By Jan Glidewell, Off/Beat
Saturday, October 16, 2010
I venture out here, gingerly, to write about the gastric banding surgery I had last month. More about that later.
First: Why gingerly?
Over the years I have found that columns on some subjects are more apt to draw public response than others.
Occasional offerings about gun control, gay rights, abortion and, for some reason, cats, would bring an outpouring of letters, e-mails and telephone calls. By the way, if you can avoid it, don't mess with the cat people.
But weight loss tops even those hot-button issues.
Write about a diet and/or exercise regimen, body wraps, weight-loss drugs, aversion therapy — anything that anyone says will cause people to lose weight, and it is like throwing a basketball into a room of cocked mousetraps.
I suppose there are psychological reasons for that. Even as we slide further every day into becoming an increasingly obese nation, people are desperate to know what to do about their own love handles.
Two things I have noticed. Everyone wants a magic bullet. And people tend to have horror stories about someone else who tried the diet, treatment, operation or regimen, "and almost died."
I don't doubt my well-meaning friends when they tell me these things, but sometimes there seems to be an element of, "If I can come up with enough reasons why this particular solution is bad and dangerous, I don't have to try it, and I can still have Twinkies for breakfast."
When I have lost weight through dint of deprivation and hard work, I have been besieged by people demanding that I tell them my "secret," and insisting that eating less and moving more could not possibly be the answer.
I have lost and gained somewhere around 800 pounds in my life, in increments of a couple of pounds up to 80 or 90 pounds. I have weighed as much as 320 pounds as an adult, and as little as 150, and I have owned pants with waistlines from 28 inches to 54 inches.
Another columnist once described me, accurately, as being a man of "intermittent iron will." I would lose the weight, buy the new wardrobe, then decide one piece of pizza wouldn't hurt — and leapt, not fell, off the wagon.
When you are younger, most attempts to lose weight are motivated by vanity, like wanting to get into that size 8 dress for the high school reunion, or being able to button your collar without going to a large man's clothing store and buying one of those button-hole extender things to put on it.
But as we age, health becomes more of an issue. (It should be an issue from birth, but it usually takes a few aches and pains to get us moving in the right direction.)
I knew I had become a Type 2 diabetic, and after open-heart surgery 19 months ago I resolved to keep my weight under control.
It didn't work.
I opted for lap-band surgery after hearing from people who'd had it how satisfied they were, and after carefully researching the subject.
Basically lap-band surgery involved a surgeon entering the abdomen with a laparoscope (several actually) and placing an adjustable silicone band around the top of the stomach, creating a pouch that holds only a few ounces of food and slows passage of the food into the rest of the stomach. That creates a sense of fullness early on in the process of eating.
Some insurance companies and Medicare will cover most of the cost, if you meet certain criteria involving body mass index (calculated on a formula based on your height and weight) and co-existing conditions like heart disease, sleep apnea, diabetes and others.
The appeal to insurance companies is that it is cheaper to get rid of the obesity than to treat all of the medical conditions likely to arise from it. Without insurance, it can be costly. Just the hospital bill for mine (I was in and out the same day) was more than $30,000, and I haven't seen the surgeon's bill yet.
Not everyone qualifies and not everyone is right for the surgery. It takes a major commitment to adhere to dietary restrictions and to exercise properly. Good clinics and physicians have a thorough vetting process involving nutritional counseling, a sound understanding of what the surgery will and won't do, psychological screening and regular meetings with doctors and staff.
The bottom line is that I lost 32 pounds in the four weeks that included a two-week pre-op liquid diet, surgery, and two weeks of post-op liquid diets. That process has begun to slow as I advance into thicker liquids and, eventually, soft food, but that was expected. It should take me a year to shed the 100 pounds I want to lose.
I haven't had any hunger problems. I can watch my wife or friends eating meals I used to love, and really not be bothered by it. I had to buy a hole punch to put extra holes in my belt and I am gradually weeding the fat clothes out of my closet to donate to charity.
A friend who had the surgery said she elected not to discuss it with people, who she said might be "just waiting for me to fail."
I have spent most of my life with people around me waiting for me to fail and have managed to disappoint them somewhere around half the time. The more I know they are watching, the more determined I am to succeed.
I have agreed to write about this for another section of the Times near the end of the process, and they already took the "before" picture, so I have that motivation going for me also.
I'll talk to you then.