A Narrow Path – My Weight Loss Journey (Part 2)

After struggling with weight loss and dieting for many years, I decide to proceed with weight loss surgery. The decision is not a light one, one that takes courage and dismissal of many preconceived notions, but I forge ahead.

Disclaimer: this segment contains a lot of technical information about the pre-op process. The process may look different for everyone based on their insurance plan/doctor and any other circumstance.

With every new diet I have embarked on in my life, I have always felt a sense of momentousness. This will be the one thing I will always refer back to as the diet, or rather lifestyle change, that changed the trajectory and set me on my weight loss journey.

Hope never dies. With years of attempts and disappointment behind me, hope still flutters anew with every new idea. While some might call it denial or lack of self-awareness, I always cherished the promise of a fresh start—until it fell through almost before it began.

This time, I know things will be different. For all my wishful thinking in the past, I am very aware of what it is that sabotages every plan I am on, including those that have brought great success to others. I tend to start every plan with great ambition, but it is simply difficult for me to stay on track. This time, that choice will be taken out of my hands. This thought brings me hope, heavily laced with trepidation.

I am not hasty in my decision to proceed. I examine my reasons for wanting to undergo surgery; is it only society telling me I must be thin to earn the right to exist? It is difficult to separate my own feelings on the matter with what is ingrained in me from years of pain and judgment, but I do know that I am doing this for myself. I need this. I deserve this.

Starting the process that will hopefully lead me to surgery gives me a great sense of purpose. For the umpteenth time in my life, but also for the first time in my life, I feel that my life is truly and deeply about to change. And taking care of the technicalities involved is a concrete step that leads me to my goal.

My first appointment is scheduled for two weeks hence, which is disappointing as I am raring to go. I do get a link to some seminar videos and paperwork to complete in preparation for my first appointment. They speak about the risks, the benefits, the differences between the different options of bariatric surgeries. It is a bit frightening to hear how I am heading into an irreversible path, yet I know it is the right one for me, and my excitement grows together with my apprehension.

I examine my reasons for wanting to undergo surgery; is it only society telling me I must be thin to earn the right to exist?

Starting a medical process during COVID has its perks, as most appointments are telehealth visits instead of in-office visits. I had been worried about how I would swing all appointments between my job and my kids, and I knew that I wanted to schedule them all in the shortest period of time possible. Virtual visits make things so much easier.

The reason it is usually a drawn-out process to get approved for the surgery is due to most insurance plans requiring a six-month period of nutritional counseling, which most people start at the time of their decision to go ahead with surgery. I wonder what the statistics of potential “sleevers” being successful during those six months and passing up on surgery are… I am willing to bet it is a low number. No one chooses surgery as their first option, and I’m guessing most patients are already far past the point of nutritionist visits making much of a difference.

The good news is that due to my extensive dieting history, I contact a nutritionist I have been seeing in the past and she provides me with documentation of six months of check ins. Thus, I avert this lengthy process and throw my all into getting everything I need out of the way.

The BMI needed to qualify for surgery with insurance is between 35 and 40. That is one concern I do not have, I fully qualify at a BMI of 48.

Doctors’ visits have always been a source of anxiety for me, with the dreaded scale in the corner mocking me and my failures at every visit. I was prone to bouts of bronchitis as a teenager, yet I always postponed seeing the doctor until absolutely necessary. I was tired of the disapproving looks, the lectures, and the blaming of every ache to my weight.

My first meeting with the doctor is conducted in the comfort of my home and is over in less than 15 minutes. I give him a brief synopsis of my history, and he gives me a brief overview of what the surgery entails. Dr. R. is pleasant enough, if a bit abrupt. I feel a pang of shame as I tell him how much I weigh, though I know it does not faze him; I will not be his heaviest patient.

After this initial consultation, which does not really teach me anything I didn’t already know, I am on a frenzied race to schedule all appointments in the shortest amount of time possible.

I speak to the nutritionist, who asks me to describe what I eat in a day. I am happy she cannot see me over the phone as I try to be as honest as possible, detailing the snacking and gorging that is sometimes out of control. She tells me what I already know: I will need to learn new habits. Surgery is a tool, and a great one, but I am the one who will need to make the changes.

I speak to the psychologist, who asks me about my motives, and once again I describe my struggles and my need for a fresh start. She asks about my childhood, about my kids, and whether I am safe at home. I tell her about my beautiful family and life, and how this is a decision I do not take lightly, but one that will hopefully bring with it a solution and relief to the weight issue that has dominated my life.

I visit my general doctor for a well visit, bloodwork, and his opinion. Though I know my doctor is not one to advocate for going under the knife, I value his opinion and hope he will not try to dissuade me. He has known me for years and, while noncommittal, does not do so. It is reassuring to me to have him confirm that, of all options, the sleeve gastrectomy is best, and he proceeds with checking off the boxes on the forms I have provided him with.

I work every day but manage to sneak out for appointments, as well as for a myriad of phone calls coordinating all results and documents to reach my surgeon’s office. It is not easy, but every time a box is ticked off I feel a sense of accomplishment and mission.

There is some imaging I need to take care of, and I make several calls until I find a center with the soonest appointment. With all the conveniences it brought, the downside of doing pre-op during COVID is the limited in-person appointments when telehealth appointments are not an option, but I manage to get an appointment for Monday, only a few days away.

After taking two relatively simple scans, I anxiously await the result, just to get that box ticked off. I am completely thrown when my surgeon calls me a few days later. “The chest X-ray showed some swollen lymph nodes. We need you to do a CT scan before we proceed with clearing you for surgery.”

I panic, I google, and I schedule the soonest CT scan for the coming Friday at a local imaging place.

I come in for the CT scan and anxiously wait my turn. I muse that if I am this anxious about a scan, how will I react when I am about to be operated on? But I know myself, and know I will forge ahead and through everything until I get there.

My name is called, and I go in for the test. I have never, baruch Hashem, needed a CT scan before, so the procedure is unfamiliar. I am told to lie down on a narrow bed, and a scanner is used on top of me. I seem to recall that a CT scan should be done in a circular machine, but I may be wrong.

I get home, it is on a Friday and I have a lot to do. A half hour later I get a call from the imaging center.

“We’re calling your name and you are not here for your scan. Are you keeping your appointment?”

I do not know whether to laugh or cry. I rush back and explain that I was tested for something. They check their records; it seems I had gotten a bone density scan meant for another patient… They are gracious about it and I get my CT scan done. After the hassle I find this incident extremely amusing. At the very least, I’ve got a funny story to tell!

I am not laughing, though, when I am presented with the results of the CT scan, which finds a dilated artery with recommendation to follow up with a cardiologist. At this point I am afraid. Despite my size, I have never struggled with health issues, and I am afraid that my weight and the dire predictions it always brought along with it have finally caught up with my heart. I make an appointment with a cardiologist, who sends me further for an echocardiogram.

Baruch Hashem, after a few weeks of anxiety, the echo shows nothing abnormal. My cardiologist sends over a letter of clearance, and I am finally ticking off that box.

Another visit with my PCP for final clearance and yet some more bloodwork, another talk with the nutritionist, a final call with the surgeon, and we are on. Surgery date is looming and, while I cannot be more prepared, I cannot help questioning myself. Am I truly going ahead with this?

Apparently, I am.

(To be continued…)

Leeba Wein

Leeba Wein (a pen name) is a freelance writer living in New York. For inquiries, she can be reached at leebawein@gmail.com

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