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Hi All,

I'm Jade from Aus -I've just had my first consult with my surgeon and surgery dietician (I had been seeing another dietician for a while).

I'm currently feeling pretty overwhelmed, and have heaps of questions that I have thought of since my appointment.

I'm hoping losing weight will help my chronic migraines. I also have PCOS and a number of other health issues.  I'm scared I will either fail to lose weight, put it all back on, or lose it, still be sick, and be even more unhappy with the loose skin....  so many doubts at this stage.

I'm booked in for my gastroscopy next week, and when I get the results on the 24th, I will know the surgery can go ahead. 

I was originally planning September for the sleeve, but now I am thinking July.  How long do people usually take off work? I have a somewhat active job (chemistry lab), I can go back on modified duties, but want to go back as soon as possible.  My surgeon said 2 weeks at home, then another 2 at a desk, then prob more till I can do any heavy lifting, but I have previously found that surgeons estimates pre-surgery can be optimistic (i.e. for my shoulder surgery the estimate was 3 months, but it took a year for me to be back on full duties) so I am worried.

I'm also somewhat terrified of the pre-surgery diet. I have to do 2 weeks of optifast. 3 meals a day with 2 cups non starchy veg.  I have failed shake diets previously before - and couldnt keep going for more than a couple of days, and that wasn't all the meals. I'm hoping that with a definite end date this will be different!

Thanks everyone

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Sending a warm welcome to Thinner Times Jade!

Keep a notepad to hand for those questions - my surgeon told me that the only stupid one is the one you don't ask.

I had to take 6 weeks off because my work had a 70lb lifting restriction.  I went insane the last couple of weeks but it's best to err on the side of caution.

From experience, doing a shake diet pre-WLS was totally different from the past liquid diets I've been on.  You'll have your surgery date and you'll have us to support you.

You can do it Jade.

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Hi @Jade35 Three focused comments:

- Everyone worries they will put the weight back on. You follow the diet, have the surgery, the average person loses 60-70% of their excess weight. WLS reliably works. The average includes people who cheat and who do dumb things. Be sensible and follow your diet and honestly you will do fine and likely better than the average. The great thing about WLS is that it works, even for idiots like me.  If you look at the YouTube videos of people claiming WLS did not work, they are sitting there eating a bag of Cheetos or a pizza. The surgery makes your stomach smaller and reduces physiological hunger. It does not do brain surgery on you or cure your psychological problems. Having social support and a network of supporters - in person or online or both - helps keep you from backsliding. If you eat Fritos because Mommy did not treat you well and you haven't dealt with this, stomach surgery will not take you back in time and make Mommy treat you better. The main reason for WLS to not work is psychological. It is 90% a head game. The surgery restricts the amount you can eat, and during the honeymoon period lessens hunger. 

- Choose a shake that is lower in carbohydrates than Optifast. On an Optifast diet you may still be getting 70 grams of carbos a day and only a minority of people will be in ketosis.  If you are on a low carbohydrate diet and go into ketosis, your hunger will be much less and the liquid diet is much easier to tolerate. A lot of us use Premier Protein shakes that are 160 calories, 30 grams protein, and I think 1 gram carbos.  I think @Michael_A and @Jen581791 can comment on the ketosis angle. 

- If your sleeve is uncomplicated, as it is for > 95% of people, 2 weeks is indeed enough time before returning to work. You might feel a stomach tug or some discomfort at a surgical site for a bit afterwards but in a poll here on the Forum recently, most respondents replied they were okay to return by then. I could have gone back after a week but took more time to cement some exercise habits which were a form of physical therapy for me (lots of orthopedic problems). 

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Hi @Jade35, I think some fear of the unknown is totally normal. You'd be silly to consider WLS without considering the possible negatives. That said, WLS is probably the best thing I've ever done for myself. 

Whatever happens with your various health issues, they probably won't get worse if you lose a bunch of weight! Weight loss is basically guaranteed for the vast majority of people who have WLS - I think most who don't lose much aren't whole-heartedly following their program, for whatever reason. There are people who confess to that, but I hope that you will be able to address your emotional reasons for eating before and after surgery so that won't be you. As for loose skin, I'd take it any day over a whole bunch of extra weight. 

If you're doing your WLS in the Australian health system, they may require Optifast, I suppose. I'd agree with @BurgundyBoy that choosing something lower in carbs would get you into ketosis and losing faster, but not sure how your health system will deal with that request. During the pre-op diet, you just have to keep your eyes on the prize and remember why you're doing it - it's not a shot in the dark diet scheme like other shake based diets you may have done are (destined to fail eventually). It's a way to shrink your liver so your surgery is safer and easier to recover from. Your very immediate health outcomes are dependent on it, and the pounds you lose while doing it are never coming back! :) As long as you do the hard work of being diligent, of course - it's not magic.

I had RNY, not VSG, so not totally relevant how long I needed to rest afterwards.

Best of luck to you. Let us know how things go.

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Welcome! I don't have much to add that @BurgundyBoy and @Jen581791 haven't already covered. For me, the pre-surgery diet was the hardest part. I was supposed to do all shakes for all meals for 2 weeks. I didn't even last two days. I ended up having shakes for breakfast and lunch and then having a small portion, low-carb dinner. I am not suggestion you cheat on your pre-op diet. Just letting you know that I understand your fears about it.

You don't say your age or how long you've been overweight but I wouldn't worry too much about the loose skin. Most of us have it to some extent but there are a lucky few who don't have any. Whether you have it or not is based on your age, how long you were overweight, genetics and how heavy you were. If you have loose skin and you really hate it, you can consider plastics. 

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Welcome!  There is lots of great advice above and on other TTF postings. 

Our most active Australian member @Aussie Bear may have some thoughts on making your country's medical system work. 

By the way, I had a gastric bypass, which is more surgery than the sleeve, and I was back at my desk job part time (mornings only) six days after surgery, and back full time about a week later. 

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Welcome . I had 4 weeks off which worked great for me x

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Welcome Jade. Hope the endoscopy goes well and you can keep the ball rolling in the right direction. If they do find something out of the ordinary, then know that resolving any issues prior to surgery is actually in your best interests. Many of us have experienced delays in the process due to previously undiagnosed issues that crop up during the extensive pre-op testing regimes. 

As for the liquid diet,  I just looked at it as something that had to be done, and pretty much did it. Mine was 4 weeks pre-op though. That said my surgeon told me to replace two meals a day with optifast and the third could be low carb meal....the dietician said replace three and have the green veggies. I couldn't digest veggies very well prior to my surgery, so I only replaced the two meals. I also swapped out optifast for optislim VLCD, and none knew any the wiser. Don't worry about the carbs mentioned by @BurgundyBoy, while he makes a valid point, optifast is optimized for mild ketosis which is all you need for liver shrinkage. Plus your surgeon will tell you it's non-negotiable....I think Aussie surgeons must all have shares in the brand. While we don't have the brands our US counterparts swear by, we do have alternatives here that might well be okay after surgery when you have your vitamin regime in place. Before surgery though you need to stick with a VLCD rated meal replacement, because they contain everything you need for sustenance.  I personally don't mind the Isowhey  shakes, but I do know of a local bariatric practice that has now switched to Formulite. Some of the other shake brands like Tony F, Terry White, Fatblaster,  celebrity slim etc fall well short on the nutritional requirements for meal replacements (and often well short on protien).

I can't really help you on the time off from work thing either, but your surgeon's guidelines are probably adequate for the average patient, the uncertainty is whether your recovery will be average or not. We are all different, and all will recovery at our own pace with different thresholds for pain etc. I, for example had a very speedy recovery from my bypass, but later orthopedic surgery has seen me at a snails pace for recovery.

Edited by Aussie Bear

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Welcome, Jade! I am not far out from when i had my surgery. My fears were much the same as yours are. The good people of this forum helped talk sense into me every time that my fear got to be overwhelming.

I do know that if I can get through this and be happy about it, anyone can do the same.

Please stick around. Ask questions. You will find much information and support here from folks that have already been through the entire process.

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I couldn't edit my post above for some odd reason but, I did want to add this.

BTW- I too did the Optifast diet for 4 weeks! I only had one tiny meal per day. I got through it by taking it one day at a time. It does get so much easier after the first few days. You will see.

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Thank you so much everyone!!!!

I feel so reassured by all of your replys.

I'm glad my pre-op diet will only be for 2 weeks - the surgeon/dietician does seem very set on optifast - you are right that it's like they have shares in the company :-). The post op diet is much less specific with protein powder and several brands of commercially available drinks on the lists. However, I'm sure if I swapped out the optifast for another brand with similar nutritional values (not one of the sugary ones) then it would be fine.

Glad to hear lots of people were back to work quickly - If I can even manage working from home at least I won't be burning through my leave. I'm just conscious that my boss has been really good about covering my projects in the lab while I have been unable to several times in the last couple of years. I guess by going through with the surgery I'm going to hopefully reduce the need for this in the future.

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