Adjustable Gastric Band

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Susanne is a 20-something nurse who had lap-band surgery at Penn in 2012. In this blog post, Susanne discusses her lifelong struggle with weight, and the decision she made to have weight-loss surgery at Penn.

Few people feel good about themselves in winter - especially in January when you are acutely aware of the softness that has developed around your middle. Those aren't merely "love handles," they're the red flags calling "FOUL" on all those naughty plays you've been executing at the dinner table.

They're the extra pounds that have been accumulating since the first pass of your hand through the bowl of candy intended for trick-or-treaters, right on through Thanksgiving pie, Christmas cookies, and New Year's Eve champagne cocktails.

In January of 2011 I found myself at my doctor's office for a check-up only to receive a fright that might have been better reserved for Halloween. The scale was clearly not correctly calibrated. Surely, I was not 307 pounds. That was a number usually reserved for contestants on The Biggest Loser!

307 is not a "whoops I ate too much this holiday" number. 307 was the culmination of 20 years of bad eating habits, of consoling myself with sugar and fat, of eating in secret, of 2 attempts at Weight Watchers and countless other fad diets, and plus-sized clothing.

It was also the result of taking high doses of steroids for 6 months after being diagnosed with an auto-immune kidney disorder that had come out of left field earlier that fall. My physician was minimally empathetic, telling me that individuals were capable of managing their weight while on steroids and that I could hardly use my medication regimen as an excuse. Devastated seems too soft a word for the feelings I had at the time. Rock bottom feels appropriate though cliche.

A Struggle

I didn't consider it an option to remain at that weight. As a nurse, I knew all too well that I was already at risk for any number of lifestyle-related illnesses: hypertension, diabetes, cardiac disease, sleep apnea and on. I also knew that I felt out of step with all of my friends who enjoyed active lives that included running marathons and hiking. I felt that I might as well be standing at the bottom of Mt. Everest without any climbing gear.

I was 25 years old and had gotten myself into a royal mess.

I had considered bariatric surgery almost 2 years prior to this incident in my doctor's office but my insurance coverage at the time was not covering any of the available procedures. In my disappointment, I talked myself out of the option and told myself that I would lose weight the "natural" way. The "natural" way has always been considerably difficult for me. I would put in a great deal of effort in changing my eating habits, reducing my calories, and sweating at the gym for very little reward. One pound here, another there, but there was never any dramatic decrease in pounds. Eventually, I would become discouraged eating so little food, counting every calorie, and agonizing over whether or not I could get away with 30 minutes at the gym or if I should push myself for a full hour.

Maintaining a very strict diet was hard at 25 when socialization is focused mainly on food and alcohol. No one wants to go out with friends and sip water. In February, I started my first nursing job and more or less put my weight struggles aside. I was able to stop taking the steroids later that spring and a minimal amount of the weight came off without any intervention, but I was still hovering between 290 and 300. In August, I had a frank discussion with both my primary care doctor and my kidney specialist. We discussed bariatric surgery and I felt ready to pursue the option, especially now that I had an insurance carrier that was willing to approve the procedure.

Preparing to Change for Good

I decided that the laparoscopic gastric band was the most appropriate surgical option for me. I found the staff of the bariatric surgery clinic at Penn Medicine to be extremely encouraging and supportive of my choice. I spent 9 months with them before the procedure. I might have much preferred to get the results I craved right away but I now appreciate the months I spent going to the support group meetings, improving my knowledge of nutrition and exercise, and the thorough medical assessments needed to ensure my health and safety.

My surgery was completed in May 2012 and I am learning to use this new tool that I have to manage my weight. It felt like such a relief to know that I now had help in achieving my goals. It is still difficult to change my habits and behaviors but my changing shape and increased endurance motivate me to continue to live a healthy and active lifestyle. It has been exciting to fit into clothes that I hadn't worn in over a year and to buy smaller sizes from my favorite stores.

On a recent trip, I no longer needed a seatbelt extender on the airplane and I didn't feel that I was smothering my neighbors. I started a running program and marvel at my new capabilities in the gym. Even though the scale doesn't always show me dramatic results, I know that I have lost inches in places where I lost fat and gained muscle. For the first time, I am excited about continuing this weight-loss journey. I finally know that I am capable of success.

This winter, I look forward to feeling better about myself even after the holidays are over, to being in more pictures, and to bundling up because I am cold not because I am trying to hide my body.

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