Getting ready for bariatric surgery! Tips, Tricks and Tools
ladybug2659
Posts: 91 Member
Getting ready for surgery is exciting and scary! You've jumped through all the hoops and set the date! This discussion thread is focused on sharing experiences and preparing yourself (as well as those you have told) for your special journey.
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Tip! There are a variety of free apps to support your bariatric surgery!
Free: Protein Rich Food App and Water Drink Reminder App
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Baritastic is also a good app. It was recommended by several participants in my orientation group.3
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My story? Getting mentally ready was the hardest part for me. I am now one week post-op following gastric sleeve, and I have to laugh at how I got myself all worked up for nothing!
I am taking it one ounce at a time, one day at a time. Each day has been a little different, but I know the effort will pay off! 8 -
I believe wrapping one’s brain around the surgery is difficult. Obviously, we must eat to live and part of living is enjoying delicious food and being healthy. Then, you wonder how in the world to begin the approval process and set the date. You can read, research, and watch countless testimonials on YouTube. Ultimately, it’s your choice and you decide to do it. Some people will be supportive, some will not. It’s a bit of a roller coaster but in my opinion it is worth it. I treat my new pouch (I named her Delilah) like a new baby’s stomach, I am introducing nutritional foods and track my protein, sodium, carbs and sugars. I have learned exactly how to portion and time my meals—little to no hunger or cravings. At 4 weeks out my stomach is still a little bit sore—no vomiting or heartburn. I do have to avoid sorbitol and other similar sugar alcohols because they give me gas that hurts! I really recommend the the unflavored whey protein which you can add to any soup or meal—the protein helps metabolism by boosting its ability to burn fat and not muscle. One Day at a time and you will transform your body and your health.... not to mention your wardrobe!2
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TIPS, TRICKS and TOOLS....
Did you know that all bariatric doctors do not require a pre-op diet?
New Whey Protein Bullets (Amazon) come in a variety of flavors and provide 47 grams of protein in 3.8 oz.
You can purchase a portable case containing a baby fork, spoon, knife so you train your brain on how big your bites of food should be?
Always eat your proteins first, veggies then fruits — limit yourself to complex carbs only.
Weight Watchers markets a low fat, sugar free chocolate truffle ice cream with no sorbitol (no dumping syndrome).
TUMs are inexpensive and offer quick relief from stomach pain due to acid; know the downside to long term use of Prilosec, Zantac or Pepcid.
You can purchase a portable snap shut ice cube tray and put all your puréed food selections into each section and keep it in the frig.
Little Journey organic puréed baby foods come in squeezable pouches that you can carry in your purse to curb the growls or hunger pangs?
Avoid going to a chiropractor for a minimum of two weeks after surgery (always get an ok from your doc).
Track your blood pressure if you are on meds for hypertension! As you shed weight you may need have it adjusted to lower dose (or better yet, be given the ok from your doc to stop taking it)!
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Thank you for sharing. I've been seeing a nutritionist. I've seen a bariatric surgeon. My insurance company insist that I diet for 90 days before they consider the approvals. I need to lose 100 pounds and I'm 58. I've tried everything else so I rejoined Myfitnesspal hoping it helps.2
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You can certainly put yourself on the bariatric preops diet with the protein and supplements. This record or history will help you and your nutritionist in providing pertinent data over the next 90 days. If you have co-morbidity issues such as hypertension, pre diabetic, ME/CFS, arthritis etc. Then your chances of getting approved increase. If your BMI is high, that too works in your favor to getting the surgery. Type of surgery is a factor too. It is helpful to talk strategically with your surgeon’s case management team or person. They will give you a checklist to help you and them fast track you through the process. This surgery is a tool, it’s benefiting many however, it’s not a quick fix, it will govern everything you put in your mouth.... so learn all you can and know that being 58 post-menopausal that we have hormonal issues that contribute to obesity. I am glad I had the sleeve but everyday is one of choices and improving my health through lifestyle changes. Good luck!1
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So how much of your stomach does the doctor remove? What does it look like full? As in “a whole pizza”..
See Inflating the Stomach on YouTube by Dr. Alvarez.
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I am scheduled to get the sleeve. My insurance does require a three month period of seeing my doctor's and maintaining weight. So my surgery will be in June. I am so excited and nervous. I am also tense about these three months, because if I gain even half a pound, I can't have surgery.3
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Don’t think I have ever heard of insurance saying to maintain your weight —rather they sometimes require that you do a pre-op diet to show you are committed to the process. Perhaps they feel if you maintain that you are trying not to overeat? I wish you the best moulia, I would see what your doctor recommends. Maybe the doctor would like you to transition to the post-op diet to ensure your approval? Don’t be nervous, go to some local support meetings (which should be free) and maybe you can find a sleeve buddy. There are a couple pre-op patients in my group and they find it helpful. Keep us posted!0
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Staying hydrated can be a challenge, and if you are a bariatric patient getting water, essential vitamins and ensuring that your electrolytes are maintained is a daily essential. LyteShow is an electrolyte-replenishing, liquid concentrate made for those who don’t want unnecessary additives, sweeteners, or calories in their hydration products. Its mineral base is naturally sourced in the USA and clinically tested to be a significantly more efficient form of hydration than water alone. I noticed my hands, arms and legs were extremely dry. Post-op 8 weeks today and down 35 lbs (zero complaints about that) but getting down 64 oz of water is not yet possible. I noticed that since using this product, I have less dizziness upon standing, getting out of the car, or getting out of bed in the morning.1
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My program requires 6 months of monthly weight management meetings where I review/learn different areas, such as incorporating more protein, cutting soda, etc.
I’m in the last month, and then I’ll have to do 1 month of the pre-op diet because I have fatty liver syndrome. I’m not looking forward to that!
I’m worried thatcher haven’t made enough progress/changes as I’m leading up to surgery.
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Stephie_W you are almost there! The meetings are good, especially if you have access to a nutritionist who understands your challenges. It is most helpful to purchase your portable knife, fork, spoon as well as your vitamins, protein shakes and start eating as you will after surgery. Logging your food diary is very important, you can print it and give it to your doctor’s office for your file. Fatty liver makes it hard on your liver to work optimally, believe me, your body is going to go for every energy source it can get after surgery and eating that 65G+ protein is important. Any weight you may lose during your pre-op diet is great but establishing good habits “food is fuel not entertainment” and being aware of “triggers” that the brain tricks us with (emotional eating, sugar cravings, etc) is essential to success. Best of luck to you on this journey! You can do this!2
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TIP! Lifting weights help tone but what about DRY SKIN which is a common side effect. USE ALOE and Skin Brushing. Why?
Skin brushing involves treating dry skin with a large body brush and creating small circles around the areas of loose skin. This treatment is said to tighten the skin and improve circulation. Use this treatment daily--shortly after gastric VSG or gastric bypass and for the duration of the weight loss period.
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What to ask your prospective surgeon. Personally, I want to know if they graduated at the top of their class, with honors? Did they practice in a University Teaching Hospital? How many surgeries have they performed? May I speak with a few of your patients? Do you have Hospital privileges vs outpatient clinic (my doctor NEVER opts for outpatient surgery —in Hospital with 1 night stay over for observation). So, here are more specifics if you are considering bariatric surgery.
1.) What is your experience?
When it comes to surgery, experience is important. However, don’t confuse having performed a lot of surgeries with being the most skilled. Often, young surgeons coming from quality training programs don’t have as many cases under their belt as a surgeon that has been doing bariatrics for 10 or more years.
Don’t write off a young surgeon. Experience can come from a quality bariatric fellowship program. What’s a fellowship program? A fellowship is typically a two year program where a surgeon trains under another surgeon specializing in that surgical specialty. In the case of bariatric surgery, the surgeon spends two years after their standard surgical training to gain further skills in bariatric surgery (typically the trainer is a very well regarded bariatric surgeon).
But experience does count. If everything else is equal, a surgeon with more cases under his/her belt will often be more able to handle difficult cases. They’ve honed their technique, built-out quality resources, and will continue to be around for years to support you after surgery.
2.) What resources do you offer before and after surgery?
This is an important and often overlooked part of bariatric surgery. As I mentioned, weight loss surgery is a journey. It’s not an act. Successful weight loss surgery patients change habits, they dedicate the time to learn how to keep the weight off, and they’ve developed a close group of family or friends to support them.
Your bariatric surgeon should know that success is not just a result of his skills on the operating table. The staff dietitian should be truly concerned with your health. You should feel comfortable telling the dietitian what you eat and drink. The dietitian should be a good listener and able to offer advice catered to you and your situation.
Your surgeon should offer quality support group meetings. I’d ask if you can attend one of these. Typically, support groups are held once per month. Some practices offer online support groups, weekly support groups and even Facebook support groups. Support group topics range from, ‘Eating healthy during the Holidays,’ to ‘Sex after weight loss surgery.’
Some bariatric practices offer smartphone apps to help you stay connected. All of these things are important factors that lead to your success.
3.) Which procedures do you perform?
Don’t assume every surgeon performs every bariatric procedure. They don’t. But there could be a good reason for not offering every procedure.Some surgeons offer gastric bypass surgery, gastric sleeve surgery, duodenal switch surgery and revision surgeries, but they don’t offer Lap Band. Ask why? The reason could be that they have found, through experience, that too many patients did not meet their weight loss expectations with that procedure. That is an acceptable reason for not offering the procedure. In fact, it may indicate that the surgeon is more concerned with your success than he is with making money from offering another procedure that you may want.
If, on the other hand, the surgeon only offers Lap Band surgery, ask why. It could be that he or she was never trained in the other procedures. If Lap Band is the procedure that fits you best, then this surgeon may be a good option. However, a surgeon that only offers one procedure has a direct interest in making that one procedure sound like your best option. At a minimum, I’d recommend sitting through a weight loss surgery seminar with another surgeon that offers more than just one option.
4.) What procedure would you recommend for me?
A good bariatric surgeon knows that there isn’t one procedure that fits everyone. This question is good to ask because to answer the question properly the surgeon needs to know about you. The surgeon should ask you about lifestyle, your risk tolerances, your exercise habits, and your dietary habits. Gastric bypass, gastric sleeve or gastric balloons may be appropriate.
The surgeon shouldn’t choose a procedure for you. Instead, they should present you with the benefits and risks associated with each procedure. This shouldn’t be a rushed process. Bariatric surgeons are busy but a good bariatric surgeon is going to take the time to explain each procedure to your satisfaction. If a surgeon rushes through your consultation then you can probably expect the same in future interactions.
5.) What are your complication rates?
Complication rates vary from procedure to procedure. According to a study in July 2010 issue of JAMA (Bariatric Complication Rates 2010), serious peri operatives (during surgery) complication rates for gastric bypass were 3.6%. Serious complication rates for gastric sleeve surgery (sleeve gastrectomy) were 2.2% and serious complications for Lap Band surgery were 0.9%.
Keep these rates in mind when speaking with your bariatric surgeon. His or her rates should be around or lower than the national average.
Note:
The complication rates mentioned are serious perioperative complication rates. They do not include minor complications after surgery.
6.) Why should I choose you?
This question may throw the bariatric surgeon for a loop. It’s not every day a potential surgery candidate will ask this. But I think you’ll get some interesting responses. What’s the right response? That’s up to you.
Personally, I like a response that tells me why the bariatric surgeon loves his job and why he’s going to be with me to support me in this journey. A surgeon that touts his skill probably wouldn’t be the answer I’d want from this question.
Ultimately, your level of comfort in the surgeon’s skill and the knowledge that he’s truly there to help you get healthy will make your decision. The questions above will have you walking out of your initial consultation with confidence that yes this surgeon is the right one for you. Or, you’ll know that you still have some more surgeons to interview. And that’s ok. Weight loss surgery is the first step towards your new life. Start off on the right foot. Take your time and ask the right questions.
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It's my turn now.... I'm planning for a sleeve this month end... just very nervous about the complications that I've heard.....
Unable to decide.... I've been given a week more to confirm it.... what do i do0 -
Posting link to Pre-op through post-op staged diet for those interested. https://www.obesitycoverage.com/the-big-gastric-bypass-diet-guide/
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I have a consultation scheduled. I'm at the very beginning of the process. I am not so much worried about the surgery, I am already trying to get prepared for the diet and plan afterwards to lose and maintain the weight loss. I am worried about regain afterwards. My sister had the surgery and she regained her weight and then some. I don't know how that happened and even she is struggling to figure out what happened. So, I am wondering what do people do in the case of regain? Do they go back and ask for revision? or do they just try to lose the weight all over again on their own? Maybe I am worried about too much as I don't even have a date scheduled.1
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fit4sho42 it’s good to do all possible due diligence. Learn as much as you can to inform and prepare. Then, you can make the right decision for you. Please don’t focus on “what if” rather, focus on WHAT IS and your focus and commitment to this process. As I always say... bariatric surgery is a tool... not a magic solution because all of us that are on this journey knows it takes discipline and learning to live a different way. Keep us posted!1
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I'm on the pre pre-surgery diet of 1200 calories per day. I won't have the surgery until March or later and won't see my doc & dietician again for several months. The one thing the dietician didn't tell me was what % of nutrients I should be aiming for. MFP has it automatically set up for 50% = carbs, 30% = Fat and 20% = protein. (I am usually over on the protein). Everything I read about nutrition for bariatric surgery patients is the importance of protein. Should I aim for different percentages now, or should I just concentrate on the calories? Any advice would be appreciated.0
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So, endoscopy is tomorrow!!!! yaaaay!!! My Psch eval is next week. I am a little nervous about that because I do have some depression and anxiety and I hope it won't delay the process any longer. My insurance is also requiring that I have 6 visits with a dietitian, one a month. I've already had one visit. She told me how to make small changes in my eating habits and lifestyle that can help but no actual diet to follow for now because I am actually doing pretty good. I really have to focus on getting some weight off before I can even get the surgery. My surgeon gave a great book on the whole process which includes the diets he wants us to follow post op for each of the stages after but nothing on how to lose the weight we need to qualify for the surgery right now. Weird, I know. Thank goodness for the dietitian.2
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Congrats on getting this far in the process.
All of our insurance requirements are different. I need to see the dietician 3 months in a row and on my first visit all she told me was to eat 1200 calories a day and I can't subtract my exercise calories from my food. She gave me suggested food items and how many calories are in each type of food, but they were very generic. Thank God for MFP for the exact calories.
I also have my psych eval next week. Not sure what to expect. Insurance won't pay for the psych eval. <sigh> If I don't pass, I figure it is better to know now that I'm not mentally ready than to find out after the surgery and gain the weight back or end up with more health issues. I met someone who had the surgery several years ago and she didn't follow the post op diet. She had major problems. She let it slip that her psychologist didn't think she could handle the behavioral changes needed for the surgery but approved her anyway. What a shame.
Good luck with everything. I'm just at the beginning of my journey to get this surgery but I know that it is life changing in many ways. Wishing you success and smooth sailing through all the steps.2 -
frau5, what a coincidence about our psych evals next week! lol. You know you see a lot of the before and afters of the surgery but not much of all the hard work and steps you have to do before the actual surgery. That's why I say weight loss is weight loss, you work hard for it no matter how it happens. I am also at the very beginning of this process. It's nice to know we are not alone out there. So, congratulations to you as well.1
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I found some websites that helped me understand what to expect for the psych eval. They were:
http://www.mybariatriclife.org/bariatric-psych-evaluation/ and
http://www.obesityhelp.com/articles/the-truth-about-the-psychological-evaluation-for-wls
Finally this article from Clinical Endocrinology News states "Psychological screening prior to bariatric surgery is not effective for identifying who will do poorly after the procedure, but it can identify patients who are at risk for less weight loss and likely to benefit from additional support." This article tells me that months or even a year or two after the surgery I should seek a mental health professional if I am struggling with my post surgery life.
I'll let you know how my psych eval goes. I have it tomorrow.1 -
Wow thanks for the info, I will definitely check it out. Good luck tomorrow. I'm sure it will go fine.0
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The psych eval wasn't bad at all. There were a lot of questions about my history. Any physical or verbal abuse as a child? What does my family think about the surgery? The last time I drank alcohol, the last time I used drugs, etc. How old was I when I started having issues with my weight? What have I done to try to control the weight? The psychologist wrote down my answers and then gave me a paper test with 165 T/F statements. Although he said to think of them as "mostly true or mostly false" because some of the questions won't be an obvious true or false. He said that he wouldn't be able to get to writing up the report until this weekend and then will send it on to my bariatric center. The whole thing took about 90 minutes.
We talked briefly about how insurance requires these psych evals but then won't pay for them.
Let me know how your psych eval went.0 -
I had a good psych eval since I seen my therapist there for my depression and anxiety. So the psychologist could pull up a lot of my history. So, she basically asked questions from a questionnaire, I did not have to fill out one. It was hard too because I could not lie when they asked the questions from the questionnaire since they could easily pull up info. LOL. And there were other questions like, "what do you think would be the hardest part of this process? my answer was not turning to food for everything that happens in my life. Another question was, "Do you know what are some of the things that could go wrong in the surgery?" things like that. Are you developing new habits that will support your weight loss? Things like that. It went well.0
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fit4sho42, glad your psych eval went well. I'm also glad you didn't have to do the questionnaire. I forgot that I was also asked about worst case and best case scenarios after surgery. When I mentioned that a best case scenario would be getting totally off my BP and arthritis meds, the psychologist chuckled, and added, "probably won't happen."
One thing the psychologist said is that without attending the support groups after surgery, 66% of the patients regain their weight. He stressed how important they are and that more people have long term success once they started implementing the post op support groups. My insurance only requires 3 post surgery sessions but I know that I will need to go to many, many more for the accountability.
I meet with my dietician tomorrow. That should go well since I've been losing weight and sticking to the 1200 calorie diet.0 -
Yes we did talk about the support groups post surgery also. I plan on going to as many as I can. Do you know about how soon you will be getting your surgery yet? I do not know yet, since my insurance requires 6 visits with the dietitian and I have only been to one. I am so glad you are losing weight with your 1200 calorie diet. My dietitian did not give me that to follow. When did you start losing? how much have you lost? I haven't lost anything yet. I have two weeks before I see my dietitian and I hope I have some sort of weight loss.0
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I know I don't want surgery until March or later because of my work schedule. That is assuming my insurance will approve me. However if I keep losing I will keep moving the date back. I've done well with the reduced calorie diet. I've lost 41 lbs so far and I started 8 weeks ago. That's a lot in that short of time and I'm not complaining, but I also have A LOT of weight to lose before I'm no longer classified as morbidly obese. There are many days I crave high carb/high calorie foods but end up eating "rabbit food" instead. I'm not good at portion control so I wouldn't stop at only half a cup of Mac and Cheese.
You said in a previous post that your dietician is having you make small changes. Small changes are usually better than large changes because they are easier to stick with over time. What are the small changes you have made already?
Since you need to have 6 visits with your dietician there is plenty of time to show weight loss and your ability to stick with the plan they want you to follow.0
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