As most of my longterm pals here on the Cliffs know, I underwent a Rouxen-Y gastric bypass operation on 22 March, 2004. For any newbies thinking of having the surgery or scoffing at me, thinking I took the easy route out, do not delude yourself that any part of it is a breeze. You have to go into it with the mindset that anything can go wrong, from your not surviving the operation, to your body developing health issues directly related to GBS. The procedure is a tool that you must be emotionally and psychologically prepared to use safely and correctly; otherwise, it would have been all for naught, and I couldn't imagine such a horrible end to what seemed like my last, best hope.

My surgeon, Dr. Paul Ross warned me that I would have excess skin and probably a lot of it. He explained that, as he understood it, no insurance company in South Carolina, be it workplace insurance, Medicare, Medicaid, or anything like that covered that surgery. In SC, the skin removal was considered cosmetic and, if I decided I wanted it or I very much needed it to avoid constant skin infections, the surgery would be self-pay.I made my peace with that information and proceeded, because my genetic history combined with eating cheap and not wasting anything (this is one of the reasons why so many people at or below the poverty level are fatter than those with extra coinage.) had me hurtling toward an early death. And it wasn't just death. It was the constant pain I was in, especially my knees, and the vitriol I had endured from 1st grade and on through college. I wasn't in it to look good, because I never thought about my appearance. I'd had family and peers to keep me abreast of how "chunky" I was. The Paternal Grandmother Unit made my clothes, because we couldn't find outfits in the girl's department that would fit me. What few clothes we could afford to buy had to be found in the "Husky Boys" department. The last reason I wanted the surgery was my appearance.  My self-worth as far as my looks were concerned had been eradicated years before I had ever heard of the surgery.

I had tried every diet then known, and nothing worked worked past the maintenance portion of whatever plan I trying. The screenings for GBS in the late 90s and early 00s were intense. I had to go through a bevy of tests and even talk to a psychiatrist, who as an utter prick. Still, I held in my knee-jerk reaction of weeping and shutting down. By the end of all poking, prodding, unprofessional antagonism, and appearing to be appropriately worshipful of the insurance company BMG offered, I was deemed a good candidate by the doctors. At the time, BMG offered Cigna Insurance, who refused to approve the surgery and told me to go to Weight Watchers for six months, then they'd revisit my claim. But, with the year change, BMG dropped Cigna and went with United Healthcare. The doctor sent UH all his paperwork, my current comorbidities - deteriorating knees, chronic pain, skin infections, clinical depression, and sciatica. Thankfully, I had not yet developed diabetes or heart issues, which were prevalent on both sides of my family. Within a week I was approved.

I made one promise to myself as I was wheeled into the O/R:  No matter what happens, I will never regret getting this surgery.  There have been moments of difficulty, over the decade since the operation, but I've never broken my vow.  In early 2011, I was prescribed a medication the doctors said would help with my depression and insomnia.  I can't remember the name.  It worked for the insomnia for the first week, then I was back to square one.  It didn't do a thing for my depression. They kept me on it for three months and in that time, I gained 60 pounds, despite my increasing my exercise and adding even more protein to my diet.  I stopped the meds and was beginning to lose the weight I'd regained when Aunt Tudi died.

Since August 2011, I have not paid much attention to what I eat or if I eat.  I lost the rest of the side effect's weight plus 20 more by doing nothing but lying in a foetal position on the love seat and watching reruns of Law & Order: SVU.  And I did not stop losing weight.  I ate whatever was available when I had any appetite at all.  A lot of what I did eat just came right back up.  There were days I just didn't even try.  The only time I felt enthusiastic about anything was when I'd look at myself in the mirror and see how truly gaunt I was getting, because I wanted to disappear.  I began to fall down a lot.  There were times I couldn't even stand up.  My blood pressure kept tanking out on me, and my anemia got worse, because I stopped taking any of my vitamins.  I had 0 fucks to give, so why bother with any of it?  In mid-August, 2012, I began vomiting copious amounts of blood and could barely raise my head.  Aunt Janice had me rushed to the same hospital in which Aunt Tudi died.  I couldn't even stand for an x-ray of my stomach, probably because my blood pressure was 62/35.  I had developed an ulcer because I'd been eating aspirin for my Fibromyalgia, headaches, arthritis, and injuries from falling, even though I knew GBS patients are supposed to avoid that like the plague.

A few months later, at the end of February, I attempted suicide by taking all the meds I could find in the house and washing them down with Vodka.  Obviously, I survived.  I spent some time in the hospital and one of the doctors I saw was concerned about how ill I appeared and had some labwork done.  Everything was fucked up.  He asked me about my eating habits, and I told him the truth - that I ate when I thought about it, but I rarely thought about it.  He asked if I was taking my meds properly, and I told him that I was not.  I only thought about the day Aunt Tudi died, and I had no desire to engage in Earthly matters that always end up being senseless and not worth engaging in.  He asked about my weight, since he knew I was a GBS patient.  I told him about the medicine that made me speedily gain a lot back, but I'd since lost it all and more.  When he asked how and I told him about my great invention, The Grief and Stress Diet, consisting of curling up on your love seat and watching TV without moving except to maybe go to the bathroom, he told me that what I had been doing and was still doing was attempting passive suicide.  Those who engage in such behaviour usually don't realise that's what they're doing.  They just want the world to stop, but may fear doing anything proactive to make their final dream come true, so they just stop.  It's a slow, painful way to go, which is also a motive for those who feel they've irreversibly damaged someone or something they dearly love.  It's a kind of capital punishment for the crimes they perceive they have committed.

So when I moved out here and found a physician, the first thing she did was draw blood and have me give a urine sample.  It wasn't long before I was getting an urgent call to come in and see her.  She wanted me to start taking vitamins again, and urged me to at least try some protein shakes, because I had let on that almost everything I ate, what little I ate, I usually lost shortly thereafter.  She said that I was close to entering starvation mode, like an anorexic person, and I needed to do anything I could to pull myself back from that threshold.  It mostly went in one ear and out the other.  My teeth had already begun to feel the brunt of my vitamin and mineral deficiencies, and vomiting at least once a day, without fail.  It has now gotten to the point where the doctor is demanding I come in once a month for a B12 shot and I must get labwork done every three months.  She groused that I was just a hair away from Malapsorption Syndrome.

I'm trying to remember the things she told me I must do.  I keep up with the calendar in typical OCD fashion, which is constantly.  I'm still not eating as properly as I need to, but the extenuating circumstances are the issue in that matter, so it's not of my subtle slide into anorexic thinking.  Still, though, I'm doing the best I can, and plan on getting a hotplate and pot and pan so I can properly cook vegetable dishes, now that I can actually chew.  Yeah, my passive suicidal behaviours did in my teeth, which were never good, thanks to my dad's genes.  There were complications in getting the dentures properly aligned so, after a year of eating soft food - mostly instant potatoes that I can whip up in my microwave - I can now begin to relearn how to chew with the faux fangs.

Another thing the doctor discovered after seeing I had gained over 20 pounds in two months, was that my thyroid had finally died.  Having been diagnosed with Hashimoto's Syndrome back in the 90s, I knew this was going to happen eventually.  Once I got on thyroid medicine, though, the weight has been coming off.  My only exercise resource here is walking, but much of it is very hilly.  The more I walk, the more my back feels like it's going to shatter.  About that, I was also diagnosed with spondylosis that is pinching four discs in my back.  My pain doctor mentioned month before last that she was glad to see me losing weight, as that would help take stress off the problem areas in my spine.

And I got to thinking...  The medical care and programs made available to disabled people here in California are like the polar opposite of South Carolina, so I took the chance and called my insurance to see if panniculectomies were covered in my policy and, if so, how much the copay would be.  As I mentioned here a couple of weeks ago, I was informed that the surgery has to be precertified and, if it were approved, my portion of the bill would be $264.

So, yesterday, I went to see this dude, one Dr. Jason Hess, to whom Dr. Denysiak had referred me.  After an examination, he said he wouldn't see any problem getting not only a panniculectomy approved, but also an abdominoplasty, since the insurance I have has covered the surgeries for patients who had far less skin to get rid of.  I should know in two weeks or less.

One more thing about the gastric bypass surgery and how my actions years later could have easily killed me.  On the morning of 1 July, I decided to take a walk with Toby.  Toby refused to cooperate, pulling out of his harness several times, so I brought him back to the house, then headed out again.  But I forgot my water.  Where I wanted to walk, though, a little convenience store with some Mexican name, has lots of water, and I figured that would give me incentive to reach my goal.  En route, I found a homeless elderly lady working on her cardboard sign for the day.  It wasn't even 10 and she already looked hot, miserable, and defeated.  I didn't have cash, just my debit card, so I offered to get her something to drink and bring it back to her.  She thanked me and assured me she'd be right where I initially found her.

I was gone for hours.  I missed a turn somewhere - this neighbourhood is like a maze - my voice navigator wouldn't work, and the sun prevented me from seeing the phone screen.  The only things I can recall about this adventure gone wrong is that, at one point, I collapsed in some shrubbery in front of an apartment building, and the tenants came out to see if I was okay.  I told them I was, but I wasn't.  I sat there for about 15 minutes, got up, and started calling for Toby, as I thought he'd run off.  I remember a soccer field.  I remember a dude who refused to give me any directions to a store or fastfood joint, just so I could pull myself together, and he told me I looked and acted like a drunk and to keep away from him.  I finally swallowed my pride and called the Mother Unit, who sent Matt to try to find me.  Eventually, miraculously, he did.  I had walked almost 4 miles, making a wrong turn every time.  I never saw the old lady again.

After that incident, I didn't feel right for a few days.  I kept blacking out, I had to hold on to whatever I could when I made my way through the house or to the bathroom.  I couldn't bend over without getting swimmy-headed, and then the Migraine from the Inner Ring of Hell came upon me and decided to linger for three days, leaving behind nausea and auras to keep me company for two extra days.  Once I was able to look at the computer screen, I began hunting for reasons a person would suddenly become so confused, unbalanced, and feel as though a seizure was about to come on, and I found something very interesting.  Apparently some people who have had gastric bypass surgery develop seizures a few short years afterward.  Most of the time they are associated with hypoglycemia, which also causes a person to fall down more than stand up, and behave like an erratic asshole.  Confusion is also a player in this Olympic team of NOPE.  This could be why my neurologist has not found the cause of the seizures I started having 4 years and 4 months since my GBS.

Finding all this out, you'd think I'd give in and say I regret having the surgery.  You would be wrong.  The surgery allowed me to help Aunt Tudi more.  I recovered swiftly from my knee replacement because I was half the woman I used to be.  I'm no longer gawked at wherever I go (unless, of course, I'm acting like an escaped mental patient).  I've gotten to travel, and hope to travel more.  It has made it easier to go vegetarian and is the reason why I haven't had to get my right knee replaced before the preferred age of 50. Everything I do is much easier than it was before the surgery.  I wouldn't be able to sleep on this wee bed with a cat and dog if I hadn't had the surgery.  And if the surgery ends up having a hand in my death, I want the record to show that the malapsorption and defenciencies that may have led to my death were the result of my actions, or lack thereof.  The gastric bypass surgery did not kill me; rather, the tool I chose to accept, I later used against myself, even though I didn't realise what I was doing at the time.

If I die, I die.  There will be less of me to cremate after Dr. Hess has his way with me with Aetna's blessing.  I hope I don't die any time too soon.  Whenever and however I die, I shall do so with no regrets about the gastric bypass surgery.