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The Teeter-Totter of Weight Bias

DssButton2FB2-150x150As a Weight Loss and Wellness Coach, I often use the illustration of a teeter-totter when sitting down with a new client to go over the theory of “calories in, calories out” and to explain the importance of putting good fuel in our bodies to support vigorous activity.

As I lay in bed restless tonight, I am thinking about an article I read about people who sit on both sides of the spectrum of weight bias. That is, those who know what it’s like to be overweight and struggle with obesity but are not anymore and now live as people of so-called normal size.

In thinking about this strange predicament, that image of a teeter-totter resurfaced.

 

Being the Chubby Kid

As a victim of emotional, physical, verbal and sexual abuse in my childhood, my mind is my playground. My imagination was my escape mechanism from the time I was very small child. As I grew older, food became my friend, confidant and lover. Before I even realized it, my escape into food had pushed me into the furthest reaches of the weight spectrum.

From as young as five years old, I recall being the chubby kid that nobody wanted to pick for dodge-ball and the target of weight biased jokes. “Fatty Fatty two by four she can’t fit through the kitchen door” is one of the first childhood rhymes I remember the “mean kids” chanting at me.

I remained the largest child in my class long into high school. That fact affected my relationships with both girls and boys alike. I was an unpopular outcast who got teased and ridiculed. In the sixth grade, I became the target of a school bully – shocking, considering that the bully was a boy very much in the same predicament as me.

He was heaviest boy in our class, endless teased himself, and in reaction he started punching me as his way of lashing out. One day, after he shoved me out of the lunch line and into a wall, I asked him one day with tear-filled eyes, “Why do you pick on me?” His answer was to punch me in the stomach. Confused and bewildered, that night I asked my father “Why do they hate me so much?”

His reply: “Because you’re different and unique and sometimes that scares people or makes them jealous and people do some really mean things when they are scared or jealous. They make fun of the thing that makes you different because it’s the only thing they have to justify their feelings.”

 

A Traumatic Adolescence

As I got older, this life lesson followed me as I grew in age and, unfortunately, also in size. As the bullying continued, I continued to question why people seemed to hate me so much. I also developed coping mechanisms to deal with it with what I felt was an inevitable fact. I was overweight, actually now I was plagued with obeisty.

So I became sexually active. I dressed in all black. The other kids called me “goth” and considered me uncool for it. I began to cut myself and the other kids accused me of doing it simply for attention. I cried myself to sleep at night, wondering why nobody understood me. I wasn’t doing any of these things for attention, but to try to feel better.

Sleeping with boys made me think someone loved and cared for me. Dressing in black, I thought, was figure flattering. I cut myself because when I got to a point where I was emotionally numb, the pain reminded me that I was still alive. But no matter what I did, I couldn’t seem to win. The more I tried to survive, the more the bullies tried to push me underwater.

I did have a few brave moments when I stuck up for myself. One time a girl in my class took a note I had written to a boy we both liked and she photocopied it, passing it around for lots of other kids to see. I confronted her, asking why she hated me so much. Her answer was sharp and simple: “Because you are fat and ugly.” With nothing to lose I challenged her, demanding to know, “Why do you care that I’m fat?” She had no response.

I was fifteen at the time and I had spent nearly a decade – most of my life at that time – being  of the victim of weight bias, bullying and fat shaming.

 

Coming of Age

When I finally decided to take my life back from obesity, I was shocked that my true battle was to stop seeing myself as a victim and learning to see myself as a survivor. From there I learned to live, to thrive and strive. I’m proud to say I lost my weight, I have won that round in my fight against obesity. In this victory I told myself, “I will never again be defined or disliked by the number that shows up on the scale or the way my body looks.”

But oh how wrong I was. Because I hadn’t learned yet that in the world of weight bias, there was a teeter-totter – and a whole different end of the spectrum.

I’m new to the world of being slender. It’s ironic how hard I fought to get here – thinking if I did I’d win my battle – only to find new battles to fight and new demons to face! Body image issues took their toll on me, and I found myself associating the extra skin that hung from my body with my former abusers and the emotional addiction that perpetuated my obesity for so long.

To help free myself of the remnants of that past, I turned to reconstructive plastic surgery. I fought with body dysmorphia – that is, not being able to see the true image of myself in the mirror. I also felt haunted by “ghosts of the past,” the people whose behavior drove me to inflict so much harm on myself.

I beat myself up emotionally when the number on the scale, along with the Body Mass Index, told me that despite the fact that I’d lost more than 250 lbs, I was still “overweight.” I allowed that emotional self-abuse to hinder where I wanted to go in life and who I wanted to be. I put off my career in the weight loss, wellness and fitness industry because I thought I needed to be perfect before I could help others fight obesity.

Thankfully around this time of my life I found an organization called the Obesity Action Coalition, an organization that fights weight bias through education and empowerment. I got the amazing opportunity to attending their inaugural “Your Weight Matters Convention” in 2012. There I was able to sit at a “Lunch with the Experts” table with Dr. Robert Kushner, M.D. who helped me realize that neither the BMI nor an extra 5-10 pounds of weight loss was going to change how effective I could be or how inspirational my story would be to those that employed me seeking help in their weight loss journey.

Over the past three years, my membership to the OAC has taught me more than I can ever write in one article. It has also given me the courage to stand up against weight bias, weight stigma and weight discrimination whenever I see them.

You’ll understand the irony, then, when I tell you that it was at the third “Your Weight Matters” Convention this month in Orlando, Fl. that I discovered for the first time that I would battle weight bias no matter where I fall in the weight spectrum.

 

A New Day, A New Battle

Without going into the details (and perpetuating a lot of drama), I found out that someone had made a very harsh and superficial judgment about me based on this new body I’m working so hard to love.

I have to say I was shocked when I first found that out. Part of me thought it was a joke. But over the past three years of being in the weight loss community there seems to be a recurring cycle of drama and bullying. I’ve seen individuals targeted and shut out. I’ve seen others discouraged from associating with those so-called outcasts and I’ve heard from people who felt pressured to alter themselves and their friend lists just to fit in – or at least to prevent themselves from being the next victim. I’ve heard stories and recounts of this sort of behavior that predate my own presence with this community.

It puzzled me at first, how a group of people who have fought such similar battles – and have had such similar experiences with bullying, weight bias and stereotyping – could behave that way. You would think our common experiences would bond us together in a united front, make us join arms and rally for the same cause and empower us to support one another. After all, we’re all fighting the same fight against a disease that impacts more than 93 million people in our country.

But there I was facing a situation I had been through so many times. The fact that I was on the other side of the spectrum didn’t make it any less hurtful. I found myself once again asking that question, “Why do they hate me so much?” Apparently, now it’s because I’m skinny and my breasts are too big.

The shock I felt at that moment is about the same as the shock I felt when plastic surgeon told me that there wasn’t enough fat left on my body to perform the procedure I was asking him to do. My jaw hit the floor.

Never in my whole life did I think people would dislike me for being “too thin.” I won’t even touch the ridiculousness of the comments about my breasts.  After taking a moment to recover from that information, I asked, “Don’t you find it a little hypocritical that we’re sitting here at a convention that fights weight bias and weight stigma and that we protest judging and shaming people for the size of their body, the number on scale and their outward appearance and yet, that is exactly what I am apparently being judged for?”

 

Balancing Your Core

The answer to that question made me angry. Yes, it is ironic. It’s stupid really. And it needs to stop. I’ve sat on this experience for a few weeks now. I’ve dissected it to figure out what lesson it was supposed to teach me. Now, as I lay in bed tonight with that image that teeter-totter in my head, I’ve finally sorted out what I want to say.

While I was in Orlando, I met with a remarkable woman named Melinda Watman, the chair of the Weight Bias committee of the Obesity Action Coalition. I explained to her why I’m so passionate about fighting weight bias, why I wanted to be a part of OAC’s Weight Bias Committee and why the OAC’s Bias Busters programs calls to me.

Every year that I attend the OAC’s convention something absolutely life changing happens to me and I learn something I would never have had the chance to learn otherwise. This year, I learned that there is two very different sides to weight bias and that each of them are equally stigmatizing. I also learned that stigma, in general, is a lot less traumatizing when you have a solid foundation and a strong perception of your core strengths and beliefs.

Because when I was told that some people didn’t like me because they thought I was too thin or they thought my breasts were too big, I didn’t react the way I did so many years ago. I didn’t crawl into the solitude of my room and weep. Instead, I stood firm in my convictions and called it for what it was: weight bias.

The truth is, neither the size of my body nor the size of my breasts define who I am. When I am gone and the winds have called my name for the last time, neither of them are what the world is going to remember me for. In fact, I rather hope that the only numbers in my eulogy are the years I existed in the world. Instead, I hope to be remembered for the person that I am and the way I lived my life.

As an exercise instructor, my class and I stand in front of the mirror constantly moving our bodies in an effort to improve them. There are days I like what I see, and there are some days I don’t. But at the end of each day, the only person that has to like my reflection is me.

So if you ask me what I took away from the OAC “Your Weight Matters” 2014 Convention this year, my answer is very simple, I took away not only the education, but also the realization that if I want to truly stand up against weight bias, weight stigma and bullying I have to be prepared to do it from all sides and angles.

In the gym my clients often quote my tips on maintaining good posture while exercising and to build their core strength: “Shoulders back, girls out, core engaged.” Finally tonight, I understand why that teeter-totter was so prevalent in my mind. Because no matter what side of the battle of obesity you are on, if you can stand in the middle of that proverbial teeter-totter and engage your core, retain you balance and posture, you’ll be much stronger in your stance and your fight.

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Pandora Williams author of Desperately Seeking Slender is a  Cooper Approved Wellness Coach Trained in Weight Management Strategies and Motivational Speaker studying to become a Certified Personal Trainer.

After Hurricane Comes a Rainbow – Selecting my Surgeon

As I spoke to several of my closest friends yesterday to share my news, one comment stood out most to me among them all.

“You lead a charmed life Pandora, Life is making up for every horrible thing you have been through.” –  Keisha (Waning Woman)

I believe this to be 100% true. Somewhere along the line in my weight loss journey, the universe decided that it was time to turn the cards around for me, and start dealing me some hands that were truly in my favor and for the first time in my existence I truly believe I am Charmed and Blessed.

Let me rewind to just two years ago for a moment. I weighed 266 lb. a far cry from the 420 lb. I started at. I had just had my Gastric Bypass 9 months prior and had lost 75 lb. since my surgery ( The other 85 I post pre-op on my own in order to get on the table ) and I was sitting by a Hospice bed in the living room of a house I hadn’t been in since I was sixteen years old holding my Daddy’s hand as he was passing away. I needed to know, without a shadow of a doubt that my Dad was going to see me through this journey and that he was going to somehow know that I would accomplish my goals and that I would achieve that happy healthy life that he wanted for me.

Daddy“I need to know that you’re still going to be with me through the rest of this journey Daddy,” I cried as tears poured down my face.

He tapped my hand three times, and I knew based on 34 years of having him in my life that it was once for every word in “I love you.”

“I’m going to make a deal with you Dad. I don’t know what happens from here, I don’t know what I believe in, where we go when we pass or what comes next, but what I do know is if there is a place where you get to sit and watch over me, guide me and keep me safe, you’ll be there.” I sobbed.

He squeezed my hand.

“So here is what I am going to do. I’m going to know that when I exercise, you’ll be with me, that when things are rough and I need help, I can exercise, spend time with you and talk to you and that you’ll be there to see me through the end of this journey.”

My Father, who had lost the ability to speak at this point after 3 days of Hospice, squeezed my hand tightly and moved his eyebrows and I knew that we had a pact.

Just four short days later, on the evening of the 4th of July I ran for the very first time. Running around the block over and over again as a Hospice nurse sat with my Father with Fireworks going off over my head and searched for a way to say good-bye to my Dad. My father passed away the next morning, my world shrank, my gravity shattered, my life was falling apart at the seams and the next six months was going to be an emotional hurricane as my narcissistic family put me through the most emotionally trying moments of my life since I had left them behind twenty years prior and not looked back.

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For six months things got worse as I struggled with dealing with a mentally unstable mother that had no income, tried and tried and failed over and over to quit smoking again, got sucked back into the Family that had abused me so badly as a child and struggled to put the pieces of my marriage back together. We were drowning financially, living on credit, and there was no light in sight. I was out for a run on a raining January of 2012 and I stopped at a park that was a half a mile from my apartment to sit and talk to my Dad.

“I don’t know what to do here Dad, I need a little help with this smoking thing, and Mom, I know you would want her taken care of, but me trying to do it is quickly bankrupting Jason and I, I just need help, I need to know what you want me to do.”

As I was sitting there the sun came out and when I looked up, a rainbow adorned the sky.

There were three things in nature my Father loved more than anything, rain, rainbows and humming birds. He always told me when I was a little girl that rainbows were God’s way of cleaning up the world when he had made a mistake.

Life started taking a turn for me that day, and since then, as my friend Keisha commented yesterday, with the exception of a few moments of cloudy skies and a few times of emotional storms, my life has been Charmed.

Not even two short weeks ago, I had an emotional storm over my journey through reconstructive plastic surgery after massive weight loss and nearly fell apart over not only trying to figure out how I would pay for it, but also, what Surgeon was going to do it as my head swam in a sea of confusion when I consulted with five different surgeons, getting five different suggestions and five different prices. I was in a very dark place. But I wasn’t left there long at all before some very important people in my world started reaching out to help me.

Things started happening very quickly, first my Godfather decided he was going to provide me with the financial ability to move forward with out that part of my journey as a concern. Then Bobby Whisnand, my Mentor in the journey to becoming a Trainer, reached out to assure me that no matter what was to come, not only was I going to be a Trainer, but I was going to be a damn good one. And Joy Muller, the closest thing I have to a therapist, sat with me as I found oxygen again and my personal hero; Chris Powell, a man whose words of pride in me have pretty much replaced the ones my Father cannot say, reached out to me to remind me that no matter where I go from here, I am beautiful and that I am doing wonderful things as I try to help others understand the struggles that come with this journey.

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As I bounced back from this emotional storm with the help of all these people, I started to work on what was going to likely be one of the biggest decisions of my journey thus far. Which Surgeon I was going to use for this last round of reconstructive surgery and body contouring after my 260 lbs. of weight loss.

I had three offers on the table, and they ranged in prices from a bit under my budget to way higher than my budget. – I had consulted with two AMAZING surgeons at the WLSFA Event, I had two surgeons at home in Oregon that I had consulted with and had the option to use, but each one had pros and cons.

I’ve always been very honest with you about my journey and I really hope that none of the surgeons I mention are at all offended by what I have to say next, I admire each and every one of them and each of them is amazing in their own way. But each did have pros and cons and I feel like if I am not open and honest with you about them, then I have done a disservice to what I have stood for all along, to share this journey with you honestly from the patient perspective.

First there was Dr. Katzen – I wanted to choose Dr. Katzen so badly, he was the only surgeon in the ones I had consulted with thus far that wanted to do the surgery I had wanted from day one. An anchor incision that would address the excess skin in my abdominal region. I was really impressed with his plan to do some liposuction to my arms to help alleveate the asymmetry that exists there, I loved his proposal for scar placement. My quote from Dr. Katzen came out under my budget but only included my abdomen and arms, it didn’t include the implants I also wanted because I knew adding them would put me over budget.

Then there was Dr. Aly – I adore Doctor Aly, I have heard him speak at the OAC Convention, I have seen photos of his work, and he is a Pioneer in skin removal surgery after massive weight loss – his approach was a little different, he wanted to redo the lateral abdominoplasty that I had to try to remove more of the skin in my abdomen and he wanted to redo the brachioplasty that I had to address some of the skin and asymmetry I had there. His quote for me also came out under my budget and included the breast implants that I wanted.

Choosing between these two amazing surgeons was literally breaking my brain. – They are both renowned in their field, they are both amazing, kind, and generous and they both spent time with me in phone consults and talking to me in person at the WLSFA Event. Both of them were amazingly generous with me. Before I even had a budget thanks to the generosity of my Godfather, Dr. Katzen and his staff were willing to do anything they could to help me get the surgery I wanted including offering to have someone assist me with writing an appeal letter my insurance trying to get them to approve the surgery, as well as offering to write me a letter of recommendation if I wanted to apply for a grant through the WLSFA for the surgery. His office personnel made me want to hug them repeatedly.

Doctor Aly, when I talked with him in Vegas, had done something nobody else had done thus far, he had re-instilled my confidence in my own Surgeon in Oregon when he agreed with her method of attack and when his own suggestions for the revision matched her opinion of what she wanted to do. Because of this, I decided that before I made any decisions I would go back to my original surgeon and discuss my revision work with her once more.

When I went back to my Surgeon in Oregon, I did so with a lot more confidence and a better understanding of what I wanted and what I was asking for. I was honest with her, I told her I had consulted with other surgeons and I asked for the same surgery that I had asked for the first time around. I asked for the anchor incision, a revision to the brachioplasty and breast implants. I felt met with the same resistance and hesitation that I felt the first time around.

While my Surgeon made amazing strides with my body; just look at my before and afters. I will say honestly that it was my personal experience, that every time I wanted something she didn’t really want to do, I was given answers and information that pretty much scared me into submitting to what she suggested.

The first time that I had asked for a brachioplasty that went past my elbow I was told that she didn’t want to do that because there were concerns about joint movement. This time her suggested method was to do the brachioplasty and extend the incision all the way down to where I wanted it the first time. When I asked her why we hadn’t done that originally the first time around, instead of the same answer about joint movement, this time the answer was that if we had put that proposal on my insurance they would not have approved it because there was no foundation for medical necessity.

I had a similar situation with her when we were doing my breast lift and I wanted to do implants at the same time. The insurance denied it, we resubmitted without the implants, it was approved and I was given the option to cash pay that portion of the surgery. I declined when she scared me by telling me that I could end up with a situation where due to skin elasticity being damaged I could end up with an impact where my skin dropped around it and the implant could rest at the top of the muscle and the skin could fall down, causing it to look malformed and need revision work and informed me that if I got implants I would likely need maintenance to them over the course of my life in the form of breast lifts.

When I asked her about doing liposuction to my arm before removing the skin to address the issue I have on my right arm where I have a genetic band about half an inch thick that lays closer to the muscle that the rest of my arm and creates a look similar to my having a fat roll on my arm. She advised against it 100% and told me that doing liposuction and skin excision at the same sight at the same time could cause serious wound break down and result in skin necrosis where pieces of my arm could literally fall of. She told me that while she would not say that the concept of doing liposuction to my arms was wrong, she felt it was extremely aggressive, and that it was someone being extremely aggressive with *my* body. She also, without me having told her the names of any of the Surgeons I had consulted with, suggested that if I called the office of Dr. Aly and asked him if he would do liposuction and excise skin in the same area at the same time, he would tell me that under no circumstance would he do that.

When we discussed the anchor incision she advised me that I could end up distorting my cleavage with a scar that came up to the center of it and created a pucker between the breasts and that I could have an issue where the scar was very tight and my skin could relax around it sort of folding over it. All I could envision when she described it was a flabby butt crack going up the middle of my tummy. She told me that I would risk damaging the amazing belly button she had given me after my circumferential 360.

And this time, when I asked her about the asymmetry in the breasts, that I saw more pronounced in the 3D models of the implants, she told me that I could do another lift to help it a little but that really wouldn’t fix it, that everyone had some asymmetry in their breasts and that she didn’t see a need to do that, and that really if the asymmetry didn’t bother me that much now it shouldn’t be that bothersome after the implants despite what the 3D images were showing me.

As I left her office completely scared out of everything *I* really wanted, there were a few things that still stood out in my mind. 1. Dr. Aly had thought she had done a good job, he agreed with her plan of attack, she knew my body and how it responded to surgery having worked on it three times and her price was MUCH lower than anyone else’s and required no traveling to another state on my part. But hey, she had dropped Dr. Aly’s name and my arms, were the thing that bothered me the most from day one, since she suggested I call Dr. Aly and ask him about the liposuction approach, I decided to do it.

Dr. Aly was out of the county when I called, but his office manager Danielle was extremely kind and when she heard my questions and how emotional I was about this whole experience and how I was struggling so hard to make a decision she let me know that she would talk to Dr. Aly and see if she could get him to call me himself. The day after he returned from Europe Dr. Aly phoned me and we had a very long conversation where he explained to me the why’s and hows of why he would select each of the methods he wanted to use on me, and even took the time to explain to me why the price quotes I was getting were so different. Which pretty much came down to three big things to my understanding; experience, cost of operation and demand for services. A more experienced surgeon, who has a big clientele and stays busy will be more expensive than another and overhead is much higher for a surgeon that say works in an area like Beverly Hills California where his zip code is 90210 than a surgeon that works out of an area with lower overhead costs. Makes perfect sense. Dr. Aly and I spoke for a very long time, he was very humble and kind as he answered so many of my questions without scaring me and explain to me that all the different opinions I was getting didn’t mean that one surgeon was right or one was wrong or one was good and one was bad, just that each one has different experiences with success at different things. Dr. Aly stressed to me that the most important thing I could consider when selecting a surgeon was that I selected someone I was comfortable and confident with. We discussed how much I wished I could choose him, but his price, though worth every single penny was higher than I could afford and Dr. Aly, so kind and generous, offered to reduce his price so that he fit within my budget.

My decision was made. I was going with Dr. Aly, he had the experience I wanted, specialized in this type of surgery, his price was within my budget and included everything I wanted to get done including implants, and I hung up the phone with a sigh of relief that the decision was made and phoned home to tell Jason and Heather the good news.

And the door got slammed in my face. It is RARE for this to happen. Through this entire journey Jason and Heather both have been 100% supportive of any decision that I wanted to make. They have voluntarily given up nearly three years of their life and any extra comforts they wanted, to make sure that I could do whatever it takes to get to the end of this journey and be happy with my weight, my body and my career. They have NEVER just put their foot down and said “No,” to me. But this time they did. Jason absolutely refused to allow me to travel to CA, to have surgery in a place where I would recover in a hotel room that didn’t provide all the comforts of home and where the only person I had to take care of me after was Heather who would fly with me. He said that I had incurred too many complications after each of my other surgeries, including repeatedly passing out and hitting the floor during early days post op, several swelling that lasted weeks and weeks at times, and that when we were talking about such a huge amount of surgery, with an estimated 6-10 hours of operation time, that there was no way he was going to allow me to do it in California. I was shocked, confused, a little lost, and freaking out over what I was going to do now. Both surgeons I was considering were based out of CA, and now I was back to square one as my family vetoed not only the surgeon I had selected, but my second choice… AND one of the other surgeons I still had a consult with, Dr. Stoker, the surgeon that Chris Powell uses on his show for his clients.

My friends, I believe, whole heartily that sometimes the reason one door closes is to force you to walk through a different one and as I sat in my dear friend, Yvonne McCarthy’s (Bariatric Girl ) car after having just hung up the phone with Dr. Aly and my Husband as she drove me to a consult she had set up for me with the surgeon she used for her  reconstructive surgery, I was wondering what I was going to do next. Because honestly, I had never heard of Yvonne’s surgeon, he wasn’t some big name surgeon in our community that specialized in excess skin removal, and bluntly, in my head, I wasn’t taking this consult seriously because let’s face it, I lost ALOT more weight than Yvonne did and had ALOT more excess skin issues. My expectation as outlandish as it was, was that Yvonne was taking me to someone who probably did really good Mommy Makeovers, not someone who specialized in excess skin removal after massive weight loss. ( Yvonne and Dr. Yaker you may both smack me upside the head next time you see me, I deserve it. )

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Let me just say … Boy was I wrong, I will admit it, let me eat some humble pie here. Never-ever should I have doubted Yvonne and the quality of who she would suggest I allow to work on my body knowing how much she loves and cares for me. It was a horrible mistake, and I was completely wrong. Like survey says XXX Wrong.

Yvonne and I sat and chit chatted on a couch as Dr. Yaker walked in and sat down. He began to ask me about what I wanted to achieve, what I had done thus far, and we talked in great detail. As Dr. Yaker spoke to me, the first thought that entered my head was, “This man has been doing this longer than I have been alive.

Over the course of the next two and half hours that Dr. Yaker spent talking to me, the best thing I think I could say to describe my experience with him was “I felt safe, one hundred percent safe, for the first time in my entire plastic surgery journey.”

Unlike my experience with my Surgeon in Oregon where everything I wanted and every question I had received resistance and an answer that scared me, Dr. Yaker, had an answer for everything that put me at ease, reassured me and offered me a solution that was comforting.

We talked about my abdomen first. Dr. Yaker suggested doing a Fleur-de-lis incision that would not only allow him to excise the skin that is still in my abdomen, but also allow him to redo the incision on my bikini line from my 360 that would excise skin in a horizontal direction, addressing not only the issue of excess skin still left in my mons area that I wasn’t even bothering to ask someone to fix, but also remove the unsightly pucker where my skin healed a little straggly around the drain tubes during my thigh lift which look sort of like little mini belly buttons located at the tips of the V of my mons. Additionally it would remove some pockets I have in my skin from sores that got when I had a lot more skin there that didn’t heal quite correctly. When I asked him about it messing up my belly button he assured me I would have another new, and even more aesthetically pleasing belly button once the skin was gone and my tummy and mons were flat. But where I was sold my friends, was when I asked him about what my Oregon Surgeon had said about the chance of me having this bulge between my breasts ruining my cleavage or an unsightly scar that could resemble a flabby butt crack up the inside of my stomach. Dr. Yaker looked at me with the most caring and compassionate look I have ever seen on a surgeons face and said “That won’t happen, but if it did, I would fix it.”

When we discussed fixing my arms. He told me in great length how he would go about doing it, using a different type of incision near the elbow to insure I didn’t end up with that dog ear deformation, how he would wrap the incision around the elbow, excise the skin on my forearm, and as I stood in front of him completely naked where I would normally feel exposed and vulnerable, he made me laugh, and Yvonne too as she sat in the front part of his office where she could hear everything but not see us, and when I asked him about doing liposuction to my arms remarked “I’m not sure what we would liposuction you don’t have any fat, it’s all skin.” He went on to suggest that instead of doing liposuction on my arm to try to get it to match that little half-inch band that bothers me, that if removing the skin did not reduce it enough to make it unnoticeable the next time I was in town he would do a fat injection to that small little portion of my arm to balance it out with the rest of it. “I’m not sure where we will get the fact from you don’t have much on you at all, but I’ll find some.” – If I hadn’t been naked I would have hugged him right then and there. It was truly a WOW moment for me to be standing there naked in front of a doctor telling me he didn’t know where he was going to find fat on my body.

When we discussed my implants and the asymmetry I saw in my breasts on the 3D models I had seen from another surgeon, he took the photos, agreed with what I saw, and not only did he suggest that perhaps we could use different size implants to balance out the size difference of my breasts, but said if he needed to he would excise a small portion of skin from under my left breast, which is larger, and do a small lift on that side to get it closer to the size of my right breast as he put the implants in.

When I pointed out to him the place on my right hand side where I had wound break down after my lateral abdominoplasty and the small pucker I had on my left hand side where that same lateral incision met my 360 line he assured me that he could also fix both of those things.

Additionally he explained to me how he would work on reconstructing my abdominal muscles and abdominal wall while he was doing the Fleur-de-lis and how he would anchor the skin to the abdominal wall in order to avoid any movement, the build up of fluid and avoid seroma’s after surgery.

I received a tour of his operating room, I got to see the patient recovery room I would be staying in overnight after the surgery, I got to meet several of the women on his staff, some of which had worked for him for well over twenty years and spoke candidly about how well he treated them and took care of them.

And when it came to deciding what size implants I wanted, I wasn’t faced with just pictures of my breasts that I could where I could hardly distinguish the difference in size; instead I was put in a bra where the implants could be inserted so that I could put a garment over them, spin around and see what my breasts would look like when they were done, and pick the size that I was most comfortable with as his lovely assistant helped me decide what would look the most natural and proportionate on my body.

I felt at home, I felt safe, and I knew at this moment that the door my Family had shut not allowing me to travel to California for this surgery, had led me through this one; because not only had I just met the surgeon that cleared up the sea of confusion in my head, but made me feel safe and secure. I knew two things for sure. If there was anyone I could afford Dr. Yaker I was going to use him and fate had led me right here, because the only other place that my Family would support me having this surgery in other than at home in Oregon was here in Dallas where I could recover in the comfort of my own room, fully equipped with all the comforts of home including a Tempurpedic bed, recliner, television and my own walk in shower. In truth, this environment will probably be even easier for me to heal in because we won’t have the issue of me stepping in and out of a tub based shower right after surgery and we won’t have the added concern of the animals jumping up and down on me when I am healing. Additionally not only will I have Heather here to take care of me after, but my best friend in the entire world, and her husband, who trained as an EMT when he worked for a non-profit organization known at the Guardian Angels.

The timing on finding this surgeon could not be any more perfect, as I am already here in Dallas and instead of flying home as originally intended on the 1st of July, I will cancel my flight back to Portland, stay here for my surgery which is now schedule for July 11th, and remain here to heal until it is time for me to fly to Arizona to attend the Obesity Action Coalition Second Annual Your Weight Matters Convention YMW2013 on August 14th. This actually saves me a little bit of money on airfare and makes it possible instead of just bringing Heather to Dallas to help take care of me, also take her to Phoenix with me, so that I’m not trying to negotiate suitcases, a plane ride and Convention weekend alone jus four weeks out of reconstructive sugary.

The only problem that we had at all was that Dr. Yaker’s quote exceeded the budget that my Godfather had given me by $2,275 – it wasn’t a huge difference, but it was more than I had, and really, I wasn’t comfortable with the idea of trying to borrow any money or putting it on a credit card because quite frankly, the last 2.5 years of this journey has, not counting automobile loans, put my entire family nearly $56,000 in debt from beginning to end. Now that is NOT all medical costs, about $20,000 of that includes things like my insurance deductibles, co-pays from start to finish, Gastric Bypass to Reconstructive Plastics. The rest of it can be attributed to cost of living and making up for me not having a steady income through this last two and half-year journey as well money I spent taking care of my Mother and constantly bailing her out when my Father passed away. It includes the money I spent ensuring my Father had the most comfortable life I could provide him when he had his first stroke just three months after my Gastric Bypass. It includes money I have spent on my education to become a personal trainer, and the few items that we purchased to help me get there like the laptop I write all my blogs from. It includes costs I’ve charged to attend the conventions I have attended, like the Obesity Action Coalition and the WLSFA Event. But we’re getting to a point where the minimum payments are getting bigger and bigger and until this last surgery is done, my certification is achieved and I can start working again, doing anything else or taking on another payment that I am not 100% confident I can repay just isn’t an option.

Though I knew Dr. Yaker was the one for me, when I left his office early Tuesday evening I had to tell his office Manger that I couldn’t book yet because they were a little over my budget and I had to see if there was anyway I could manage to afford it. I couldn’t sleep at all Tuesday night, I spent the entire night texting Heather about how guilty I felt. She and Jason of course told me to go ahead and we would find a way to come up with the money and get through until the surgery was over and Heather and I could both get back to work. But them being willing to do that for me just made me feel guilty and selfish, they have given up so much for me in the last two years, I couldn’t ask them to give up more. When I left the house Wednesday morning for a run I hoped that if I spent some time running, spending time with my Father in his home state of Texas, the answers would come to me. I don’t know what answers I was expecting, but I was hoping for them. I was on my way home from my run she I got the call Dr. Yaker’s office that Dr. Yaker was willing to drop the price for me to try to make it possible. Dr. Yaker graciously waived $2,225 dollars of his surgeons fee bringing the total down to just $50 over my budget.

I walked through the door of my best friends house, jumping up and down, excited, relieved and KNOWING that I could find a way to come up with that last $50 that I needed. The first thing I did was call Yvonne to thank her and tell her the good news. I laughed a little as the first thing out of Yvonne’s mouth when I told her that Dr. Yaker was able to come down to just $50 over my budget was “I will cover that for you.”

I spent a lot of time yesterday on telling all  my dear friends the wonderful news. I booked the surgery, made my pre-op appointment and re-arranged flights as well as getting Heather’s ticket to fly to Dallas the day before my surgery, which thankfully only cost $135 – So at the end of the day, I ended up $135 over budget since Southwest won’t allow me to use the flight credit on my flight back to Oregon for Heather instead of me.

This has been one of the most emotional two weeks of my entire weight loss journey but today, I breathe easy, and I have absolute confidence that life and my Dad’s guidance and presence in my life and weight loss journey has brought me to where I need to be and as this part of my life falls into place, the rest of it begins to as well. I am doing extremely well with my commitment to studying for my Personal Trainer Certification Test, I spent two hours yesterday shadowing my Trainer Mentor Bobby Whisnand as he did fitness assessments with two pre-op bariatric surgery patients, I ran a 5k, walked two miles, booked my surgery, shared all the amazing news with my friends and managed to get flash cards made for eleven out of fourteen pages of my notes on Major Muscle groups.

Today I’ll spend some time exercising in the house getting my cardio in on the elliptical and maybe squeeze in a trip to the gym tonight to do some strength training after I spend my committed noon – 8pm studying. As I do, I will be listening to the song I ran to that first night when I made the deal with my Father that he would be with me through exercise during this journey on repeat a few times and smiling as I appreciate the Universe smiling on me and the significance of the song.

“You don’t have to feel like a waste of space
You’re original, cannot be replaced
If you only knew what the future holds
After a hurricane comes a rainbow
Maybe you’re reason why all the doors are closed
So you could open one that leads you to the perfect road
Like a lightning bolt, your heart will blow
And when it’s time, you’ll know”

As my friend said yesterday, I feel like the Universe is making up for all the horrible things that once happened to me. I feel charmed, I feel blessed, and I feel free, free from being haunted by my past and ready to come out of this ready to show the world what I am worth. I said 2013 was going to be my year. I still believe this. It’s my time, and I love each and every one of you for being a part of it with me.

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Author: Pandora Williams

Author of Desperately Seeking Slender

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