MOTIVATION

I got word today that I am set to have my surgery on October 23.  I also received a very strict diet to follow prior to surgery and a suggestion from the doctor that I try to lose 20 pounds before then. He wants my BMI down 3 points!

The diet is basically 2 protein shakes and a "lean and green" meal, preferably at lunch. The week before surgery is a little different; more variety in the protein and as few carbs as possible. I feel confident that I can do that, with the exception of the weekend getaway we have planned for our anniversary. 

That trip actually had a lot to do with my making the decision to go ahead with the surgery.  Tom was talking about going hiking and bike riding and I felt so bad and embarrassed that I have gotten to the point that I can't do those things.  At least not for long and not easily.  My knees have gotten so painful that I can't sleep well some nights and my gait is really different.  I miss being graceful.

I have been wearing my gym shoes to work every day and walking for 5 minutes here and 10 minutes there throughout the day.  I need to build up my stamina and strength, both for the trip and for the surgery.  More than anything - and I mean this- I look forward to being able to exercise.  I have always liked my gym time, hard as it may be to fit in.

I like the idea of looking better and shopping in regular stores, too,  but I have no illusions that this old body is just going to snap back.  I am going to get Tom to take some "before" pictures this week to put aside. I have taken my measurements already, bought my post-op vitamin and mineral supplements and some samples of high protein foods and supplements.

Making this happen.

A BIG DECISION - A LONG POST

In the weeks prior to our high school reunion, I was e-mailing back and forth with my good friend.  I was talking her into coming to the event (she has been my date for all the previous reunions) plus it is pretty much the only time I get to set eyes on her.

 Suddenly the topic changed and she asked me if I had ever considered weight loss surgery.  I told her I had gone pretty deep into the pre-op planning about 8 years ago before we lost our coverage - why?  Well, turns out she would like to help me pay for it.  It was one of those "life turns on a dime" moments.  I said I would look into it and we would talk.

Turns out my insurance company not only doesn't cover it - they won't cover anything at all related to it, ever.  They were very emphatic!  Wow.  I got the feeling they had put me on a watch list just by inquiring!

So then I looked into the options.

Eight years ago I had planned on  the Duodenal Switch which is a reduction of the size of the stomach itself and then a re-routing of the intestines which creates a "malabsorption" effect.  It is considered the riskiest, most complicated surgery but the life long weight loss, maintenance and reduction of other weight related problems is the best. It is the only surgery which allows, over time, for me to eat somewhat normally, drink alcohol and take Nsaids. Considering my arthritis - I need that! There is a significant vitamin regimen and certain foods will likely cause distress - like refined carbs and sugar. But apparently it is different from person to person.

They also offer the "Sleeve" which is just the reduction of the stomach size but leaving the pyloric valve, which some of the other surgeries, like the popular Roux en Y, removes.  The new popular one is the Lap Band which is an inflatable band positioned at a spot around the upper stomach.  It can be inflated or deflated to alter the size of the pouch for food to be digested and slipped through into the rest of the stomach.  It is the easiest and least expensive surgery but there are lots of issues with the way you can eat and what you can eat and it requires frequent adjustments (ongoing costs).  There also seem to be a lot of ways to circumvent its effectiveness - not that I would set out to do that...

Anyway, I researched and went on weight loss forums and blogs and learned more than I wanted to know about the different types and how they have affected people and I came back around to the DS.  The DS costs between $30,000. - $40,000. Hard to pin down  (and why the range?), but that is the way our health care works in this country.

My friend and I talked and the amount of money she is offering is not going to cover my surgery of choice.

More research, and the answer has been found. They call it "Medical Tourism."  Going out of the country for medical care which is priced much higher here. 

I am communicating with two surgeons in Mexico and the cost for the same surgery plus a longer hospital stay is  $11,000 and $13,000.  Both are highly rated, very experienced surgeons working out of hospitals.  I have communicated with a dozen of their previous patients and read, probably 50 testimonials and blogs and other writings about them. Can't find anything bad about them - no complaints; more than I can say about some of the US surgeons and hospitals.

Plus, by circumventing all the BS that the US docs do (which runs up the costs) I can get a surgery date in weeks instead of 6-12+ months.

I also discovered a number of post-op people who have taken to YouTube to chronicle their experiences.  YouTube seems to attract a certain kind of person, at least on this subject.  Let's just say they like to hear themselves talk.  There are glimmers of good info, but for the most part - not so much.

However, the benefit of YouTube is the visual. For the topic which concerns most of us very large women it is:  what happens after the weight is lost?  What remains?  Answer:  Lots of skin.  The women brave enough to show it prove that it is not pretty.  In fact, it gave me great pause.  The likelihood of being able to afford plastic surgery is slim to none. 

That shut me down for a couple of days.  No - in truth, I went on a bit of a binge.  After all, when stressed - eat.  How crazy is that?

And yes, I know that having this surgery will mean big changes to that particular issue of mine.  I have given a great deal of thought to it and also read a lot about it.  I know that there are people like Carney Wilson who managed to circumvent the surgery and gain weight back and I don't want to be one of those people.  This is my opportunity to make the changes that need to be made.  Like one guy said on a forum: "I went into surgery a fat guy and I came out as a skinny guy.  I decided to live that way the rest of my life." 

The surgeon required a low carb, low fat diet for at least the week or so before surgery.  I had pasta for dinner tonight and that is going to be the last time for a long time.  Maybe forever.  It will be worth it.

BORN 2 BREAK THE RULES



Maybe they are right - I Googled "fat woman reading food labels"
and only skinny women showed up!!

 There are so many times I read things about fat people, being fat, statistics about obesity, etc. and all I can think of is - not me.  Why is it pretty much every time there is some generalization about fat people, I am outside it?  And, frequently, my skinny sisters are inside it?  I am such a rule breaker.

The new one I read today: 

Ladies Who Read The Nutrition Labels On Food Weigh Less Than Those Who Don’t

Sorry researchers - not this fat lady.  I ready labels top to bottom like they were novels.  My skinny sister does not.

Read further and you know what the big difference is between the fatties who read the labels and the super smart, slim people who don't?   Eight pounds.  Yep.  A BMI difference of  1.49.  Woo-hoo!

Actually, when I read the label on the "good" wheat bread my sister thought she was buying, I pointed out how high the carbs were indicating all the sugar in the bread and she did admit it tastes sweet and that she should read the label beyond whole wheat.  True story.

We can all do with more education on nutrition, but reading labels is only as good as the understanding of nutrition and the accuracy of the labelling itself, which is not so good:

...the law allows a pretty lax margin of error—up to 20 percent—for the stated value versus actual value of nutrients. In reality, that means a 100-calorie pack could, theoretically, contain up to 120 calories and still not be violating the law. The same margin of error goes for other nutrients as well, which doesn't bode well for diabetic carb counters, folks with high blood pressure who are watching sodium intake, or moms looking to boost the iron content of their babies' diets. The FDA has never established a systematic, random label-auditing process, and compliance with the law is expected to be self-enforced by food manufacturers.

Research that, Center for Disease Control and Prevention.  Maybe you government agencies could get together and, ya know, do something useful. Like get the manufacturers to get real with the labels, and the schools to teach current nutritional information and not ye old food pyramid.