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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.
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.
What happened to my protective system of denial and apathy, like “but I have a good life” or “we’re all gonna die form global warming soon anyway!”? How has this New Year, my 47th, brought me such crisp awareness that obesity = sickness = feel bad = soul-sucking, energy-depleting, ego-crunching, mind-fogging half-a-life. No longer can I excuse it, compensate for it, or rationalize it with beliefs like, “but I work and get around OK.” No, I really don’t (any more). I’m often too f’ing tired (physically and emotionally) to be nearly as focused in both work and play, and I dare not push myself because I’ve learned my body will rebel if too much is asked of it any more. As my husband says so eloquently, ”You’re only 47!” - yet I feel 87. Hobbled, achy, out of breath, slow-moving. Lack of exercise has atrophied muscles and I now have poor balance and struggle with steps and simple maneuvers like getting in and out of high car seats. Sometimes I watch my thin contemporaries squatting, walking, taking steps (especially with things like laundry loads in their arms), and crossing their legs - and such simple movements amaze and perplex me. I can barely remember ever doing such things (especially the crossing-of-the-legs thing) and have trouble fathoming how different from them I am. Only when I let myself see and feel, that is. Like now. Mixed blessing, I guess. Sigh.
OK — I’ve done it. Someone online wrote to: decide, commit, then act. I feel astoundingly relieved, light, exhilarated! I called the Bariatric Center after finding the number on-line the other day, and left an eager message in the morning while on my day off. I knew they’d call back because everyone on line had written that they were excellent with such things at this place. However, hours of nerve-wracking silence had to be endured first. Then, when she finally did call it was while I was stuck on the other line with a neighbor seeking advice about roof repairs and I could barely click over, breathless, in time, to sound like the calm patient fat person I had hoped to. Then, while she was in the middle of being flummoxed by the fact that my social security number matched another me from 9 years ago (when I had my past surgeries there ) - the lawyer for a lingering estate matter called thru on the other line (I love/hate caller id!) and I lost her when I tried to briefly click over to ask him to hold that thought!
Once this crisis was resolved and she explained that her only role was to send an on-line questionnaire and video presentation (complete with quiz!) to my e-mail address, I relaxed. I’m not sure what I had expected.
Intent on setting a world record for compliance, eagerness, and timeliness, I immediately retrieved my “package” and set about completing the questionnaire. In addition to all the usual demographic questions, it included pages of questions on weight at different times in my life (e.g., high school, 10 years ago), historic/family/support information, and health history.
Most difficult for me was the required “Diet/Exercise Program” history from the last 5 years (2003-2008) with samples included. “Bob” - or whoever completed the sample - clearly had a better memory and better diet and exercise history than I did! Atkins, Weight Watchers, Nutri-System - you name it, “he” had tried it. What didn’t “he” try!? I can only hope my prior attempts to lose look as pathetic and futile on paper as his do.
Tomorrow I will attempt to do the next step: call my primary for an exam, and to have him complete his “medical necessity” forms and authorize that I won’t drop dead engaging in the required pre-op exercise class.
Oh, and I “accidently, on purpose” told the first person (other than my husband) what I’m considering, and this from an innocent telephone call that began with a dining room set for sale and ended up with her concerns about my “messing with what nature/God gave you.” Her being an organic-minded, Italian, homeopathic, skinny woman in her 50s, just what did I expect? Not that she was hurtful, dissuasive or a naysayer - just a realist and skeptic … I guess. I’m sure she’ll remain a great and loyal friend, support, and help. I’m OK with her shock, really. In fact, it is shocking.
The thoughts are solidifying and taking form — I can do this; I must do this; others before me have succeeded with this.
I spend the day researching the topic both generically and at the local front. I look up bariatric surgery, bariatric surgery vs. lap-band, dangers of bariatric surgery, success rates of both types, statistics, and side effects. Somehow, whereas the horrors associated with things like mortality rate, vomiting, diarrhea, and other unpleasantries were enough to deter me and send me reeling from the computer in the past, now I merely skim this information and find myself much more drawn to reading aspects of positive change. I especially revel in personal stories of success - and read and reread entries by individuals in particular who have undergone bariatric surgery with Dr. JC in Buffalo, New York - my city, my chosen doctor, maybe soon to be my disciple too!
I am heartened by and feel fate has led me to this Dr. C. He is who has performed both gallbladder (removal) and hernia (repair) surgeries on me in 1999/2000. He is the kindly doctor with the compassionate manner and excellent bedside manners that I remember and have now read others speaking well about as they bare their soul and bodies before him.
I am definitely one who bases every relationship whether personal or medical on not so much the degree, professionalism, or knowledge one possesses, but by manner of relating and degree of empathy. I once ran crying from an exam preliminary to a colonoscopy when the highly recommended and supposedly knowledgeable gastroenterologist hurt my feelings. Only years later and at possible jeopardy to my colon did I carefully hand choose the most gentle, kindly, Doogie Houser like young and cute doctor to perform my colonoscopy without even using anesthesia! (Relevant needle phobia - make note!).
Same with my primary M.D. He seems to care, has a good sense of humor, has apparent compassion, and is strict but not foreboding. This allows me to tolerate comments like: “You’re fat - stop eating a million calories a day!” and “You’re lucky you’re still somewhat healthy despite yourself.” Perhaps I should be appalled, hurt, indignant…horrified. I guess it’s all in the delivery and honesty. It’s hard not to like him and feel he’s on your side despite such comments. Something about the way he conveys humility and genuineness despite it all. And, I can’t help but sympathize with any doctor stuck with perpetually fat and ever gaining me who has developed sleep apnea, diabetes and high blood pressure while on his watch. As a social worker invigorated by others’ receptivity to my guidance and wisdom (ha!), I know firsthand the sad resign that comes when clients can’t or don’t grab hold of life preservers I send their way.
It’s likely though that I’ve embodied society’s view of myself (fat people) as deserving differential treatment, bordering on disrespect, even by their doctors. Perhaps you’re cringing as you read this and I should have cringed as I wrote this. It’s scary that I can’t even tell for sure. Interestingly, when the doctor’s comments were run by a skinny friend of mine who sees this same doctor, she had the chutzpah to be appalled for both herself and me … unless she was just doing so to sound like a protective, sympathetic friend.
Perhaps the answer will come in my 100s (pounds, that is, not years)!
 Donna (Broad in Buffalo) before surgery I’ve always been fat. As I write this, I struggle to catch my breath after walking to retrieve paper and pen to write my memoirs.
Why write about such an embarrassing, grotesque matter at all? Because I am about to embark on what I hope to be a life-altering, skinny-making experience called Bariatric Surgery - i.e., make my stomach the size of a peanut so hereafter I eat like a size 2, not 26/28.
In sharing my early thoughts with my husband, his reaction both hurt and didn’t really surprise me. An exact quote is: “My first wife died at that hospital” (when I gave the broad brush, including the name of the center and hospital that the local bariatric surgeon works out of). Upon further discussion, I know him and understand deeply his concerns at many levels including fear of “losing you,” worry that “you’re doing this for me,” and that he’ll lose his eating partner (something we do well together). Normal worries shared by me - but not appreciated in stereo. Clearly we have lots more talking to do if/as I get approved and time goes by.
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January 12th, 2009 | 
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