Getting Real about my WLS problems by Glenn Goldberg

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Getting Real About My WLS Problems July 15, 2003 (illustrated with a drawing of man in jail) Glenn Goldberg


Lately, as I've reread my newsletters in sequence, I've become concerned that, in my exuberance to celebrate and share my successes after Weight Loss Surgery, I've overemphasized the positive aspects and minimized the negative. While there's been a preponderance of the former, there's also been an abundance of the latter. I've taken my concern seriously because my greatest complaint about the reports I read pre-op in most email groups and books is that they were more cheerleaders than realists, and glossed over the negatives. I was particularly resentful about this in my first 10 weeks post-op, when I felt unprepared for the intense discomfort I experienced moving to the Losing Side. I much prefer to know exactly what to expect from an ordeal.

So I've done some self-examination as I begin my ninth month post-op and add to my 135+ lb. weight loss, and I've renewed my commitment to being real — with myself and with my readers - about my problems with Weight Loss Surgery. Getting real means acknowledging my gnawing frustration and irritation at the severe limitations upon what I can eat - not about the quantity of food I can consume, but the variety (or lack thereof.)

Two weeks ago, my doctor performed his second endoscopy on me. The first procedure happened about three months ago when I was unable to keep any food down for a week. The endoscopy revealed that I had a bad case of acid reflux, and that this had caused ulcers in my esophagus and stomach pouch. The resulting wounds and inflammation was preventing food from being evacuated from my stomach and causing a backup. So my doctor prescribed a medication (Protonix). The good news revealed by last week's procedure is that my ulcers have healed. The other thing he found was that my stoma appears to be the optimal 10 mm and didn't need any stretching. Some scarring and inflammation remains.

I was disappointed. I wanted a quick solution or magic bullet. I wanted the stretching of my stoma to suddenly make it possible for me to eat more than my bland, boring standard selection of foods. I hoped that henceforth, like most of my correspondents, I would be able to "eat just about anything, only in small amounts and with a lot of chewing." It appears that's not to be.

Let me be clear: I remain totally thrilled with the outcomes of my surgery and, even if nothing were to ever change with respect to my eating options, I'm very happy with the outcomes and tradeoffs. Still.... I am very, VERY limited in what I can eat and how much I can eat. And that disturbs, frustrates, irritates, and angers me. Nothing I can't handle, but it's important for me to acknowledge and accept these yucky feelings so that they don't distort and bite me in the butt.

Basically, I'm living on a semi-liquid, semi-solid eating program that doesn't change. Yogurt for breakfast; Real Meals protein drink, supplemented with a daily multi-vitamin and Juice Plus supplements (to provide the nutrition I'm not getting from fruits and veggies) at lunchtime and mid-afternoon; a very small dinner (e.g. 2 ounces of broiled fish or 1 oz. of extra lean steak/ground beef or 3 ounces of tuna/chicken/salmon salad, plus some mashed potatoes); and then I nibble on some graham crackers or have some kind of pudding, etc. for my evening snack. I can enjoy Smoothies, clear soups and broths, ice cream and (dare I say it!) lemon meringue and key lime pie. I drink only water or Crystal Light, with some occasional nonfat milk. I believe I'm averaging 500 - 800 calories a day. What I've NOT been able to eat includes: bread, anything with yeast/flour/egg, salads, pasta, or just about anything else not listed. When I eat anything off of my "ok list", I experience extreme digestive discomfort, and usually end up inducing vomiting to eventually end the discomfort. When I experience only mild discomfort, I go for a long and vigorous walk and that usually improves things.

I know that removal of my gallbladder imposes some digestive limitations. I understand (and am pleased) that my pouch hasn't stretched much, if at all, and that my internal staples are holding tight. Finally, I understand (as my doctors and their staff remind me again and again) that everyone reacts differently to WLS. But I very much want to know whether or not my present eating limitations are likely to persist, or whether they are likely to improve as my post-op extends.

It certainly does APPEAR that most of my post-op WLS colleagues have a much easier time of it. Most claim to be able to eat anything, only in small amounts. And I understand that those experiencing problems like mine are the least likely to talk about them.

I no longer have any doubts that I will reach my goal weight (I'm now a bit below 220 (started at 355), and my best guess is that my goal weight will be between 180 and 190. (I keep hearing that my baggy folds of excess skin may weight 20 lbs. themselves; does anyone know the truth?) I occasionally have concerns about continuing to lose weight after reaching my goal, but I figure that is a natural bit of distorted thinking and is mainly my fear and anxiety squawking.

I also have to admit that there's a big part of the smaller and leaner me that welcomes, even enjoys, the freedom and ease that I find in being confined to limited choices. I'm spared the necessity (and danger) of choice, even as I bemoan my loss of dignity of choice. For me, boring and bland can be wonderful and even liberating. While I insist on choices in every other area of my life, when it comes to food and eating, I really do like it easy and simple. Even during those terrible and counterproductive years of incessant dieting, my favorite was Stillman, where if it was protein, I ate it, and if it wasn't, I didn't. Also, I recognize that for me, this tendency toward bland repetition is part of my transformation into a person who eats to fuel my body, not for comfort, joy, sensation or fun.

Honestly, I treasure the tool of negative conditioning and reinforcement that has blessed me in my post-op period. I feel so terrible and awful when I eat things I can't that even starvation - and certainly monotonous blandness - is immeasurably preferable to feeling sick. And that, together with my restored appetite regulator from the surgery, makes it so much easier for me to ignore the emotional hunger and temptations that used to push me over the edge into compulsive overeating.

One of the best tools I've found and used to neutralize my tendency to make myself the Victim and the Martyr is "reframing" - looking at a problem or situation from a different perspective, through new eyes, searching for the gifts contained within the difficulty. For example, during my trip to Cuba - when I couldn't join my family for restaurant meals because they served nothing I could handle - I chose to reframe the situation and turn that negative into a positive by walking during their meals, endlessly and joyfully, and seeing things and having adventures I would have missed if I had sat through their dining experience. Just the other night, when something I ate caused some gastric discomfort, I walked myself through the pain and enjoyed a spectacular sunset amidst the splendor of nature, growing things and critters on my rural block.

And yet.... I'm tired of social meals where I can't fully participate. I'm tired of needing to go for a walk every time a restaurant doesn't have anything I can eat. I'm tired of needing to bring my collection of safe foods with me when I travel. I'm tired of the constant stress and strain of keeping my body healthful with minimal resources. I'm tired of being so limited by circumstance, not choice.

And still... it is undeniably clear to me that all of these frustrations and irritations are NOTHING compared to the health and fitness, the comfort, the freedom of movement, my improving appearance, and all of the other joys, gifts and blessings that my WLS has brought to me. But it is important to me - as a matter of principle, ethics and integrity - that I be real about them, and share them with my colleagues (quickly approaching 1,000) who subscribe to my newsletters. And in my WLS book that I intend to write after reaching my goal weight, and in the WLS coaching for newbies that I intend to do after that milestone, and in all of my interactions with and service to correspondents, I will be real and honest and authentic about the difficulties and challenges of the surgery itself, the recovery period and life after WLS.

Getting real about WLS doesn't mean trashing it or living like a victim or sitting on a Pity Pot. It simply means sharing the whole story - the positive and the negative - and never losing sight of the bottom line. My long, happy, productive and healthy life - and the love it will let me share, and the work it will let me create - will be the penultimate testimony to my WLS reality.

Glenn