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Okay...so a lot of people have posted questions on here about the psych evaluation. I don't expect this to necessarily help anyone but I wanted to share my experience. It is somewhat different that any other post I have read. First of all I struggled with the decision to see a psychiatrist or a psychologist. I know a psychologist on a professional level so I knew I would feel comfortable with him. I also knew if I went to him I would have to complete testing whereas if I went to see a psychiatrist, it would only be an interview. In the end it was money that made the decision for me. I only had a copay with the psychiatrist whereas I would have to pay for the testing and interview with a psychologist, which was considerably more than my copay. How did I find the psychiatrist? An acquaintance had the surgery and said she could only find one who would do the evaluation. I would have to drive 90 min one way. Fine. I asked about her experience with the evaluation and the first thing she said was "I felt like she was trying to talk me out of it." The acquaintance was 5'5 inches, 300 lbs and had no co-morbid conditions. So, I was curious to see if I felt like she had tried to "talk me out of it." I am 150 lbs overweight. I have diabetes, high blood pressure, sleep apnea, and a long history of high cholesterol and triglycerides (although I do not currently have this problem). The psychiatrist asked questions I expected to be asked: current medical conditions, medications, family history, occupation, marital status, past and current mental health issues, past trauma, past relationships and how long they were, etc. She asked me what procedure I was having (sleeve). She did not ask me anything at all about my weight history, if I had a support system or if there were any stressors in my life. So at the end of the interview this is what she had to say: 1. You need to know there is currently NOT a cure for obesity. If there were, everyone would be having the surgery. You should also know the statistics say there is a high rate people who regain their weight back. My response to her was i felt like without the surgery I had a 0% chance of losing this weight and keeping it off. With the surgery, at least I will have a chance! I added I think the benefits will outweigh the risks. 2. There is a phenomenon known as addiction transfer and you are at a very high risk for this. I immediately stopped her and told her I was aware of this concerned about this as well and talked to my therapist about it. With regard to the transfer of food to alcohol addiction, I don't drink at all now. So, in order for me to avoid this, I should not ever drink. Of course, at this point she had to tell me about her "friend" who never drank before surgery who ended up being an alcoholic. I'm not quite sure why she said I was at a "high risk" for this because the only addiction I've ever had is food. However, my father and sister both died from drug addiction so I am statistically more likely to have addiction problems. I understand this may occur so I will be more cognizant of it. 3. You need to be aware this is a "dangerous and risky procedure." Well so is life saving brain and heart surgery! She said this on two different occasions. First, she told me about another "friend" who had a leak at the staple line. Then, the kicker of it all is this psychiatrist was morbidly obese herself! Not just obese, morbidly obese. Round as she was tall. So then she says to me I would have the surgery myself if it wasn't so "dangerous and risky." So..did I feel like she was trying to talk me out of it? Hell yes! I find it ironic that a person who I know understands the struggles of being obese would have this perspective on WLS. Her responses were the kind of feedback you get from a normal, lay person. Another oddity...she also out of the blue said "you look good." What does that mean? My hair and clothes were clean or I didn't act like was experiencing psychosis? I didn't ask. She did clear me for surgery so I guess that is the most important thing but that experience left me scratching my head......

when is your surgery? Your nutritionist will tell you what your surgeons/programs requirements are. Just like you said, oddly enough, everyone is given different instructions depending on their doctor's requirements. For me, I am currently following a 2 week pre op diet. My surgery is 3/4. I am allowed 5 Protein shakes a day, one serving of veggie a day, one serving of fruit a day and one serving of starch a day. I can also have all the Clear liquids I want which include sugar free popsicles, SF Jello, broth, SF liquids etc (I can not have any caffeine, carbonation or alcohol). I thought it was going to be torture but it really hasn't been that bad. I'm sure the next time you meet with your nutritionist he/she will start providing you more and more info regarding this, if not just ask. Good luck on your staring weight loss, you can do this!

I'm almost 1 month post op, so I'm just out the gate. I used to LOVE wine, but I've been a good girl and have had nada. I am a bridesmaid in an upcoming wedding and I REALLY want to imbue. Be honest. How have you dealt with alcohol? I don't want to go bananas and drink all night, but I'd sure like a glass of wine at the bachelorette party (this Sat) and one at the wedding (June 4). Go for it? One or the other? Avoid? Do you drink? Please put in your 2 cents.

How about a teacher's perspective? I work in elementary schools, with kids in grades K - 5. I see MANY parents fight the labeling of ADD/ADHD, and that is understandable to a degree. However, I see what happens when parents do that.......I see the kids when they are left back a grade, or are needing to be placed in a resource room situation rather than a regular classroom due to their lack of control - yes, even the very smart kids with ADHD! An example: I am working with a family that has one child, a boy, who now is 11 years old in 5th grade, with an IQ of about 130, upper average. He has struggled with school since Kindergarten. Nice little boy, who WANTS to do well, but can't help it when his impulse is to yell out an answer, or to turn the game board over when he is losing....things that don't work well in a public school! He is receiving Cs and Ds, and there is discussion of having him repeat the year....he's been so unavailable to learning.........His teachers reached out to parents each year, asking parents to have him evaluated. Unfortunately, he couldn't sit through the school evaluation long enough for the results to be valid. Parents don't want to medicate, even though his family pediatrician believes he has ADHD. They wanted to try hypnosis, the FienGold Diet (from the 70s--eliminates sugar, etc..), nutritional supplements.....each year it was something new and different. Meanwhile, his grades have absolutely plummeted - parents are not hurting for money, so they hired a homework tutor every day so that they could remove themselves from that battle; his peers laugh at him, and he sits alone at lunch time because he seems so different to the others; doesn't do well on team sports since he is so impulsive; was recently suspended when he snapped a classmates bra strap cause someone told him to do it, and he lacks the impulse control to stop and evaluate; How sad is all of this? He asks his parents for medication so he can be like the others.....just breaks your heart, yet the parents don't believe in medication. I see many kids throughout my day who are on meds that might be able to handle contracts, charts and stickers....but as they get older, these aren't as helpful to kids, and contrary to what someone wrote earlier, this generally doesn't "go away" and they don't tend to "grow out of it." What happens, is they stop making the growth their peers continue to make, and are kept apart from the group, making them feel like outcasts....grades suffer, and many have to stay back because they have no sped help, and no medication to help - so they learn to self medicate, with drugs, alcohol, food.....pick your poison! Instead, with help from professionals, these kids learn how to help themselves with organizers, check in/check out in school, extended time given for tests and assignments....but not if the child isn't identified as having ADHD. If you hide from it, nothing good will happen, that I can guarantee you! I have a lot of experience working with kids and families dealing with ADHD...can you tell have a lot of passion about this subject? I'm not promoting medication, but just warning that if it really and truly is ADHD, medication can work wonders..........and doesn't need to have the stigma many wish to attach to it. I had a student a couple years ago that by the time he had reached 5th grade, he wasn't able to complete any homework independently, was failing many subjects......friendship issues....parents finally decided to try meds. They tried one, and it caused eating issues. Tried another, didn't work well. Almost ready to give up, and tried another---this was the winner! The child commented to me, "Mrs. K, the room stopped spinning! I hear your voice so clearly now-" Wow - how powerful is that? (ADD kids often have trouble isolating noises - they hear everything all the time and aren't sure how to tune in to one thing and let the others fade...) This kid had been so unavailable to learning for so many years - he had a lot of catching up to do! Last I heard, he was making honor roll! Talk about success........... A good source of information is Dr. Hallowelll.........can't recall the books he's written at the moment - it's been a long day already, lol! But if you do a search on him, you should come up with a couple books he's written. I believe he equates kids with ADD needing their meds just like a diabetic needs their insulin..........it's a brain chemical interferences, and it's cruel to assume they can themselves can "fix" it with just a behavior modification chart, or something along those lines......... Feel free to email me any questions - I can be a bit long winded about this stuff! :nervous

I was updating my blog tonight and went back to my pre-op journal to see how it relates to my experience and how I am doing. One of the best things in there was this Plan for Success that I wrote out. Here it is, verbatim, with my comments from today following each item. I thought it would be interesting for us all to share ideas on what things we can do to help ourselves to succeed! Add anything you want to this string! Plan for Success: In reading one of my "band" books tonight, I came across an article that said that having a game plan can really improve my chances for success. I've been thinking of a few things I can do, but hadn't really formalized a plan. So, here goes: THINGS I WILL DO TO HELP MYSELF SUCCEED: - Tell family and friends about the surgery so that I will have a support network (and won't feel weird when eating with them) - (DONE!) - Commit to staying exactly on my pre-op Clear liquids diet - (DONE!) - Commit to the post-op plan of 2 weeks full liquids, then 2 weeks of soft foods - (DONE!) - Think of ways to Celebrate my birthday with friends where eating won't be an issue (maybe a girl's day at Ohm?) - (DONE! Had a great time at Ohm Spa, by the way!) - Hire a personal trainer as of 11/08/08 (I didn't do this on schedule, but I did hire the trainer and recommitted to exercising in a serious way . . see bruise photo from previous post!) - Keep good, correct foods in the house. (DONE!) - Avoid alcohol to the extent possible. (I could be better about this to be perfectly honest. . is just such a big part of my social life that it's hard to really avoid, plus I love a nice glass of wine) - Commit to taking SMALL bites and chewing until food is dissolved (DONE! I'm not perfect, but I do a pretty good job at this) - Commit to small sips (Honestly, this hasn't been all that necessary) - Commit to avoiding calorie-filled beverages (DONE! Well, except for wine!) - Journal/blog regularly and chronicle your success -- AND admit it if you mess up (DONE! And is an on-going part of my plan!) - Look for NSVs if/when your weight plateaus (I'm doing this!) - Try out the support group at NYU (I haven't done this, but I feel like LBT and the people who I know through my blog do what I would have hoped a support group to do) - Be proactive about your care -- don't wait so long for a fill that you gain weight. (DONE!) - Measure yourself periodically and write down your measurements (DONE!) - Know that this is not going to be easy, but that this will be worth while. And, know that this WILL be easier than staying on a diet on your own for a whole year, then maintaining your weight long-term. (So true -- and I do fully know that.) - Try to notice NSVs (like less foot and back pain) as they occur (DONE!) - Make mini-goals for yourself, e.g. 10 lb goals, and feel free to reward yourself with facials, massages, nice mani/pedis, etc. (Oh believe me. . DONE!) - Go through your closet and "size" it so that you won't miss wearing cute things that you like on the way to goal (DONE!) - Don't read too much about negative/failure stories on the lap band chat rooms. (DONE! I do read some of those stories, but I don't get sucked in, which accomplishes my fundamental objective.) - When you start going to restaurants again, do trial runs with your friends who know about the surgery (plus, will be fun). (DONE!) - Don't get disproportionately upset if any of your good friends don't understand, say the wrong thing, etc. They love you, and no one is perfect. (Honestly, my friends have been pretty freaking amazing. I'm very lucky in that way.) - Focus on your other hobbies and interests (Get new letterpress projects, enjoy the Van Gogh course at MOMA) - (DONE! Unfortunately, the Van Gogh course was totally sold out, so I never did get to take it, but I've been spending more time on my hobbies, which is always very enjoyable). I hope that was helpful

Hi, My Doc has said I can have anything except bread, alcohol and fizzy drinks. I can't drink with a meal either. He dosen't want me to have a liquid diet as he says these tend to contain more calories. I am eating sensibly and chewing well, mainly soup, salads, fish and yogurts really.He says my stomach is not that different to before size wise though it is a bit swollen. i am only eating small portions as I don't want to have too big a shock when I have my fill!

My stomach has been pretty happy with everything I’ve thrown at it, but I’ve categorized some things as “not for me anymore”. I know this isn’t popular and everything in moderation seems more sustainable but i also recognize that there are a few foods I can’t control myself with once I start. For me that’s candy and chips/popcorn. I know from past experience I can’t have it in the house and if I start with it I will eat too much. I also recognize that I’m the daughter of alcoholics and that I have addictive tendencies. Try to think about if you are able to eat well in moderation or if you have some trigger foods that might not be able to be incorporated into your long term diet. Fast food and cookies might be something that won’t work for you.

Byron Katie's (AKA Katie) Besteselling Book, "Loving What Is", is the singularly best book I have every read (and teaches you her simple 4 question and "turnaround" process to follow) to deal with the thinking that leads to overeating, drinking or any of the other things we do to medicate our thoughts. I could NEVER have gotten through this lapband process without using these 4 questions. I also gave up alcohol, drugs and cigarettes over 1 1/2 years ago using the process which is called "The Work". It helps me identify my stressful thoughts, question them, and miraculously they "let go of me". I don't need to change my thoughts, I just question them, and they leave me - and "Peace" is what's left. I rarely eat "emotionally" anymore. If, like me, you start reading it and it sounds too simple, don't give up - I stuck with it, and as my husband says, "I have a whole New, Wonderful, Wife!" And this is PRIOR TO WEIGHTLOSS. Also her book, "I need your love is that true" Is just as amazing and explains how to do this work and also a lot more about how we seek "Love, Appreciation and Approval. You can see video demos of the process, called "The Work" at www.thework.com. You do not need a teacher or to buy a bunch of stuff; it is a simple process where YOUR answers are all you need, these 4 questions are soooooo penetrating and you get to tap into a self-wisdom that you may have had no idea you possessed. And the process is SIMPLE! You can contact me anytime if you need help - at no charge of course. I just love sharing this remarkable tool. There is a free hotline too, at the website, and so much free support from Katie, it is unprecedented. Give it a try, and if you want, I still have some boxes of free cds and mini-books I can send you until they run out. I will send you a set. But her book is at any bookstore, or you can ask them to order it, or get it on her website. I am not affiliated with Byron Katie International. I am not trying to sell anything. I just think this the THE WORK for those of us that struggle with food and other compulsions and I love spreading the word. LOVE TO YOU ALL!

Of course, we can be friends with ANYONE. But it's a fact that fat friends tend to make us fat and keep us fat. Here are just two of the research studies with this finding: http://www.health.harvard.edu/blog/how-your-friends-make-you-fat%E2%80%94the-social-network-of-weight-201105242666 http://www.dailymail.co.uk/health/article-2765271/Fat-friends-make-eat-MORE-You-likely-ditch-healthy-eating-goals-eating-overweight-companions.html IMHO, there's strong agreement in these relationships that fat / food/ fitness won't ever be discussed seriously. The friends agree that those topics are too painful / embarrassing / irritating / upsetting to deal with and that they will continue to issue permission to each other to continue their unhealthy behaviors. The same dynamic dominates relationships among drug users, alcoholics, and other substance abusers.

In the end, it's about two things... (1) your own head, and (2) the arrangement you make with those around you. Regarding #1 -- You can "flip the switch" in your own head to turn off all the food noise around you. You just have to find the switch!! Many of us have no problems with people eating around us, because we were very focused on what we were doing and why. I'm not saying you SHOULD be in that place, I'm just saying that if you can find a way to get to that place, the journey will be a little easier... Easier said than done I know!! Regarding #2 -- You and your husband need to talk about what support you need. And he has to agree to it. If you ask him not to eat in front of you and he agrees, and then does it anyway, he's a big old jerk and you have a right to be angry. But if he's not signing up for that, then you guys have to negotiate for what he will agree to do... In my house, I don't care what my husband eats in front of me. However, I've asked that we remove the alcohol from the house. I love to drink. And before surgery, we used to have a drink or two every night before bed... I don't want to give up drinking entirely, and I really don't think I can be trusted to only drink "sometimes" or "in moderation" if he's going to drink every night in front of me at home. So I've decided to try drinking only when I'm out, in a social situation... Is that totally fair to him? Not if he is resentful or angry about it... But sure, it's totally fair if he's happy to support me and agrees to do it. As it turns out we had a big fight one night because (during pre-op phase) he snuck booze into his juice and I caught him. I flipped out (more that he was sneaking it) and basically told him that I refused to be his mother, and that if he's so dead set on drinking regardless of the impact on me, he should just pull all the alcohol back in the house and act like an adult and make the decision that he didn't want to support me... I'm a big girl, I can deal with being told no, but don't pretend to be supportive and then make me the bad guy when I find out that he's lying about it... Grrr... Anyway. Point being that I understand what you're going through, but it is YOUR journey... Your family will hopefully help, but it's not actually their journey...

Ill admit it, I've had a few days where I was probably around there. Ill be honest, alcohol was involved in one of them (no lectures please!). The others were just way too much grazing and where there was food all around me. Those are not normal numbers for me. I am for 600-800 cals most days. I always feel crappy with myself if I go over 1,000, but we are human, we have slip ups. I've been fortunate enough (or unfortunate really) that no food bothers me. Bread is fine, sweat don't get me sick. Nothing. I don't even get drunk off of alcohol the way others say they do. I had my first drink after surgery and was waiting to get drunk and it never happened. So I have to really watch myself carefully with my choices. I wish I had some issues with SOMETHING lol. But yea I've had a few high calorie days but as long as you pull yourself back up and do the best you can after, that's all that matters.

Will drinking alcohol make you fail a sleep study test

yes check for sugar alcohol in your drinks... usually it is malitol or some other ingredient ending in -ol . They can produce gas and diarrhea. Working so hard to stay hydrated you do not want to let it go on too long.

A lot of people talking about caffeine withdrawals but I don't experience them. I have given up caffeine several times and I don't see a difference, except lack of focus maybe. I was taking one caffeine pill in the afternoon, then I went back to coffee after 6 weeks. I went without coffee 6 weeks, then I slowly added it back it. Slowly because I have never had any acid issues, and I know coffee is acidic. I have never had GERD issues and I don't want to start. I drink cold brewed coffee for the lower acid content. No issues. I do limit myself to 8-12 ounces. I used to drink 24-36 ounces a day before surgery. I gave up sodas and alcohol about 3 years ago, and I only had black coffee, tea and Water. I also make an iced coffee Protein drink. I put cold brew coffee, water, unflavored protein and ice and my blender and I will have that sometimes in the late morning. I forget to eat a lot and if it is mid day and I haven't had anything to eat yet, I will do that to get my protein started for the day. It is a very nice change of pace.

I am anxiously waiting to have my first drink, I drank massive amounts and got into 2 or 3 day stupors in college 30 yrs ago, I decided to stop on my own and combined with getting older I became a very light but discriminating drinker, maybe once every two or three months and even then very specific about what I want, I prefer beer or fun wines, and if it is beer I limit myself to one or two and stop, but this 4th of July was tough, I was BBQing for family and craving my favorite beer, a chilled Dos XX dressed up, I still researching on the use of alcohol after gastric, so far the studies of pros and cons seem to be about even 50/50, so if I do I will try to be smart about it and if I see any negatives from it it will be the last time, interestingly no one seems to know exactly why, theories range from sugars in the body to fast alcohol absorption and intoxication, so we will see.......

@@Djmohr I had to sign a contract for smoking and drinking alcohol also. It's something new because I didn't have to do it when I was banded 5 years ago but had to do it for my revision (same dr.).

Quick response ... The 85% of the stomach that is removed during VSG surgery is the FUNDUS. This is the part of the stomach that stretches. The rest that is left is the non-stretchy part of the stomach. That's a good thing. The other thing the FUNDUS does that the non-stretchy part of the stomach (your new sleeve) will NOT do is to produce ghrelin -- the hunger hormone. And believe me, you will be so grateful for the lack of / reduced level of ghrelin post-op. Immediately after surgery, your new sleeve will feel like the surgeon removed 95% of your stomach. She/he did not. However, right after surgery your remaining non-stretchy sleeve will be traumatized, inflamed and swollen terribly, making its capacity incredibly tiny. This inflammation and swelling will go down gradually as the severed edges of your new sleeve (which are stapled together) start to heal, repair themselves and grow / knit back together. This healing takes months. The severed nerves have to find each other and make new connections. So do the stomach muscles and other tissues. And that's why you have to be incredibly compliant and careful about what you eat during the early months post-op. This is when complications can occur caused by eating inappropriately at that time. One of the hardest things for some patients to learn is that post-op they are NOT on *just another diet* and that eating inappropriately is not *just cheating*. This is also why vets and well educated newbies have such strong reactions to people who want to eat cheeseburgers and tortilla chips and drink alcohol and what-not a week or two or three post-op. How long does it take for your sleeve to fully heal? I'm sure it varies from patient to patient. But in my case, I had the sense that by six months my sleeve was intact again. I know that when I and other family members have had other injuries / surgeries of various kinds that we've been told by surgeons that it takes a full year for our bodies to recover from severe injuries / surgeries. This would be a great question to ask your own surgeon. Keep learning about the sleeve. The details about the surgery and its aftermath really do matter and your self-education will improve your compliance. And teach your husband what you learn. The more he knows, the more effective his support for you can be.

Don't panic? (Oh, that was the Hitchhikers Guide... Sorry, lol) Everyone eats different stuff at different stages. I don't personally eat meat (by choice, not because I cannot) I don't drink carbonated crap, even the diet stuff, I don't eat processed foods, I don't drink alcohol. I don't do a lot of things. What I do do that should be common for all bandsters (and non bandsters), is exercise regularly. Everyone needs exercise.

I have the same co-morbidities. I was sleeved Sept. 26th at a Bariatric Center of Excellence. The doctor said my diabetes would go away in 3 - 4 days. It went away in 2! He said the sleep apnea and non-alcoholic fatty liver would go away in 3 - 4 months. I never wanted my insides re-routed or the dumping you get because of the removal of the pyloric valve with bypass. I also didn't want the higher level of aftercare necessary to make sure I didn't develop Vitamin or mineral deficiencies. I was sleeved on a Friday morning. By Sunday morning I felt as though no surgery had happened! VERY happy I chose the sleeve.

Don't want to sound like I'm an alcOholic or anything, but at times I enjoy a glass of red wine. I'm 2 weeks post op, have a bridal shower I'm hosting on April 1st and was wondering of its ok to drink? I totally forgot to ask the doctor. And if so has anyone had any issues with drinking? I know it's empty calories...

My doctor says no alcohol. I'd check with your doctor since all are so different. Good luck!

Do you honestly think it's a good idea to tell a brand new bander (This person was three days post op when she posted.) how to sneak in as many alcohol calories into her diet as possible? At three days post op you should be concentrating on healing and setting up good habits for the future. You act like I'm so anti alcohol. I'm not. But no, I don't think a person three days post op should be drinking. I'm an RN, alcohol that soon after surgery IS NOT good for you. But if you can't give it up long enough to heal it's not my problem. The truth is alcohol should not be a majority of your diet. Period. And giving new banders ideas at how to sneak in MORE alcohol is not good. Justify it anyway you want but it's not.

On the nausea part I had it right out of surgery and my nurses told me of a trick they said they used with cancer patients that have nausea ... They gave me alcohol wipes so anytime I would start to feel the nausea I put one at the end of my nose and breathed it making the nausea go away I was amazed on how it worked for me.

AlAnon, CODA - great great 12 step groups and there are many books available. These programs saved my life, emotionally. Do I still have the tendencies? Yes, they were ingrained in me, growing up in an alcoholic, dysfunctional family. However, today, i see the red flags much earlier and I have developed new tools and new guidelines for my reactions and behaviors. I have come so far thanks to these programs and the great people you meet there. here is a link to the Hazeldon foundation, a great resource for literature as well. http://www.hazelden.org/ The Language of Letting Go - by Melodie Beatty is still one of the most valuable books I've ever owned.

@ My clinic made me take a written test. It was not an easy one either! I agree with you, I do think every bariatric doctor should require it. I also had to sign a contract stating I would not use alcohol for a minimum of 12 months.