Skinny_Krissy

Hello Phewforaminutethere,
I totally sympathize - I lost four years of my life to UHC's WLS exclusions. Unforatunately you're dealing with a heartless, amoral company that doesn't think twice about ruining people's lives.
You have a couple of options: You can try to convince your employer to switch insurers or buy a rider, though UHC wouldn't even price one for my company. Put differently, it wasn't willing to sell my employer WLS coverage for ANY price, not even $1 trillion/year. Switching plans for one employee was a no-go for my HR department.
You can TRY the healthcare.gov marketplace, but since Texas chose not to require WLS benefits for its citizens, it's very unlikely that you'll be able to purchase a policy with this coverage. Typically when companies aren't required to offer this option, none of them do.
During my four years of hell, I found that I was unable to buy a policy on the "open" market for any price. Companies that cover the surgery typically won't sell to people who are fat enough to need it. So this is probably not a good option either.
Your best shot if you live near a border with another state (one that offers bariatric coverage to its citizens) is to consider moving across state lines. Otherwise, you might start looking for another job, though I changed jobs 5 times and never did get WLS coverage. Because of where you live, it's extremely unlikely that you'll be able to ditch your employer's plan and take your dollars to a company that does cover surgery, as those companies won't want to sell you a policy. Your only remaining option is to pay out of pocket, maybe in Mexico if the US is too expensive.
However, as someone who almost went to Mexico, waited until I had insurance coverage at one the best WLS surgery centers in the country, then had a life-threatening surgical complication despite having no risk factors, I can't stress enough how careful you need to be. I required weeks of tube feeding, several EGDs and a six-hour revision surgery that cost ~$136,000 before insurance discounts ($76k afterward). My good friend needed 8 corrective surgeries and was on daily TPN (IV nutrition) for 11 months. As a result, my feeling is that you need to think through the non-trivial possibility that you could have to file for bankruptcy if you self-pay and have a serious complication.
Good luck and sorry there isn't happier news.

Hello Phewforaminutethere,
I totally sympathize - I lost four years of my life to UHC's WLS exclusions. Unforatunately you're dealing with a heartless, amoral company that doesn't think twice about ruining people's lives.
You have a couple of options: You can try to convince your employer to switch insurers or buy a rider, though UHC wouldn't even price one for my company. Put differently, it wasn't willing to sell my employer WLS coverage for ANY price, not even $1 trillion/year. Switching plans for one employee was a no-go for my HR department.
You can TRY the healthcare.gov marketplace, but since Texas chose not to require WLS benefits for its citizens, it's very unlikely that you'll be able to purchase a policy with this coverage. Typically when companies aren't required to offer this option, none of them do.
During my four years of hell, I found that I was unable to buy a policy on the "open" market for any price. Companies that cover the surgery typically won't sell to people who are fat enough to need it. So this is probably not a good option either.
Your best shot if you live near a border with another state (one that offers bariatric coverage to its citizens) is to consider moving across state lines. Otherwise, you might start looking for another job, though I changed jobs 5 times and never did get WLS coverage. Because of where you live, it's extremely unlikely that you'll be able to ditch your employer's plan and take your dollars to a company that does cover surgery, as those companies won't want to sell you a policy. Your only remaining option is to pay out of pocket, maybe in Mexico if the US is too expensive.
However, as someone who almost went to Mexico, waited until I had insurance coverage at one the best WLS surgery centers in the country, then had a life-threatening surgical complication despite having no risk factors, I can't stress enough how careful you need to be. I required weeks of tube feeding, several EGDs and a six-hour revision surgery that cost ~$136,000 before insurance discounts ($76k afterward). My good friend needed 8 corrective surgeries and was on daily TPN (IV nutrition) for 11 months. As a result, my feeling is that you need to think through the non-trivial possibility that you could have to file for bankruptcy if you self-pay and have a serious complication.
Good luck and sorry there isn't happier news.

Hello Phewforaminutethere,
I totally sympathize - I lost four years of my life to UHC's WLS exclusions. Unforatunately you're dealing with a heartless, amoral company that doesn't think twice about ruining people's lives.
You have a couple of options: You can try to convince your employer to switch insurers or buy a rider, though UHC wouldn't even price one for my company. Put differently, it wasn't willing to sell my employer WLS coverage for ANY price, not even $1 trillion/year. Switching plans for one employee was a no-go for my HR department.
You can TRY the healthcare.gov marketplace, but since Texas chose not to require WLS benefits for its citizens, it's very unlikely that you'll be able to purchase a policy with this coverage. Typically when companies aren't required to offer this option, none of them do.
During my four years of hell, I found that I was unable to buy a policy on the "open" market for any price. Companies that cover the surgery typically won't sell to people who are fat enough to need it. So this is probably not a good option either.
Your best shot if you live near a border with another state (one that offers bariatric coverage to its citizens) is to consider moving across state lines. Otherwise, you might start looking for another job, though I changed jobs 5 times and never did get WLS coverage. Because of where you live, it's extremely unlikely that you'll be able to ditch your employer's plan and take your dollars to a company that does cover surgery, as those companies won't want to sell you a policy. Your only remaining option is to pay out of pocket, maybe in Mexico if the US is too expensive.
However, as someone who almost went to Mexico, waited until I had insurance coverage at one the best WLS surgery centers in the country, then had a life-threatening surgical complication despite having no risk factors, I can't stress enough how careful you need to be. I required weeks of tube feeding, several EGDs and a six-hour revision surgery that cost ~$136,000 before insurance discounts ($76k afterward). My good friend needed 8 corrective surgeries and was on daily TPN (IV nutrition) for 11 months. As a result, my feeling is that you need to think through the non-trivial possibility that you could have to file for bankruptcy if you self-pay and have a serious complication.
Good luck and sorry there isn't happier news.

Moonlitestarbrite, I definitely see where you're coming from, and clearly your actions come from a place of deep concern. But my response to you and to the OP, Shazam, is that this is just none of your business, even if you mean well.
With a very limited number of exceptions (i.e., minor children who need their parents' guidance and who should be encouraged by all means available to avoid a lifetime of obesity; close intimates who have expressed a willingness to confront their weight problem and asked for your help), it is no one's place to confront, intervene on or otherwise evangalize fat people, and just because we've lost weight post-WLS doesn't give us a license to insinuate ourselves into other people's struggles. This is true even if they'd be better off making the same choice we did.
For one thing, these "interventions" almost never benefit the person being targeted; they tend to be more about the person initiating the conversation's feelings (which have apparently been hurt by the target's weight gain), rather than offering concrete help. Are you prepared to go to this person's house every week and help him/her cook healthful foods? Are you offering him/her a gym membership? Even if you are, obesity is a terrible disease with all sorts of underpinnings, and I think you'd be better off dealing with your feelings of disgust and alarm over other people's weight choices. Not all fat people are going to die this month or this year or this decade, and people can choose to be fat in this life.
Also, I can tell you from my experience that conversations about my weight were deeply, deeply embarrassing to me for most of the time I was morbidly obese. This was a combination of 1.) yes I know I've gained weight, thank you and 2.) my feelings of total helplessness over how to change. These things were solved only when I made the conscious adult decision to change my life and pursue WLS, and the four or five "interventions" that various people in my life tried before then probably delayed this decision by an entire year or two. These discussions were never effective, served only to plunge me deeper into denial, and were among the most offensive and traumatic experiences of my life.
I would look at this situation as a chance to continue healing by repairing your own interpersonal boundaries, which are askew if another person's weight gain is having this kind of impact on you.

Hello Ortega07,
I just converted from a sleeve to a bypass this past week, on June 2.
A few words about my situation: I was originally sleeved on March 14, 2014, and had two weeks of *perfect* recovery. I went back to work on day 4 post-op, had absolutely no pain, and went straight from the hospital to a support group I enjoyed because I wanted to see all my friends.
On day 15, I threw up 13 times. Though I didn't know it at the time, I'd developed a mechanical obstruction in my sleeve, which had folded over on itself and was preventing food and even liquids from going through. Every day since, I threw up between 4 and 12 times and I lost 93 lbs in 2.5 months due to, well, starvation. I also developed severe acid reflux, which kept me from sleeping most nights. I had to be tube-fed and barely held onto my job during the 10 weeks of hell that followed.
In my case, the decision to convert to bypass was relatively straightforward. I wanted a sleeve, not a bypass and was afraid of malabsorption. But the chances that the obstruction would return were relatively high with an exploratory surgery to save my sleeve and after so much suffering I was ready for anything that would help me rejoin the land of the living. Bypass was the much better bet.
What I wanted to share with you was the other part of my conversation with the surgeon. He kept emphasizing how much more weight I would lose with the bypass, and said that where the sleeve would have left me around 200 lbs, while the bypass would take me down to 175 or lower (I started at 330 lbs, which was a BMI of ~50). On a 5'7" frame, that's a big difference - 200 vs. 175 is the gap between a pretty "normal" silhouette and someone who still heads to the plus size department. (Not that I'm knocking someone who loses 130 lbs and gets down to that weight - both are a massive improvement over life at 330.) Although this didn't influence my medical decision to go with the bypass, it was interesting and acted as a sort of "bonus."
Given the situation you've described, it sounds like you need the additional "boost" of malabsorption the bypass provides to get closer to your goal weight. If your insurance will pay for the bypass, you'll have a lot more support post-surgery... and either option does involve an operation with risks and benefits. The other thing I can say on the other side of the surgery is that you do re-start the "honeymoon" phase of low appetite, basically no food intake during your hospital stay (and ok with it), etc.
The last thing I have to add is that you do NOT want a feeding tube placed during a conversion surgery (whether to bypass or a resleeve). I have one and it is so uncomfortable that I don't know how I'll stand the next 2 weeks until I can get it removed. But somehow life goes on, even when you're hurting.

I want to echo what others have said above - please be kind to yourself and don't underestimate how much trauma your body has been through in one week. I am also seven days post-op (I had surgery on the 14th) and the difficulty of staying hydrated and lack of variety have definitely gotten to me a couple of times.
Especially since you've had to be readmitted to the hospital twice, I would strongly recommend leaning on your surgeon's support team for help (you should be able to get emergency appointments with nutrition, psych and the surgeon himself - why not ask for both a pain consult and a session to figure out why you're having such a hard time with fluids?). I don't mean this in a bragging way at all, but I haven't had anything stronger than a Tylenol since post-op day 4 and have been off pain meds entirely for over 48 hours... your pain could be entirely normal, but it could also be a sign that you need some follow up medical attention. Make sure it's not the latter, even if they make you feel like you're wasting their time or being a hypochondriac.
If there isn't anything medically wrong, please have faith that you will feel very differently about the surgery in a week or a month when you're X lbs lighter and feeling healthy again. Our minds can't be trusted this soon after invasive surgery (not to mention tons of huge changes to what and how we eat), so try to think of your brain as a trickster and resist its attempts to get one over on you when you're vulnerable.
I'm wishing you a positive and hopeful recovery from Ohio!

I want to echo what others have said above - please be kind to yourself and don't underestimate how much trauma your body has been through in one week. I am also seven days post-op (I had surgery on the 14th) and the difficulty of staying hydrated and lack of variety have definitely gotten to me a couple of times.
Especially since you've had to be readmitted to the hospital twice, I would strongly recommend leaning on your surgeon's support team for help (you should be able to get emergency appointments with nutrition, psych and the surgeon himself - why not ask for both a pain consult and a session to figure out why you're having such a hard time with fluids?). I don't mean this in a bragging way at all, but I haven't had anything stronger than a Tylenol since post-op day 4 and have been off pain meds entirely for over 48 hours... your pain could be entirely normal, but it could also be a sign that you need some follow up medical attention. Make sure it's not the latter, even if they make you feel like you're wasting their time or being a hypochondriac.
If there isn't anything medically wrong, please have faith that you will feel very differently about the surgery in a week or a month when you're X lbs lighter and feeling healthy again. Our minds can't be trusted this soon after invasive surgery (not to mention tons of huge changes to what and how we eat), so try to think of your brain as a trickster and resist its attempts to get one over on you when you're vulnerable.
I'm wishing you a positive and hopeful recovery from Ohio!

I’m a longtime lurker on this forum and this is my first stab at actually participating. Today marks seven days since I was sleeved and I’m feeling fabulous. I am so grateful for the support and information you all provide, and hope I can return the favor by being a resource for some of you.

As great as I’m doing, I am starting to understand what you all mean by the phrase “head hunger" (alas). I’m not sure if someone who hasn’t had weight-loss surgery can really conceptualize what this is, and though mine hasn’t been a huge deal so far, there is a certain novelty in finally “getting” it.

Appropriately enough, I heard a perceptive analogy about head hunger today that I wanted to share with the group. It happened while speaking with a neighbor who is an amputee. She noted that her foot and lower leg had been removed due to a chronic condition that caused debilitating pain, and she described her post-amputation life as vastly improved despite the need for a prosthetic limb.

As I explained the sleeve to her, I observed that although I have absolutely no appetite right now, I do find myself occasionally preoccupied with food. It’s not exactly a feeling of being hungry for the food, and it doesn’t seem to be related to how long it's been since I last ate. Rather, it’s closer to a sense of being fascinated by a food item. Even if I couldn't swallow it (which of course I can’t right now), I would want smell it, touch it, be close to it. Sometimes I find myself thinking how much I want to buy the food and cook it for someone else, or more often I’ll fantasize in minute detail about how it’s going to feel in my mouth after I’m back on solids. It’s the kind of feeling that might have put me in danger of having a binge episode in my life before, except that it’s not accompanied by a feeling of emptiness or “hunger” in my stomach… which makes the sensation especially bizarre and unexpected. This is head hunger.

She seemed to understand completely. What she said next took me aback: According to my neighbor, the pain in her diseased foot actually had two sources. The first was obviously her foot, where pinched nerves and misshapen bones fired off distress signals day and night. But the second site of the pain was inside her brain, and its role in her suffering turned out to be non-trivial. She said she only fully understood this after the amputation, when she continued to require prescription pain medication for discomfort in a foot that no longer existed. She could see that the foot wasn’t there and her “thinking brain” knew that it had been removed even when she wasn’t looking at her leg, yet she continued to feel that awful ache for years after surgery.

I found the end of her story especially interesting: My neighbor said that although the pain has not gone away, eventually it diminished significantly. I asked how she deals with the lingering discomfort. She replied that she made it a smaller part of her life. I didn’t understand at first - I mean, pain is pain, how do you just ignore it? She said she uses cognitive-behavioral therapy techniques, which have trained her to think of the pain as a cognitive distortion formed by years of suffering with the pre-amputation foot, as if those neural pathways became so well used that her brain can’t turn them back off. She also practices of mindfulness. She pauses each morning to record her level of pain and how her stump feels in a medical record book, but otherwise she resists letting her thoughts drift in this direction. Instead, she focuses on savoring what she’s doing, or she may change her environment when she feels the pain intensifying by (mindfully) smelling a special scent or reading a book of quotes. This helps make the sensation bearable until it recedes again.

I have no idea how scientifically sound this narrative is and it may be an over-simplification, but I thought it might appeal to members of this crowd. I definitely buy the idea that my brain has been permanently changed by 28 years of cognitive distortions related to obesity and binge eating, and it makes some sense that these thoughts might not just “turn off” with the removal of most of my stomach.
However, it seems equally possible that by filling my life with healthier thoughts and continuing to root out cognitive distortions, I can take steps to minimize head hunger’s interference with my recovery. [indeed, I just realized every time I’ve felt this way has been late at night, which is when I tend to be alone with my brain.] This helps me feel more confident that when (not if) head hunger-type feelings do recur, I can learn to “make them a smaller part of my life” rather than suffering with them or giving in.

What do you guys think? Thanks again for all you do - I couldn't have gotten to this point without you!

I’m a longtime lurker on this forum and this is my first stab at actually participating. Today marks seven days since I was sleeved and I’m feeling fabulous. I am so grateful for the support and information you all provide, and hope I can return the favor by being a resource for some of you.

As great as I’m doing, I am starting to understand what you all mean by the phrase “head hunger" (alas). I’m not sure if someone who hasn’t had weight-loss surgery can really conceptualize what this is, and though mine hasn’t been a huge deal so far, there is a certain novelty in finally “getting” it.

Appropriately enough, I heard a perceptive analogy about head hunger today that I wanted to share with the group. It happened while speaking with a neighbor who is an amputee. She noted that her foot and lower leg had been removed due to a chronic condition that caused debilitating pain, and she described her post-amputation life as vastly improved despite the need for a prosthetic limb.

As I explained the sleeve to her, I observed that although I have absolutely no appetite right now, I do find myself occasionally preoccupied with food. It’s not exactly a feeling of being hungry for the food, and it doesn’t seem to be related to how long it's been since I last ate. Rather, it’s closer to a sense of being fascinated by a food item. Even if I couldn't swallow it (which of course I can’t right now), I would want smell it, touch it, be close to it. Sometimes I find myself thinking how much I want to buy the food and cook it for someone else, or more often I’ll fantasize in minute detail about how it’s going to feel in my mouth after I’m back on solids. It’s the kind of feeling that might have put me in danger of having a binge episode in my life before, except that it’s not accompanied by a feeling of emptiness or “hunger” in my stomach… which makes the sensation especially bizarre and unexpected. This is head hunger.

She seemed to understand completely. What she said next took me aback: According to my neighbor, the pain in her diseased foot actually had two sources. The first was obviously her foot, where pinched nerves and misshapen bones fired off distress signals day and night. But the second site of the pain was inside her brain, and its role in her suffering turned out to be non-trivial. She said she only fully understood this after the amputation, when she continued to require prescription pain medication for discomfort in a foot that no longer existed. She could see that the foot wasn’t there and her “thinking brain” knew that it had been removed even when she wasn’t looking at her leg, yet she continued to feel that awful ache for years after surgery.

I found the end of her story especially interesting: My neighbor said that although the pain has not gone away, eventually it diminished significantly. I asked how she deals with the lingering discomfort. She replied that she made it a smaller part of her life. I didn’t understand at first - I mean, pain is pain, how do you just ignore it? She said she uses cognitive-behavioral therapy techniques, which have trained her to think of the pain as a cognitive distortion formed by years of suffering with the pre-amputation foot, as if those neural pathways became so well used that her brain can’t turn them back off. She also practices of mindfulness. She pauses each morning to record her level of pain and how her stump feels in a medical record book, but otherwise she resists letting her thoughts drift in this direction. Instead, she focuses on savoring what she’s doing, or she may change her environment when she feels the pain intensifying by (mindfully) smelling a special scent or reading a book of quotes. This helps make the sensation bearable until it recedes again.

I have no idea how scientifically sound this narrative is and it may be an over-simplification, but I thought it might appeal to members of this crowd. I definitely buy the idea that my brain has been permanently changed by 28 years of cognitive distortions related to obesity and binge eating, and it makes some sense that these thoughts might not just “turn off” with the removal of most of my stomach.
However, it seems equally possible that by filling my life with healthier thoughts and continuing to root out cognitive distortions, I can take steps to minimize head hunger’s interference with my recovery. [indeed, I just realized every time I’ve felt this way has been late at night, which is when I tend to be alone with my brain.] This helps me feel more confident that when (not if) head hunger-type feelings do recur, I can learn to “make them a smaller part of my life” rather than suffering with them or giving in.

What do you guys think? Thanks again for all you do - I couldn't have gotten to this point without you!

I want to echo what others have said above - please be kind to yourself and don't underestimate how much trauma your body has been through in one week. I am also seven days post-op (I had surgery on the 14th) and the difficulty of staying hydrated and lack of variety have definitely gotten to me a couple of times.
Especially since you've had to be readmitted to the hospital twice, I would strongly recommend leaning on your surgeon's support team for help (you should be able to get emergency appointments with nutrition, psych and the surgeon himself - why not ask for both a pain consult and a session to figure out why you're having such a hard time with fluids?). I don't mean this in a bragging way at all, but I haven't had anything stronger than a Tylenol since post-op day 4 and have been off pain meds entirely for over 48 hours... your pain could be entirely normal, but it could also be a sign that you need some follow up medical attention. Make sure it's not the latter, even if they make you feel like you're wasting their time or being a hypochondriac.
If there isn't anything medically wrong, please have faith that you will feel very differently about the surgery in a week or a month when you're X lbs lighter and feeling healthy again. Our minds can't be trusted this soon after invasive surgery (not to mention tons of huge changes to what and how we eat), so try to think of your brain as a trickster and resist its attempts to get one over on you when you're vulnerable.
I'm wishing you a positive and hopeful recovery from Ohio!

I’m a longtime lurker on this forum and this is my first stab at actually participating. Today marks seven days since I was sleeved and I’m feeling fabulous. I am so grateful for the support and information you all provide, and hope I can return the favor by being a resource for some of you.

As great as I’m doing, I am starting to understand what you all mean by the phrase “head hunger" (alas). I’m not sure if someone who hasn’t had weight-loss surgery can really conceptualize what this is, and though mine hasn’t been a huge deal so far, there is a certain novelty in finally “getting” it.

Appropriately enough, I heard a perceptive analogy about head hunger today that I wanted to share with the group. It happened while speaking with a neighbor who is an amputee. She noted that her foot and lower leg had been removed due to a chronic condition that caused debilitating pain, and she described her post-amputation life as vastly improved despite the need for a prosthetic limb.

As I explained the sleeve to her, I observed that although I have absolutely no appetite right now, I do find myself occasionally preoccupied with food. It’s not exactly a feeling of being hungry for the food, and it doesn’t seem to be related to how long it's been since I last ate. Rather, it’s closer to a sense of being fascinated by a food item. Even if I couldn't swallow it (which of course I can’t right now), I would want smell it, touch it, be close to it. Sometimes I find myself thinking how much I want to buy the food and cook it for someone else, or more often I’ll fantasize in minute detail about how it’s going to feel in my mouth after I’m back on solids. It’s the kind of feeling that might have put me in danger of having a binge episode in my life before, except that it’s not accompanied by a feeling of emptiness or “hunger” in my stomach… which makes the sensation especially bizarre and unexpected. This is head hunger.

She seemed to understand completely. What she said next took me aback: According to my neighbor, the pain in her diseased foot actually had two sources. The first was obviously her foot, where pinched nerves and misshapen bones fired off distress signals day and night. But the second site of the pain was inside her brain, and its role in her suffering turned out to be non-trivial. She said she only fully understood this after the amputation, when she continued to require prescription pain medication for discomfort in a foot that no longer existed. She could see that the foot wasn’t there and her “thinking brain” knew that it had been removed even when she wasn’t looking at her leg, yet she continued to feel that awful ache for years after surgery.

I found the end of her story especially interesting: My neighbor said that although the pain has not gone away, eventually it diminished significantly. I asked how she deals with the lingering discomfort. She replied that she made it a smaller part of her life. I didn’t understand at first - I mean, pain is pain, how do you just ignore it? She said she uses cognitive-behavioral therapy techniques, which have trained her to think of the pain as a cognitive distortion formed by years of suffering with the pre-amputation foot, as if those neural pathways became so well used that her brain can’t turn them back off. She also practices of mindfulness. She pauses each morning to record her level of pain and how her stump feels in a medical record book, but otherwise she resists letting her thoughts drift in this direction. Instead, she focuses on savoring what she’s doing, or she may change her environment when she feels the pain intensifying by (mindfully) smelling a special scent or reading a book of quotes. This helps make the sensation bearable until it recedes again.

I have no idea how scientifically sound this narrative is and it may be an over-simplification, but I thought it might appeal to members of this crowd. I definitely buy the idea that my brain has been permanently changed by 28 years of cognitive distortions related to obesity and binge eating, and it makes some sense that these thoughts might not just “turn off” with the removal of most of my stomach.
However, it seems equally possible that by filling my life with healthier thoughts and continuing to root out cognitive distortions, I can take steps to minimize head hunger’s interference with my recovery. [indeed, I just realized every time I’ve felt this way has been late at night, which is when I tend to be alone with my brain.] This helps me feel more confident that when (not if) head hunger-type feelings do recur, I can learn to “make them a smaller part of my life” rather than suffering with them or giving in.

What do you guys think? Thanks again for all you do - I couldn't have gotten to this point without you!

I’m a longtime lurker on this forum and this is my first stab at actually participating. Today marks seven days since I was sleeved and I’m feeling fabulous. I am so grateful for the support and information you all provide, and hope I can return the favor by being a resource for some of you.

As great as I’m doing, I am starting to understand what you all mean by the phrase “head hunger" (alas). I’m not sure if someone who hasn’t had weight-loss surgery can really conceptualize what this is, and though mine hasn’t been a huge deal so far, there is a certain novelty in finally “getting” it.

Appropriately enough, I heard a perceptive analogy about head hunger today that I wanted to share with the group. It happened while speaking with a neighbor who is an amputee. She noted that her foot and lower leg had been removed due to a chronic condition that caused debilitating pain, and she described her post-amputation life as vastly improved despite the need for a prosthetic limb.

As I explained the sleeve to her, I observed that although I have absolutely no appetite right now, I do find myself occasionally preoccupied with food. It’s not exactly a feeling of being hungry for the food, and it doesn’t seem to be related to how long it's been since I last ate. Rather, it’s closer to a sense of being fascinated by a food item. Even if I couldn't swallow it (which of course I can’t right now), I would want smell it, touch it, be close to it. Sometimes I find myself thinking how much I want to buy the food and cook it for someone else, or more often I’ll fantasize in minute detail about how it’s going to feel in my mouth after I’m back on solids. It’s the kind of feeling that might have put me in danger of having a binge episode in my life before, except that it’s not accompanied by a feeling of emptiness or “hunger” in my stomach… which makes the sensation especially bizarre and unexpected. This is head hunger.

She seemed to understand completely. What she said next took me aback: According to my neighbor, the pain in her diseased foot actually had two sources. The first was obviously her foot, where pinched nerves and misshapen bones fired off distress signals day and night. But the second site of the pain was inside her brain, and its role in her suffering turned out to be non-trivial. She said she only fully understood this after the amputation, when she continued to require prescription pain medication for discomfort in a foot that no longer existed. She could see that the foot wasn’t there and her “thinking brain” knew that it had been removed even when she wasn’t looking at her leg, yet she continued to feel that awful ache for years after surgery.

I found the end of her story especially interesting: My neighbor said that although the pain has not gone away, eventually it diminished significantly. I asked how she deals with the lingering discomfort. She replied that she made it a smaller part of her life. I didn’t understand at first - I mean, pain is pain, how do you just ignore it? She said she uses cognitive-behavioral therapy techniques, which have trained her to think of the pain as a cognitive distortion formed by years of suffering with the pre-amputation foot, as if those neural pathways became so well used that her brain can’t turn them back off. She also practices of mindfulness. She pauses each morning to record her level of pain and how her stump feels in a medical record book, but otherwise she resists letting her thoughts drift in this direction. Instead, she focuses on savoring what she’s doing, or she may change her environment when she feels the pain intensifying by (mindfully) smelling a special scent or reading a book of quotes. This helps make the sensation bearable until it recedes again.

I have no idea how scientifically sound this narrative is and it may be an over-simplification, but I thought it might appeal to members of this crowd. I definitely buy the idea that my brain has been permanently changed by 28 years of cognitive distortions related to obesity and binge eating, and it makes some sense that these thoughts might not just “turn off” with the removal of most of my stomach.
However, it seems equally possible that by filling my life with healthier thoughts and continuing to root out cognitive distortions, I can take steps to minimize head hunger’s interference with my recovery. [indeed, I just realized every time I’ve felt this way has been late at night, which is when I tend to be alone with my brain.] This helps me feel more confident that when (not if) head hunger-type feelings do recur, I can learn to “make them a smaller part of my life” rather than suffering with them or giving in.

What do you guys think? Thanks again for all you do - I couldn't have gotten to this point without you!