Thou Shalt Never

Once I was sold a weight loss surgery, the information session continued on and on. Two women who didn’t understand the concept of presentations – the presenter talks and only the presenter talks – provided constant commentary on each slide, and they also fell into the category of heckling like Statler and Waldorf from the Muppet Show

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when the doctor was discussing how the surgeries are performed.

The doctor explained the 3 surgeries the weight loss clinic will provide in high school health book detail. Then he moved on to the list of activities we could never do again if we chose surgery. According to the presentation,

WE CAN NEVER:

  • Drink Soda or any other “fizzy” drinks
  • Use a Straw
  • Chew Gum
  • Drink Caffeine
  • Drink Alcohol
  • Eat Hard Candies
  • Eat Coconut
  • Smoke
  • Snack between the 3 meals per day
  • Drink less than 64 ounces of fluid per day
  • Drink less than a ½ hour before a meal and after a meal
  • Skip Vitamins
  • Drink Very Cold Fluids

This list took a very long time for the doctor to explain due to the confusion from the crowd. One woman asked, “What do you mean I have to give up Diet Coke?” And the doctor’s response was, “Some of the fattest people I know drink Diet Coke.” Well, now that’s an answer.  Why didn’t he treat her like an adult and explain that the carbonation in Diet Coke will cause her pain once the surgery is performed? Another woman asked about the no alcohol, and the doctor backed off on this rule. He said, “It’s something you can enjoy occasionally. Like champagne at a wedding.” This seemed to satisfy most people in the audience, including me. However, at my first nutritionist visit, she said she wished the doctors would stop using that example because champagne is “fizzy” so technically we couldn’t have that type of alcohol anyway.

The presentation continued with more rules. A bariatric surgery patient has to meet guidelines before they can be considered for the surgery. These include having strong, healthy teeth and the ability to walk unassisted for 5 minutes. Another guideline the doctor informed us about was that we will have to lose a certain amount of weight before our surgery because it helps to reduce the risk of complications during the surgery. Losing weight makes the liver smaller which makes it easier for the doctor to move it out of the way to perform the operation. He stressed to the group that if we don’t lose the weight, we will not be cleared for the procedure. We were also told we would be weighed on the day of operation to make sure that we hadn’t gained any weight from being cleared for surgery to the actual surgery date. He said that if we are even 1 pound over our required weight loss on surgery day, he would cancel it. “I’ve done it before, and I won’t hesitate to do it again.” This statement haunted me as I tried to lose my required weigh throughout the gastric sleeve preparation process. Every time I stood on a scale at home that didn’t say what I needed it to, I imagined myself standing in a blue surgical gown on a scale and refused the surgery. But his threat threaded its way into the lobes of my brain to become the first fear I would visit when my mind was quiet. It fueled my depression.

The entire process for this clinic usually takes AT LEAST 4 months to get the surgery. Like a fool, I took comfort in this time frame. I thought it was going to take 4 months or less to get approved and onto that operating room table. That time would be filled with so many hoops, it will take another blog post to properly list them. For now though, it’s important to note all these hoops had financial repercussions as well.

We hit our out-of-pocket insurance requirements for the year in August, and my goal was to complete the surgery before the end of 2016 so the surgery would be free. My husband tried and tried to convince me that it would be ok to have it in 2017, but I just couldn’t figure out how the bills would work out with our 2017 budget. I was determined to get it done before New Year’s.

But, no matter how many times I went to the clinic, or how far I came in the process with the checklists, when I asked the question “When do you think we can schedule the surgery?” The answer was, ALWAYS, “We’ll have to see.” So, each hoop I jumped through, there were no encouraging words, no estimate of a possible surgery date, no indications as to when the hoops would come to an end, or even if I could get through all of them and have the doctor turn me away for some random hoop they never mentioned. Instead, I was always greeted with the “We’ll have to see” and the vision of me cowering, cold and vulnerable on a scale to be turned away at the very last second became clearer and clearer in my mind. The hoops, the uncertainty, the self-consciousness about my body, the pain to move, the desperate attempt to lose the required amount of weight, kept me up at night and sent me spiraling.

SIDE NOTE

I was diagnosed with depression when I was a freshman in college. I should have been diagnosed much, much earlier, but that isn’t how my family worked.  All my family members had untreated mental illnesses of their own when I was younger.  It was too difficult to see outside their world to see mine. Interestingly enough, once I began my treatment for depression, many of my family members followed suit. It was like I was giving them permission to get help. I do not know a lot about how depression works in other people, but for me, it ebbs and flows. It seems to heighten in intensity for a period of time, usually a month or two at a time, but I think the intensity helps me recognize that I need to focus a bit more on self-care. In this heightened intensity stage, you know, logically, that eventually the sea of depression will subside. For me, incredibly difficult, stressful circumstances push me into the depression sea to drown. I’m dropped into the “Pit of Despair.” My depression moves me into darkness where I don’t have a hope or a belief that the depression will ever subside. I look back at times I was in that pit, and I was surviving, but I do not remember how I functioned. I think about those times and all I see is life shaded black. It’s like depression redacted whole months of my life at a time.

Those months when I was hoop jumping for the weight loss clinic and for my insurance company is a portion of my life when I was drowning in the sea of depression or the pit. I can’t remember day to day, ordinary activities through the black marker redaction.  And it all started with this info session.

Once the presentation concluded there was time for questions. While I sat in a trancelike state, unable to focus on the doctor, women or my husband, the women launched questions at him that only sounded like a quiet buzzing in my ears. I wanted to leave, I wanted to never lay eyes on the doctor or these women ever again, and I wanted to run to the car and hide. After the women rushed the doctor to ask him questions, my husband and I made our way out. Even though the car was in the farthest possible parking lot, I managed to make it to the car. Once inside the car, the emotions stuffed into my chest exploded. I cried, I yelled, I screamed. But I knew there was no choice for me but the surgery. This was the path I had to take because nothing else was working.

When we got home, I shoved my shame into ice cream and planned to make an appointment at the clinic the next day.

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