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Life, liberty, and the pursuit of happiness after a 95 pound weight loss

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The Fat Angst Of The Long Distance Lapbander

What made me think that maintenance mode would automatically result in freedom from fat angst?   My husband thinks I am too thin by several pounds. When I went shopping for jeans today and asked for a size twelve in Cruel Girl, the store clerk suggested I start with the nines since "you are quite slender." The scale tells me I am at goal but the mirror reflects what appear to be fat deposits clinging to my hipbones and upper thighs. I've spoken about this with the health coach my insurance provides me with and I am wearing a pair of size nine Wranglers, but... my head is still in fat mode.   Is it a matter of chanting an "I'm not fat ohmmmmmmm" mantra several times a day? Perhaps I'm afraid if I start to feel thin I'll get overconfident and back the weight will come, especially since in the last two weeks I've had 1.75 cc removed from my band. My band tightened over the course of the summer, perhaps due to a series of mild stomach upsets that caused some swelling. For a month almost everything I ate and drank came back up in short order. Removing .75 cc made it possible for me to drink liquids comfortably, but I still struggled to keep solids down so opted for another unfill.   What a challenge this last 1 cc unfill has turned out to be. Dr. B tells me it is easier to adjust up than down and he’s not led me wrong yet, but I have essentially no restriction on what I can eat right now. We were supposed to begin fills next week but he will be out of town, making my next fill appointment ten days away.   Can you say “trepidation,” Dear Reader?   Now, no doubt practicing self-control without physical restriction is good for my character, and I realize that if I gain a few pounds in the next ten days I can lose a few pounds in the ten days immediately following. I did gain a couple of pounds which I know logically was water returning to my dehydrated tissues, but- GAIN? Did I actually write GAIN?   All of a sudden the ghosts of the ninety-five pounds I lost crowd around me, trying to find a place to reattach themselves to my body. Fat angst.   In retrospect, I wonder how much fat angst contributed to my overnight stay on the hospital’s telemetry floor this week? Here’s the story of that:   Wednesday afternoon, I sat on a hill above the creek, watching my sorrel mare graze on one of the last semi-green patches of grass in the pasture. My knees were drawn up to my chest, a position I love and had not been able to achieve during the years I hauled around almost a hundred extra pounds. I thought perhaps this position caused the dull cramp across my chest. I straightened up but instead of loosening, the cramp grew worse and wrapped itself around my back as well. More position changes and a few stretches later, the cramp tightened into a sharp band of pain that took my breath away. I eyed the distance between me and the barn, took Star’s lead rope in my hand, and started up the hill, thinking surely the walk would release the pressure on my lungs.   It took me far too long to cross that expanse of pasture; I must’ve stopped a dozen times to bend down and will the knives to quit stabbing me. I thought about calling out to the two women riding in the arena, but suspected I couldn’t make a loud enough noise for them to hear. Besides, who wants to cause a scene, hmm? By the time I reached Star’s run and fumbled open the gate for her, I was ready to cause any scene necessary to get myself some help. I made it to my car, found the cell phone I almost never turn on, and lay down on the ground to call 911.   The next twenty-four hours of my life were blessed by medical personnel who were kind, compassionate, and competent, from the dispatcher who stayed on the phone with me until the ambulance arrived to the CNA who walked me to the door of the hospital when I checked out the next afternoon. The ambulance driver was an acquaintance who used to keep his horse at the stable. The EMT who hooked me up to an ambulance IV and a heart machine apologized for his own wheezing as if his allergy to horses (activated by the horsiness of my clothing) was more inconvenient to me than it was to him.   When an ambulance hauls a 57 year old woman with chest pains into a hospital, things happen fast. Preliminary tests determined that I was not having a heart attack, but the ER doctor told me he was concerned enough that he wanted me to stay overnight for observation and a stress test the next day. To make a long story short, subsequent tests determined that I have a fine healthy heart. The hospitalist discharged me with a caveat from my internist to make an appointment for next week to determine what had actually caused the attack. Suggestions ran the gamut from blood clot to esophageal spasm to panic attack. Panic attack? I didn’t feel panicked. There was that fat angst thing, but… surely not. How completely embarrassing would it be for fat angst to simulate a heart attack?   Sitting now at home in front of my computer, I must relate something in which I take intense satisfaction: not once did any health professional lecture me on the health risks of obesity or relate my weight to the attack. To them I was simply a normal sized person who needed to spend a night on the heart floor. It’s time to make the same commitment to that normal sized person as I did to her hugely overweight sister two and a half years ago. She needs- no, I need to treat myself with patience, compassion, and firm kindness and go into this new phase of my journey with the same determination and hope with which I entered the initial phase.   I am not fat, ohmmmmmmmmmm.
Shoshanna

Shoshanna

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Once Upon A Time There Was This Fat Girl

Once upon a time there was this fat girl. Me. Like many fat girls, I was an expert on inner thigh chafing, aching knees, swollen ankles, shopping for ugly prints and polyesters in the Plus Department, and taking deep breaths before leaning over to tie shoes. The Weight Watcher Points for fifty different foods and the calorie counts for three dozen more were etched into my brain and I truly believed (Hallelujah, sister!) that eating fewer calories than I burned was the Holy Grail of weight loss. Forty years of dieting seared the fear of doughnuts into my soul and I sought salvation a dozen times. Alas, try as I might to avoid bad company, peanut M&Ms, bacon burgers, and extra-large portions of fries remained my guilty pleasures and emotional solace.   Decades passed and the fat girl (me) evolved into a fat woman despite Mr. Atkins, Jazzercise, Lean Cuisine, salads without dressing, broiled meat, and personal willpower. I lost weight many times only to have those familiar pounds return home to roost, bringing along friends and relatives to take up residence on my hips and thighs.   I'd have quit looking in the mirror when the scale registered 240 pounds, but that wasn't possible since I teach belly dance classes that require me to face a mirror for a couple of hours each Wednesday night. Looking like a round black dot with a head was bad enough, but arthritic knees and limited mobility are not conducive to teaching dance. Still, denial was my watchword when it came to physical damage caused by my weight. I broke my foot during a simple chaine turn and ignored it for a month, earning an exasperated sigh from my good doctor when a belated x-ray showed the break was almost healed.   Not long after the broken foot incident, I went for my annual physical. Dr. Renee Stirling has long been witness to the ups and downs of my weight, encouraging me and gently admonishing me as necessary. Though I had never seriously considered the procedure in terms of myself, that day I asked her, “What do you think of bariatric surgery?” Dr. Renee is a conservative doctor and I expected her to recite the litany of burning more calories than are taken in. To my astonishment, she promptly replied, “I think you are a perfect candidate and I will write whatever letters and fill out whatever papers you need in order to have it done.”   Obviously the time had come to consider the matter seriously. That was mid-October of 2009; I naively hoped I could get the procedure done by early December at the latest. After three visits with the hospital nutritionist, several visits with the nurse in charge of Wyoming Medical Center’s Weight Management Program, one meeting with the surgeon and his staff, a psychiatric evaluation, a pile of paper work, and a nerve-racking six week wait for insurance approval, I finally had surgery on March 3, 2010.   I’d tell you about the surgery and aftermath except I remember nothing at all about it (lucky you). I don’t recall if it was done in the hospital or Outpatient Surgery. Even once my husband assured me it was done at the hospital, I couldn’t recall if I stayed overnight or not (he says I did). I was off work for several days and when I went back I did not share the nature of my surgery with coworkers except to say it was done to improve some matters involving a gastric problem.   To make a two and a half year long story short, I lost weight slowly and with long plateaus between ten pound losses. In January of 2012, still 13 pounds from my goal weight, my surgeon asked if I would be the poster girl for the Wyoming Medical Center Weight Management program. Recognizing my chance for fifteen minutes of fame when I saw it, I agreed, and for a couple of months my before and after pictures appeared in the local newspaper along with the caption, “I can dance again!” Actually I never quit dancing, but it was certainly easier when my feet were no longer in danger of cracking under my weight. In return for allowing my picture to be used for promotional purposes, I got a nice set of professional photographs and some atta-girls from friends and acquaintances.   Two weeks ago while on a business and pleasure trip to northern California, I reached my goal weight of 145 pounds. I haven’t weighed 145 pounds since I was 24 years old and I wasn’t quite sure what to do next. My inclination was to set a weight goal of 135 and keep the downward momentum going, but my husband and son protested vociferously that I was getting too thin. I expected it from my husband who likes a bit of meat on ladies, but hearing it from my son surprised me; he’s a rancher and since I’m not a horse or a cow, I wasn’t sure he’d even noticed I was 95 pounds thinner.   For reasons known only to God, my band tightened this summer until it was difficult to even drink liquids some days. Last week I went to see my surgeon, Dr. Todd Beckstedt, to get a bit of liquid removed from the band. In the course of removing .75 cc from my band, he asked me if I was interested in being the WMC Lapband poster girl again. My initial thought was, “What? Isn’t anyone else losing weight?” but I decided I wouldn’t mind a new set of pictures at my goal weight and so agreed.   The unfill allowed me to drink water again (oh, the heavenly feel of liquid running down my throat unimpeded!) but I realized the remaining restriction was not going to allow me to eat enough for maintaining my weight. I went back today and to my utter horror, Dr. B removed an entire cc of liquid, explaining that it is easier to adjust up than down.   On one hand, this will be good for me, allowing my stomach to relax following the bout of gastroenteritis that probably caused the tightening and giving me a taste of life without stern restriction after 2.5 years of banding. I am particularly excited about the prospect of being able to eat a good salad tomorrow after so many months of having lettuce get caught no matter how well I chewed the stuff.   BUT...   Dealing with this relative lack of restriction is the biggest challenge I have faced since filling out the first paperwork two and a half years ago. I am frankly terrified of gaining weight back. Dr. Beckstedt will be gone next week and I have two weeks to deal with this unsettling state of non-restriction and the fear that I might revert to old habits and go into one of those blind fugues where I eat everything in sight without being hungry.   Fortunately my medical insurance gives me access to a nurse who calls me once a month to go over health concerns with me. I can contact her whenever I need guidance or support regarding health challenges that I face. I spoke with her today and she helped me work through how I am going to deal with some of the challenges of maintenance. I am considering reestablishing contact with my in-town counselor and the local bariatric support group for a couple of months to get me through the transition period. The Lapband forum has been a good source of support and information in the past and I’ve started this blog in conjunction with it. I’m not a blogger by nature, generally preferring to keep my meandering written thoughts to myself, but I hope by writing under a pseudonym I can remain relatively private while keeping myself in line and giving back to others some of the guidance and encouragement I continue to receive from the generous souls around me.   With any luck I won’t bore any of us to death, either.
Shoshanna

Shoshanna

2
 

Attack Of The (Feels Like) Killer Gall Bladder.

Dear Reader, you might recall that two weeks ago I visited Dr. Todd Beckstedt to have some fluid withdrawn from my band. You might also recall that I took a trip via ambulance to the hospital the next day to check out some chest pains that turned out to not be heart-related.   Today: the rest of the story, or at least the next part of the story.   Upon returning to Dr. B this morning to begin my maintenance refills, I apprised him of that exciting little adventure in medical care. He told me that it is fairly common for folks who’ve lost a large amount of weight quickly to have gall bladder problems (two and a half years is quickly?). He decided to send me for an ultrasound and some other kind of test then determine a date for surgery. Bless his little prompt heart, the ultrasound is tomorrow and I see him again the day after. In the last five years I’ve had at least three or four surgeries, so I suggested that while he is in there he should look around for anything else that might need to be removed in the future and yank it out now.   He just patted my hand and said we’d wait until after the gall bladder thing is resolved to start refills.   Urk.   I suppose I haven’t done too badly without restriction though I have indulged myself in food groups I haven’t visited in two and a half years: biscuits and gravy, a hamburger and fries, and BREAD. Real, warm, honest to goodness bread. My weight went up about two pounds over two weeks, but since it can shift that much in a single day I didn’t go into complete Freak-Out Mode when faced with the scale of justice, but moderated back to only Justifiably Alarmed.   Having access to unlimited amounts of foods I used to love was worrisome, but by indulging a bit, I learned a few things: Hamburgers and fries do not constitute Manna From On High. In fact, I disliked the very meal that once drove me relentlessly toward 240 pounds.
One really can have a) too much bacon; too much ice cream; c) too much biscuits and gravy. The jury is still out on too much watermelon. More study is needed.
Fresh bread is a serious temptation if hot from the oven and sitting next to fresh butter, but the stuff that comes prepackaged tastes a lot like construction paper.
Carbonated drinks keep me awake at night, no matter how early in the morning I drink them.
After the first rush of pleasure is past, junk food makes me feel… well, junky.
I have enjoyed eating salad that contains normally prohibitive amounts of fiber. Oranges taste wonderful right out of the skin and I had forgotten the joys of eating grapes that weren’t divvied into mouse-bite-sized portions. With any luck, my maintenance restriction will not be as severe as my weight loss restriction and I’ll be able to eat fruit and vegetables again without mincing them.   But if not, I will survive.
Shoshanna

Shoshanna

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