Queen ApisM

I'd say he is partly right and partly wrong. The right part is that outcomes are not that vastly different between sleeve and bypass. You can have great success with both, and also completely regain weight with both. So, the fact that he's not bought into the higher weight loss with bypass rings true. It's about what you do with the tool. It isn't a magic bullet. The acid reflux thing is just totally wrong, though... If you have GERD or severe reflux the bypass is definitely better. My practice required an endoscopy before doing a sleeve. If I had had it - even silent GERD - she wouldn't have done the surgery. I'd consult with other surgeons if you have options where you live and see what they say. I spoke with 3 different practices when I was considering mine and I learned a lot at all the consults. It really helped me make the right choice (for me) in surgery type and also the surgeon.

Ask for the extender. Like @lizonaplane said it is no big deal. I've flown a lot while 350+ lbs, including extensive international trips, and pretty much all the flight attendants around the world have been extremely discrete and kind about it. And I have never had a passenger say anything. It is also helpful to be on the aisle, as it makes it even easier to be discrete.

Miralax every other day keeps things moving along

Great comment above. Doctors sometimes reduce certain health conditions to weight when it is more complex than that - for example, my very fit, thin cousin has uncontrollable high blood pressure, while mine is well controlled with meds. Just looking at our weights, you would assume the opposite is true. Regarding NSVs, big ones for me have been cutting my HBP meds (again, I have well controlled HBP, so I have had to reduce meds), more energy, a better sex drive (a bit embarrassing to share on a forum but it is true so...), less anxiety about fitting in places, fitting into old clothes in my closet, feeling eager to move more (when in the past activity was harder and I wanted to avoid it.)

Oh man, my first week back I only worked half-days and thank goodness I did. I needed two hour afternoon naps for the first month or so post surgery. I'm not sure if you are working from home or going into an office - I was exhausted commuting from my bedroom to my home office across the hallway. If I'd had to go into an office and all that entailed, I would have made it 2 hours before crawling into a corner to sleep the rest of the day away. It gets better, and once it does start to improve I found the improvement to be exponential.

I slept laying down from the very beginning after getting my sleeve done and had no acid reflux issues immediately after surgery. My practice proactively prescribes medication to reduce acid for the first month. Since surgery I have 2 acid reflux situations, but that didn't happen until I was on solid food again and getting more adventurous in my eating choices. In both cases it was because I ate right before going to bed, and with specific food choices/amounts. The second time I totally knew better but ignored my logical brain and went with a poor choice (eating a questionable snack when I knew I would be sleeping soon). Yeah, not making that mistake again. I wouldn't worry too much. Everyone is different and many people with sleeve don't have any reflux issues.

I think we waited at least 4 weeks for the full deed, but we were still intimate in other ways. My sex drive skyrocketed, so I doubt we waited more than 6 weeks. And I'll just leave it at that! 😈

This is awesome! Congratulations on all the great milestones you have hit. It can be really hard to see changes day to day but when you get a chance to see the big picture of all the changes, like in your post, it really hits home. Keep up the awesome work.

We have all been in that moment where you are seeing surgery on the horizon and the creeping terror of the unknown is making you question everything. I was also very worried about all this, terrified even. I was convinced I would die on the operating room table and made sure I had a will in place before surgery just in case that happened. But, this is where the personal equation of risk is important: are the potential benefits of the surgery better than the alternative, which is the status quo or gaining even more weight, with little likelihood that I would be successful losing it and keeping it off. This answer is going to be different for each of us. I'm 8 months out, and still in the honeymoon period, but I can honestly - in this moment - say this is the best thing I have done for myself, and I wish I had done it sooner. Even if I don't lose another pound, I already feel 1000x better than I did, mentally and physically. I was self pay, too, so this was a huge monetary investment in myself and my future. Have there been challenges? Yes, but in my mind it is no different than the calculated risks people with other health issues have to take to chase potentially better outcomes. We all have to weigh the factors and decide what is more important: the possibility of success or the risk of complication.

In the early stages post surgery, many of us have to eat & drink on a schedule, regardless of whether we want to eat. I had no hunger at all for a while, but forced myself to eat and drink at intervals. Previous posted gave a good suggestion of setting alarms as reminders. I would also track carefully, with little goals like, "drink this 16 oz of fluid before XX time", knowing that if I didn't, I wouldn't make my fluid goals for the day. It is easy to fall into the thinking that not eating is okay and will result in more weight loss faster (I know my brain went there in the beginning sometimes, when eating was a chore), so when we don't feel hungry we can be tempted to just go with it and not try and stick to a plan. But, it's not true, especially if you are missing protein goals. Too low of calories is not good for us long term, and can have the opposite effect on weight loss. And lack of protein means your body may cannibalize your muscle instead of the fat we want it to use up.

All these post-surgery water weight stories make me so happy my surgeon had me take Lasix while at the hospital to get the fluids out. I have a heart issue and a standing prescription for Lasix as needed (which is very, very rarely). At the time I was a bit annoyed as to why they made me take it in the hospital, since I take it so rarely, but sometimes it's almost like the doctors have reasons for what they do! Looking back I am really happy they made me take it. I hadn't realized before surgery that you can gain all that water weight. It's also not unique to WLS. My brother got his gall bladder out a few months ago, and legitimately gained 20 lbs in water weight as a result. It took a good 4-5 weeks to get it out. Patience is a virtue when dealing with post-surgical water weight...

I got the sleeve, and to get where I fantasize about being (top of healthy BMI range), I'll have to lose 225 lbs. That is a crazy large number, and I have debated whether bypass or another surgery might have been a better choice. But, I remember what one surgeon I consulted with told me early on: "It's a tool. It doesn't do the work for you" and that helps me a lot. He reminded me that plenty of people are really successful with both surgeries, and that many people also fail with both surgeries. They are not magic bullets. Moreover, you have to be comfortable with the physical change you are making to your body. Initially, I wanted sleeve but let everything I read convince me that was a bad choice to maximize weight loss. I was going to do bypass, but I was never happy with that decision. The surgeon above really forced me to rethink why I was going the bypass route and once I thought about it, I knew sleeve was right for me so long as my endoscopy didn't preclude it. After I made that switch, I was just so at peace with my decision (at least until the pre-surgery jitters came up right before surgery!) I also realize I may not get to where I would like to get to, and that is also okay. I have an "ultimate goal" in mind, but I've also set some interim goals that would result in much improved health outcomes, and will be moments for me to reassess where I am and whether I want to try and keep going. I also don't want to be constantly fighting to maintain a certain weight, if another weight still provides health and appearance benefits without that constant battle I may decide to stay there. Basically, I want to find a weight where I can be at peace with my body while also taking better care of it.

Interesting note on the blood thinners: my program used to only prescribe them post-op for higher risk patients (esp those of us starting at higher BMIs). But, during COVID information was coming through about post-surgery patients coming in with strange/unusual clots (not sure if it was all patients, or just WLS patients). They theorized that it may have been COVID infections, especially asymptomatic infections prior to or just after surgery, causing it since COVID has a blood clotting component to the infection, so they changed their post-surgery protocols to add in the Lovenox for everyone regardless of BMI.

Liquids are handled very differently than solid food. Believe me, when you start adding solids in, the restriction will become very apparent. Honestly, after the first week or so, I didn't notice any problem taking in liquid amounts (initially I had some funny stomach pain along the place my stomach was cut out or so I think). I wouldn't worry.

I had to do 14 days of Lovenox, 2x a day. Absolutely hated it but took every one because they are so important for preventing clots. It always felt like they burned when going in. I just dreaded them. I did get bruising but nothing else, really. I'm not even sure I mentioned it to the doctor because it's a blood thinner so I wasn't surprised by the bruising occurring.

I had sleeve, and typically it is one night for sleeve patients. I had to stay two nights though, simply because they couldn't get blood out of me! Seriously, I was fine - I passed the drinking test (certain amount of fluids in a certain amount of time), was walking, had gone to the bathroom plenty - but they wanted a post surgery blood panel before releasing me, and NO ONE (including the Difficult Vein Access team) could get anything out of my veins, even using fancy vein finding gadgets. Finally the morning nurse after my second night got totally lucky and we got enough blood for them to confirm I was fine and let me go at around noon. If she had failed I was going to offer to cut my hand and bleed into a cup because I was not staying a third night. I was self pay, it was not happening.

Estrogen gets stored in fat cells, so losing weight releases it, and losing a lot of weight dumps a lot of it into your system at once. Fun ensues. Having said that, mine started almost immediately, including me getting a cycle one month after surgery when I had been incredibly irregular prior. It's continued since - I'm more regular than I have been literally a decade. I'm curious what the BCP is. Some of them can cause extended cycles or spotting, so you may want to investigate that. Between the pill side effects and the hormone dumps in your body, it might be taking some time to sort itself.

I'm not sure if I count as a slow loser - possibly, since I see others with similar surgery dates who have lost quite a bit more than me. I had surgery in August and have lost 85 since surgery, 96 if you count preop liver diet, which I do. But, I am trying hard not to think about myself as a slow loser, just as a loser (in a good way!) My program has been really happy with my progress. I feel amazing. My BP meds have been reduced. My endurance is much improved and my energy through the roof. I don't feel like my body is sabotaging me anymore. When I stop and look at the big picture and not the day to day numbers I remember that I am on a consistent downward trajectory. I worry about getting to my ultimate goals because I worry what will happen after the 12 month and 18th month marks, because I know this will get harder at some point, but then I have to tell myself to focus on what is going on now, how I am using this new tool, and how I already see so many positive body and emotional changes even if I am far from my ultimate goals. And, in this "honeymoon period" I am trying to build some good habits around food choices, exercise and added movement, and even just the way I think about myself and my body. Good luck!

Weigh and measure. I agree with another posted, you will need a food scale, but a good set of measuring cups (both regular ones and liquid measuring cups) are also invaluable. Look at the nutrition labels - the serving size for each food is there, and you can use that as a guide. Weighing food (unless it is liquid) is the best way to keep track of how much you are having and avoid the "but this cookie is small, I can have another cookie above the serving size for the same amount of calories" game. Of course you can eat more or less of a serving, so this leads to my next comment - start writing it all down and tracking how much you are eating vs. what you think you are eating. You should also measure any drinks with calories to know exactly how many calories you are drinking. For example, my idea of a "cup" of milk is very different from the reality. Even now, 8 months out, I measure the soy milk I use in my protein shakes because I don't trust my eyes. I track it all in the Baritastic app, but MyFitnessPal is great, and there are many others.

I think the item that most needs to be budgeted is the vitamins. I still use protein powder (even now 8 months out) but lots of people don't continue with them, after the first few months. I just like them so I still have them. I don't care for the prepared ones, though I keep some on hand when I am on the go. I try to buy the prepared ones at Costco to save some money vs. other retail options. I like the Unjury protein powder with soy milk - the Chocolate Splendor is delicious. You are eating so much less food, though, the costs might get balanced out by reduced grocery bills and restaurant eating. I know it is true in my case, but of course that depends on your current lifestyle and other factors.

I should have been clearer - I know (now) that the pain I had was from the gas, and honestly had I realized it I probably would have handled it better! It sucked that one night, but it was only made worse by the lack of sleep and post -anesthesia crappiness. But it wasn't something that lasted days, at least for me.

My gas pain wasn't that bad. I had really bad shoulder and back pain the first night in the hospital, which was literally the worst day in this whole process and the only time I cried. But, I was also coming off anesthesia (never had general before) and just could NOT sleep that night so all my emotions were a disaster. Once I started walking on day 2, the shoulder and back pain dissipated and I was good. Everyone is different, but it isn't something I would stress too much about!

My skin was so, so itchy early on! It drove me nuts but then it stopped. Re: hair loss, mine was shedding. Massive amounts of shedding. I shed a lot before surgery, but afterwards it was nuts. I really did wonder how I had any hair left on my head. It started in month 2 or 3 and continued through about month 7 (roughly). I have very thick hair, so most people cannot notice but I did, as did my hairstylist! I did not take biotin beyond what is in my bariatric vitamin - I just let it run its course. I have been very good about my vitamins and protein intake. That's not going to stop it from happening, but it is good for the regrowth. At about 7 months out, I cut my hair to my shoulders (it was very long before) and that made it less noticeable (to me). My stylist also said it had started coming in again, because my roots were thicker than the midshaft and ends of my hair. I also have been trying not to wash my hair too much and my stylist and I agreed to avoid anything that strips the hair, though I am still dying the roots, but no balayage for me for a while. Not going to lie, the hair loss stressed me out, but cutting my hair helped lessen the visual impact. And now I can tell the hair shedding has reverted to normal levels and my hair is growing back.

I can tell you my experience living in Virginia with doctors in Washington, DC but having Seattle-based BCBS coverage. Because certain employees were out of area, we just were able to use the other area BCBS providers. Honestly, it never was an issue for anything. But - I can't tell you that'll be the case here or for surgery (I did not get my surgery while there, nor was mine covered by my current insurance). I'd confirm with the employer and BCBS directly how this will work not only for surgery but also the providers (including hospitals) covered under your plan.

It is such a personal decision! Most of my friends know, as well as my immediate family and my husband's family. Everyone has been supportive (to my face, at least) and no one has given unsolicited opinions. Lots of questions, but I don't mind that at all. My extended family doesn't know - I don't live near them, and they are the unfortunate combination of gossipy and judgmental, so I didn't feel the need to broadcast it. I'm reaching a decision point, potentially, as I will see them for Easter in a few weeks. While I am still obese, by the time I see them I'll have dropped around 100 lbs, so I can't imagine someone won't realize I'm losing weight. I need to decide what I will say when they ask. I don't feel ashamed of surgery, and I want to be a good advocate for the procedure as an option for people so educating them could be good. But, I know I will be the topic of conversation (and probably conversation on whether I will keep it off or not this time) so I need to think through how to handle it. In the end, you have to decide what will give you the best support. I have found having a good support network has been so helpful - they are happy for me and are good cheerleaders sometimes when I need it. But, if the people around you are likely to be toxic, then I would keep my mouth shut. You don't owe anyone an explanation and the potential impact of toxicity on your success is huge.