Amanda Dutton LPC

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."