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December 9, Dr. Ponce de Leon

This was my last pre-op thanksgiving. I intended to stay full Protein, but ended up with a serving of turkey, then 2 bites of mashed potatoes, green Beans, corn, and a slice of pumpkin pie. Didn't lose - but didn't gain, and that's a lot less than I usually eat. I'm hoping that next November, almost 1 year post op, will be similar - but at goal. I'm making pot roast and chicken Soup for Christmas. I figure I can have the broth.

I have been looking into bariatric surgery since my early 20's. I was initially talked - or more appropriately - guilted - out of roux en y. I never found enough evidence or personal desire to overcome that initial hurdle to go down that path. Although I have seen bypass work for a few people, most of the people that I personally know who had it initially reveled in their ability to 'eat what they want' and still lose weight. Those same people regained as their intestines increased the ability to absorb and as they stretched their pouch one bite at a time... two are now bigger than they were when they first had the surgery. The people who followed the plan have been wildly successful and kept it off. I have been looking at VSG for 4 years. I believe the article I read was specifically written about VSG, but I can not find it now to say one way or the other. Peer reviewed? I honestly don't know. I do know that the timing coincided with me 'realizing' that my youngest had crossed over the 'big but healthy' to the 'overweight' side... and that was enough to push me past that 20 year old conversation. If gastric bypass is what you feel would be best for you, I think that is exactly what you should get. I read this question as "what made YOU choose VSG".. not why someone else should choose it. I believe that, whatever form of surgery you have, if you live a healthy lifestyle afterward, you are likely to be successful. I believe that seeing mom have a healthy lifestyle, whatever the cause, will be helpful to the kids. FWIW, while looking for the article, I found a newer one (based on rats) that showed rat pups born to moms post vsg were lower birthweight till puberty, then started packing on the pounds... scientists hypothesized that it was due to the prenatal lack of exposure to mom's ghrelin.. but they're not sure. I'm not having any more kids - and I'm still planning a VSG for 10 days from now.

Mine are natural - boobs in general aren't terribly comfortable to lay on top of without a pillow. The bigger you get them, the more that they sag and the more likely you are to have to have them relifted in 10 years. A lot of the difference in shape has to do with the position (above or below the muscle), the shape of the implant (round vs. teardrop, anatomical projection). If you haven't had a consult with your plastic surgeon yet, when you do he should have 'samples' of the different implants he uses and the different sizes. If you like the way you 'look' in a 36 d, get one with no padding.. see which size fills your cup in a way that you like, and get your surgeon's opinion - they know their wares, so to speak.

@@della street Lactose is milk sugar.. gives some people the runs.. Lactose intolerant, more common (apparently) after WLS (and as you get older)... Lactaid, Lactase supplements usually help. whey Protein isolate is a yummy source of protein for these people... because almost all of the sugar is typically removed anyway. Whey is milk protein... gives some people hives, closes their airway... ALLERGIC to milk, don't try it in anything - not even baked in a cake. So whey protein isolate would be completely off limits to these people.

I am staying at the Lucerna. I figure it doesn't really matter to me; I typically fly Southwest and sleep LaQuinta or Extended stay. My biggest reason for staying at a ritzier hotel is 1. reputation in a foreign country and 2. proximity to the hospital. My husband has forbidden me to go shopping. I'm to have surgery, pace the halls, read a book or five, and come home.... He's a little worried about me. My children actually wanted me to have the surgery and then stay at a hotel in SanDIego until time to come home.

Define low? They sell glucose gel that you can put on your gum.. Absorbs through the capillary bed. If you are checking your sugar, though, could be your meds for diabetes? Talk to your doc.

I think my topic title says it all.. I'm looking to get to know people before the surgery day; I'm going by myself... and my daddy used to say that if there was just me and one other person on earth, I'd have to start walking to find them so I had someone to talk to.

Eat before or after?

Did your surgeon not recommend one? It would probably be a beast to get on now, especially if you have staples.. but http://slimpressions.com/shop/index.php/tops/arms.html is very nice for afterward (or before)

For me it has been reassuring to know that I can do it and stay on it post op... knowing that you 'can't' have something can really screw with your head, especially if you have control issues - or food issues - or use food as stress relief - or, yeah.. all the stuff that caused me to need surgery in the first place.

With regard to keeping your husband and kids out of prepared food - why not just make the same food for everyone. No junk food in the house. All food is 'on plan'... since they like eating it anyway.

I read a lot of studies... in a rat study I read studying the long term effects of VSG, the rats fed LCHF had the greatest energy intake and the highest body mass compared to the LC LF and the LCMF rats... both of whom had no significant difference in their body mass. So no LCHF for me after this, I think. LCMF should be sufficient to induce ketosis, and then I have plenty of my *own* fat to break down for the remainder... The biggest issue is to not go so low in fat that you eat more Protein than your body needs, because protein is broken down into the various amino acids - and about 18 of those can be used to build glucose on, thereby throwing you out of ketosis... But given how little we can eat after sleeve anyway, I'm not worried about getting 'too much' protein after surgery, and I'm working on getting half my body weight in grams of protein for the two weeks leading up to it, to speed up healing.

@@anneeo I can relate to your 'Holy cow, what must they think of me'... but then I realize they aren't really thinking of me at all. Because *when* I only needed to lose 10 or 20 or 50 lbs, obviously I didn't do it or I wasn't able to do it.. because now I need to lose an extra 100, in addition to that 50... and at no point in my life have I noticed someone else's weight, unless they were my patient and I was talking to them about it as part of my job. I too thought I was gigantic at a size 10 in high school; that's my goal weight now. I think almost all of us are screwed up about food and weight in some way or other; the very skinny, the sort of skinny, the medium, the large, the extra large, and the - wait for my doctor's words - "morbidly obese". We're just varied in how we show our issue. But we all *almost* all criticize ourselves 10 times harder than we criticize others, and we all feel our own pain and issues much more than we think anyone else feels theirs... and certainly more than *we* notice their issues.

It obviously isn't killing most of the people who do it - but if you have complications related to not following the doctor's plan... who would you be most upset with?

I was chubby as a child, about what is considered 'normal' for kids now... but compared to my age mates, about 20 pounds bigger. I was the biggest girl on my cheerleading squad - but small enough to be on it, if that makes sense. I was put on Lithium at the end of my teenage years after an errant diagnosis of bipolar disorder. I gained 50 lbs in less than 4 months. I lost about 10 lbs in the following year, then had an activity restriction during my first pregnancy. I didn't gain much in the first four months, but I gained at least 50 in the last 5. I lost most of my pregnancy weight, but with a new baby - exercise just didn't happen... so I gained it back afterward. And then I lost 50 lbs and found 60. And then I got pregnant again. And gained 30 more. And then everything hurt, and I had two babies hanging on me, and ugh. I gained another 40 lbs in nursing school. And lost 40, gained 40, lost 30, gained 40... so now I'm looking at surgery. And I need to lose 150 lbs to be healthy, 180 to meet *my* target goal.

All good. I like unjury too... chocolate splendor in a cup of decaf feels like desert. I like Nashua Nutrition's pink lemonade liquid too.. I will be taking that to Mexico with me. Regarding wearing scrubs at the hospital - I have to wear them at work every night; I don't want to dress like a nurse when I'm the patient. I'm digging the loungers, though. I'm a little worried about getting cold after surgery - I'm looking forward to the side effect, but at the same time I'm not bringing a jacket because I don't *GET* gold until it's 40 degrees, windy, and I'm in the shade. I'm only bringing one bag, since I'm traveling alone and I have to carry it. I wish you were having your surgery at the same time.. it would be nice to know someone ahead of time who's there with me. I'm leaving my husband home to take care of the kids.

Klock, I agree with you r/t just colonoscopy - I'm used to having cameras 'meet in the middle'. Definitely not a GI nurse here. I don't even enjoy it as a patient. Psych and wound care, though - I am all over.

Slimpressions. They have several that cover the tummy completely, open bra (so I can wear my own), with shoulder straps (so it doesn't roll down) - I like the ones that start with bike shorts, but some don't.. and you have to have time to go to the bathroom... but all of them are made where you step into them and pull them up, instead of putting them on and pull them down.

You make my heart smile. Sometimes, a little love to help displace some of the self loathing is very helpful in realizing what a strong person you are.

Re:colonoscopy In looking at the diagram of the intestines, where there used to ne a straight line with a finger sized branch for the appendix, there is now a fork in the road. For a straight colonoscopy.. Shouldn't affect anatomy there. An upper and lower gi, diverticulosis, crohns, anything involving bypassed tissue... I don't know what if anything would be different. I just know I would want a gi doc with a lot of post wls experience. My logic says the sleeve is still a straight shot, therefore IMO less likely to have blind spots. Also.. I take a lot of NSAIDs and steroids, and long term meds that have been studied in people with intact absorption. Not enough studies done for dosing after malabsorptive procedures for me to make that my first choice

Isometrics might be your best friend right now. Thirty to sixty seconds every time you should on yourself. And depression, tsh, and vitamin d evals

Sounds like a plan. Early happy birthday. Mine just passed. I too wish I could just go now. I have calmed my nerves by focusing on getting things in place.. I have five diff protein supplements to try, I am walking at least half a mile a day and taking stairs... Taking vitamins, bought loungers for Mexico... Cause I don't want to be that patient in scrubs at the hospital.

congratulations on what you've accomplished!!! I gained some weight after my hysterectomy as well; I have to ask - when did you last have your TSH checked? If that's normal, you know how to do this... the same thing that got off the first 50 will get off the last 10. Planning, counting, exercising. You can do it, and you've already said it's worth it.

Why I chose VSG: 1. Decreased risk of dumping syndrome. Three years from now, if I want a bite of donut, I can have a bite of donut - enjoy a bite of donut, and odds are, not feel like I'm going to fall out. 2. Increased ability to eat 'healthy' food.. Lean and green are the mainstays of this lifestyle. 3. I read a study that indicated that families where the mom has had VSG lose weight and the children are less likely to be obese. I think that has to do with #2.. I want that; I want my kids to see me eating healthy, not to see me able to eat 'whatever' and still lose weight. 4. I work with ALOT of people who have had both surgeries. It has been my observation that post bypass, while the weightloss is faster, the skin is MUCH looser, the overall appearance is less healthy (dry, ashen, etc..), and to quote my husband they look like 'a pillowcase with the s*t slung out of it'. 5. I'm not the best at taking supplements long term. I stuck with prenatals for a year of planning + pregnancy and then another year of nursing.. and then Vitamins became hit or miss for me. I don't want to lose bone mass, blood cells, etc because of massive supplement needs secondary to malabsorption. 6. Research indicates that the part of the stomach left after gb can restretch; not so much with vsg due to the fact that the fundus is removed. 7. The intestines increase their ability to absorb, it's a survival thing. What if I get used to being able to eat crap and lose weight, stretch my stomach out, and my intestines start absorbing enough calories that I put it back on? 8. I want a normal colonoscopy, where all my insides can be visualized without having to have a special procedure. For me - bypass was a very brief fleeting thought. I believe the VSG will be effective. If it's not, I can always have a revision to the DS. If it is, I've avoided all the stuff that steered me away from gastric bypass for the last decade.