Nearly 16 years later

[RonRN18 10]

I am a male who had a gastric-reduction/duodenal-switch surgery performed on March 12, 2004. At the time of surgery, I was 483 pounds and I am nearly 6'5" tall; yes, I am a big & tall man. By my 1-year anniversary, I had slimmed down to 275 pounds.

I was 32-years-old at the time of surgery. Up to that point in my life, I had only been on three dates in my life; never a second-date. This was not for lack of trying... at least at first. I had been rejected so many times when trying to ask a girl out that I liked and it appeared she liked me. So many times, after asking a girl out that had been nice to me and appeared to like me, the act of asking them on a date killed the "relationship" and they would keep their distance after that. Instead of developing a personal life, I focused on work. My self-esteem at romance was less than zero.

In addition to being overly fat, I also weighed a lot because I am both big-boned and very muscular. When I say "big-boned," it is not an excuse for being fat (like Eric Cartman of South Park), but literally, per physicians who have seen my X-rays, I have very large and thick bones. When I was in high-school, I was "big" into weight-lifting. I set records at my school in weight-lifting that still stand to this day, more than 30 years later. One such record was the "sitting leg-lift", where I straightened out my legs to lift 1,400 pounds. I would do many repetitions of isolated leg lifts of over 2,000 pounds. After high-school, I stopped weight-lifting as an exercise but still would make a point to move heavier objects than anyone else in practical life. I was a volunteer firefighter for 10 years; as I was in college and for the first several years of my professional life (as a nurse). It was during my life as a nurse, my lifestyle became more sedentary and I went from being "obese" to "super-morbid-obesity".

I was an emergency department nurse at the time I had weight-loss surgery. Thankfully, I had no significant co-morbidities with my super-morbid-obesity. After surgery, I dropped weight extremely fast. The first week, I lost 28 pounds. The second week, I lost an additional 23 pounds. By one month, I was already below 400 pounds. By six months, I was down to around 300 pounds.

By this time, I felt like a new person. I decided to start seeking a romantic life. I had many female friends that I worked with, but they all treated me like a brother and I didn’t want to ruin another “relationship” by trying to transition it into romance. I didn’t know what to do, so I went to eHarmony.com. I went on one date from the site, but that didn’t go anywhere. My next date from the site, I married, and we have been happily married for 14½ years so far.

Over the years, I still deal with “letting go” and ballooning up to the highest weight of 315 pounds, before refocusing on what I am eating and losing weight. At one point, I was exercising like crazy and was on an extremely low-calorie, ketogenic diet. People actually told me that I was looking unhealthfully thin. I got down to 212 pounds. I did several body-composition testing procedures and all seemed to corroborate with a body fat percentage of around 8%. I had a lean-body mass of around 196 pounds. I was “proud” of this accomplishment, but I did not feel that well and I was torturing myself to accomplish it too. I finally decided to stop torturing myself; this was back in 2013.

Since then, I’ve kept my weight about 270 pounds, plus or minus 15 pounds. I’m told, by people that don’t see me naked, that I look thin or “healthy”. What they are NOT seeing is all the excess skin and fat folds obscured by shorts and a T-shirt. Even with just swim trunks on, people don’t realize all the abdominal skin I have tucked below the waistline. Since I don’t wear “Speedo-style” swimsuits, they don’t see all the excess in my thighs either. At this particular moment, I weigh 267 pounds and have a body fat percentage of 26%. I have long wanted to get rid of all this excess skin. I have no way of knowing this for sure at this time, but it is my belief that the excess skin weighs around 50 pounds; I believe that much of this excess skin is counted as body fat in composition testing.

As mentioned, I’ve been living with all this excess skin for quite some time. While I get chaffing between the thighs, which can get raw from time to time, I have not had sores or skin-breakdown/infection due to the excess skin. I was originally told that this was the only way health coverage would pay for the skin removal process. I have since heard that my health coverage company has successfully been sued for not covering skin-removal surgery, so their stance has changed. I’ve reached out to my primary care physician, but he told me that due to my “Body Mass Index,” I don’t qualify for surgery. I’m told that my BMI must be less than 30. This frustrates the heck out of me, as I’ve already pointed out, my lean body mass is 196 pounds. If I had ZERO body fat, my BMI would be 23, which is the middle of “healthy” when obviously 0% body fat is NOT healthy! I’ve pointed this out to my PCP, showing that BMI is NOT a valid indicator of a healthy weight; it does not take body composition into account. He said he’d reach out to the departments that handle this to re-evaluate... hoping to hear back soon.

[Healthy_life2 8,324]

Thanks for sharing your story and fabulous results,

Your primary care physician is not the deciding factor for plastics. You can also get a second opinion by another Dr. You may want to call your insurance provider to see if they changed their stance on plastics.

Most insurance companies don't cover plastics. Many people have to self pay if they choose skin removal.

[🌱VeGan❤️HeArT🌱 97]

Thank you for sharing your story! You have been through so much, and I hope you find the answers you seek.

[Lady VS 1,147]

Any word yet?

Sent from my SM-G965U using BariatricPal mobile app

[RonRN18 10]

15 minutes ago, Lady VS said:

Any word yet?

Sent from my SM-G965U using BariatricPal mobile app

My PCP got back to me, saying he'd refer me to plastics. I had a telephone conversation with a plastic surgeon, who said that BMI is not the SOLE decision factor and said that the next step is an in-person exam. Our telephone appointment was about 20 minutes of talking, then he transferred me to the scheduler and have an appointment for next week, face-to-face with the surgeon. I hope all goes well. Even if it is not a 100% covered expense, I'm hoping that it will be affordable.

[RonRN18 10]

Well, I had that appointment with a plastic surgeon back in January and he approved the thigh lift at 100% coverage. In case anyone wants to know, I have Kaiser Permanente Northern California now... not the same insurer as when I had the GR-DS surgery in 2004. I really want the excess abdominal skin removed but that part isn't covered. The abdominal surgery will be around $9000, $1000 paid prior to scheduling. Unfortunately, this whole COVID thing canceled all of these surgeries for quite some time. Kaiser started performing elective surgeries in late July but they are rationing OR time with all of the many different surgeons. I have been waiting to hear when exactly I'll be having my surgery. On Tuesday, I got a call from the OR scheduler and I was given a surgical date. October 8, 2020; that would be 16 years and 30 weeks from the date of my weight-loss surgery.

Oddly, they are telling me that having a thigh-lift/panniculectomy/tummy-tuck is an out-patient procedure. Thankfully, the surgery is performed at a hospital, so if there is any complication, I'm already at a hospital but the plan is to send me home the same day.

Now that I have my surgical date, I have a video appointment with anesthesia and a physical appointment with the plastic surgeon this coming Monday. Two weeks after that, just a few days before the surgery, I have to go in for a COVID screening. I also have a physical visit with the plastic surgeon four days after surgery and one week from surgery with a nurse.

I'm getting excited. I am hoping it will be much easier to find clothes that fit after surgery. My current actual waistline, going over these folds of skin, is 38" but I have to go with 42-44" or sometimes even a 46" waist in order for pants or shorts to fit over my thighs. Because my inseam is 36", it is quite difficult to find pre-hemmed pants that long enough. Apparently, pant makers think that it is either big or tall and not big AND tall. Most pant makers, even in specialty stores, stop 36" inseams at a waist size of around 36-38" and almost never at 40" or larger. Due to this, I'm hoping that I can go with pant sizes with the waist size 10" or smaller than I currently do.

[GreenTealael 25,335]

On 9/17/2020 at 5:24 PM, RonRN18 said:

Well, I had that appointment with a plastic surgeon back in January and he approved the thigh lift at 100% coverage. In case anyone wants to know, I have Kaiser Permanente Northern California now... not the same insurer as when I had the GR-DS surgery in 2004. I really want the excess abdominal skin removed but that part isn't covered. The abdominal surgery will be around $9000, $1000 paid prior to scheduling. Unfortunately, this whole COVID thing canceled all of these surgeries for quite some time. Kaiser started performing elective surgeries in late July but they are rationing OR time with all of the many different surgeons. I have been waiting to hear when exactly I'll be having my surgery. On Tuesday, I got a call from the OR scheduler and I was given a surgical date. October 8, 2020; that would be 16 years and 30 weeks from the date of my weight-loss surgery.

Oddly, they are telling me that having a thigh-lift/panniculectomy/tummy-tuck is an out-patient procedure. Thankfully, the surgery is performed at a hospital, so if there is any complication, I'm already at a hospital but the plan is to send me home the same day.

Now that I have my surgical date, I have a video appointment with anesthesia and a physical appointment with the plastic surgeon this coming Monday. Two weeks after that, just a few days before the surgery, I have to go in for a COVID screening. I also have a physical visit with the plastic surgeon four days after surgery and one week from surgery with a nurse.

I'm getting excited. I am hoping it will be much easier to find clothes that fit after surgery. My current actual waistline, going over these folds of skin, is 38" but I have to go with 42-44" or sometimes even a 46" waist in order for pants or shorts to fit over my thighs. Because my inseam is 36", it is quite difficult to find pre-hemmed pants that long enough. Apparently, pant makers think that it is either big or tall and not big AND tall. Most pant makers, even in specialty stores, stop 36" inseams at a waist size of around 36-38" and almost never at 40" or larger. Due to this, I'm hoping that I can go with pant sizes with the waist size 10" or smaller than I currently do.

So exciting! How did Monday's appointment go?