I had my 1 year post-op follow-up appointment yesterday. It ended up being with the nurse practitioner. I was kind of hoping it would be with the surgeon, but I kind of knew it wasn't a likely possibility given his busy schedule. I went prepared with all of the questions/issues I'd written down over the past few weeks in preparation for the appointment. My weight on their scale was 144 lbs which is 3 lbs higher than my scale, but I was wearing clothes and shoes and had eaten. So, I didn't let it bother me. That weight puts me at 130 lb loss from my pre-surgery weight. The NP showed me a chart of my loss over the past year and the percentage of excess body weight that each number represents. So, as of yesterday's number, I was at a 98% loss of excess body weight when an ideal body weight of 134 lbs is used. I don't know where they get that number, the IBW, some chart I guess. But anyways, she said she was very happy with me at my current weight. I expressed my desire to get down to my goal of 135 lbs, and she was ok with it as long as it doesn't get below that.
One of my questions was about weight maintenance strategies, and that was answered by a "new" diet. They want me to increase my calories to 1200/day, but I won't start that until I reach my goal. It's not a whole lot different from what I'm already doing, though, so she said that once I reach my goal if I continue to lose weight to give them a call to re-evaluate. She asked me to keep in mind that the number on the scale is just a number and that it's how I feel that matters, but that number is part of how I feel. For me, 140ish is still too much. Yes, I'm wearing a size six, something I never thought I'd be able to do, but I'd like to be a solid size six. And, some sixes are still a bit tight on me, so I think losing the last 6 will get me there. I also I have a pretty strong desire to really start toning things up even though I do recognize that toning up certain areas won't help the loose skin situation.
On that subject, she did mention that she could refer me to a plastic surgeon at their affiliate hospital, Strong. She said that for an abdominal tummy tuck, hip to hip, w/ a regular plastic surgeon the cost would be about 10-12k. But, they have a residency plastic surgery program where the head resident does the surgery (and gets 1k) and the hospital costs are about 3k. So, it's a pretty significant cost reduction. She said she'd recommend I not consider it until I'm finished losing and only after having children (if there are any plans to). But, given the cost (even the 4k option), it's unlikely I'll do it. There are many other much more important things that need my money right now. And, she said that my skin isn't that bad; most of the time, I agree with her ... but not always.
I took the bloodwork results I had from late April with me, and she said everything but the B12 levels looked good. It was at the low end of normal, but they like it to be a bit higher. So, she's going to wait until the results of the blood draw they took to decide whether or not to put me on a supplement. Oh, and she did suggest I start a calcium supplement again. So, on the way home, I stopped at Sam's and picked up a box of the Caltrate Creamy Lemon chews (thanks for the recommendation, Sandi!). They're quite yummy!
We discussed my exercise habits (one of the reasons she's concerned I may continue to drop weight), and she was quite pleased. She said that I'm above average in the amount and level that I regularly do; I was surprised by this. I mean, I figured people would be more apt to exercise after having this surgery given that it's just so much easier, but apparently, in her experience, people still don't. They say, oh, I walk the dog, or I walk around the block sometimes. I guess it all depends upon the person. Yes, I did allow myself to get to 274 lbs, but I'm still the type of person that somewhat thrives upon exercise. I get tremendous enjoyment from it. Now, if summer would ever hit here (it's finally somewhat sunny here today but it rather chilly w/ the wind) I'd be able to do things outside again.
I also had somewhat of an ah-hah moment with her. I remember thinking the first time I met her "of course, she's really skinny". I figured she was about a size four. So, when we were talking about my weight, how happy I've been with the loss, etc. I mentioned how I was wearing size 8 jeans and had a couple of size 6 pants, and she said, wow! wouldn't that be nice. Incredulously, I said, what do you mean? Aren't you a size four or something? She laughed and said, no way, at the smallest I'm a 10! I was dumbfounded! Guess my perception is still rather askew.
In wrapping up the conversation we had, I mentioned how happy I am with my results. She said I, of course, had every reason to be very happy and that she hoped I recognized that my success is only partly due to the surgery. Yes, it played a big part, but the work that I've done over the past year is integral in my success. She mentioned that she's had other patients come to her and ask her to tell Dr. O'Malley thank you for their weight loss, that he's their only reason for losing weight. So, she just wanted to make sure that I wasn't thinking this as well. I let her know that I do commend myself for my success but that I also recognize that Dr. O'Malley's experience, knowledge and skills played a part as well.
I'm off to Chicago on Monday morning. I'm really looking forward to the trip even though it's for work. The work stuff doesn't begin until Tuesday morning and lasts through Thursday afternoon, so I'll have Monday evening and most of Friday to enjoy the city. Yippie! I plan to go to NoMI for dinner Monday night and do the Frank Lloyd Wright Home & Studio on Friday. I'll try to post from Chicago, but if you don't hear from me, I'm sure I'll post a full discourse when I return. ;)