ktgrok

timing..surgeon and OB differ in advice

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So, some background. I've had 3 children over 16 years..oldest is 16, youngest two are 5 and 3. Two different marriages :)

I'm also 39, going to be 40 in April. I had VSG in June of this year. Starting BMI was 40, current BMI 32. My intial goal was to lose 80 lbs, putting me at 140 which is what I was when I met my husband. Technically to get to a normal BMI I should get down to 130. I'm 172 right now. I can eat and drink just fine, and get my protein in without a problem thanks to some high protein milk and one quest bar a day. Right now I'm working on getting in more veggies, and that is going better than I expected. I had a bit of a mental block on veggies. My nut says to eat between 800 and 1,000 calories, which is where I'm at. Depending on what I eat I could easily go over that, but I am careful, so I stay around there. 

Anyway, I want one more kid. Husband had said no way, but now all of a sudden is mostly on board, and considering it. So, now we discuss timing. Surgeon's office says to wait a year from surgery, but that lost of people don't and are fine. OB says start trying right now, that the risks of the surgery on the pregnancy are much less than the risks of age as I continue to get older. That my risk of miscarriage goes up every single month, and my risk of not being able to conceive does too. 

Now, I'm not ready to listen to him and start trying now, and neither is my husband. But I'm thinking maybe Feb? My minimum goal is to no longer be in the obese category at all, as I never want another obese pregnancy. I was overweight but not obese with the first, and had a baby under 8lbs. Was obese with second pregnancy and baby was 9lbs. Was MORE obese with the third and baby was over 10lbs! Born at home, and let me tell you, I do NOT want to have an 11lb baby at home! So, I want to be close to my goal, and not obese. Hoping that will help, as that was the only factor I had for macrosomia. I actually gained less weight withthe big babies than the small baby!

Any thoughts? I know waiting is better surgery wise, but I am able to eat and take in nutrition just fine, my vitamin levels were checked and are all optimal, my blood pressure is perfect at 110/70, glucose and A1C are perfect, etc. And I'm taking seriously the warning from my OB, that over 40 my chances really drop. 

Any thoughts? None of this is happening right now, like I said. I have an IUD in, and my husband is having work drama that needs to be dealt with before he will be okay with saying yes to another. But I want to think this through now, before we are ready to try, so I can be a bit more logical about it. 

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I'd proceed at you and your husbands  comfort level. There are many women who have babies in their early 40's but I've heard that it can be more of a challenge. Weigh out all the pros and cons and come up with a decision you're both in agreement over. 

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I'd proceed at you and your husbands  comfort level. There are many women who have babies in their early 40's but I've heard that it can be more of a challenge. Weigh out all the pros and cons and come up with a decision you're both in agreement over. 

I really like this advice. 

I'm sorta in the same situation as you OP. I'm actually 41 and my husband and I are planning for one more as well. I will probably be 42 when we start trying in earnest (and with the help of an RE), but this is pretty much our planned approach as well. Good luck to you!

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Each doctor will give you the best advice based on their area if expertise, so it makes perfect sense that your surgeon said wait, and your OB said, 'time's a wastin''.

In the practice of medicine, doctors always look at the risk benefit tradeoff through the lens of their specialty (bias). Your needs should be the biggest part of that equation. Take their counsel, determine what's best for you, and proceed accordingly.

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I'm 38. When we decided this year to try for our third, my OB warned me it won't be easy, will take time, yada yada yada. Guess what? I got pregnant the first month off IUD. They make such a big deal about age, but just do what feels right.

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I sure hope it goes that way! I've always been very fertile up until now, so maybe that will help. My first was concieved when I was in my twneties, while on birth control pills. (when they say take them every day they mean it!), second was when I was 35, the first month we tried. My third was when I was 38, and we were actively trying to avoid using natural family planning type measures. I was 4-5 days before ovulation, no cervical mucus at all, and yet here he is :)  So hopefully I'll be lucky!

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I was 6.5 months post op when I got pregnant. We had been told we would not be able to concieve naturally due to male fertility issues, which was the final push that made me decide to have RNY. We have 2 daughters between us, 14 and 4 and we absolutely wanted more together. My surgeon says to wait 12-18 months, and that would have put me at 35 when we would be able to start trying. We decided to use our "waiting period" wisely and meet with the fertility docs and start the extensive testing and harvesting during that time so we could hit the ball rolling. At almost 5 months post op we had our first appointment with the specialists and were told that as soon as my weight stabilized for 2 months we could start harvesting eggs as my nutritional intake and vitamin/mineral levels were great, but my husband should have a surgery to help our stats and make it so we could hopefully do IUI vs IVF. He had that surgery, which was far more extensive then the docs expected, within the month and well what do you know we wind up conceiving naturally.

We are 24 weeks today, I lost weight for the first couple months and have now been stable for the last 2. Our little guy, Oliver, is growing wonderfully and everyone thinks I am still losing weight as it is just redistributing. There is definitely a mental part to pregnancy this soon after surgery though. I had barely gotten used to having a fletter stomach that didn't stick out so when it started growing I had to keep telling myself its just him and its for a good reason. I also have to eat 4 times a day now minimum (about every 4 hours) or I get hypoglycemic.

Best of luck in figuring out this tough choice. I am a firm believer in everything happening for a reason so I hope when you are ready that your next little one comes along easily.

 

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I was 5 months and 3 weeks post op when I got pregnant and my surgeon said wait 12-18 months as well. I have a hereditary condition and they told me I would need medical help even if i lost all my weight. Low and behold only needed to lose the weight. I am now 26 1/2 weeks prego today with a healthy boy Xander.

 

I would really talk to your hubby and discuss all options and then go from there . I have read where ladies are around 43 and getting prego after surgery and have happy healthy babies.

 

best of luck.

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I wouldn't worry about nutrition since you are hitting a decent amount of cals/protein each day plus baby will take what it needs from you regardless.... do keep in mind with rapid weight loss you're as futral as you will ever been! So if you don't want to get pregnant now keep your birth control for now. My surgon suggested I get on birth control yesterday at my 3 month post op visit for this same reason  (being extremely futral right now) I laughed and said that won't be a problem as my husband gave her the "snip snip" hand signal lol which is not a good thing, I want a baby with my husband more than anything :-) we each have 3 soooo I think I'll just have to deal....

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You may have had GD and not have known it. I work in L&D and I see lots of overweight/obese moms passed th GD test early, but then have 9-11lb babies and at their 6 week follow up an A1C is done and it's elevated, meaning late onset GD. Following a GD diet, avoid dairy fat can all help with baby size. That said it's pretty rare babies get over 5000g

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I'm not seeing what triggered the comment about passing the OGT early but actually having GDM which develops later. I had my children before surgery and did the OGT as soon as I could. I failed the one-hour then barely passed the three-hour. Excessive weight gain continued, along with serial ultrasounds to monitor for macrosomia, followed by a term c-section delivery of a 9#7oz baby. No mention of diabetes late in pregnancy, but in retrospect I'm confident I had it.

Next term pregnancy was twins, and I failed the diabetes screening and began treatment early. My endo explained that children born to diabetic moms are typically average weight until 6-8 years old, then often become overweight or obese. My son was 5 and normal weight at the time. Then as if on cue, he became overweight before turning 7 and at 9 is now likely obese (4'9" and 112#). No matter what we do to try to control his weight, it just gets worse. It breaks my heart.

My GDM was diagnosed early with the twins, and I kept tight control of my sugar levels throughout the pregnancy. With my youngest we began treatment with an early marginal but not failing test value. I kept tight control of my sugars, gained less weight than before, and delivered a 7#7oz term baby. Hopefully my three youngest will be spared the fallout of being carried by a diabetic mom.

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I'm not seeing what triggered the comment about passing the OGT early but actually having GDM which develops later. I had my children before surgery and did the OGT as soon as I could. I failed the one-hour then barely passed the three-hour. Excessive weight gain continued, along with serial ultrasounds to monitor for macrosomia, followed by a term c-section delivery of a 9#7oz baby. No mention of diabetes late in pregnancy, but in retrospect I'm confident I had it.

Next term pregnancy was twins, and I failed the diabetes screening and began treatment early. My endo explained that children born to diabetic moms are typically average weight until 6-8 years old, then often become overweight or obese. My son was 5 and normal weight at the time. Then as if on cue, he became overweight before turning 7 and at 9 is now likely obese (4'9" and 112#). No matter what we do to try to control his weight, it just gets worse. It breaks my heart.

My GDM was diagnosed early with the twins, and I kept tight control of my sugar levels throughout the pregnancy. With my youngest we began treatment with an early marginal but not failing test value. I kept tight control of my sugars, gained less weight than before, and delivered a 7#7oz term baby. Hopefully my three youngest will be spared the fallout of being carried by a diabetic mom.

ACOG (the governing body for OBs) now recommends an early OGTT (diabetes screen) preferably in the 1st trimester, and again in the 3rd if previously GDM or obese. I'd definitely try to get down as much as possible before trying to get pregnant. 

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Just an update, I'm 9 months out from surgery, and have less than half a pound to lose to be no longer obese! That's my big goal, not be obese. In the meantime, my husband is having job drama, so we won't be trying anyway until that settles down. He has an interview on Friday, had another a few days ago, and has another company trying to hire him. HIs current job will be moving to another state in 9 months and we won't relocate, so he needs to find a new one. So while he job shops I'm just working on losing the weight and getting healthy. I'm having some dental work done later this month an the beginning of next as well, then hoping after that to start trying. I should be well below Obese by then, which would be a wonderful thing. 

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