Amanda Dutton LPC

Hey, y'all. Posting in the vet thread so if it is not appropriate I can get your feedback and quickly delete without getting early WLS folks involved. I don't want to break posting rules, so if anyone can lead me to the rules about this, please help - I've been away for awhile and have only re-engaged in the last couple of weeks. I'm a therapist and a coach who works pretty exclusively with bariatric surgery folks. I want to create a couple of low-cost courses for bariatric surgery folks, both pre and post surgery. I want patient input on what is needed so I only create something really helpful and know this is the best community to ask. There will also be a free "bariatric bootcamp" mini course. But, I want to be transparent, so I don't want to ask something like "what do you wish you knew before surgery" or "what are your biggest worries going into surgery" without being totally up front as to why I'm asking. Are there rules against this? Can someone direct me to this info if so? Can y'all tell me if this even sounds like a good idea??? Again, if I find out I'm breaking some forum protocol by even asking this, I'll take this down ASAP - I just figured other vets could help me figure this out. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Oh, and I've always gotten my meds from my primary care doctor. So it wasn't because I saw a psychiatrist for a year either. [emoji4] ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

So glad I came across this thread. Hopefully I can help. Therapist, specialize in treating us, also complete evaluations, also have Bipolar I (and had surgery so...🤷🏼‍♀️). According to the actual guidelines that we are supposed to follow regarding who has to be considered as not ready for surgery: - actively psychotic - recent (past year) inpatient hospitalization for mental health (suicidal/homicidal) - drug/alcohol abuse within the past 6 months - unstable mental health diagnosis (e.g. not actively in treatment, not keeping up with meds and appointments, etc.) Now, the good news is, NONE of those things mean the person will NEVER be approved - they may just have to have a period of time that they show stability/treatment compliance BEFORE they get approved. That info is straight from the ASMBS (American Society for Metabolic and Bariatric Surgery) guidelines. If the psychiatrist says otherwise, he can take it up with them! 🤣 I hope that helps. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Ok, this totally made me 🤣🤣🤣 ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

You are totally right (but I may be biased, too - LoL - also a counselor!), we lost our #1 coping tool and have to start feeling "all the things," probably for the first time in a really long time. For me, it was like being an addict (who am I kidding, I am an addict) jonesing for the next hit so I could "numb it all away." For some of us (yes, us - even some therapists), we will always need medication. I look at it like this - the meds are like my life raft - but it's still up to me to paddle if I want to get anywhere. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

That's why it's all about learning! Who knows? You may have totally just helped someone else who wouldn't have been brave enough to ask! Glad you got the answer - especially since you were able to figure it out yourself! I use this website to reference when trying to get an idea of how much protein something has and I don't have a label. Hope this is helpful to you! http://apjcn.nhri.org.tw/server/info/books-phds/books/foodfacts/html/data/data2d.html ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

I don't think the two items you have circled are related. The thickening in the abdominal muscles, based on where it's located, is most likely scar tissue - probably from the gallbladder removal (cholecystectomy) and they were also ruling out the image being from sutures from your current surgery, since both of those use an instrument that goes in through the belly button (umbilicus). Those findings wouldn't be critical, so they wouldn't need to be reported to the hospitalist right away by the radiologist, unless it was to alert them of any sort of pain management protocol to order and have on hand for you ASAP. Scar tissue/adhesions make healing from additional surgery more difficult and painful, but again, I don't think that would be a critical result. 🤷🏼‍♀️ The good news is, they would need to treat you for anything critical before release and get it under control, so at that point, you would be okay. For your peace of mind though, call and ask your PCP. No harm in that! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

I've found out (as a therapist myself) that some insurance companies are the ones that won't let a therapist write the letter, not necessarily the doc. That may not be the case here, but just my own experience. It sucks. I figure I could help better than someone who hasn't had the surgery, but the damn insurance companies know better, I guess (insert eye roll - LoL). ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Here we go! Net Protein Utilization is the percentage of the protein that your body actually absorbs. So, if you are using Whey protein isolate or concentrate (make sure it's not a blend, because it may be mixed with soy or something else that can lower the score), you are getting almost 100% of the protein. Hope that helps! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Keep in mind that protein shakes don't have proteins that can be 100% absorbed, so you are totally fine to go over 30g with them since not every gram will be processed. Let me go check my Pinterest boards and see where I saved that graphic that shows percentages... ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Not drinking while eating was hard for me, too! I had to just not fix one. Ugh, I thought it was terrible at first, but it becomes the "new normal" pretty soon. I'm doing well! At 14 years out, I'm happy to report it *is* possible to stay successful. There are still those days I want to snack myself in the head for filling up my plate based on my "old brain," but food doesn't rule my life anymore, so I'm definitely gonna say I'd do it 1000 times over again. [emoji175] ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Sounds like you are rocking along! It probably won't take long after you finish with the dietitian. Like you said, probably by the end of May. I'm excited for you! Caffeine is tough. I've always been a coffee drinker, so I started cutting mine with decaf, a little at a time, until I was fully switched over. Same with diet coke - I kept caffeine free around and cut it in as I went. And kept telling myself I had to drink as much water (flavored, couldn't do it straight at first) as coke or coffee BEFORE I could have one or the other. Except a small cup of coffee in the morning. Still can't stomach water on a completely empty stomach but I can do coffee. Strange, I know. Keep us posted! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

You are so welcome! I'm glad it was helpful and that you found a calcium that works for you. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Don't panic. The PCP sounds like he needs to do some continuing education on WLS. That study primarily focuses on people who had RNY, since the sleeve didn't become popular until later.Those of us who had RNY can be at higher risk for bone loss because we have had several feet of the top part of our digestive tract removed. That's the malabsorption thing people talk about. VSG folks are still essentially intact but with just a smaller stomach (one of the highlights of VSG). Of course, keep taking your Calcium unless instructed otherwise by your surgery center, but as long as there are not other non-WLS factors that could cause bone loss (ongoing untreated low Vitamin D, heavy smoking or alcohol use, etc), the chances are low. This is based on findings from several studies by the ASMBS (American Society for Metabolic and Bariatric Surgery) - the managing organization for everything WLS. See screenshots. No more risk than with a lab band, and those have NO digestive tract change/removed. Hope that helps! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Therapist here, 14 years post RNY. [emoji1327]‍♀️ Definitely see a different clinic AND start seeing a therapist (preferably see the therapist at least once so you can tell the new clinic you are going). Based on your post, nothing stands out that would indicate that you couldn't have surgery. 1) even if you were stress eating - not something that can't be dealt with in therapy (e.g. I think most of us stress eat at some point, TBH) 2) My original doctor said I "wasn't bog enough" for surgery (278lbs, 26 years old, arthritis in knees and high blood pressure) - so I fired him and went to another doc. She saw and heard me, so she agreed that I could have surgery 3) if all else fails, go ahead and see a psychologist for an evaluation. Find one in network with your insurance AND that is approved by the surgery group, if they have a list). Nothing like having a step out of the way AND validation that you are ready. Hope that helps! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Oh that stinks (well, maybe it will - I guess in this case that would be a good thing [emoji38] )! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

I take one of the Bariatric Fusion Multis (it doesn't have iron in it) twice a day and just take my iron separately, about 2 hours later. I agree about the calcium absorption, Alex. The BF multis have a good amount of calcium, so I haven't had to take a separate one. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

That's the one! As a side note, it also doesn't seem to cause the constipation issues that regular iron does. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

I also take Feosol Complete, and it was recommended to me by my Hematologist. I ended up with a serious iron deficiency several years ago, despite taking iron (my ferratin was a 6 - anything under 10 is considered "critical") and had to have an infusion the day after I met the Hematologist. She recommended the Feosol Complete because a poly/heme iron absorbs further down the digestive tract and iron salts (the usual iron supplements everyone takes) are absorbed in the duodenum, which RNY and DS patients no longer have access to. I had one other infusion as my body tried to regulate itself, but haven't had a low ferratin level in over 5 years since taking Feosol Complete. And it DOES have to be the "Complete" version. The regular Feosol is not a poly/heme. Hope that helps! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

If you have reflux before surgery, sleeve generally won't help. I know there are a few that have gotten relief from occasional heartburn, but since the sleeve leaves access to stomach acid in the sleeve (RNY separates it and it doesn't meet the food until after the pouch), it's not going to change the cause of reflux. It's definitely something to consider. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

You are very welcome! I have the options set in my area, and also added bariatric surgery (we can add any specialties that aren't listed), but I don't know if many therapists think to do that. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

So very normal! If we think about it like an addict (which most of us are, whether we realize it or not), we are in "withdrawal" after surgery from the carbs, sugar and fat our bodies are used to. So our brains start saying "hold up - where did it all go? Did you forget we like this stuff? Let me remind you!" Drug addicts call these "using dreams." They can be so real, they will wake up convinced they relapsed. It happens to us too. So look at it as your brain realizing that it's not getting all the "bad stuff" - not the lettuce, but the fatty things that would go with it - and celebrate. You may feel like you're going crazy, but you're really going through detox. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

There is a great website that we therapists use to list ourselves and makes it easier for people to find us. It's called Psychology Today. You can filter the therapies by location, insurance, problem (there isn't one for bariatric surgery, but weight issues and maybe obesity are options) and even preferred gender of therapist. Working with a psychologist or therapist is a huge help, and a letter from them should make your docs, surgeons and/or psychiatrist take you seriously. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

I hope it helps! I feel like it's something that isn't shared enough. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

I posted this last week, but I hope it is helpful for you. https://www.bariatricpal.com/applications/tapatalk/index.php?/topic/421945-Sharing-my-knowledge---my-14-year-Surgi-versary!#entry4731671 ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."