Ready or not, here we come, London.
[Chris] Previously on 1000-lb Sisters...
[Tammy] Hey, how are you?
Ooh.
[Amy] Hey, can I take a picture with y'all?
[Tammy] Amy, [bleep].
[Amanda] She's loud.
Bitch, we are in a foreign country.
Get your act right out your pocket
and hold on tight to that mother[bleep].
Shut the hell up.
Our people was on the Mayflower?
-Dun dun dun. -[Amy snorts]
[Chris] Two more, girl. We got this.
[Tammy grunts]
[Amy speaking]
[Amanda] Amy, stop.
-I ain't even done nothing and y'all are getting... -Okay. Stop.
[Amy] ...on to me for bull[bleep].
[Misty] Amy...
-[Chris] Amy. -[Amy] I'm done.
I mean it this time. I'm done.
[Chris speaking]
[Amy speaking]
I got told multiple times to shut up,
and that last time was my [bleep] breaking point.
There's only so much one person can take.
[sniffles]
[Chris] Because you're overreacting.
[Chris] You're yelling at me right now.
[Amy speaking]
[Amanda] Is that Amy?
-She's outside, though. -[Brittany] I can hear her outside, yeah.
[Amy speaking]
-[Chris] No. -[Amy speaking]
[Chris] Come on.
You're going the wrong way.
We came to The Mayflower
just because our nine times great-grandfather
drank here.
And it should be a big moment for the whole family.
But I feel Amy's being kind of a little bit childish.
Like a spoiled brat.
You went off the handle in there in front of everybody.
And we're better than this.
[Amy speaking]
[Chris] All I see you doing is showing your butt, girl.
[waiter speaking]
It's okay, honey. It happens all the time.
You're okay. You're doing a great job.
Poor guy. Damn Americans are crazy.
[laughs]
[Misty speaking]
[Tammy speaking]
Some of them don't. Caspe... Are they the dark ones?
-Mm-hmm. -[Tammy] Yeah.
[Birttany] Those are Kalamata.
This one has a pit.
Hey, bubbe.
You want an olive?
-[Tammy chuckles] -[Misty] They taste
totally different than the ones that Grandma used to buy.
At this point, we're gonna pretend like this [bleep] didn't even happen.
So we gonna talk about whatever we gotta talk about
to get past this little blow-up.
[Misty] I hate olives.
But I'll talk about olives all goddamn day if Amy...
Okay, guys. Your food is ready.
That's the fish and chips.
-[Tammy] Thank you. -Fish and chips.
-[Amanda] Fine. Thank you. -You're welcome.
Enjoy. See you in a bit.
-[Misty] Thank you very much. -[waiter] You're welcome.
[Chris] The fish is wonderful.
-Yeah, it is good. -The fish is wonderful.
[laughs]
[Brittany chuckles]
[Chris] After Amy eats, she cheers up significantly.
[laughs]
[Brittany speaking]
[Chris laughs]
And you're supposed to be the nice one out of all of us.
-[Chris] She is. -[Brittany] Eh.
[Amy speaking]
But it's our last day here in London. And...
[Tammy speaking]
-[Brittany laughs] -Well, this is better than the dick.
And I'm saying that.
[Tammy and Brittany chuckle]
[Amy] Come on, y'all.
Let's go.
After we got done eating at The Mayflower,
we walk up the little cobblestone street
to this little garden that's overlooking...
Overlooking the river that runs through the middle of England.
How about that? [laughs]
[Misty speaking]
[Chris] You go ahead, girl.
And my question of the day is, they got catfish here?
'Cause that look like good catfishing water to me.
[Misty laughs]
As this vacation comes to a close,
I'm just ready to go home. I want my boys so bad.
I love London.
But I want my boys.
[Chris] It's just been a great trip.
-[Misty] Yeah, it has. -[Chris] I mean,
I know we don't get along every second of the day.
But the bottom line is, is we're a family.
And we're a family strong.
Now we know a little more about ourselves.
[Misty] Where we came from.
I think that we should start being courageous,
just like our ancestors, and just living life...
-[Chris] To the full. -...to the best of our ability.
Now that I've got my life back,
I mean, that's what I'm trying to do.
[Amanda] You just wait until the skin is removed
and you're healed,
because life is gonna change again.
Tammy and Chris, for each of you.
[Chris] Back in Kentucky,
my surgery is literally right around the corner.
Amanda is the only one in the family
that's had skin removal surgery...
Am I worried about it?
My recovery time could be
10 to 16 weeks, according if I have bad healing.
It's gonna be the worst thing you've ever been through physically.
Tammy, including you. Like, you've been
-near death several times. -[Misty] Yeah. 'Cause you're gonna have more of it
-than the rest of them. -[Amanda] But just be ready.
After my last appointment,
Dr. Turner referred me
to a specialist in Pittsburgh
because he has a bigger team
and a bigger hospital,
and he takes on more complicated surgeries.
Tammy, I just want to say I'm proud of you.
You have really done excellent
this time we've been here,
with the stairs,
climbing in and out of the bus, the walking.
-The steps we just did. -You have improved so much
that it's just mind-boggling.
[Amanda] Normally you just give up.
"I can't do this."
But this time you didn't, and you pushed through,
and I'm proud of you for sticking with it.
I can't even put into words how proud I am of you.
And even though me and you get into it,
I love you very much.
And I will give my life for you.
I think this honestly brought us closer together.
Absolutely. Me too.
Tammy and I are actually getting along.
I have no explanation as to what's going on.
There was no big ta-da moment.
You know, there was no angels singing.
It's just happening.
And I'm just letting it, and she is too.
And I'm grateful for that.
[Chris] You know, other than a few little hiccups,
it's been a great week,
doing what we do best,
acting fools.
[Amanda] Some of us are not acting, and that's okay.
[laughs]
This vacation has done as good as it could possibly do,
bringing us back together as a family.
Now, with that being said,
I really just hope when everybody gets home,
the peace that we've kept in England
continues to ride the wave.
We all got some pretty big things coming up here real soon.
And we need to support each other
more than ever.
-[Misty] Here we go. -[Amanda] Perfect.
Yes!
[Amy] Today, me, Tammy, Chris,
and Brittany are gonna take a self-defense class.
If you were going to hit a part of the body, what would you hit?
[all laughing]
-Today's the day, huh? -[Chris] Yes, sir.
-Been a long time coming. -A long time coming.
[Amanda] With a surgery like this,
there's a possibility of blood supply not being
sent to the right areas.
What's taking this so damn long?
[Amy] Gagey, Gagey.
You gonna be mommy's big boy helper?
[babbles]
I mean, I got to see the sights.
I got to see the sounds.
Yay.
Not my wall. On the paper.
It's all washable.
If they get it on the wall, they get it on the wall.
But at the end of the day, they are
making their kind of art.
They are being creative their way.
Get it on the wall. Good job.
And he would make a thousand bucks.
Or, well...
[chuckles]
-[Gage exclaims] -[Amy] Are you done, darling?
-Are you done? -[Gage babbles]
[Amy] Silly.
But when we were in London,
I was out of control.
So, it's time for me
to learn how to communicate
and not walk away. Or blow up.
I just want to be a better mom,
better friend, better sister.
A better everything.
Be careful.
[Chris] Y'all ready to get in there and learn how to kick some butt?
You're gonna need it.
[Amy] So today, me, Tammy, Chris, and Brittany are gonna take
a self-defense class.
The last time I broke a board is when I fell through the floor.
[laughs]
And it was at the yellow house, so come on.
That's why I said I'll be nice.
[Chris] Since we got back from London,
I've been busting my ass
quite literally.
[laughs]
All the painting's pretty well done in the yellow house.
And the only thing left to really do is clean.
And then she'll be ready to move in.
[Tammy] I am
so freaking excited
to move into a house by myself.
But Chris has always been...
I don't really know
what I need to
defend myself from...
[laughs]
But I'm just gonna go with it.
Okay, guys, let's go ahead and line up, please.
[woman] Yes, sir!
[Robert] What do you think is the most sensitive part of the body?
If you were gonna defend yourself
and hit a part of the body, what would you hit?
There's no wrong answer.
-[Robert] Crotch? -[all laughing]
Kick him in the nuts. [laughs]
And run! [laughs]
[Tammy laughs]
[Robert] The eyes.
The eyes have so many nerve endings.
But also, believe it or not, you can
actually rupture the eardrums.
So we're gonna go to what we call BOB.
And those are the body opponent bags.
Lord only knows how this is gonna go.
Because Brittany is a very timid person.
Tammy's kind of like a T.rex.
And Amy...
And you can't fight if you can't see.
[laughs]
[Robert] All right, on my count. Ready?
You just kind of step forward
and you're gonna clap the ears.
[grunts]
Nice. Good job.
All right. Excellent. All right, next two.
-[Amy speaking] -[Tammy] All right.
-[Amy] Oh. -[Tammy speaking]
[Amy] Excuse me.
[Robert] Here we go. [grunts]
[Amy and Tammy laugh]
[Robert] All right.
Ready?
-[grunts] -[Tammy grunts]
-[laughs] -[Amy laughs] I can't stop laughing.
Learning the moves were just weird and awkward in getting the hang of it.
[Tammy grunts]
Facts.
-[grunts] -[man] There you go.
There you go. Good.
Right there. Did you see that?
Yeah.
Yeah, yeah, yeah, yeah! [chuckles]
-[Tammy] Yeah! -[Robert] All right.
Nice!
Good job. Good job.
-[Tammy grunts] -Yes!
Yes!
Good job.
[laughs]
All right.
-Would you? -I would too.
[Tammy] I think it's great that Amy's
found the healthy outlet.
Maybe she'll continue going to the self-defense class...
Or we just...
[Chris] You ready to get your [bleep] up and go?
[Tammy] Yeah.
[Chris] After about six months,
the yellow house is finally finished.
And we're able to move Tammy in today.
I'm relieved
because my skin removal surgery
is scheduled in a few days.
And I ain't gonna lie,
I'm really excited.
I finally get to have the house to myself.
Where am I going?
Well, with me and my wife anyway.
[chuckles]
[Tammy speaking]
[Brittany] Wow.
At least the carpet and the lawnmower's
-not in here anymore. -Yeah, you ain't got no rug no more.
[Tammy speaking]
-[Brittany chuckles] -[Tammy] I'm excited.
It's a very big upgrade.
It's awesome.
Now, we still got some cleaning to do in here, but,
you know, it's able to be lived in and enjoyed.
[Tammy speaking]
I could see me living here for a while.
[Chris] Well, Tammy,
it ain't Buckingham Palace,
but you can be the queen of this castle.
[Tammy] In the last few months,
me and Chris never really fought.
Did we get on each other's nerves?
Probably. [chuckles]
So, I am ready to
have my own space
and my own independence back.
Well, as long as they treat you fine,
that's all that matters to me.
[Tammy] Lately, I've been feeling like
it's time for me to start
moving on,
and...
It just doesn't feel right.
I don't even have those feelings for a guy anymore...
[Chris] How do you feel about taking this long trip
to see Dr. Rubin?
[Tammy] It sounds promising.
In a couple of days,
I'm gonna go see Dr. Rubin in Pittsburgh.
See if he will take me on as a patient.
[Chris] You know, Dr. Turner said
when he put you to sleep for the surgery,
he didn't want to keep nobody under
more than eight hours.
And for you to have done what you need done,
it would take him 12 to 15 hours by himself.
And I'm sure Dr. Rubin's got a team to take care of you.
When I was bigger, seeing a new doctor was terrifying.
I hated it. I still don't care for it.
I mean, the first thing that always comes out of their mouth is,
"You need to lose weight."
Well, clearly.
So...
before having surgery. But...
[Amy] Are y'all ready?
I've decided to create an online dating profile.
So, today I'm doing a sexy photo shoot.
[Greg] Well, yee-haw!
Look at you, girl!
I'm looking for a family man, a businessman, whatever...
[laughs]
[Amy speaking]
[woman] No, it's gonna be fine.
We always do the most clothed down to the least.
[Amy] Today I'm doing something that I've always wanted to do,
but I was too chicken [bleep] to do it.
Are y'all ready?
[woman] Yes, ma'am.
[Greg] What? Look at you, girl!
I'm ready to get out there.
I'm ready to open my heart again.
I'm ready to find love.
[woman] No, we can't see no nipple. We'll let you know.
-And you're on cooter duty. -I got you.
Cooter duty.
-[Amy laughs] Cooter duty. -Oh, my God.
[Greg] Now, here's what we gotta do.
You gotta hang on while I photograph that fat ass.
Poke your ass way up in the air. Go.
Girl, you got it. Got it. Hold it. Three, two, got it.
-Good deal. -[woman laughs]
[Greg] There, we did it.
[Amy speaking]
[Greg] Yee-haw! Look at you, girl!
[Amy] Self-defense class has got me ready
to take on multiple dates.
And if they come at me in the wrong way,
I know how to defend myself.
Now, we're gonna help in editing just a little.
Okay, don't move, 'cause what I'm doing is cheating.
Don't move.
Put that arm back down.
Look at there. Okay. All right.
Looks amazing, girl. You do. You look wonderful.
[Amy speaking]
A family man, a businessman, whatever...
But not no [bleep] boy man.
[laughs]
[Greg] There you go.
That's what I'm talking about.
-Say yes. -[Amy whispers] Yes.
[Amy] It just feels good to get out of my element.
[Greg] Awesome. That is beautiful.
Some of these pictures are just for me. Or...
[Greg] Look at the confidence beaming out of you there.
[Amy speaking]
Well, you know, it's kind of the idea.
[Amy speaking]
[Greg] There's just something about you and that fat ass.
[laughs]
Brittany, what do you need to take with us for snacks?
[Brittany] Whatever snacks you want.
Well, I'd say the whole house,
'cause I don't know what I want until I get there.
Tomorrow is the big day.
I'm finally getting my skin removal surgery.
Before we leave on our road trip,
Misty, Tammy, and Amy
are coming over to send me off.
I'm so excited, but yet I'm still
kind of leery of the whole surgery process.
And I'm really not looking forward
to the pain afterwards.
[Amy] I got a question.
How nervous are you?
-I probably won't sleep much. -[Amy] Yeah.
You know, the doctor said it would be...
-[Misty speaking] -And then Amanda...
And Amanda said it was worse
than anything she ever dealt with.
[Misty] Mm-hmm.
[Tammy] I am very proud of Chris, and...
Hell, you got, what,
a child right here
on your lap 24-7 because of
all the excess skin.
[laughs]
Amanda's coming up from Florida
to be at the hospital the day I have surgery.
Somebody to keep me company in the waiting room.
Well, I'm gonna go to Pittsburgh
with Tam and Ames so I can, you know,
keep them out of trouble, all that good stuff.
And who's gonna keep you out of trouble?
[all laughing]
[Tammy] While Chris is in surgery,
Amy, Misty, and myself are fixing
to go to Pittsburgh
to talk about my skin removal.
[Amy laughs]
All right, be safe.
-[Misty] Love you. -Bye, love you.
[Chris] It's about a four-hour ride,
and hopefully a decent night's sleep.
And then we'll be at the hospital
bright and early just to get my surgery started.
Getting skin removal surgery is life-changing,
but there's always a possibility
that something goes haywire.
So it's the what-ifs that's in life
that's always
the hardest to deal with.
[Chris] You got everything pretty well packed?
Yeah, I'm just putting my fan in here.
You know, I can't go anywhere without it.
[Chris] It's been a long time coming,
but I'm finally getting skin removal surgery.
I'm really excited for you.
-Appreciate it. -I know you worked hard for it.
[Chris] Yeah, it's bittersweet.
It feels like I'm at the end of a marathon...
and I finally made it.
At my heaviest point,
I was 520 pounds.
I'm gonna be somewhere around 250.
That's what I'm talking about, baby.
That's game over.
Hey.
You don't fillet a squirrel, you skin them.
[Brittany] Well...
-No, not really. -[Brittany chuckles]
[knocking at door]
Well, good morning.
[Chris] Good morning, doctor.
-Today's the day, huh? -[Chris] Yes, sir.
-Been a long time coming. -A long time coming.
Well, the last thing I kind of got to do,
I think everybody's ready for you, you know,
kind of the anesthesia team and the surgical team.
And I just have to do some markings on you.
-[Chris] Okay. -And, uh,
basically kind of
gonna get you ready and get you back.
Today, Chris is going to receive what's called
a fleur-de-lis abdominoplasty.
It's done to not only remove skin in a horizontal manner,
but it's done in a vertical manner
to remove horizontal skin excess as well.
Chris is a good candidate for this surgery
because the majority of his skin excess
on his torso is in the front.
[Brittany] Hi.
-[Brad] Hi. -[Chris] Hey, buddy.
[Brittany] Hi.
[Amanda] Listen,
this one over here, they've been biting the bullet
-to get in here and see you. -[man] Yeah.
What are you doing, baby?
Some of the most important people
in my life are here today supporting me.
My son, my soon-to-be daughter-in-law,
and two of my wonderful grandbabies,
and my mean-ass sister, Amanda.
[Brittany chuckles]
[Chris] It means a whole lot that
she's taken the time
and effort
to drive 12 hours for my surgery.
[Brittany] It means she loves you.
[Chris chuckles]
In-between bossing me around.
-[Amanda] So it's... -Yeah.
...gonna take, what, four to six hours
-for surgery? -Uh, probably closer to three or four.
-[Amanda] Three or four? Oh, that's great. Great. -A little less. Okay.
All right, partner. We'll get you back here in just a minute, okay?
-All right. -We'll take good care of you.
-Nice to meet everyone. -[Amanda] All right. Thank you so much, Dr. Turner.
We'll come talk to you right after we're done, okay?
-[Amanda] All right. We'll be anxiously waiting. -[Brad] All right.
He's put the work in, and he's earned the prize.
But with a surgery like this,
there's a possibility of blood supply not being sent
to the right areas. If you lose blood supply,
the skin dies.
The risk of going under anesthesia alone is great.
Chris has lung problems.
He has some medical history there that
kind of works against him.
I'm just really, really worried for him.
[tense music playing]
So you want to divide and conquer,
and, um,
I'll grab her bag,
-and you can help her get in? -Yeah.
Today we're getting on a flight
to Pittsburgh...
Yeah.
Is there a Pittsburgh, Ohio?
[bleep], I don't know.
We're going to Pittsburgh, Pennsylvania.
We're going to Pennsylvania.
[Amy speaking off-screen]
Yeah.
[Misty sighs]
[knocking at door]
[Misty] You ready, chick?
[Tammy] Yeah.
[Misty] You got everything you need?
ID, meds, all that good stuff?
-Yeah. -[Amy speaking]
Passport?
[Misty] Yeah, most current ID.
Nervous as [bleep] and I'm ready to go.
[Tammy speaking off-screen]
I'm nervous enough.
[Tammy speaking]
[Tammy] I'm nervous enough.
That's all you need to know.
Let's go.
[Brittany] Chris has been in surgery
for about three hours now.
Having my grandkids here has really helped
calm my nerves,
keep my mind off of things.
But...
I'm ready for it to be over with, and...
I'm ready to see him again.
[Amanda] My nerves are shot.
What's taking them so damn long?
Now I'm starting to get anxious.
He needs to come on, Dr. Turner.
Brittany is
beside herself.
Dr. Turner said
this surgery should only take three to four hours,
but it's been almost five now.
[tense music playing]
[door opens]
Okay, Brittany, you ready to come on back?
He's all done.
[Amanda speaking]
[nurse] He's asking for a cheeseburger already.
-[chuckles] -[Brittany] He said he was going to.
[Dr. Turner] You remember this girl?
[Brittany] How you doing?
Tired.
We'll get you up to your room pretty soon, okay?
Everything went wonderfully for Chris today.
We took our time,
did the procedure
exactly how it's designed to be done,
and he did very well.
You did great, partner.
Get some rest tonight, okay?
And let me know if you need anything, okay?
Okay.
[upbeat music playing]
All right, well, mother just called.
We did give her an update, but he's doing great.
[Amy] Okay.
You update the kiddos back home
and everybody back home,
-and we'll go from there. -[Amy] Yeah.
All right. Well, I love you, you guys. Be careful.
[Amy] All right. Love you, too.
-All right. Bye-bye. -[Amy] Bye.
Thank God, my brother's safe.
I can breathe now.
Y'all need to quit having surgeries.
My nerves can't handle this!
One of the reasons that you're here is
because we handle more complex cases.
[Tammy] There's one thing
I haven't told my doctors about.
[Dr. Turner] Good morning.
-[Chris] Good morning. -[Dr. Turner] Doing well?
He's been running up and down the halls.
[Dr. Turner] Running up and down the halls, I heard that.
Not nowhere near as fast as I'm used to.
[Chris speaking]
But really,
with this drastic of a surgery,
you're going to be slow moving.
[coughs]
That hurts, by the way, quite a bit.
Have you seen the picture yet?
No, I really-- I mean, I felt the picture.
-You felt it? All right. -But I don't know
too much about what was taken off or anything.
[Dr. Turner] Let me let you take a look at that.
[Chris] Big belly roll.
[Dr. Turner] So that almost covered the whole table.
[Chris] Dr. Turner shows me a picture
of all the skin he removed.
And when it's laid there flat out in the picture,
you're sitting there thinking...
I estimate it was four plus feet of skin
that we had to stitch up.
So that's why I took a little time
to get all that stitched up.
So is he still going to have a belly button?
[Dr. Turner] Yes. You know, for now,
if everything heals well,
his belly button should effectively look normal
or maybe even better than the one you had before.
[Chris speaking]
Yeah. Now you've got a nice little cute one.
[Brittany chuckles softly]
[Dr. Turner] I'm sure that was a top priority.
-No. No. -[Dr. Turner and Brittany laughing]
[Chris] This is the best journey
that I've ever decided to take and stick with.
Everything that I've done has finally paid off.
But really,
to be able to keep up with the grandkids,
and keep up with my wife,
and to be able to make your life better
and extend your life by 15 to 20 years.
You know, that's just icing on the cake.
[Brittany] Off we go.
[phone ringing]
[Tammy] Hello.
What are you doing?
[Tammy speaking]
Well, they let me out.
[Tammy] Well, that's good.
[Brittany] Did they get the picture I sent?
-Did y'all get the picture Brittany sent? -[Tammy] Yeah.
[Tammy speaking]
[laughing]
[Amy speaking off-screen]
The fanny pack.
The fanny packs...
[Brittany groans softly] Oh.
[bleep], that hurts.
[Amanda] Tammy, I'm sending you
good thoughts on this, okay?
[Tammy] Today, we are here in Pittsburgh
to see Dr. Rubin
to see if I'm qualified
to get my skin removal or not.
Here, ladies.
[Tammy] I'm nervous as [bleep].
I'm not ready to do this, but...
[nurse] Hi, Tammy. This is Dr. Rubin.
[Dr. Rubin] Hi, Tammy. It's so nice to see you.
Welcome to Pittsburgh.
This is Dr. Frederick.
[Tammy] Nice to meet you.
Dr. Turner said
that Dr. Rubin has a bigger team
and a bigger hospital.
He wasn't joking. [chuckles]
Dr. Joe DeRenzo,
I'm the chief of anesthesiology.
My name is Dr. Stephen Esper.
I'm the cardiac anesthesiologist
here at UPMC.
I'm Ashley Donatucci.
I'm a senior physician assistant.
[Tammy speaking]
Good God, how many people are going to fit
in this goddarn room?
Apparently 20.
[chuckles]
So let's spend a few minutes talking
about your priorities and your goals.
I just want to see if...
what you thought about, maybe, do the arms and legs...
the stomach and face right now.
We shouldn't do everything at once.
It's a great stress on the body.
We will break things up
into different surgical procedures.
[chuckles]
Face and stomach, those are the bigger things. Okay?
And to understand--
[Dr. Rubin] Absolutely.
[Tammy] It's hard to walk because of the skin.
My belly go this way,
and I'm going that way, and just...
[chuckles]
[Dr. Rubin] Tammy, what we're going to do now
is we're all going to step out,
give you a chance to change into an exam robe,
and then we're going to do a physical exam.
Okay.
We'll let you have some privacy.
[Dr. Rubin] Okay. Tammy, let me have you stand up.
We're going to look at your back, okay?
[Dr. Frederick] You are a tiny person
-inside that body. -[Dr. Rubin] Yeah.
Again, I think it's going to be really important
-that we think about doing this in stages. -[Tammy] Mm-hmm.
[Dr. Rubin] And I think that what I would say
in the first stage is
-that we take care of this apron, okay? -[Tammy] Mmm.
-[Dr. Rubin] This is really bothersome to you, right? -[Tammy] Yes.
[Dr. Rubin] You can go ahead and cover up.
Cover up there.
[Misty] I think Tammy is extremely nervous
for this appointment,
you know, 'cause she's already been turned down once
by a skin removal doctor.
It would be heartbreaking
if, after coming all this way,
he's like, "I can't do it for her".
I would feel so bad for her.
[Dr. Rubin] So...
I think we can start planning for the surgery
for the lower part of the belly
and for the chin.
-[Amy speaking] -[Dr. Frederick chuckles]
[Amy speaking]
[Tammy speaking]
[Dr. Rubin] With that said,
I had a chance to get some records
from Dr. Smith
and some key laboratory tests
about your nutrition
were pretty low in January
and actually dropped lower in May.
Uh, you need to get your protein up.
It's so important in terms of wound healing.
[Tammy] Lately, I've been having a really hard time
getting my proteins in.
I haven't been like, wanting my protein.
I don't want the powder.
I don't want the protein bars.
I don't want none of the proteins,
not even meat.
The other really important thing is
your medical history.
How long did you have the tracheostomy for?
Uh, 15 months?
-[Misty] Something like that, yeah. -About 15 months.
Any active problems with your kidneys, your heart?
As far as I know, everything's good.
How about your lungs?
[tense music playing]
[Tammy] So there's one thing
I haven't told my doctors about.
Um...
[Tammy speaking]
[melancholic music playing]
-You vape? -[Tammy] Mm-hmm.
Is that a daily thing for you?
Yes.
'Cause I mainly use it for, like, anxiety.
It helps calm me down.
Right now, I am vaping every day,
several times a day.
And even sometimes,
I'll get up in the middle of the night
and hit it--
and hit my vape a couple times,
and I go back to sleep.
[Dr. Rubin] If you're using nicotine products,
your risk of wound-healing problems
and wound infection is dramatically increased.
I know it's going to be really hard
for her to quit vaping
because instead of turning one addiction,
she went to another one.
She went from food to vaping.
I think it's her security blanket
at this point.
If we were to go and operate right now,
your chances of having wound-healing problems
are almost 100%.
So number one,
we've got to get you off the vapes.
Completely.
Number two,
the nutrition is really important.
We've got to get those numbers up.
That's going to take about two months minimum.
So we can't schedule the surgery now
until we can get all these things worked out.
[tense music playing]
I don't want to talk about vaping.
I don't give two [bleep] about it.
[vape crackles]