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.