The Chairs

According to the weight loss clinic’s flyer, the information session is:

To make sure you have the information you need, we require patients to attend an information session before their first clinic appointment. Sessions are hosted by our surgeons and give you a chance to meet them and ask questions. We’ll guide you through surgery requirements and discuss the risks and benefits of each procedure. You are welcome to bring family or a friend with you.

Looking back, I should have noticed the word: “require.” The weight loss clinic that performed my surgery used the word “require” or “requirement” more than they used the words “gastric sleeve procedure.” I didn’t know, at the time, the information session would begin the relinquishing of my autonomy to repetitive requirements. I want to believe that someday I will become comfortable enough with my weight loss journey to regain my autonomy.

I accepted this hour and a half long “session” at face value: a simple meet and greet with surgeons and a Q&A afterward. As I said before, this session began with a heartbreaking bang as I overheard a woman say to her friend, “Wow. You’re not as big as her.”

This comment didn’t shake me right away. Instead, I was more concerned about finding 2 empty chairs next to each other for my husband and myself that were NOT in the front row. I found two extra-large chairs in the second row.

Looking around, I realized the entire room was full of these extra-large chairs. I don’t understand extra-large chairs. I will admit that a couple reasons on the “pro-surgery” list included eliminating the fear of breaking a chair and getting on a plane with confidence because I would not need more than one seat or a seat belt extender.

The only places I have seen extra-large chairs, such as these, have been in therapist and doctor’s offices, which already have sturdy regular chairs that I’m not afraid I will break. Plus, when you go back to actually see the doctor or therapist, you are given a couch to sit on by the therapist and an unstable, wobbly plastic chair by the doctor. So, why have these chairs at all?

I think the goal of the chair is show how politically correct and “accepting” of people who are morbidly obese the offices are. But, I think it does the opposite. When I am forced to sit in one of these chairs, because it is the last available one in the room, I feel like I have a giant, flashing arrow over my head calling attention to the fat girl, who is so big she needs a giant chair. In a passive aggressive way, the chair is fat shaming the person sitting in it. It makes me feel as though I am not “normal” or “good enough” to have a regular chair.

The other issue with the chairs is they are not engineered to be comfortable in any way. Sitting in the extra-large chair at my heaviest weight, there was still a good 6-8 inches of spare room on the seat, and my husband’s had more. After the verbal fat shaming I received, I wanted to sit close to my husband. The chair had a different idea. The sharp angular wooden arms were at just the right height to bite into my ribs when I leaned over. Even though there was physically more room on the chair, there was less useable room. The structure of the chair confined me, as if my obesity was contagious.

Later on, I would learn that the weight loss clinic had only these types of chairs in their waiting room and their examination rooms. I will never avoid these fat shaming prison chairs.

The chairs and the “requirements” were the covert dehumanizing treatment that would  turn me from being a human being into only “a super morbidly obese.” The covert dehumanization made traveling from the information session to the surgery to today an act of sheer will, and I uncovered an unknown fount of resiliency I had no idea I had.

The First Step

When I decided to write this blog, I did a lot of research about what it means to produce “good” writing. The theme of the research was that “good” writing should be both authentic and vulnerable. I’m not sure what that looks like or what that means. When I write about my story, it physically hurts. Sometimes the tears from pain, sadness, and heartbreak spill down my cheeks, and I can barely see through them. I just keep writing because I want to be authentic and vulnerable. This blog post is the beginning of the “official” bariatric weight loss journey, so the tone is going to change a bit. The first three posts were the multi-path journey that led to the decision to have the surgery.

The first step in having an elective surgery was finding out if our insurance company would approve or cover the procedure. On his birthday, my husband received word from the insurance company: “Weight loss surgery including the gastric sleeve procedure is eligible for coverage under your plan.” The letter continues by providing a link to a list of “designated weight loss surgery providers.”

Although the “designated weight loss surgery providers” came directly from our insurance company and we were told that we were covered, still the letter, strangely and a bit unsettling, came with a caveat stating: “Please note that a provider appearing on the list above is not a guarantee that they are in-network for your specific health plan.”  The insurance company says: Yes, the procedure is covered. AND here is a list of people who we want to do your surgery, BUT make sure that the provider is “in-network” for your plan. My question is, we went directly to the insurance company to make sure everything was covered under OUR plan, why would they give us providers who would be “out-of-network?” These logical questions, as well as future ones, I didn’t ask. Once I make a decision, I push forward with that decision against all logic, setbacks or roadblocks. Looking back, jumping in with both feet without looking for sharks, was negligent on our part. But after Chicago, there was no turning back. I was going to do this!

We chose one surgery provider out of the 12 listed. We chose our provider because this was the same hospital system where our Physician’s Assistant works.  I wish I could say my husband and I did research on the providers or thought about how this would be a good place because they could share my information with my primary doctor through their software systems. But none of this crossed our minds.

I called the “Surgical Weight Loss Clinic” located in one of the stereotypically richest areas in the city. Maybe for some people this would mean quality or extravagance, and in some ways, it did. I have to say, several times we enjoyed the valet parking service the hospital provided.

On my first phone call with the clinic, I was scheduled for an “information session” on June 28, 2016, at 7:00pm. The only question she asked was, “What kind of surgery are you hoping to have?” “Gastric Sleeve” was my response. The person on the phone didn’t ask why I chose this procedure; she just said I was to bring my identification and health insurance card. I thought this was really strange for something called an “information session.” Blindly, I followed their instructions. We were to meet in the Au Fait room. I had never been to this hospital, and I should have asked for directions on how to get to the Au Fait room. I didn’t.

I was nervous on June 28th for this hour long presentation. I dressed in my cutest clothes: black skort, sheerish red tank, and a black, short sleeve, cotton, lightweight cover-up jacket. I wore a pendant with a fake red stone in it, and my only pair of sandals. I thought I looked adorable, but I hardly ever looked in the mirror before surgery. Sure, a glance here or there to make sure something was on straight and nothing in my teeth, but I never REALLY looked into a mirror.

My husband and I work about a mile away from each other and often carpool to work, so instead of going home, we went out to dinner at a sushi bar, Nakamori. My husband and I walked in just in time for happy hour. We both had 2 glasses of plum wine and several rolls of sushi. I’m not good with chopsticks, so I dropped a piece or two on my shirt causing some stains. After we finished, we had time for dessert. We shared a Tempura Ice Cream and a Cheese Cake Tempura … basically deep fried ice cream and cheese cake. It was all delicious, and we were in high spirits from the food and the drinks.

I remember every moment of this meal.

This was the last one I ate for pure pleasure.

I wasn’t worried about the consequences; instead, I was in the moment, enjoying each bite.

The sushi place is about 6 blocks from the hospital, and neither of us could find a map of the inside of the hospital. I allowed my husband to just park in the parking ramp he figured would be the closest. Once we were in the parking ramp, I took off my shirt and turned it inside out to hide the soy sauce stains, touched up my makeup and lipstick, and we were off.

We walked in the closest door to the parking lot and it was a door at the corner of two empty hallways, with the exception of a bench. I promptly sat down on the bench and my husband wandered off to find a map or something. He managed to find a volunteer information person. He asked her where the Au Fait room was, and she said she didn’t know. They both looked at the map she had, and the Au Fait room was not marked on the map. Instead, she simply pointed to where it should be: on the far end of the hospital from where I sat on that bench.

My husband offered to go get the car, pick me up and drop me off at the closest door to the room. I thought that was absurd. I knew if we took it slowly, I would make it there. The problem was that I was anxious now because we were going to be late. The bottom of my feet rubbed against the leather of the sandals and began to burn as we walked. My lower back cramped up, and I was forced to sit down every chance I got.

By the time we made it to the Au Fait room, I was hot and out of breath. My feet burned so badly, I was anxious to sit down and take off my shoes. Instead, I stood in a line where a nurse, who I would come to recognize as the only “nice” nurse in their organization, checked my insurance card and ID. I was handed a pale-yellow packet, “Gastric Sleeve Surgery and You,” and was told to sit down for the presentation.

The first thing I noticed as we were finding seats is that every person (but my husband) was a woman, and they were all dressed in black. The chairs were extra, extra large, looked a bit like this one:

:chairs

and were incredibly uncomfortable.

As I sat down, I heard a woman whisper, “Wow. You’re not as big as her.”

This was both the end and the beginning for me.

Olive Green Backpack

The final shove to actively pursuing bariatric weight loss surgery came during a Chicago vacation in June 2016. My husband had a work conference for a couple days in Chicago, and we decided that we would stay in Chicago a few extra nights and make a mini-vacation out of it. We had not had a vacation that required a flight since our honeymoon in 2011.

Having never been to Chicago, I checked out many travel guides from the library. I researched what I wanted to explore in Chicago while he was at the conference and what we would explore as a couple. I made a full itinerary for the 2 days I was by myself including the museums I would visit and walking tours I would take. I bought an olive green backpack and filled it with items I needed on my adventures. My husband even put a tracking app on my phone so that if I got lost, he could easily find me.

Side note: I grew up in a town of 2,000 people in Minnesota. I went to a college, within an hour driving distance of my parents, which had 2,000-2,500 people tops in attendance. In a college of this size, I knew the majority of people either by name or by face. My college years were comfortable, no real personal growth or exposure to ideas that were different than my own. I didn’t party because I was working all the time, either studying or at a job to pay for school. In the last month of college, I was accepted for a Master’s Degree program in Boston. By that August, I was alone on a train to my new life in Boston.

My program was 2 years long, and I had every intention of sucking up as much of the city’s culture as possible in that time. My class schedule was Monday through Thursday with Fridays off. I used Friday as my “explore Boston day.” I went everywhere with my trusty backpack learning from public transit systems, museums, the North End, Southie, the Freedom Trail, Faneuil Hall, the Common, the arboretum, the flower shows, the ballet and Fenway Park. I was always alone, and I walked anywhere and everywhere. My daily commute was an 8 block walk, in all weather, to the subway station.

I would not trade a moment of my time in Boston. When I look at the diploma, I don’t just see all the classes and papers and exams. I also see my daily introduction to a wide world with diverse people and points of view. I see grip worn shoes and a threadbare backpack. My experience in Boston created and established the person I am now. End side note.

Since I have been married, I haven’t had the chance to go to a new place and explore on my own. We explore new places together, which is wonderful and I am grateful to have a fellow adventurer, but, this trip I was going to pull on my new trusty olive green backpack and explore Chicago. I wanted to feel the wind of discovery blowing in my hair and on my face. I wanted my eyes to open wide and witness experiences that only travel can provide.

We left early morning for the Minneapolis Airport with our luggage, carry-ons and my backpack. In my experience at the Minneapolis Airport, everything is far away from wherever you are. No matter which parking ramp, departure or arrival gate you are going to, from WHERE EVER you started, it will never be a short walk. Our departure gate was no exception. I only made it about 60 feet from the car into the terminal before I needed to sit down due to the pain I experienced from walking.

On the Chicago trip, I was the heaviest I would be.

To me, walking meant deep, sharp, pinching shooting pain down my back so extreme I would have to sit down. If I did not sit down, it would grow to the point where my thigh muscles and mid-back muscles would cramp and force me to sit down. Along with my back, my calf muscles could not hold my weight and would begin to pulsate and cramp, and my feet gripped my shoes to the point that I was squeezing my feet to the ground.

Even though my husband took my luggage, these 60 feet at a time through the airport threatened our ability to be on time to board. We made it onto the plane on time, but my seat belt didn’t buckle. This was a first; I was mortified and didn’t know what to do. We hid the unbuckled section under my husband’s shirt, and I was not caught by a flight attendant.

Once we were in Chicago and all checked into the hotel, I laid in the comfortable bed watching tv, with my backpack shoved into a hotel closet. The next day, was to be my first day of exploration. I got up, got dressed, threw my backpack on, walked to the elevator, walked down the hall to the hotel’s Starbuck’s 20 feet from the front door and sat down. I ordered a drink and sat for a while at a table and realized there was no way with the pain I felt that I could leave.  Instead, I went back to the room, ordered room service and spent the day lying in bed watching Law and Order: Special Victims Unit re-runs.

On my last day of solo exploration, I didn’t even try. I was so humiliated and ashamed. So, the backpack remained on the floor where I left it the night before and spent my 2nd day lying in bed, again watching Law and Order: Special Victims Unit and ordering room service.

The remainder of the trip, as a couple, was a mess of cabs driving us 3 blocks to see landmarks where I would vary between 40 feet to 20 feet before I needed to sit down. In one occasion where there was not a bench, I simply collapsed on the ground. As the vacation continued, I couldn’t stand in a line at a drug store to buy lotion to help the sunburns we received, I couldn’t climb the 5 plus flights to reach our seats in the Cubs Stadium, and I was only able to enjoy A Sunday Afternoon on the Island of La Grande Jatte by Georges Seurat at the Art Institute of Chicago from a sitting position.

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On the flight home, the seat belt buckled this time. I looked at my backpack, and it looked exactly as it did when I bought it off the rack. The majority of the pictures my husband took didn’t have me in them. In the ones I was in, I was standing with half of me behind him. All the pictures I took were taken from the backseat of a cab, attempting to capture a moment of exploration while I had no control of the speed of the world around me.

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After our return, my husband called our insurance to find out about bariatric sleeve coverage, beginning what I did not understand then, the extent of the NOTHING WILL BE THE SAME journey.

But as I look at my worn olive green backpack on the floor next to me, I think of all the places I have gone with that bag, especially the day it came with me to surgery.

Living Inside Myself Among the Trees

I like to believe that the bariatric surgery journey began when I heard the words from my doctor:  “Women with a Body Mass Index higher than 35 have a 9x greater chance of having uterine cancer” in April 2016.  But my journey began in July 2015, 9 months earlier, in Itasca State Park, the birthplace of the Mississippi River in Minnesota.

Itasca is what I think of “home.”  From age 15 on, I’ve visited the park for sporadic day trips or summer weekends.  My great-grand-parents and my grandparents had their honeymoons in Itasca. This love for the park was passed down and around the family. Currently, if my immediate family wants to vacation, we go to Itasca because this is the only place we will have fun and not fight. In spite of the family vacations, my family understands my connection and bond to Itasca runs far deeper than any I have had with anyone .

When I lived 1-2 hours away from the park, I would drive there alone for a day trip or a weekend away to clear my head, fill my heart, escape into the woods or read along the beach. No matter what, I would visit the trees. Henry David Thoreau explains this far more eloquently. In Walden, he writes: “Trees indeed have hearts…I frequently tramped eight or ten miles through the deepest snow to keep an appointment with a beech-tree, or a yellow birch, or an old acquaintance among the pines.”  Having a tree or many trees as your confidants brings about such peace and a sense of well-being. The longest I stayed away from Itasca was 4 years due to graduate school, but when I returned the trees welcomed me.

2015 was a difficult year in my family because of my mother’s health. We almost lost her several times that year, and she was forced to stay in a nursing home for a year for recuperation. Although, she has since returned home, her inability to walk on her own is a constant thought that brings me to tears. In 2015, my husband and I had not been to Itasca for 2 years because I had lost my job during that time, and we needed time to save for a return to Itasca. I never needed my park’s confidants’ comfort more than I did in 2015.

On a warm July day that year, my husband and I drove into the Douglas Lodge Parking Lot. Douglas Lodge is the main office for Itasca Park lodging and dining.

Douglas Lodge at Lake Itasca

I got out before the car was in park. My husband went up to Douglas Lodge to check us in, and I recreated a moment that I had repeated from when I was ages 15 to 24, I ran down the long, staircase which heads directly down to Lake Itasca. I truly believed I was young and that my body was strong.

Stairs Down to Lake Itasca

I made it about 6 stairs before I fell. I caught myself with my left arm on the railing and my knees and right palm caught the rest. I was bleeding, in severe pain and weeping because I couldn’t perform this ritual. My husband took me to our cabin and bandaged me up. For the remainder of our visit, the injuries I sustained kept us stuck in the cabin instead of enjoying my “home.”

At age 35, I had been living disconnected from my body for who knows how long. I was unaware of the hindrance of my weight because, in my mind, I was still 20, many, many pounds lighter and believed nothing had changed. I liken it to an inversion to Body Dysmorphia, where instead of being thin and seeing a fat person in the mirror, I was a fat person who always saw the strong, healthy person who had not aged, changed, or gained weight. I would look at pictures of myself and if I didn’t like what I saw, I just thought the camera must have hit me at the wrong angle.

I realized later I wasn’t living in my body anymore; I was not connecting or fully feeling like a complete person.  I tried, hard as I could, to learn how to live connected and inside of myself, but I was unable to find this beautiful gift of wholeness until after the surgery. The surgery has forced me to be aware of my body and its place and significance in the world. Being whole is incredibly difficult to get used to and is frightening, almost terrifying, on an hourly basis. But, the mind-body connection establishment is a benefit and bane of the surgery. Because of the surgery…

I’ve had to reclaim who I am to myself.

I’ve had to teach myself who I am.

And, in the future, I hope I learn how to accept myself.

I haven’t been back to Itasca since before the surgery. I can’t wait to return, as a stronger, more connected human being. And, I can’t wait to meet up with my old acquaintance in the pine trees.

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Preacher’s Grove in Itasca State Park

Terrifying Words & Shame

The path to bariatric surgery all started at a doctor’s appointment in April 2016. Sadly, all of our doctors at our regular clinic left within months of each other, and we had to find another doctor. Living in an urban area, the choice of doctors becomes so distant, so cold, that if you are lucky enough to have a friend who has a recommendation, that doctor is usually not taking patients. Instead, my husband and I relied on which one didn’t look like a serial killer in her professional photo. I found myself half naked on a strange doctor’s exam table.

Side note: In the months between January and April, I needed to get a pelvic exam due to excessive bleeding, and I need to have one done every year because my mother had uterine cancer when she was 40. The first doctor only discussed my vaginal pain and heavy periods and didn’t check any private parts during my yearly physical. “They” say you don’t have to have a pap smear every year if you have never had an abnormal one. However, you should have pelvic and breast exams every year, no matter what. I then went to another doctor in the same clinic. This time, she just gave me a pap smear and nothing else. She told me I had to go somewhere else to get a pelvic exam. Note: she also did not check my breasts as well. End side note.

Back to Half Naked on the new doctor’s table. Amazingly, she did her job. Who knew it would take 3 doctors to get them to shove their hand up my vagina. I had better luck in grad school with random boys than this. But quite quickly she changed the topic from my concerns about bleeding to how everything was normal to weight loss surgery.

I’ve had a weight problem / been on a diet / hated my body and myself since I was in 2nd grade. At this time, that meant 29 years I have been battling my self worth, trying diets, succeeding on some, overcame anorexia, overcame bulimia, but everything failed. At this point in April, I thought it was the heaviest I would ever be. I read and tried every weight loss book out there. I tried everything.

Returning to vulnerable and half naked, this doctor suggests the gastric sleeve, a new procedure- where they remove all but a banana size section of your stomach. I told her I didn’t trust weight loss surgery, and what about all the extra skin, and she told me the percentages. Less than 10% of people who try to lose 100+ pounds or more do not gain it back. She also spoke about how she attended a conference about women’s reproductive health where they cited a statistic that women with a BMI higher than 35 have a 9x greater chance of having uterine cancer. She handed me a brochure and disappeared to have me clothe myself and get ready for another A1C (a blood sugar test).

I don’t think there are more terrifying words anyone has ever spoken to me. But, my husband and I were in the middle of a strict diet at that point, and thought, we can do this, we can defy the odds. We decided that we’d try to do it on our own until January 2017, and then, if it didn’t work, we would look into weight loss surgery.

I wasn’t sure if I could ever stop feeling that weight loss surgery is a shameful thing. That “How could I allow myself to grow so big that I would need weight loss surgery.” But when given the chance to look at others who have had weight loss surgery, I do not feel as though they should be ashamed. I think the shame should only belong to me and me alone.