Going to have to roll up my sleeves, this ain't gonna be easy.

Approximately 3 months and 3 weeks ago, I met with a bariatric MD to discuss possible surgical solutions to my obesity.  Obviously, I was just starting my journey to health by way of the Times Colonist Health Challenge, and I wanted to explore all possible options.  The surgeon explained the different operations, talked about what a successful candidate I would be, and then sent me on my merry way.  Lose 20 pounds in 3 months - doctor's orders.

So I did.

As I sat comfortably in the regular sized chair (if you hadn't already guessed, there are plus sized seats available for larger people in the office of a bariatric surgical consultant), I wondered what the doctor would say when I saw him.  I don't know what was going through my mind, other than I did what I was told...and I seemed to be on a roll.  No gains, all losses and an average of 4 pounds lost per week.  The receptionist ushered me into a little room and told me to get on the scale, she recorded my weight and left.  Then there was a quick knock at the door and she popped her head back in and said, "You've lost over 50 pounds in 3 months!  You're amazing!"  Awww...shucks!

Then from behind the door I heard, "Waaaaaaahhhhooooo" and a second later the doctor entered the room full of excitement.  He proceeded to tell me that he has never had a patient lose that much more than the required 20 pounds, and I had shown my commitment to getting healthy.  Out of 10 people that come into his office, only 1 person is chosen to have the surgery.  I even brought my BMI from 53.4 to 42.1, he seemed impressed and then went into more detail about possible procedures.  The operation he recommended for me was the sleeve gastrectomy, which is less drastic than gastric bypass.  In fact, he told me again that I was a perfect candidate for this kind of surgery during which most of the stomach is removed, but the intestines are left intact.  It's done laparoscopically, and he could probably get me into surgery in 3 or 4 weeks.  Recovery is also 3 to 4 weeks.   "Please, can I do surgery on you?  The timing is perfect, and you're not working..."

WAIT!  

I've been doing pretty well without any nip tuck.  Why wouldn't I just continue what I'm doing?  I have a personal trainer, memberships to 2 gyms, I got some fancy biking shoes and have a yoga mat, and I'm still on a leave of absence from work...I can do this without surgery, can't I?

Then I experienced something that I hadn't experienced since starting down this path to wellness...self doubt.  I walked into that office knowing I had lost a huge amount of weight in 3 months, that I was getting healthy and fit, and as I sat there and listened to the surgeon talk statistics the confidence I had in my ability to do this the natural way gradually dissipated.  90% of people who try to lose weight on their own fail to lose the weight and keep it off, whereas 85% of people who have weight loss surgery are successful in their weight loss endeavors.  It is especially hard for women to lose weight and keep it off, he pointed out.  I had to make a decision...and fast, because as soon as my BMI slipped below 40, I was no longer eligible for the surgery anyway.  No pressure.

I was supposed to take the bus to the gym after my appointment, instead I chose to walk there...and I wept the whole way.  WTF?  The doctor was extremely nice and über professional, and thinks that this surgery would be the best way to guarantee my weigh loss success...but I'm not so sure.  By the time I got to the Crystal, I was in a peculiar mood and pretty much ignored everyone there, including the ninja.  Usually, I'm tickled when he takes a second to check in with me but any sort of conversation would probably have ended in more tears, so I kept my gaze low and just stomped out my frustrations on the treadmill and spun out of control on the bike. 

Frustrated at being a "perfect candidate" for surgery, I talked to one of the administrators at the Crystal Pool & Fitness Centre.  Amongst other things, she suggested I write down the advantages and disadvantages of this operation for me.

Advantages:

• The part of the stomach which produces the hormone responsible for stimulating hunger is removed.
• The average excess body weight loss is between 40% to 60% at 1 year and 50% to 83% at 5 years.

Disadvantages:  

• It is surgery...I'd be going under the knife.
• It is just plain cheating!  I've lost 69 pounds by working out and eating a proper healthy diet...it would feel like getting straight As and then cheating on the final to assure myself a really high grade.  Ridiculousness. 
• Some people need more weight loss surgery to achieve their goals i.e. going from sleeve gastrectomy to full gastric bypass.
• Weight loss can be slow if the diet plan is not followed. 
• After surgery, you have to be on anti-ulcer medication for the rest of your life.
• Complications include infection, gastric leak, bleeding, strictures/fistulas, gallstones (though that won't be possible as I have no gallbladder), and incision site hernia.
• It may cause reflux symptoms and inflammation of the esophagus.
• The procedure is not reversible. 
• How am I ever going to learn how to eat properly when my stomach is the size of a walnut?

That list of disadvantages is not so insignificant, and as I sometimes do when I'm faced with a difficult decision...I stewed.  Until my best friend since I was 2 came over with some wine and we hashed it all out, but not before she invited two of my neighbours over (it was the friendly Manitoban in her) and involved them in the conversation, and then fell asleep on the couch.  Elizabeth says no to surgery, Stéphane says no to surgery, Jill and Erin both say no to surgery, yet I still have thinking to do...and, I haven't yet been able to speak to my parents...and I need to talk to the ninja as well.

 

The next day, I attempted to stamp out my despondency on the treadmill cursing the amount of wine I had imbibed the night before when the ninja approached.  I told him that I was not feeling very well and it was due to the series of events that transpired the previous day.  When I switched from treadmill to spin bike, the conversation intensified.  

I told him what had happened, how I had gone in feeling confident and successful and that after being quoted abysmal statistics and essentially told I would most likely fail, I came out of there believing it.  The ninja questioned the statistics that the doctor mentioned; agitated, he said of all the overweight people that he's trained, the stats are very different.  Obviously, 100% of the people he trains do not make their weight-loss goals, but it is a lot higher than 10%...60% or so.  And anyway, who says I'm not part of that elite 10% of people who don't give up!?   

Jonathan has seen me train hard pretty much 6 days a week for the last 4 months, and the doctor only saw me twice for a few minutes each time...at this point, I trust the ninja more than the surgeon.  He brought up a valid point, if I hadn't been able to lose 69 pounds in 4 months then maybe it wouldn't be a bad option.  But, I did lose 69 pounds and no one can take that away from me.  Who's to say that I can't keep going and lose an additional 73 pounds?  Ack!  If only I hadn't gone to that appointment, my mindset would still be positive, strong, and determined...now it is riddled with uncertainty!

Also, isn't weight loss surgery...well, cheating?  I can't get that out of my head either...and that is by no means how I feel about this life-saving/life-changing surgery for other people, this is how I feel about it for me personally.  In four months, I have not had 1 single binging incident, and I've been motivated to eat less at each sitting and spread out my meals throughout the day.  I have successfully changed what I've been eating as well, choosing fresh, unprocessed food...lean proteins, fruit and veg, whole grains, and I'm drinking an insane amount of water and tea.  Things are working...they're working really well, so why would I change all that by removing part of my stomach?  What about the recovery time...I mean, I wouldn't be able to work out!  How would that work?  Would the new tiny meals be enough food to fuel my intense workouts after recovery?  Would I lose muscle mass because I'd be burning that tissue instead of building it?  Arghhh!

The ninja offered more words of wisdom, "If it ain't broke, don't fix it" or something to that extent...and then he called me tiny and didn't see me stalling with my weight loss until I was probably under 200 pounds.  Nice!  Though, I'm not tiny, I am just significantly under tall.  After seeing my face scrunch up in consternation, he said, "I have a solution...*dramatic pause*...don't do it."  Haha...how do you really feel, Jonathan?  And, I just kept rehashing the same old scenarios over and over, "What if I can't...what if it doesn't...what if I let this opportunity to have surgery pass me by and it really is the only way I can lose the weight and keep it off!?"  As ninjas often do, this statement came out of thin air, "Why don't you try your luck with me...and I'll get you down to as low as you can go...and if you don't like it, then you can eat your way back up to 220 pounds and have the surgery then?"  Well played ninja, well played.  Then he did a training session with me that involved lots of kicking and punching...and I felt a lot better.
 
After exercising, I consulted with my dietitian, my doctor, and the crazy Mexican. Overkill?  Maybe, but I was surprised that my mom, dad, and their dog were pretty much on the same page as the ninja and everyone else.  Here's the thing, if I had tried to lose weight with all of the crazy support afforded to me by the Times Colonist Health Challenge and my friends and family and failed, then surgery would seem a necessary choice.  That was not the case.

So with my sleeves rolled up, I forge ahead with my regular workouts, my ninja workouts, my healthy diet, and a slightly dented sense of confidence...don't worry, all I need is a few good weigh-ins to get that ding out.