Meanderings...

Wishing you the best for your journey, and yes, agree with others that you seem to have researched it throughly, stay positive with your plans, good luck in making your decision, and keep us posted.

PeggyC said:

My SIL had the older gastric bypass surgery many years ago and did extremely well for awhile. Lost nealry 100 pounds and looked great. Unfortunately, though, she has put back on a fair amount of that weight in the past couple of years, so I have mixed feelings about that particular surgery. I'm hoping the potential to regain the weight is smaller with the sleeve version. As Marylago said, be sure to follow your doctor's advice to the letter. I suspect that might be where my SIL went astray.

I hope everything goes perfectly for you, DB, and that you have an easy procedure and completely successful recovery afterward. I'm not familiar with this new twist on the surgical options, but I am in no doubt that it's not "taking the easy way out."

Yeah, it's not the surgery that's at fault, per say. The surgery pretty consistently has a high success rate in the first few years, but it does require a consistent behavioral change for long term success. It's possible to revert to bad habits and overwhelm the constraints that the surgery puts on you. Hopefully the initial success - the feeling of what it's like to be a more normal weight again (because for me being this big is kind of a recent phenomenon) - is enough of an inspiration to keep the behavior mod going.

marylago said:

Wishing you well, DB. Remember that it's a process. You certainly didn't put on the weight overnight so, even with the sleeve, don't expect it to come off overnight. Be patient and most importantly, follow your doctor's orders about it! I had a friend who wouldn't and she ended up having the sleeve removed. It's going to be hard, but keep at it.

Sounds like you might be confusing the lap band with the sleeve. Understandable - the first time I heard reference to the sleeve I was kind of confused too. But the sleeve operation is a one way ticket, no turning back on that one. Once they remove that 85% of your stomach, they toss it away and it's gone for good. The band, on the other hand, can be removed, and what I'm finding on the forums is that tons of people are having what are known as revisions - changing from the band to a more drastic solution like the bypass or the sleeve, because the band is not working.

ctrzaska said:

I haven't ever been overweight and consequently not needed any type of surgery to help move forward on a more healthy path (I could use some other things however), and so please disregard my comments as you see fit, but I've no idea why someone not in your position would exhibit disdain for what you're about to do.

Regardless, I'll offer the opposite: sounds like this is a rather big decision/move, sure as hell doesn't seem "easy" to me in the least (and on a whole host of counts), and clearly has its own risks and future demands. Here's wishing you the best of luck and all success with it.

Regarding the question of disdain - I'll tell you, you just wouldn't believe what I'm reading on these support forums. From acquaintances accusing people of taking the easy way out to spouses being outright hostile to the decision to have surgery, some spouses or SO's walking out of the relationship, to PCP's poo-pooing the idea of surgery and just telling people to hit the gym, the amount of non-support that some people have to put up with is staggering. I've been lucky so far in that I haven't had to deal with any of that from anyone.

And just let me say thanks to everyone for the kind words of support.

i have a good friend who had this surgery year before last. He was 430 pounds, now he's a different person, sized at 215 or so. Once you get the surgery, you have no room to eat a big meal, a forkful is enough to fill you up.
He works out regularly with a personal trainer now and also on his own in the gym.

Good luck, wishing you the best.

Drummerboy, You have my kind words of support in all you choose to do. Keep on keepin on.

One of my friends commented, about 10 years after her surgery (the old kind) that even then she still couldn't eat or drink much at a time, and although it was a bit boring she was OK with that. Nutritionally it was difficult as she aged - she needed to get the right proportions of everything as the stimulus to eat naturally diminished on top of the other changes. But the real annoyance for her was the continual social impetus to do everything (almost) with food - very little socialising takes place without food or drink in a big way. So that made it very hard for her. But still she wouldn't have changed her decision.

There's lots of new research now on how to reinforce willpower, to resist temptations. But you need to have good habits established first. And it's never a replacement for acknowledging that some people simply need other strategies to make the shift.

drummerboy said:

Carson is still a putz for how he behaved. As if he has to give his blessing for her career moves. She obviously felt bad about it and tried to apologize.

Carson took his wife to Hollywood parties, got sihtfaced, and then beat her AT THE PARTY. That's all you need to know about him. He was low life.

Drummerboy
Best of luck with the surgery. I wish you great future health.

Wow, good luck DrummerBoy.
and FWIW, I never tire of Word Crimes.

Have you considered an alternative approach, like homeopathy?

Haha, just kidding.

Good luck.

Sundays said:

Have you considered an alternative approach, like homeopathy?

Haha, just kidding.

Good luck.

haha!

All good wishes for the ability to sustain this life change.
Perseverance will be your partner ..and your will your guide..

Each step will be an affirmation of life.that you deserve.

I had RNY (gastric bypass). a few years ago. Best decision I ever made. I had some complications at about a year out, but it was still worth it. I lost 170 lbs or so, but I was actually too skinny for awhile due to the complications. I've gained back about 10lbs more than I would like, but feel pretty awesome.

Does the sleeve instantly reverse diabetes like RNY often does? I was off my insulin resistance meds and blood pressure meds right after surgery.

Part of the reason for weight regain for many bypass patients is that the remaining non bypassed intestine adapt so that it can absorb more calories and nutrients.

I will say as far as fat shaming, I was treated much differently than I was before I lost the weight. Men holding doors for me, strangers in line are kinder etc.

Good luck, DB! I hope you do really well!

Thanks for the good wishes.

As for diabetes, not sure about the "instantly" - I've never quite understood how that worked, unless someone's diabetes was very highly diet dependent. Then it would make sense, since you you've all of a sudden gone to a basically zero-carb diet. I'm not expecting an instant reversal, but am expecting a dramatic change over time - it's one of the main reasons I'm doing this, and my endocrinologist has been pushing me to do this for awhile.

Its been awhile, so I don't remember, but it has something to do with the part of the stomach that is stapled off being what controls some of the hormones. That sounds off since the pancreas produces insulin, but it definitely had something to do with the surgery on the stomach and made sense when the doc explained it. Maybe its not completely instant, but many people on my support forum came home off of all diabetes meds.

Things are more complicated nowadays since leptin and ghrelin have been characterized. Understanding exactly what they do is going to take some time. Somatostatin, growth hormone, insulin, insulin-like growth hormone and the various receptors - so many factors but one thing they all come down to is your diet. It's a big step and you're right in thinking it won't be instant change.

probably "instant" was the wrong word to use, perhaps rapidly was better. with some WLS diabetes goes into remission even before much weight is lost

No, instant is not necessarily wrong. A lot of people on the forums report not needing their meds immediately after surgery. Others require some medication long term, but reduced. It's rare to hear of anyone who doesn't see some remission. But I'm certainly not expecting any miracles here.

The surgeries vary in their effectiveness regarding diabetes. The most effective is one called DS, or the duodenal switch, which I originally thought about getting. That combines the sleeve with a more drastic rerouting of the intestines, resulting in a very high malabsorption. I ultimately decided that was a little too drastic, though the DS remains an option as a revision in case the sleeve fails me. Or I fail the sleeve. Though I hear the fart of a DS'er can knock out a lesser man.

drummerboy said:

Though I hear the fart of a DS'er can knock out a lesser man.

Vegans' farts smell like carrots, just saying...

Oh, and I think you are right about the lap band. I knew she was considering both...

Hey DB. I hope this all works out for you.

Be Well,
Terp

That's very interesting, about the diabetes connection. My SIL was most likely headed toward diabetes, because her father had it (essentially was about to die of diabetic complications when he fell and hit his head and died of that instead ) so perhaps that was part of her motivation in having the surgery.

I suspect one of the biggest issues with the surgical approaches is changing the mindset that is often part of what allows a person to become morbidly obese in the first place. In my SIL's case, massive self-esteem issues and depression contributed to her eating issues, and I do wonder if those came back into play a few years after the surgery, when the euphoria of the initial weight loss wore off and she was back to struggling with everyday life.

DB, I'm not saying this is anything to do with you, but if I remember right, therapy is either required or highly recommended post-surgery, to reinforce lifestyle changes that will make it easier to maintain the weight loss.

Yeah, I'm not averse to therapy if I see that I'm having problems maintaining the weight loss long term. As far as I know it's not required, though. Most insurance companies do require a psych evaluation pre-surgery though, and I guess I passed mine.

There are few standards for post surgery care, I'm finding out. Some surgeons have an extensive support system, like mine. Some doctors just operate surgery mills, leaving the patient to kind of flounder on their own post-surgery.

That psych eval for the insurance company must what I'm remembering. It was a long time ago.

I'm glad your doctor has a strong post-op support system. That could make a big difference in how well you do with the regimen. The ones that don't have such a system in place would be a big red flag for me.

Best of luck to you!

When is the procedure, DB?? (sorry if you already said...)

Tentatively December 11th. I might push it a little later because that's about when my son ends his semester, and I'd like to get it done when he's home.

I wanted to get it done sooner but my ins co, United Health Care, has a bozo requirement that requires me to see a nutritionist once a month for 6 months to do a weigh-in each month. That's it, a weigh-in. No weight loss. No nutritional education. Just a weigh-in. It's very frustrating. Apparently UHC is one of the few companies that has such a requirement.

Many insurance companies require 6 months of supervised weight loss. I weighed in, but also received some education during that time. The surgeon's nutritionist and I also discussed my food log and I began making some of the changes I needed to make to prepare for surgery.

Peggy, the analogy the psych eval guy made with me is that the surgery changes your hardware, but you must work to change your software.

drummerboy said:

Thanks for the good wishes.

Best of everything to you, Drummerboy. I would only add that you make certain that you do your follow-up visits with your health care provider and stay on top of your nutritional (supplements?) needs. I am looking forward to updates on your new healthy journey. It's an inspiration.

carolanne said:

I will say as far as fat shaming, I was treated much differently than I was before I lost the weight. Men holding doors for me, strangers in line are kinder etc.

This is very true. It's worst in California and the NYC area. It's nice to travel to south Jersey or other parts of the country and be treated like a human being.