Life (And Stomach) Altering Decisions
A very dear friend of mine asked me to write about my weight loss surgery experience. I know some of you are struggling with the same decisions. I know some of you are already fighting insurance companies to improve your health. And I know some of you are completely resistant to the idea of surgically altering yourself. But here goes: soul-bearing honesty.
With the exception of the first few years of my existence, I was fat. I do not mean a little chubby. I do not mean I carried some extra “baby weight” though that is what my Italian family always told me. Eventually, when people could no longer deny the truth, I was told what a “pretty face” I had.
In the South, it is common practice to end with “Bless her/his heart” when you are giving a backhanded compliment. That is what “You have such a pretty face” has become to me, because it has always spoken volumes about the rest of me not being good enough.
It was not that I was inactive. I played soccer. I played softball. I was a tomboy. I rode my bike everywhere. I climbed trees. I ran around the neighborhood without any shoes on. I hated shoes. I lived in Miami; I swam a lot. But I did not eat well. When you have a mother that works three jobs to support her family, it is hard to not live on fast food. We supplemented fast food and takeout with defrosted Pepperidge Farm cakes. To this day, I get nauseous looking at them in the freezer section of the grocery store. I stole my brother’s Halloween candy; but only the chocolate. I lived on Reese’s Peanut Butter cups and red licorice and Rolos. Oh, Rolos.
And so, I stayed fat. When I was on the cusp of 17, I lost 25 pounds. I was not trying; I just could not afford to eat. I lived on one orange and a can of tuna a day. Yes, that is it. One orange and one can of tuna. No mayo. I went from a size 16 to a size 12 in less than a month.
Of course, once I started eating again, I gained it all back and then some. And so began the vicious cycle in which I found myself for most of the rest of my life to this point. I would lose 10 pounds and gain back 15. I would lose it again and gain back 20. I went to nutritionists. I hired trainers. I worked out 5 days a week. I ran 5Ks. I swam. I biked. I played volleyball. I danced.
I went on Jenny Craig. I went on Weight Watchers. I tried the Cabbage Soup Diet. I took amphetamines. I became a vegetarian. I tried South Beach. I followed Atkins. I read diet books the way some women get absorbed in “Fifty Shades of Grey”. I went Paleo.
When I hit 240 pounds, I knew I could not continue like this. I had high blood pressure, was borderline diabetic after spending years being hypoglycemic and fainting in public. I had to have my gallbladder removed. I decided to try a medically supervised program – HMR. This program cost me almost $600 a month for the food, lab tests and weekly weigh ins. I learned absolutely nothing except that I was wasting $600 a month on a program that did not work for me despite my following it to the letter. I hit my bottom. I gave up.
When I walked into my surgeon’s office, he took one look at me and asked “You know what your problem is?”
I nodded. “Yeah, I’m fucking fat.”
“Well yes. But you’re also not 7 feet tall. That’s really your problem.”
I laughed. And I knew that this was going to be life-altering and more importantly, it was necessary. I had done my research. I talked to people that had been through it. I decided not to get the Lap Band. If I’m going to do something drastic, I’m going to go all the way, I told myself. I opted for a Roux-en-Y procedure. After spending months going to support group meetings and getting medical clearances from cardiologists, psychologists, my primary doctor, a gastroenterologist, and my surgeon, I was approved by my insurance carrier and scheduled my surgery.
On July 5, 2011, I weighed 250 pounds. I am 5’2″. I wore a size 22/24. And I still had a pretty face.
I was wheeled into the prep area of the hospital and hooked up to an IV. I said my ‘See Ya Laters’ to my family and was taken into the operating room. I was cold. I blinked and went under. When I woke up, my surgeon was smiling in my face. “Why the fuck are you so happy,” I asked.
“Because today, I changed your life. Just watch. You’ll see that I’m right.” And he dashed out to prep for his next willing victim.
I was sore. I was nauseous. And when the operating room medications wore off, I wore the hell out of my morphine button. Then I discovered I had developed a severe morphine allergy. I was instantly covered in hives and was so doped up I could not even scratch my face. I laid there in agony until a nurse shot me full of Benadryll and steroids and switched me to another pain medication.
Within a few hours, a nurse prodded me. “Time to go for a walk,” she said in a far too chipper tone.
“I’m not getting out of this bed.” She put an elbow under my armpit and started lifting me out of bed. “I hate you,” I said simply.
“Yep. You sure do. You’ll thank me later.”
And so began a series of three walks a day. It helped tremendously. In two days, I was wheeled to my car and driven home. I had friends to keep me company every day for the two weeks I was out of work. The first few days without the heavy pain medications were awful; I am not going to lie. It hurt to move. It hurt to breathe. The staples pulled. They itched.
But most of all, I hated that I had to drink shakes. I hate shakes. When you have been fat your whole life, your brain tells you that there is no way that tiny little one ounce medicine cup is going to fill you up. I stared at it, skeptically, and then I struggled. I struggled to get an ounce at time down. This is absolutely crazy, I told myself.
By the second week, I was feeling infinitely better every day. I was able to do everything for myself again. I looked forward to going back to work. I begged my surgeon to let me eat semi-solid foods. I was supposed to wait a month before introducing them, but not chewing actual food was really bothering me. “Fine,” he said. “You can have cottage cheese.”
“You’ll like it.”
“No, it’s gross.”
“Trust me. Your taste buds have changed. You’re going to like it.” I stormed out of his office. “You can have apple sauce too,” he called out behind me.
“That’s better,” I yelled back.
I tried cottage cheese. I liked it. Say what? Yeah, I liked it. But I lost my taste for a lot of other things when I was able to finally start eating again (I was back on solids about 6 weeks post-op). Steak was difficult. I could not eat pork at all. I no longer craved sweets. I had trouble with bread and rice. Too much and it felt like my staples would burst. Too much was more than a teaspoon of either.
Not long after my surgery, my blood pressure was back to normal. My sugar was back to normal levels. Much to my chagrin, my periods became normal again. I was losing weight at a scarily rapid pace. I begged friends for clothes. I could not keep up with how fast I was losing weight. I started losing my hair because I was not getting enough protein. “Cut it,” my surgeon said.
“I’m telling you, cut it short. By the time it starts to grow out again, your protein issues will be resolved and you won’t have that problem anymore.”
“Yeah right. There’s a totally bald woman in the support group.”
“That’s because she didn’t listen.”
I listened. I cut a pixie. Two years later, I am still growing it out.
I have lost about 90 pounds. This year, it’s been much slower, but without doing anything to actively lose weight and not being the least bit active for most of that time, I have lost almost 10 of those pounds. I started running again. I started rock climbing. I started partying, though the drinking negated the benefits of dancing.
I am now wearing a solid 7/8. Sometimes, I can wear a 5. Sometimes, I wear a 10. Designers are arbitrary and you do not notice it in plus sizes because that is a place most designers do not bother to go. My body shape completely changed from an hourglass to an athletic shape (described as one where your bust, waist and hip measurements don’t have much variance). I can now eat about 6-8 ounces in one sitting. I still do not get enough protein.
One of the most frustrating aspects post-op is that my brain has not changed. I still order too much food. I still eat too fast. I still make poor food choices at times. But really, I still see myself as a 250 pound woman. I still go to the plus size section first. I still pull 1Xs and XLs off the rack first. Then I get frustrated when they do not fit. Then I remember it is because I wear a medium.
A medium. A fucking medium. A 7/8. I was never this small. Not even as a child. And the sad truth is that I just do not see it until someone else points it out to me. I tell people all the time that I am too fat to wear certain things. “I can’t go out in leggings and a t-shirt,” I’ll lament. “I’m too fat.”
“You’re fucking nuts. Go change.”
And I do. And then I realize that I can do things like that now.
My friends and The Boy give me constant reassurances. They help in the moment, but they do not stick. “You don’t absorb things,” The Boy tells me. I nod in agreement because it is true. Not just about my body, but about everything.
“I can’t wear a Star Trek Fleet Uniform,” I tell The Boy on a regular basis.
“They make them in all sizes.”
“So? Just because they make them in all sizes doesn’t mean everyone should wear them.” He generally just shakes his head.
Late last year, my weight loss psychologist finally had enough. She put up a piece of brown craft paper, handed me a Sharpie, and told me to go draw an outline of myself. Then she made me stand inside it and she drew around me. Then she made me look at it. I mean, really look at it. And it sucked. It sucked because I drew myself significantly larger that the physical reality that is me. And no matter how hard I try, I simply cannot wrap my brain around it.
I had 33 years as a morbidly obese person. I know it is not rational to expect that in two years of being a “normal” size and weighing less than the average American woman now, that I am going to completely change how I think and how I see myself.
On the other hand, I did not expect the body dysmorphia to get worse. I always said I would be happier when I was thinner. And overall, I am. Getting the surgery was the best decision I have ever made about my health and I would do it all over again.
But the brain? That’s going to take some more work.