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Away We Go!

I've been in planning mode ever since I got my pre-op date last week!

I've got lists on lists on lists! Shopping for the liver shrink, a few basic staples for the post op diet as well, what to take to the hospital, meals to cook and freeze for the husband, paperwork to complete, chores I want done prior. I am always happiest when I have things to check off, and man, did this give me those organizational feels :D 
So today, I finally met my surgeon. There are two at OSU, and I have previously met one of them, as she is the one who did my EGD. I really liked her, but she has less availability overall because she does a lot of general surgery as well as bariatric surgery, and she was also taking two weeks off in November, so they scheduled me with Dr. Needleman. I feel very comfortable with him after today, and he was very thorough and took his time with me. We signed consents today. I also signed consent for the research study I am a part of to have the surgeon take a few biopsies while they're in there. 
I then went on to meet with the dietician. They'd already sent me the stuff for the liver shrink diet, but we met to go over it. Ours consists of 3-4 protein/meal replacement shakes a day and either 6 ounces of chicken + non-starchy vegetables, or a frozen entree from a pre-approved list. I still haven't found a ready-made protein shake that isn't sickeningly sweet to me - I have so many just hanging out in my fridge! I do find them a bit more tolerable if I can dilute them, but I did discuss with them I do have protein drinks I dont mind - syntrax, namely - but they arent "meal replacement". He suggested doing half and half - half meal replacement and half protein drinks.  
After the dietician, I went on to meet with Suzy, the surgeon's assistant, who confirmed my surgery date of the 29th (!!!!!) and loaded me up with all the instructions. They also give you an incentive spirometer ahead of time, and two gatorade-like drinks. I have to drink one the day before, and one 4 hours prior to surgery. After I got back to work, I gave my boss the news (although as far as work knows, this is hernia surgery. I have several outspoken coworkers who are against WLS and I don't have the nerve to deal with them while going through everything). 
My liver shrink officially begins the 15th, although I am currently drinking a normal protein drink (syntrax nectar) once a day currently rather than snacking. They actually said they're fine with me partaking in Thanksgiving, just to stay away from starches and stick with meat and veggies, which is fine by me. 
I've been continuing the hiking every weekend. I pushed through two weekends ago and went to a really well known state park about 90 minutes away on a 34 degree drizzly morning. Most of the trails near me are pretty well maintained, but many of the trails here were nothing more than mud slicks and rocks - which is sometimes a lot of fun!
My calves were murder for the rest of the week, but these three views alone were worth it, albeit I need to go back on a sunny day :D A waterfall, a cave, and a beautiful big lake in a valley. 


Updates galore :rolleyes:

1) I finished my last classes on Monday and did my final fit test and exit interview for the Living Well program yesterday. On the one hand, it feels like this has been the longest 6 months of my life, and on another, it feels like its gone very quickly. I even made my initial deposit on the surgery.The only thing that really sucks is they told me they were going to submit to insurance, and then told me I needed a letter of necessity from my PCP. At no point in the past six months, nor on any paperwork, have I been told I need that. I love my PCP but he is unfortunately the type that to get any paperwork signed, I'll likely need an appointment and to shove it directly under his nose to get it done. Sooooo close and yet so far :)
2) So last Wednesday was supposed to be the big day of the research study. A full 12 hours of being hooked up to various IVs and machines testing how my body processes glucose. I got there at 545 am....and left at 745 am, after two hours of them attempting to get dual IVs in me. I'm not normally a hard stick, but vein after vein kept blowing. They finally exhausted all options and sent me home. They and I want to reschedule, but they need it done prior to my pre-op appointment apparently, which could easily be this month, and they arent sure they can get me back in that quickly. They hinted at wanting me to delay my surgery to get me rescheduled, but I'm not game for that. So we'll see!
3) I joined a gym, as the weather is getting cooler and before I know it, I will have every excuse to not get out and walk or hike. Also, because speaking of hiking, I know strengthening my legs would super improve my endurance ability for hikes, so my goal for cold weather is to come out swinging as soon as snow melts off the trails in spring. Theyre developing an old quarry into a metro park near me, and I'm psyched, but it looks like the trails in it will be considerably tougher than what I've been doing so far, so thats considerable motivation to hit the gym and get stronger!
4) My little brother in the military has made it to Tennessee. They were initially planning on sending him all the way home (Ohio) for his hernia surgery, but now they are keeping him there for it. We'll probably be traveling down to see him in the next couple weeks. 


I knew once I signed a contract saying I'd keep my weight stable for this research study, I'd break that damn plateau. True to my word, I finally - FINALLY - fell below 300 pounds at last week's weigh in, and at Monday's weigh in, dropped another pound. No one at the study can tell me exactly what they consider to be stable - 5 pounds? 10 pounds? 5% of my body weight? - so I'll just keep chugging along. Even losing a couple pounds a week, I shouldn't lose more than 6 pounds before the pre-op phase of the study is over, so I'm focusing on the good - which is finally falling through that plateau!

I had the second visit for the research study today. I did indirect calorimetry - wearing a really tight face mask for 30 minutes to measure my calorie burning at rest - and a long form glucose tolerance test with blood draws every 15 to 30 minutes. They had an issue getting my sugar to come back up after I drank the sugar drink. My fasting was 85, and peaked at 146 about 30 minutes later, and then quickly returned to 85. Then 68. Then 60. Then 54. They called the doc, who said they could keep going as long as I didn't get symptomatic. I didn't feel shaky, just tired and headachey, which was more from lack of caffeine. Anyway, 3 hours later, my sugar was still at 62. Upside, they gave me a sandwich and orange juice before I could leave. 

I have my 3rd out of 4 "life after surgery" classes this week, and only 4 more of the "Living Well" classes left as well. I can't wait. The classes have been great and the people who have been with it the longest are like a mini family group to me now, but I'm so ready to move past it. I do think it'll be a great resource for the future, though, as they have similar classes for post-ops that need reinforcement or to get back on track or just to have motivation. 
Also, I went hiking this weekend. Have been getting bit by the "get outdoors" bug and started researching local hiking trails and parks and was blown away by how much there was to do. Went down to a park here that normally has bison out roaming. Naturally, there were none to see when I went down there, but I tromped around a couple short trails and then some wet prairie. Made a side trip to an excellent waterfall before I returned home. I can't wait to go try another trail at a different reserve this coming weekend! 






So two kinda cool things:

First, I finally decided on a surgery, and I'm going with the sleeve. I've been weighing things heavily, and was more recently leaning towards RNY, but after a frank discussion with my cardiologist and the NP, my occasionally necessary use of high-dose NSAIDS would be more problematic if I had an RNY. Since the stomach stays in you in RNY, I could still develop an ulcer from NSAID use. Since that stomach is no longer accessible via EGD, however, I'd need surgery to fix it, and that's not something any of us would be happy with. I also have some interest in seeing how getting rid of the ghrelin and leptin receptors in my body could help me, so I'm trying to be super positive :D 
Second, I was contacted by my hospital university to take part in a research study regarding patients cognitive changes and metabolism changes after bariatric surgery. I find the science behind bariatric surgery fascinating, so although some parts of the research totally sound not fun, it's pretty well compensated and I get a free liver MRI and DEXA scan, among other things. It's really only two days both before and after surgery I give to them, although one of the days sounds ugh...I essentially have to stay in bed for 10 straight hours while they put sugar and insulin in me to measure my sugar metabolism. After I've lost 15% of my pre-surgery weight, I'll repeat the two days of testing. Upside, the payout from the research will put a very nice dent in what I owe for my surgery.
In other parts of delila-land, I am still stuck in my little plateau, but unbothered by it currently because I feel great, and I now need to keep my weight within a 10 pound range for the study. We hosted a little Labor Day cookout for friends and neighbors yesterday, and fun and good food was had by all and I find lately Im not even tempted by a lot of food. 
My dad is having back surgery this week after fracturing his T7. My mom just got out of the hospital after a canker sore got crazy infected and she needed IV antibiotics. And for more fun, my little brother, who is currently deployed to the middle east, has a double hernia and needs surgery and currently they wont let him come home - current plan is to send him to germany for surgery and they'll even make him make up whatever time he stays for recovery and add it on to his deployment. Ugh. I can't wait until this time next year. God willing, no more medical things going on with my family and my brother will be home safe and sound. Whew!



Four weeks at the same weight, so last week, I really crunched down, you know? Lunches around 300 cals, dinners around 500, totals between 1200-1300 a day (I am pre-op). High protein, low carb, all the water.
I gained 3 pounds at last weeks weigh in. 
No doubt its hormonal (grr) water weight given the timing but man. I would just like to see the scale go down for the first time in over a month!
At least this week I am back down to the same damn weight I've been plateauing at. How I can hit a plateau this long when Ive only lost 11 pounds, I have no idea. 
ANYWAY, on a note that isn't crying over my scale being a jerk, last Tuesday I had my mid-term fitness eval. I'm a few weeks past the middle of our classes, but thanks to the the boot, I couldn't do the eval prior. I can hold a wall sit for 20 seconds longer and do four more pushups than I could twelve weeks ago! Its not much, but I lost a lot of activity when I was waylayed by the boot for 4 weeks. 
I put sticky notes on the back of my bathroom door so I see them every morning. I overall don't have an issue sticking to the diet (given I have to be accountable for classes and weigh ins!) but sometimes I need a reminder of what I'm doing this all for. Things like "to travel comfortably" and "to finally have children". I'm not typically someone into mantras or affirmations, but the visual reminder daily is helping a bit to look forward to the changes rather than be annoyed that I'm eating cauliflower. Again. <_<
In the real world, I'm annoyed and irritated constantly at my current job and just not super happy here. The job is mostly me endlessly nagging diabetics and heart failure patients to stick with their diets and take their meds. To top things off, I apparently dropped my badge in the parking lot (I have no idea how, its incredibly loud, so Im not sure it wasn't stolen from my car) and it was used to break into our facility overnight by a couple people known for arson. Truly wonderful to walk into work and find an email directing you to call the police. 
So they really just needed a statement from me basically saying I didn't knowingly let them have access to the building. I went through security hell to have a badge reissued to me, and as I was coming back to work, an elderly lady on oxygen fell over a bump in our parking lot and hit HARD. Broken foot be damned I went flying towards her. She wrenched her shoulder hard and I couldnt stand her up because of the pain. We waited for a squad, getting nearly hit by a car twice in the process (one of them being anothe rpatient who refused to wait to leave, despite the fact the fall was behind her car).
It reminded me that emergency, trauma, and "real" medicine is what I love. I like the relationships I have with my patients but nagging people is not my jam. Grabbed my GRE book and started studying so I can apply for my NP for real this fall, rather than just talking a good game about it for forever.
Puppy tax for long windedness - him and his lil "bow chicka bow wow" collar :D 


(holy crap already 8 weekly entries? I don't feel like its been two months...)

So my MRI cleared my foot and the reigning days of das boot are over! Which is fabulous, except my foot still hurts like mad. Docs aware, he just kinda shrugged and ordered some physical therapy for me to see if that helps. Grr. Physical therapy starts tomorrow.

Last week was an exercise class, and I powered through 2.5 miles on the recumbent cross trainer like it was my job :D Now that the boot is off, I'm going to spend the week researching more about the gyms in this area, although I'm pretty sure I'm going to be joining this one. I'm hoping this week I'll find out if my hours are being changed, which would super help with making time for the gym. The changes won't go into affect for several weeks, but that's okay given the limitations with my foot. 

Last week's class was otherwise about long term success with exercise - how to not burn out, try new things to stay interested, etc. Nothing mind blowing, but a solid course. I think today's class will follow in the same vein - long term behavioral success.
My EGD was Friday, and it went alright. The resident introduced too much air into my stomach and I had the weirdest episodes of long belching while they were trying to take biopsies of my stomach. I'm pretty sensitive to sedatives and don't remember anything else. I dont even remember talking to the doc (who is also a bariatric surgeon) after. Thankfully my DH was present and they gave me a printout of everything. Other than some mild gastritis that they're putting me on prilosec for, everything looked really good. 
Overall, I can't complain, as beyond synthroid I was on no meds prior to starting this, but in the past 4 weeks, but I am now up to 5 pills a day and it feels so foreign to me. I'm horrible at remembering to take everything (which is pretty sad coming from a nurse!). Getting myself a little weekly pill minder to carry with me this week in hopes that helps and gets me in the routine of taking everything, as I know I'll be adding at least 1 or 2 supplements after surgery as well.
Ended up having crazy dreams bordering on hallucinations (I kept dreaming people were outside my window, or that my puppy was thrashing about in his crate, and would feel so strongly about it I'd wake up and check the windows or the pup), but no other untoward craziness :) 
So that's the last major testing hurdle prior to surgery! Now just minor hurdles: finishing my 6 months of classes, meeting with the pre-anesthesia clinic, and meeting with my actual surgeon to set the date.
My DH has been supportive but nervous about this entire shindig. One of his favorite youtubers, Boogie2988, just went through a VSG last week and has been really open about his process and is sharing it on youtube and twitter. He's been showing me the videos and I really hope it helps lower his stress level regarding it, to watch someone he's a fan of go through it for the next few months while I prepare for mine :) 



This week. Whew. 

Monday, I was annoyed in the morning to weigh and still be the same weight as last week's weigh in (3 weeks now of only plus or minus a few ounces). It had me in one of those WHY BOTHER THEN?!?! kind of moods. I stuffed up and ate my stupid chicken and spinach all the same. Weigh in went as expected (6 whole ounces down). It is just wholly frustrating to eat 1300-1400 calories a day (sometimes even less) and not see anything like the weight loss they say you will! I know you all know that pain :) On the upside: I am 6 ounces away from being under 300 pounds :D:D:D 
Yesterday was my cardiology eval to get clearance for surgery. No problems there. They repeated an EKG (which makes it my fourth this year!) and it looks the same as ever (some permanent damage from years ago), so he happily gave me approval for surgery and wished me lots of luck. 
Today was a follow up with sports medicine about my stupid foot. Unfortunately, he's super unhappy about the healing (or lack thereof) and ordered an MRI and for me to be in das boot for the foreseeable future. MRI is this Friday, here's hoping things are alright, I'm terrified that this fracture will need surgery and that will delay my bariatric surgery.
Overall it's been a busy week! Next week is my EGD, which (I think?) is the last big obstacle besides finishing the next 2.5 months of preop classes. And I get to take the day off work for it, which is a total bonus. =] Hope everyone is having a lovely week!


I share my office with another nurse, who lost 70 pounds last year after a visit to her doctor put her in the prediabetes range. She ate a ketogenic diet for 6 months and dropped it all. Since taking a desk job and stressing about a few things in her life, she's gained some of it back - and while she constantly talks a good game about needing to get the weight off, she's also one of those "frenemies" who constantly tries to push you into eating something. I don't think she does it meanly, I think she wants me to keep eating the way I used to because then I was her excuse, you know? "Delila ate x, so I ate some too!" But for the past couple months I pack a healthy lunch most days and this seems to have almost made her more aggressive. 

Yesterdayy, I ate what I take pretty often - chicken salad that I fork onto small slices of cucumber to eat. It's a nice meal to try to focus on eating slowly and listening to hunger signals, and the cucumber helps keep me from wanting to drink too soon. She asked me three times if I wanted anything from a local sandwich shop and I told her no, pointing at my lunch. She said, semi sarcastically, "Oh, so healthy" and rolled her eyes. My boss also brought in brownies as its been one year since our office opened, and my officemate started in about that too, that I wasnt going to have "at least some?". Mondays are my official weigh in days for my pre-op program, and she knows as such. She offered me a pickle as well, and when I declined I got a rather harsh "Pickles don't even have calories!" I've tried explaining before it isn't about the calories - it's about the fact I'm satiated and don't need anything further, but it just falls on deaf ears. 
I finally told her it had to stop yesterday. I despise personal confrontation. If someone is interfering with a patient, I'll be on your butt so quick you can't even blink, but when it comes to defending myself...not so much. Asking her to stop and respect that I'm doing what I need to do to get healthier was super hard, and she took it wrong ("I'm just saying a little brownie won't hurt you, I don't know why you're so upset" etc) and we sat in an awkward silence until it was time to leave. I can suffer through some awkward silence for awhile if it means the badgering stops, though. I have enough food demons to battle without someone I sit next to 8 hours a day encouraging them!
TLDR: badgering coworker finally put in her place (kinda). 
I also had my weekly class last night. Only a few ounces lost, but between hormones (TOM) and having a broken foot reducing my activity, I'll take it. At least its not a gain!  Last night's topic was "Self Care". Was pretty interesting to see everyone's different definitions and rituals for psychological, emotional, and relationship self care and how it can relate to weight loss. Several people graduated over the last couple weeks, so our class is a bit smaller now and kinda cozy with each other - its made it less of a chore to attend for sure!
Puppy tax for long winded personal issues posting :D This is my patriotic pupper, Wifi. 




No class last week because of the holiday - right back at it this week with a weigh in and group exercise class followed by an exercise lecture. However, I found out last week that I stress fractured my foot!

Whomp whomp :( My motto was all 'go big or go home' but I think I went too big :) I've got a big ol' walking boot for the next four weeks. Upside, I am allowed to bike as long as my foot doesnt hurt when I do it, so rather than jumping on the arc trainer during our exercise class, I got on a recumbent bike with huge pedals I could fit my boot into. My nephews love my big boot, they think it makes me look like a transformer :P
Two weeks ago, between the heat and some general apathy, I wasn't doing well in the motivation arena. I wasn't cooking, wasn't eating healthfully - the only thing I did was watch portions. I was eating crap, but at least it was...less crap? Funnily enough, after a few days of that, even looking at fast food had me nauseated, and I rebounded like crazy. Cooked every single night and made all my lunches except one for the work week. At my weigh in this week, I was a total of 10 pounds down from where I started. It's not amazing, but it's a start!
Saw the NP and had the official pre-surgery nutrition visit. Both said they see no reason I can't have surgery, although I need cardiac clearance thanks to a history of swelling around my heart. I already have the cardiology appointment scheduled, so now just a matter of getting my EGD done and finishing the last 3 months of classes!




When I started looking into WLS, I was 75% sure I was just going to go with a lapband. Easily removable, I thought. No big malabsorptive issues. Just a bunch of restriction - a kind of hand-holding into making me eat the way I need to. 

Then I began my real research, and saw the complication rates were higher, and the amount of appointments necessary were higher, and that overall weightloss was considerably lower. Many people complained of still feeling hungry - which makes sense, when you consider that the rest of your stomach is still there, still largely empty, and still playing on hormones like grhelin to mess with satiety. 

So I began to slowly embrace the idea that "real" bariatric surgery was my answer. I've come a long ways since being stalwart in my belief that I didn't need WLS - even if it took me years to get there. For the last couple months, I've been pretty set on VSG. 

Lately, fear is creeping in as I read the experiences and see the weightloss of those with VSG versus GB. Don't get me wrong, I see plenty of people who have done absolutely exceptional on VSG and I know it can work - I'm terrified I will make it not work. That I'll end up being one of those people who eats ice cream as a "pureed" food, manipulates what can go in, and will suffer with little weightloss because of it. That I'll need the further restriction and malabsorption offered by a GB in order to have real weight loss. 

I've devoured every thread on "how did you choose?" here on TTF and I know that some of my questions will be answered when I finally have that sit down with a surgeon, but in the meantime, I keep adding to my list of "Am I going to be one of those people who goes through a major surgery just to sabotage it?" 

I try to shake off the thoughts - I wouldn't be surprised if they're fairly normal. I'm doing well in my pre-op classes (small gain this week, but there was a considerable amount of partying for my parents anniversary this weekend). I understand all that the surgery brings, and I think seeing success after surgery will be a fabulous motivator towards continuing the plan. 

All that certainly hasn't stopped the "what ifs" though! <_< The mental part of weight loss is certainly exhausting. 



Another week, another weigh in, another tiny bit closer to the operating room!

This was a stupid stressful week - my dad (who is 5 months post liver transplant for hepatopulmonary syndrome) has been in a lot of weird pain this week, and my youngest brother was in a serious car crash. He's doing surprisingly okay, besides some stitches and a mild concussion and a lot of bruising, thankfully. 
I also happened to be diagnosed with lupus this week, which is kind of a total shock, and I hope it doesn't affect my chances at surgery. I'm not medicated, as I barely have symptoms (the only thing that prompted the testing even is a non-ending face redness in the typical butterfly pattern) so since I'm not on steroids or anything, I hope it won't mess with my weight loss.
My weigh in went okay - down another pound. Slowly but surely! I'll take it considering it was so hot last week (over 90F every day) that I was loathe to come home and cook over a hot stove, so I wasn't nearly as on-the-ball with cooking and leftovers like I normally am - we ended up eating out way more often. However, when I'm stressed, I don't eat as much (I am the opposite of an emotional eater), and I almost feel like that balanced it out, ha. Thankfully, this week is cooler and I have a nice bunch of dinners planned out for the week. 
This weeks class was #8 out of 24. I am slowly but surely counting them down! Our topic this week was was about negative self talk and the feelings that come along with being overweight/obese (shame, disappointment, etc). It was a very interesting discussion, and I was surprised at the different things people in the class endorsed as their #1 emotion over their weight - things like loneliness, for example. It was definitely a good class. 
Got a sampler pack of Syntrax Nectar, and have enjoyed them quite a bit - thanks for the recommendation @jen581791 ! It's nice to get away from protein powders that need some form of milk to be tolerable. Also, Unjury's chicken soup protein powder is also good when I want something warm. 
Currently counting down until July 6th, when I meet the surgeon's nurse practitioner and get some preop work done, like the EKG. I can't wait - I feel like that'll make it more "real" :)


I'm so excited to be on this pathway, and at the same time, I have so many regrets. In 2013, I had actually applied for the surgery. I was told to schedule for psychiatry, which threw me off and I abandoned the process without a look back.
Then two years ago, I had a doctor prod me in this direction. After 3 years of off and on infertility treatments, my SO and I were told the next step was IVF. Which was terrifying, as very few insurances pay anything towards it, and the cost of ONE attempt is more than the down payment on my house. 
The doc told me then he had a physician friend who specialized in weight loss surgeries, and that he thought it would be best I lost 20-30% of my weight before I went spending that kind of money and trying IVF. I kind of froze, shaking my head. I have a personal trainer, I thought desperately. I'll lose this weight. 
I knew better. I knew better. I know the stats about people losing weight on their own vs WLS, especially with hormonal issues (PCOS and the all too common thyroid issue in my case), and still I stubbornly refused. I got on the phone that day with my mother and my husband and told them I was dropping treatments for awhile to focus on losing weight. 2015, I said. 2015 will be the year of the weight loss, the year of the baby. 
And here I am, halfway through 2017, 15 pounds heavier than I was then, nearly in tears at my first weigh in with my LW Classes six weeks ago. It was the highest weight I've ever been. I've lost 7 pounds since then and had to fight tooth and nail for every pound. 
I'm SO excited to finish my prerequisites for surgery and get this ball really rolling. That's in large part thanks to you guys. I had initially surfed around the internet and saw so many people complaining of regain and stretched pouches that I was still hemming and hawwing over what to do. But now that I'm here, and I can see constant, real-life examples of people who are truly making it work - now that I've seen those who failed didn't stick to their program - now that I've seen it's totally a manageable thing...I can't wait. 
That excitement propels me through the exercise and the salads and the lack of sugar. But the regret sometimes weighs me down. Where would I be if I'd started this 5 years ago, or even 2 years ago?
I know there's nothing I can do to change it, but that knowledge unfortunately doesn't stop the regret. In some ways, that regret keeps me moving to get all this done so I can have the surgery as quickly as possible. I'm lucky that I now have an insurance that not only covers 70% of WLS, but also at least one attempt at IVF, which is pretty rare. I want to take it for all it's worth!
Tonight is class night, and exercise class at that! It's so nice to exercise as a group, even if we are each kind of doing our own thing. Then a quick lecture afterwards and a nice free night after that. 
Hope everyone is doing well :)

Today, I met with a psychiatrist for my pre-op psych appointment, and thought it may be about time I started logging my expedition :)

A little background on me:
I'm 32, a registered nurse, married with no kids, but the kickass aunt to three nephews and one niece. I worked ER and critical care for years, did one year stint as a prison nurse, and currently work as a chronic care manager. I am the person who calls to (politely!) tell/encourage/bribe people with heart failure and diabetes to take their meds and follow their diets to try to keep them out of the hospital. As a side job/hobby, I narrate audiobooks :)
I've always been a little overweight, but problems really began for me in college. I didn't gain a freshman 15, I gained a freshman 50. I'm not an emotional eater, but instead struggled with mindless, constant grazing. I could devour a bag of chips and a jar of salsa while studying and not think twice before then going to the cafeteria and eating the nutrition-less slop there as well. After college, I maintained my (obese) weight for a few years, gaining ~5ish pounds a year, until I entered nursing school and tossed on another 50 pounds, again from mindless grazing and cafeteria food. 
My parents just opened a popcorn store, too. God help me. 
Anyway, although I always maintained the attitude of "sure, I'd like to lose weight" I was not someone whose self confidence was tied to their weight. In fact, I often don't feel like a morbidly obese person at all. I don't yet (knock on woood) have any health problems associated with obesity. It wasn't until my husband and I began trying for kids and my reproductive doc mentioned surgery to lose weight to make pregnancy chances better. And that was 18 months ago! I decided I didn't need surgery, and forged ahead with diet and exercise like a fiend. Like every other diet attempt, I lost motivation when I hit a plateau after 3 months. My doctor put me on saxenda, which I oddly gained a considerable amount of weight on. Still I refused to entertain the idea of surgery until the last couple months. First, tentatively sticking a toe in the water and signing up for the Living Well classes at work. Then, by researching medical journals that discussed bariatric surgery to satisfy my nurse side. Finally, by joining here and seeing the "real life" examples of the work, effort, and success of bariatric surgery.
I'm about 6 weeks into a six month mandatory nutrition/counseling/exercise course that my university health system (also my employer) puts on. It has been a wonderful resource in total, and is great for accountability since we weigh in prior to every class. The class rotates each week between nutrition, exercise, and behavior management. The nutritionist is also my case manager. Exercise classes are not only a lecture, but we go work out for ~45 minutes as group. Behavior classes are led by a psychiatrist or counselor. Any of these individuals are available for appointments with us as well. Although at times it feels very "diet and exercise 101" it is a very well thought out course. I go every Monday after work. Today is an exercise class :)
Anyway, today I met with psychiatry. I took a few tests first - a behavior test, a binge eating test, and a vocab test - before sitting down to talk with him. Overall, went quickly and he was very pleased with my testing and that I am already in the classes - I guess most people do not start with the classes. The next step is to see a nurse practitioner who will go through my health history to see if there is any screening tests I need prior to surgery, as well as labs and an EKG - and as I wrote this, this just called, and I am scheduled for July 6th to see them! At this rate, I should hopefully be done with all my pre-op requirements right around the time the class ends in late September.  
I want to thank everyone here. I've been reading the ever-living hell out of these forums the last few weeks, and it was reading the stories (both struggles and successes) here that helped me embrace that bariatric surgery is a tool I want to have in my corner. 
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