(note - this entry was written at a particularly bleak time
in 2006. )
I had finally arrived. I was at “goal”
weight. At 170 pounds, I had reached the nirvana I was seeking
before I would proceed with reconstructive surgery. It was significant
because 164 pounds was the top of the normal weight range for my height. Once I
had reconstructive surgery, at least 10lbs of skin and fat would be
removed. So, in my head 170 seemed like the best place to start the
reconstructive process. I would guarantee myself a trip into “normal”
land.
Looking back, I’m amazed at the power of numbers and
strangle hold that they have on me. When I started this process, I would
have never guessed that this might happen to me. My original goal was to
be under 200 pounds and a size 14. It was a reasonable goal and a success
by ANY measure. As my weight went lower, my lust for an even lower number
increased. Being a Psychologist, this chase for the numbers was always
niggling in the back of my mind as disturbing. Clinically, I could step
back and know that there was a lack of balance. I had started this
journey for my health, yet the highway I was on was the fast lane to an
emotional train wreck. It didn’t matter. I was so ebullient about
the weight loss that any reservations I had about my zeal to become thinner was
easily pushed aside.
I contacted the plastic surgeon’s office to schedule a
consult. I knew that I wanted the extra skin from my abdomen removed and
my breasts lifted and augmented. My panniculus (commonly known as “the
apron”) hung way down on my thighs. My breasts had continual infections
underneath them as the loose skin rubbed against my bra. All of
this skin, left over from a 160 pound weight loss, was unsightly and it
impinged upon my quality of life. I looked in the mirror and was
disgusted by the remnants of my obesity. The abdominal skin flopped and
flapped as I did anything active. I could hear it hit my legs as I
bounded up a set of stairs. Climbing stairs was both an expression of the
sheer joy of being able to do several flights without becoming winded and of
the deep shame of actually being able to hear the skin from my panni slap my
thighs. I can hear it in my mind although years have passed since it has
happened.
My amazing husband, who supported me all the way through the
weight loss surgery process, had never complained about a thing. He loved
me as a 330 pound woman and often referred to my curves as “luxurious.” (talk
about getting bonus points!) His fear was that he would end up being married to
a stick. I didn’t think his fear would ever possibly be realized.
And bless his heart, as I lost the weight he made only one comment on one
occasion: for no particular reason, he came up behind me and lovingly
wrapped his hands around my waist, and sadly said, “I miss the girls.” At
my heaviest I was a “DD” kind of gal. He liked that. Now that I was
170 pounds, I was barely a “B” and most of that was skin. To be
honest, the state of “the girls” was pretty darned pitiful. If it weren’t
for my lily white skin, I could have easily doubled for the tribal women that
are often featured in National Geographic. One of my bariatric friends
often referred to her girls as tube socks with tennis balls at the toe. I
could relate.
So, Dr. Mooney and I devised a plan to address the issues
that most impacted my life and my health. He decided to do a full
abdominoplasty (commonly called a tummy tuck), and a bilateral mastopexy with
augmentation (a breast lift with implants). These were truly
reconstructive procedures. My body had been so ravaged by the disease of
obesity that to consider the surgery to be cosmetic would completely negate the
reality of the impact large quantities of sagging skin actually has on an
individual.
There was another on-going medical issue to deal with as I
was preparing for reconstructive surgery. My lap-band, the very reason
for all the weight loss and thus the catalyst for the reconstructive surgery,
had been “acting up” for about 7 months. The bariatric team and I had
been working to get my band properly adjusted after having had a brief
obstruction back in the spring. To be honest, this adjustment issue was just
background noise in my life. Having reached an amazing weight and loving
every second of my new smaller body, I was fairly dismissive of the seriousness
of an incorrectly adjusted lap-band. In addition, the bariatric team was
diligently working with me. We had every faith that it would be resolved.
My reconstructive surgery was successfully accomplished on
December 8th, 2005. After eleven hours on the operating table,
eight pounds of excess skin was taken off of my abdomen, my long-damaged core
musculature was repaired, and my breasts were lifted back into their
appropriate position. I expected to be in a huge amount of pain, but by
the grace of God, my pain was well managed. I was able to be up and
walking just a few hours after surgery. I was even able to go home from
the hospital a day earlier than anticipated.
When I arrived home and looked at my flat stomach for the
first time with eyes that were not clouded by morphine, I dissolved into
tears. I was overcome with the emotion of feeling normal, for the first
time in my life. I did not have a stomach folded over onto my legs.
I actually had a lap. I looked at the tops of my thighs and thought about
how odd it was to see them. I stood up and looked down; there were my
toes. I had not seen them from this angle for at least 30 years. I
gently ran my hands over my newly crafted abdomen. It did not seem
possible that this body belonged to me.
The sobs welled up from a place deep within my spirit as if
I were the movie underdog screaming in slow motion across the goal line with
every last ounce of my effort. I cried and cried wondering how life had
just changed for me. I wondered what was going to happen when all of the
confetti finally fell to the ground and the air horns stopped blowing… and in
the silence, it was just me and my new body. Would it matter? Would
I still find reasons to hate my body, or would I truly recognized the gift I
had been given in this new, functional body that now had the potential to burst
across that goal line, rather than barely lumber across it? I cried as I
prayed for the latter.
As my recovery continued, I couldn’t stop looking at myself
in the mirror. I was startled every time I accidentally caught my
reflection in a window or a door. “That can’t be ME,” I would think to
myself as I stopped and gazed. I hoped that no one caught me looking so
intensely. They would never understand. To the casual observer, it
would look like a female who was completely absorbed by herself, self-centered
and self-important. To me it was complete disbelief. It was the
beginning of the process of living in a body that was half the size of the one
I had become accustomed to. The person in those reflections didn’t look
like me, didn’t move like me, and she certainly didn’t FEEL like me.
I didn’t have much time to “enjoy” my new shape because this
extensive reconstructive surgery had two severe, rather obtusely connected
ramifications. First off, I stopped sleeping. I had been having
trouble with getting a full night’s sleep on and off for years and had always chalked
it up to a variety of stressors in my life. Something was very different
after this surgery. It seems as if something inside my brain changed.
There was NOTHING that my personal physician could do or suggest that would
help me sleep longer than 4 or 5 hours a night. The sleep disorder
relentlessly wore down on a body that needed every single ounce of energy for
healing surgical injuries. My mood plummeted and my physical
ability to function began to diminish rapidly.
Second, my lap-band, which had been on the edge for the
better part of a year, had finally had enough. When I came home from
reconstructive surgery with 10 extra pounds of fluid in my system (from
swelling and from I.V. hydration), my band became tight as a drum around my
stomach. I tried to baby it to avoid a serious problem. However,
two weeks after surgery, I had the first of three acute post-operative
obstructions. These acute obstructions were so severe that I was not even
able to swallow my own saliva. This first one, the bariatric team was able to
treat in clinic and send me home. The second and third bought me
in-patient hospital stays for I.V. hydration.
Between trying to heal, the sleep disorder, the difficulty
with my band, and a crushing depression, my body was taking a beating.
Weight was just falling off of me. At least THAT was a good thing.
(Or… so I thought) I watched the scales go down at an intriguing speed. I
saw numbers that I thought I would never see. There was, of course, a
small voice in the back of my head that said “this is not healthy weight
loss.” So what. The larger voice said, “It’s weight loss… and that’s all
that’s matters.” I can’t tell you how many times friends said to me,
“You’re done losing weight, aren’t you?” “You’re not going to lose TOO much
weight, are you?” Sometimes people even asked if I was getting
anorexic. I merely chuckled at them and told them that I had it all under
control.
For the next 6 months I battled the medical issues.
Unfortunately, those battles culminated in trip to the O.R. for a lap-band
revision and a completely unrelated mental health diagnosis that explained the
sleep disorder and severe depression. I also managed to stay employed as
an Executive Director and continue work on my Doctoral dissertation. It
was a completely insane time in my life. I can hardly remember how it was
that I managed to put one foot in front of the other.
The thing I do remember is feeling “skinny.” I weighed
close to 150 pounds. That meant that I weighed less than when I was in
sixth grade. It was astounding to me. I was a size 8/10 on a 5’8” frame
with a flat stomach and newly perked breasts. I had the body that I was
incapable of having at age 25. I found a great deal of pleasure in shopping
for clothes to fit my new physique. Nearly anything I put on my long,
lanky body looked stunning. I began to have fun catching my reflection,
especially in clothes that fit snuggly across my flat abdomen. I
became obsessed with looking “perfect” every time I walked out the door, even
if it was just to go to Wal-Mart. Tummy in, shoulders back, bust out…
that was the mantra.
You can see what a contradiction my life was. On the
one hand, I was a desperately depressed, physically ill woman who was barely
making ends meet regarding the demands that never seemed to quit coming.
On the other hand, there was this euphoric, laser beam focus on the scales that
were dropping precipitously. A focus reinforced by the outward rewards of
beautiful clothes and the body that had only been a pipe dream for 35
years. There were actually times that I contemplated just experimenting
on how low I could make the scales go to satisfy my curiosity. You know,
just for fun. Because I was depressed and was on a restricted diet due to
my lap-band issues, it would have been easy to simply stop eating. I was
standing on the edge of the cliff of a new eating disorder. I was looking
over the edge and considering the pros and cons. It was seductive to go
ahead and take the leap. I had to make a decision. Was being skinny
more important than being healthy?
Fast forward a few months. I decided to go forward
with all of the treatments that were recommended to me. I got the new
lap-band that allowed me to eat more and to eat healthily. I began
working with an amazing psychiatrist that quickly identified the specific
mental health disorder that was interfering with my sleep, my mood and
(unfortunately) my judgment. It took me a while to put two and two
together, but I began to notice that getting healthy on all of these fronts
also meant that scales were beginning to go back up. Wait a
cotton-pickin’ minute!! This wasn’t in the deal. I was supposed to
get healthy AND keep my new, svelte body. But, everything was
against me. I was back to eating normal amounts of “real” food with a
larger lap-band that wasn’t properly restricted yet. I was on psych meds
that were known for causing weight gain. My depression had begun to lift
so my appetite was returning to pre-depression levels.
By Christmas, my weight had climbed to a whopping 180
pounds. None of my 8/10 clothes fit any more. My nearly concave
abdomen had a definite “pooch” to it. It was soooo OBVIOUS that I had
gained weight. I had to buy clothes again. I was deeply,
desperately ashamed. In my mind, I was a public failure once again.
Everyone could see that I was re-gaining my weight. And, it was just too
hard to explain to people that I had been sick for nearly a year. Anyway,
I didn’t actually “buy” that story myself. I just knew that I was
becoming a statistic of one of THOSE band patients that regained their weight. (which is a label I would only ever apply to
myself… never to another person.)
So, let’s look at the facts. I’m 180 pounds. By
ANY evidence based standard, I am a wildly successful WLS patient. I have
lost 79% of my excess body weight. The surgeons would have been ecstatic
if I had lost 50% of my excess body weight. I am a size
12/14. I started at a size 28/30. I can walk into any clothing shop
and buy clothes. In the past, even some specialty shops did not have
clothes large enough for me. My BMI is 27. My highest BMI was 50-52,
a medical time bomb waiting to happen; especially with my family history of
heart disease, diabetes, high blood pressure and cancer. I am more
physically fit than I have ever been in my life. I can do a full hour of
advanced, high-impact aerobics. I can lift weight with the boys. I
kayak, whitewater raft, hike, ride horses, and many other activities that I
would have never done before WLS.
There’s only one rub. I know what its like to “be” 25
again. I think that the surgeons wouldn’t be the only ones who would be
ecstatic with my current weight. I’d be right there celebrating with
them. Except…. I know. I know what being “skinny” feels like.
I know what kind of looks I get from people, men in particular. There is
a feeling of power; there is a feeling of unconditional acceptance. On
the one hand, everyone is watching because they appreciate tall, slender,
well-heeled women. The confidence with which I walked when I was 25 again drew
the eyes of those who saw me. On the other hand, no one is watching or
scrutinizing what you buy at grocery stores or put on your plate at
restaurants. You’re so small that they don’t care what you put in your
mouth. (when you’re fat, people watch what you eat) If I didn’t know what
it was like to be thinner, I would be perfectly content with 180. It is
20 pounds under my original goal of “anything under 200.”
So, I’m 180. I look in my closet, and once again I
have fat clothes and skinny clothes. How in the world did I find a place
in my brain where 180 became “fat?” Well, the answer to that is simple…
because I experienced a place where 153 felt normal, even though it was
sick. It was sick. It was sick. I can tell myself that a dozen
times. Yet, it was real, it was mine, and it is now emblazoned in my
psyche as a loss. It is very hard for the people around me to understand
how I can feel fat at the weight that I am currently at. I’ve even had
friends tell me I’m silly. I wish they understood how not silly it truly
is. I very much wish that I had never experienced the illnesses that led
to my artificially low weights. The visuals, highs and experiences
related to my lowest weight will forever be with me. I fear that they
will forever shape the way I feel about my body, even though by every objective
standard, I’m at the healthiest place of my life.
