Sunday, August 22, 2010

Weight Loss Surgery Monday

After eight long years of trying, tomorrow I am finally having weight loss surgery. A vertical sleeve gastrectomy is scheduled August 23rd at 9:30 am. It seems odd someone who has spent her life teaching natural birth and healing would need surgical intervention to lose weight, but it is a chance for me to have a healthy and normal life. I started gaining weight with the birth of my first child 34 years ago, never lost the baby weight, and with each child gained a bit more until I was over 200 lbs. I stayed in the 200s for a number of years, slowly putting on the weight, trying various diets, losing, then gaining back, got to 300 lbs and could not believe it. The more I gained the harder it was to lose, to exercise, and the more sedentary I became. After I hit 350 I realized that weight loss surgery was my best option. However without medical insurance it was out of reach, I kept gaining weight, slowly creeping up, until I was over 400 lbs and disabled due to my weight. Not having insurance to pay for it considered going down to Mexico, but did not even have the funds for that. I knew it generally takes years for people to get SSI Disability, it took me over six years. Finally I got my Medicare, but there was no surgeons in Eugene, so I went to Portland and started jumping through their hoops, that took months. A center opened in Eugene and I transferred in 2008, hoping to have the surgery that year. As I started going though their program, a six month diet, physical and psychological tests. Then I had to wait for the surgery center to get accredited so they could take Medicare, there was a delay after delay in that. They finally got approved and then all the surgeons quit. I am serious; the Eugene center had no doctors. So I had to start all over with Portland and at the same time hoping they would hire surgeons in Eugene. It took months, but they finally did and after that surgeon was approved he decided that I needed to lose more weight before the surgery. Being too fat for weight loss surgery, I am not sure how I got there. Actually I do, one pound at a time, too much food and too little exercise. Morbid obesity and the category I am in super morbid obesity is a complex condition, an addiction disorder. Addiction can best be defined in persisting in behavior despite adverse consequences. Some people can drink, others can't stop and drive drunk. Many people have the ability to stop overeating and can lose weight. But there are some people like me that need intervention. With surgery I will simply be unable to overeat. Having half your stomach removed is drastic, but I feel like my choices are limited. Having the surgery will not be a magic bullet, I will still need to make a lifestyle change, learn to incorporate exercise daily, and address the emotional/mental issues that led me to this point. But it is the tool that will help me get there. I am grateful that the day has finally come. Cooking and eating are so much a part of my life it will be a big change not being able to eat more than a ounce or two, and being on a restricted diet for life. I know quite a number of people who have had the surgery and are extremely happy with it. This will be a positive change in my life after so many years of struggling with my weight and eating disorder, and the subsequent debilitating health consequences. A year after surgery I will off most of the medications I take, my diabetes will most likely be gone, and I will be able to be more mobile. It will be a whole new life.

After much research I initially decided to do the lap band instead of the gastric bypass. The lap band is less invasive and potentially reversible. The vertical sleeve gastrectomy is not as radical as the bypass, so is a good balance between the two, and only recently became approved for Medicare. It was a big decision to go for the sleeve instead of the lap band, it is newer therefore less research, higher mortality, but faster weight loss, and the important factor for me was I would be done with it. The lap band needs ongoing medical attention. With the sleeve if there are no complications, no more medical procedures. There is a very small risk of death with the procedure, higher for me because of my weight, age and health problems, but it something I feel ready for. Death seems like the relative easy part, living is much harder. I am not worried about the surgery itself, my surgeon seems competent and capable, although he has never done a sleeve with someone a heavy as I am, and has not done that many compared to lap bands. I am a bit concerned about post operative infections or having complications that will be disabling, don't have a lot of trusts in the medical system. I value my independence highly, and have no wish to come home and be unable to care for myself, even for days or weeks.

I have been thinking quite a bit lately about death getting ready for surgery, finalizing my will, tying up loose ends, and although it is unlikely I will die from this procedure I am of the age where death will happen sooner rather than later. There is a really cool project started by the Farm in Tennessee where Ina May is from, Rocinate they are creating a community of elders and midwives. Including midwifery in end of life care does seem fitting. Although I don't think I want to move to Tennessee there may be something closer that I could plug into. I am not ready to change my focus away from midwifery education yet, as I am starting graduate school next week, working on my Masters in Education with a concentration in Technology Leadership. I will hopefully learning lots of great tools to integrate in my work, and be able to be healthier and be able to continue for many years to come.

It will be a new chapter in my life, and I am very excited this day is finally here. I am doing everything I can to prepare for surgery, but I do believe in the power of prayer, so any prayers tomorrow for a successful surgery and an uncomplicated post operative course, will be greatly appreciated.



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