To Sleeve (or Not to Sleeve) Series - #12, The Process: An Update

(This is part of a series I posted on my other (formerly anonymous) blog, tobypass.wordpress.com. An index of all posts in this series is located at the bottom of this article.)

I’ve alluded several times to the fact that I had my initial consult with my surgeon last week and that as of now, I have several assignments to work on before any operation will take place. I haven’t discussed much the nature of our conversation and what I’ve decided with regards to surgery — nor have I outlined the process between now and then.

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First of all, I was very impressed with the surgeon. He seemed competent, empathetic, kind, and ‘present’ with me. He spent what I considered to be a great deal of time with me — probably pushing 40 minutes — happily answering all of my questions (I came with notes stored up on my phone). He told me about he and his group’s complication rates, death rates, and history with procedures. He described their recovery floors and the process that patients go through for surgery. He carefully gave examples and outlined answers to my questions. One of the things I most appreciated was how he sensed my anxiety about going forward with surgery. As I’ve described, while I’m not unwilling to do it, I just want to be SURE that it’s right for me — and have NO regrets. He sensed this and responded without me really having to dive into it in detail.

At one point near the end, he actually offered that I could begin the process — the march toward surgery — and if, say, in 6 months I decide that I’ve lost a lot of weight and been successful with lifestyle change and want to put surgery off — they’ll celebrate that it’ll be all good. This made me feel a great deal of relief and freedom: as though this group is more interested in helping people than processing them like cattle for a payday. I trusted him more when he suggested it.

My secret was that I had planned on asking him if this very thing was a possibility — before even entering my appointment that day. He himself bringing it up felt like a boon.

As I’ve described thus far, I’m trying to make some serious changes in my life and in the back of my mind, I want to make a valiant effort at real change before I go through with surgery. Maybe I need the tool. Maybe I don’t. But I really want to give it half of a chance without. First. And that’s my current plan.

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My insurance requires a 4 month process of supervised medical dieting. So over that period, I’m going to be visiting the clinic about once per month and seeing their dietician, weighing in, and working through a list of pre-op items. As I’ve outlined in previous posts, I’m already tracking my meals, staying within a certain caloric intake, using protein shakes in the morning, weighing and measuring portion sizes, and generally being more conscious of my nutrition. According to the dietician this last visit, I really don’t have to make any changes yet. Just to keep going.

And believe it or not — just this bit of paying attention has yielded me a reduction of about 12lbs over the past month. That’s legit!! I feel good.

The pre-op items for me (beyond permanent lifestyle changes) include getting an EKG, a full blood panel, sending off my CPAP data, and obtaining a psychological evaluation. Each of these items are in process already.

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Now — all this leads me to think about dates. The surgeon and I tentatively talked about December as a possibility — that was, at the time, about 6 months away — well past the 4 month insurance requirement and yet a long enough window for me to feel like I have given myself a fighting shot at real life change. In my mind, I picture the scenario going something like this: If, come November or so, I’m down in the realm of 250 and feel fantastic, and have a super positive attitude about continuing the process of losing weight, I’ll most likely choose to delay surgery — for a year — if not indefinitely. If I’m down in the 280s, have stagnated, and feel positive but also a little discouraged, I’ll go forward with it in the knowledge that I’ve already lived these exact steps many times in my life before.

So that’s it. Hoops to jump through on the way to December. Or maybe not…