CheeringCJ

I keep thinking of something my psychiatrist said....

Recommended Posts

when I went for my preop psych eval, he was asking me about the RNY vs GS and I said I was thinking about the RNY simply bc my cousins (sisters) both had WLS ....one had one, one had the other.   They both did well, but the one with the RNY, 15 yrs out is still maintaining and the one w/ GS, 4 yrs out gained 10# back already.  I asked the GS one and she said "the beauty with GS is there is no dumping but the problem with GS is there is no dumping" meaning you can eat more stuff you shouldn't have and not have to "pay for it later"so to speak.  So she eats sugars etc and her mom and sister who have both had bypass don't.  She said when they all go out, the bypassers eat right and she doesn't always.  So, I told my Psych and he said "why is it that people always think they need to punish themselves?" and I keep going over and over that line in my head!  So, am I wanting to "punish" myself or is that what I know that I need to keep me in line?  I always start diets out with tons of will power and they fizzle....so what happens if I get the sleeve and have all intentions of doing it right and then I get to goal (or worse yet, never get there) and then start "cheating"?  

It really doesn't matter since my dr will determine what surgery I need (he is suggesting sleeve) but is waiting until after my endoscopy to determine if my reflux will prevent that....but the thought process behind it is still playing over in my head.  

I have the right frame of mind...for the moment, but this has to last the rest of my life....I know all of the benefits of making it a life long change (but since I have never been able to keep up a change, I am doubting myself) and thinking the bypass's "dumping" might be a blessing in disguise that I need to keep me to task and keep doing what i need to do.

What are your thoughts, especially those of you that have had the surgeries a few years ago or more?

Share this post


Link to post
Share on other sites

Sometimes I wished I dumped but only for a brief moment.  I really do enjoy to once in awhile have a bite of birthday cake or a frozen yogurt.  No matter which surgery you have, it will always be about what you choose to put in your mouth, period.  There are plenty of bypassers and sleevers who regain and it is always about choices.

Share this post


Link to post
Share on other sites

I am leaning towards the sleeve so I wouldn't have the dumping then, but honestly it scares me to death that I could have a bite of bday cake....and that it could all go down hill from there.  I just do not want to do this surgery w/o making lifestyle changes, so I am researching, taking notes, here on this forum every day and determined to make it work, but still the fear of letting myself go and gain it back is real.

Share this post


Link to post
Share on other sites

To be clear, many people who have a gastric bypass do not dump or (like me) dump only after eating a relatively large amount of high sugar foods.

Now that I am at my goal weight, and as part of my mindful eating and balanced healthy diet, I can and do have limited amounts of sweet foods almost every day without dumping.  Thus, I can eat a few bites of birthday cake or a few spoonfuls of ice cream without dumping - but I almost certainly would dump if I ate a large piece of birthday cake along with a big scoop of ice cream. 

There are many good reasons to decide to have a gastric bypass instead of a gastric sleeve (lifelong caloric malabsorption, no acid reflux, generally easier ability to drink liquids, statistically greater chance of losing weight long term, statistically quicker weight loss, better ability to treat diabetes, not having any portion of your body removed during surgery, etc) but dumping is not (in my opinion) a reason to have gastric bypass. 

Share this post


Link to post
Share on other sites

Interesting. I do think our society generally 'punishes' fat people by collectively thinking/stating we are lazy, no discipline, etc. I've wondered how many of us internalize that. I know pre-op I would go on crazy restrictive diets that made me miserable. Some people here pre-op have grappled with the idea that by having surgery they are taking the easy way out. My POV on that has always been. Who cares if it's the easy way? I did it the hard way off and on for 20 years. I ended up with a closet full of clothes in sizes from 12 - 24 and even more baggage in the form of shame and self-loathing. My days of punishing myself are over. I know this isn't quite what you were asking, but I think it relates. 

Share this post


Link to post
Share on other sites

Just remember too, that not everyone that has RNY will get dumping. I read that only about 30% actually get it. I have 5 people in our in person support group that had RNY and never experienced dumping. So even if you get RNY you might not get the affect you want. 

 

Share this post


Link to post
Share on other sites

Like everyone has said, there is no guarantee of dumping with RNY. If you have reflux, RNY is very likely the best option for you. Had I had diabetes or reflux, I would have gone that way. I think you truly can be successful with either surgery, but I don't want you needlessly suffering with acid. I don't think you're trying to punish yourself. I think you're trying to set yourself up for success.

I can totally relate to the will power then fizzle phenomenon you mentioned. I chose the sleeve because of the hormonal benefits of having a large portion of the stomach removed from my body. I truly think my problems with weight were largely hormonal. I can tell you, I truly feel a change in these hormones. I used to diet and exercise with tons of will power. My body would fight to get back to it's higher weight setpoint by giving me headaches, waking me up at night, finding a way to gain weight on 800-1000 calories a day and tons of exercise. An endocrinologist who specializes in weight management told me I had the second lowest leptin levels he'd ever seen, and he believed my body could find a way to gain weight even if I ate nothing. He said I was the product of generations of famine survivors and not to waste my money going to him, because they had no hormones to treat me yet. That made me feel hopeless. I was convinced that I'd be one of the few WLS doesn't work for, but it IS working for me, and I really think I chose the right surgery for me.

Edited by Gretta

Share this post


Link to post
Share on other sites

And on the flip side, I had the sleeve and I DO get dumping!!! Too much sugar or fat will do it, and oddly, so will too much salt. 

Share this post


Link to post
Share on other sites

Interesting remarks.....you guys always make me think!  Thanks. 

So, my next thought is....why don't they do a combo surgery where they cut the stomach out AND bypass the portion of intestines?!?!?  Should I rush off to med school so I can perfect the surgery?  Then you could get the hormones gone, the diabetes gone and the reflux gone!!!  THe best of both worlds. Surely I'm not the only one who's wondered about this. There must be a downside. 

Share this post


Link to post
Share on other sites
4 hours ago, CJireh said:

... So she eats sugars etc and her mom and sister who have both had bypass don't.  She said when they all go out, the bypassers eat right and she doesn't always.  So, I told my Psych and he said "why is it that people always think they need to punish themselves?" and I keep going over and over that line in my head!  So, am I wanting to "punish" myself or is that what I know that I need to keep me in line?  ... and thinking the bypass's "dumping" might be a blessing in disguise that I need to keep me to task and keep doing what i need to do.

This is a really important question!

So many of the people posting here are worried that if they are not PERFECT in their approach they will eat their way back to their starting point. And, so many of us are so desperate after years of failed attempts to lose weight, we are hopeful that the surgery will provide a physical obstacle to our bad habits. And we all know that we are not perfect. (Well, I'm not perfect,  and won't make any assumptions that you are not perfect). ;) The fear is, how can this succeed if we are not perfect?! 

The great thing about this surgery is that it works for nearly everyone, reliably, despite our being imperfect. No, not everyone loses all their excess weight, but they lose enough weight that their extreme health risks get cut down to size, and they feel better about themselves. It is a "robust" enough solution that people can have the occasional bit of dessert or glass of wine or piece of bread and the world doesn't fall down. And I would suggest to you that part of the answer to your really important question is Forgiveness. 

People with a bypass can certainly figure out a way to defeat the tools that the surgery has given them. You could eat bags of potato chips all day long, or buy 3 giant pizzas and cut them into tiny pieces and eat a piece every 20 or 30 minutes. But most people don't do this self-destructive stuff. Most people have a good result and have reasonable approaches to food. So the real world tells us we don't have to be perfect for this to work. 

The surgery changes your stomach and (with a bypass) reroutes it. It doesn't change your head, e.g. the person who is in charge. It's important to understand yourself well enough to know if you think you have to be rigid about things - need punishment - then so be it, but I would worry since none of us are perfect, you could be set up for an unreasonable dynamic. Me, I'm not able to color inside the lines, I goof up, and when I do... I try to learn from the experience and move on. I confess to having already eaten bags of potato chips; had too much wine; eaten an entire baguette; and had pie. (No chips in the house now, and any pie in the house gets sent away with someone at the end of the dinner party).

When I have goofed up, the goof is 300 calories too much, not 3,000 too much as it was before my surgery. My surgery helps limit the damage. This is the physical aspect of the surgery putting a limit on things. That is good. But 300 or 600 extra calories a day over time leads... to my former self. 

I think in the long run my relationship to food, and WHY I had that relationship... are things that are in my control now, in my head. I can eat reasonably, not emotionally, and can avoid the need for punishment. Surgery gives us this wonderful period where hunger is rare and we can recalibrate our relationship to food. I can forgive myself when I don't adhere to the diet so long as I do better tomorrow, because as part of the process I examined my head and heart and know I can do this. 

Good luck. I would think about not being perfect, about being resilient. Thanks for posting this. 

Edited by BurgundyBoy
added one sentence

Share this post


Link to post
Share on other sites
7 minutes ago, CJireh said:

Interesting remarks.....you guys always make me think!  Thanks. 

So, my next thought is....why don't they do a combo surgery where they cut the stomach out AND bypass the portion of intestines?!?!?  Should I rush off to med school so I can perfect the surgery?  Then you could get the hormones gone, the diabetes gone and the reflux gone!!!  THe best of both worlds. Surely I'm not the only one who's wondered about this. There must be a downside. 

They do....it's called a duodenal switch. That surgery isn't done by all surgeons and is really more for the super morbidly obese. The malabsorbive part is really stepped up a few notches and the side affects can be very severe. The gastric sleeve was originally just the first part of a two stage surgery where surgeons performed the sleeve part to help reduce weight and surgical risk. Later surgeon's would go back in and perform the second stage of the surgery....the bypass part. What they found though during the process was that many patients did so well with the sleeve that they didn't need the bypass later.....or didn't want it perhaps.

So no rushing back to med school for you.

Share this post


Link to post
Share on other sites
29 minutes ago, CJireh said:

Interesting remarks.....you guys always make me think!  Thanks. 

So, my next thought is....why don't they do a combo surgery where they cut the stomach out AND bypass the portion of intestines?!?!?  Should I rush off to med school so I can perfect the surgery?  Then you could get the hormones gone, the diabetes gone and the reflux gone!!!  THe best of both worlds. Surely I'm not the only one who's wondered about this. There must be a downside. 

I had read somewhere that sleeve surgery used to be the first part of a 2-part RNY procedure. Some patients with a high BMI would have the sleeve done, lose a lot of weight, then have RNY. This was done to make RNY safer. Many patients had so much success with the sleeve alone, it became an insurance-approved WLS in its own right. This says something similar: http://surgicallyslim.com/sleeve.htm

Share this post


Link to post
Share on other sites
28 minutes ago, BurgundyBoy said:

. And we all know that we are not perfect. (Well, I'm not perfect,  and won't make any assumptions that you are not perfect). ;) 

I didn't want to brag, but since you brought it up, I AM perfect, all except for eating, thinking, and living but other than that, I am perfect! :)  Haha!  

You had lots of great points.  I just think presurgery I can't even comprehend any of the outcome and the changes in eating....I think I will be shocked later on but for now I can only be puzzled by having just a small amount of food....and not cheating by eating 3000 calories and not feeling horrible/guilty/needing punishment! 

It's a process...I will have to keep that in mind and let my thinking change along with my body

 

Share this post


Link to post
Share on other sites

Im bypass and even this far out I dump on fried foods or high grease content food, and 80 per cent of the time -alcohol.  Some sweets but I can have a cupcake (2 would do me in)...again, not all with bypass dump.  

Share this post


Link to post
Share on other sites
9 hours ago, CJireh said:

I am leaning towards the sleeve so I wouldn't have the dumping then, but honestly it scares me to death that I could have a bite of bday cake....and that it could all go down hill from there.  I just do not want to do this surgery w/o making lifestyle changes, so I am researching, taking notes, here on this forum every day and determined to make it work, but still the fear of letting myself go and gain it back is real.

The first thing I thought about was an RNY as you mentioned reflux. 

My daughter and I each had an RNY. I had severe GERD. It was gone immediately after surgery. I do dump and am kept on the straight and narrow most times because of it. I am grateful for that tool.

My daughter does not dump from sugars and carbs. She can with excess fat, such as a a bowl of cheese soup or icecream for instance., but it is rare.  I think she wishes she had the fear of dumping.

Share this post


Link to post
Share on other sites

I dump very easily on sugar. Even my morning latte (1 serve has just 8g of sugar)  will cause me dizziness and blurred vision even if I only have half....the same with my optifast shakes. I had a vanilla slice one day and ended up sleeping the next 12 hours after I lay down due to the dizziness. It's very inconvenient and my tolerance seems to have reduced even further since surgery. I wouldn't wish it on anyone if I'm honest, but it does keep my out of the lolly and biscuits aisle.

Share this post


Link to post
Share on other sites

I have RNY and haven't had a real dumping episode (yet). I've had mini-episodes twice after eating carby things. I have eaten chocolate cake (once) but scraped off the frosting, and didn't dump. So, I'm not sure what will actually trigger it for me. I'm also not testing that out, since the two mini-episodes were not pleasant. Before surgery, I thought if I had dumping, it would certainly be a good deterrent, but sweets are not so much my thing, so it wasn't something I felt like I would want to "rely on" for keeping me in line. 

Working on making my relationship with food healthier and giving myself room to be imperfect are two of my big goals right now. Like @BurgundyBoy, I am finding that when I overindulge, it's a question of 200 or 300 calories, rather than multiples of that, so I think I'm coming around to the idea that I won't have to be perfect all the time. Being perfect all the time is easier - it's very black and white - but I can't sustain that forever. I want my relationship with food to be healthy enough that I don't have to to worry about my body shouting stop because my head will have already made me do so. That's probably a goal I'll have to work on for the rest of my life, though. 

Share this post


Link to post
Share on other sites

I may have answered my own question...rather my body may have determined it for me.....I have GERD but I thought it wasn't so bad...just from eating crap (like chocolate, high fat foods etc) so yesterday I forgot to take my Protonix (which I have been on since May) and I laid down in bed and the acid came up and I swear burnt my throat! It still hurts this am.  I ran in and took 3 tums chews and then my protonix, propped my pillows and basically slept sitting up.  I hadn't had any trigger foods...it was a rather bland dinner of chicken breast and rice.  So, yeah, as much as it pains me to admit, I HAVE GERD!!!  And it's pretty bad w/o meds!!!  Good to know now rather than after the surgery.  

Share this post


Link to post
Share on other sites
3 hours ago, CJireh said:

I may have answered my own question...rather my body may have determined it for me.....I have GERD but I thought it wasn't so bad...just from eating crap (like chocolate, high fat foods etc) so yesterday I forgot to take my Protonix (which I have been on since May) and I laid down in bed and the acid came up and I swear burnt my throat! It still hurts this am.  I ran in and took 3 tums chews and then my protonix, propped my pillows and basically slept sitting up.  I hadn't had any trigger foods...it was a rather bland dinner of chicken breast and rice.  So, yeah, as much as it pains me to admit, I HAVE GERD!!!  And it's pretty bad w/o meds!!!  Good to know now rather than after the surgery.  

It does sound like you may have an answer here. I know you will, but make sure to bring this up with your team when the discussion about which procedure is best for you happens. I didn't have big issues with acid pre-op, but occasional bouts of reflux, and that alone makes me pretty glad I went with RNY. 

Share this post


Link to post
Share on other sites

I will...I am making a list.  I actually have a pill thing to organize what I take when and at dinner I saw I forgot the am ones, so I grabbed my biotin but skipped the protonix saying "let's see if I STILL have reflux"....I was kicking myself when I laid down and battery acid filled my throat!!! :(  It was so nasty, I thought "I can't possibly have the sleeve!"  haha...you can tell  my mind is 24/7 about WLS!  (I was thinking I should stop taking the protonix since I have my endoscopy in 2 wks and I want them to see if there is irritation there but thought the med might clear that up.....but there is NO way I can stop it even for a half a day.  Sigh.  I turned 50 last year and I feel like I have completely fallen apart since!  Next year is my healthier year!!!

Edited by CJireh

Share this post


Link to post
Share on other sites
4 minutes ago, Jen581791 said:

I didn't have big issues with acid pre-op, but occasional bouts of reflux, and that alone makes me pretty glad I went with RNY. 

I also had occasional acid reflux prior to my RNY gastric bypass, and have had no acid reflux since the surgery.  Not having any acid reflux is wonderful. 

Share this post


Link to post
Share on other sites
6 hours ago, Jen581791 said:

I want my relationship with food to be healthy enough that I don't have to to worry about my body shouting stop because my head will have already made me do so. That's probably a goal I'll have to work on for the rest of my life, though. 

This is an excellent goal and I know you'll get there. I doubt it will take the rest of your life. Once you've been eating in you new way for a while, you are likely to completely forget how you used to eat. 

Share this post


Link to post
Share on other sites
17 minutes ago, Stephtay said:

This is an excellent goal and I know you'll get there. I doubt it will take the rest of your life. Once you've been eating in you new way for a while, you are likely to completely forget how you used to eat. 

As usual, I totally agree with Stephtay.

Share this post


Link to post
Share on other sites

agreed!!!

Share this post


Link to post
Share on other sites
5 hours ago, Res Ipsa said:

, and have had no acid reflux since the surgery.  Not having any acid reflux is wonderful. 

Agreed. Having had reflux daily for many years, waking up after surgery and not having even a single bout since, has made surgery so worth it. The weightloss really was secondary for me. Reflux and ongoing abdominal pain were what started the whole process for me this time around. I never dreamed the end result would be a revision of my old surgery......but I'm glad it was in the end because it helps fix so many other health related issues.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...