Daydra

Thanks, and yeah, bmr testing is definitely in my plan, even though I believe that this isn't truly the issue (I wrote my working hypothesis in my previous post, I'm sure everyone will appreciate if I don't type it again...) I could have been way more clear on the hospital visit. I had nausea. No vomiting. I was only getting around 20 oz most days in addition to very low calorie/nutrition. I was reaching the point where I was having near misses with passing out, fatigue, little strength, didn't feel like I could do much other than sleep, frequently light-headed. My biggest fear was that I was dangerously dehydrated and thought that was what was causing the nausea and everything else. My surgeons biggest concern was that I had an abscess or something causing the nausea. Turns out, not clinically dehydrated and after surgeon got test results she stated that she felt that the nausea was due to residual swelling and everything else was because I wasn't getting enough calories. I was forcing enough Protein by sheer force of will with protein supplements and what I could manage to get down. So, technically, the reason for the trip to the er was the nausea/fear of dehydration, but had it gone on much longer, I would eventually have passed out and ended up there anyway. Still not getting enough water, but doing much better than I was, and you are right. If you go by the 1 oz for every 2 pounds of body weight, I should be getting in 120 oz. I'm nowhere close to that, but considering at about 20 oz a day I still wasn't clinically dehydrated, so I don't worry about it and just get what I can for now. As far as the body monitors go, I agree that the devices are powered by algorithms based on averages. However, the bodybugg/bodymedia devices factor a lot more into the calculations than the simpler devices like the fit bit and others that only measure movement. The bodymedia devices are not only triple axis accelerometers, but they also measure skin temperature, heat dissipation, and conductivity, so it "knows" when you are sweating. Also, it's worn on the upper arm instead of the wrist, so it gets a more accurate picture of movement. For the metabolic changes after surgery, there are tons of papers on improvements in the function of several metabolic hormones (insulin, PYY, GLP-1, etc.), but I haven't run across anything about a dramatic shift in overall calorie burn immediately after surgery, other than the reduction in Total Expended Energy that comes with every calorie restricted "diet". If you have a source for a paper on that, I would really appreciate it if you could send me a link or something. This would be exactly the kind of thing I would like to read. At this point, I just simply haven't come across anything that would lead me to believe that it would be appropriate to expect that still being at 240, I would only be able to lose weight if I ate 40% or less of what I could eat to maintain only 90 days ago. Thanks again for taking the time to read and respond. I have always thought you give valuable and considered input.

Thanks, and no worries on skimming. I totally can't blame you! I totally agree that you can go for quite some time without food. I believe in general its up to 3 days without water and 21 days without food. However, in my case, I had been eating below what my nutritionist had given me as a caloric floor for around 9 weeks. (pre-op diet, then recovery, then nausea) At any rate, the result was near-passing out and fatigue to such a degree that I could not function. I was managing to make it to and from work at least some days each week, but I couldn't manage to get out into the field to do inspections, so I was stuck in the office with my fieldwork backing up. I'd pass out the instant I got home and would sleep between 14 and 20 hours a day on the weekends, which dropped my intake even further. Both times I had to go into the clinic or the ER, were Mondays after a weekend like that. Thank you, I know it will stabilize. I feel much better physically, and I am collecting lots of info and have a plan, so it's going to be all good. My current working hypothesis on what's going on is that while I was not clinically dehydrated (Lab tests at the ER show the specific gravity of my urine to be just this side of clinical dehydration. No freaking way is anyone going to get me to believe that not needing to pee when you wake up in the morning and literally never feeling like you need to pee during the day is okay.), the 2 liters of Fluid I received coupled with being better able to hydrate myself after getting better anti-nausea meds and the ability to eat again actually popped me up to the weight I "should" have been, had everything gone more smoothly. I only had a "net" loss of about 1/2 a pound from the morning before I got fluids and meds, but if I count from the weight I topped at a few days later, I think it's about 10 pounds (well, 10 pounds from my appointment on Thursday, now it's more like 12). Unfortunately, my doctor never let me get that far, she just went straight into the non-compliant patient routine. Regardless, I'm still down 45 pounds since July 15. I'm not at all dissatisfied with my overall loss. I only wanted to discuss the concern and bounce my thoughts off her. I'm totally floored that something that should have been so simple turned into such a debacle.

Thank you for the support. Yeah, I really don't expect to get a "complete" answer from any one source. I think each discipline has a piece of the puzzle. I just need to collect those pieces and put them together. What I'm really looking for at this point is to understand exactly what is happening at this time, whether normal or slightly off. That's not really something I can get from a research paper or a diet book, so I'll continue to read to get some background, but if I still need to find out what's happening with me, particularly, I'll need testing. You are so right. We have a long way to go to get to a place where the majority of medical professionals in this country consider the patient as a whole and not a list of discrete ailments that have to fit in 15 minute chunks of time... The complete disregard was the worst. I felt crushed. This is the kind of crap I gave up $500/mo of Health Reimbursement Arrangement contributions to get health insurance at work so I didn't have to deal with this kind of discrimination in the military treatment facilities I had access to as a dependent. Of any medical specialty, this should have been the one place I didn't have to worry about this kind of thing. The good news is I can schedule further followups with the nurse or with one of the other surgeons if necessary, and now that I'm not experiencing nausea and major fatigue or other side effects, I can do many of my monthly followups over the phone.

Thank you, I didn't take it as a flame, but I think we're kind of missing each other here. I am, actually, following my prescribed calorie and Protein intake guidelines from my clinic's nutritionist. I'm right in the window of where I was advised to be. I'm only just starting to exercise again, the previous calorie far below what I was advised should be my minimum intake left me in an intolerably low-energy state. After nearly 5 weeks in the prescribed intake window, I can finally function mostly normally, but I still have a lot of muscle weakness and need to begin to rebuild strength. My surgeon is an excellent surgeon. I would trust her to cut me again. She saved the life of one of my coworkers when she overrode a decision made by one of the other surgeons in the office. However, that doesn't necessarily mean that she and I can effectively work together. After this interaction, it is apparent that she is not someone that can partner with me to problem solve with some of the more nuanced aspects of the process. My post was an expression of my hurt, anger, and frustration at this interaction with her. I expressed a concern, and instead of discussing it with me, she immediately decided that I was merely non compliant and must be lying about my nutrition stats. She prevented me (by frequently cutting me off mid-sentence) from completely expressing my concern and my thoughts about it, or fully answering even a single one of her questions. I don't care how much experience she has. I can not have that as a "partner" in my healthcare decisions. There are other professionals out there that are just as experienced. As far as my "old philosophies" go, using my philosophies and my measurements, I was able to lose 115 pounds between 2009 and 2011. I feel like I can confidently consider that success. I only began to gain weight again when the maintenance of those strategies began to require more effort than I was capable of. I only know that I could maintain at 2400 cal because of 4 years of monitoring. That is certainly no indication that my system didn't work, just that I couldn't maintain it forever. I decided to have the surgery because I was struggling to pull it back together again and was terrified I was going to see 349 again before I managed it. Not to mention being at significant risk for having to go through that all over again, perhaps multiple times throughout the rest of my life. That possibility was untenable. I felt that the surgery would be a significant factor in my equation for long-term success. My life never stopped, so there wasn't really any restart to consider. My health has always been reasonably good and I have 8 triathlon completion medals. As far as the health part of the equation goes, my biggest concern was my health as I age. The last thing I'll say is that no one is an expert on me, but me. I can totally own when I'm wrong, but not to be considered to have any valuable input on decisions that concern my healthcare and to be expected to accept everything my doctor says without question is not something I will accept.

Thank you everyone for your time, thought, and responses. I do appreciate the input. I will respond to each comment, but I think I may need to clarify the intent of my post, as I think that my post (or the intent) may have been misunderstood by some (easy, since it was horrifyingly long...), or perhaps I misunderstood the intent of some of the responses. I posted this simply to put my experience out there. In doing so, I am hopeful that it might somehow be of use to someone out there. Maybe someone has had a painful experience with their doctor, but doesn't have the confidence (or whatever) to be upset on their own behalf and believe that he/she is the only expert on his/her body and experiences. We can never really guess how what we share might help someone else. At any rate, the two things I wasn't doing, was complaining about a perceived insufficient weight loss, or asking for help.

And fiber! They have fiber! See, they should be considered a supplement! (yeah, that's the ticket...)

Although... if I can work out the right "dose" they're far more exciting than the 1/2 dose of Miralax I've been having to take every day to keep the constipation at bay.

I'm prescribed 1500mg/day. I was advised to stop it a week before the surgery, but only for the surgery. I chose, without doc's recommendation not to restart it after surgery, simply because nausea is one of the side effects, and when I started a new antidepressant that also had nausea as a side effect, I would find myself going through some pretty serious gagging while I got used to the new med (this lasted weeks!). Either med alone, I have no problem with. I mentioned it to my surgeon when we were discussing the nausea I was experiencing post surgery, and she said that if I could manage it, she would prefer I continue to take the metformin, as it can help support consistent weight loss. I haven't restarted it yet. I want to talk to my pcp about it first, but I'm expecting to begin taking it again (along with keeping anti nausea meds on hand to keep that under control). She may decide not to advise me to start taking it again, i don't know. I am having a significant amount of menstrual cycle weirdness despite birth control pills, though, so who knows what she might suggest. Not being able to figure out when you might start, no matter where you are in your pack is just ridiculous! Altogether now... "Hormones Suck!" Good luck! This is yet another example of a question where everyone and every doctor seems to have a different answer!

OMG! There are too many to read at once! I think I just broke a rib! Definitely forwarding this the work... (Only the people that I want to warn off any mysteriously appearing bowl of community gummi bears, of course!)

Thanks for linking this!! I'm going to save it for later!

Great description! I will stay away from that stuff (unless they offer me a free sample, of course... I like free). I've had to trade in my Pure Abundance shampoo/conditioner for Avon crap... (trying to support my mom and there are very few of their products that I actually like. I haven't tried any makeup product of theirs that I like other than lip gloss, which I rarely wear anyway. I don't use lotion. I don't need or want anti-aging crap. Perfume in my house goes bad before I even put a dent in the bottle. That pretty much leaves me with shampoo/conditioner and body wash... Last time I counted I had more than 20 bottles of body wash... I don't have kids and I can't talk my husband into using it... So I literally have 20something bottles of body wash just for me. I think I'm going to start donating them to the local YWCA. To be fair, the shampoo and conditioner really isn't that bad, but I've always had really healthy hair, so I can get away with just about anything.) Ahhh, I digress... I need to run by my local Aveda salon, though. I'm out of the Pure Abundance style prep. I've been using the mousse (can't remember what they named it), which is fine, but I like the style prep better. I was using the Smooth style prep, but now that my hair is getting longer, that just makes my fine hair super flat. Good night!

Thanks all, for sharing in my (my mental thesaurus is failing me, the best I've got at the moment is...)chagrin... Better (perhaps "more effective" would be more accurate than "better") than any laxative I've tried to date! Including the old standby Fleet enema! Splenda is a component of the "sugar substitute mix" of these. If I had a package at hand (Oh yes of course I have more, I bought a case online... because pooping one's drawers should never be limited to "just once"!), I would list more info, but you can probably look it up online pretty quickly if you are interested. Okay, grabbed a package because it really wasn't that quick to find the info online... Maltitol (a sugar alcohol) and Maltitol syrup are the first 2 ingredients on the ingredient list (ChihuahuaMom, stay far, far, away from these!!!), so that's where the beloved "laxative effect" comes from. Most definitely, there is the carb issue. They're about 37g carbs/serving w/8g Fiber, so that's what, like 2 carb servings I think? Pre-sleeve, I'd always bounced back and forth with my personal "sugar philosophy". Is it better to just have a little sugar or is it better to go with a substitute. Fortunately, I've never had an A1c or fasting glucose test that was high (though my docs kept poking me because my "fat" square peg didn't fit in their "must be diabetic" round hole...), so I've had the flexibility to have the choice. MIJourney: I would guess one bad sugar free candy experience would make you suspicious of them all. To which I would say "Good call!" Thanks all for having a laugh with me! What good is a "I Just Pooped Myself" story if you can't share it, right?!?! And it sounds like I'm in good company!!!

I can totally see myself being the same way. And since the Invati line is supposed to help specifically with breakage, and that's not what vsg-ers are dealing with, I'm not at all surprised that it didn't seem to help much, if at all.

I am so glad that you continued to pursue an answer and finally got the treatment you needed. I hope that you quickly begin to feel better!

Many of you have probably read some posts of mine... I apologize for the ridiculous amount of time you must spend reading my excruciatingly detailed posts! I keep promising myself that I will learn not to type every relevant (in my opinion, of course) tidbit of information into the box! Unfortunately, I never seem to learn. Thank you, dear VerticalSleeveTalk member, for having the patience to read my ramblings and spending the time to think about them and respond! Ha! A reasonably short post! Have a good night!

:wub: :wub: :wub: :wub: :wub: :wub: I'm feelin' the love!!!

Agreed. The reason that people start losing hair after surgery is it just shocks a lot of hair into the resting phase all at the same time. I don't believe it has any effect on the strength or resilience of your hair. I expect that you'll be fine, but your hairdresser will probably warn you if he/she senses anything amiss. Good luck!

Thank you! I wish you the best dealing with all of your health challenges as well! We're up at Bangor, so fortunately, I've only been sent over to Madigan for just a couple things. It was really kind of funny... I got my own insurance to escape Navy Hospital and the Bangor branch clinic, but when I selected my own civilian doc, it turned out she was a former navy doc at Navy Hospital! She's good, though, as far as I can tell and I like her. She has not done or said anything that made me feel judged or marginalized. So much happier. That kind of cracks me up that you're a psych major! My main circle of friends are all therapists and social workers. I'm the token science degree in the group! We are forever talking about how much overlap there is between their profession and mine. My friend that's one of the therapists says that I'm getting the precontemplative people that may someday find themselves in her office, at least she gets the people that are a little farther along... :-) (I'm a solid waste inspector. The largest portion of my work is responding to residential garbage complaints. I get to go out to the residences of people that for whatever reason (mental health, lack of funds, skewed priorities, substance abuse) are unable or unwilling to appropriately dispose of garbage and various types of solid waste. I get to walk up to their house, tell them they are failing to manage their affairs appropriately and that if they don't do what I tell them, I will be writing them a $500 ticket. I'm sure you can imagine how well that goes sometimes... I do my best to connect people with whatever help is available and seems appropriate, but I don't have any human services training and I'm pretty much winging it out there. Our agency is small enough that we only have a couple social workers, and they are both dedicated to the HIV program, so it's not really that easy to consult with them and nearly impossible to pull them out of their responsibilities to attend an inspection to provide guidance. It's good to have connection to my friends to run some of these situations by them. They always tell me that I could easily have gone into their field instead of mine. I tease them that there isn't any money in it. :-) I really wouldn't want to be a social worker or therapist, it would totally burn me, but I do feel like I make a good hybrid between enforcement and support. My fellow inspectors often consult with me or ask me to assist on delicate situations. That makes me feel good, like I've kind of carved out a niche for myself within the agency. Anyway... way off topic (I suppose I can hijack my own thread if I want to ) I doubt that I'm really upset about the money, deep-down, otherwise I'd have spent a lot more time thinking about it. It just seems the whole situation is stooopid! :-) Have a good night!

That's great news!!! I'm really happy for you! Give it a couple weeks and see what happens with chicken again, sometimes it takes a little while (That's what they tell me, anyway )

Oops! Hit post before one of my thoughts were completed! Saying I'd better go to bed was just because I tend to get more verbose when I get tired. Probably seemed totally random in that post! Night!

I suppose that is possible, but I don't know that my personality would really fit that scenario. My aversion to doing my makeup, fixing my hair, and wearing fussy clothes seems to be driven by practicality. There have been several times over the years that I've decided I was going to start wearing makeup. New job, getting older, whatever the reason. I'll spend a bunch of money on new stuff (because the stuff I had on hand got old enough that it probably wasn't really safe to use), and then use it for a week, maybe two or three, and that was it. The makeup goes back in the drawer and I go back to staying in bed until the last possible minute! As I'm nearing my adult low weight again (It's only been since 2010), I am finding that I'm actually getting the urge to by women's clothes (not frilly, crap-ified (you'll see that word in Webster soon!) stuff, just items that aren't decidedly masculine or gender neutral). Men's clothes have typically fit me better, and I'm a total tomboy anyway so it works for me. Plus, since I have to dress to work outdoors everyday, being willing to wear men's clothes makes it a little easier to find good, outdoor wear. (Since everybody knows, fat women don't go outside! And if they do, they don't actually do anything, so outdoor wear for plus size women doesn't' actually need to be functional.) We'll see as my body changes, whether or not my body shape and frame will fit women's cuts or men's cuts better. I think I'll refrain from holding my breath, though. Yikes! I think I'd better go to bed! Have a good night!

Thank you! My goodness, I am so sorry that your health deteriorated so much under military care. While I've so far been fortunate in that I haven't had the same severe issues, I feel completely traumatized by my experiences in MTFs, mostly at Navy facilities, but also at Madigan Army Hospital. I, unfortunately, can relate to being passed around and dismissed. I, too, started the process of getting approved for bypass, I think it was around 2005 or 2006. I met the surgeon that I would have been assigned to, and I basically got a "what are you doing here, you should be dieting" attitude from him, and I totally bailed. Didn't feel like I could trust that he would have my best interests at heart. I have been so frustrated over the years. At first, I didn't have periods (PCOS). I hadn't been diagnosed and we were trying to get pregnant. Despite not having any menstruation, my PCP refused to refer me out and forced me to wait a year before she finally consented to put in a referral to ob/gyn, where I finally was diagnosed. Even this doc that diagnosed my PCOS, who I actually really liked (Dr. Muffley... I just can't make this crap up!), performed a hysterosalpingogram (totally unsure if I spelled that right, an HSG at any rate) to determine if I had occlusions in my fallopian tubes, argued with me after the procedure was completed. I told him he "left a tube or something in me". He said that no, it's common to just feel like that after this procedure. Well, when I stood up and a significant amount of blood ran down my leg, it was clearly apparent that he had left the guide tube in my cervix. I had to send my husband for a maxi pad and someone to clean up after me. Every problem I've ever had seems to be because of my weight. I have spoon fed a doctor symptoms of anemia, knowing that was exactly what I had. She gave me hydrocortisone cream to put on extremely delicate skin that absorbed it very quickly. The physical sensations that caused made me think that My brain was going to blow out the top of my skull, like a blender without a lid, combined with a racing heart. That could have killed me, and I stupidly did what I was told. I have been asked why I came to the ER in the middle of the night when I was in my early 20's (really just a kid) and had this growth thing on the inside of my lip that was growing by the hour, like being scared was somehow irresponsible. I asked to have my Mirena IUD removed so that I could seek treatment from a naturopath to attempt to address my hormone issues, and the male doctor started asking me about what birth control method I planned to use, like I was some 17 year old kid, despite the fact that, at the time, I was over 30, had been married over 10 years, my husband was well established within the military, and I had a college degree and a professional career. He ultimately told me I was welcome to waste my money. I once saw a female OB and asked to have a tubal ligation. She started with telling me in an indirect way, that I was not old enough (30) to make that decision since I had not yet had kids and I might change my mind. When I explained to her that we had already been through infertility treatments and had realized through that process that we were only pursuing it because that was what society expects from a young married couple and we never really had any desire to have children and that we were very certain of and comfortable with that decision, she switched tactics and told me that I weighed too much to do it safely and she wouldn't do it unless I lost 30 pounds. I immediately began to cry and told her that I had tried so many times and didn't think I could do it. She talked me into the Mirena IUD, and then wrote in her notes that I "was not interested in weight loss". When I would finally be assigned to someone that actually had a caring demeanor that I felt comfortable with, I was lucky to see them more than once. I got to the point where if I was scheduled to see a male in uniform at a military treatment facility, the moment he walked it the door, I would start to cry, even if it was a twisted ankle or just a med refill. I had finally had enough, and got my own insurance so I didn't have to go through that anymore. I'm actually pretty comfortable with spending the money to prevent me from having to experience the anguish that I know I would have had to endure at an MTF, regardless of the talent or bedside manner of the surgeon. At this point, I simply am no longer capable of giving them my trust. I'm in Public Health now, and actually provide some general training to the Navy docs in our area as part of their residency training (all our EH inspectors take turns). I'll spend a day out in the field with one to expose them to what the Environmental Health division is all about. It's actually kind of fun showing them what we do, and they are frequently amazed at some of the things we encounter in the community. I've had a chance to talk to some of them about the frequent transfers and how terrible that is for consistency in patient care. I've started to rebuild respect for them, because the docs that I've discussed this with hate the situation as much as the patients do. They would much rather develop relationships with their patients, and they find it personally difficult to maintain a kind and empathetic demeanor when an endless stream of patients they have never met before are forced through in 15 minute appointment blocks. The way the system is structured almost forces them to shut down any part of them that might respond to their patients with any kind of human connection. That admission gives me a lot of perspective for the position they are in, and I can understand how it could be difficult to maintain true caring for each patient when the system forces you to deal with them like cattle. I truly don't (and never really did) harbor any hard feelings for military medical personnel as a whole, just those with which I have had painful experiences. I definitely want to make it clear that I separate the deficiencies in the system and some specific negative experiences from the vast majority of good people that are just doing their best to work within an imperfect system. I'm more annoyed with the timing of my primary insurance company deciding to cover vsg. Oh well. You can't know what you don't know. I will probably feel a lot better about the money when United Healthcare finally returns their denial and I can submit my reimbursement from my HRA so I can pay off my loan and cut $400/mo back out of my monthly responsibilities... You know, I know it was really, really long, but typing out that litany of grievances with my experience with treatment actually felt kind of calming. A little like a bit of weight has been lifted off my chest. I never really felt like I had the interest or time for journaling, but puzzle pieces seem like they move around and fit together in my head differently and much more constructively when I'm writing than when I'm talking... I'm thankful this kind of forum exists, and that the vast majority of participants are kind and supportive. Thanks all. Your eyes might be bleeding, but I feel better! (just kidding!) Thank you all for your responses (and being part of my therapy session! ) and I hope you all have a good night!