brightfaith

I have had a really hard time managing my diabetes (type 2). My A1c climbed to over 14 and now is back under 10 and going down, but I had an eye appointment this morning, and moderate retinopathy was found in my left eye. It's not serious enough to require treatment, but I do worry very much about the damage long-term high blood sugar levels have done to my eyes and the rest of my body. Improving my diabetes is second only to improving mobility as a motivator for having RNY in the spring. My main worry in this process is my depression. I have had pretty serious depression for most of my life. I have been in the best place in my adult life over these last 18 months, which is by far the longest stretch I haven't been in despair. There have been some low periods, but I've been able to come out of them more quickly and manage through them. I have the best combination of medications I have been on and have a good therapist and psychiatrist for medication management. Coming up for air like this is what is enabling me to envision a better future and start the path toward surgery. However, I am worried about relapse. When I am very depressed, I devote what very little energy I have to work, and self-care becomes a mighty struggle . Exercise or moving at all is sporadic at best, and anything more than opening a package to prepare a "meal" (even microwaving) is often too much (which leads to things like an A1c of 14). I understand that many people experience depression after surgery, and that was in fact one of the first things my surgeon told me at the consult. I am very concerned about going down the hole and what will happen if I can't care for myself in the way I will need to. Right now, in preparation for surgery in the spring, I am eating three relatively healthy meals, taking my vitamins, keeping a food diary, drinking fluids, exercising, even cooking a little, and things are going well...it's like a different world. I'm not sure what will happen if I become depressed again. I am really working on mindfulness and a meditation practice to keep me grounded through tough times, but I do not know if that will be enough. If anyone else has had similar struggles, how are you coping?

I did a nutrition session at Hopkins Bayview (before deciding to switch to University if Maryland), and there were several people in my class who had Priority Partners. If you go to one of their scheduled information sessions, you will be able to meet one of the coordinators who can likely help. But I think you will be covered.

Thank you so much to everyone who replied. I really appreciate it, and I feel much better about pushing back on the low fat guideline and choosing to eat full-fat foods. Thank you again!

Had my consult today and this was very helpful. Thank you!

It is so frustrating not to feel progress, especially with something like pain and mobility. But you are well on your way with weight loss, physical therapy, and lifting, and I am hoping your pain eases. Is there an in-person support group near you where you might be able to connect with some new people in similar situations?

Genetics for me also -- my father was more than 550 pounds when he died. I was already big as a toddler, and as a child showed signs of significant insulin resistance (acanthosis nigricans). Starting at about 6 years old, I was on restrictive diet after diet, which threw me into rebellious secret eating by about age 10 and then full blown binge eating disorder shortly after. I was about 260 pounds in my early 20s and then got very depressed and gained about 120 pounds in 18 months. (I'm only 5 feet tall.) I've been stable at about 20 pounds below that, 360 pounds, for years, but my mobility and health are really declining now. Depression really does not help at all. Thankfully, I've finally been on a good combination of medications for depression for the last year, and I believe the improvement in my mood is what has driven me toward the possibility of surgery. I want a more active life than I can lead right now. But binge eating disorder still rears its head, so I have to contend with that as I begin the surgery journey.

I am just in the early phases (having consults with surgeons and beginning the 6-month medically supervised weight management program), but I decided to tell my boss as I knew I would be requesting time out of the office for various appointments. We have a good relationship, she is very supportive, and she agreed to keep it confidential. I trust her, and I am lucky for that. I think you would be fine telling your supervisor you're having a minor procedure--there's no reason you have to go into detail about private medical issues. I also have a very good friend at work, and I've been talking with her about it as well. Other than that, I would prefer not to share with others at work, but I anticipate comments about my food and weight and am dreading dealing with that. Two people in my immediate vicinity talk about food and weight constantly, and even today, one of them loudly announced after walking past my office what I was eating for lunch, giving their approval for it being healthy...thanks, but no thanks, I'd just like to eat in peace.

I also have this question. I spoke with my psychiatrist at my last appointment about the possibility of weight loss surgery, and he said if I decided to move forward, he would work with the surgeon to determine whether any of my medications may pose difficulty, and we could find alternative ways to take them or consider different drugs (which I am loathe to do, because the combination I have been on for the last 18 months is the most effective I have ever taken). Has anyone had to change their medication?