Vol 69: As good as it gets
People rarely ask ‘how are you?’ anymore. Perhaps it’s a consequence of this new era in a post-pandemic world, one where unmasked individuals, flanked by their own problems, no longer feel the need to make small talk with strangers. Or maybe it’s not that we don’t care, but we don’t want to open the conversation for fear of hearing about yet another person who’s died from Covid or cancer. For those who miss the connection generated by this traditional opening line of conversation, it can feel like the warmth of humanity has unceremoniously seeped away with tacit consent and minimal chance for resurgence.
But, for the wild and reckless who dare to dream, pockets of resistors march forward unphased by the events of the past two years. Charging ahead, they recall the importance of community and remain willing to not only ask how are you, but also offer a proper handshake or a hug, friendly advice and a hot meal for any and all in need.
Today, whenever Summer wants to feel that human connection, she thinks of life on Long Island, one of the many breathtaking islands in The Commonwealth of The Bahamas.
Situated just 165 miles southeast of Nassau, Long Island was Summer’s home for many years before she was offered a higher salary and relocated to the United States for work. There, people still say good morning and smile. They wave at strangers and stop to enjoy a hot meal of seafood caught earlier that morning, seasoned and boiled and served with buttered grits and a sweet bread locally referred to as Johnny cake. For the rest of the day, they dine on fruits and vegetables harvested in their backyard with meat from livestock born and killed at their own hands, but laden with the respect that their life sacrifice deserves.
On Long Island, where the ocean glistens a majestic turquoise blue and the air is so fresh it melts the stress off your shoulders, Summer learned the true meaning of life, honesty, hard-work, family and a deep respect for food. Even at a young age, she knew that this was as good as life gets. She believes that those values which were instilled in her from childhood, by a village of loving aunts and uncles, cousins and neighbors, is what ultimately saved her life as an adult.
My patient chose the alias Summer because it represented an incredibly happy and peaceful time during her formative years.
It wasn’t until she had her only child, a son, at the age of 20 that Summer began to struggle with her weight. Despite only eating three healthy meals a day and exercising regularly, her weight ballooned from 185 to 257 pounds in a few months. She went from wearing a size 12 to a size 20 and at 5’2, she was nearly as wide as she was tall despite her healthy lifestyle. Summer tried multiple diets over several years but nothing helped. She could not drop below 215 pounds no matter how hard she tried.
When Summer finally sought the assistance of a medical professional to discuss her irregular periods, he dispassionately told her that she was obese and simply needed to stop eating. She tried to explain that she doesn’t overeat and the weight gain only started after her pregnancy but he wasn’t interested. Summer’s family alternatively felt that she was worrying over something silly and didn’t see her weight gain as a problem. In fact, they encouraged her to stop dieting since it was causing constant anxiety without producing results.
It took seven years before Summer’s concerns were justified and following blood tests and an ultrasound, she was finally diagnosed with Polycystic Ovarian Syndrome (PCOS) by a doctor who cared enough to listen. With this incurable condition, her ovaries produce an abnormally high amount of a male hormone called androgen. This hormone imbalance caused her to develop Diabetes. Left untreated it could have also caused other health complications like high blood pressure and uterine cancer. So, she was prescribed birth control pills and Diabetes medication by an endocrinologist.
At the time of her diagnosis, Summer was suffering with truncal obesity where an excessive amount of visceral fat was housed around her stomach and abdomen. This then predisposed her to developing insulin resistance where the cells in her body stopped responding to insulin and couldn’t absorb glucose as effectively as they once did. As a result, Summer’s blood sugar levels rose unabated to critical levels, coming dangerously close to sending her body into shock on more than one occasion.
When her weight increased further, Summer sought a second opinion from another endocrinologist in the US. It was then that she was diagnosed with Grave’s disease, an autoimmune disorder that causes your thyroid to become overactive thereby leading to an irregular heartbeat, sweating, muscle problems, changes with vision and complications with fertility. Summer was devastated but was determined to stay as healthy as possible for her son.
But in 2010, at the age of 30, Summer nearly lost her life and the chance to watch her son grow up after she contracted the H1N1 swine flu. The influenza virus ravaged her body with symptoms of diarrhea, vomiting, fever, fatigue and body aches so severe that minute by minute she felt herself slipping closer and closer to death.
Pale with scabbed lips and no energy to speak or walk, Summer was given IV drips constantly to replenish her electrolytes. Her situation was dire and doctors had essentially measured her for her coffin, with little hope or belief that she’d survive. Barely able to sleep, nightmares of her impending death also robbed her of a justified slumber. But survive she did and after a few weeks, Summer was released from the hospital weighing 165 pounds.
A year later, Summer’s weight was back up to 215 pounds and she was referred to a weight management team where gastric bypass surgery was recommended. Summer jumped at the opportunity to forego taking medication for the rest of her life. For the next six months, she met regularly with a psychiatrist, started a food journal and underwent an endoscopy to assess her upper gastrointestinal tract for any abnormal findings.
For the first three months following her surgery, she only drank liquids and she dropped down to 145 pounds, the smallest she’d ever been in her entire life. Once she began consuming solid foods, her weight increased to 155 pounds and a size six where she remains to this day.
Summer goes to the gym three times a week and she’s no longer on any medication except for a daily (bariatric) multivitamin and calcium supplement. Summer says that it takes a lot of effort to maintain her weight and she has an alternative for every food option available at the food court where she eats lunch at work. But she doesn’t deprive herself and practices balance by satiating her cravings once and a while and never over-indulging.
Summer’s take home message to readers is to always listen to your body because no one knows your body better than you do. She adds never giving up on yourself even if the first doctor you see seems to have done so. Doctors make mistakes or miss a diagnosis that a second medical professional might find.
Summer also stresses that our bodies were made for movement and a sedentary lifestyle straps a tombstone around your ankles. But what you eat is so much more important than what you do so she also encourages everyone to seek the assistance of a nutritionist or weight management professional to get advice specific to their own needs.
A teacher by trade, Summer willingly shares her experience with anyone who’s interested in learning more about what she’s endured and how she overcame it, hopeful that her journey can smooth a path for others facing similar trials. She does it because embracing others is a trait passed down by her mother and generations of hard-working and caring Long Islanders. And, since distance is not a counter to memory, this characteristic remains fervently on display in her classroom thousands of miles from where she grew up in The Bahamas.
Bariatric surgery isn’t for everyone and for many people it’s caused more harm than good. In Summer’s case, however, it was a life-line that transported her from a past littered by struggle and self-doubt to a day where she feels healthier and more energetic than ever before. One where she can find wonder in the mundane and excitement just dancing with her son, music blaring, no matter the genre, because life in all honesty doesn’t get much better than that.
This is The KDK Report.
