OKCPirate

I know Alex and B-52 and others have had success with lap-bands, but I also keep hearing about people who have had them and the initial restriction helped them lose weight, they eventually gained it back. And that makes sense to me as more and more evidence comes out showing sleeves and gastric-bypass are much more than restrictions. At some point, they might figure out that it is hormonal surgery. There are diabetics who are off their meds more quickly than people who were losing the equivalent amount of weight.
Well, how long this hormonal effect last? The Cleveland Clinic Study is showing it works for at least five years...https://www.sciencedaily.com/releases/2016/04/160404152903.htm
I am going to make a hypothesis based on this study: just because your honeymoon period (the first 6-8 months post surgery) is over, you can still get the benefits of WLS a couple of years out. I keep wondering if the reason I was losing so quick up front is because I was really mindful for the first few months. And yes I was really excited too. But like many, I slacked off. The very real restrictions in my stomach/sleeve have made it easier to maintain, but I can restart my weight loss.
I posted about how my view of how I see my body has changed over the last 18 months (http://www.bariatricpal.com/topic/386931-who-dat/), and I'm about ready to start a rather intense six-week program this week designed to jump start weight loss. It should be interesting because the diet looks like what I was eating on week five following my surgery, only this time with more intense exercise. In short, I'm really excited, but also I'm looking at this as a follow-up experiment. I feel like I did when my post-surgery restrictions ended and the weight loss journey really began.
I've sort of beat myself up mentally for not being as diligent as I could have been, but I've been putting some of the techniques from this article into practice: http://www.nytimes.com/2017/01/03/well/mind/the-year-of-conquering-negative-thinking.html?ribbon-ad-idx=5&rref=health&module=Ribbon&version=origin&region=Header&action=click&contentCollection=Health&pgtype=article. I embraced what I did and didn't do. I believe it is possible to have multiple second chances.
If I'm right, my sleeve is still a great tool, even 2.2 years out. I'd love to hear from others who lost their focus but came back years later to finish what they started when they had their surgery.

Just please put a towel down when you sit nekkid on the sofa to watch TV. LOL.

This morning, Mrs. LittleBill up and left me. You might say I drove her to it - literally. She is traveling out to visit our middle daughter and her family to help watch the little monsters while our son-in-law is out of town on a trip. She is also taking a car out to them that they are acquiring from my parents. So, I drove her to pick it up at Mom and Dad's house early this morning.
She plans to come back though, so I am not a permanent bachelor. But for the next little while, I will be eating my high Protein, low carb meal selections off paper plates using plastic forks and spoons, and quaffing my liquids from a paper cup. Because hey, that's what bachelors do, right? I know there are other things bachelors do, but I have already been warned not to do them. So I will content myself with paper products and not putting the seat down on the toilet. It's a wild life around here, let me tell you.

@@LittleBill I totally agree. I had a horrible experience at a restaurant in OKC which I found out was part of a local management group. I did a check of Quicken account and I documented that I spent over $5K at their establishments in the last year (hey, I was single and date a great deal). I let them know how mad I was, never heard a response, so I organized a boycott ("let's avoid this place during Lent" - it was an issue with me showing a date a vaping device, and the waiter went ballistic). The company is publically traded, so when I noticed his companies 20% drop in revenue during the boycott, I reminded him, "it is amazing what a pissed customer can do." He actually called me, asked what he could do, I told him to have a talk with a friend of mine who was one of the best customer service people I know. End result, he ended up hiring her to train his wait staff and I feel safe going back to his restaurants. I turned down all of their offers for gift cards etc. I just wanted to be treated fairly.

Bariatric Dietitian Elizabeth Anderson explains why feeling sunshiney is the perfect reason to keep visiting your local phlebotomist.


New Year, new calendar, time to enter in to your digital devices all those reminders and important events for 2017.
Birthdays, anniversaries, car inspection and for bariatric post-ops…don’t forget your LAB WORK!
I know this is one of the first things that gets forgotten in the avalanche of to-do’s in the first year after weight loss surgery.
As a bariatric dietitian, I try to make it easier for my clients by sending reminder emails and letters to them and their PCPs.
Many of my clients will say, “Elizabeth, I’m healthier than I’ve ever been; I feel great! Why waste time and co-pays on lab work?”
Short answer? It’s critically important—no matter which procedure you had done.
The American Society of Metabolic and Bariatric Surgery (ASMBS) recommends lab work after bariatric surgery at 3 months, 6-9 months and 12 and 18 months. After that, an annual work-up is usually sufficient.
Here’s why:

Vitamins and minerals play many key roles in weight management. If you don’t get adequate amounts, you’re compromising your health and slowing down your weight loss.
Gastric Sleeve, Gastric Bypass and BPD surgeries ALL change your metabolism. This means the digestion and absorption of nutrients, Vitamins and minerals can be negatively affected.
Some nutritional deficiencies lead to severe consequences--some irreversible and at least one, fatal.
Nutritional deficiencies continue to occur after surgery—some as far as 20 years post-op.
a. Iron deficiency is most commonly seen 4+ years after surgery!
b. Dietitians in Boston, MA report that in one group of post-ops— 43% were B12 deficient 15 months after surgery.
Many patients are deficient in key vitamins before surgery.
a. One study showed 48% of WLS patients had at least one nutritional deficiency before surgery! (1)
b. Another study showed more than 50% of all WLS patients are low in Vitamin D preoperatively. (2) It’s safe to say those pre-op deficiencies don’t improve with weight loss, reduced calories and smaller meals.
I send my patients to their doctors and NPs with this list of recommended labs:

ü Thiamine
ü Folate
ü Vitamin D
ü Vitamin B12
ü Vitamin B6
ü complete protein
ü complete metabolic panel (CMP)
ü complete blood count (CBC)
ü Lipid panel
ü Liver function tests
ü Parathyroid hormone (PTH)
ü Bone density test or (DXA) every 2 years. More often than I like, providers will pick and choose from the list. They too, wonder if all the tests are truly necessary.
I gently push back with the research data and thankfully, more labs are ordered.
When the labs come back, make sure your bariatric dietitian or some member of your bariatric team reviews them.
Many healthcare providers aren’t well-versed in the nutritional concerns after WLS and might miss an important trend.
I know regular labs are one more thing on the to-do list, but remember, you made a life-changing investment in yourself and your health when you had bariatric surgery.
Consider all those vials of blood just part of your insurance policy protecting that investment!
-Elizabeth Anderson MA, RDN, LD

References:
1. Ernst B et al. Obes. Surg 2009;19(1):66-73.
2. Gehrer S et al. Obes. Surg 2010;20(4):447-53.

Yeah, what @@Babbs said. For those of us with long term weight issues, even the best supervised weight loss programs have a very low long-term success rate. Another round of yo-yo weight changes messes with body's weight set point at the hormonal level. If you take care of the emotional issues, along with this tool, your chances for long-term success jump from 5% to over 40%. @@pvechiola please take a look at this: http://theweightofthenation.hbo.com/films/main-films/Choices And the younger the better as far as skin sag and less damage to our joints and organs.

@@LittleBill I totally agree. I had a horrible experience at a restaurant in OKC which I found out was part of a local management group. I did a check of Quicken account and I documented that I spent over $5K at their establishments in the last year (hey, I was single and date a great deal). I let them know how mad I was, never heard a response, so I organized a boycott ("let's avoid this place during Lent" - it was an issue with me showing a date a vaping device, and the waiter went ballistic). The company is publically traded, so when I noticed his companies 20% drop in revenue during the boycott, I reminded him, "it is amazing what a pissed customer can do." He actually called me, asked what he could do, I told him to have a talk with a friend of mine who was one of the best customer service people I know. End result, he ended up hiring her to train his wait staff and I feel safe going back to his restaurants. I turned down all of their offers for gift cards etc. I just wanted to be treated fairly.

You might find this article interesting, it explains why WLS is not like wiring your jaw shut...in other words its not just about restriction, but bigger changes in your hormones, hunger signals et.al. But if you have to take care of the emotional issues which got you into this place, or you will find yourself back at square one...http://phenomena.nationalgeographic.com/2014/03/26/the-humble-heroes-of-weight-loss-surgery-stomach-acids-and-gut-microbes/#comment-3309413

@@LittleBill I totally agree. I had a horrible experience at a restaurant in OKC which I found out was part of a local management group. I did a check of Quicken account and I documented that I spent over $5K at their establishments in the last year (hey, I was single and date a great deal). I let them know how mad I was, never heard a response, so I organized a boycott ("let's avoid this place during Lent" - it was an issue with me showing a date a vaping device, and the waiter went ballistic). The company is publically traded, so when I noticed his companies 20% drop in revenue during the boycott, I reminded him, "it is amazing what a pissed customer can do." He actually called me, asked what he could do, I told him to have a talk with a friend of mine who was one of the best customer service people I know. End result, he ended up hiring her to train his wait staff and I feel safe going back to his restaurants. I turned down all of their offers for gift cards etc. I just wanted to be treated fairly.

I wiped out all my credits on Audible.com in the first month. I'd put a good book on an MP3 player and start walking. Started with light weights in the gym after week four was done.
I'm guessing you have been sort of sidelined by your weight from doing many physical activities? If so, start dreaming while you are walking for the next few weeks about things you want to do (snorkel, ski, run, yoga). One of the things that happens to people who just have not been able to do things because of their weight is they forget what is possible. You get limited by an image we have of ourselves. Well it's going to change. So start dreaming...and dream HUGE.

You might find this article interesting, it explains why WLS is not like wiring your jaw shut...in other words its not just about restriction, but bigger changes in your hormones, hunger signals et.al. But if you have to take care of the emotional issues which got you into this place, or you will find yourself back at square one...http://phenomena.nationalgeographic.com/2014/03/26/the-humble-heroes-of-weight-loss-surgery-stomach-acids-and-gut-microbes/#comment-3309413

You'll have to carry tupperware. Steel will make you lean to one side now.

That's exactly what I did. I kept my composure, while still voicing my concern and confusion. And you're right. I should have posted that I was angry about the treatment. Thanks so much for your very thorough input, LittleBill! You never disappoint! I was like, "Ok, when is LittleBill going to comment?" *taps foots*
I love this! So glad it ended well for you! And both parties won!

For sure!!
I'm bound to want to go sky diving for my 26th birthday next year once I'm under the weight limit!
I tried yoga once while existing as overweight and while it's not impossible it was not fun!
Sent from my iPhone using the BariatricPal App

Two years and a couple of months post surgery and I am in that "new normal" area. For the last 18 months, I have been buying size Large shirts, 36" waist pants. My weight has been consistent. I pushed myself early to do a 5K and climb a mountain. But 2016 was busy. I met a spectacular woman over a year ago and was more interested in building the relationship than trying some new physical challenge.
Last October she did a six-week 20-pound weight loss challenge (which she really didn't need to do, but she felt like she needed to reset her system). I didn't have time then to join her, but she did well, she lost 18.2 #'s, and her abs are killer - she is 54 and can rock a bikini, I find that impressive. After the program, she had an accident and needed knee surgery just before Christmas. Because she was in such good shape, her recovery is going better than expected. That was a wake-up call to me that I can do better than just being average.
So I decided to jump start this year by doing the same program she did. Four weeks ago I already started doing the C25K program again to get ready for another race in April. So things are getting moving again. But today as I was cleaning up old files and I found a picture from 10 years ago, and my first thought was "who's that?"
I didn't recognize myself.
We joke in the beginning of our weight loss journey that we often have a moment where we don't recognize ourself in the mirror, well one cool thing to look forward to is getting to the place where you don't see yourself as the fat guy anymore. And even when you don't, it's also fun to push yourself a little further and strive for an even better normal.

@@LittleBill I totally agree. I had a horrible experience at a restaurant in OKC which I found out was part of a local management group. I did a check of Quicken account and I documented that I spent over $5K at their establishments in the last year (hey, I was single and date a great deal). I let them know how mad I was, never heard a response, so I organized a boycott ("let's avoid this place during Lent" - it was an issue with me showing a date a vaping device, and the waiter went ballistic). The company is publically traded, so when I noticed his companies 20% drop in revenue during the boycott, I reminded him, "it is amazing what a pissed customer can do." He actually called me, asked what he could do, I told him to have a talk with a friend of mine who was one of the best customer service people I know. End result, he ended up hiring her to train his wait staff and I feel safe going back to his restaurants. I turned down all of their offers for gift cards etc. I just wanted to be treated fairly.

I realize that testing hormone levels via blood tests are kind of hit and miss, but as a guy, I can tell you it was really critical. Pre-surgery my testosterone level's were really low. So I was receiving supplementation, the first few months following surgery the T levels spiked during the hormone dump (rapid fat loss led to everything stored in the fat cells to bounce into the blood stream). Now everything has leveled off. If I had just done a "one and done" blood test we would have missed this. And too much T can cause blood clots, and actually make it difficult to do aerobic exercise. If you don't have insurance, check online, there are places where you can get the blood work done affordably, and you can take the results to your doc and NUT.

@@LittleBill I totally agree. I had a horrible experience at a restaurant in OKC which I found out was part of a local management group. I did a check of Quicken account and I documented that I spent over $5K at their establishments in the last year (hey, I was single and date a great deal). I let them know how mad I was, never heard a response, so I organized a boycott ("let's avoid this place during Lent" - it was an issue with me showing a date a vaping device, and the waiter went ballistic). The company is publically traded, so when I noticed his companies 20% drop in revenue during the boycott, I reminded him, "it is amazing what a pissed customer can do." He actually called me, asked what he could do, I told him to have a talk with a friend of mine who was one of the best customer service people I know. End result, he ended up hiring her to train his wait staff and I feel safe going back to his restaurants. I turned down all of their offers for gift cards etc. I just wanted to be treated fairly.

Two years and a couple of months post surgery and I am in that "new normal" area. For the last 18 months, I have been buying size Large shirts, 36" waist pants. My weight has been consistent. I pushed myself early to do a 5K and climb a mountain. But 2016 was busy. I met a spectacular woman over a year ago and was more interested in building the relationship than trying some new physical challenge.
Last October she did a six-week 20-pound weight loss challenge (which she really didn't need to do, but she felt like she needed to reset her system). I didn't have time then to join her, but she did well, she lost 18.2 #'s, and her abs are killer - she is 54 and can rock a bikini, I find that impressive. After the program, she had an accident and needed knee surgery just before Christmas. Because she was in such good shape, her recovery is going better than expected. That was a wake-up call to me that I can do better than just being average.
So I decided to jump start this year by doing the same program she did. Four weeks ago I already started doing the C25K program again to get ready for another race in April. So things are getting moving again. But today as I was cleaning up old files and I found a picture from 10 years ago, and my first thought was "who's that?"
I didn't recognize myself.
We joke in the beginning of our weight loss journey that we often have a moment where we don't recognize ourself in the mirror, well one cool thing to look forward to is getting to the place where you don't see yourself as the fat guy anymore. And even when you don't, it's also fun to push yourself a little further and strive for an even better normal.

I wiped out all my credits on Audible.com in the first month. I'd put a good book on an MP3 player and start walking. Started with light weights in the gym after week four was done.
I'm guessing you have been sort of sidelined by your weight from doing many physical activities? If so, start dreaming while you are walking for the next few weeks about things you want to do (snorkel, ski, run, yoga). One of the things that happens to people who just have not been able to do things because of their weight is they forget what is possible. You get limited by an image we have of ourselves. Well it's going to change. So start dreaming...and dream HUGE.

@@LittleBill I totally agree. I had a horrible experience at a restaurant in OKC which I found out was part of a local management group. I did a check of Quicken account and I documented that I spent over $5K at their establishments in the last year (hey, I was single and date a great deal). I let them know how mad I was, never heard a response, so I organized a boycott ("let's avoid this place during Lent" - it was an issue with me showing a date a vaping device, and the waiter went ballistic). The company is publically traded, so when I noticed his companies 20% drop in revenue during the boycott, I reminded him, "it is amazing what a pissed customer can do." He actually called me, asked what he could do, I told him to have a talk with a friend of mine who was one of the best customer service people I know. End result, he ended up hiring her to train his wait staff and I feel safe going back to his restaurants. I turned down all of their offers for gift cards etc. I just wanted to be treated fairly.

I did not read all the replies. I can see both sides of the split fee issue. It costs money to keep the doors open. I have no patience at all with rude people. It gets even worse with disingenuous people. If I had been in the situation you were in, I would have asked about the fee, which it seems you did. I would have very politely maintained my position with the manager, no matter how rude he became, finishing up with something to the effect that I understood they have every right to charge what they want for their food or services. I have every right to not eat there again. I have also been known to inform people that they will be surprised just how much bad advertising their (insert monetary value here) just bought them. However, I do not go online publicly. I merely discuss it with people I know.
As for split fees, I never heard of one before today, which tells you what kind of dives I hang out in.
ETA: I forgot to add, I would have emphasized that I was angry about the treatment and not the money, but the monetary thing I mentioned above still exists.

Geez, this is tough. Esp. for women. Please create a new mantra for yourself. You are creating a "new normal." This means you are transitioning. During any transistion, people will be different in their reaction to you. You are also different because hormones are dumping out of your fat cells (and this applies to males too). Focus on your health now. The new normal will be coming soon. It's not easy. But when you are stable, that's when you will be in a great place to start re-evaluating your relationships.

Geez, this is tough. Esp. for women. Please create a new mantra for yourself. You are creating a "new normal." This means you are transitioning. During any transistion, people will be different in their reaction to you. You are also different because hormones are dumping out of your fat cells (and this applies to males too). Focus on your health now. The new normal will be coming soon. It's not easy. But when you are stable, that's when you will be in a great place to start re-evaluating your relationships.

Never run into it before, but if I was the manager/server, I would have said "oh I'm sorry you didn't notice that was on the menu. We add it so we can enhance your experience and stay in business." Or something to that effect. End of the day, same effect, but at least you would feel better and they get to keep their doors open.
I know restaurants have low margins, I know customer service isn't easy, but a little imagination, fun and training just makes everyone's experience better.