Flying to the Summit

In the world of weight loss, particularly in the world of online weight-loss support among peers, there is much talk about NSVs, or non-scale victories. NSVs are the things you cling to when the scale just isn't moving, successes like, "My jeans are too loose," or "An old friend didn't recognize me at the grocery store." You would imagine that bariatric surgery patients, like myself, wouldn't need to focus on these, as our excess weight would simply pour off continually, without fail, due to our minuscule dietary intake. That isn't the norm, however. For me, while the overall trajectory has been weight loss, I have had weeks at a time when the scale does not budge. This morning, for instance, I lost a couple of pounds for the first time in at least two weeks. I wasn't slacking off while the scale stayed still; nothing I did this week with my diet and exercise is any different than anything I did the week before, or the week before that. During those lulls at the scales, NSVs have become an important focus.

I've written before about how my life felt restricted before my vertical sleeve gastrectomy—not only did I know that obesity would kill me, it was physically and psychologically hurting me every day. While I still am overweight, and have a long way to go, taking 85 pounds off of my frame has had a tremendously positive influence on my overall well-being. NSVs for me include, but are not limited to:

1. Not constantly worrying about fitting in seats at restaurants, theaters, etc., making me reluctant to go out and enjoy life
2. Not waking up in the morning with back/knee/ankle/arm/neck pain
3. Not being restricted to my orthopedic mattress (which is now in storage with the rest of our stuff, pending our upcoming move) because sleeping on anything else caused agonizing back pain by 3:00 a.m.
4. Not panicking when I have to shop because I am inching out of the highest sizes typically sold, even in plus-size shops
5. Fitting comfortably in a queen-size bed with my husband (who lifts weights, and is very broad in the shoulders—only one of us can take up extra space if we are going to sleep peacefully!)
6. Not wondering if the first thing people think when they see me is, "Wow, she has gotten bigger."

At Christmas, my husband capitalized on the first NSV mentioned above, giving me tickets to see Carousel this spring as my present. To quote him, when he gave me the present, "I know you love the theater, and have avoided going to see shows for a long time because you aren't comfortable in the seats. I thought that, by April when the show is on, you would be able to go and fit in a seat without worry." Two weeks ago, we went to see the show at the Chicago Lyric Opera, and it was fantastic. I was so giddy when I sat down and fit beautifully in the seat, I actually started to cry. We took a selfie to commemorate the moment.

I am grateful for all the weight-loss wins that led up to that moment, and tomorrow, I am excited that I will catapult over another previous hurdle, in what will likely the be the pièce de résistance of NSVs. Tomorrow, I am flying, alone, to the Mom 2.0 Summit.

I cannot recall a time in the last decade when I have flown alone. Once EJ was born, and my weight started to really pile on, I just didn't feel safe flying on my own, sitting next to strangers, worried about spilling out into their space, not being able to put my arm rest or tray table down all the way, and asking for a seat belt extender. Then, in 2010, there was the whole Kevin Smith/Southwest debacle, in which he was escorted off the plane because he was too big for his seat. I mean, if a famous movie director could be told he was too fat to fly, I was certainly not going to get any special treatment. I love Southwest, and continued to fly it when traveling with my daughter and husband, borrowing space from my child within our family row. In my mind, though, in 2010, a door slammed shut for me: as long as I was obese, I could not fly on my own.

It was convenient that, during this time, our family was grad-school poor. It was easy to justify not spending money to attend conferences, visit friends, or to pursue work possibilities on our own travel dime. Heck, we didn't have money for essentials, why on earth would I book unnecessary flights?

For someone like me, who loves to travel, loves to meet new people, loves to explore the world, swallowing the reality that I could not go where I wanted to go (and do what I wanted to do, Mama Cass-style) was too painful to think about. I didn't face it, fully. I imagined travel for another time and place in my life, unsure of when that would (or could) happen.

Tomorrow, it is happening. I am flying to Phoenix. Alone. To a conference that is suited just for me, to meet new friends and learn new things. To feel the sunshine, and go swimming in fancy hotel pools in my plus-size bathing suit. To visit with family I love. To test out the new freedom that comes with being in a body that, while still heavy, is reasonably proportioned and not extraordinarily difficult to haul around.

I have to give a shout-out here to my friend, Kate, whom I met last year at another blogging conference—one in which I flew out with my entire family, and attended with a close friend—for tipping me off about the sold-out Mom 2.0 Summit, and helping me to get in touch with another blogger who was hoping to transfer her ticket and hotel reservation because she could no longer attend. Having someone cheer me on through the process made me feel like I could actually do this. 

The conference's opening party theme, "Rise of the Phoenix," is not just a metaphor for me; I feel like I have been through a fire, and am reemerging, ready to fly again. To my fellow passengers tomorrow, please excuse the inevitable tears of joy at take-off. To my fellow conference attendees, get ready to meet the most grateful participant at a blogging conference you have met in years.

Sweet Sixteen, Four Months

December 16th—April 16th

Over 82 pounds down, fresh from a walk to pick the kiddo up from school, in a shirt she picked out for me two sizes smaller than what I wore the day of surgery. "Believe in your selfie," indeed. If I had not have believed in that gal taking the selfie on December 16th, I would be here right now.

As always, thanks to everyone for the outpouring of love, encouragement, and support. I still have a long way to go, and I'm very grateful to be doing it with all this great company.

Sweet Sixteen, Three Months

December 16th—March 16th

Seventy pounds down, feeling healthier, walking further, eating lighter, drinking sippier (I know, it isn't a word, but it should be), and generally being Kori a lot more happily.

Sweet Sixteen, Two Months

December 16th—January 16th—February 16th

Or, for full photo comparison, from surgery day to today:

I purchased the pants I'm wearing in today's photo last week while on vacation, one size lower than those I wore on my surgery date. They didn't quite fit when I bought them, but they were such a steal, and the pants I was wearing at the time were becoming so loose, I had to get them. Today, they fit just fine. Nutty. 56.4 pounds lost. I'm still hippy, but hey, you can't have everything. 

Today's non-selfie photo credit goes to the kiddo. 

Surgery Recap Series, Post #2—Getting There, Getting It Done

(This post is the second in a series about my vertical sleeve gastrectomy, performed on December 16th, 2014. To find out about my pre-op physician selection, you can read my first post here.)

My first in-person consultation with my physician was on the Monday before Thanksgiving. At that time, I was weighed, measured and photographed, and I must admit that I felt a bit like I was being prepared for showing at the county fair. My physician asked me if I was at my highest weight, and although I had measured three pounds down from my very highest, I said yes, speaking generally. He told me that that is a red flag, and he would expect me to have lost weight before I came in for surgery, three weeks later. If I came back the same weight, or heavier, he would not perform surgery at that time.

I immediately regretted not replying, "Oh, no, I was three pounds heavier earlier this month!" If you want to scare a fat person, tell them that they have a limited amount of time in which they must prove they have lost weight. My brain was screaming, "If I thought I could lose weight, I wouldn't be here!" 

I didn't worry about starting my pre-op, liver-shrinking diet until two weeks before my surgery, as recommended, which allowed me to eat normally on Thanksgiving later that week. Did I eat as much as I might have if didn't know I had to lose weight by the 16th? Nope. I was moderate in my choices, and gained no holiday pounds, thankfully.

There is talk among the bariatric surgery community about "food funerals," opportunities to really eat those foods that you absolutely adore, but are terrible for you, before you may be unable to eat them again. I held no funerals. I didn't feel compelled. It wasn't an act of heroism, it was primarily a laser focus on my goal of being surgery ready by my surgery date.

In the end, I needn't have worried about the doctor's warning. Once provided with the nutritionist's recommendations for a pre-op diet, created specifically to shrink a pre-fatty liver (which, as an obese person, I was already the proud owner of), I found that the pounds started to fall off. The first two days were tortuous: no sugar, no carbs, and no caffeine, all at once. I called the nutritionist in desperation, I was so hungry. She told me to go ahead and add a lot more lean carbohydrates and good fats. By day four, I had figured out a decent protein shake recipe, and was cruising along.

In fact, about a week before the surgery, I started to have doubts about even moving forward with the operation. If I could lose weight so quickly, why would I get cut open?

It was at this point I had a lot of tears, doubt, and self-examination. I began to remember that I have lost weight quickly like this many, many times before. In the end, I always ended up gaining the weight back, plus more. I sought reassurance from family, friends, and other gastric sleeve patients I had met online. I told myself, "If you show up that day, and it doesn't feel right, you don't have to have surgery," all while continuing to prepare.

Thankfully, I was soon in the thick of our daughter's Nutcracker ballet performances—getting her ready, doing her super-sticky-will-not-fall bun several times a day, and volunteering in the front of house during performances we did not attend. It was exactly as I hoped: between being busy, hosting relatives coming into town to see EJ perform, and getting repeatedly covered in hair gel, I didn't have a moment to worry about the upcoming surgery. I mean, look at this kid—how could you worry about anything when you get to watch this kid dance, right?

On the evening of Sunday the 14th, two days before surgery, I started to make piles of everything we needed to take with us to Michigan. A Magic Bullet blender, protein powder, sugar-free jellos and puddings, homemade broth frozen into ice cubes, the Aeropress coffee maker and Colectivo coffee (decaf for me, regular for Mike), GasX strips and Milk of Magnesia, bottles of grape-flavored Isopure clear liquid, and comfy pajamas and slippers for lounging around were all sorted, and various coolers and ice packs were set up for early morning packing.

My folks had agreed to come with us for the surgery, which was a huge blessing. After I was discharged, they would return to Chicago with the kiddo, get her to school and activities, etc., then bring her (and our dog) up to their place in Wisconsin for a fun weekend with family, while I recuperated in Michigan with Mike, waiting for my one-week post-op appointment. It made our daughter very relieved to know that she could be at the hospital to visit me, and it made me very relieved to know my parents would be there for support.

Early on Monday the 15th, we were all packed in two cars and heading out. Mike and I stopped for gas, while my folks went through the adjacent McDonald's drive through to get everyone but me some breakfast. As it was the day before surgery, I was on clear liquids, only, so I had a bottle of water and a bottle of Isopure for the road. EJ decided to go with her grandparents (smart kid), so I drove Mike and I there, knowing I wouldn't be able to drive for several weeks after surgery. We listened to an audiobook, chatted, and generally had a relaxing time. Once in Michigan, we checked into our Residence Inn, loaded up our mini-kitchen, then headed right to my pre-op appointment with Dr. Pleatman.

Fancy, right?

Because I had come earlier, I did not need to attend nutritional or informational sessions with the staff, which were being held for other surgical patients that week. Mike met my doctor, though, and we discussed my concern about having the smallest recommended bougie (size 32) used for my surgery.

In a gastric sleeve, a tube called a bougie (bougie means candle in French, to give you a visual) is placed down your throat and positioned in your stomach, making a guide for the staple line that removes your excess stomach. Dr. Pleatman favors the the smallest bougie recommended, a 32, in his procedures. I was worried about that, though, as I have had years of GERD, and a smaller-sized stomach is indicated in increased post-op acid reflux. Mike and I had read research stating that bougie size did not matter for long-term weight loss outcomes (comparing 32 to 40, and 32 to 36), but using smaller bougies could increase patient discomfort and short-term complications.

After our appointment, I left, having agreed to the 32, but once in the car, I started crying. Even though the difference between a 32 and a 36 is only a matter of millimeters, I didn't want the smallest pouch. My doctor, who I trusted, felt it was best, based on his patient outcomes, but I just couldn't feel good about it. Mike and I drove to a nearby soup restaurant, where they painstakingly attempted to strain out all bits of vegetables from a broth for me, and I started to obsess about this issue. This was the absolute, most difficult moment for me in the pre-op process, and it was less than 24 hours before surgery. If I didn't trust my surgeon, I wouldn't have picked him; at the same, time my gut (metaphorically and physically) couldn't get on board.

God bless my husband, who said, "Let's go back to the office right now," as soon as we finished lunch. We did. We asked to see the surgeon again, and even before I reiterated my concerns, he volunteered something like, "Why don't I just use a 36 bougie. It's fine. It's your stomach, you need to be happy with this."

At that moment, I was completely relieved, and completely ready for surgery. I'm sure you could see the stress lift off my face. I knew I was doing the right thing, and had picked the right doctor.

We went back to the hotel, where we rejoined my folks and kid. There was swimming in the pool, talking to friends on the phone wishing me well, and Christmas manicures for my mom and daughter with the new Jamberry nails I had purchased. Yes, I gave out manicures the night before surgery, and it was terrific! The family time was perfect, and it kept my mind off feeling hungry.

I then did the (gross, unfortunate, necessary) Milk of Magnesia pre-surgery prep, let that do its work, and headed to bed. Before falling asleep, I had a mental conversation with my grandparents, who are deceased. Granddaddy was a doctor, and Grammy was a doctor's wife (so practically a doctor, as we all were repeatedly told.) I asked that, if they could come around tomorrow, be in the room with me, be with the doctors and nurses caring for me, I would really appreciate it.

I woke up feeling calm and happy. My original surgery time was scheduled for mid-afternoon, but I had learned the day before at my appointment that it had been moved up, and I should plan to arrive at the hospital around 11:30 a.m. I had a lazy morning, not eating or drinking anything as requested, just hanging out with Mike and monitoring the comings and goings of our kiddo with my folks in the room across the hall.  I took a photo of myself in my pajamas, for a last "before" picture.

I got into the shower around 9:30 a.m., and it was at this time that we got the call that surgeries were running ahead of schedule, and I could arrive as soon as possible. With hair still wet, I kissed and hugged EJ and my dad goodbye, then Mom, Mike and I headed to the hospital.

What happened next is a little bit of magic, if you ask me. As we walked to the surgical wing, Mom and I noticed the name of the unit I would be on: Gustafson. Gustafson was my Grammy's maiden name. I had come all this way, picking this surgeon and hospital from options all over North America, and this is where I had ended up, in Grammy's wing. To me, this was just one more little confirmation that I was in the right place doing the right thing, although others might call it simply coincidence. I knew Grammy and Granddaddy were watching out for me. We stopped to take a picture on the way to check-in to honor the moment.

Registration didn't take long, and before I knew it, I was in a gown being prepped. At this point, we realized that, in our haste to leave the hotel, I had forgotten my CPAP machine. Mike had to run back to get it—the hotel wasn't that far away, but I was worried he wouldn't make it in time for me to see him before getting wheeled back. That was my only worry before surgery, and it was a good distraction from any pre-op nervousness that could have formed. My surgeon came in to see me, and confirmed that he was using a 36 bougie. I thanked him. My nurses were terrific—the lady who weighed me said, "I know, this is everyone's least favorite part," but I was actually thrilled to see my before number right before surgery. As it turned out, I was 23 pounds down from my highest weight, 20 since starting the pre-op diet. Both nurses cheered with me, then a PA came in, heard my news from the nurses, and got on board with the encouragement. My IV was started, after I explained that the IV I had in my hand for Ellerie's birth had become swollen and painful, the nurse said, "I hate putting them in the hand, for that exact reason," then nearly painlessly put one into my forearm.

Mike and Mom came back about ten minutes before I was wheeled into surgery, with plenty of time for us to share hugs, and for them to be there when the anesthesiologist walked me through what she would be doing to keep me asleep and comfortable. They also took a goofy pre-surgery photo for me—specifically requested by EJ—a tradition of ours starting back to when my dad had surgery a few years ago, and he posed in a silly way right before his anesthesia kicked in.

Dad and Mom are better at it, as you can see here, but I did my best.

Once wheeled back, I don't remember much. I remember seeing the surgical lights, which looked like a giant, glowing lotus flower. I also remember the nurses bragging about my progress to the surgical crew. According to Mike and Mom, a nurse came out 30 minutes later to tell them the surgery was going well, and a little after the hour mark, my surgeon came out and showed them my inflated, removed stomach (a test that shows that there are no leaks internally, which both of my anatomy-geek relatives loved), as well as the bougie he used. He also told them that I had done a great job shrinking up my liver on the pre-op diet, making the surgery easier to perform, as it was quite small.

For my part, my first thoughts and feelings when awaking from surgery weren't quite as rosy. I had just been cut open, of course, so that is pretty reasonable. Want to hear more about it? Stay tuned for the final installment of my surgery re-cap, coming soon.

The Screwed Uped-ness of the Thinking

It amazes me that I have been following this sparse diet for weeks, healing from surgery, following the letter of the law as my doctor and nutritionist have recommended, losing weight throughout it all, and yet, I can still worry fervently that this surgery is not working.

I have been around the same weight for a week now, hovering between 43 and 45 pounds lost. It is a stall, I guess, but I don't know how much it counts, given that I lost over 6 pounds the week that I had stomach flu. Even so, even if I hadn't lost a pound when I was sick, and I was still stalling here, it would be completely normal. There is no need to worry. 43 to 45 pounds is a lot of weight to drop, and my body needs time to adjust.

My doctor's materials make all kinds of notes not to weigh yourself too often, or to worry about the results. "Just do the work, and let the results follow."

Huh.

I have one more day, officially, of the soft solid diet, and then on Wednesday, I am cleared to have at it. Try new things. Go crazy and eat something crunchy, for instance. Even with soft foods, I am inching my way to my new normal. Today, I had a lean breakfast sandwich: multigrain bread, egg white, chicken and apple sausage, and a bit of cheese. The whole thing was really perfect, split in half and eaten for two meals, because I couldn't get more than a few bites down at a sitting. Two hundred calories, with 16 grams of protein. By all accounts, a great choice.

And yet, there I was, thinking, "Oh, no. This is bread. I haven't had bread in over eight weeks. What on earth am I doing?!? Now I'm going to start having wild food cravings. Tomorrow I'm going to have gained five pounds."

That, my friends, is the screwed uped-ness of the thinking, the obese mind trying to make sense of the obese-but-forcibly-losing-weight body.

I simply can't fully believe this is working. I think I'm afraid to hope, and a part of my brain is saying, "Hey, 40+ pounds, look at that! Not ideal, but you can live this way. You feel so much better. If you do everything right, and it just doesn't work, this will be just fine."

It's meant to be helpful coping thinking, I'm sure, but it leaves me feeling afraid; afraid to move to a regular diet, afraid to reintroduce any complex carbohydrates (lest I interrupt the weight-loss machine that has been my body lately), afraid to be part of the 1-5% for whom this surgery isn't effective.

Screwed uped-ness lives.

It has been so long since I have really lost weight, significantly, it just seems impossible that the consistent weight-gaining pattern of (almost) my entire adult life could end. No amount of my work or dedication on my part can completely shake this feeling, and the more normal my diet and life becomes post-surgery, the more I think, "Somehow, this is going to end."

Even worse, I think, "Somehow, this is going to end, and it is going to be my fault."

I know, rationally, that something about my body helped to trigger or fuel my obesity, beyond my behaviors or choices. It was never all my fault, as if fault should even be assigned in such a matter. I know that all the shame that I have felt as an adult for being obese—primarily because I assumed all thin people I encountered thought me lazy and gluttonous—was pointless, and only made the problem worse. If I didn't think that I needed a medical intervention in order to treat this, I wouldn't have pursued one, and the results of this intervention are clear: you can't eat much, you aren't hungry much, you lose weight, end of story. All that said, old thinking patterns—even ones that I have worked hard to address—can still strong-arm the new thoughts, the ones that only began to take root in December, as I witnessed my pre-op diet work effectively. 

Is this working? I can't know. I can only do what I'm supposed to do. I can only move forward. It would be shocking if it wasn't working, practically speaking, but to my brain, it is shocking that it even could.

Do you have your own screwed uped-ness of the thinking, those patterns of thought which remain indentured from an older version of yourself, but that don't match your current life? I can't imagine that the obese have the whole market on this. If so, come join the evolution, where we see the old thinking, recognize it for what it is, and kindly tell it that is doesn't work anymore...over, and over, and over.

Surgery Recap Series, Post #1—Pre-Surgery Week: Deciding Where to Go

For those who are regular blog readers, and specifically momblog or dadblog readers, today's entry might feel vaguely familiar. This post begins a series, which will effectively be my surgical equivalent of "the birth story," the often anticipated post after a parentblogger has been writing about an upcoming birth for months, and then sinks into the black hole of exhausting infant care, and is unable to post the actual details of the birth for a few weeks.

It took me FOREVER to post a birth story after having EJ, mainly because the birth was so darn horrific, way beyond the norm (as if the norm isn't just a freak show to start), and I just couldn't get pen to paper, so to speak. I didn't even want to think about it, and I certainly didn't want to scare anyone else. I believe what I wrote was pretty cursory, and within the following years, my blog revealed more details of the event as they were germane to new thoughts and feelings.

But, hey, here's the good news, readers! For those of you who are interested in what my experience of receiving a vertical sleeve gastrectomy was like, I can tell you this: it was MUCH better than birth! Maybe 10,000 times better? That sounds about right. Of course, I didn't get an adorable baby out of it, but I sure am sleeping better than I did when I came home with a baby.

So, for those who have been interested, here is the first in a series in which I flip back in time just over a month, and give my play-by-play account of my surgery experience. For those interested in this same surgery, and who may have questions, feel free to leave a comment with your contact info, and we can chat directly.

Pre-Surgery Week: Deciding Where to Go

After several years of research, attending informational sessions, and going back and forth with our insurance company, we got the final word that there would be no way that my surgery could be covered via insurance.

THIS IS A MAJOR SCAM. Obesity kills people, and bariatric surgery shows the most promising outcomes for helping to combat obesity, in conjunction with health behavior changes. I could go on and on about the silliness of all this, but suffice it to say, this isn't cosmetic surgery, and I hope that insurers stop thinking of it as an expensive elective soon.

At that point, I knew I would not be able to have the surgery here in Chicago, as the local (amazing) hospitals did not have a fixed, set rate for the surgery, which meant that I could pay as much as $55K once all the costs were covered. I felt pretty despondent, but after reaching out online to communities of people who were having/had recently had vertical sleeve gastrectomy, I discovered that affordable options were available if you were willing to travel.

For those in America and Canada who want to self-pay for surgery, the main affordable option is Tijuana, Mexico. For a set price (minus airfare), you can fly to San Diego, get picked up at the airport, brought to the hospital, receive surgery, get put up in a hotel after you are discharged, then brought back to the airport 2-3 days later. I had heard rave reviews online, and began calling different practices to determine who might be best.

Here's where things got complicated. There is an entire world of marketing and competition that happens in this industry, and surgeons have coordinators and staff members specifically hired to encourage you to use their practice, and to avoid others. Some folks had nothing negative to say about other doctors, others used vague jabs and innuendo to let you know other doctors were really not as safe, and a few basically called out others as butchers or hacks.

I found this entire process very difficult to swallow. I talked to some really great coordinators and some very thoughtful surgeons, and I know (through meeting others online who have had surgery in Mexico), that many of these doctors have excellent outcomes. Still, though, as an intuitive, it was hard for me to decipher through the propaganda to figure out who was best in this market. In addition, different doctors had wildly differing techniques, none of which I could verify as best practice through my own research.

It occurred to me around this time that, for general surgery, if you have a great local referral and good insurance coverage, you likely wouldn't ask so many technique questions. There was something about having to seek out providers, and having it completely in my own purview to make the decision, that brought me straight back to my days as a health care researcher. I simply could not get enough information. The problem: the more information I received, the less clear I was about my choice.

Throughout this entire discovery time, I posted my insights on Facebook, and got a lot of feedback from friends who work in health care. One of my former colleagues (when I was a health care researcher), who went on to become a registered nurse, reminded me to think volumes. Every surgeon can have complications: sometimes the best surgeons have higher complication rates, actually, because they work on the trickiest cases and/or the sickest people; volumes are the key to becoming an expert technician. It was nice to have my memory jogged about such an important point, especially as I was sifting through varying reports of outcomes for different surgeons via phones calls and online searches.

Around this time, I went back to a post I had made on a sleeve community forum, asking for self-pay physician referrals, and remembered that someone had recommended a surgeon in Michigan, only four hours away. I had also found a different self-pay doc in Michigan, one who has a terrific series of videos about obesity, the surgical options, and healthy eating/exercise.  

The first doc, Dr. Pleatman, was described as an excellent surgeon, but not the best interpersonally. The second, Dr. Weiner, was so engaging on screen, I wanted to find out more.

I made appointments with both, and was happy that, unlike with Mexico, I could meet these surgeons in person, not just online. I hit it off immediately with Dr. Pleatman's coordinator/receptionist, Cari. She was friendly, personable, and not the least bit a salesperson. She's a great ambassador for his practice. She also warned me that the doctor is not very "touchy-feely," or something like that, which was consistent with what I had heard from his previous patient. That's not why we hire surgeons, of course, so I wasn't deterred. When I called the second doctor, they were hesitant to book me, as I wasn't local, and had to get specialized approval.

Dr. Pleatman called me the evening I first spoke to his office, and I found him extremely personable. I was surprised I had heard otherwise. He was patient, went through my medical history on the phone, and made me feel hopeful.

A few weeks later, I travelled to Michigan, stayed with my aunt and uncle, who made me delicious meals and fancy cappuccinos, and interviewed both doctors on a whirlwind day.

In the end, I chose Dr. Pleatman, for a variety of reasons, and I am so glad I did. While surgery in Michigan is twice the cost as surgery in Mexico, it was one-fifth the cost of surgery here, so still a bargain. While I highly recommend Dr. Weiner's videos—truly, if you want to understand obesity, how this surgery works, what kind of diet is best, etc., he is your guy, and I am so grateful for what I learned from him via these videos—the main reasons for choosing Dr. Pleatman were, as follows:

1. Volumes: Dr. Pleatman had performed at least 3 times as many surgeries, and that is just within recent years; beyond comparison between the two surgeons, specifically, his volumes are excellent (with a low complication rate, too.)
2. Facility: The hospital at which Dr. Pleatman performs surgery was fantastic, and when you come from out of town, and don't know hospital reputations from local chatter, it is nice to find such a modern, well-equipped, and quite frankly, aesthetically lovely place to have surgery waiting for you. My aunt in Detroit, who is a nurse, liked that it was a part of the Catholic health system there, which she recommended. I like a nurse's approval!
3. Out-of-Town Accommodations: From material on their (robust) website to the services provided at in-person visits, Dr. Pleatman's practice has everything worked out to ease this process for out-of-town patients. I got a special rate at a hotel just minutes from the office and the hospital that had a kitchenette (to make eating my specialized food easier), and received an hour-long consultation with both the nutritionist and the patient-care coordinator, with accompanying reference materials, diet plans, exercise plans, and dates to remember to take home.
4. Trust: I trusted him, from the start. I realize this is intangible, but it may be the most important factor of all.

(There are a few additional reasons why I made the decision I did, and if you are someone considering this surgery with either physician, I would be happy to share my insights, privately. For public consumption, this is all I want to share.)

Once home, I began the process of ordering protein powders and vitamins, and starting my two-week pre-op, liver shrinking diet. I received great online support from Dr. Pleatman's nutritionist during this time, and the results were terrific. 

Interested in more? Stay tuned for more on my beautifully-small liver and my actual surgery!