Today was my first doctor’s appointment in more than 7 years.

I told her about my 105+ pounds of lost weight. I told her my menstrual cycles have become regular again. I told her I’m training for not one, but two half marathons this year.

She told me I was doing everything right. She told me maybe I didn’t need to drink quite so much water. She told me to get lab work and come back at the end of the month.

We talked about my complex medical history. We talked about my current nutrition. We talked about my future goals.

And we began a conversation about one big thing that’s been on my mind for the past few months: skin removal surgery.

Because in several places on my body where there used to be fat, my skin hangs low. It wobbles to and fro. Before too long, it wouldn’t surprise me if I could tie it in a knot and tie it in a bow. God forbid I should wind up with enough to do what’s described in the lyric that comes next.

I’m not done yet. There’s no certainty about much more time it will take me to reach my “end state” — but it could be about a year, give or take. Starting the conversation with my doctor is the right move strategically for insurance purposes as well as for my own psychological and logistical purposes. My doctor gave me a referral for a practice that has done good work for a past patient of hers for an initial consultation, as a first step, which I look forward to taking. And, if I’m being 100% honest, it motivates me to keep going. Yes, I am interested in the aesthetics of this because I’m a person with deep-seated body issues and some (probably standard-issue) vanity to boot; no question it’s unsightly. But also, it is physically uncomfortable. Loose skin hanging from my arms, belly, and inner thighs is in the way. It chafes. It bulges. It gets irritated. And it’s not the kind of skin that just burns off when you lose more weight; it gathers additional mass.

This is just the beginning of a longer discussion, but it’s the right time. A surgical option is a big decision with a lot to think about, and I’m ready to start doing that in a real way with professionals who can paint it all in practical terms. My body isn’t finished changing yet, but the progression has been so rapid — 92 lbs since mid-June — that the finish line is going to get here fast no matter when that is.

I want to be prepared for it, not blindsided by it.

So, yes: today was a big day. It felt like the start of a new chapter. Not the exit from an old chapter, but the beginning of a concurrent one that has never been foreshadowed in anything that has been written so far. It’s as grounding as it is exciting, because for the first time, I’m looking at something that feels within my reach. I believe I have a doctor who is on my side and is invested in my health. I don’t have to do it alone.

Going forward is going to get harder because it’s going to demand more and more from me. I’ve already had to persevere through the slog of the 200s, sticking to my plan without taking drastic measures out of desperation to finally cross that threshold. I’ve already had to work around injuries and modify training sessions. I’ve already had to creatively reconfigure my schedule to ensure my workouts and meals didn’t fall off. It’s nothing I haven’t been able to handle, but it is the type of demand that tends to produce fatigue that compounds with time and demand. I’m trying to be prepared for that, too.

I heard somewhere, in a different context, perhaps the most affirming and applicable quote that fits my whole approach to my self-improvement work: “Motivation is fickle; discipline is consistent.”

I’ve shown up.
And I’ll keep showing up.
Because god damn if I’m not disciplined.