Monday will be my 3rd anniversary of being sleeved so I figured it was time to post to the blog. Hope you all are doing well!

Maintenance is a b*tch. No way around that. My first year of losing was easier than my first year of maintenance but this last year of maintenance has been hardest of all. The upside is that I'm at a relatively steady weight. I had gotten down to 165-168 for a few months after my tummy tuck, then got in the 170-175 range. This past year I got up to 178# but righted the ship and have maintained at 175# for the past several months. Considering I am almost 6' tall (5'11") and a man, this is a decent weight. I wear a 31-32" waist pants and a medium shirt, though I do have a few small shirts on brands that run big.

It is hard maintaining. I have an insane amount of capacity, or at least it seems insane to me. I predict it to be roughly 16-20 ounces. I was hoping for 8 ounces. And it moves through their fast. I can eat a petite filet with a small salad, no problem and have a few bites left for bread or desert. I am far hungrier at night than I am during the day. I have the same breakfast virtually every day -- 3 organic, free range eggs and 3 prunes -- and now usually have a protein shake for lunch and some veggies for snacks. Because then I get a bit naughty at night so it helps me cover for that. It always comes down to the calories we take in. My normal range is 2K-2.5K and I maintain in there. It's annoying because I know people far less active than me that eat more and are roughly the same size. I think WLS messes with our metabolism but I'm glad it's a price I have to pay.

Tummy tuck. I'll post pics soon. It's a really slow recovery, not functionally but aesthetically. My surgeon went tight. When I get to like 178 and above, I feel pressure on the incision. It's super annoying. It's like a built-in shame infliction device if I get big. If I had serious regain, this could be a problem. It was uneven for quite a long time but it is settling into a straight line. The main issue right now is that there is a bit of fluid that builds up above the incision. That is going away but only in certain spots so when it evens out across the incision, then I'll post pics. Sensation took almost 2 years to fully come back. Don't kid yourself kids, a tummy tuck is a big f*cking deal and while you are fine physically and functionally, there are little things with the recovery that take a long time. I'm very fair skinned so I have a very pink incision on my lily white skin. You can't even see my sleeve scars, so I know I heal pretty well. This is just ridiculous.

My only "problem" area is my back flanks. I'm debating getting like a Venus Freeze or other lipo-like laser to work on them. Some loose skin and fat deposits there that just won't go away no matter how much I work out.

I still work out like a fiend. Since my last blog post I have run 2 more full marathons and several half marathons. Until my "injury" (next paragraph), I was running 30-40 miles per week and doing 3-5 Pilates/yoga/TRX/Boot camp classes. Active and fit. Nice muscle tone. I even am able to do unassisted pull-ups without the bands now. Just pure pull-ups! Can't believe I can do that at 43 and never could have imagined doing it as a teen.

I'm injured, I need a new hip and it sucks. It turns out I have congenital hip dysplasia and with my condition it's actually lucky that my hip lasted as long as it did. I'm highly annoyed. Running was my sanctuary. Since a marathon last fall, I noticed increasing worse left hip pain. I tried it all: chiropractor, acupuncture, cold laser, TENS treatments, physical therapy, strength training, private yoga/Pilates lessons, copious amounts of foam rolling. It just kept getting worse. Finally got referral to sports medicine and x-ray/MRI soon followed with the bad news. It was too far gone to scope. They tried a depo-medrol (steroid + pain relieve) injection and for 8 days it was amazing. Then it got really bad and now I walk with a pronounced limp. I've given up running for now so I ride my bike 2 hours for every 1 hour I used to run. It's getting to the point that I have to give up tennis too.

My hip replacement surgery is scheduled for 12/15. I'm terrified. First there is the replace versus resurface decision. Resurfacing has fallen out of favor except that it works well in men under 55 with a normal BMI who are very active and have good bones. That's me! But it's still a replacement, just less bone loss. I did some research and the chance of failure on that for me is 5-10%. The chance for failure on a traditional hip is less than 2% and that's over the course of 10 years. I found a surgeon who uses a new type of implant and bigger femoral head and will allow me to run. But I will have to keep it at more like 15-20 miles per week. So I'm going to become a half marathoner. That sucks but maybe I will become a Tri-athalon doer or a Half Iron Man - the 70.3 one. That I could do.

As some of you are aware, I was quite a mess going into my sleeve surgery. This one is kind of the same. Back then my agony was the surgeon and type of surgery (plication versus regular sleeve). What a mess. This time is a bit different because I'm debating a much higher risk of failure against an extra 10 miles of running per week. I have to go with the safe choice. Ugh. Recovery and not being as active as I have gotten accustomed is going to be the worst. I'm terrified of getting fat and out of shape again.

A few more thoughts. I had my sleeve surgery in Mexico. I'm pretty open to that. But what I've seen coming from Tijuana is insanity. Dr. Quinones had a rapid following and now I know two of his coordinators who are bad mouthing him. He appears to dump them pretty quickly. I guess he sent his patients a letter giving them the "opportunity" to invest in his practice. Shady. I really think it is unfortunate that our insurance / health care system (no matter whether you are red or blue) doesn't cover WLS better. My health insurers have recouped the money I spent on surgery many, many, times over on savings for things I don't need treated now or was nearing the point of requiring treatment for (gout, Achille's issues, metabollic syndrome, high blood pressure and pre-diabetes). It's unbelievable to me that even as an insured person, I had to take all the risks of going to Tijuana to save my life. I don't regret it, but it's a shame we have to do it.

Anyway, that's all for now. Long post, sorry for it. More later.