Surgery: A Year On

If you scroll back just a tiny bit, you’ll see that I had weight loss surgery a year ago.

What I was told before and directly after surgery was that there would be a “honeymoon period” of twelve to eighteen months. During that time, the weight would come off kind of no matter what I did. And, for that most part, that’s been true. But a lot of things have changed.

  1. Nothing spicy
    My stomach is tiny. I can still eat only less than 8 ounces of food at a time. Spicy food has a tendency to irritate my stomach, making it even smaller than usual, making me instantly nauseated. It’s sad, because I used to put Tabasco on everything, eat pickled jalapeños with my eggs and beans, love a good vindaloo. Nowadays, if it’s spicier than green Tabasco, it’s out.
  2. Nothing bubbly
    For a while, I tried little sips of lightly carbonated beverages. I swished them around in my mouth for a while, then swallowed. It was fine. Then I tried with regular soda. Again, fine. Then I tried just drinking something carbonated. Tiny sips. I had maybe two, and then felt the most alarming sensation I’ve felt since surgery. One of my biggest problems is not being able to burp. It sounds hilarious, but the feeling that I’m going to burst from the inside out isn’t funny. The gas bubble makes it up to about my throat and no further. It feels as though I could I could truly injure myself.
  3. Nothing starchy
    As odd as it sounds, three bites of bread, pasta, rice, or potato fills up my stomach quicker than three bites of meat. Maybe it’s because starches have more air incorporated in them, and when I get air in my stomach, well, see above. I’m not saying I don’t eat starches. I’m just saying I can’t eat a lot of them at a time.
  4. But not too much protein either
    Back in January, I had an attack of gout. I’d never had it before, and it was kind of alarming, but I went to my doctor, got some meds, and it was fine. He asked me if I knew what caused gout, and I told him I had heard it was from eating a rich diet and drinking too much. It’s why it’s called “the disease of kings.”
    “Rich in what?” my doctor asked. I hate when people ask questions that they have the answers to and you don’t. It’s rude and wastes time.
    It turns out that the answer is “protein.” Which put me between a rock and a hard place because the additional protein was called for after surgery. I’ve cut down on protein, and I’m fine.
  5. Watch the sugar
    Thanksgiving. Christmas. Easter. Birthday. Halloween. What do they all have in common? Tons of sweets everywhere. And the problem isn’t so much the calories I shouldn’t have as the fact that the sugar hits my system like a ton of bricks. My heart races, I lose focus, I start sweating. It’s not a pleasant feeling at all.
  6. Alcohol is out
    The last time I had gin (my favorite) was in February, when I poured myself a nice gin and tonic to enjoy during a Zoom meeting (yeah! in February!). After a single sip, my face felt flushed. After a second sip, it felt sunburned and went tight. I excused myself and went into the bathroom to look in the mirror – my face was beet red and the kind of swollen where my smile lines were white creases. So…that’s out.

Before surgery, I would have looked at that list and thought “that’s not living,” but there are a few things that make it okay.

Before surgery, restricting my intake meant dealing with intense cravings. The kind of addict thinking where, even when I knew the thing I wanted was killing me, I rationalized why I needed to have it anyway. Every pound was a struggle, and I consistently lost. After surgery, I don’t miss the food. It’s alarmingly easy to forget to eat for long periods of time. The strangest thing to me is that things I used to love no longer appeal to me. Almost nothing is as tasty as I remember it being.

The result is that as of today, I weigh less than I have at any other time in my adult life. My BMI is within the normal range (not that I care, but my doctor seems to feel it’s important). I feel amazing – healthy and energetic and as happy as anyone can be in 2020 (although things are looking up).

I’d say it was worth it.

Weight Loss in the Time of Coronavirus

There’s a well-understood phenomenon that comes along with bariatric surgery called “dumping syndrome.” When a person who’s undergone bariatric surgery eats too many carbs, their body can respond with vomiting, diarrhea, extreme fatigue, rapid heartbeat, flushing, sweating, light-headedness, loss of concentration, and unconsciousness. It sounds dire, but it’s not life-threatening and usually just signals that you should knock it off, for crying out loud.

But then, along comes COVID-19, and all bets are off. Stress is at an all-time high as people are told to stay home, grocery store shelves are empty, infection rates and death tolls rise, and the truth about our poorly-managed healthcare system is revealed. Being unable to leave the house while simultaneously being bombarded with terrible news is a perfect recipe for stress eating, and stress eating is very often carb-rich. Snacks, baked goods, comfort foods – they’re mostly carbs, and therefore off limits for the bariatric patient. And yet, like everyone else, I’m only human and I only have so many outlets for relieving stress when I can’t leave the house.

Couple this with the fact that it’s spring. Here, it’s been raining for days, which means a lot of mold, to which I’m allergic. And when it dries out, everything is in bloom and spewing pollen into the air, to which I’m allergic. My nose is running like a marathoner and I’m sneezing constantly, and even though these aren’t symptoms of COVID-19, I’ve gotten death stares from people at the grocery store.

Which brings me to the point where I’m sitting on the toilet in some pretty acute distress, my forehead beaded with sweat, worried that the next time I sneeze I’m going to spew from both ends in a way that will involve a whole lot of cleaning up. And because it’s March 17, 2020, my mind does not go immediately to the tamale and beans I had for dinner last night. It goes to coronavirus. And the fact that my daughter, who was staying with us for the past few days and has only just gone home, has a compromised immune system.

It took me way too long to connect my symptoms to dumping syndrome, and once I made the connection, I immediately felt better. But it’s scary that this is what life looks like right now. Every time my nose itches or I feel a little warm (so, add climate change into this mix) or I have a tickle in my throat, I worry that I’m a plague victim, and a danger to the people I love most.

Like everyone else, I don’t know how long this is going to last, or what the world will look like once it’s over, but I do know that the only way to get through this thing will be to take great care of myself and the people around me. I hope you all can do the same, and that if you’re in a tight spot, there will be people there for you.

 

Clothing a Lava Lamp

Two months after my surgery, I have lost 40 pounds, and I’ve started The Pile – all the clothes I can’t wear because they’re now too big.

At my heaviest, I had three kinds of clothes – those that were slightly too tight, but I could still fasten, breathe in, and move around in; those that were big and loose and baggy (and therefore comfortable); and the Goldilocks clothes that fit just right. By far, this was the smallest group, and now, it’s even smaller.

Clothing you buy off the rack was designed to fit one specific shape of person, and odds are excellent it’s not you. It doesn’t help that for women, clothes sizing has come unmoored from anything as objective as measurements. The dresses I fit into have all come from the same brand, and range in size from 16 to 22. Apart from that brand, I’ve got 14s that fit. Most women I know would give up vanity sizing just to be able to go into any store and know that every garment of a given size will have consistent measurements.

But even if you know that you’re, say 5′ 7″ and weigh about 200 pounds and know your measurements, you’re not going to be able to breeze into a store and find a garment that fits and flatters. Everyone carries their weight a little differently. What’s worse is that as the weight comes off, it’s not like it comes off evenly all around. My face got thinner immediately. My calves and thighs got thinner because I exercise by running. My belly? Not so much. I worry that I’m going to end up like some kind of bug – a gigantic body being held up by tiny stick limbs. What kind of clothes fit Gregor Samsa?

What’s even more frustrating is trying on all the clothes in my closet that used to wear before I gained weight. Many of them don’t fit, even though I weigh less than I did when I wore them, because I’ve changed shape. I had some clothes I really loved, and now I’m worried that I won’t ever be able to wear them, because by the time things fit around my hips, they’re too big in the waist, or by the time I can button a shirt over my boobs, it’s huge and boxy around the middle.

The biggest challenge, though, is the changing size/dysmorphia/specific taste trifecta. I know the look I’m going for, but I have no idea whether, when I hit my goal weight, it’ll look good. I guess I’ll have to do what I’ve always done: I just assume I’m the most amazing looking person in the room.

 

But You Don’t LOOK That Big

As I’ve talked to people about my experiences with bariatric surgery, I’ve heard the same thing over and over – “But you didn’t look that big.” “I never thought of you as fat.” “I just thought of you as my normal friend.” It reminds me of things I’ve heard about other parts of my identity: “You don’t look Mexican.” “I never think of you as introverted.” “I just thought of you as my normal friend.” But just because you don’t acknowledge one part of my identity doesn’t mean I don’t live it. And when denial of the problem is the response to the fact of my surgery, it assumes exactly the thing I was trying to avoid: that I did it because I wanted to improve my appearance.

I’ve talked about the numbers, but if you’ve read my earlier posts, you know that just numbers don’t tell the whole story. The experience of living in a body that carries a significant amount of excess weight is constant, it’s difficult, it’s humiliating.

The insults and limitations start at the beginning of every day. I get up and go to my dresser or my closet, and think “What can I wear that is both comfortable and doesn’t make me look like I’ve given up on myself?” Women’s bodies vary so much in shape, and as we gain and lose weight, that shape can change drastically, so it’s not a matter of finding a style of clothing that works for me, it’s a matter of finding a single brand, manufacturer, or single item of clothing that reliably fits and is comfortable (I am of the opinion that clothing that fits correctly and is comfortable is automatically flattering. Feel good, look good.)

Now I’m dressed, and I face the challenge of breakfast. What to have? I could skip breakfast, telling myself that I’m sparing myself the calories, but I also know that one of the down sides of having a suppressed metabolism is that if I miss a meal, it may spur my body to either eat more at my next meal to “make up” for it, or to hang onto calories it would otherwise burn easily because it’s in starvation mode. So, skipping breakfast not a great idea. Most days I’d have tea (I don’t drink coffee, but I drink so much tea…) and toast, perhaps some fruit.

Now comes the challenge of incorporating exercise into my day. I would sit at my desk for a few hours working on stuff, and the longer I sat at my desk, the more guilt I felt because I know I should be getting my steps in, should be taking breaks to walk around, etc. But because I work from home, if I got up from my desk, I had a choice between go out for a walk or getting actual chores done, and there are always chores that need to get done. This is a reality for a whole lot of people – the time it takes to work out is a luxury a lot of folks just can’t afford. Similarly, if I’m out running around on errands and it’s way past lunch time and my toast and tea have worn off, it’s easy to make choices that aren’t the healthiest. Have you ever tried eating a salad while driving down the freeway? It’s worse than texting. But you can eat chicken fingers with one hand.

Dinner time is the next hazard. I have a family, and nobody has the time to make three entirely different meals and then clean up afterward. It means that there was not just food that wasn’t the best for me (tons of pasta) but a whole lot of it (because my family can put away a whole lot of pasta). Worse, there were a lot of days that we didn’t even start thinking about dinner until it was too late in the day to begin cooking, so we opted for take out – pizza, Indian, Thai, Chinese. And I would eat not just because I was hungry at the end of the day, but to be social with my family and to ease the tension and stress of the day. It wasn’t uncommon to get up from the dinner table with some variation of “I’m stuffed!”

Bedtime. The final challenge. By bedtime, my lower back and left hip were so painful that I knew I won’t be able to sleep. I take ibuprofen, I take CBD, I put a couple of Salonpas patches on my lower back and hip. One doctor said I should stretch more because I hike without stretching first. Another just said to take more pain killers. Every doctor said “lose weight,” although not one would tell me how. It could be hard to fall asleep and impossible to stay asleep because the pain in my lower back was so great.

And then I would get up the next day and do it over again. And none of this includes doing things like shopping for clothes (I couldn’t walk into a mall, go into any clothing store, and count on finding clothes that would fit me), taking public transportation (being embarrassed because people would rather stand than sit next to me on the bus, and if they were standing and I was sitting, it wasn’t unusual to get hostile stares from them as though I were purposely denying them a seat), grocery shopping (the feeling of shame and self loathing as I put things like ice cream or potato chips in my cart, even if those things weren’t for me), or doing anything that required me to ask someone for help in person (it would be unusual to get the attention of a service worker, and when I did, they were almost never motivated to put much effort into helping me solve my problem).

So, while I appreciate that you didn’t see me as fat, I hope that you understand that I didn’t do this to change anyone’s opinion of me. That’s ultimately not my business. I did it because there were realities of my day-to-day existence that I didn’t want to live with anymore.