Fat Shoes

I haven't been shy about admitting that I reached my heaviest weight while going through the process of qualifying for surgery. What I never could have imagined was that my fat knows no boundaries. When I was pregnant and my ankels swelled up to the size of my knees, I thought it was some freak pregnancy-related mishap caused by all the hormones in my body. Turns out that I'm an idiot:

It's being fat that causes fat ankles.

On the end of my fat ankles are sausage-like feet. I had wide feet before the massive weight gain, but now I have something else entirely. I'm not even sure they make shoes for feet like mine, unless they are custom-made by short, festive little men in Italy (note to self: look into custom-made shoes). So, I'm in a bit of pickle when it comes to footwear. At my new job, all the women wear high-heels. The other female broker in the office only comes to work in heels higher than 3". I'm much more of a flats kind of gal, but I'm trying to embrace the power suit. No power suit is suitably impressive with a pair of sensible flats on a woman. It kind of looks like your legs got cut off at the shin, which is rather disturbing because I've never worn heels every day.

I have one pair of official, work-endorsed pair of  black high heel shoes. They're size 9 and still don't fit. I can actually feel my toes going numb in them. Then the pain starts. By the end of the day, I'm hobbling along in my shiny black shoes. Sure, my feet might look respectable, but the nasty thoughts that I'm thinking in my head at these blasted pair of shoes are anything but.

Now I'm torn. I know that my feet will decrease in size (maybe) when I lose weight. I also know that I'm getting my surgery in a month and it's realistic to think that my feet won't immediately get smaller. I'm not even sure that I'll get immediately smaller, let alone the potential consequences to my feet. I just don't want to spend money on good shoes that won't fit me for very long. But then I remember that I can't even wear uncomfortable shoes for a full day, let alone an entire month.

I think I just talked myself into some quality shoe shopping time. I'm glad we had this talk.   

Food Cravings

As the prospect of the two-week liquid diet comes closer and closer and my surgery date is around the corner, I feel like I'm in my third trimester. For the first two trimesters, you know that labor is coming, but you can't imagine what it will be like. You know, at least theoretically, you are going to have a baby soon, but actually holding the baby in your arms seems fanciful and unrealistic. Suddenly, you are two weeks from your due date and holding newborn clothing and freaking out, occasionally stopping to stare at babies in the mall. That's where I am right now. I'm overly conscious of every piece of food that I stare at, every aroma, every texture, and beautiful, beautiful piece of food.

Take last night for instance. I guess I should clarify for one moment before moving forward. Just because I'm conscious of what I'm eating, doesn't mean that I'm eating healthy. In fact, the opposite is true. It's a well-understood fact in the gastric bypass community that almost everyone gains weight while waiting for their surgery. How could you not knowing that you face almost six weeks of liquids? The first protein shake is D-Day. To cram as many metaphors as I can into one, small blog post, I'm T-13 days to drinking only liquids. You better damn believe that I'm eating all the food that I can possibly imagine.

That is all just a long way of trying to explain why I got home last night and ordered a Papa John's Hawaiian pizza. Then sat on my couch and talked to Zac, who was drawing pictures. I flipped on the tv and found myself watching every food commercial with intense interest. A Sargento cheese commercial came on, the one where some invisible hand is slicing through huge blocks of cheese and I knew, right then and there, I had to have some cheese. This is the sick part - I had already ordered the pizza. That commercial broke me. I went to the fridge and found my own large block of cheese and shared it with Zac....while waiting for pizza.

"Hello, my name is B, and I'm a food addict."

Less of Me

If we are friends on Facebook (and if we’re not, why aren’t we friends yet?) then you know that I’ve been alluding to a “surgery” that I’m having. Not many people are stoked when insurance companies approve them for surgery, but I had been waiting for a year to receive the phone call that I got on Monday with the good news. I’m having lap band surgery on February 24th to lose weight, lower my cholesterol (total cholesterol: 317!!), and high blood pressure (regularly 140/100). I’ve decided to chronicle my process through the surgery to let my friends and family know: 1) I haven’t completely lost my mind and 2) maybe encourage some people along the way to take measures to take care of their health.

First, let me start with the naysayers. Yeah, you over there. And you. And the person that I’m related to that I will not name in this blog. You all have expressed concern that I’m “taking the easy way out” and even before I’ve started the process, have tried to convince me that I’m going to fail. The conversation that I have with them goes something along these lines:

Naysayer: “Have you even TRIED to lose weight?” (like the thought hadn’t occurred to me yet)

Me: “I’ve tried everything I can think of. In order to medically qualify for gastric surgery on insurance you have to demonstrate obesity for over two years. Some insurance companies require a weight history going back five years."

Naysayer: “I get that you haven’t been successful at losing weight, but why give up now? Losing weight is hard! Think of how much pride you’ll have in yourself when you lose weight through diet and exercise”

Me: “...I plan to lose weight through diet and exercise”

Naysayer: “No, you plan to have an invasive surgery that has potentially long-term side effects that haven’t been fully studied so you can fit into society’s image of ‘thin’”

Me: “The surgery is an out-patient procedure done laproscopically. Lap bands can be removed at any time, for any reason. I don’t want to be skinny. I just want to fit into the medical profession’s idea of “healthy” and it’s pretty obvious that I can’t change your mind about surgery, so I’m just going to step out of this conversation now. M’kay?”

If I don’t end the conversation, it can go on for hours. I never really realized what a red-hot issue bariatric surgery was before I started down the path. For those of you that might think that surgery is the “easy” way to become skinny, let’s just review what I had to do to get my insurance company to approve the surgery, shall we? I started in December 2009, with a visit to my PCP. She referred me to a bariatric surgeon because of my weight and persistent co-morbidities. After that, I:

1) Attend eda three-hour educational seminar about the impacts of gastric bypass surgery and the pre-and-post surgery requirements

2) Talked to my shrink and therapist about what impacts, both positive and negative, the surgery could have on me.

3) Met with the bariatric surgeon for the first time to discuss the kind of surgery that would be most appropriate for me (lap band).

4) Went through a two-hour psychological test of endurance that included a 350-question personality test and hour long interview with a psychologist to assess suitability of the surgery for me. Was told that I have to get a note from previously mentioned shrink and therapist.

5) Went back to shrink and therapist. Asked them for letter of approval from. Felt like I was in the sixth grade. Called them three weeks later and asked, “No really. I’m serious this time. Can you pleeeease write the letter?”

6) Went to six months of nutritional counseling where my nutrition guru convinced me that if I didn’t lose SOME weight that I wouldn’t be approved for surgery because I couldn’t demonstrate the ability for short-term behavioral change. Considered finding a new nutritionist. Kept a food journal for six months and try to follow the American Diabetic Association diet which involves limiting carbs, fats, and meat. Contemplated just giving up food all together. Lost four pounds, then gained nine. Then gained some more when I found a new job.

7) Was informed that my surgeon switched hospitals. Went through a painful process of getting my records, individually, transferred one-by-one to the new hospital. Hit my head on my desk several times a day each time the new hospital either didn’t receive my record or lost it

8) Made an appointment with a new PCP to get a formal letter of medical necessity. Had my cholesterol and blood pressure checked to confirm co-morbidities. Found out that my cholesterol could take now a small ox.

9) Called the new hospital almost every day for a month, trying to get all my records in one place for submission to my insurance company.

10) Waited for two weeks for my insurance company to approve the surgery

AND…I finally got the good news on January 24, 2011. I’m tired from just writing about it. For anyone who says to me, “Couldn’t you just have spent all the energy losing weight?” I’d like to point to #6 on the list and tell you to suck it.

On deck for tomorrow, more procedures, tests, and protein shakes…