In the year leading up to my 30th birthday, I set myself an ambitious goal to lose 100 pounds before I turned 30. It was the first year of my life that I consistently worked out, but the progress on the scale was nonexistent. The entirety of my effort focused on adding activity, not shifting my eating habits.
In 2018, I did Whole 30, mainly as an experiment to see if I could drastically change my eating habits. For 30 days from October to November, I cut out added sugar, grains, dairy, legumes, and preservatives. The goal of this wasn’t to lose weight–in fact if you follow the program strictly you’re not allowed to weigh yourself–but at the end of that month I had lost 20 pounds. The entirety of my effort here was focused on controlling what I was eating.
While of course this evidence is anecdotal, I learned an important lesson through this. At least for me, if I wanted to lose weight, I needed to go to the kitchen, not the gym.
The truth to this has been proven to me time and time again since I started the process of getting approved for bariatric surgery in 2020. In the time between October 2020 until May 2021–in a time where I wasn’t going to the gym thanks to COVID–I lost 60+ pounds solely by controlling my eating.
Since having surgery in May 2022, I’ve had to focus on both the kitchen and the gym–plus so much more. It’s been a period of adjustments–new rules, new foods, new responses, new vitamins. So much new all at once. There have been times where I have mentally compared myself to a new mom AND a new baby. The mom has got a whole new thing to take care of that has a schedule all of its own and there’s a lot of new information for her to take in, but life goes on for everyone else. She’s tired, disoriented, and afraid to make a mistake. But on the other hand, I also felt like the baby, who has *feelings.* It doesn’t know what it wants, but it wants you to know it’s not happy. As someone who has not had a kid, this is the closest analogy I’ve been able to come up with to what life is like post bariatric surgery. Everything is new. (FWIW, I’ve named my new stomach Her Majesty.)
A little after the two month mark, I started feeling like I was finding solid ground. I’d been progressing out of all of the various stages of post-op diets and finally could eat, within reason, normal foods. I was starting to see progress both visually and on the scale. As a creature of habit, I was finally starting to feel settled after 2 month of straight up upheaval.
Right around the 2.5 month mark, I had my first post-surgery trip. After the first leg of my trip was done, I realized that travel itself had been worrying me more than it had in the past; another familiar thing made a stranger by this experience. Before surgery, I could just go and get food wherever. Now, there are certain goals I have to meet: get the requisite amount of protein (80g per day), drink the requisite amount of water (at least 64 oz), take all of my vitamins (way too many). Also for the first time since May 2022, I wouldn’t be fully in control of preparing my own meals–I would be a guest in someone else’s home. It was a lot to process and preparing to travel had me very nervous.
Fortunately, the trip was incredibly affirming and as per usual my anticipatory stress was unfounded. I was supported by those I was visiting. I felt at liberty to get what I needed and was able to adapt what was available to me to fit my needs. Even better, I was able to judiciously sample foods that I had not had before within reason. For example, one evening dinner was spaghetti and meatballs–I was able to eat a protein-packed dinner of ricotta, meatballs, and sauce AND try a few bites of pasta. The best part of trying these old (problem) foods was to see just how little would satisfy me. I was able to try pasta, bread, and even bites of bagel and brownie in the perfect environment. I did not need to bring these troublesome treats into my home and I was stealing bites from those willing to share.
The feeling of empowerment this trip gave me was a huge boon–to my mental health and to my overall satisfaction. I am no longer feeling quite like the new-mom/baby combo; rather, I know I’m in control. The week I got back, I had my 3 month post-op appointment (2 weeks before the actual 3-month mark). I told them about my travel and what I had eaten–slightly fearful they would tell me I had done something wrong. I had also been concerned because I have had very few poor reactions to food. However, they told me I was doing everything ‘correctly’ and the reason that I hadn’t had any poor reactions was likely because I wasn’t eating too much of these foods. Problems–quelle surprise–usually happen when eating these foods in excess.
Beyond these non-scale victories (NSVs), my travel also made me aware of many other such victories. I am able to move my body more easily: I navigated NYC subway turnstiles with my fat body and a suitcase with so much more ease; I did not need a seatbelt extender when I flew; in general, I felt like my body took up less space and attracted less attention from those around me. I gloried in each one.
All of these positive realizations seemed to spawn even more. Since then, I have been able to do more in barre, achieving positions that I had not been able to do previously. I haven’t had a nap in ages. I have energy and concentration the likes of which I haven’t had before. Then, this week, I achieved one of my goals that I wanted to reach by 3 months post-op: I have lost 100 lbs from my highest weight, when I started this journey in October of 2020.
100 lbs seems such an incredibly large number of pounds to have lost. For comparison, here are some things that weigh 100 lbs: a baby hippo (55-120 lbs); grown Rottweilers (95-120 lbs); a 2-month old foal; around 12 gallons of water; 119 cans of soda; and a mother effing cheetah. The mind boggles. In my appointment, I marveled at the doctor about how much easier I was finding every-day things. She remarked that people–especially those who have been morbidly obese for a while–often drastically underestimate the toll that the weight makes on the body. (She did note that not all bodies are built the same and have different limits. I know this seems contradictory to a lot of fat people’s experience in the world of medicine, but some of the best–most humane–treatment I’ve received by doctors has been in the bariatric space.)
The past 3 months have not been easy, but I feel like I’ve turned a corner. I’m not suggesting it will all be sunshine and puppies from here on out, but I feel in control and excited to test out this new normal. I’ve done something I honestly never thought I’d be able to do–the majority all on my own without the help of surgery. All of the NSVs, and to be sure, the scale victory, too, have given me an unexpected boost of confidence.
I’m looking forward the victories and challenges that the next 3 months will bring.
May of 2022 will perhaps go down in history as one of the impactful months of my life. To sum up, I started the month in Bloomington after a quick visit to see some of my BTown loves. About a week or so later, I went to NYC for a conference, and ended that trip by seeing THREE BROADWAY SHOWS with one of my besties (blogs forthcoming on both her blog and mine), and then immediately upon returning home, I began my pre-op liquid diet.
Before I knew it, it was May 23rd the date of my scheduled Roux-En-Y gastric bypass. On of my besties Ashley agreed to be my person at the hospital and I asked her to aggressively document and to contribute to this blog with stuff I couldn’t or wouldn’t remember. Thanks, boo.
Ashley’s stuff is in teal.
The 7-Day PreOp Liquid Diet
On May 15, I had my last Before meal. It was nothing exciting—I definitely gave a tasteful goodbye to food in NYC. It was strange to think about how something as routine as eating food would not be part of my next month or so and how my habits, hopefully, would never be quite the same.
In order to prepare for my surgery, I had to follow a very strict liquid diet for seven days. On this diet I could only consume protein shakes (4-5 times a day), broth, water, sugar free popsicles or jello, and decaf coffee or tea. THAT IS IT. NO VARIATIONS. Drinking off that strict list could put my surgery in jeopardy.
I was expecting this week to really suck. I spent a long time prepping mentally for this week as well. I convinced myself that it was going to be a fun experiment in not having to do dishes for a week (that def worked, yay laziness). I had heard wild stories about this phase—the one that sticks with me is a woman who was cooking dinner for her kids and just desperately wanted to lick her kid’s pizza just to taste the salty cheesy grease. This phase seemed to be the one that people struggled with the most.
I didn’t have a terrible experience. The first day was not bad. The second day, as my doctor warned me, was AWFUL. I was tired, achey, and emotional. I cried in front of my boss. I had a headache and felt like literal and physical shit.
Day 3 through 7, however, felt totally fine. A creature of habit, I quickly developed a routine that worked. Put some decaf espresso in my first protein shake in the morning for a delicious faux latte. Drank another protein shake at noon and at dinner time. Depending on how I felt, I’d usually have one in the afternoon or at night after dinner.
Weirdly, I’m a little nostalgic for this period now because it was SO EASY to drink that fluid. I also can’t stand the protein shakes I had pre-op. Now, post surgery, drinking liquid and getting protein is a struggle. It was so easy to get that protein!
One of the most emotional days of this process was the day before my surgery. I was nervous, excited, and pondered whether I was crazy to be doing this. It was a Sunday so I cleaned my house and made it as ready as I could to not really be cleaned for a few weeks since I didn’t know how long it would take me to recover. I read a book. I cried. I pondered some more.
It ended on a high note, though! I went to get Ashley, who was going to be my person at the hospital. We watched a movie I’ve needed to watch for a LONG time and then tried to go to bed a decent hour since the next day we had to be up EARLY.
I can’t even say it was BRIGHT and early because it was pitch black dark as night when we left the next morning. Unsurprisingly, I didn’t sleep well. I had to chug a thing of gatorade before leaving, but we managed to leave my house at about 5:15 AM to get to the hospital at 5:30 AM. I checked in, then waited for maybe 20 minutes before getting called back to the pre-op prep area.
This is where my anxiety really started to climb. I had to don the operating gown; pee in a cup; got my IV hooked up; people asked me my name, birthdate, what surgery I was having precisely 100 times; chatted with my surgeon, nurses, anesthesiologist, etc.
You did NOT seem overly anxious! You seemed very calm and matter of fact about everything.
Everyone was so nice, and efficient. What a seemingly well-orchestrated machine they have going on.
I may be projecting, but sometimes when people asked “And who do you have with you today?” it felt like they were expecting “partner” or “sister”, but I was just “friend” — and not that they had a LOT of surprise on their faces, but there were moments where I got the impression that wasn’t the answer they were expecting?
(I also got this impression.)
Remember we thought the anesthesiologist may have been attractive? He was nerding out with you about art history, seemed about our age, maybe a tad younger, had kind eyes. And then I found him on the hospital website….. and it was NOT a flattering photo. At least he turned out to be good at his job!
He totally WAS nerding out with me about art history. He had an MA in art history and you could tell he still really loved it. I called myself a “failed art historian” and he said, “well, in that case we both are, and we’re not doing too bad.” Or something like that.
Eventually, it was time. I don’t actually remember saying goodbye to Ashley, though I’m sure I did (she says we high-fived!), or being rolled down the hall to the surgical suite. I DO remember being in the surgical suite and remarking “IS THAT THE ROBOT?” (I had a robotic laparoscopic procedure) and having it confirmed that it was the robot and that one of the nurses showed me where the surgeon would sit to control the robot. And that’s all I remember of before.
The older nurse, with the long hair, very hippie dippie, was soooo sweet and was just bragging on you when I got to recovery. She said you were basically a model textbook patient. Gold stars across the board. Great pre-op weight loss, a perfectly tiny liver, no issues at all going under or coming out (though you were slow to come off it). She was VERY pleased and told me all about it 🙂
Your face looked like grumpy cat for a solid hour.
Apparently, I took a while to wake up afterwards, but my first memory was having two nurses fussing over me and not being very happy about it. I think slowly I realized Ashley was there too. I think I became moderately happy that yay, I hadn’t died on the table (a small risk, but nevertheless one that had worried me). The pain was not too bad, but I was definitely uncomfortable. They had placed an abdominal binder on me and I wanted it OFF. I felt a lot better after it was off, but I still was pretty grumpy in recovery.
Embarrassing/funny story: So after surgery, before they admit you to your room, you need to pee. They pump you full of fluids so usually after surgery your bladder is full. However, since they essentially temporarily paralyzed you for a few hours, your bladder doesn’t always get the message, so they have to drain your bladder with a catheter. WELL. This happened to me. I tried to pee IN FRONT OF THE HIPPY NURSE and it just wasn’t happening. Well, as they were situating everything they asked me to lift my hips and I did, apparently really well—because the nurse said, “nice hip lift!” And I—grumpily and somewhat arrogantly told them “I DO BARRE.”
After recovery, it was time to be admitted. Two nurses came to transport you and I followed with all of our stuff. We chatted with them along the walk, about all sorts of random things including hairstyles and how much they walk around in a day.
We had to trek pretty far and I would have gotten lost if I wasn’t walking with y’all. They pushed your bed manually, until we got out of one of the elevators and to a very long, UPHILL hallway. They pushed the bed into this motorized contraption that pushed the bed for them and we slowly made our way from one building to the other, to go into the children’s hospital… which was REALLY nice and like a total scene change. The nurse you were assigned over there was kinda sassy and reminded me of our friend Lin in her speech patterns and mannerisms. I could tell you were in good hands with her!
Bladder drained, I moved to my room, which was a lot nicer and more private than I was expecting. My room was in the children’s hospital (I later found out that they keep adult patients who are stable there—bariatric patients, orthopedic patients and the like). Not too long after getting to my room, Ashley headed back home and I was in for the night. It was a continuous cycle of sleeping, getting woken up every few hours to be poked and prodded and get meds, drinking water, peeing, and walking around.
In order to go home, I needed to demonstrate that I could keep myself hydrated, that I could walk, and that my pain was under control. Walking wasn’t hard. I wasn’t in too much pain, though I definitely had some discomfort on both of my sides. The hardest bit was honestly getting in the liquids. They gave you four little 1-oz cups and you had to try to drink four of those cups in an hour with tiny little sips repeatedly. It was DIFFICULT. They also brought soup and jello (no thank you) at dinner, breakfast, and lunch time—though I was not interested in any of it.
For my first ever hospital stay, it really wasn’t that bad. I wasn’t in nearly as much pain as I expected, walking around was easier than I thought, but I was a little frustrated I couldn’t just sleep. The nurses were a delight. My last nurse didn’t want me to go home and said I was a “good one.” I got to go home around 1 PM.
Home & Recovery
The ride home was honestly one of the most painful things so far, largely thanks to NASHVILLE’S VERY BUMPY ROADS AND CONSTRUCTION. #potholeseverywhereallthetime
COME ON NASHVILLE FIX THE GD POTHOLES
At home, my cats pretty much immediately glommed onto me and I developed a very lazy routine where I wore the loosest fitting clothes possible (soft dresses and nightgowns), tried to get my water, vitamins, and protein in, and mostly failing that first week (as expected). However, before my one week post-op appointment, I had already stopped taking my pain meds and generally was feeling great. I tired easily, but all in all, I wasn’t feeling too bad. I began wondering if surgery wasn’t so bad, and the first week wasn’t so bad, maybe the transition to soft food is the super hard part?
After two weeks, I moved on to soft foods. I could now eat yogurt, cottage cheese, ricotta cheese, refried beans, vegetarian chili, tuna (YUCK), and vegetables that could easily be cut with a fork. I didn’t have any problems with this transition to soft food–the only thing that occasionally makes my stomach hurt is water–it’s sometimes hard to remember that I can’t take as big of sips as I used to do.
Right now, I’m about a week into the transition to solid/normal food. I was excited to eat a vegetable, something I have not had since May, but I still struggle to eat all my protein. From here on out, I will eat my protein first, then veg, then carb and I will have to pay close attention to my portion sizes and make sure that I listen to my body as I eat. I am starting to wonder if THIS transition from such a strict diet to “regular food” is the hard part—and it’s going to last for the rest of my life! Again it came with a learning curve, but so far it is progressing, slowly but surely as I learn my new limits.
On June 23, I reached a month post-op and am officially cleared to do fun things like zumba (yay!) and get into pools and hottubs! I need to wait a little bit longer for core-centric activities like barre and water aerobics (I love the outdoor classes at the Y in the summer!), but I’m fine waiting a bit on that.
Surgery Done: As I’ve been prepping for this for so long, it’s been wild to actually experience it and be done with the “surgery” part of the journey. It’s done and in the past—no longer something to anticipate.
Physical Restriction: It’s strange to feel the physical restriction. It changes something as basic as how you drink water. This makes it really difficult to get the appropriate amount of water in—at least 64 oz of water a day. It’s gotten easier over the past month but every once in a while I forget and gulp down a sip of water and OW. It does not feel good.
I have decided to name my stomach “Her Majesty” because when she has opinions she demands that you listen to them.
Habit Changes: Both my liquid diet and my post op experience so far has really highlighted how much of what I considered previously as hunger was mind hunger. I imagine this too will be a continuous journey and process of learning. I am physically not hungry and that in and of itself is a weird sensation.
Before, I habitually would eat my meals in a fashion that would save the “best” bite for last. The one that had the perfect combo and ratio of ingredients. Now, I 100% eat that bite FIRST.
There are times where I feel like a teeny tiny baby that’s on a very strict feeding schedule, and sometimes that baby doesn’t want any more protein, but that baby really doesn’t want to lose more hair than she has to (as is typical for most bariatric patients 3-6 months post op, because of the surgical trauma and lack of protein, but then it comes back). And that can be frustrating.
All in all, I am incredibly glad to be done with the surgery part of this journey. But so much of this is still mental and it’s going to be a process and I have a lot to learn about myself and my new tumtum.
A huge, huge thanks to my sisters-from-other-misters, Ashley and Tina, and my Nashville family, Sherra, Winn, Justin, and Arthur, for checking in on me and making sure I had all I needed. Your support was so valuable and I love you all to pieces. Thanks too to my family and friends who were far away–experiences like this really do show a person just how lucky they are.
Perhaps unsurprisingly, I’ve been thinking about my mom a lot lately, with the impending celebration of Mother’s Day and my upcoming surgery.
Since she died 5 years ago, any time big personal changes loomed on the horizon I have felt that familiar swell of emotion that seems to be located somewhere between my stomach and my lungs, overwhelming me physically and mentally. This sensation can last for mere minutes or even long hours.
As I would imagine is normal, I imagine how she would react to these changes and achievements. Sometimes it’s easy to imagine her reactions.
When I defended my dissertation, she would have been proud and so pleased to see the culmination of years and years of work at last at its joyful end.
She’d have celebrated as I taught my first (and probably only) study abroad course (something I always wanted to do!) in Italy in May 2019.
She’d have hurrah’ed when I landed my first post-PhD job (with benefits!) at the Institute.
She would have been proud, excited, and disappointed when I got a job at Vanderbilt and moved to Nashville. Disappointed, because I wasn’t moving back to Virginia, choosing my Nashville family “over her” (that’s how she’d see it), but still she’d have been proud and excited for my accomplishments. She loved me.
But…as my surgery date approaches, I am having a hard time picturing how she’d react to this choice and new frontier.
Mom could—at times—let her own emotional hang-ups color her response to things going on in my and my siblings’ lives. Would her own struggles with her weight have influenced her reaction to my weight-loss goals? Would she have been less supportive than she’d have liked, whether intentionally or not? Would she, as she was sometimes wont to do with others who had gone through similar procedures, make snide comments about my potential to fail or relapse? Would her encouragement be a little too cloying, her smile a little too bright, suggesting that she didn’t actually believe what she was saying? Or worse, and definitely possible, would she barely attempt to contain her unique blend of judgment and jealousy?
On the other hand, she may have reacted excitedly, full of support and pride. She did often tell me to try to lose weight before I got too old, because the older you get the harder it is and the more physically painful it is to try to take it off. My mother lived with daily pain in her joints and back, moving, sitting, and existing was a struggle. I know that this physical pain manifested itself emotionally too. I know she’d want me to avoid that. So perhaps knowing that I will avoid some of that pain in my life would make her happy for me.
But at the same time…would she have even realized that her reality was the very future I am trying to avoid? Even worse, would the idea that I was trying to avoid becoming like her— to not share this daily pain and struggle—give her (more) emotional pain?
In some ways, her death has made this easier. The risk of not taking steps is clear. I need to go on this journey for my own mental and physical well-being. Because I will never know how she would actually react, I can choose to imagine her response as loving and supportive as I would like it to be at any given moment.
However, this too is a hard emotional line to walk, because in reacting this way, her death becomes akin to a gift. One that has allowed me both the freedom to act without causing her hurt and provided me the motivation to change….
How could her death ever be a gift?
Right now, I like to think that my choice to pursue a WLS and strive for a healthy life honors both her life and her death. My mother wasn’t perfect. (I mean, whose mother is?) In many ways, I am on this obesity-related journey because she was. Since, in the long run, my mother would want the best for me, I’d like to think that she’s pleased by my choice to move forward with a gastric bypass, hopeful that it will work, but fearful that it will not.
Finally, I have a date for my surgery, and it will take place in late May.
I’ve decided to answer some questions here that I have been asked often since deciding to go through surgery, and a few I think people probably have even if they haven’t asked directly. I plan to update this at a few points after surgery to compare.
Q: What made you decide to get bariatric surgery? This seems drastic.
It was a decision that was simultaneously gradual and all at once. I didn’t realize until recently how long it had been in my head. Ultimately though, there were several factors that led me to this decision and kicked my butt into gear.
I’ve seen very clearly what can happen if I don’t get certain habits under control through my mom’s example. This is a thing I’ve known for a long time, but have not been very successful altering on my own or with many of the “commercial” options out there (noom, weight watchers, etc). I am an emotional overeater. I can literally draw lines between certain life changes and stressors to moments when I gained weight, exactly 20 lbs each time in most cases. This incremental growth is not unlike what I saw happen to my mom. I wanted to break the cycle.
As for the timing, several things all became really clear to me when I turned 35 a few months into the pandemic. There are things I want in my life and I was tired of feeling stalled. I had gained a pandemic 30 (more than my usual 20). I want a kid. I want to be more active and I didn’t want to tire quite so easily. I know that you can do and be all of these things while being fat.
It is hard to be in my body physically as it presently exists. Of course, lots of the external things that make it hard could be (and should be) shifted to easily make room for bigger bodies—seats on planes, societal expectations, etc. However, there were lots of internal things. I was beginning to feel constraints—things that were harder than they used to be because of my size. Some recurring issues that were directly caused by being overweight. I didn’t always feel as stable on my feet. It was becoming harder to get up and get down and get comfortable.
I have always been fairly physically active–and I’ve definitely kicked that up since 2019. This past week, I danced my ass off for 2 hours with no breaks with 3 super high-energy dance instructors. Every jump, every skip, every move, while carrying double the weight of the people around me. It’s, I can only imagine, doubly exhausting.
I knew all of these problems wouldn’t get better with age, and I want to get myself in the best shape possible for (hopefully) pregnancy, childbirth, and parenthood, and just simply for the rest of my life. I want to have more endurance. I’d like to be able to walk farther, go longer, and dance harder. I’d like to trust my body to be capable of things it hasn’t and hadn’t been able to do in the past.
Q: What procedure are you having? What were your choices?
There are two types of surgeries that were on the table: a roux-en-y gastric bypass and a sleeve gastrectomy.
Both surgeries, in essence, make the stomach smaller reducing the amount of food you can consume in a sitting. Neither surgery is a magic pill and neither will work without hard work on the part of the patient to change various behaviors.
A sleeve gastrectomy involves removing the lower part of the stomach so that it resembles a sleeve and is vaguely the shape of a banana. The pros to this surgery is that it is less invasive; it’s a shorter surgery and a simpler procedure. The cons are that it tends to not work as well—folks frequently regain the weight and or need surgical revision to a bypass; it can make worse or cause new acid reflux problems; and the weight loss tends to not be as profound.
The RNY Gastric Bypass is more involved. It makes a small pouch out of the stomach and connects the small pouch to the small intestines thus bypassing most of the stomach, the pyloric sphincter, and the intestinal duodenum. The pros are that the weight loss is more profound and sustained over time and it can often cure GERD/acid reflux. The cons are that it is a more complicated procedure, and thus more dangerous.
Both surgeries tend to see obesity-related illnesses and side-effects reversed or see them under control, like Type II diabetes and high-blood pressure. (On the other side of the coin, 15% of people who go through weight loss surgery become alcoholics. They replace food with booze.)
I am having a RNY gastric bypass. I have had issues with reflux caused by postnasal drip/allergies, so the sleeve wasn’t a great choice. Additionally, at the beginning of my weight loss surgery journey, if I lost 200 lbs, I would still be considered overweight (according to BMI calculators, which is of course, a questionable indicator of health).
Q: What is your goal weight?
I don’t have a goal weight and contrary to what a lot of people think, my doctors have not given me one. Generally, you can expect to lose 70-80% of your excess weight. For me, that would be around a loss of 100 lbs post surgery, and I’ve already lost 56 lbs in the prep stage.
I think my goal would be around 120 lbs post surgery. This, as absurd as it may seem, would still put me in the overweight part of the BMI chart.
Q: You lost weight before surgery, why not just do it naturally/why are you taking the easy way out?
Dude, this is hard. I lost 56 lbs, but since moving, I have maintained but not lost much. I’m okay with this, and I see this as success in and of itself. The more weight you have to lose, the more stalls you have and the easier it is to backslide. I’ve seen the reality of this in the months since moving to Nashville. Surgery is a tool to help me both lose weight, but most importantly, to assist me in getting some unhealthy habits under control. The program I went through helped me to, for the first time in my life, NOT gain 20 lbs during a major life change. I eat relatively healthily, I work out three times a week and I’ve seen no movement (in inches or lbs).
Q: What did you have to do before surgery to qualify?
The first time around: I had to do 6 months of supervised weight loss, a psychological evaluation, an appointment with a nutritionist/dietician, and several meetings with my surgeon.
The second time around: 12 independent meetings that could consist of meetings with my surgeon, dietician, a psych evaluation, screening for sleep apnea, etc. The meetings from my previous office counted toward the 12. I had to do the psych evaluation over again and that definitely was frustrating, and took a very long time to get straight.
Q: What is recovery like?
This seems to vary widely. I will stay in the hospital at least one night, and then will be off work for at least a week. My work is an office job and I work primarily from home, so I’ll play the weeks after that first week by ear.
The surgery will be done by robotic laparoscopy so it won’t be full open/large incisions, but several smaller incisions. Some people bounce back quickly, others take longer.
It’s hard to know where I will fall! I’ve only had one minor surgery on my hand, not much pain, but sleepiness. This is entirely different.
Q: How have you been preparing mentally and physically for the surgery?
Oh boy, the prepping mentally is really what it is all about. I’ve been working toward getting this surgery since October of 2020. The surgery is not a magic pill. It will not make my bad food habits disappear. I see both surgery and therapy as co-tools to becoming a healthier version of myself.
Physically, I have just tried to stay active and hydrated, both things that will help me recover faster.
Q: What will you be able to eat post surgery?
This is a process.
Before surgery, I have to go on a liquid diet for a week, drinking 4 to 5 protein shakes a day, plus at least 64 oz of other liquid such as water, broth, etc. This liquid diet helps shrink the liver before surgery and prepare the stomach for surgery (which the surgeon has to move aside to perform the procedure).
After surgery I will be on a liquid diet for 2 weeks, followed by 2 weeks of soft foods, and then I’ll move on to ‘normal’ foods, which will be dictated by what I can tolerate. Soft foods will be things like yogurt, refried beans, ricotta bake, etc. Once I’m back on “normal foods” I may have issues with fattier meats and “stringy” vegetables. People tend to have a hard time processing things that are ‘tough,” fatty, rich, or sugary—a good thing.
Q: What other potential side effects are there?
It’s a surgery so there are plenty of risks that come with going through a procedure and under anesthesia. To mitigate these risks I get to go through a bunch of pre-surgical screening.
After surgery, there’s the risk of ulcers and hernia as well as nausea for a while as I adapt. I will also be susceptible to what is called Dumping Syndrome (it sounds awful) and is a good motivator for sticking to the plan. I will likely lose some hair temporarily 2-3 months after surgery (I might be more nervous about this than all the other things).
Q: What other lifestyle changes are there?
There are some things post-surgery that I will have to do forever.
I will need to keep meals to around 1 cup of food at a time for the rest of my life.
I will take a vitamin regimen for the rest of my life in order to avoid becoming deficient.
I will need to not drink 30 minutes before or 30 minutes after eating–as the stomach’s lower sphincter will no longer be there, drinking that close to eating will cause me to become hungrier sooner. (You can take tiny sips.)
One of the hardest is that I will no longer be able to use ibuprofen (my chosen pain reliever) or other NSAIDs post surgery because the risk of ulcers will be too high.
Carbonation will forever be a no no–it can stretch my stomach and lead toward overeating and slipping back into bad habits.
Q: Is there anything you think you will miss about your pre-surgery self?
Sure. I definitely have thought about how right now my identity is as a fat person. I like me. I like who I am and it will be weird to lose that part of my identity, and to look different than I have my entire life.
I will also miss eating cake. (After I am pretty far out from surgery, I may be able to have some cake again, but sparingly, and only a few bites.)
Q: What do you look forward to post surgery?
Honestly, at this point, I am looking forward to it being done and being past this limbo moment. Having to go through the approval process twice under two different programs and insurances has been frustrating.
I am looking forward to seeing how I look after weight loss, but in a very analytical rather than vain kind of way. I’m astounded at how different people look in their before and afters. I’m curious to see–will I look more like my mom when she was younger? More like my sister? Just myself with less fluff? Or will I look mostly the same?
Q: What are some weird things that have come up that you did not expect as part of surgery?
Do you have other questions? If so, let me know!
This post is not intended to be medical advice. Any and all discussions about your own post-op bariatric care or the choice to have bariatric surgery should be had with your own doctor.WLS is a choice that every individual should make for themselves. It’s not going to be everyone’s cup of tea, and that’s okay. Big is beautiful, wonderful, and strong. I am lucky to have had really excellent medical care that hasn’t been–as far as I can tell–negatively impacted by fatphobia. I know this is not everyone’s situation. This was a choice I made and one that I brought up to my PCP, not the other way around. She helped me talk through some of the pros and cons, as well as some other medical weight loss options (such as drugs that encourage weight loss), and made it clear she supported whatever decision I made–even if it was to be none of the above.
I love to travel so much that it is part of my identity. There is no Charlotte without travel. I love the planning, the execution, and, most especially, the return home.
Over the past two years of pandemic life, I’ve reflected a lot on travel–what I miss about it, what I don’t miss about it, and what I can’t wait to do when it becomes a regular part of my life again.
During that same stretch of two years, I also made some pretty big life decisions that will impact how I travel going forward. The first is to proceed with weight loss surgery (WLS). The second is the revisioning of my career and my life: no longer am I on the quest for a tenure-track life, but rather a much less circumscribed path.
Both of these decisions have changed how I think about travel. The WLS angle is complicated: I’m really excited to go places feeling more fit and hopefully having more energy, but WLS also means that I won’t be able to eat certain things anymore, and food definitely factors into what I enjoy about travel.
As much as the WLS disrupts things, the life change that impacts my travel habits the most is actually the career flip. Nearly all of my travel so far has been in service to my education and research. The places I have gone and the things that I have seen have all been dictated by my professional goals. Granted, my professional goals were closely tied to my personal interests and desires, BUT…I had to have a legitimate academically-motivated reason to go where I did, because I had to intellectually justify that reason to people who judged that rationale (and helped fund these trips).
It hit me.
My future travel will no longer be dictated by professional reasons.
I can go where I want because I want to go. I don’t have to apply for funds or offer supporting rationales for why I need to go there.
I can go where I want because I want to go there. I don’t have to schedule time for research or site visits. I don’t have to meet with other professionals in my field.
Within reason. And within budget. (Ugh.)
Because…wanting *is* a reason.
This realization felt at once freeing and terrifying. I am one that likes to have purpose and intention in all that I do. I like there to be an end goal. I’m not great at “for the sake of” adventures. But now I wonder: how much of that is from habit? What if I am able to just go for the sake of going, and I just don’t know it yet?
With all of this swirling around in my head, I started thinking about what I love about travel and the different types of travel that exist. Because I am, and forever will be, a recovering art historian, I love putting things into categories (and perpetually revising and expanding those categories), I present the first iteration of my categories of travel.
Categories of Travel
The Visit There is no other reason for you to visit this place besides seeing someone who lives there. Your primary goal is to see that person or group of persons, and anything else is secondary. You stay in their home and “spend time” with one another.
The Event Rather than simply going to visit someone, you go somewhere for a specific event, be it a holiday, baby shower, graduation, concert, wedding, or themed party. Generally speaking, the Event requires your participation. You buy a gift, you prepare, you must engage with the event, as well as the people you see at the event. The locale is irrelevant.
The Destination You are going to see a place that cannot be replicated elsewhere, such as architecture, art, food, shopping (I guess? for some people?), and other cultural experiences. This requires engagement instead of simple passive existence in the space. You will get out of it what you put into it (which, your goals may be different depending on how you travel). You can do this by plane, train, or automobile.
The Wandering There are some who can just wander. See where the day takes them, motivated by god knows what, by their own two feet or by car and public transit. I think camping, backpacking, and some road trips fall into this category. I am not a wanderer.
The Vacation Ahh, the elusive vacation. Some might call the above 4 categories vacations, but I would argue that they are not at all the same category. A vacation can happen anywhere, but the goal is to vacate….your responsibilities, your agendas, your obligations. Travel is not necessary to vacate, but is oftentimes more enjoyable when you do. You can have a staycation or a destination vacation, subcategories which I think are self-explanatory.
The Trip This category can comprise facets of each of the above. Elements of relaxation, visiting specific destinations and people, but there is an agenda. You have things to do, places to go, maybe even people to see. Some trips are more akin to vacations, while others more akin to a visit. It depends.
The Extended Stay For some, this will take the form of a study abroad, for others perhaps a home exchange (my friend and fellow blogger can talk your ear off about this). I categorize an Extended Stay as remaining in one place longer than 3 weeks in order to really understand the place that you’re visiting. You’re there long enough to develop some kind of routine, an understanding of the local grocery store, and pick out a favorite something in your “neighborhood,” be it a gelato shop, fruit stand, pizza place, bakery, etc.
Modes of Travel
Group Travel “Group” can be loosely defined. I would say that this is not family travel, though families can participate in group travel. The dynamics of the group can be ever variable. You can have smaller groups of non-related individuals or large groups of non-related individuals such as a tour group or class, or somewhere in between. Your travel will be impacted by the way that you interact with the group creating an additional layer to the experience.
Family Travel Family travel can have lots of the same features as group travel, but the dynamic can shift and change more rapidly, and is infinitely more mercurial. Anyone who has been trapped in a car with their siblings knows how rapidly that dynamic can shift.
Solo Travel You fly solo. You arrive solo. You may meet up with people for an activity or share a hotel for a few days, but for the most part, you drive the itinerary and the pace, pick all of the restaurants, and dictate the agenda. There are definite advantages to solo travel: not having to fight with people about what’s for dinner or doing activities you do not like. There are also disadvantages: being alone; sometimes not feeling safe; people seeing your being alone as an invitation to talk (it isn’t, ever, in my case); and being the only one to make decisions can be exhausting…but rewarding.
Business Travel This is a type of travel that I have only had some experience with, though you could make an argument that lots of my research travel was business, none of my trips were driven by commercial reasons. Most were not collaborative in any way. I see business travel as traveling to a location for a meeting, be it with collaborators or investors; travel for participation in a conference as a representative of an organization or institution; and travel for which someone else foots the bill.
Most of my travel so far has been some combination of solo/business, extended-stay, destination trips. There’s so much more I want to do and see! It’s liberating to know that I can do what I want rather than having to provide justifications for why. The only person I have to justify anything to is ME.
Here are some immediate goals that come to my mind:
An all-inclusive vacation type vacation. I want to go somewhere pretty and scenic, where I can experience a view, eat tasty food, and read books all day long. This could be a colder climate vacation. I’ve always wanted to go somewhere like Aspen or Vail, not for the skiing (because clearly I would kill myself) but for the cozy. Snuggle by the fire with a good book and make some trips to the hot tub (to read there too). It could also be a warmer climate vacation at a beachy type resort. Same activities, just different bodies of water, and different drink choices. Choice of location can be based exclusively on how pretty the view is and how comfortable I am able to be while enjoying that view.
A non-research related destination trip, international. The place that immediately comes to mind is Ireland. I have always wanted to go. Like many Americans, I’m vaguely of Irish descent (Forstall is an Irish last name, though there are many spellings). I could…just go? I need to start thinking outside of my research-driven travel box and think about other places I want to go…just because.
A non-research related destination trip, domestic. I’ve been to a bunch of places in the US, but my list could expand greatly. A lot of my travel in the US has also been in the category of The Visit (again, not a bad thing) but there’s a lot to do and see in this big dumb country. Similarly, I need to start thinking outside of the box.
What do you think? Are there categories and modes I’ve neglected? Where should I go? What type of travel should I try? What should I add to my list when literally anything is on the table? (Besides camping, I don’t camp.)
While not being *wrong*, the process has not been as straightforward as simply having the doctor’s look at my file and send it to insurance. On the whole, I would argue that this part of the process has been the hardest. I don’t feel like I am making progress or moving forward and I feel a little stalled. Most of the time, I know that it’s not true, but it’s hard in difficult moments to keep perspective.
I made an appointment in August for October 27 (exactly one year since my first appointment). When October 27th came, I was a little frustrated and ready to get started—I also wished I had not scheduled my appointment so late. Moving had proven to be a very big shakeup to my routine. This was expected to some degree, but there’s so many new temptations and things to try, I definitely allowed myself to engage in some bad habits and was not as rigorous about the food that I was consuming as I had been.
On the whole, however, I haven’t gained weight, and more than anything, I have been in a super consistent work out routine. I see that as a huge win because ultimately, I don’t care about the number on the scale as much as I do being healthy and in control. While physically I may not see progress on the scale, I do think it’s resulted in me becoming a little more trim and compact. (I’ve never measured inches so it’s hard to say). It’s a balance and it’s a process. Rome wasn’t built in a day, and neither will my bad habits be overridden in a day.
At the appointment, I mentioned to the new surgeon what my previous one had said, about it being relatively easy to transfer. The new surgeon smiled and said, ”well, it’s easy to say it’s easy to transfer.” Unfortunately, she hasn’t been wrong. While yes I did complete strict insurance requirements, my new insurance measures things differently. Previously my insurance required 6 visits spread over 6 months. My new insurance requires 12 distinct visits and some of those are required to have a certain amount of time between them. Fortunately, my old appointments count to this number and I have subsequently squeezed in several more. In addition, this program has different requirements itself, whose requirements I also have to meet. It’s not going to take as long as it did before to get from the beginning point to the end, but it does feel a little like starting over. And that is frustrating.
So right now, I’m trying to finish up these old/new requirements. After I finish up all of the steps, my file will be sent to my insurance for approval. Once we have insurance approval surgery will be scheduled. Not really too sure what that timeline looks like; my general guess is sometime in spring, March-ish seems likely.
This period has also been the one that’s made me question why I am doing this surgery. I believe that body positivity is really important—and this includes loving and appreciating fat bodies and not seeing them as broken or less-than. I have ALWAYS been fat, so what will it mean when I am no longer fat and that part of my identity is no more? Will I recognize myself? What if I don’t like the ”new” me or miss the ”old” one?
For example, I had an experience at the gym where a fellow big girl approached me and asked if the class I had been taking was hard for big girls. We chatted and exchanged info, and most importantly, encouragement. I realized in that moment that I like being a safe space for fellow fat people in gyms—one of the scariest spaces for someone with a fat body to occupy. But, when I go through with surgery, there will come a time when my support is no longer desired and will likely be unwelcome. I will be a “former fat,” not an “always fat.” It’s hard for me to imagine that person.
It is good to remember why I am doing this though. I am doing it because my relationship with food is not healthy. I am doing this because if I continue down the path I was on, it is almost a given that I will have an unhealthy future with type 2 diabetes, high blood pressure, and other health ailments. If I don’t do something to change, I could end up dead at the relatively young age of 59 like my mom did from obesity related issues. And I wish more than anything that she had done bariatric surgery and were here today. I have plans, and all of them involve me being alive and active. There are people I love who I want to spend as much time as humanely possible. They mean more to me than food.
**I hesitated to share pix because I think it perpetuates the idea that before is “better” and after is “worse.” I like to think that I was pretty before and after–I am still me. I share only as a mark of visual change. This is probably definitely not for everyone, but I’m a visual person. I find that a better indicator than the number on the scale. Ultimately, the best indicator is how I feel.
In April, I had my last supervised weight loss appointment. I completed 6 months of ‘supervised weight loss’ losing 60 pounds since I started the program in October. I passed the program with flying colors. After completing the program, the next steps are insurance approval, then scheduling the surgery, then surgery. However, LIFE happened.
In short, I got a new job! One that requires me to move to a new city! Get new insurance! Switch doctors! This move is great for me both personally and professionally, but it does require me to revise my timeline for surgery for a bit, while I settle into a whole lotta new. Instead of having surgery in June/July, I will be moving.
Fortunately, I knew this was a possibility at my last appointment and discussed that option with my surgeon. The timing to switch was really perfect. I completed the strictest pre-surgery requirements (as required by most insurances), and the results of that were good for a period of 2 years. So basically, all I need to do once I get settled is find a surgeon I like, have them contact my previous office, and schedule my surgery.
Until then, I’m in a holding pattern. The goal is to continue my weight loss and stick to the food plan. So far so good! I haven’t lost a lot in the past month, but it follows the basic trend of the previous few months of slow and steady forward movement. I suspect that there will be hard moments, particularly as it becomes less and less convenient to cook as I move, but I am hoping that the process of moving won’t be too disruptive to my overall trajectory.
General feels right now: I feel GREAT. Losing 60+ lbs does wonders for your energy levels. I can move and be flexible again in ways I hadn’t realized had diminished. At my heaviest, I felt so uncomfortable in my skin, but in a way that is constant so you can’t really articulate exactly what that discomfort is. The absence of that discomfort is WONDERFUL. Clothes either fit better or are now too big. I move with greater ease and comfort and power. I do not get winded nearly as often. I *feel* so much better. The number on the scale right now is just one single metric of many.
2020. Unlike most years, I’m not really interested in doing much ruminating on 2020. It was a rollercoaster, one I don’t care to ride ever again. While I totally get that many of the problems we faced in 2020 aren’t magically gone, I am super ready to take reset that a new year offers (even if it’s only a placebo).
2021 will hold a pretty big adventure for me, one that I’ve been wanting to do for a while, and now I’m at a place (read: not a grad student) to do it. If all goes to plan, I will be having gastric bypass surgery in 2021.
I wasn’t sure if I wanted to go public with this info. There are stigma associated with bariatric surgery. There’s a belief among some that it’s “cheating” or for people that don’t have the willpower to lose weight “correctly.” There are others that believe that weight-loss surgery is fatphobic and irreparably alters a healthy body for no reason, putting thinness ahead of health. Neither of these things are true.* To do my part in breaking down that stigma, I’ve decided to be open about what I’m doing to people in my orbit.
I am doing this surgery because I have always been obese, for as long as I can remember. I am not doing the surgery to lose weight, but rather to keep it off. I also am hoping to stave off type 2 diabetes and high-blood pressure, for which I am particularly high risk owing to family history.
I am doing the surgery because I wonder every day how my life would be different right now if my mom had had the surgical intervention. Would she have died at the age of 59 from a pulmonary embolism (a pretty direct consequence of being obese)? Would she have been happier? Would she have been able to do things with us in the last few years of her life? It is true that skinny does not equal healthy, while it is similarly true that morbid obesity (the worst term) is a deadly state.
I don’t want to wonder those questions about me. I am taking a proactive stance, and trying to prolong my current health for as long as possible. That’s the primary reason why I’m doing this.
It would be wrong for me to say that I am not looking forward to no longer sticking out like a sore thumb. To no longer see people’s eyes rolling when they see that their seat on the airplane is next to mine. To little kids, well-meaning dears who really don’t know better, asking if there’s a baby in my belly. To seeing people’s eyes look you up and down and know that they’re forming some assessment of your interior worth because of the exterior of your body.
Right now, I’m in the pre-op stage, which is dictated by my insurance. In order to qualify for them to cover the surgery, I have to have 6 consecutive months of weigh-ins where I either lose or maintain my weight, pass a series of medical pre-checks, and take several classes. My surgeon requested that I lose 20-25 pounds before surgery and I was put on a diet that’s called a “liver reduction diet” that reduces my carb intake in order to make my liver as small as possible for the surgery.
In the past 2 months, I’ve lost 25 pounds and I feel great. I’m proud of the steps I’ve taken for my health. I’m excited to see where 2021 takes me with this process. I’ve always felt like I was in a war with food, but in the past 2 months, I’ve felt so in control.
I do have concerns, questions, and anxieties about the risks this process entails, but that is for another post and another day. Today, I am excited about possibilities.
*I do think the approach to bariatric surgery can vary highly. If your surgeon and practice don’t put health first and privilege the goal weight over the rest, I’d find a new surgeon.
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