This is the third in a series of I-still-have-no-idea-how-many parts about a gastric bypass operation that I underwent in 2006. To read the first part, click here and to read the second part, click here.
Monday morning before I could call Dr. Preston's office for what I hoped would be a same-day appointment, he called me. He said, "Dr. Bush tells me you're ready to discuss Gastric Bypass Surgery. I'm booked solid with patients all day. The only time I'm not is an hour for lunch…so let's have lunch." We had lunch and I asked him about the "odds" I'd been hearing about G.B.S. leading to complications and even death.
He said, "Forget about those numbers. First off, with a lot of the people who are having the surgery, it's like a last, desperate roll of the dice. They're 68, they're three hundred pounds or more, they have bad hearts and a dozen other things wrong with them."
And he had a story. That was one of the great things about Dr. Preston. Hw always had a story. This one about a patient whose case he was familiar with, a man who had died following the surgery. "He had like a 5% chance of survival if he didn't have the surgery. You can't compare the stats on people like that to you. You're ten years younger than he was, your heart is in great shape and so is your liver and just about everything else. You're in excellent health except for the fact that you need to lose a hundred or more pounds."
He went on: "This surgery is relatively new and there might be some surgeons doing it who maybe don't have enough experience. I'm not going to let you go to one of them. There are several in town who are terrific at it." He mentioned a few names — one was the doctor who did Alice Maltin's surgery — and he singled out one in particular. Again, I am changing names here. The surgeon he thought was the absolute best is a man I'm calling Dr. Perfect. That's what his track record to date was: Perfect.
But Dr. Perfect was not totally perfect for my needs. His services were in such demand that he had a wait list of at least two years. "I don't want to wait two years," I told Dr. Preston, to which he replied, "You won't. Dr. Perfect owes me a couple of favors and I bet I can get you moved way up on his list. Besides, this is not something you just go in and do next week. There's a whole process you have to go through and qualify before he'll operate on you and it could take months." I made the decision to start the process and it did indeed take months — and more than a few of them.
I had to have all sorts of check-ups and heart scans and meetings and my bravado occasionally faltered. I told a few people I was "contemplating" the surgery before I learned that telling just about anyone was a mistake. It yielded lot of under-informed, rumor-based "facts" and theories I really didn't need in my brain, co-mingling with what I was hearing from Dr. Preston and others who really knew what the were talking about.
Most of the folks I told knew (or more often, knew of) someone who'd had some form of Gastric Bypass and regretted it dearly. One or two friends felt an obligation to save my life by talking me out of such a reckless, self-destructive, sure-to-end-in-disaster decision. In some cases, the conversation went like this…
ME: Where did you hear about this person who had Gastric Bypass Surgery and died three days later?
OTHER PERSON: Oh, somewhere. I think it was on the Internet somewhere.
As we all know, you can believe each and every word someone remembers reading somewhere on the Internet.
One person who was very worried about what I was considering was my dear lady friend/companion Carolyn — but then she'd always had a deep distrust of hospitals and conventional medicine. Partly because of her, partly because of other friends and partly because I still had some natural apprehensions, I found my commitment to the procedure softening a bit. Over the months of qualifying for it, I kinda inched from "I'm going to have the surgery!" to "I'm going to do everything I can to qualify for the surgery! If and when the day finally comes when I get a date for Dr. Perfect to perform it, I'll decide whether of not to go through with it!"
One of Dr. Perfect's associates later told me that of all the people who came to that moment — who were offered firm dates for the operation — about 10% (in his words, not mine) "chickened out." As you shall see in a later chapter of this series, others chickening out turned out to be a benefit to me.
As I recall, the first thing I had to do was to attend a kind of "orientation" meeting. Once a week, the hospital would welcome folks who were considering the procedure or at least curious about it. Such folks would fill a classroom-like hall and view a video about Gastric Bypass Surgery. Then a doctor who worked on such cases, though not at Dr. Perfect's level, would deliver a Powerpoint lecture about the procedure. He'd be followed by someone who'd undergone it and then the doctor and the patient would answer any and all questions.
The day I attended, I found myself in a room full of very, very large human beings, many of them way larger than I would ever be. The start of the presentation was delayed because when I got there a tad late, there was only one seat open and I had a lot of trouble just getting to it. The aisles were clogged with fat people. Some of them moved aside as much as they could, some of them couldn't move enough and I just about climbed over one very large lady like I was conquering Kilimanjaro. She actually seemed to enjoy it.
At the moment when it looked like I'd never make it to that open chair, the doctor who was waiting to begin the festivities asked, "Can't you get to your seat?" and I replied, "If I could get to my seat, I wouldn't be here!"
That evoked a very big laugh from the very big people in the not-big-enough room with the not-big-enough chairs and aisles. As I would learn, there was a very healthy amount of camaraderie to be found among overweight individuals. We all had a lot of the same problems.
The presentation though didn't really tell me anything Dr. Preston hadn't told me. The best thing about it was that huge laugh I got and the fact that the seminar was one of the few things in the qualifying process that didn't cost me anything. Some of the other stops on my journey were mostly-covered by my insurance and only cost me a modest co-pay but some were not covered and not cheap. The actual procedure would cost me almost nothing but. uh, there was one kinda important thing missing: It did not include the services of Dr. Perfect.
As Dr. Preston explained to me, the hospital had very good surgeons who could do it without me paying an extra cent but Dr. Perfect was, as he kept saying, the best in the business. As in most businesses, the best costs extra. In this case, I think it was $10,000 which, Dr. Preston assured me, was well worth the money.
Lest you think for a nano-second that he was suckering me into some bait-and-switch scam or maybe getting a cut of Dr. Perfect's action, no, no, no. That was absolutely not the case and it turned out to be the smartest ten grand I ever spent. Among the least beneficial (but still required) amounts I spent was that for the one and only time in my life as of this moment, I had to pay for and have a session with a psychiatrist. The entire session went roughly like this…
HIM: How do you expect your life to change if you have this operation and it results in you losing a hundred or more pounds?"
ME: I expect I'll be smaller and healthier and I'll fit into airline seats and feel like I fit into the world better.
HIM: Okay, we don't need to go through the other stuff…
I could have left then but since I was paying for a 45-minute session, I insisted on chatting for at least a little while longer, mainly about why the hell I had to see a psychiatrist at all. He didn't really give me a good answer but later, Dr. Preston did: "There are many people who have the surgery, lose a lot of weight and then experience severe emotional problems because it doesn't change every single thing in their lives that they were hoping it would change."
As always, he had a real-life example — a true tale about a patient one of his colleagues had counseled: "This guy couldn't hold a job, he couldn't attract a mate and he didn't have any friends, not because he was grossly overweight but because he was just an obnoxious, angry person. He had the procedure, he lost the weight…he probably saved his life. But then he was furious that he didn't suddenly get a great job, a great girl friend, a circle of friends and so on. That was because he was still obnoxious and angry. In fact, the failure of the surgery to make all his dreams come true made him even more obnoxious and angrier."
Doc Preston went on: "Seeing a shrink really shouldn't be necessary in your case but one of the reasons Dr. Perfect has had such good results is because he insists on knowing every single thing about his patients, inside and out. He requires more tests and x-rays and ultrasounds and scans than anyone else." Indeed, over the next few months, I found myself driving all over the city for test after test after test…and this was just to get on Dr. Perfect's long, long waitlist which I was not yet on.
If and when I did get on it, two things would have to happen. One was that Dr. Preston would have to use his clout to get me leapfrogged over many others and moved up on the list. He was confident he could. I wasn't. And the other thing was that if I did, I would probably have to have most of the same tests performed again before Surgery Day since they'd be months old by then. At the end of 2005, I'd been on that journey for over a year and my determination to go under the knife — even a knife wielded by Dr. Perfect — was waning.
Then in February of '06, three things happened in rapid succession that got me thinking that it could happen, it should happen and it would happen. I'll tell you about them in the next chapter. We still have quite a ways to go. This will not be over in another chapter or two or three, I'm afraid…