The "Easy Way Out?"

I've been thinking about this for a few weeks now.

The University of Iowa Hospitals and Clinics has a monthly support group for people who have had or are considering having weight loss surgery.  It is held on the first Tuesday of every month.

At the July meeting, we were talking after our speaker had left.  There were 5 of us who had all had surgery - ranging from 4 weeks out to 5 years out.

We were discussing many different aspects of life after surgery.  But something came up that has been bothering me since then.  ALL of us have had at least one person say that we "took the easy way out" by having surgery.

This made all 5 of us laugh.  Easy way....I think not.

Let's start with the 6 months leading up to surgery.  During this time you have to change the way you have lived for your whole life.  MANY, MANY people said to me during this time, "You're doing so well and losing weight, maybe you won't need the surgery."

The problem is - I was in a constant state of hunger.  I was having to keep a food diary and monitor every bite that went into my mouth.  I was on a 1,400 calorie diet.  That sounds easy enough....until you start keeping track of calories and figuring out how quickly 1,400 calories is gone.  I can honestly say that during that time, I never felt satisfied, I always had a gnawing hunger pain.  But, I had to see the dietitian monthly and she reported to insurance.  And if I wanted insurance to approve my surgery, I had to prove I could change my ways and stick to a regimen.

After 5 months I had lost....ready... a whopping 20 pounds.  I had followed every single rule, done everything they asked and I had lost a whole 20 pounds.  And this is what people said would make it so I didn't need the surgery?!?!  I think not.

I remember talking to a friend who was saying that I was doing so well and she hoped I wouldn't need the surgery because it would be so hard to live the way I would have to post-surgery.  I told her that honestly - it will be a WHOLE lot easier to live after surgery than it was then.  I was eating very little, doing everything "right" and still lost only 20 pounds.  When you have 6 times that to lose....that is daunting.

So - that first 6 months was horrible.  I was hungry all the time, felt lousy about myself that even doing everything "right" I still couldn't lose weight...I felt like a failure.  And yet people think I was taking the easy way out?

Now it's the 2 weeks before surgery.  During that time they want you to lose as much more weight as possible.  Why?  The lower your BMI going into surgery, the lower the risks.  The more weight you have lost, the more your organs will have shrunk making surgery easier.

I went onto the 800 calories one day, 1,200 the next rotation.  Oh, and it was a liquid diet packed with protein.  And lucky me - since there were so few options I had the same exact thing for every meal for 14 days.  Just some days I had less of it because it was an 800 calorie day.

But this is easy...right?

Now I'm at surgery.  Honestly - that was the easiest part - they put me to sleep and I woke up like 6 hours later on a morphine drip!  I DID, however, have 6 holes in me and a tube sticking out of one of them draining this nasty looking crud.

After a few hours they made me start getting up and walking around.  But first they had to take the compression things off my calves - they were on the whole time in the hospital, squeezing my calves to help circulation and reduce the risk of blood clots.

I can honestly say that yes, my 6 incisions hurt, but the morphine did a nice job of controlling that.  What hurt worse was my shoulder.  When they do abdominal surgery they puff you up with gas so they have room to work.  They do suck it out, but there is residual gas - and it goes to your shoulder.  And the morphine and tylenol does NOTHING to touch that pain.  They had warned me about that - but I had no clue what I was in for.  Wowsers.  Luckily that lasted only a couple of days.

Oh wait - but this is easy.

Now I am at home.  I have NO energy, I hurt, but I MUST get up and walk every 2 hours.  I had to look quite a fright when people saw me and Mike walking around outside.  I could NOT stay awake, so I was constantly sleeping and then going for walks, then sleeping, then walking, etc.  When you are used to being constantly moving - it is weird to fall asleep waiting for your 3 minute timer to go off.

Why a 3 minute timer?  Because I had to take tiny sips of liquid.  It was supposed to take me like 8 sips to drink ONE ounce.    One ounce is the size of those little medicine cups you get with children's liquid medicine.  They sent me home with a bunch of those to use to drink my water, broth, milk, etc.

But I can't just take the 8 sips right in a row - I am supposed to space them out and take 20-30 minutes to drink that one ounce!  Talk about an effort in patience!  So I set a timer for 3 minutes and seriously would fall sound asleep after taking my sip.  I had to mark tallies for when I finished a 1 ounce cup because I was so sleepy I could not remember how many I had drunk.  And let me tell you - I know I forgot to mark tallies and sometimes double marked - I was so out of it.

AFter a day or so - I could do 2 ounces in 30 minutes and eventually 4 ounces in 30 minutes.  That is how my first week went - sleeping, drinking, walking, sleeping drinking, sleeping, drinking.

But remember - this is the easy way.

Then came FULL liquid diet - now I can add creamed soups and yogurt and pudding and jello.  Woo hoo.  I craved chewing SO MUCH.  And this phase lasted THREE weeks.  Yes, THREE WEEKS.  But remember - this is easy!

I was so sick of liquids and yogurt and pudding and jello.  I haven't had yogurt, pudding or jello since.  I should again, but it may be a little while.

During this stage I really struggled.  By 2 weeks post surgery I had lost 20 pounds...then I stopped losing.  For the next 2 weeks I lost nothing.

In addition to being down about that, I was so weak it was crazy.  I couldn't be alone if I needed to shower.  Mike had to be there because more than once I nearly passed out in the shower.  WE finally figured out to put a chair in the shower so I could sit and wash my hair.

I learned the hard way that I MUST eat (in this case drink) something before showering or I would collapse.  I would get so weak and so light headed, it was crazy.  But hey, don't worry - this weight loss surgery stuff is the easy way out.

Finally I talked to a friend who did surgery last year in July.  She made me realize that my body was telling me I was starving - and when our bodies go into starvation mode, they hold weight rather than lose it.  So I "cheated" and started pureed foods a few days early.  AND, actually I majorly cheated and skipped puree and went straight to soft foods, like fish and mashed potatoes.

What happened?  I started to lose weight again, and I had more strength and energy!

At my 1 month appointment I was cleared to swim and now that is how I exercise rather than walking.  Why?  It burns like 4 times the calories and I enjoy it MUCH more than walking and sweating and getting eaten by the gnats and mosquitoes.

Now I am on to a "normal" bariatric diet.  What is normal?  Well honestly, what I want.  I tried red meat for the first time tonight and it seemed to go okay.  I have been nervous because red meat is hard to chew to applesauce consistency.  But I had a hot beef sandwich (minus the bread).  So it was shredded beef already and that helped.

Now comes the "easy" part...right?!?!  NOT!

I have now had 5 incidents of dumping syndrome and other than one of them - I did nothing that I would have thought would cause it.  The one time...well, I had some monkey bread.  Nope - I learned that sugar is NOT a friend to me any more at all.

But seriously - the other 4 times, I had eaten something that I had eaten before and for some reason this time it caused me to get sick.  I never know if I am going to get sick or be okay.  Eating is a constant guessing game.

A couple of weeks ago we were travelling to my in-laws' place.  I needed to eat something along the way.  WE stopped, I found something that I had eaten before and it had gone well - so I got it again.  I was fine.  TWO hours down the road, horrible cramps - like breathe through the labor pain type of cramps.  And then all of a sudden - I knew I was going to be sick.  I grabbed the tub we use as a garbage in the car and vomitted several times.

I prayed and prayed that I would only vomit, since usually I get diarrhea as well.  Luckily, I was able to only vomit and then hold the rest for 15 miles until Mike could find a gas station to stop at so I could "finish" the job.

But remember - this is the easy way.

What I am trying to say through all of this.  Weight Loss Surgery is NOT an easy way out.  It is NOT a miracle cure.

Weight Loss Surgery is a "tool" to help the severely obese lose weight.  It is most certainly NOT for everyone.  in order to be approved, you have to show them that you are serious - you can change your habits and commit to a new, changed life.

PEople who choose weight loss surgery have struggled with their weight, have tried diet after diet after diet and feel like a yo-yo.  People who have surgery often times feel horrible about themselves and their inability to lose weight.  We can eat the same thing as the person next to us and they lose weight and we gain it.

Being severely obese is a horrible feeling and you feel like you can never win.

I was given a tool on May 7 and I am using that tool to my advantage.  I now eat 800 calories a day and exercise 60 minutes.  I drink lots of water.  I have given up all pop for the rest of my life.

Every surgery patient is different and finds what they can and cannot eat.  I found out this last week that eating sugar is NOT something I will try again for a long time.  I do not want to feel like that again.

I used to enjoy eating, going out to eat.  I would look forward to planning meals and what I would have.

That is gone.  I now eat because my body says it needs food.  I can't say I am scared of food, but I am defintiely tentative about what I will put into my body now.  I don't look forward to food, I eat because I need to.

I have been told that will change and I will enjoy food again.  I just know that right now it is easier to stick to the things I know won't make me sick.  Trying "new" things is an adventure - I mean, who thought cantaloupe would cause me to be sick?!  I simply do not know how my body will react to food that I have eaten my whole life.  So I add things one at a time and make sure they are okay before making them a staple in my diet.

Surgery is most certainly not the easy way out.  Deciding to do this and doing this and now living this is the hardest thing I have ever done.  But I would do it all again in a heart beat.  Why?  Because I have accepted that it is a tool to help me lose weight and be healthier.

Today I have lost a total of 67 pounds since last October when I started the process, 37 pounds since surgery.  Today I am able to listen to my body in a way that I was never able to before surgery.

That is a key thing - surgery patients really learn to listen to their body and what it is telling them.  We don't get full like you do - it's a VERY different feeling.  Hunger, too, is a VERY different feeling.  And learning what those feelings are and what they mean is difficult.

So to all out there who think that people who have weight loss surgery are just taking the easy way out - I say, NO.  We chose the hard path because we desperately wanted to make a change in our lives and we took this chance to gain a tool to give us some extra help.

So please - if you know someone, remember, this is the hardest thing they have ever done in their lives and they need your encouragement and support, not your condemnation and judgement.  Help make their path a little easier.