Failing a Test

When I first saw Dr Atiles about undergoing a Gastric Bypass, I was given a list of clearances required before I could qualify for surgery and insurance coverage.  My immediate goal was to get through the list as fast as possible.  I’m not a competitive person, but I wanted to get through that list faster than anyone and to be the best behaved, most compliant patient ever.  I set about making my appointments as fast as possible.  And with each one completed and checked off the list, I felt a sense of accomplishment.  At the beginning of this week, I had two more to go and I was getting excited about scheduling my surgery.

Note of approval from my Primary Care Physician:  check

Psychiatric Evaluation:  check

Upper GI and Ultra Sound of my Gallbladder:  check

Attend Pre Surgical Support Group:  check

Cardiac Evaluation with Echocardiogram and EKG:  check

Nutrition Clearance and Weight Loss of > 15 pounds:  check

Pulmonary Function Tests:  check

EGD and Colonoscopy:  ______

Sleep Study to rule out Sleep Apnea:  check

Pulmonary Clearance post Sleep Study and PFTs:  _______

Down 25 pounds, I was so close and everything was going smoothly.  On Thursday I had to get an EGD and Colonoscopy.  Anyone who has ever had a colonoscopy knows the worst part is the prep, but I was able to get through it.  I reported to the endoscopy lab and I couldn’t wait to get it done, but as a precursor to my day, they were running late and two hours after my appointed time, I was wheeled in.  They were going to do the EGD first followed by the colonoscopy.

I woke up coughing.  Something was in my throat and the harder I tried to cough it up, the worst it became.  It felt like a large lump of something on the back of my tongue into my throat.  The nurses didn’t seem very interested, probably because it was the end of the day and I was sent packing, with my results in hand, far more efficiently than I had been checked in. I was relieved to read everything was normal, but my throat hurt like hell.  So much for the burger I had been dreaming about for hours.  My friend Kim collected me and brought me home.   My throat continued to be excruciating, far worse than any sore throat I’d ever had.  I finally looked in my mouth and I was shocked to see how swollen my glands were and my Uvula was so swollen it was resting on the back of my tongue. Eating and drinking was out of the question.

I woke up Friday in even worse pain.  Swallowing was very difficult  and painful but I made myself drink a protein shake for breakfast.  I had two appointments, one in the morning with my Primary Care Physician and my second in the late afternoon to see Dr Sokol, a pulmonologist, to get the results of my sleep study.  Finally my check list would be complete, and I could concentrate on getting insurance approval and schedule my Gastric Bypass surgery.

My Primary Care Physician is one of the most caring, empathetic men I had ever met.  He has been supportive of me since the beginning and, without judging me for my weight, has been compassionate and encouraging.  One look at my throat and he was horrified.  He gave me a prescription for prednisone, two in the office to take immediately (to bring down the swelling) and suggested I call the physician who did the procedure and question why my throat was so sore and swollen.  I called as soon as I got home.  Dr Ben got on the phone immediately with me.  I had stopped breathing during the colonoscopy and they had to intubate me quickly.  Scolding me, he suggested getting tested for sleep apnea.  He said my tongue kept “flopping back and covering my airway” and they had no choice.  That also explained the multiple scratches on the roof of my mouth, but not why I had to call to find out what had happened.

I ended my afternoon seeing the Pulmonologist for my Sleep Study results.  It should have come as no surprise, after my experience from the day before, but hearing that I had failed the sleep study was so emotional.  I had severe sleep apnea, not slight (as I had hoped), not moderate (as I prayed), but severe, potentially life threatening apnea.  And then he examined my throat and patiently explained what had happened to me during the procedure yesterday.  My tears started mid way through it and by the time he stopped talking I was in the middle of a massive hot flash and had moved on to sobbing.  Between the tears, the sweat, my sore throat, and my hunger, I was one big hot mess.  I had failed.  The second kindest, most empathetic doctor of the day comforted me.

What people don’t realize is that when you are fat, you want to be invisible.  Even though your biggest failure stares you in the face every day when you look in the mirror, and your big belly precedes you into every room you enter, you still pretend you are normal, that you fit in.  Going through this has put a big glaring light on the shame I feel about my body.  No one knows the courage it takes to walk into a room when you are obese, unless you are like me.  And when you fail a health test, break a chair, or don't fit in something, your fat cells scream "FAT GIRL" and you pray no one mentions or notices it.

My journey continues, maybe not the way I wanted, but I haven’t given up.  I have another sleep study scheduled on Tuesday night where they will try to find the right breathing apparatus for me.  And when they do, and I stabilize, I will be finally cleared for surgery.

“It’s not just a question of conquering a summit previously unknown, but of tracing step by step, a new pathway to it.”  Gustav Mahler