Describe your behavioral and emotional battle with weight control before learning about bariatric surgery.
I considered bariatric surgery about 10 years ago when I had insurance that would cover it. I decided against it on several grounds: I thought the surgery was still a relatively new procedure and didn't do enough research; I was young (32) and worried about the long-term effects of the surgery; and most importantly, I hadn't yet given up on my ability to lose the weight myself - despite the fact that I had been overweight all my life and hadn't been able to do anything about it up to that point. Two years later, at nearly 400 pounds, I buckled down, joined a gym and hired a personal trainer. Flash forward a year and a half and I had lost nearly 120 pounds, and was incredibly strong - I could outlift almost everyone in the gym. I was down to a 43" waist, but I still needed to drop about another 80 pounds. I ultimately stopped losing even though I was doing about 4 hours of cardio a week and lifting 3 times a week. I even convinced my doctor to prescribe adderall (amphetamines) to boost the weight loss. Despite all of that, I ultimately reached a plateau I couldn't break. Eventually, the weight started creeping back on and I started giving up at the gym. By last summer, I had put back on 80 of the 120 pounds I had previously lost, and with them came a host of medical problems: high blood pressure, high blood sugar, high cholesterol and triglycerides. By this time, I had turned 40 and I found it nearly impossible to lose weight. Whereas I could easily lose 5-10 pounds in a week or two of devoted dieting before, I could only lose 1-2 pounds now. Rejoining a gym and hiring another trainer didn't help - after 6 months of that, I had lost a whopping 10 pounds. Despite being on maximum levels of metformin, I couldn't get my blood sugar under control and my doctor told me I was going to have to go on insulin. I was miserable all the time: I felt bad; I looked bad; I was withdrawn socially; I had no energy and I had no motivation. Worse yet, I knew that if this is what life held for me at the age of 41, I would either be dead by 50 or in such bad shape that death would seem a better alternative. I began thinking about bariatric surgery, this time doing my due diligence on the research part and talking with people who I knew had undergone the surgery in the past. I ultimately made the choice to do the roux-en-y gastric bypass. I was more scared than I thought I would be going into the surgery. I was naturally concerned about complications with the surgery and I was worried that I would regret my decision down the road. I also worried about losing the weight, only to regain it years after the surgery. I am six weeks post-surgery on today's date as I am writing this. I am a completely different person that I was just two months ago, and I am not sure I know how to describe the change, although I will try below if you would like to read further.
What was (is) the worst thing about being overweight?
Pick your poison - you know what being overweight is like or you wouldn't be here reading this. Everything about being overweight is horrible, but I do not know if I can single one thing out above everything else - and I'm sure the worst thing for me would be different than the worst thing for you. Also, I think the worst thing changes over time as you age. A negative self-image was always problematic for me, even though I used to be an incredibly outgoing person. I went through a premature mid-life crisis in my mid-30's (which was non weight-related) and on the other side of it, I recognized that I was fundamentally not as happy, social and outgoing as I used to be. Coupled with the negative self-image, these factors made life lonely - especially since I relocated to a new area a few years ago. Also as I aged, the recognition of the excess weight's significant and escalating negative impact on my overall health (both physical and mental) became an overriding concern. I felt horrible all the time - physically, mentally and emotionally. I became preoccupied with thoughts of my own mortality and my inability to do anything about it. I think that in the last few months before surgery, this was probably the "worst thing for me" about being overweight: I had a lifelong weight problem that I had never been able to solve. Before, it was just a part of my life that was a single negative factor; lately it had become essentially the sole determinative factor in my life - and it made my life miserable. I committed myself to having the surgery notwithstanding my reservations. My personal doctor recommended a bariatric surgeon and my research on him was encouraging. I was fortunate enough by this point in my life that I had the ability to pay for the surgery out-of-pocket (although it definitely took some budgeting). My insurance plan specifically excluded bariatric procedures (which is pure lunacy if you ask me since I will save them a fortune in future medical care costs), and I had neither the time nor patience to fight them on the issue. And, since I am the co-owner of my business, I had the ability to take enough time off for the surgery and estimated recovery period. From the moment I made the final decision to proceed (in late January, 2012), I moved forward with all deliberate speed and had the roux-en-y procedure on April 17, 2012.
If you have had weight loss surgery already, what things do you most enjoy doing now that you weren't able to do before?
I said earlier that I am a completely different person than I was two months ago (right before the surgery), but I was unsure how to describe the change. The reason for my uncertainty is because the changes in my life are still occurring pretty fast. I was a completely different person the moment I woke up from the surgery.
The only time I have been put under before happened when I was 17 years old, and I have foggy recollections of it. I was very afraid of being put under for surgery this time - the anesthesia worried me more than the surgery itself - and I was worried about complications after the procedure. I had to get cardio clearance for the surgery due to an abnormality with my EKG, and the cardiologist said that I would be at a slightly higher risk than most patients for surgery. The day of the surgery was ridiculously long because the hospital was running late on everything - when I reported at the time they had instructed, I had to wait 45 minutes just to be able to sign in. It was a 2 hour wait before they called me to the back, and then another hour before anyone came to get started. I met with my surgery nurse, the anesthesiologist and my surgeon before the surgery and I remember them asking me, how are you doing today. I honestly told them I was nervous, but fine, and the more important question was how they were all doing. I was asked by each of them what type of procedure I was having (these questions seemed to be routine) and I would reply that I knew what I was having, but I wanted them to tell me to make sure they knew as well. I think my surgery started sometime after 5:00 p.m. on the 17th, but I'm not really sure because my anesthesiologist gave me something to relax me shortly after he met with me. I vaguely remember being in the OR with anesthesiology and surgery nurses there (one standing behind me and one to my right), but I don't remember getting to the OR or anything after that until I woke up.
I had a brief moment of consciousness in recovery and remember them telling me they were moving me to surgery ICU for the night (it turned out it was so late in the evening that they were closing down recovery and didn't have anywhere else to put me that late - my parents were completely freaked out by this because no one explained to them why they were putting me in ICU). I remember rolling into my room in ICU and briefly meeting my nurse. I also remember telling the nurse that I wanted to be up and walking by 11:00 p.m. (it was after 9:00 p.m. by this time). I was out for about another 45 minutes and them BAM - I was awake. There was no grogginess and nothing unsettling about my situation. Remarkably, there was also very little pain. I did my first walk at 10:30 p.m. (halfway around the ICU ward); I did the whole ward at 3:00 a.m. and 2 trips around at 6:00 a.m. I slept intermittently throughout the night and felt refreshed each time I woke up. I passed my x-ray leak test early that morning and had my own hospital room by 9:00 a.m. I had my first food - 2 gigantic ounces of water at 10:00 a.m., with instructions to drink 2 ounces every 2 hours. I started walking laps around my hospital floor with the first feeding: 3 laps the first time, 4 the next, then 5 and finally 6 laps. By 4:00 p.m. that afternoon, I was doing 6 laps every 2 hours which took about 25 minutes. I was beyond ready to go home, but I wasn't discharged until the following morning. I recovered at my parents' home and was lucky enough to have a branch office near their house. I was back in the office the day after I got out of surgery, for a few hours each day. In less than a week after surgery I was walking 3 times a day for a total of about 5 1/2 miles. I felt great!
The day of surgery, on 1500 milligrams of metformin and some other supplemental diabetic drug called Tradjenta, my blood sugar was 218. Three days after surgery, on no medication, it was 99; four days after surgery, it was 83 and I stopped testing it for a while. Three days after surgery, on no medication, my blood pressure was (and has consistently been since then) about 20 points lower for both the diastolic and systolic numbers. My heart rate is consistently about 10 beats per minute less at a resting or active rate. 6 weeks post surgery, triglyceride and cholesterol levels are back to normal (with no medications) and my blood sugar runs around 130 (presumably because I'm eating more than immediately after the surgery when it was pretty much liquid protein all day long). Taking my readings is actually fun. For the first week or so, I would actually laugh out loud every time I took my blood pressure, pulse or blood sugar levels. My parents would ask what was funny and I couldn't explain it to them - it wasn't so much funny as it was simply incredible. Thankfully (and knock on wood), I have not had a single problem with the surgery to date. The worst that has happened is some mild discomfort if I drink water too fast, or if something gets hung up on the way down (which has only occurred a couple of times when I was transitioning from liquids to purees and purees to soft foods). I feel completely different and I am a different person. My parents have noticed a change in my personality and outlook on life and that's only from observing me while I stayed at their house.
Inside of my head, the whole world is different. Saying that I feel at least 10 years younger would be an understatement - I simply feel different - not necessarily younger, but more like when I was younger and my weight was only a single negative factor in my life. Only now, it's a factor that I am in control of and which is diminishing day by day. I feel alive - I feel energetic - I feel optimistic - I feel in control - I feel motivated - I feel great - I feel well-rested - I feel healthy - I feel incredible - I feel inspired - I feel victorious - I feel awesome - I feel like I made the best decision of my life and the decision that will have the greatest impact on my life - I feel grateful and thankful - and again, I feel alive. I don't know how to explain it, but I suspect that other people who have had the surgery will know exactly what I'm talking about.
Before the surgery, I remember asking people who had undergone a similar procedure (even some who had had major complications) if they had any regrets about the surgery. I never found a single person who regretted it, and that always confused me. I was worried I would have regrets and that I was going to miss food. Sometimes, you just want to go out with friends, family or co-workers and have a big meal or go out drinking or celebrate (which of course involved eating and drinking). I didn't think I was ready to give that up. And what about Thanksgiving, Christmas and other holidays? How could you not eat a big meal then? I resigned myself to the fact that I would never be able to indulge in a good hearty meal again. Fortunately, I'm not a big fan of sweets or breads, so I knew I wouldn't have too many problems in that area - but I do like to eat and I knew I wouldn't be able to eat after this surgery. I also like to drink - bourbon and ginger is my drink of choice. While I understood you would not have to give up alcohol completely after the surgery, drinking was not encouraged, and carbonated beverages should be completely off limits to reduce the risk of stretching your pouch. I prepared myself mentally to give up my beloved bourbon and gingers, and I was not happy about it. I also prepared myself to give up these big meals that seemed to define social or family events.
However, as each day passes post-surgery, I note how much my relationship with food has changed. I was trying to explain it to a friend of mine (a skinny friend), and he didn't get it - he said, "Wow, I've never even thought about my 'relationship' with food - didn't even know I had one." Well, if you're reading this, you probably know exactly what I mean when I talk about a relationship with food. Granted, I am only six weeks out of surgery, and I cannot predict how I will feel 6 years out, but I cannot imagine having a single regret then about my choices and I certainly don't have any regrets now. It's no wonder I couldn't find anyone with regrets when I was making the decision to have the surgery. I don't crave food anymore - don't get me wrong - if I don't eat enough or go longer than I should without food, I will get hungry, but the insatiable urge to eat is simply gone. I cannot imagine wanting to have a big huge meal or feeling sorrowful that I couldn't indulge myself. Besides, if I really want to get that feeling of just having finished an all-you-can-eat-buffet or a smorgasbord of food, all I have to do is drink 3 or 4 big swallows of water.
I find myself becoming a label whore - especially when it comes to protein, fat and iron. If it doesn't help me get enough of the first and last, while limiting the middle item, then it doesn't go down the hatch. I have limited space for food and if it doesn't give me what I need, then it's not worth it. I have never been able to make eating choices like that before without some huge internal struggle between taste or hunger vs. nutrition. There is absolutely no struggle now - food is fuel, and if it doesn't make the cut, it doesn't make the gut. I have no desire for many of the types of food I used to eat and while my sense of smell hasn't diminished (some things still smell great), my sense of hunger/need for certain foods has. And amazingly, simple foods that I used to take for granted now taste incredible to me or seem like delicacies. I cannot get enough watermelon - it is nectar to me. Simple cranberry juice tastes so sweet that it's practically undrinkable - it's like a syrup. I went to Zaxby's the other day with my business partner for lunch and ordered the Blackened Blue Salad. I was only able to eat a few chunks of chicken with blue cheese crumbles, but I swear it had been prepared by some gourmet chef and not in the back of the restaurant - it was indescribable. Squash and plain mashed sweet potatoes thrill me and even tuna fish (TUNA FISH!) with a little light mayonnaise, chopped onions, lemon juice and pickle relish tastes good. I grilled a cajun flavored filet of salmon the other night and thought I was going to die it was so good. I can only hope that this flavor awakening I have experienced will continue in the future, but so far, it seems to be getting stronger each week rather than diminishing.
Energy levels are out of this world. Unfortunately, I cannot walk 3 times a day now that I am back at work full time. Technically I guess I could if I got up a little earlier, and walked during lunch, but I've never been an early riser and I've always been a sweater. Since the surgery, however, I have noticed that I go to bed earlier and find it easier to get up in the mornings - in fact, I will frequently wake up before the alarm goes off and will not be able to go back to sleep because I feel so rested. I've also noticed I'm not nearly as hot now as I used to be. Previously, I slept at night with the air-conditioner on 63 and I only covered myself with a sheet. Now, I sleep at 68 and I bundle up under the sheet and comforter. I even had to put socks on the other night because I felt cold. Over the next month, I plan to start sleeping at 70 and see how that goes. At the office, I was constantly turning the air-conditioner down because I was so hot - now I am constantly turning it up because it feels so cold. Regardless, I still sweat when I exercise, so I can't really go walk during lunch (especially living in Florida where it's already in the 90's each day). But, I can and do make it to the gym after work, and once I get started on my cardio, I'm not going to quit until I get in at least an hour and a half. Most days, I will do 2 solid hours of cardio. I don't know where the energy is coming from, but I am absolutely not complaining about it. I have also found that I cannot stand to sit around doing nothing anymore. Don't get me wrong - I still like watching television and vegging out on the couch or in the recliner. But, I find myself wanting to go do things all the time now. I bought a couple of tennis rackets the other day and am constantly on the lookout for someone to go play tennis with (I haven't played in probably 15 years but I want to play all the time now, and I'm thinking about taking some lessons). Last weekend, I went to a walking trail that runs along a creek in a nearby town - I'm going back this weekend with a float so I can walk down the trail and float the creek back. I want to get out on the beach, but I don't have a boat, and my friends that do have one have been out of town for the past two weekends. I think I'm going to go buy a Wii or Kinnect system this weekend and get the weight loss program (I think that's just on Wii) and one of the dancing games - even though it will be embarrassing. I simply cannot find enough things to do and I' don't think I've ever had this high of an energy level - at least not since I was a child. It's very exciting.
My weight loss surgery has changed my life - I noticed the change almost immediately from waking up after the surgery and it has been exponential since then. I can only assume the change in my life will continue to grow in the weeks, months and years to come and I welcome it. Even with this brief passage of time, I truly believe that my weight loss surgery saved my life. The health benefits alone are worth much much more than the financial costs of the surgery. The fundamental changes in my mental and emotional well-being are astronomical and the 42 pounds lost (in 42 days) are just icing on the cake. I can't wait to see where this journey takes me and I hope yours is as exciting, if not more so than mine. Thank you for letting me share my thoughts about my surgery and I'll do my best to keep you posted with more results in the future. Until then, be good - be safe - be happy.