Assya

Hi everyone

Happy 4th of July! Newbie here seriously exploring a sleeve. I am looking for advice from people who use food as an emotional crutch, a friend, the only relationship you really have etc. I have always known my obesity since I was 16 was always related to psychological issues and not physiological. I am in therapy and until now I never considered surgery because I knew it was a tool but if deep down I did not choose to get better, surgery was not going to change that.

I started researching surgery because the health consequences of the weight are manifesting very seriously. But as scared as I am of diabetes, arthritis, and loss of mobility, for some reason none of that convinces me to put the food down. It's so irrational that no matter how many issues the weight brings or how much life I feel like I am wasting (no boyfriend, very few friends, limited social life and few activities) I still choose 2 minutes of food bliss over a leaner option. I tried WW, food anonymous, therapy, hypnosis, CBT... At the end of the day if you don't want to change deep down, no one can change in your place. It terrifies me because part of me really wants to move forward in life and part of me can't put the fork down. I plan to go to a residential treatment center (a rehab in other words) to try to get to the bottom of this but in the meantime, can you guys (who may relate) share your own journey?

I am convinced food addiction exists (we can debate that later) and I have seen the folks at food anonymous use the 12 steps to beat food addiction and reclaim their lives. But I couldn't follow the plan and my head hunger got the best of me. I am frankly desperate because I don't know if the surgery can help me. I want to know how you guys managed, what happened in your head that made you go through liquid diets without your cravings crawling under your skin and drive you crazy? Every month I get an epiphany that lasts a few days but then I sink back into a carb loaded food coma and the pounds keep piling... How did you keep the aha moment going? What tools or strategies did you have to follow through?

Thank you so much!!

On 7/3/2018 at 7:31 PM, kdveri said:

I had my VSG surgery a few weeks ago at at Mount Sinai Beth Israel in Manhattan

Thank you so much for sharing your experience! I will look them up. How are you doing post surgery? I suppose you're on a liquid diet right now? How is that going?

On 7/2/2018 at 11:15 PM, sillykitty said:

That's a great idea.

I never realized how powerful head hunger is, and how it feels identical to real hunger. I could definitely eat around my sleeve if I didn't stop myself. I totally underestimated this struggle.

That's what scares me. I have no physiological issues that explains my obesity, it's all in my head. I know the sleeve removes some of the hormones like ghrelin and people are not hungry but I never ate out of hunger. It was always psychological and I am concerned that I will have the surgery and. this will be a problem and I won't be able to manage my compulsions and ruin things.

This is why I haven't had the surgery even though I have been morbidly obese for years. But now I am facing health issues that force me to reconsider it. Something to take back to my therapist I suppose

On 07/02/2018 at 23:01, elmatador said:

Bessler had me on a liquid diet plus a little crunchy veggies for 2w pre-op. It was HARD but doable. And if that's what it took to lower the risk of surgical complications, well, I can do anything for 2 weeks.



But doing the work to think through your emotional component with professional help, and thinking hard about what you'll replace that crutch with, will be key to getting through this and making it stick...

Oh god 2 weeks + 4 weeks... I mean of course if that’s what it takes you do it but I’m half hoping they can sedate me through the 6 weeks lol
I am seeing a therapist to work on these issues and I won’t commit until I have some assurance from myself that I won’t give up...

On 07/02/2018 at 22:52, elmatador said:

It's been pretty good, Assya - the first 72h postop were hard, and then things have gotten steadily better. My energy is great, eating full foods (sticking to the plan of course!), In the gym semi-consistently for the first time in a long time, and feeling positive. With the heat just taking extra care to hydrate and moved my exercise indoors. All doable!

Thanks for the feedback! I have to say I’m a very emotional eater (this is the only cause of my obesity, I just use food as a crutch) and the thought of being on a liquidy diet for close to 4 weeks (with some before surgery as well), I have to say I’m not confident yet that I can manage that. I know you’re not hungry and even struggle drinking but knowing myself I would NEED to eat something and these urges feel like a tsunami... I mean I guess I need to be sure I can do it before I commit to anything!

On 07/02/2018 at 14:01, elmatador said:

I used Marc Bessler at Columbia - I'm a physician so asked around and he is widely respected as a careful surgeon.

Thanks for the recommendation! I looked him up and made an appointment (need to see the nurse practitioner first, this Thursday). How was your sleeve? I see you’re a few weeks post op, is it not too hard with the heat?

On 07/02/2018 at 11:40, sillykitty said:

I started by researching VSG on RealSelf. The Dr. I used caught my eye because he was a frequent contributor and answered a lot of questions, and was super local. I figured only passionate surgeons would spend their time answering questions for free. And to me, I figured that was a good sign. He also had good reviews on RealSelf.

I next looked up the status of his license, and it came up all clean, no issues at all. I looked at his CV. He went to excellent schools, for his BS and his MD. He then did a Fellowship in Bariatric surgery. That was really important to me, as he took the time to educate himself in this specialty. He is a member of ASMBS. Finally, he is on staff with some of the best local hospitals. Prestigious hospitals do not allow bad Dr.'s on their staff. He also is the Medical Director of Bariatric surgery for the hospital I had my surgery, which is a Center of Excellence.

So I took all those pieces together, and I concluded that a surgeon with a poor record would have a red flag, somewhere. Since I found no red flags, he was local, he was in network, that this was the best surgeon for me.

07/02/2018 10:51 AM, Assya said:

I was wondering if surgeons who know their patients as people and not as cases are not making better decisions for their patients?

I would agree with this, if I were having a more complex surgery. Or if my treatment was for something chronic or severe. But honestly, VSG is in the scope of things, a simple and routine surgery. There really isn't a lot of variable my surgeon would have to know me personally to decide.

I get what you are saying though. I'm going to have plastics later this year (hopefully!). For that surgeon, it will important that they understands exactly what I want. It will be important that we are able to communicate clearly to one another, and that I am definitely not a statistic. But plastics has so many variables, where bariatric surgery has few in comparison. I'm fine with my surgeons standard VSG operation, but I don't want a standard boob job!

Thank you I think that’s an awesome vetting process! I’ve started doing the same hopefully I narrow down a shortlist tomorrow! What plastic surgery are you looking at?

4 minutes ago, sillykitty said:

I looked at it differently. I didn't need to feel any connection to my surgeon. I wanted him to have done lots and lots of surgeries with low complication rates.

Are there any websites or rankings that you recommend? I don't know how objective and impartial these rankings are, you never know what ties exist between these doctors and the institute or organization providing the ranking.

I understand your point of view. I see how this is valuable strategy but I was wondering if surgeons who know their patients as people and not as cases are not making better decisions for their patients? I know it's silly but I rewatched early seasons of House MD (I don't know if you watched) and there is this episode where House is an actual patient and the doctors plan to amputate his leg. And as a doctor he explains that they made this decision not only because it was easier for them to amputate instead of trying to save parts of the leg (easier surgery, clean cut instead of working around necrosed tissues etc.) and since it is easier it exposes them to less potantial liabilities. I know it sounds silly and it's a tv show but this calculation of time/liability instead of what benefits the patient (keeping his leg even if not fully functional) just stuck with me...

I know there are great doctors in the USA but every time I have an issue I just feel like a potential paycheck rather than a person with problems. It terrifies me to the point that I am considering leaving my job here and going back to France to get the surgery. That being said you might be right, maybe it's better to count on a supportive surgical team and let the surgeon be a House MD type of doctor with great credentials

44 minutes ago, Lyngolean said:

I would agree with Bariatric Hero that it's important that you like your surgeon. I think it could affect your recovery. You don't see him or her all that much, but having a bad vibe...ugh! You are VERY vulnerable during surgery! I could have hugged my surgeon when he told me his views about how determined patients are who keep trying to lose weight despite the lack of long term success, that they are the MOST determined in light of continuing to try despite proof that it doesn't work. Our scheduled consult time was 40 minutes, but I could have picked his brain for longer than the 75 minutes he seemed to happily spend with me. He shared a lot about the most recent research which was informative and thought provoking. I had a list of questions prepared prior to my consult. Good luck!

Now I want to move to Minnesota! Your surgeon seems like an amazing person, I think you're right, gut feeling matters and you should feel comfortable with that person... I have never had surgery so I am a bit apprehensive of being asleep on a table... but I know it's one of the safest procedures out there too!

1 hour ago, Frustr8 said:

Well many have weighed in, let me at least say a few things.
Plan on sitting down and having conference with your prospective surgeon. This was a mistake I made with my,first program, I did meet with their medical assistants, nurses and nutritionists before,i even met him.bAnd intinctively,i did not like,him, oh Frusrt8, I said you are expecting too much, this is not a popularity contest, he is supposed to be skillful maybe you will fine. But I was uneasy with him. There is a old English poem " I do not like you, Dr Fell. The reason I cannot truly tell" but I perservered, did all the interviews with other medical specialities, but there was something inherently,wrong. I was just another source of income, no commitment to me or my future well--beingm If I had walked,outside their door and been run over by traffic, they would have stood there watching with detachment. Oh it hurt when the surgeon suddenly decided not to,perform my surgery, I had invested much time, my insurances had paid much,money and I was left with a profound sense of failure.
Make and take a list of questions. He can advise you,on which form of surgery can best benefit you, but he or she will be holding while you are asleep your very life in the it hands - make sure it is someone you like and feel you can trust. A warm interest in you and your future health is up most. I am certain others will tell the points to bring up but this weighs heaviest on my mind. And God sustain and bless you andbwa5ch over your future surgery whatever,variety you choose.

You are absolutely right... I am so scared of these surgeons who see patients as a source of income or even a statistic... Thank you for your advice!

1 hour ago, Staceyb2121 said:

New York Bariatric Group is fantastic.. I’ve used Dr.Garber and Dr. Holliver but im sure all the surgeons in their practice are fantastic. I’ve been with that practice since 2012 and they are great from the office staff, nurses, pa’s, and surgeons

Thank you so much, I will check their website now! How long did it take you from the first consult to the surgery?

Hi everyone,

I recently decided to have bariatric surgery and I am new to the forum. Does anyone have advice on how to choose a surgeon? Beyond the obvious criteria (insurance approved) what process did you go through to find the one? Just to give some background, I am originally French and even after 4 years in the USA I struggle to understand healthcare and medecine in the USA. Everytime I visit a doctor I feel like I am talking to a used cars salesman, peddling costly procedures before he/she even listens.

I live in Manhattan, NY so I think there are good and bad options. I don't trust vitals and healthgrades anymore but as I don't have family here and few friends, my information source is very limited. I have insurance (Aetna) which covers bariatric surgery (hoping for the VSG) but for me an Institute of Quality or whatever distinction is no proof that I have a serious through doctor in front of me.

Any suggestions? Thank you!!