It’s been a week since my pulmonary doctor appointment, and I’m feeling much improved from the bronchitis. I still have a bit of shortness of breath (especially when climbing the two double-flights of stairs in my work building). I’ve cut my usual soda consumption dramatically…in the last week I’ve had 1 20 oz bottle, sips of Taylor’s big fountain drinks, and two cans of Diet Dr Pepper. I’ve gone over 24 hour since my last caffeine…and I’m feeling it. It’s so hard to cut it out completely, especially with all my daytime sleepiness. I suppose that now I’m in the South, and live in the land of Coke, and work for “Coca-Cola University,” I should just call my fizzy addiction Coke instead of soda. At least I don’t snort it.

I’ve been doing a lot of research this week on bariatric surgical options. I’m pretty certain that if I do surgery, it will be Lap-Band. I checked with my insurance pre-auth department, I meet the requirements for medical necessity, and they pay 90% up to my annual max, and then will pay 100% of the remainder. My max out of pocket cost for the year is $1125. So if I max it out with the surgery, any medical care for the rest of the year will be free. My upcoming sleep study will take up some of that money, and I opted for $1000 flex spending benefits for the year….so realistically the cost to me will be negligible. Nothing more than my $45/paycheck flex cost and a few other copays.

My mom and husband are very supportive of the surgery, almost too enthusiastic about it. Both have seen the ways I’ve struggled, persisted, and suffered to get myself healthy for the past 5 years. But if I had to make a decision RIGHT NOW….it would be hard.

Another reason it feel urgent to me is because I’ve been feeling emotionally ready to get pregnant for several months. I had 26 friends have babies in 2008 and I felt like I was missing out. I haven’t ever felt like my family was complete, and I don’t want there to be such a tremendous age gap with Rosie that she feels like her sibling is too young to be close to her. I also don’t want to have a baby any later than about 33. I am fairly certain I will remain a career woman, and want to have some independent time without kids at home before I retire. But I don’t want to get pregnant until my health is under control. I weighed 255 when I got pregnant with Rosie, and lost 30 pound in my first trimester because I couldn’t keep anything down.

Ever since my doctor appointment Wednesday, I’ve been thinking often about having surgery. In some ways it seems like a cop out. I’ve always believed that weight loss should a personal journey of cutting back, becoming more active, and changing the way you use food in your life. But at what point does it become impossible to make the changes you need in a drastic enough way? When is surgical intervention required? I’ve already done medically-assisted weight loss, using Phen-Fen both in 1995-97 and in 2007. The first time I lost 53 pounds, which made for a much more enjoyable high school experience. But as soon as I stopped the pills, I ballooned out to my starting weight within 3 months. When I tried again with a doctor in 2007, I’d lost 13 pounds in a month, but I stopped because of the high cost, many unwanted side effects from the pills and a crazy food plan I couldn’t stick with (which included 90% meat and protien, no fruits and only a handful of veggies).

I’ve done Weight Watchers 6 times, South Beach Diet, Sugarbusters, Intuitive Eating, and a mass of other plans. But once I hit the 25 pound mark, I plateau and eventially gain it back. With a track record like this, how can I lose 120?

I told my mom about what I was thinking about the surgery, and she said that I should do it and not tell anyone. She also said I’ve been chubby since age 1, and she’s seen me put more long-term effort into weight loss than anyone she knows. She thinks I need to do it as a “shortcut” so my other healthy behaviors make a difference. But I hate the idea of a “shortcut.” I want my results to be based on how I’ve impowered my life, not because of a scalpel.

That being said…lap band is looking more and more tempting.