WLS Journal Part 9: 11 Things NOT to Say to A WLS Patient

From the start of this journey I've experienced lots of different reactions from people when they find out that I've had surgery. Most of them are positive. There are a few that do not approve of the surgical option. A lot of people are just generally uncomfortable talking about someone else's weight problem. It's like they know you're heavy but hearing you say "I'm tired of being fat." mortifies them because you are almost literally addressing the elephant in the room. Anyway, along my journey I've had some comments that I found funny or hurtful and I thought I would share with you. 

Things NOT to say to a Weight Loss Surgery Patient.

1. "You look great. I hope you can keep it off this time." I know that sounds like something really nice to say. And it was a really nice thing... until you added the "this time" to it. Believe me, no one is more frustrated with my failed diet attempts up to this point than I am. I am quite aware of my past failures and yo-yo dieting. I know all too well what it has done to my body. I don't need you to be passive aggressive and remind me under the veil of a compliment. I'm not trying to be snotty but the "this time" sounds like you don't expect me to succeed and when I know that you don't expect it, it just hurts.
2.  "I would love to have the surgery but I can't make myself do it (or can't afford it, or am not brave enough). I guess I will have to lose my weight the hard way." Really? Because having a major operation where they remove 80% of my stomach sounds easy to you? Because I recognize that my eating disorder was so severe that the only option to help save my life was to have to physically alter my anatomy to the point that I could hurt myself if I overeat? That sounds easy to you? I will be the first to admit that the weight has come off faster and steadier than any diet I've ever tried. It hasn't been as hard for me as it is for some people. I have friends that vomit every single day because their new stomach is super sensitive. There is a lady in a support group that I'm a member of that has to be tube fed now because she had a bad surgeon and started leaking after surgery. She nearly died. I cried the night before because I was worried something would go wrong and I wouldn't see my kids again. It was never an easy decision. It was the hardest most prayed over decision I have made about my health. It's been a hard journey retraining my mental game with food. It's been hard to get up and work out on days that I don't feel like it. It's been hard to go out to eat and really want to finish a meal but not being physically able to. It's a constant battle with my mind over what it wants versus what my body can have. I've been lucky that my outcomes have been so good so far, but easy is not a word that I would use to describe it. 
3. "How much weight have you lost?(insert my reply) "That's amazing, how much more do you want to lose?" Just ask me how much I weighed before surgery. You know you want to. I don't mind telling you. I'll tell the world. I have to own up to how big I once was so that I will never get to that point again. But when you don't ask directly... when I can see you adding the numbers I tell you up in your head it's uncomfortable. It's a little funny to me too, because I'm one person that doesn't hold any of that back. I'm sure there are others that do feel ashamed of their high weight and for this reason, just don't follow up with the second question. 
4. "You look so pretty now!" Thanks. I'm sorry I was such a fat ugly troll before. (honestly, I don't think that every time but on a snarky day I do.) Once again the solution is to just stop talking. Don't add the "now". Just leave it at "you look so pretty" and we are both happy.
5. "I would have surgery but I just like food too much." Because I got to 334 pounds because I hate food? And it's not like I can't have food anymore. I still get to eat. I just am learning to eat like a normal person eats. It's that simple. We all like food too much, that's why so many adults are obese now. 
6. "Be careful which doctor you choose, my _____ had that surgery and she died." This is mainly for the pre-op stage. Yes this surgery can be dangerous (see #2). But for me, I always ask follow up questions to the so-and-so died story. First, I ask when she had surgery... it's usually pre-1985. Old school, open gastric bypass. That was over 30 years ago. Doctors still smoked in the hallways of hospitals in 1985. The gastric bypass surgery of 1985 was totally different than the surgery today. And I'm not even having gastric bypass. Then I have to go into how my surgery is different. And usually this isn't even from someone that I know. This is the type warning I get from a lady that notices I'm buying protein shakes in Wal-Mart and feels led to warn me about aunt Eunice that had a bad bypass in 1983. Now, don't get me wrong. I extensively researched this surgery. I researched my doctor, and the hospital that he used. I knew every symptom of every possible complication. I put my nurse brain to work and I was prepared. I was probably more prepared than the average patient but that's just because of my medical knowledge. Regardless, I know people die of complications of surgery, but just because a friend of a friend of yours had a bad outcome does not mean that everyone else will.
7. "Are you gonna trade your husband in for a new one when you get skinny?" This one really made me laugh. The answer is no. No other words for this one... just no.
8. "Did you ever try diet and exercise before?" You mean I could have dieted and lost weight? I never knew? Why didn't you tell me that before I let that crazy doctor cut my stomach out? ........ Are you kidding me? Stop.
9. "What do you eat? (Usually followed by "well I might just try to eat exactly that and see how much I lose")" Go for it. I mean if I could have stuck to my tiny portion sizes before I might not have been in the mess I was. I struggle to get 800 calories a day, even with nutritional supplements added in. It's not a diet for the faint of heart. I don't know many that could stick with this regimen without the physical restriction that surgery provides. Go for it and let me know if you still think this is an easy way out. 
10. "Better not gain it all back." I'm so glad you told me that because that was exactly what I was planning to do. If it hadn't been for your warning, I was gonna pack every pound back on. Thank you for warning me! I don't know what I would do without friends like you........ Come. ON. 
11. "Are you supposed to eat that?" This one is tricky. I don't mind if my husband tells me this as I pop a chip in my mouth. He's in this with me. He is keeping me grounded and on track. But when I have one tiny smidge of pie on my plate and some one at the party that knows I've had surgery, but doesn't really know me that well says it? That's a different story. I'm not telling you what to eat. What gives you the idea that you have the right to tell me? 

I know there are probably other things that I could add to this list, but you see my point. As I said before, there has been so much encouragement in my life these days. It almost makes it easier to pick out the things that bug me because I've heard so little of these. If you have someone in your life that is considering this surgery just be there for them. Offer your support. Ask them gently if they want to talk about their fears and their hopes. Compliments are always appreciated just be sure to keep your own doubts and judgements from showing through. I can't speak for everyone but I can assure you that this is one of the most emotional and rewarding journeys of my life. I'm loving the changes that I'm seeing but I'm mourning the loss of my old coping mechanisms. It helps to hear encouraging words. It's also really helpful to have a sense of humor and I hope that some of that shows through the list above. Thanks for reading! If you are a WLS patient I would love to hear some personal stories of your own encounters in the comments!

Don't Fake It Til You Make It!

Fake it 'til you make it. 

These were the battle cries of my nursing education. In many cases they worked. I could convince people that I was equally convinced of certain patients' diagnoses. I could often say I was efficient in IV Initiaton and then "try three times and out." It worked up until I was successful in starting one. Honestly, IV's didn't take that long. I was trained and prepared for those.

Unfortunately, the "fake it til you make it" philosophy would only get you so far. Eventually, you HAD to make it. There was NO more faking it after a certain point. I assume this point was different for each nurse. I remember well when mine was.

I had a fifty something female surgical patient. I had been nursing on the med surge floor for about a year at this point and I felt completely sure of my self. My patient was ordered a foley catheter as part of her AM surgical prep. I confidently secured the catheter kit from the supply room. I took it to the patients bedside.
 at 5am I woke the patient and confidently explained what was about to happen to her. I walked out feeling 100% sure that I could accomplish my goal. I was a registered nurse now. School was in my past. So what if I had never started a catheter on a female. It was something a nurse should know how to do. No need to be nervous.

I went into my patients room and brought a CNA with me. I told her what we were there to do and I confidently swept her bedsheets back. She spread her legs as instructed and I opened my catheter kit as i was trained. I prepared her sterile field and I froze. I took the catheter out of the box and contemplated where I could put it. The patient tried to help, she really did but I was too proud to accept any help. I insisted that I knew what I was doing. I was determined to fake it until I made it.

Unfortunately for the patient, my stubbornness ended up in a couple of unsuccessful catheter attempts. I had to eat crow and ask the oncoming day-shift nurse for assistance. She was a seasoned nurse and after one look at the patients' chart she looked at me and said, "come on then, I'm not doing this on my own." We went in and this seasoned nurse explained to me, step by step, what she was doing, and why she was doing it, and where she was putting things. I watched, amazed, and saw my first ever female urinary catherization.

"Fake it til you make it" is a phrase that's widely used in many technical college programs. I'm sure that, as it was proved with me, eventually you will have to MAKE it. The phrase says you will. I was unprepared in my moment of making it. I don't blame it on poor teaching, I had some of the best in the state. I blame it on my own lack of preparedness. I wasn't ready to make it. 

More importantly, I wasn't ready to admit that I needed help. I needed to admit that I wasn't able to "fake" it anymore. It was the worst thing that any graduate nurse had to do. I had to humble myself to the mercy of the seasoned older nurse. I had to let her teach me. After that incident I never had to ask anyone to help me cath again. In fact, I became the nurse people called to help out when they couldn't cath a patient.

So this got me to thinking about a couple of things.....

1) "Fake it till you make it doesn't work with God" It didn't work with my senior nurse, It's not gonna work with God. He knows what our works mean. No matter how many good works we do, If we aren't doing it because we trust in Jesus then our works don't matter. There is no such thing as faking it til you make it for salvation. Faking it means an eternity in hell. We all know you don't want that. Please contact me to find out how to find salvation.

2) Don't be afraid to ask for help! I'm sure that my patient would have loved me a whole lot more had I stopped prodding her with that 14fr foley and asked a more competent nurse for help!! Instead of putting her care first, I put my pride first and refused to ask for help until the absolute last minute. I even blamed my failure on the patient and pretended that it was somehow her fault that I couldn't get the cath. If I had asked for help from the beginning I would have learned to trust my mentors on my own shift. I would have learned that I was not the only one that didn't know EVERYthing from the get-go. I would have learned the importance of asking for help before my patient suffered. Same thing in my Christian life. If I had asked for help when I knew I was failing, instead of relying on my own merits to get me out of trouble; I would have come to understand God's unfailing forgiveness and his own sacrifice through His son Jesus. I would have known, sooner, that I could learn from my mistakes, and even better, I could be forgiven for my failures...... and that was the greatest lesson of all.