Born in Missouri

There is one thought I can't get out of my head. What are the long-term effects of weight-loss surgery? Because WLS is still in its infancy in many respects, none of us can predict the outcome of our decision when we become old and frail and we are in need of all the nourishment we can get. We've limited our bodies to benefit us now, but later... what about then? What struggles do we face when every spoonful might count. I love older people to pieces. I enjoy their company. I'm genuinely interested in what they have to say about their lives, past and present. I've also noticed that many older people don't eat much. If the little I eat now is only partially being absorbed, what will happen when I get older... when I'll conceivably need all the nourishment I can get to live a long and healthy life? Let's hope that knowledge keeps pace with our surgeries. Heck, there are still unknowns about which medications are poorly absorbed as well as other unknowns about how our bodies process various vitamins and minerals. Are we creating ailments that didn't exist on the same scale before millions of people embarked on these surgeries? Outside of pregnancy, I can't recall ever being concerned about a nutritional deficiency (well, except for Vitamin D, but that's because I abhor the sun and I'm too stubborn to spend even the lousy ten minutes required to absorb what I'd need.)

@Bellasoo Is your surgeon's office really serious about putting in a feeding tube, or do you think they're just trying to scare you into action? A feeding tube sounds a bit drastic. I guess the threat worked because you're drinking the awful stuff they recommended.

What scars? I can barely find the incision sites for my bypass. All that remains are very faint lines. As for my pregnancy stretch marks, those are here, front and center. I guess having multiple ten-pounders will ruin any belly for life. Where was my scar cream then?

I had a bypass on June 13, 2018. I have had virtually no appetite since day one. Appetite Zero. I'm not even close to meeting my protein and fluid requirements. Dismal levels of both, really. I probably take in fewer than 250 calories per day as well. This is not on purpose. The only thing I am able to maintain with any regularity is my vitamin regime. And because I have more malabsorption issues as a bypass patient, I take the risk of deficiencies very seriously. Taking vitamins is effortless. Eating not so much. I've been told not to worry, so I am not stewing about my protein, fluid, or calorie deficiencies any longer. I've been assured that this is temporary. How long is temporary? How many more days, weeks, months? My "problem" is not about gagging or restriction or any of the other reasons suggested. It is only my appetite. Food is an afterthought. I only think about it in terms of "I guess I should probably try to eat something today." It's not that I've forgotten the look, taste, and enjoyment I received from certain foods in the past... Chipotle's hard-shell chicken tacos with tomatoes/cilantro, sour cream, and extra cheese come to mind... but I just don't have the craving to follow through with cooking favorite foods or seeking them out (like Chipolte's where my daughter has always offered me with an endless supply of gift cards for an occasional eating-out treat.) I'm a scratch cook. I can cook just about anything I put my mind to... but I have little interest in cooking anything now. I have an empty nest which means fewer mouths to feed. It's just my husband and me, so I mainly cook enough to satisfy his primitive "need to eat", but, for me, it's become a mindless chore and a bore. I have replied to other posts on this forum with pretty much the same words... mainly because very little changes from day to day. I know there are those who struggle with something at the other end of the spectrum: intense hunger. I can understand the frustration with that problem, too. Perhaps I should feel "lucky" that I have no appetite. I don't actually feel lucky, but I'm willing to accept my lack of appetite as temporary and a version of normal.

“It is also well known that obese individuals face weight-bias job discrimination compared to non-obese individuals.” “This positive change is more obvious for women, who are more discriminated against than men for work, because of their obesity." “It’s possible that losing weight helps people find work by improving their physical or mental health, or by making them less likely to experience weight-based discrimination when seeking employment.” https://www.reuters.com/article/us-health-obesity-employment/weight-loss-surgery-linked-to-better-job-prospects-idUSKBN1L1299 Have you experienced what you felt deep down was weight-related discrimination? What about after your surgery and after you lost weight? Any difference?

Dang. I hate it when I show up and the fun is over. Wait... that sentence makes it sound like that my showing up halted the fun. Oh, well. I think I'd be insulted, hot or not. Men who objectify women are pretty much cavemen... dragging women around by their hair if they could (except for WLS women. Some of us "got" no hair!)

Which are sprays and which are in liquid form? What about those waxy around-the-clock deodorizers? I'm guessing the products Alex tested are made for five-alarm poos.

I narrowed my decision to two programs. One at a larger hospital with a very structured in-house program that required participants to use their nutritionist, physiologist etc. The other program had no structure. It offered a list of possible nutritionists and psychologists to contact for pre-op evaluation. You were basically on your own in deciding what to do. The only requirement the second program had was attending a one-hour talk about bariatric surgery and nutrition with a Q&A afterward. It was very basic information and a waste of time to attend. I chose the second program. I don't like hovering professionals telling me what to do. I dislike rules and oversight and heavy-handed regimes. When I was told that I "had to" use their nutritionist (that the nutritionist I had already seen wasn't acceptable for their program), I knew that they would be sticklers every step of the way. I know some people thrive on structure and feel safe and cozy being told what to do and what not to do. I can't function that way. Even if it's for my own good, I don't like the idea of someone monitoring my behavior. While I feel as though I was tossed out on the curb sometimes, I'm doing okay. I have my primary doctor. I have my own kids (a pharmacist and two medical doctors) to look out for me, and I have myself. I'm not a clueless person waiting to be told what to do next or what I shouldn't be doing. If I ever find myself in a position in which I need help, I know how to ask for it. I just don't want "help" imposed on me. Does any of this resonate with anyone?

So why do patients face longer wait times to receive bariatric surgery compared with surgeries to treat other life-threatening conditions such as cancer and heart disease? . One big reason: Many insurance companies (including Medicaid) require those seeking bariatric surgery to lose weight before their surgery, even though there's no data or evidence to prove preoperative weight loss affects long-term success. Patients with complex medical histories enrolled in Medicaid experienced the longest delays. Nonwhite patients also waited longer... Smokers and patients with high cholesterol or psychological disorders also had longer wait times for bariatric surgery. https://www.sciencedaily.com/releases/2018/07/180730090141.htm How long did it take before you had your surgery? How long did you wait calculated from your first visit to your date of surgery? What requirements or obstacles did your insurance carrier impose? Supervised weight loss attempts? Were you told that you had to lose weight during those attempts… and that any weight gain would impede your path to surgery? Did you have to meet with a psychologist, nutritionist, and attend required bariatric surgery classes before your surgery was submitted to your insurance for surgery approval? For those who were self-pay… did you circumvent your insurance carrier because of the obstacles/delays imposed by your carrier, because your BMI or other insurance mandated requirements did not make you “eligible” or because you had no bariatric benefits?

You are correct. I did not know about his past. I tried (unsuccessfully) to read between the lines and give him the benefit of the doubt. It was a mistake on my part to make those assumptions. I feel empathy for the pain and hurt you experienced as a younger man. I'm sure it took a toll on your social confidence and self-esteem. Being a community of "fat people", we have all experienced different degrees of pain and self-imposed shame. Thank you for pointing out that I should not have made any assumptions about your friend when he was his younger self. I'm glad to hear that he has matured into a finer human being. Thank you for sharing your story.

Only I Can Change My Life, No One Can Do It For Me The Struggle You Are In Today Is Developing The Strength You Need for Tomorrow The Road May Be Bumpy But Stay Committed To The Process If You Are Tired Of Starting Over, Stop Giving Up Be The Best Version Of You Be Stronger Than Your Excuse It’s Not A Diet, It’s A Lifestyle Change Doubt Kills More Dreams Than Failure Ever Will Will Is A Skill Nothing Tastes As Good As Being Thin Feels Stressed Spelled Backwards Is Desserts An Active Mind Cannot Exist In An Inactive Body Strive For Progress, Not Perfection Success Is Never Certain, Failure Is Never Final No Amount Of Security Is Worth The Suffering Of A Life Chained To A Routine That Has Killed Your Dreams A Goal Without A Plan Is Just A Wish Success Is The Sum Of Small Efforts, Repeated Day In And Day Out You Can’t Cross The Sea Merely By Standing And Staring At The Water --(attributions unknown)

"Effort only fully releases its reward after a person refuses to quit.” --Napoleon Hill "Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, 'I will try again tomorrow.’" --Mary Anne Radmacher "It's hard to beat a person who never gives up.” --Babe Ruth "Patience, persistence, and perspiration make an unbeatable combination for success.” --Napoleon Hill "Energy and persistence conquer all things.” --Benjamin Franklin "Waiting for perfect is never as smart as making progress."--Seth Godin "Permanence, perseverance, and persistence in spite of all obstacles, discouragement, and impossibilities: It is this, that in all things distinguishes the strong soul from the weak.” --Thomas Carlyle

It sounds like your friend is a true friend. Your feelings of being ignored and that your friend didn't seem to take you seriously in the past, were your feelings; according to your story, he didn't go out of his way to make you feel like the "fat guy". Enjoy your moment of weighing less, but never forget how it felt. Not to say that you would! You sound like a good friend, too.

I had a huge hematoma on one side. Actually, my entire belly was black and blue. It was tender but it didn't hurt. I remember cushioning my belly with a soft pillow while sleeping on my side. I also found that sleeping somewhat upright (pillows piled high) was more comfortable than sleeping relatively "flat". I was tempted to sleep on my belly (something I was eager to do after giving birth), but I decided no.

Your username says it all. apositivelife4me . Keep being positive, keep sticking to your diet/exercise and more positive things will happen. I am genuinely happy for you and for anyone who is losing weight. It's something everyone here can understand and celebrate. Woo-hoo!

Boston-based medical researchers published an article in 2017 ( https://jamanetwork.com/journals/jamafacialplasticsurgery/article-abstract/2688763 ) warning of Snapchat dysmorphia. The pervasiveness of filtered images of unattainably perfect pictures on apps like Snapchat can take a toll on one’s self-esteem, make one feel inadequate for not looking a certain way in the real world, and may even act as a trigger and lead to body dysmorphic disorder (BDD). Classified in 1987, BDD is an obsessive-compulsive preoccupation with perceived flaws in one’s appearance, impairing one’s functioning and often leading to repeated plastic surgery. Dysmorphia literally means ‘bad form’ in Greek. https://www.independent.co.uk/life-style/cosmetic-surgery-snapchat-instagram-filters-demand-celebrities-doctor-dr-esho-london-a8197001.html

This advice was directed at Bootscraper's case. It wasn't meant for the VirginiaRN's PA/staff case. Two different scenarios. I saw absolutely no point in confronting the PA/staff. They needed the "guidance" of a higher up. Confronting them would have done about the same as confronting the elevators.

Three-quarters of severely obese patients had unhealthy, not very diverse gut microbes (low microbial gene diversity). This unbalance was associated with a greater tendency to have a high-fat mass in the trunk of the body and an increased likelihood of having type 2 diabetes, hypertension, or more severe versions of these comorbidities. According to the researchers, more work is needed to determine "whether specific interventions (specialized diets, prebiotics/probiotics, or gut microbiota [fecal] transfers) may be useful to consider prior, or post, bariatric surgery in severely obese individuals." "This is "an exciting field" of research… one day we'll probably have the perfect combination of gut organisms in a fecal pill form.”--Samer G. Mattar, MD, president of the American Society for Metabolic and Bariatric Surgery (ASMBS). https://www.medscape.com/viewarticle/899158

That worst part of this is that you have to keep reliving the impact of their comments and kicking yourself for not saying anything. The lesson everyone on this forum should be hearing is SPEAK UP. Don't let the comments slide. Report, confront... but "do" something. When we do nothing, we essentially are telling ourselves that we don't matter. That our feelings don't matter. And that others are free to speak about us as they please. I am looking forward to future posts here in which someone was so moved by the stories and advice here that they spoke up. Everyone: be a self-advocate. You matter.

You are a classy lady. I have not been moved by another story on this board as much as this one. You have a gift of speaking from your heart, which gave everybody here a front-row seat to your pain. I applaud you for that courage. It's not easy to put your hurt on display. Your son learned more that day about you and your strength than you realize. Your restraint in reverse-shaming your PA/and staff was not a weakness in my view. You are a consummate professional. You behave as a professional with your patients and in your everyday life. Lucky are the patients who have you as their care-guide. It's easy to admire people who do "great things", but it's people that go through everyday struggles, survive them, and keep moving in a positive direction that I look to for inspiration. Being big (and former big) people, we've all tasted some of the pain that was unceremoniously dished out to you that day. We've all had to figure out how to process that pain. By sharing your story, I believe you gave those (here) who are not as gifted at expressing their inner feelings, a voice. You mentioned the idea of writing a letter to the head of practice. I would start drafting a letter now while your thoughts are still fresh in your mind. Composing such a letter in itself would be therapeutic for you. Whether you decide to send it is another matter for you to consider. If you do send the letter, however, I would NOT send it anonymously. As a self-advocate and a role model for your children, it is important for you to stand behind your words. It would be too easy for the head of practice to dismiss a letter written anonymously. The PA/staff would not be able to deny the words that came from an actual person as easily as words coming from a ghost. By signing your name, you also leave the door open for a response. If one receives a letter like this from an actual person, there is an obligation to follow up. If you send it anonymously, you will always wonder whether it was intercepted and destroyed before reaching the head of practice, whether it was read and acted on, etc. Just as you were placed in the position of having to process the hurt they caused, let them now defend their unprofessional patient-shaming. By writing this letter, you are not only helping to correct a wrong done to you, but to future patients who would be at their mercy. This PA is young. She obviously still has some important lessons to learn about being a compassionate caregiver. While it might have felt good to lambaste that PA/staff directly (in front of your son), I think being shamed professionally by her superior is a far better lesson. Just my two jellybeans....

Great tip, Kitty.

@Sosewsue61 Let's keep each other in the loop. Our symptom overlap is striking. I'm most intrigued by your scar-tissue supposition. I'm thinking that my reason is probably mechanical rather than a deficiency. As far as I know, keloids and hypertrophic scars don't occur under the skin. I know when I had an umbilical hernia repair, though, the scar tissue that formed under my bellybutton has been uncomfortable at times.

I'm not looking forward to Bony-Butt Syndrome. I don't even want to think about not having enough booty to cushion my body. The idea of my tailbone being compressed while seated is not what I signed up for!

The hardware and the way my knees were configured has to be of some relevance... yes?

I've made a conscientious effort to avoid using the word "love" when talking about food. "I love chicken wings. I love French fries. I love tacos. I love spaghetti." No more! I'm breaking off my love affair with food. We're just good friends now. But food keeps trying to win me back. "Give me another chance!" "No, Food. I'm moving on. There's someone else in my life now. Someone that I love more than I ever loved you -- myself, my health, my life." - What word will I use in place of "love"? Probably good ol' "like". "I like okra. I like shrimp. I like garden-fresh tomatoes. I like pecans." I'm also going to avoid using the word "hate". Hate gives Food more importance than it deserves. "I don't like pineapple. I dislike Brussels sprouts. I don't care for liver." - For me, it's easier to give up the word "love" rather than "hate". Not sure why.