"I am not a number, you aren't either."

i am a lousy sleever

So, the main "complication" I am experiencing at the moment from my surgery is a consistent and persistent lack of energy. My surgeon told me to to expect this for about 10 weeks, so I am not alarmed by it, but I am annoyed. I am living my cat's lifestyle. I sit or lay around watching things between naps, I get up to go to the bathroom or eat, and then brace myself for some more sitting around.

I've also been hunting around on the Intarnets for on-line support groups, and there are plenty of them, as well as sites that simply use feeds from other boards. I am finding scant comfort there, and here's why:

  1. The people who post most frequently clearly have serious unaddressed issues with food and eating. There's this desperate and frantic obsession with low-calorie and low-fat foods, just as if they were at Weight Watchers. I think this is dangerous and I want to just blast them all with a dose of "open your damn eyes people!" If you can only eat a bit more than two cups of food a day your problem isn't caloric density, it's nutritional density.

    I am actually a bit alarmed at my rate of weight loss right now, I am losing more than a pound a day, and I'm eating (not exclusively, just among other less interesting foods) bacon, pate, potatoes au gratin, chili, eggs, butter, and full-fat diary products. I've lost my sweet tooth, so I don't eat a lot of simple carbs, and I make sure at least half of my calories come from quality proteins, but artificial sweeteners and manufactured low-fat food-like products are not a part of my diet, just as they weren't pre-op, and for the same reasons. They aren't really food.

    Part of the problem is the bariatric health-care community. They are universally condescending and paternalistic, as if their patients got fat because they were too stupid and weak to eat properly and exercise regularly. In the years before my surgery, I confounded three Registered Dietitians in a row with my food diaries. They'd take a look and come back to me and say, "I don't get it, your food choices are exemplary, you should be losing weight, try eating a little less." Yeah, no shit, Sherlock.

    There's so much of "you know, the surgery is just a tool, you're still going to have to make permanent changes in your lifestyle in order to get good results." I just want to slap somebody and say "Look, I've been making lifestyle changes my entire adult life, so much so that I don't even know what my 'lifestyle' really is." Walk a mile in these shoes and then tell me if you have anything useful to say.

    Clearly, there is a fundamental and pervasive belief among bariatric health providers that bariatric surgery patients are behavioral failures. Well, take it from me, there's more to the story than that. How else do you explain that after 30 years of trying to manage my weight behaviorally, I have surgery and suddenly am met with alarmingly rapid success? Did the surgery suddenly turn me into a completely different person? No. I'm the same, believe me.

    Yet, on the other hand, it's hard to ignore these post-op patients who swap recipes for low-cal sugar free chocolate-chip cookies, clutching their water bottles full of Crystal Light while they complain about losing their hair and having chronic diarrhea.

  2. I hate the lingo. People who have had my procedure, which is formally called a vertical sleeve gastrectomy, call themselves "sleevers." They bond around this, and act as if it is some special club of mutual understanding and unquestioning support. There's a lot of discussion around the post-op diet, and I can tell there are widely, widely variant instructions given by the various surgeons. Basically, right after surgery you are on a liquid diet and protein is the primary macronutrient concern, so people drink protein-supplemented beverages, referred to as "protein shakes."

    Then you are advanced to well-pureed foods, again with the emphasis on protein, and clearly some surgeons tell their patients to only eat very lean proteins like white chicken and fish. I guess they're afraid to let their fat little gluttons get the idea that they could eat real food, lest they run to the nearest McDonald's and start on the milk-shakes and french fries again. But, the worst part of all this is this stage of the post-op diet is referred to colloquially on these support groups as "the mushies." Argh, shoot me now, please. Why the juvenile language? Are we trying to demonstrate that we are helpless little babies flailing around so that someone will care for us?

    If I see another post from someone saying they're "loving their mushies" I am going to start shooting.

  3. The obsession with the scale. Here you are, someone who is moving from severe obesity, with all of it's attendant serious health risks and problems, to a lower weight that will improve your health and lengthen your life, and you get completely hung up on what is displayed by a scale as if that was some linear measure of your worth as a human being.

    The plateau, the wall, the hump. This stresses people out severely. I've already had one, and it was at the same weight I've always had one (I've lost past this weight about four times in my life). That's interesting because it reveals that there is some completely mysterious force at work in the body that seems to "know" how much it weighs, or what it's composition is, that's actually, very, very interesting, but it is not an indication that something is wrong.

    Every single last person who has lost a substantial amount of weight has experienced a plateau or two, or six. No one knows what causes them, what they are, or even if they mean anything other than this is how the human body undergoes this change. But, to read the forums, you'd think it was a demon from the 7th circle of hell.

    I get on the scale every now and then, mainly now because I am trying to see if I can slow-up my weight loss (mainly to avoid cholecystitis if I can, i.e., gall bladder disease), but the number is just a very blunt measure of what is changing. More important to me are things like the way my clothes fit, my contours, ease of movement, my blood sugar, and the increasing ease with which I can get up from the floor or climb stairs. That's success to me, the number on the LED is just a number, the same number can mean different things in different contexts, and there's always a varying amount of fluid and solids passing through me at any particular point in time.

    So, to all these people who live and die by the LED (or the analog dial), I just want to say "throw the scale away. Weigh at your doctor's office and get a psych referral." You have bigger problems than being "stuck."

  4. "Addiction transfer" is such a common problem that there are specially designed groups just for it. What the fuck? You knew you had an eating disorder before the surgery and you're waiting until you've started hitting the crack pipe post-op in oder to do something about it? What the fuck is wrong with you and your doctors? Surgeons should be taken out and shot for operating on someone with an unmanaged eating disorder.

    I have an eating disorder, it's called "Binge Eating Disorder" and it took me about five years of weekly psychotherapy to acquire the insight and skills necessary to manage it. I insisted on doing that before I even considered surgery, and for a long time I believed that if I could get this under control I would never need surgery. I was wrong, but my eating disorder was well-managed for almost two years before I began to seriously contemplate surgery, and even then I was worried that I might blow a gasket somewhere and have to face it down in some new way.

    That hasn't been the case, thank goodness, managing it now is identical to how it was pre-op, except I no longer have hunger as a confounding influence, so it's actually a bit easier. If I had received this procedure when I was still being buffeted by the gale-force winds of it's influence as it operates below the level of awareness, I'd be a ticking time-bomb for all kinds of complications, some of them potentially fatal. The knowledge I have now, that is, that there are plenty of surgeons willing to operate on someone after they've been "cleared" with one session with a consulting psychiatrist (basically just being evaluated for frank psychosis is all you can do in one visit), scares the shit out of me. Hell, I still am scared by this.

    These support forums are replete with people who are deep in the throes of their eating disorder, be that binge eating disorder, bulimia and yes, anorexia, and they all act as if this is just what happens to fat people who have surgery. It's unconscionable.

  5. Then, there's the shorthand and the tickers. Today, mine would look like this: 510/403/372/185. That's highest weight / pre-op weight / current weight / and goal weight. Shoot me, please.

    There's tickers, little graphics that show some disgustingly sweet graphic along a line. Get yours here. Hello Geocities, now we know what your design people are doing these days.

    Plus, you are requested to include these in your sig, along with the date of your procedure and your surgeon's name. T. M. I.

    I am not a number, I have never been a number, I will never be a number. I am not a procedure, I am not a date.

  6. My surgeon did not change my life. I changed my life. My surgeon performed a procedure at my request, for money, and he still has his stomach, and he won't be living with the sequellae for the rest of his life, I will. He is not a God, not a Saint, I have not been touched by his Noodly Appendage.

Get over it, people. Take control of your ship.

There. I feel better now. I needed that, thanks for reading.

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