TBH183

If I could afford to pay for it I could have the op before the year is out but I can't so I have to play the cards as they're dealt. I'm still undecided whether I'll choose the operation when the time comes anyway so this process gives me time to research and weigh it all up.

In the UK the NHS will fund bariatric surgery but the process is a long one between 18 months and 2 years BEFORE having surgery - and the NHS will only fund ONE operation! The entire process is to ensure that all help short of surgery is given before surgery is offered as a last resort not a first option. it is a four tier service with Tier 4 being the surgery itself. You have to be referred for each stage. I was referred from Tier 2 to Tier 3 in November and Tier 3 involves Dietician, and 8 Week Group Therapy Session (once a week) and a seminar on the different types of surgery available - all of which are compulsory. The NHS wants to ensure that each person is mentally and physically able to make the changes necessary before surgery is carried out which includes the requirement that each person lose at least 5% of their weight at referral to Tier 3. Perhaps that is the purpose of your insurer insisting on a 6 month diet pre-surgery to ensure that you're able to make the lifestyle changes necessary to make your surgery a success. Good luck on your journey. Dave

There is only one person I can blame for my being overweight - Me! Despite whatever happened during my childhood, emotionally, physically or otherwise, for the last 20 years the only person responsible for putting food in my mouth is myself. I've come to terms with this even though it is so very easy to blame someone else for everything. The course I'm now travelling includes an 8 week group session whereby my own personal relationship with food was challenged and discussed which does go back to childhood and the way food is used to motivate and reward but I certainly do NOT blame my mother for the way I am now. I could also blame my partner for the food I've eaten for the last 14 years - but again that's not the point. I could have said something and reduced intake - but I didn't. I wanted to show my gratitude by eating what was placed in front of me. My partner was happy that I'd eaten the food so I was happy that he was happy. I can pinpoint 3 occasions when I had a ballooning of weight. Made a stupid mistake when I was 15 and blamed my best friend for something that, with hindsight, really was an accident resulting in the loss of said best friend and others. Started using my dinner money to buy junk food and sweets. The death of my Grandfather. This was just after my divorce and I also started shift work so was buying all the wrong stuff and eating at the wrong times of the day. Takeaways and TV dinners are soooo convenient. When I stopped smoking in 2008. My taste buds started working again and I discovered that I liked eating the food I was being given - put on 8 stone (112lbs) over 3 years - but still not smoking. I managed to do something after the first 2 (even if only temporarily) and now I'm dealing with the 8 stone and more after reaching 25 stone (350lbs). Each person's relationship with the food they eat is the result of their own journey through life and because each life is different, each person deals with their own demons in their own way - even if they're baked in short crust pastry. One remedy certainly does not fit all and blaming someone else is an easy excuse without having to identify the root causes. However your journey continues, I wish you all the best. Dave

Thank you for bringing this up. Although I'm not even at the pre-op stage yet due to NHS access requirements needing to be satisfied even prior to the offer of surgery, this is something that I need to factor into my own personal cost/benefit analysis that I'm compiling to aid my decision on surgery. Or at the very least need to have a coping strategy in place before it's needed. Dave

UPDATE. Before I continue with my update, I'd just like to wish all our American cousins here a happy July 4th - be safe and enjoy all the festivities but don't sabotage all the excellent work done be each of you up until now. Apologies for seeming to disappear but I've been away on vacation to a remote part of the UK where mobile phone and internet access was non-existent at worst and patchy at best. Anyway - I've started the cost/benefit analysis that I was going to do but all the research I was hoping to get done whilst on vacation didn't happen - which was a disappointment to say the least. I've begun it at least now and I can now do some serious internet research so that I can make an informed decision when the time comes. I'm still generally opposed to surgery but not so vehemently opposed to it as I was when I started this thread so I have made some progress on this issue. I've also had some serious discussions with both my partner and my mother-in-law about the whole process. I know that sounds strange but my mother-in-law is a retired Ward Matron who worked in a Children's Hospital in Glasgow so has a medical background and we have had some serious non-judgemental factual discussions. These were both helpful and distressing at the same time but managed to identify some issues I'd never thought of before. She was quite blunt with me which I found helpful - if a bit hurtful at the time. My parents on the other hand, although well meaning and concerned for my welfare, aren't really the type of people with whom to have a serious factual conversation on the subject. As much as I love them both, it's just not something I can discuss with them on the level that I need. Some excellent news for my weight loss journey. I attended a Dietician's appointment last Thursday and am happy to report that I've lost a further 12lbs since May 11th. I have now reached the pre-required weight loss of 5% referral weight during my Tier 3 programme to qualify for Tier 4 - the actual surgery - providing I can maintain the loss. I have a further 5 months to go on Tier 3 so have time to complete my cost/benefit analysis before having to make the decision on whether I take the surgical option and to lose more weight. If I continue to lose weight at the rate I have done so up until now (net 24lbs since June 2016 - I had a little hiccup in the late summer last year - the less stressful the whole surgical question becomes. I still have a lot of reading and investigation to do. Not least what my employer will allow in terms of time off etc. and I can't even ask those questions until I know what the timescales are pre- and post-operatively. This will be my next task. Any information will be very much appreciated. In the meantime, I feel empowered by my success to date and am optimistic for the next 5 months and beyond. Keep up the good work y'all. Dave <a href='https://www.bariatricpal.com'><img src='https://www.bariatricpal.com/tickers/319706-tbh183/bodyweight.png/?ts=1498920688'></a>

Thank you each for your replies thus far. It is certainly giving me much more to think about. Up until now I was vehemently opposed to surgery of any kind but perhaps I was a bit premature in that. I'm still not sold on the prospect and probably will never be entirely comfortable with the notion of surgery to solve my problems - it just seems too easy and I was always told if something seems to good to be true then it usually is. I think I need to sit down and do a full and frank cost/benefit analysis and have further talks with family. And both of those tasks fill me with dread! [emoji43] Sent from my F8331 using BariatricPal mobile app

Thank you Joann. I googled GERD and I don't have that.

Thank you for your quick response and thanks for letting me know about the holiday in the US. I'm not sure what a GERD is so will have to Google it. The Surgeon will have final say over which type of surgery I go for - if I finally opt for it. As the op will be funded by the NHS s/he will opt for the one that is most beneficial to me - in their opinion - taking into account everything health-wise that relates to me. That decision will be made after various appointments with psychologists, nurses, dieticians, etc. so we're a long way from that point. Of the 3 types of surgery offered (Sleeve, RNY, can't remember the other one), I would personally opt for the sleeve but may be over-ridden later. The 2 week milk diet pre-op is a bit daunting though as is all the pre-planning and cooking for post op meals (if you can call mush a meal).

To begin with - this is very difficult for me to do. By that I mean talking to strangers about something I'd much rather ignore. This path however, is no longer open to me and if I don't do this now - it'll never get done and by that I mean serious weight loss and the route to achieving it. I'm not sure how familiar you good people are about how things work in the UK so a little background info is unfortunately necessary or you'll think I'm just barmy! Which may be the case but I don't want to frighten you too soon. The NHS run a 4-tier programme that deals with tackling obesity with surgery offered at the end funded by the NHS. This is a one-stop option whereby if after surgery, the person regains the weight, a second chance is NOT an option. The NHS will only pay for ONE operation. Additionally, any cosmetic procedure to deal with flaps of skin post surgery is also NOT funded by the NHS. I entered at Tier 2 which is a monthly series of appointments with an advisor to steer people in the direction of self-help. The Starting weight I've listed is my weight at the start of my Tier 2 journey. Ultimately it's more of a self help stage whereby you discuss options with the advisor and have monthly weigh-ins. The result of this is that I joined a gym near where I live and started going religiously. I also started looking at my diet and trying to come up with ways to cut down on calorific intake. My progress was slow but steady but I stalled at month 5 and after discussions with my advisor, was referred onward to Tier 3. Tier 3 lasts from 6 months to a year and deals with all the psychological issues surrounding a persons relationship with food. It also provides additional support in the body of a dietician, an 8 week series of group sessions (which are compulsory) plus a follow-on seminar "Bariatric Surgery - warts and all!" which is also compulsory. Upon acceptance to Tier 3, the question "Are you looking towards bariatric surgery at the end of this process?" is asked. If you answer no, then you can still go through the programme but surgery is taken off the table and if you request surgery at a later date, then you have to repeat Tier 3. Another part of this stage is that you have to lose between 5% and 10% of the starting bodyweight to even be eligible for surgery. For me that equates to losing between 30lb and 40lb. I'm currently half way through this stage, completed the group session and attended the seminar and at my last appointment with the dietician at the beginning of May had lost 10lb since February. I started writing a food diary at the beginning of the Group Sessions and my dietician recommended between 1800 and 2200 calories a day. This has helped reduce portion size and focus my mind on just how much I am eating and of what - most beneficial even if really inconvenient at times (both in terms of writing the thing and of what it reveals). I've since joined a second gym so that I can continue my exercise regime (mainly cardio) before I start work. I work shifts - 12 hours, days and nights, 14 shifts in 28 days. This has allowed me attend a gym from between 4 and 6 days per week. I don't attend when I'm on nights because sleep is also important and due to the nature of my job, I will not sacrifice more sleep than is necessary by getting up early just to go to the gym. Tier 4 is the surgery itself with all that that entails. I have yet to investigate this in depth and quite frankly, I'm frightened to do so in any depth but basically requires collaboration between 6 different professionals including a psychologist and the main players in the surgical team led by the Surgeon. So back to my original question: "Am I making the right decision?" This question is more a way of focussing my mind on the whole topic of surgery. The whole idea of going under the knife frightens me silly. I'm afraid of the process. I'm afraid that the Surgeon will dictate a different operation from that which I want. I'm afraid of the risks. I'm afraid that after all is said and done, it won't work. I'm afraid of what happens if I don't take the surgical option. I'm afraid of the dietary restrictions pre and post surgery. I'm afraid of what will happen financially when, if I opt for surgery, the whole process starts, as I will need to arrange time off for pre-op appointments at a location to which I will have to travel. I'm afraid of the next 30-50 years post surgery and the dietary restrictions over that length of time and will I be able to continue with those restrictions? I'm worried how I'll be able to do mundane things like food shopping post surgery. And I'm also VERY afraid if all other steps short of surgery don't work and I'm left with only one course left open to me. I'm getting advice from a variety of sources. Close friends and my life partner say that if I can do it without surgery, do it that way. It'll take longer but would be more beneficial. My dietician is stating that having the op could seriously help with my Type 2 Diabetes (tablet and diet controlled) and potentially cure me of it (my current HbA1c, cholesterol, BP, liver and kidney functions are all good as were the results from my recent retinal photography). Also that I'd lose a lot of weight very quickly so any up-and-coming mobility impairments are mitigated before they even become a problem. This would also address my original concern - weight loss while there is still time to benefit from it. I have yet to speak to my diabetic nurse about it but I've an appointment with her in September so I'll raise it then. In the meantime. I'm lost. I know of no-one within my acquaintance that has undergone this form of surgery to ask. It was suggested that I join a forum and get the story straight from the horse's mouth as it were. How did you good people come to terms with the implications of surgery? How did you cope with all the life changing decisions required by surgery? What advice did you get? Which did you follow and which did you discard? And why? I'm not even sure that I'll get a response from you good people but I must try and get more information from those that have gone through the process and what the successes were and where the potential pit-falls are. Thank you in advance and apologies for the length of this post. Dave