Monday, August 10, 2009

Morbidly Obese

Morbidly obese. That's an ugly phrase. It just sounds awful. The clinical definition of a person who is morbidly obese is someone who is more than 100 lbs. over their ideal weight. That's a description of me. Another measure is having a BMI over 40. Mine is 48. That's awfully darn close to the definition of "super obese" or having a BMI of 50. To be just plain "overweight" by clinical standards I would need to lose 120 lbs. or about one average woman. The standard charts say that a person who is 5' 6" should weigh between 117-143 lbs. At my current 300 lbs. I have a long way to go to get to "ideal." This brings up the question of just what exactly will be a good weight for me?

I think that I have been seeing myself through such a warped lens for so long that I wouldn't know an "ideal" weight if it came up and bit me. Since I have always felt fat, I haven't really noticed the degrees of fat. There is a huge (pardon the pun) difference between the 200 lb. fat me in high school and the 300 lb fat me I see today. But in my mind, fat was fat. So I think I have developed a false picture of myself. I thought that I was the same fat girl of 20 years ago. Instead I failed to see how much I had really changed. I definitely have some body image work to do.

I am still waiting to hear from my insurance company. I called last week to make sure that they had received all three of the initial consultation reports, which they had. But they offered no information about how long the approval process might take. It is a long process, and I am finding that it takes quite a bit of patience. I need to think about a plan, whatever decision is made. If it is OK'd to go straight to surgery or if I am put on up to a 12 month weight reduction plan; I need to piece all of this together and prepare for the many changes ahead.

Sunday, August 2, 2009

Bibliotherapy

One of the things the psychologist suggested was bibliotherapy, in other words reading books as a healing experience. When you read about other people's experience, it helps you identify with your own feelings. It's sort of in the same vein as writing as a form of therapy or understanding one's self. Since I know that I enjoy keeping a journal and blogging, I figured that bibliotherapy would probably be something that I would like. So I bought a couple of books; Anatomy of a Food Addiction: The Brain Chemistry of Overeating, Gastric Bypass Surgery: The Psychological Journey and Exodus from Obesity: The Guide to Long-Term Success After Weight Loss Surgery. So far, I have read the Anatomy book and the Psychological Journey one.

Of the two, I got much more out of the second one. The Anatomy book had some good things, but at one point it got really preachy about that "you must have had a traumatic event in your past" kind of thinking. Which really isn't the case with me. The Psychological Journey one gave some great insight on what to expect as your body changes after WLS. All three of the books were written by someone who was in the medical field, either as a social worker or nurse and all three are by women who have had weight loss surgery. So I hope to find some bits and pieces from each of them to help me think things through.

Working on Insurance Approval

In early June 2009 I contacted my insurance company about starting the process. Technically, I had contacted them a few years ago, but had never done anything more than get some basic information. At that time I decided I could do things on my own. Since that time, I have had both success and failure. I lost 45 pounds, going from about 300 down to 255 in 2006. By 2009 I had gained back all of those pounds, finding myself back at 300, or the dreaded "OL" on the scale.

Realizing that I had found my way back to 300 pounds and also a visit to my Dr.'s office in early June, got me thinking about weight loss surgery. I was actually there to refill my allergy meds, when Dr. M brought up things about my overall health, like my asthma and high blood pressure, it was 140/92 I think. He said he was willing to support me if I ever wanted to pursue weight loss alternatives. He asked about my history of being heavy and talked about the struggles his sister had. It was brought up in such a way that it was not preachy or negative, but a true concern about my quality of life, knowing that at 303 lbs. I was not living well and was on the verge of a lot more health issues in the next few years.

So from there things just sort of snowballed. While I hadn't been really thinking directly about it, I had been feeling miserable and struggling with moving, breathing and just living. So I got the ball rolling, I called my insurance company, or more accurately the third party company that handles these requests for my insurance company. I made the initial appointments for the three evaluations required to get insurance approval. I had appointments on July 1-2 with a surgeon, a nutritionist and a psychologist. After their evaluations, insurance will either be approved or denied and the surgery may happen either right away or they may make me go through a 12 month weight loss program. So now I wait patiently to hear from HCMTI on a decision.

I was filling out some paperwork and having to document my previous weight loss attempts. I hadn't thought about it but I have really tried several things over the years; swimming, walking, Richard Simmon's Deal-A-Meal and Sweating to the Oldies tapes, Walk Off the Pounds DVD from Leslie Sansone, 10,000 Steps a Day, pedometers, Sparkpeople, 2 different electronic food diaries, walking logs and who knows what else I am forgetting. I looked back at school picture and there was never a time that I was thin, even a a little girl I was that sort of cute cherubic, round kid. Then at about age 8 or third grade the round wasn't so cute anymore and you can see the first double chin. What was it at that time that switched on? Is it environment? Genetics? Is it mental, emotional or physical? Or a little bit of each?

I think at some point you start down a path as a child and that forms your life as an adult. I remember being teased as a child, being called the fat one. Knowing at an early age that I was different, having to shop for different clothes, with names like "pretty plus". Then it became a self-fulfilling prophecy. By the time I was old enough to make my own choices about food, I had always been the fat kid, the chubby one. I craved attention, I didn't fit in and food was the one thing I could count on. I always felt like I wasn't doing enough to be liked by friends, to be noticed by boys or to live up to expectations from parents, teachers and other adults. My self esteem and confidence were always measured by the fat suit I was wearing on the outside.

Now I find myself at 36 wondering how I let my life get here. As a kid you might have an excuse. As an adult, living independently for 15+ years the blame falls entirely on me. Anyway, I am trying to prepare myself emotionally and mentally for the potential changes ahead. It will be interesting to see what's next for me.

Saturday, August 1, 2009

Creating a Lap-Band Blog

Thought I would work on a lap-band blog as a way to document the road ahead. Trying to come up with a cute background and header.