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.

The Hard Part Isn’t What You Think

It’s been five weeks since my surgery. At this point, the pain from the surgical sites is gone (although that’s only been in the last week), and as of tomorrow, I’ll be able to eat regular food. I’ve lost just a hair under 30 pounds.

When I was first contemplating surgery, I understood that my eating habits would be changed forever, but I don’t think I really understood the mechanisms behind it. I knew that the surgery itself wasn’t going to be what took the weight off. It would be the diet and exercise that happened afterward. While that’s strictly true, none of it is happening the way I thought it would.

Won’t or Can’t

In the 34 hours I was in the hospital, they tried feeding me 3 times. Each time, I was able to take a few sips of water and about as much food as would fill half a baby spoon. That was it.

Over the next two weeks, I had nothing but liquids – protein drinks and shakes, three times a day for the first week, supposedly going up to five times a day the second. Except that I couldn’t. It would take me half an hour or more to drink the entire 8 ounces of liquid, and by the time I was due to have my next protein drink, I was still full from the last one. And being too full meant risking vomiting. My one goal through this whole process has been to never vomit.

Week 3, I graduated to “blenderized” food. “Blenderized” meant baby food consistency. Which meant a lot of actual baby food. If you add salt and spices, it tastes like food. I put a chicken breast in the blender with an equal amount of chicken stock, giving me about 32 ounces of chicken baby food. Here’s another issue: since I could only eat ~2 ounces of chicken at a time, I had enough for 16 meals. Even eating 4 meals a day, that’s 4 solid days’ worth of food, and who wants to eat the same thing every meal? If I put 2 ounces of chicken and an ounce of veggies in my dish, I was often still too full for my next meal. Sometimes, nausea from pain made eating hard.

Week 5, I progressed to “soft” food. By now, I can eat 4 ounces at a meal – four and a half, sometimes. Any more than that, and I can’t do it, and I’m too full for my next meal.

All this is to say, it’s not that I won’t eat, or that I don’t want to as in I have no desire for food (although that’s certainly true, for the most part). It’s that often, I can’t eat.

What does “rapid” mean?

All the literature I was given said “You will lose 10-20 pounds in the first two weeks, 30% of your goal in 3-4 months, half in 6. You will plateau in 12-18 months.” It seems pretty fast. I did lose 20 pounds in the first 3 weeks. And I hit my 30% goal about a week later. I credited the rapid loss to the fact that I was eating almost nothing but protein and vitamins.

I log everything I eat so I can ensure I’m getting enough protein – too little and you can lose muscle and your hair will fall out. I eat somewhere between 350 and 550 calories in a day (meaning I have never had fewer than 350, or more than 550). So I know exactly how much I’m taking in versus how much I’m putting out. Every day, I’m on the treadmill for between 30 and 60 minutes, although yesterday, I took my first hike since my surgery.

I stopped weighing myself every day after the first day I gained a pound relative to the day before. How can a person eat almost nothing and not only still function, but put on weight? Beats the fuck out of me. Years ago, I read an article dating back to WWII that detailed Queen Elizabeth’s very frugal diet (I presume to prove to people that the monarch wasn’t living opulently whilst her people were doing without) that said that the Queen’s diet amounted to about 750 calories per day. At the time, I couldn’t believe that anyone could function for a long time on that little. Right about now, I don’t think it’s even possible for me to take in 750 calories in a single day, and I’m functioning just fine.

I weigh in on Mondays, and take my measurements so I can see not just how many pounds I’m losing, but how many inches. This past week, I lost a single pound, and gained 2.5 inches in my hips.

Half the game is 90% mental

Here’s the hardest part of the whole thing: Not losing weight, occasionally even gaining, is phenomenally discouraging. Downright depressing. And yet, I can’t angrily binge eat a pizza or down three Snickers in my car where no one will see me. If I eat the sugar, I’ll get violently sick. And at this point, the pizza would likely make me sick as well. Doing anything except taking care of myself will literally make me sick. And the only thing worse than being depressed is being depressed and sick.

Which means that the only thing I can do when I get depressed is to look at the horizon. I can’t afford to think short term anymore. Being discouraged now is just an emotional state. It doesn’t have anything to do with how I eat, exercise, take my meds.

It’s still early days for me, and yet, I don’t feel like the same person I was five weeks ago. We’ll see where that goes.