Surgery is the easy way out!

(Reposted from the Vertical Sleeve Gastrectomy forum by request)

 

Yep, you heard that right.  I've decided that I agree with the myriad non-surgical, gym-loving, overwhelming weight loss successes that feel strongly (and vocally) that surgery is the easy way out. They really are correct.  We all should be ashamed of ourselves for taking the shortcut approach and racking up an "un-earned win".

 

Just think about it.  To successfully lose weight without surgery, all you have to do is two things:

 

1)      eat less

2)      exercise often

 

With surgery, you only have to do one thing:

 

1)      pay a surgeon to make you lose weight

 

Well, perhaps that's a minor oversimplification.  There are a few other steps, but they are tiny and insignificant.  Not everyone has to do them either!  But, just for the sake of objectivity I’ll list most of them that I can think of.  (I might miss a couple, but since surgery is the easy way out who cares really.)   Let’s see, there is:

 

1)      Convince yourself that you want to do this.  This is much more complicated than it seems, so take your time. Don’t get sick before you make a decision.

2)      Convince your doctor that this is medically necessary.  Convince him/her that you really do want this and you aren’t just someone unwilling to sweat a little. Convince them that you won’t die on the table.  Convince them that you aren’t doing this so you can keep eating cake for breakfast. And lunch. And dinner.  Because that’s the only reason big people are big people.

3)      Spend anywhere between 3 months and a year working with your PCP to make a preliminary run at losing weight.  This should include:

1.        A special diet
2.       Exercise
3.        Constant office visits to measure progress
4.       Significant expense to participate in the diet (Nutrisystem, Medifast, and Jenny Craig, I’m looking at you!)
5.       Lots of documentation
6.         Likely (if not anticipated) painful, humiliating failure (PS, this is a requirement!)

4)      Spend hours to days or more working with your insurance company website, phone reps, and via letter to determine if weight loss surgery is covered at all, assuming they will admit to it.

5)      Once you find out it is covered, find out what exactly is covered.  Type of surgery, location, type of doctors required, pre-op programs necessary, pre-op medical requirements, pre-op diet requirements, and documentation.   Make sure you understand it all clearly because…

6)      Meet with your PCP to go over all of the above.  Explain to them what most of it means, because they don’t understand.  Make sure your work so far will meet the needs of the insurance company.  Convince him/her to do the work to get the approval.  If not, return to step 1 and try again.  (Note: make sure you do all of this quickly- most of these rules are subject to change on January 1, even if you have a 12 month diet requirement.  You’ll need to find a way to violate the laws of space and time on your own.)

7)      Get a psych evaluation.  People who want this surgery are invariably crazy, so we need to confirm that.  Don’t use a doc you know. Go somewhere you’ve never been so that they can get that first-blush, cover of the book impression of your particular brand of crazy in the 45 minutes you get with them.  Let them write their report confirming your “crazy flavor” to your docs and insurance.  They will approve you anyway. 

8)      Take an online class that confirms the crazy diagnosis.

9)      Take another online class that basically tells you if you have the surgery you will likely die horribly on the table, if you’re lucky.  You might just become a vegetable and be a possibly fabulous looking skinny burden on everyone you know and love!

10)   Find a surgeon that can both perform the surgery (practically, legally, and allowable by the insurance)  as well as doing so without causing

1.        Errors
2.       Infections
3.        Hernias
4.       Leaks
5.       Death

11)   Make sure that doc can take your insurance.  Not just yoru insurance, but your exact insurance.  This may require them to check at least a dozen contracts. 

12)   Do the same for the hospital.

13)   Make sure that hospital you’ll have the surgery in isn’t a festering wound itself.  The surgeon can only do so much if when you get to the floor you’re placed in the same bed last used by an Ebola patient with a cold and cleaned by “Blind Larry”.  Fortunately there are many websites sponsored by government agencies to help you with this.  They will all disagree with each other.

14)   Get insurance authorization to have the surgery.  Fortunately this process starts the weight loss, as one arm and one leg weigh a surprising amount when removed and given to them. This should take no more than a day or two, tops.

15)   Have a discussion with your employer.  Let them know that you’ll need a full week off from work in the near future.  You know, when you aren’t busy and won’t be missed.  Again, if you’re lucky you’ll have vacation and can use that.  If not, think of how much extra weight you’ll lose when you can’t afford to eat for lack of a paycheck!  OH, you may need more than a week.  If you come out healthy.  If not, it’ll be more.  A lot more.

16)   Have a discussion with your family, if you haven’t yet.  If you haven’t yet, shame on you for your discretion, personal space, and recognition of the gravity of this decision.  Make sure that you convince them that you won’t die, runaway with David Beckham or Eva Longoria (or both if you’re flexible), or otherwise ruin the home.

17)   Get answers to all of the questions you have.  Fortunately ObesityHelp is a great place for that. You will get no less than 10 answers to every question. Some may actually agree.  J

18)   Make sure that this is really what you want.  This isn’t like buying a car or getting married. This is permanent and there is no going back.  Still confident this is the right choice?  Now you know your flavor of crazy from item 7.

19)   Go on a liquid diet.  You may not have anything that you cannot “read a newspaper through”, is solid, has calories, has carbs, has protein, has flavor, or is made of a natural substance.  This will last anywhere from two days to a month.  Your surgeon will tell you how long. 

20)   While on the clear liquid diet, please try not to cheat on the diet.  More importantly, please try not to defecate on yourself.  Here’s a mantra for you: “Never trust a fart!”

21)   Have the surgery.  This will include:

1.        Large, but not quite large enough gowns with special butt exposing panels
2.       Freezing rooms
3.        Needle fears
4.       Vein scavenger hunts
5.       Panic attacks
6.         Several other fun moments no one will spoil for you to discover

22)   Recover from the surgery.  This will include:

1.        Amazing drugs that will make you fear for the poor 110lb nurse that will help you walk at first.  Please don’t fall during this time or you will crush her. You’ll fear this, but only briefly (great drugs remember).  Just don’t fall.
2.       Walking.  Yes, you’ve just had your entire insides rearranged and have more stitching in you than a rented tuxedo, but hey, let’s go for a walk. Every hour.
3.        Eating.  This is really a game.  You have a 3ish ounce container that replaces your stomach.  It is swollen, but you don’t really know how much. If you over fill it, you will be in serious pain, and may hurt yourself severely.  Here’s the fun part- you’ll be given a selection of hald a dozen clear liquids to choose from.  Some will make you retch.  Some will taste like heaven.  All are more than 3 oz. You- the person who’s complained that Mickey D’s quarter pounders have never once been a quarter pound – now get to determine what 3 oz looks like.  Don’t forget two very important things. 

                                                               i.      You are stoned on anesthesia. Your judgment aint what it should be.

                                                             ii.      So is your stomach.  It’s not going to help you by saying “I’m full” for about 2 weeks to a month.

1.       Going to a bathroom.  The author of this article is a male, so with that perspective in mind, consider the male stereotype of urinating.  Now imagine that sharpshooter in the hands of someone who cannot see straight, or single vision, is falling asleep on their feet, whose prostate is not yet awake from surgery but whose bladder most definitely is, and who is currently on their 4^th IV bag of saline with lactated ringers running wide open. Don’t forget to measure your output!

23)   Go home!  This is the easy part.  Stuff your swollen and now anesthesia free self into a car and try to avoid potholes, cough, sneeze, or breathe too hard.

24)   Continue the clear liquid diet for a few more days

25)   Progress to protein drinks.  These are a joy.  There are few if any samples, so make sure you get the 5lb bottle to be sure you love it.

26)   Progress to pureed or baby food

27)   Progress to cat food or tuna

28)   Progress to gourmet cat food or flavored tuna / canned chicken

29)   Progress to dog food or chunky soups / heavily cooked soft and unflavored chicken

30)   Progress to human food.  During this time you will need to learn a few things.  These will include:

1.        How to eat.  Remember you’ve been doing it wrong all your life so this should be easy. 
2.       You may only have dense protein. 
3.        You must take in no more than 3-4 oz. 
4.       You must take an entire 30 minutes in which to do so. 
5.       You may not drink before, during, or after the meal.
6.         You may not have anything spicy.
7.        You may not have anything with carbs.
8.       No alcohol for at least 6 months, or maybe forever.
9.          Nothing liquid. 
10.         Carbonated anything is permanently off the menu for the rest of your life.
11.        Nothing with caffeine.
12.          Nothing with less than a 10:1 ratio of protein to carbs
13.     Keep calories as low as possible.
14.       Learn to keep something that meets all of your dietary needs handy.  If you need to eat, not every place can meet your “special needs”.
15.       Make sure that you understand that you need to do this for the rest of your life.  You can’t change this.  Non Surgical people can indulge once and awhile.  They can cheat.  We rupture.

31)   Please remember to keep your intake to levels that would make Ethiopians send you food.  This is generally 800 calories, less than 40 carbs, and more than 80 grams of protein per day.  You must do all of this in 3 meals with no snacks.

32)   Take your supplements:

1.        Calcium.  Note that it isn’t the same calcium that you can get for a dime on any gas station shelf (Calcium Carbonate).  This is a highly refined form of easily absorbable calcium (Calcium Citrate).  It will come in three forms:  A disgusting snot textured liquid found at Wal-Mart for $11 per week, a myriad of chewable pills that all taste like flavored drywall and cost about $20 per month, and delicious chewable candies that cost $40 per month.
2.       Multivitamin.  You’ll be doing double doses.  Get the adult gummy ones.  Find the ones with no carbs.
3.        Fiber. Get the adult gummy ones.  Find the ones with no carbs.
4.       Iron. Some people will take iron.  Get chewables. 
5.       B12. You can do pills under your tongue that taste like yesterday’s fish for $10/month, injections at the doc’s office every 3 weeks, or a nasal spray that costs $350/month.
6.         Do all of the above for the rest of your life.  Don’t stop or you’ll die.

33)   Start to exercise! What, you thought that you didn’t have to exercise?  Yep, here’s the trick.  You are going to lose weight even if you don’t.  Here’s the other trick.  It’s easier to take that weight from your bones and muscles if you don’t exercise, so if you don’t work out, all that’s left will be fat!

34)   No really, you have to exercise.

35)   Yes, that means sweating.

36)   Make sure that while you’re going through this easy time in which every hormone you have is at full tilt, every part of your body looks and feels funny, nothing fits, and you generally are proud that you’re losing while also being weirded out by how different everything feels you also take into account everyone else.  Remember, this is about them and how they perceive you.  You can’t be the popular kid.  The healthy person without diabetes, hypertension, edema, or apnea. The more confident employee.  The more confident lover. The physically stronger person.  The person who wants attention. The person with self-esteem.  You need to apologize frequently for these failures and must work hard to gently help these people along to where they can think of you as a lesser person for altogether different reasons than they did before, to preserve their psyche. Stop making your weight loss about you.

 

See?  Even with these minor things, it’s obvious.  Surgery is the easy way out. Don’t be a sucker.  Be strong, and just eat less, and exercise more. It’s that simple!

 

I,personally,  never found this process difficult, so it definitely was the easy way out for me!  I certainly never "suffered" as you seemed to.

I think it's way harder to lose 100lbs without surgery, but maybe that's the minority view on here?

EDIT:  I'M CHANGING MY RESPONSE TO THIS MESSAGE.

Basically my response was out of line, and I was wrong.  I was pissy when I shouldn't have been.  Sin Kim was correct, and I was being reactive.  I can get that way sometimes.  Sin Kim, I hope you'll forgive a *****y day and a half considered response. I'll leave my original response here not because I stand by it, but because the context is necessary for the discussion.  

 

ORIGINAL RESPONSE: With respect Sin Kim, one of the many points I was trying to make was that this surgery is simply one tool of many.  There are few shortcuts in weight management, and surgery is definitely not one of them.  We still have to exercise, eat less, slay our demons, and we still have to invest effort into the process.  My experience thus far has been that there is a perception that overwhelmingly this is a decision made lightly and quickly by people unwilling to invest effort into their own health and want a simple solution.  In fact, based on what one could read here in the first page of posts alone the reality for most people is far better described as a challenge than easy.  

My experience, as several who know me here, was far easier than what I described in the posting.  I was fortunate not to struggle with insurance challenges (it pays to know all the rules and loopholes), with my aspect of the financing, or the physical challenges. My surgery was as boring as they come and I breezed through thanks to an outstanding medical team and home nurse (my beautiful bride) I'm also blessed to have an ego far too inflated to care what others thought of me when I was big or my choice to have surgery.  

The posting was really not entirely about me.  It was an amalgam of my experiences as well as many others I've encountered on this forum and others, as well as my interactions with several OH members I've met personally in the last few months.  It wasn't as much a complaint about the process as a complaint about the misconceptions present in the non-surgical population with respect to our choices here.  That said, had I experienced every single one of these debacles I mentioned, I would still have made the choice to proceed.  This decision has been nothing but reinforced in the 2 months since surgery. 

Please understand, I posted this in part as an inside joke for those of us who are considering or have had surgery.  It was never meant in a mean spirited or hurtful way.  I hope that if you re-read it, or read the comments in the VSG forum, you may realize that.  I do appreciate your opinion, and I do see your point, but I hope you can consider it from a less serious perspective as it was intended. 

Well, we don't "know" each other so I only had your post to go on and it sounded a bit whiny to me ...  I can accept that wasn't your intention, as you have said that now, but I still stand by my opinion that I, personally, didn't find it difficult and in nearly 10 years have never posted a complaint about my surgery or journey.  I have nothing but sparkles and unicorn rainbow farts to give on that! 

I think the "I, personally" did stress that I have no expectation that others had the same experience and in fact, there are people on here who do not share my expectations or experiences and I'm sure they'll all be happy to agree with your post!

 

I don't think those of use who didn't find it to be a  funny "inside joke" (it DOES have to be funny to be a joke) thought you intended to be entirely serious, let alone mean.  Anpparently, however, the people you know IRL are much less informed than the people I know IRL because not a single person I know is under the impression that having my intestines rearranged was an easy way to lose the weight.  (Now, if you're "just" having part of our stomach removed, maybe the people you know think that is easier than if a bypass is involved???)

Anyway, just because some of us thought it was far too hyperbolic to be funny (or just thought it was long and not funny) doesn't make us angry or negative (or, dare I say it... hungry! people).  It just means we didn't find it funny.

 

Lora

EDIT:  I'M CHANGING MY RESPONSE TO THIS POST.

I've gone back and looked at this again because it was bugging me.  It bugged my conscience.  I was out of line, and I'm sorry. It was a crap day, I was in a crap mood, and I was responding to posts faster than my brain could process.  You had a valid point then, and you do now.  Perhaps it was over the top, but there was a point I don't know you saw because I didn't mention it here.  I wrote this kind of spur of the moment after I ran into a dude that used to call me "Jabba" all the time and it stirred up some pretty strong feelings I apparently didn't have as good of control over as I should have.  I projected those emotions onto you and Sin Kim, and I'm sorry for that.   Please know I do see your points, you are correct, and my response was totally out of line.  I'm sorry.  I'll leave my original jackass response here so people have context.  Also, because you responded in another forum, I'm going to repost this message there too.  You didn't deserve my response, but you do deserve my apology everywhere I mouthed off.  

 

ORIGINAL POST: Point taken.  I have no intention of engaging in "Who has the bigger scar" ******g contests with anyone nor will I lower myself to the point of ad-hominem attacks.  You may in fact know alot more people that are spectacularly more intelligent / informed than I or those I know. Bully for you! I rather like my friends, and those I've trusted so far.  I'll holler when I need you, mkay?  I don't think you're angry, negative, or hungry.  I don't really think much of anything of you actually. 

You didn't think it was funny.  Great, thanks.  Some did.  I did. Life's funny that way. Just tossing it out there, but maybe if you deeply dislike something, perhaps discretion is the better part of valor?  Simply put- if you hate it, don't read/watch/do/think about/focus on it.  Move on.  I shall. 

 

I thought it was funny, but I have a strange sense of humour being a Brit !

I loved your article and had a good laugh but understand the seriousness of this surgery!!  had I been able to drop the weight with diet and exercise alone, I would have!! thankyou for writing it and giving me a morning smile!! 

 

You do realise we can read posts on the VSG forum?   That thread where you accuse me of calling you names is actually much funnier to me than this one!     

Posting on any board on OH (unless it's private) doesn't guarantee that everyone will agree with you - part of the support here is getting differing opinions.    I'm sorry you found it necessary to be rude about me, just because I disagreed with you and it's a shame you decided to do it in a place you thought I wouldn't see, rather than on here.   I didn't call you whiny or insecure - I said your post was whiny - which is a very different thing and I certainly never said you were insecure - where did that come from or was it to guarantee a pile-on by your friends?

Good luck in your journey -   I wish you continued success and I would suggest some big girl knickers if you venture outside of your own surgery forum (apparently)

I don't have the slightest thought about you coming onto any forum you choose.  I just personally think you are wrong.  I think you seem to deeply desire to pee in someone's Cheerios (I miss Cheerios). 

And for the record, you didn't call me whiny or insecure.  The person who PMed me about 30 seconds before you posted did.  I never called you out by name, and in fact I saw your point.  I thought you had a good one.  In fact I responded to yours in a kind and respectful way because I respected your position. Still do. Humor's weird that way.  A really awesome fat joke in a room full of skinny people will get a raucous laugh. In a room for of OH board members it'll probably get your butt kicked.  Not everything is funny to every one.  Most of us are mature enough to walk away when we see something we deem "not funny" rather than trying to convince everyone that we must see things their way.  

As far as big girl knickers, you might attempt to engage in a teeny bit of research before you launch your snarky little ad hominems like the other one that I DID just call out. I'm a dude.  At least, that's what I'm told.  I'll let you know for sure when I lose more weight and can see my toes.  If there's not something in the way when I look down at them, I'l consider myself offended.  For now, I'll move on.