I started this blog years ago, not knowing what really to write about. I thought it would be my fitness journey would be about getting into shape - working out, eating right, all the things that they tell you that you have to do in order to be healthy. I did all that. I got down to 190lbs and I was thrilled.. and then, I just couldn't get below that. No matter what I ate, how restrictive I was with calories, and how much of a caloric deficit I had between what I took in and what I burned thru fitness, it just wasn't happening. No matter what I was doing, my body seemed like it was fighting against me. I built up some great muscles, improved my cardiovascular system (resting heart rate went from being in the 100s down to the low 70s), managed to lower my A1C from being pre-diabetic and right on the verge of being diagnosed with type 2 diabetes to a normal level, and lowered my cholesterol and triglycerides - although not to a healthy range. But the one number I couldn't seem to bring down was the number on the scale. And as a result, I continued to have high blood pressure as well as the high cholesterol and triglycerides. Also, no matter how much I trained, I couldn't keep pace on a run or jog for more than 2 minutes at a time without tiring out. I assumed this was due to just having too much weight on my body.
About 6 months ago, I began to notice that my energy levels were fading. Within a span of 2 months, I could bearly stay awake, do anything around the house, and I surely couldn't work out like I had been doing. I knew something wasn't right, so off to the doctor I went. After TONS of blood work which all came back normal, my doctor finally suggested I might have sleep apnea. This was kind of a final wake up for me - I have bad knees, high blood pressure, high cholesterol, high triglycerides, and now possibly sleep apnea? What is something that contributes to all of these things?? If you said being overweight, well then Ding Ding Ding!!!
Let's talk health and science for a moment. There's something that every single overweight person hates more than anything, even more than the number on the scale.. That something is the BMI (Body mass index) chart. Doctors came up with this torturous device as a way to fat shame people.. Well, no, not really, that isn't the reason why, but sometimes it feels that way. This graph is pretty simple to work out.. Find your height, find your weight and where they meet up, that's your BMI, or the percentage of your total weight that is fat.
Sadly, my father was short and my mother was short. So, I was destined to be a hobbit as I barely reach 5'1. My current weight sits at 195lbs. This means my BMI is 38 percent, putting me in the "Obese" category. At one point, I was in the "extremely obese" category with a BMI of 45 but the hard work at least knocked me down to just "obese".. I guess that's an accomplishment, right? Regardless, I'm still "obese" and while many will tell you "healthy at any size", being an ex healthcare worker, I know this isn't true. I was seeing issues that were weight related and I have a family history of diabetes, heart attacks and strokes, something I realized was in my future if I didn't make some changes quick.
With all this in my mind and hearing the words "sleep apnea", I asked my doctor something that I had thought about but hadn't really considered. Would I be a good candidate for weight loss surgery? After all, I wasn't 300lbs overweight.. Heck, I'm not even 100lbs overweight at this point. I didn't know if the doctor would tell me that no, it wasn't even a consideration for me but I felt compelled to ask.
Her answer shocked me... "Actually, I think you would be a great candidate for WLS." She already knew my struggles with my weight and explained to me that for some people, they can do everything right but their bodies just don't let go of the weight. She felt that for me, WLS would probably be the perfect tool to help me achieve weight loss.
"Let me go run some numbers really fast and see if you qualify". She left the room and 5 minutes later she returned and said that sure enough, I met the insurance requirements, that there was a new surgeon in the area who had lots of experience in bariatric surgery and she would put in a referral that day, as well as a referral for a sleep study. No judgement, no criticism, just complete support.. Can I just say, my PCM totally rocks!!!
I got approval for both referrals with two weeks. It was time to make some appointments.
The first referral approved was for the sleep study. I called and a consultation with the sleep medicine doctor was made for the following week.
At this consultation, I met with Dr Simmons, a jolly guy from Texas who likes to talk quite a bit. After asking my husband and myself questions about my sleeping (where my husband admitted I often "snort" during sleep, Dr Simmons began his physical exam. Before even starting, he said he had a sure sign that he could see that would almost guarantee whether someone had sleep apnea - something he called a "Class 4 airway", where he explained that the tongue had a serrated look to it. He had me stick out my tongue and called my husband over - sure enough, my tongue had these grooves in it.
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Not my tongue.. but an example of Scalloped Tongue
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He said "Well, if I was in Vegas right now, I'd put all my money on you having sleep apnea. But we still have to do a sleep study to document it for the insurance, which is just a formality."
Next step. Sleep Study.
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The pure misery on my face says it all
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I had an "in lab" sleep study, because I guess my insurance will actually pay for it rather than a home study. I WISH i had had a home study, because you put on a few wires and you get to sleep snug in your own bed. Instead, I had what felt like 100 wires attached to me - in my hair, up my nose, on my legs. And they were all bundled behind my head. So trying to sleep on my back was painful. Trying to sleep on my side was painful because the wires went from behind me to the side of me where they connected to a box, which meant the wires dug into my arm (remember - 38 BMI so there's alot of arm there!!) There was a fire alarm over the door, so every minute a bright white light was flashing (and I'm sensitive to light when I'm trying to sleep).. one of the wires that went to my leg was very taunt and where it wrapped around behind me, pulled on my neck.. and to make matters worse, there was another patient in the next room throwing a fit, screaming and hollering at the technician. Needless to say, I only slept for about 3 hours before the tech woke me up at 5am saying we were all done, time to go home. I asked her if she thought we got the information needed and she said she felt like we did but it was up to the doctor to make that ultimate decision. I headed out the door with a 3 week wait to find out the results.
A few days after the sleep study referral was approved, the referral for the bariatric surgeon came in. This proved to be a bit more frustrating than the sleep study.
When I called to make the appointment, I was told by the front desk that I had to actually physically bring the referral to them. Since I already had to go to the sleep study office to fill out paperwork for that referral, I decided to swing over and drop it off at the same time, since the two places were about a mile apart. I get there and give the referral to the front desk and the woman starts making an appointment for me. She gets about halfway thru and asks me "So what will this be in regards to?". I tell her it's for weight loss surgery.
This woman's attitude completely changes. She hands me the referral back. "I can't make that appointment" she says. She asks me "Did you do the info session". I have no idea what she's talking about and tell her this. She says "You have to do the infosession. I can't make the appointment". I ask her what info session as nobody mentioned this to me when I called when I first got the referral, only that I needed to bring the referral in. She huffs at me and finally says "Let me go get her nurse for you". Okay, you do that.
The nurse comes out. Luckily, she's much nicer than the lady at the front desk. She explains that before I can make an appointment for weight loss consultation, I have to attend the surgeons info session, and while she knows that date and time, she doesn't yet know where it will be at. She takes down my name and phone number and promises to call me with the information once she has it. I thank her and head on my way, grateful that she was much more pleasant than the woman at the front desk. She called a week later, giving me the necessary information and I was all set.
Info session. Cut and dry. Basically, the surgeon introduces herself and her experience, explains the various procedures that she performs, explains the process to obtain WLS, and allows everyone the opportunity to ask questions. I was also given a HUGE stack of papers to fill out with all my medical history, ect. I filled it all out, turned it in and was told that the nurse would call me to schedule the appointment. The following week, she called and again, we're all set for an appointment with both the surgeon and the dietician.
Fast forward to the appointment.
Now, I moved to this state recently, after spending 11 years in California. This is a new hospital system to me, so I have no clue how they do stuff. I knew where the surgeon's office was, after having the whole ordeal of trying to turn in the referral. So, that's where I went. Tell the girl at the front desk I'm there for a 4pm appointment with the surgeon. "Did you check in downstairs?" Nope, didn't know that was a thing. "You have to do downstairs and check in first".. Okay.. ride the elevator back down, go thru the check in process. Head back upstairs to the front desk. "Do you have the folder you were given at the info session?" I have it, I didn't bring it with me (as I had already filled out all the paperwork and turned it in AT the infosession). "There was a packet of papers you were required to fill out and bring back with you". I explain I've already turned in that packet of papers at the time of the infosession. "Hang on, I need to go talk to someone".. I see her walk over to three other people, in a group.. Each looking over at me as they are talking. I have a mask on (covid protocol in a hospital) and I tell my husband "They are over there talking shit on me" lol Finally, the nurse whom I turned the papers into comes over to them and I guess they tell her that I don't have my packet of papers.. She waves at me and says "No worries, I have them, you're good" and the girl front the front desk comes back and says "they will get you in a moment".. Needless to say, I'm REALLY not impressed with the front desk staff!! LOL
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At the appointment
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Finally brought in to the office. My first "official" weigh in - 195.6lbs. We head to a room where I have my vitals taken (bp was 149/90 I think). Finally, the surgeon enters, along with a nurse and the dietician. This is when I start worrying - will she tell me to buzz off, because while my BMI is 38, I only need to lose about 80lbs?
Nope.. quite the opposite. She tells me that I'm actually in a really good spot for WLS - no major health problems yet, even though I have 4 comorbidity. She will have to do some research to find out if I have to wait 3 or 6 months before surgery, but in the mean time, I'm in the program (After paying the $200 program fee). She gives me referrals for a bariatric psych evaluation, a fitness assessment ( I think this is because I have knee issues and she wants to document that for my insurance as another reason why I should be approved for surgery), as well as scheduling me for a colonoscopy (since I am do for one) and endoscopy. I'm also told since I took fen/phen back in the 90s, I need to arrange with my PCM for an echocardiogram as well as a mammogram (since I'm past due for it).
Time for the dietician.
My dietician is a nice woman by the name of Stephanie. She informs me that the $200 that my husband was so awesome to go downstairs and pay covers all her services with me for the next 5 years. She explains that at any time, I can call her office and speak with her as well as make appointments to meet with her, regardless of if it's every day, once a week, once a month, FOR THE NEXT 5 YEARS!! (I hope the surgeons office pays her well - $200 for 5 years??) She then asks me a bunch of questions about my diet. How many meals do I eat (3 meals a day), how often do I snack (I don't), do I feel that I eat until I am overly full, like being stuffed at Thanksgiving (no, not really.. I often push my plate away without finishing once I'm full). How often do I go out to eat (maybe 2 times a month, I typically cook all meals at home). I explain to her that honestly, I'm not an emotional or stress eater - I think my biggest problem is probably my portion sizes. She asks what my typical portion size is. I tell her rather than try to explain, I can show her, as I often photograph my food. She likes this and says yeah, she would like to see. I load up an album on my phone that is several photos of meals that we typically eat. Her reaction?? "I need to come over to your house to eat. This looks amazing!!!".. She says she wished all her patients had photos of their food, though she doubts that their plates would look as healthy as mine. She says that my meals look balanced, but that I should make 50% of my plate contain my vegetables and then other 50% of the plate contain my protein and carb. She also suggests to get a smaller plate, switching to a 9 inch plate as I use a 12inch plate. But overall, she approves of my eating habits.
She explains that in my case, she feels that my body's weight "set point" is set at a specific weight and that regardless of cutting calories and exercising, my body wants to stay there. That's why I can lose to a certain point thru diet and exercise but then can't get beyond. That this is why I've seen improvement on all the other aspects (lower resting heart rate, lower A1C, lower cholesterol, ect) but not the success I would like on the scale. This is the third person to say that I've done everything right - that it just seems my body won't do it's share. This also makes me feel I'm making the right choice about WLS.
I always told myself that I didn't want surgery - that I would lose my excess weight the hard way - thru sweat equity. But after years of putting in the work and seeing very little results in weight reduction, I'm kinda at a point where I just feel defeated. I've put on so much muscle mass with the understanding that muscle would burn off fat but instead, my sleeves of my shirts are way too tight because my I've now got some pretty awesome biceps but no reduction in weight on top of them. I can hold a 5 minute plank because I've focused so much on core work, but the excess bulk that sits upon them won't budge. It's discouraging to hear both a doc and a dietician say "you're doing all the right things" but your body just defeats you. Sometimes, it's not all about calories in/calories out.
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First day of this journey - No Filters.
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Sooooooo, now begins a new journey. Hopefully, one that yields more success than I've been on for the last few years. And I'm planning on documenting all of it, each step of the way. So that maybe, I can look back on it years from now and know I made the right decision. I also want to document my thoughts and feelings thru the entire process, because I know that it's going to be an emotional journey full of ups and downs.
Hopefully, the next step is going to the sleep doctor and getting a diagnosis for obstructive sleep apnea and getting a cpap so I can start feeling somewhat better. Because at this point, I am so tired of being tired. I'm tired of feeling worthless. I'm tired of not being able to do the things I enjoy because I have absolutely no energy.. Fingers crossed!!!
