My first full year in Nashville was a momentous one. Here’s a look back in pictures of some of the highlights.
2022 was the year of the musical…..
I saw ten* live stage shows this year, nine of which were musicals, including my FIRST, SECOND, THIRD, FOURTH, and FIFTH shows on Broadway. (I never did a full write up of my second trip to NYC where I saw Funny Girl, A Strange Loop, and SIX, but maybe I will, because I still have thoughts.) I saw PATTI FREAKING LUPONE, Sutton Foster, Hugh Jackman, Beanie Feldstein, and Jane Lynch.
*Shows on Broadway: The Music Man, Company, Funny Girl, A Strange Loop, and Six; Broadway at TPAC: Mean Girls, Hamilton, Oklahoma!, and To Kill a Mockingbird; Nashville Rep: RENT
I wish I could afford to do this every year, but instead I will see every traveling show that I can at TPAC and most things that the Nashville Repertory Theatre does. Already have two shows on the books for early 2023!
2022 was the year of finally having bariatric surgery….
After a long wait, I finally had bariatric surgery. It’s been a journey, and I’m so glad to be on THIS side of things. I’ve lost almost 75 pounds since surgery, and almost 140 lbs since beginning this process. The best part of this journey is just FEELING better. While none of my numbers were in danger territory, they were all on the high end of normal pre-surgery, and 6 months post op my blood sugar, cholesterol, etc., are all on the lower end of normal. I feel in control around food and trust my body in ways I did not before.
2022 was the year of flying to LaGuardia thrice…..
I took the exact same flight to LaGuardia from Nashville three times this year (it was at 5:50 AM). I flew literally nowhere else all year either. Two trips to NYC one in January and May, and then a trip to NJ in August to see one of my besties and to finally meet my godson! I hadn’t been to NYC since 2006, so two and half times in one year was nuts!
2022 was the year of a Framily trip to Disney!
In October, my framily (friend family) went to Disney World, and a few of us went to Universal so that we could finally go to Harry Potter World (everyone else had gone before). It was exhausting, but SO much fun to a) experience my nephew’s first Disney-trip, b) to see how much easier these exhausting days were 100+ lbs lighter, and c) to see Disney with adult eyes with some of my favorite people.
2022 was the year of the book…
As I mentioned in my previous post, I read over 100 books this year, most of it new fiction!
2022 was a year that reinforced how very lucky I am to have a lot of amazing people in my life. A year with such big life changes required that I have a solid support system in place. I am truly rich in friendships. Thank you ❤
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….
But…
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.
But.
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.
Sweaty and tired, but I had so much fun!
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.
L: Gastric Bypass, R: Gastric Sleeve
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?
Left, April 2021 after my supervised weight loss. Right, July 2020, right around when I took steps to get started with WLS.
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?
TBD!
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.
Since moving, I’ve gotten a few inquiries on what my progress and timeline toward surgery is now. For those of you that don’t know, in October of 2020, I started the process of getting approved for bariatric surgery. All went really well, and had I not gotten a new job and moved to Nashville, I’d have had my surgery in Summer of 2021. The idea was, once I got settled, I’d get in touch with a new surgeon and get the process rolling, which my previous surgeon told me should be fairly easy.
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.
Sometimes I can still see my progress in pix, other times, I feel like I am where I started. I think I can see my progress in this pic.**
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?
This picture is on that shocked me because to my own eye I even seemed smaller, even potentially “normal fat.” Most importantly, however, I felt great and I spent an entire day outside chasing a toddler without feeling (totally) wiped.**
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.
Left: April 2021 compared to (right) July 2020 at my heaviest. Difference of 60 lbs.
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.
My passport photo taken in early 2015, nowhere near my heaviest (this was pre-mom’s death and dissertating!) and May 2021 65 lbs down.
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.
My stats as of January 1, 2021
*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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