Bariatric Surgery Journey

I might as well just admit it: I absolutely love my new body. Sure, I'm not all that enamored with my excess skin or my far-too-flabby upper arms. But I am thrilled with my lean, muscular legs. I'm astounded at my newly long and skinny neck (after all, I always thought of it as short and stocky). And I can't help but check out my skinny stomach every morning in the mirror.

Just a little context here: All of this comes from a girl who long hid herself in dark clothes, only scowled when she looked in the mirror, and couldn't say anything positive when she saw a picture of herself. On that last point, I still have to improve. But, otherwise, the world better watch out, because I'm turning into a vain, self-focused monster!

I am skinnier now than I ever -- ever -- really thought possible. Even after deciding to have gastric bypass surgery, I believed this weight (145) and size (8/10) was out of reach. In September last year, when a woman at the Lenox Hill support group pointed to two of the panel's success stories and said I'd look just as skinny as them in a year, I completely rejected the idea. No way, I thought. The best I could hope for then was a size 12 -- and I thought even that would be amazing. Now, nine months later, I've surpassed my "normal" goal weight and am now being labeled "skinny" by friends and colleagues. I'm stepping into some size six shorts and skirts. I'm actually occasionally wondering when the weight loss will end.

Sometimes, I can hardly believe it. I still don't think of myself as fat; I am in fact very (some might say too much) aware of my newly slim shape. But I am frequently amazed by my transformation. How can it be possible that in less than a year, I've gone from being a morbidly obese, unhealthy blob of a girl into a slim, attractive woman?

Even beyond the change in appearance, I've been completely revamped. I am strong; I am empowered; I am healthy. I can bound up escalators without a rise in my heartbeat or breathing. I can push myself on the elliptical machine and in aerobics classes and still struggle to get my heart rate above 140 beats per minute. I can move with ease through this world, and I can feel right in it.

I still get so many positive comments from friends and colleagues. Just this week, I've been complimented by nearly a dozen people for my new look (and my new clothes). Maybe I'm vain. Maybe I'm self-centered. Maybe I'm desperate for attention. But, God, I love the affirmation. I can't help it. Every little positive comment lifts me up. Perhaps, because I've spent so much of my short life hating my body, it's only natural that I would delight in any contradicting comments.

Obviously, despite the glowing way in which I describe my new look, I still am plagued by some self-doubts. After all, I sometimes think I'm pretty, but it's not as if eligible men are lining up to take me out on dates. Maybe I'm still an ogre -- just now a skinny one. Every compliment bolsters my ego a little bit more so that I can at times really, truly believe I'm attractive.

So many people on this site say their decisions to have bariatric surgery were the best they ever made. I've always thought that a kind of hyperbole, but I feel that way now. When I went under the knife, I took my life back. This journey has been life-changing and so very affirming. I only wish more people could have access to it -- and would feel comfortable taking advantage of this amazing, miraculous gift.

Last week, I went to a beach on the Delaware coast with five of my best friends from college. They all know I had the surgery; in fact, they're among the few people, outside of others who have had bariatric surgery, with whom I regularly talk about the journey. I've always felt at home with this crowd; we are, I hope, lifelong friends who will always be there for each other. But even in their company, I've always felt just a little out of place, a little too conscious of my bulk. During this year's annual reunion at the beach, I at times was self-critical (concerning both physical and non-physical aspects of myself). But I felt even more as if I belonged.

When I got back from the beach, a male friend who has never been effusive about my weight loss asked me about the trip. I was describing one of our vacation outings when he asked, "Were they impressed?" "Oh sure," I said. "They loved seeing the wild horses --" "No," my friend said. "I mean, were they impressed with you?" I was thrown off by the question. Of course I appreciated my college friends' compliments and acknowledgment of my new looks and health. But it was just very odd to me that someone else -- someone who has not regularly complimented me on my change or journey -- could see them being impressed with my transformation (and, in fact, was curious about it).

I think many people rejoice in the significant weight loss of others even when they don't share it. Sure, there are people who are jealous of weight loss success. But I've found so many people are genuinely happy for -- and, in some cases, inspired by -- me and my journey. One coworker earlier this week told me that it makes her happy to see me. One person suggested that the wave of dieting that has swept my office might in part have been kicked off by my own transformation. With my weight loss, "they saw it could be done," she said.

I don't credit myself with starting any kind of weight-loss movement in my office or with spreading joy by virtue of my smaller waistline. I'm happy enough with my own change to worry about everyone else's reactions. I feel wonderful.

Maybe all post-ops go through this. For a time, once you hit a major goal, you're ecstatic. Then, the euphoria gives way, and in its place arrives a dose of realism: Okay, now what? If I'm supposedly "normal" weight, why do I still have so much fat left to lose? If I've hit my goal, how can I create another that is both achievable and lofty enough to be worth working toward? How do I fight the generally subconscious desire to return to old habits -- i.e., using food to medicate my way through emotional and other stress? And why -- after losing more than 100 pounds -- is all of this still so hard?

I've gone through quite a few emotional phases in the past few weeks. And my weight has come along for the ride. My weight dropped as low as 147.5 (just .3 pounds shy of a total loss of 110 pounds) before it started climbing, at first inexplicably. There was that night out at the Melting Pot with friends (all cheese, no chocolate). Oh, and then there was the excessive eating while family members were visiting me for just under a week. And, for a week or so, my exercise at the gym dropped off considerably. Finally, this weekend, there was an all-out binge (done slowly, over several days, with all sorts of sweets).

And now, I find myself back up to 150.5. Fortunately, I woke up resolved to get back on track, and, though it's only been a half a day, I think my derailment is over, even if its aftereffects (those high weigh-ins) will last for a while. Where this weekend, I dealt with the stress of planning and hosting a vacation for five of my best buds (they begin arriving at my place on Friday), I'm going to work on other ways to channel that stress. For instance, just to remove temptation, I'm going to throw out the vat of Edy's low-sugar ice cream sitting in my freezer. (Jen, throw food out? Nahhh...)

Seriously. The minute I get home, the ice cream is going in the trash. Maybe, just to be extra sure it's gone, I should dump it in the disposal. And, this week, I'm going to really focus on consuming lean proteins and lots of veggies. For breakfast today, it was an egg-white omelette with a single serving of cheese. For lunch, it was a salad with fat-free dressing, salmon and egg whites. For a snack, I had an iced latte with skim milk. Dinner will be fresh corn and cooked spinach (and, if I'm still hungry, a little bit of chicken).

But the return to healthy eating won't be enough to get me through this funk -- and get me back on a path to 145 pounds, my next minor goal. I'm embarking on a renewed obsessiveness with the gym. This will take some work. Right now, I don't really want to go. The elliptical machine is holding no appeal. It's been so long (in reality, it's been a week and a half, tops) since a solitary 40-minute routine on the elliptical machine that I'm past missing it. Now, I dread it. But I'll be there, after work and after pitching the ice cream today. And, I'll be back again tomorrow. And the day after that.

After all, once Friday arrives -- and for a week afterward, during which I'll be lounging with friends at Bethany Beach in Delaware -- it will be challenging to incorporate rigorous, regular exercise in my daily routine.

I recognize that everyone slips a little bit. And, I'm just as vulnerable as anyone to this. After all, the behaviors and beliefs that got me fat in the first place haven't disappeared. And while I don't think I used my goal-reaching as a justification -- even subconsciously -- for recent poor eating choices (and downright sabotage this weekend), I know that having reached goal weight, in some ways, it's going to be harder to maintain my loss.

But I want to exceed my first goal. There's still so much fat on my body, and I know that by sticking to a healthy lifestyle, I can slowly trim it off my body. I'd like to wind up in size 8s or less (not the 10s I'm generally wearing now). I'd like to be lean and strong. I'm well on my way, but even at and around a "normal" weight of 150, I'm not there yet.

Now, I've just got to be vigilant and keep pressing forward. After all, 150 is nice, but 140 will feel so much nicer.

"Don't forget what happened to the man who got everything he always wanted. ... He lived happily ever after." -- Willy Wonka

I haven't gotten everything I've always wanted quite yet. But, I'm getting pretty close. :)

Yesterday, I first hit -- and, a bit later, exceeded -- my "normal" weight goal of 150 pounds. I ended up with an official weight of 149.5 yesterday morning, and today, I dropped another pound to 148.5.

I was ecstatic and riding the high of this major achievement yesterday morning. And, of course I was thrilled to see the number on the scale drop yet again today. It feels amazing to have hit and now surpassed the weight at which my BMI is normal -- and my one major goal for myself from the beginning of this journey.

But I am already looking ahead to future goals. I'd like to make it to 140 pounds, especially now as 145 seems not just achievable, but just barely out of reach. Heck, if I'm lucky, I'll reach 145 sometime in the next few weeks.

Honestly, it's difficult to understand how I weigh just 148.5 today, given that I'm still lugging around so much extra skin and so much fat. The skin on my upper arms is scary -- it's unattractive and, on occasion, physically uncomfortable. My belly only looks good when I'm lying down; otherwise, the excess skin is really hideous. And my body -- at least, my torso and arms -- generally is so soft; it feels much weaker and out-of-shape than I think is the reality. It's disappointing to me that I've added so much strength and muscle in my abs and arms, and yet, there's still so much flabby skin covering it all up.

I am also beginning to more seriously contemplate plastic surgery to deal with excess skin around my abdomen. I know some skin will retract and shrink over time, but I'll need more than time to fix some areas of my body. My arms are among these areas that are probably beyond help, but at this point, plastic surgery to remove skin on that area of my body is not attractive to me, largely because of the resulting scars. In a way, it's only fair that I have a few very unattractive body parts to pay for all of the abuse I put my body through for so very long.

I'm probably experiencing a small wave of post-goal-reaching depression. :) Or, it could be that I'm taking a post-lunch energy nosedive. But, really, I am very, very happy about the 150-pound milestone. I'm just looking to the future already -- and wondering what other goals to work toward once the numeric ones disappear.

I've experienced a major breakthrough, finally crossing the 100-pounds-down threshold. On Saturday, after two and one-half weeks of plateauing between roughly 162 and 157.5 pounds, I finally made it below 157.2 (which represents my century mark). As of Saturday, I've hit 156, a total weight loss of 101.2 pounds since my surgery on Sept. 9, 2003.

Now that I'm just six pounds away from my original goal weight -- at which point I'll have a "normal" BMI of 25 -- and now that I'm in reasonably good shape, the pounds are coming off much more slowly. That said, the weight is still coming off more quickly than I would have expected it to at this point. Heck, I had doubts about hitting 150 at the beginning of my journey, and now, I really do think lower weights are acheivable.

I'm currently wearing sizes 10 and 12 generally. I wear size 12 jeans, but size 10 jeans do fit (albeit uncomfortably, and in a forgiving brand). In suits, I can fit into size 10s, but on a daily basis, I'm wearing size 12s. Nevertheless, I have a size 10 skirt that's too loose.

I've bought tons of clothes in recent weeks, largely out of necessity. I didn't have work clothes in these sizes, and I only had two or three warm-weather clothing items in these sizes saved from college. I wish I knew for sure where I'd end up size-wise at the end of this journey; it sure would make clothes-shopping easier. As it is, I generally will go with a tight, not-yet-fitting outfit before going with something that fits comfortably, since I'm "shrinking into" clothes still, albeit more slowly.

At this weight, size and shape, I've been encountering a clothes problem I never have experienced before. After years of carrying a dozen items into a store dressing room only to find one or two that fit, I've become conditioned to buying whatever fits. Before the weight loss, it was hard enough finding something that could accommodate my girth, so whenever anything did, I snapped it up, to hell with whether it looked great or not. Now, I have the opposite problem. When I carry a dozen items into a dressing room, I generally find that every single item fits. Now, I've got to recondition myself; I have to learn to buy what looks best (and to be a tough critic). Otherwise, I really will break the bank with my wardrobe purchases. I realize this is a great problem to have -- but, honestly, it is a problem, and I'm not adjusting as easily or as quickly as I'd like.

Still, I have made plenty of clothing purchases recently, and I must say, I look absolutely great. I love wearing suits to work now, because I look so sharp in them (before, I always felt like the suits looked big and ugly on hangers, and only looked worse on me). I wore a skirt suit the other day to work, prompting quite a few remarks from friends and colleagues. "And you thought I didn't really have legs," I joked to a friend and coworker who generally sees me in pants. "I was beginning to wonder," he confessed.

I get *so* many compliments -- still! -- from coworkers and even folks who barely know me (or don't know me at all), but pass me in the Capitol halls. Security guards have commented on the weight loss. One co-worker, who doesn't know that I've had the surgery (the vast, vast majority of my coworkers don't, in fact) has complimented me profusely on at least three different occasions. The last time, she told me she worried about making too big a deal about it, but I look so great she just always wants to say something. As I told her, what person doesn't mind hearing she looks great? A woman who has been on maternity leave since November saw me recently and was effusive in her praise of my transformation. The same day, a receptionist in my office shouted "You look *good*, girl" after passing me in the lobby and doing a double-take. A male editor at my publication told me I looked "really good." Someone else told me I was "beautiful." A guy proclaimed me "a total knockout."

Of course, I cherish -- and hold onto -- these compliments. I *love* hearing the praise, whether it's for weight loss or just generally looking good. (In fact, I prefer the ones that are more generally about how I look, since I have some unresolved feelings of guilt for not revealing the most important secret to my success, the bariatric surgery). I just confessed to a former supervisor taking me out for a drink tonight to celebrate the 100 pounds down that I worry about what I'll do when the positive feedback ends. Have I become addicted to the compliments now that my food addiction is, if not cured, at least substantially in check?

Even so, I get positive affirmation most every time I look in the mirror. Sure, I've got tons of flabby skin on my upper arms, and my belly has plenty of it too (so much so that jumping jacks and jogging in aerobics classes is occasionally painful). And, my boobs are needing some significant help these days (despite having shrunk to a B-cup). But with clothes on, I look great. And I'm constantly marveling at the new shape of my body. My clavicles are now fully visible. I don't remember ever even seeing them before, even as a teen!

The transformation is huge, and it alone is so affirming. I feel good -- no, I feel *wonderful* -- about my body, even with its flaws. I feel empowered by the strength of my body, too. Sometimes, I'll lightly touch my thighs as I'm walking and marvel at the feel of so much muscle working there. I've always had strong legs, but now the muscle is so much more pronounced than before. I still run my hands over my hip bones sometimes, just to remind myself how bony that area feels (but bony in a good way!). :)

I feel healthy and empowered. I know that my body is no longer an obstacle for me, as it was for so many things before the surgery and resulting weight loss. I really feel like I can do anything I want physically -- or, at least, that I can try. For instance, I'd really like to coerce my brother, who ran track and cross-country in high school and is moving to my area in a few months, into doing a 10K with me. No, it's not a marathon, but it would be a big -- and symbolic -- achievement for me.

One new issue that has cropped up with my transformation is something of an identity crisis. Having heard about this from other post-ops (and having just read Carnie Wilson's second book about her journey, "I'm Still Hungry," once identifying these issues personally), I know this is all-too common. I'll dwell on this more in a future post, but essentially, while I recognize myself as a normal-weight girl in the mirror (I'm clearly not one of those people who looks in the mirror and still sees fat), "Fat Jen" is still hiding inside me. It's not that I ever feel fat now; again, I'm blessed in that I don't have self-doubts related to my weight anymore at all. But, I do feel like the fat girl I was sometimes; I feel shy and awkward, at times. Sometimes, now, I feel like I'm playing a role -- that I've stepped into the character of "normal Jen" or "thin Jen," and even though I believe that's who I am, I'm not quite sure what to make of the change. When I meet new people -- in this new body of mine -- it's very odd for me to recognize that they've never known "Fat Jen." And, for years of my life -- roughly a decade -- "Fat Jen" was me. The issues I experienced in my old, obese body haven't disappeared, just because my body has taken on a new shape.

Glancing over this post, I know I'm just gushing about so many good things. And, I realize I should post when I'm down or facing obstacles in my journey -- because it hasn't always been wonderful and easygoing. But, honestly, every day now is such a gift -- more so than it ever was before. And I really do feel great -- about everything related to body-image, the surgery, my eating and my lifestyle -- 99.5 percent of the time. I'm happy, I'm healthy and I feel great!

The biggest frustration for me lately has been the ease with which I've sometimes slipped into old, bad eating and binging habits. One day about a week and a half ago, when I was frustrated with the number on the scale in the morning and just generally down, I plowed through a heck of a lot of food. It was like a mini, pre-op binge -- just done on a slower, sustained level. In the course of a day, I devoured one-half to three-quarters of a block of low-fat cream cheese (*at least* it was low-fat, though calorically speaking, it still delivered a massive wallop), a bagel, ice cream and more. Fortunately, the next day, I righted myself. I knew I had to get back on track, and I couldn't let one day of horrible eating derail me. So, I didn't. With workouts that rebound day and the very next day, along with focused eating, I think I successfully climbed out of the bad binge. And, though I sometimes eat more in a day than I should, and though I definitely can eat more in a sitting than I could even two months ago, I'm generally still on track.

The experience a week or so ago proved that I can and will continue to slip occasionally. But, as long as I'm vigilant, I can check myself. I'd love to say the surgery cured my compulsion to overeat and binge, to use food as a coping mechanism. But clearly, I will continue to struggle with those issues on some level. Now, though, with my new body, my new wardrobe and my new fitness, I've got a constant reminder of what I've worked so hard to achieve. And I'm not going to throw that away.

I'm in the middle of yet another mini-plateau, but I'm still losing at a fine overall rate. Even if I don't lose another pound before my seven-month anniversary on April 9, I'll have lost 9.5 pounds in the last four weeks. And, at 163 pounds as of this morning, I'm just a short distance away from reaching my goal of a normal weight: 150.

I now weigh approximately what I did when I left my parents' home in Tampa, Fla., and headed to college in Missouri in 1995. (I didn't stay at 163 long; of course. I think I gained the "freshman fifteen" several times during just my first semester at school). I'm wearing sizes 12 and 14 in pants, generally, although I just bought a skirt in size 10 that fits, albeit tightly. In blouses and shirts, I'm generally a large or extra large. That said, the trend of stretchy, tight shirts sometimes poses a challenge for me, even with size XL tops.

In recent weeks, I've been challenging myself more physically. I typically do at least 30 minutes of cardio at the gym (usually that cardio is on an elliptical machine with moving arms) three times a week. But I'm trying to step that up to four times a week now. And, I'm trying to diversify my workout regimen a bit. For instance, on Monday, I took an hour-long cardio-kickboxing class at my gym; it was my first cardio exercise class in years. Instead of empowering me to kick butt, I'm sad to say, the class kicked my own. Although the pain in my shoulders, arms, neck and back has largely dissipated as of this morning, I'm still sore in my legs, three days later. I only hope I adapt to this class as well as I have to the ab classes I've been doing every Sunday at 5 p.m. for the past three weeks. The week after my first ab class, I was in agony. But ever since, my post-workout pain has been insignificant; I think the muscles just wanted to revolt to the new ab routine once.

On many levels, I feel good about stepping up the exercise. For instance, I feel a great sense of accomplishment after I finish a workout. I know the exercise is key to my weight loss success, especially in recent weeks and as I go forward, since I'm definitely hungrier and consuming more calories per day than I was even two months ago. I'm excited about improving my body's muscle tone and overall health. And it's thrilling to discover new muscle growth throughout my body. All that said, I'm still not in love with the work -- and it is work to me. I don't crave my gym routine, even though I admire those folks who start a workout program and then find themselves loving and craving the exercise.

It's not easy to fit the workouts into my life -- and I'm only aiming for four bouts of cardio a week! I can't even imagine making exercise such a priority -- over my social life, my work, et cetera -- to accommodate even more exercise.

I do recognize that this kind of exercise will always have to be a part of my life, to keep off the weight I've lost and to maintain a healthy lifestyle. Frankly, I love eating just too much to maintain even the 163 pounds I'm at now without burning more calories through exercise.

I actually recently got a scientific read on exactly how many calories I consume each day -- even at my most lazy. At a checkup with my surgeon March 18, I had my resting metabolic rate tested. The doctor offers the test mainly to prove, in his words, "that [we're] not metabolic cripples," and to reinforce the importance of achieving an energy balance (where the amount of energy -- or calories -- consumed equals the amount of energy expended). In my case, I guess I am a little bit crippled in this department. I burn 1400 calories a day doing nothing but sitting and breathing in and out. But, for my height and age, I should have a resting metabolic rate of 1547 calories per day. So, I should be burning 147 calories per day more than I'm burning now in a resting state. I was pretty disappointed in the news, though, of course, I do a lot more than sit on my butt on even my most slothful days.

Today, I celebrated my six-month anniversary. I'm down roughly 85 pounds, and, though I appear to be stuck in a mini-plateau at the moment, I'm thrilled with how far I've come.

In many ways, it's hard to believe six months have passed since my surgery. After all, in some ways, I'm still the fat girl who had to resort to this last-ditch effort to regain control of my body and my health. I still haven't shed all of the negative self-perceptions and self-doubts. Still, in other ways, it seems like it's been ages. I'm a completely different person physically than I was six months ago. My body has been completely reshaped by six months of malabsorption, limited food intake and physical exercise. I live my life in an entirely different manner now than I have at any time as an adult.

I still thoroughly enjoy food. I highly doubt the epicurean side of me will ever disappear. But for the moment, at least, food does not rule my life like it once did. I eat to live; I don't live to eat.

My physical transformation has been dramatic. When I started this journey, I weighed 257.2 pounds. Today, 184 days after my surgery, I have lost 84.7 pounds and weigh in at 172.5 pounds. The last time I was at this weight was September or October 1995, when I had just started my freshman year at college. I started my freshman year at roughly 163 pounds; by Thanksgiving, I weighed 183 pounds.

At the time, I could wear sizes 12 and 14, but now, I'm still generally confined to size 14 attire (and size 16 jeans), which, of course, is a marked improvement over the size 24 clothing I was wearing six months ago. I hope to get into a size 10 once my journey is over, but I recognize that to fit into size 10 clothing I might need plastic surgery to remove excess skin, and I probably will have to exceed my initial goal of 150 pounds.

My initial goal was 150 pounds because at that weight I'd be at a BMI of 25 - the highest BMI in the "normal weight" range. I'd love to get down further, but I'll be happy to hit and maintain my initial 150-pound goal, which is just 22 pounds away.

Friends and colleagues -- and even people I *barely* know at all -- are still constantly remarking on the change. Some days I've gotten as many as nine comments from folks saying such things as "Jen, you're wasting away," or "you look amazing!" Yesterday was more typical; two coworkers remarked on my transformation. I have to admit, I am a glutton for the compliments, even though I feel a bit guilty about it at times, mainly because I've had such an easy time post-op, and I'm unwilling to share the secret to my success with everyone. It's a great feeling to get that daily affirmation from the scale and from the people around me. At times, I actually wonder how difficult it will be to leave that behind when my weight finally does stabilize, when I've reached (or, hopefully, surpassed) my goal!

Already, though, I feel so very normal. I'm no longer self conscious taking a seat on the subway or on an airplane. And, now, the airplane seat belt fits around me. My belly doesn't bump the bottom of my car's steering wheel. I can climb two flights of stairs with ease.

Interestingly, even though I'm still a good 20-30 pounds heavier than some of my friends, I appear to be in much better shape. I'm working out and doing strength training regularly; as a consequence, I'm stronger and healthier even beyond the significant weight loss. This was most clearly illustrated to me a few weeks ago when I was hiking with a friend. Although she had to stop a few times to rest, I was ready and willing to keep going the entire time.

Beyond the physical transformation, I feel changed emotionally and mentally. I've told close friends I feel more fun now. I'm more flirtatious and more confident. I'd like to think that I didn't need to experience dramatic weight loss to unlock all of this great personality that had been covered up for so long, but perhaps I really did.

I'm down (slightly) more than 75 pounds as of this morning, and I have to tell you, it feels great. With a BMI of 30.1, I'm just a smidge over the boundary that separates overweight from obese. I could be only overweight by next week!

Maybe that sounds a little sad, but as I go along this amazing journey, I realize more than ever how I spent all of my adult life not only overweight, but obese -- and how that has hampered me in so many ways. Every day I discover new reasons I'm happy with the new me; I sometimes find myself smiling on Metro rides as I randomly think about my new, slimmer self.

A fun discovery of late has been finding my hip and rib bones, previously buried under so many layers of fat. My hip bones are actually prominent to the touch -- at least when I'm laying flat on my back -- and in this horizontal position, my stomach is actually somewhat concave! I've woken up in the middle of the night several times in recent weeks feeling as if something were poking me, as if I were sleeping on a pebble or something. In fact, I've just been sleeping on bones that previously were cushioned by far too much fat and flesh.

Every new little discovery about the slimmer version of me is joyous. Living a life where food does not govern me is truly freeing.

This year, for the first time in ages, my New Year's resolutions did not include any mention of losing weight. That will come, I know, especially as long as I keep working out and eating according to plan. This year, I can focus on other things, including living a healthy lifestyle, without focusing solely on dropping the weight.

The problem with letting months lapse between profile updates is that when you finally get around to writing a new entry, you've got way too much ground to cover. :)

I'm at 192.5 pounds, about where, essentially, I've been holding for more than a week now. This could be my first real plateau, and it's been frustrating. Last week, I had an unusual and robust craving for fats (guacamole, cream cheese, et cetera), and I have to admit to succumbing to the desire a few times. I also didn't work out for five days straight last week, and that might have contributed to the mini-plateau.

This week will be a light one for me work-wise, and I fully intend to go to the gym regularly. As it is, when I went Saturday I set a new record for myself in terms of my cardio regimen: I did more than 40 minutes on the elliptical machine. When I go tonight, I'd like to bump that up to 45 minutes (and follow it with my usual routine on the weight machines, a process that takes roughly an hour to finish).

This latest weight struggle aside, I've been doing great, and I've come a long way since I last wrote here. I tolerate most foods with ease, though dry chicken can be a problem. I still occasionally worry I'm able to eat far too much. I don't usually have problems getting my protein in (and without using meal replacement shakes, which I abhor).

A typical breakfast for me is an omelette made with one egg, an additional egg white and an ounce of cheddar cheese. I find the eggs very easy to tolerate in the mornings, a time when eating more dense foods can be a struggle. In the mornings, I also generally will have about six to eight ounces of skim milk (to wash down one of my twice-daily Nexiums and half of my daily assortment of vitamins).

There isn't any consistency to lunch, as probably three days a week I buy my meal out. Where I used to have soups for lunch (because they were reliable, easy-to-consume foods as a relatively recent post-op), I now tend to eat a lot of salads for lunch. I generally get salads with protein (such as tuna, tuna salad, salmon or chicken). There's a gym two blocks from my office that makes delicious salads to order (there, my usual is romaine and spinach with salmon, egg whites, bleu cheese and light Asian dressing - yum!). When desperate, Subway's salads can be handy (I usually get a Subway salad with tuna salad on top). Another lunch mainstay has been sandwiches; I typically will eat one half of a deli sandwich for lunch, and even then, I'm eating maybe a bite or two of the bread.

My dinners vary. Pseudo crab cakes (made out of tuna) are great. Anything with 90-93 percent lean hamburger meat is perfect. Until a stomach bug in December, I was eating tons of salmon for dinner. I'm still wary of veggies (broccoli remains untested), so salad is usually the only kind of produce you'll see on my plate at dinner. That said, I've had zucchini and corn in recent weeks with no problems.

I don't make a habit of snacking, but if I feel like I need something more, I typically will eat a string cheese at work. Although I loved sugar-free desserts in the first few months after my surgery, now I typically don't have a bad sweet tooth (or, if I do, I'm not giving into it that frequently). For the occasional treat, I indulge in no-sugar-added Klondike bars. But, since those pack a hefty 200-(or so)-calorie and 10-fat-gram wallop, those indulgences are more and more rare.

During the holidays, I felt like I ate more than I should have. My heartburn/ulcer issues were acting up a bit, and that contributed to my hunger and appetite. Even though I feel like I ate more than perhaps was ideal, I certainly was eating far, far less than I would ever have eaten during the holidays as an adult before my surgery. For the week I was visiting my family in Tampa, Fla., I indulged in essentially one sweet a day, with no problems; I felt comfortable imposing this restriction on myself and I didn't experience any negative side effects.

One day, though, I had more than just a bite of pecan pie. I had probably a third of a normal slice of the pie. And, boy, I did pay for it. Though I can eat at least 15 grams of sugar on an occasional basis without dumping (unfortunately, my holiday eating adventures revealed this to me), the pecan pie must have been too much. After eating the piece of pie, I was lightheaded -- a classic sign of dumping. As it happens, I get drowsy and lightheaded with most meals, even ones that are high-protein but extremely low-fat and low-sugar, so I wasn't overly alarmed by this. I also got very queasy. I didn't feel like I was on the verge of throwing up, but I felt sick to my stomach, so much so that I was relieved I could head to bed for the evening and sleep it off.

As you might guess, I have avoided anything with more than 13 grams of sugar per serving ever since. The one borderline item these days is my occasional (three times a week) indulgence in glaceau vitaminwater. I'm not imbibing in the stuff for its vitamins as they're negligible. This stuff is just a handy, very tasty way to help me get my water in. The dragonfruit vitaminwater is just phenomenal. Unfortunately, the drink isn't calorie-free, like all of the other flavored waters I drink. Instead, the vitaminwater packs a 50-calorie-per-serving punch; it's also 13 grams of sugar per serving. So, when I drink the vitaminwater, I will drink a bottle (2.5 servings, 125 calories) very slowly over the course of a day as a treat in between other beverages.

I've had a few more experiences where I eat something that just doesn't go down right (one at a holiday party). But so far as a post-op, I think only twice have I actually had to throw anything up. Generally, some hearty coughs in a bathroom is enough to take care of the problem. I've also learned to avoid doing the one thing that seems most intuitive -- drink a sip of water -- when I feel like something has gone down wrong. Typically, I can get through an experience having swallowed a morsel that's just a tad too big or dense with relative ease, as long as I don't take a sip of liquid. The minute liquid hits the mix, what was an uncomfortable feeling in the middle of my chest becomes fairly intense pain.

This past December was my busiest holiday season ever, when it came to parties and social engagements. I went to a lot of shindigs, and I felt comfortable having essentially one drink per party. At one party I abstained altogether; at another party, I had two drinks over the course of several hours. One drink doesn't make me drunk or even particularly tipsy, compared to the effect alcohol had on me before the surgery. I joke that this is yet another signal that I really didn't have the surgery I'm purported to have had in September last year! At any rate, since it isn't ideal for my heartburn/ulcer, I'm back to abstaining from alcohol.

My weight loss has been fairly consistent, despite the recent mini-plateau. A big moment for me was crossing the 200 pound threshold -- a milestone I passed before the end of 2003. The last time I was below 200 was in late 1998. When I get below 185 or so, I'll be in territory I haven't seen since at least 1996.

I'm now wearing larges and extra-larges in tops and size 16 in pants (in jeans, I'm a 16W). I can shop in department stores without having to go to the plus-size department on the top floor. I can walk into an Old Navy and find clothing that fits. I can buy clothes in the normal size section of Target.

Friends and colleagues definitely have noticed the weight loss, and they've all been very positive. I wonder if some people suspect a link between my mysterious surgery in September 2003 and my dramatic weight loss, but if so, no one's said anything to me. I'm a reporter, and I work in a newsroom full of journalists, people whose lifework is to be skeptical, to be analytical and to be observant. "You can't keep a secret in a newsroom," a colleague said to me just last week, when his own secret -- an internal job change -- became top gossip at the office for a few days. He's right, and I guess I need to brace myself for what is inevitable: that some of my colleagues will put two and two together. Until that happens, I try to accept compliments graciously (and, trust me, I *love* hearing them) and quickly extricate myself from conversations about weight loss (and how I'm succeeding) without lying or misrepresenting what I've done.

If a morbidly obese coworker asked me about my weight loss, I think I'd be completely honest and forthright -- and hope he or she wouldn't share the news. I don't think it would be responsible or morally sound to mislead someone who has the same issues I have had with food and fat and indicate that I've had this dramatic weight loss through nothing but diet and exercise. Still, I'm not eager to reveal this to my colleagues otherwise, and unless my hand is forced, I don't intend to.

As my weight has fallen, my self-esteem has soared. Beyond the clothes -- and, really, it's a huge, huge thing to be able to choose any clothing without feeling restricted by available sizes -- I just feel more attractive. I feel like I fit in more. Now, when I enter a crowded subway train and see empty seats, I have no shame in sitting down. I have no problem following someone into an Express or similar store catering to all-but-the-plus-size women, and when I do, I don't feel like an imposter who can't wear any of their clothes. I feel like I belong in social settings -- as opposed to my pre-op feeling that I'm an odd misfit who doesn't belong and who is in way over her head.

I even carry myself differently now; when I walk, my head is up and my back is straight. I'm no longer quite as anti-social as I was before; I'm taking advantage of more and more social opportunities. I have a renewed sense of pride in how I look and dress. I'm wearing eyeliner for the first time in my life. I got my hair cut in November; now, it's stylish but short. I was hiding behind my long hair for quite a while; it's liberating to feel like I can pull off a shorter cut. Where before the surgery I used to always feel fat and ugly, now, I feel pretty. I feel like I belong. I feel like I'm normal. I feel hopeful for the future and full of happiness for where I'm at.

Truly, I'm in a completely different place than I was just 64 pounds ago. I can't even imagine what awaits me when I get closer to my personal goal weight (originally 150).

Before the mini-plateau of the past week or so, I was feeling really good about my prospects for not only reaching my goal of 150 but also surpassing it. I don't know if 145 is reachable -- and sustainable -- for me, but I'd sure like to try.

The last three weeks have been insanely busy, which is largely why I haven't written. I've had some extremely long days at work, thanks in part to the U.S. Senate, which last week held a marathon, 39.5-hour debate on the judicial selection process. I wasn't there for the full debate -- each day I went in early and left by midnight -- but the hours were nonetheless long.

As a result, I've fallen a bit off the workout wagon. With a friend arriving late Wednesday (and staying at my home until Sunday), my family's arrival next week for Thanksgiving and endless work on my house to get done before any visitor appears, frankly, I'm not sure if I'll be able to get back into my routine of three times a week anytime soon.

Perhaps the slashing of my workouts is why the weight loss has seemed to slow a little. This week, the pounds have come off slowly, as was the case two weeks ago. Of course, last week, the weight dropped quickly. Meanwhile, I'm still fitting into more and more clothes. I wear a lot of size 18 pants; in fact, I'm wearing pants I last wore a year ago.

On Nov. 2, I celebrated my 26th birthday, and partly as a reward, I went through my closet, organizing everything, trying on clothes to see what fit and setting aside items I'd shrunk out of to donate (to charity and the ObesityHelp.com clothing exchange). Somebody's going to end up with some nice, barely worn stuff, since I was a size 24 only a short while.

It's finally cold enough that I have to don my wool jacket whenever I step outside. I actually have two jackets. One is labeled a size 14, although I wore it until December or January of last year before I was too big for the jacket. The other is -- I believe -- a size 20, but otherwise, it has a very similar look and design. The small one is worn and several years old. The big jacket is less than a season old; I got it last winter to accommodate my increasing girth.

At any rate, I've been wearing the newer of the two jackets, though at this point, the smaller one fits (albeit snugly) and the new jacket is way too big. The first day I wore the big jacket to work, it felt like I had donned a fat suit. No one could easily see that my body was much smaller than the jacket, especially the way it billowed around me. When I sat on a seat on the Metro, I felt huge in the space. I felt a self-conscious as I did just a few months ago.

The experience was enough to show me just how much losing roughly 40 pounds has changed my self-perception and outlook. I'm still a large woman -- gosh, at this size last year, I felt huge, and I prompted at least one person to label me a "fat chick" -- but I feel so much smaller now. I feel almost normal, even. And, in just a few sizes, I will be.

Now, this journey for me isn't all about finding new clothing and looking good, even if I spend a lot of time talking about the former. Frankly, the health benefits aren't as easily quantified, although I must say, my plantar fasciitis is disappearing. I now hop out of bed in the mornings with little or no pain. The rare times I have noticeable plantar fasciitis pain, I've spent significant time standing or walking in the hours and days before.

I've settled into something of a routine with my gym. I've been going three times a week, and each time, I do at least 25 minutes on a cardio machine (all but once, so far, that machine has been a bike) and then work on a few weight machines in a bid to build muscle in my arms. My workout on Friday was my longest yet. I did 25 minutes on the bike, and then I did a circuit of three weight machines three times.

But then, I decided to try out a cardio machine I've long been interested in. (Frankly, it helped that on a Friday night, not too many people were at the gym). I hopped on the elliptical machine, set it for 10 minutes, and I started running. Within two minutes, my heart rate was at a whopping 172 beats per minute. Sweat was pouring down my face. And 10 minutes seemed very far in the future. But, I made it to the end, and I felt a great sense of accomplishment at having done so. The next day I go to the gym, probably tomorrow night, I'm going to include the elliptical machine as a part of my workout.

Yesterday, I worked out in a different way, outside the gym. I went on a mini-road trip by myself, through Virginia and Shenandoah National Park. In the park, I took a four-mile hike on a trail that followed a river and ended at a waterfall. I didn't make it to the waterfall; if I had, I'd have hiked 4.5 miles. But, next spring, I'm going to head to Shenandoah again -- and this time, it will be early in the day and I'll be sufficiently fit to make it all the way.

My brother offered this "advice" the other day to me: "You know, Jen, you're going to have to work out forever." I complained about it to my mother, who notes that he probably feels compelled to say such things because of my past history. "But when have I ever used a gym this much or worked out this much?" I asked my mother in response. It's true: I've never been as committed to a gym or workout program (even this early on; even though it's only three days a week).

There is something different about exercising after this surgery, at least for me. And there's something different about working out, about exercise, about absolutely everything on the way down. It's like, once you've been 257 pounds, 225 doesn't feel *nearly* as fat as it did on the way up. On the way down, you feel lighter than you should. You feel better about yourself than you should. You feel more able to exercise than you did on the way up -- after all, you've been strong enough to carry all this weight around; now that you're lighter, you can handle so much more.

This past week, I headed up to New York for a follow-up appointment with my surgeon and a support group for Lenox Hill Hospital bariatric surgery patients. The appointment, as always, was brief. In short, I'm doing fine. Since the Nexium my doctor prescribed seems to be doing the trick -- and my ulcer-like symptoms have disappeared -- my surgeon said he saw no reason to have me scoped (to get a look at the stomach and identify the ulcer, assuming it exists). I'll probably be on Nexium for a year, Dr. Roslin said.

The best part of the trip, by far, wasn't the appointment, but the time spent chatting with other patients in the waiting room beforehand and later, during the monthly support group meeting. Those of us who have had gastric bypass surgery share so many things -- not the least of which is the weight that drove us to pursue such a drastic corrective measure. There's an automatic sense of kinship with these people, regardless of age or creed.

At these monthly gatherings, post-ops swap recipes and advice (i.e. "Light and Lively yogurt works great for me." "Cantaloupes and I aren't getting along right now." "There is no low-sugar canned fruit."). But, perhaps more important, we're all a source of inspiration for each other. It's so energizing to be surrounded by people who have had the surgery and are so exuberant about the future.

At the meeting Thursday night, someone observed that usually, support groups revolving around weight are not nearly such happy occasions. Usually, the most common shared emotion is negative in nature. But indeed, attendees of Thursday's meeting were buoyant and happy; we all are looking forward to a future in which weight doesn't rule our lives.

I worked out again on Saturday, and I'm planning to go on Monday after work. I've been sticking to 25-minute cardio routines on the stationary bike, followed by some work on the weight machines (focusing on my arms). I really need to schedule a session with one of the trainers or an orientation on the weight machines so I can use more of them confidently and safely. I'm really limited in what I can do now.

Today, I went clothes shopping for the first time since my surgery, and, I have to say, it's amazing how just a few sizes dramatically changes the landscape. I'm in 1X blouses and tops now; in pants, I'm wearing 20W and 18W. I started out wearing 2X and 3X tops and size 24W pants. My shopping excursion actually yielded wonderful results: So much of what I tried on fit (a dramatic change from at the beginning of my journey), and I feel like I made some good purchases that will last me for a few more sizes.

I can't wait until I'm solidly in a size 18. And, then, I'm more than eager to hit 16 (in fact, I can hardly even believe that's possible) and watch the options open up even more dramatically. Size 16. Wow.

An hour ago, I came home from my first workout at the gym near my house. I did 25 minutes on a stationary bicycle (keeping my heart rate above 130) and after that, I did two sets of 10 presses of 30 pounds on an arm press machine. Even though I knew I needed to go, I still had to force myself to leave the house and get over to the gym. Afterward, I was glad to have gone through with it.

Frankly, it helped that midday Sunday isn't exactly a bustling time at the gym, particularly when the Washington Redskins are playing at the same time. :)

Soon, I hope to sign up for an orientation with the weight machines and a free session with the physical trainers at the gym. I'm trying to convince my family to chip in and buy me a package of sessions for a Christmas or birthday present. :)

One of my big goals is just to work on building strength in my arms and back. I really want to do everything I can to ensure I look toned, not flabby, at the end of this journey.

Incidentally, the journey is going pretty slow these days. Yesterday morning, I finally hit 231.5, the same weight I'd been six days before. In between, I climbed up to a high of 233.5 before losing the weight again. Hopefully, working out and getting all of my protein in will help with the weight loss.

I'm also optimistic that the weight loss and my attitude will improve over the next week, since my surgeon prescribed medication for some serious heartburn I've been having. The heartburn really appeared on Wednesday of this past week, and each day it grew more intense. Friday, my boss actually told me to go home early because I was in such agony. Whenever I ate, the pain and discomfort (in an area between and just below my breasts) would disappear. An hour or so later, the pain and discomfort would return.

So, to avoid the heartburn, I was nibbling on string cheese, crackers and no-sugar cookies constantly -- not exactly good for the diet or eating plan. Meanwhile, the pain was growing more and more intense. I was popping Tums like crazy. On Friday, I even took a dose of Carafate (a horrid pill designed to coat the stomach before meals).

Thankfully, Friday afternoon, my surgeon called me back and said I was probably developing a marginal ulcer. He called in a prescription of Nexium to my pharmacy and 160 bucks later, I was all set. I took a first dose on Friday night, before a second dose Saturday morning. After just three doses (I had another this morning), I am feeling so much better. Just now, it's been more than four hours since my last meal, and I'm feeling only slight discomfort.

I hope it keeps getting better. I see my doctor for my one-month follow-up appointment on Thursday, and it would be great to feel 100 percent (and finally lose some more weight)!

It's been a very long time since I've written and in the past few weeks, I've gone through an awful lot. I'm adjusting to my new, post-op life fairly well, but there are clearly some things (a possible new lactose intolerance, intense drowsiness after even the healthiest of meals and growing difficulties eating foods I've tolerated with ease at other times since the surgery) I'm having trouble dealing with.

Before I delve into those issues, I want to note that at roughly 233 pounds, I've now dropped 24 pounds since the day of my surgery. I actually weigh every morning (and record the information), but I'm not letting the numbers get me too excited (or too depressed). Frankly, it would be possible to have both reactions. There are days where the weight just seems to slide off (days in which the scale shows a loss of two pounds over the morning before). There are many days in which I stay the same weight. And, there are occasionally days where I weigh more when I wish I should weigh less. For instance, two days ago, I was a good pound or a pound and a half lighter than I was yesterday and this morning.

I started out this journey wearing a size 24W. Now, my 24W pants are way too big. Of course, I don't have any 22Ws to slip into in the meantime. So, I'm creatively using safety pins in the waists of my pants since, God knows, the buttons and zippers are doing nothing to help hold them up.

I haven't had many comments on my weight loss, save for some observations from friends who know I had the surgery. One observed that my face and arms look slimmer. My supervisor at work actually noticed the baggy pants.

I generally feel good about the weight loss, but it hasn't always been easy. I had a particularly tough time the week of Sunday, Sept. 21 to Saturday, Sept. 27. It was my last week out of work, and my mom stayed with me for half of it. On Wednesday, when I took her back, I was having some pain from stomach cramps. They would come in intense waves that were painful and occasionally made me especially nauseated.

Once I got home from taking my mother to the airport, around 3 p.m., I was in severe pain. I lay down and tried to relax, but the pain was intense. Every minute or two, I would feel an intense abdominal cramps, which were accompanied by chills. The cramps were debilitating, and they lasted until I went to sleep around 10, despite my consumption of plenty of over-the-counter remedies, such as Gas-X. By the next day, the pain was largely over, but I still felt the effects of the abdominal cramping.

After the pain subsided, I thought perhaps the episode might have been caused by some kind of stomach bug. But, the experience seemed to happen again (this time over just a few hours) on Sunday, just a few days later. Maybe it was a stomach virus. But, I'm worried it was something related to the surgery. In particular, I'm concerned my problems might have been caused by the dairy products I'd eaten a good 24 hours before the problems surfaced. I've always enjoyed milk, but I know some people develop a lactose intolerance after the surgery. Frankly, that was one of my big fears going into this, so I hope I'm not lactose intolerant.

That said, ever since, I've avoided the sugar-free ice cream in the freezer, and I haven't had any milk. I bought some Lactaid at the store this weekend, and I had a swallow of it today, but it's so sweet and unlike the skim milk I know and love. I'm not sure that I can handle it, either.

That has been my biggest issue post-op, which is remarkable since I've been on a soft-foods diet for a little more than a week. Initially, I was tolerating all of the foods -- including the meat/protein elements of frozen Lean Cuisine meals -- with ease. But this past Friday night, four days ago, two bits of salisbury steak from a Lean Cuisine did not go down well at all. I think I chewed thoroughly, and the food was something I'd tolerated before. But, unfortunately, I got a pain in my esophagus/stomach (others have described this as a sensation like swallowing a brick, which I think is apt. The pain was in the middle of my chest, and it was intense. I kept hoping it would subside, but when the pain remained, I started hoping to throw up the offending nibble of salisbury steak. Eventually, I went to the bathroom and I coughed it up.

The vomiting experience wasn't dreadful, as I'd feared. Because there was only two bites of food in my stomach, I didn't have a lot to regurgitate. The worst part of the whole experience was the pain that preceded the vomiting and the length of time I had to wait to get rid of the agony.

Monday, when I tried eating lunch at work, I had a similar experience, again on food that I'd easily handled before. This time, I walked calmly to the bathroom, where a cough was enough to do the trick. Nothing really came up, but the pain subsided.

The weird part of these experiences it that I've had problems recently with foods that were no problem as recently as a week ago. Maybe I'm getting overconfident and not chewing enough. Maybe I'm eating too quickly. Maybe the entrances to my pouch and intestine are getting tighter because of scar tissue. Who knows? I'm just trying to be extra careful with everything I eat now.

I definitely eat faster than I should, and slowing down is an ongoing struggle for me. I never realized how important temperature was to foods, probably because as a pre-op, I just wolfed food down before it could cool off at all. Now, my food is like ice by the third bite.

After eating, I'm often very, very drowsy, almost as if I'm on medication. The fatigue usually lasts a half hour or so before I return to normal. This happens regardless of the amount of protein, fat, carbs or sugar in my meals, so I can't attribute it to an overdose of carbohydrates or to dumping. Hopefully, this will disappear as I get further out from the surgery. It's a real drag getting so tired at work.

Another interesting side effect: I'm getting cold more easily. I've always been a very warm-natured person. My ideal outdoor temperature was 65 degrees and summers were very, very cruel to me. Now, all of a sudden, I'm freezing outside when it's 60 degrees, and I'm certainly not comfortable at 65. I'm cold in situations where I would have been comfortable or even hot pre-op. It's odd, because I know this isn't just the weight loss. After all, I've been this weight before (and not too long ago, in fact).

So far, the foods I've tolerated easily (and on multiple occasions) include:

• Fake crab cakes made with canned tuna


• Chili with cheese and low-fat sour cream


• Scrambled eggs with cheese


• A slice of fat-free bologna and a slice of American cheese rolled up


• Sugar-free peanut butter cookies


• Low-fat peanut butter and sugar-free strawberry jelly


• Chicken salad


• Mashed potatoes


• Refried beans with cheddar and low-fat sour cream

I'm back home in Washington, D.C., and spending one more week concentrating on recovering from surgery before I go back to work.

Things continue to go well, though I developed this very odd bulging protrusion under my left breast and above the main incision on that side of my body. I called my doctor about it on Friday, and he was unconcerned. But he put me on Levaquin (an antibiotic I intensely dislike) for seven days just for kicks. The bulge has not decreased in size since I first noticed it Friday morning, and, if anything, it's gotten a tad bigger. Even if my doc isn't concerned, it's distressing to me. Other post-ops have shared stories of similar problems with me; most often, the swollen areas are pockets of fluids, such as blood. Some post-ops have had these areas drained by their surgeons; others have seen them disappear over time.

Otherwise, I'm fine. In fact, since I was able to sleep on my stomach for the first time last night, you might say I'm fantastic! I'm a stomach-sleeper, and it's been rough. I started sleeping on both sides of my body a few days ago, probably on my eighth or seventh day post-op. I started on my right side and, after a few days, I progressed to my left. Last night was the first time I moved onto my stomach, where I apparently stayed immobile for hours.

As it has now been 12 days since my surgery, I'm still on a pureed diet. I'm tolerating most foods I try, though I've largely run out of palatable options. I never tried low-sugar applesauce, because the "protein first" edict has really precluded such a luxury. I had refried beans with a few strands of melted cheese and a little dribble of sour cream for dinner last night. I had the same for lunch just a short while ago.

Last night, it was fabulous. Today, it was good -- a little too good. I ate more than I should have, I think, since I'm feeling a little queasy.

I haven't experienced dumping -- I think -- though I did have a bad experience one day after sipping some flat diet Sprite mixed with an ounce or so of orange juice. I was on the subway in New York, and I was sweating and experiencing some cramps. Eventually, it dissipated.

I've been coming very close to (if not outright hitting) my protein target of 50 grams each day, simply by eating meats and other high-density protein foods at every meal. But, I've also found one protein shake that isn't completely off-putting, and I've been using it to supplement my diet. The pre-mixed Atkins Advantage drinks seem palatable so far. I've been having the can of chocolate shake each day. Each can contains a whopping nine grams of fat and a modest 20 grams of protein.

My cravings for sugar haven't disappeared; I'm as aware of them as ever, and I've been sorely tempted to over-indulge in the no-sugar-added Edy's chocolate ice cream in my freezer. But today, I cleaned out my pantry, removing anything with more than 10 grams of sugar per serving. Some canned fruits that challenged that boundary remained, on the off-chance I can eat them at some point. I really don't want to give up fruit, canned or fresh.

I've lost about 16 pounds from my weight Sept. 9, the day of surgery. My waist is down about three inches, but I haven't really noticed a big change in my body yet -- probably, that's because my stomach is still tender, so I haven't been wearing any of my pants with button/zipper connections. (I've practically been living in a pair of drawstring black pants for the past few weeks).

Perhaps my biggest challenge lately has been taking all of my pills and vitamins each day. I inevitably miss something on the regimen, and all too often, it has been one of my two daily vitamins and calcium supplements. I know I have to get better in this regard, but for some reason, I find keeping up with these requirements quite difficult.

I also haven't been getting my 64 ounces of water in daily, a goal that I'd have easily surpassed in my pre-op days. Then, I guzzled water and sparkling waters; now, I'm really struggling to get the liquid in. Water isn't terribly appealing for some odd reason, and I grow tired of other liquids very quickly. Plus, the slow-sipping requirement makes drinking tricky.

Sometime this week, I'm going to go tour the gym I'm planning on joining soon. I know I only have a limited time in which I can use exercise and strength-training to help my body keep up with the rapid weight loss, so I need to get busy soon. I want to do everything I can to avoid a flabby apron of excess skin on my abdomen and arms.

I had my first follow-up appointment with my surgeon, Dr. Roslin, today. Everything is healing fine, and some disconcerting shortness-of-breath issues I'd had when physically exerting myself are apparently nothing to worry about.

The big news is that I now weigh 243.9 (244) pounds, roughly 13 pounds less than I weighed the morning I reported for surgery. It's actually 16 pounds less than I weighed in May, when I had my first consultation with Dr. Roslin.

I was fortunate today to be able to attend Lenox Hill's monthly weight loss surgery support group, and I've scheduled my checkup next month for the day of the meeting. I saw a number of faces I recognized from obesityhelp.com. The room was full of pre-ops, but it was so nice to hear from everyone: their concerns, the common experiences and their successes.

It really was energizing seeing everyone, and hearing the Q and A among the audience and my surgeon and his partner, Dr. Kurian. In the room was one woman who was four years out; she looked great. Another woman, who is more than a year post-op, looked even better in person than she did on her photos online.

Post-op patients talked matter-of-factly about the "mind hunger" they still feel, especially a year or so after surgery, when the weight loss gets a lot harder. And, they reconfirmed in my mind the value of working out and sticking to an exercise plan. This surgery truly is a tool, but it's one of many I will soon have in my toolbox.

As long as my last post was, I feel like I've still left out so many details. And, since it's been really helpful for me to read about the post-op diets, pain level and activities of others immediately post-op, I'd like to provide the same kind of information for anyone reading this. Consequently, the information/entry below is organized into categories

It's been five days since my surgery (lap RNY gastric bypass) and two days since I was discharged from the hospital. On the day of my discharge, I had gained one pound, to 258. Today, a hotel scale put me at 251, but I don't think that scale is calibrated anywhere near the hospital scales.

Diet:
I've been able to tolerate a lot of food and liquid, and in some ways, that really worries me (more on that in a bit). In the hospital, I was only on a diabetic/low-sugar liquid diet for three meals. I was served trays with tea, orange and green diet Jell-O (Blecch! Why can't they provide good flavors?), and various broths. At the time, I'd eat a few bites of the Jell-O (we're talking 1.5 tablespoons at most here), swishing the substance through my mouth until it was completely dissolved before swallowing it. And, I'd typically have a few small spoonfuls of broth.

All in all, I would get maybe 2.5 tablespoons of fluid in all, but it was over an hour at a time, and it was rough. I'd lie all the way back down for comfort or drift off to sleep after taking one bite of Jell-O and feeling some pain, and my mother would try to get me to have another bite as soon as I woke and started moving around in bed again. I was definitely forcing myself to eat at this early stage. I was not feeling any hunger, and eating was not holding much appeal.

After three meals of this liquid diet, I was moved to a diabetic/low-sugar pureed diet. I expected to have some really vile stuff put in front of me, but honestly, the hospital's purees were pretty tasty (even if the texture wasn't exactly dreamy). The highlight of my first pureed meal (lunch) in the hospital was pureed macaroni and cheese. This was served with a little gravy-like substance, some hot tea, pureed soup of some kind and pureed green beans. I concentrated on the mac and cheese, since it was the most protein-bearing food on the plate. I used a one-ounce measuring cup provided by my nutritionist to scoop out a portion, but I only ate about half that. I was interested in the solid food at that point, and I enjoyed the flavor of the food, but I was not truly into it.

That all changed soon. My second pureed meal featured pureed low-sugar sesame chicken and mashed potatoes. The sesame chicken didn't taste like any sesame chicken I'd ever had before, but it did taste like chicken. :) Doesn't everything? By this meal, I was starting to experience some hunger, and I ate a full serving (one ounce) of the pureed chicken.

By my third pureed meal (breakfast the next morning) I was experiencing real hunger. My stomach was growling a little, even. That meal included orange juice, applesauce, pureed oatmeal and pureed scrambled egg, as well as coffee and skim milk. Obviously, as you can tell, my hospital portion sizes were enormous, and way out of proportion to my new eating. But, of course, these trays are made to fit a number of different eating styles and needs. At any rate, I had a little less than a tablespoon (1/2 liquid ounce) of the oatmeal and a little over a tablespoon of the scrambled eggs. And let me tell you, I savored those eggs.

My fourth pureed meal, lunch, included pureed Manhattan clam chowder, pureed chicken pot pie, pureed carrots, applesauce, skim milk and tea. That clam chowder had a wonderful flavor; I ended up sipping on it for a while after eating, for good or bad. I had a little over an ounce (two tablespoons) of the pureed chicken pot pie.

At this point, I was discharged from the hospital. My first night home I had an ounce of egg salad (yummy - and I never was a huge fan before!). Breakfast the next day was 1.25 ounces of cream of wheat sweetened with Equal. Lunch was an ounce of egg salad and a little less than a half an ounce (or a tablespoon) of cottage cheese. Dinner was 1.5 liquid ounces (three tablespoons) of tuna salad. Breakfast today was three tablespoons of scrambled eggs.

I worry that I'm enjoying food a little too much post-op. I've been savoring the foods presented to me, and I've been eating down the portions I've been given. They're tasty, and their appeal has not decreased. Plus, I'm eating quickly and more than I think I should be able. I just had a half a cup of yogurt with ease.

That said, my brother just ate some chicken teriyaki in front of me, with my blessing, and I wasn't desperate to have some. In fact, though it was nice to smell real food, I never thought of it as anything other than off-limits. It probably helps that I'm not quite yet hungry for lunch.

I haven't been able to identify various feelings of satiety. Frankly, fullness is still something of an alien concept; I feel like I shouldn't eat more at times, and at times, I feel like my stomach is full. But the full feeling is not full as I remember it from before surgery. Now, at five days post-op, I still have not felt stuffed. I also have not thrown up, though I have at times been nauseated. I also feel some, very minimal pain after eating. Most of this pain is on the left side of my torso.

Not drinking with my meals is just as frustrating as I thought it would be. But I'm sticking to the rules on that (no drinking 30 minutes before starting and 30 minutes after finishing eating). I'm not drinking nearly as much liquid as I should be or as I'd like. Before my surgery, I would easily swill more than eight cups of no-calorie, flavored sparkling water, tea or Crystal Light a day. Now, it is a struggle to get all the liquids down.

Pain:
As I said, I experience some mild pain on eating and drinking. By far, the most pain I feel, though, is when I'm walking, standing or otherwise vertical. Getting out of bed after lying down for any length of time also tends to be quite painful. I still need help getting out of bed. Generally, I just need to be able to grab on to someone's arm or shoulder and use that for leverage.

The pain I feel is on the left side of my torso. It's like a line of pain from under my left breast down toward the level of my belly button. There, it extends horizontally all the way to my left side. I can have both a steady pain (that, I'm feeling now, as I sit) and sharp stabs of pain (typically upon walking or changing position, such as moving from a horizontal position to sitting or standing).

Yawning also is painful, and odd, in that it's more like three short, frenetic spasms and breaths than a full inhalation and stretch. I can't cough fully; that's a painful experience, and it has been from day one. I'm terrified of sneezing.

Most of my pain comes from the inside. The surgical openings themselves don't produce pain; primarily they itch. That is a minor nuisance. Even the pain is relatively minor, in the grand scheme of things. But it is there, and it - along with a shallow breathing pattern now -- is enough to keep me from exerting myself too much. Tomorrow, I'm going to try and walk two to four blocks with my mother on the streets of New York, just outside my hotel. We'll see how that goes.

Random Observations:
It would have been a great help -- particularly if I didn't have someone at my beck and call -- to have had some kind of adjustable bed, bed with side rails or a recliner available post-op. Not being able to climb out of bed alone is a real frustration.

So far, one of the best bits of advice I've gotten is to use the one-ounce medicine measuring cups to scoop out servings. That was particularly useful early on, because it helped me easily identify portion sizes and, in a way, it's already started to train me to identify such small food quantities.

I wish I'd known the kind of pain I'd be in post-op, and I wish I'd known how long it would last. I certainly didn't expect this level of pain five days post-op, though probably I should have. It's not exactly excruciating, and I am managing with Extra Strength Tylenol. (I did take two Vicodin last night before I went to sleep, but they made me a little nauseous, as do all narcotics, so I think I'll try to avoid them in the future).

I'm home! Well, almost. :) My discharge papers were ready mid-morning, but I hung around the hospital waiting for my doctor (who was stuck in surgery) until 2:30 or so. I am now situated in my hotel, where I'll be staying for a week on the orders of my doctor.

If you just want to know how I did, suffice it to say that the surgery went well and I'm now on a pureed diet. If you want to read an exhaustive report on my surgery and hospital experience (minus a great deal of griping about the management and hospital staff), read on.

My surgery and post-op recovery went pretty smoothly. It all started Tuesday morning, when I showed up at Lenox Hill Hospital at 7 a.m. I was told to wait on the 10th floor at 7:30 a.m., but I struggled to identify exactly where I was supposed to be. No nurses or aides were staffing any of the desks I saw, but I wandered around until I found one who told me I was in the right place (the day surgery waiting room).

A nurse whisked me away promptly at 7:30, and she took me to a curtained-off "room" inside the pre-op staging/waiting area. My mother waited outside as I answered questions, took off all of my clothes (and put on a gown) and underwent a few basic tests. Some blood was taken, my blood pressure was checked and I was weighed. I was given a shot of Heparin, a drug that helps prevent blood clots by thinning blood. I saw a nurse, a physician's assistant and a doctor who specializes in pain management. Then, I was asked to go sit in another pre-op waiting area.

I sat there for a couple of hours - long after my surgery's scheduled 10 a.m. start time. Around noon, I was taken to yet another pre-operative staging area. I was told only one visitor could come with me, but eventually, we were able to get my brother (who is in his third year of med school and could have worn his whites and badge for access regardless) into the room with us.

There were several gurneys in that room, where patients were brought for prepping before surgery. This was the final staging area for most patients; here is where they met with their doctors, got on gurneys and answered final questions. I was told to sit in some chairs in the room while patients came and went. It seemed there was a problem with my doctor's first surgery of the day, which only ended sometime around 12:30 p.m. So, I waited while doctors frankly discussed their patients' cases in front of their charges (and me). It seemed like a clear violation of the intent of HIPPA -- if not the letter of that law designed to protect patient privacy.

My doctor took a breather between the first surgery and mine; I suspect he also checked on other recuperating post-ops who were still hospitalized. Meanwhile, hospital staff prepared the operating room where my surgery would be performed. My surgeon's physician's assistant as well as the anesthesiologist came by and asked me some questions while I waited about my sensitivity to latex, whether I had loose teeth and what other surgery I'd had done, among other subjects.

At 1:40 p.m., I was finally taken to surgery -- but not on a gurney. When everything was finally ready, my surgeons had me walk to the operating room and plop myself on the table. That, I'll admit, was a little weird.

It took six or seven attempts before the anesthesiologist could get an IV into me; even then, the success only came after a second anesthesiologist was called to the room to try his hand at poking my veins and threading/flooding an IV tube. Most every attempt was preceded by some local anesthetic, which made things much more tolerable (though initially painful). At one point, my surgeon came in and held my arm while asking for information about the situation. I didn't think about it at the time, but it was comforting and nice. Also a nice touch were the interns/residents/medical students who offered me their hands to grip while the docs kept poking me.

When the second anesthesiologist failed a second time to get the IV started, one of the docs muttered something along the lines of, "What is this, a joke?" That first surgery of the day must not have been pretty; I'm not sure how good I felt following a case that didn't go as smoothly as planned.

Moments after the doctors finally managed to get a line in me, the primary anesthesiologist said he was sending me off. Almost instantly, my mouth was flooded with a very odd taste. I think it was metallic, but I didn't get much of a chance to assess it before my feet started tingling. "It feels like I'm drunk," I said, in my last words before I went off to dreamland.

Actually, there were no dreams -- none that I remember, anyway. I woke up about two hours later when I was moved from the operating table to a gurney and taken to the recovery room. I couldn't really focus on anything in the recovery room, even when I left it another two hours later, although at times I tried to examine my surroundings. I vaguely recall nurses sitting at a table to my left and coming to my bed and telling me I couldn't leave until my pulsox was at 95. Everything was blurry, and I had some very frustrating double vision.

At some point my brother and mother were brought in. I remember telling them I saw double of everything, but I don't remember much else. My family reports that I complained "my mouth is so dry and they won't let me have ice chips until tomorrow," and that I told them about the troubles my anesthesiologist had sticking me before my surgery could begin. Always a reporter, I also shared some of the dialogue in the operating room before my surgery began.

My family was whisked out of the room just a minute or two after they arrived. And around 7:20 p.m., I was transferred to my room on the eighth floor. Normally, bariatric surgery patients end up on the ninth floor of Lenox Hill, but I was told that floor has been taken over by the cardiac wing.

I'm not sure how lucid I was that first evening. My mother reports that I really was really complaining about my dry mouth. I wasn't allowed to drink anything, but I was given a sponge-like sucker to swab my mouth with water.

The first night was difficult, in that I had a great deal of trouble sleeping. I remember feeling significant pain generally, though I couldn't pinpoint a direct site of the troubles. I woke up roughly every fifteen minutes when the nurses came in, when my IV started beeping, when my cardiac monitor blurted a signal or because I was so very hot.

My nurse that night was one of the best I had; she was new to Lenox Hill from Idaho, and I wonder if that was part of the reason she was so kind to and gentle with me. She brought me a fan after my apparently endless complaints about being hot. She told me I needed to breathe deeply; one of the reasons my monitors kept issuing angry noises was because my pulseox kept dipping lower than ideal. And, she encouraged me to use an incentive spirometer -- a device that measures how much air you can take in on a single breath, and, by its design, encourages you to keep trying to suck in more oxygen.

I slept through most of the day after my surgery, but it started rough, at about 6 a.m., when nurses and aides forced me out of bed for a sponge bath. "You want to get clean, don't you?" one aide said. "Well, honestly, I'd rather not right now," I replied. "Well, you need to get out of bed and get clean," the aide shot back.

You can't blame me for trying. I was in a lot of pain every time I moved, and even with help, moving from my hospital bed to a chair was a rough, rough transition. I washed a little with a washcloth and the aide changed my bed linens.

Just a little later, two doctors came in and took out my catheter. I was pretty out of it at the time, and thankfully, I don't remember much. I kept hitting the button on my patient-controlled-analgesia (PCA) pump, to supply me with hits of Dilaudid.

Shortly after that, I was taken downstairs -- on a different gurney -- for an upper GI. I had to move from my hospital bed to a gurney, and once in the X-ray room, I had to get up and lay against the X-ray machine's table, which was initially vertical and slowly tilted until it was in a horizontal position. If it weren't for the pain of my surgery, this procedure would have been far more comfortable than my pre-op upper GI, which I've already complained about. I wasn't forced to drink a "barium milkshake;" instead I had some other, fairly light, syrupy-tasting substance. And, the radiologist didn't force me to drink tons of the stuff. Initially, I had about four swallows, while she watched on the fluorscope. She asked me if I could tolerate some more, and in the interests of getting a good study done -- and, since the stuff wasn't half as vile as the barium I'd had weeks before -- I went for another round.

My surgeon came in, told me he hadn't been worried because I'd "peed like a racehorse" the night before, but that he was glad to have a snapshot of my new stomach regardless. I'd love to get a copy of the study -- and hopefully I can at least get another look at it. From what I remember of the X-ray, my esophagus looked bigger than my new stomach.

I waited on a gurney at least 20 minutes before someone took me back to my hospital room. By that time, I really had to go to the bathroom, and I was not a happy camper.

I slept most of Wednesday, that day after my surgery. I was in a lot of pain most of that day -- but I can't really remember much of that now, oddly enough. I was also exceptionally nauseous. I also was on a liquid diabetic diet (tea, broths, sugar-free orange Jell-O), and I was learning to tolerating eating even liquids again.

At some point late Wednesday, I was taken off the PCA and put on Torodol, an injectable NSAID, as needed. Initially, that drug had some really pleasant effects. Unlike the narcotic I'd been on, this didn't add to my nausea, and it didn't make me really sleepy. It also seemed to put a big dent in my low-grade fever (of 99.5 or so), so that by the time visiting hours were over and my mom was heading out, I was talkative and thoroughly lucid for the first time since my surgery. I probably would have been ready to walk the halls that night -- and it certainly would have been a smart move -- but with my mom gone and the nurses stressed, I didn't really get a chance.

Even with the Torodol, Wednesday night was miserable. I had a temperature of 100.2 degrees, but apparently, in a hospital, that doesn't count as a fever. Lenox Hill defines a fever as something around 101 degrees. I also was really congested, and I couldn't breathe easily. I insisted that my nurses keep an oxygen supply to my nose, since I felt like I wasn't getting nearly enough oxygen.

My nurse that night, Lisa, was excellent. Early Thursday morning, she told me that my fever and anxiety about breathing was really a function of being in bed so much. I'd walked to and from the bathroom and the bed, but I hadn't cruised the halls by that point -- something I knew I needed to do soon. The more I stayed in bed, the more scary being outside of bed was. Frankly, the biggest deterrent to being out of bed was the pain associated with climbing out of it.

But, Thursday morning, with an aide's help, I worked my way out of bed. I did at least two laps of the hallway outside my bedroom and worked up a horrible, drenching sweat. My face was really red -- and apparently, the back of my gown was gaping open -- by the time the resident who had been assigned to my case and a group of medical students caught me in the hall during their morning rounds.

It was a little embarrassing showing my backside to the world, especially since I'd been holding on so fiercely to the sides of the gown in an attempt to prevent such exposure. Worse was the resident's acknowledgement of my plight: "And can someone get her gown closed correctly?" The gowns for big patients don't have ties throughout (just at the neck), so that was a challenge, but a female medical student helped me. I shot a sheepish look to the doctors; I think my mortification was muted by the drugs I was taking.

At that point, I was still on my IV, which was being used to give me my pain medication, an ulcer-preventing drug (Zantac) and saline and other fluids. But the doctors said I could get off the IV, and Thursday morning, it was taken out. By lunch, Thursday, I'd been switched to a pureed diet.

I did about twelve laps of the halls on Thursday, and each trip got a little easier. One big hassle Thursday was getting my dressings changed; they'd been soaking through regularly and my day nurse insisted the docs wouldn't let her change the dressings on my drain ports. When my resident finally came to work on the dressing Thursday night, he lectured me that the nurses were allowed to change dressings. Here I was, the patient, caught in the middle of this usual and unfortunate tug-of-war between nurses and doctors.

Thursday night was the best night in the hospital; I actually slept soundly from 11 p.m. until 2 a.m., despite the many noises on the hall and in my room (my roommate, who was in for a chronic condition, was in a lot of pain).

Friday morning, the resident assigned to me woke me up at 4 a.m. "Oh, it's early," I observed. He responded that rounds started early on Fridays, and then asked me how I was feeling. "Well, I've been asleep, so I don't really know. I haven't been nauseous, because I've been asleep." Of course, as soon as he left, I was feeling nauseated again, just from drinking some liquid and moving around.

During rounds on Friday, I was told I was being discharged, and by mid-morning, my paperwork was ready and I was free to go.

I was told to call my doctor or report to the hospital if my temperature got above 101.5, if I had sever shortness of breath or if I experienced unusual pain, among other problems. I was also given five prescriptions -- for vitamins, pain relief, ulcer-prevention and to stave off gallbladder stones.

Now, I'm in my hotel, where I've just finished some finely minced egg salad, prepared by my mother. Earlier this afternoon, I had a half a protein shake (two ounces of milk and a half a scoop of protein powder). I'm sitting in a chair, and I'm maneuvering much better than I was at the hospital this morning. It's probably a big psychological boost to get out of the hospital (and to finally get a shower and wash one's hair), even though I wasn't itching to leave the hospital last night, when I was concerned about my mobility in a non-medical setting where beds aren't made to assist you and walls don't have grab bars just in case.

I find I'm still enjoying food an awful lot. And though I wasn't hungry Wednesday and most of Thursday, I now find myself hungry before each of my regular meals. I'm also still feeling pain at the two main incision sites (of five total) that also served as drain ports until the drains were removed this morning. The main incision site on my left side is the one giving me the most trouble. I'm experiencing a steady, stingy pain, as well as an occasional stabbing pain there.

I learned today that the next Lenox Hill bariatric surgery support group is next Thursday, a few hours after my follow-up appointment with my surgeon. I'm looking forward to going, and hopefully meeting some people I've read about on obesityhelp.com.

I'm filing this from my hotel room in New York, N.Y. Tomorrow morning, at 7:30 a.m., I report to Lenox Hill Hospital. My surgery is scheduled for 10 a.m.

I'm nervous, and I am experiencing a few "what if" fears and bad thoughts (What if I get a blood clot? What if I have undiagnosed sleep apnea? What if something goes horribly wrong?). I'm trying not to give those thoughts and fears much attention, frankly.

It's also somewhat surreal knowing that I will be completely out of control and unaware for several hours of my life; the notion of going to sleep and waking up more than four hours later with a completely different digestive system is just inherently odd.

I've had very occasional mini-questions and last-minute jitters enter my mind over the past day, too. "Am I making the right move?" I'll ask myself. "Will I regret this?"

I'm not a fan of IVs and catheters - really, who is? - so of course, that's a source of some anxiety, too. In actuality, that's probably the most anxiety-inducing part of all of this.

I'm not a nervous wreck, but I am taking care to recognize and detail all of my fears and qualms now, just 13 hours before I go under the knife.

My mother is here with me; she'll be at the hospital all day tomorrow, of course. And my brother, a med student in New York (who happened to just finish a general medicine rotation at Lenox Hill) was able to get the day off so he can hang around, too.

Tonight, as one last treat, we had dinner at the Four Seasons. Dessert was a divine chocolate souffle. It's the last time I'll ever eat anything like that again. I'm sure a part of me will miss the indulgence and the sweets, but I'm hoping my newfound health and beauty taste far better than the chocolate syrup and sugar ever did.

My insurance company, CareFirst BlueCross BlueShield, has approved my surgery! Any anxiety I had about my insurance company signing off on the procedure and my surgeon's office getting the paperwork ready in time clearly was misplaced.

When I called my doctor's office manager on Tuesday, she told me she sent the application to my insurer on Aug. 27. She suggested I call to check on the status of the application (I think she sensed my anxiety). At the time, BlueCross was in the final stages of vetting my application. By the time I called this morning, they had approved me.

Now, I'm in the final days of preparation for the surgery. I find myself consumed by practical planning and preparation (making arrangements for boarding my cats, ensuring my colleagues are familiar with issues I normally handle, cleaning out my fridge, doing some preliminary packing, et cetera). I suppose mental preparation will come on Monday, the day before surgery. :)

My mother is coming to D.C. on Sunday night, and we're heading up to New York City by train Monday morning. I haven't been told what time to get to Lenox Hill Hospital on Tuesday, but I suspect I'll be told to arrive sometime in the morning.

I'm not spending a lot of time thinking about this now, but in the past few weeks, I've been excited about my post-op prospects with regard to exercise. I've read so many journals and blogs by post-ops who credit much of their amazing success to exercise programs that include strength training and aerobic exercise. Several credit the workout programs with reducing their need for plastic surgery to remove excess skin and improving their body tones. Similarly, my surgeon has said that there is a definite and obvious (to him, anyway) look to post-ops who haven't exercised. They're flabbier and bulkier up top, he's said.

If I'm expending all this effort to get healthy - and by that, I mean going under the knife - I want to go all the way. I've been looking at gyms near my home and eagerly thinking about how to fit a workout regimen into my life. It's not going to be easy just because I'm losing weight. The big obstacles - primarily scheduling workouts around a hectic job and lifestyle - will still be there. But I know that this is important for my long-term health, and it's important to my attractiveness down the road.

Somehow, I need to fit exercise into my schedule, just as I'll fit the new eating and cooking requirements into it.

My surgery is just over a week away, but I still don't feel any real trepidation about the surgery itself. I've had some anxiety about the IV, catheter and such whenever I talk or think a great deal about them. And last night, when I woke up suddenly, I had a somewhat irrational fear that I might have untreated sleep apnea, which of course affects the safety of anesthesia.

But, generally, I'm not worried about the surgery itself. I continue to be more concerned about adapting to the new, post-operative lifestyle. But even that anxiety has begun to fade away.

Last weekend, I went to Red Lobster with my father (who was in town helping me with some projects in my house) and had five of their yummy "cheddar bay biscuits." I'm not a huge fan of Red Lobster, but the memory of those biscuits lingered from my last visit more than three years ago. Knowing that I might never again be able to tolerate untoasted, soft bread, I decided to get the cheddar-butter-bread goodness one last time.

I'm not stopping with the biscuits. I bought two frozen slices of pecan pie and cheesecake, along with some brownies, which I plan to have sometime this week. As I've explained to my friends, I might never tolerate these foods again (and even if I do, it will probably be in very limited quantities and a long, long time from now). I want to experience these favorites one last time.

I'm not alone. Many other people have done this. Of course, I've read the journals of other bariatric surgery patients, who have "last meals," before their procedures. And, I've seen documentaries on Discovery Health or other channels in which the protagonists have their fill of sugary, fattening treats before going under the knife. I didn't really understand before. In fact, even two months ago, I didn't really get it. But, as the surgery and new lifestyle loom, I find myself behaving in the same manner I questioned just a short time ago.

Over the past few weeks, I've been working to meet my pre-op requirements, including lab tests. I didn't have that many tests, but it took a while to get everything done and to get the results ready for my doctor. My testing orders included: an EKG, an upper GI series (barium swallow), a chest X-ray, a urinalysis and a number of blood tests (CBC, prothrombin time, APTT, chemistry 20, thyroid function, pregnancy test, glycosylated hemoglobin). My primary care physician was able to perform all of the tests in his office -- all except for the upper GI.

Unfortunately, I ended up having to give blood twice because the first collection didn't allow enough blood for the laboratory to do all of the requested tests. (A word of caution: If you're a pre-op and your doc only draws a vial of your blood for testing, he or she might not be getting everything done). Both my primary care physician and I had trouble reading the preoperative physician's order form that specified the tests, and we almost missed one, even on the second try, a week after my blood was first drawn.

No one likes giving blood, and I'm definitely no exception to that rule. Because of the amount of blood required for some of the tests, because we didn't get enough the first round and because my veins are small and tend to roll, I was pricked five times (including once in the wrist area). None of that was fun.

But by far, the worst test was the upper GI series. I had a modified barium swallow a year or so ago for a swallowing problem I was having, so I knew what to expect. But even so, the test is just awful. Essentially, you have to swallow a thick, white "barium milkshake" in sips and chugs while your stomach and esophagus are X-rayed. I've heard the liquid barium described as chalky, but that's not really an adequate modifier for this vile, vile stuff. It's so thick it's hard to suck through a straw. It's almost the consistency of Elmer's Glue -- only it's thicker and probably tastes worse.

Every swallow I took, I gagged. And, each time I swallowed, I was having to fight through my gag reflex just to make my tongue, throat and tonsils work to accept the stuff. Because of the gagging, I had tears rolling my cheeks. Because of my size, the gown I was wearing barely covered me. Because of the stress, I was soaked in sweat, even though the room was a comfortable 70 degrees.

At any rate, the test was dreadful, and I'm glad it's over. I joked to my mother that if my surgeon's assistant fails to get my paperwork in to my insurance company in time -- and, God forbid, my surgery date is postponed so I have to do my tests again -- she will be undergoing the upper GI for me.

All of my pre-op hurdles are now cleared, except for the insurance approval, which is handled by my surgeon's assistant. I'm a little nervous, as I've had difficulties communicating with her before, and I suspect she's not yet called my insurance company, even though my surgery is just around the corner. I'm trying to keep my faith in my surgeon and his staff, and I've been comforting myself with the knowledge that surely my doctor's assistant knows what she's doing. She probably feels comfortable pushing things to the last minute because she knows what various insurers require.

Still, I plan to call her the next business day to check on the status of my application for insurance approval. And, I'll probably call my insurance company to verify that.

But really, I'm calm. :) Trust me.