Hi I am Kate. I was an active member a few years ago, then fell off the wagon. Tried to hop back on about 18 months ago, but the ride was short lived.

So here I am again...not exactly a newbie, but more of a lost friend looking to come back.

My weight struggles began when I was about 12. I have been on Weight Watcher, Low carb, low fat, Redux, the soup diet, Slim Fast, Dexatrim. Some more successful than others, but I alway gain it back...plus more!

So here I am today. I am ashamed to admit that I have gotten to 315 pounds. Tuesday I went back to the doctor and we discussed weight loss surgery. I will attend an informational meeting on July 12th and start filling out "the paperwork". I know I need to do something to get healthy. My blood pressure is up, I have sleep apnea, asthma, and arthritis. On Jthe 16th of July I will have knee surgery.

Surprisingly my husband is very supportive of me have WLS. Not so surprisingly my mother is very opposed to me having WLS. She "knows people" who have had the surgery and it "hasn't worked", she "knows people" who have had surgery and "are sickly" ever since, she "knows people" who had died "from surgery". **** I didn't know she knew SO MANY people! She says I will have to eat differently for the rest of my life (which I know I will), she say so just eat like that, lose the weight and don't have the surgery. Or she tells me find out what you have to eat, how much and what I can"t eat after I have the surgery and see if I can live like that for the rest of my life.

If anyone would be willing share there experiences either n the post or via PM I would love to hear the highs and lows of the surgery.

I do have some more specific questions:

I will be having a Roux En Y bypass. How long can I expect to be off work? I have a seated job, no lifting.

I have read some people experience hair loss, did any of you have that? is there anything that can be done to prevent it?

What can you eat (or can't you eat) post surgery?

Is it a big hassel to dine out? Are there restaurants or meals ou recommend?

How do you deal with "nay sayers"? The general public I am not so concerned about, but do you have any close family or friends who are less than supportive and how do you deal with it?

Is there anythig you feel someone who is going to have surgery should know, but the docs might not cover before hand? Those things that you say, WOW would have been nice to know that before hand.

Thank you for your time and I look forward to meeting others who have been down this road.

Hi Kate -

Congrats on making a decision to look into it. sometimes simply examining the options is a big help, whether or not you decide to have surgery. Many of your Qs have been answered in earlier posts, BUT someone has taken down several pages of posts - not sure why.

I'm trying to get them back. so, please give me some time. In the meanwhile, I'm sure others will chime in.

Thank you jiffypop. I guess I am more than "considering" surgery. I have had my first appointment with the bariatric doctor, although she is not the surgeon. My next step is go to a group meeting which is July 12th. I am currently on an 1800 calorie diet and food journaling. The dietician said there will be a pre surgery diet and of course post surgery diet. At the meeting on the 12th I will get a packet and there will be paperwork to be filled out. My bariatric doctor and I have a goal set...we would like this surgery done before the end of the year.

I tend to say "considering" because I know how opposed my mother is to me having GBS. I have decided I will give her information as she asks for it, I will offer no additional information.

I have been reading through the other threads and finding them interesting.

Welcome (err, welcome back?) I had a midified Duodenal Switch (DS) performed in March 2009, so a little over 3 years ago now. I have since lost more than 100 pounds, put my type 2 diabetes into "remission," and had a perfectly healthy pregnancy and baby! I dieted as a kid, too, as I was overweight since about age 4 and over 200 pounds upon entering high school

One thing I didn't see you mention in your post is insurance. Are you going to self-pay, or will insurance cover your surgery? If the latter, make sure you check the insurance company's requirements, as many have a 6- or even 12-month required "medically supervised diet" before they will approve you for surgery, which could impact your timeline of having surgery by the end of the year.

I will be having a Roux En Y bypass. How long can I expect to be off work? I have a seated job, no lifting.
This varies from person to person, unfortunately. I have a desk job as well. I had my surgery on a Friday and took off the following full 2 weeks, then returned to the office full time. I've read others who said they couldn't go back to work for a month, some 6 weeks...I think it depends on a lot of factors, including age (I was 26 when I had my surgery), level of fitness, how your body responds to surgery (if you've ever had surgery before - anesthesia is tough for some to recover from), how well you take care of yourself in the first few days and weeks after surgery (especially getting up and moving as much as possible, as soon as possible, and getting plenty of fluids in each day), etc.

I have read some people experience hair loss, did any of you have that? is there anything that can be done to prevent it?
I lost some hair, but it was never enough to be noticable to anyone else (just to me by the hair in the shower drain and in my comb!). This is just something that often happens after major surgery or any major trauma; it is happening to me now after having my baby (also common after childbirth). It is a process called telogen effluvium by which the body stops the normal hair growth cycle while you are recovering, and it then begins the cycle again once you're healed, but then ALL your hairs are at the same point in the cycle, so you lose a lot of hair at once instead of a little here and there like usual. This will work itself out over time. Keeping up on protein and vitamins can help to keep the new hair growth healthy, but if you're gonna lose hair, you're gonna lose hair, and there's really no way to know ahead of time if you will or not.

What can you eat (or can't you eat) post surgery?
I had a DS, not RNY, but I can really eat pretty much anything. Too many starchy carbs will give me gas, but that's about it. I do best with my weight, evergy, and overall health when I stick to a low-carb, high-fat way of eating.

Is it a big hassel to dine out? Are there restaurants or meals ou recommend?
Before my baby, it was just me and my husband, and we ate out literally EVERY day. He doesn't cook at all, and I don't enjoy cooking, so it was purely a matter of convenience that fit our lifestyle at the time. I could find something to eat anywhere I went. Just focus on protein (chicken, fish, steak, burgers, pork chops...) that is not batered or breaded, replace starchy sides like fries or mashed potatoes with less starchy veggies like green beans, broccoli, or side salad, and order things that reheat well because you WILL have leftovers Some will recommend ordering off the kids' menu, but I never do that because it's usually full of junk like mac n cheese, grilled cheese, wimpy little burgers, and breaded chicken tenders.

How do you deal with "nay sayers"? The general public I am not so concerned about, but do you have any close family or friends who are less than supportive and how do you deal with it?
My family and friends were all pretty supportive. If anyone ever had something negative to say, I was able to combat that by offring information or data, as most of the negativity was rooted in misinformation, misunderstanding, or a single personal experience that was not representative of the much more common outcomes. For example, your mom saying to just eat the way you will after surgery implies that it's all about self control. While that is a factor, having a phsyically smaller stomach that does not constantly feel empty will make it easier for you to manage portion control and certain food choices (at least for the first year or two) without you feeling hungry and miserable all the time; surgery doesn't just change how and what you eat, but also how you physically FEEL when you're eating, as well as often decreasing hunger for many patients.

Honestly, I used to BE a "nay-sayer." I thought, why would I rearrange my insides just to eat less? Or to be physically punished for eating the wrong foods (such as with dumping syndrom)? I'd rather just hire someone to follow me around and punch me in the stomach any time I ate junk food! It was only when I really got into the research and realized all the changes the surgery can have on the body, including hormonal changes that can affect hunger and the resolution of certain comorbidities even before you lose any weight, that I "got it."

Is there anythig you feel someone who is going to have surgery should know, but the docs might not cover before hand? Those things that you say, WOW would have been nice to know that before hand.
Just make sure the RNY is what YOU want and what you want to live with for the rest of your life. Many people don't know there are actually 4 WLS options available in the US, not just the RNY and band - there is also the DS and the VSG (vertical sleeve gastrectomy). Read about them all, compare, and choose the procedure that will be the best fit for you, your desired outcomes, your lifestyle, etc. Most bariatric groups do NOT perform all of these procedures, so they are likely to either not even mention the ones they do not perform, or they may provide negatively-slanted misinformation to deter you from choosing a procedure they do not perform (which would mean they would lose you as a "customer"). I will never say one procedure is best for everyone, but I have seen MANY people say they wish they'd know about XYZ before they had their RNY or band. When I started researching WLS, I knew the band wouldn't be enough for me, and I found the RNY very scary for me, personally. Then I discovered the DS, and it was like someone had found just the right puzzle piece to fit for me. Each procedure has its own stats, post-op requirements, and potential risks and side effects, so just make sure you go into that operating room completely confident in your decision.

I FOUND THEM!!!

here's a list of threads with a lot of info that might help and certainly feel free to ask more Qs.

enjoy!

http://www.3fatchicks.com/forum/weig...ds-family.html
http://www.3fatchicks.com/forum/weig...-question.html
http://www.3fatchicks.com/forum/weig...-i-choose.html
http://www.3fatchicks.com/forum/weig...e-help-me.html
http://www.3fatchicks.com/forum/weig...ing-about.html
http://www.3fatchicks.com/forum/weig...aving-wls.html
http://www.3fatchicks.com/forum/weig...ly-advise.html
http://www.3fatchicks.com/forum/weig...eeking-me.html
http://www.3fatchicks.com/forum/weig...ating-out.html
http://www.3fatchicks.com/forum/weig...r-surgery.html
http://www.3fatchicks.com/forum/weig...r-surgery.html
http://www.3fatchicks.com/forum/weig...eed-share.html

Jill-

Thank you so much for your thoughts on WLS. And a BIG CONGRATULATIONS on your weight loss and more importantly the birth of your son!!

I know everyone has there own reasons for choosing one WLS over another. I have ruled out Lap Band as I am not sure it is "enough". I read a lot about RNY but have only seen DS mentioned a few times. Could you explain the differences?

Insurance-Yes I have insurance, Yes they cover bariatric surgery...BUT only at a Blue Distiction Center. The doctor i am currently seeing does not operate out of a Blue Distinction Center. She did tell me that they work with other doctors at such centers. I should be able to do all (or most) of the pre op stuff through her and her collegues and have the surgery at a Blue Distiction Center. Most follow up can be done with the doctor I am seeing now. yes there is a 6 month medical supervised weight loss plan period. My doc is hoping we can slip it in right before the end of the year...Merry Christmas! I have other co morbidities, she said that sometimes can speed up the process. I have also been on a medically supervised plan twice before. She is unsure if that will have influance on the insurance company or not.

I have my mind made up that this is what I am going to do. (Although I will look a bit more closely at a DS v. RNY) I will have to take each step as it comes.

Thanks again for your input!!

Thanks Jiffy!!! I will keep reading...good thing it's slow at work!

Hi Kate. Here are my answers to your questions. I had laparoscopic RNY 11 months ago.


I will be having a Roux En Y bypass. How long can I expect to be off work? I have a seated job, no lifting.

I teach and had a little less than 4 weeks off between my surgery and the first day of school. Other than being very tired at the end of the day (and I can't recall a school year where I wasn't tired at the end of the school day the first week), I had no problems.


I have read some people experience hair loss, did any of you have that? is there anything that can be done to prevent it?

I lost a lot of hair, starting at around 3 months. I'm still losing hair, although not nearly as much, and new hairs are beginning to sprout up. There really isn't anything you can do to prevent it; people say that keeping up with vitamins and protein can lessen the impact. I'm pretty good with both of those and I know I've lost 50% of my head (and my hair dresser agrees...).



What can you eat (or can't you eat) post surgery?

My first six months were unlike others and I was pretty limited to soft foods; pudding, applesauce, cottage cheese, and yogurt were my only safe foods. Now I can eat almost anything within reason. Only rice and pasta are off limits to me, mostly because they feel heavy (and are not good for me anyway).



Is it a big hassel to dine out? Are there restaurants or meals ou recommend?

Nope. I order the most protein-dense appetizer or meal that I can and usually take the leftovers home.



How do you deal with "nay sayers"? The general public I am not so concerned about, but do you have any close family or friends who are less than supportive and how do you deal with it?

I'm lucky; my family has been incredibly supportive. I did not feel the need to tell many other people and only a few friends "officially" know I had surgery, but I'm sure everyone else suspects. I mean, how often do people lose over 130lbs in one year?




Is there anythig you feel someone who is going to have surgery should know, but the docs might not cover before hand? Those things that you say, WOW would have been nice to know that before hand.

First, I hope you know that the malabsorption of RNY does not last forever; only the restriction should. For some reason, many RNY patients don't seem to be told this by their surgeons.

Second, be your own personal advocate. Do not rely on doctors, nutritionists, and/or pharmacists to "know" and do what is right for you. Many PCPs are not overly familiar with the requirements of WLS patients, especially in terms of nutrition and supplementation, and may inadvertently harm your health with their advice. For example, there are many NUTS who recommend WLS patients take Flintstone or gummy vitamins, which are not the best vitamin for RNY patients to depend upon, or prescribe NSAIDS, which can not be taken by RNY patients.

Finally, the surgeries do not fix your head or food issues. They will still be there, waiting for you, once you heal a bit. If you think this will be a concern, you might want to start therapy now.



Good luck. My advice is to do lots of research into the four main WLS procedures and talk/ask questions of long-term postops. Newbies like myself often glorify their respective surgeries and do not give a clear perspective of what the long-term effects can/may be.

Hi Kate!

I'm Julie. I had laparoscopic MGB (mini-gastric bypass) on May 17. The difference between MGB and RNY is that the MGB is a vertical stomach connected straight into the small intestine. There is only one limb instead of two. I have a six-foot bypass. My stomach is a little larger than RNY and shaped differently - it's more like a sleeve minus the pyloric valve and holds 4-6 ounces. It's also nearly unstretchable, although you can stretch your small intestine's holding capacity over time.

So my surgery is a little different than yours. It's been around about twelve years. I am active in my surgeon's support group, and for MGBers, standard weight loss seems to be in the 60-70% of excess weight lost area. There isn't a lot of regain with my surgery - about half of us put on 10-20 pounds in year three post-op, and then pull it back off in year four. I do have to do vitamins, protein, things like that.

Your questions, my answers

I will be having a Roux En Y bypass. How long can I expect to be off work? I have a seated job, no lifting.

My understanding is that RNY is a longer recovery time than MGB. I was out of the hospital in 24 hours and up running around shopping two days later. I work at home, and I felt okay to work the week of surgery. I know a few RNYers who needed two weeks, so if you can plan for a few weeks off you might be glad you did, just for energy's sake. I still get tired at the end of the day seven weeks out.


I have read some people experience hair loss, did any of you have that? is there anything that can be done to prevent it?

Jilly explained that beautifully in her post, so I'll just say that I've always shed a lot of hair, and I don't think I've hit that falling-out stage yet. My dad, who had surgery in late February, now has thinner hair and a little bald spot in the back. I think it'll grow back just fine, and he's 67 so the craps he does not give would fill an empty box. My surgeon told me to get my damn protein up or I could lose up to 40% of my hair, and I am vain like that, so I am drinking protein shakes like a mad woman.


What can you eat (or can't you eat) post surgery?

Yogurt was supposed to be one of my main foods the first few weeks. Then it turned out, post-op, that I became lactose intolerant. Whoops! I don't do bread yet either. I don't miss it - I forget to buy it now. My surgery is not as low-carb as RNY, so I'm allowed to eat whatever I want as long as I eat "protein first".

The difference is that now, my stomach will tell me what I want. If I put something in my mouth it does not like, I know. Immediately. Also, I do very well with meat, something I didn't expect so soon. I like a nice rare burger - and then I eat 1/4 of it, no bun, add cheese (I can do cheese - lower lactose than milk). I'm experimenting with soy milk in shakes and so far, I don't like it. In fact, the only protein shake I like now is Click espresso.

My surgeon is not a fan of tannins. This means no real coffee, no soda, no wine, no alcohol for now. I can maaaayyyybe have a little white wine or brewed coffee much later, but none for now. Also, no NSAIDS forever (ibuprofen, Aleve, Excedrin, aspirin.) Tylenol is okay in moderation. My doc's reasoning is that post-ops have a 4x higher rate of ulcers anyway, why put things in there that can cause ulcers? Other than that, I don't have a lot of restrictions. It's just what my stomach likes and can handle.

Is it a big hassel to dine out? Are there restaurants or meals ou recommend?

Taco Bell is my friend. Pintos and cheese are just the right size, with good protein. I kind of want a crunchy taco soon. I can even do the patty from a small McD's cheeseburger and maybe a couple of fries if there's room. Chinese buffets are good because I can do boiled shrimp and egg drop soup. My best post-op meal so far? Joe's Crab Shack. I ordered the crab dip and added a small crab legs. It was so good I did not listen to my stomach when it said STOP, and that hurt. But it was delicious.

How do you deal with "nay sayers"? The general public I am not so concerned about, but do you have any close family or friends who are less than supportive and how do you deal with it?

Honestly? They can get on board or get out of my way. I'm not thin yet. I've only lost 33 pounds, so far, which is a little bit slow on the loss side. So to most people I don't even look all that different yet. My friends who weren't supportive? Screw 'em. I don't need people who want to keep me unhealthy. Family you can't get rid of, but I find that they try, even if they disagree with my decision. Once they learn that I am off all my heart meds, that my blood pressure went from 179/117 to 112/80, that I put away my CPAP? They get supportive, or they don't get to hang around so much. Basically people just need to know that you're still you, just healthier. I didn't do this to look pretty. I did it to live longer.

Is there anythig you feel someone who is going to have surgery should know, but the docs might not cover before hand? Those things that you say, WOW would have been nice to know that before hand.

Gatorade might go down easier than water at first. At about three weeks out you might wonder why you thought you could eat last week and now you can't. (Answer: healing nerves in your new stomach.) Lip balm is your friend. You are not even going to get close to the fluid and protein intake they want for a month, minimum. You should try for it, but don't panic if you don't make it. Head hunger can be as bad as tummy hunger - turn off the TV during commercials. Eat SLOWLY. I still tend to eat too fast and I pay for it.

And my favorite piece of advice: if you are losing a lot of weight fast, and suddenly you start crying for no reason, please call your doc and ask for an estrogen patch. It will help. Estrogen is stored in the fat cells. You lose a bunch of fat real fast, you will also take an estrogen dive, and it can feel like postpartum depression. Some of it is real depression caused by the trauma and the huge changes - but some of it is easily fixed with a quarter-sized patch on your tummy for a few months. My doc has a standing order for it if we need it - ask yours.

Wow, that was LONG.

Julie-
Thanks for the info!! BTW I LOVE your hair!!!

I am only really concered about getting my Mom on board and be supportive, even if the only way she can be spportive is by keeping her yap shut.

I have done some more research and talked with my insurance company. My bariatric doctor now pretty much only does RNY for people with a BMI as high as mine. BUT I found out from insurance the hospital/clinic my doctor works out of is NOT in the Blue Distinction Center, so I have to have another doctor do the surgery. My doctor said they run into this and I can still do most of the pre-op stuff through her. With that being said I am looking at other WLS procedures, just to make sure I get the right one. RNY may not be what I end up with. I have arthritis in my knees and currently take Celebrex and A LOT of Advil. But if I lose weight I may not need to take those. More to think about!

I am currently trying to do some of the post surgery requirements, just so I have more time to get used to them. Things like eating slower, taking smaller bites, chewing til food is mush, and drinking more water. They are small things but I figure I have six months to make it a habit I will have an easier time adjusting after surgery.

The three things that scare me most:

1. FAILURE What if I do this and I still don't lose weight?

2. HAIR LOSS Because I am vain like that.

3. ARTERIAL BLOOD GASSES Because I am a coward! I hate needles A LOT! A few years back I had part of my left lung removed and had some complications they wanted to do an Arterial Blood Gas and they tried, for 35 minutes, they could not get in the artery. The reason they quit? I hade thrown up 3 times and passed out twice. I had a briuse the size of a tennis ball on my wrist/hand/arm.

Thanks again for the info and congrats on your loss!! Looking forward to following your progress!

Kate - just a quick note because i have to get my cat to the vet [she has lymphoma and has to have the excess fluid removed from her abdomen].

that whole left lung thing - of course you're going to tell every doc you see about the surgery about it at just about every visit. the anesthesiologist will come up with a plan to keep you safe during the surgery, but be prepared to be intubated after they put you to sleep. make sure that they explain every detail to you.

they'll monitor your oxygen levels with those little finger gadgets, so most likely, they won't need to go diging for arterial blood.

more later.

imp and Jen made some GREAT points that I forgot about! These posts are good even for us post-ops to remind us of some things to mention to pre-ops when we're trying to help

Jen's point about RNY malabsorption not lasting forever is dead on - and, like her, I'm surprised at how many surgeons don't mention this to their patients. While you will always still have trouble absorbing all your vitamins/minerals (so you'll need to take supplements forever), you will absorb more calories over time as the intestin works to compensate for the bypass via hypertrophy and the grown of additional villi t increase absorption. However, the vitamins/minerals will always be malabsorbed because certain micronutrients are only absorbed in certain PARTS of the intestine, and if those parts are bypassed, then increasing the number of villi in the remaining parts won't help. Also, some micronutrients, such as B12, are largely absorbed in the stomach and/or require a chemical typically released primarily in the stomach in order to be broken down for absorption (B12 requires intrinsic factor), so since they RNY bypasses the majority of the stomach, that also factors in for micronutrient malabsorption.

An imp is so right about water arly out. Before my surgery, I easily drank at least 2 liters of plain water every day, so I figured I'd be fine with liquids post-op. However, plain water made me nauseous in the early weeks, and I actually ended up dehydrated by about a month post-op and had to get IV fluids at the hospital to get me going again. So make sure you've got some other low-sugar options on hand (non-carbonated) besides water, like some sugar free Crystal Light type drink mixes (which you may find you'll need to water down a bit since the flavors may be too sweet at first), Gatorade G2, teas (preferably decaf), etc.

Jif- I hope the kitty will be ok. Poor furry baby! I will definately inform every doc about the lung thing. I am starting to feel like I should wirte the whole long drawn out story on a sheet and laminate it and hang it around my neck everytime I go to the doc. Even ones who have heard it before ask me about it again.

I thoght I had read somewhere that Arterial Blood Gasses was one of the standard pre op tests. If that doesn't have to be done that will make a whole lot less anxious!

I am glad Crystal Light will work after surgery. I currently have trouble with plain water right away in the morning, and I HATE Gatorade.

I love hearing every body's stories and experiences. I have been doing a lot of research too! Seems like with every post I am looking up something else!

thanks, Kate. She's actually doing surprisingly well - the vet is surprised that she's lasted this long and in such good condition. she's eating, drinking, bodily functions OK, playing a little, and being very affectionate. but he took out 1200 mL of fluid today [and 1800 mL a few weeks ago]. as long as she's happy and comfy, that's what matters!

they WILL need to know your oxygen saturation [one of the components of arterial blood gas measurements], but that's measured with the little finger thingy. if that's abnormal, though [and i DO MEAN abnormal], they'll do the full ABG study - carbon monoxide, oxygen, ratios and so on. I wouldn't rule out that they might do a full ABG while you're on the table. so be sure to get ALL the details from the surgeon AND the anesthesiologist.

i had breathing problems before the surgery - i was hypoventilating, and had HORRIBLE ABG results at the start. by the time of surgery, i was FINE, but they did take a little extra care with my oxygen sats afterwards.

as for post-op drinking. everyone's different, and what works one day won't work another. so, having said that, temperature plays a BIG role in what i can/can't consume comfortably. water that was cool [not icy!] worked better for me. but protein shakes had to be poured over ice. there was NO WAY i could whip them up in a blender with ice and consumer them. too much air! and at times, i spooned the protein into my mouth because i just coudln't drink it without a tummy problem.

all this to say - don't give up! keep experimenting with temperature, flavors, textures, tastes, eating styles to find out what works for YOU. and then be prepared to change if/when your body rebels

while the surgeon's skill is really important, the BIGGEST factor is attitude. You can go into this with the attitude that [1] you'll never be able to make this work, OR [2] you'll want to figure out how to eat around the surgery, or [3] you have a new chance to learn what works for you, and you'll be flexible enough to make changes as you need to.

guess which sort of attitude works better than the others?

just wanted to add a note in response to something that IMP said - about the NSAIDS. her surgeon says NO. my surgeon said YES to the occasional NSAID dose, after the stomach was healed, and as long as i took them with a little food.

with the following warning: if my knees were ever in so much pain that i had to take NSAIDS a few times a day for weeks on end, we'd have to have a serious talk about knee surgery, because that dose of NSAIDS is too high for someone with the tiny tummy. And my PCP is careful about what he prescribes for pain management. For example - i was in a car accident in December, complete with whiplash. the doc gave me oxycodone instead of NSAIDs, but said that i could supplement it with occasional OTC NSAID doses.

ALL THIS TO SAY - listen to your surgeon. they don't make the same recommendations. and make sure you ask WHY they make these recommendations. some docs make recommendations based on the current medical evidence, others make them on 'feelings,' or their personal experiences, and others take the recommendations of other docs - who may or may not have a good reason.

And then share the instructions from your surgeon with every other doc you have. they ALL have to understand what the others are doing and saying - and it'll be up to you to make sure that they TALK in order to come to a good decision for YOU. but this is something we all should be doing, regardless of whether we've had WLS or not.