Alex Brecher

I am aware of some supposed plastic surgeons operating in TJ that do not have a license to practice (any) medicine, let alone plastic surgery! One of them dropped out their last semester and has been taking training courses for years. When you walk into his office he has literally hundreds of "diplomas" hanging on his office walls from courses he's taken over the years. It's actually Tuesday late noon. I will most definitely keep you updated.

Great question! I've been hesitant to partner with just any plastic surgeon in MX. There are many to choose from but not many that are 5 star. I have a meeting with whom I consider the #1 plastic and reconstructive surgeon in Mexico tomorrow. She's operated on hundreds of post-WLS patients and is a super surgeon. If all goes well, we will start working with her shortly. Stay tuned for further info.

Obesity: Major Factor in Infertility About 1 in 8 couples has trouble conceiving and carrying the fetus to term. The rate is far higher among overweight men and women. Obesity causes hormonal changes in both men and women. In men, obesity can lower testosterone levels and make sperm less healthy. The result can be trouble fertilizing the woman’s egg. In women, obesity can lead to a disturbed menstrual cycle. Even when obese women have regular ovulation, they have a lower chance of establishing a pregnancy. If they do, they may have insulin resistance that can cause miscarriage or other harmful outcomes. If you are overweight, you may have tried to become pregnant for years without success, or without being able to carry a healthy baby to term. Fertility treatments such as IVF can help, but your chances of success are lower when you are obese. Obesity and Pregnancy: A Dangerous Mixture Obesity can also make pregnancy more dangerous. The mother is more likely to have gestational diabetes and preeclampsia, or high blood pressure and damage to the kidneys. There is a higher risk of C-section delivery, overdue delivery, and infections. Your child may be at higher risk for birth defects, obesity, and diabetes later in life. Weight Loss Surgery to Achieve Your Dreams of a Healthy Family If you are dreaming of starting a family or adding to yours but you have been unable to, obesity may be getting in your way. If you have tried other weight loss methods and none have worked for you, WLS may be the answer. As long as you follow the necessary diet, WLS can help you get your weight down to a level that can support a healthier pregnancy. Weighing the WLS Decision Should you get WLS to improve your chances of being able to have a baby? It might be a good option for you if you meet the criteria: for example, if you have not been able to lose weight and keep it off with diet and exercise alone, if you meet the BMI requirements for WLS, and if you feel ready to commit to the required diet – for life. The next question is the same one faced by all WLS patients: which type of surgery should you get? Just like any other WLS patient, you have to make the decision that is best for you. The lap-band has the advantage of being completely adjustable, so you can get it loosened while pregnant in order to get more nutrients. However, many gastric sleeve and gastric bypass patients have healthy pregnancies, too. Finally, consider the time-frame. You should wait at least 12 to 18 months after surgery before planning to get pregnant. That’s because you are better off getting pregnant after you hit goal weight. As soon as you get pregnant, you will need to stop losing weight if you want to support the baby’s proper growth and development. Supporting a Healthy Pregnancy: Don’t Let down Your Guard After weight loss surgery, it is harder to get in all of your nutrients. Plus, surgeries like the gastric bypass can reduce nutrient absorption. To make sure you are staying nourished and providing the fetus the nutrients it needs for development, you may need a prenatal multivitamin and mineral supplement, plus additional vitamin D, vitamin B12, iron, folic acid, and calcium supplements. The amount of weight you gain is critical, but it may take some mental preparation to allow yourself to gain weight after the 12 to 18 months you just spent working to lose weight. Also, be aware that you may still have a higher risk for complications if you are starting your pregnancy at an overweight BMI. Your ob-gyn should monitor you carefully. You may need to educate your ob-gyn if he or she is not used to caring for WLS patients! A Healthy Foundation for Years to Come Of course, a healthy family isn’t just about the newborn. With WLS, you may develop long-term healthy habits that your children will pick up on as they grow up. You can teach them to love healthy foods and to beg to play outdoors – with their active parents! Some WLS patients get off track after hitting goal weight because there is less motivation and excitement during the maintenance phase. You have the advantage of having plenty of motivation. How much more motivation do you need than having many more healthy years left to enjoy your family and watch them as they fit the healthy habits you modeled for them into their own lifestyles? There are almost unlimited reasons to get WLS, and one of them is starting a family. If that’s one of your goals, talk to your doctor and surgeon about it. You may be able to achieve this dream more easily than you had dared hope.

Before and after comparisons come up all the time. There are the before and after pics, of course, showing how you looked before WLS compared to how you look now after coming so far. Then there are the comparisons like how much weight you lost, how many inches, and which new activities you can do now. Here’s a fun thing to compare before and after weight loss surgery: your kitchen. There may be a few of us whose kitchens have always been well stocked with healthy fare and free from packaged treats, but I think there may be many more of us whose kitchens looked a little different before WLS. I can think of two likely possibilities. The first is that the kitchen had too much junk and not enough healthy stuff. It could be Pasta, chips, and snack cakes in the pantry, ice cream and TV dinners in the freezer, mayo, salami, and butter in the fridge, and white bread and Cookies on the counter. The other scenario I envision before WLS is a pretty empty kitchen, except for possibly containers filled with leftover take-out and delivery, and drawers with single-serve condiments like soy sauce, parmesan cheese, and ketchup. Back before WLS, pizza delivery and Chinese take-out may have been a way of life. And the “after” picture of your kitchen? Has it changed much? Does it have fresh fruits, vegetables, Proteins, and dairy? Is there a well-stocked pantry with canned tuna and tomatoes, spices, and oatmeal, and a freezer full of vegetables and fruits so you can make a healthy meal at a moment’s notice? Tell us how your kitchen has changed from before WLS, and how that reflects your changes in eating and food prep habits! If you’re pre-op or post-op, maybe you can learn a few things about how to make your kitchen even more weight loss-friendly!

@@Lisa1996, Congratulations on your surgery! Now, you’ve lost 25 lbs in 18 days, and you’re worried about a stall?? Your poor body’s just trying to catch up! It’s been through surgery, it thinks it’s starving, and it’s reacting to sudden weight loss. Just keep up with the careful eating, and your body will lose more weight when it’s ready. In the meantime, you can support yourself by nourishing your body as well as possible. How many calories did your surgeon recommend? I’m guessing it was more than 500 per day. And are you getting your fluids in? That can really help with recovery and also with learning to recognize fullness, hunger, and thirst. You’re doing great – keep it up!

You can get tuna packets at Walmart and Target as the others have said, and any big supermarket should have them. You can also find a variety of protein powders at Walmart, Target, and big supermarkets – just browse for a while. Usually there’s a whole section with protein bars and protein shakes, so it’s kind of fun to look. Maybe your parents can go through the store with you on the phone so you can find some good products. GNC is a dependable place for protein powder, but it’s a little expensive sometimes.

@ and everyone else with surgery coming up – good luck!

@@needtorecover, All you can do is laugh at these things. I mean, you can get angry, but it won’t do much good. Just try to be grateful that you’re in this situation. Of course, if you do tell someone you need $70 for a new pair of pants and they give it to you, that sounds like a nice idea, too.

@@ridgerunner, Talk to your doctor, for sure! Ask about the alternative medications. Also, ask whether some of your conditions might get a lot better (and less painful) if you do lose a lot of weight. I’m not certain about the rules, but are you allowed to take NSAIDS after the sleeve but not the RNY? If that’s the case, I wouldn’t rule out the sleeve just because of its slower rate of weight loss. In reality, we’re probably talking about a difference of a few months to hit goal weight after sleeve versus RNY. That’s not a lot of time in the context of life! I know you’re 49…and that is not “old” in the slightest. Whether you hit goal when you’re 50 or 51, it doesn’t really matter. You have decades left to live! Just my opinion. Good luck getting answers. I agree – those natural medicines don’t usually seem to do much.

@@heather5565, You look fantastic! Thanks for sharing these inspirational before and after photos, and congratulations to you!

@@Beck90, Sorry you’re feeling so bad! It’s perfectly normal, though, so at least it’s nothing to worry about. It’ll definitely get better as you stick to it. You’re doing a great thing by developing the habit of drinking more liquid. It’ll help you as you recover from surgery, and long-term it’s a good habit because it’ll help you lose more weight and stay fuller and more energized. Being cold might last for a while, though. It could be several months as you lose weight pre-op and post-op, since it comes when your body is reacting to having very little food. Good luck with your surgery!

@, Sounds like you’re ready to go! Will you want a book or crossword puzzles or something else to do just in case you’re bored out of your mind? Even if it’s not something you normally do, it might come in handy if you have down time and need something light to do.

@@becomingmandikaye, I know – it is super frustrating not to be able to find exactly what you are prescribed! I would first ask your surgeon. It’s possible that your surgeon knows of a specific brand that has exactly what you’ve been recommended to take. If not, it’s also possible your surgeon might be willing to change the recommended amounts of the ones you’re supposed to take so that they actually match the amounts in a multivitamin that you can find. The recommended Vitamin and mineral amounts are just estimates, since not every person needs the exact same amount of each nutrient, so your surgeon might be able to suggest different amounts that can work for you. Otherwise, I think the idea to ask a pharmacist is a great one. You can also do what you said, which is to supplement with Iron on top of the multivitamin. @@Proud2BMe, a lot of research shows that sleeve patients are likely to develop nutrient deficiencies.

I am always interested in the family dynamics surrounding overweight and weight loss surgery. It seems as though there are so many different scenarios. For example, you may be the only overweight person in your immediate family, while the others have no weight struggles. Or maybe you look around at your family and almost see yourself reflected back at you because your parents, siblings, and aunts, uncles, and cousins all are overweight and have been for as long as you can remember. Beyond the question of who in the family struggles with weight and who doesn’t, it is also interesting to see who supports your WLS decision, who doesn’t, and why. If you’re the only one in your family who may qualify for WLS, your other family members may not understand why you can’t just lose the weight on your own. Or, they may see that you’ve been trying for years, and that you really do need an extra tool to help you lose weight. If you’re one among many overweight family members, they may support you, and some may have already had the surgery. Or, they may try to convince you that you’re fine at this weight, since that’s where they are. What is your family situation with respect to weight and WLS? Are many of your family members overweight? Did they support your WLS? If not, and you’ve already gotten WLS, have any of them changed their minds? What convinced them to support you?

@My Bariatric Life, As always, great article! You have so many insights here about getting ready for a successful WLS journey. It is so tempting and common to postpone “the conversation” about what will happen after WLS. It is so easy to just hope things will fall into place; that either your weight loss surgery or new lifestyle will not change your relationship, or that your relationship will change to accommodate your new lifestyle. It is necessary to face the possible changes head-on and in advance, as you say. I would also add one more thing, which is the possibility of looking at this in a positive light. You and your partner can look at what the relationship can gain from your weight loss surgery, and emphasize the positives rather than what you may lose. For some things, there’s no need to wait until WLS to start. For example, the couple can start to cook together, or take walks together, before you get WLS. Thanks for the good article!

Wow, quite the variety of situations! Whether or not all or some of the others in your family are overweight, WLS is so much easier when you can have their full support. I was so lucky in that respect since nobody in my family was disparaging or negative. I always think it is so unfair when family members are not supportive. I can understand if they don’t agree with your decision…but it’s YOUR decision! Once you make it, it’s basically their duty to support you in it! At least, that’s how I feel about friends and family. They can and should give their opinions, you can and should consider those opinions, and then you can make your own decision and they can support you.

Thanks for the answers! As always…quite a range! Yes, @@Inner Surfer Girl, condiments are more present for me, too, than they were before. They help break things up a little. @@2goldengirl, good luck with the remodeling! If you end up eating out a few extra times because of your lack of kitchen access, I am sure you know exactly what to do to get the healthy foods you need. @@KristenLe, it’s great that you can pass up your boyfriend’s sweets. It’s also good that you’re thinking about how to put the healthy foods front and center in your kitchen so it’s easier to remember to eat them. As you organize, you might also want to make room for a kitchen scale so measuring becomes second nature if it isn’t already. @@Ryan TN…it’s working for you! @@Valentina : do tell! Do you eat out a lot?

We all know restaurant meals can be challenging for WLS patients. There’s the sheer size of the portions you get, the trouble identifying healthy options, and – especially for sleeve and bypass patients – the potential for dumping syndrome. It’s harder to get a healthy, small meal at some restaurants than others, but you can often end up with one if you order right. It’s just that “ordering right” might involve a lot of creativity on your part, and some lengthy discussion with the server! I don’t have any particularly crazy stories to tell. I just know that during many of my restaurant trips, I take a long time to order! I am used to ordering something from the menu and seeing the server write it down and turn away. But I’m not done ordering yet! I then ask my server for a long list of modifications…sauce on the side, no dressing, veggies instead of rice, etc. Sometimes it feels like it takes forever and the server seems stunned that one person could be so fussy. But they’re almost always extremely good natured about it! What is the craziest thing you’ve done at a restaurant? Maybe you’ve lied so you can order off the kids’ menu? Have you ordered nothing and just taken a bite from your friend’s or spouse’s plate? Share your restaurant stories here!

Guys only please..... I'm doing some quick research and would love some assistance from our guy members. What do you consider your ideal pants size after a successful weight loss surgery ?

Good idea! How about you start off a topic and if it grows nicely we will split it off in to its own forum.

Many WLS patients think of their pre-op relationship food as an addiction. Even if it wasn’t an addiction for you, food probably served one or more roles in your life that it doesn’t serve now. It might have been your source of comfort, a way to reduce stress, the focus of birthday and other holiday celebrations, and a dependable source of company. After surgery, you can’t turn to food in the same way, but those emotional and other needs are still there. So, how have you replaced them if you already had WLS? If you’re pre-op, how are you planning to replace food as an emotional or boredom outlet? For me, food isn’t the center of everything now. A celebration can involve food, but it can also involve other activities like taking a bike ride with my children. And luckily I’ve been able to stay so busy that boredom eating isn’t much of a problem. What about you?

I came across this article about a woman who says she regrets her decision to get weight loss surgery 10 years ago. She had the gastric bypass at the age of 22 when her weight was 274 lbs. She lost 146 lbs., and then her life spiraled. She abused drugs, alcohol, and sex, could not hold a job, and even tried to kill herself. She also gained back 100 lbs. Here is the link to the article on Fox News. After being forced into treatment due to an arrest for driving while intoxicated, this woman was able to make the choice to turn her life around. She finished her college degree, got sober, and got the mental health she needed. She now has lost 100 lbs. through changing her diet and ballroom dancing. This young woman regrets getting the gastric bypass because she replaced a food addiction with even more destructive addictions. First and most important, I am glad she has turned her life around! Now, I have some questions for general discussion. I’d like to get your opinions. Do you think she may have been too young for gastric bypass? This is a hard question in my opinion. On the one hand, people in their lower 20s do not have much life experience. On the other hand, I was fairly young when I got WLS, and I have never regretted the decision. So, when should a very young adult get WLS? What do you think about her decision not to have psychotherapy? I think it underscores the importance of appropriate mental help. Maybe it would have prevented her from getting surgery in the first place and instead helped her work through some of the underlying issues. Or, maybe it would have helped prevent her from transferring her food addiction to other addictions. Now, she is losing weight by making the right food decisions. WLS or not, that is the only way to lose weight. I wonder whether her gastric bypass surgery is helping now. It could be helping with portion restriction and nutrient malabsorption. So….what are your thoughts on this story? Here is the link to the article on Fox News.