okay with it because I know this is only part of the reason why I'm doing it.

I'm doing this so I don't die from heart disease at 50.  I'm doing this so I can have a chance of having a normal cycle and maybe having a baby before I'm 40.  I'm doing this so I can enjoy my life.  I'm doing this so I can know what it's like to move without pain.  I'm doing this so I can feel better about myself.  I'm doing this so I can feel better in my own skin.  I'm doing this so I can move, play, and run.  I'm doing this so that stairs will no longer make me winded.  I'm doing this so I can be around to help my parents as they age.  I'm doing this so I can be stronger for my husband as he gets older.  I'm doing this so I can be everything I want to be.  I'm doing this so I can stop holding myself back.  I'm doing this for roller coasters and sky diving, and bungee jumping.  I'm doing this for myself.

I had my psych evaluation the other day.  I had to give the lady my history and then take 4 different tests.  The tests covered things like my eating habits, feelings about food, exercise habits and general mental health.  There was also a fairly extensive form about past drug use.

I don't know about anyone else who's gone through this, but I'm constantly worried that one of my answers is going to disqualify me from being able to do this.  I'm always worried that they're going to call me and say, "Nope! Nevermind! You fail!"

My next appointments are Tuesday of next week.  At 9 A.M. I have my nutrition & movement (i.e. diet & exercise) class.  I'm actually looking forward to that the most.  That means on Tuesday things change.  I need to start researching cleaner ways of eating.  Right now we do a LOT of chicken, boxed rice sides and frozen vegetables.  If it's not a boxed rice side that I'm making it's some kind of potato.

Things I want to accomplish:

1. Learn cleaner (and tasty) sides to make.
2. Start shopping more frequently for fresh produce.
3. Learn good carbs from bad carbs.
4. Practice portion control.
5. Learn how to make lunches that do not involve sandwiches or wraps.

Those are my main goals right now.  Oh, and I need a new water bottle.  The gorgeous one that I had has randomly gone missing.  I need to go to Price Chopper or Hyvee (I can't remember where I saw it before) and replace it :)

My husband works at the same hospital as my PCP.  In fact, he works in the lab attached to the clinic that my PCP works for, so they see each other frequently.  Since we share a car, my husband often just speaks to my PCP on my behalf (since he is there and I am not).  Yesterday he came home with the bad news that my referral for my bariatric surgeon had been denied by our insurance company.  I tried not to freak out about it too much overnight and first thing when I woke up this morning (okay, second thing. I read a few chapters of book four of the Game of Thrones series first) I called my insurance company.

The surgeon that I was working with works as part of a team.  It is himself and another surgeon.  We'll call them Dr. Adam and Dr. Steve.  Dr. Adam is the guy that I had seen up until this point and the gentleman that my insurance company denied the referral for.  When I called my insurance company to see what was going on they confirmed that Dr. Adam is not in their system.  I asked if Dr. Steve was, and the lovely woman on the phone confirmed that Dr. Steve is in their system, so we just transferred my referral to Dr. Steve.  When I said that Dr. Adam and Dr. Steve work as a team Insurance Woman agreed that it was odd that Dr. Steve would be in their system but Dr. Adam would not be.  She said she'd look into it.  Who knows if she actually will.

Now I have to wait 24-48 hours for the new referral to get mailed out.  I already called the bariatric coordinator who works for Dr. Adam & Dr. Steve to let her know what was going on.  She said it was no problem, that they'd just change my surgeon in the system to Dr. Steve, especially since he's the one I would be meeting with for the majority of my visits between now and surgery anyway.  Dr. Adam will still be there on surgery day to assist because, like I said, they're a team.

So what I thought was going to be a rather large hiccup ended up being just a tiny bump in the road. 

I had my first one-on-one meeting with my surgeon the other day.  First I talked to the woman who does the insurance portion.  She researches our coverage and lets us know exactly what hoops we have to jump through in order to get the surgery.  Remember how I said that at the seminar I found out that they prefer you wait a year before trying to get pregnant?  Add another six months onto that.  My insurance requires that I go on a doctor supervised diet for 6 months before they'll approve the surgery.  So I'm at least 18 months away from even being able to start trying to conceive, and then, assuming I get pregnant immediately (which there's no guarantee) there's another 9 months before I have the damn baby.  I'll be lucky if I have a kid by the time I'm 40 at this rate.

One of the qualifications I have to meet is an appointment with a psychologist.  I was in therapy for nine years, but had to quit when I moved out of state.  I've been without a therapist for the last 3 years.  I'm actually excited by the idea of getting to see a therapist again.  Even if it's just one visit.  I don't much care!  Maybe they'll be able to give me recommendations for a therapist I can go see on a regular basis.  I have some pretty killer mental health insurance.  I'd be able to afford to see someone at least once a month, if not twice a month.  So yeah, I'm definitely looking forward to that.

A few days later I have two appointments in the same day.  The first one is with the diet & exercise people who are going to go over the actual diet I have to be on and all that fun stuff.  They're also going to go over the various vitamins and supplements that I need to begin working into my daily life.  I honestly can't remember what the second appointment that day is for, and my information is on the other end of the house (and I'm lazy right now).

Talking with the surgeon was good.  My husband was with me so he got to absorb the information as well.  It was especially nice to find out that my surgeon understands my motivation for doing something this drastic.  He and his wife also struggled with infertility and had to use en vitro fertilization to have their children.  He was sympathetic and empathized with me.  That was a welcome surprise.

He was surprised that I had only decided to do this a few weeks ago.  He said that normally the patients that he talks to have been considering bariatric surgery for years and they have tons of questions.  We talked for maybe 30 minutes.  Most of my questions were things that they'll answer when I go to the diet & exercise class/meeting/thing.  He did say that the "one year post surgery before getting pregnant" is a guideline, not a hard and fast rule.  He said if I'm healing well we might be able to try after 9 months post surgery.  So we'll see.

I found out that the side effect of my antidepressant medication has been coming in handy.  Normally I weigh in around 328-335lbs on my scale at home.  I weighed in at 318.5 on the scale at the doctor's office.  I've just been so completely bored by food lately that I haven't even wanted to eat... and the scale shows it.  I still want to cook, I just don't have the desire to consume.

I thought I had more to say, but I guess not.

Our seminar was today.  I have an appointment with the doctor who hosted it in a little over a week.  He seems like a nice enough guy and that he really considers each case individually.  I like that he said he doesn't prefer the Lapband procedure, because that's not the one I want.  His preference is the sleeve, but my insurance won't cover that.  They will, however, cover the gastic bypass, so I will most likely be heading in that route.  

I am proud of myself for making the room laugh.  During the question and answer portion I mentioned that he had said the hospital stay for bypass was two days, but he didn't mention how long we would possibly be at home recovering.  He said that it (obviously) depended on the type of work involved, but that he could be persuaded to write the orders for however long we asked for.  My response was, "Six weeks it is!"

I'm encouraged by the numbers for the amount of weight lost after a year.  I'm encouraged by the number of people who manage to keep it off long-term.  I am extremely discouraged by one answer he gave me.  "Talk to me about pregnancy post bypass," I said.  His reply was, "We encourage you not to get pregnant for at least a year while your body is still healing."  That means if I had this surgery tomorrow I wouldn't be able to get pregnant until I was 37 and I'd be nearly 38 by the time the kid was born.  But I'm not having this surgery tomorrow.  It's still a good 3-6 months off.  If I'm lucky enough to have a child, I'm going to be in my late 50s by the time s/he graduates from high school.  My husband will be in his 60s.

I'm conflicted.

My husband and I will be going to a seminar on February 12 to learn about the various surgeries before I get my initial consultation with a doctor.

I had my appointment with my PCP this morning.  I don't know what to make of her just yet.  She and I have only met once before and she hugged me both when she entered the room and when she left.  I'm not used to that.

She had a Nurse Practitioner student with her named Laura.  Laura was very sweet.  Both of them are a healthy weight for their height and it was wonderful of them to not fat shame or judge me at all.  I felt completely heard and validated, which was lovely.

I left with a referral to the bariatric surgeons that work in the hospital next door.  My next step is to call and make an appointment for a consultation.  Hopefully before that consultation I will have the referral approval in the mail from my insurance.  I guess it doesn't matter since I have the paper one from my doctor.  Either way, my point is still the same.

Yesterday my gynecologist told me that if I didn't lose weight I wouldn't be able to have a baby.  Because of all the extra tissue, my body is producing too much of the hormones that are needed and my poor little uterus can't filter it all.  I have an appointment on Friday for a uterine biopsy to make sure that the thickened lining they saw on my ultrasound doesn't mean that my uterus is turning to a giant cluster of cancer cells.  

She doesn't know it, but those simple words pushed me into one of the biggest emotional tailspins I've been through in a while.  I'm normally a pretty upbeat person.  I greet my husband and our pets warmly when I walk through the door.  Yesterday I just came home and hung up my keys.  When my husband asked how my appointment went I quietly said, "I don't want to talk about it" and then I went to bed, pulled the sheets over my head and cried.  When he came in to check on me 20 minutes later (and managed to drag out of me what happened), I sobbed.  I cried like I haven't cried since I went through my divorce.  Gut-wrenching, hiccuping, stomach spasming and not breathing SOBS.

I've been overweight for as long as I can remember.  I started gaining weight in the second grade.  By the time I graduated from middle school I was 200lbs.  I hit 300lbs in my early 20s and I've stayed there ever since.  My 36th birthday is a week away and my current weight is 331.4.  There are two more important pieces of background information for you to have: 1) I have wanted a child since I was 12 years old and 2) I never EVER wanted to have weight loss surgery.

I am having a tough time reconciling all the horrible things I told myself about people who have bariatric surgery with the fact that I will most likely be one of those people soon.  I told  myself they were weak, that they were cheaters, that they didn't have it in them to do it the "right" way.  I looked down on them.  And because of that, I'm looking down on myself right now.  I have no idea where I got these notions, either.  Obviously having bariatric surgery isn't easy.  How did I ever get the idea that it was the easy way out?  Healing from any surgery isn't easy! And the care and commitment that it takes both pre-op and post-op is hard, too.  Yet, for some reason, I still feel less-than because I can't manage to keep the weight off on my own.  I feel like a failure because I need help.  

I've been on Weight Watchers three times, I've used Sparkpeople once and Myfitnesspal twice.  I have Runkeeper on my phone.  I always manage to lose the same 30-40lbs, and then once that image in the mirror starts to change I freak out and gain it all back.  Hell, I'm even using an alias here because I don't want my friends and family to watch me fail *yet again*.

But my gynecologist said something that I internalized differently and it struck a cord with me.  She looked at my chart and said, "You're 35. You don't have a very big window."  My brain changed that to, "You're 35. You don't have time to dick around anymore."  If I want to have a baby I don't have time to try to lose this weight on my own again.  If I want to have a baby I don't have the time to say, "Well, give me a year and then we'll see if I've lost it, and if I haven't, let's talk about weight loss surgery."  Because if history is any indication, I won't have lost it and I'll be right back where I started except that I will have lost yet another year and my window will be even smaller.

I fought it hard when I was in the gynecologist's office, but once my brain flipped it into harsher words, it lit a fire under my ass.  I have an appointment on Monday with my PCP to talk about it so that she can put in the referral with my insurance.  I'm a little concerned about some of the requirements that my insurance lists on their website.  I also don't know how having a tiny stomach will effect a pregnancy.  I'm worried about not getting the nutrients that I need to support both myself and my child, but I will cross that bridge when I come to it.

And bless my husband for holding me yesterday while I sobbed.  Bless him for being willing to start this process all over again with a new child, when he already has a 16 year old.  Bless him for being willing to be 60 when our child graduates from high school.  He once told me that he never wanted to be the "super old dad," when his kid was in school, but now he's willing to do it, for me and if that doesn't tell me how big of a heart he has and how much he loves me, nothing will.

"The brick walls are there for a reason. The brick walls are not there to keep us out.  The brick walls are there to give us a chance to show how badly we want something." (Randy Paush, The Last Lecture) And dammit, I want this BAD.  I have wanted this for nearly two and a half decades.  If having weight loss surgery is what it takes for me to get it, then weight loss surgery I will have.  In the meantime, I'm going to have to come to grips with how much of an ass I was to other bariatric patients.