Overwhelmed with emotion, teary-eyed, I gently ran my fingers along the skin of my old ally.
“Goodbye, Old Friend,” I said, caressing and connecting for the very last time.
My stomach purred in response.
I lay back on the gurney, an IV needle embedded in my right hand.
I was sedated, holding my wife’s hand, just minutes from the surgery that would remove 85 percent of my stomach in an effort to control my dangerously rising weight.
The physician’s assistant asked what I did for a living, and when I told him I was an editor at a Toledo newspaper, he assumed I meant The Blade and began an enthusiastic monologue about reading the daily newspaper online. I did not correct him; it did not seem wise to piss off the man with the long needle.
My surgeon stopped by the curtained area and asked, “Ready to rock and roll?”
I said I was, but inside, as the sedatives took effect, I felt more like a light waltz.
I was wheeled into the operating room and transferred to the main table. The anesthesiologist leaned over me with a mask and lied, “I’m going to give you some oxygen.”
I nodded and glanced at the large TV with my name and case details on the screen.
It was 10:02 a.m. Sept. 18.
Baby steps
The journey to bariatric surgery began Jan. 3 with the first of six monthly visits to my primary care physician, or “doctor,” as I call him. Each of the visits focused on my progress, or lack thereof, with breaking bad habits. Fast food, carbohydrates, soda, a sedentary lifestyle. Between those visits, I worked with clinicians at the University of Michigan Adult Bariatric Surgery Program. This included visits with nutritionists, physical therapists, support groups, chat rooms with former and future patients, psychiatrists and more doctors.
There are three main options for bariatric surgery. It is a huge decision, and being immersed in the culture for six months, often with mandatory spousal attendance, helped me prepare mentally and begin making necessary changes.
As described by the UM program, “LAP-BAND Surgery, also known as laparoscopic gastric banding, is a restrictive surgical procedure whereby the size of the opening from the esophagus to the stomach is reduced by a silicone band, decreasing the amount of food that can be comfortably eaten.”
The most drastic option is “Roux-en-Y gastric bypass: First, the surgeon creates a small stomach (permanently reduced to an egg-sized pouch) to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine).”
So the LAP-BAND is the least invasive and is technically reversible. The gastric bypass is common, but all that rerouting made me nervous. I also did not like the idea of my disconnected stomach slowly atrophying in my abdomen for the rest of my life. Like Goldilocks looking at two extremely opposite options and seeking a middle ground, I gravitated to the sleeve gastrectomy.
“Gastric Sleeve Resection is a restrictive form of bariatric surgery that helps with weight loss by limiting food intake and controlling hunger sensations. The procedure calls for removing about 85 percent of the stomach, while keeping both ends of the stomach intact. It does not involve cutting or rerouting the small intestine and it does not require an implanted weight loss device.”
Choosing sleeve surgery would mean more work for me, but I wasn’t looking for a panacea, I was looking for a tool to help me turn my personal Titanic around.
To accomplish the surgery laparoscopically, with six small incisions instead of one big abdomen slice, I was required to lose enough weight to shrink my liver down so it would not be an obstruction during surgery. I was supposed to embark on a 14-day liquid diet, but I’m an orderly man, so I chose to start Sept. 1. That would give me four extra days and an easy way to keep track of the liquid diet. That daily diet consisted of three 8-ounce, sugar-free, high-protein drinks, with between-drink small servings of oatmeal, nonfat yogurt and sugar-free mini pudding cups.
In other words, I was consigning myself to the Gulag, not just for 18 days before surgery, but for the four weeks following it as well.
The Goodbye Tour
Knowing that tremendous sacrifices awaited, I decided to say goodbye to my favorite foods in style. I asked three of my closest friends, all of whom enjoy a good repast as much as I do, to join me on my Goodbye Food Tour.
We started at noon Friday at Tony Packo’s, enjoying the multiple Mother of All Dogs for the final time. That afternoon we went to Rave Cinemas at Levis Commons to see a movie and enjoy one last feedbag bucket of movie theater popcorn with a depth-charge size soda. For dinner, we visited Fricker’s for a plate of my favorite deep-fried, honey barbecue chicken wings, with curly fries and more soda.
I went to bed overfull but determined to soldier on.
Saturday started with an early breakfast at a local diner, with a skillet full of scrambled eggs, hash browns, a number of selections from our pal the pig and a pile of shredded cheese. Lunch was at Burger Bar 419, where we shared fried cheese and some of the best gourmet cheeseburgers in Toledo.
After another movie (with another bucket of popcorn and another large soda), we went to Five Guys Burgers and Fries in Rossford for another version of my favorite burger. I knew I was slowing down when I did not finish my fries. Nonetheless, we traveled to Mr. Freeze for a large turtle sundae, which should be the final ice cream I enjoy, on that scale, for the rest of my life. After a few hours, we met at Buffalo Wild Wings on Central Avenue, for a last round of appetizers and chicken wings.
For the first time in my adult life, I left the table with uneaten wings on my plate.
Sunday morning was a last order of our neighborhood bakery’s best doughnuts. A late lunch took place at Olive Garden, with an endless pasta bowl order that ended midway through a third bowl.
There were still days before Sept. 1, but I used those days to start getting used to the protein drinks, with one solo goodbye stop each day during the week: The Blarney Irish Pub, McDonald’s, Spaghetti Warehouse and Wendy’s.
I will spare you those gastronomic details.
That left Friday, Aug. 31, as an opportunity for one final meal. That night was reserved for my wife and me, and I knew where I wanted to go: Final Cut at the Hollywood Casino Toledo. Not only did a steakhouse date night appeal to me, I thought the name was more than appropriate. And I knew exactly what I planned to order — the 64-ounce porterhouse, a cut of steak so big it comes with its own Final Cut dog tag, which I planned to carry with me as a talisman against the upcoming hunger and fight.
Every bite of that steak was exquisite. I lingered on the final cut as long as I could. Swallowed. Paid the bill. Went to bed knowing that the next 30-plus days would be the biggest challenge of my adult life.
The liquid diet
It turned out to be even more difficult than I expected. The 8-ounce liquid medical protein drinks, Unjury, come in flavors of chocolate, vanilla, strawberry and chicken soup. It would be easy to mock and deride Unjury, but it’s not the company’s fault. The drinks could have tasted like Willy Wonka’s Special Oompa Loompa Extract and it would still curdle under the heat of the resentment, despair and ravishing hunger I brought to the table. Each day for 18 pre-surgery days, as the rest of the world around me ate what it wanted, my self-exiled liquid diet had my betrayed stomach roaring like a lion with thorns in all four paws. Not consuming was one thing; not chewing was another. If I met my protein goals for each day I was allowed a few celery sticks or cucumber slices, but for a man used to eating cheeseburgers for snacks, every day was like a crawl through a desert.
The only solace was from my wonderful wife, who, in sympathy, went on the 18-day liquid diet with me. It was a major help to look across the table and see her grimacing as I did. I was moody, depressed, angry at myself and restless without meat, bread, pasta, potatoes, all of the glorious food I centered my life around.
But on Day Five, an interesting thing happened. I took that restless energy and began walking. Just a few blocks at first, then a mile, then two miles a day. We took long family walks with our young sons, spending an hour or so together on sidewalks, nature trails and park walking paths.
And while I did not at first see a difference, I started to feel … better. I quietly tried on one shirt size smaller and found it fit. Walking got easier. I still missed eating, but I did not feel as empty as I once did.
Throughout the 18-day diet, I intentionally stayed away from our bathroom scale, which wasn’t meant to weigh anyone my size. I believed it held only false promises.
So it wasn’t until the morning of the operation that I stepped on the hospital scale.
The end of the beginning
I weighed 380 pounds on Aug. 31. The morning of Sept. 18, I was down to 339.8 pounds, a 40-pound drop.
My smile was so wide, my Blade-loving IV inserter said I looked like I won the lottery.
I was wheeled into the operating room and transferred to the main table. The anesthesiologist leaned over me with a mask and lied, “I’m going to give you some oxygen.”
I nodded and glanced at the large TV with my name and case details on the screen.
It was 10:02 a.m. Sept. 18.
When I woke up at 2:30 p.m., I looked down to see six small incisions where 85 percent of my stomach used to be.
I tried to swim to consciousness, but kept falling back asleep.
The first words I heard were from a nurse, who was talking to another nurse. About me.
“His blood pressure is way up,” she said. “At 190. We’re giving him meds to try to get it down.”
Michael S. Miller is editor in chief of Toledo Free Press and Toledo Free Press Star.
