Thursday, January 10, 2013

The Beginning

In the interest of sequential information, this entry is about how I came to arrive in need of and at the decision to have RNY. The easiest explanation is that I always ate too much, of "bad" things, and took in little to no exercise.

I remember first becoming conscious that I was much larger and treated differently in middle school. Now, I am of the opinion that middle school is horrible for everyone, no matter how high on the social ladder you might sit. But for me, it was especially cruel. Exit my safe, small elementary school where you were under the care of one teacher all day, enter the big, intimidating middle school with tons of new kids, where I seriously sucked at pretending to navigate all the new intricate social rules and expectations. Other kids would make comments when I walked by. Even people I thought were friends would make "funny" jokes and call me "chub chub". It didn't help that I had a horrible "boy" bowl haircut, which I thought was super cool. This was my first time to think that there was something wrong with me. I hadn't ever given a second thought to my food choices, which consisted of lots of carbs, sugars, fats and pre-packaged items. However, as the bullying and teasing got more frequent and overt, I started to realize that these items were now forbidden. My family had never really been big on "talking it out", so it was very difficult for me to reach out to anyone. And, since I had become increasingly convinced that there was something intrinsically wrong with me and that I was unworthy of love and care from others, I retreated deep into myself. Enter a world of secrecy.

Around the same time, I started engaging in secret eating on a monumental level. The pantry and fridge were always stocked with snack cakes, cookies, hot dogs, and other treats. Whether it was because these were now "forbidden" and "dangerous" and I was rebelling in the only way that felt safe, or because these foods signified lovingly selected treats and, therefore, comfort and care, I was ravenous. I would sneak into the kitchen when no one would notice and gorge on these newly forbidden foods. I guess I thought that if no one saw it happen, it didn't count. Somehow, my body didn't agree. I also worked at the same lab building as my dad, taking care of research animals. I would finish a little before him in the late afternoon and go to the snack machines before it was time to leave and spend my cash on snack cakes, chips, and at least 1 candy bar. I would scarf all this down before he would come to collect me, then make sure to put the wrappers in a trash can that I wasn't sitting next to. Again, my mind and body disagreed on this plan. Even up until a few months before getting surgery, I would still do things like make and consume an entire box of macaroni cheese in one sitting. By this point, I had learned how to even better justify this to myself. I would add a can of corn and a packet of tuna to the pot, to make it "healthy". Never mind the ridiculous serving size. Frequently, I would find myself stuffed so full that I thought I might be sick. Instead of save the rest for later (didn't like the taste when reheated), I would wait half an hour and finish it. Throwing out extra was not an option, as it would be wasting both food and money. I'm not sure where that mindset came from, it wasn't prevalent in my house growing up. If I had someone coming over later, I would put the boxes under other trash or take out the bag to the dumpster. For some reason, until I really started examining my eating habits, this seemed like a perfectly good process. In front of others, I would always eat normal portions. This is probably why no one ever thought to approach me on the subject, since it was somewhat mysterious. During the self-reflection of pre-op, I realized that intervention when I was still living at home could have made a huge difference. I battled with feelings of being let down and ignored by my parents but, at the end of the day, that's in the past. Besides, what do you say to a teenage female on such a subject without worrying about her developing psychological problems?

The decision to have surgery was not easy. It isn't like I never tried to remedy the ever growing problem (har har) on my own. As a lifelong thrifty person (translation: cheapskate), I never got into any of the as-seen-on-TV programs or pills like Jenny Craig or Fen Phen. As with "intimate" piercings, I figured that if it was so great, safe and effective, that everyone would be doing it. There were plenty of modifications to diet and lifestyle that I tried over the years. Many were as simple as eliminating something: salt, carbs, fats, etc. I would do great for a couple weeks or months and drop 15-30 pounds. Then, as people started to notice and I got compliments, I would give myself a pat on the back...and go right back to my old habits. On the way up, there were several times where I told myself that I had reached "maximum capacity". Give a few months, and I had passed that number and set a new limit. Repeat this cycle over and over and add on an annoying brain chemistry, history of keeping anything difficult and personal to myself, and a particularly hard breakup and, by 2012 I found myself unable to be weighed on a standard scale. In 2011 at my annual doctor appointment, she suggested I consider medical intervention. There were a couple great outpatient programs through Penn Medicine, but they were very expensive and 100% out of pocket. Although I'm not poor, I have just enough to pay my bills and not much extra to spend, even on medical expenses. She had also raised the subject of surgery. At the time, it had crossed my mind a couple times, but I quickly dismissed the idea as "the easy way out", and convinced myself that I could do it on my own.

By the 2012 annual visit, it was clear that this wasn't going to happen the old fashioned way. I needed help. I had done some research before the appointment and as I learned more about what I would have to do to prepare for life after surgery, it was obvious that this was not easy at all. However frightening and overwhelming, the permanent medical intervention seemed like the only option left. I couldn't trust myself to take care of this by myself anymore. My doctor was great and suggested a specific surgeon to visit. I've been extremely pleased by her referrals in the past, and this one was no different - during the initial consult, I decided that I was going to do this. It was the beginning of August, and I weighed 365 pounds.

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