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Easy Way Out Statement
eat less
exercise often
With surgery, you only have to do one thing:
pay a surgeon to make you lose weight
Well, perhaps that's a minor oversimplification. There are a few other steps, but they are tiny and insignificant. Not everyone has to do them either! But, just for the sake of objectivity I’ll list most of them that I can think of. (I might miss a couple, but since surgery is the easy way out who cares really.) Let’s see, there is:
Convince yourself that you want to do this. This is much more complicated than it seems, so take your time. Don’t get sick before you make a decision.
Convince your doctor that this is medically necessary. Convince him/her that you really do want this and you aren’t just someone unwilling to sweat a little. Convince them that you won’t die on the table. Convince them that you aren’t doing this so you can keep eating cake for breakfast. And lunch. And dinner. Because that’s the only reason big people are big people.
Spend anywhere between 3 months and a year working with your PCP to make a preliminary run at losing weight. This should include:
A special diet
Exercise
Constant office visits to measure progress
Significant expense to participate in the diet (Nutrisystem, Medifast, and Jenny Craig, I’m looking at you!)
Lots of documentation
Likely (if not anticipated) painful, humiliating failure (PS, this is a requirement!)
[*] Spend hours to days or more working with your insurance company website, phone reps, and via letter to determine if weight loss surgery is covered at all, assuming they will admit to it. [*] Once you find out it is covered, find out what exactly is covered. Type of surgery, location, type of doctors required, pre-op programs necessary, pre-op medical requirements, pre-op diet requirements, and documentation. Make sure you understand it all clearly because… [*] Meet with your PCP to go over all of the above. Explain to them what most of it means, because they don’t understand. Make sure your work so far will meet the needs of the insurance company. Convince him/her to do the work to get the approval. If not, return to step 1 and try again. (Note: make sure you do all of this quickly- most of these rules are subject to change on January 1, even if you have a 12 month diet requirement. You’ll need to find a way to violate the laws of space and time on your own.) [*] Get a psych evaluation. People who want this surgery are invariably crazy, so we need to confirm that. Don’t use a doc you know. Go somewhere you’ve never been so that they can get that first-blush, cover of the book impression of your particular brand of crazy in the 45 minutes you get with them. Let them write their report confirming your “crazy flavor” to your docs and insurance. They will approve you anyway. [*] Take an online class that confirms the crazy diagnosis. [*] Take another online class that basically tells you if you have the surgery you will likely die horribly on the table, if you’re lucky. You might just become a vegetable and be a possibly fabulous looking skinny burden on everyone you know and love! [*] Find a surgeon that can both perform the surgery (practically, legally, and allowable by the insurance) as well as doing so without causing
Errors
Infections
Hernias
Leaks
Death
[*] Make sure that doc can take your insurance. Not just yoru insurance, but your exact insurance. This may require them to check at least a dozen contracts. [*] Do the same for the hospital. [*] Make sure that hospital you’ll have the surgery in isn’t a festering wound itself. The surgeon can only do so much if when you get to the floor you’re placed in the same bed last used by an Ebola patient with a cold and cleaned by “Blind Larry”. Fortunately there are many websites sponsored by government agencies to help you with this. They will all disagree with each other. [*] Get insurance authorization to have the surgery. Fortunately this process starts the weight loss, as one arm and one leg weigh a surprising amount when removed and given to them. This should take no more than a day or two, tops. [*] Have a discussion with your employer. Let them know that you’ll need a full week off from work in the near future. You know, when you aren’t busy and won’t be missed. Again, if you’re lucky you’ll have vacation and can use that. If not, think of how much extra weight you’ll lose when you can’t afford to eat for lack of a paycheck! OH, you may need more than a week. If you come out healthy. If not, it’ll be more. A lot more. [*] Have a discussion with your family, if you haven’t yet. If you haven’t yet, shame on you for your discretion, personal space, and recognition of the gravity of this decision. Make sure that you convince them that you won’t die, runaway with David Beckham or Eva Longoria (or both if you’re flexible), or otherwise ruin the home. [*] Get answers to all of the questions you have. Fortunately ObesityHelp is a great place for that. You will get no less than 10 answers to every question. Some may actually agree. ☺ [*] Make sure that this is really what you want. This isn’t like buying a car or getting married. This is permanent and there is no going back. Still confident this is the right choice? Now you know your flavor of crazy from item 7. [*] Go on a liquid diet. You may not have anything that you cannot “read a newspaper through”, is solid, has calories, has carbs, has protein, has flavor, or is made of a natural substance. This will last anywhere from two days to a month. Your surgeon will tell you how long. [*] While on the clear liquid diet, please try not to cheat on the diet. More importantly, please try not to defecate on yourself. Here’s a mantra for you: “Never trust a fart!” [*] Have the surgery. This will include:
Large, but not quite large enough gowns with special butt exposing panels
Freezing rooms
Needle fears
Vein scavenger hunts
Panic attacks
Several other fun moments no one will spoil for you to discover
[*] Recover from the surgery. This will include:
Amazing drugs that will make you fear for the poor 110lb nurse that will help you walk at first. Please don’t fall during this time or you will crush her. You’ll fear this, but only briefly (great drugs remember). Just don’t fall.
Walking. Yes, you’ve just had your entire insides rearranged and have more stitching in you than a rented tuxedo, but hey, let’s go for a walk. Every hour.
Eating. This is really a game. You have a 3ish ounce container that replaces your stomach. It is swollen, but you don’t really know how much. If you over fill it, you will be in serious pain, and may hurt yourself severely. Here’s the fun part- you’ll be given a selection of hald a dozen clear liquids to choose from. Some will make you retch. Some will taste like heaven. All are more than 3 oz. You- the person who’s complained that Mickey D’s quarter pounders have never once been a quarter pound – now get to determine what 3 oz looks like. Don’t forget two very important things.
[*] Going to a bathroom. The author of this article is a male, so with that perspective in mind, consider the male stereotype of urinating. Now imagine that sharpshooter in the hands of someone who cannot see straight, or single vision, is falling asleep on their feet, whose prostate is not yet awake from surgery but whose bladder most definitely is, and who is currently on their 4th IV bag of saline with lactated ringers running wide open. Don’t forget to measure your output! [*] Go home! This is the easy part. Stuff your swollen and now anesthesia free self into a car and try to avoid potholes, cough, sneeze, or breathe too hard. [*] Continue the clear liquid diet for a few more days [*] Progress to protein drinks. These are a joy. There are few if any samples, so make sure you get the 5lb bottle to be sure you love it. [*] Progress to pureed or baby food [*] Progress to cat food or tuna [*] Progress to gourmet cat food or flavored tuna / canned chicken [*] Progress to dog food or chunky soups / heavily cooked soft and unflavored chicken [*] Progress to human food. During this time you will need to learn a few things. These will include:
How to eat. Remember you’ve been doing it wrong all your life so this should be easy.
You may only have dense protein.
You must take in no more than 3-4 oz.
You must take an entire 30 minutes in which to do so.
You may not drink before, during, or after the meal.
You may not have anything spicy.
You may not have anything with carbs.
No alcohol for at least 6 months, or maybe forever.
Nothing liquid.
Carbonated anything is permanently off the menu for the rest of your life.
Nothing with caffeine.
Nothing with less than a 10:1 ratio of protein to carbs
Keep calories as low as possible.
Learn to keep something that meets all of your dietary needs handy. If you need to eat, not every place can meet your “special needs”.
Make sure that you understand that you need to do this for the rest of your life. You can’t change this. Non Surgical people can indulge once and awhile. They can cheat. We rupture.
[*] Please remember to keep your intake to levels that would make Ethiopians send you food. This is generally 800 calories, less than 40 carbs, and more than 80 grams of protein per day. You must do all of this in 3 meals with no snacks. [*] Take your supplements:
Calcium. Note that it isn’t the same calcium that you can get for a dime on any gas station shelf (Calcium Carbonate). This is a highly refined form of easily absorbable calcium (Calcium Citrate). It will come in three forms: A disgusting snot textured liquid found at Wal-Mart for $11 per week, a myriad of chewable pills that all taste like flavored drywall and cost about $20 per month, and delicious chewable candies that cost $40 per month.
Multivitamin. You’ll be doing double doses. Get the adult gummy ones. Find the ones with no carbs.
Fiber. Get the adult gummy ones. Find the ones with no carbs.
Iron. Some people will take iron. Get chewables.
B12. You can do pills under your tongue that taste like yesterday’s fish for $10/month, injections at the doc’s office every 3 weeks, or a nasal spray that costs $350/month.
Do all of the above for the rest of your life. Don’t stop or you’ll die.
[*] Start to exercise! What, you thought that you didn’t have to exercise? Yep, here’s the trick. You are going to lose weight even if you don’t. Here’s the other trick. It’s easier to take that weight from your bones and muscles if you don’t exercise, so if you don’t work out, all that’s left will be fat! [*] No really, you have to exercise. [*] Yes, that means sweating. [*] Make sure that while you’re going through this easy time in which every hormone you have is at full tilt, every part of your body looks and feels funny, nothing fits, and you generally are proud that you’re losing while also being weirded out by how different everything feels you also take into account everyone else. Remember, this is about them and how they perceive you. You can’t be the popular kid. The healthy person without diabetes, hypertension, edema, or apnea. The more confident employee. The more confident lover. The physically stronger person. The person who wants attention. The person with self-esteem. You need to apologize frequently for these failures and must work hard to gently help these people along to where they can think of you as a lesser person for altogether different reasons than they did before, to preserve their psyche. Stop making your weight loss about you. See? Even with these minor things, it’s obvious. Surgery is the easy way out. Don’t be a sucker. Be strong, and just eat less, and exercise more. It’s that simple!
You are stoned on anesthesia. Your judgment aint what it should be.
So is your stomach. It’s not going to help you by saying “I’m full” for about 2 weeks to a month.
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