For about A month now "this time next year," has been said daily in our house. By this time next year I'll be Shopping more ... By this time next year, I can sit in a booth ... By this time next year, I will ride bikes with the kids .... But every " By this time next year-ism" has been stated by me. I had began to wonder if Michael felt the same way I did about this surgery, was he excited to have a wife who could enjoy time outdoors with him, was he excited to see what I might look like. Did he even think about the transformation? Of course I do remind him daily, but he is a man, so who knows. Well I got my answer tonight. After spending the day in Branson and waiting in long long lines for the tram at silver dollar city, we had finally made it back to the car. I said to no one in particular, "it probably would have been faster if we had just walked..." Michael's response was " By this time next year maybe..." he let the comment fade off into nothing, but it was then I realized that he definitely thinks about it. For him though talking about it is like answering the "does this shirt make me look fat" question. He is not sure what he can say and what he can't. How did I not think of this? I quickly encouraged the conversation and made sure he knew that my feelings were not hurt at all. I have to keep in mind the feelings of those I love at all times along this journey. It is for them that I will be making the changes, their well being is #1 to me.
Speaking of the ones I love, my phone died while we were in SDC so I didn't get the chance to take any pics of the kids, but my mom snapped this shot as we were on our way out I <3 these guys so very much.
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In case you have never had the privileged of enjoying DS meal ... here is your menu ... Whole Rotisserie Chicken, Smoked Pork Loin, Creamy Vegetable Soup, a Biscuit, Corn on the Cob, Herb-basted Potato, an apple pastry for dessert & Unlimited Pepsi, tea or coffee ... It really is a good show, and when the kids are older and they change up the show, I plan on enjoying my meal a little at a time from a doggy bag! It's funny, this journey has already opened my eyes to so many things. This coupled with a new found dedication to Christ have forced me to examine where I am and where I want to be. I see evidence of Him working in everything we do. One week when Michael and I were looking for a new church for our family, a woman slipped in behind us in the last row. I later found out it was the preachers wife & since then I have come to realize that she always takes a seat at the front of the church, but this Sunday she had been lead to sit behind us. After church she handed me the note photographed below. I have carried this in my Bible since that day and even tried to over analyze it to the point of Crazy Frick ... but it always seems to apply to me and it always comes back to one simple thing ... "God knows you and he knows where you are ... he desires you ..." That is it ... I think God knew today that I needed to get emotional about this journey! ... I thought something was wrong with me ... I had wondered why I had been on pre-op cloud nine excited more and more everyday. I have even dealt with bouts of nervousness, worry, fear & wonder but in all of the emotions I have not shed one tear. I have dared to imagine the future of me with a skinny girl body, I have wondered about excess skin and cutesy clothes but never allowed myself to picture it. Tonight I had caught up on my daily homework assignment and thought I would check the Clusie channel just in case she posted something tonight, I have found that I am mildly obsessed with her videos. Anyway, as I am clicking over to her channel I am willing the computer "please have a video, please have a video" and low and behold there is a video... not just any video either... it's the highly anticipated before and after video! Words cannot describe my reaction, it was somewhere between a 3 year old meeting Santa and a cat tail under a rocking chair in a thrilled sorta way. So I quick click play and watch Clusie drop 170 pounds in 5 minutes. around about 4 minutes it hit me, if I lose 60% of me I will be 140 pounds, I will be her size. Kneeling in the flowers, posing in the dressing room mirror.... I cannot wait to shop at anthropologie ... I got a little misty eyed thinking about who I will be 2 years down the road. There was one thing I noticed though throughout the video that was a comfort to me. In every photo you can see Clusie's personality and her infectious smile, she didn't lose who she was, she didn't sacrifice her personality for a smaller booty and cuter body. Her smile remains her best feature. Here's the video, check it out! It cracks me up to hear all of the reasons that people have come-up with to try to convince me NOT to have the sleeve. They lump all weightloss surgeries together and they start telling stories about their Aunt/Grandma who had the "Real bi-pass" done and it about killed her, she can't eat bread anymore or she will vomit and since she can't eat bread her arms and legs are the like of very fragile twigs, no chopstick, yea that's right , skinny straight chopsticks with a chunk of chicken hanging off like big wrinkled feet. To be honest, I feel sorry for Aunt/Grandma Twiggy, but I am not too interested in her weightloss freak out ... the bright side is that I don't plan on having the "Real bi-pass" so we're good... right? ANYWAY, I have compiled a list of top 10 reasons people don't want me to get the surgery, and my response ... #10 - Your hair will fall out! It will grow back! I have hair now, I have never seen a case where it doesn't fall out... but if I am the acceptation to the rule, I will rock the hat and wigs! #9 - Your husband may get jealous & your friends and family won't know you anymore. I hope he gets jealous, in a healthy way. We are secure in our relationship, weight loss is the least of our worries. Will I change? SURE! Will they recognize me? Ummm yes! If they know me now they will know me then. #8 - You can't have Soda anymore Yea, and guess what I can't have beer refraining from that hasn't killed me yet. and I can't have greasy food or junk either, that is not something that is going to kill me, however, continuing to consume it might! #7 - People have had WLS and gained it back! I know a guy who cut his hair and it grew back... what's your point ... It is a life style change ... #6 - You LOVE food too much, you will never be able to handle it. You're right, I LOVE food, but not as much as I love my family and myself. After the surgery I will have to handle it, I have no choice, it isn't like they can sew it back on, or give me a donor stomach. There is no turning back & that is exactly the commitment I need to make the change! #5 - Are you even mentally ready to be Skinny? Are you kidding? There is FINALLY hope for me and I can't wait. Of course I was concerned about missing Fat Frick, but I will work through it and find Frick'n Awesome!. Again, I have no choice, what is done is done, and the thought that I can't mentally handle being a skinny girl is laughable when you think about it. #4 - This is the EASY way out! Yep, it is ..... 5 holes cut into my abdomen, a portion of my stomach pulled out through one of those holes. Letting go of so many things that have defined me for so many years. Leaving my kids for a week and flying for the 1st time across the country on the week of my son's basketball tournament. Weeks on a liquid diet, then eating ping pong sized portions, are all easy things to endure. I suppose that you are going to tell the paraplegic that his prosthetic are the easy way, or the woman who just got laser eye surgery that she took the easy way. Maybe the man who had a triple bypass should have just powered through. Nope not buying that one. This will not be easy! #3 - You will have to take Vitamins forever! As opposed to the metformin, the blood pressure pills, the cholesterol pills the insulin shots... Yep I'll take the vitamins. #2 - You could Die ... and so could you, on your way to work or walking out the door or brushing your teeth ... Thanks for that! So very encouraging. I could also die of a heart attack tomorrow. If it is my time, then it is my time. #1 - You can do it on your own! Have you seen my salads? 1/3 lettuce 2/3's toppings and dressing... and my exercise program, 2 laps to the mailbox 2 days in a row ... yep I am really making a commitment to change! OH and for those who worry about the surgery because it is in "Mexico" the bonus answer is for you... Bonus - Why do you have to go to Mexico, they do the surgery in the USA you know. Yes I know. Let me break it down for you ... It's true the hospital is in Tijuana, but it is in Baja California and is completely safe. It is certified by the American Academy of Hospital blah blah blah and it is just as clean as the hospitals her... there are 2 reasons I chose Mexico... #1 They have made it affordable, and #2 I have been telling you all forever I am Mexican... no really, I cannot handle all of the overkill procedures that the US requires, I am all about getting in and getting it done. I have to go drastic to make a difference. This is what will work for me, I am grateful to all of those who have concerns & know you worry, but now you can see that I have weighed the pro's and con's. With every passing day, I get more and more excited. Today, I did research, worked on passports, checked into airplane tickets and looked into protein drinks. Hopefully by the end of this week both Michael and I will have filed for our passport, there is a maximum of a 6 week wait, I don't want anything holding us up.
I have never even been in an airplane and I don't know what to expect. Frankly the only thing about this trip that makes me even slightly nervous is the flight. I have all of the usual preoccupations, will I freak out in the air, will I pack a small enough bag to skip checking one, should I sit near the window or in the aisle? But then I also worry about if I will fit in the seat & if the seat belt will fasten. I went as far as measuring my seat at work... 21 inches... that happens to be the size of the seats in the first class portion of the plan.... if I upgrade my seat, I upgrade to an $800 ticket ... no thank you! A regular seat is 17.9 inches... think I can squeeze myself into this seat for the duration of the flight without panicking??? I sure hope so ... the ticket difference is $400! I am thinking that is Fat-sisim! Guess I will leave that thought for another day! 90 days!!! ..... women marry, bear children, guide the house, give none occasion to the adversary to speak reproachfully. 1 Timothy 5:14 Instead of our regular Sunday night mission visit to Yarbrough, we had to attend our Church because the kids had to practice for the Christmas program. They are studying the Book of 1 Timothy and Brother Jared brought up something that stuck with me. He asked if we knew what it meant in 1 Timothy 5:14 when they say "guide the house" other translations say "manage the House" after a few attempts at explanation from church members he explained that he believes that it is the woman who sets the tone for her home. Her attitude sets the mood. What she does is a direct result of what make the house a home. It hit me, The hormonal issue I have due to my weight really effect my home. They obviously effect my attitude, but they also keep me from doing more to make this place a home. I want my husband and children to feel like this is the one place they can go to retreat. That my attitude will be calm and Christ like in order to set the standards for their future. I can try as hard as I can, but I am expecting the shift in my hormones to be huge. I am expecting an even personality without all of the hormone surges. My attitude about the surgery and weightloss before and after will make a HUGE impact on the health of my family also. It is a lot of responsibility and something no one tells you about. Father God, I ask you to be with me tonight as I prepare my heart for this journey. I pray that the changes it brings in my life and the life of my family set the attitude of the family.Thank you for opening my eyes to what a bad attitude or poor personality might do to my family. I know that it is what I do that will effect who they become. Give me patience and consistency, give me discernment and wisdom everyday Lord to grow them into amazing Husbands and Wives who teach their families to live for You! Let the choices I make influence the choices they make in a positive way. Help me to be the wife my husband deserves. That I am able to set the tone of our home in such a way that he desires to be here. That he experiences overwhelming joy when he is at home and that the stresses of our daily lives do not stand in between us and a loving relationship in which we honor you 1st and foremost. Thank You for Your grace and love, In His Holy Name, Amen Not too long before the proposal of the sleeve I was talking to someone about their newest tattoo. She was super proud of it and completely in love with all the ones she had, she asked me if I had any and my response was 'No, I'd like one but I have never found something I love enough to carry around forever.' Her response was thought provoking, she said, "yes, you have to find something you become completely obsessed with in order to make that kind of commitment." It hit me that this is true for absolutely every single big commitment we make. A few short weeks later, I became absolutely obsessed with the idea of this surgery. It is on my mind every single day, I think this is Gods way of preparing me for the emotional changes I will be making. I am so completely excited to be 92 days away from the day that will change my life! I have always thought that it is funny how people are always talking about Barbie and the body image that she is giving the girls of the world. That girl was never ever me... I never wanted her body ... her car... sure I'll take that, the condo, I thought that was cool too... but I never thought I had to have her waistline, boobs or even her hair. On the contrary, if Barbie had friends, my sister and I chose the one we were going to "be" based on which one resembled us more. As I got older, I began to relate to the "Biggies" of the entertainment world. I find people who look like me, inspirational, often times I can relate to them. I admire their carefree personalities and their ability to be true to who they are accepting their "Fatsique". In some ways, I know it is crazy, but I am scared I won't be in the funny & fat club anymore! I mean Fat people are funny right? There is nothing funnier than Melissa McCarthy trying to jump over the counter of a fast food restaurant & who doesn't know "Fat guy in a little coat?" Jolly & Funny! Undoubtedly it is hilarious to watch fat people being fat & funny... but let me tell you what is NOT funny! Not fat people, pretending to be Fat and gross or acting like they think fat people would act, slobbering, sitting on people and eating everything in sight until they blow up. I can barely sit through Shallow Hal without screaming at the screen, I have never even been able to make it through Norbit & although I have been known to quote the Fat fella in Austin Power's, "Get in my Belly," there are some scenes that I just can't handle. Let me give you a tip, when talking to a big girl it is not ok to ask them if they have seen Norbit and go on to describe a particularly offensive scene as if something they did reminded you of the movie. I am scared! I am scared that one chicken wing won't be enough. I am scared I will die when I walk my 1st mile. I'm scared, and for this one I might be crazy, but I am scared that I may never again be compared to Mama June Boo Boo, Fat Amy or Melissa McCarthy, the thought of this makes me kind of sad. In the next few days I plan on tossing this thought around in my brain and coming to terms with the fact that it isn't the fat that makes me personable, but the person I am. Making some changes on the Blog ... It has become a Buddy Blog! This makes me excited, because now not only do I get to chat with Sunny on Tuesday evening about how we are feeling, but she and I will be blogging together. I cannot wait to read her posts & share in her excitement. Today we talked a bit about our taste buds changing and the fact that foods we currently LOVE may not be foods we can even handle after the surgery. That is a scary thought! What is the one food I cannot live without... ummm ... Steak, stuffing, potato soup ... not really sure I have a "favorite" I LOVE way too many things, but I can tell you not liking any of these again would make me very very sad and I am sure I will morn the loss. It still isn't enough to keep me from the surgery. I found this picture below and I think it explains exactly how I feel, I will keep reminding myself of this! I am currently obsessed with watching youtube videos by people who have been sleeved. Early on I found Clusie L. She is hilarious, she is real, a little raw, but real!
I am glad she posted this one this week. I have been really thinking about excess skin lately, I am already saggy, so here is to hoping I am a Humpty Dumpty! I also have been worrying since day one that I will miss Fluffy me. I plan on spending the next 98 days enjoying it. Then I will enjoy the new me after that! Thanksgiving is it ... The day I condition myself for the entire year! The day I am going to miss the most post-op ! So today I savor it ,.. today I pack it in! We have the honor of celebrating 3 times this year ... 2 down 1 to go! As I pulled the plate higher and higher I honestly couldn't believe how much I was eating thousands & thousands of carb loaded calories. I think it is important to note that I only do dessert on occasion... today was no different ... I enjoyed several servings of homemade cranberry sauce ... yummo! After all these years of stuffing myself I have perfected the art. I noticed when all others were so stuffed they couldn't walk I was over here like .... hmmmm what was so so yummo I need more"
This plate is from party #2 at the Price family feast... I had already dug into whatever was next to the potatoes. Throughout this journey, as I break the news to different people in my life, I discovered reactions are so different. They range from completely shocked and non-supportive to complete compassionate and on board. It's funny how people are either ALL for it or totally against it. I usually don't even start by talking about Mexico, I break them in with the news of the operation, then when the timing is right, I say oh yeah and the operations is in Tijuana. The people who were very supportive, remain supportive, but those who were against it are even more so and tend to blame their apprehension on Mexico. On thanksgiving, I got a text from a friend, it read, - happy thanksgiving, enjoy eating as much as you want of anything.- This person understands my sense of humor & this is the kind of support I appreciate. Just a little comment that says thinking of me every step of the journey. I've said several times that the reason I'm getting the surgery #1 is for my kids ....
I do not want them embarrassed by their mama, and I do not want them following in my footsteps. As you know, Jaxen has had a problem with his weight since he was diagnosed with asthma at about age 2 1/2. He was on steroids and albuterol and he started gaining weight like crazy. When he was on the meds he would eat and eat and eat, when he had an earache or a cough he would eat and eat and eat and it became an obsession with him, like he was filling a void. Sadly, I didn't know enough to stop it, even my pediatrician said, it would be fine we should just maintain as he got taller, Ha no such luck. Today he's a 165 pound 4th grader and for that I'm worried. He wears a mens clothing and it is not fun shopping with him, it is very frustrating for all of us. I love that boy beyond words and nothing he could ever do can change that, I do not ever want him seeing this post and believing otherwise. The truth of the matter is, if I don't do something today I will have a 500 pound 35 year old son, that to me will be devastating, because I know what that weight will bring with it. I feel like he will go through a life of misery, because you see Jaxen, internalizes being fat. I don't remember crying over my weight until I was a teen and it only lasted a minute. In 4th grade alone Jax has cried over his weight countless times. We've been in the dressing room were recently, within minutes, it was like dressing a 15 year old girl and I've been there. I know that you start trying on pants and they don't fit, so you get the next bigger size and it doesn't fit, you keep moving up and eventually you're depressed and just shut down. You hear your siblings in the dressing room next door excited that everything fits, they can pick up their size shirt off the rack and put it on and it fits, they don't have to go back for the next size in the next size and the next size ... eventually you give up trying and you go to the accessories, sunglasses or hats or purses because those will fit no matter what, Kinda. Ultimately, you find yourself sitting by the door, waiting for everyone to finish their shopping while convincing yourself that owning one pair of jeans and 3 shirt are fine , keep your head up and you go on. I have learned to despise shopping and avoid it at all costs. That being said ... I've picked up a few tips and tricks of from being an obese child/person and raising an obese child. I will also share from our journey along the way. I'd like to give some insight to parents who may be going through the same thing.
Bottom line is, it starts with me. I will be posting throughout this journey the things I've learned in raising in a big boy and hopefully by the end of this journey I can celebrate that he, like me, has gotten healthy. I pray everyday that God gives me the wisdom in raising him to teach him what's good and what's not good. Today has been a rough day, a lot to do and a lot of waiting. It is 2 days until my last "fat Thanksgiving" and boy am I excited! It is also 3 days until black Friday so all of the department stores have started their deals. Today while Dacota and I were waiting, I found a scale that was $30 off at Kohls. I have a regular old Walmart scale, sometimes it weighs me and sometimes it says error, sometimes I weight 295 and sometimes I weigh 361, I think that this scale is only set to weigh 370 so I thought maybe I was too heavy for it. So I decided to start my journey with a brand new scale. The scale I found is called Taylor Digital Bathroom Scale (pictured) it will weight up to 400 pounds and it beeps when it is finished. I decided I didn't need anything fancy, nothing that measured BMI or bone mass or memorized 4 different peoples stats. Just a scale that help enough weight and that beeped when it was done, so that I will not continue to move and mess up the results. When I got home I unboxed the new scale, inserted the batteries and read the directions. Stepped on the scales and they beeped ... 293.2 ... WHAT ... so I am not as big as I thought!!! Step off... step on ... beep 295... What? Test it with Kaid..... step on watch feet placement ....beep.... 362.4 .... step off... beep.... 362.4 ... step off... beep.... 362.4 ..... finally some consistency! So here it is the number you have all been waiting for .... my official starting weigh is ... 362.4 pounds ... I cannot believe I am putting this out there for the world to read! Phew... I feel better! Sunny called and paid our deposit, our days are secured and the rooms are secured! I am beyond excited. The last few days I have started realizing exactly how much I will be able to eat once I have the sleeve. That is a bit disturbing, but there is no turning back. I will make it happen! While she paid the deposit, Sunny had to make a few executive decisions, the main one being that we will not go with Dr. Garcia as our main surgeon, but with his partner, Dr. David Vazquez. He has just as much experience as Dr. Garcia, he is just newer to the area, so his cost is less. Dr. Garcia assists him on every single operation and Dr. V assists Dr. G on all of his, so either way we are getting both surgeons. I am very comfortable with this decision, it almost makes me more excited! I did it, I made the decision to change my life ... NOW to tell "My People" ... Who are "My People?" - My People are those who have my back NO MATTER the out come. The people I turn to at a moment's notice and for the most part my very closest family members. I feel like not everyone wants to, nor do they need to hear the details of my every whim, but My People are out of luck, they have no choice! This is how I broke the news all at once in a Facebook group message ..... This is a link to the Dr. I will be using and the facilities ... it answers a lot of questions ... http://www.tijuanabariatrics.com/bariatric-surgery/gastric-sleeve-surgery You are my people so I need you to know .... We have a Date! MARCH 9th, 2015 ... that is the day our lives are set to changes! Step 2 is complete, "Our Girl" is out of the office sick, so we will pay our deposit when she gets back, but we have been assured that our date is set! Feelings Today {Excited} to get this show on the road already {Nervous} the pain will be more than I expect {Uncertain} about how I will react to spending that many days, that far away from my Kids {Wondering} Should I make a living will before I go {Hopeful} that I will gain what I am looking for {Apprehensive} about flying {Eager} to put this behind me {Passionate} about my decision Heavenly Father, I just want to thank you so much for this opportunity. I pray that you are with Sunny and I as we go through this process. Please speak to us along the way sending us sparks of encouragement as we go along. You know our doubts, our fears, and our limitations, please keep us focused, calm & excited not only for the surgery, but in the months that follow. Be with all of the professional staff, even this far ahead, as they prepare to do what they do best, especially our surgeon, pump him full of any knowledge he might need to treat any unique situation that may arise with either one of us. I pray that you use me as a testimony and a witness for you and that all that comes from this journey only glorifies your name, that it makes you famous for what you do! Please be with our families and those who love us, give them the insight to accept what we have decided to do, give them peace as we travel to Mexico and give them patience as we tread unknown waters. and Always always, thank you for putting people and opportunities in my life, and setting events into motion that have lead me to today! I love you and honor you! In Jesus Name, Amen Today Sunny and I had an appointment to chat with our coordinator, we were going to conference call and set the date for the surgery. Today was the day we were set to pay our deposit, to lock in the date, from this day on there would be no turning back! Today, our coordinator messaged me to let us know she was down with the flu, so we would have to hold off on the appointment until tomorrow. I have always been a firm believer that things happen for a reason, in fact in my StrengthQuest class I have found that Connectedness is one of my top 5 strengths. So, I couldn't help but take this as a sign; Is this Gods way of telling me that the surgery isn't for me? is the hospital not all it is cracked up to be? It is times like this in the quiet peacefulness after all of the kiddos have hit the sack that I sit and talk to God, just he and I, talking about life, searching my heart, just getting to know each other. It is often that he reveals himself to me through mindless web browsing. Tonight, I just couldn't shake Michael's initial question... "is it biblical?" I had prayed about it and even quoted verses and justified my thoughts to him and others, but I had never searched the thoughts of other Christians. So tonight I searched "A Christian's view on weightloss surgery." I finally did it! I hit submit! Now we wait. This step is like yanking off a bandage ... say a little prayer with the one sitting closest to you and jump. .. at least that's how I did it!
it's the waiting game though that is about to kill me! They say I'll know something within 48 hours... but everytime my email songs I jump... I just need to km know either way what the future holds. I know I must be making Sunny crazy ..... Today my 10 year old son decided to finally get back on the scale, he called me in and we read it together 171 it said ... shock ... sadness ... disappointment in myself! He played football summer long and gained 6 pounds, I can't believe it, when did it come to this? I don't know what to do, it's a downward spiral and we have to get a hold of it. I hate it for him he burst into tears and I all I can do is hug him and move on. I didn't know how to comfort him. That night I talked to my boys about having the surgery and about the reasons I wanted to have the it. We were in the car on the way to pick up our foster daughter. Kaidan and I were talking about his fears, and I hear Jax in the background sobbing and saying "I hate myself because I'm fat." I can't believe I let it go that far I can't believe we took it so far that my poor baby hates himself and it's all my fault, so for this I have to have the surgery, I have to change who I am so that I can change who he is and hopefully in this he sees that it's for health reasons. Hopefully I get the energy to run with him, hopefully I figure out how to feed my family and change our lives. That's the day I decided to have gastric sleeve surgery, if for nothing more than for him. I have to change what we do! I have to get through to him though that the surgery is not the answer. I don't want him to think that he can go through life and eat and eat as much as he wants until he's old enough to have the surgery, and that will fix it. I want him to know that it stops today... now to the hard part, figuring out how to make that happen. Lucky for me I have access to 1 of the best therapist in the area, Mr. Parks is amazing and I've spoken with him and he's agreed to see J. Lord Jesus, I come to you and I pray for my family father, Please comfort Jaxen and help him to keep his personality and gain confidence. I pray he learns to love himself the way everyone else does, help him to see himself through the eyes of those around him and not through fat glasses. Please father be with me as I try to change my families life and be with families who may be suffering from the same thing. I pray that my baby does not have to suffer the way that I have had to suffer. Be with Mr Parks, give him the knowledge to tackle this situation. I pray that you also give me the knowledge and the strength that I need throughout this journey and give Jax the insight to know the surgery is not because I hate myself but because I love myself. Thank you for the opportunities that you've given us and the family that you've given us. In Jesus name, Amen *It is important to note that I later found out he had grown 3 inches throughout the summer ... and weighed 6 pounds less 2 weeks later. |
This weight loss is only from June 2015 (I had lost another 51 pounds prior to this)
Blog MissionIt has taken me a long time to get to this point, but I feel like God opened the right doors at the right time. My vision for this blog is not only to document and share my journey with those who care, but also to encourage those who may be following in my footsteps. First and foremost though, I want to give all the glory to God & to focus on his plan for me throughout the journey. What you talkin' 'bout?VSG = Vertical Gastric Sleeve Categories
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