Sleeve to Skinny

Photo Credit: MidMichigan.org (http://www.midmichigan.org/conditions-treatments/weight-management/bariatric/sleeve-gastrectomy/)

Next Tuesday, I will be having weight-loss surgery, and I have learned it is not an easy solution, but I do think it is the right solution for me. This is something I have been researching and thinking about for a long time, but I never really talked about it to anyone other than my husband. And even then, he was still surprised to hear that I really wanted to do it.

For the record, I am 100 pounds overweight although many tell me I don’t look it. They are wrong. I do look it. I can see it, and more importantly, I can FEEL it. I notice when I sit in a vehicle and feel the seatbelt latch in my butt cheek because my butt is wider than what the seatbelt was made for (that is embarrassing and something I’ve never told anyone before, but I’m not stopping there). I notice when I grab the seatbelt to latch it and have to readjust it by a lot because the last person to use it was a skinnier member of my family. I notice it when I wake myself up snoring. I notice it when we go camping for a week, and I don’t wear my bathing suit or go swimming. I used to love to swim. I notice it when I try on clothes and realize I have a pocket of fat under my armpits that is very visible from the back view.

I notice it when I hesitate before reaching down to pick something up off the floor. I notice it when I ask one of my kids to fish something out from under the table instead of doing it myself because I don’t want to have to put forth the extra effort it would require for me to do it. I notice when I sit on the back of my husband’s motorcycle or in the front of a canoe. I notice it when I sit on anything that floats: a raft, a pool chair, a boat….

And these are the little things. The biggest issue is that I notice how my excess weight impacts my ankle. My ankle isn’t right, and I have been told I should consider ankle-replacement surgery to fix it. THAT surgery scares me.

On June 30, 2011, I went to a weight-loss surgery informational meeting. There were about 15 people at the meeting, and I was among the smaller sized in the room. I listened to one woman heavier-than-me ask, “what if the problem isn’t eating too much? What if you don’t eat a lot, and you still gain weight?” The person leading the meeting was nice in his answer. He allowed that the woman might be right and in that case, weight-loss surgery wouldn’t help her. Later, I told my daughter, who was with me at the meeting, that the woman was delusional. She hadn’t yet done “the work” she needed to. I’m not saying the woman was completely wrong. She might not eat very much, but she was probably eating the wrong things or taking in calories in other ways such as drinking lots of pop.

That was me back in 1999. I’d had my fourth child and lost all of my excess weight. I was skinny again. Then I started gaining weight and couldn’t figure out why. It was only after I started becoming aware of what I was eating and how much that I started to figure out some of it. Clue: For lunch, I tended to have a 20 ounce Coke (240 calories) and a half can of mixed nuts (850 calories). That is over 1,000 calories from one meal. And if you asked me, I thought the nuts were healthy. I just didn’t realize I was eating 5 servings of nuts. I eventually learned how to read food labels and realized those 99 cent “snack bag” of chips were not intended to be “one serving.”

I’ve dieted. I’ve used prescription and over-the-counter diet pills. I’ve lost weight, and I’ve gained it back.

In 2003, I weighed around the 170 range, which was about 20 pounds over for me. I also started a new job that required long hours of desk work, my dad died, and I started eating more fast food since I was rarely home to actually cook. In 2006, I was working full time as a journalist, part time teaching, going to grad school full time and everything involved with being the mother of four and the wife of one. It was a lot, and my day began around 6 a.m. and didn’t end until around 11 p.m. For most of that time, I was not at home and spent at least 4 hours of that day driving to work and school and home again. I ate a lot of fast food. By the end of 2006, I was at my highest weight ever: 250 pounds.

By March 2007, I was able to get down to 207 pounds, and I had high hopes of dipping below the 200 pound mark — a goal that many call “onederland.” I never made it. The weight started creeping on again.

It can take me 2 months of very careful choices to lose 10 pounds and 1 weekend of 1 or 2 bad choices to gain it back.

At the end of that informational meeting, I heard I could have my surgery scheduled in as few as six weeks. I was shocked thinking that could never happen. I left the meeting thinking I’d love to get one of the three procedures described, but I didn’t think my insurance would cover it. I know so many people have had problems getting their insurance to cover this type of surgery. I went home and talked to my husband about it a little and forgot about it when we went on vacation.

A week later, we arrived home to a message on my machine from the weight-loss surgeon’s office. Did I want to go forward with surgery? I did. I started doing more research and found www.verticalsleevetalk.com . I started reading everything I could and started getting hopeful.

I called my insurance and found out the surgery was covered and no pre-approval was needed. As long as I qualified, it would be covered just like any surgery. I qualified.

I was feeling pretty good about all of it and then I saw a photo posted by someone who had just had the surgery 8 days before. The photo was of her belly, and I looked at that photo and got queasy. Her stomach was full of bruises and stitches, and it looked painful. Did I really want to do this?

I kept researching and learned more about the actual surgery and what I can expect in terms of pain. It isn’t pretty or easy.

****Warning, the squeamish might want to skip to the end of the next section. There aren’t any pictures, so scrolling on by will be OK.****

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For the surgery, I will have several smaller incisions made in my stomach area. One will be where the doctor inserts a camera. The others are for the various tools. My belly will be bloated by gas to allow the surgeon to see everything clearly. In the surgery, the doctor will cut off 85 percent of my stomach and staple along the cut line. It will make a football-sized stomach the size and shape of a small banana. This bariatric surgery is called a “sleeve.”

I decided on this option because it doesn’t require anything foreign being inserted into my body like gastric banding (lapband or realize), and it doesn’t require any rerouting of my intestines like a gastric by-pass. Still, the sleeve is a permanent change to my stomach and can’t be reversed like gastric banding can. The sleeve is a new option in weight-loss surgery, but it isn’t a new surgical procedure. It has been done as the first of two surgeries for patients who were extremely obese. The sleeve allowed those patients to lose enough weight to safely have the more traditional gastric bypass.

The 85 percent of my stomach that is cut off will be removed through one of those small incisions. I will be in the hospital for two nights and three days.

When I wake up from surgery, I will most likely have a lot of pain high up in my chest. It is from the gas pumped into me to bloat my stomach area. I will need to start passing gas to make the pain subside. Isn’t that a pretty picture?

There will be a drain, and this part is pretty gross. The drain needs to be emptied, and I may still have it for the first week after surgery when I’m at home. It needs to be regularly emptied, and the stuff inside it starts out at extremely gross and may get to “really gross” but always remains gross. It is from the site of the incision inside.

Remember how bad I thought the picture of someone’s belly (the outside of the belly mind you) looked? By comparison to what the inside looks like after this surgery that outside stuff is a mosquito bite. Annoying but mild.

The drain may not be removed for a week or two after the surgery.

Other stuff about the surgery is pretty normal for surgeries: anesthesia, breathing tests, massage wraps for your legs and maybe not so normal — a catheter for the first day.

It’s surgery. It isn’t pretty, painless or easy.

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*** The description of the surgery is over. It is OK for the squeamish to read again. ***

Prior to the surgery, I have to be on a special diet. It involves lots of protein and avoiding caffeine, carbonated beverages, alcohol, sugar, fats and carbohydrates.

That means it has now been about 5 days since I’ve had any wine or beer or bread or pasta or hamburger. I can eat all the veggies (non starchy veggies) I want. And I’m OK with that. I’ve always loved salads and veggies and the things my husband jokingly refers to as “rabbit food,” so I don’t feel that deprived. I also like chicken. I’m not a big fish fan, and fish is a source of lean protein. I might need to change that in the future.

It is a different way of eating. Many of my family’s standard meals are things I can’t eat right now. In preparation of my special diet, I stocked up on some lean meats including tuna. It wasn’t until after my diet started that I realized I couldn’t eat that tuna on bread or crackers. It took me a bit to figure out what to do with it.

For the last three nights, my dinner has been pretty similar — a salad with a lean meat (3 ounces) and a tablespoon of salad dressing. It’s yummy, but it is different than what the rest of my family eats.

After the surgery, my diet will be even more different. For the first two weeks it is a sugar free clear liquid diet with lots of protein. After that, I progress to full liquids for another six weeks. That’s right. Two months without food I can chew. The next step is “mushies,” which is soft foods (think baby food consistency).

Many people have suggested that I just skip the surgery and just do the liquid diet. It sounds simple, right? I’d never be able to do it. After my surgery, a half-cup of liquid will fill my stomach. I’d never be able to take in enough liquid to fill a football-sized stomach in order to feel satisfied. It isn’t a lack of will power. The comment also doesn’t take into consideration all of the times that I’ve lost weight in the past just to gain it back.

This surgery isn’t the complete answer to weight loss. It is also a chance for me to relearn how to eat and what to eat. It forces me to take it slow because my stomach is healing. It helps me change my taste buds and learn new ways to shop, cook and eat. It gives me time to change my habits and mind set about what to eat and portion sizes.

I will never be able to eat like I did in the past not because the surgery will prevent me but because I don’t want to end up back here again. After surgery, there is only one thing that my surgeon’s office said I shouldn’t ever have again: pop (or if you are from the South, soda). Carbonated beverages aren’t good for small stomachs. I can deal with that. In the past, I’ve gone as long as a year without drinking pop and even now I’m not a big pop drinker. There are some things that in the past I’ve eaten regularly in the past that will become occasional foods. I am also going to start thinking about quality more rather than convenience.

The surgery shouldn’t make me feel nauseous or cause a lot of vomiting. If I do feel that way, my understanding is it is because I am doing something wrong — eating too fast or taking too big of bites.

Before my surgery, I had to do a number of things. I needed my doctor’s referral, an endoscopy, a sleep study and finally my insurance required a psychiatric evaluation. I passed all of these things. (Yes, I have been certified sane. Some of you may be surprised to learn that.) I also took a four hour nutrition class.

As part of my surgery, I will get a couple of appointments with a personal trainer as well. I will be taking advantage of those after I’ve had surgery and healed a bit.

My goal is to lose 100 pounds. My doctor said my ideal weight is 135, and I that I should make my goal in the 135 to 150 range. My senior year of high school, I weighed 145 pounds. For those of you trying to do the math, I currently weight 250 pounds; yes, I’m back at my highest weight.

My surgery is scheduled for next Tuesday, August 9. I’ll be out of the hospital Aug. 11. It’s a journey to a healthier to me.

And that date? It is just under 6 weeks from the time I attended that first informational meeting.