Second, Third, and Fourth Thoughts.

[byako 4]

Hey folks!

So I'm kind of JUST starting out on this ride, and I'm already having yo-yo-ing thoughts about whether to have this done or not. Many of them are my own, but I've also got my father's constant disapproval buzzing in my ear about it.

I'm 30 years old with PCOS. I'm pretty sedentary, but even with my previous, highly physical jobs I've been unable to break past 220lbs. I've tried the low-carb, weight watchers, and Meal Replacement shakes, and still, that's as far as I get. I also have issues with fatigue, poor sleep, anxiety, depression, and knee pain, much of which I expect to at least somewhat improve with weight loss. So with all of this, the surgery seems like a GREAT idea... until I start thinking of all of the restrictions.

Most of the restrictions aren't really a huge deal... If I super duper put my mind to it, I can stick to all of the restrictions... when I'm in a good mood, at home, and don't have any sort of temptations staring me in the face. However, from time to time I'd like to indulge in some of those No-No foods! I enjoy baking (sweets) and love my noodles and rices (especially of the Asian variety), but these are big NO's in my program. Same goes for caffeine. I can totally switch to decaff, and some times I don't want tea or coffee at all, but from time to time I'd like to have my favorite (caffeinated) teas and boba drinks! And I am an emotional eater/drinker, so when I'm feeling down, my will does tend to bend and crack quite easily. I'm also rather worried about the issues with absorbing nutrients after surgery -- is it really so much more difficult with the sleeve?

I realize that for the first half-year at least I have to be good, and I know that this would be great for my health... but do I really have to give up on all of these things for LIFE, or can I get away with an occasional indulgence? I know at the very least they'd slow my results down... but at least I wouldn't feel like I'd sort of devolved.

[kmorri 1,689]

@@byako First I'd like to say you're doing well by really thinking about this decision rather than jumping into it without doing your research and addressing your issues with food.....The big thing to remember is this surgery does not do anything to your brain....only your stomach. It's your job to address the brain issues with therapy or whatever it takes....You must have your head in the game in order to be successful....So take your time and do some sole searching and determine if you're ready to make the changes necessary to be successful.

Now to address your other questions. It seems like everyone has a different plan....so try not to be discouraged....My plan doesn't have any food on a "never again" list. During the weight loss phase it's very low carb, with no breads, or starches like rice, Pasta, or potatoes.....But once I'm at my goal weight I am to slowly add in the whole grains and starches...being careful to maintain....(gotta find the sweet spot).....After goal and maintaining my weight is the scary part for me...but I'll get it figured out by the time I get there. I just don't think I'll want to add back foods that I know are a big part of putting me in this position in the first place.....we shall see!

The only things I can think of that are forever are no drinking while you're eating, always eat Protein first....and eat slowly.....and no grazing! Oh and yes taking Vitamins for here on out is required.

I hope this helps you in making your decision.

Kathy

Edited July 13, 2016 by kmorri

[AvaFern 3,516]

After you have fully recovered from surgery, you no longer have any medically-required restrictions. There is literally not a single rule I can think of that if you break you will actually physically hurt yourself. There are plenty that will just make you fat again, which isn't the point either, but no, the sleeve is great because it allows you to be a normal person and eat normal food.

For example, the other poster noted you can't eat while you drink. Yes you can. I was not willing to have a dry mouth with food for the rest of my life and the only reason they tell you not to drink while you eat is because it washes the food through your stomach faster so you eat more. It doesn't hurt you it just makes you lose less weight if you don't pay attention to what you're eating. You also don't HAVE to eat Protein first- it won't kill you to eat a piece of cake for dinner sometimes. You can drink with a straw...in fact a straw is a really great way to get all of your fluids in after surgery when drinking without a straw makes it feel like you're swallowing rocks. I do agree that you should take Vitamins. If you miss them sometimes, no biggie, if you don't take the bariatric ones after the first few months, this is fine too, but B12 especially is important because your stomach no longer helps produce this and you have the potential to end up anemic without a supplement. I have forgotten my B12 for months at a time and my blood values are always fine...but based on science, you need to take that one- the rest are negligible but again, based on evidence, you do need to take Vitamins if purely because right now that is what research says is best. I haven't found I do better or worse with vitamins- my body processes food fine without them, however while I am 3 years out and feel like I know it all, I also recognize that in 5 years this may no longer be the case so I take vitamins now even if I don't see them as being overly helpful. I take the ones that don't make me feel sick and that I like, which would not be the gross bariatric ones they tell you you have to take.

Past that in terms of food, after your stomach is healed you can medically eat whatever you want. If you eat too much or you eat too quickly, you're probably going to get sick and barf. You're only hurting your own ability to lose weight- once you are healed, you aren't physically hurting your stomach, you're just going to make it mad and it will respond by making you feel like crap. That's about the extent of what happens when you eat garbage. I have a sleeve that doesn't really like fried food, cream, sugar, or oily stuff...she pukes when I try to feed her those things, but gradually I have learned that I can still have a few bites, slowly, and I'll be fine. I just can't go eat half a burger anymore and expect it to go well. Most people though are able to tolerate the majority of foods just fine, which again, before surgery I can see as being important, but after surgery, it's really kind of a blessing to not be able to eat foods that make you fat. At almost three years out, this week I have not eaten very well at all. I had dental surgery, which seems to be an ongoing miserable process until it's all finished. My mouth hurts and I'm cranky, so I've had some Peanut Butter and jelly, a few half-cups of corn chowder from Panera (which I usually avoid because of the cream), a few sushi wonton thingies from the grocery store, and a few other things that are soft and which I don't generally eat a lot of. I haven't gained any weight (I weigh every morning) and the calories I'm eating are really not much more than usual. My sleeve has not remotely prevented me from eating anything I've felt like eating this week, but my head has kept me in check. There is a sandwich in my fridge that looks really good and is probably soggy because I left it in there overnight...before the sleeve I would have eaten it because I didn't want to waste it and today I'll probably throw it out. I have a bag of candy in my pantry leftover from Easter of which I haven't had a single piece and a little bit of sorry for myself sugar might be nice, but really, I don't have any interest in eating it because it will either still be there tomorrow if I want it, or I can always go get more.

After awhile the idea is that you recognize that if you want to have a brownie, you can, but you think, eh, I don't really want it. If you want a few bites of cake, you can eat some, and then go back to munching on veggies at a party. If you want to have some food at a BBQ, you eat the meat, or 1/4 of a burger with a roll, and then you don't feel the need to eat half the macaroni salad too. The sleeve does not prevent you from eating whatever you want whenever you want after a year or two, but it teaches you that you don't need to eat as much as it seems like you want because you can stop at a few bites and be completely content. Had I said that three years ago I would have thought it was hysterical, but I am now the person that can have a bag of Cookies in the pantry, eat only one of them and then forget that they are there. The goal is to be thin and while you CAN eat whatever you want, this does not mean that you SHOULD and if you do things right, in the end, hopefully you decide that even though you can eat something, you have no real desire to. It may not sound like a win at the moment, but I promise it is.

[Christle810 3]

Kathy made some good points. I am scheduled to be sleeved on August 24th. I am an emotional eater too but slowly over the last few months I've given myself "food funerals" (one last time foods) and staying away from them from then on. I don't drink coffee anymore. I do have tea but Decaf. (Many great flavors).

It's something you will need to mentally prepare for. I start preop on August 10. I've already started with just having a Protein shake for Breakfast. ( Aware: only a few Protein shakes are good, premier and muscle milk light are my two faces)

I am no longer doing pastas, potatoes only veggies and meat. My hardest battle will be a couple foods I enjoy eating everyday, Cinnamon rice pudding and Noosa yoghurt ???? I will miss these but later maybe the yoghurt I can add some back in.

After the surgery your body may react differently to food too. Some people have no problem eating what they want but others can't eat certain foods at all. I.e sugar

Once you stop eating the sugars and starches and heavy carbs within a week or two it will be easier.

There are tons of recipes out there. Pre-op diet will depend on your doctor. Amazing how different they can be.

11 days I am on a strict diet but luckily I can have foods I enjoy. Plus for the sweet factor we can have sugar free Jello and pudding. Then the last two days uo to12 hours before surgery it's liquids only. Protein Shake, broth, Water, sugar free Jello or popsicles.

You will and MUST take Vitamins the rest of your life. You can learn more about those if you choose to do the surgery.

There is so much more but that's why it's important to do your research before jumping in.

I am going to ALM, Dr Ortiz in Tijuana. My insurance puts me through the ringer and still has no gaurentee so for me this is the best option.

Good luck!

Sent from my XT1080 using the BariatricPal App

[kmorri 1,689]

@@AvaFern I agree. Even the things I mentioned as "forever" is just stuff that is indicated as "forever" on my plan....other than the Vitamins breaking the rules after you have completely healed won't "kill" you....but could very well make you fat again.

[erp 2,016]

@@AvaFern is completely accurate. However many of us don't have healthy relationships with food. So while none of those things like eating and drinking will kill you, many of the rules are in place because of our unhealthy behaviors with food.

OP, I think having doubts is good.

What you haven't mentioned is what you will do differently, beyond surgery to be successful. Will you start exercising? I did, I even hired a trainer to help me get started. Will you work with mental health professionals? You may already based on your anxiety/depression- so how about your emotional eating? Will you bring support people into your life? I still go to support group meetings a few times a year.

Doubts are good. They mean you need a plan. Go make one.

[KristenLe 5,979]

@@byako It's great that you are getting answers to some important questions. I also have PCOS - and wish I had made the decision to have surgery at your age. I too thought I could do it on my own - and I did lose several times - only to gain back even more. I eventually developed hypertension (in my 30's), pre-diabetes, high cholesterol, high triglycerides, sleep apnea, depression, joint problems, degenerative disc disease, and other obesity-related problems. It was only a year ago I was still saying I could do it on my own. I couldn't! Sadly, statistics show that only 5% of morbidly obese people who lose weight on their own keep it off. I decided my best chance at living was to have surgery. I pictured myself riding around in a hoveround by my 50th birthday at the rate I was going! :-( PCOS makes it even more difficult to lose weight. If you wish to have children in the future - you increase your odds significantly after WLS (resolves PCOS symptoms). I waited to do something about my weight and won't be having children (which sometimes makes me sad).

In terms of what you have to give up - there's not much and you most likely won't miss those things you do need to give up (or at least limit). The only thing I was told I should "never have" was Pasta, rice and bread. I actually think that's over-conservative and I could have them at some point - but even if I can't - I can live with that. Even losing weight on your own - you'll have to give things up - or you won't be successful! Eventually, with the Sleeve, you can eat most all foods - just limited amounts. The pay-off is worth some sacrifice!

Good luck in your journey - no matter what you decide!

~Kristen

I forgot to add the importance of dealing with emotional eating (regardless of whether you get WLS or not) - I started to see the psychologist at my Bariatric Center to address these issues and found that it helped tremendously (in more aspects than just emotional eating).

Edited July 13, 2016 by KristenLe

[theantichick 2,204]

As I haven't had the surgery yet, I can't comment on any of the after stuff.

I can share my thought process in getting to the decision, and hope that helps. First, if you recognize you have issues with emotional eating, I strongly recommend seeing a therapist. I'm seeing one because I have some trauma to deal with around food, in addition to being a stress/emotional eater. I knew that whether or not I have the surgery, I need a healthy relationship with food. It's really helping me work through some of those issues.

I'm a nurse, and know a lot of people who have had bariatric surgeries - lap band, RNY, sleeve. Many of those people had complications and problems, and a few have been really successful. I have successfully lost 30+ lbs with diet/exercise in the past and kept it off for a few years, so I believe I could be successful without the surgery, so I was seriously on the fence about it. My therapist also had the concern that I'd be trading one set of issues with food for a surgically imposed eating disorder, and that was a serious concern for me.

That's really where the fabulous people here on BP helped me. I and my therapist both had the idea that the picture of highly restrictive and controlled eating was the life-long picture after sleeve. Many of the vets here shared what their life and diet looks like 2, 3, 4+ years out, and it's actually pretty normal. Diets range from about 1,000 kcal to about 1,800 kcal (women), some are low carb, some are balanced carb to Protein, and most eat "treats" when they want. Certainly not a picture of disordered eating. What struck me most was that almost to a person, the only regret anyone shared was that they waited so long to do it.

I was still on the fence, until a conversation with my rheumatologist. I have auto-immune arthritis, and I was not aware that the surgery itself would make huge improvements in the hormones that drive both hunger and cravings, but also inflammation that worsens my condition. Then, losing weight will reduce the stress on my joints as well as further reduce inflammation. I know historically many of my health concerns have worsened with my weight gain, so things like my asthma and Migraines will improve as I lose the weight as well. So while the surgery and weight loss will not cure my auto-immune, it can vastly reduce the severity and help the meds work better.

So I went to a seminar with my surgeon, and started doing some research in the medical journals. We're learning so much about weight gain and why it's so hard to lose. It's a serious uphill battle for anyone, fighting setpoint and cravings and metabolic rate slowing. In my situation, the pain and fatigue from the auto-immune and my other chronic conditions make it even harder. So the surgery gives me a tool to help make it a little easier, especially at the beginning when I'm trying to gain momentum with all of these lifestyle changes. The surgery alone isn't enough, but it can be the edge I need to be successful long term this time.

My parents will support me, but they are against the surgery. My Dad thinks I just need to buck up and have willpower. Mom is worried because my older sister who had the sleeve has a huge number of health issues, and Mom incorrectly associates them with the sleeve. Some of my closest friends are concerned because we have a friend who died several years after having bariatric surgery and they believe she had nothing but problems after the surgery which eventually caused her death. As a nurse, and now with the research I've done, I do not believe the surgery was a significant factor. I understand and appreciate their concern, and am grateful that they'll all support me whatever choice I make. But I know it's hard to hear so many voices saying "don't do it".

I think a lot of people go into this thinking the surgery is a magic bullet, and they won't have to make huge changes in order to get healthy, and that they set themselves up to fail. I know I went back and forth for a long time about it, and know that it's not a magic bullet, just a tool to help the process. Right now I'm just trying to keep my chin up through the insurance nonsense, and am hoping for a quick approval and surgery in August.

Keep questioning, investigating, and learning. Start doing the work needed to move to a healthier place, because you'll need it whether you decide to have the surgery or not. And best of luck!!

[byako 4]

Thank you all SO much for the responses! They are fantastic and have definitely reassured me! Like I said before... I don't NEED or even PLAN to have or do any of these things often, but it's honestly the option of being able to that means more to me.

I've seen our program psych, and he's given me a referral to see an additional one, so I do plan to do that. I'd also like to get into exercise, but at the moment I have pain that is stopping me. I haven't been to a support group yet, I've been missing them, but I'm planning to hit up the next available one. Sadly, my father is very much against this surgery, and quite unsupportive, but my friends are still backing me for it, and BP is turning out to be an amazing resource as well.

Again, thank you all so, so much for your responses!!