Skywalker

I've gotten a couple stupid pieces of advice: A friend recently, who is hypothyroid, mentioned she might take more than the usual dose of levothyroxine to speed up her metabolism, and I warned her not to do that as it could actually cause more issues with the thyroid (I'd actually rate this under the "dangerous" category, if there was one). The VA MOVE program told us to "eat less, exercise more" (because we've never heard this before, anywhere) and to "take the stairs at work" (look, if you're pushing 300 lbs and you take the stairs once or twice a day, it won't help, sorry. What might help is 30+ minutes per day, 4+ days per week on stairs, at your target heart rate, and not a minute less).

Possibly. I'm not trying to start a shitstorm here (so apologies in advance to any religious people), but the counselor I saw is Mormon, and they inherently disapprove of alcohol and caffeine anyway. In addition to this, one of his relatives had the surgery and gained all of the weight back because she kept eating crap. So I don't know if any of this played a role in his negative review. I'm a disabled veteran, and he also mentioned in the psych report that I had a rating for major depressive disorder, and I kind of don't like that being out there that way. Not that it's anything to be ashamed of, exactly, but it is my personal business and really doesn't keep me from being productive and living life (I still go to work and work hard, and I still have a 3.8 GPA at college). The irony here is that my massive weight is a large part of my self esteem issues and contributes to any unhappiness I have in a major way, so denying me the surgery wouldn't be doing my health any favors.

@CowgirlJane: All very good points, and I like the scenarios you ran through for people with the wrong mindsets. There are a couple people I used to work with, and they both had bariatric surgery. One is still keeping the weight off, and the other isn't. I had lunch with the successful one (she'd banded) the other month to pick her brain and see what it is all about. She says she still has some demons and daily choices to make, but overall she's so much better and healthier. FYI she looks great in pictures, too. The other lady, who appears to me to be really heavy, apparently did the whole thing where she ate whatever she wanted and went back to her original size.

All really good advice, thanks. The Starbucks wasn't a daily thing, and it was an honest mistake, because I don't have it a lot, but I see now why I definitely shouldn't have brought it in with me--in a way, I was "performing" for him to achieve a desired result, and I didn't really pass the test. In fact, I'm pre-op now, and I can't think of the last time I had a Starbucks. I came to the conclusion (without dieting) in the last couple months that I would rather grab an Egg McMuffin on the way to work because it fills me up and the protein/heat makes me feel better than the morning Starbucks sweetness, which makes me hungry about an hour later. The weird thing now is, I submitted this letter to my bariatric surgeon's office, and even though I thought the psych eval was a tepid piece of crap, she thinks it's just fine. She said she's never seen a patient get denied with a "guarded" rating for a psych eval. Regardless, I pushed her for the list her office has of psychiatrists, and think I'm going to follow that route. The insurance approval that's at stake is worth $17,000, so I don't want to give them any excuse to deny.

Yes, I believe I did, but I think there may have been more than one way to read that. The way I meant it was--getting this surgery will not take away anyone's eating disorder. This is what I have studied and been told by people who got WLS. Whatever was going on in their mind prior to the surgery--they still have to work on that. Do you disagree with this? Yes if you have reading suggestions I'll take them, thanks.

@InfiniteButterfly: The Starbucks is something you would not be able to have post-surgery. Definitely not immediately, and with the amount of sugar in even the non-fat varieties, it's definitely a very, very occasional treat (if even that. I used to LOVE non-fat, no-whip green tea frappucinos pre-surgery. I took one look at the sugars post-surgery and said goodbye forever) When you say you don't have Starbucks, etc. anymore, is that because you just don't want it, or is it forbidden for some reason? I've read conflicting things on the sleeve/WLS, but I'm learning all I can. Some people discuss head hunger, while others state that it biologically altered what they actually can eat and/or crave from that point on. And honestly, if your goal post-surgery is to follow Weight Watchers? I don't know that it's nutritionally sound for a bariatric patient. You would need to discuss that with a nutrition counselor (I know from when I tried Weight Watchers that there was a helluva lot of food that I couldn't possibly eat post-surgery or likely ever) I'm not really sure what the "right" answer is for a psych consult, all I can say is that I'm not a lazy WLS candidate. I've done a lot of things in my life, up to and including being an athlete, and I've never been non-compliant with medical advice. I don't, by any means, plan to eat small amounts of unhealthy foods until my stomach expands to its original size, because I've seen WLS people do that and think it's such a waste. I want to get thin again and stay healthy. @Moonlitestarbright: since you havent done your nutritional counseling, how are you supposed to know? go get your nutritional counseling and then another psych eval. i think you might have put the cart before the horse. Right....how would I know? I'm not non-compliant and I'm not post op (yet); I'll follow whatever diet plan the doctor deems appropriate, because I want to heal and look good and keep it off for the rest of my life. Perhaps you were right that I put the cart before the horse. I don't believe I'm a bad candidate for surgery, because I've molded my diet to a lot of different things before and adhered to them (Weight Watchers, South Beach, etc.). The hunger, at least on Weight Watchers, is what is currently getting me to surpass the points I'm allotted, so I thought stomach reduction and getting the hunger hormone cut out would be especially helpful.

Misslex, I understand the hesitation with money; if money was not a consideration, I would have already had a WLS and be on my way now. From what I understand, insurance companies will cover one WLS in your lifetime. If you were self pay for the band, can you Dr. annotate the slippage/complication and try to get you in for the sleeve? I know the savings of 17,000 would sure seem worth it to jump through a few hoops.

I just want to make sure I'm understanding this correctly....did they disapprove you because you were two pounds too thin and had no co-morbidities?

bikrchk--I haven't had the sleeve nutritional classes yet, but when you mentioned the Protein intake, how does your doctor(s) advise you to balance that? We have protein powder in my house, and my daughter in particular loves it, but her PCP said no more than one a day or it's hard on her kidneys. I assume the same will be true for me for the long term post op diet....was just wondering if they tell people to fall within a certain protein range post op for the rest of their life (not too much and not too little)

bikrchk--On the note of nutrition, has anyone found (post op especially) V-8 drinks helpful? Noticing that I don't tend to get a lot of vegetables normally, I have tried to drink one or two of these a day (and have my daughter do the same) to get some valuable nutrients. I would think, being liquid, that these might also be easily consumed post surgery.

That's all I want is a fighting chance. I don't think my current provider wants to give it to me. God damn the VA.

Excuse me (to everyone)--When people say "the nut" to what are they referring? I used to think it was the lap band but the sleevers use this term too, so I'm confused.

Go to the hospital right away. If you are feeling dizzy it probably means your blood pressure is low because of low fluids in the bloodstream (an IV would help this). I'm not a post op patient (yet), but I went to the hospital last year for gastroenteritis--so a lot of throwing up and diarrhea--and could have died without the IV assistance.

"i have found there are a lot people around here who are still poorly educated about basic nutrition post op. maybe that is what he means? do you have an idea of what you would need to eat post op to get 60-80 grams of Protein per day?" I did hear that, and I've been trying to learn as much about the surgery as possible to be successful. I will literally follow any plan my Dr. wants me to. I understand the higher protein is important for wound healing; the first time I heard this was actually after I had my C-Section, and the protein/wound healing connection was solidified during my medical training (I'm a CNA). I have a couple cases of the Premier Protein Drink stored in the garage right now to have pre and post op. Edit: I think each of those Premier Protein drinks is about 30 grams of protein per drink, I'll have to check again and correlate it with the nutrition requirements.

@Nothingupmysleeve: Honestly I don't know how this misunderstanding occurred. Either he doesn't want me to get the surgery for personal reasons, or he didn't listen to me, or he doesn't think I'm telling the truth. I normally get along well with this guy, but he wrote the following things in the psych letter that aren't favorable to approval: “She showed up to the interview drinking a Starbucks non fat iced mocha with cream” (I do this occasionally, and this was one of those days. And it wasn't cream, it was light whipped cream, but whatever) “She drinks iced tea and sees nothing wrong with this” (I told him I drink unsweetened iced tea as much as possible, it helps me hydrate and get my Water intake. I don't know why he missed the unsweetened part) “This provider is concerned she may not have sufficient understanding of good nutrition and meal planning to help her maintain a lower weight after surgery” “…..this will be a very difficult adjustment for her” “….she has only recently made some changes necessary for success after the surgery” (Not sure why he put down these things. I have told him that I've been on some kind of diet and exercise for many years, the most recently being Weight Watchers from 2012 to now; I studied nutrition, bought special foods and logged everything. I lost 30 lbs. with great struggle but due to hunger and busy schedule gained it all back. The way he writes it's like I've never tried anything.)

I just want to hear some of everyone's thoughts on this. I'm a little discouraged tonight, because my private mental healthcare provider wouldn't write me a recommendation and said I lacked nutritional insight to have the surgery and keep off the weight afterwards. I know that the surgery will shrink your stomach size, and not do anything to one's metabolism or mind. Without going into great detail--I've basically been on some type of diet and exercise since I was 14, and I'm 36 now. Sometimes it hasn't worked so well (the last couple years) and sometimes it's worked great (I won a trophy in basic military training for coming in first in a marathon and kept the weight off for 8 years). I have been on almost every diet from Weight Watchers to South Beach to juicing, but they're not working for me at this point to the extent that I am still hungry. My goal for surgery is to be able to follow Weight Watchers and maintain dietary/exercise changes without being so hungry and feeling deprived. I want a meal of a small bowl of Cereal or a yogurt + apple to satisfy me without stomach growling. Is this the right frame of mind or is there something else I'm missing?

Who gives a s***, Suzy? This is your big insecurity, not anyone else's.

Lots of people have commented on my weight loss, however, invariably they follow up with "did you mean to lose weight?" They ask because they're making sure you're not sick, like with cancer/chemo or something. The first time my husband did Weight Watchers with me, we both did very well. After about 30 lbs, he got some compliments, but also his boss said, "You're trying to lose weight, right?" I would just take it as a compliment, especially since most weight loss attempts (at least with standard dieting) tick off incrementally and aren't even noticed.

Not to be snarky with you Susysleever, but I'm a CNA, and if I were actually practicing/working, I'd consider myself to be in the medical field. What else would it be, anyway? It doesn't matter whether someone is a Dr., nurse practictioner, RN, CNA, orderly, whatever, if they work in a hospital or something, they're in the medical field. I've found many RN's to be extremely rude, by the way (apologies in advance to the ones who are actually nice people who don't eat their young), and I'm fairly certain that you would get your hackles up if an M.D. talked to you this way.

It might have to do with your decreased intake of food, or body changes. Regarding the decreased intake of food, carbohydrates/glucose is brain food, so a reduction in that (as well as a reduction in portion size) can cause some fatigue and blues. Regarding the body changes, I remember distinctly each time I got out of the hospital (first time for giving birth, second time for gastroenteritis), I felt depressed. I think my body knew it had gone through something and was sending some strange signals to my brain. I didn't feel "right" for several weeks or months until I snapped out of it and felt like myself again. I'm actually planning on having some sort of depression after I get the sleeve; it's surgery after all. But I would still go talk to a Dr. or therapist if this depression doesn't subside.

Damn....this isn't weight related, so I'm not sure it belongs here, but my husband and I have a "friend" we've known for about 15 years, and in the time we've known him he's basically bled us dry when possible by having us cover his meals, run him on errands, and use our car (he has no car, he doesn't feel like getting one). He has major issues with money and delinquency. Despite my desire to be independent, he keeps coming back into our life every couple years. He'll start out nice, but move in quickly, like by suggesting we take out loans or go into business together. When I shy away from the idea he gets hostile and will call off plans to visit, saying things like, "You helped me readjust my priorities. I will NOT be extending my summer trip to see you." Arguing with him is pointless. Worst of all, when he throws these temper tantrums, he waits a couple months and then contacts my husband, saying, "Is she still mad at me?" and acting like I'm the mean one, trying to completely ignore his own behavior and deflect it to someone else. Apologies in advance if this isn't the right thread, but how the hell do I deal with someone like this?

We have a place near us that can make really unique pizzas like that. I think it's called Angelo's. I always like to try mine with artichoke hearts and goat cheese if I can. I also, for the record, love Round Table's Chicken Garlic pizza (with white sauce), although I've only been able to find that chain of restaurants in California...

For high protein? Have you been doing any meat, such as turkey bacon or Spam? I also really, really love hummus--it tastes like tangy refried Beans. Might make an interesting addition.

A good point. Eating 3/4 of one slice of pizza or one piece of pizza, while filling for the WLS person, is seldom enough for those who haven't had the surgery. I think I had 4-5 pieces of pizza last night. But on Weight Watchers, a person could easily lose weight having just one piece of pizza per meal (it's at most 10 points). It's just hard (without the surgery) limiting your intake to that.

So with the sleeve, what does consuming pizza feel like? Do you get through half of one slice and then feel extremely full and bloated? Or do you pick off the cheese and just eat that?