#i live in a part of the us where yall and ain’t are common terms at least

[enders-redemption]

rdr fan culture is playing the game, looking at so many posts, and reading so much fanfiction that arthur’s dialect unironically starts slipping into your every day vernacular

[phatbulousfashionista]

Going under...again.

I’ve been in my head over the past couple of weeks about this.  Should I share? Shouldn’t I? Is this too personal? Is this anybody else’s business?  Do you really want the whole world to know Tia...

Well after much back and forth and strategic procrastination, I ultimately decided and finally got up the gumption and nerve to share this very private thing with you all...

2 weeks ago today, on April 11th, 2017 at 7:30 am, I underwent bariatric surgery for the second time in 8 years.  

The procedure I had is not as common or popular as some of the more well known procedures: lap-band, gastric bypass, or gastric sleeving.  I underwent a procedure known as a duodenal switch (DS) which is a combination of a restrictive approach (which is what the band and sleeve are) and malabsorption (which is what bypass is).  In this procedure, the small intestine (the duodenum) is rerouted in order to prevent the absorption of certain fats and nutrients (malabsorption). During the second part of the procedure, a sleeve gastroectomy is performed in which a portion of the stomach is removed, leaving it resembling a banana.  Hence, the name gastric sleeve. This portion is considered restrictive because it restricts the amount of food one can consume at one time, thus leading to weight loss.  In layman’s terms, the surgeon goes in, rearranges some stuff and cut some stuff out to help you lose weight.

I can just about imagine the look on some of your faces as you’re reading and you’re probably wanting me to just cut to chase and explain to you how in the hell I got to the point that I would undergo this process not once, but twice.  How does one’s weight loss struggle lead them down the path of risky surgical intervention twice in 8 years?

Nine years ago, when I first made it up in my mind that I wanted to pursue the surgical route, I was at my heaviest: seven pounds shy of 400 pounds.  I mean I was literally looking 400 pounds in the face! Now up to that point, I had tried and had been somewhat successful at various weight loss interventions.  I had done Weight Watchers, gone to a couple dietitians, tried my own weight loss and exercise regimen.  In fact, I can even remember my mother taking me to Jenny Craig when I was in about fifth grade. ( Yes, fifth grade! I’ve been at this weight loss thing my whole life!) Anyway, none of them created long lasting and/or extensive results.  I would get overwhelmed and discouraged at the thought of losing an entire person and a half “naturally”.  It just didn’t seem rational or doable in my honest opinion.  So I did some research, and I finally decided that surgery was the best route for me.

Now up until that point, the only bariatric surgery I was familiar with was gastric bypass and I was absolutely terrified of it.  I had heard the horror stories of how they slice you down the middle and rearrange your guts and how painful it all was and about the risk of death from complications.  But more than all that, I was discouraged by the way people who had undergone bypass looked.  They all seemed to have the “lollipop syndrome”.  You know, where the head looks really big and the rest of the body looks really small.  And I heard about the skin. Oh Jesus the extra skin! I was terrified of losing a large amount of weight and not looking like myself; but a saggy, big-headed version of someone that used to be.  So when I spoke with my doctor and told him of my concerns, he referred me to my hospital’s bariatric program.  It was there that I first learned of the lap-band procedure which was all the rave at the time: a procedure in which a silicone band is placed around your stomach laparoscopically, reducing the amount of food one can eat, thus causing weight loss.  It was a laproscopic procedure which meant no slicing me down the middle which meant shorter recovery time and less risk.  The weight loss would be a slower process than bypass which meant my body would adjust to the weight loss easier which meant less saggy skin and no lollipop syndrome.   I thought, “Yes, yes! This is the answer! Lap-Band it is!” Sadly I was mistaken...

In preparation for surgery, I went through six months of nutrition and group counseling with other bariatric patients (which I honestly hate but we’ll explore that on another day).  I underwent a battery of medical and psychological tests to ensure I was fit physically and mentally fit to undergo a major surgery, and finally I had to go on a liquid diet for 3 weeks.  Morbidly obese people (which I am unfortunately considered) have enlarged livers.  An enlarged liver makes it difficult to operate on the stomach. So I was put on liquids in order to shrink my liver.  Those were thee hardest 3 weeks of my life! Oh and did I mention it was Christmas time?? I was weak, pale, fatigued...miserable! While the rest of the family ate Christmas dinner, I ate chicken broth and drank V-8.  It was pure torture.  But my mind was focused on the end result: smaller, healthier, happier Tia!  In that 3 weeks, I lost nearly 35 lbs!  And on December 26th, 2008, I went under the knife and would come out a new woman!

The first few months after surgery were great.  None of my clothes fit; I had to buy all new clothes.  I had a collar bone.  I could cross my legs.  My knees weren’t hurting anymore.  I was working out with a trainer.  Eating right.  I mean life was good...  Except the vomiting.  Oh and the times my band would slip out of place causing me excruciating pain.  Then the weight loss plateau.  Then the realization that I NEVER made it out of the 300s.  And that, in fact, the most weight I had lost was when I was on the liquid diet pre-op.  

Now, don’t get me wrong.  I had lost about 4 dress sizes and had gotten down to a size 20 in jeans (I used to be a 26/28 or 30/32).  But it bothered me that I was still holding steady at around 330.  Then this past year,  I saw my weight slowly creep back up to the tune of a 40lb weight gain.  My knees began hurting again.  My clothes no longer fit me.  I noticed I got easily winded.  Things that I was so glad to be able to do like cross my legs, I could no longer do.  I was devastated. I was disappointed.  I was disgusted...

So I began my research again.  I began looking up the data on Lap-Bands. And lo and behold, the research now shows they aren’t really effective for the morbidly obese and that a great majority of people who had bands had them revised to other procedures.  Ain’t this a blip! So here I am with this foreign object in me, that may times causes me discomfort, and it ain’t even working! WTF! I decided to go back to my same primary care doctor.  He heard me out.  He listened to my frustration and he understood.  He told me he supported me and he would do whatever he needed to do to make sure I got what I needed. He referred me to the University of Chicago Center for Surgical Treatment for Obesity, and in December 2016 I began my bariatric journey all over again.

I have to say the team at U of C is amazing!  They have taught me so much and they are truly passionate about their patients.  At my initial consultation, I met with the psychological team, the nutrition team, my nurse practitioner, and finally my surgeon.  They listened to me, they addressed all my concerns, they gave me tons of information and answered all my questions.  The most significant moment was sitting with my surgeon one to one and going over my options and what he felt was best.  It was during this conversation that I learned I should’ve never gotten a band.  He explained to me that a person with my BMI (52) is not a good candidate for a band because bands simply aren’t effective in enabling significant amounts of weight loss.  He told me that he doesn’t really even do them anymore because in his experience they don’t work. Period.  He was visibly upset that a surgeon recommended and pushed banding on me without providing me other alternatives. He wished he had known me 8 years ago.  He also expressed to me his disdain for surgeons who claim that the band is reversible; its not.  It is removable, but not reversible because of how they stomach is altered due to the scar tissue caused by the placement of the band and the port.  Before I knew it, I was looking this man in his eyes with tears in mine.  I felt both anger and relief.  I was angry that I wasn’t presented with all my options.  But I was relieved at the fact that it wasn’t all me.  I didn’t fail the procedure; the procedure failed me. It was in that meeting that we decide I would move forward with the removal of my band and would revise to a duodenal switch.

Again, I went through the pre-op medical stuff: medical tests to ensure I was physically able to withstand another surgery, nutrition class, and pre-op diet (no liquids this time: just high protein, low carb, low fat).  And on April 11th I walked through the doors of the University of Chicago Center for Care and Discovery, said a prayer, kissed my teary-eyed mother goodbye, and went into surgery.

Recovery this time has been way more intense.  The Lap-Band procedure is a relatively simple procedure.  I went home that same day.  However, the DS is way more involved and required a couple nights’ stay in the hospital.  I was in a great amount of pain in the abdominal area.  My energy is extremely low.  I’ve been on pain meds and stool softeners and some other medicine for my gallbladder.  I have to take give myself 2 injections per day in my side which has left my stomach a mural of blue and purple bruises. If I don’t inject myself, I run the risk of getting a blood clot which could cause death. Some days are good; others not so much..  

So back to how I got to this point. I was tired of being fat yall.  There is no other way to put it.  I love myself.  Don’t get me wrong.  But my weight is something that I have never been totally comfortable with.  I have dealt with it.  I haven’t let it keep me from living life totally.  But I wanted it gone.  And this is what I felt was best for me.  Yes, I know some people say, “just eat right. Work out. Be disciplined.  You’ll lose it!” And while I don’t disagree with those methods, in fact I STILL have to do those things, that simply was not enough for me.  People struggle with losing 10 to 20 lbs.  Can you fathom losing 200?

Contrary to what others may think, weight loss surgery is NOT the easy way out.  This is THEE hardest thing I’ve ever had to do and I’ve done it TWICE.  Surgery is only a tool!  It doesn’t work on its own.  I have to still work it.  I have to be disciplined.  I have to be focused.  I have to be determined.  Now more than ever, because at this point my life literally depends on it.  I have to take about 6 dietary/vitamin supplements for the rest of my life.  If I don’t, I run the risk of malnutrition and other health complications.  So no, this is’t easy.  Not by a long shot.  But when you’ve been fighting the war on weight literally all your life, there comes a point where you have to make some hard decisions.  And this is what I decided.  I know my family and friends were concerned and quite frankly some were not in agreement, whether they expressed it outwardly or not.  But again, this was a decision I had to make for me; no one else

For those of you who may be considering, weight loss surgery, please take into consideration the above-mentioned things.  But first and foremost, have a real conversation with yourself.  Ask yourself, is this what you want? Why do you want it? Are you looking for an easy out? Are you ready for the changes that will come with it? Are you strong enough to stand in your decision?

Remember at the end of the day, this is about you, your body, your health, your happiness...