All my life I have struggled with weight. My mom put me on my first diet at age 2, upon my Air Force pediatrician’s recommendation. Looking at pictures of myself at age 2, I was a little chunky, but not horribly overweight. But it was 1971 and the standards for height and weight charts were more stringent back then. My 2-year old self in 1971 looks like a lot of 2-year old’s look these days. But that’s when I believe my weight insecurities were first imprinted on me.
It’s Time for a Change
Fast forward through 43 years of painful weight highs (347 lbs. was my highest) and a couple of lows which were never in a healthy weight range, even at 5’11” (think 250-280 lbs.), and I found myself staring a huge reality in the face: at age 45 I was never going to get my weight back under 300 lbs. on my own. Oh, I had tried. I tried and tried since my kids were born. But with the increasing risk of diabetes, high blood pressure, cancer and heart disease, I decided it was time to talk with my doctor about surgical options.
My family doctor is fabulous! She has the right mix of listening skills and assertiveness. She warned me that surgery was a drastic choice. I agreed, and assured her it was not one which I took lightly, especially with a husband and two kids to think about. I told her how I was always tired, my weight was creeping up even though I was exercising and eating healthy, I was frequently achy or sick, and I was ready to get rid of my morbid obesity for good. So she referred me to an excellent weight loss surgeon.
My Pre-Op Process
In May 2015 I visited the weight loss surgery doctor, called a bariatric surgeon, for the first time. He told me that because of my polycycstic ovary syndrome (PCOS), my most successful option would be a gastric bypass. None of the other surgical options would likely allow me to lose half my body weight, which is what I needed. And none of the other options, such as the sleeve, would be as restrictive as a gastric bypass, and I knew in my heart I needed the severity of restriction to be successful.
According to the guidelines set by my insurance company, I would spend 3 months in the program offered by my bariatric surgeon’s hospital attending monthly nutrition classes and undergoing a battery of tests and appointments. These included checking my heart and lungs, having blood work done, getting an upper endoscopy (an outpatient procedure where they put a camera down your throat and check the condition of your stomach) and completing a psychological evaluation. After all the results were submitted, the insurance company would decide if I qualified for the surgery.
During the early stages of my weight loss surgery journey I found out that gastric bypass was the only surgical option my insurance company would cover. Even if I wanted to have a different, less invasive procedure, it wouldn’t be an option for me. So the choice became whether to have surgery or to not have surgery.
I Chose Surgery
A gastric bypass, or a roux-en-y (RNY), is the most extreme surgery among the bariatric surgery options. During RNY, a significant part of the patient’s stomach is closed off and a small stomach pouch is created. A portion of the digestive tract is bypassed and thus can no longer absorb fat and calories. The intestines are then surgically attached to the stomach pouch. This is usually done laparascopically, which means the surgeon makes several small incisions in the patient’s mid-section to insert a camera and tools to perform the surgery instead of cutting a patient’s abdominal region open with one huge incision.
The combination of a much smaller stomach and the inability to absorb some of the calories and fat consumed means the patient will lose weight. Sometimes this surgery can lead to issues with malnutrition because the patient isn’t absorbing all the nutrients their body needs. And some people experience a new set of health issues post-op including stomach ulcers, losing too much weight and not being able to gain any back, osteoporosis, hernias, gall stones, low blood sugar, or stretching their pouch out and gaining all their weight back.
I did my research before having surgery. I knew about many of the possible risks and complications during and after surgery. I went to all the nutrition classes, never missed an appointment for testing, and waited my 3 months (which is a shorter period than some insurance companies make patients wait). I put in for 2 weeks of vacation at my job, did everything at work in advance to make sure things would run smoothly in my absence, arranged for child care during the 2 nights I would be in the hospital while my husband would be at work, and mentally prepared myself for this huge life change the best I could. And I prayed. A lot. Then less than 24 hours before my scheduled surgery in August 2015, this happened.
I was rejected for an 8 pound weight loss!
Yep, you read that correctly. I lost 8 lbs. in 2 months. I was 332 lbs. and went down to 324 lbs. Still morbidly obese. I followed the eating plan prescribed by my bariatric surgeon, which I was required to follow during the pre-op period. The insurance company claimed I could magically lose the weight on my own after all these years. They had 12 years of my medical records from when I was covered by them, showing that I was morbidly obese the ENTIRE 12 years, but that didn’t matter because of these 8 lbs.
So how did I feel in the weeks following this rejection? Crestfallen. Angry. Incensed at the injustice of being rejected over an 8 lb. weight loss. Humiliated that I had to tell people I had been rejected at the last minute. And sad. Sad that I would possibly never be able to have this surgery that I had idealized and dreamed about.
There Was a Reason
During the weeks and months after my surgery denial, I kept telling myself that there must be some reason this happened. I reminded myself to trust God and to trust that I would eventually be approved for surgery if I was meant to have it. At the time I worked as the Director of Children’s & Youth Ministries at a church, so between my work schedule and my own children’s school schedule, I only had 2 windows of time to have surgery: January and August.
The surgeon’s office told me to continue coming to monthly nutrition classes to show the insurance company that I was committed to this process. They also wanted to track my weight over a longer period of time to prove to the insurance company that I needed the surgery. And they wanted to encourage and support me on my journey. They assured me I wasn’t the first rejection they had seen and that many patients are eventually granted approval for this surgery. When I was ready and able, they would resubmit my surgery request.
In the meantime, I dove to the bottom of more than one pint of Haagen-Dazs peanut butter chocolate ice cream. I felt worse than ever, but I decided I would do my best to gain weight since the insurance company had denied me over 8 lbs. I had to show them this surgery was necessary and I couldn’t lose the weight on my own. That’s when my weight climbed to its highest, at 347 lbs. I was hurting myself whether I ate healthy or ate crap, so I might as well eat what I loved. I just couldn’t understand how I was feeling so rotten, even when I was exercising and eating healthy.
Then I received test results that changed my life.
I was diagnosed with 14 food allergies in November 2015. Almost everything I had been eating in an attempt to be healthy was causing me to feel horrible! My allergies include eggs, dairy, peanuts, wheat, kidney beans, and bananas, among other things. Things like veggie omelets, beef, cheese, green beans and plain greek yogurt were making me ill. I will write another post which speaks in depth about my food allergy diagnosis and some of my experiences since then and link it to this post.
This diagnosis revealed the reason why I was fortunate to have my surgery denied in August 2015. Had I not known about the food allergies and had the surgery, I most likely would have become very sick. In the early stages after surgery, soft foods like scrambled eggs and cottage cheese are recommended. And protein shakes are a staple of new bariatric surgery patients to help them get the required amount of protein. Many protein shakes are made with whey protein, which is milk-based. Much of what I would have eaten post-op would have caused major inflammation and swelling in my body at a time when it needed to devote all its energy into healing from surgery.
Timing is Everything
With my new food allergy diagnosis in hand and a 25 pound weight loss ONE MONTH after getting off all the foods I was allergic to (can we say “edema”?), I decided to give my body a break and not attempt to have surgery in January 2016. I didn’t know how much weight I might be able to lose on my own with this new eating lifestyle. And I was worried that the insurance company would deny me again based on their previous rejection. After all, if they rejected my surgery over an 8 lb. loss, what were they going to say about a 25 lb. loss?
So I set a target surgery date at my surgeon’s office of August 9, 2016. There was more wrangling with the insurance company, but thankfully my second attempt was approved! I went through some of the testing a second time since a year had passed, put in for my vacation time at work, prepped my work stuff before my absence, got the child care arranged, and had my surgery. The pics below were taken on the day of my surgery, which was August 9, 2016. I weighed 307 lbs. I lost 10 lbs. during my 1-week pre-op diet and another 30 lbs. in the months before surgery, after my food allergy diagnosis.
Success! Or was it?
Surgery went well. I was in a lot of pain for 2 days in the hospital. To be expected. I had pain meds. I’ve given birth twice, so I could get through this. My husband took me home once I was discharged. He and my kids took exceptional care of me during my lack of energy, post-op pain, and inability to do much of anything, including lifting a gallon of milk (which I couldn’t drink) or making dinner. But we all knew I would be out of work recovering for 2 weeks, so we were prepared. What we weren’t prepared for was the major complication I developed one month after surgery that landed me in the hospital 3 times over the course of 3 weeks before the doctors figured out what was wrong. You can read my post about my complication here, which includes my most current pics. (If the post isn’t linked yet, that means I’m still writing that post! Please check back soon!)
Your Gentle Nudge: In what area(s) of your life could you stand to make changes? It could be something large like choosing surgery, or something much smaller. How would those changes positively impact your life?
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