[Handlebars, Flobots]

I have an announcement to make, and I know some people won't like it.  But on with it...

I went to an informational seminar this evening, led by the surgeon I would have perform my WLS.  I prayed that I would learn something new and not just be bored hearing all of the stuff I have researched all over again, and I believe God answered that prayer.  I really liked Dr. Chebli- he is clearly very knowledgeable about obesity, morbid obesity (and super morbid obesity, etc.), and current research findings.  Jason and I were impressed with his vast knowledge about recent studies in particular.

See, I've been pretty sure I wanted to get a restrictive band surgery.  But recent long-term studies released by doctors in France found that after 10 years most patients with the band surgery regained weight, and they listed their findings of restrictive banding at a 60% failure rate.  Likewise, the Swiss released a similar study, this time at a 75% failure rate.  Not good.

Dr. Chebli believes this is because banding surgery does nothing to affect the metabolism, and that eventually the obese will regain the weight because their metabolism doesn't change and once food intake creeps back up to pre-surgery levels the person puts the weight back on.  His personal conviction is that banding is not a good option, particularly for the morbidly obese (anyone with a BMI over 40... mine's currently a 54.3... or maybe 54.7, I don't remember).  Just so you know, he does perform banding surgeries; he is honest with patients about the facts I shared here (and more) but if someone wants that surgery then so be it.  He actually doesn't specialize in one certain surgery, instead choosing to be an expert in like 5, because he doesn't want to become biased toward something that doesn't work simply because it's his specialty.  And he admits that the medical field will argue amongst themselves about these issues and it's only his personal convictions, but I was fascinated with the studies and was rather swayed.  Also, other studies have found that, for the morbidly obese, diet and exercise and / or weight loss drugs end up at a 100% failure rate in the long term for staying at or near a goal weight.  It just doesn't work.

Caveat here: I love The Biggest Loser.  But do you know why they don't do reunions?  It's because the vast majority of contestants end up regaining weight... some back to where they started or worse.  Think about it- would you keep watching if you saw Bernie from last season or Eric from New York or Matt and Suzy and they were all various degrees of overweight and obese again?  Even those who don't get back to where they were look nothing like our glorious last image of them at their smallest, thus our viewing of the current season would be tinged with cynicism.  And, really, if someone with all of the tools and success TBL allows can't succeed long-term, what hope is there for the rest of us, the simple people who didn't have Jillian or Bob literally riding their arse for 5 months, or all of the knowledge and 24 hour (probably free) memberships and Body Buggs and what have you?  We got nothing, and if they can't succeed, those TBL alums, then our outlook is pretty freaking bleak.

It was interesting, because he talked about the fact that the medical arena simply doesn't understand obesity.  They are beginning to, but they still don't quite get it.  Why some people can have caloric intake and exercise levels similar to a person who weighs 160 pounds yet that person weighs upwards of 300.  The fact is, there is stuff that goes on in the bodies of obese people, from hormones to insulin to metabolism to cravings and appetite and never feeling full, that simply doesn't make sense yet.  For this reason he strongly recommends surgeries with both restrictive (limits food intake) and malabsorptive  (limits absorption of food) aspects.

I am going to call tomorrow and schedule my first appointment with Dr. Chebli to get me on track to having surgery.  This is the first big decision- I am definitely going to pursue this, and if it all works out with insurance then I will have WLS.  Secondly, though I will speak with him and get his professional recommendation for which procedure to have, I am going to pursue having gastric bypass (or, it's medical name, Roux-en Y Gastric Bypass).  Jason and I discussed it, and after the seminar we simply feel it is the best option for me.

I know there are risks- some people have leaks, or problems with dumping , or develop lactose intolerance (my personal biggest fear.  I can handle getting medical issues fixed, but never having milk again?  So scary.), or get pulmonary emoboli (blood clots blocking veins... well usually a pulmonary embolism, not multiple), etc. Dr. Chebli did reassure me that so long as I follow the plan and take the correct vitamin supplements in addition to prenatal vitamins there are no complications with malnutrition in pregnancy (including breastfeeding).  The risk of dying on the table is slightly higher with gastric bypass (though out of nearly 600 surgeries, Dr. Chebli has never lost a patient.  In fact, he was rated the best bariatric surgeon in Seattle two years in a row by Seattle Magazine, which is considered fairly prestigious around here) but that number is still very low.

Here's the thing, though-- even if I have complications, and they suck, I recognize that they will not be worse than my life right now.  Because right now I feel imprisoned in my own body.  I can't go to concerts (there was a horrible experience at Key Arena last year, where I went to a concert and I didn't fit in the seat and it was digging into me and I was in tears; finally a nice aisle monitor asked if I'd like to sit in a chair in the disabled section after seeing me squirm for an hour and I quickly obliged), I can't go to baseball games save for the bleacher seats at Safeco (where the Mariners play) and I can't go to a Seahawks game at all (I can't stand for 4 hours and I know I won't fit in the seats).  I pretty much never want to go anywhere.  Last weekend I told  my husband I didn't feel well and bailed on going out for a drink with a friend of his... truly, I didn't feel well.  But it was in part because I feared the seating situation and mainly because I'd be meeting the friend's girlfriend and I've seen pictures of her, and she's really pretty, and though she seems incredibly nice I was intimidated and afraid that she wouldn't want to talk to me because I'm so fat.

Listen, anyone who has known me for any length of time knows that girl, the scared-to-meet-people-hermit, is not me.  I'm usually the life of the party, the funny chick that everyone is drawn to.  I mean this with humility, but I can't tell you how many times in my life I have been told my smile lights up a room- including once by my old principal, when I was a teacher, in front of 60 some odd other staff in a meeting.  But that Tami is fading.  I want her to stay, but she's disappearing.  It seems that every additional pound on my body strips another layer of her away.  I am becoming cynical and incessantly negative.  I have constant health issues and I keep trying to be positive, even asking Jesus to help me stay focused on Him, and I feel like I am losing the battle.

I don't want to be this way.  I am trying desperately not to be.  Yet, here I am, and it's getting worse.

What do I do?  Keep plugging away at the diet and exercise program that isn't working?  Listen to me, heart disease runs in my family.  I don't have problems with cholesterol yet, but I have an aunt who weighed less than me, nearly 75 pounds less and about my height, who died of a massive heart attack at age 43.  I was only about 7 at the time, and to be honest it scared the hell out of me.  I'm barely 27 years old, and my quality of life is worse than most 72 year olds.  Really, to tell you the whole truth, I would rather die from complications of weight loss surgery, pursuing my goal of losing weight and actually living, than to remain trapped in this body and to keep on dying slowly.

I don't believe I will die, though.  I won't pretend I'm not a little scared- it's a major surgery.  But then I look at my incredible husband, I envision holding a little baby who is the combination of us, watching him grow, having brothers and sisters for him, holding their children, being active and living a long and healthy life and growing old with my husband, and I know that I must do this.  I haven't had tests done, because we're not trying to have babies yet, but I know in my heart that I already have issues of infertility due to my weight.  I simply know it.  I'm going to be tested for PCOS , and I'm so fat that for the ultrasound they have to poke a camera on a stick up my vag (and by vag I mean vagina) because there's too much stomach fat to do a normal ultrasound.  I'm so looking forward to that one, trust me.

The point is, no longer am I the chubby fun girl (woman, whatever) who is mostly comfortable with herself and who just enjoys life, loving Jesus and loving people.  Obesity is changing me, and diet and exercise aren't working.  I'm not lazy.  I'm not eating like a glutton.  I'm legitimately trying to lose weight and my screwy metabolism clings to the pounds as if I were starving.  Gastric bypass not only limits food intake and limits absorption of calories and fat, but it's been found to actually change people's metabolisms, to speed them up. I know that I won't be one of those people who lose weight and then eat like a buffoon and get fat again- I know my life will change and it will be for the good and it will be incredible.  Even if I have complications it will be worth it.

So, insomuch as insurance continues to comply and my doctor agrees it's the best option, and as long as Jason's and my consciences remain clear before God as we pray, I am going to have gastric bypass surgery.