Part Two: Consultation Appointment
I had high hopes for the appointment with the first general surgeon. I had verbally given my surgical and weight history to the nurse and she replied that the doctor said, “Congratulations on your significant weight loss! We can see you for a panniculectomy at your current weight to discuss it.” YES! So excited and so anxious!
But as I got more details closer to the date, I realized the appointment was likely to tank. The consult was scheduled for only 15 minutes in-person and included a mandatory bare-skin exam. I spoke with the nurse several times, pleading for a longer appointment, and to postpone the exam portion till a second appointment. This was firmly denied as a possibility until I was in the car on the way to the appointment. I had childcare so I could not reschedule.
When I got there, the surgeon walked into the appointment and stated that I was not far enough out from my revision for a panni. They were also irritated that I did not reschedule with their “generous” offer of a longer appointment a month from then. Immediately after that, they wanted me to show them my skin for evaluation which I declined as I needed more time to build rapport and safety. Their body language became even more defensive.
When I explained that I was regularly stalling, they told me I needed to eat less as “clearly [I was] eating too much.” I could come back when I reached 9 months post-op and they wanted me closer to a 40-45 BMI. Um, that was my goal weight and there was no way that I would get there with this mass of skin and fat!
I left the appointment and proceeded to weep in my car. I don’t remember how I made it home, but thankfully it was not a long drive. I already had a second consult set up for the next a week after that but I was so shaken by the miscommunications and dashed hopes that I called his nurse the next morning. I begged for any option possible to be able to get a message to the doctor in my words. She allowed me to email her something to give to him.
Well, he read the email. He signed on to the video appointment on April 13, 2021, visibly pensive with a slightly furrowed brow. He jumped right into talking about the risks as the email provided my history and purpose for seeking one at 377lbs. But right off the bat, I felt heard. I felt seen—my struggles, my determination, my fear of failing.
His words were honest and vulnerable—not common traits in an experienced surgeon. I could feel his unease and uncertainty from 43 miles away. I don’t think I was breathing much. I was furiously writing down all the risks as he described in great detail what was likely to happen, and it was grim. The heaviness of this appointment seemed to be affecting both of us.
He told me, “I can do this surgery, but I don’t want to put my name on it. You will NOT look okay. You’ll have dog ears, more hanging skin as you lose weight, and you’ll likely be re-hospitalized with wound complications. I also don’t want to make the body dysmorphia you mentioned worse. I can’t say it enough. You will not look okay if I do this surgery now. Knowing all that, do you still want to do this?”
I started to cry. I answered, “Yes, I think this is what is holding me back from meeting my health goals.” He quickly asked me how I felt about blood transfusions and said the chances of needing one were high. “I won’t force you to have one but for safety, I cannot do this surgery if you’re not comfortable with having one.” I awkwardly choked out the words, “Yes, all life-saving measures! I am doing this in hopes to live, not to die!”
And with that, his relief was evident. He asked if I was comfortable standing up to show him my skin and I was. I felt safe enough to even pull my pannus out of my pants to show him better how far it hung! That is a feat no other doctor has ever accomplished before then. I didn’t feel judged at all. I know the physical distance of the virtual appointment helped greatly with my comfort.
He said to get off as much weight as possible before the surgery but he wasn’t going to require a specific amount. That relieved a lot of stress and prevented me from the pitfalls of perfection and past failure overshadowing my drive. We wrapped up the appointment and set a date for 2 weeks from then for the physical in-person exam.
(Part 3 coming!)
Wisconsinite Yooper 