As I stepped off the elliptical this morning with a nice “glow” (okay I was sweating like the proverbial pig), it suddenly came to me - DUH, I could have had a V8…No, all kidding aside I had an epiphany of sorts.  I am currently 9 years 6 months post-op LAP BAND.  I began my journey at 424 pounds.  This morning I weighed in at 183 pounds, 7 pounds up from my lowest recorded weight(174 plus 2 for my silicone implants).  That’s acceptable and I am thrilled.  So what was the epiphany?

From about January - June I have been struggling to maintain my weight.  I noticed I was hungry more often and was able to eat more than what my portion size had been.  I put it off to allowing processed carbs into my mouth a few times too many, and having a glass or two of wine on the weekends.  This definitely contributed to the problem since the calories from processed carbs slide down quite easily through my banded belly.  OK, so I was accepting responsibility and had to make the choices to change that so that my skinniest pair of jeans were comfortably wearable.  Did you notice something missing here?  I had NO CLUE how much I weighed.  The only metric I was using was my clothing.  Granted, it’s a good metric, but certainly gives me too much wiggle room (pun intended).  Still I did not step on the scale that sits right there in front of me as I brush my teeth, wash my face, put on my makeup, do my hair….you get the picture.  The scale intimidated me because I knew I would not be happy with what I saw when I stepped on it.  Wow, denial, imagine that?  Yes, even I, empress of losing 250 pounds with a band despite my doctor’s concerns that it was not possible, could go back in time to my emotional denial of reality.  What can I say, it happens to the best of us.  I tried to eat clean and was succeeding, although I still found myself hungry all the time.

Then I went to New York for a few weeks for my sister in law’s funeral and I was surrounded by pasta, cookies, cakes and all of the food that goes along with a wake and a funeral and the aftermath.  In addition I was dealing with my emotions and the emotions of family all around me.  Guess what I did?  Yup, you got it right the first time.  In order to try to be emotionally available to my brother, his kids and the rest of the family I stuffed my emotions with food.  By the time I headed home from New York my jeans didn’t fit and I was uncomfortably bloated all over.  This translated to weighing in at a very disturbing 213 pounds.  Now, let’s go back over the past several years.  My maintenance weight range had been 174-184 so how did this all “suddenly” creep up on me?  The next question is obviously how and why did I “allow” this to happen?

The why to me is pretty clear and easy.  It is the complacency that a successful weight loss surgery patient can suddenly find herself in…I’ve done, been maintaining for years, not necessary for me to place close attention any longer.  I work out every day, I eat healthy.  I’m good!  NOT!  BEWARE that very thought process.  It will come back to bite you somewhere along the way.  It had been almost 2 years since I had seen the doctor, and then it was only for a tiny fill that he gave me after hours.  I failed to meet my responsibility to head into the doctor’s office with a clear written accounting of my hunger, my emotions, what I was eating and what I weighed.  That cost me 30 pounds, and some heartache.  I knew it was ME.  I blamed myself for my choices.  Yup, I own the choices of what I put in my mouth, and perhaps my gain would not have been so much, but the fact was that my band was not holding fluid.  THAT is where the hunger came from.  I had a band, but no fill in it.  That meant with care I could eat anything I wanted to.  Even pasta and rice went down.  So why did I eat it…that’s the mental issue I work on daily as I make my choices, the emotional component of this complex disease called obesity.  Now the how did it happen becomes clear.  I ignored the signals my body was giving to me regarding hunger and satiety - they had changed and I found excuses for them.  Had I made an appointment and seen my surgeon, we would have found out that I had a leak in my port earlier, replaced my port earlier, and kept my weight gain to a minimum.  It took a couple of months to get this all worked out, show that my band wasn’t holding a fill, have an endoscopy to make sure everything was good inside and schedule and have surgery to replace my port. 

From the day my port was replaced my constant gnawing hunger went away!!  When I began eating solids again my satiety was clear to me.  Bingo, I had a working tool, and now my plans were NOT derailed by HUNGER.  I could clean up my eating (I used pre-op and post-op liquid days to do just that), and get back into losing.  By my first post-op appointment much of the weight I had gained was gone, and I will go back again at the end of December to see my doctor.  If I don’t need a fill at that point I will schedule an appointment for June and at least every 6 months after that.

I am officially down 30 pounds this morning and my next goal is to hit my lowest recorded weight, and then after that I plan to go for 10 more shed.  Why, because my doctor and I believe that with the proper lifestyle choices I CAN!

The moral of this story:  AFTERCARE is one of the most critical components to long term success with your LAP BAND.