The Beginning of my Bariatric Journey

I've been overweight almost all of my life. I wasn't bullied as a child. I wasn't abused. I've come to believe that overeating was a comfort, a habit. There are a lot of reasons I could hypothesize were triggers or contributing factors to my current situation; sedentary lifestyle, emotionally coping mechanism, stress, among many others; in the end the causes of my obesity are not what are killing me. The obesity is.

For quite some time before that I had been diagnosed with a small stable of complications that the doctors seem to have come to expect from overweight patients: hypertension (high blood pressure), diabetes, high cholesterol, sleep apnea (that loud snoring during the night? Means they may not be breathing for periods of time, or actually getting into a restful state of sleep). I am on several drugs taken daily to control some of effects of these ailments.

I felt I was being treated well by my doctor in internal medicine in that she didn't sound like she had given up hope on me, but at the same time I was a typical patient in that I would listen to her but not really hear her. How many patients honestly hear instead of listen to the lectures they get from their doctors? Well, she referred me to a another doctor that was an endocrinologist/weight loss specialist.

I walked in to see him in his office. He appeared a few minutes later with my chart in hand. He sat down, looked through the chart, and began to rattle off the "symptoms" on my paperwork, the reason I was there to see him. Then he looked me in the eye and said I was going to die.

Okay, I thought. This guy doesn't waste time getting to the point.

"I'm going to refer to you a bariatric surgery office in (a town north of us)." That was it. I spent all of five minutes in his office and that was my ticket on the surgery express. Well, it wasn't much of an express train since it took about a year to reach this point, but that was still how I got on this track.

I had thought that the surgery could be done within a few months' time. Nope, that is most definitely not the case. I'm one of the small percentage of Americans with decent medical insurance, which, while covering this type of operation when my physician deems it necessary, also means that I have to follow their terms.

What followed was nearly a year of filling a checklist of requirements. I had a couple thousand dollars in a copay to raise (no doubt a tiny fraction of what the hospitals will end up paying). I had to meet with a nutritionist. I had to document previous weight-loss attempts. I had to take a special psychiatric exam called an MMPI which in turn said I was a depression risk, necessitating therapy.

As a matter of fact, the insurance company called and said that they weren't going to pay for surgery since I wasn't in therapy...even though they had been paying for over a month of therapy sessions already. The first bills of what I had to cover had arrived the day they told the surgeon's office that I was going to be turned down.

My attitude towards hospitals, insurance companies...anything involving bureacracies...can pretty much be summed up by that type of incident. For the year of work I was supposed to be putting in to prepare for surgery I waited for the ultimate denial from the insurance company. I expected a denial or another setback, and instead I got another hoop to jump through. Because of this I didn't put full effort into what was recommended I do; I hesitated to track my food intake. I hesitated to look into the implications of the surgery. Why waste the time?

Only in January did it look like things might fall into place, that I was in a home stretch. Only then did I start to take things really seriously beyond just reading information (which even then I took half-heartedly). I started tracking my weight and food intake because, well, the surgeon said that at that point if I didn't lose weight to the sub-450 range then the best they could do is refer me to another state's surgery center where they could handle larger patients. Ideally he wanted me less than 400.

Yes. That's right. In order to get weight loss surgery, you have to lose weight.

As of Christmas of 2008 I weighed approximately 458 pounds. Since then I've lost approximately 77 pounds. So far the only effect seems to be my blood sugar has noticeably fallen. I hope my blood tests will be more normalized, or at least improved, but that is something I get periodically from my physician in internal medicine, not every day like my blood sugar checks. I don't get too excited about this...I've had one person tell me that I look liked I lost weight so far, aside from my immediate family.

At any rate, I was called again a day or two after the insurance company said they were going to deny my surgery and told that I had been approved for the surgery. I had to make frantic calls to the psychologist's office and his office faxed information back and forth with the center doing the surgery on me and they faxed information to the insurance company until all of the paperwork was sorted out, and they approved it.

They actually approved it.

This was the culmination of a year of work. A year of thinking this wasn't going to happen. A year of not knowing, of completing some giant obstacle course to, as Randy Pausch of "Last Lecture" fame might have said, prove how much I wanted this...it was approved.

For now this will be my first post. An introduction, if you will. At this point I suppose you could call this the home stretch. Information on what I've learned, what I've observed, what I'm feeling...those can come a little later.