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I haven’t written here in some time as I’ve been quite depressed lately and my juices have stopped flowing. The best news this week was that Tom found his wedding ring - blaming the fact that it was under his writing desk on “the cats!”
The “bad” news stared with the overall let-down feeling I’ve had since meeting with the psychologist, and has continued into the week relating to a sudden insurance change and (over-)exposure to graphic details about bariatric surgery and its aftermath. Suddenly I feel as if reality has slapped me in the face - I’m anxious and sad and worried and mad. Upset and sad at what a unilateral and self-serving experience the psychologist visit turned out to be; worried and anxious about our finances with the 2/1 changeover from BC/BS of WNY to BC/BS of Michigan through Tom’s retiree plan at Delphi (soon to be switched to GM). When the 14-page notice came in the mail a few days ago announcing such significant changes in coverage, I nearly puked with anxiety at its bad timing. I immediately called the Bariatric Center and engaged in a conversation that probably made little sense to either of us as I was still struggling to absorb the meaning of new terms like “co-insurance,” “deductible,” and “allowed amount.” What I was told is that BC/BS of Michigan, up to just recently, had had a requirement that candidates must undergo six months of medically supervised diet prior to authorization for surgery. Not that I’m against the concept but thankfully this requirement was recently dropped and hopefully plans can continue as I had originally anticipated - although more expensively now that we must pay for “100% of routine office appointments” and other larger co-pays.
I wonder if visits associated with this surgery are “routine.” To me there’s nothing “routine” about stomach amputation!
In other anxiety-provoking and depressing news, I made the mistake of 1) doing more research on-line, and 2) reading the book my friend Nancy delightedly lent me (Life After Bariatric Surgery), which she’d discovered on a recent library visit. Gak!
Suddenly, fear and uncertainty have overtaken the honeymoon calm of having made my decision. I feel overwhelmed at the “big picture” from pain to recovery to commitments of lifelong diet, exercise, and vigilance as described by those who know. For now, I am subscribing to the “TMI” theory - something my friend often refers to her young nephews saying when they hear something yucky or private. “Too much info! Aunt Debbie, please stop!”
I believe that if I am to stay sane and reasonably centered I will likely need to minimize my exposure to all but the earliest steps - which right now feel overwhelming enough. Even just waiting for the call to meet with the surgeon and begin preliminary medical testing is exhausting and difficult enough, and basically I’m not doing anything yet. In fact, in my second telephone call to the Center I asked if I should be dieting or exercising or something while I’m waiting, and was told that it was OK to just hang tight until given instructions by the surgeon. I ‘fessed up that I’m probably eating even more now as I wait, out of both anxiety and some feeling that each meal may be my last. The lady at the Center laughed and said, “that’s normal, everybody does that.” God bless her 100 times over! At least now I can eliminate guilt from my list of angst-ridden and tortured emotions!
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Did I mention that my husband and I have wanted to buy a recumbent bike for some time now? I’ve been searching Craigslist for a good used one and last weekend found what sounded like the perfect choice for us.
So some days back, after contacting the older couple who no longer have use for it, off we went along a country drive through bigger and bigger snowflakes and frigid weather to “probably buy it.” Only to find the computer inoperational and the husband stymied by its alleged sudden death. Well, we found another even better bike soon after. My husband purchased it while I was at work today and I looked forward to coming home to try it out. Unfortunately, as I busied myself reading the instruction manual, I noticed that “THIS BIKE IS NOT TO HOLD INDIVIDUALS IN EXCESS OF 250 POUNDS!”
I never even told my husband exactly what the weight cutoff was - simply that I had a “little weight” to lose before I could actually use it.
I can’t believe that I’m upset that I can’t exercise! Damn, now what’ll I do? What, lose weight you say? Now, why didn’t I think of that?!
In the meantime, my husband is getting a kick out of his new toy.
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Ack — my husband seems to have lost his wedding ring! In typical man fashion he can’t seem to recall if he even put it on as usual this morning - or when he even last saw it, for that matter. We married in 2001 and he inherited this heirloom ring from his stepfather, and now it may be gone! Despite having belonged to a local metal-detecting group for half a decade and owning our own machine that’s done little to pay for itself through the years by actually finding anything of value, my husband is refusing even to consider using it now to search recently-visited parking lots, our driveway, etc. I just may have to exert energy and calories to do this myself in the light of day tomorrow. What a spectacle I’m sure to make: 300+ pound me, bundled against the Buffalo winter, climbing snow banks if necessary, beeping my way through Aldi’s parking lot. Ha! Made me eat an extra serving of Aldi’s grapes just thinking about it!
In better news, my good friend and co-worker Nancy called tonight just to see how I fared yesterday. What a kindness that she not only remembered about my psychologist visit, but cared to ask - especially in light of those others who seem to avoid any talk of my intention as if I were planning to join a cult or have an affair or something. Although the same friend who’d initially spouted reservations and worries about messing with biology, Nancy has proven to have reconciled her personal feelings (or whatever) enough to have become more wholly supportive in her manner since she first heard the news. Plus Nancy asks intelligent, probing questions that reflect genuine interest, concern, and curiosity - to me, the best medicine for a difficult time and a difficult decision. Unfortunately for Nancy, however, I had quite a mouthful today on the heels of such a disappointing and deflating experience … but, like with any good friend, at least our talk turned even this into something to “file away” and try and move on from.
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What an anti-climactic experience from a long-anticipated day! Today I met with the “bariatric psychologist,” Dr. “L,” as is required. His name itself made me expect a kindly, warm older gentleman - perhaps an ex-fat person with great compassion for those presently awash in extra weight.
Wrong!
This arrogant and insulting man without an ounce of extra weight, my age or so, was “just the facts ma’am” bland and about as jovial as dry toast. Thankfully the sweet young woman who greeted me (and my husband, who was off work for today’s holiday and insisted on driving me) made up for his manner with her kindly candor and sense of humor. When she set me up in the wait area to take the requisite “260 Yes-or-No-questions test” (I knew it would be the MMPI!), it immediately got me chuckling at the inanity of many of the questions; she often laughed with me from behind her desk and even commented that it is the ones who get offended at or take the questionnaire too seriously that she worries about.
As a social worker I am all too familiar with the Minnesota Multiphasic Personality Inventory test, ambiguously worded on purpose to screen out lies and detect any number of possible mental health diagnoses — from psychoses to phobias to depression to narcissism. Unfortunately, I found many questions either comical enough to read out loud (”Do you find yourself covered in gray spots when you get up in the morning?,” or something like that) to my husband (thankfully, no one else was in the waiting room!), or worded strangely with seemingly improper English (Wrongest? Baddest?). Plus, there were those questions that cried out for “maybe” or “sometimes” options because I knew that answering yes or no would either condemn me as mentally ill or as a liar - e.g., “Have you ever stolen as a child?” (Y = Klepto Kiddie and N = Liar, as every kid steals!).
The test aside, my ensuing 45-minute meeting with Dr. Bland was similarly insufferable despite my best efforts to liven and loosen him up. While conducting a rather transparent mental status exam on me (”Spell world. Spell world backwards. Where are you right now? What day is it?” Aack!), one of the directives was to write any sentence on a piece of paper and then hand it to him. I wrote: “I hope I don’t flunk this mental status exam!” which he then read without even an eyelid flutter of humor. And as to the Q&A opportunity I had expected, the “doneness” of our process became apparent when he abruptly got up and ushered me out without even asking psychologist-like things such as, “Anything I can answer for you?” or “How are you feeling with things now?”
I must admit I selfishly feel somewhat insulted by how much this process felt all about the requirement that I be sane rather than the forum for reciprocity, questions and answers, a springboard for things to come, or whatever else I expected it to be.
Well, maybe in that sense it may have been the first step of blind compliance and trust in the system to do what it needs in my overall behalf without my thinking so much or exerting too much free will into the process. God I suck at that!
Oh, and a last aside about today: How startled was I to see the name of my esteemed teammate and colleague Dr. H. on the door of the room just down the hall to Dr. Bland in this office building I’d never been to before? Both interested to see where Dr. H. hangs his shingle while in private practice opposite days to ours, and mortified at the thought of bumping into him, I peeked - but not long enough in case the door were to open. If this isn’t a representation of my ambivalence about and inner shame over my patient role, I don’t know what is! Pass the mental status exam indeed!
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All right — this one is downright hysterical. So last night, rather than stare at each other in Barb’s and Rick’s absence, Tom and I invited my longtime size-zero friend Debbie over to stare at both of us instead. She is wonderful hang-loose company - you know, the kind with whom you can just watch TV, talk, snack, and vegetate. In fact, this has always been our favorite thing to do together, aside from travel in my younger, heartier single days when she and I used to do everything together. Now she is more like “Jackie” on the Roseanne show - blending in with Roseanne’s and Dan’s everyday routine, comfortable and familiar.
In any case, she was (of course) one of the first friends I’d told of my surgical plan. Although I thought I had explained somewhat what surgery entailed and eagerly shared what I was learning about various aspects of the process, I guess I’d never given her a quiz (like the one I’d had to take on-line!) to be sure she “got” it. So, here we are talking late last night about future plans, hopes, expectations, etc., and somehow she mentions her belief that I am likely to be much thinner soon. It takes me some time to understand and absorb what she was saying - only to realize that she actually believes that this bariatric process is going to unencumber me of my weight while on the operating table! I still can’t quite imagine exactly how (I think she’s been watching too much Sci Fi TV!), or just what she thought I’d come out of the O.R. looking like - but, COOL!
I was never so sorry to have to burst anyone’s bubble in my life!
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Tonight Tom and I were scheduled to have our friends Barb and Rick over to reciprocate for a terrific time and meal shared at their house over Christmas. At that time, we feasted on a seven-course meal partly made and partly ordered, including the best French onion soup from a “famous for it” restaurant down the street from them and cake for dessert. We discussed concepts of obesity, diet and exercise and health throughout the meal, especially owing to the fact that Barb also struggles with weight problems, as does her grown daughter.
Even more interestingly, following dinner, they had presented us with our Christmas present - a gargantuan tower of Hickory Farms candy and snack items wrapped in about ten various-sized boxes stacked together in the shape of the Great Pyramid!
So, to get them back - I mean, reciprocate, dinner plans tonight were to include our favorite Mexican restaurant near our house, possibly complete with flavored Margaritas, and then our friends were to be treated to stories of my intentions for gastric bariatric surgery. I know this timing and dying art of overeating bad (or good, depending what basis you judge by!) food with good company is hokey - but really, where better?
Well, unfortunately (or fortunately) for them, they had to cancel - leaving Barb to be told on the phone instead. As I expected, she was intrigued, concerned, but very receptive to information about it, citing a wish for her daughter to possibly consider this for herself someday. She made clear her intention to watch closely how I fare to help determine the efficacy of this for her loved one - and I mostly feel proud and happy to provide some kind of template that may prove helpful to them.
In fact, journaling here provides me quiet hope that someday even others may read these “memoirs” and benefit in some way from this journey.
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Tonight my husband and I had dinner with a single girlfriend of mine whose friendship dates back to graduate school (about 25 years ago). Although thin herself, she watches “Biggest Loser” religiously (while snacking!) and, I thought, understood the difficulties of the obese. I had purposely invited her tonight to talk to her - but was surprised at her response and chagrined at her apparent lack of support.
Her first reaction was that I hadn’t tried everything yet and that I haven’t even dieted for a while now. When I explained my lifelong struggles and the weary, hopeless state I now found myself in when it comes to traditional methods without the edge offered by bariatric surgery, she cited Biggest Loser’s methods instead and asked me if I’d considered changing my diet (again!) instead. When I told her I found this insulting, as if I’d neither thought of this before or tried it before, she said that her intention wasn’t to be insulting but that she felt there were better ways to lose weight. Sigh! And, as if this weren’t painful enough, throughout the evening she randomly added comments ranging from, “So, you’ll never get to eat ______ again?!” to “No more buffets for you!” to “Oh, geez, I bet we’ll have to limit what places we get to go to when we’re together like we had to in the past when you were on xyz diet(s)”.
My husband was noticed to go largely silent and, despite my best attempts to advocate and inform, my girlfriend never really relented and ultimately left with clear misgivings, prejudices, and preconceived notions about me, obesity, and bariatric surgery.
I know that she is a long-time, loyal, and caring friend, but I must admit that not only was I taken aback but deeply offended by her lack of even feigned support. Another note to self - further talks with her (and to Tom, etc.) are necessary.
I will clearly need some guidance in the management of external and internal reactions. Admittedly my girlfriend’s reaction, although understandable and maybe even typical in some ways, does raise some questions for me (What can I really eat? What will life be like?) that are troubling and reflect likely changes in all of life’s dynamics and in important relationships currently spent with food as a centerpiece.
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Today I had to work a long day as we had a 5:00 staff meeting after normal work hours. I have been aware and had reinforced at the meeting that our little “Health Care Center” is both facing a Medicaid Audit and about to transition to an alternative operating mode (possibly by March 1st, we’re told in the meeting). It is not exactly clear what this will entail, but secretly I sit wondering, at each timeframe referenced, where I’d be at that point in my journey. Mostly I worry about when I would need to take off, and especially if this would interfere with my supervision of my student (whose last week is in early May) or the “feelings management” clients group we hope to co-lead thru early spring.
Finally, unable to contain my feelings and at a timely point in the meeting, I reveal my intentions to my bosses and co-workers - five social workers, a mental health counselor, and one psychologist. Two already knew about it, and I prefaced what I said with this, as they are my good female friends when not at work.
Interestingly, colleagues said little, other than Zoe’s offer of “support” and my supervisor’s (Mary Ellen’s) congratulations, reinforcing of my need to do what is healthy and necessary for me, and offer to take on my student if I must leave before her tenure.
Although the otherwise silence was awkward, I can certainly understand the muting effect that such a pronouncement can have. And exactly WHAT are people (even those trained in human wisdom) supposed to say? “You are fat!” “Good luck,” “Good for you,” and “Way to lose, girl!”
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All right, today’s the “big” doctor day and wimp me has asked my friend to accompany me for moral support. We’ve even made lunch plans for after to either celebrate or so that once again I can drown my sorrows in food. NOT the right answer!
Surprisingly, my blood pressure was only a tad high (128/88) when the kindly nurse practitioner took it, along with my oxygen level and WEIGHT. Once again I’d gained “a few pounds” since last appointment - this time with mixed feelings both as I hoped if necessary it might bolster my case for bariatric surgery, and because I finally have hope for real weight loss in sight.
Interestingly, the nurse practitioner was totally unaware of the purpose of my visit (despite my clarity on the phone recently when I made the appointment), which made me that much more nervous when I had to explain all over again. I even brought photo representation of my ups and downs and lifetime battles with weight, starting in infancy (really, you can see them too!) in case anyone doubted my attempts or history. When I showed her (I think she humored me by looking), her primary comment was that I was a “cute baby” - not exactly the response I expected.
Before she went to retrieve the doctor, I shared my apprehension that he might “yell at me” for my decision; she not only pooh-poohed this, but (I love this woman!) told me that he has referred others for bariatric surgery with great success!
When Dr. T. entered the treatment room in a booming manner, his first words (yelled!) were, “What were you thinking?!” I nearly jumped out of my seat before he laughed and said the nurse practitioner had told him about my fear of his reaction. He then reassured me that he was pleased with my decision and thought that, with my age and the fact that I’m still in relatively good shape “despite myself” (ha ha!), I’d do fine. He added that he knew I’d struggled for a long time (at which point I once again whipped out my photos); he was compassionate and warm in his overall understanding and acceptance of my decision. He agreed to complete all necessary paperwork to prove medical necessity, etc., on my behalf, and I was heartened by his respect for my feelings when he whispered to his support staff my intention and the requirements associated with it, to ensure their cooperation.
When I asked him why he had not suggested bariatric surgery to me in the past, he mirrored what the nurse practitioner had also just told me - that it is not his place to recommend radical and potentially dangerous surgery, but rather healthy lifestyle changes instead. I guess I get this.
Lastly, the assistant accompanying him also seemed heartened by my choice; whereas she is usually mostly silent as she does the doctor’s bidding, she now took the time to tell me about a patient and a friend of hers who had successful bariatric surgery and has lost 80 of her 100 excess pounds so far and “looks and feels great.” Yes — there is a God!
After the appointment, I couldn’t wait to tell my friend Debbie how it went. We “celebrated” with a nice lunch. Strange irony, I found myself talking about fears associated with my husband’s reactions and feelings, and worries about early signs that our marriage may become sorely stressed by significant changes I make. I have rather obsessively been watching episodes of “Ruby” on the Style Network, as well as “Big Medicine” and all of the “half-ton” people specials on Discovery Health Network. In some episodes I’ve paid special attention to spouses’ reactions to their wives’ or husbands’ decisions and changes, including one episode in which a divorce nearly occurred (and, without psychological intervention, probably would have). The doctor in “Big Medicine” was noted to say that people shouldn’t underestimate the dramatic effect on family, too, and the possible concerns that may arise from this. I wonder if I should plan to discuss or make a plan for addressing this issue when I meet with the psychologist next week. A very scary concept but, as with everything, perhaps awareness, prevention, and communication will be the best solution.
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I was born a fat white child. Really, I was. In 3rd grade I remember my teacher sending home a note that I had gained 30 pounds (!) that school year and that the school requested my parents’ attendance to discuss this alarming matter. Although I don’t remember this meeting being discussed or its outcome, I recall new words being used to describe me and semi-hushed conversations that made me know I must be bad.
My mother’s beloved sister, my aunt whom we visited most summers in Michigan, tended to reinforce this belief by ensuring I dieted each visit, noting with histrionic concern that I had a problem that “must be controlled.” So, when her children and my brother were indulged with summertime goodies and vacation treats, I was taught that peanuts have 6 calories each (what’s a calorie?) - gasp! And that nobody would want to marry a fat woman. At eight and nine years old!
By the time I might better have grasped the concept of calories and developed a comprehensive (a la the 1960s and ’70s) sense of nutrition, all I knew was that I resented the hell out of this aunt and her shaming, judgmental manner, whether intentional or not.
Unfortunately, she, both as a fashion plate herself and as an embodiment of society’s view on obesity, became the template for many others to emulate, including others who professed to love me. Affecting not just my relationship with them, but with myself and my body as well. Till now. I hope.
My husband and I went out to eat tonight. I’ve sort of been dieting (again; always; so what else is new?), sort of. Last year I nearly gave up. Even when my doctor threw new ideas my way (e.g., obesity clinic, medication changes) I accepted referrals but knew I was unlikely to follow up any more as I’d hit the wall. No more, please. Tired of trying, and mostly of failing. I weighed over 100 pounds less in 2001 when I married my husband - and 100 pounds more than that in 1999 when I discovered Atkins and gave it my all. And 100 pounds less than that when I dieted throughout high school and college to reach my all time low of 115 (for about 5 minutes).
So, now when I go out to eat, my best effort to diet is “sort of.” I’m losing a little, slowly, sort of. Eating less, better choices - but can’t muster the energy or wherewithal for all-out dieting - er, lifestyle changes necessary to save me from me. And exercise - great idea, tough reality. Attempts; binges; joined Curves; walked; gave up; waddled; gave up; vicious circle more vicious as failing body parts sabotage further efforts.
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January 29th, 2009 | 
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