One of the questions I get asked by people considering weight loss surgery is, “If you had it to do over, would you do it again?” My answer is qualified and requires a lot of discussion and ends with, “Well, maybe. Maybe not. It depends on how I feel at the moment because the life I live now bears precious little resemblance to the life I use to live and that is because I chose to have bariatric surgery.” So, event though you think you're making an informed choice, I am here to tell you that what you think you know isn't what you know. You cannot plan for all of the possible outcomes and, trust me, there will be plenty of unexpected things in this journey. And they all stem from choosing to have bariatric surgery.
People ask if weight loss surgery fixes all of your problems. The answer is, yes it will. You will have a new relationship with food, your body, and life as a whole.
But life is quirky and capricious. Please remember the law in physics: natures abhors a vacuum. Truly it does. So although you will cure a bunch of problems, new and unexpected ones will crop up. And there is no way to anticipate them all and many will take you by surprise. They'll shake you up, burn you down, and you will emerge a completely different person.
When I had my surgery, I was miserable. I couldn't walk. I couldn't breathe. I felt that food controlled my life. I was terrified that I would die and I felt that there was almost nothing short of extreme that I could do to change the course of my life. So I chose to have surgical intervention.
I chose gastric bypass over the lap band because I would be required to make significant and immediate changes in my life and my relationship with food. And that was absolutely true. I did have an immediate as well as a long term change in my relationship with food, water, and nutrition in general. I also had a bunch of unexpected issues almost immediately.
You go out and get informed on bariatric surgery. You learn a lot. You learn to read food labels. You learn to make good food choices. You learn to plan your cheats and accept that they will happen, even to someone who has had surgery to alter her digestion. You get an idea of how your life will change after surgery and you stock your pantry appropriately.
You do a lot of things on your own. Sure, you have the discussion with your partner and let he or she know of your plans. And, like a good partner, they support you. But can they really plan for the moment the nurse comes out of the surgical bay and tells you that the surgeon is too busy trying to save your loved one's life to come out and tell you things have gone bad? That happened to me and my partner. No, there was no medical misconduct. Something weird and completely unexpected happened. And, there wasn't going to be a way to find out if I'd wake up with an intact brain for at least 12 and more like 24 hours.
YOU might have planned for this possibility, but did your partner plan for this? Did they really? No one wants to think that something horrible could happen. And really, what do you know? You're unconscious and hooked up to a ventilator. If a fly landed on your nose and was tickling you, maybe you could think about swatting it in a week, or 8+ hours when the drugs wear off. You're dead to the world. No, really. There's no bright light and no close encounter with g-d. Just unconsciousness.
Just so you know – TV dramas lie. When you're intubated and on a ventilator, you get your hands tied down. Why? Because if you regain consciousness, the first instinct is to pull the endotracheal tube out. That's bad if you are unable to breathe on your own. So your hands get tied down. Gods help you if you're blind and left your glasses with your partner because there's just no way to know that the call button is sitting on your thigh. You barely know you're awake, much less have the sensation to feel a pressure on your thigh. Just so you know – if you bite down on that endotracheal tube, bite down and hold it down, alarms will go off and eventually, someone will come investigate. In the meantime you've managed to throw up a god-awful amount of blood and clots around that tube and now it's getting cold and slimy...
In the meantime, your partner's in the ICU waiting room trying to get some sleep on a loveseat. She's 5'11” and trying to sleep on a loveseat. She's sweated through her clothes and hasn't eaten in hours. She's called the few friends who know what's going on and is trying to hang on to her sanity by her fingernails. See, she's been told that there's no way to know if the oxygen deprivation has left the woman she loves with a mind, much less the ability to care for herself. Imagine her relief to find out you're awake and pissed off that there's a tube inside and it ain't gonna come out until someone from respiratory can come check you out. That'll be in about 5 hours. Meanwhile you're trying to communicate via sign language since the hands are still tied down.
That's just the beginning. Now your partner is stuck with trying to arrange oxygen at home because you're not going to be released unless there's full time oxygen in the house. Denver's just had a 3rd blizzard (you were unconscious through blizzard #2 and blizzard #1 was just before you had this surgery). And the hospital cafeteria has stopped charging her for food because, “honey, you've just been here too long.”
But this drama ends. You go home and start the healing process. Some people get to a week out from surgery and are full of energy and ready to go back to work. Not me. I wanted a nap. Maybe a nap after that. When I was released to go back to work, they fired me for being out too long. Now I have to search for a job while also trying to recover from major surgery and a major complication. I have to have health insurance so we bite the bullet and get COBRA. The payments are higher than your rent because you're paying the entire deductible instead of just the portion that the company didn't pay. And, guess what? You've got another complication: a stricture at the anastamosis. Another, albeit minor, procedure to dilate the anastamosis so liquid can pass through. Yeah. You're on a liquid diet for three weeks and then three weeks of a soft food diet. If you never see another bottle of Isopure or drink another sweet protein shake, it'll be too soon. You dream of a roast pork flavored protein shake and start to hate yogurt and refried beans and cottage cheese.
Then the day comes and you can eat real solid food again. So you start to reintroduce foods to your body. No, you're NEVER hungry, which is a problem because not being hungry also means you really don't have an appetite (here's a hint – I still don't have much of an appetite and finding food I actually want to eat remains a challenge). And I booted into every trash can in the house because something would unexpectedly disagree with my new tummy pouch. And, people get really weird when you go out to eat and end up eating ½ a meatball. They think you hate their cooking and take it personally even though you tell them it's truly not them but you. You loved that one ounce of meat and thought it was the best thing you've ever eaten (until you throw it up at home) and want to come back. Yet they look at you suspiciously and suspect you're just being nice and actually hate their cooking. Honest – it's a true story.
Which brings me to gastric dumping. That is a singular hell in and of itself. You have no idea what will bring it on. There are some things that are almost guaranteed to cause you to dump. A cookie will cause you to dump. So will fatty foods. Alcohol too, at least initiallly. I learned that the hard way. I asked for liquid Zoloft in the hospital. BAAAAAAAD idea. It was suspended in a 40% alcohol solution. Yep. I just had a shot of 80 proof alcohol on a brand new anastamosis. It's a special kind of hell. But I digress.
I ate a cookie. Just one cookie. Never caused me problems before. Now I want to die. No, seriously – I was praying to die. See, by the time the cookie has hit your duodenum, it's too late. You hope and pray that you can throw up this horrible thing. But it's passed into the intestine and there are no muscles to reverse the flow and back it up into the tummy and back out the mouth. You are now stuck with nausea, fever, and gross sweats for the next two hours, at least. You learn your lesson and vow to NEVER EVER EVER do that again. But you will. You won't necessarily mean to, but you will and it'll happen all over again.
You keep learning. You make mistakes but you start to get the idea of how this new way of eating works. You love how the weight seems to fall off. Until your boobs fall out of your bra. I was lucky. Very lucky. I had friends who kept absolutely every article of clothing and had closets full of clothes sized 12 to 30. I visited their closet monthly for a year to keep clothes that fit me. They weren't necessarily my style, but you can't be choosey when you're unemployed and working temp jobs just to keep a roof over your head while you're interviewing and hoping to find just the right job.
You revel in your new body and what it can do. Sure, you hate the saggy skin that's developing on your upper arms, but hey you can walk from the carport to the townhouse carrying your bags plus the groceries without any help. You miss that your partner is feeling unwanted and unneeded since she did all of these things in the past because you were too short of breath to do it on your own. And you miss that your partner is feeling more and more irrelevant to you.
You discover alcohol. Wow. What a rush!!! It turns out that processing alcohol is a two-part thing and you miss (bypass) part two of the process. You can get drunk faster than anyone and oh boy does it feel good! And you also can get sober faster than anyone when you stop drinking.
But hey, your surgeon is concerned because it's been more than six months (yeah, just six months) since your surgery and your liver enzymes are still elevated. He sends you off to a hepatologist (liver specialist). He runs a blood test that is presumptive for a genetic disorder called Primary Biliary Cirrhosis. He schedules for a punch biopsy (oh yay! More amazing drugs!) and it comes back positive. And stage 3 of 4. Yep, you just got a CORRECT diagnosis because you had bariatric surgery and your surgeon is a cautious SOB. Congratulations. No more alcohol.
Wait – no more alcohol? But I LIKE how I feel when I drink? And it makes the pain less. Yep, I said pain. Because having people really and truly SEE you as a sexy woman (not the fat girl) is scary. The cute IT girl at work and the trucker in the adjacent lane are flirting with you. No one told me that would happen. It's scary and I don't want it to happen, but it just does, no matter what I do. You go dancing and revel that you can dance the two step when you never could before. And some cute girl wants to dance with you. She's flirting and you're responding because you have never ever learned how to say “thank you but I have a lover.” You hurt your partner and embarrass your friends.
And there's someone in the wings waiting for your partner to see that she's wants her. Not you. Her.
You are too caught up in the body changes and the emotional discomfort to see that she's pulling away. You are too busy trying to get a job and get situated in the new job environment to understand her pain. You used to need her. Now you don't. Someone else needs her, though. And she's making her move.
That day comes. Yeah, THAT day. She's done with you and your selfishness and self absorption. There's someone else who needs her. Wants her. Values her. And she's gone. Gone to the woman who looks just like you used to look. Yep. You've been traded in. For a model who looks like you used to look.
Why? Why did you do all of this? Why did you almost die to get healthier and feel better and be sexier than you've ever felt before? It's all over. Thirteen years gone down the drain.
And you're not doing so well either. Somehow you've managed to herniate a disk. And badly, at that. But your job is reading medical records and you know that fusions and laminectomies go bad. But you can barely care for yourself, much less walk, or pack boxes of your stuff to move to a smaller apartment with fewer stairs so you don't fall of your ass daily and develop amazingly scary bruises. Just before she left, you had an MRI showing severe spinal compression. You have incontinence, for fuck's sake. Yet she's left you. And with a mis-sent text – She has to have spinal surgery. Do I still leave her? Cold fucking comfort after the fact.
You meet people. People who, for some unknown reason, seem to care for you. Love you even. You screen your lovers carefully to make sure no one can truly fall in love with you. You try to be a good poly girl and make sure that you aren't the dirty little secret. You end relationships because their primary relationships aren't stable and watching another relationship fail is simply too much to bear. You take that leap of faith and have the damn surgery. You wake up normally this time. No drama. No intubation. No ICU. You even have a sense of balance again. You still walk funny, but it's getting better.
Slowly. Oh so slowly. You;ve meet a new man. Really you met him before surgery but he's been there for you. He even brought you a soda while you were still in the hospital. He's pretty damn cool. You're scared to death because you love him and are in love him. What the hell? You're the one who wasn't worth loving. But he loves you and you don't know what to do. You don't know how to find your own value and still let him be who he is and what he is – married to a wonderful woman and still in love with you. You try to drive him away and break his heart. But being away from him hurts worse than being with him. You ask for him to take you back. Wonder of wonders, he does.
You develop this insane need to have your own primary relationship. You find someone you think might be THE ONE. You fall in love with him. He's what you want – kinky, loving, and poly. He says he's poly. You tell him about your other relationships and you want to honor them. He says he understands.
You move in. And make a date for later in the week. He comes unglued – apparently he expected a period of monogamy. Funny, he failed to share that little tidbit.
All you wanted to do was preserve a bit of your routine. Everything had been thrown into upheaval when you moved in because when you needed to have that spinal surgery, there was a one-month period in which you received NO pay (yeah that's zero dollars in income for an entire month) before your short-term benefits kicked it. You got behind on your rent. Eventually your landlord evicted you.
Sure, you left before being kicked out, but you burned your bridges. You're committed to him now and he's pissed and hurt that he's not number one for you. And that liver disease? It turns out that serious intractable fatigue is an effect. To make matters worse, it seems your brain is melting. You can't handle the stress, you can't handle your work and caseload. You're missing work and you can't keep up with your case load. You can't do your job. You've got hepatic encephalopathy – your' brain is turning to mush because of your liver disease.
The day comes and now you're fired from the job you swore was your dream job. And you're so tired you just don't care. You go to bed and stay there for three months. No joke. You sleep 18 or more hours a day. You can barely function to care for yourself. You barely are able to hold it together to get unemployment. And your boyfriend is just getting more and more angry.
Fast forward 18 months. That's it, you're each done with the other. You move in with your lovers who have managed to still love you during an enforced hiatus and are happy to help you get out. You have no money and no job. You reach out and – wonder of wonders – you get the gold star from a benevolent goddess in the form of being able to rekindle your relationships. Things are improving.
You get Medicaid. You try working. It doesn't work out but you know what didn't work. You work hard and try and try and try and finally get a new job. This one seems good. You're not sure because while the new meds help the hepatic encephalopathy, the fatigue is still something that needs careful managing. You learn to listen to your body – something that's never happened. You learn to stock convenient foods for the days that you're too pooped to cook. You learn that you're going to have to plan for days you can't get out of bed. And yet you're happier now than you've felt before. The weight that the enforced idleness caused you to gain starts to come off again. You topped out at losing 190 pounds but then regained 50. You start to lose again but knowing that the secret is eating enough. Not just drinking enough protein, but truly eating enough calories to sustain your body through work and yoga and date nights. And you feel good.
But would I do it all over again? Well, that depends. A good friend once shared a message from the goddess to me. She told me I'd walk through fire and feel my skin burned off and reduced to the essential me. That's absolutely true. I think I'm better for the experience but there is absolutely no way I could ever have imagined how my life would have worked out eight years ago. So for those who are embarking on a life-changing event, I salute you. And I'll be there to hold your hand when the unexpected happens. I won't promise you'll feel better soon. I will promise it won't hurt forever and things will get better. They'll be different though. Different in ways you can never imagine because you simply lack the imagination to see what could happen.
But your life will change.
What you make of it is simply up to you.