A decision to make

This picture was taken last March, when we were outdoors with Tomas blowing bubbles. This is the heaviest I've ever been in my life and I was horrified and embarrassed when I saw the picture. I didn't think I'd ever post it online but it sure makes a great before picture, doesn't it?



TB took these pictures this past Friday. Between March and now, I've lost about 27 pounds, the last 10 of which I've lost and regained too many times to count. It's very frustrating.



On Friday, I had my appointment with a bariatric surgeon to discuss my options and begin the process of fulfilling presurgical requirements. I went into the meeting determined that I wanted a lap band and would not consider anything else. Now I'm not so sure.

I told the doctor I was afraid of an invasive procedure, meaning that I didn't want my insides rearranged. The doctor took a different meaning to it.

Based on my BMI, he explained, I qualify for two surgeries: the lapband and a laproscopic gastric bypass. The procedure Ted had is "too aggressive" for someone with my BMI.

The risks associated with the lapband and the gastric bypass are about the same, although the death rate for the lapband is 1 in 1000 whereas it's 1 in 500 for the bypass. I would have rejected the bypass altogether except for two things: my duodenum would be bypassed and that could mean my diabetes would be cured, almost certainly would go into remission. The other is that the part of my stomach that makes grellin (the hormone that makes you hungry all the time) would be bypassed. Ted says he eats because he knows he's supposed to but doesn't have the ravenous hunger he always had before.

I also gotta admit I've been pretty impressed with how quickly TB's been losing weight.

The doctor said I'd have to work really hard with an exercise program to make the lapband more successful. Some people have lapbands and don't lose much weight at all. He said the first year I would probably lose about 45 percent of my weight, at the rate of a pound a week. The second year, I would lose another 10% and after that it's hard to predict. There's only so small you can make the pouch and it's easy to cheat. If I lost 50 pounds, the doctor wasn't sure I'd get rid of the diabetes.

Hmm. But I've read so many stories where people have lost 100 pounds and more. How do they do it? Why do the others fail?

The thought of getting rid of my diabetes is very appealling. The doctor made it sound like the bypass is practically no big deal these days. He said I would need vitamins and supplements but that he hadn't heard of any problems with protein insufficiency--not like with the duodenal switch (the procedure TB had). The doctor said expected weight loss the first year is about 67% with another 20% or so afterwards. That's pretty appealling.

I've read that people who had the bypass can gain and have gained all the weight back. How does that happen?

I have a lot of research to do and a lot more questions to ask.

The doctor said, you don't have to decide now. He wants me to see a pulmonologist, a psychologist, and a nutritionist...I guess to make sure I could withstand the surgery, am psychologically ready to make a permanent life style change, and to find out what kinds of things I'd need to be eating after the operation.

I have a lot of thinking and praying to do.