Questions/concerns about the lifetime commitment...

[theantichick 2,204]

@@theantichick So, long story short, the most experienced surgeon is not necessarily the best choice in every circumstance

This is absolutely true. I have worked around enough doctors to get a feel for their competence from talking to them. My surgeon was teaching at a university medical center until she was hired away by the physician group my rheumatologist is in. I found a paper she co-authored that reinforced my opinion after speaking with her. And from what I've been able to find, the "rock stars" don't do most of the surgeries at their centers, they oversee young docs starting out. So even going to one of those clinics doesn't guarantee you anything. Not to slam the other guys, I'm sure they are also great. But this one is in the group with my rheumatologist, and is across the street from my office, so it's super convenient as well for appointments and support groups.

[Inner Surfer Girl 12,015]

@@theantichick just so you know, I let my sister pick my surgeon for me. She's a physician and I trust her judgment. She researched the four bariatric surgeons practicing in my town and said my guy, who had the least experience, was the best choice. She spoke to personnel at the hospitals where these surgeons practice and they all had terrific things to say about him -- and my sister also pointed out to me that as the person who was most recently in medical school and residency, he was the one trained in the most up to date techniques and practices.

Anyway, I had a fantastic experience, at least as fantastic as major surgery can be. I had a very quick and easy recovery and zero complications. I absolutely adore my surgeon and have recommended him to three other people who all had similar experiences. So, long story short, the most experienced surgeon is not necessarily the best choice in every circumstance

One of the reason's I felt really comfortable with my surgeon was that he was old enough to have a lot of really great experience/track record and young enough to be current.

[VSGAnn2014 12,992]

@@theantichick just so you know, I let my sister pick my surgeon for me. She's a physician and I trust her judgment. She researched the four bariatric surgeons practicing in my town and said my guy, who had the least experience, was the best choice. She spoke to personnel at the hospitals where these surgeons practice and they all had terrific things to say about him -- and my sister also pointed out to me that as the person who was most recently in medical school and residency, he was the one trained in the most up to date techniques and practices.

Anyway, I had a fantastic experience, at least as fantastic as major surgery can be. I had a very quick and easy recovery and zero complications. I absolutely adore my surgeon and have recommended him to three other people who all had similar experiences. So, long story short, the most experienced surgeon is not necessarily the best choice in every circumstance

One of the reason's I felt really comfortable with my surgeon was that he was old enough to have a lot of really great experience/track record and young enough to be current.

Sounds like my surgeon.

BTW, hubby and I are both in our 70s. We have a rule here -- no doctors older than 49. They're old enough to know what they're doing and young enough to know the newest stuff.

They're also going to have to be in practice as long as we will be seeing them. Over the next 20 years, we won't have the patience or brainpower to groove in any new ones.

[~Pam~64~ 15]

This is a great post. I'm having some of the same feelings.

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[Heidi.E 10]

I am loving this post and all the responses.

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[AvaFern 3,516]

I can appreciate the lifetime commitment fear, but it's kind of like getting married to your best friend- the best friend who isn't a doormat and periodically puts you in your place. You aren't sentenced to a life of drudgery and misery, just a life of balance that pre-marriage might have made difficult.

To get out of my analogy, I've had my sleeve for 2 years and 8 months and I was also afraid of the forever commitment. I can completely say though that this isn't something I regret and I ended up with a sleeve that still makes me puke a few times a week because it doesn't like oil, sugar, or milk. Most people have about a year of major restriction, a year of not being able to eat certain foods, and then they pretty much either learn to stick with the small portions diet naturally or they learn to eat around their new stomach. I know that I can eat Wheat Thins by the box without ever feeling sick, so I just don't buy them. I know that my stomach doesn't love sugar in baked goods form, but it is just fine with chocolate, so I don't eat that either because I just really don't have a craving for it any more and being thin is better than eating Peanut Butter cups.

At this point, I still put my food in MyFitnessPal, but it's mostly because I've been on like a 250 day streak and I don't want to mess it up. I don't ever look at the nutrition section anymore and I rarely pay direct attention to the calories I'm eating. Sometimes I will gain a pound and then I pay attention to what I'm eating for a few days and I drop right back to where I was, within 2-3 pounds of goal. Our bodies are kind of awesome in how they learn to adapt. People have been having their stomach cut out for other reasons for decades and yet we don't generally read stories about how they are forever stuck eating tiny portions. They learn to eat more slowly, but you can still pack in a ton of calories eating slowly. Your stomach also learns to adapt to its size, so most people don't get sick or overly full after a year or two.

The whole idea of the sleeve is that you get about a year to change your life, and after that you can pretty much go back to old habits or have a brand new way of living. As far out as I am, I still pay attention to what I eat, but in the way normal people who don't eat entire boxes of brownies in one night pay attention to what they eat. The sleeve has given me the freedom to think about something other than weight. I was just thinking this morning about how my entire life is different because I don't have to wake up every morning and think about how I'm going to lose weight. I don't dread stepping on the scale, but I do every morning because it is a great way to stay on track. For the first time in like ten years I can focus on a future that doesn't involve being fat, spending all of my time trying not to be fat, and telling myself that when I am thin, THEN I will deserve to do something other than workout and starve.

The sleeve is as much of a lifetime commitment as a modern marriage. You can stick with it, get through some rough Patches, and often find yourself better off in the long run, or you can get a divorce after a year or two and go back to the single way of life. You aren't signing a "til death do us part" deal when you get a sleeve because you will be able to eat around it and do whatever you want with your diet eventually. It's more of a "if you love and cherish me, I will love and cherish you" kind of deal.

[VSGAnn2014 12,992]

@@AvaFern ... that's an awesome metaphor and an awesome post!

Thank you.

[Talaria 50]

I had the same issues (angst over the permanence of the surgery plus the lifetime changes) then a few days ago I finally realized something: My pre-op life was big giant mess of disordered eating. Will I ever eat "normally" post-op? Not technically, but I never ate "normally" prior. This way of eating has me feeling in control and will improve my health, though.

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[theantichick 2,204]

The sleeve is as much of a lifetime commitment as a modern marriage. You can stick with it, get through some rough Patches, and often find yourself better off in the long run, or you can get a divorce after a year or two and go back to the single way of life. You aren't signing a "til death do us part" deal when you get a sleeve because you will be able to eat around it and do whatever you want with your diet eventually. It's more of a "if you love and cherish me, I will love and cherish you" kind of deal.

I get what you're saying. I guess extending the analogy, I'm trying to find out if I'm marrying a decent guy, or a psycho.

[cpil15 2]

@@theantichick

I'm glad your are putting time in with your therapist before making a decision about your health. I don't see your post as critical of surgery at all. Doing your research has you on the right path.

Here is my thought's..Most of us have an eating disorder that got us to the point of surgery. You only get out of surgery what you are willing to put into it. I don't put much faith in statistics. Success is up to you.

I am almost 2 years out. I had a good nutritionist and aftercare/education. Learning to eat healthy was eye opening for me. I now look at food as fueling my body. ( A big change in my relationship with food) Cooking has become a norm. food is still wonderful and flavorful. Here is a link to my nutritionists recipes. She gives a great cooking class in my area. Hope it gives you an Idea of what meals will look like.

http://insidekarenskitchen.com/bariatric-friendly-recipes/

That learning phase..Yes I tracked and had to think about Protein etc.

Since I've been in maintenance, My food choices are now automatic because I'm so accustom to eating healthy. I do not think about every bite (Quick meal for me is chicken fajitas - the family has the tortillas. I don't ). I have times I indulge. Just means I put some extra time in the gym if the scale moves up.

My number one priority is getting out and living life.( not planning meals and gym time) So many things my body kept me from enjoying. I don't take my health for granted. I'm making up for lost time

I really like your response. I was not able to lose the weight I needed to through "dieting", healthier choices or appetite suppressants. I was to the point of not being able to walk for exercise due to severe back pain.

I had GB on 4/4/16 and I am down a total of 38 pounds from my highest weight. The "restrictions" are far outweighed by the benefits of having the GB tool on my side. I no longer have the back pain at all and am able to now walk 2 miles a day and working on adding more walking each day.

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[cpil15 2]

@@theantichick First I think it's great that you're putting a lot of thought in this before committing.

For me the lifetime commitment is what I want! I want a tool that will help me the rest of my life. I don't ever want to go back.....

Good luck. I know you'll make the right decision for you.

Kathy

Same here! I was looking for a tool to help me get back to healthy and be able to stay there for the rest of my life.

I am not quite to three weeks post-op and already feel so much better. No more back pain. I sleep thru the night almost every night and the best of all is my husband says I don't snore anymore so he is much easier to live with too.

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[Inner Surfer Girl 12,015]

One thing that may help you keep things in perspective that my surgeon explained really helped me:

Our bodies are very well adapted to a world where famine is rampant. We are designed to survive times of extreme famine. We are not designed to survive perpetual feast/times of plenty. Our modern world is killing us: cheap, easy, low nutrition food available in large amounts at every drive-thru.

For me, the surgery felt like it was the best chance for me to adapt to our modern world. Basically, one way I look at it is that my stomach is now the proper size for the modern world. (My old stomach was the right size for my distant ancestors' world.)

[cpil15 2]

First, thank you all so much for the support and feedback! When I stopped to re-read it before I hit post, I was concerned that it was going to be perceived as surgery bashing and I'd get a ton of negative feedback. But this is really my main concern, the ongoing changes to my life, and what my life will look like 10 years from now.

I'm a nurse, and underwent a massive knee reconstruction in 2008 which involved 4 months direct physical therapy and another 14 months rehab on my own at the gym. So I know the things to check on a physician, how to choose a physician, what kinds of complications are possible and what can be done to prevent some of them (not all, unfortunately, but life is a risk). The surgery itself and the post-op recovery don't scare me at all. The pre-op diet scares me more, because I know myself and that I'll really struggle through that part.

I also know that losing the weight is not optional for me at this point. I have 155 lbs of "excess body weight" by the official surgeon's calculation. The weight I ideally want to lose is actually about 125 lbs. I have sleep apnea and an auto-immune arthritis (psoriatic), as well as high cholesterol and borderline high blood pressure. My rheumatologist says the surgery would immediately change some of the hormone production that directly drives the inflammation with the psoriatic arthritis. Not that it will cure it, but it can definitely help the meds work better. I am so out of shape that only a few minutes of walking tops out my training heart rate. My therapist is trying to get me to embrace the "health at every size" concept, but I am not healthy. Nowhere close. While I'd love to be able to shop in "normal" clothes stores, the aesthetics are really not that concerning for me. I want to be healthy again, period. I want to go dancing and get back in a belly dance troupe and be able to do anything I want to (within the limits of the auto immune condition).

I also know that losing weight, whether with or without surgery, demands permanent lifestyle changes. Hence the work with the therapist.

I've been on diets off and on for over 30 years. Obviously that hasn't worked. The best I've ever been able to maintain was a 35 lb loss for about 2 years. (I only had about 45 to lose at that point). Which was great, I don't want to belittle it. But bottom line, it wasn't long term. I gained it back, plus another 100. I just want to make the best decision, and timing matters now because of the treatment plan for the auto-immune. If I were looking at this clinically on behalf of a patient, I'd recommend the surgery. My head's there. I just know how important of a decision it is, and need to know it in my gut as well.

I was also diagnosed with psoriatic arthritis prior to GB surgery and I am almost 3 weeks post-op and the pain has decreased immensely for me. My back pain has almost completely stopped. I am now able to walk two miles a day with no back pain. Prior to surgery I could not walk more than a 100 yrds before it was intense pain. I was not able to load or unload the dishwasher or cook dinner for my family without the intense pain.

I hope this helps you. I had no other health problems just the arthritis. It helps me to be able to relate to others in a similar situation.

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[theantichick 2,204]

I was also diagnosed with psoriatic arthritis prior to GB surgery and I am almost 3 weeks post-op and the pain has decreased immensely for me. My back pain has almost completely stopped. I am now able to walk two miles a day with no back pain. Prior to surgery I could not walk more than a 100 yrds before it was intense pain. I was not able to load or unload the dishwasher or cook dinner for my family without the intense pain.

I hope this helps you. I had no other health problems just the arthritis. It helps me to be able to relate to others in a similar situation.

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Thanks! Good to hear from other PsA patients who saw improvement. Apparently there's a number of reasons for the improvement beyond the weight loss alone. Which has figured greatly into my decision to have the surgery. My mom thinks it's a bad choice, but she'll support me in my decision. My husband and daughter are 100% behind me, as are my group of chosen family. Now it's just all the insurance hoops for 3 months.

[cpil15 2]

I was also diagnosed with psoriatic arthritis prior to GB surgery and I am almost 3 weeks post-op and the pain has decreased immensely for me. My back pain has almost completely stopped. I am now able to walk two miles a day with no back pain. Prior to surgery I could not walk more than a 100 yrds before it was intense pain. I was not able to load or unload the dishwasher or cook dinner for my family without the intense pain.

I hope this helps you. I had no other health problems just the arthritis. It helps me to be able to relate to others in a similar situation.

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Thanks! Good to hear from other PsA patients who saw improvement. Apparently there's a number of reasons for the improvement beyond the weight loss alone. Which has figured greatly into my decision to have the surgery. My mom thinks it's a bad choice, but she'll support me in my decision. My husband and daughter are 100% behind me, as are my group of chosen family. Now it's just all the insurance hoops for 3 months.

It will be here before you know it. I hope things fall into place for you and the surgery brings you relief.

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