On Sept. 4, 2008, I underwent gastric bypass surgery. I'd already dropped 25 lbs. on my pre-surgery diet; as of today, my one-year "surgiversary," I've lost a sum total of nearly 150 pounds. I'm down 8 sizes (and no, that's not a typo) and am now wearing clothes I haven't been able to fit into for 12 years. My sleep apnea is gone, my Type II diabetes is in remission, and my blood pressure is perfect. If it weren't for the wacky hormonal fluctuations I've been having the past four months, I'd say I feel the best I have in my entire life.

This is all of the good stuff.

There is some not-so-good stuff. Like the fact that good bras are expensive, and right now I'm needing a new size at least every two months. Ditto for panties. Yes, I know there are worse problems to have. But money is tight, and I cycle through clothes so quickly that my wardrobe is very limited at times. Either that, or I end up wearing things that are two to four sizes two big, which just makes me look hulky.

Vanity Gripe #1: The last time I was this size/weight, I did not have a double chin. WHY DO I STILL HAVE A DOUBLE CHIN? I hate the double chin with a fiery and irrational passion.

Vanity Gripe #2: Skiiiiiiiiiiiiiiin. As in, loose skin. As in, crepey skin. As in droopy, saggy, riddled with tiny, nude-colored stretch marks skin (because yes, you get stretch marks when you lose a lot of weight in a relatively short period of time). If I lay on my side and kick my leg straight up, I have athletic-looking thighs. When I stand, loose flesh and the remaining bits of flub droop down around my knees. And don't get me started on my boobs, which look like tube socks with tennis balls at the bottom of them. Joe will kill me for admitting this, but I can smack my own face with the right boob, which cracks me up and makes him shriek "Stop!" like a little girl.

Lastly, after a year of losing weight and inches very, very quickly, all of it has slowed to a crawl. My surgeon says I should be shooting for a 1 lb. a week weight loss. Say wha? I still have 75 I'd like to lose, and about 40 that I should lose before attempting the bun-in-the-oven thing. I'd like to drop two more pants sizes and three more tops sizes. I WANT TO FIND A WAY TO GET RID OF THIS DOUBLE CHIN.

The upside: even though the weight is coming off more slowly, my body composition is still changing pretty frequently. For instance, I've only lost about 10 pounds since early June, but I've dropped an entire clothing size (normally, I have to lose about 20-30 lbs. to switch) and one whole bra size. I can do more physically than I have since I was in middle school - and feel (mostly) good while doing it.

So, yeah. Mostly good things (chin not included).

And oh! Here's a really good thing: to mark the occasion of my first ever surgiversary, Joe got me a little silver scale charm for the bracelet he gave me at Christmas. (He also got me a book charm, as an overdue congratulations gift for SWEET LIFE's pub date.)

Best. Fiance. EVER.

Hope everyone has a great Labor Day weekend! I'm off to labor right now in our bonus room, which is in desperate need of purging and sorting.


P.S. I posted updated progress pictures on my Facebook page, but they're accessible by friends only. At least, they're supposed to be.

So, remember how I was pretty much absent from LiveJournal (and, if you know me personally, from pretty much everything) last August through mid-October? There was a really good reason for that, and here it is:

On September 4, 2008, I underwent gastric bypass surgery at St. Francis Hospital, under the skilled hands of Dr. Gail Wynn.

Some people say that the decision to have weight loss surgery was one of the most difficult they've ever made. For me, it was easy. I'd battled obesity most of my life - probably since I was eight years old. My parents sent me to a Weight Watchers camp the summer between sixth and seventh grades, and I lost something like 29 lbs. I came home needing to lose another 20, dropped 10, and then slowly but surely put it all back on and then some. The summer before eighth grade, my dad took me to NutriSystem and got me signed up. I lost about 25 lbs. before quitting the program, and then slowly but surely put it all back on and then some. This was a pattern I would follow year after year after year. My senior year in college, I dropped 45 lbs. the old-fashioned way, through eating healthfully and doing Jazzercise three to four times a week. Then I went through a really bad break up and ballooned back up.

Even through all of the yo-yo dieting, I never passed a certain weight point - until 2001. I was living with my boyfriend at the time, a good ol' Southern boy who really liked red meat, anything starchy, and mass quantities of sweet tea. During our seven months of co-habitation, I put on a good forty or fifty pounds. It was probably the first time in my life that I wasn't dieting in any form, or watching anything I put into my mouth. My best friend at the time said, "Lara, I have never seen you keep a pack of Oreos in the house" - and said it in that hushed tone that screams, "OH MY GOD, WHAT ARE YOU DOING?" When the boy and I split suddenly and unexpectedly, the break up was probably the most devastating I've ever gone through. I quit my job, moved back to Delaware, and in the half year it took me to get over him, I packed on another forty or fifty pounds.

That summer, my grandmother gave me the money to do this medically supervised weight loss program through Christiana Care. It was fashioned on the traditional low-fat, high fiber diet and emphasized behavior modification and exercise. I was unemployed at the time, and spent every day cooking healthy vegetarian meals and swimming endless laps in my condo's pool. I got tan, strong, and dropped 65 lbs. But that fall, I started teaching full time. I was juggling six classes across three different college campuses, and soon my nutrition degenerated into a bagel and cream cheese and extra large Dunkin' Donuts coffee for breakfast, a muffin or bow tie for lunch, and then whatever was quick and easy for dinner. When I stopped exercising, back came the weight.

More yo-yo-ing followed: my mom had had great success with Atkins, so I tried it and joined Curves and lost 30 lbs. Then I got bored with bacon and Curves and quit. I tried Ladies Workout Express, which was slightly less boring, and South Beach, which allowed more complex carbs, but something would always happen, and I'd fall off whatever wagon I'd been on.

I need to note that through all of this - from December 2001 on - I didn't have health insurance. The closest I came to medical care was the yearly gynecological exams I'd get at Planned Parenthood. And it was the care I received at PP that ended up saving my life. (More on that later.)

The summer of 2005, I'd gone to a low-cost health care clinic in Claymont, to get the red, angry spots on my feet checked out. This was when my psoriasis was in its early stages, but I didn't know I had psoriasis yet. Neither did the clinicians at Claymont Family Health. But seeing how overweight I was, they did what any doctor would've done, had I actually been seeing a doctor: they checked my blood sugar. And sure enough, I had Type II diabetes.

I couldn't have had the diabetes very long, because when I did that medically supervised weight loss program, I did see several physicians and I know that was one of the labs that had been run. So I was really fortunate that I found out when I did. Of course, I didn't feel fortunate at the time. I felt stupid. Embarassed. I remember calling my mother to tell her and crying repeatedly, "Please don't be mad. I'm so sorry. Please don't be mad." I spiralled into a fairly significant depression, and then I took charge. This was the period when I was doing South Beach and Ladies Workout Express. At Claymont Family Health, I had to see this one particular doctor that worked with everyone who had diabetes. But the doctor only came in every other Thursday, and one Thursday a month I was out of town the entire day. After rescheduling too many appointments, I was kicked out of the practice and told I couldn't be a patient there any longer. I still didn't have health insurance, and I didn't know what to do. So, I stuck my head in the sand and pretended that I didn't have the disease.

A year and a half later, during my annual visit at Planned Parenthood, the nurse practitioner read me the riot act. She told me she didn't care what happened at Claymont - I needed treatment and I was going to have to fight to find it. She told me that if I didn't start taking care of myself, I was going to be dead within 10 to 20 years. She printed out a list of places where I could go to get medical care and gave me pointers about each one. She yelled at me - literally yelled at me - and I left shaking and in tears. But, I called and made an appointment right away at Westside Family Health. This is how I met my doctor - Dr. Mary Leddy Snyder - who Joe and I call Dr. Awesome. And that's when I started to get treatment again for my diabetes, and that's when I started to take things seriously.

Then, when Joe started working at Bank of America and I got health care coverage, I knew my goal: weight loss surgery. I wasn't sure if I wanted to go with the Lap Band or gastric bypass, but I knew surgery was the way to go. I'd done everything I could to lose weight, but it never stayed gone for long. And it wasn't like I had a simple lack of will power, either. To treat my diabetes, Dr. Awesome put me on insulin therapy (in addition to a bunch of other medications), but something was never right with me and insulin. I put on another 40 to 45 lbs. within a matter of months of starting it. This was while Joe and I were eating things like salmon, quinoa, and sugar-snap peas for dinner. The more weight I gained, the more insulin resistant I became, and no matter what I did, the weight just wouldn't come off.

So, yeah. Surgery was an easy choice to make.

But those people who think having weight loss surgery is taking the easy way out? They're either ignorant about what goes into the process, jealous that they can't have the surgery themselves, or too scared to make the decision to have it. Because let me tell you: there was nothing easy about preparing for surgery.

I won't bore you with all of the details, but I will say this: I had my first meeting with my surgeon about nine weeks before I had actual surgery, and in that time I must've had at least two dozen doctors' appointments and three sleep studies. I had to get an EKG, an echocardiogram, and a stress test. I had two attend two nutritional classes and two support group meetings. I had to create an eating plan for post-surgery and purchase $100 in vitamins and supplements. On July 26th, I started a pre-surgery liquid diet that I had to stop 10 days later because it was spiking my blood sugar, and you can't have surgery unless your blood glucose levels are at a certain level. Then I was put on what Dr. Wynn called the "zero carb" diet - really, a super-strict version of Atkins where carbs had to be kept to under 20 grams a day. Finally, two days before surgery, I went on clear liquids, where I was only allowed to have things like sugar-free Jell-O and clear broth. Then, midnight before surgery, I wasn't allowed to have anything, not even water.

The procedure - a laproscopic RNY - went exceedingly well. I was out far earlier than expected and had no complications. My hospital stay was ... well, I'll leave it at unpleasant. But I was released two days later and by my two-week follow-up, I'd lost so much weight that I was taken off my blood pressure medication, which had been making me lightheaded and dizzy. Two weeks after that, I stopped using the Bi-PAP machine I'd been issued for my sleep apnea, because the pressure was so high it was popping my ears constantly and besides, I was sleeping through the night on my own.

My recovery was long and hard. I spent a lot of my second month post-surgery puking my guts up. The first weeks after surgery, you eat nothing but pureed foods in very small amounts. Like, a meal would be 1/4 cup of runny Cream of Wheat, or cottage cheese, or - the one thing that got me through the pureed stage - 1/4 cup of Wendy's chili put through a mini-food processor. But then you're supposed to start transitioning to soft solids, like canned vegetables and fruits and hard boiled eggs. That transition was really rough for me, and foods that other post-ops have no problems with made me hurl like nothing.

Also, I was going through crazy hormonal changes like a pregnant woman. My sense of smell was intense and everything made me nauseated. One whiff of a milk-based protein shake made me want to vomit, so I was forced to buy these super expensive clear drinks that are made for cancer patients. Plus, I was tired like I've never been before. I normally get by on six or seven hours of sleep a night; post-surgery, I could barely keep my eyes open. For six weeks after, I was sleeping 15-hour days.

Finally, toward the end of my second month post-op, I started to feel like myself again. I was keeping more foods down, I was needing way less sleep, and I was able to start an exercise program. I would do a yoga DVD at home and work out with a Fit Ball and free weights. I started taking walks on this trail over at the Delcastle Rec Park. Then Joe and I got our Y memberships and now we have gym dates three nights a week. We've worked up to 35 minutes of cardio, 30-40 minutes of strength training, and a 5 to 10 minute stretch routine. We're even preparing for a 5k walk in April. This is vastly different from my pre-surgery life; at my heighest weight, in July, I could barely make it around a grocery store without having to sit and stretch on the floor.

I still have a long ways to go, but losing this 100 lbs. has improved the quality of my life 1000 perecent. I no longer loathe exercise. Now, I love it! I seriously can't sit still; even when I'm watching TV, there's always a foot bouncing, or I'm running from room to room doing stuff as I watch. I'm off every single diabetes-related medication and am no longer considered diabetic. My BP is good. My sleep apnea is gone. I'm smaller, I'm stronger, I'm feeling incredible. My confidence has increased ten-fold. To be honest, I can't really quantify how I feel with a number or percentage. It's too big to contain that way.

But I'm sure you're curious about the numbers, so here they are: I lost 25 lbs. during my pre-surgery diet and another 39 my first month after surgery. Then, over the next 10 weeks, I dropped another 36 lbs. I never did measurements, and I'm kicking myself, because with the strength training I've noticed that I'm much, much narrower. I'm down three clothing sizes. My engagement ring stays on with half an inch of bandage tape wrapped around it. Even my feet have shrunk.

Why am I telling you this? Because I'm not ashamed that I had surgery. I never wanted to be one of those people who pretended they lost an enormous amount of weight by eating rice cakes and working out six hours a day. I needed help. I needed the tool that weight loss surgery provides. It shrunk the size of my stomach and took away my hunger. It rerouted my intestines so that even the stuff I do eat - which probably amounts to a maximum of three cups of food daily - doesn't all get absorbed. I dropped a lot of weight quickly, which helped make exercise not only easier, but possible.

But also, I wanted to talk about this publicly because there are so many misconceptions about weight loss surgery. How it's "cheating." How it's a "shortcut." And that's so not the case. I've had to modify my behavior more than anyone on a "normal" diet. HAD TO. Because if I eat too much, or eat too fast, or eat the wrong thing, or eat too quickly after drinking a lot of water, I puke. At Thanksgiving Take II, the dinner we had at my mom's house the Friday after, I made the mistake of having half a glass of white wine while dinner was heating up. A glass of wine for a gastric bypass patient is equivalent to three to five for a normal person, because of the way our intestines are routed. So I was three sheets to the wind on 4 oz. and didn't pay attention to what I was putting in my mouth. I threw up five times over the course of two and a half hours - painful puking, embarassing puking, puking punctuated with uncomfortable jokes from my stepfather like, "I see a lot of teeth-brushing in her future." Then there are other incidents, like the other night when I tried shrimp for the first time since surgery, and it simply didn't agree with me. It took more than two hours to expell the three shrimp I ate, and it made me feel like I'd been run over by a MAC truck.

So why am I telling you all of this now? Because I said I'd do it once I hit 100 lbs. lost. And I did. Two days before Christmas, on December 23, I hit the milestone I'd been waiting for. That's the day I officially lost 100 lbs. I just haven't had time to blog about it before now.

Do I regret having surgery? Hell, no! I would've done it years ago, if I'd had the insurance. Surgery gave me my life back. Now I'm the one who's got to make the most of it.

And I am.


[P.S. If you have any questions about weight loss surgery or anything else contained in this post, please feel free to leave them and I will answer them all as honestly as possible.]