Bariatric Surgery

Crystallee145

I went to see an endocrine/metabolism specialist at the UoM today. Long drive from home but worth the trip. He was open and honest with me about the medical problems I've been having and how they have been treated thus far. He brought up bariatric surgery as an option. He had told me if I don't lose the weight, my medical problems will get worse. This is something I figured he'd say, I just didn't realize how bad the problems were until this conversation. It's just that the doctor's I've been seeing in my home town are telling me not to worry, just lose the weight I will be ok. I hear 'cut the calories' 'work out more' and other phrases of the day. I've been sent from one local specialist to another. One told me "you're doing all the right things so I'm sure you'll be ok, how about I see you in another year?" This specialist was for the most serious of problems. I'm frustrated!

Well, I've been hard at it for 18 months with out much success. I tried many times before, and I've participated in many different programs, WW, Medical Weight Loss Center, Atkins, tracking calories, meeting with a nutritionist and some weird program I cant remember the name of.... I've always been active in sports and working out, so my thought is to work off this weight by myself.

Well, it's not that easy. I've finally leaned that I cannot do this on my own. Since June, I have been training with a personal trainer once a week and working out 2-3 times more. Then this fall I began meeting with a counselor who focuses on weight loss and what brought me to the point where I am (or was). I have made huge strides with getting physically fit and working thru emotional trauma's that I turned to food to ease the pain. I'm eating healthier than I have ever eaten and I'm working out hard. Needless to say during this time I have gained and lost the same 10-12 lbs. What's wrong here!!! I'm finally enlisting the help of professionals and doing all the right things and my weight is still causing sickness that can become irreversible. What do I do now?

So, back to today's doctor visit. He brought up gastric bypass. I'm scared to death of making this decision, I know going to the information sessions will be informative I feel this is the easy way out. Although, I know the reality is this is not easy. Getting over that hurtle is the first step in learning more.

I truly want to lose this weight without medical intervention. So, what now?

I don't know if anyone here has had surgery, I don't know if anyone would like to talk about it. Either way I'm looking for support, not sure what type of support. I feel confused and angry that my life is now at this crossroad.

thanks for reading my vent and concerns
~Crystal~

Ignaura

I can I say I have some experience with the surgery, since several friends of mine and people around me have had it. Based on what I've experienced with closed friend, I wouldn't do it myself. My dad offered me to pay for the surgery three times and I said no each time.

Before I give you my opinion (it's going to be discouraging, since I'm mostly against it) I want you to know that at the end of the day it all depends on you, what you want and your health needs. If your medical condition needs for immediate weight loss and you see the surgery as your only way out, then go for it. If not, give your diet another shot. As you, I've been to many nutritionists, tried every diet out there and all the time I gained the weight back. Now I have an online coach who has helped me make peace with food and taught me how to eat to nourish my body. I've lost weight, I'm still losing it and it doesn't feel like a sacrifice at all!!!

Here is what I can say about it.

1. I see it as an easy way out (I'm not saying this is your case, but it has been my friends cases). It's definitely way easier to just have your stomach cut in half, eat tiny portions of food for 4 months and lost all the weight you want to lose and more instead of dealing with cravings, going to the dam gym everyday, stressing about food, etc.

2. It's too much of a sacrifice. A very close friend of mine had the surgery back in 2006. I had to live with her anxiety, he urges to eat and not being able to do it because she just couldn't handle any more food. When she was finally eating somewhat normally, (three to four months after the surgery) she would have so much gas that it would take her twice the time to eat.

3. I can't deal with the loose skin. I just can't. And having another surgery to put everything back in place is not even an option, at least to me. After the surgery you are not allowed to exercise for a couple of months, and those are the months when you lose the most weight. So loose and saggy skin are a consequence of the surgery. It's not worthy to me to weight 134 pounds and not being able to wear a bikini because the excess of skin makes me self conscious.

4. And this is what I believe is the most important part. The surgery doesn't deal with the real situation, which is eating healthy and exercising. I know about three people who have the surgery twice and gained all the weight back because their habits didn't change after losing the weight. It's not a permanent fix and you need to really change our habits to keep the weight off.

I'm sorry this took so long! This is very sensitive subject and is something I feel very passionate about.

dward59

OK,

I'm going to give you the flip side of Ignaura.

First, if you think this is the easy way out, disavow yourself of that thought immediately. You don't get the surgery and suddenly live in the woods with bambi and thumper and everything goes swimmingly. You still have to earn this weight loss. The surgery is just a tool that will help.

I too believed for decades I could do this without the surgery. I got up to 475 lbs and was dying. I scared myself enough that for six months I followed Weight Watchers to the letter, dropped 152 lbs and thought I had it licked. Life happened, I won't go into all the crap that came my way, but I fell into old habits and gained back to 438 lbs. Lost a few, but finally had a doctor that talked to me straight. He was not a surgeon, he was my PCP and he told me what I already knew. If I didn't do something and fast, I was going to eat myself to death and sooner than later. I knew this, and honestly there were times I thought it would be easier to just do that and get it over with. What was worse, was my wife was so unhappy with me and life that she was going through the same thing. Slower than I was, but headed the same way.

We started the process in November of 2012 and had to have multiple sessions with Nutritionists and psych counsellors to determine if we really were prepared for this and ready to lose the weight. We passed all the sessions, lost enough weight that the insurance needs were met and had our surgeries on May 1st. 2013, just under 6 months from when we started the process.

I was scared spitless. I didn't want to do this, and when my surgery was postponed, I swear if I had my clothes available, I would have left the hospital. But we went through it and it was the best decision I could have made. Loose skin, yes it is nasty to contemplate, but being at a healthy weight is much more important to me. After losing nearly 300 lbs when I get to goal I'm sure I'll have major sags everywhere. But I don't care. I've never won any contests for good looks and in my 50's it doesn't matter anyway. I'd rather live a few more years healthily than die fat with nice tight skin.

I'm sorry Ignaura's friends have thrown away the opportunity given them. I can't at this point stand up and say that at some point in the future I won't have gains, but I will say it is much more difficult with a reduced stomach size. You can always work your way around the surgery. Ice cream, slider foods that are high in fat and moist that just melt and go right through your stomach will do the trick. What a lot of people find is that their tastes change after the surgery. Things I used to love are now less than appealing.

If you can do it without the surgery, do it. But if your life is on the line, don't fear the surgery. Just be sure you are really ready to embrace the lifestyle change that comes with it.

I suggest you lurk on some of the Groups on MFP and see what people think, questions asked and problems reported. I will tell you up front that 2% of the surgeries result in problems that result in death. In my case, I was dying anyway. I was on 24 hour a day oxygen, I was borderline diabetic, high cholesterol, etc. By August, 3 month checkup, I had NONE of these co-morbidities left. THIS is the chance you take and the holy grail that I sought for.

This is as I said, not an easy way out, but if you can't deal with food in a normal reasonable manner, it can help. I can provide you with a number of names of others on MFP that also have had some sort of surgery if you want. I imagine some will probably post to this thread also.

If you have questions, PM me. I will be honest with you in everything I've seen and been going through for the last almost nine months.

PaulaKro

Crystal,

I managed to lose over 50 pounds - several times - and always gained it back plus some. I will lose it again this time, and with a smaller stomach, will not gain it back.

At 317#, with no cartilage in my knees and heart problems, it was getting impossible to even walk. The cortizone shots weren't working anymore, and the knee surgeon said my weight would destroy any replacements. He suggested bariatric surgery.

Long story short, I wish I'd done it sooner.

Part of most WLS programs involves teaching people how to eat right. This includes, tracking (MFP), 60-80gm protein daily, 8 glasses water daily, vitamins, exercise. And I'll add for myself, avoid over-processed foods (not everyone is, but I am addicted to carbs and my best defense is good choices and minimal use).

If I'd known this before I was morbidly obese, I think I could've lost the weight without surgery. And I think you can too.

The surgery is not an easy way out (which is unkind from people who don't know better). It makes it easier to lose fast, since you can't eat much. But it can be stretched out, and as Dan said, if you eat junk food (high calorie or carbs which dissolve easily), the surgery won't matter, it'll go right through.

But if you limit yourself to 800 calories and fill yourself up with good protein, good nutrition, vitamins, water and exercise, you will lose at the same speed. (Be careful, we're on Ursidol to prevent serious gall bladder problems related to fast weight loss.) The protein will fill you up and help avoid hunger pains. If you're carb-addicted, go cold turkey to avoid cravings. Make sure you get your vitamins (2 multis and 3 Citrical) so your body is satisfied with your nutrition. Drink 8 glasses of water a day, it is important. Track hour food on MFP.

You're going to have to be more careful to stop when you have what you need, because the size of your stomach isn't going to do it for you. But for us, after some months, our stomachs will let us eat more too. And we also need to know when to stop. The nice thing is that we've had months of great training to get there.

According to my doctor, 20% of WLS people gain their weight back but 80% don't. Lap-band isn't as successful. Sleeves and gastric bypass lose about 80% of their excess weight. (I'm going for 100%).

Look into the vertical sleeve gastrectomy. It's not as extreme as the gastric bypass. It doesn't bypass your stomach and the gastric acids altogether. It just makes the stomach slimmer. It's an overnight procedure, and in my case there were no side effects. It was like getting my teeth cleaned.

If you want to hear from the people who have done it, go to the VSGers or Sleevers group.

Whichever way you go, best wishes,
Paula

hollyla9905

From another who decided again surgery! It was right for me to not have surgery but It is a life saving surgery!

When I made my final decision to not go for surgery it was actually based on my medical history of not doing well with surgery and feeling like this risk wasn't worth it! Either option requires dedication and control! I am currently watching a co-worker who had the surgery gain her weight back a few lbs at a time cause she chooses to ignore medical advice and snacks on cookies donuts and breads! That is bad for all of us regardless of a surgery choices! I guess in the end you could start the process, depending on where you are there may even be waiting lists, and you could talk to more people so you can make an informed decision! Either way the choice is one you will get to live with! Go to the information session meet with a bariatric doctor! You can always say no later on!

p1xyn1xy

Please nobody get offended.
That choice is actually available to me if I choose to pursue it. I think of it as a tool. Sometimes more mainstream options don't work. I don't think of it as a cheat... the people who lose after these procedures have a long road ahead of them. Of healing, of a forced diet... and it takes away a degree of free will. You can no longer have a really bad cheat day.... you will get ill. Good in some ways but hard in a whole different. And you will still have to exercise and change your eating habits if you want to maintain it.
I was willing to do it at my heaviest.. then I took some classes and found MFP and started to lose. I would like to see how far I can get myself.
My husband had emergency bowel reconstruction surgery this last summer. It is scary and I'm no longer sure I could put my family through that if there is another way for me. I don't have high blood pressure, I'm not diabetic or have other serious medical conditions, and I'm losing by myself. However If it is necessary and you have given it your all and its just not working... consider.
It could save your life... and make it better.
From what I read the sleeve is the least invasive and the most effective. Gastric bypass is also effective but it is a much more invasive surgery and can have greater chance of complications. The lapband seems rather faulty to longterm weight loss and it seems more of a short term measure.

emmerin78

I apologize in advance that this will be a lengthy post, but I find that full disclosure is most helpful whenever I'm gathering information on important topics.

For what it's worth, I'm happy to share my experience. I was put on my first diet at 6 months old for gaining too much weight from breastfeeding (no, not kidding) and the ensuing 34.5 years have been a litany of nutritionists, endocrinologists, various weight loss programs (both medical and commercial), psychotherapy, support groups, gyms/fitness classes, etc. I had/have thin (although not healthy) parents who struggled with why both their children were always overweight and did their best to follow the medical professionals' advice. We went through every diet recommendation of the last three decades and then some - low fat, low carb, high protein, vegetarian, vegan - you name it, we tried it. Throughout that time, there's only one immutable truth I've come across:

Everyone walks their own path, and each path is different.

For many years, I prided myself on being active and healthy; even though I was fat, I always participated in sports, walked/rode long distances for the 3 Day and AIDSRide. My doctor regularly told me that I was one of her healthiest patients and that as long as I remained active and continued making positive choices (i.e. I don't drink/smoke/use drugs, and was always on one diet or another), then there was no reason to worry. Thus, I convinced myself that things really weren't "that bad" and that I was going to conquer my weight issues on my own - I just had to keep working at it and someday the tide would turn in my favor and I would lose all I needed to/wanted to lose. Many well-meaning family members and friends asked me if I would ever consider surgery, but I told them that I really didn't need it since I don't have hypertension, high cholesterol, not diabetic, etc. - I'm :just fat". Truthfully, my war with my weight has always been a lifelong struggle, and I believed that surgical intervention would be tantamount to me waving the white flag. Even when my younger sister opted for the LAP-BAND, I just couldn't give it up - I had to do this on my own.

So, for my entire adult life, I kept on doing what I had been taught to do since childhood - diet, exercise, and then invariably fail at one diet and begin another. All of that continued until I was sitting in my OB/GYN's office about 18 months ago. I was newly engaged and she sat me down to talk about my future plans. When I mentioned wanting to have children, she gently informed me that at my age and current weight, the odds weren't looking good - and if I did become pregnant, I'd be considered high risk due to my weight. Granted, you'd think someone who's reasonably intelligent and wakes up every morning to see a 379 lb person staring back at them in the mirror would have had that realization earlier, but I hadn't. I had never felt like more of a failure then I did at that moment. When she mentioned surgery, I automatically said "I don't need it - I can do it!" Her response to me was "You've been at this over 30 years - how's it been working for you?"

I attended several surgery seminars after that to gather information and find out about the different procedures, the various programs offered, and the outcome statistics. I spoke with surgeons, nutritionists, and other staff members before making an appointment with a program at our local medical center. I then began a year long process of group and individual meetings, lifeskills classes, endocrinology, pulmonology, cardiology, psychology, and nutrition appointments. All of these were requirements for the program I went through; I must say that in hindsight, and after meeting many patients from different practices without stringent requirements, I'm so glad I had a surgeon and a practice that recognize that surgery is a tool that will not work without addressing the psychological and emotional components of weight loss as a permanent life change. From the moment I met him, my surgeon emphasized the importance of personal commitment and responsibility in both the surgery and weight loss processes - he never once "sold" me on surgery as a quick fix or as a "get out of jail free" card. He made it abundantly clear that I would have to sustain a high level of activity and a restricted diet for the rest of my life if I wanted to be successful with my new tool. I've met patients who have had each of the three major procedures - gastric bypass, LAP-BAND, and vertical sleeve gastrectomy (VSG) - to get a sense of what their lives were like before and after surgery, complications they've experienced, things they would do differently, advice they have to share. Ultimately, I decided that VSG was the tool that would provide me with my best chance of reaching my goal.

I began the final phase of my surgical preparation on 7/1/2013 when I began a 2 week liquid diet to shrink my liver in preparation for surgery. I had surgery on 7/15/2013 and a normal hospital stay of 2 nights/three days with no complications. I was encouraged to get up and walk within three hours of getting out of recovery (which I did) and was pretty uncomfortable from the gas bubbles created by the surgery and the drain in my abdomen. However, I kept on walking around the hospital floor to minimize the risks of blood clots. I should say that during my time in the hospital, I met several patients (none from my surgeon's practice) who had experienced complications ranging from severe nausea/vomiting to leaks that required follow-up surgeries. I think it's important to remember that no procedure is without risk for complications, even if patients are diligent in following their pre- and post-op instructions. Bariatric surgery may be more "routine" nowadays, but it's still major surgery.

Since my surgery, I have progressed through several phases of "eating recovery" - liquids, pureed foods, soft foods, and eventually solid foods. My caloric intake for a long time hovered around the 800-900 calorie mark, but I wasn't seeing much movement on the scale. My nutritionist (with whom I have regular follow-up appointments, in addition to support group meetings) finally suggested that I up my caloric intake to 1200 calories per day - and I have been seeing good losses since that change. Again, each person is different - what number works for one person may not work for another, and numbers may change as you lose weight. My diet these days primarily consists of lean protein, vegetables and fruit, with some unrefined/whole carbs added in when I have room (which is rarely). I have cut the majority of processed foods out of my diet and find that I don't miss them as anything with too many refined sugars/chemicals tends to make me feel icky. It has been a learning curve to not eat too much or too fast, but I've gotten the hang of it and actually enjoy food more now than I did before when I was focused on quantity over quality. I walk or swim 3 to 5 times per week and lift weights at least 3 times per week. I have some saggy skin (and I'm sure I'll have a lot more as time goes on) but for me it is a fair trade for the progress I'm making.

Bottom line: surgery ended up being a part of my path, even though I was sure it wasn't going to be. Is it easy? No. Is it a lot of work both before and after? Yes, and definitely. Could I have lost this weight without the surgery? I tried for 3 decades without long-term success. Have I met other people who have lost weight without surgery and kept it off for more than 5 years (i.e. the clinical definition of "long-term")? A few, depending on how much weight we're talking about - I've met some who have lost 50-80 lbs, two people who have lost more than 100 lbs, and one who lost 200 lbs and kept it off.

Ultimately, you need to make the choice that is right for you - how heavily that is influenced by your family or other factors only you can know. Don't be rushed into anything and if you do decide to explore surgery as an option, try and gather all the information you can; meet several patients of each kind of procedure and look at different surgeons/practices to see what their program requirements are and what kind of pre/post-surgical support they offer. And remember: no matter what you decide, we'll all be here to support you as you continue on your journey. Good luck!!!

Crystallee145

Thank you everyone for talking to me about this. It's not an easy topic to discuss as views are wide spread. I appreciate the honesty. I am in the beginning phase of looking into this. I met with my counselor today and we discussed the long term changes this would bring and about a more restrictive diet to see how well I do in the interim. The Endocrinologist from yesterday suggested that I may need to eat closer to 1200-1300 calories a day versus the 1810 that MFP recommends. I think I'm going to try this lower caloric intake and reassess.

I will be logging everything including water to see how I'm doing. I thought I was doing well, but I honestly don't think I was being as honest with myself as I need to be.

dward59

I will be logging everything including water to see how I'm doing. I thought I was doing well, but I honestly don't think I was being as honest with myself as I need to be.

We can tell ourselves that we are doing what we should, but the body doesn't believe our fantasy calorie posts. Been there, done that, too often to even count.

Good for you. I strongly urge you to concentrate on lean protein, dark leafy greens, and fresh fruit for the bulk of those calories. You may be amazed how much food you can actually eat within that calorie range if you aren't eating junk.

Best of luck Crystal. We are pulling for you!

Crystallee145

Once again, thank you everyone for your input. This has been a hard decision. What I have decided to do is the Weight Managment program thru the Univerisy of Michigan's Endocrine Center. They had laid out all the options from low cal diet to surgery. I met with two doctors there and a nutritionist. This program is 100 weeks and I will be meeting with my nutrionsit and doctor regularly.

On Friday I get the tools to start the initial 12 weeks of the program, and will be meeting weekly with the nutritionist and biweekly with the doctor. I'm nervouse and excited.

Etherlily1

I know you can do it. You have it in you to do anything you want. We'll be here for you every step of the way. I would be excited and nervous at the same time as well.

E. Maelyn

PaulaKro

Excited for you Crystal. Congratulations on finding such a great support system.