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In order to have the best chance of success, I tried to ensure that my symptoms of depression and anxiety were well managed before surgery. I also continued to work with my psychologists and psychiatrists. I think it's helpful to remember that WLS or losing weight won't magically solve all your problems. It's quite common to go through relationship issues (divorce rates are statistically higher according to most bariatric studies) and even transference to other addition issues (you can go from food to alcohol or even opiates). I think it's also quite easy to slip into orthorexia (an eating disorder that involves an unhealthy obsession with healthy eating). On the other hand, losing weight can be great for your mental health. You can find self esteem and confidence that you have been missing your whole life. I definitely put myself "out there" more. I think everyone's journey is different. Best of luck!

The place I'm looking at for my surgery seems to have a very comprehensive team, including a psychiatric. I'm absolutely going to be open and honest about my mental health. I have an appt with my NP next week, so I'll talk to her about it then as well. It sounds like you have a great plan, thank you for the pointers! Sent from my SM-G988U using BariatricPal mobile app

I'm three years post op, and I aim for about 80grams of protein a day. WLS patients need to prioritise protein, so it's just a way of life for me at this point. You just have to focus on each meal being very high in protein. I find it helpful to learn what foods are high in protein (e.g. lean chicken breast, eggs, almonds, beans, chick peas) and always have them available in your kitchen. Even now, I still supplement with protein powder/protein creamers. I will make a smoothie or stir it into my coffee. I do prioritise protein over anything else. I never, never eat a meal or snack with just empty carbs (other than some dark chocolate for a treat). There always has to be protein in each meal. It helps that I'm a bit of a carnivore though. I like the taste of carbs, but I'll have meat with only a spoon of gluten free pasta or rice. The priority is always protein. Sometimes I think of myself like a player in a video game where the objective is to score extra points by having as much protein as possible. I eat so much chicken, it's ridiculous. High protein milk is good too. You get used to reading the labels on everything to check macros and protein. My other tip would be track your food with MyFitnessPal. Even the free version will keep track of your protein. Right after my surgery, I also had a special bowl and plate which marked out the ratio of how much protein should be on the plate. If I'm low on protein, I'll usually make myself drink a smoothie, that's 20grams of protein right there. If you haven't had your surgery yet, it should be relatively easy to hit the protein goals because you're not dealing with restriction yet.

This touches on one of my concerns. I'd stay locally for an extended period of time after the surgery and I'd have some nursing assistance, so I wouldn't be completely on my own. I think I can handle the extra misery, but I am concerned that I'm more likely to rip stitches or cause some other complication because of my inability to compensate with my legs or arms. I have thought about splitting the difference and having two surgeries. I've looked at this every which way and I think you're exactly right about compromises. Decisions, decisions... Thanks for your input!

I'm so sorry to hear that! Between my incision hurting and the awful pain after swallowing, this really sucks. The only thing keeping me going is the supportive words of people in this group telling me it's all pretty normal. The only thing I can suggest to you is that you absolutely continue with your pain meds. I just got a refill (granted, they only gave me 20, to begin with), and COULD NOT WAIT to take them. The majority of the pain was gone within 30 mins of taking my meds. I would also suggest taking a stool softener as the pain meds can be constipating. Good luck!!!

The main advice that I have seen, and my wife and I were given when going through this, is that things are a lot more difficult on the recovery side if you have both your upper body and lower body worked on at the same time. Think of trying to get out of a chair, or out of bed, with both your arms and legs (along with your abs) impaired. Usually, it is best to have one or the other fairly healthy and strong to help compensate for the other. They can all be done at once, and I know of people who have done that, but that really puts you down and makes you seriously dependent upon someone else to help during that recovery period. That, and you have that many more JP drains to fiddle with! As with most things in life, there are compromises and trade offs. Getting it all done at once is appealing, but it does tend to put you that much farther down for a while, rather than being semi-functional for a longer overall recovery time.

I didn’t have a drain tube but I did have surgery last week. It’s normally to be nervous but it will be worth it in the end. You got this.

Of the mainstream procedures, the sleeve will be the most benign of them when it comes to supplement needs and the amount of trouble one can get into by ignoring them and the labs. Supplementing with the sleeve is largely an individual thing - there is much more influence by individual variations and dietary habits than there is from the surgery. I've never heard of B1 being a particular problem, but given that the primary dietary source is from the grain complex, and many people are into low carb dieting (Atkins, Keto, etc.) that minimizes that food group, it isn't surprising that such deficiencies would be showing up - not from the procedure, but from the chosen diet. My wife is chronically low in Potassium, but that is just her, not her WLS (as DS in her case.) That is managed by checking levels periodically and adjusting supplements as needed - just as if she had never had WLS. I have heard it hypothesized that there might be some iron absorption issue with the sleeve owing to the somewhat more rapid transit times of food through the stomach, but I haven't seen any validation of that concern. The malabsorbing (RNY, DS) procedures specifically do malabsorb minerals such as iron to varying degrees as much of the mineral absorption happens in the duodenum which is bypassed entirely (in the RNY) or partially (in the DS) so iron levels can certainly be more of a challenge with those patients. I had a bleed a few years ago that sapped my iron/ferritan levels, but was able to restore them to normal in a few months by doubling my oral iron supplement; most with an RNY or DS would need iron infusions to recover from those levels. I tend to lose a bit of D normally so have been supplementing that since before my VSG and continue to do so at moderate levels (2-5k IU) both from that perspective, and also our surgeon prefers to see us in the higher end of the normal range on the blood levels; some in the malabsorbing camp will use 50k IU supplements to keep things in line (particularly the DS folks who specifically malabsorb fat soluble vitamins such as D) I know quite a few long time DS people (10-20+ years) and have seen very little problem as long as labs are regularly taken (annually usually) and responded to; however ignore those at your peril as weird things can happen if you don't. And that's with the DS, which is the fussiest of the procedures in that regard. With a sleeve, you are much more likely to get into trouble by something that you bring to the table - whether that be intrinsic or behavioral - but that is good reason to keep up with periodic lab checks just the same (my labs are a lot simpler than those of a typical DS or RNY person, as there is less that is needed to be monitored with the VSG.)

Good luck, my RNY was 8/10. I agree with the walking. The more you move around, the better you will feel. Also, one day at a time. Don’t be discouraged if you have a setback or a bad day. I’ve definitely had some not great days and struggle with fatigue and drinking enough liquids but give your body time to heal. This is a big, life/body changing ordeal! Be well!

I call it "internet arrogance". The anonymity afforded by the web lets people say whatever they want and they often go with their first, worst instinct. Then because there's no consequence to being wrong, people often will simply ignore it when they are being corrected.