13th November 2018 The Pre-op
Feb 04, 2019
After establishing that I wanted to go through with, or at least take the tests to see how eligible I am for the operation, I had to take some tests.
So how does one go about it? I live in Belgium, but I think the overall principle is the same. In order to undertake an operation, you need to be cleared.
Belgium is an insurance based medical system. Fit the right criteria, the insurance will cover as much of the pay as they deem necessary, however, you have to pay a certain percentage. These tests were to tell the doctor I was up to it, but also to prove to the insurance that there was more than just a BMI index to say that this was necessary.
What did I have to do?
- Blood tests
- Abdominal ultrasounds
- Psychological interview
- Overall check-up by a cardiologist
- Blood tests
There were some administrative issues, but those are not for here, so I’ll leave you with a brief anecdote, the reason for the test, the results and the result they had on how I was to behave before my operation.
The Blood Test:
The blood tests confirmed my blood sugar levels and cholesterol levels. Despite doing a fair amount of sport over the years, my ‘good’ cholesterol has been under average and my ‘bad’ cholesterol has been high. My sugar was around 108.
The Abdominal Ultrasound:
The abdominal ultrasounds were odd. I was handled by a medical student (male) who was clearly doing his nursing training. The doctor was out, so I didn’t quite realised, but I felt sorry for the boy, who clearly got more than he bargained for when he entered the room to find a young, big woman with her shirt off waiting for him to go ahead. He tried to stifle his surprise, but it was obvious, and I felt both apologetic for what he was having to look at, as well as feeling very self-conscious. After being told repeatedly to breathe in and hold, an older woman came in and asked him how he was doing. Unlike the firm, if gentle, hand of the student, the master’s approach was to dig the scanner into my belly like a mad thing. I was not particularly pleased by this.
The point: to check the organs around the operated area for fat, lumps, and anything that could prove obstructive to the operation.
What was found: A non-lethal, not unexpected amount of fat around the liver which needs to be reduced, as the stomach is behind the liver and it will be easier to get behind a leaner liver than a fatty one.
Result: a ten day-protein based diet before the operation.
The endoscopy was equally unpleasant. I was drugged, the effect of the drug was to basically make me drunk, in fast motion, to stop me from trying to swallow around the camera or vomit it up. On a screen on the wall, I could see the inside of my throat, the decent towards my stomach and the inside of the food sack itself.
The nurses and doctor were very kind, told me how well I was doing, while I was drugged on the table, a rubber hole gag on my mouth forcing me to keep it open in a small ‘o’ and a very uncomfortable, scratchy thing in my throat I kept reminding myself not to swallow. They pumped air into my stomach, telling me that I was doing great, and that this was nearly over. Then, the camera was pulled back out of my mouth, as scratchily as it went in until a sense of relief flooded through me, along with some serious hiccoughs. I removed my rubber ring gag and staggered out of the room, woozy and feeling awful. All of these tests needed me to be ‘fasted’, i.e. not to have eaten.
The point: to check for acid reflux scars which would be a serious repercussion after the operation, and to check for any foreign bacteria in the stomach.
What was found: my throat and stomach were completely clean. No worries and nothing to do to fix it.
Possible Result: should there have been bacteria in my stomach, I’d have been put on antibiotics for a few days to kill them off. If I’d had acid reflux scars, I would have been rejected for the surgery (I think, please check with your doctor and don’t take my word as gospel).
By the time I got to this point, I was tired, hungry, grumpy and miserable. The woman I saw was a non-English speaker, she was French speaking. I’m a fluent so it wasn’t much of a problem. However, trying to explain the deepest recesses of your mind and reasoning for undertaking this procedure when, in all honesty, I was using these tests as a way to check that it was possible and not to think of it as a certainty.
I was asked deep questions: had I ever been abused by a partner? Had I had problems at school? What was my opinion about my weight?
Straight talk: I don’t trust women who are like this particular psychologist. Thin, blonde, who come across as both clever and not clever enough, with high pitched voices that try to sound sympathetic, but really sound quite patronising. Belgium is full of these women and they tend to work as psychotherapists, in job centres and a lot of government-based civil servant positions. The kind of women who tend to use ‘okay?’ as a full stop, a full two octaves higher than the rest of the sentence, whose eyes show little warmth and no compassion. I’d rather sit with a Mediterranean who shouted at me to pull myself together and get my shit straight, I’d feel less bad about hitting them. These ladies annoy me to the point of wanting to pull my hair out.
The point: to establish whether or not I was mentally ready for all that the operation entailed.
What was found: I have a deep-seated anxiety that needs to be addressed and that I might be using my weight as a shield against the rest of humanity.
Result: Prescribed therapy following the operation. Having already been in therapy, I’m sceptical, but I’ll be happy to give it a go.
I was probably not in the right frame of mind for this guy. He was blunt and had no real time for feelings. I felt sorry for his children. He took one look at the photo on my ID card, looked back to me and said ‘yep, you’ve gained weight.’
‘Thanks’ was my scathing response.
‘Well what? You have!’
He weighed and measured me, calculated my BMI, and checked my heart. All about as unsympathetically as a butcher that's weighing sausages for Mrs. McCreedy on Sunday. To the sausages that is. I'm sure Mrs. McCreedy was given full moral support in her buying of produce.
The point: to see if I’d pull through the op.
What was found: my BMI should satisfy the insurance that this is necessary, and my heart is just fine, if not great.
The results were given by the surgeon in another private consultation, and then I had to go and meet the anaesthesiologist a couple of weeks later due to the Christmas period. The operation was scheduled for 9 January 2019, and I would remain in hospital for 3 days.
4th January 2019: The Anaesthesiologist.
Technically, this was not the same series of tests, but belongs here, so I've added it for good measure.
This was merely to check for previous operations under anaesthesia, to check for allergies, and basically took on the form of a question and answer session.Luckily, I come from a good stock of non-allergic people, the main one in the family being a mild nut intolerance for my dad, and mild dust allergies for the rest of us.
Unlike the cardiologist, this guy clearly cared. He was also obviously stressed, his hair all over the place and it looked like he’d been sweating. He must have operated that morning.
I was told to ask any questions I had. While I realised that this man was not my doctor, I thought he may have some answers.
When could I go back to sports?
Did I need to take time off work?
As only French speakers can do, he launched into monologue after monologue about how I was to act, how to behave, that I should tell my trainer as he was someone who had to care about my health unless he was a dick. It is a strange thing when someone decides to take such a hands on look into your life that they can talk at you for about 20 minutes at a time, uninterrupted, about the fineties of how to behave about an operation like this.
I left, feeling condescended and patronised, similar to when I’d left the psychologist. But I was given the all-clear.
Feb 04, 2019
So I decided to meet a surgeon. In Belgium, where I live, you can either book an appointment with a ‘Specialist’, a doctor reserved specifically for a certain type of operation, via a General Practitioner, which inevitably means that they feel you genuinely need surgery, or else you can book on your own. The only real difference is that you pay the GP to send you and then pay a reduced fee at the Specialist, as the insurance will subsidise the visit. You go yourself, you pay the specialist full whack. In the end, doing the maths, it amounts to the same.
How did I reach the decision?
After about 8-9 months, my trainer had basically given up on me. He didn’t say as much, but our sessions involved more faffing about than they had at the beginning, he stopped looking me in the eye, he’d started smoking (whether that was my fault or not, I couldn’t tell), he’d plonk me on a machine and then run off to either chat up new clients, or more often, hang out with the other members of staff and friends he’d made of the regulars. In the end, in September, he quit and joined the hospitality field of work. The Irony. Either way, he palmed me off on another trainer, who turned out to be much better (so far).
I felt, and saw, my physique, which in all honesty hadn’t been fabulous since the beginning, deteriorating as well, which didn’t make any sense to me as I was putting in the effort. It was soul destroying.
Thirdly, my mother. We have a strange relationship. The love we have for each other is unconditional. There’s no question about it. She’s a good person, and I strive to not be a bad one. We are both, however, exceedingly flawed. She feels her filter and the respect she shows her friends and people outside the house do not apply to family and therefore she can just say what she thinks and everyone else has to lap it up, while I see everything she says as a direct attack and I can’t handle it and meltdown. Sometimes it means I break down and cry, sometimes I shout at her and a large fight blows up out of nothing, a lot of the time, we ignore the other until we’re ready to just ignore what happened. Throughout my timeline, our arguments were (in reverse order):
- My grades
- My attitude towards people and reading the mood
- My loudness
- My nail-biting habit that I have quit about the same number of times as a chain smoker
- My weight.
If I’m on a diet, our relationship is far better and supportive than anything, and there have been many times where I have pretended to be on a diet just to keep the peace. And cue everyone telling me we have a toxic relationship. I don’t care, quite frankly.
Meeting the surgeon, it was clear what motivated him: the cash. Gastric surgery, up until recently, has been mostly reserved for the rich in Belgium, but now, the health insurance companies have cottoned on to the fact that if they prevent obesity levels sooner rather than later, they don’t have to cover the cost of diabetes treatments and visits, cancers, and everything else linked with the condition. Similarly, they’ve started a free ‘how to quit smoking’ helpline to avoid the bills for illnesses that inevitably stem from the habit. He will receive a nice fat pay check and it’s clear that this is where his priority lies.
He asks me a few questions: what’s my weight? Height? Weight loss goals? Reasons? All with a self-satisfied smile on his face. He’s not a young doctor, forties, fifties maybe. Full head of hair, silver with streaks of dark brown. Face slightly lined. Clearly someone whose line of work is not so stressful that he has to pull grimaces, nor to cause a receding hairline. Actually, he’s the second of his kind that I have met: the first, a Lasik surgeon, a surgery that has changed my life for good a million times over.
The doctor asked me what I was thinking of opting for on the buffet of weight loss surgery options.
"The Gastric Sleeve," I replied.
"Because I know a few people who’d had it and swear by it."
"Actually," said the doctor, "I feel you would be a perfect candidate for a mini bypass, it’s safer, less strain on the body and, if need be, it is reversible or changeable: it can become a full bypass, a sleeve operation, or any other of the bigger surgeries."
Given that his name had been given to me by another family friend who had undergone a mini bypass at his hands, this was not surprising news. He proceeded to show me the difference between the sleeve, mini and full bypass surgeries. I was quite convinced.
So he booked me in for the preoperation tests.
Pity Party Alert.
Feb 04, 2019
To get the weight right, I guess, I’m going to have to get into the psychological nitty-gritty. If you don’t want to know the innermost workings of my mind, by all means skip ahead.
My current status is Know-It-All. I’m that person at the dinner table who will inevitably start a conversation along the lines of potatoes not being a root vegetable, but an edible tuber. Never won me any popularity contests. Not that I was trying to win them.
I was the kid at school that was isolated and shunned. Didn’t drink. Didn’t smoke. Never went out. Not that I didn’t want to go out. I always assumed that if I were to go out it would be with an invite: someone asking me ‘would you like to join us at the bar’ kind of thing. I was bullied by isolation a lot. No invites, I only went to birthdays because the entire class was going: I was inevitably on my own. So, I naturally developed the belief that I wasn’t worth time, therefore, others were not worth my effort.
I had been a thin kid, photos prove this. I wouldn’t have believed it. Under the guise of care, my mother used to fuss about my weight. A clear memory was of sitting on a bin in primary school (this for some reason was the height of cool, because you, a five to six year old could climb up a bin that was taller than you, and conquer it by sitting on it), finishing a yoghurt and watching my school fellows playing cops and robbers with a chocolate waffle in their hands when a thought crossed my mind:
It doesn’t matter what I eat. I will always be fat.
Anyone believing in the law of attraction will tell you that these are core beliefs that will merely serve to act as a concrete block upon which my ego will be built.
That gives us a total of
- ‘you’re so pretty, but you’re fat.’
- ‘regardless of what you eat, you will always stay the same: fat. Therefore, permanently unattractive’
- ‘nobody likes you, so why try.’
Couple that with the fact that till this day, people feel able to just comment on my weight, it’s no wonder my mind can’t handle reality some days. I’m not talking about family or close friends. I mean random people on the street, or in the gym (twice a week, for an hour), who, either vocally, or in a way that makes little to no sense, tip me off that I’m fat.
I’ll give a perfectly good example of both scenarios.
Scenario 1: My boyfriend and his friend from India are spending the weekend in my flat, so we do the usual trick with first time, overnight guests: sightseeing around my home city, before coming back home tired, but cheerful, prepared to jabber into the evening about what we’d seen, where we’d been, what we’d done. This was the plan.
In order to do this, this being a city, we decided to take public transport. If you’re American, we took the subway. If you’re British, we took the tube. If you’re from nearly the entirety of the European continent, we took the metro. As I live on the European continent, I will keep with metro.
We get on the metro. Nothing to report, we decide to stand rather than sit, in a little cluster near the door, next to a separate cluster of older ladies. These ladies were Muslim, which only adds to the fact that you could not define their body types, and I’m particularly bad at guessing people’s ages. Let’s say they weren’t thin, and they were anywhere from late forties to mid-fifties. The wildcard: a middle-aged man, thin, in the corner between the door and the seat. I had gotten onto the train through a different door to the guys, so I walked the few metres between to stand with them. As I do so, Mister Wildcard barged past me to stand at the other door, knocking into me. That was the only reason it registered. During the train ride, he came back to his original position, takes out his phone and starts pretending to have a conversation. How can you tell: he didn’t pause for breath, and there was not enough time between contact with ear and the beginning of the diatribe for someone to have actually picked up on the other end. And he’s muttering in French. I’m a fluent speaker, but given the noise of the train, his conspiratorial stage whisper and my chatting within my cluster, I catch the words ‘fat women with their fat arses.’ I know full well I belong in the category, but as I said before, I wasn’t the only non-stick-thin woman in the area. However, once the cluster of Muslim women left the train, he swapped languages: first to German, which I do not understand, and then to English. In English, he proceeded to relate to the phantom party how he was ‘sick of being confronted by short, fat, ugly women.’ And I’m the only woman around now. My boyfriend jumped to my defence, and when the man followed us off the train, he told him to watch his step.
Consider my day ruined, because someone decided they had the right to throw into my face something which I’m painfully aware of.
This leads to
Scenario 2: At the beginning of 2018, I decided that maybe it was time to throw money at the problem. I didn’t think I was bad enough for surgery, I was fed up with the latest fad diets. Nope. I was going to get a personal trainer. Everyone now thinks I’m loaded. I’m not. I decided to try and invest in myself. And having haggled with said trainer, I was in.
The gym where I train can only be described as the Ryanair of the gym world. You pay a rock bottom monthly rate for membership that has to last you a year. Any add-ons are purchased separately. Therefore, setting up with a personal trainer means that you pay their fee, and it’s easy enough to haggle or to arrange for a budget.
So we started in January/February 2018. It was going well. However, there is a guy on the desk who gives me the creeps. Maybe it is because when I was with the trainer, he’d come and sit and watch everything. Like he was entitled. I can’t say if this was a regular thing with other clients, or if it was just the fact that ‘fatty’s deadlifting again, this I’ve got to see’ and his biggest regret was that he didn’t have a bucket of popcorn to enjoy with the spectacle I was making of myself. Regardless of whether or not this is true, that is how it felt. And there were other people who were allowed to just hang around, like X’s girlfriend, Y’s mate, Z and a million and one other people. At one point, I was so self-conscious because I was asked to run down a corridor in front of other people during circuit interval training. This corridor got longer and longer till I was in full view of the treadmills. I have never felt more humiliated in my adult life. It was like gym class all over again, but this time, I was proving why I was always last pick. Fortunately for me, I was able to change trainers without hassle or bad feelings. I’m happier now.
Scenario 3: I know this was not mentioned, but this is where family can hurt you worst and they can’t even begin to understand why. They can only see where they’re coming from and not where their comment is going.
I am a sensitive person. Might have been obvious, might not have been. My mother feels she has a right to say exactly what she thinks about everything and not have to sugar coat it on the basis that she is family and I’ve just got to take it. This is the basis for this story.
My contract was coming to a close, I needed to find a new job. I was called to interview for a very large fashion company. I had the interview. I called my mother, did the usual question-answer relay of how it went, what was asked, when would I start. At a given point, she just says ‘I wish you were thinner’. I blew up. It is a harsh reality that everyone can look at your achievements based on your looks. If you are presentable, you’re in with a shout above the rest. If you’re heavy, something is perceived as being wrong with you, mentally, health-wise, a lot of different ways. You’re not thin, so you clearly hate yourself. Or at the very least don’t value yourself.
What’s upsetting is that I have a degree, I have a Masters, I have five years work experience scattered around in very different areas, around Europe. All of these achievements mean nothing due to the unhideable weight.
It is lamentable that in this day and age, I can think of no TV shows, films, with a significantly heavy person playing a lead. Everyone is thin and beautiful on Television, unless they are the dumpy best friend, or hated person (How I Met Your Mother: Patrice), Extra. If you’re not beautiful, slender, muscly, you’re not enough. There are some famous heavy people and film characters: The Nutty Professor, Big Momma, Fat Man Scoop, Nicole Byer. Their personas have to be labelled as heavy. They are a laughing stock because of their size, or else they have to own it, or play the buffoon.
It is simply unfair.
What makes it unfair is that it’s not like I haven’t tried to be, as a very good friend described it, ‘indisputably hot’. For years, I did six hours of martial arts a week. I can hear the titters now, but the sensei was a national sparring champion for years. Jumping up and down and kicking a man head and shoulders, often head to elbows taller than me in the face, is no mean feat. Never enough. As I said before, one year of a personal trainer. Years upon years of yo-yo dieting, because guess what, I don’t want to have to deprive myself to enjoy a meal with friends, family, anyone. I don’t want to have to worry about whether or not I can afford a slice of birthday cake. I don’t want to crack and then think I can get away with it and then have to face the deep guilt that brings you back to where you were, and further away from where you want to be, and then to top it off, forcing you to hit repeat. To feel like people look at me and see something that they think they could love. Because that’s what we want, right? To attract people. One thing I have succeeded in, though. I have a partner, who I love to bits.
Add to this a healthy dose of health scare and you have a picture. In 2017, I was told I had high blood sugar, and a real risk of diabetes. Diabetes, heart disease and osteoperosis lie thick within my mother’s family. Add to that an insulinoma and pancreatic cancer, both of which can be caused by obesity: I’m both terrified that it will happen, and in denial that it could. I’m 26 after all.
This is the basis for the decision I have made.
- My health. To prevent diabetes and pancreatic cancer.
- To finally believe that I look good.
- To finally get my life on a path that is worth it career-wise.
I have so much to offer the world, I’m just not getting my break.
Until next time.
Why I Did It.
Feb 04, 2019
So we’re now the 31st December 2018. The ultimate change of year for me. As it is the ultimate year of change.
How is it different to any other year? No, I’m not turning 30, 40, 50 or any other important age this year.
This turn of the year, at the age of 26/27, I’ve decided to put the fate of my weight and by extension health in the hands of a surgeon.
It was a massively tough decision, born of complete desperation. Weight loss surgery is something that I, and my friends and family have seen as a massive cop out, a cheat code, something that only the most desperate attempt.
That is not to say that I don’t know people who haven’t undergone it, succeeded and fulfilled the aspect of their lives that they felt was lacking due to their weight: partners, pregnancy, job offers. All of them rolled in for them. They were significantly older than me. They had probably tried and failed more times than me. They had probably had it worse. That’s what gave them the go ahead. Didn’t mean I didn’t ever say to myself ‘I will never be that bad, it will never happen to me’.
But I did get that bad. I did hit the obesity target that I was in denial of ever reaching. And now, I’m preparing to go under the knife for the sake of multiple things: my fitness, my health and, in all honesty, my looks.
So why am I writing about it?
When I was trying to make my mind up, one thing that I felt would have really helped me get my life in order and make the decision; something that was not forced on me by concerned relatives, or me looking for the easy way out, would have been a diary entry, video or otherwise showing the thought process, the way these people had grappled with the decision for themselves and how they came to the conclusion to go forward. What I got, and was somewhat helpful, was a series of people wishing that they’d known certain things about life after having half of your stomach removed.
I decided I might try, as realistically and humbly as possible, to show my own workings, to help others. More importantly, I wanted to help myself. Not in any other way; I’m not looking for fame, or fortune for a small blog about a weight loss surgery, but only to solidify my convictions about the next week of pre-surgery dieting. About undergoing something that is apparently barely noticeable, but that impacts the rest of your life. About the choices I will inevitably have to make when I go to restaurants, parties, even to the bar for a drink after work.
I’ve left this very late. For one reason: who really wants to hear it? Well, maybe someone somewhere grappling with the same choice. For that one person in a million: this is for you, from me. Good luck.
Weight: 105 kg
BMI: between 38-40