New to all this...and with a few questions

[rattlingwalls 3]

So a couple months ago my mother called me saying she wanted us to try getting accepted for weight loss surgery together. After a little hesitation I said okay, so we both made appointments with our doctors to see if we could get referrals for bariatrics at Carle. I was accepted, she wasn't. Fast forward to a couple weeks ago and I had my consult with the surgeon and nurse. But because I had previously been doing a weight check-in each month with my regular doctor (and lost about 10 pounds over the past 6 months) they have decided to have me skip the 6 month weight loss portion of pre-surgery, saying that what I was doing with my regular doctor qualified. So I've skipped to the lab work/nutritionist/psych eval portion of their pre-surgery checklist. Right now I'm waiting for the first half of April for my appointment with the dietitian, only I have NO IDEA what I'm supposed to be doing in the meantime. I left the initial consult with instructions to eat 3 meals a day with 1-2 Snacks, eating Protein first and up my exercise, as well as creating one nutrition and one exercise goal for myself. But I'm clueless as to where to even start with any of it since I haven't been able to speak with the dietitian yet.

Was/had this been normal for anyone else? I kind of feel like I've just been left hanging here until that April appointment, with no idea what to do in the meantime. Is there a specific diet I should go ahead and try to stick to? It kind of seems like there should be, but without being able to speak with the dietitian until April I've got no idea what I'm doing, even though I have sort of been given instructions, I feel like I don't have all the info I need to start on any specific diet on my own.

Also my surgeon told me that I can pick between the lab band and the sleeve, without any indication which he thinks would be better for me. I assumed that the surgeon would tell me which surgery I would be best suited for and that would be that. Has anyone else been left with getting to choose their surgery? If so how should I go about choosing one?

Thanks for any help given,

A friend drowning in too-much/not-enough information.

[Healthy_life2 8,322]

instructions to eat 3 meals a day with 1-2 Snacks, eating Protein first and up my exercise, as well as creating one nutrition and one exercise goal for myself. Sounds like your Dr is prepping you for how you will eat after surgery.

(1) you are awaiting approval from insurance..Make sure the instructions to skip lab work/nutritionist/psych was correct.

(2) Start with eating 3 meals Protein first. You can research bariatric recipes to get ideas what to eat.

http://theworldaccordingtoeggface.blogspot.com/

(3) exercise goal. Pick an activity put it in action

(4) nutrition goal. Might add more vegetables

Ultimately the decision of what type of surgery is up to you. He gave you a few suggestions. Would be a good idea to research the surgeries. Find out what would be best for you.

[bikrchk 1,313]

What to do... besides what they've told you, (manage your diet, get more exercise and eat more protein). Do your research, on this site and others. Attend a support group or two, from your clinic or another hospital, (most are open). Meet people who've had the surgeries you are considering face to face. Learn what they're challenges are. I was up in the air over sleeve or R\Y myself and my doc didn't shove me in either direction. He kind of lead me through a list of the pros and cons to each until I came up with a choice, (sleeve for me) on my own. For some, there is no choice, your doc will insist on a particular procedure because he\she believes it to be safest for your particular case. Based on MY research and attending support groups\talking to WLS patients, I decided the band was out. I'd seen some success in others, but A LOT of problems, (prolapse, latex rejection, food sensitivity, never getting to goal then having weight rebound). Do your research. Speak with others living with WLS of all types. Not an ounce of regret here with my sleeve!

[CowgirlJane 14,259]

Do you really want this?

The patient must pick their own surgery, with counsel from their surgeon. You are the one that has to live with it, the one who has to "make it work"

[Bandista 7,466]

Hi there, so glad you found this forum -- a good place to get information. No surgery is better than another. Do your research and don't be swayed by people who promote a particular path. Only you and your doctor know what's best for you. While I was waiting for surgery I decided to get some therapy. It's not like I hadn't worked on my issues before (I'm 53) but this time I was in brutal self-honesty mode. I realized that if I was considering surgery that meant I was really admitting I had a problem with food. we worked to identify my triggers. It was tedious but I'm glad I did it. The therapist kept me at it, going deeper. For instance I just wanted to say I'm an emotional eater. We took that so much further, finding specific incidents. Quelling anxiety, rewarding, "prepping" with food for something I didn't want to do (conference calls for work, meetings, etc.). Or procrastinating - a little cruise for something yummy prior to working on a project, etc. Sorry, going on here but you get the idea.

It was helpful for me to have a notebook to write down everything -- all the appointments, phone numbers, etc. I also wrote down my goals and reasons for having surgery. Fun to review those now! Pre-op varies by surgeon -- I had two weeks liquid diet. Purpose of that is to reduce fat around the liver to make the surgery easier.

I love my band and it has been great for me. But the main thing is that in choosing weight loss surgery of any kind we are choosing ourselves and our healthy futures. Way to go!

[Bandista 7,466]

Great point, Cowgirl Jane! Rattling Walls, make sure this is for you, about you, not your mother. Weight Loss Surgery for me is a great assist as I could not achieve success dieting and exercise. Now, with the appetite monster off my back I can make good choices for myself. But it's on me to do that.

[Debbieduck4 399]

Does your surgery center offer a seminar on the types of surgeries offered? That's where I started... If not, maybe try to find one at a local hospital to hear more about the differences between the band and the sleeve in order to make the best decision for yourself. It sounds like your surgeon is giving their opinion that either one would work well for you and the choice is yours... so now you will need to do some research. Both have their benefits.

The diet they told you to follow is basically what you will be eating later... high Protein. 3 meals, 2 Snacks. Although you can expect direction from your surgeon, it is good to look to other sources for support. Does the surgery center have a support group you can attend while your waiting for your surgery date? Best of luck to you!

[mae7365 372]

I was also fortunate that I had been under my primary care's supervision for weight loss the six months before I had the surgery consult. So I to skipped ahead to nutrition/psych eval and EGD. I have Aetna, and Aetna makes their approval decision upon the weight and BMI at the time of consult and submission for approval. Therefore I didn't have to show any additional weight loss between my consult and day of surgery. I was only required to eat a high Protein diet for one week before my surgery. So I really had no specific diet that I had to follow between consult and the week before surgery. I was a low BMI patient (36.1) so I did have to be careful to not loose weight that would have put me under the 35 BMI cutoff for Aetna.

As far as lap band or sleeve.........ask your doctor how many lap bands he's doing each week vs. VSGs? When my doctor told me he was removing more lap band than placing them, that made up my mind immediately.

[JustWatchMe 7,117]

All great advice above. I will add:

Stop TV eating.

Give up carbonated beverages.

Practice not drinking with meals or for half an hour afterward.

Good luck!!

[Djmohr 6,965]

The best thing you can do for yourself is research these surgeries now. There is a ton of info on this site and you can actually find tutorials on line that will explain each surgery. It is very important that you understand the pros and cons of each.

My surgical team shared with me they rarely perform lap band surgery and if they do it is usually to take them out and do an RNY or sleeve.

There are also reasons why you would have an RNY vs. a sleeve, it all depends on your personal health issues. For example if you suffer from Gerd/ Reflux, the sleeve can make that worse for you.

This is why research is so critically important. Ask your surgeons office lots of questions about the surgeries they perform and why.

In terms of diet now, it is important to begin building the right behaviors now. Others have mentioned what those are above.

Good luck to you! It is a long but incredible journey and the results are definately worth it?

I am wondering why Mom was denied? Did they give u a reason?

[James Marusek 5,244]

I would recommend walking about 20 minutes per day. This will help your recovery process dramatically.

Give up all carbonated beverages and caffeine now. I was up to a 6 diet coke a day habit before surgery. I went cold turkey 6 months before surgery. I had severe withdrawal syndrome (head and body aches). This lasted about a week. It is better to do this now because you don't want to compound the withdrawal syndrome with the effects of surgery. Oh and I lost 20 pounds solely on giving up my diet cokes.

Attend a regular bariatric support group meeting. They are free and will be more than willing to give you any help.

I had a RNY and from interaction with others in my support group, I would be wary of lap band surgery because it can lead to a number of problems that require revisions.

[Inner Surfer Girl 12,015]

My Pre-op goals included:

Weaning myself off of carbonation and caffeine.

Drinking at least 64 oz of Water a day.

Doing some kind of physical activity at least 60 minutes a day.

Trying out various Protein shakes.

[rattlingwalls 3]

Thank you all for your replies!! I hope I can cover all follow-up questions and replies below:

Someone had mentioned waiting for insurance approval - that's a step I get to skip actually. Carle - the clinic and hospital foundation I go through for all doctor appointments and now surgery - has a 'charity case' program that I was automatically enrolled in which covers 100% of all costs that my insurance won't cover, as well as their community care program, which is pretty much the same thing. I'm also covered 100% by that as well, so basically as long as everything medical I do is done at a Carle facility, it is covered 100%. I got very lucky there and it is the only reason I'm able to do any of this.

As for my mother, I would be doing this even if she hadn't mentioned it first. It's just that she had. I've looked into it before, but then I was underage and had a different doctor that would have made me go several hours away to a different hospital if I had been eligible at the time. It just happened that she decided to look into it and called to see if I'd like to try to go through it with her. I only hesitated because I had been planning to move out of state mid-summer as well as a few other things that would have made being off work and surgery more stressful/difficult. These plans have just been pushed back a few months to accomodate the time I'll need for surgery now. Also, she wasn't approved because of her BMI. Carle requires a BMI over 40 unless you have a morbid obesity and a health problem related to that. Her BMI is hovering around 35-36 and she doesn't have any of the related health problems, so she was denied surgery.

Support groups are sadly not available where I live. There is one at the hospital where my pre-op appointments are, but it is impossible for me to get there (a little over an hour away) in time for the meetings and back in time for work because they currently meet at night, and in the middle of my work week. I'd LOVE to go - especially since I really could use the support from others I could talk face-to-face with - but it just won't work for me right now. If meeting times change or I happen to find a new one starting closer to home, I'll definitely be going. I do happen to know one person who has had WLS and have emailed her to ask about her experience (she had her's back in '09, before I met her), and am waiting for her reply.

Thanks for all the info about everyone's diet/exercise pre-surgery. At my consult they didn't really discuss what I need to be doing right now (more about what I'd be doing post-surgery), but I had noticed in my visit summary information they give me at the end of every appointment it mentioned the diet/exercise notes in the instructions section, so thank you all for helping clear that up! I've been weaning myself off the carbonated drinks, and after that I'll be working on not drinking coffee (working nights is gonna be a blast! :/), as well as trying to eat better, so I think I'll be sticking to those goals, as well as starting to go on walks more often until my appointment with the dietitian. Especially since I'm supposed to be watching my Protein intake because of a different health problem anyway.

[Inner Surfer Girl 12,015]

One thing I forgot to add. Take a D3 supplement of you aren't already. My program stressed how important it is to take D3 starting early in the process.