I am 16 months out tomorrow.  I have been maintaining my weight for several months now.. but, I realize this isn't TRUE maintenance as I probably still have some malabsorption of calories.  Up until now, my surgery has really had control of my weight, but VERY soon, it will be all me.  Me.  The person who has failed diet after diet.  I have never thought of my surgery as a cure for my obesity.  I always looked upon the honeymoon period as a time to retrain myself on how to eat so that I COULD maintain my weight.  I weigh myself almost every day.. not to see if I have lost, but to see if I need to pull it in line... to catch a gain before it gets out of control.  
  Yesterday, I saw a guy that I hadn't seen in about a year.  (My daughter's boyfriend's father).  He used to be a customer in my store back when I managed a gas station in Napa.  He commented on my appearance and asked how I had lost so much weight.  (I have lost 155 lbs so far).  I am not shy about my surgery.  I don't believe it's the easy way out and I am proud of my progress, so I told him.  As usual, the first thing out of his mouth was "I knew a guy who had that surgery and he lost a ton.. then he gained it all back.".    I get that response a LOT.  I read the boards and see a lot of people complaining of regain after 2 years out.   I'm terrified.  Seriously.. terrified.  
  Ok.  I am outta here.  I am off to try out my new elyptical machine.  I can't wait!   Happy Halloween, everyone!!!
  

 REGAIN.  Yes.   The dreaded R word.  I haven't gained a single pound.  Actually, I am slowly losing again.  I am sort of bouncing between 142 and 145.  I keep reading about the DS and how it's a superior surgery for many reasons, but one that is listed most often is the regain that a lot of RNY patients have.  I really should just quit reading this stuff, but I have sort of made nutrition/WLS/WLS related issues my hobby... so, I can't.  I want to be as educated as possible so when the subject comes up, I can share proper information.  Anyway, besides now having a nasty case of DS envy, it got me looking up the actual statistics of RNY weight regain after 5 years/10 years/etc.  It looks like about 35% of people who started out SMO (like I did) have significant regain after 10 years.  (Significant weight gain meaning that they ended up with a BMI of 40+).  The lowest weights were reported at an average of 19 months.  I'm 16 months out on the first.  I really should have made notes of the sites I read so I could paste links, but I wasn't thinking that I was going to post a blog about it.  Damn.  
  Ok.  First, I can't go back and redo my surgery, so I just need to get over my DS envy right now.  It wasn't an option for me (my insurance didn't cover it) and I can't turn back time.  So far, my RNY has worked beautifully for me.  I should just be thankful.  Second, although there are plenty of people who regained because the surgery failed THEM, a lot of them regained because of lack of discipline.  If I follow the rules, there is no reason to believe that I will be one of the 35%.  Or is there?  I started to write all about what I had learned about the medical causes of regain after RnY, but I realized that I am not nearly educated enough and I sounded like an ass, so I'll write more when I learn more.  One of the reasons was a stretched stoma.  If you stretch your stoma, you don't hold food in your pouch long enough and you feel hunger sooner, so you eat more.  You can actually stretch your stoma out to the same size as your pouch which, in essence, creates a 20 foot long stomach.  Scary.  The other reason listed had something to do with insulin production.  (Reactive Hypoglycemia, maybe?).  I will do more research.  
 One can argue that if you follow the rules, you won't stretch out your stoma and that Reactive Hypoglycemia is controllable (it must be.. there are plenty of RnYers that have it and seem to be able to control their weight while dealing with it).  
 I have had a flawless RnY experience from the beginning.  I had none of the post op gas pain, very little pain at all, actually.  After I left the hospital, I was fine with just Tylenol.  I have had no complications of any sort (knock on wood).  I have exceeded the weight loss expectations of my surgeon by quite a bit.  I have only dumped once or twice (I am thankful that I did, though.. I was hoping to be a dumper).  I have only gotten food stuck once or twice.  I didn't lose much hair, and what I did lose grew back beautifully.   I have excess skin, but it's minimal considering the amount of weight I have lost.  (About 155 lbs, so far).  I don't even need to wear body shapers.  The skin is crepe papery on my stomach and a LITTLE hangy, but not too bad (unless I am bending over.. then it's gross.  Standing up it looks alright, though).  It doesn't hang down any more than it did when I was heavy.  I had four c-sections in six years, so my stomach was never all that great to begin with. My boobs are pretty much gone, but honestly they are so much better looking than they were when I was bigger.  When I was heavy, my boobs looked like Sumo Wrestler boobies.  Not at all like a woman's breast should.  *TMI warning*   Now, my nipples are where they are supposed to be instead of pointing at the floor like they did when I was big.  Also, they look like normal nipples.. not all stretched out and flat.   The skin on my breasts is a little loose, but it's not bad.  My butt is probably the worst part of the whole thing.  It's gone.  My backside is FLAT no matter how much I work it out.  There is more loose skin there than most anywhere else (except my stomach).  Still, it looks alright in clothes.. just flat.  I said I didn't wear body shapers, but that's not completely true.  I do sometimes wear padded underwear.  Not Booty-pops.. they don't make any real difference.  I have some nice ones with fairly thick removable pads.  I don't wear them often.. but, sometimes when I need a confidence boost.  I bought VERY padded bras, but decided that as much as I miss filling out a sweater, I actually look better with my small boobs.  They fit my size 4 frame better.  Anyway, I don't wear them.   
  I have been really blessed with my surgery.. really, I have.   I look and feel better than I have .. well, pretty much my entire life.  My skin color is better, my hair is shiny and thick, my eyes are bright and clear.. all due, I'm sure, to my vitamin intake and my improved diet.  I could be a success story.  I guess only time will tell.  I hope to someday be an inspiration to those looking to have WLS (of any form).  I have actually recently decided that I want to become a Nutritionist or a Registered Dietitian and I would like to specialize in helping obese people.. whether or not they want to have WLS.   I am looking into starting classes.  
  Wish me luck.  

  So, long story short, I wasn't getting enough calories, so I increased my calories by about 600 a day (more than double was I WAS getting)  and POOF.. instant weight gain.  This was followed by a meltdown over the weight gain.  
  I haven't been able to poop in days (don't ya just LOVE the way we can discuss these things with strangers now?), but I got on the scale this morning and it was back down to 144.6.  My period is getting ready to start and, like I said, I haven't been able to poop.  So, it seems that my body just needed a few days to adjust to the increase in calories and it looks like I might even come out of this a few pounds smaller than I started.   
  Good times.  I still think I need therapy, but for now I am alright.  I can't wait until my medical coverage kicks in!!!  Labs (LONG overdue), therapy, etc.    I am especially excited about my labs.  Right now I am taking vitamins left and right, but WHO KNOWS if I am overdosing on one and not getting enough of another?!?  I suspect I am still anemic (I have been anemic my entire life), but my skin color is better than it ever has been.. so, maybe not AS anemic?  (I am sure that's too much to hope for).   The three I am most worried about are: Iron/Ferratin, Calcium and my protein levels.  If you have read my earlier blogs, you know that I went through a period of depression where I didn't take good care of myself at ALL.  No vitamins, not NEARLY enough protein, and not enough liquids.  My protein has been a minimum of 70g a day for months and I am a NAZI about my vitamins now.  With any luck, I haven't done too much damage to myself.  If so, well, it's my own damn fault.  
  Ok.  So, crisis averted.  I have to say.. this has been one HELL of a ride.  =]

 What is wrong with me??

  So, recently I had a conversation with The Cowboy and during that conversation he told me that he liked me better a little heavier.  I also felt pretty good at a size 8 or 10.  There was less loose skin, I still had some curves.. I was happy.  Then I reached a size 4.  I have no curves and lots of loose skin.  At the time that we had this talk (it's in a previous blog, if you're interested), I felt like a weight had come off my shoulders.  Like "Ok.. I can stop now.  I don't need to try so hard."  Then I started thinking that I could even gain back like 20 pounds or so and be alright with it.  I felt a sort of freedom.  I gave myself a pat on the back for being so well adjusted .. I thought "I must be the only weight loss surgery patient that has ever been OK with the idea of gaining weight and therefore no longer a slave to the scale. "  Bear with me.. I am going somewhere with this.

During this time, I have also had a lot of trouble getting in enough calories.  If you have read any of my previous blogs, you know that I have gotten an average of 522 calories a day since July.  I am just never hungry.  I forget to eat and when I DO eat, I still can't eat very much.  I concentrated on protein rich foods, so I have been getting 70+ grams of protein in.. but, not much else.  I posted in the forums about it and got several responses about how I need to up my calories or risk messing up my metabolism.  *ACK*  So, in the interest of "I don't care if I gain back a few pounds" and not wanting to screw up my metabolism, I have been upping my caloric intake.  Yesterday I got over 800 calories in and today 1100.   

Here's the issue:  I don't know if it's in my head or maybe it's due to not having a good BM in a few days or maybe it's water, but I SWEAR my pants are getting snug.  I weighed myself yesterday morning and I was 147.8.   That's the highest weight I have been in months.  I didn't weigh myself today.  I'm scared.  Suddenly,  I realize that I am NOT alright with gaining back any weight.  I am NOT well adjusted.   I ENJOY being tiny.   I am SCARED to eat.  I am scared of food.  I am TERRIFIED of gaining back my weight.  I just posted this as a comment on someone's blog, but, I feel like a fat girl in a skinny suit.. like this is all temporary and fake.  I am acutely aware of the fact that at 15 months out, my honeymoon period is just about over.  I will soon start to absorb more calories and the real work will begin.  (It sort of has already, I think).  I am worried that I am going to scare myself right into an eating disorder.  I made a joke today about how I needed to go get some size sixes and how strange it was to think that I would be buying size SIXES to be my "fat clothes".  It does sound strange to me when I say it, but it also terrifies me.. I don't want to go back to size 6.  Then thinking that scares me because what kind of freak is scared of being a size SIX?!?!?   A year ago I couldn't even DREAM of a size EIGHT.. let alone FOUR.  

So, here I sit.. feeling fat and miserable.  It's almost like a time machine has taken me back to my pre-op days.  I am right back where I started.  Unhappy with my body and obsessed with the scale/calories/food.  I am a hot mess.  

I submitted my pictures for the before and after photos.   I'm not sure why this is so exciting to me, but it is.  =] 

I'm normal.  That's cool.   

 Today is another "complete lack of desire to eat" day.  I added a scoop of protein to my coffee this morning.  That's all I've had (besides my vitamins, of course).  
  I am trying to get myself motivated to go make myself some egg whites with a little ham, but I may just have another coffee with protein.  I need to get it together.  Otherwise, today will be another 400 calorie (or less) day.  
  Another recent observation:  I don't really care about my weight right now.  I NEVER want to go back to where I was, but I step on the scale in the morning more out of curiosity then anything else.  It doesn't change much anymore.  That's ok.  If I were to suddenly drop a few more pounds.. that would be ok.  If I gain back 20.. that's kind of ok, too.   I think if it got back up to 175, I'd really start watching it, but, really.. anything under 179 is fine with me.   Getting into a size 2 would be fine with me, too.. *shrug*.  I think after COMPLETELY freaking out, weighing myself EVERY TIME I saw the scale, having complete meltdowns over "should I gain back some weight?  Should I try harder to LOSE a few more pounds?  ACK!", I just sort of gave in and realized that I can only do my best and what happens happens.  
  I have been maintaining 144 to 147 for months (usually the higher end), but since I just decided that gaining a pound wouldn't be the end of the world, now I see 144 more often.  
  The GOOD news is that I have noticed that my hair is MUCH thicker than it was.  I lost some after surgery (like everyone does) but, it never got TOO thin.  Recently, though.. I think it might be thicker than it was to begin with.  Nifty.  
  Also, I have decided that I do want to save up for plastics.  I miss my boobs.  I want to get rid of the loose skin on my tummy and maybe lift my ass back up.  Sooo... a lot of saving.  LOL.  Wish me luck!

Update:  I decided to go with the eggs. I went to sprinkle pepper on them, but I accidentally opened the vent side of the pepper.. so... I had some VERY peppery eggs with ham.  I DID get my calories up to 209, though.  41g of protein so far.  

  Of all the things to dump on.. it was a pear.  A TINY pear.  I am working as the manager of a gas station that is getting ready to open up.  We have one bathroom.  It's indoors.  Today I had a BUNCH of workmen in the store installing the new registers and working on the pumps and such.  My assistant brought in these pears.  I can't remember what kind they were, but they were tiny, expensive and AMAZING!  It was almost worth it.  Almost. 
  So, *TMI WARNING* I have been constipated for days.. probably due to the massive amount of iron I have been taking.  About the time I took the last bite of this heavenly morsel, I KNEW I had done something wrong.  My stomach was making noises that reminded me just a little bit of a dying monkey.  All bad.  Then, my heart started pounding.  Then I got a light case of cold sweats.  Then came pain.  I thought it might be gas.. I was HOPING it was just gas.  I excused myself to use the restroom.  I go in there and ... nothing.  More rumbling.  Severe cramping.  Then nothing.  
  A few minutes later, I get cramps that I can't begin to describe.  Well, yes I can.  It felt like there were razorblades ripping through my abdomen.  All bad.  I go BACK to the bathroom (now everyone is paying attention because apparently, when razorblades are ripping through you, it shows on your face.  Who knew?)  This time... well, all bad things.  Keep in mind, I have been stopped up for a couple of days.  THAT had to come out first.  It was NOT pleasant.  Following the ... well, the thing that has no name... came the worst case of the backdoor trots I have ever experienced.  OMG!  So, WHILE this is happening, I realize that I need to throw up.  Good times, right?  There is no garbage can in the restroom yet, and I can't get up.  Sooo... I have to AIM it between my legs. 
  All I have to say is I DID get kind of an NSV.  I realized today that my legs are small enough that I COULD aim between them.  NO WAY I could have accomplished that freakish feat before.  Ugh.  Yay me.