ouroborous

Guys, I can empathize with not wanting to comply with the diet, it can be hard. I love me my carbs, the breadier, the better (as you can tell by looking at me). However, I cannot emphasize this enough: do what your doctor tells you to do, to the letter. Do not take the advice of people on the Internet over your doctor. Do not decide that you know better than your doctor. I know it can be frustrating, and we wouldn't be here if we didn't have problems with a healthy diet. But I know from my research as well as my own personal experience that the best outcomes are those who do what the doctor says, even when that's hard. They don't just make this stuff up for fun, I promise. Tiffykins has some info on why the pre-op diet is necessary, and apparently it isn't just about shrinking the liver, it's about making it less "slimy" and slippery and easier to retract during the surgery. Trust me when I say: you don't want to get liver damage just because the pre-op diet seemed too "hard." I'm sorry if I seem a little unsupportive, but this is sort of the "dark side" of medical support groups, in my opinion: you run the risk of people taking the advice of, let's face it, random strangers on the Internet over the advice of trained, experienced medical professionals. This group is great for support and general advice, but please, please, if in doubt, ask your doctor. Edit: re-reading this, it seems a little harsh. I don't mean to disparage anyone; we all have good intentions. It's just that I get worried for people who seem all too willing to be non-compliant with their doctor's orders. That can get you dead.

Congratulations, Midwest! That's tremendous progress. With a positive outlook like yours, I bet you'll get to your target weight!

My girlfriend had a really sizable hiatal hernia repaired during her surgery. I know how big it was because the surgeon and basically everyone on his team kept commenting on how huge it was. The only real side effect she noticed during her recovery (which was very, very easy, according to her) was that when she'd take a deep breath there would be a little "hitch" that felt weird (and hurt a little at first). She said it could be alarming if you didn't know what it was. So maybe, if you're aware of it going into surgery, it will help you be prepared for it after the surgery. And honestly, it will really help your quality of life afterward to get it repaired :biggrin0:

I believe that even if your insurance is in flux, you can just get the surgery done (if your doctor decides you need it), and work out payments. Then you can fight with your new insurer to get them to cover it. That's better than living with a bad gallbladder!

So, my lovely girlfriend took a number of pictures of me standing around in just my boxers, and, yeah... now I remember why 1) I never go shirtless, and 2) I don't like pictures! I believe that, under all the flab, I'm still a basically good looking man. But I have let the fat pile up, in roll after roll, until I'm almost unrecognizable under it. I think I've never really let myself accept just how very fat I've become. I have this bizarre mental image of myself as much more "normal" weight than is reality, but I also live in constant apprehension of someone seeing just how large I am. It's a bizarre mental double-image, and the photos today (which are in my private profile, and are going to stay private until I have some real progress to show!) were... a shock. My weight looks... ungainly, unhealthy, and just unsupportable, long-term. In some ways I think I haven't been fully committed to the surgery until this moment, just now, when I realized "man, if you stay like this, if you don't change something, you are going to die, painfully, and soon." I really understand now why... My back almost always hurts. If it's not my back, it's my shoulder from lying on my side to read or sleep (all that weight on my shoulder causes problems). I almost never sleep well, and fight constantly with apnea. I'm sick so often. I hate exercise so much -- if I walk long distances (or even stand up straight for too long), something is always chafing or rubbing or constricting. It's not surprising... with that much flab to move around, who would be comfortable? I have such a hard time finding clothes that fit. I buy huge, tent-like clothes to try to fit into and "hide" my flab, but let's be real... I'm not fooling anybody. I feel so awkward in social situations -- I'm very body-shy, and it's very difficult for me to avoid the belief that someone is "judging" me for my body. Some years ago, I had LASIK surgery because I was very nearsighted. I had to wear thick, coke bottle glasses (or contacts, but they were killing my eyes). I was very frightened of the surgery, to be honest -- I was worried I would go blind or something. But I got through it; I did my best to follow the surgeon's instructions TO THE LETTER, and when my eyes had fully healed, I had better than 20/20 vision (20/10 in one eye, 20/15 in the other). It wasn't entirely a positive experience; I had to shell out five thousand dollars of my own money (LASIK was still new). It was a little painful and a lot frightening, but I still consider it one of the best choices I've ever made. I still just stare out on this beautiful world, sometimes, and marvel at how nice it is to be able to really SEE without thick lenses or frames chafing my ears or getting smudged or slipping down (and making everything look small, that's one odd effect of glasses that they never mention -- everything looks so SMALL). It was totally worth the money, and I would do it again in a moment. So that's how I'm thinking of the weight loss surgery. I've done the research; on almost every single metric, this surgery will improve my life. It will add years of life expectancy, and (maybe more important), it will likely be QUALITY life, not years spent in sickness and decline. It will restore my mental image of myself as a "normal looking" guy to reality. It will hopefully ease my constant anxiety that something is Dreadfully Wrong with me, health-wise (I'm fortunate that almost all of my anxiety is, for now, ungrounded -- but how long will THAT last?). YES, there will be some initial pain, but apparently not much. YES, I'll have to likely deal with some nausea or "sliming" or whatever, but that's a small price to pay. YES, I'll have to re-learn how to eat, and make good food choices every single day, but to be honest, I should have been doing that anyhow. I'm hoping that, like the LASIK surgery, I'll look back on this in a few years and say "would I do it again? Absolutely, yes. In a heartbeat." Because after looking at myself in all of my non-glory today, I don't like what I see. That much fat just can't be sustained. This kind of life of pain, embarrassment, discomfort, and always waiting for the "other shoe to fall," health-wise, just can't last. I have to do it. I think, now, I may finally WANT to do it.

This is going to be really hard for me, too. I'm so used to having a glass of water or a diet soda with my meal!

So, I dug up some research on obesity and hypogonadism (low testosterone, for men), and the numbers were pretty eye-opening. I've lost the link, but basically for men who had low testosterone (I'm borderline), having weight loss surgery caused the free and bound testosterone in the blood stream to basically DOUBLE. In short, for these men, losing weight via surgery was more effective than exogenous testosterone (shots, creams). I thought there would be some change, but not THAT much of a change. For me, if that ratio holds out, it would basically put me squarely in the middle of the "normal" range instead of perpetually hovering near clinically low testosterone. So, I'm excited! Edit: here's the study: http://www.endocrine-abstracts.org/ea/0002/ea0002p79.htm And here's the abstract: IMPROVEMENT OF MALE HYPOGONADISM IN SEVERE OBESITY DURING WEIGHT LOSS AFTER BARIATRIC SURGERY M Monteiro1, H Cardoso1, G Vargas1, P Mendes1, A Sergio2, M Santos3, C Santos3 & H Ramos1 1Dept of Endocrinology, Hospital Geral Santo Antonio, Porto, Portugal; 2Dept of Surgery, Hospital Geral Santo Antonio, Porto, Portugal; 3Dept of Pathology, Hospital Geral Santo Antonio, Porto, Portugal. Objectives: To evaluate changes in gonadotrophins, total (TT) and free (FT) testosterone, SHBG, insulin and c-peptide levels during weight lost after bariatric surgery. Material and methods: Seven (n=7) patients submitted to bariatric surgery for treatment of severe obesity were followed-up over time. Before surgery mean age was 32,857 (19-56) years old, mean weight was 170,571 kg (? 37,362) and mean BMI was 58,824 kg per m2(? 14,211). Results: After a mean follow-up of 13 months (min 6, max 25), mean weight and BMI decreased respectively to 126 kg (min 97, max 196; ? 33,872) and 43,767 Kg per m2 (? -13,845). The mean analytical values before (:thumbup: and after (A) surgery were: FSH (mUI per ml) B:3,245 ? 1,380 A:2,330 ? 0,948; LH (mUI per ml) B:3,142 ? 0,780 A:2,700 ? 1,009; TT (ng per ml) B:2,050 ? 0,825 A:3,653 ? 1,452; FT (pg per ml) B:6,028 ? 2,377 A:13,400 ? 5,702; SHBG (nmol per l) B:21,237 ? 15,329 A:26,666 ? 10,366; Insulin (microunits per ml) B:44,528 ? 39,321 A:17,716 ? 12,1598; C-Pep (ng per ml) B:6,833 ? 2,320 A:4,116 ? 1,621. After surgery all patients improved their weight and BMI in a significant way (p=0,001). Weight loss attained with bariatric surgery resulted in significant increase of TT and FT (p=0,019 and p=0,026), and decrease of c-peptide (p=0,034). Gonadotrophins and SHBG increased and insulin decreased, with weight loss, but not significantly. Conclusions: Weight loss in men with severe obesity and hypogonadism, attained by bariatric surgery, improved hypogonadism with increase of TT and FT levels.

Tiffykins has a good point, and I would also make sure it's not general protein sensitivity (when you feel nauseous, do you experience any pain in the right upper quadrant of your abdomen? Especially, does it radiate to the back?) If so, it could be the beginning of gall bladder issues, which are very common in WLS patients.

So, I've read some studies showing that obesity can lead to poor memory. I was wondering if anyone has experienced improvements in mental function since losing all the weight. I have an off-the-charts IQ, but even so I've felt for a while now that my brain feels "fuzzy." Specifically, my recall is poor and I often fumble to remember names and facts and information. Anyone felt like their mind is "sharper" after losing weight?

I think pnw may be on to something, too -- even if you're not diagnosed w/sleep apnea, us heavy people always have poor sleep. Sleep quality has many, many documented connections to memory and overall cognitive function.

Here's a bit of advice: keep your receipts. You can deduct the sleeve costs on next year's tax returns (in fact, I believe you can deduct all medical expenses above $500, although I'd check with your accountant to be sure). My girlfriend did that with her sleeve, and this year she got back almost $8000 instead of the usual $1500 or so. It didn't quite "pay for itself," but that sure takes away some of the sting!

Oh, those cocoa dusted almonds are great if you're craving sweets (particularly chocolate). I still have to be careful on volume, since there's 6g of carbs in only about 20 almonds. But still, in moderation, they're great. And yes, almonds are insanely good for you in terms of Protein digestibility and essential fatty acids.

I'm not sure if men are allowed to post, and I don't know if this will help, but... The "you're great, but... [you're too fat]" thing goes both ways. I can't count the number of times that I -- naturally a fairly shy man -- finally got the courage up to ask out a girl I was attracted to, and was told something like "I like you, like a brother" or "let's just be friends." It's more polite than the "radio silence" you mention, but still the message is the same: you're a great person, but because you're so fat, you're unacceptable. It even goes further, for me. When I was a good deal younger -- but still pretty heavy -- there was a very beautiful girl who, for some bizarre reason, seemed fairly fixated on me. In retrospect, she was sending me EVERY sign that she wanted some kind of intimate relationship with me, but I was so sure that I was fat and unattractive, that I "froze up" and didn't reciprocate, and the opportunity was lost (one of my "normal" weight "friends" swooped in on her). In retrospect, it turns out that she wouldn't have been good for me, but still, it makes me wonder how many experiences I missed out on because I didn't think I was good enough. In a weird way, I sorta get why we don't get picked for the mating dance when we're fat. Despite all the Disney films in the world telling us that "it's what's inside that counts," the bottom line is that in many ways dating and marriage are about breeding and genetics. On many unconscious levels, we are attracted to someone because we think we would make good, strong, smart, healthy children with them (well, maybe not explicitly, since that wouldn't explain homosexuality, but you can't deny that basic health is almost always a prerequisite for attraction). So, it's unsurprising that we obese people might not get "picked" because let's face it, who'd want unhealthy, obese kids? But even knowing all of this evolutionary psychology stuff, it's hard to be the one who's constantly waiting by the sidelines in life. Even knowing that there's a biological basis for it, that doesn't make it any easier when you feel like you're defective because you're fat. And that may be the worst part -- not just the rejection from society, but the internalization of it. Once you start to buy into it, once you start to buy into the idea that you're defective and undesirable because of your weight, you really start to live your life differently -- you stop taking chances, and you avoid situations where you just "know" you won't be accepted. And that may be the biggest tragedy of all. Ultimately, it would be great if society didn't reject fat people, but like I said, I think a good portion of it is wired into our biology. And with the sleeve surgery, we finally have a chance to escape the physical trap; it's up to US to learn how to escape the mental trap.

Well, my girlfriend (who is also a sleever) and I went out for a "farewell" dinner tonight. I ate my last meal (ever!) where I won't be thinking about protein grams or carb grams. I had a big ole cheeseburger, with fries. I drank two large mugs of beer since that will likely be my last beer. I had two big glasses of Diet Coke. It was glorious, but I was also saying goodbye. For the most part, I don't think I'll miss it. But I kinda needed to do it so I didn't feel like I'm getting a raw deal. On Tuesday, I'm going to start my pre-op low-carb diet, which I'm actually going to informally begin on Monday. Edit: oh, I also took some "before" photos of myself just in boxers. Jeesh, it's mortifying. I guess I didn't really want to admit, even to myself, just how fat I've become. Well, that's going to change...

I'm with you. It's nobody's business except for those I choose to tell, and those people have been overwhelmingly supportive.

So actually, the science points to obesity causing memory loss: Obesity is associated with memory deficits in youn... [Eat Weight Disord. 2006] - PubMed result Obesity Tied to Memory Loss | Psych Central News

So, the consensus is that my memory may well get WORSE after surgery? Great...

Well, I can tell that I'm going to have to re-learn EVERYTHING about how and what to eat. After discovering that one of my little "snack bags" of raw almonds (a healthy "snack," right?) was nearly 40g of carbs and over 1100 calories (almost 1000 calories of fat!), I have been SUPER cautious about EVERYTHING I put in my mouth. This is going to be tough!

I may be the only 39 y.o. man without ANY tattoos. After I've hit my "target weight" might be the time to finally get one, it sounds like :wink0: Who knows, maybe a bit of clever ink might hide some stretch marks!

Interesting. My cautions regarding melatonin came from a doctor, who told me to "save my money" since the body just metabolized it away during digestion. Here's a link to a double-blind NIH study showing that melatonin was no more effective than placebo for treating primary insomnia: Treatment of primary insomnia with melatonin: a double-blind, placebo-controlled, crossover study However, AFAIK, oral melatonin doesn't cause any harm, however, so if it helps you, go for it. Even if it IS just a placebo, don't underestimate the power of placebos. If you have something that makes you believe you "can sleep now," just that belief alone might be sufficient to LET you sleep! Bottom line, it doesn't cause any harm, and if it helps you, why not? Edit: doing further research shows that the verdict isn't yet final. Here's a slightly less "authoritative," but still insteresting study showing the opposite: http://www.springerlink.com/content/756t11t76616540k/ Doing more research, it appears that melatonin may be useful in treating some specific CAUSES of insomnia, such as asthma and Alzheimer's disease. As a generic "sleep aid," however, it appears ineffective. As is so often the case, however, there are "warring studies." So I'd still stick with "if it works for you, go for it."

Thanks for all the responses. I'm SOOOO hopeful that my apnea will resolve. I've been diagnosed with apnea for 10 years now, and I'm used to sleeping with the machine, but it's a constant struggle -- every night, I fight with it, and the "good nights" where I lay down and sleep deeply through the night, are still rare. I'm REALLY looking forward to good, healthy sleep after I drop the weight. NB: Apparently playing the didgeridoo (specifically, the "circular breathing" that it requires) can significantly improve apnea. I may try this (even though I may feel silly). Anything for health, right?

I'm going to use the 2 week pre-op diet (starting Tuesday!) as an opportunity to start working exercise back into my routine. For me, it's all about habit changes, and exercise is a habit that I really WANT to acquire.

The poor self esteem that can result from overweight and obesity is a big deal, and should not be written off. But it's also important to remember that overweight and obesity can cause real, physiological problems that can lead to reduced sex drive and reduced sexual performance. Obesity reduces stamina and physically complicates sex -- even if you and your partner are the most willing partners around, if you're in pain or out of breath, it gets hard to maintain the mood. Add to that the evidence that obesity disrupts hormonal function significantly -- I don't know about women, but in men, fat cells aromatize testosterone to estrogen, which is a Very Bad Thing for sexuality in men -- and you begin to see that it's not just "all in your head." Obesity is, to some degrees, a sex killer! In fact, despite all of the fat acceptance sites saying otherwise (and, for the record, I'm pro-fat acceptance... I just think that you have to be realistic), I'm more surprised when an obese person has a NORMAL sex life. I suspect that for many obese people like my girlfriend and I, sex just sorta drops out of the picture. I'm really looking forward to getting that part of the picture BACK again. We're too young to be sexless!

Oh, we all have issues, I suppose. I just tend to be more outspoken about the things that trouble me. I doubt that, when you boil away the unimportant parts, I'm that much more messed up than anyone else. I think that I've just learned a few things about changing habits, and was using you all as a sounding board for my plans for exercise changes! Thanks for all the feedback :wink0:

I actually haven't had that in years. It would be nice!