The diary of an overweight woman

The American Medical Association refers to it as diagnosis code 278.01.

A disease that affects 9 million Americans and kills 400,000 each year.

A serious disease that attracts stares on the street and the occasional snicker from strangers, family and friends alike.

The weight of obesity is measured in more than pounds.

After years of struggling with her size -- with failed diets, unsuccessful exercise routines and cutting criticism -- Joyce Stroup-Tummins decided to undergo gastric bypass surgery.

She knew the experience was likely to change her life; she had no idea how much.

By Joyce Stroup-Tummins

Special to the Southeast Missourian

Monday, Nov. 13

Today, I'm on my way to St. Louis to St. Alexius Hospital for pre-operative testing.

It's been quite an ordeal to get this far in my quest to shed almost 30 years of accumulating extra weight. I've probably completed at least 100 pages of medical history at this point. Genetics plays a major role in obesity and whether people want to acknowledge it or not, morbid obesity is a disease.

The first time I got a glimpse of my medical records while waiting for my internist in her office, I saw "morbid obesity" scrawled between "hypertension" and "depression."

I was so embarrassed, hurt and angry. My throat constricted as I choked back the tears. I've always been a sensitive person, but the doctor's words seemed just plain mean-spirited, demoralizing and discriminating.

The term stung. Now I felt that everywhere I went, whoever I spoke to or walked by on the street would look at me with the words "morbid obesity" running through their thoughts.

I've always had a pleasant disposition, a humorous outlook on life, a pretty face and nice hair. But now, more than ever, when I looked in the mirror, all I saw was a fat, grotesque middle-aged woman who was definitely not pleasing to look at. Going clothes shopping had lost all its fun once I had to go to the plus-size section. I would shop for hours for something slimming and fashionable, only to come home empty-handed.

I noticed that men had stopped looking at me when I gassed up the car. Years before, this is how I judged my sex appeal. When I walked in the mall, stopped to pump gas for the car, went to an automotive parts store or repair shop, there would always be "that stare." You know what I'm talking about. You feel someone eyeing you up and down and it's humiliating, yet appreciated at the same time. The "look" that tells you that you are desirable to the opposite sex.

Since my divorce eight years ago, the last couple of years have been my longest dating dry spell. A few years ago, that would have devastated me, but now, it really isn't one of my priorities in life. I'd like to remarry someday, if that is what God has planned for me.

I had just opened up my own business -- a hair salon in the basement of my home -- and my daughter had recently gotten engaged, so between wedding planning and advertising for clientele, all of my time and energy was being consumed.

Thursday, Nov. 16

I just found out that I have to have an angiogram next Monday afternoon.

This is definitely going to throw a wrench in my gastric bypass surgery. I even began my two-week liquid diet two days ago. A day before that, I quit smoking. With no food and no cigarettes to quench my stress, I've been pathetically sobbing and feeling sorry for myself. Overly obese people live to eat. It's the comfort foods we seek whenever we are feeling happy, sad, nervous or even bored.

My mother used to be a home economics teacher, so cooking was instilled in me at an early age. By the age of twelve, I was making homemade pizza crust, fudge and casseroles. It was cooking that brought me joy and it was even more enjoyable to sit down and eat the fruit of my labor. I won the Betty Crocker Homemaker of the Year award when I was in high school. By the time I was married and living on a farm in Tennessee, I was known in my rural community as being a fantastic cook. I won first place ribbons for my giant chocolate chip cookies and chocolate pecan pies at the fair, won awards from the Farm Bureau Homemakers Association, and my white beans and ham were always in demand at the annual fish fry for our local volunteer fire department that I was instrumental in getting started.

In order to make my bypass operation successful, I had to completely change my mental outlook on food. Instead of living to eat, I would have to train myself to eat to live, instead.

When I went to St. Louis for pre-op testing on Monday, my EKG was abnormal. Frightened by the anesthesiologist's precautionary warning that I would have to have a cardiologist's clearance before proceeding with my surgery, I used my best sales techniques to attempt to change his mind. After all, I had a complete cardiac stress test last January and nothing was said about any abnormalities.

It was, I reminded him, a computer that recorded my heart's rhythm and everyone knows computers are not always accurate. Despite my pleadings, he and the nurse firmly reiterated that the doctor would refuse to do my surgery unless I had clearance from a cardiologist.

I had one problem. I didn't have a cardiologist, and I didn't want my surgery to be postponed. I had worked too hard and too long -- nearly two years -- to research the surgery, choose my doctor, get all the tests done and the paperwork sent to the right hands.

In a month, I'll be facing the big five-0.

I will have been around for half a century. That's enough to make me cringe.

You would think that by now, surgery would not be a big issue with me.

After all, I've had my share -- eight teeth were extracted by oral surgery prior to having orthodontics; both of my children were born by Caesarean section; a short while later, I had a hysterectomy; and a year after that, I underwent urological surgery, which was significantly painful with complications and a slow recuperation period. After the surgery, I had to wear a catheter for two weeks.

But even with these experiences behind me, I realized today I'm not prepared for what's to come.

Follow Joyce's weight-loss journey each week at www.shethemagazine.com

About the surgery

Laparoscopic Roux-En-Y Gastric Bypass is the most common gastric bypass surgery.

In normal digestion, food passes through the stomach and enters the small intestine, where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon), and the remaining waste is eventually excreted.

In a Roux-En-Y gastric bypass, the stomach is made smaller by creating a small pouch at the top of the stomach using surgical staples (or a plastic band as in the Lap-Band method). The smaller stomach pouch is connected directly to the small intestine, bypassing a large part of the stomach and duodenum. Not only is the stomach pouch too small to hold large amounts of food, but by skipping the duodenum, fat absorption is substantially reduced.

This procedure can be done by making a large incision in the abdomen (an open procedure) or by making a small incision and using small instruments and a camera to guide the surgery (laparoscopic approach).