A lifelong change
It’s fair to say I thought about his decision thoroughly before having surgery, but it is similarly true that I didn’t really know what to expect in the medium- to long-term.
I knew to expect nausea in recovery, I had even practised my meditation techniques for the inevitable hours of wanting to vomit. I had also had the forethought to think about a strategy to alleviate the thirst associated with nil by mouth after anaesthetic. Ask your ICU nurse to allow you to rinse your mouth with water and then spit it out again.
I’d thought about the weeks after surgery, about coping with fluids only, soft foods, having my Mum to look after me. I had even asked for no visitors for the first couple of days that I was home. That was summarily ignored. When Mum is visiting my home becomes the centre of my family’s universe. Everyone takes the opportunity to see Mum so there was an endless stream of siblings, nieces, and nephews. I just took refuge in my bedroom and allowed Mum to play host to her loving family.
I don’t care for surprises so I had thoroughly researched what to expect in the aftermath of the surgery, and like when I’d climbed Mt Kilimanjaro, nothing was a surprise to me.
What I hadn’t really thought about was life as a normal weight person, and more importantly, how I would avoid the inevitable weight gain.
I used to be a heavy smoker, but though I haven’t had a cigarette for over seven years, I still consider myself a smoker who is not currently smoking. Failure drives us to devise all manner of mechanism to defend ourselves from the inevitable disappointment of falling back into patterns of behaviour that have been learned over years and years.
For me, smoking is closely linked to alcohol consumption, in particular, drinking alcohol in an environment where cigarettes are readily available. I had spent much of my adult life in such an environment. Being a publican means unlimited supply of cigarettes and alcohol, so it’s hardly surprising that my repeated attempts to quit smoking had failed.
I can remember one night when I was eating dinner in the public bar of a pub I was running. I was wearing nicotine patches, and they were very effective in staving off my cravings during the day. But come evening, when I would have a drink with a customer or two, the patch would be ripped off and replaced by a cigarette in the mouth.
The impact of a constant flow of nicotine through the patch augmented by hits of nicotine was, what I imagine to be, a nicotine overdose.
On this particular evening I was standing at the bar (up on the ashtray that ran along the floor the length of the bar because I am shorter than the average man), and bouncing from foot to foot as I ate my steak. I couldn’t sit still for more than a moment.
I have long since left the hospitality industry, long before I gave up smoking. Learned behaviour is difficult to unlearn. The change of career meant less exposure to an environment that encouraged smoking and drinking. It’s been many years since I regularly went to a pub, and while I didn’t do this as a conscious choice, this gradual withdrawal from the pub scene has meant I am no longer regularly exposed to smoking stimuli. Add to this the fact that the vast majority of people I work and socialise with are non-smokers, and my exposure to cigarettes nowadays is almost non-existent.
I can’t remember the last time I craved a cigarette, but I can vividly remember the many times I have declared myself a non-smoker, avowing never the again draw cigarette smoke into my tortured lungs, only to be smoking heavily again within months.
I have repeatedly tasted failure!
The story of my battle with overweight is scarily similar. I think my first ever diet commenced when my age wasn’t yet into the double digits. I can remember a contract being drawn up with my father. I was to lose 10 lbs and in return I would be given a bikini. I never wanted to wear a bikini, but I didn’t tell Dad that. I just wanted to end the agony of not being skinny like the rest of my family. While I can never remember being treated badly as a child because of my weight, clearly it was unacceptable, as evidenced by the constant efforts of my parents to encourage me to lose weight. If it wasn’t acceptable to them then it wasn’t acceptable to me. But I guess I loved my food more than I despised my weight.
I fulfilled that contract with my dad, but declined the offer of a bikini.
The weight inevitably crept back on.
Then there was the humiliation of joining Bowen’s fat women at the local “Waist Watchers” club. To this day I remember the lyrics of the song that any member who had gained weight that week would have to stand and sing in front of the room of overweight women who had honed their censorious looks, no doubt through years of practice on hapless husbands! Their faces were as severe as their arses were wide. The song was sung to the tune of “Clementine” and went like this:
I’m a piggy
I’ve got fatter
I’m ashamed to show my face
Overeating
Oh, what cheating
What a terrible disgrace
As sad as it may sound, that wasn’t the most degrading part of being a Waist Watcher. I yet had greater depths to sink to. The zenith of my humiliation came at the Gem of the Coral Coast Festival, when the Waist Watchers decided to put on a display.
Now what could a bunch of middle-aged fatties do for a display?
Why, don black leotards and perform a choreographed dance routine, of course. I’ve got no idea who came up with that idea, but I’ve always been up for giving things a go (like volunteering Mum to make the Anzac day wreath every year), so I joined in.
We rehearsed the routine for some weeks at our meetings, and by the time the festival came around we had it down pat, moving as one, swaying from side to side with gentle arm swings and half-arabesques. I am thankful that being the junior member of the troupe I was relegated to the back of the formation.
On the fateful evening of the performance we lined up four by four, rolls and bulges of white skin barely encasing the fat and cellulite, oozing out through arm, leg, and neck holes of tortured black leotards.
The music started and within seconds we were an undisciplined mass of adipose tissue, some moving left, some moving right. I was appalled, and my shame was complete.
I don’t think I ever went back to a Waist Watchers meeting.
I’m sure there are other times that I have been equally embarrassed, I just can’t think of any right now.
Whenever I look back on those experiences it is not with fondness, but more an inner eye roll and imperceptible outer cringe. These things help to shape the person that we are, but they by no means need to define us.
My eldest sister once told me that she had openly blamed my mother for my lifelong battle with my weight. “You obviously fed her too much”
My mother said she couldn’t stop my eating.
There is little doubt I was a month overdue because my conception can be pinpointed. Mum was one of the first women in Bowen on the pill, but that was back in the time when you periodically had to go off the pill for a month. She’d been off for a month and suspected she was pregnant. Dr Harbison gave her a script and said to go back on the pill for a month. After a month she would know whether she was pregnant, and the pill would do no harm. If she wasn’t pregnant then the pill would have prevented it from happening during that month. Perhaps pregnancy tests weren’t available then…
But Mum and Dad were a fertile combination (I am the last of four – and at one stage Mum had three babies under three years old), and I was well and truly on the way.
I was due in January, but didn’t arrive until the following month. By that time I was 10 lbs (4½ kgs). That’s a big baby, but consider also that Mum was less than eight stone (<50 kgs). She very nearly bled to death giving birth to me.
When I arrived I had a ‘caul’ (a part of the embryonic sac like a second skin) over my face, the result of being overdue.
I began my life overdue, overcooked, and overweight. My lifelong battle with the bulge had begun.
Mum tells me that with three babies that had never slept through the night she thought women who claimed their baby slept through were fibbing. When I came along I was big and lethargic. I had to be woken for my feeds (though I was usually awake waiting for the next one), and basically slept until I was two years old.
So where did my voracious appetite come from? Was it genetic, or was it learned? I know that I have watched my father in later years and he would continue to eat until the food was taken from him. When I was a child I remember him not being particularly overweight, certainly pictures of him as a young man show a good looking, well-built frame. But his stomach continued to expand until as a middle-aged man he had a bulbous beer belly, a huge veranda protruding far out from his front. It remains to do this day. Much of his overeating was alcohol-fuelled, but that is another story.
So the nature versus nurture debate continues. I have looked at long since passed aunties on both sides of my family and for years had a conviction that my fate was sealed.
But to break a lifetime of habit and to overcome pre-dispositions to certain behaviour takes a sustained commitment. I am convinced that to maintain my normal weight range is going to require vigilance for the rest of my life.
The fact is, I never believed, even after my surgery, that I would be a normal weight adult. I can remember some years ago actually telling myself to accept that I would be fat all my life, and to get over it. Post-surgery my target weight was 61.5 kgs (135 lbs). That put me at the top of the normal weight range for my height. Frankly, I expected to continue to be a bit overweight. I would have been happy wearing a size 14, ecstatic with a size 12. I was blown away when I bought my first size 10 pants. In fact, I emphatically told the sales assistant, “I am NOT a size 10.”
Those pants have long since been taken in by Mum, and my wardrobe now mostly contains sizes 6, 8, and 10. So I have made it into single-digit sizes from sizes beyond the teens. The surgery has been wildly successful.
So how the hell am I going to keep the weight off?
I am well and truly in the middle of the healthy weight range for my height. I am 55 kgs and 1.57 metres tall (121 lbs and 5’2”). I’ve never been this weight, at least not as an adult. The lightest I ever remember being was about 58 kgs (128 lbs), and that was when I was about 14 years old, before I’d finished growing.
I dropped 10 kgs (22 lbs) before both my weddings, but inevitably put that on again, plus some. I was 62 kgs (136 lbs) on my first wedding day, and 80 kgs (176 lbs) on my second wedding day. I was 110 kgs (242 lbs) when I separated from my first husband, and about 72 kgs (158 lbs) when I met my second husband.
To say my weight has fluctuated over the years is an understatement of monumental proportions. The fact that I can quote my weight is testament to the significant role it plays in my life, or perhaps more realistically, how it has ruled my life.
And this final fact is the one that I have to acknowledge and accept.
The bottom line for me is that maintaining the weight I have attained is going to require work, and lots of it. I cannot afford to take my eye off the ball, not ever.
Do I sound like I live in fear?
Well, the fact is, I probably do. Fear of failure. Fear of being overweight again. HELL YES!!!
But it is not a fear that I intend to allow to ruin my life. I have just spent a wonderful weekend with my mum and my sister. We have drunk vodka and a couple of bottles of wine and eaten chips, chocolate, and ice cream.
Do I feel guilty? Of course not!
But am I going to be a little more vigilant, mindful of my food intake this week? Yes, I am.
Life should be about balance and moderation.
Mum, my sister, and I were a bit naughty this weekend. That much is certainly true. But we are not naughty every weekend.
Naughtiness, like everything else, should be taken in moderation.
And this week I will balance this naughty weekend with perhaps a good exercise regime, perhaps some moderation in my food intake, and I probably won’t have any wine (or vodka).
Am I beating myself up?
ABSOLUTELY NOT!
But I have tasted failure, and so I have to put measures in place to combat future failure.
One of those measures is my food journal. Two years after my surgery I still maintain a daily record of my food intake. I write down the time, what I ate, the calorie content, and the grams carbohydrates and protein. I also note my exercise and the steps I have walked on the pedometer I wear 24/7. This costs me perhaps 15 to 20 minutes per day.
Every Sunday morning I record my weight and body composition stats from my bathroom scales and I measure key parts of my body. I also report my weight to my husband and if I have gone outside our agreed weight range we discuss it.
Am I obsessive?
I don’t think so.
But I do know that keeping in shape is hard work. I once read an article about Hugh Jackman when he was preparing for one of the “X-men” movies. He was on some kind of diet that meant he had to fast for a number of hours and then carb-load. Obviously there was a good amount of weight training in there as well. His body in that movie was quite, mmmm, spectacular! I’ve seen Hugh Jackman live in “The boy from Oz”, and while he was gorgeous, he wasn’t that buff!
The point is, we have perfect bodies paraded in front of us every day, in the movies, on TV, in magazines. Perfection is not a natural state of being; that’s what body doubles and Photoshop are for. There is an unrealistic expectation that lean and buff is the default state.
IT ISN’T!
Like Hugh Jackman, those who have attained that state have done so through hard work; through tremendous sacrifice; and they can never stop if they want to maintain their perfect state. Those who haven’t attained that state have body doubles for the more revealing scenes if they are in the movies.
There is so much pressure on us now to attain perfection in our bodies. But we are human beings. We are imperfect!
The sooner we accept that, the better.
Does that mean we should allow ourselves to be obese?
It most definitely does not!
Obesity is the single largest health risk faced by our modern society. Obesity is related to so many chronic and acute disorders. Type 2 diabetes, for instance, is a ‘lifestyle’ disease. Mostly it can be avoided by maintaining healthy weight and regular exercise. Left untreated it can result in poor circulation resulting in poor blood flow to the extremities which can result, for instance, in having your feet amputated. It can also result in loss of eye sight, or death.
Obese people are also at higher risk of heart disease, and of elevated cholesterol levels that can lead to stroke, or even cancer.
Apart from all that, there is the additional strain that carrying extra weight can have on your body. In my case, for instance, I’ve led a fairly active life. I was obese when I climbed Mount Kilimanjaro, and I used to work in hospitality which meant I spent most of every day on my feet.
The result?
I have virtually no cartilage left in my right knee, and only a little more in my left knee. My specialist has told me that the only way I can avoid knee replacement surgery is to die, or to have my leg amputated.
It was my knees that ultimately spurred my decision to have bariatric surgery.
In 2012 I spent four weeks in Vietnam. In the first week I failed to climb Mount Phan Xi Pan. My friends went on ahead and summited while I turned around and went back down the mountain.
I was simply too fat!
In the final week of our holiday it was too painful to ride a pushbike around the canals and villages in the Mekong Delta, so I had to sit it out.
I was ashamed, and thoroughly disappointed.
And while my knees had always given me a bit of trouble, Vietnam was the proverbial ‘straw that broke the camel’s back’.
I went to my GP six months later and said, “My knees are really bad and I need to get them fixed. But I figure if I ride my pushbike over a road scattered with tacks and get a puncture, then I fix the puncture and ride back over the same road, I’ll get another puncture and I’ll be back where I started. So I want a referral to a Gastroenterologist.”
“OK”, she said, “But let’s also see what’s wrong with your knees.”
So she wrote me a referral to the gastro specialist and a request for X-rays on my knees.
I refer to my first conversation with my gastro elsewhere. That was pretty ugly, but it wasn’t as ugly as the pictures of my knees.
So nowadays I am about half the size I was in 1993, and over 40kgs lighter that I was on my 49th birthday in 2013. I’ve still got my own knees. But I go to the gym at least twice a week, trying to build my quad muscles so they can take the pressure off my knees.
I also walk every day, and hike most weekends. I’m hoping to remain active, trekking up and down mountains well into my 60s. My knee specialist tells me otherwise, but I’m stubborn, and I’m out to prove him wrong. I’m also hoping to avoid knee replacement surgery until I’m at least 60, another nine years. I’m less confident about that, but the younger and more active you are when you have a replacement, the shorter it is likely to last, so I need to delay the surgery as long as possible.
The fate of my knees was sealed by a lifetime of obesity. I don’t bother looking back with regret; what is done, is done. Instead I am looking forward to how I can spend a happy, healthy, and active life.
And I’ll do whatever it takes. The changes I have made need to be lifelong. That is going to require hard work and vigilance. If that means writing down everything I eat every day for the rest of my life, and weighing and measuring myself every Sunday until I am no longer able, then so be it.
It will be worth it!