I had high hopes of being able to announce, today, that I’d finally broken through my low. Alas, no — one pound stands between me and my low weight. That’s not much in the grand scheme of things; much better, in fact, than the position I was in several months back, so I have faith that some future blog very soon will be screaming about finally breaking into new territory.

I’m actually quite thankful to be this close and in this position just a couple weeks after the holidays; I managed to keep them fairly in check. We all know someone — perhaps even you — that hopped on a diet just a couple weeks ago, not only to get those holiday pounds back off, but perhaps achieve more weight loss than that.

Soooooooon.

There are plenty of people that have already given up on their efforts. Go to practically any gym in the country during the week after January 1 and you’ll see how packed they are with new members, hoping to get their lives in order. A month later, these numbers will have dropped off substantially.

When I made the commitment over four years ago to give it another try, I wasn’t enthusiastic about my chances of staying on a longterm diet, but I also knew myself well enough to take steps that would increase my chances of success. They include:

I made progress videos. These are for my eyes only. I recorded them with messages to my future self, so I wouldn’t forget the things I’ve struggled with, so I’d keep hold of the dreams I had at those moments in time. I have not made one in quite some time since I’ve recorded the videos at certain weight loss milestones, but I am very near one, now. Personally, I know how easy it is to convince myself that I’m just fine where I am, but stating the truth of my life on video has been an extremely emotional process that has kept me grounded.

I made myself accountable. That’s why I created this blog, after all. It took some guts to admit to the world — and especially to myself — the state I was in when I took my first steps toward better health. After all, how on earth can you know where you’re going, if you don’t know where you’re starting? Being in denial about my weight and health only got me deeper in a hole I’ve spent years climbing back out of.

I surrounded myself with support. This is one of the most important things I did for my own mental wellbeing. I am not a joiner by nature; I tend to try to do things alone. This is indelibly tied to accountability, though; when I have felt like dropping out of view because things haven’t gone well, friends who care have been there to remind me that this is just a detour in the journey. Whether it’s a kind word or a group sharing of ideas for change, being among like-minded people who care is one of the most generous gifts you can give yourself: don’t be alone.

So here I stand, a pound above my low. I could be frustrated that it didn’t happen; after all, this is far from the first time I’ve come this close to finally setting a new low during the past 8 months of weight loss plateau. Instead, I feel both fortunate to be surrounded by people who support me, even when I stumble, and I know with confidence that I’ll be sharing good news with you, soon.

I’ll be honest. I don’t know what to write, this week, so I’ll just tell you where I’m at.

It’s no secret I’ve been dealing with a long plateau. I once had a 2.5-year plateau and then finally just gave up trying to break it and ate all the things, regaining all of the 140.5 pounds I’d lost on that particular journey, and probably about 35 pounds or so more. I was tired of trying to figure out what was going on, felt like I’d deprived myself for far too long for no good reason, and gave in to the “it isn’t fair!” cry in the back of my head.

So needless to say, those things are on my mind, now. I’ve learned to turn down the volume of that insidious “it isn’t fair!” cry, but occasionally, the volume increases and I have to address it.

Like the longest plateau, I started seeing my weight creep up. I lied to myself about whether or not what I was doing was detrimental. At one point, I was up 25 pounds, and then (perhaps quite fortunately) I was refused knee surgery because of my weight, and it got me angry.

GIF visual of a weight loss plateau

Not that I didn’t get angry while I was on that very long plateau years ago, but this time, the difference is that my anger drove me to re-evaluate what I’m doing and why it wasn’t working. Before, I just stubbornly kept on the same path, and my journey started looking like I’d been caught in a huge traffic circle; I finally jumped off at the wrong exit and that was the end of what had been a very successful journey.

Journeys in the interim were moderately successful, but I just didn’t have the heart to stay on them long term. There’s only so much personal beating up you can stand before you just numb yourself with food, and I did that a couple of times.

I know all that is depressing to read, but I promised transparency when I first started this blog, and at times, I’ve strayed from it, so I feel it’s best to be honest about things now. The important thing is that unlike my earlier trials, I’ve done some crucial work on my own mindset, and it’s brought me to a different place; a mentally healthier one.

Instead of anger over the unfairness of being given a particularly tough go of it leading to frustration and then surrender, I’ve turned that anger back into what it should have been in the first place: being a scientist on my own behalf and actually evaluating myself for the possibility of change.

I am close to being off the infernal roundabout, and I know which exit to take. I am hovering just above my low weight after battling through the holidays. I am looking forward, again, to seeing the number on the scale each morning. I am confident my lot will change, soon, and holding firm.

The biggest change I see in my current circumstances over all the times I’ve thrown in the towel, before, is my mindset. I have far too much to lose and everything to gain by continuing to work on my own mental strength. So, I leave you with this: soon. Keep watching this space.

Another year nearly gone. Where does the time go?

This year has taught me much about my body, my abilities, my mental processes. As my fourth complete year on a trek toward better health draws to a close, these highlights come to mind:

I said goodbye to using a cane — for good. Not only that, but it’s the year I seriously started walking, again. I started last February or March… I forget, now. I walked around my backyard. Getting 1,000 steps in a day was a major accomplishment.

While I’m not exactly running marathons, I easily reach 5K steps in a day, now. I do need to recommit myself to walking in a more structured manner, so this is a reminder to me that every step matters. Just a few days ago, my FitBit program told me I’d walked 500 miles. Imagine that! It all truly starts with one step.

I decide who I am. No one else.

I dealt with a longterm plateau. And I still am, but things are looking up. I’m retraining my eating habits and while I am still lingering just a couple of pounds above my low, I’ve lost weight I regained. Even here after Christmas, with a few indulgences under my belt, I’m not lamenting snug clothes or feeling bloated.

I am close to breaking this plateau; I was within one pound just last week, before the advent of company and traveling. I know it’s within my power, now, and I feel firmly back in control. Expect me to break this plateau soon! I am ending the year weighing less than I did when I started it, and that is always a success.

I recovered from bad news. When I had to fight for a surgery date, I struggled mentally with what I saw as an injustice. It still is, to a point; BMI is complete hooey and was never meant to be used as a medical requirement. I am positive that insurance companies are totally in love with the idea of classifying people by BMI, because it benefits them financially to do so.

Regardless, I was faced with the decision to give up or fight. And I’m not giving up. Not when I have come this far.

It also taught me something about myself and how I need to overcome exterior hurdles. To this point, just about all the constraints I had were ones I put on myself. Adapting was necessary. Was I up to the task? For a while, I really wasn’t sure. But I took the advice of my surgeon and I’m getting better results. It pays to get my ego out of the way.

I faced challenges. Many of my challenges this year weren’t actually my own; today is the one year anniversary since my husband had an accident that resulted in two knee replacements — when it was originally going to be my year. I had to put that aside and be there for my husband’s recoveries. I had to be the strong one; the ass kicker at times.

I have spent so many years being the one with the lesser physical abilities that it struck me as a complete reversal to be the stronger one. How the heck did that happen? But it also gave me a unique perspective as a caregiver. While my inabilities were not from surgery, I know what it is to be restricted, what it takes to overcome it, how to function in those situations.

I defined myself. This is one of the biggest battles we all face: who are we? Who do we let define us?

The answer, for me, is that I define myself — I will not live with how others choose to define me. I’ve done that for far too much of my life, and as I look back at stages of my life, I realize how much I allowed that to happen. How unhappy I was. It had little to do with weight; that was only a symptom.

I have big hopes for the year ahead, not the least of which is the ability to look back a year from now and know I have made even greater strides toward health. One of the biggest accomplishments of this past year is settling into who I am, with no apologies, and I plan to continue that.

This is me.

This past weekend, my husband and I attended an annual Christmas party event that included dressing asking attendees to dress up as pirates. Those of you that know hubby also know that he’s got a penchant for costumes. I don’t.

He finds dressing up in costumes fun. He’s been a pirate a few times, now. Over the years, at various events, he’s been Santa Claus, the Easter Bunny, a beer keg, and most often, a leprechaun. There are probably a few costumes I’m missing, and I’m sure he’ll fill me in after he reads my blog. 😉

Aaaargh!

As for me, though — I used to wear costumes on occasion. I once won a costume contest at work, dressed as Mae West, back when I had curves in the right places. I also used to be a member of a craft guild, and historical dress at events was encouraged. As someone who was in band for many years growing up, I also wore tuxes, black dresses, and a variety of band uniforms; believe me, uniform makers back in the 70’s and 80’s didn’t make good options for those of us with curves, and back then, I was a normal size.

Now, though? Hubby kept after me about dressing up as a pirate, and I finally made my own secret plans. I went as outrageous as possible, and told him flat out that if no one recognized me, I had accomplished my goals. As it was, there were a few folks who didn’t, so I considered it a success.

On the way to the party, hubby asked me why it is that I don’t like dressing up in costume. The simple answer is that when you spend much of your life as the largest person in any room, the last thing you want to do is attract attention, even if that reason is no longer for being large. Having that attention makes me uncomfortable.

Being very large brings with it both attention for being large, with (hopefully!) silent judgment, and a certain level of invisibility once people have dismissed you. I would prefer to exist somewhere in the middle: noticed without judgment, existing without disappearing afterward. I’d simply prefer not to draw attention; in my mind, attention and judgment still go hand in hand.

I’ll admit I had fun with the costume. (Note to husband: this does not mean I’ll do it again!)

On a related note, I’ve been attending this particular party for four years, now. The first year, I ambled in at nearly my full weight, and sat in a corner; I didn’t know anyone because we were new members. Year 2, I was in a travel wheelchair so we could move around without me imposing a limit. Year 3 — I had progressed to a cane and was able to get around on my own; I even danced a little bit. And Year 4, this past Saturday, I entered the doors with no cane, pulled my own weight, danced, and even wore low heels. Who knows what next year will bring?

Folks on Facebook are familiar with the term Throwback Thursday, where people post pics from their past. It’s usually meant in fun.

I had a Fallback Wednesday, and it wasn’t a fun one. Nor was it on Facebook.

It was in my own back yard, during my morning walk with Bonnie, my dog. We have a normal path we take before breakfast; her, so she can do her morning thing. Me, to put in a few steps before breakfast. We’re fully into fall weather, now; it was brisk out, first thing in the morning, with plenty of newly fallen leaves to kick through — which is what I inadvertently did.

Stunt leaves that may or may not look like leaves in my yard.

It wasn’t anything more than nudging a stick with my toe in passing, but that’s all it took to push my knee out of alignment. When that happens, I can’t straighten my knee and I can’t put weight on it. To complicate things further, I was wearing a new brace that had partially slid out of place (and might have contributed a bit). So there I was, standing on one leg like a ticked off flamingo, leash in hand with a dog ready to take on the rest of our walk, 50 feet from the door.

It might as well have been 50 miles at that moment.

I haven’t had this happen, lately, except for a couple little minor skirmishes. I had convinced myself that building muscle around my knees has helped, as well as losing close to 150 pounds. And they have; the number of incidents of my knee locking up like this has gone down considerably, and it had been many months since I’d dealt with even the hint of it, so this caught me completely off-guard. I managed to hobble into the house, but between aggravating it and not being able to straighten it for several hours, I’ve been dealing with a throwback in time of a kind that I’m certainly not happy about in the least.

I’ve been pretty happy with my progress, doing away with having to use a travel wheelchair, and then a cane, and lately, walking around 6500 steps a day. It took one tiny incident to send me backward to a time when I couldn’t hobble around my own house without some sort of mobility assistance. Add to this, my surgery date has been kicked back six months. Maybe my knee knows I’m going to evict it.

After considerable pain and feeling sorry for myself, I realized that this was my lot every single day just a couple of years ago — and it wasn’t so long ago that I was dependent on a cane just to get around the house, dealt with debilitating pain to the point that I had to take breaks to sit down just to get through washing dishes by hand, and had developed all sorts of ways to get by because of my knees.

Mind you, it’s on the mend, now. I still need to take it easy for a few more days, by the feel of things, but the difference between then and now is huge. I am both physically and mentally stronger than I was just a couple years ago. I laid down to put my knee up, after taking some heavy duty pain reliever, and then got mad for having to do it. I don’t want to be waylaid, when even a couple of years ago, having the excuse to put my feet up for a few days was a welcome thing. Now, it frustrates the hell out of me.

I suppose that’s a good thing, right? It’s a reality check to remember a time when every day brought me pain and difficulty. Now, it’s a hiccup, not a way of life. I just made the commitment last week to get a new brace to support my knee so I can increase my steps — and then this? Oh, nope! I’m not going to let this sideline me. I will continue to fight with everything I’ve got.

PS: Just to be clear, it’s not the fault of the brace, although having it move on me while I walked may have contributed. I have experience with braces, so understand the issues at hand.

Over recent weeks, I’ve been dealing with one of the biggest challenges I’ve met since starting to lose weight. Not just for this time — for any time.

If you’ve been reading along, you know I was sent home from my orthopedic surgeon’s office with instructions to lose 20 to 25 pounds. That was roughly six weeks ago, and at that time, I managed to get them to pencil in a surgery date in December, with the agreement that I’d lose the weight. I was pretty angry after that appointment because I felt like I hadn’t been heard. On the advice of friends who are also medical professionals, I rescheduled the checkup to make sure I met with the actual surgeon. And that appointment was on Wednesday.

There’s bad news, and there’s good news — of a sort. First, the bad news: I was turned away yet again. I lost 16 pounds between the appointments but was sent home with the instructions to lose 20 to 25 more pounds. I fought my case; I showed my progress photos of 140 pounds lost, I lined out the previous four years of progress I’ve made, I pointed out that it’s quite likely at least 15 pounds of the weight I currently carry is excess skin.

I’d rather be a pirate and make my own rules.

But it didn’t make a difference: their goal, pure and simple, is to be below a BMI of 40. I’m hovering just above it. I have until February 2, now, to get below that mark. If I meet it by then, I’ll have surgery in early summer.

Just as an aside, I think BMI is a convenient construct of insurance companies, and I wouldn’t doubt it a bit if my insurance company has a hand in this; I’ve never been a fan of insurance companies dictating health care. Those decisions should be between my doctor and me. Even the creator of BMI stated that he thought it was too general a rule, but at the time, it was at least a consistent measure. And apparently, being over a BMI of 40 brings with it notable increases in health risk.

I understand that. With a few exceptions, the more weight we carry, the more health issues we end up with. I’m talking averages — not specific cases — but I totally disagree with the (insurance-driven?) notion that those risk factors suddenly drop off once we pass a magical number. No, risk factors are on a sliding scale, not a drop-off. While I am more than willing to embrace the idea that my risks were far greater when I was at my original weight, I don’t truly believe that the risk factors are all that different for me at my current BMI and the mere two points I am away from their magic number.

Nonetheless — my surgeon will not do a total knee replacement for me until I lose even more weight, no matter what evidence I was able to present. What stands between me and knee surgery is an illogical (and mathematically rather than biologically based) number devised by a mathematician in the 1830’s, before The Alamo fell. For all our technology, we cling to this outdated and unreliable system of measurement. Regardless, I’m stuck and my choices are to abide by it or keeping living with debilitating knee pain.

The good news? I was heard, at least. I was treated with kindness and respect. I was listened to. I was given options. Not all of them are viable or preferable, but if I want this particular surgeon to perform my knee surgery, I have to go by his requirements — and I do want that. He did talk with me about my biggest concern: that I am at an impasse with my weight and my ability to exercise, so asking me to lose more weight seems nearly insurmountable.

He made some recommendations that I am considering, and I was also fitted with (yet another) knee brace that may help me get a few more steps a day without as much pain, and therefore, burn a few more calories.

I have to fight for this. I refuse to do anything else than fight; giving up never got me anywhere. I suppose on some level, I’m angry because I felt I was ready and I was not prepared to hear otherwise, but what I have done to this point is not enough. Imagine that — losing close to 150 pounds isn’t good enough. Not for this.

For the first time, I’m being pushed to change when I stubbornly want to remain on my current path, and it’s a hard thing to internalize. To this point, the choice has been mine; but now, if I want to achieve what I believe is the next step in pushing my health forward, I have to play by someone else’s rules.

I’ll do what needs to be done. I don’t like being told no.

Some days, I honestly don’t know what to write. Today is one of those days, so I asked people what sort of questions they’d like to have me answer. Here are a few.

I’d love to read what motivates you when you feel like you just can’t do the healthy eating any more or when you are having a stressful day.

Believe me, there are days when I get absolutely and horribly frustrated, especially when I’ve pulled out every trick in my bag and it doesn’t seem to be working. That’s happened to me, lately, and I needed a reality check that luckily came from an outside source.

I can’t always rely on outside sources, though, to remind me to get my head in the right place. On talk radio tonight, coming home after eating dinner, I heard the host put forth the idea that we often give up on something just before we achieve success — weight loss being one of the things mentioned, and the reasons are often because what motivated us, in the beginning, is no longer motivation. In my case, when I first started losing weight, being able to move easily and fit in semi-normal size clothes were big motivators, but now that those things have happened, they’re not as motivating as they once were.

You betcha.

The host suggested that prevention becomes more of a motivator that can help that final push of success, and I believe that. I have photos of where I used to be. I have journal entries of how tough things were at that time. I made videos of myself at various stages, and look back on them. When I’m having a moment where I just want to trash it all and give up, remembering where I’ve been often pushes me past whatever is holding me back at that moment.

I don’t see myself as a stress eater, but can be prone to it at times; I let myself stress eat months while caring for my husband after his first knee surgery. And that fact is — I love food. I’m not gonna lie about that. I used to kid myself into believing food is only fuel, but I love a fine glass of wine, the satisfaction of a great meal.

Mindless eating isn’t that. Being selective in my eating actually makes the meals in which I choose to have something I don’t normally eat much more special. I can fully experience it and go on, instead of just eating whatever fills the space. When I do that, I end up feeling like crap and feeling sorry for myself.

Besides, none of us ever get closer to our goals by doing the exact opposite of what we know will get us there. Throwing my hands up in frustration and diving into a bag of Doritos certainly won’t make me feel better. I have to focus that stress somewhere else.

I would love to hear your thoughts on the willpower you muster in regards to avoiding unhealthy foods.

I think most of us know how to eat healthy when we’re at home and we have the time to fix meals; the challenge is when someone shows up with cupcakes with three inches of frosting on them, or your well-meaning aunt is pouting because you’re trying to resist that marshmallow salad with whip cream on top that she made just for you. Or in my case: Bavarian pretzels are my kryptonite. (Salt is a food group, y’all. Honest.)

I try to look at these sorts of temptations in two ways. The first is that I view each day much like a bank account: I start with a set amount I can spend. If I want a treat, I have to consider whether I can afford it, or what I’m willing to give up so that account isn’t overdrawn. I will also plan times when I can spend more from that account, and thinking this way tends to make me evaluate what I’m willing to spend on, and it had better be worth it. (I actually get pretty upset if I plan for a special meal — or pretzel! — and then it’s not up to snuff. I feel like I got ripped off. Eating selectively makes you appreciate each bite a lot more.)

The second is that I know what the consequences are when I eat (or drink) outside of my norm. Eating clean helps balance cravings for treats, and it also amplifies how different I feel after I do have a treat. Someone who doesn’t drink caffeine for months and then has an espresso will have a more pronounced reaction to it than someone who has caffeine daily, and the same holds true for sustained clean eating. That pretzel might taste fantastic, but it could very well make me hungry for a couple of days when I don’t normally deal with a great deal of hunger. Am I willing to possibly deal with food cravings for a couple of days if I have that pretzel?

Sometimes it’s about limiting the amount of the treat, too — a bite of pretzel might satisfy that desire for the taste rather than eating the whole thing. It’s a longterm choice rather than an immediate “gosh, that looks good!” reaction.

I’ve become a picky eater. I want food to be a joy, so those decisions are actually not big decisions. When I do make those occasional decisions, I do so in a way that I can appreciate them instead of regret them.

Are there certain foods you substituted to satisfy a sweet tooth or a salt craving?

I don’t do a bunch of substituting. That way lies craziness and turkey bacon, but I do workarounds on occasion.

During the summer, I like my backyard cocktails, and I like combining sugar-free drink mixes with clear alcohols (rum, tequila, vodka), as well as adding things like sugar-free ginger ale. But really, I don’t crave a lot of sweets. I like my salt. I will snack on bacon or pepperoni. I like my hot sauces and spices, too.

For me personally, I stay away from processed foods that are meant to duplicate other foods. I also don’t make rice out of cauliflower or noodles from zucchini. I know there are folks who swear by them, but I don’t miss rice or pasta, so have no desire to duplicate it.

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Thanks to my friends for posting questions — I hope I’ve given a little bit of insight. Got questions? I may consider them for a future blog.

Last week, I talked about not accepting no as an answer, and with the help of friends, found even more ways to fight for yes. Thanks to those of you who encouraged me; I have since rescheduled my follow-up appointment, which was initially just a weight check, to be specifically with the surgeon who will replace my knee. A bonus: it’s also a week later, so that gives me more time.

I am still dedicated to losing as much weight as possible between now and then. It’s given me the drive and focus I’ve needed to get my head firmly back in place. I’ve even noticed a shift in my thought processes over the past week, and I’m grateful for that. I’ve also dropped more than half of the weight the physician’s assistant requested — something I suspect he didn’t think I was capable of doing. I knew I was carrying water weight and said so; he simply didn’t look past the easily available stats in front of him.

Gotta play those cards!

I hit a low weight in May, and since then, I’ve let circumstances become an excuse for weight creep. My mind has been slowly changing and losing that drive I had months ago, thinking I must accept where I’m at. I don’t have to accept that at all, and if nothing else, I needed this wakeup call.

Now, I’m not far above my low, again, and I’ve been thinking of where I’ll be later this fall — and what I’ll be able to accomplish after knee surgery. I’ve been working toward meeting all of my fitness goals each day, despite needing to care for my husband after his second knee replacement surgery. (As you can see, I’m pretty familiar with this entire process — which is one of the reasons I was thrown for such a loop when the PA threw a wrench in the works.) I let his first surgery in July throw me out of my regimen; I allowed myself no such excuses this time.

Life’s not fair — I’ve been dealt a number of physical complications that make weight loss quite difficult — but I can either whine about it or do something about it. Lamenting my issues instead of dealing with them not only got me up to at least 371 pounds (that’s the number on the scale when I finally looked; not necessarily my highest weight, just the one I know about!), but it destroyed both of my knees from carrying the weight of my body, robbed me of years when I could have been living a better life, destroyed my skin (need extra skin? Give me a call!), worsened any health issues I had, including depression — the list is a long one.

Playing the cards I’ve been dealt instead of just accepting them has changed much of my life. It’s my responsibility to research, change, adjust when necessary, and keep moving forward. I spent too many years creating my own limitations; my life, these days, must be about tearing them down, wherever and whenever possible, and doing the unexpected.

“Every hand’s a winner, every hand’s a loser”. When that PA glanced over my numbers and spoke to me, he didn’t see me. He saw stats and he judged. I am still a large woman. I’m sure there are a legion of women my size that are doing absolutely nothing to improve their health; that adhere to a regimen, that walk daily, that put in the effort. That isn’t readily visible on a medical chart or just by looking at me.

Conversely, there are plenty of people in this world that look entirely fit but ate Cheetos for breakfast, if they ate breakfast, and lead sedimentary lives. The truth is we don’t know the full picture of anyone until we dig deeper. My goal is to make sure my physician knows the whole person, rather than the stats. Then, we’ll be partners in my surgery and recovery. Whatever I do in the meantime to improve my health is a bonus.

Thanks for being there for me. Had I not taken the step of being publicly accountable in my weight loss journey, these current hurdles may have created enough of a limitation that I might have started to turn back instead of moving forward. That support means the world to me.

No.

That’s what I was told earlier this week. No, you’re not ready for knee replacement surgery.

I couldn’t believe it when I heard it. I went in for x-rays and the physician’s assistant told me immediately that my x-rays look horrible. That’s nothing I don’t know, already; they looked bad years ago when they first started telling me I needed total knee replacement on both knees.

The next words were even worse: come back when you’ve lost twenty to twenty-five pounds, and then we’ll talk about surgery.

I narrowed my eyes at him. Uh, say what? He then told me that this was “something new”, which astounded me, because I’ve seen my husband through two knee replacement surgeries, now, and I’m telling you that there were a lot of people much larger than me, out in the hallways and making those first post-surgical steps with newly bandaged knees. Further, I’ve been seeing this particular surgeon for around 12 years, but never this particular physician’s assistant. No one in that office, including the surgeon himself, has ever told me to lose weight; in fact, when I have said I need to lose weight in the past, when I just wasn’t ready physically or emotionally, their response was you can’t put surgery off forever.

That “no” will be a YES.

Two things hit me, immediately; the first is that one of the reasons I wanted to get this done by year’s end is because of insurance advantages, since my husband has just had his second surgery since July. If I wait until next year, my cost savings are lost, and they are major savings. I’m not a wealthy woman by any means, and one of the many reasons I haven’t had this particular surgery yet is because of the cost. If I don’t at least get the first knee done by year’s end, I realistically don’t know when I’ll be able to have it done.

The other? The amount of weight he told me to lose is identical to the amount I’ve recently gained over my low weight, achieved last May. I’ve been struggling with getting that weight back off and I haven’t done nearly enough to make it happen. I have to own that responsibility; had I walked into that office at my low, there would have been no discussion of my weight. That’s entirely my fault.

Mind you, I don’t much care for no, not when I’ve come this far, fought this hard. And I didn’t stand for it.

We have a deal; we penciled in a surgery date for me in December, but only on the condition that I come back, weigh in, and lose at least those twenty to twenty five pounds. Honestly, I know what they’re after; it’s that blasted BMI number, and I am tottering on the edge between weight classifications. It’s numbers, stats, and risks. But it doesn’t make it any easier to accept. (The good news here is that I know a good deal of the excess is water weight, which is relatively easy to lose, if I set my mind to it.)

Yes, I’m angry over it. I’m angry, because that physician’s assistant doesn’t know me at all, doesn’t know my weight loss history, and it was obvious by his manner that while he agreed to allow for penciling in a date, he has zero faith that I can pull it off. He doesn’t think I’ll make it.

I’m angry at myself, too, for not having put in more effort and remaining steadfast; I’ve let things creep in my way while knowing I’ve needed to return to my focus.

But oddly, I’m also thankful. I have a goal to achieve. I have a point to prove — not just to that smug physician’s assistant, but to myself. It’s time to stand and deliver, and I’m going to turn that no into a yes. Part of that weight is already gone, and I’m going to be pushing hard during the weeks ahead to beat those stats.