This morning I had two appointments. One involved someone sticking a needle in my hand, and the other involved someone telling me to stop eating chips at my desk. Both were, technically, medical care.
Part One: The Blood Draw
I drove to Quest Diagnostics at what I can only describe as an uncivilized hour. I had not eaten. I had not had a Diet Coke. I was, by clinical measure, fasting. By personal measure, barely functional.
The technician was pleasant and efficient. She had a signature pad that wasn’t working, a printer that wasn’t printing, and we needed to switch rooms to use someone else’s printer. This is a relatable amount of early morning chaos for any organization. I signed with her mouse. It looked more or less like my actual signature, which tells you everything you need to know about my actual signature.
She drew blood from my hand, which is where my accessible veins have chosen to set up shop. Most technicians treat this as a moral failing. She treated it as a logistical challenge and solved it on the first try, which is so rare it felt worth documenting. I told her she was the first person to get it in one shot in a long time. She explained that the vein just needed to be anchored so it wouldn’t move. I did not ask follow-up questions about what anchoring a vein means. Some things are better left as abstractions.
Then came the H. pylori test, which I had never done before and which I would describe as: fine, but aggressively sour.
The procedure is this: you breathe into a bag, you drink a small cup of what tastes like weaponized lemon, you wait fifteen minutes, and then you breathe into a second bag. The technician describes the drink as having “mixed reviews.” This is accurate. It is not great. I drank it with a straw, which helped approximately nothing. Then I sat in the waiting room for fifteen minutes with the quiet dignity of a man who has accepted his circumstances.
Breathed into the second bag. Done. The whole thing was, objectively, not a big deal. This did not stop me from reporting it here in detail.
Why does any of this matter before bariatric surgery? H. pylori is a bacteria that lives in the stomach lining and causes ulcers, and it turns out that having it while someone is rearranging your digestive plumbing is a bad combination. The concern is twofold: it increases the risk of marginal ulcers forming after surgery, and it complicates the long-term picture because once your stomach has been restructured, the remnant bits are significantly harder for doctors to get to and check. If H. pylori is quietly doing damage down there and nobody can see it anymore, that’s a problem. So they test you now, while everything is still in its original configuration and accessible. Find it, treat it, then cut. Sensible enough that even I can’t complain about it.
Part Two: The Dietician
The dietician had a checklist. Of course she had a checklist. Everything in this process has a checklist. I’m starting to think the bariatric world runs entirely on checklists and the psychic energy of unused protein shakers.
We went through mine. Labs: done this morning. Physical therapy evaluation: April 8th. Behavioral health: yesterday. Sleep study: in progress, final appointment tomorrow. The checklist was nearly complete. I felt briefly, irrationally proud. Same feeling I get when I close all my browser tabs.
She covered the dietary ground rules. Cut carbs. Prioritize protein. Eat some veggies. If you’re going to eat a burger, get two patties and take the top bun off, because apparently there’s a version of bariatric eating that is just deconstructed Fast Casual. Under 50 grams of carbohydrates a day after surgery. No carbonation. No caffeine. That last one, as a person who has consumed Diet Coke with the dedication of a religious practice, is the part of this conversation I try to let wash over me without fully processing.
She also covered the eating mechanics, which I have now heard enough times that I could recite them in my sleep: chew thirty times, put your utensil down between bites, wait thirty minutes between eating and drinking. No eating at your desk while you’re distracted by other things. You and the food, alone, paying full attention to each other. A mindful consumption experience. Tiny bites, slowly chewed, with your full presence.
I, a person who has spent decades eating lunch while staring at a database schema, nodded and said yes, I understood.
She asked about my food logging. I told her I had written my own app because I didn’t want to hand all my data to another company. She thought this was cool.
The Honest Part
I told her I was afraid I was going to regret not having done this sooner. And also afraid I was going to regret doing it at all. That I’d spend the rest of my life missing the version of food I’ve always had. The pastime version. The “let’s get pizza and talk about nothing for two hours” version.
She pointed out that my hunger hormone gets removed during the procedure, which means the constant mental background noise around food largely stops. The “what am I going to eat, when am I going to eat it, why am I thinking about food again” loop. My satiety signals start working properly for the first time in who knows how long. The gas pedal disappears. The brakes come back online.
I told her I’d been thinking about it this way: I’ve spent the last 50 years eating whatever I wanted, whenever I wanted. If I have to spend the last thirty years of my life treating food as fuel rather than a hobby, maybe I come out ahead on the deal.
She nodded. I nodded. We agreed I’d see her again May 12th.
Another box ticked. The checklist marches on. Now with better vein anchoring technique and a stomach full of weaponized lemon.