Leaderboard

The first meeting with a patient preparing to have weight loss surgery, whether it be sleeve, bypass, or balloon, carries so much hope, anticipation, and excitement- that you can almost cut it with a knife. For many people, by the time they have reached the point of considering weight loss surgery, they have gained and lost hundreds of pounds. They finally have a beacon of hope in what was once a desolate psychological place of despair and hopelessness. Trying to emphasize the need for simultaneous behavioral and psychological change, often makes me feel like Rachel Dratch in her SNL portrayal of Debbie Downer. The reality is that there are many people who go into the surgery, carrying a magic bullet fantasy who don't intend to change anything about their lifestyle or psychological landscape, and that actually still works - for a while.... The sheer reduction in portion size over time would dictate that most will lose a significant amount of weight. There is no other way of losing weight that has such a fail safe element to prevent "cheating," or "relapse." You simply can't go overboard after the surgery, or you will get very sick and regret it. However, after the party is over. All the folks have gone home, all the social reinforcement has diminished, and six to twelve months post- you are still faced with the demons that got you here in the first place; depression, past trauma, abuse, a bad relationship, lack of purpose, addictive propensities, boredom, loneliness, lack of a sense of self efficacy, etc. Your Psychological Tool Belt is Here. Baptism - go back to the drawing board when you know you've gotten off track. I am in the midst of potty training my three toddlers at the moment and am reminded of her directive if the kids start to have accidents more frequently that we need to go back to square one and do another three day round of the pants off dance off, where we are sequestered to our home for 72 solid hours so that I can act like a psychological seismograph and quickly put a peeing kid on the potty mid stream. Same thing applies to bad habits or addiction. To have the same motivation and gusto you once came out of the gates with, you have to go back and come out of the gates again. Perhaps this means reading the literature that got you motivated to change in the first place. Maybe this means going back to OA meetings. This could mean training for a half marathon. Whatever helps to signify to you that another major shift is coming. Psychological Absolvement- This is a layer of guilt that I see many who relapse, carry. This serves no one. In fact, it sometimes perpetuates the problem because when we feel bad, we do badder (that's a word right?). Understand that this journey you are on is not a simple downhill road, but a twisting, winding, and sometimes uphill battle. This struggle is all part of your process. In any true change process or metamorphosis there is significant struggle, whether it be the caterpillar in its cocoon, or the crucible in the kiln. Higher Desires- Make a list of what you at your best self feels and looks like. Are there famouss people or celebrities that have recovered from addiction that inspire you? Are there people in your life that live it with vigor that you would want to emulate? Environmental prompts- make sure your life is surrounded by items that inspire and motivate you. It could be a beautiful quote on your mirror, a poem on your bedside journal, a beautiful picture on your phone's wallpaper, making sure your favorite health sites are showing up first in your social media feeds, making an effort to tune out negative social media, or triggering/toxic people. Whatever the things are that you know lend to you being your best self, need to be in place. Think of it like psychologically nesting for change. Cons list- you need to have a list on your person or on your phone of all the reasons you did this in the first place; heart disease, hypertension, sleep apnea, chronic pain, not being able to keep up with the grandkids, poor sex life, feeling of embarrassment in public, social isolation, etc. These can be powerful reminders of why we started such an endeavor in the first place. Spirituality- This doesn't mean religion but it can. If you have a solid faith- wonderful, use that. Allow your guiding principles to help you during your most vulnerable weak moments. If you don't have any form of spirituality - think about what that might look like for you; yoga, mindfulness, realignment with nature, serving your community. Spirituality allows us to connect with our soul. It allows us to be in a place of openness and vulnerability without knowing all the answers. It provides us with the opportunity to have faith that everything is going to be alright even though things are really uncomfortable right now. Daily/Weekly- What are you daily and weekly rituals that keep you on the right track? Make a list of the things you know you need to be doing daily and weekly to signify you are in a good space. Maybe daily it is drinking hot lemon water in the morning, meditation or "bed"itation, prayer, exercise, vitamins, meal prep. Then maybe weekly it is acupuncture, therapy, journaling, volunteering. Try starting with these tools and see if you don't start to feel a sense of renewed motivation. For more tools, please check out the full psychological tool belt here. For my free supplemental course on weight loss, click here.

Paperwork and Documentation Photo ID. Credit card, checkbook, and/or cash. List of contacts. List of questions and notebook to take notes. Insurance card, letter of reimbursement acceptance, or any other paperwork. A list of your medications. Passport or passport card Visa Bring a photo ID and any money you will need. You may not need any if you are going to a local hospital and your insurance covers your surgery. You may need a lot if you are self-pay and payment is due at the time of service. Bring money for any incidentals, such as a taxi ride home or to the airport. Bring any insurance paperwork you have if your insurance is helping to cover your surgery. Also bring a list of contacts such as family and friends that you can call if you need help. Include your doctor on the list. You or your surgeon may need to ask about medical conditions or medications that you are on. You need to bring the proper documentation if you are going outside the country for your bariatric surgery. At the least, you need a passport or passport card, and to be on the safe side, you should be sure it expires at least 6 months after your scheduled return date. You may need a visa for some countries, although not for Mexico if you are American. Clothing Slippers or socks with non-slip rubber soles or grips. Loose-fitting clothes to wear home. A change of underwear. You will wear the hospital’s gown, but should bring something loose-fitting to wear when you are discharged. Be sure the waist is very loose and the outfit is easy to slip on since you will be in some pain and will not be very agile after surgery! A gown or dress can be best. Non-slip slippers or socks will let you walk around when you can without needing to put on shoes and without risking falling when you are tired and weak. Do not take expensive clothes, tight fitting clothes, or accessories. Toiletries Toothbrush, toothpaste, deodorant, soap or body wash, shampoo, and conditioner. Lip balm and lotion or Vaseline. Hair ties. Baby wipes Just take the basics. Keep your teeth clean, and take what you need for a shower, if you have time to take one. You might feel very dry after surgery. Lip balm can keep your lips from getting too chapped, while lotion can keep your skin moisturized. A scrunchie or elastic hair band can keep your hair out of your face if you have long hair, and baby wipes can help you freshen up without much effort. Go light with your toiletries. Do not bother taking makeup since you will not have time to put it on, and you probably will not have the energy, either! Electronics and Entertainment Phone and charger. Book or eReader with books on it. Crossword puzzles or other paper or electronic games. Movies. Do not forget your charger for each device! Time will probably pass very quickly in the hospital and you may not have a chance to get to any of your entertainment. You may also be too tired or distracted to focus on it. Food and Drink Tea bags and water enhancers. Protein powders and shakes. Water bottle. Protein blender bottle. Your first priority after weight loss surgery will be to stay hydrated. Water can taste funny, so you might want to pack some water enhancer powder or flavor drops. Decaffeinated herbal tea bags are easy to pack, too. Just make sure you let the tea cool before you sip it so it does not hurt your surgery scar. A water bottle and protein blender bottle can be useful for the trip home. You do not need to take any solid food since you will not be eating it for several days to weeks after weight loss surgery. For Your Health and Comfort Pillow. Medications. Ear plugs and face mask. CPAP machine. Gas-X. Throat lozenges. A pillow on your lap can make your ride home much more comfortable. It can also help you sleep better in the hospital if you are fussy. Ask the hospital about which medications to bring, whether you should bring your own CPAP machine, and how they feel about you using GAS-X to combat your post-op flatulence. Do Not Bring Jewelry. Irreplaceable keepsakes, such as photos. A simple rule of thumb is if you do not need it and do not want to lose it, do not take it. This goes for pricey items, such as designer handbags and jewelry, and for anything irreplaceable, such as family photos.