Battle of the bulge

How I lost 55 pounds in six months—with a little help from modern medicine

This photo, taken last week, shows how far I’ve come since June (right).

This photo, taken last week, shows how far I’ve come since June (right).

Photo By matt siracusa

Surgery more common
According to the Centers for Disease Control and Prevention, as of 2007, 25.6 percent of Americans were considered obese. As obesity has increased, so have bariatric surgery rates, which doubled between 2002 and 2008, with 220,000 procedures performed in 2008, according to the American Society for Metabolic & Bariatric Surgery.

I’ve always struggled with my weight. In my adult life, the thinnest I’ve been was 165 pounds—at 5-foot-3—and that lasted all of a month before the rebound, which eventually launched me to my all-time high, 242 pounds.

I’d tried just about every diet on the planet, from pills like Metabolife, TrimSpa and Alli, to programs like Jenny Craig, Nutrisystem and Lindora (a Southern California, Jenny Craig-like program). I tried exercising more, eating less. Nothing worked. If it did, it was short-lived.

So a year ago, when I heard about the Lap-Band surgery, I thought I’d found a solution to my lifelong addiction to food. I was tired of having low self-esteem, of not being able to go for a simple hike, of feeling like I was living in a fat suit.

At 242 pounds, my BMI (body mass index) was almost 43. That’s considered “morbidly obese.” And on the eve of my 29th birthday, I decided I was ready to take a big step into the future of my health. I made the appointment. Now, six months after surgery, I’ve lost 55 pounds and am still going strong. Here is my story, as told along the way in my journal:

June 19, 2009

It’s all happening. Six months of pondering, researching, going back and forth in my mind have landed me here. My weight: 242 pounds. As I write this, a cold protein shake sits on the table beside me. It will not be the last. I bought a case of Cookies and Cream 50 Gram Slams at GNC in preparation. Today is the first day of a 20-day-long liquid diet. My biggest hope is that I’ll shed a few pre-surgery pounds to add a little bang to my buck.

Yesterday I forked over $3,500 at the doctor’s office, non-covered fees for access to a nutritionist, support group, follow-up appointments, etc. As my research showed, most offices do charge such a fee. This one was steep, but more worth it than driving an hour and a half down to Sac or Davis every month or so. More worth it to use a doctor I know—Dr. Ludwig took out my gall bladder in ’07. That was a good primer for the operation I’m about to go through, as they’re both laparoscopic, both through the abdomen. I just don’t like all the scars—though I suppose that’s preferable to stretch marks. Two new ones recently appeared on my stomach, gross reminders that I’ve let myself go.

Everyone I’ve told—the precious few thus far—has been very supportive. I’m thankful for that. Surgery in 10 days.

June 20, 2009

One day of liquid diet, and I’ve lost four pounds. Damn. Yesterday I went to Safeway, realizing quite quickly that I was not adequately stocked for my liquid diet. I picked up chicken broth and various flavors of Crystal Light. Variety helps.

Over the past few months, I’ve realized that food is an addiction for me. Oprah said the same thing about her own yo-yoing weight. A lot of people laughed at her. In me, something clicked.

So here I was in Chico, weighing more than I’d ever imagined I could. I had to do something. So, after reading for hours and hours on, a message board site, and researching the procedure online, I decided to make an appointment with Dr. Ludwig.

It’s been a long process. First there was the four-hour class, a meeting with the nutritionist and a metabolism test, followed by a one-on-one meeting with Dr. Ludwig.

During each visit to Dr. Ludwig’s office, he goes over my chart, discusses how I’m feeling, my eating and drinking habits and how much exercise I’m doing.

photo by Jasmine Roufchaie

Then came the psychological evaluation. Apparently it’s required by insurance companies prior to approving these surgeries. I went to Nancy Rarick, who works out of her amazing home in the Canyon Oaks neighborhood. It was my first experience with a therapist, and she dragged feelings out of me—about my weight, about my life—and asked lots of questions.

Then another pre-op class, this one led by the staff nutritionist. She gave us the down and dirty of what we’d be able to eat—and how much (ultimately, not much). Then an upper-GI and chest X-ray along with a number of blood tests. And one more meeting with Dr. Ludwig. He’s a man of few words, but nice. I feel I’m in good hands.

June 23, 2009

Six pounds down. I thought this was supposed to get easier. Today, an ad popped up online about “best summer casseroles” and I just about broke down.

Good news: I’ve kicked caffeine altogether, starting with coffee and followed by my beloved Diet Coke. My third favorite thing I’ve given up: beer. It’s still a weird concept that I might never be able to crack another can of Bud Light or Diet Coke, as the carbonation might be too much to take.

I went to the gym yesterday for the first time in a long time. It felt great! Biked for 20 minutes, then two weight machines. Gotta start out slowly. I went before work—another first. What I realized was: In Motion’s towels are like the kind you find in a motel. They’re made for someone who’s half my size. Had to change in the shower stall to avoid embarrassing myself. Mental note: Next time bring my own towel.

June 28, 2009

Surgery tomorrow, and I’ve already lost 13 pounds! The liquid diet got a little easier toward the middle of the week. And I’m confident it will be much easier after the surgery.

I’m about as prepared as I think I can be. Cleaned the house. Did laundry.

Yes, I’m ready. A little nervous as I’m not looking forward to the pain, though. I have to be at the hospital by 5:30 tomorrow morning. Wish me luck.

June 30, 2009

The surgery went well. We arrived at 5:30, and I forked over $500 toward the estimated $3,200 it will cost after insurance.

Shortly after check-in, we were brought to the pre-op room. They took my vitals. All good. I was pleasantly surprised to get a visit from a nurse from Dr. Ludwig’s office. She explained my aftercare and wished me luck.

The Lap-Band is adjustable, so every four to six weeks since surgery I’ve gone in for a “fill,” which requires I lie on an exam table with a pillow under my lower back and my hands behind my head. In this position, the doctor can best locate my “port,” located just underneath my skin.

photo by Jasmine Roufchaie

When I was set and ready to go, they rolled me, my boyfriend following, to the post-op room, where Dr. Ludwig came to say hello and I met with the anesthesiologist. The coolest visitor by far was the nurse who would be helping with my surgery. She’d undergone the surgery herself, 18 months ago, and had lost 82 pounds. She even showed me her scars to give me an idea of what to expect when I woke up.

After that, I was brought into the OR, a big room with one of those round lights above the operating table. The anesthesiologist was funny, making jokes. The nice nurse was by my side and, as I drifted off, she asked, “Are you ready for your new life?”

I was.

That’s the last I remember before coming to back in the recovery room. By the time I was ready to be wheeled back to where my boyfriend was waiting, I was still a little groggy but not in a lot of pain, thanks to the morphine. About 45 minutes later, I was allowed to get up to pee and then get dressed. I can’t bend at the waist easily, so luckily I brought a stretchy tube dress to wear home. Had to bag my bra, though, as one of the incisions is right in the path of the wire.

Then it was home at last, to my own bed. My boyfriend brought in the dogs one at a time to say hi, so they wouldn’t maul me and get at my tummy.

My left side hurts the worst. That’s where the port is.

Lying down and standing up are the most comfortable positions right now. It’s the in-the-middle—getting up or lying down—that hurts the most. As I write this, I’m standing at the kitchen counter. I think it’s time for a nap.


June 30, 2009, nighttime

The pain is just getting worse. If I don’t take the pain meds every four hours exactly, it’s near unbearable. I’m talking audible groaning here. Can’t walk the dogs yet. I would if I could, but it’s hard enough just to get from the bedroom to the kitchen—I can’t have two dogs on leashes—and picking up after them (i.e., bending over) would be out of the question.

The port incision on my left side still hurts the most. When I roll onto my side to get out of bed it’s almost like I can feel it moving around, just a little bit.

The good news is I’m not hungry. Just very thirsty. I know now why they kept emphasizing sipping—it’s all I can do. Particularly because I know if I drink too much or too fast I’ll puke, and upon leaving the hospital, the nurse said, “You are not to be vomiting.”

Hopefully tomorrow will be a little better and I’ll feel like taking a shower. Right now, it just sounds horrible, painful.

July 2, 2009

Got up the nerve to shower this morning. Felt great, actually, especially because I got to wash away that gross iodine. I swear it was literally itching to come off.

Got a couple nice phone calls from co-workers yesterday. And my parents have called every day. I haven’t felt like telling a lot of people yet. My dad was the first. He’s my personal medical adviser. In fact, if he hadn’t mentioned a patient of his who had gotten this done, I might not have a plastic band around my stomach right now.

July 4, 2009

Weight: 226. Finally some weight loss since the surgery. I’ve been using my Wii Fit to chart my progress. Sixteen pounds and counting. I’m starting to feel hungrier—they said at first I might feel full because of swelling.

I’m a little bummed because I’d hoped I’d be feeling better by now. I’m nearly out of my pain medicine. I really tried to take it easy today, wondering if doing too much moving around the house yesterday is why I’m still in such pain today.

Monday I have another upper GI. I wonder how they will do it if I can’t gulp? And then my first post-op class.

I had to drink milk of magnesia last night because I hadn’t pooped since the surgery. Gross. At least it worked.

Once Dr. Ludwig finds the port, he injects from 0.5 to 1 cubic centimeter of saline solution into my band, which makes me feel fuller on less food. It also means I have to take smaller bites and make sure to chew thoroughly.

photo by Jasmine Roufchaie

Last night the incision site where the port is hurt so badly that I went to sleep with an ice pack over it. I hope it’s all healing OK.

July 6, 2009

During my post-op class I learned a few things: It will take four to six fills before my portion sizes will be significantly smaller than normal. I need to stay away from acidic things for now. For my pureed diet I can eat anything that will go in a blender. Carbonated beverages might be OK after six months (revelation!).

I also learned that they actually cut a chunk of fat, about an inch square, out of me during surgery in order to make room for the band. Weird.

July 10, 2009

It’s been a long week. I ran out of Lortab. Not that the pain is that bad. It’s just that it hurts after sitting for long periods of time. Good news: I’ve lost 19 pounds! I don’t see or feel much of a difference yet.

Monday I had my post-op upper-GI. Didn’t know what to expect since my pre-op one had me chugging and rolling all over the table. But they knew what they were doing and what I couldn’t do. I sipped the thin barium, and they watched it travel down my esophagus to the stomach, hit the band and keep on going. They said everything looked good. Hurrah.

Yesterday I started mushies! All I’ve had so far is mashed potatoes. Gonna try something else today. They said basically anything you can blend to a mushy consistency—nothing you have to chew—is A-OK. One thing’s for sure: It beats the hell out of liquids.

July 21, 2009

I’m eating real foods now, finally. It’s slow going, as I’m paranoid about everything going down all right, but so far so good. First real meal: tilapia with some scrumptious little potato wedges. Last night it was chicken stuffed with cheddar and asparagus.

I went to the gym Friday. Just 20 minutes on level 3 on the stationary bike. It was actually a little difficult—partly because I was sitting, which kind of hurts—but it felt great. I’m excited to make the gym a part of my life again.

Saturday morning I got my first reward (I decided every 20 pounds lost deserved a reward). A spa pedicure—wonderful.

Aug. 13, 2009

I can hardly believe it—in just seven weeks I’m already 30 pounds down. I’m definitely noticing a difference in my clothing, the way it fits. Suddenly I’m able to wear shirts that two months ago would have looked ridiculous. Other, little things show progress too. Like, I can cross my legs without physically picking one leg up and placing it on top of the other.

I’ve been going to the gym religiously. Started weights last week. Hooray!

I must catch up on a few things. First, I want to explain my first fill, which was a few weeks ago now.

After being weighed in on Dr. Ludwig’s special scale and having my vitals taken, I waited a short time in the exam room for the doctor to arrive. He took a look at my chart, then my healing scars. I lay down on the table, with a pillow underneath the small of my back—a bit awkward—and he asked me to put my hands behind my head and then flex as if I was about to do a crunch. In this position, he pulled up my shirt and felt around my belly for the port. This part was particularly uncomfortable because that area is still quite tender. Then he took a large syringe, inserted it into the port, and squeezed the saline solution into my band.

“Better or worse than you imagined?” Dr. Ludwig asked.

“I didn’t know what to expect, but it wasn’t too bad,” I replied.

When he originally inserted the band, it had 2 cubic centimeters of saline in it. Its capacity is 10 cc’s. During this first fill, he put an additional 1.5 cc’s in, so I’m at 3.5 currently. He said sweet spots vary, but most people find theirs somewhere around 4.5. Good deal.


This is a model of the stomach with a Lap-Band attached. At the end of the tube that’s affixed to the band is a port, which is surgically placed just below the skin for easy access.

Photo by Jasmine Roufchaie

Oct. 10, 2009

Forty pounds. Two more and I’m out of the 200s—hopefully forever this time. It’s a weird feeling, knowing I’m about to be a thin (i.e., normal) person. Part of me doesn’t really believe it. I mean, I got down to about 165 with my last diet and almost immediately started to gain it back. Hence the box full of size-10 clothes, most of them hardly—if ever—worn, sitting in my closet.

I don’t know how to be a thin person. That sounds strange, like it’s a career option or something, but my self-image is so engrained in my mind that changing it is a major event. I think that’s why part of me thinks this is temporary. I am and always will be a “big girl.” But maybe not …

Maybe my 30s will be filled with activities—hiking, biking, being generally outdoorsy—that my weight has kept me away from. Maybe there will be a whole new me.

Oct. 26, 2009

I went to the doctor last Thursday and brought Jasmine along to take photos. The biggest thing Dr. Ludwig told me was to stay away from sweets. It can be so tempting sometimes, though, to grab some ice cream instead of a meal—because I know I can eat it! Oh, and it tastes good. I do have a sweet tooth, but I promised to work on it.

It’s hard to explain this transformation that’s occurring. I put on newly washed jeans today and, rather than having to stretch them, they fit just right. It’s crazy to think that in a few months I could be squeezing into my size 14s or even 12s. At this rate I’m losing about nine to 10 pounds a month—so six months from now I could weigh 140. The idea is surreal. I have never been that small. I have never been below 165 in my adult life—and here I am, well on my way to thinner days.

Dec. 8, 2009

I had my fourth fill on Thursday and started eating real foods again yesterday. The doc says he thinks I will see a big difference after this fill (I told him I didn’t feel much after the last one). Now I have 5.5 cc’s in my band. And I definitely feel a difference. It was actually difficult to eat pureed lasagna on Sunday.

Got on the scale today: 195. Three more pounds and I’ll be me, minus 50 pounds, more or less at my halfway mark. I’ve got to get motivated to go to the gym. These past few weeks, with Thanksgiving in St. Louis and the travel, planning, etc., have gotten me off track a bit. I’m going to go tonight. I must.

I want to take this opportunity to write a little about getting food stuck. It’s a horrible feeling, like a tightness in the chest, and it’s not all that pleasant to talk about either. If I eat too fast, or take too big of a bite, I get the tightness in my chest. Then I have to stop immediately. One more bite can put me over the edge, sending me straight to the bathroom, where the food comes up. It’s not like puking though—there’s no retching. It’s more like a baby spitting up—the food just kind of comes up with a burp, and it’s not a lot at once. And sometimes it’s just a bunch of mucous that comes up all at once, slimy and gross.

Dec. 14, 2009

I got on the scale Friday and am happy to report I hit the 50-pound mark! Fifty pounds. That’s crazy. So I’m at 192 … soon I’m going to fit into my size 14 jeans, I can just feel it.

On a not-so-happy note, I’ve been losing hair like mad. This is not a fun fact for me to share. Thankfully I have a ton of it, so I can certainly spare some, but handfuls every time I wash my hair? I was reading on the LapBandtalk site, and other people have had the same experience, at the same exact time. They say it can last from four months after surgery till a year—yikes! I seem to remember having a similar experience the last time I lost a significant amount of weight, so I’m not completely freaking out. But it is unnerving. If it keeps up too long I’ll call my doctor and see what he recommends. It’s probably been happening for more than a month now. Not fun.

Dec. 15, 2009

I’ve been having a hard time eating lately, as most everything I try faces resistance from the band. Revelation: I need to rework my menu options. So I ordered a book called Eating Well After Weight Loss Surgery. It should arrive in a week or so. Hopefully there’ll be some good ideas in there.

I’ve also been religiously using a lotion for pregnant women (or those losing weight) to minimize stretch marks. It seems to be working—the two on my stomach that appeared shortly before my surgery are nearly gone.

Dec. 31, 2009

The holidays have been interesting. Christmas dinner proved a bit challenging—much different from Thanksgiving, which was before my latest fill. I took an appetizer plate, rather than a big plate, full of food. Still I have trouble remembering to take smaller bites sometimes. “Bite-sized” foods are no longer bite-sized for me. For instance, there were these delicious, small glazed meatballs with toothpicks for grabbing. Instinctively, I grabbed one and popped it in my mouth. Big mistake. That sucker, just an inch round, is at least two bites for me now. Must. Learn. These. Things.

It also appears that I’m suffering from a lack of fiber. This is not fun. I’m going to pick up some Citrucel … just another thing to add to my daily list that already includes multivitamins, a B-vitamin complex (they sell a liquid version at Walmart) and protein.

Jan. 5, 2010

Weight: 187. I’ve been thinking a lot lately about my surgery. Everyone I’ve talked to has been extremely supportive. But I know there are a lot of people out there who think of bariatric surgery as a cop-out, as taking “the easy way out.” I have to disagree.

I’ve met people who had the Lap-Band procedure done and they lost some weight, but ultimately didn’t put in the effort to exercise and eat healthier—so they’re still overweight. Same with the gastric bypass. These are not “cures” for obesity—they’re merely tools. I know if I followed every dietary guideline and worked out five times a week I’d probably be another 10 pounds lighter. But I’m working at it the best I can, using my new tool the best I can. And I’m not ashamed that I needed surgery to get where I am today, especially if it can actually help keep the pounds off in the long run.

That is the hardest part, after all.