Wednesday, August 17, 2011

The final frontier

I love how experience can make us wiser. About two years ago, when I was contemplating WLS, I had some pretty strong opinions about what I would and wouldn’t do if I went through with it. I also had pre-conceived notions about who should have the surgery and why. For example, I thought if someone were born thin, gained weight later and couldn’t take it off, they shouldn’t be granted the surgery. In my mind, it should have been reserved for people like me, who had been fat for their whole lives – not former thin people who blew it! I also thought that plastic surgery following massive weight loss was a farce. I figured it was reserved for those vain people who wanted to look like supermodels, and by extension, didn’t deserve WLS in the first place, because it should only be used to cure obesity-related ailments. Wow, was I wrong on all counts. If the past two years have taught me anything, it’s that I should never judge other people for their choices and decisions. Nobody has the right to tell anyone how to live or manage their own lives, and it kind of shocks me a little that I was so naive to think that I had all the answers for everyone else back then. My, how I’ve changed.

I think WLS is a wonderful tool that is going to revolutionize our North American society. It has the potential to cure a lot of obesity-related ailments, extend the lives of millions, and save us countless health care dollars in the process. I don’t think anyone who needs help to lose the minimum amount of weight should be denied the opportunity to use this tool, and I hope we’re moving towards greater access for all.

I’m also hoping that we make some gains in subsequent treatments needed after WLS. For the past 6 months, I’ve been researching, asking questions and visiting more doctors than you can shake a stick at to prepare myself for the final frontier – plastic surgery. This is a huge step for me, considering that I swore up and down that I’d never partake! I figured I’d just be happy to have lost the weight, and that my life would be great without all of my extra (literal) baggage. What I’ve discovered is that the human body doesn’t always work the way we’d like it to. After losing more than 100 lbs, I’m left with a lot of excess skin that is bothersome and painful. It causes some health issues with chaffing and rashes, plus it’s almost impossible to do a lot of high-impact activities without serious discomfort. The jiggling and bouncing of excess flesh is not pleasant! Then, there’s the overall self-esteem issue. I mistakenly thought that losing 100+ lbs would make me look better on the outside. The irony of folks telling me how fantastic I look is not lost on me – because the real result is not quite so pretty. Picture a melting candle. That’s how I look without clothes on. Flesh that used to be filled with perky, pert fat cells now droops and sags. Formerly firm body parts are now squishy soft with little definition. I can grab handfuls of skin from just about anywhere, and pull them away from my frame like taffy.

I’m happy to report that I’ve found a surgeon I trust, and together we were able to convince my provincial health insurance to cover some of the costs of surgery. This is where I think we need some improvement. I’d love to see OHIP (or other provincial insurance) cover the entire costs associated with post-WLS plastics, but we’re just not there yet. There’s still quite a stigma attached to “cosmetic surgery” (as they like to call it) in that it’s assumed that it’s an elective, non-essential, purely-for-looks treatment. Clearly, that’s not the case. At this point, I’m scheduled to have a breast reduction & lift, double brachioplasty (removal of skin from my upper arms) and a full abdominalplasty (also known as a “tummy tuck”). In all, the surgeon will remove up to 15 lbs of excess skin from my body. OHIP will cover the cost of the breast reduction, and by virtue of me already being in the OR they are paying for, a bit of the costs of the other surgeries, but I will be covering a large portion myself. Don’t get me wrong – I knew all along that if I opted to have plastics, I would be responsible for a large portion of the costs, and I’m happy to have the means to do so. But given the health benefits that I will enjoy due to these surgeries, I hope this changes soon. I think the WLS community (and especially our provincial insurance providers) need to recognize a “whole patient” approach and see patients through to the end of their whole journey, not just halfway through.

As I approach my surgery date (in a little over 8 weeks), I’m filled with a little bit of fear and a lot of hope. I’m excited at the prospect of finally shedding my physical fat shell, and nervous at the idea of a 5-6 hour surgery to accomplish it! But given the vast numbers of folks out there who have opted for WLS or who know someone who has, I’m happy to share my experiences here. Wish me luck – I’m rounding the curve and heading for finish line!