keithf

After losing 110# and being not too far from where I'd like to be (about 210-220#, where my body weight was stable during one of the more active periods of my life), I'm strongly considering PS (thigh, panni, chest -- maybe the full LBL). I'm curious about how much tissue is typically removed during these procedures. I've seen anywhere between 10-20#, but no comment on how much weight the patient had lost before plastic surgery. This would help me gauge when I should bother going in for a consult. Also, how dramatic a change in waist/hips size did this incur? Would I need to immediately buy new pants, or would cinching my belt a little more be adequate?

I remember life immediately post-op with my lapband. I eventually grabbed the bottle and hose and convinced things to move. Felt much better after. I should have done so pre-op. Trying to move things when my abs didn't want to do anything but crawl off into a corner and weep was just painful.

I'm already not *thrilled* with LBL, any more than I'm *thrilled* with bariatric surgery. Nonetheless, just as bariatric surgery was the best option for me to get where I wanted, LBL is looking, overall, to produce better results for the effort. I don't like the idea of having my largest organ sliced in half and re-stitched, and then spending a good amount of time in pain. It smacks of a bad horror flick; maybe I should time it for Halloween? :w00t:

Of course there's going to be variability -- patient, surgical technique, post-op experience, gender, age, etc -- which is why I was asking what people (preferably of a particular phenotype -- 30-something male, about 5'10, large frame, peak weight around 350# sustained, etc) were seeing. And I am absolutely comfortable with knowing that the variability is pretty significant. What I wanted to see was the range -- and that looks to be 10-15# typically -- so I can have a better of idea of whether a stable point I reach is something I shouldn't hold my breath on leaving, and I should start talking surgery dates. I'm also aware of the "wait six months" advice, and it's advice I agree with. Even with my lower rate of loss the past couple months I've seen my shape shift about. Whether that's elasticity in the skin or redistribution of fat, it's smoothed things out, but only slightly. There's obviously non-elastic remnants hanging about (I had a fair amount of stretch marks in those areas), and now they're doing the imitation dead balloon thing. So yes, except for a possible consult to discuss future plans/expectations, I'm not expecting to see a surgeon until possibly next year. My loss is much slower than it was, but it's still not quite zero, and I'm not expecting to hit a "final" weight until maybe this summer at this point. FWIW, I'm also looking at LBL (congrats on yours, btw) and inner thigh work. Probably a small tuck under my arms.

Hear hear! I ate these almost daily pre-op, when I was losing about 3#/wk. Post-op, the chicken can be a bit dry, so be careful. The basalmic will cost you about 40cal, and the salad about 250. Decent serving, though.

I ski as well as Sonny Bono did on his last day. The only way I know how to stop is to aim myself at a tree. I don't ski much, obviously. :rolleyes2: Have you investigated alternative footware, like MBT-brand shoes (available at The Walking Company)? It may help alleviate some types of pain that happen to be due to weight/posture -- obviously pain from joint damage would still remain. If you have plantar fasciitis or runner's knee, I can state that it cleared mine in about 3 days, which helped a lot in getting my walking in. Anything to help you get that much extra activity in will be valuable, particularly at the early stages. I actually can't walk long in flats anymore, and use my old shoes only for weight training sessions (where a rounded shoe becomes very unstable). As far as "you gotta lose weight" .. okay, yes, that is still true, even though they may be a bit short with how they state it. I think part of the problem they see is that, without weight reduction, effective treatment of other issues becomes difficult. It's akin to why we as WLS patients give up half our blood supply to the endocrinology lab, so they can screen for underlying disorders that need to be dealt with in order to make the surgery worthwhile. They could still be a little more helpful about it, though. My MD at GHC is Gelgisser. Nice guy (almost too nice -- I can see him being a pushover), and has no problem sending someone off to a specialist, or to the diagnostic lab. I've not had any problems with him. Sure, sometimes he's forced by policy to go through the stuff we all know won't work, but he doesn't stand in the way of progress.

Everyone worries about the psych, yet nearly everyone needlessly so. So you should be covered effective tomorrow, and your husband should regain consciousness sometime around lunch Tuesday, when NEO ends and he gets his badge. He'll be just around the corner and down the block from where I'm stationed half the week. I think if you get your GHC physician and your prior physician chatting, it'll help on the application, but I suspect you'll be needing to get the referral primarily through your GHC physician. Mine was reluctant, but his reluctance was simply wanting to make sure I knew this wasn't some miracle surgery, and that I could (albeit with more difficulty than before) just regain everything. But after our discussion he got things going on his end. He doesn't get to see me very often, but did see me shortly after surgery, and was pleased with my progress. Incidentally, you'll need documentation for any sleep studies for apnea, etc, that were performed elsewhere, which GHC won't have record of. They won't simply accept your word that you have it or any other condition -- they'll want to see evidence that an actual diagnostic study was performed. This was the cause of my initial rejection. A simple phone call to the records office at my old medical provider, and I had my entire record shipped to GHC. My appeal was approved very shortly thereafter (just in time, too.. I really delayed just making that stupid phone call). I'm very pleased with GHC -- I'm pretty sure you will be as well. Sign up for MyGroupHealth, and you'll get online access to your appointments, email with your docs and specialists -- including the ones on the bariatric team -- test results as soon as they're approved by the physician, etc. Very worthwhile.

In my experience, the psych eval is looking for underlying emotional issues that would impede success of weight loss. You have a few months after surgery to really make it count, because that's when you'll be losing weight the fastest. The psych will at worst delay the process, but that delay will be toward ensuring a greater chance of a good outcome. Heck, with all the bloodwork, they may discover an underlying condition that explains things, so you never require surgery at all. Same idea here. So just be honest, and cultivate the support structures you need among friends, family, and yourself, particularly as ragards realistic expectations about how much success, why/how prior attempts to lose weight didn't succeed, and so forth. If for some reason the psych raises a concern, you certainly wouldn't be the first, and it would be for your greatest benefit to not worry about it. If it happens, it's all part of the treatment, of which surgery really is the last (and common) resort. IMHO, you really shouldn't *want* the surgery. You should instead simply be open to the idea that surgery may be the best option in the long term, for whatever reasons apply to your case (in the case of lap band, portion control -- if you have other issues, you probably should consider a different surgical treatment). Bloodwork, psych, etc are simply standard ways to convince both you and the bariatric program that yes, indeed, there are no known medical conditions that would render the surgery ineffectual (some endocrine diseases cause obesity), no significant mental blocks that would prevent you from following the program (you're mentally ready to change your lifestyle radically), and you've created relationships that are supportive of a post-op lifestyle (your husband's not going to insist you go out and eat pizza with him, your mother will understand if you don't eat her apply pie, you've learned to ignore your uncle's recriminations about your current body shape, etc). Again, good luck.. just remember that every successful patient out there went through pretty much the exact same thing.

Congratulations to your husband! Microsoft is a large company, with many different groups and brilliant people therein. Finding the perfect fit can be a challenge, but once found is very rewarding. I found orientation boring as hell. I encourage him to get his Prime Card from the receptionist. The benefits attached to it are numerous and valuable. There are also a lot of other partnership benefits with other companies (Ford, etc) which you may be interested in. Definitely worth him checking out. The following applies to Redmond (and probably Puget Sound, generally): There are two weight loss programs available which I have undertaken. Both required BMI of 40+ or so, or 35+ with comorbidities (my memory may be lacking, but that sounds right). From the sounds of it, you undoubtedly qualify. The first is a non-surgical, supervised nutrition and fitness program covered (at least when I took it) by Premera. There are various vendors contracted to provided the services, such as Pro Club's 20/20 program, Sound Health Solutions, and so forth. The OOP cost is on the order of $2k as I recall. It certainly works for some people. It didn't work well for me. The second, via Group Health, is the bariatric surgery program. Total cost of lap-band placement for me was about $28k, of which I paid zero, and an additional OOP of about $1400, for a (mandatory) nutritional counselling program. This worked. You *may* be required to enroll in the first program before you are admitted in the second. However, once admitted in the second, things move quicky. You will have about 10 weeks of pre-op weight loss, blood work, and so forth, then a quick surgery, and probably home by that evening (if your surgery was in the morning, as mine was). Nutritional counselling (which you paid form, remember) continues post-op for the better part of a year. The surgery is performed at Overlake Hospital in Bellevue (next to Group Health's new offices, where you'll go for testing and, eventually, fills). They have a floor more or less dedicated to the weight loss program, with appropriately-sized beds and chairs. I don't have any bad memories of the staff. I find Dr Bock & Co to be responsive but no-nonsense. They are more interested in making sure you get the fills you need than being either generous or stingy. The nutritional counsellors are appropriately enthusiastic and scolding (without being patronizing or insulting). As long as you're honest and dedicated, I expect you'll have a good experience. If you're not, I expect that'll be found out quickly (for your sake) as part of the psych eval or the pre-op nutritional counselling. I lost about 40# before my surgery on 30 June, and since then another 60#. This is in excess of typical lap band loss rates they generally see (my nutritinist sometimes forgets I was banded, and talks as if I were RNY). My loss has been zero for the past month, but I'm still getting twice-monthly chats with the nutritionist, who's working with me to get things moving again to lose the remaining 40-50#. Especially compared to what I hear from other programs on this site, I'm impressed with the bariatric program at Group Health. If you're going to have weight loss surgery, I definitely count GHC as one of the better places. (As a side note, I understand from Dr Bock that their *typical* patient has a BMI > 50, so I was somewhat lighter than typical, and you would be moreso, but still qualifying.) Microsoft also offers area gym memberships. I can certainly recommend Pro Club in Redmond. It's a vast complex just off-campus with a variety of facilities: pools, weight rooms, cardio theaters, etc. They also have a restaurant and spa, as well as hot tubs and saunas, and even car detailing while-you-sweat. Your husband will get access for free, and adding you should be a comparatively little cost. This can be useful (recommended) as part of the Group Health program. I happen to be enrolled with a trainer there, who's torturing me with heavy weights. He's a good kid, who's worked with weight loss surgery patients before. It seems to be working out well enough.

All the above said, the point about the mechanics of sex while obese really does enter into things. I suspect moreso than people will want to admit generally. I will note that my sex life perked up a fair amount over the past 100 pounds. It was easier to engage in and much less clumsy for both of us. That helps out quite a bit in the interest department, when you realize it's not as much work anymore. It further helped that nagging worries directed toward my health were greatly reduced once the decision to have surgery was made and everything started happenning.

In addition to the above, you might consider Black Friday, since it's coming up. I plan to hit Macy's for some insulated pants since this is going to be a colder winter than I'm used to. That is, *I* will be colder :confused: Further, some weight loss forums have set up clothing exchanges. I have no experience with them, but you might investigate those.

Whatever helps you prep your food -- blenders are certainly common. Small spoons and forks can help adjust how you view your portion sizes. Small bowls/plates as well. A good-size drink container -- 16oz, 32oz or whatever, to help you monitor your Water intake. A pill grinder might be helpful for medications post-op, if your medications *can* be ground (some pills should not be). A food diary of some form. Online ones have access to nutritional information for a variety of foods. Use whatever produces results. This isn't just to monitor calories (which is an important skill to develop consciously or subconsciously), but to monitor your reactions to food -- was the meat dry? How much of it did you consume? When? Had you taken any water earlier that day? Hot tea, or ice water? ... etc. Once you're post-op, you'll have to learn this for yourself, and a diary can help you remember things and perhaps see patterns in why certain foods don't sit well while others do. Start your exercise now, if you can, to get in the habit. It's an easy habit to fall out of. Relax :confused: You'll have enough anxiety to make up for it later.

As of the past week or two, I'm now 100# below my heaviest weight, 7 months ago, when I started my 2-month pre-op diet. This is the lightest I've been in probably 7-8 years. Another 30-40 and I'll be happy. My pant size has dropped from a tight 46 to a comfortable 40, and my shirts from 3-4x to 2x or less. I actually fit into my partner's shirts, for the first time ever. Spent the last weekend buying some better-fitting clothing, including a new belt about a foot smaller than the last. It's a little snugger than I should like, but targetting a New Year's Eve party, it should be somewhat better by then. I think I'll be having surgery to clean up the mess, which should help even further. But that's not for some time yet.

So, uh.. where's the dare? Congrats A lot of nudist groups I've frequented haven't been the muscle-bunny nudist groups. A lot of overweight folks in attendence, etc. Getting over the "but they'll see me nekkid" was, for me, more a matter of being nude among strangers than relative size (belly, butt, whatever) in that environment. I rather enjoy them, and I think it's a good suggestion for folks in general.

Ironically, elliptical machines make my knees hurt, while the treadmill I can keep going on. I keep telling people to check your footwear -- switching mine made all the difference. Regarding weight training: I would *expect* weight loss to slow down if you're working to *keep* muscle mass. The important thing is not how much weight you lose, it's what weight you're losing. You want to lose fat, but keep muscle; you'll lose both as you drop weight, but you can influence the balance of what's lost. I'd expect a physical trainer to be able to take a reasonable measurement of your body composition to point out that, while you only lost 10 pounds the past month, 8 of it was fat, rather than 5.

I was the same about brocolli until I started eating a lot of chinese food. Even then, there are a lot of places that overcook it -- Outback doesn't. :thumbup: They're also in the US, which has skewed ideas of what's "healthy" compared to, simply, "normal". Well-meaning if inaccurate concern for your well-being. Actually, I'm going camping. :smile2:

Have you tried their broccolli? They tend to cook it nice, soft, tender, and do so without overcooking it. Wonderful flavor, no bitter, lightly salted. Best I've had, and they serve enough to last a couple meals. I take salads carefully, just because I don't trust myself to chew down the leaves well enough. Queensland salad has done me well, as has the wedge salad with chicken at Fatburger. Coleslaw works well for me, too, and the fine chopping I think helps make up for my potential failure to fletcherize. Can't do raw mushrooms, myself. Coolness. I'm expecting another 4-6 months before I get where I should be, as well. No worries expressed. They're quite happy for me all-around. I loaned my stuff from GHC to an aunt who's been thinking of it, though her son could certainly use it. Actually, a second cousin of mine, who was a nurse, was amazed at how well I looked -- no signs of malnutrition or anything. I suspect she's used to seeing bypass patients, and I suspect she's used to seeing the ones that are having problems. You should explain to them the fact that your loss is in fact medically supervised by folks with a lot more experience in massive weight loss than they do? :thumbup:

See above.. my plateaus have been lasting about 2 weeks then I drop. I had been dropping steadily, daily. So far about 50 pounds since surgery, and 40 since my pre-op started in April. Got another 30-70 to go, depending on where I decide I want my % body fat to be. Eating out: Outback Restaurant is my friend, but I'm pretty good with beef. They have a filet mignon dinner, which I can get with double broc, and maybe a salad. That'll last me 2-3 lunches.