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Thoughts and fears



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I am very happy to be here and have enjoyed reading this site over the past few weeks. I would love to get down some of my thoughts and hear any feedback anyone has for me. I tend to write essays so I apologize for the length.

I am scheduled to meet with a surgeon in two weeks. I also have the psych eval and nutritionist appointment as well as some medical tests that day. The hospital is almost two hours away so I'm packing as much as I can into each trip. I have bcbs fep so still have the 3 months supervised program which has not started.

I weigh 278 and have been around this weight or higher (highest around 300) for at least 10 years. I am 35, normal weight as a young child but as soon as I hit puberty quickly became obese. I am not saying it is all genetic, but I know that is part of it. My parents and brother all suffered with obesity or morbid obesity. My brother had gastric bypass surgery several years ago, and to make a long story short he had complications, and died two years after the surgery at age 30. This was not from the surgery but was medically fragile since the surgery. My parents blame the surgery although I do not. They have made it clear that they would be very, very upset if I chose bariatric surgery.

Despite this, I have considered this for years. I try to base most of my major decisions on good data. I know that long term weight loss in significant amounts (like, 100 lbs) is quite statistically improbable. I have successfully kept 20-30 lbs (back and forth in this range) off for 6 years. Despite that I am concerned about my health. I have high blood pressure and take three medications to maintain this. I am in the prediabetic range for blood sugar. I see my dad with worsening neuropathy from diabetes type 2 despite really hard work on a very low carb diet. My paternal grandpa lost 3 of his limbs from this disease before he died. Despite being fairly young my knees are starting to hurt when using stairs. I worry that I won't have very long ahead of me. I honestly have come to terms with how I look and while being thinner would be nice, that is not a major motivation for me. Sickness and early death from health consequences of morbid obesity terrifies me.

I work full time as a clinical psychologist at a Veterans Affairs. The work is my passion and I would not want to do anything else. However it can be very stressful. It is also very cognitively and emotionally demanding and therefore exhausting while being super sendentary. My salary also supports my family (son and sahd husband). I have recurrent major depression. I am doing very well, taking medication and when needed connect back with therapy. I always live with the fear of depression relapse due to fear not being able to keep up at work and how hard the last one was on me and my family (4 years ago).

Fears: will such low amounts of calories allow me to have sufficient cognitive energy to do my job well? Will the mood effects bring on another episode of depression? Should I hide having surgery to my parents, which feels dishonest, or tell them the truth and live with their anger and fear of losing their only remaining child? Will I be able to regularly engage in moderate exercise which honestly I haven't done since my early 20's?

If you made it to the end, thank you. I don't expect answers to the above questions but feels good to tell them to people who might relate. Any thoughts welcome. Any experiences of going through this while maintaining a demanding job are appreciated.

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Hi Caitlyn! I don't have magic answers. What I *can* say is that I'm struck by how you have a very realistic handle on your situation. That's just impressive, and it says to me that you are well on your way to success. As far as the job, I'm only 3-1/2 weeks out and returned to work today (at home, just reading and answering my mails from the last few weeks). I didn't notice any particular cognitive fuzziness. As far as the mood effects, I do read that some people have them, but after the first few days of being a little freaked out, I haven't had any problems. As I said, I'm only a few weeks out, but I feel like I'm doing well!
You are intelligent, realistic and positive: try to have faith in yourself. Please keep us posted! [emoji8]


RNY 14 April 2017
SW: 295 lb / 134 kg
GW: 187 lb / 85 kg (I'll see when I get there)

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I think who you tell is your business. It's your life, you body, your future! Not telling is not being dishonest in my opinion.

As far as energy, I had my sleeve on a Wednesday and was back to working on the following Monday. (Sedentary job here too). I was only tired the first two days and I feel the majority of that was due to anesthesia and the lack of sleep I got the days leading up to surgery.

I was around 366 at surgery (392 at my highest) so quite a bit larger than you... But once I dropped down to around 350, my energy definitely went up and I started moving more. I started walking before surgery and try to get a minimum of 1.5-2 miles a day. I wasn't expecting to run a marathon immediately , I just know I have to keep moving, whatever that may consist of.

I will say for the emotional aspect, my hormones have been a roller coaster at times. I was told this was due to the release of hormones as the fat drops off. I went through an acne stage which I have never dealt with before and I have had some major mood swings from time to time. More impatient/angry than depression for me.

I'm reaching 3 months out next week, so no expert at all. Just sharing my experience so far!

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First if all let me say I'm sorry for the loss of your brother.
I also agree that you have a good hold on your situation and a good attitude going in.
With that said, the most important thing I can say is , you have one life to live, and you have to do what us right for you. I can understand your parents fears but when it comes down to it, you have to live in your body. No one but you . I am a firm believer that you must do what makes you happy first. Your health takes precedence over everyone's feelings, thoughts, concerns, fears and anxieties. If you fell this is right for uou, then go for it. Save your life and your health because you never know what age your parents are going to live to be and you just might be taking care of them at some point. And you don't want to be overweight and sick and regretting that you didn't take this route.
If it is easier , do not tell them. Just do it and when they start to notice, just say, I have been going to a nutrionist and she is really helping me make progress. Sometimes it's best to not tell your parents everythung. I am struggling right now because I cannot tell my sisters. It's hard but I made this decision and my husband supports me 100%. I have told no one else but a niece who had the surgery. No one in my family knows, none of my friends know. I don't owe them any explanations or need their approval. It's my body. My parebts,are deceased now for overy 25 yrs. My mother was always overweight and struggled. If she were five today she would have had the surgery first.
Next, give it to God. Pray and have faith. If it's right the path will open. Follow your heart and you can never go wrong. God Bless.

Sent from my SAMSUNG-SM-G900A using BariatricPal mobile app

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You have good insight toward yourself, but it sounds like your job takes a huge toll on you emotionally, mentally and thus physically.

Ask yourself where you will be in 5-10 years if you don't have the surgery? Can you sustain the job stress along with regular life and deteriorating health?

Don't tell anyone you don't want to tell, that may sound harsh but self preservation takes precedence over being judged for a decision you really need to make without feeling as if it would hurt them more, but it actually hurts you more.

Good luck in your decisions. Let us know.

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It is nice to see someone well informed.

Don't tell you parents. You don't have to, it will make them stressed out and unhappy and add stress to your life.

If you suffer from depression and take medicine for it then you need to discuss WLS with your Psychiatrist. WLS is very taxing mentally. You need a good therapist and a lot of support. The hormone dumping and all the changes your body goes through is really rough. Increased depression to the point of having suicidal thoughts is a real possibility.

You only eat a limited amount of calories for a short period of time. You will have enough energy. You body will burn the fat is has for energy and the Protein and other foods you eat will fuel you.

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You're getting good advice in this thread. In addition, you sound extremely well informed about the surgery, grounded in your expectations as well as attuned to your own body. recipes for success in my mind.

Dont tell your parents if you think that will cause an undue amount of stress for both you and them. You're still a few months out from surgery, so you can reevaluate this strategy at various points in your journey. My advice to you at this early pre-operative stage would be to focus on your own needs. I posed the same question to this board when I was pre-op and it was recommended to me that I re-evaluate telling my parent (who I knew would freak out and be unsupportive) once I had a surgery date. Ultimately I chose not to tell and I'm pleased with that decision. I'm 10 months post op now.

My chosen field (journalism) is also intellectually demanding with longgggg hours, many spent sitting and writing. But it's also personally fulfilling, I know I'm serving the greater good and not many people are cut out for performing the job at the level I've attained. What's amazing is that I made it as far as I did while morbidly obese, which I fully know was holding me back. Not only do employers inherently trust and respect me more now that I'm thinner (not saying this is right, it isn't) but I simply have more intellectual and physical energy since regaining my health. It feels like my synapses are properly firing for the first time in years. I honestly think I had fat brain in retrospect, that sometimes my thoughts were sluggish.

That said, I also have experience with depression. There were times pre-op when I would cry everyday. I struggled to get out of bed and go to work in the morning. As a psychologist yourself, I don't have to tell you the importance of discussing this with your physician. What I can say is that for me the increased energy and activity levels have helped improve my mental health across the board. I went through some really difficult personal stuff over the last few months, unrelated to surgery, and the newfound mental acuity combined with therapy and medication helped keep me from slipping into a deeper state of sadness. I honestly felt better equipped to handle life's obstacles and the reason for that, I think, is the confidence that comes from knowing I have taken charge of my health in a way most people never do in heir lifetime.

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Oh and meant to add- about 2 days after surgery I felt 100%. I went back to work quickly. But at some point in that first 10 days or so I was suddenly hit with extreme fatigue and had to spend 1-2 days resting and catching up on sleep. Luckily I had a very flexible work schedule at the time, but do know that even in a perfect, easy recovery like I had you still need to rest when your body tells you.

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Thank you all so much for the outpouring of support, it means a great deal to me. I'll have a longer reply when I have more time but I wanted to share my appreciation.

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It sounds as if you have a good handle on this. I'm 10 months post op and would do it again, but years earlier than I did. I had surgery on a Tuesday and returned to work the following Monday. My work is also cognitively demanding and I was tired the first week, but able to keep up. I believe staying busy helps me heal and it was a good decision for me; although your caloric intake will be dramatically reduced if you have surgery, you will be able to feed your brain. You will notice a reduction in energy level, which will increase over time.

With weight loss you will be able to participate in exercise as your body mass becomes more manageable for your joints. The amount of exercise will depend a lot on your discipline and commitment.

I had a very easy recovery and was able to achieve a healthy BMI with surgery, diet, and exercise. For me, the surgery wasn't a magic trick but the tool I needed to be successful with diet and exercise. Unfortunately I still have high blood pressure but it is lower than it was before surgery. My other health related issues have resolved.

Good luck!

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