This is very interesting to me, since I also have RA/PsA. When we started discussing biologics, I asked my rheumy's opinion of WLS. She was enthusiastically behind it, citing WLS as many times reducing the inflammatory factors. However, she and my surgeon (and my research) all said that the bypass was NOT a good option for someone with auto-immune because of the complete contraindication for NSAIDs and steroids, where the sleeve only has a relative contraindication for those meds.
Not criticising you or your docs, just find it interesting how there are so many differing opinions in the medical community.
BTW, biologics are now off the table for me for the forseeable future. My inflammatory factors are down, and we still have dosing room on sulfasalazine and we haven't tried plaquenil yet. Mtx failed and I developed an allergic reaction to it, so at least I don't have to give myself chemo anymore! LOL. So the sleeve has worked amazingly well for me. Not remission, but meds are working better and we're able to avoid the real heavy hitters indefinitely.
It is interesting how doctors differ in their opinions. I have autoimmune diseases as well. Medications really truly were the reason i packed on so much weight so quickly. I have Psoriatic Arthritis and hypothyroidism.
At the same time, I had a very severe case of GERD causing me to cough every day all day for over a year with no solution.
We had to heavily weigh the right choice of surgery for me. GERD is 100% resolved, issues with pain control for my joints are an everyday battle and I can not and will not risk taking any nsaids even with treatment.
Because I have Psoriatic arthritis oral steroids are out as well as it kicks up the psoriasis so bad that it has caused serious infections that have caused me to be hospitalized over the years.
I also never over ate. However, I ate crap all the time so i was actually malnourished while being morbidly obese. In fact my family and friends could not understand how i was so heavy because they saw how much i ate, they just did not realize that all the carbs were killing me.
Anyway, since bypass I am still on biologics (Stelara) and Cyclosporine to keep my Psoriatic arthritis under control. It has been well controlled for the last 2 years so we have slowly be reducing the quantity of those medications. We tried lowering the dose of Stelara over a year ago and I went into a full on several month episode so we increased it back to where it was. We are discussing trying a reduction again in the spring as everything looks like it is going into remission. That being said, anytime i have surgery it seems to kick back up again so we are going to wait until after my plastics in January to try again.
The biggest thing about having WLS is the head game. You have to change the way you live and learn to make better choices. I think for the most part i have done this well. Of course there are times when i indulge but 90% of the time, I do have to fight with my head.
In the beginning, it was easier for me because even if i did indulge, the weight still came off.
Now that I am two years post op, those decisions matter. I will gain or lose based solely on my behaviors. I believe this MUST be true of anyone going through or that has gone through WLS.
Yes, some people will lose slower than others - I was one of them. It took me 18 months to lose my excess weight and alot of hard painful work to actually get there. Others have lost their weight of similar proportions within the first 12.
I am sort of glad it took me longer, and took me understanding that I am now in the drivers seat, not my pouch. What i choose to put in my body and how often will dictate whether i lose, gain or maintain. If i choose to get no exercise at this point, it will and does have an impact on whether i lose, gain or maintain.
I am in the drivers seat......not my surgery. The sooner some people realize this there will be less need for revisions in my opinion. Of course, I am NOT referring to those that have a equipment failure.
I personally feel that a surgeon that is considering a revision for those persons who failed to lose the weight (not by malfunctioning equipment/surgery) really do need to see someone to assist with why they have not lost the weight.
There is a nurse in my doctors office who had bypass surgery at the same time i did. I know this because she told me and seemed almost upset that I lost all of my weight and she has lost very little. She immediately blamed the surgery for not working. Then proceeded to tell me that her schedule simply did not allow for her to focus on herself so she is unable to get the right Protein and even fluids in her body. She skips meals and then eats whatever is handy in a few minutes in between patients.
Ok, that is not the surgery failing, clearly she is still following the same behaviors she was before surgery. Dont get me wrong, I get it....she is taking care of patients. But, there comes a time when we have to be selfish and focus on ourselves if we want to be successful in the end.
I literally started taking care of everyone else but me from the time I was 16 years old. I was a working married mother of 2 by the time i was 19 going through a horrible marriage. By 22 I was divorced and a single mother working 3 jobs just to make ends meet. By 25 i was remarried to my wonderful hubby of 29 years and working a high paying very stressful job. I did so well in my career and became the primary breadwinner. Well, then there was the stress of that so again, not taking care of me just working like a crazy person.
By the time i was 51 i was in big trouble health wise and was literally told, i would end up in kidney failure soon if i did not lose weight.
So, it was time for me to be very selfish and start taking care of myself.
For the last two years, I have been focused on my health and well being and when you are morbidly obese, that is a necessary part of getting your health back.
So, i say again......your head really has to change in order to be successful. It is why they send you for physch evals before this surgery. I honestly think they could do a better job of assessing patients and setting them up with the right people to help them through the mental part of WLS. Most of us need some sort of help.
@@Djmohr, thank you for your comments. I was on the October 2015 forum and your posts have been encouraging. I am finally going to have gastric bypass surgery on December 12th and I have learned a lot from you and others in that and other forums. I just wanted to let you know that you are appreciated.
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