Exactly a year has passed since I first applied the idea of lap band surgery to myself. I don't recall what put it into my head, but when I went to see my doctor for my annual check-up, I asked her casually what she though of bariatric surgery. Dr. Renee favors conservative treatment in most cases, which suits me fine, and I expected her to be lukewarm at best about weight loss surgery. When she promptly answered, "You are a perfect candidate for the surgery and I will fill out any papers you need in order to arrange it," I nearly fell off the examining table.

She went on to tell me the differences between gastric bypass and lapbanding, both available in Casper via three excellent surgeons. She left the final choice up to me, but explained she thought lap banding was the best option since it involved less extensive surgery and had fewer risks. I left her office with a list of surgeons, instructions to call the Wyoming Medical Center Weight Loss Program, and her firm support in whatever decision I made.

RN Deb Miller was in charge of the WMC Weight Loss program at the time and was the advocate that everyone hopes for when entering a life-changing and frightening new endeavor. She explained the program, the paperwork, the procedure, and WMC's policy on borderline cases such as myself. My BMI was not the suggested 40 and I had less than 100 pounds to lose, but I had arthritis, joint pain, GERD, and a family history of DM that strikes people at about age 62 (I am 55). Also weighing in opn the side of approval: my husband works for WMC and the hospital is growing more interested in allowing the surgery in hopes of reducing insurance costs down the line for weight-related co-morbidities.

Nothing ventured, nothing gained. I filled out the first paperwork, crossed my fingers and plunged into the preliminaries.

Insurance required me to meet with the hospital dietician once a month for three months to discuss pre-op and post-op diets. Deb warned me that missing a single meeting with the dietician had been used as grounds to disapprove surgery. I appeared at my appointments faithfully, attended the informational program for perspective clients, read all the literature, checked out the short course online, and met with the surgeon I chose.

The first meeting with Dr. Todd Beckstedt was brief and essentially consisted of "You got any questions?" and "You sure you want to do this? Okay, then." My questions had been answered via my research and it seemed the main purpose of shelling out the money for this visit was in order for his business manager to spell out how much more money I would be shelling out and how payment was arranged.

I was privately dismayed at how long the preliminaries stretched out before the paperwork could even be submitted to the insurance company. I underwent a number of lab tests, medical exams, and psychiatric testing, all of which the insurance agreed to pay for, even if the procedure was ultimately denied. I had hoped to be able to have the surgery in December, but it quickly became obvious that was not going to happened. I resigned myself to the slow turning of the bureacracy.

The psychiatric exam tickled my fancy: was I sane enough to want to lose weight? Was I stable enough to follow through with the program? Did I have the brains God gave a sagebrush? I went for my oral psych exam and several times found myself answering a question with some version of, 'I know the answer you are looking for is A but I really think B because..." When I went back to discuss the results of this exam with the doctor, I asked her if I was psychotic, neurotic or had some other kind of deadly -tic. She answered, "No, but you are unconventional." My, I was happy to have professionally confirmed what my family, friends, business associates, and I have known for many years.

Once the psych exam was done, I turned in my paperwork to Deb and the wait began. It dragged on through January and well into February, a much longer time than it generally takes for surgery to be approved. I decided I was going to be denied because I was twenty pounds too light and began to wonder if I needed to increase my weight to the prerequisite 260 pounds i order to be approved (more even than I had weighed nine and a half months into carrying a ten andf a half pound baby).

When Deb called to tell me the procedure had been approved, I think she was more excited than I was because she is a dear person who cares about all her patients and she had also decided I was about to be denied. I thanked her for the call and faced the next set of hurdles I needed to jump. We set a surgery date of March 3, 2010, I arranged for a couple of days off work for unspecified gastric surgery, and began my two week liquid diet.

I managed to stay on the liquid diet without a great deal of trouble, but I was so sick of sweet gunk like Ensure and Boost by the time I was done that it is hard to look a chocolate liquid in the bottletop to this day.

As I've written before, I recall essentially nothing of the day I went in for surgery or the day or two after- only that ghastly tray of bland, inedible (okay, undrinkable) hospital fare that was presented as my first post-surgical meal. I stayed on liquids a few days, then was given permission to eat whatever I wished as long as I chewed the hell out of it and could keep it down. I had little or no trouble with this first solid food and never has a bite of baked potato tasted so good as that first post-liquid spud.

I actually ended up on a mostly liquid diet for longer than expected since I went to Texas to visit a friend who was recovering from chemotherapy and radiation for throat cancer. He was limited to Ensure-like fare and though he had real food for me, I was certainly not going to eat pork chops while he sat across the table from me sipping one of those ghastly meal substitutes. We drank the nasty stuff companionably for the several days I was there, though I did bring in some grapes and strawberries to supplement my meals.

I didn't lose much weight prior to the pre-op liquid diet and didn't lose much more on the liquid diet. Shoot, I thought for a while I was going to have to gain weight in order to be approved, so why bother? My first fill was posphoned by a couple of weeks due to my trip to Texas and didn't have a lot of effect on me. The second fill was better- hooray! Restriction achieved.

This summer I've gradually adjusted to my new eating habits and requirments. Fortunately foe me, my doctor is less strict than many I've read about in terms of what I can injest and when. Three meals at designated times of the day simply do not work for me; I am a grazer. Food too early in the morning makes me sick; I start feeding myself around eleven o'clock and by late evening, I've got my food in for the day.

I don't count calories, either. I started using the Weight Watchers point system that worked well for me in the past, but the endless task of writing down every ort of food just infuriated me- been there, done that, regained the weight. As much as anything, I want to learn to live like a normal person and not think of food every second of every day. I ask myself "Am I hungry or just bored/sad/irritated/procrastinating/fill in the blank?" If the answer is "hungry", I eat what I want and stop when I'm no longer hungry.

I was thrilled the first time I couldn't finish a restaurant meal and took enough leftovers home in a box to last me another two meals. When I lost my desire for french fries, a life time passion, because they sat in my stomach like bricks, it was the triumph of a lifetime of poor eating. I still struggle with not drinking water with meals, but it doesn't seem to affect either how long I stay full or my weight loss. When it does, I will put more effort into conquering that weakness in my program.

The one bad habit I have not given up is carbonated beverages. I did give them up for several months, then confessed to my doctor how difficult it was and how much I missed diet Pepsi and Perrier water. He asked if I drank "the fully leaded (sugared)" variety and I allowed as how I have drunk only diet soft drinks since Tab came out in the Sixties. "Then what's the problem?" He asked. Well, didn't it stretch the pouch or something? He smiled and said that was more of a problem with gastric bypass than with banding and to drink the carbonated beverages if I wished.

So comforted by my favorite bad habit, I've come almost six months since banding. My weight is down to 203 from a high point of 240. My joints don't protest every move and while leading horses up a steep hill last week, I realized I wasn't the least bit breathless. Things are better, definitely, and I am sitting here in jeans I haven't been able to wear in three years or more.

I don't have a firm final weight loss goal because I tend to slip back into obsessive compulsive anorexic/bulimic thinking when I get centered on a number. My next short term goal is to drop below 200- I'm getting there. The goal after that is to drop below 180. After that- well, we'll see how I feel about the matter. I'm happy with my progress and for now, that is enough.