This coming December 6, I will be going in for surgery at Montgomery General Hospital in Olney, where I will be having a sleeve gastrectomy procedure, commonly known as a gastric sleeve. This is a surgery that will help with weight management. This is done laparoscopically, and it removes a portion of the stomach, leaving a much smaller stomach behind that’s roughly the size of a banana. This one only reduces the size of the stomach, and preserves the original path of the digestive tract. Compare to the older Roux-en-Y procedure, which separates the stomach into two sections, and reroutes the digestive tract.

I am doing this because I have been heavy for most of my life (I haven’t seen the underside of 200 since eighth grade), and diet and exercise alone haven’t gotten me nearly as far as I needed to be. Sure, I looked far better at 275 than I did at 384, but it was still too much weight to carry, and I still had weight-related health issues at the lower weight. Over the course of the past year, I have attended classes with a dietitian, had various evaluations and tests done (the endoscopy that I wrote about last April was part of that), and after all of that, the insurance gave the surgery their blessing.

I have to say that I have a bunch of different feelings running through me about this. On one hand, I know that this is a necessary step. My primary care doctor first suggested it to me about a year ago, and then I unexpectedly got a second opinion within a month or so from a specialist that I was seeing when they suggested it as well. As far as I was concerned, that was a pretty strong indicator about what I needed to do, when two out of two doctors, in their professional opinion, suggested it, completely unsolicited. I also feel like I’m ready for it. I know what I’m supposed to do to prepare for the surgery, I know what I’m supposed to do immediately after surgery, and I know what I’m doing during the healing process and thereafter on the maintenance diet. At the end of every dietitian class, they told us “Chew, chew, chew, sip, sip, sip, and walk, walk, walk.” I’ve also stocked up on my multivitamins and my calcium citrate, as gastric sleeve patients will take multivitamins and calcium supplements for life. This also has the potential to get me off of some of the medications that I’m on as well as the CPAP (for sleep apnea). That latter point is exciting, because while I’m used to the CPAP, it’s still a bother, and I would be more than happy to be rid of the device that I’ve described as “the most expensive fan that I’ve ever owned”. I’ve also spoken with colleagues who have had the same surgery, and they have generally had good experiences, which leaves me feeling optimistic. After all, if they can succeed with this while doing very sedentary work, then so can I.

I’m also tired of being this heavy. I was at my lowest in a very long time for about a year in 2012-2013. Then after I left my nonprofit job, the scale started moving upward again, as I was put off of my routine. I was able to slow it and even slightly reverse it for a brief period, but ultimately, I ended up back at my original weight. Let’s admit: even though I love what I do now, working in public transportation is not exactly conducive to physical activity. I’m not strapped in a seat all day, as was the case when I was driving a bus, but you’re still sitting down all day. Some days, I would just love to operate the train standing up, but it’s not possible with the design of the trains. Most of my exercise is the walking that comes with the job, i.e. going from the rail yard to the station and back (not an insignificant distance), and reversing ends on the train platform.

I’m also a bit nervous. This is not a minor procedure like getting a toenail removed or something. This is the removal of about three quarters of the stomach. If that doesn’t give you some pause, I don’t know what will. I wonder how much it will hurt, and how well I’ll be able to take it. I never was big on taking pain medication with past surgeries, such as the wisdom teeth in 1995 or the pilonidal cyst in 2005, so hopefully I won’t need to take any pain meds for this. I’m most concerned that the work zone is in such a central location in my body. While I’m not concerned about all of the walking that I will be expected to do during the recovery process, I am concerned about how long I will be out of the car. I would love to do said walking while doing other things, like photo walks and such, but I don’t want to be a risk to myself and others on the road by driving before I’m ready. In other words, I don’t want to be stuck at or near home for longer than necessary, but I also don’t want to rush things just to get out in the world. Staying at home for the duration of the recovery is out of the question, because my surgeon has already told me that I need to stay active during the recovery process, and not have someone taking care of me (in other words, my mother will remain in Stuarts Draft). Meanwhile, I’m also concerned about how my body will react to things with this new configuration. I had two episodes of food poisoning in the last few months, and in the more severe of the two, I threw up so hard that my stomach muscles were sore. That was a new feeling (how often do those muscles work so hard that they get sore?), but it raised some concerns for me about how things would go the next time that I got sick.

The big sticking point with this whole surgery, meanwhile, has been Elyse. She is worried that she will lose her freedom during the time that I’m recovering, because I’m the only driver in the house, along with other concerns. Overall, she doesn’t feel supported throughout the whole process, despite my best efforts to make sure that she’s well informed about the whole process. I want her to be involved in this. She has been to every appointment and every class with me by her own choice, and asked questions, too, but the whole process still stresses her out greatly. I don’t know what to do, because I’ve offered every bit of help and other resources that I can come up with, including the MedStar bariatric group, and /r/gastricsleeve on Reddit, but she still finds it extremely stressful. If it tells you anything, she doesn’t even want me to talk about it to other people in her presence. I have a feeling that when it comes to Elyse, she’s just going to have to plow through it and come out on the other side. Yes, the process may be stressful (and even with my being mentally prepared for it, it’s still undoubtedly going to be a challenge), but once we come out on the back side of it, it’s going to be okay, and there will be normalcy again. Like Mrs. Pennypacker said in the Today’s Special episode “Hospitals“, everything will be fine.

Meanwhile, this is my last week eating solid food for about a month. I start the pre-op liquid diet on the Sunday before Thanksgiving, go to clear liquids only during my hospital stay (expected to be just overnight), back to a liquid diet for two more weeks, then transition to soft foods for another two weeks or so, and then a month after the surgery, move to the maintenance diet, which is lifelong.