Balls Deep in Bariatric Surgery

While I know it has done wonders to improve some folks quality of life, I must say that after tonight’s consultation session at Reading Hospital, bariatric surgery is mostly a big racket. Of the hundred or so people in the room, maybe ten or fifteen were really obese enough to qualify (including myself). Mostly, the consultation was a waste of time, a waste of a trip to Reading through thirty miles of torn up highway, and a poke in the right direction.

I had been considering getting the lap-band type of surgery, which is the least invasive, and has a patient geared up to lose a pound or two a week (the other types, gastric sleeve and bypass surgery, provide a much quicker weight loss). I sat there and thought “Fuck, if I can’t do that myself by cutting out Cheetos and peanut butter sandwiches at midnight, I deserve to be slit up a fucking treat (which is what the other two types of surgery do to a person).” Also the doctor mentioned about one person whose lapband went through his stomach wall and came out his mouth. That didn’t sound too appealing.

Mind you, I have met some folks who are happy as clams with their surgery results, and more power to them! I am truly happy they got the results they wanted, and are true to themselves. I saw the results on one of Mona’s friends and it was truly amazing and inspiring.

But many people seem to go into this thinking that losing a few pounds the easy way (as opposed to dieting and exercise) is going to make them these wonderful, popular people. Sorry folks, if you’re an asshat to begin with, nine times out of ten, you’re going to be a bigger asshat as a slightly-thinner person. Consider the fact that you’re going to be on protein and vitamin supplements, among other medications, for the rest of your fucking life. That’s seems like it would be a major annoyance, and you’re gonna be taking that out on a lot of folks around you. And we won’t even get into the annoying flaps of empty, now-fatless skin that no insurance company will pay to remove.

The doctor’s spiel at the meeting, and the number of comparatively thin people there, made me realize why it takes an armload of paperwork to get insurance companies to pay for this kind of operation, even when it could seriously increase a person’s quality of life (or just keep them alive): The doctors treat it as cosmetic more than anything else. Sure, he said quite plainly that the insurance companies in this country deem weight-loss surgery as elective surgery (he did even use the term “cosmetic”). If the doctors are using it as a major profit generator (these are very short operations at about $10,000 USD each; he mentioned he had done three that morning), like face lifts or botox, yeah, the insurance companies are going to look down on that. Need bigger boobs? No problem. Need a face that makes you look like a Joan Rivers mannequin? We got you covered. Want to lose a lot of weight really quick? Buddy, you came to the right place.

The doctor and his representatives were virtually condoning insurance fraud to get the companies to pay for the procedure; you have to go through three to six months of counseling, losing weight to prove you’ve got the cojones to do it after the operation – but not TOO much weight. If you lose too much weight, you may lower your BMI too much to qualify, or the insurance companies will think you can actually do it on your own and not pay for the hack-and-slash. “Don’t lose weight too fast” the woman at the meeting said. “Lose some and then level it off.” In other words, you may have the wherewithal to lose the weight on your own, without a shiny blade being involved, but don’t do that, because then we won’t get paid you won’t get the full benefits of the procedure.

Yes, before you start leaving nasty comments, I realize that bariatric surgery IS the only option for some people. There are many legitimate conditions that preclude normal weight loss after a point. My PCP thinks I’m one of those cases, which is why he sent me there. I can’t walk more than twenty or so yards, or stand still for more than five or ten minutes, without having pains in my legs – to be honest, they feel like someone’s slicing my thighs with flaming, electrified katanas.  But I know it’s just a matter of pushing through that pain and getting more exercise and trying to eat less junk (and less of everything). It’s going to be slow at first, and it’s gonna hurt. But I also won’t be spending $10,000 (well, Medicare won’t be spending that, I should say, since apparently bariatric surgeons LOVE Medicare, as long as it’s the right one; however, they don’t like Obamacare, since none of the plans cover this type of procedure) on something that I can do without.

Beginning the first of the month, Mona and I are going to start watching what we eat a lot more closely. And I am going to start trying to exercise more. I’ve never been one to trust doctors unless absolutely necessary, since several of them have out-and-out killed members of my family, and my best friend. While my PCP certainly has my best interests at heart, I’m going to try my best to prove him wrong on this particular point.

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6 thoughts on “Balls Deep in Bariatric Surgery

  1. Rich, I’ve considered it as well, and have opted for the slower, more natural way I’ve been losing weight (down 27 lbs since January)

    I kind of diet in spurts. I started by dieting and exercising until I lost 10 lbs. Then, I simply watched what I ate as to not gain any back. If I had a pig-out day and put a couple of pounds back on, I watched my caloric intake until I dropped those few pounds back off. Once I’d maintained that weight for a few weeks, I dieted again, trying to drop 5 more lbs. Lather, rinse, repeat.

    The main thing I’m doing is working to NOT put a bunch of weight back on. It’s easier to reduce if I only have a pound or three to worry about, rather than feel like I have to drop ten. Dropping two, three pounds is easy. No sugary drinks, cut out the starches for a few days, mix in a fruit salad instead of a burger and fries….

    I started at 330 and am down to 303. I’m hoping to get to below 300 by my birthday (Aug 29). It’ll be the first time I’ve been under 300 since I moved to Florida in 2004.

    I’d like to be under 280 by Trivia 46. We’ll see.

  2. What a great overview for anyone who might be considering this type of operation. I’ve known a few people who’ve gotten the lap band and, while they certainly lost a lot of weight, their pallor was as weird as the way they picked which few crumbs they could consume in one sitting without immediately refunding them.

    While I don’t have a weight problem, I recently learned that I had to exclude the one type of food I ate at pretty much every single meal, every single day for my entire life: wheat. On top of the health issues which drove me to that, I also learned at 42 that my spine is abnormally curved (something not discovered in my youth, which might have been corrected with treatment), and now *have* to exercise regularly in order to keep myself upright for the rest of my life. Talk about a lifestyle change!

    What keeps me on course is feeling well for the first time in 20 years. Yes, it was painful at first – physically, psychologically, emotionally. I had to mourn the loss of my old ways of doing things, my old staple food items. It took a while to let go of all that. I am not adventurous when it comes to tasting new foods, but my choices were so limited, I’d be tempted to cheat or just sit their and pout like a child. The former made me physically ill, and the latter never satisfied.

    If I can offer some advice for anyone having to make big lifestyle changes it’s this: start slowly, be consistent, and be patient with yourself. Exercise hurts when you’re not used to doing it, but you’ll feel so much better after moving large muscle groups that you’ll wonder what the fuck took you so long to catch onto the idea of doing it. Make feeling better the goal, not a number on the scale.

  3. My father-in-law had gastric bypass surgery in 2012. Six weeks later he was dead. His death was from a combination of factors, mostly stemming from the damage already done by his poor management of the Diabetes that was killing him. The man was in no condition so survive such a radical surgery, and he was not mentally prepared for the commitment that was required afterward. He opted for gastric bypass rather than the sleeve or lap band because the gastric bypass actually has the ability to cure Type 2 Diabetes. The procedure removes the section of intestine responsible for absorbing glucose, so the person is permanently on a Diabetic diet regardless of what they eat. The problem is, the same section of intestine is also responsible for absorbing other key nutrients, which must be taken in supplement form afterward or life-threatening deficiencies can set in within a year. My father-in-law wasn’t interested in any of those details. He didn’t read the material given to him by the doctor, refused counseling beforehand and refused to speak to the dietician. All he wanted was a magic surgery that would cure his Diabetes and make him lose weight with no effort on his part while he crammed his mouth full of sweets. We tried to reason with him, but in the end they pushed the surgery through and his magic bullet killed him.
    Bariatric surgery can be lie-changing, for someone who is committed to being part of the change. Going into it well-informed can not only save one’s life but ensure that the option you chose is the best one for your situation.
    My personal opinion, having had family members who have experienced both lap band and gastric bypass, is that the sleeve looks like the most sensible option. It’s not reversible like the lap band, but you don’t lose a vital part of your digestive system in the process, so there isn’t the risk of malnutrition that exists with gastric bypass. Just my experience. YMMV. Best of luck in whatever route you choose.

    • My sincerest condolences on the passing of your father, Mandy. That was just wrong for the surgeon to even allow him to get that surgery with the obvious physical and mental obstacles he had in front of him.

      I had almost been thinking of the sleeve, but then Mona pointed out that what happens in the future if you develops stomach problems, or even stomach cancer? You’ve already gotten rid of 90% of the organ when it was healthy; that doesn’t leave the doctors much to work with if something goes wrong. The bypass surgery is even worse in that aspect. Yeah, you may lose a lot of weight quickly, but are you ever going to be happy with your diet again? At least with dieting, the lapband or even the sleeve, you can still treat yourself now and again for some positive reinforcement; the doctor at the consultation explained the big problem with the illustration of ice cream. With the bypass, if you like ice cream, you can still eat it, but when it hits your small intestine, something not used to absorbing all these complex substances without any processing first, you’ll feel like you’re dying. Sure, it’ll go away in an hour or so, but WTF? “You can eat ice cream, if you get used to the pain” is a paraphrase of what he said. If you can get used to feeling like death warmed over after a spoonful of Rocky Road, more power to you. Me, I think I’ll stick with the old-fashioned way.

  4. Yes, he didn’t understand how drastically the bypass procedure limits your diet. When he found out after the fact, he said he never would have done it if he had known. (his own fault, sadly). You make a good point with the sleeve. I never considered the possibility of something like cancer hitting the remaining part. The old-fashioned way is still the safest way, for anyone who is able. Surgery should be considered a last resort, not the easy way out, as it is often viewed by those who seek it. Best of luck in your endeavors.

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