I was always a little on the "chunky" side as a kid, but never what I would call "obese"; (maybe like 10 pounds overweight). When I was 13 years old I was pretty much my full-grown size: 5'2" and 130 pounds. I wore a size 7 jean. I guess, by medical standards, that was still overweight. And, what teenager doesn't feel fat? But really, as short as I was, I was pretty large-boned. I wore a size 9 shoe! Looking back on it, I don't really think I was overweight. My hip bones, my ribs, my clavicles, were all very visible, and there wasn't any 'fat' to pinch anywhere on my body. But, like most teenage girls, I thought I was "fat" and was constantly (mentally) worried about dieting. Sometimes I would try OTC diet pills (Accutrim, etc.), but I never liked how jittery they made me feel, so I never really got into a habit of taking those. I tried laxatives a couple times, but those always gave me cramps and unpredictable results, so I never really got into too much of a habit of that either. And bulimia is something I could never own because I HATE throwing up, and will avoid it at all costs. So I just kind of experimented with various weight loss techniques, not because I really needed to, but because I thought of myself as fat and was curious about the effectiveness. None of those experiments impressed me.

At 16 years old I gave birth to my first child. I gained 20 pounds with that pregnancy, and lost it within 6 months of delivery. However, at 19 I gave birth to my second child, and had gained 70 pounds during that pregnancy. I ate a LOT of sweets, as that seemed to be all I craved, and being uneducated about nutrition in pregnancy, I justified my eating on the basis of "eating for two". I struggled to get that weight off, and while I did lose about 20 pounds, I still remained about 50 pounds overweight. At 22 years old I gave birth to my third child. I was still about 50 pounds overweight when I got pregnant with that last child. It was a very stressful pregnancy, and I lost, then gained, but by the end of it, I didn't gain any weight. So I was still about 50 pounds overweight. My marriage of 9 years ended in divorce, and I decided to try to do something about the excess weight I had gained from my second pregnancy. I tried many diets: calorie counting, fat counting, vegetarian, etc. If anything, I tended to just resort to fasting because either I didn't have time to eat (3 kids, a full-time college student, and working, while going through a very stressful divorce), or I didn't have a good idea of what to eat that was quick, but healthy. But then when I would eat, I think I would overeat because I was starving from not having ate all day. So I struggled with getting that 50 pounds off. My PCP prescribed Fen/Phen, which was all the rage back then, and I easily dropped the weight. I was walking over a mile a day, had no appetite, and felt great!

So in 1997, back to my 'normal' adult weight of 130 pounds, size 7, I met another man and we started dating seriously. He convinced me to start exercising in a gym. I enjoyed that, but as always seems to happen to me when I start a serious exercise program, I gained weight. I think I just have one of those gymnast-type bodies- short, but muscular. It isn't  (or wasn't) hard for me to gain muscle weight really quickly. But that sure was discouraging- because I wasn't going to the gym to GAIN weight! Anyway, this man who was soon to be my husband, was encouraging me to exercise at the gym. But then, after every workout he would want to go out to eat. I wasn't used to going out to eat so much, but he seemed to enjoy that as part of the routine, so I went along. As time went on it just became a habit- eating out. Fast food, fast food, fast food. Well, by the time we married in 1999 I think my weight was about 145, size 12. I was overweight, but it was manageable, and I could still wear "cute" clothes and feel good about that. But a major move, job changes, etc. and I ended up in a very sedentary (desk) job. We still exercised, and did a lot of weekend activity (hikes, etc.), but that wasn't enough to combat the slow and steady weight gain. By 2001 I was about 165 pounds, and in a size 16. We made another major move, but I transferred my job, so I was still in a very sedentary environment most of the week. As most of us know, finding time to exercise while working 40+ hours a week and raising kids is awfully hard! So we slowly fell out of an exercise routine, and also stopped doing outdoor activities on the weekends (the kids were older and complained about any little trip we took, so we just stopped putting ourselves through that). So, frustrated about my weight gain, and now starting to feel the effects of it, I went to a local "weight loss" doctor, who was offering injections of B-12. After about 3 months of weekly injections I stopped them. It was making me feel ill, and I wasn't losing weight. On top of that, I had now developed my first co-morbidity: hypertension. I thought the injections may have caused that, so stopping made the most sense. Well, about a year later, in mid-2003, I was diagnosed with Stage IIIc Inflammatory Breast Cancer (that's a whole different forum)! I was 30 years old.

At the time of my cancer diagnosis my blood pressure was out of control (even while medicated). I was also hovering at 190 pounds- about 60 pounds overweight. The surgeries (biopsies), coupled with the immense fear (and other emotions), caused me to gain even more weight (eat without regard, really), hitting the 200 pound mark by the time I started chemotherapy. I fluctuated between 190-200 pounds during this time period. A lot of people think cancer/chemotherapy makes one lose weight. The problem is that they have to give you so much steroid to prevent your body from reacting to the chemo, that you can easily GAIN weight. The nausea caused me to want to eat to settle my stomach. The steroids gave me an insatiable appetite (and diabetic condition, which did reverse after chemo). And then the sedentary habits that happen from significant health problems left me very inactive. So it's no wonder I started gaining rapidly. Three years later and I had a metastatic recurrence to my ovaries and some lymph nodes elsewhere. That resulted in yet another major surgery- to remove my ovaries. So while I was in chemical menopause (at 30 years old) while I went through chemotherapy, this hysterectomy with oopherectomy left me permanently in menopause. Of course that didn't help my weight gain, or the fat around my stomach, as cutting through all that muscle in my abdomen (a 12 inch incision from my pubic bone to above my belly-button) really did a number on my muscle tone. So, from the months before my cancer diagnosis to the current day, I gained a whopping 100 pounds!

I've had a lot of complications from cancer treatment, and a good number of surgeries. It's a lot of medical trauma to go through. I am still in chemotherapy (every 3 weeks for the rest of my life, or until they find a cure, or my cancer recurs and I have to change treatments). I have fibromyalgia, which developed from all that chemotherapy I've had. I have pretty significant lymphedema in both arms, but mostly my right (dominant) arm. (This happens when they remove lymph nodes from the armpit area). I can't do repetitive tasks, lift heavy objects, or leave my arm hanging, as all will result in significant, painful, and debilitating swelling of my entire arm. I also have lower extremity lymphedema (not as severe as my arm) that resulted from my hysterectomy. I have neuropathy in my hands and feet because of the nerve damage caused by chemotherapy. And, because of the significant damage done through radiation, my right pectoris is basically fried. It's completely atrophied, and I'm left with hard, knotty scar tissue. So all of this, along with the extra 150 pounds I am now carrying, has made exercise a really, really big mountain to have to climb. I've tried repeatedly to get on an exercise routine, but I always seem to fall off that wagon. Over the past 5-7 years, as I have continued to gain weight, I have tried numerous diets: Atkins, Weight Watchers, The Zone, etc. I would have to say the two biggest problems I am going to have to overcome in my bad habits are 1) not eating, and 2) eating crappy foods when I do eat.

You would think, having been through all this medical stuff already, that surgery would be the last thing I want to have to go through. I hate it so much that I didn't even seriously consider going through breast reconstruction. But at 150 pounds overweight, with no ovaries to help me, and a really sluggish metabolism caused by lots of chemicals and being sedentary for so many years now, I just don't see any other way. I've tried and tried. And this extra weight is like a ticking time bomb strapped to me- it is raising my risks of recurrence by a whole lot. My C-Reactive protein levels have been more than twice normal for a good while now. My blood pressure is still high. My joints are already aggravated by auto-immune issues. And then, chemotherapy is dosed on a per-meter-squared basis, which means it goes by weight. The more you weigh, the more you get. So the less I weigh, the less I get. Ya. So I'm really ready for surgery, in hopes that it's the tool I need to help me regain control over my dietary choices, and allows me to lose enough weight that I can start exercising again.

I'm still not sure what procedure I will have. I really want a VSG because I worry about the malabsorption issues with RNY, since I am already osteopenic (because of loss of ovaries). This is only going to get worse as I age, and as I lose weight. Also, the neuropathy is B-12 sensitive, so I already have to take a HIGH daily dose to ward it off as much as possible. With my future health needs so uncertain, I just don't feel comfortable with the malabsorption issues. I also don't like the idea of the RNY being so much more difficult of a procedure- I've already had enough medical trauma! Laproscopic sounds so much nicer! But I'd like to talk to a surgeon who does all the procedures and can give me a straight answer. I've had the psych eval, talked to a nutritionist, have seen my PCP for monthly weigh-ins. So I'm pretty much ready............

While I'm excited to have the opportunity (and hope) of bariatric surgery, I'm also really nervous. I went through depression as a teenager, and then another serious bout while in aggressive chemo. I had to take an SSRI for a few years to get through that chemical change. I am already thinking I may have to get back on a medication, as I think the forced (although elective) change in diet and lifestyle if going to trigger things emotionally for me. But the positive side of it is that I'm realistic. I'm not going into this naive about it. I'm already expecting the worst, and have a plan to address it. I think it's really hard for people who haven't been struggling with their weight to understand how deeply tied it can become to our emotional selves. But I'm thankful there's a forum like this for us to safely share the struggle...on whatever level that sharing is!

I blog at: ladyminusbreasts.3three3.org, but my writing there is mostly about my spiritual journey with cancer.

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Oct 01, 2010
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