My Bariatric Experience, part 4--Re-emergence

The following blog is part 4 of a series describing my experiences with having surgery on Sept 25 of last year.  I'm writing because of requests I've received from some of my friends.  The surgery and the immediate recovery.

Shortly after surgery,  I visited Dana, my nutritionist.  She got me started on a program called Myfitnesspal.com.  In many ways, this has been as important to my success as the surgery.  I use it every night to keep track of every bite I eat.  It gives me the nutritional value of everything, and a record of how much I eat.

This was important because there were many restrictions. Six hundred calories at first. No more than sixty grams of carbs.  At least sixty grams of protein, sixty ounces of liquids, and sixty minutes of exercise.  I would never have been able to keep track of all this without computerized assistance. 

Every day,  the exercise got easier.  I've been a sporadic exerciser all my life, but this gave me the incentive to make it consistent. 

Before surgery, I thought that the disruption of my life would be short-lived. I was wrong.  This was a commitment that took time from everything else I was doing--time which I could not spare.  Between the record keeping and the exercise, it turned out to be close to an hour and a half a day.  Walking the dog and a stationary bike made up most of my exercise at first.  I had to give up time on everything else.

It isn't a consistently forward motion.  Some weeks I lost more than others.  Some days I missed going out with my wife, eating at restaurants. We still go out, but I was limited in what I could order. Sometimes we would and there would be nothing on the menu I could eat.  I was dropping close to five pounds a week, but it was never fast enough for me. 

Two weeks of liquids.  Two weeks of purees. Two more weeks of semi soft. I looked so forward to my first egg, but when I finally could have scrambled eggs, I almost choked on the first one.  Part of the routine was that I could not eat and drink at the same time, and most foods were too dry, at first. Once I forgot and had water after dinner, and threw it up.  I am on a vitamin routine, taking five supplements a day.

But on the positive side, there were the clothes. I never gave up my old clothes. As I gained weight over the years, I kept my old clothes in boxes.  The summer before, I sorted through my closet and made a pile of clothes that no longer fit. My closet was almost empty of wearable clothes.  Most were too small.  Day by day, more clothes came off the small pile, and before long, most of my clothes from the year before were fitting. 

But more than that,  I was beginning to gain more confidence every day.  People were starting to notice.  Every day, I was beginning to become more thankful to God for the surgery, and what it was beginning to mean for me in my life. 

There are little things you give up when you gain weight, like sitting comfortably in a chair, having clothes that fit, buying clothes off the rack,  turning around while seated, crossing your legs,  or seeing your toes. They go so slowly you hardly notice.  Now, these simple pleasures were coming back.  I was beginning to be grateful for the change.  

By Thanksgiving, I was down over fifty pounds.  I remember having turkey that day, and a quarter cup of oatmeal.  It seemed almost decadent. 

I was consistently exercising a full sixty minutes daily.  I think I only missed three days in the first three months.  My calorie intake was increased to a thousand a day, which made life a bit easier.  By Christmas, I was down almost seventy pounds.  Christmas I received mostly clothes,  which I would have hated before, but now I very much liked. 

I talked to a man before the surgery who was two years out from gastric bypass, and had dropped more than a hundred and seventy pounds.  He said he had a burst of energy at two months, which had not stopped.  With me, the energy burst came much later. But one thing I did notice, my mind was getting sharper.    The sleep apnea was gone, and I was sleeping all night.  I was doing things faster at work, and better. 

Every so often, people would see me that had not seen me before, and they would compliment me on how much better I looked. I can't take any credit for that, I would say. It's God's doing,  through the doctor.  I just followed orders. 

In truth, I do not think I had much choice.  It is my last chance, after all.  At my age,  it was probably the only way I could be free of this excess weight.  God has given me an opportunity to push the reset button on one of my most troubling shortcomings, and I had better take advantage of it. 

Day by day that pile of too small clothes shrank.  Day by day, the pile of clothes that were too big for me has grown. As it has, I've been giving them away. Today,  I have few clothes, not even socks and underwear, that I had before.  I've learned to shop at Goodwill, and other places, as the pile grows smaller. 

As I've been progressing through my recovery, though I've become increasingly aware of how many other people around me are suffering from being fat.  It makes me sad for them, because I know how hard it is for them.  We are a nation obsessed with food, and diet. The more we try to diet as a nation, the more we eat. Every time some well meaning person goes on a crusade for physical fitness,  they only increase the shame that those who are suffering feel. The more we complain about fat, the worse people feel. The worse they feel, the more they eat. It is a vicious circle.  Diets make it seem easy when it is not.  It is nothing but hard work to stay on a track.  I have been really blessed--I who have poor willpower when it comes to food--to have God,  my doctor, and my nutritionist walking with me,  showing me how to eat and live.  I wonder who will help so many others. 

We like to fool ourselves into thinking that there are some other reasons for our problem besides food addiction.  We tell ourselves we are big-boned, that it's just temporary water gain, that we just don't get enough exercise on our jobs,  or that everyone is wearing a gut nowadays.  We also like to tell ourselves that whatever discomfort or physical ailments our addiction brings on is not related to it.  Our difficulty with moving is just because we're getting older, and our joint problems are bad genes. But I can tell you  that for the most part it's hogwash.  If you're overweight, you are paying a toll for it.  You can either pay the toll forever or change your ways. 

The difference between dieting and not dieting is something like the difference between renting and buying a house.  Either way, you have to pay on a regular basis.  But when you buy, you at least have something to show for it in the form of equity.  Being overweight is like being a renter.  Your "rent" will be paid in lost energy, sleep apnea,  diabetes,  joint problems, etc.  You can eat anything you want,  but you also become partially incapacitated. That's your "rent".  If you diet and exercise you pay in lost leisure, lost pleasures, and maybe hunger and soreness,  but all that gets better.  In the end, you gain a healthier,  stronger mind and body that allows you to build up equity in the future.  I'm not denying myself any pleasure, I'm banking them for retirement,  exchanging the constructive for the destructive. This is how I have come to look at it. 

Believe me, it works.  I can already feel the difference.  My old self, who I thought long gone, is beginning to reemerge--more energy, more enthusiasm,  more life--is back.
And I am glad of it.  

My Bariatric experience, Part 3: Surgery

The following blog is part 3 of a series describing my experiences with having surgery on Sept 25 of last year.  I'm writing because of requests I've received from some of my friends.  The surgery and the immediate recovery.

I slept very little the night before surgery.  I got up at four thirty, took a shower, and stepped on the scale.  It read 309. 

My wife drove me to the hospital. We were there a half hour early. I dressed in one of those open backed surgical gowns and put a plastic cap over my head, and felt ridiculous.  The hardest part was getting my wedding ring off my finger.  It had not been off my hand in years.  I had to use soap  to get it off my fat finger. 

They stuck a needle in my arm and started giving me "happy juice."  Joy said I was singing by the time they rolled me down to surgery.  

The surgery took about two and a half hours.  Most of this time was spent in fixing the hiatal hernia, which was worse than they thought.  The main thing I remember about waking up was how tired I was.  Since I had never been under the knife before, I didn't expect that. I was sick at my stomach. There were tubes coming out of me in weird places.   I looked like a target after archery practice.  There were five holes in my abdomen, and something that looked like a large blue tick coming out of my side. When they pulled it out the next day, it felt like a large blue tick  coming out of my side.

Food did not look good.  The only thing I could have was protein drinks,  which I sipped out of tiny little cups. They seemed enormous, though. I wondered.  how I could get an entire protein shake down, even in a day..

The rest of that day, many friends came to see me, and it was a real blessing to have them .   You never understand what's so special about people visiting you in the hospital until you are there.  

 I went home the next day.  People came to see me, and they were most welcome.  My family came over and ate pizza, while I sipped protein drinks out of little plastic cups.

I remember feeling--well, freakish, actually.  So much of our life centers around food. It's the way we enjoy ourselves, and celebrate each others' company.  I had just consented to having my stomach permanently changed, which would change the way I ate from now on. This bond of pleasurable eating which unites us had been broken for me, and I felt like an outsider.  That more than anything, made me wonder if I'd made a mistake.   Would I ever enjoy a pizza again, or a slice of birthday cake?  I was happy because my clothes were already getting loose, but depressed because I was tired. I did not cherish the thought of being a stranger at the table, always eating separately from others. 

But by the third day,  things started to improve.  I started walking.  It was late September, and the weather was perfect. I started walking with a cane, but within a week, I did not need it. I began to realize that as pleasurable as food was, it had been robbing me of other pleasures,  particularly the joy of walking in nature, smelling the autumn air. I was beginning to actually enjoy myself again.  

My friends and family were a great support, constantly reminding me that I'd done the right thing.  It would have been different, I'm sure, if I were socially isolated, but I was not.  Many friends encouraged me, including some who had already had similar surgeries.  

It taught me the value of support in our lives, and bearing each others' burdens.  They were a great support to me.  Without them,  I don't think that all the good things which happened later would have happened.  

I also learned something about surgery, which many people seem to forget.  Mostly, you survive it, and come out better on the other side.  Surgery is not something you want to have.  It's messy,  degrading,  and painful. But if you need it, get is as soon as possible, because,  it really does make you better, generally.

I had heard lots of scary stories about this surgery. It seems that everyone knew someone who knew someone who died of it, or went crazy after it, or for whom it did not work. I don't doubt them, but for every story like that, I heard ten of people for whom it was worth it.  I was one of them.  

In the next two blogs,  I'll tell you what God is doing through it for me.  

My bariatric experiences, part 2 Nine Dark Days

The following blog is part 2 of a series describing my experiences with having surgery on Sept 25 of last year.  I'm writing because of requests I've received from some of my friends.  This describes the time leading up to surgery.

I was delayed for nine months before I had bariatric surgery.  This is  typical of many people who have it. There are many tests to go through first.
I had to have another meeting with my General Practitioner, who was to make the referral.  Then in April I was contacted by the surgeon's office.  The first step was to  attend an informational seminar.  In May I met with the surgeon, who filled me in on what was expected. I had to have an endoscopy, a meeting with the nutritionist and a psychological evaluation before insurance would approve it.  Meanwhile,  my father took ill and died and I cancelled all upcoming appointments until we dealt with more pressing issues.  As I was dealing with my father's death,  the specter of a life-changing and potentially dangerous surgery loomed over me, and there was a heaviness on my soul for several months.  

My endoscopy revealed that I had a hiatal hernia that would have to be fixed at the same time. The nutritionist described the eating regimen that I would follow for the rest of my life--quarter-to-half cup servings, sixty grams of protein and sixty ounces of fluids a day, along with sixty minutes of exercise. No eating and drinking at the same time. That in itself almost put me off the procedure, since walking up a flight of stairs got me winded.  Not only that, but carbonated drinks could potentially send me to the hospital.

Surgery doesn't take off the weight--it only makes the diet more bearable.  It still must come off the old-fashioned way--by eating less and exercising more. 

The last hurdle before surgery was the psychological visit.  Piece of cake,  I thought.  They gave me an online exam to determine if I was a good risk for  the procedure.  While the overall response was positive,  one answer almost got me branded as a poor risk. The question said, "I will change my lifestyle if the doctor tells me I should."  If I had changed my lifestyle when the doctor told me I should in the past, I would not need this procedure!  I had to go back and change my answer.  So finally I passed the tests, and my surgery was scheduled.  

I misunderstood the doctor's instructions. I thought I was to start watching my weight a couple of weeks before my surgery.  He meant that I should start watching it right then, in April.  Instead, that summer, while awaiting my next appointment, I ate like every meal was my last.  So it was no surprise when following my father's death, I put on extra pounds.

On September 16, 2013 I met with the surgeon for a pre-op visit.  Since my last visit four months ago, I had gained fourteen pounds!  The frowning nurse said she was not sure with my sudden weight gain the doctor would proceed with the operation. 

The problem was the liver. In the procedure they have to lift the liver. When we gain weight,  fat is initially stored there. So it can grow to twice the normal size after an eating binge.  In order to have successful surgery, the liver needs to be in normal shape.   

I was  nearly in tears.  I felt like a failure. I wondered if I had come so far only to lose my chance at the end.

The doctor was matter-ofact about it.  He put me on a pre-op diet for nine days consisting of three protein shakes a day, one meal entirely of protein and nothing else.  He said that I must lose ten pounds in nine days, or the surgery was off. 

That night,  after a dinner of salmon and salad, I started on protein shakes. In the middle of the night though I woke in a cold sweat.  Whether it was an anxiety attack or sugar withdrawal I cannot say, but it was a dark, oppressive feeling that prayer would not remove.  By the morning the feeling had passed, but it recurred over the next few days.

I have heard people talk of carbohydrate addiction.  I always thought is was psychological, but now I know it is as real as heroin addiction. There were moments I would have taken hostages for a Bojangles biscuit.

I thought about St. Anthony, one of the fathers of monasticism. Just after he went to the desert he was being beset by demons.  He wrote that they were all the temptations of the world he had left behind.  He never kew the power of them over his life until he left the world.  So it was with food,  as I found during that nine day fast. It's not until we stop a behavior that we understand how completely it grips us.  Getting away from carbs caused me to realize how much of a captive to food I actually was.  At times, I couldn't think of anything else. 

Even so,  it became a crucial experience to me. Other joys became much more real.  Stuffing myself with food was easy comfort,  but I had numbed myself to more important things. The problem with addictions is that they dominate the pleasure centers in your brain so that nothing seems good or pleasing without them. I had trouble conceiving of a life without comfort food.   As food recedes in importance, other things fill their place. Food had comforted me when I was down,  but it should never have been my comfort.  It's fuel--that is all.  Using it for comfort made it into an idol. 

Looking backwards on those nine days, I learned that we can get over addiction if we are willing to face the pain.  Those nine days did more to assure my progress than the surgery itself.

By the end of those nine days, I had lost fifteen pounds.  The doctor said my liver was perfect.  

My Bariatric experience--part 1 Facing Surgery

I've been off my blog for almost a year.  It's not because things have not been happening, or that I have had nothing to share, but because I have been too busy in life to stop and write about it.  I have been told that this is a selfish attitude, since much of what has been going on I should have shared.  But I also confess that sharing attitudes and opinions about big ideas and concepts is much easier for me than sharing personal stuff about myself. What has been going on in me has been very personal.  Ten months ago, I underwent bariatric surgery and to date I have lost more than one hundred and seventeen pounds.  But I have not posted anything about it on my blog, in spite of urging from a few of my friends to do so.  I wrote about it, but kept it private.  Sometimes, I think big things are better shared after the fact, when we have the coolness of past reflection.  Now that almost a year has passed, I am finally getting around to writing about my own personal struggle, and what God has been doing in me through it. 

I do not write these blogs to advertise for the kind of surgery I had, nor do I recommend it to others unless they and their doctors have already come to that decision It's a purely personal, difficult choice, and it is definitely not for everyone.  But for those who are compelled to it,  and for those who live with the obesity struggle,  I hope you might find some encouragement and enlightenment in these blogs. Most of them were written a few months ago,  during the recovery time.  I hope you enjoy them.

The next few blogs are going to be very personal. 

It all started in January of 2013, when I visited the doctor.   I was  59 years old  My doctor has been very concerned about my weight.  I had been diagnosed with hypertension, and sleep apnea, and now my blood sugar was creeping up into the diabetic range.  He said that if I did not get my weight under control, I would soon be a full-blown diabetic--in fact I could be considered a diabetic now, by some estimates.  

None of this was new.  All my life I had been in a wrestling match with my own fat.  Two years before, I recently failed at Weight Watchers for the sixth time.  After managing to lose forty pounds,  I gained it all back, with interest. Over forty years, I had lost approximately three hundred pounds, and gained  it all back.  
"maybe you should consider bariatric surgery" he said.

 I didn't want to hear it. His words were to me the ring of defeat.  He was saying I needed surgery to do something I ought to be able to do myself.

 I didn't know why I was fat.  Was it lack of willpower, upbringing, environment, heredity, or all of it together? I deeply resented the thin people who think they knew--who made snide comments like "Come on, man just push away from the table."  They never realized how many times and how diligently I had done all that, and still found it hard to lose.  I have to forgive them--people who think it's all about willpower and control are just ignorant.  If a fat person could change his or her status as fat person, they would.

People who haven't been there  don't know what it's like to grow up a fat kid, or how aware you are of your weight all the time.  Your size is reflected in the eyes of every kid who picks you last in a ball game, or laughs behind your back, or calls you names.  In a world where people are judged mainly by appearance,  no one has to tell you that you are fat.  You have to be twice as good to be taken half as seriously.

Over years of going up and down in weight, it's pretty easy to notice the pattern.  Weight down-- people notice and respect you. Weight up--people don't.  Only by being smart or funny or working harder than others  do you receive the same attention good-looking people receive just by showing up. 

Now, I was being  offered a chance to change all that, for the sake of my health and well-being.

I asked my doctor if he were in my place, would he do it.  "Bariatric surgery is  like bankruptcy," he said. "You don't want to have it, but if you need to, you take it."

I asked him, what were the odds at my age of winning the war against fat at my age without surgery?   One in a hundred, he replied.  This rings true to me Most people I know are gaining weight, not losing it.  My whole life had been adding fat, not subtracting.  What were my odds with surgery? About  three out of four. 

I've never had surgery before. I've never been seriously ill, so I was very anxious.  But when I thought of my friends  and relatives, especially the fat ones,  I realized how blessed I actually was.  Most people my age and my size have serious health problems--joint problems, diabetes, apnea.  I am not sure whether or not obesity leads to early death, but it certainly does lead to incapacitation in old age--mental problems, joint problems,  metabolic disorders, even cancers.  I see myself at the beginning of the most significant chapter of my life, not at the end of my usefulness. I could use seven or eight years of more and better health.

I did not want to do anything out of vanity.  It does not matter to me whether or not people see me as good looking or young. But it does matter to me whether or not I can effectively be what God had given me the freedom to be at my age. My weight is and has always been an impediment to that.

I wasn't yet convinced. The thought of having to resort to surgery sounded like a capitulation to moral weakness. 

Then I remembered the words of Jesus.  "If your right hand offends you cut it off." You can't always win by willpower.  Sometimes, you must cut your losses and go forward.  Freedom,  however achieved, is better than bondage, and health is better than sickness.  

It took me months to make the decision.  Then there were months of appointments and tests to satisfy insurance.  During that time, my father died,  and that set me back three months.  We also had to deal with various other emergencies. on September 25th, one week after my sixtieth birthday,  I finally had it. 

In the next blog,  I will share about the events leading up to surgery.  They are also I hope helpful  to better understand what obesity and bariatric surgery means for those who experience it.  My experience are  my own,  I do not suggest they are the "norm," but as with this blog, I hope my experiences will be helpful.