Tag Archives: bariatric surgery

Two-Month Update Part 1: Immediate Post-Surgery

May 5, 2022 By in health, surgery, weight Tags: Leave a comment

I had skin surgery on the 1st of February. I had a huge amount of trepidation in the lead up to the event, and not without reason.

This wasn’t done at a hospital. It was done at a “surgery center,” which is where you do your surgeries if you’re a surgeon who doesn’t want to do all the other stuff one has to do to have hospital privileges – things like spending hours doing rounds and filling in paperwork.The consequence of having surgery in not-a-hospital is that there is no such thing as an overnight stay for observation. I was sent home a few hours after major surgery.

The good thing is that hospitals are not restful places. Between the noisiness of the surroundings, the smells, and the constant intrusion of staff taking your vitals, bringing meals, and cleaning, sleep is not really happening. The bad thing is that if I had a reaction or needed anything I didn’t have in the house, I couldn’t just ring the nurse and have it addressed.

I didn’t even really see my incisions for a week. I was sent home in a cross between a corset and one of those elastic and velcro knee wraps – a thing that wrapped my entire torso tightly in a thick layer of stretchy fabric. It was hot, itchy, and uncomfortable. I suspect it contained latex (to which I’m allergic, although no one asked me about it before the surgery) because I have what look like burn marks in places where it directly touched my skin. I wasn’t allowed to remove the wrap, change my dressings, or shower for a week. A lot of sponge baths happened, but they never felt quite adequate.

My surgery was complicated in scope: not just the normal “tummy tuck,” where they make an incision from hip to hip, pull the skin down, cut off the excess, and sew you back up leaving you with a smile-shaped scar across your lower abdomen. My surgery meant one incision from the bottom of my sternum to my pubis that intersected with another incision from one hipbone to the other. But, as they say in the infomercials, that’s not all! He also did a thigh lift, which involves making one incision nearly all the way around the circumference of the top of the thigh and another incision on the inside of my thigh from the groin to about three inches above the knee. That’s six incisions, each at least 12″ long, all around my body.

I had two surgical drains to take away the excess fluids (they’re called Jackson-Pratt drains, and I don’t want to link to them because they’re gross) that had to be emptied twice a day and the amount of fluid recorded. It’s disgusting, the effluvium smells weird, and I couldn’t just drain them, I had to pour the liquid into a graduated cylinder to measure it. Having the tubes inserted right at the outside of my hips meant that there was no way I could recline that wasn’t resting on staples or the insertion point of the tubes. This is what opioid painkillers were created for.

The abdominal incisions were closed with dissolving sutures and glue, the leg incisions by dissolving sutures and STAPLES. Yes, I had over 100 staples holding my skin together around the tops and insides of my thighs. It took two weeks to have the staples removed, by which time the pain of having those staples removed paled in comparison to the aggravation of having them in. Once I was able to shower, the glue of the abdominal incisions came away in bits over time.

The drains were the last thing to go. Most people have them removed after two weeks, but I’m a special, special snowflake and got to keep mine for an entire month. I saw the surgeon twice a week, each time showing him the records I was keeping and hoping that today was the day I’d get the drains removed. I suspect that he removed them after a month, not because the drainage had stopped, but because leaving them in much longer would somehow lead to a bad outcome.

Once the drains were out, I was sent out into the world in an uncomfortable, and yet strangely sexy, compression garment. I thought the hard part was over.

The Next Step

January 31, 2022 By in health, weight Tags: , , , , 1 Comment

The Lead Up

In thirteen hours, I take the next step in this whole bariatric process. Back in September, I went to a follow-up with my bariatric surgeon and asked when I should think about getting all the extra skin removed, and he said now would be the right time. He said he recommended it as the final step in the journey.

That was the first shock. For some reason, I had gotten it into my mind that skin surgery, the step that would take off a bag of fatty skin from my lower abdomen that’s been there since before I was 20, was something I had to earn. What did “earn” mean, though? I’ve already lost over 100 pounds. My weight has been steady for months without the rebound I’ve heard of from others. What else did I think I needed to do?

Nearly 20 years ago, I tried getting a tummy tuck. I went to a surgeon who first told me I needed to lose another 20 pounds. He said that weight loss for people “my age” was nearly impossible, though.

I was 36.

I lost the weight and paid him far more than I could afford for the surgery, and instead of doing an abdominoplasty, he did liposuction on my inner thighs and under my breasts. It wasn’t what I asked for, it wasn’t what I paid for, and at the time, I didn’t know what to do. I never talked about it, I tried not to think about it, and to this day, I have a hard time thinking about it. Every part of that experience was deeply damaging, starting with this man’s dismissive assertion that I’d never be able to lose weight, and that what I wanted was not just a waste of time, but an outcome I didn’t deserve.

I went into the entire bariatric surgery thing knowing that I’d be facing this scenario at some point. What I have on my side is many more years of life experience, and a good grip on the knowledge that what happened to me the last time should never have happened to anyone. If the statute of limitations on medical malpractice hadn’t long since run out, I would have sued this man for everything he was worth (which would have been a whole lot financially and very little morally).

But this leaves me in such a weird place. In twelve and a half hours, I’m having the surgery I wanted decades ago.

The Next Few Hours

But that’s not the only thing freaking me out. The other thing is the surgery itself.

The doctor came highly recommended, and I’m sure I’m in good hands, but this will be the fourth abdominal surgery I’ve had. I had my tubes tied after my younger daughter was born, I had an emergency gallbladder removal, and then bariatric surgery. After every one of them, I was in a lot of pain. When you can’t use your abs, anything that involves changing position is hard. Standing to sitting, sitting to lying, lying to sitting, sitting to standing, agony to agony. In a perfect world, I’d be able to stand on a step with my back against a soft surface, and the entire thing would gently lean back until I was lying down. Not going to happen.

The anticipation of pain is a punishment all by itself and is the basis of many forms of torture. It’s why I believe most doctors avoid the use of words like “pain” and “hurt.” Most doctors will come at you with a bone saw and tell you that as they take your leg, you’ll feel “discomfort.” But this doctor has told me more than once that this procedure is “very painful.” It wasn’t just the one time he said it during the initial consultation. There was also the several times he said it during the second consultation. And the eight million times it was mentioned in the sheaf of paperwork I had to sign in the pre-op appointment. These people want to make sure I know this is going to hurt. A lot.

Into the Future

This is the final step toward becoming something I’ve never been. As of tomorrow, I will be yet another size and shape. There are certain clothes I haven’t worn because they just don’t look right, and this surgery will remedy that. It will make finding bathings suits and skirts that fit easier. It’ll mean that I won’t be dressing around the one part of my body that’s still out of proportion.

This is it. The last step. The last thing I have to do. Apart from the familiar maintenance of eating right and getting enough exercise, this is the last step toward a goal that I’ve realized is always going to hover on the horizon.

A Country Where I’ve Never Been

August 21, 2021 By in health, weight Tags: , , , , Leave a comment

I had a meeting with my bariatric surgeon. It’s only my second since the pandemic began, although I was supposed to check in twice a year. I reported my weight to him (142.6 as of that morning) and told him I had been stable, plus or minus about a pound and a half, for the last couple of months.

I’ve been struggling with the idea of having the excess skin from my abdomen, buttocks, and thighs removed. Right now, it looks like a deflated balloon – sort of limp and slack. It’s never going to go back, in no small part because I have never, even for one single day of my entire life, had a flat stomach. No matter how thin I’ve been, I’ve always had a flap of fat hanging off my stomach like an apron. I come by it honestly – my grandmother had the same thing, which she always called her “panza.”

I asked my bariatric surgeon how long I should wait before getting skin surgery, and he said now would be the perfect time. I don’t know why, but hearing from my surgeon not just that I should get the surgery now, but that he considered it the last step of the entire process, made me feel a lot better about it.

Now comes the really mind-bending part. At the age of 56, I will be getting a body that I’ve been wishing for since puberty. I’ll be able to wear any bathing suit I want. I’ll weigh less than I did in high school. I will wear an adult clothing size I’ve never worn.

Before the bariatric surgery, I wasn’t sure how my life would change. It has changed, but not a lot. And I’m wondering if it will change any more once I have skin surgery. Here are the biggest surprises from “I’m now 100 pounds lighter.”

  • When I find something really cute at a store, chances are better than even they won’t have it in my size. When I was heavier I never found clothes in my size because high-end stores didn’t carry them. Now it’s because they’ve sold out.
  • It doesn’t matter how great I look in clothes – my gray hair means that no one’s staring when I walk down the street.
  • Nothing ever fits quite right. It doesn’t matter what size you are, there is no way to buy clothes off the rack and have them fit perfectly. The places they’re too tight or too loose may change, but the lack of fit stays the same.
  • I will never have whatever body type is currently fashionable. And that’s okay, because neither does anyone else I know.

Who’re You Gonna Trust?

April 23, 2021 By in health, practical advice, weight Tags: , , , , Leave a comment

Spring is here! And with it comes Easter eggs, chocolate bunnies, jelly beans, and all the other rich, sweet foods that have always been my Achilles heel. I had gotten pretty sloppy with my eating, but after all those cookies, candies, and pies, I knew I wasn’t doing as well as I should be. Whenever I get anxious about my weight, I do that thing most people do: stop weighing myself. But if I don’t know the truth, I’m free to imagine all sorts of worst-case scenarios.

And that’s exactly what I started to do. Because I wear leggings a lot, my shape is right there on display. Leggings may be able to even out a bit of cellulite or smooth a silhouette, but they can’t disguise the extra pounds you may start to pack on. I would look at my calves and think that they looked huge. My stomach looked bigger. Everything just started looking like I had gained at least 15 pounds, and I was panicking.

Once the orgy of Easter gluttony was over, I needed to get back to some discipline. I went back to recording my food intake (one of my main tools), and weighing in.

Which do you trust – the scale, or your own eyes?

The first time I stepped on the scale, my heart was pounding. It was first thing in the morning, I had just peed, I was completely naked, I had even taking off the three rings I habitually wear. If I could reduce a 15-pound weight gain to a 14.8 pound weight gain, I’d consider it a victory. The little digital numbers started at zero and went up, and….I had lost two more pounds.

This is part of my dysmorphia. At my heaviest, I couldn’t tell what I looked like, and often thought of myself as much thinner than I was. Now that I’ve lost over 100 pounds, my brain is still telling me I’m fat, even though I exercise every day, and I mostly try to stick to foods I know will work for me – salads, chicken breast, Greek yogurt, fresh fruit and vegetables. But I haven’t said no to treats, and spend a decent amount of time planted on the couch, and all my past experience tells me that if I’m not starving myself and working out 10 hours a day, I will never lose a pound, and in fact might actually gain weight.

The knowledge that most people stop automatically losing weight and start having to be more mindful of their habits 12-18 months after bariatric surgery is always at the back of my mind. My surgery was at the end of October, so I’m right at that 18 month mark. I don’t know what it will look like when the honeymoon period is over. My weight loss has slowed from a high of 10 pounds per week (the first couple of weeks right after surgery) to about half a pound per week for the last six weeks or so, but it’s still heading downward.

How is it that, even as I continue to lose, my perception of my own body is that it’s getting bigger? Now I have two competing feelings to muddle through. Even though my clothes aren’t any tighter and my measurements continue to go down, all I see is the fat. At the same time, even though I’m still more than 20 pounds away from dipping below a “normal” BMI, I worry that I’m never going to stop losing weight. That I’m going to dwindle away into a sack of bones. My desire to keep to a healthy diet and exercise routine is always at odds with my desire not to disappear.

All this is to say that losing weight is great and solves many problems, but getting the pounds off is just the start of the process. Understanding how to take care of a body that’s changing all the time – with age, with the seasons, with stress – and how to feel good about the body I’m taking care of is a much, much longer journey.

You Can’t Outrun It

January 1, 2021 By in health, leisure Tags: , , , , Leave a comment

You probably won’t believe it, but even when I weighed nearly 100 pounds more than I do now, I liked to go running. There’s a perception that all you need to do to lose weight is diet and exercise, but as I’ve said before, it’s just not that simple. Even as I ran almost every day, I was still gaining weight. After a while, the running slowed to walking, although I was still walking miles and miles a day. But after a while, even that became difficult. I had orthotics for my chronic plantar fasciitis, but they did nothing for either my knee pain or my hip bursitis.

Right after surgery, I was counseled to walk. It’s well known that people heal better on their feet than on their backs, and since I like walking, it wasn’t difficult. As with most people right after surgery, the pounds flew off with very little effort. But, as with most people, the honeymoon phase is coming to an end. The pounds aren’t just falling away anymore. That’s fine. My BMI is within the “normal” range, I feel physically good, and I’m satisfied with how I look. Then again, I was always satisfied with how I looked.

Still, I was afraid to get back to running. Hip bursitis and plantar fasciitis are persistent, and while I have an entire regimen of stretches and exercises to relieve the hip bursitis, I was afraid of aggravating it again. I still use the orthotics for my feet.

So last week, I took the plunge. I’d been walking a three-mile loop around my neighborhood, and decided to see what happened if I tried running it.

Running on a treadmill the way I used to is very different than running on the earth, and my loop has a lot of uphills and downhills. The uphills are harder on my thighs, the downhills harder on my knees. I didn’t run the entire three miles, but I did a fair amount of it. My normal routine is to run as long as I can, and then count to ten. Only then can I slow to a walk. I start running again after 100 walking steps.

After three runs this week, I can tell you how I feel. Way, way better than I thought I would. Better attitude, better sleep, better energy. The biggest problem is the fact that it’s getting hard to sit still and work on anything, and with the covid lockdown, that’s difficult. My house is clean, my stuff organized, my yard immaculate. The only thing I have left to do is…go for a run.

Surgery: A Year On

November 13, 2020 By in health Tags: , , , , 1 Comment

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

March 17, 2020 By in health Tags: , , , , Leave a comment

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

December 30, 2019 By in health Tags: , , , , 1 Comment

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

December 8, 2019 By in health Tags: , , , , , , Leave a comment

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.