Gin820

Questions and Wonderings

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I'm so nervous and excited as my first appointment with the weight loss surgery enter is next Wednesday. The first appointment is with a nurse and nutritionist. I know they will answer many questions but I can't quit scouring the Net for answers and before and after photos!

So in anticipation and preparation I threw out all junk food and brought only fresh veggies, lean meats, and very few carbs into the house. I've cut out the soda. It is very hard and I feel hungry often, but I know it's because I'm taking in less than I was. I don't expect to lose a lot of weight this way as I've done it before with little results. I'm doing it to prepare and get used to this way of eating. My question here is have I made too many changes at once? Have I set myself up for failure?

Secondly, I initially considered lap band. After a lot of research and talking to those I know who had lap band I've decided against it. Now I'm thinking about the sleeve or RNY. I would prefer RNY, but have some concerns. I know I most likely will not have to take meds for type 2 diabetes and hypertension anymore, but I also take preventive meds for severe migraines and meds for bipolar disorder. With the malabsorption RNY creates, will it be impossible for me to take these meds?

I apologize for the long post. I know I can ask these questions next week and I will, but hope that some of you know or have anecdotal stories. Thanks!

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I don't think you're doing too much. You've decided to make a change, and you want it to start happening NOW. One thing that's really helped me is tracking what I eat on My Fitness Pal. I use the app, but you could also use the website. I originally thought I wanted RNY but decided on sleeve mainly to be able to take NSAIDs for menstrual cramps and because I like that they remove the unused stomach portion (I like that for hormonal reasons, which have always been my weight loss Achilles heel). You'll figure out what's right for you and be successful either way. Excited to hear how your appointments go!

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Keep an open mind and discuss your goals and concerns with your bariatric center.  The choice of sleeve or RNY is personal, based on your individualized needs.  I discussed both at length with my surgeon who preferred the sleeve for my circumstances.  If you're going to a decent center, they are up on latest developments and info about the surgeries, etc. and are the best source for individualized recommendations based on your medical history.

Pre-surgery, do all that you can comfortably do but it's a long road.  Marathon, not a sprint....

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Before your surgery you need to quit drinking alcohol, smoking, drinking caffeine, and drinking any carbonated drinks.  You also will go through a pre-op diet for 1-6 months which will allow you to lose some weight.  This weight loss will make your surgery safer by shrinking your liver and starting your body on weight loss mode.

In terms of medications after surgery, you need to discuss this with your doctors, but we have had quite a few successful gastric bypass patients here at TTF who were bi-polar.  They had to adjust their medications as they lost weight in terms of dosages and could not take any medicines that were extended release or XR.  Keep in mind that gastric bypass has a better success rate than the sleeve, both in terms of speed of weight loss after surgery and, more importantly, keeping the excess weight off long term.  

The malabsorption of gastric bypass is, to me, a very positive thing as it allowed me to lose weight faster after my surgery and currently allows me my maintain my weight for the rest of my life while still eating more calories than if I had a sleeve.  I have read one peer reviewed medical study that found that calorie malabsorption for gastric bypass patients both short and long term averaged about 17 percent.  Of course, I need to take vitamins every day, but that is no big deal.

When you meet with the nurse and "nut" be sure to ask lots of questions and become an informed consumer.  Also, be sure to have the best possible surgeon and hospital for your surgery.  

Reviewing this guide on what to eat after a gastric bypass, from one of the best hospitals in Boston, should help you prepare for your meetings at the weight loss center.

https://www.tuftsmedicalcenter.org/~/media/Brochures/TuftsMC/Patient Care Services/Departments and Services/Weight and Wellness Center/GBP Diet Manual12611.ashx

 

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If you have a bypass, it is essential to take your vitamins daily as prescribed. Gastric bypasses are more likely to have vitamin deficiencies than sleeves. Also make sure you go to all your follow up appointments. Best wishes...

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Thanks everyone! I will of course make sure I ask my surgeon all the important questions. But your responses give me hope that I can still have gastric bypass over the sleeve. Of course I will see what they recommend. In the interim I have given up carbonated drinks and cut way back on carbs. Giving up my coffee will probably be the hardest part and one that I will mourn definitely. But I'm prepared to do what I have do. Can't wait!

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You've come to a great place for support and information! You're on the right track and asking a lot of great questions.

There are pros and cons to every procedure and as others have noted, it's a personal decision that each of us made based on our individual medical needs and goals. I would encourage you to have an open mind about the procedure type and choose what makes the most sense for your long term physical and emotional wellbeing. Your surgeon is the right person with which to talk this over. Make sure he/she fully understands your medical and psych history.

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When I was ready, I was ready. Overnight I totally revamped my diet. It was like a switch had been flipped in my head - I had no problems with it. It made the changes I'm having to make now after surgery much easier, in fact. I don't think you're doing too much. 

As for which procedure is right for you, it's a pretty personal decision, and one you of course should seek advice from your surgery team on. I had RNY but I'm early days yet, so I can't help you much there. I can tell you why I chose it, though: the studies I looked at generally had a bit better results for RNY patients, and I don't mind taking vitamin supplements forever. I can't speak to your meds issue because I don't have experience with that, but these are some great questions for your surgery team.

Purely looking at numbers, if the stats say I'm a bit more likely to lose a bit more, that sounds good to me, so RNY it was. I found the other physiological changes brought about by RNY to be interesting, as well, and the fact that it's been around for a long time and studied a lot was reassuring. There are so many people who are happy with the sleeve, though, that I think either option is valid and people's emotional responses to the *idea* of the different procedures can't be minimized. Most importantly, make sure you're as well informed as you can be before you decide. It sounds like you're doing your best to make sure of that :) 

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Thanks everyone. I met with the dietician and nurse today. I have to do 6 months of a supervised diet. I don't have a set amount to lose, but I have to at least lose and not gain. Next is the appointment with the psychologist. There are a few classes I need to take and that's it. I will have to complete a liquid diet 2 weeks prior to surgery and have an endoscopy done. Nothing too complicated. So I am officially pre-op! Yay!

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So nice to get so many of your questions answered. Congrats!

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I would track everything in My Fitness Pal. Focus on getting in enough protein and when you are hungry and you already ate enough for the day try eating veggies or something that is low calorie to fill you up.

 

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21 hours ago, lightenupwoman said:

I would track everything in My Fitness Pal. Focus on getting in enough protein and when you are hungry and you already ate enough for the day try eating veggies or something that is low calorie to fill you up.

 

I started using My Fitness Pal, but found I liked Baritastic better. But I am definitely keeping track. My issue now is I'm sure how many calories to aim for. My NUT said she did not want to give me a number. She asked me to focus on low carbs instead. So I am doing that but afraid I am eating too many calories. So far I am holding at 2000, which seems like a lot. But I used to eat 4000 calories a day! So big change....We'll see if the scale changes. I think I will just slowly decrease the calories each month so I don't starve. I am definitely getting in plenty of protein though. At least 90 grams a day or more.

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The concise dietary instructions for all of us are essentially the same, 60+ grams of protein, half gallon of water, carbs from fruit and vegetable, and stay away from sugar and other simple carbs. I don't think many of us get calorie targets, I didn't, and while I could give you a rough estimate of what I take in every day, I only pay attention to the protein because if I don't get enough, I don't feel well.

 

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