Preparing For Weight Loss Surgery After Breast Cancer

Back in January, I mentioned that after enduring many frustrating months of bureaucratic boondoggle, I received approval from my insurance provider to pursue having weight-loss surgery. The process began in earnest the other day, and like the time spent waiting for corporate bean-counters to give me their official okey-dokey, I’m looking at yet another steep, uphill climb.

Obesity has become a worldwide epidemic, and the health issues it can cause are nothing short of catastrophic. Just this morning, I found an article about a World Health Organization study that shows the number of people diagnosed with type 2 diabetes has reached about 422 million worldwide. Moreover, the number of people living with type 2 diabetes quadrupled between 1980 and 2014. Countries including India, Mexico, Pakistan, Egypt, and Indonesia have all seen significant increases in the number of people living with the disease, and the numbers just keep climbing higher.

This is sobering news considering that obesity is the number one contributor to type 2 diabetes. Our collective unhealthy lifestyle is making us sicker, and even though modern medicine is managing to keep us alive longer, our quality of life is far from spectacular. You don’t have to look too far, at least not here in North America, to see that a huge chunk of the population is killing itself with food. I’m not talking about fruits and vegetables, people; I’m talking about fast food and processed food. Socioeconomic factors have a huge impact on what we eat, and the size of our bodies is often a dead giveaway. Gluttony is no longer a sign of success; it has become the hallmark of financial hardship, because in case you haven’t noticed, eating healthfully doesn’t come cheap.

For many people, the only way out from under type 2 diabetes and other health problems is weight loss surgery. The realities of our unhealthy habits can easily be quantified by studies, but what is not so obvious are the emotional issues that lead us to overeat. So many of us are taught that food translates to comfort, and when we’re sad or stressed, a full belly will make us feel better. That can turn into a full-blown food addiction which can be as impossible to overcome as drug, alcohol, and gambling addictions. Weight loss surgery is only a tool to be used to overhaul an unhealthy lifestyle, and unfortunately, despite the procedure, many people are incapable of embracing change.

In addition to having had breast cancer, I also have type 2 diabetes and high blood pressure. I am not obese to the point where I am disabled and not able to function independently, but let’s just say that I am of a size it would not behoove me to maintain. If I don’t drop the weight, the likelihood of my cancer recurring, along with developing other health issues, is strong, and I don’t need that looming over my head.

My experience so far has been interesting. I had four medical appointments the other day that were extremely eye opening. First, I met with an internal medicine doctor, who confirmed that physically, I am a low-risk candidate to undergo the procedure (there’s a slim chance I might die on the table). Then, I met with a physical therapist who told me I currently have the stamina of a woman 70-79 years of age (thanks chemo). The two most eye-opening sessions were with a nutritionist and a social worker. It was during that time when I realized the emotional repercussions of being obese are just as great as the physical manifestations.

The nutritionist and the social worker were at pains to try and pinpoint what exactly went awry inside my brain that lead me to balloon to my current size. Attempting to convince them that while I did go through an extended period in my life where major upheaval and stress did cause me to eat more than I should have, it wasn’t a mode of behavior I indulged in for the better part of my life. Do I like to eat? Yes. Have I ever overindulged? Hell yes. But despite coming from a substantially dysfunctional family, I can count the number of times I turned to food for comfort on one hand. I was a heavy-duty stress eater for about six years, and then came my cancer diagnosis. Plus, my Ashkenazi Jewish background isn’t exactly stellar from a genetic perspective. We have all manner of disease running through our blood. That’s not an ethnic slur; ask any doctor and he or she will tell you that people of Eastern European Jewish descent are at higher risk for a great many adverse health conditions and diseases. That’s just the way it is.

By far the biggest hurdle I have left to jump is trying to lose some weight prior to the surgery. The fact that my hormones are staging a revolt and menopause is in full swing is making the task somewhat difficult. The weight loss is required for two reasons: first, your liver needs to be as small as possible in order to make the procedure easier to complete. Second, it should be established that you are indeed capable of modifying your behavior by controlling what goes into your mouth. I’m over-simplifying a bit here, but if you’ve ever watched an episode of the TLC reality show, My 600-lb Life, you learn very quickly that the struggle is mighty when trying to overcome food addiction. You also learn that when you meet with medical professionals who are in regular contact with people who suffer from food addiction, attempting to persuade said professionals that you are not one more in a seemingly endless parade of food addicts is an exercise in futility.

Make no mistake – I am not trying to diminish the severity of food addiction. What I am trying to do is convince the people I am now dealing with, along with my insurance provider, that failure is not an option. All of the people I’ve met so far haven’t been through cancer treatment, and they have no idea what it’s like to have to endure it. When I tell them that losing weight is the most important step in ensuring my good health, I mean it. If subsisting on hard-boiled eggs, cottage cheese, yogurt and protein shakes for the foreseeable future is what I have to do to get healthy, then damn it, I will do it. I sure as hell never want to find myself back in the chemo ward getting pumped full of poison ever again. I never want to hear the word “recurrence”.  And for the love of all things holy, I am not a food addict.

The irony of this situation is that if I wanted to put my boobs back, I’d be well on my way at this point. No one would bat an eye at my decision. But the reality is, I would be putting myself at greater risk with breast reconstruction surgery post-radiation, than I would if I had weight-loss surgery tomorrow. My skin is still compromised and would likely not be able to support traditional breast implants. The procedure would involve painful tissue expanders, fat-transfer, a tummy-tuck and/or liposuction, and an extended recovery period. Plus, there is a significantly higher risk of infection and complications with breast reconstruction surgery than there is with weight-loss surgery. And yet, I am under more physical and emotional scrutiny now than I was when I was diagnosed with cancer.

Despite all these challenges, I am intent on seeing this through. I don’t have a choice. Modern medicine will be able to extend my life, but if I have to live it as an overweight, hypertensive diabetic with the threat of cancer looming over my head, thanks, but no. If I can’t live life on my terms, you’ll know where to find me. Hint: it won’t be at the local hamburger joint or sushi bar.

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