NobodyYouKnow

I don't know of any way to make the hunger stop, but I can tell you this: day 3 is seriously the worst part. I hated everyone and everything that crossed my path on day 3. The first few days, actually, are completely miserable. BUT, it does get more manageable. If you can hang on a little longer, it's almost as if your body goes, "fine, whatever, do what you want" and sort of gives up on the headaches and crankiness and the worst of the hunger. Which isn't to say that it becomes easy, but it becomes a bit less hard if you just hang in there. (And if you can make it until surgery, afterward hunger will not be a problem anymore.) Good luck!

I'm scheduled for Nov. 20, which is a year to the day since my psych eval appointment... I currently live in a very rural area with 2 surgeons to serve the entire northern half of the state, so things move s.l.o.w.l.y. But it's all good. I've had time to lose a good bit since starting (and I started with quite a lot to lose), so I've got a head start. My mom is coming up to take care of me for surgery and the week after, so we're just skipping Thanksgiving this year. Honestly, it's kind of a relief to just shrug it off and say, "eh, we'll do it next year." It'll be homemade chicken broth for thanksgiving dinner this year... maybe I'll steep a sage leaf in it to make it festive. 😉 But if my calculations are correct, and if things go smoothly, that will have me moving up to pureed foods for my birthday on 12/5, soft foods for Christmas, and done with the recovery stages for New Years. I've never *ended* a diet for New Years before... We'll see how it goes.

So, counting from my first "real" visit (not the initial information session), I began this process in early January of this year. My insurance requires only three months of a supervised diet, but the program I'm in is a six-month process regardless of how you're paying. Fine. So I've been going along, hitting all my milestones on time, dropping the weight they asked for. I got slowed down a bit over the summer by everyone taking turns going on vacation, but finally, last week, I went in to see the surgeon again. He sees my progress, sees that I've fulfilled all the program requirements, and he says he's going to submit me for approval to my insurance company. Mind, I'm currently in month seven of a six-month process. Great, doc, what are we looking in terms of timeline? When do you think this might happen? And the answer was November. Some factors worth noting: I live in a very rural state, and this is the only bariatric clinic supporting essentially the entire northern half. This clinic has exactly two lead surgeons. So I'm not really surprised that it's going to take a while... but it was a bit frustrating to think I was getting close, only to find that I'm still months away. And it's frustrating to hear that people who started after me are going to get to go soon, while I'm still waiting around. And fine, that'll give me more time to work, etc. But man, I'll be on month eleven of six before I actually get the surgery done. Anyway, yes, let's estimate eleven months for me.

Chiming in a little bit late, so you've already got a lot of replies, but here's how it went for me: The first time I saw my current primary care provider -- an awesome nurse practitioner who made it clear from day one that she was on my side and just wanted the best for me -- she never said, "you need to lose weight." What she said instead was, "have you ever considered bariatric surgery? I would be so happy to make a referral if you'd like to go check it out and learn more." And while I was very reluctant about the prospect of surgery, I took her recommendation seriously. The thing that I think made a difference was that she just didn't drop the command to lose weight into my lap, she started by offering me a potential solution. It probably made a difference that I was ready to be receptive to that kind of suggestion, and that at my weight then (464 lbs that day) there was really no question about the need to lose weight. But she didn't say it in a way that might come across as accusatory, or in a way that just stated the fact and then left me to work it out for myself. She was offering me a practical, simple step that I could take to start moving forward. That was a year ago to the week, and in the intervening time I've dropped ~75 lbs on my own, and am mostly through the six-month program at my bariatric clinic. I haven't had surgery yet, but I anticipate that I will sometime in late August, or maybe early September. This probably wouldn't work on every patient -- those with less extra weight might be a little shocked at the suggestion that they look into bariatric surgery. But even a referral to a nutritionist might be a simple, positive thing you could offer patients to help them start making a little progress.

Awww, I'm genuinely sorry to hear that you had a negative experience. As you tell it, it does sound like maybe they were just "covering the material" more than anything. I'm glad to hear that you're pressing on anyway, though. Keep at it, you'll find your way.

So JayCat, how did it go?

Obviously every dietician is different, so telling you about my first dietician visit isn't that helpful, but I'll do it anyway in the hopes that it will help calm your anxiety. The dieticians who work with bariatric clinics come into the room knowing that their patients will have some... let's say, quirky eating behaviors. At my first visit with the dietician, she talked to me a little bit about my current habits (and was totally non-judgmental about it), and gave me a few goals to work on for the next visit: try to focus on portion sizes (not caloric values), start taking a daily multivitamin, and foremost, start working on increasing my protein intake: 80-100g of protein a day. The next time, we talked about how it was going -- I'd done well about 50% of the time, and not so well the other 50% of the time; but I'd made progress on the protein and was experimenting with other changes. This time, she gave me a caloric target that was lower than I was used to, but not brutally low; and she challenged me to add some more veggies to my day. She wasn't picky about how I got there or what I chose, she just wanted me to work toward that goal. My point is, there's probably nothing about you that this dietician hasn't encountered before, and probably s/he won't be aiming to scold you or impose rigid guidelines. S/he will be looking to get you moving in the right direction. S/he will probably be interested in getting a sense of what kind of caloric reduction it takes to get the weight coming off, if only a little. S/he will probably want you to get more protein (you'll be hearing a lot of that.) My dietician also gave me a weight loss goal for the months before surgery -- mine was about 10% of my weight, an amount that is very doable in the time frame (even accounting for a spell of false starts) but still something I'd have to work toward. You'll still have to be open to doing some things differently, and trying some stuff you might not have thought you'd be ready to try. I have been stunned to discover that I'm actually kind of fond of a green smoothie in the morning -- my formula is raw baby spinach, a few frozen peach slices and pineapple chunks, a little water to "smoothie-fy" it -- but here I am, making murky green beverages every morning right before I head to work, and kind of missing them when I don't. But I'm also still eating two eggs and a strip of bacon for breakfast most mornings, sometimes a slice of toast or half a grapefruit as well, and my dietician seems not to have any problem with that. (She'd probably suggest turkey bacon, but I'd rather just not than sub in weird, failed facsimiles.) Again, my dietician won't be the same as yours, but if you're working with bariatric specialists, this dietician will probably be aware that few of us can change radically overnight. I think they're also aware that if the rigid, punitive approach to diet worked, there would be no need for bariatric surgery. Good luck!

Man, I'm jealous! I had my first real appointment way back in early January, and I'm not even to my next surgeon's appointment yet... I don't see him again until mid July! I guess it's just the product of being in a very small market with only a few surgeons, all of whom take vacations in the summer. But I'm ready to go and still thinking, will it be late summer? Will it be the fall? Will it ever happen? Congratulations on getting there quickly, hope it all goes great.

I actually just tried the Fuzzy Navel flavor for the first time yesterday; it was perfectly acceptable! And that's actually fairly high praise for a protein drink. It's rather Tang-like, but with a little peach. I find I like these better mixed with a little more water -- I do about 10 oz. (or 8 oz. and a couple of ice cubes) for a single scoop, rather than the 8 oz of fluid I usually use for other protein drinks. But the texture is closer to juice than it is to a typical shake (I didn't find it to be particularly thick at all), and the flavors I've tried so far, while not exact facsimiles of the fruits they mimic, are still a nice break from the chocolate/vanilla/caramel routine. It's also nice to get a dose of protein and some water at the same time. (I've tried mixing other protein shakes with water, but even the good ones, like ON Double Chocolate, turned out absolutely vile. This one works great with water.)