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WLS – The hard way to love yourself

I’ve been dreading writing this post, as it’s one of the few times I don’t want to do a PSA. Those that know me will know that I prefer to shout loudly from the rooftops anything in my life which may be controversial. However, this time, I don’t want the stress of airing my dirty laundry and would rather cower in the corner in anonymity. And yet, I feel a strong sense of obligation to those who need someone to speak out for them.

In September this year, I had a gastric sleeve. For those that don’t feel like clicking the link, short story, they cut away 70-80% of my stomach (Let me quickly interject that I am in no way advocating weight loss surgery). I decided to be open and honest about this, because I just can’t lie. I suck at it and hate it. I lied briefly to those around me, who would see me during my recovery period, and then had to blab out the truth because the lying killed me.  I was a lighter weight, but still had a BMI of over 35 and had three major weight-affected conditions: 1) I was told that within two years I will have type 2 diabetes, 2) I have hypermobility and the extra weight makes a massive difference to mobility, collapsing joints and a crap load of pain, 3) I have asthma which weight affects, albeit mildly.

I mention these because the point of this post is to open up dialogue about my operation and others, and to highlight things people say that they may not think is inappropriate. A surprising amount of people have asked me some form of inappropriate or really personal question. I am fully aware that no one intended it to be that way, so this is merely to help others in the future. If you have asked me any of the below or said anything like these, please don’t feel this is a dig. I assure you, I hold no ill-will and know it came from a good place 😉

  1. In 90% of the conversations I’ve had about my WLS, the first question has been: Was it NHS or Private?
    • Please don’t ask us this question – there is no right answer! The NHS means we’re wasting the tax-payers’ money and going privately means we’re rolling in the dough or heavily in debt. It’s an incredibly awkward question and the equivalent of asking if you own your house, is it mortgaged, on benefits or rented.
  2. How much did you weigh before?
    • Pretty sure I don’t need to tell you why that’s inappropriate.
  3. So, you’ve cheated. 

Now, luckily, I’ve never had anyone dare say the third one to me and mostly I’ve had supportive responses, which was not what I expected. However, many of my bariatric friends have had people accost them with their judgements on this ‘quick fix.’ So, I would like to highlight some aspects of WLS for you.

Weight loss surgery is NOT the easy way out. It is bloody hard. So much harder than the movies and TV shows will make you think. It is always the last resort. You are having major surgery (yes, it’s keyhole, but someone cutting away 80% of your stomach, putting a band around your stomach or rerouting it all, is major surgery, no matter how you look at it). The recovery period lasts anywhere from 2 weeks to 6 weeks and often more. You run the risk of death. Not just from going under, but from leaks and sepsis, which is not as rare as you would like to think.

If you ignore the initial risks, you then need to take into account the following:

  • Almost all WLS requires a pre-op diet, which is designed to shrink your liver for easy access. In most cases this requires either a 1000 cal limit a day for anywhere from 2-8 weeks, or a milk only diet. This is where you are allowed 4 pints of milk, 1 oxo cube drink and 1 small pot of sugar free jelly a day. That’s it. For at least 14 days. So, consider this when chatting to a person who had WLS: There is a good chance this person chose not to eat at all for 14 days. Don’t dare tell them they couldn’t follow a diet or didn’t have the perseverance. I did this diet. It was one of the hardest things I’ve done and I had an incredible sense of achievement from it.
  • A lifetime of change.
    • Foods you loved before, you will now either not love or be completely unable to eat. For bypassers and some sleevers, chocolate and sweet foods could result in dumping syndrome: palpitations, extreme pain and fatigue, and a good day or two on the loo, with everything flying out both sides. Again, you may think this is an easy way out of dealing with cravings. It’s not. It means every party you go to, every event, will be stressful, filled with temptation that pulls at your heart and filled with people asking you why you aren’t eating.  You run this risk with every new food you try. For some people, it’s not just sweet things. For me, it was chilli. I can now no longer eat chilli and that’s not a lesson I’m willing to learn again!
    • How you eat changes completely. You now need to follow the 20-20-20 rule for the rest of your life. Leave 20 seconds between bites, chew each bite 20 times and finish after 20 minutes. You can also add ‘eat only bites the size of a 20p coin’ to the list. In addition, you’re not allowed to drink anything while eating and need very small portions.
    • WLS is not a quick fix – it lasts for 2 years and after that, you need to stick to these rules religiously, or run the likely risk of picking up all your weight again. This happens often. However, those that do stick to the rules, manage to keep it all off.
    • Pain. So much pain.
      • Some people have incredibly long recovery times after the op. I was lucky and was back up to ‘normal’ (albeit with pain) within a week or two. Friends have suffered in serious pain for over 6 weeks.
      • Eating is agony. I’m 12 weeks post op and still have to lie down each time I eat. As the food goes down, it’s as if it I’m swallowing a knife (regardless of the food, thick yogurt does this, too). Then, as it settles in your stomach, it’s tries to find a way to fit and you’re stuck with a good 20 minutes of pain, food rising back up (trust me, when it doesn’t fit, it lets you know!) and general discomfort. And, for the love of god, don’t try bend down after a meal. The food finds the easy way out!
      • A gastric sleeve often results in a lifetime of reflux and heartburn. Yay for us.
      • After you’re fully healed, you will still have the risk of getting food stuck. Cue agony, fatigue, and pretty much all the ‘dumping syndrome’ symptoms, apart from the evacuations, mentioned above.
  • Learning to talk about the weight loss. Whether you’re telling the truth or have a cover story, it is a huge thing in your life. Someone with a cover story has the stress of keeping that up and making sure they don’t contradict themselves forever (and please, please do not judge these people. Society has left them with little choice but to keep it secret). Those of us who choose to tell the world, have to then face criticism and also figure out when to tell people. I had a lovely lady tell me yesterday that I look great for a woman who has a 10 month old. I was quiet and then blurted out, rather loudly and suddenly “I had a gastric sleeve!” Obviously, the poor woman got a shock, as did I and probably everyone else in the room. I had been trying to figure out whether to just say thank you, or admit that it wasn’t ‘natural.’ And my anxiety overcame me…rather loudly. It’s a constant balancing act, which we often fail at.
  • It may not work. Nothing in WLS is concrete and there are people these surgeries don’t end up helping. It’s a hard truth, but one every WLS patient must face.

These are the things we deal with because we have to. Please do not for a second think that this was easy for any of us. Before you judge, ask yourself if you could put yourself through all of this?

Cutting back to my story, I was living my life under a heavy cloud. I was unimaginably miserably and knew I was taking my life, my partner and my children for granted. Two weeks before my op, I was bed-ridden for three days in tears because I caught a glimpse of myself in a video. My appearance made me physically ill. I wasn’t the person on the outside that I was on the inside. I didn’t go out, I didn’t have fun with my kids, I wasn’t giving them the life they deserved and I sure as hell wasn’t giving myself the life I wanted. This op has changed my life. Merely being booked in for this op, having the balls to go ahead with recommendations and doing something about my weight, took a huge weight off. I am so incredibly proud of myself. My mental health didn’t change with the weight loss, it changed with the decision to do something about it. I suddenly me again. I still struggle with depression and anxiety, but at perhaps 10% of what it was before. I run with, laugh with and cuddle my children daily.  I walk with my head up. I smile and mean it. I love myself. No amount of stigma, judgement, pain or discomfort can take that away. I’m proud of my decision and my move and you should be proud of me too.

So, if you’re looking for what to say to a WLS patient, here is my advice:

  • Ask questions. If they’re telling you about it, they’re open to questions. Just be kind and respectful of their privacy. They can tell you whether or not they don’t want to talk about specifics.
  • Instead of saying how thin they look, tell them how healthy they look. I’ve had a few people comment on my weight loss, but those who tell me I look healthy have made me feel wonderful.
  • Congratulate them on doing something for themselves and the hard work it takes.

We each have to live our lives to the best of our abilities and those who have undergone or who are thinking of undergoing WLS know that we aren’t or weren’t doing that. If you had the chance to love yourself again, wouldn’t you jump at it?

 

 

 

 

 

 

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My needle-mark riddled corpse

My blog is becoming slightly higgledy-piggledy – lurching from politics, to literature, to ramblings and dieting. After writing the political post a few days ago, quite a few of my friends and family have suggested that I concentrate on political pieces alone. I considered this, but then realised that would entail me reading the news more.

So, this is what you have – my personal back and forth, my apologies…this is a long ‘un.

I’ve been meaning to write about this for a while, knowing that I’m bound to get some criticism, I had some hesitation, but after struggling to find personal blogs that could help me along my ‘medicinal’ path, I knew I had to post, at least to help others in my position.

Firstly, I’m not advocating anything other than diet and exercise to those trying to lose weight. Had I not tried everything and had I merely used a ‘quick-fix,’ I wouldn’t be writing this.

Long story not so short: Returning from the UK in March 2011, I decided I had to lose a few kgs, only 4 and so hopped onto one of what would constitute part of many fad diets. From that time until around November 2011, I tried everything from the Atkins diet to the Soup & Yoghurt diet (yes, it is only these two things for two weeks). Mention cutting out carbs and I may punch you in the face, I barely remembered what a carb was. Everyone had a ‘secret’ that had worked for them – I tried them all. I’m sure somewhere, under some rock, in some Persian garden, there’s a diet I didn’t try, but they’re few and far between. I still picked up. So I went the logical route, exercise and healthy eating. I followed a normal, healthy diet. A lifestyle. I ran three times a week, I did yoga twice a week and callenetics three times a week (it’s like aerobics on steroids). I still gained. I continued gaining, but slowly and only in December did I start to realise I had a problem.

In the beginning it was just an inkling…an idea that something just wasn’t right with my body. I do fully believe that we know when something’s off in our bodies. I once forced a doctor to do an operation to find out if I had Endometriosis, with him insisting I didn’t…only, sadly, to prove him wrong. At the bottom of it, we’re animals and basically instinctual, when we bother to listen to ourselves. Come April, I was getting very concerned with my weight, but was still trying.

And then, between April and May alone, I picked up 10kgs, while dieting.

Those of you who read this blog will know that I tried a dietician, who made me eat more than I could imagine, I tried diets recommended by the doctors, I took appetite suppressants even when eating only 300 calories a day. I then followed a friend’s diet, which recommended under 1000 calories a day, combined with either a 70 minute brisk walk or run. I couldn’t manage even 600 calories, so I ate 500 calories a day and I ran. Every single day. I started to lose, but only a bit, but then I picked it all up again, in one single day. It was then that I knew I was pretty much doomed.

I’ve been through some pretty rough patches in my life, but the fact that so few people believed me (the amount of people who looked at me with blatant skepticism when I said I was running 6km a night, or said ‘if you just eat healthily with moderate exercise, you’ll lose’), that one doctor said I must just get used to being this way as I’m no longer an adolescent and the fact that my body seemed to be conspiring against me, took me into a bonafide depression, that lasted a long time.

I would wake up in the morning and want to cut the fat from my bones. I felt sick, physically and violently sick, then I looked at myself in the mirror. My ‘fat’ clothes were cutting into my skin and my ‘thin’ clothes hidden so far into the closet, they could be in Narnia (where the thin people reign). I felt like I was walking around in a fat suit. I was uncomfortable when I sat, when I walked and even when I lay down. I’m not going to lie, I considered suicide a number of times. I wouldn’t do it, mainly because we’ve had a suicide in the family many moons ago and over two decades later you can still see the effects. I couldn’t do that to them, but it did come close. I can’t count the number of times I cried in my many different doctors’ office. My Google search results had nothing but diet tips and even eating disorder forums (which I got kicked out of, because even though I was only eating 300 calories, I wasn’t losing weight and when asked for help, apparently I was advocating anorexia, not desperately seeking someone to talk to).

I’ve had my thyroid checked three times, I kept hoping they’d find something wrong with me. At least it would explain it and I could tell people ‘I’m not just fat.’ So, I took what I swore was my final visit to yet another different doctor. I have only one kidney and suddenly thought, ‘perhaps something’s wrong with this kidney now and that’s why I’m picking up weight.’ This doc is the only one in town with an ultrasound. Expecting to be scanned and ignored, like always, I was shocked when he sat me down, called the path lab and asked about my previous blood results. He took more blood and then…listened more. He actually wanted to know about my weight gain, he believed me. He was slightly shocked when I rattled off the types of drugs that didn’t work, the different diets I’d tried and a lot of indepth research into weight gain. He believed me when I told him I was running every night and when I told him my diet. He then gave me a sliver of hope (I know it sounds stupid and corny, but there it is), he told me that even if my blood tests were ‘clean’ of problems, there was a drug he’d put two prior patients on, that had really worked: Victoza.

Cut to the chase, after my ramblings, I’m now on it. I’ve been on it for nearly a month now. Victoza is generally for Type 2 Diabetics, but can be used as  a last resort for major weight loss. According to my BMI I had over 15kg to lose. I was sitting at 74kgs and I’m 5’2″.

It costs…a lot. R1000 pm ($115). I just have to stay on it until I hit my goal weight and then I go off it again. I have researched this like no other. I must have read over 2000 reviews (no hyperbole), only one person didn’t lose on this drug that I read of and she was a self-admitted chocolate addict, who was shoving her face full of chocolate on a daily basis. Three people gained after stopping the drug, and only because they went back to their original habits, which were high in carbs and no exercise. Some people lost as much as 9kg in a month.

As mentioned, it’s nearly a month for me. I inject myself daily in the thigh and have gotten quite used to the routine. The nausea and exhaustion in the first two weeks weren’t fun and again when I upped my dose, but after that, there’s no difference. It works two fold, as an appetite suppressant (which I don’t need) and as somehow increasing your metabolism (which I do).

For those wanting to know more about Victoza: I noticed my appetite came back after the second/third week. I don’t have a problem with this, though. I also noticed a significant difference regarding how much water I drink. With one kidney, I’m only allowed 3lt a day, and I stick to that. If I don’t, I don’t lose. My weight plummeted on the first day (I lost 2.2kg that day alone) and then continued, slowing down, until about the end of the second week, when I stopped losing. I have to say, I panicked a lot. I stopped keeping my diary, woke up in the night fearing that I’ll be the only person that doesn’t lose. Because of this, I stopped drinking as much water and stopped losing. I still find exercise more difficult than before, but it’s getting easier. Anyway, I have once again started losing, thank goodness, so just be prepared for waves and don’t stress.

I know a lot of people won’t agree with what I’ve done, but it’s not your choice. I hated life and now I don’t. Now I see some corny light at the end of the tunnel (be it a train or not). I made a decision that has allowed me to finally feel good about myself, to buy interesting jewelry, because I’m no longer afraid of people looking at me, to occasionally have a beer in public, without fearing that everyone will think ‘oh, and she says she’s been trying to lose weight” and to wake up in the morning feeling okay about myself.

I started Victoza on the 28th of September, it’s now the 25th of October. I have lost exactly 5kg, along with losing 6.5cm around my thighs, 6.5cm around my waist and 2cm around my arms.

I may suddenly die from unknown side-effects, but hey, at least my needle-mark riddled corpse will look pretty.

 

 

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