If you had no limitations in your life, what would you do differently? Let me qualify that. Suppose you suddenly dropped any extra weight that prohibited you from pursuing a fuller life and you had no physical limitations, what would you do differently? Would you travel more? Explore hobbies or venture off on a new career? For years, I knew my answers; they played out in a series of vignettes in my mind. I would leave the balmy breezes of my home in Florida for the snow-dusted cityscape of the north. I would take my daughter Christmas shopping in New York City and afterwards for a Handsome Cab Ride (horse and buggy) to see the holiday lights throughout the city. That was my dream for her 16th birthday she is now 24. I would fly to Prince Edward Island, Nova Scotia with my son and walk the rolling hills that overlook the ocean. That was something we planned the summer after his 4th grade year he is in college now. I would join my husband on his annual winter adventure of snow skiing. We have been married 25 years. He still skis but I have never gone with him. All of these activities require strength in my legs and back, endurance to remain mobile and there would be no guarantee of a place to sit my 389-pound frame.

Being severely morbidly obese, I knew the reality of feeling breathless by simply walking from my car to the aisles just inside the grocery store. I would soon be leaning on the cart handle to alleviate the strain on my limbs. Once, I tested my limits and pushed further along the concourse of our local mall until I was half clutching myself back to the parking lot and collapsing into the driver's seat. With the majority of my weight over my abdomen, years of accumulated fat forced the abundant mass downward, hanging from my body so that when I walked, it swung like a pendulum. To sustain myself on my own feet for any length of time under such physical stress was painful and short term. Travel? I did not feel it was possible. I knew my dreams remained just that. Dreams. So how did I get this fat?

“You’re SO fat you brought a spoon to the Super Bowl”

In high school, I was a trim 130 and a size nine. I was one of those persons who made fun of fat people. I judged them as weak with no self-control (those feelings would change). Eating disorders were a part of the fabric of my family. My grandmother would binge and purge and I recognized the foul odor in the bathroom at home after my mother came out as being the same thing. The excuse passed on to the next generation, “I’m feeling a little sick.” after a large meal. My older sister would be next only she was supplementing her diet with alcohol and cigarettes. The exposure to seeing wet debris left on too many toilet seats made me unable to get to that point when the weight started creeping up on me.

“Girl, you sure ain’t missed a meal!”

After the birth of my daughter, I had gained an additional 40 pounds and by the time my son was born, it was 80 pounds. My appearance was less of a concern as I busied myself with two little ones and began college. By the time I was working full-time, I found myself avoiding people from my past feeling too ashamed of my appearance and what others would think of me. I found that out at one of the few family gatherings I managed to attend when someone associated with my southern family shouted from across the yard, “Girl, you sure ain’t missed a meal!”. On April 17, 1990 my father died. After the death of my Dad, there was so much anguish in me emotionally that it only fueled the self-depreciation I felt for myself. I had little pride no matter how esteemed my accomplishments and these thoughts were only reinforced by events that surrounded me. I deserved this and other ridicule because my family would have otherwise defended me. Right?


There is fat, there is obese, there is morbidly obese, there is severely morbidly obese then there is cutting the doorway to get you out of the building. Let me tell you the difference, nothing. Any amount of weight that impedes your life function is physically impairing and those labels mean nothing when there is physical impairment. I developed rashes in the folds of my skin and only the real high-end soaps prevented an outbreak. Where I use to get catcalls of appreciation for my appearance I was only hearing ‘you have such a pretty face’ followed by silence and a glance downward at my frame. If this was supposed to make me feel better, it did not. I once got a note in my mailbox at work with an ad for a diet supplement and a coupon. I received a phone call from someone I knew years before who I passed in glancing at the store a few weeks earlier. They were now in a multi-level marketing business and gushed endlessly about how, like a pilgrimage to Lourdes, one of their products could cure me of my obesity. I tried things on my own, I joined weight loss clubs, bought pills, liquids, and books, started walking, joined a gym, quit the gym, joined again, and started every Monday with the words, “I start my diet today”.


Pennicula like peninsula only human.

There came a point in my life where shame lost its voice and ‘Big Mama Bravado’ came forward. It was just me and the scale, me tending to the blisters under my pennicula, the access skin that hangs down from your stomach, where I had gotten a toilet seat chemical burn from sitting on the toilet with my stomach hanging over the rim. It was me clutching the walls first thing in the morning until I got my footing, me walking on the sides of my feet because my arches were cracking and ME looking at ME in the mirror before and after I showered. I had long since had a rule with my husband of ‘no nudity with the lights on’ but there I would stand, unclothed, with the only person I could truly be open with - myself. I started therapy for compulsive overeating and was encouraged to journal my feelings. The more I wrote, the more I felt. The more I felt, the deeper the pain, the deeper the pain I allowed myself to feel the stronger I got. It was in the middle of a one-year post follow-up for Type II Diabetes when my physician leveled with me. My weight was impacting my health and it was only a matter of time before a stroke or heart attack. He was being honest with me and I could not argue with him, I needed help or the conclusion was apparent. It was during that visit he told me about a new gastric procedure and encouraged me to explore it. I left his office, went directly across the street to the hospital to the bariatric department, and met the nurse overseeing the program for gastric surgery.

I believe that all things happen for a reason. There are no such things as mistakes and that, like Edith Wharton said, “In spite of illness, in spite even of the archenemy sorrow, on can remain alive long past the usual date of disintegration if one is unafraid of change, insatiable in intellectual curiosity, interested in big things, and happy in small ways.” Despite all of the debilitating consequences of my obesity, I remained determined. I would find a way out. After months of pre-surgical testing (sleep apnea-positive, chemically induced heart stress test, psychological evaluation) my health insurance denied my request. There was an exclusion in my insurance plan that would not cover bariatric surgery:

“Weight Control Services including any service to lose, gain or maintain weight regardless of the reason for the service or whether the service is part of a treatment plan for a Condition. This exclusion includes, but is not limited to weight control/loss programs; appetite suppressants and other medications; dietary regimens; food or food supplements; exercise programs; exercise or other equipment; gastric or stomach bypass or stapling, intestinal bypass, gastric balloons, jaw wiring, jejunal bypass, gastric shunts, and procedures designed to restrict the Covered Person's ability to assimilate food.”

This exclusion did not simply apply to me but also to persons who are anorexic, the opposite of my problem. The Big Mama Bravado in me drafted a letter of appeals for my denial, DENIED, a second letter, nude photos included, still denied, and an appeal to the State Office of Insurance Regulation. I could not reason in my mind how an insurance company could direct the coverage over the recommendation of several physicians and their patient but it was, in fact, true. They could and did.


Big Mama was undaunted and I went shopping for my surgery. Let me tell you how empowering this is. You call the shots. You have the cash, you can go wherever you can afford. I had never experienced that but it was truly a powerful feeling of knowing I finally had a voice in WHO and WHAT and WHERE. I was looking for price and quality and I found it in Aurora, Colorado. Another part of my thinking was the question of; where would I like to go for frequent vacations? Going from Florida to the beautiful Rocky Mountains was a no-brainer. The Lap Band Rockies and Dr. Kirshenbaum was an affordable cost saver intended to keep U.S. patients stateside where medical care is under stricter guidelines. I researched my doctor and discovered he had performed thousands of laparoscopic surgeries. This quelled any fears I had about complications, as I knew I would be flying back to Florida post my surgery. The procedure is done on an outpatient basis. Paying for the surgery myself, (why not? We make car payments without even flinching) I had my surgery date, April 17, 2007; the anniversary of my father’s passing. I knew it was a sign.

April 17, 2008

It is one year since my surgery. I am off my Diabetes medication and my numbers remain good. I can walk from my car to the store and shop, checkout and drive home without getting winded. I still have a long journey ahead but I am so many (painless steps) closer to seeing my goals. There have been four amazing trips to Denver and friendships of other ‘banditos’. I am two sizes smaller and one shoe size smaller and more than anything I have hope. Hope for journeys to faraway shores, to carriage rides and city lights and the feel of snow blowing like sand across the crest of a mountain. I dream of possibilities and for the first time in too long, I believe they will become a reality.

__________________
Alex

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