anaxila

Surgery is 1/6! Woo! Pre-op diet started 12/23. Diet consists of limiting intake to 1300kcal/day, at least 110g of which comes from Protein. All presurgical appointments are complete and no red flags anywhere. All systems go for surgery in 6.5 days! I can't wait!

My doc will "begin to discuss" readiness to return to work at the 4-week checkin. Not before. The team says to expect 6-8 weeks off work. They don't do this for recovery from surgery specifically, but for getting launched properly on the new path, developing better habits, learning how to eat, getting started with exercise, etc. I am very fortunate to work for a large company with generous leave policies that will do whatever the doctor says without questioning it. I still feel immense pressure to return to work fast, but that's all coming from within me.

I dunno, I thought "lover disease" was pretty awesome, as typos go.

Congratulations, @@bandabear22! It's a journey, not a destination, and you're taking the huge first step. Best of luck to you!! This group is great for helping navigate the process. Cheers!

@@mdnitschke, thank you for sharing your story. You obviously made the right choice, but as a dedicated rider myself I hope you get on another Harley soon. Yes, I obviously keyed in on the most important bits! I am having surgery in a week and can't wait for next riding season without the knee pain and hip pain caused by all this extra baggage.

I have nine days until surgery, so at about the point in the pre-surgery diet where things are getting easier. I've lost 6 pounds since starting the diet on 12/23, which is very motivating. I've been hitting the gym a ton too, which is helping me to finally approach the pre-surgery weight loss goal the surgeon set at our first appointment. The hardest part, by far, was the caffeine withdrawal headache. That was miserable. It wasn't until starting this phase of the journey that I realized that "head hunger" is a real thing, and very powerful. The first day of the pre-op diet, I hit McDonald's drive thru for Breakfast. I didn't even last two hours into the diet before I started to self-sabotage. I've been plodding along since then, following the rules and making progress. It helps that there's very little bad stuff to eat at home, but when I was out just now it was all I could do to avoid a drive thru of some kind for a quick fix of terrible stuff. I look forward to the post-surgery physical limitations, to help shore up the willpower that seems so fragile.

I have 9 days until surgery. I asked my nutritionist last week about baby food, and she said no, no, no, absolutely not. Too many other things in there besides plain old Protein, especially waaay too much sugar. I was surprised, as I thought that would be an easy solution for the first phase.

@@Jersrose43, FMLA only applies to businesses with 50 or more employees. @@tphillips124 works at a very small company with only "about 4 employees besides my boss", so is not eligible for FMLA. I never knew I had such cause to be grateful that I work for a large company, but this board is teaching me that. I have been grappling with the issue of how much time to take off and how much to tell people at work, but those have been unquestionable MY decisions. The idea that my my employer would have a say in when and how I do this, or that I could lose my job for having surgery, or be in some way restricted in how much time I can take to recover, horrifies me. @@tphillips124 and everyone else in this position, you have my sincerest sympathies.

I have surgery 4 weeks from today, which means I've had to start the process of applying for medical leave at work. Luckily, I work for a big company and we contract out to a faceless "leave management company", so I don't have to actually explain to anyone I know what is going on. Still I've had to tell my boss that I'm having surgery on January 6 (yay!) and will be out for 6-8 weeks. He respectfully asked if I wanted to share any information about what was going on, and I respectfully declined to do so. This is a weird feeling because I am generally very close with my boss and we share way more than we should, but I just don't want to go there with him. It's a weird barrier, though. I'm doing the same thing with my employees. I've told them I'm having surgery and will be out, but not why. And we're generally very close as a team and tend to over-share on lots of things, so it's a weird barrier. It doesn't help that one of my employees is out right now for a double-mastectomy and reconstruction, and she's been very open with her process but I'm not doing the same with mine. I fear it will cause trust issues with the team, but don't know how to avoid it without sharing more than I'm ready to do. It's probably only strange because of how open and transparent I usually am with things, but in this case the only thing I like less than concealing it would be sharing it.

My nutritionist is a big fan of adding pudding mix to Greek yogurt. She says sugar-free cheesecake flavor is the best. It has 7g of Protein per 1/4c serving. Cottage cheese is another option - small curd is small enough that you don't need to blend it. I have a recipe that combines fat-free cottage cheese, sugar-free whipped topping, and jello-flavor of choice; 9p of protein per 1/2c serving. Other options include just mixing in sugar-free coffee syrups and sugar-free chocolate or strawberry syrups. I have a book (available on Kindle) called "recipes for Weight Loss Surgery Success: Starting Your Journey Step-by-Step". The author is Chef Dave Fouts, who had WLS himself. The entire book is all shakes/smoothies, purees, and soft foods. It's all good stuff for the first phase of the journey, and has full nutrition details included. Hope this helps!

I have tried to switch back over to mfp because there are SO many users there, but I just don't like it. I am much happier with my current app: "Lose It!" The user interface is beautiful, food tracking and challenges are great, and I prefer it's broader categories of exercise. For example, Maybe if I get deep into training I will want to know exactly how many sets and reps I did on each strength training exercise, but for now I'm happy with just "weights" and a designation of light vs intense. If anyone else is using this particular app, let me know and we can connect.

My surgeon's request for pre-surgery weight loss is 5% of total body weight, which in my case is about 15 pounds. For the two weeks leading up to surgery they ask patients to follow a 1300 kcal/day with mix of 110g or more Protein, 100g or less carbs, and 55g or less fat, all the way up until surgery. However, my nutritionist gave me her blessing to have proper good-bye meals for Christmas and New Years Eve so long as I get back on track immediately after. I'm mostly thrilled to say my good-byes to favorite foods all the way up until the surgery (which is 1/6 for me), but part of me wishes I had the pre-op liquid diet to help get my head in the game and sober me up a bit. I feel like it's almost a rite of passage and I worry that I am not taking it as seriously as those who are more restricted. I guess there's just no pleasing us. The ones with the liquid diet hate it, and the ones without it feel left out.

My nutritionist recommended Vitamins from Celebrate Bariatric supplements. You can go to their website (http://www.celebratevitamins.com/) and order a sample pack of all their vitamins & supplements for $3. Look for the link on the left side of the page, third box from the bottom. The chewables are actually quite tasty.

These are some of the recommendations I got from my nutritionist this week. Hope this helps to break the monotony: 1) High Protein Milk = 1c milk + 1T non-fat powdered milk = 12.5g protein (add sugar-free hot chocolate mix, sugar-free pudding mix, sugar-free coffee syrups, or sugar-free chocolate or strawberry syrup for variety; also, mix in advance and leave in the fridge overnight for better flavor and mixing of the powdered milk) 2) High Protein Egg = 1 egg + 1T milk + 1T powdered eggs = 11g protein 3) Ricotta cheese mixed with vanilla extract, cinnamon, and/or nutmeg 4) Plain Greek yogurt mixed with sugar-free cheesecake pudding mix; 1/4c = 7g protein (cannot WAIT to try this one!) 5) chicken with Ranch = 1 can chicken mixed with 1T powdered ranch + 2T plain yogurt; 1/4c = 10g Bon appetit!

I confirmed with the nutritionist this week that my pre-op diet is to eat 1300 kcal/day, made up of 110g Protein minimum, 100g or less carbs, and 55g or less fats. They have a published meal plan of XYZ for day one, day two, etc., but I prefer to make my own meal plans and all I have to do is stick to the constraints above. I am grateful that I get to eat tasty food up until the end, but in some ways I am almost wishing for the heavy restrictions of the liquid diet to give myself a reality check. It still barely seems real, and it's hard to take it as seriously as I know I should and get my head into the right place.

@@claudi2103, my surgeon is James Wallace in Milwaukee, WI. He's the founder of the bariatric center of excellence at this hospital and has been at it for 21 years. I haven't seen any other programs that have the same approach, but I know a number of people who've been through their program and give him rave reviews. In my experience, Wallace is a bit of an odd duck (surgeons are a special breed...), but everyone else on the team has been amazing.

My insurance required a 5 year weight history. They just needed a single medical record with the weight noted: once each year in 2009, 2010, 2011, etc. I had to get records from doctors in several states, and there were some years I couldn't get. So I just went back further and had an older doc send records from 2006, 2007, etc. my insurance accepted this without hesitation. The purpose of this is to demonstrate that your weight problem didn't come out of nowhere, which would suggest that they should look for a different medical cause. So having some gaps in years was no problem because it told a very consistent story. Hope this helps! As for where to start, I went straight to the surgeon. They run a "comprehensive weight loss center" at the hospital and have regular free info sessions. So that's where I went and they told me everything I needed to know about referrals and who to ask for what. They are old pros. You might want to check and see if any hospitals in your area have similar programs. The magic google machine can probably help you there.

I am Anaxila there, as here. Any and all, please look me up and connect!

It's so interesting to see the differences between what different surgeons and their teams require. Mine doesn't do pre-op liquid diet at all. They don't believe in Protein shakes and insist on getting protein the old fashioned way. Instead, they have a 1300 kcal/day diet (men get to have slightly more) that they want us to follow for the two weeks leading up to surgery, but even then my nutritionist has given me her blessing to eat properly for both Christmas and New Year's Eve in advance of my surgery on January 6. I know they say not to eat or drink anything past midnight the night before surgery, but I think that's about it. I'll learn more at my pre-op class tomorrow morning.

I would suggest contacting your insurance provider to find out what information they require. Mine just needed one visit per month, and it could be any time during the month. For example, I just needed to have one visit in July and one in August, and it would have been okay if they were back-to-back 7/31 and 8/1. But I have absolutely no idea what details my surgeon's team submitted for the actual approval. Are you working with a specific surgeon or a specific clinic or program? I ask because my primary was also completely clueless about the requirements but that was okay because she had very little role to play. I did everything through the nurses, coordinators, and nutritionists. I've only seen my primary care doc once and the surgeon once, but that's OK because getting me ready and approved was mostly the rest of the team's responsibility. IMO, they should be helping you with this. Hope this helps. Best of luck getting ready!

Does anyone have suggestions for treatments or creams that encourage skin to go back where it belongs after weight loss? I feel like plastic surgery is inevitable, but in the meantime I'd like to do what I can within the limits of age and time.

The APA (American Psychiatric Association) recognizes something called "Body Dysmorphic Disorder" as a psychiatric condition. It basically means this (copied from wikipedia): "a disorder that involves belief that one's own appearance is unusually defective and is worthy of being hidden or fixed... If the perceived flaw has any foundation in reality, it is typically minor, though severely exaggerated." It's usually diagnosed in people with anorexia, to explain how someone can look in the mirror and describe their 80-pound body as grossly fat. I've been thinking about this a lot lately as I get ready for surgery (28 days and counting!), and review pictures of myself throughout my life. I was "the fat kid" from an early age, but when I look at pictures of myself in elementary school, junior high, etc, I hardly see what the problem was. I was on the soft side of normal, but you'd never know it for the teasing I got and the self-hatred I heaped on myself. I weighed 185 when I got married in 1993, and was so incredibly disappointed in myself for failing to lose weight in advance of the wedding and making my (ex-)husband stand up and marry such a gross person that I could hardly bear to stand up there and go through the thing. Now fast-forward 20 years. Depending on the day, I'm just over or just under 300 pounds at 5'4". That's a BMI of 50-51. I am not psychotic about avoiding them, but I generally don't spend a lot of time with mirrors or cameras. And now that I am seriously, dangerously, actually obese, my mind's latest trick is the "I'm not THAT fat" game. I am literally two little boxes from being off the printed BMI scale entirely, and even the largest plus-sized clothing made by my employer has only about a 50/50 chance of fitting. I have diabetes, sleep apnea, high blood pressure, the whole package. But somehow, I still catch myself wondering if I really need surgery. I've recently realized that in my mind I am about a hundred pounds lighter. The only times I am really aware of how I look is when I'm sitting in the hair stylist's chair for highlights (they take forever, and the mirror is huge), or when I see pictures. I finished my MBA program last weekend, and I am horrified by the pictures from graduation - "Is THAT how I look? OMG, I'm huge!" I feel it in the physical discomfort of moving through the world at this size, but in my mind's eye I'm much smaller than reality shows me. It's just interesting to me how my mind plays tricks on me. When I wasn't that heavy I was convinced that I was grossly fat. And now that I am seriously out of control, my mind tries to convince me that everything is not that bad. I wonder if I will have a realistic picture at any point: if my mind and body will match up somewhere along the way.

I have recently started using the Everyday app on iphone, and thought some of you might enjoy it as well. The app prompts you to take a selfie of your face every day, enabling you to make a time-lapse movie of your face over time. I got the idea from watching this: It seemed like fun to see how my face changes over time with WLS, and thought you might enjoy it too. You can read more about the app on their website (http://everyday-app.com/) or in the app store.

Yeah! There you go! Now you've got it.

I'm totally with @@orionova on this one: I literally can't imagine a scenario where that statement makes sense. No matter how I twist up my face or stand on my head or try to look at it from another angle, this just comes back as crazytalk. I can't imagine dealing with that objection, and I give you all the props in the world if you're able to keep your cool in that conversation. Know that we're here for you.