suzannethemom

My dietician put me on a pre-surgery diet of 1,300 calories and no caffeine (no surgery date yet). I only drink ONE cup of coffee each day, so I figured no big deal. On day two of no coffee, I was nauseous, tired, had a massive headache and was miserable. I decided “screw this” and went back to one cup per day. I decided that I will give up coffee when I really need to, like during the two week liquid diet before surgery. I will be more motivated then.

Me too! My final appointment is Thursday with the dietitian. Once she signs off, my paperwork goes to my insurance company for pre-approval. I am so nervous! I ordered some protein powder today since Target was almost completely out. I felt weird placing the order, like it was too soon, but I want to be prepared. Now I can tell the dietitian that I have almost everything and I am ready!

Ditto on both of those things! I would love not being HOT all the time.

Yesterday I met with the dietitian. I don’t have a surgery date yet, but she is having me start a 1,300 calorie diet with 45% carbs, 30% protein and 25% fat. No refined carbs. I was writing down healthy snack ideas like Greek yogurt with granola (my favorite). Then I saw that granola is not allowed because it is a refined carb. I started crying! I think I was crying more about the idea of a diet than the actual granola. It’s been an emotional week for me as I launch forward on my WLS journey. All my tests are done. Two appointments left (follow up with psychologist and dietician). It finally feels like this is really happening.

The psychologist basically has a checklist of things to evaluate you on. One of them is snacking between meals. They don’t want you to do it, period. If your nutritionist approves of the evening snack, I would just smile and tell the psychologist that you don’t eat after dinner. Otherwise, they may not approve you for surgery.

From the website Clarity Surgical: Your mood is influenced by a wide array of factors. One of these factors is serotonin, a neurotransmitter produced by the brain. Because of the surgery, your diet becomes much more restrictive. This restrictive diet reduces the amount of carbohydrates you can take in, which causes serotonin levels to go down. Decreased serotonin can cause depressive symptoms. You may also deal with mood swings as a result of your low-carb diet. It’s important to note that if you’ve had a history of depression, you are at increased risk for post-bariatric depressive symptoms.

Oh, I see. Thanks for sharing.

I hope this isn’t too personal of a question. I’m curious WHY your insurance company would not cover the surgery? Did you not qualify? I am so nervous that my insurance company won’t approve my surgery. I have one more appointment left.

THIS is exactly what I'm worried about (no surgery date yet). I don't want to find out the hard way.

I met with the psychologist for the first time on Friday. The very first thing he asked me was “what is your comfortable goal weight.” My current weight is 223, BMI of 38. A perfect BMI is 20 with a weight of 120 lbs (which was my weight before I had kids). I told him my comfortable goal weight is 140 lbs. He said that is too low and I should set my goal to a reasonable weight of 155 lbs. It kinda bugged me afterwards because he is a therapist, not a surgeon or dietitian. When I met with the surgeon on Monday, he didn’t mention a goal weight, but I figured HE would decide on my goal weight when I have the pre-surgery visit (no surgery date yet). Who decided on your goal weight?

How did your visit go with your new doctor? Did they make you start over with testing? How are things going?

It’s crazy because I can remember as a kid eating a BOWL of granola with milk. It was a trend in the 80s cuz everyone thought it was healthy. Ugh.

It makes sense to have two separate surgeries. The location of the band is right in the area where the surgeon needs to cut away the stomach to create a small pouch. That area needs to heal and contract back to normal size before he can cut there.

Woo hoo, how exciting! I have two more appointments (psychologist and dietitian) before I get a surgery date.

I’ve learned that the testing varies with each surgeon. There was someone who had to have about 8 different tests done due to her insurance requirements. I only had to do blood work, upper GI Barium Swallow and an EKG before I have my surgery. I scored low on the ESS test (Epworth Sleepiness Scale) so I didn’t have to do a sleep study. I think that the more pre-existing health issues that a person has dictates more testing before surgery.

I just looked at the BMR calculator and formula. It is based on weight, height and age. It’s hardly any different than the BMI. They just added AGE.

Really? I agree that the BMI scale is flawed, but your weight should not be ignored. Your weight loss is a one of the markers of your progress after surgery. Body measurements are also important. They are going to weigh you at every follow up appointment after surgery.

Yes, she suggested almonds or other nuts.

I had Binge Eating Disorder (BED) and did treatment from 2016 to 2019. My dietician helped me with the food issues and my therapist dealt with the mental issues. I had to figure out what void or pain I was replacing with food and what my triggers were. I also had to replace the junk food that I craved late at night with real food like a peanut butter and jelly sandwich or a bowl of soup.

I had two “first appointments” with two different WLS centers and they were completely different. At center #1, I met with a physician assistant who looked like she was maybe 28 years old. She went over my medical history and weight issues. Then I met with a dietician for an hour. She grilled me about my previous BED in 2016 and decided that I was not ready for surgery and I needed to work on late night snacking. I was pissed, so I went to center #2. First I met with a nurse for about 15 minutes (vitals and paperwork). Then I met with the surgeon for about 30 minutes. We discussed my family history, weight issues, and surgery details and questions. He gave me a binder loaded with information from pre-surgery to post-surgery. The did blood work afterwards. I got a phone call the next day to schedule necessary tests and appointments with a dietitian, exercise physiologist and psychologist.

Here is what the range looks like (see below). Technically, a BMI of 21 would be right in the middle of the healthy weight range. I get what you’re saying that the BMI scale is flawed, but let’s face it, it dictates everything regardless. Our surgery approval is based on the BMI scale. The minute we are born, doctors assess our health according to the BMI scale. It’s kind of a dumb way to determine what is healthy, but oh well. BMI Weight Status Below 18.5 Underweight 18.5—24.9 Healthy 25.0—29.9 Overweight 30.0 and Above Obese

Wow CATWOMAN, everything you do for exercise are things I love to do (or used to love to do) as well. That is so encouraging for me because it feels “doable” for me too. I was worried that significant weight loss would require heavy, sweaty workouts, which I just cannot do anymore at my age (54) due to joint pain and fatigue. The calorie thing seems to vary person to person, like you said.

Catwoman, you are amazing! That’s such a huge accomplishment. Did you exercise a lot? How many calories did you stick to?

YES, a BMI of 20 or 21 is right in the middle. I should have said “normal” instead of perfect. Anyhow, I like the idea of multiple goal weights. I will do that. I meet with the dietician and exercise physiologist on Thursday. Maybe they will ask me about my goal weight and I will be better prepared.

I did not choose the “perfect” BMI of 20 as my goal weight. I mentioned 140 pounds to the psychologist which is a BMI of 24. That is my “I feel happy weight” but 150 lbs is my “I feel healthy” weight. I get what you’re saying and I agree that too many WLS patients pick an unrealistic goal weight and are disappointed when they only lose a small amount, so they give up.