Dolores L.
I remember being pregnant and seeing the scale go over 200 lbs for the first time. I went home and cried, but then I figured I would get the weight off quickly after delivery. Pregnancy was the first time I ever let myself eat ad lib. What the heck, I was pregnant after all! Well, I didn't lose a thing, even with breast feeding; like so many others, that baby weight was only the beginning.
I had a Vertical Banded Gastroplasty in 1983, at the weight of ~290 and the age of 24 - the same year my daughter started kindergarten. For the first 6 months or so, I did pretty well, losing about 60 lbs. I didn't "push" my diet, but gradually I started not feeling full and was eating more. Obviously, the surgery didn't come with built in mental self-control. Life was busy, full and not unhappy - and I learned (while working as a secretary at the hospital), that my gastroplasty results were pretty typical. I went to see the surgeon who developed the procedure, had a barium swallow, and found out my pouch was no longer a tiny 30cc. It was stretched and the band was not restricting food flow at all. It sure felt nice not to blame that climb back to 250 on my own issues!
I started college, heading for the medical field and flirted with exercise and "dieting" but never really got below the 240 mark. I thought about having a RNY, but I just couldn't face another big open surgery. I was thirty and really felt like I could handle things. Exercise was the key for me and I tried that and weight watcher's - but I was a student, a mom and a wife; I was too "busy" to really make it a lifestyle. I was a successful student and so happy when I got accepted to medical school. I finally felt good about myself! I actually shrunk from the 240's down to about 215. In med school, gross anatomy was a good diet, and so was being on the run or having my head in a book from before sun up til way after sundown. It was exciting to get so close to my pre-pregnancy weight. My gosh, 160 was only a whisper away from 215! Ha!
Gradually, through residency, I put my weight back on and got back to that set-point of 240-250. Amazing what lack of real committment to exercise will do. I put it off to the "new doctor struggle" and went through a couple of stressful practice moves, and a major relationship upheaval. My spouse of 20 years decided to have a fling with the "sexy neighbor" because he wanted to know what it would be like to "be with a skinny girl." One would think that would hammer home my resolve, but it didn't. I think it made me more like an anti-anorexic; I was going to control my body - even if I was really out of control.
Counseling helped hold our marriage together (for a time) and my practice was finally headed in a good direction. In fact, along with an ambitious Nurse Practitioner who was a nutrition nut, we added a weight management program. "Less is More" was very successful for a few years, and those diet pills worked wonders! I was exercising, doing yoga and losing weight. In fact, I felt so good about myself that I lost that 190 lbs of dead weight that I called a husband. What a positive experience that was, and I was finally a role model for my patients! With a fantastic new relationship and a weight down to 215, I felt like I had the world by the tail and my "eating problem" solved.
My decision to start running at that point should have been a positive one. It felt like it at first. I loved it and it seemed a natural progression from the eliptical to the sidewalk. With no particular accident or injury, my knee started to swell. It was so painful, I ended up having arthroscopy and a special surgery where the cartilage on my femur had to be treated with non-weight bearing for 4 months. Crutches! No real exercise to speak of. In retrospect, I should have stuck to the eliptical. It was a good friend.
Still, I managed to keep my weight at 225- 230 for quite some time. Thank goodness for the diet pills and Overeather's Anonymous. However, when I started having chest pain (which turned out to be gastritis), I knew I had to get off the pills. I did, and it only took a matter of a few months to get back up to 240. Then with another year of dieting, I was back to my lovely set-point of 250. Now, I will be the first to admit that I didn't get there without my own assistance. Off medication, I started thinking of chocolate and goodies and not eating the right things. My exercise was still minimal. With the increased weight, my knee hurt again and I was worried about re-injury. I started swimming, tried my eliptical again - but didn't stick with anything too long.
In the fall of 2011, at about 245, my new hubby and I went to Italy. The city of 7 hills (Rome) almost killed me. My knee started hurthing so bad, I could hardly enjoy the beauty of the country. Pompeii, Sorrento, Amalfi, Ravello - they were all a blur of trying to bear up with the pain and not be a wimp. But I started thinking about how to make a change.
I called my Aunt - who is 80 years old and had her RNY in her mid-70's. She started out at 320 on her 5"0" frame, and is down to 160. She still needs oxygen but her CHF is under control. Her A1C and blood pressure are normal. Her cholesterol is perfect. I asked her what she thought and she said "I wish I would have had it done when I was your age, kiddo! I have no idea what took me so long. I would do it again in a heart beat. If I hadn't done it, I wouldn't be here today."
I worked with my PCP to follow a sensible diet and gradually found the right eliptical for home use that didn't hurt my knee. My weight has fluctuated between 245 and 260 since that time. But I have worked on being less sedentary and trying to manage some of the stress in my 60-70 hour work week. I knew that the Bariatric Program at University of South Florida was a sound one. I knew that Dr. Murr was the surgeon I wanted. My husband lost a friend of his not too long after a GBP/RNY, so he wasn't keen on the idea at first. But he's gradually come around. He's really supportive. I think the thing that did it for him was my telling him that I felt like I was going to die without it. My A1c was between 6.1 and 6.3 and I was headed for diabetes. My blood pressure was starting to climb. I had that scare with the chest pain. I had tried so much, and I had spent time proving I could be committed to exercising, but I still had a hard time with controlling how much I ate. I could maintain, but I wasn't losing. And I need to lose.
It was a devastating blow, when after all the documenting and working with my doctor-friend (who by the way, had his own RNY a few years ago and was down from almost 400 to 210), to find out my insurance would not cover the procedure. There was an EXCLUSION for bariatric surgery - or anything to do with MORBID OBESITY in my Humana medical insurance. I called HR and was told they had never, and would never, fund weight loss surgery for an employee. I was crushed. I could approve the surgery for my patients, but not have it myself. I called my doctor-PCP-friend, again, and he said "suck it up and do it. It will save your life."
As good "fortune" would have it, I'd been saving for a car. And pardon my language, but I figured "the HELL with it, I'm having the surgery. Instead of saving for a car, I was really saving for my LIFE!" So, I am paying for it myself. The insurance company can go to HELL. I owe this to me; it's my chance to get my life back and I'm going to do it.
As an aside: How much sense does it make for my particular company's decision to NOT PAY for anything related to Obesity. Um, isn't diabetes related to obesity? Isn't hypertension and CAD? Stroke? Certain cancers?
So here I am. Thanks for letting me share, if you have read this far. I have another chance, and I'm taking it. I know I'm blessed. I have a great job (despite shitty insurance), which I fully realize is a huge blessing and will allow me the financial freedom to do this. I have a wonderful, supportive family: a spouse and a daughter, now grown up and still wanting her mom around when her kids start off to kindergaten.
