Herb Kaufman
Why Am I So Happy?Recently I went to a plastic surgeon, on the advice of Dr. Christine Ren, because I have some serious issues with loose, sagging skin. At this point, I have no idea whether or not the operation will be “approved” by my health insurer. I hope it will be but even if it is not, I am still a very happy man. You may question my sanity, and believe me, you would not be the first person to question my good sense or judgment. Let me explain.
Over five years ago, in April of 2004, I had my lap band procedure performed at NYU Medical Center. Prior to that, I had been “advised” by some close friends not to have it done. They repeated horror stories which have become folk-lore on the internet. And, was I worried? You bet! The first time I actually came into Dr. Ren’s office (after having attended a seminar) I was weighed in by Barrie Wolfe, who was the nutritionist, and discovered I was a mind-popping 489 pounds. (I think that my BMI (Body-Mass Index) was 66.3 at the time.) I was stunned!
I had been to at least two bariatric surgeons prior to Dr. Ren (and NYU) and had been turned down each time. I do not have many virtues, but one of them is persistence, and in this case, it was a good thing. You see, the reason for my loose, sagging skin, is because I had lost 230 pounds since my first meeting with Dr. Ren. I am still losing weight, by the way.
I would like to tell you that it was easy—a piece of cake (if you like puns.) It wasn’t. The operation wasn’t bad and the recovery went well. When Dr. Ren began tightening the band to fulfill the reason for the operation, I began to learn more about the operation; about eating; and most importantly—about myself. I still try to keep the tightness of the band at a ‘comfortable’ level, but comfort is a relative term. Sometimes, even when I am very careful, or think that I have been, I still have some problems. They may range from occasionally throwing up to almost uncontrollable vomiting (fortunately, the uncontrollable vomiting was only in the beginning; right after the operation.) There have been many times that I have felt extremely uncomfortable after eating. Sometimes it was so bad that I wished I would throw up, only I couldn’t. And sometimes that feeling lasted a couple of hours or more.
I would also like to tell you that all of my eating problems have been “conquered;” that I no longer eat emotionally and that I only eat when I am hungry. I would like to tell you that, but it wouldn’t be true. Maybe in some fairy-tale story (or some stupid glamour magazine) it would be true, but I am talking about real life or, as some refer to it, reality. I would like to tell you that I never eat what is not good for me or that I stop eating whenever I feel full. I can’t tell you that, because that would not be true either.
I look upon myself as being like an alcoholic or a drug addict. I will never be fully cured. I will always have this disease. The only question that remains is whether or not I can keep it under control. That may not be the answer you wanted to hear, but it is a truthful answer. And I am sure that what I have said applies to just about everyone who has undergone lap band or similar procedures.
So why will I still be a happy man if my insurer refuses the plastic surgery? Well, for one thing, I am still alive—something I am sure that I wouldn’t be without the procedure. I have lost a whole litany of diseases and conditions that go along with morbid obesity and I no longer take the drugs that were used to control them. Diabetes, high blood pressure, incontinence, sleep-apnea, High LDL cholesterol and low HDL cholesterol, out-of-the-world readings on triglycerides (275); and osteo-arthritis. They are all gone now, just like a bad dream—only they were real. Along with their loss, I have also greatly decreased my chances of heart attack, stroke, cancer, premature senility, kidney failure, limb amputation, blindness—you name it.
I used to arrange my life around my medications; pricking my finger for blood; taking readings three or four times a day; as well as being extremely cautious about what and how much I was eating. Oh, and did I mention that my BMI is now 36.5? My A1c is between 5.5-5.7 on a regular basis?
You might say that my caution over diet hasn’t changed much since the operation, but it has. Previously I was watching my diet so that I wouldn’t get worse. Now I am watching my diet so I get better. I regret to say that some of my diabetic friends who carefully watched their diets, exercised regularly and religiously took their proper medications did get worse—and died. As much as I miss them, I also realize that I missed a similar bullet for myself. Yes, that is why—even if my insurer refuses to pay for my plastic surgery, I will still be a happy man—a VERY happy man.
I know some of you who are reading this may profit my experience. I also know you are scared but don’t worry, that is normal. I know that, like me, you may have friends or relatives who are trying to talk you out of bariatric surgery. Some actually have your best interests at heart. Most however, are simply unwilling to lose their “fat” friend who made them look good (by comparison) in public and who took all of their “fat” jokes (at their expense) in such good humor.
Unfortunately you have to face reality in that, with every surgical procedure, no matter how minor it might be, there is no such thing as zero fatalities. With every surgical procedure there is also the danger of complications. This is no different. What you have to do is to decide whether the risks associated with bariatric surgery is outweighed (oops, another unintentional pun) by the benefits. Whether you are more at risk by remaining morbidly obese than by subjecting yourself to a surgical procedure. Finally, you have to find out “if you’re made out of the right stuff.” Whether you’re willing to follow instructions, follow the program; follow the food plan; and see your surgeon (and a support group, if necessary) on a regular basis. And, most importantly, be realistic about your own situation.
Now you know why I’m so happy.
HERB KAUFMAN
April 10, 2008
Date of Surgery April 26, 2004
It’s hard to believe where I have been and where I am now. I never thought I would live to my present age. You see, I once weighed 489 pounds (326 kilos.) My BMI was 68;. I had type II diabetes and was on medication for that; and I also had high blood pressure, osteoarthritis, high cholesterol, sleep apnea, acid reflux disease, and onset kidney disease. I had trouble getting into a booth at a restaurant, driving a car (couldn’t get the seat belt on), flying in an airplane or just walking. I feared running into children the most. They would point at me and/or whisper to their parents. I always knew what they were saying even though I could not read their lips—“He’s so FAT mommy.” I could see the look of disgust on peoples’ faces when they saw me for the first time. I learned to ignore them but I could never get that "look" out of my mind. I had tried every diet known to man and failed every time. Weight Watchers™, Overeater’s Anonymous™, liquid protein, Medifast™, and many more, all with the same result—failure. I had lost all hope.
Then I met Dr. Ren. After many months of preparation I had gastric band surgery and I now weigh 285 pounds (123 kilos) and my BMI is now 40. I am still classified as obese but I hope to be just “overweight” shortly. A year or so from now I expect to be at, or near, my “normal” weight. I know I will have to face the issue of excess skin at some point, as I have about 40 pounds of skin to contend with, but that is a minor issue right now. I have not taken a single diabetes medication since my gastric banding operation in April of 2004. My A1c now hovers around 5.5 to 5.7, which is where it should be for a non-diabetic. My pressure is now almost normal. I still have to take Ace-inhibitors (Analapril) because of onset kidney disease in order to keep my kidneys stable and Zetia for my cholesterol. Other than that, I have no major medical issues. One of my greatest achievements, as silly as it may sound, was when I was able to wear underclothes for the first time in many years. When I proudly told this to Dr. Ren she smiled because she knew how far I had come. And, of course, I always get a big "rush" whenever I put on an old pair of pants. When I do, I can't believe I was actually that big. Success is measured by many small victories like this.
That is not how I measure progress however. I now fit in everywhere—cars, airplanes, and seat booths. People no longer point their finger at me and whisper. I have no problem walking, even great distances. I enjoy my life now. I write and I work. Writing things like this, for example, gives me inspiration to go even further. Whenever I see people in the condition I was in, I want to talk to them. I want to tell them what I have gone through. I want to tell them there is hope, not fake hope, but real hope. Sometimes I did talk to them and, like my earlier attempts at losing weight, I always failed. I then realized the cause of my failure. All of these people were in a constant state of denial, much like drug addicts or alcoholics. Something or someone else was always responsible for their condition, not they themselves. They did not want to face the truth or were not prepared to do so. Now I have come to understand that they have to take the first step in order to be successful. I cannot do it for them. Nobody can. I think the term for this understanding is called wisdom.
If you are reading this, or have attended one of Dr. Ren’s seminars, you may have already taken that necessary step of facing up to the truth. I know that this is a difficult step. I say may, because you probably have questions and are not sure that this is the right thing to do. I can only speak for myself of course, but it was the best thing I have ever done. If you are morbidly obese; if every diet you have ever tried failed or, after a successful diet you have regained all of the lost weight and perhaps more; and, if you have serious medical problems, let me assure you that it is the right thing to do. You may hear “horror” stories about bariatric surgery. I know I did. Most, if not all of these stories, are associated with bypass surgery. Gastric banding surgery is different. It is safer by far, with less complications and it can be reversed. Bypass surgery can almost never be reversed. That is not to say that there are no problems and/or no fatalities with the gastric band. There are. Every operation, even the simplest of procedures, carries with it some element of risk. The question you must ask yourself is this: “What will happen if I don’t get the operation?” In most cases, the answer is, very simply, that you will die, many years before you should. You must weigh the certainty of this happening against the possible risks you may face during and after gastric banding. In almost every case the answer is a no-brainer.
However, most of the problems associated with gastric banding are self-inflicted. You must be committed to following your medical team’s instructions and see them on a regular basis. And, NEVER be afraid to see them if you are having problems. In most cases, you will not even need an appointment. Some of you will try “to eat around” the gastric band. Let me assure you that it doesn’t work. It is like having a nagging wife that is always watching you and, unless you like throwing up or still want to gain weight, I don’t suggest you do it. Above all, you must associate yourself with surgeons whose record of success speaks for itself. Drs. Ren and Fielding’s record in this field (no pun intended)is outstanding. Dr. Fielding is himself a bit unusual because he is a gastric banding patient, as well as a bariatric surgeon.
I hope this has helped and inspired you. Always keep in the back of your mind that the operation is a tool, nothing more and nothing less. It is NOT a miracle cure although it may seem to be to you right now. It will take hard work and committment (there's that word again.) You may have setbacks and/or problems. Do not let that deter you. Always keep your goal in mind. You may fall down, but there is no known law of nature or physics that says you cannot pick yourself up and start again.You can only fail if you give up.
If you need additional help you can get it on Dr. Ren’s web site, from your surgeon and from various support groups. I wish I could speak with each and every one of you and answer your questions. Since that is not possible, this is the next best thing.