NickelChip

It's November 1st! Somehow, December feels simultaneously like it is just around the corner and also a million years away. I had my air cut today and scheduled the next appointment, and I had to move it closer by a week than I usually would because otherwise it would be the day of my surgery! So now I'll have no gray roots for my surgery

This is exciting to see the chances of hypertension remission. I just went to the eye doctor a few days ago and she showed me the photo of my eyes where she can see the difference in blood vessel size as a result of my high blood pressure, (even though it's fairly well controlled on meds). It really makes it hit home that these conditions have consequences you can see a picture of it, and I would be so excited if my blood pressure was no longer an issue. Also, this chart estimate a 12-month BMI that is lower than some of the other calculators I've seen, so fingers crossed!

I never knew the reason for the BMI of 40 or over until reading this, but it makes sense. Back in the 1990s, gastric bypass was an open surgery with a whole lot of risk. You just wouldn't do that unless you were in dire health or the future risk of dying prematurely was great. It's such a different surgery, or surgeries, now, yet the guidelines remain the same. Sometimes I wonder if more people would get bariatric surgery if those who had it talked more openly about it. Not to blame anyone who chooses not to, because people can be awful. But I wonder how many people in part believe they or others can diet and exercise their way thin if they really try because that guy they work with did it...except he actually had surgery and just doesn't say it. Only 2% of people who qualify getting the surgery is so sad. It kind of makes me mad that I would have qualified a while ago but no one told me until I hit that magic 40 BMI on the doctor's scale, even though I have other conditions that meant I would have met the requirements probably 10 years ago. Instead, I was put on Saxenda and Wegovy at different points, and neither one was a real miracle drug for me. Plus, my insurance only covered them for about 6 months, so nowhere near lifetime like you need. I think there's a lot of education that needs to happen out there on every level.

I love this advice! It reminds me of something I heard a long time ago, that when you're walking across the street, if you trip and fall, everybody knows you just pick yourself up and keep going from that spot. But a lot of times we act like when we make a mistake or have a set back in other parts of our lives, we somehow get dragged all the way back to the corner and have to start all over again, when it's not true at all.

I had my eye exam today and I was really hoping my prescription would be the same so I could hold off buying new glasses until after I've lost some weight. Unfortunately, based on the blurriness I've been getting when driving, I had a feeling it wouldn't turn out that way, and I was right. It was enough of a change that I couldn't get away with waiting. The whole time I was trying on new frames, I kept asking myself, "What will these look like if my face isn't so round?" It's hard enough choosing glasses as it is!

That's pretty cool that you're both doing it at almost the same time. Hopefully when one of you has a bad day, the other will be able to keep you both going, and you'll really understand what's going on.

I found a brand of stevia-sweetened dark chocolate on Amazon that does not contain sugar alcohol. You might try that for a treat at some point. No idea how it tastes! https://www.amazon.com/Chocolate-Squares-Gluten-Free-Stevia-Sweetened/dp/B0BWKBM5MS

It makes me sad that the pandemic put a stop to the in-person support groups at my hospital (although there is talk of restarting next year). In the "before times" they used to do tasting parties where you could get together with other people at a similar stage in the process and try a bunch of samples of different products and flavors. If only we all lived in the same place, wouldn't it be great for everybody to bring a flavor of protein powder for everyone to try, like a really weird potluck (or the world's saddest wine tasting)?

Double check with your doctor because my nutritionist recommended those calcium chews starting at 2 weeks post-op along with the other vitamins. (I have to stop all vitamins a couple weeks before surgery and then not take them again until after the 2 week check-up). The Celebrate ones taste like a chewy candy, but I think they dissolve very fast and are specifically for bariatric patients, so they are probably fine and not the same as a real candy would be. But yeah, protein bars are so dense and dry, I can't imagine they would be good to eat for a long time. Which is sad because they're so convenient.

I don't have direct experience because I'm pre-op, but everything I've read suggests sugar alcohols are not a good choice because they can lead to gas, bloating, and other unpleasantness for gastric bypass patients. That's something I would probably avoid for quite some time, if ever. I also know my doctor's nutrition guide puts peanut butter into the final stage. On a personal note, I know that candy especially is a trigger for me, so I plan to avoid it along with other sweets and focus on natural foods in hopes of killing off those cravings. I definitely fear the slippery slope. But I would also check with your doctor about sugar alcohol in general, which I believe is different than sucralose or aspertame in how the body will process/tolerate it.

Oh my goodness, protein supplements have been an obsession. I bought a big tub of "chicken soup" and "latte" flavors early on and both of them were so awful. Anyone live in MA? I will gladly give them both to you. My nutritionist gave me samples of a few others to try from Unjury. Their chicken soup was better. Not enough to buy it, but better. I got a really good introductory deal on Syntrax Nectar Naturals, so I bought several flavors, and I love the peach the most so far. I've also liked the chai flavor of Ka'chava, though it's on the higher side for calories (240 with 25g protein) and has 7g fat instead of 5g as recommended by my doctor, so uncertain of whether I can use it. But it tastes really good. I also bought cherry limeade from Wicked protein (really refreshing) and pumpkin spice from Truvani (good, but their shipping takes a long time). I've specifically been trying to find ones without artificial sweeteners, which is so hard. I got two flavors from Vega, which were not too bad and pretty affordable. With all that, I should have some choices when the time comes. Oh, I've also stocked up on Celebrate One 45 in tropical twist flavor, and bought their calcium chews, which are a nice treat. I like the fruit flavors best, like eating a Starburst candy. You've inspired me to finally follow through on buying a new, bigger purse. I have been saying for a year that I need one, but now I have an ironclad excuse so I can carry a water bottle. Staying hydrated is hard.

I am 100% NOT putting chicken feet in mine! Also, you might check Amazon if you end up liking the Kettle and Fire brand. It turned out to be about $1.50 cheaper per carton than my local grocery store if I bought the 6 pack there. I have a monthly subscribe and save order to get the best price, and since my surgery isn't until the end of December, I'm buying one 6-pack per month and tucking them away so I have plenty for those first couple weeks when I know I'll want convenience more than anything else.

I really like Kettle and Fire beef bone broth, but it's pricey. I just found a recipe for Instant Pot bone broth, and my supermarket carries beef bones for $3.99 a pound, so I'm going to give it a try. As Catwoman mentioned, chicken bone broth is what I would just call...soup. I didn't know there were other ways of making it than simmering a chicken carcass for several hours. But I've never tried making beef broth of any kind, and I really liked the beef, so this will be interesting. I didn't even know you can buy just bones from the store! Since I don't cook with any cuts of beef that come with bones, this is an intriguing option that should be easier on the budget. This is the recipe I'm going to follow: https://theforkedspoon.com/instant-pot-bone-broth-recipe/

December 27th here! I started back in July when a visit to my doctor on the non-surgical side of the weight loss center yielded the suggestion that I consider surgery. I was all too happy to do so after 6 years of nutrition and then meds never yielded more than fleeting results. I did an immersion day in August where I learned all the rules, and then I needed appointments with psychologist and nutritionist before meeting with surgeon in early October. I was hoping for mid-November, but the earliest they had was end of December so I'm making the best of it. My doctor only requires 2 days of liquid diet, which means I can celebrate Christmas Eve but will be on protein shakes for Christmas, but not longer, which is nice. I'm grateful that the kids will be off school and won't need "Mom's Taxi Service" to get them to all their after school activities that week. In the meantime, I've been working on my nutrition, slowly eliminating processed foods, added sugars, artificial sweeteners, breads, snack foods, etc. I've made a lot of progress ridding the house of unhealthy foods and adding more vegetables into my daily diet. I've also bought several bariatric cookbooks and have been choosing some recipes to try in the next 8 weeks so I have practice with them. I'm hoping a few will be winners with the kids, too. We're all working on getting better with nutrition and I'm glad to have them excited about trying new, healthier options.

This is a favorite breakfast smoothie for me as well as my 15 year old daughter. I'm pre-op right now, just as an FYI, and my daughter is an active kid at a healthy weight who likes to start the day off with a quick, nutritious breakfast. I have a 16oz blender cup, and this fills it fully, but if you have a 22 oz or larger, it would let you make it a little thinner. For me, the ginger is key to masking any taste from the powder. I use the kind that comes in a squeeze bottle from the produce department. I don't add any sweetener and I personally love the natural flavor of it. The blueberries disguise the green from the spinach in case the color turns you off. You can weigh and measure everything to be sure how much you are getting the first time around, but I tend to just wing it now since I've done it so often. I may make some changes post-op based on nutritionist recommendations, but overall I think this is a pretty solid smoothie recipe that you can change up in several ways with different fruits. Oh, you can also use Greek yogurt instead of skyr if that's not as easy to find, but I'm a big fan of the Siggie's brand skyr. I also love to buy the mixed fruit blends from the freezer section to get lots of variety in one bag. All of the produce I use is frozen, including the avocado. Oh no! I just realized I entered hemp seed twice in my recipe. That should be a tsp of chia seed!

So, I'm not an expert, but I've been doing a lot of reading and watching videos from reliable medical professionals (like the one I shared above, and the videos from Dr. Matthew Weiner in Tucson). I've also had friends and family members with both bands and sleeve surgery, and seen all of the ones with bands eventually fail, while the sleeves have had at least moderate success. Full disclosure: I'm scheduled for a bypass in December. The most important thing about all of this is it's not your fault. It's not about getting your head right, it's about getting the right tools. And the band is just not a good longterm tool for almost everyone. The biggest difference between the band and the sleeve or bypass is that while the band relies on restricting your eating, the sleeve and bypass both change your metabolism. It's not just about capacity, it's about a fundamental shift in how your hormones communicate with your body. Do you still have to have good nutrition, and be mindful, and work on your life issues that influence how you eat, and all that good stuff? Definitely. But choosing a metabolic surgery (sleeve or bypass) totally shifts the playing field in a way the band didn't. I think it was one of the videos from Dr. Weiner where he said it was like getting a second chance to draw a new card from the genetic lottery. Good luck with your meeting with your doctor, and just remember, this isn't your fault. It's not because you're not strong enough, or good enough, or any of that nonsense people like to say. It's because you got dealt a crap hand in the gene department that makes it really hard for you to manage your weight, way harder than for a lot of people, and it's okay to use every tool available to make it easier.

If you haven't already watched this, I highly recommend this video from Dr. John Pilcher, (and pretty much all his other informative videos). He's a bariatric surgeon in San Antonio and does an amazing job of explaining medical information in a really understandable way:

I got the same, and I'm curious how they compare, if you don't mind sharing. I'll see if I can scan mine and share it, too. Edited to add: this quoted the wrong post for some reason! I was trying to reply to @SpacePossumSupreme!

There are definitely other brands of 100% whey protein isolate available. I mean, it does sound like they want you to buy from them, but I would compare the price to make sure they aren't marking it up. My doctor's office just gave us a list of brands to consider, plus a few requirements for fat and sugar content. They were more concerned with us finding flavors we liked, which you can't always do with a single brand option. Then again, my doctor also doesn't require more than 48 hours of a liquid diet and doesn't do the puree stage, just soft, well-cooked foods you can chew down to mush. So they're all different. Which leads me to believe many of the "rules" are more like "preferences."

I think either way is fine, but my suggestion is just don't substitute artificial sweeteners to do it. Take it at whatever pace you need to be able to handle it and adjust your tastes for the long term. If that means cutting back on the sugar in your coffee over many months, that's fine. Better to go from two spoons down to one and then to half a spoon of sugar slowly than to start using an artificial sweetener and never kick that habit. For me, I made the decision to eliminate several things from my diet before taking a few weeks to either eat up or throw away the things I didn't want to have in my house anymore. The key has been not allowing it back in once it was gone. I am also pre-op. I started the process in July with a surgery date in late December. I happened to find the book Pound of Cure by Dr. Matthew Weiner and it's absolutely been the best nutrition book I've ever purchased (and I've purchased many). Full disclosure, I did not do the 2 week reset portion of the program, but I did start out by increasing my veg and eliminating the stuff that was easiest for me to do right away. After that, there have been certain stages that I took faster and certain ones I've done slower. But overall, in my opinion, it's an excellent guide for what your healthy diet "should" be most of the time. Higher on veg and plant protein, lower on animal products, mostly free from the vast majority of processed carbs, sugars, and artificial crap. If you're looking for guidance, his books and videos are super informative and rooted in science, not fads.

Yes, for several years. She's the one who suggested getting the surgery.

A lot of things played into it, but honestly, it was when the doctor asked me if I would be interested in it. For background, I'm turning 50 next year, so yes, that milestone is in my head as part of it. My younger brother had VSG 15 years ago, and ever since then, I wished I could do it because he had such a great outcome. But at the time my BMI was 34, so I didn't qualify, even with high blood pressure. As my weight increased, my doctor referred me to the hospital's weight loss center. They started me on a non-surgical program, and it worked a bit for a while. And then it didn't, and I gained everything back plus some. I even tried Wegovy for a while, but I could never get it long enough to see if it would work because of the shortages, plus the discounts dried up and the out of pocket was crazy. But this past summer, my weight peaked at the highest it had ever been, tied with the day I left the hospital after delivering my second child. My BMI had reached 40. My body ached, my feet ached. I was bloated all the time. Nothing fit. My heart kept doing a worrying fluttery thing. I had to increase my blood pressure medication. With the pandemic, I had stopped going to the weight management center. My doctor told me to go back. This time, they asked if I would be interested in considering surgery, and I jumped at the chance. It was like the second the question was asked, I knew it was time. If they'd asked earlier, I probably would've done it then. But for such a long time I didn't qualify, and then I probably did but everyone seemed to think I should still keep trying on my own. When I found out my out of pocket costs would only be around $3k, I nearly fainted. I assumed it would be so expensive. My brother was self-pay and it was 10k. Instead, it's the same as two months of Wegovy! Now I'm just counting the weeks until my Dec 27th surgery date.

You make some really good points about needing to be a little selfish. I think of all the people in my life who need things a certain way, and how I go out of my way to accommodate. Oh, you go to bed really early, or you must eat dinner at 3pm, or you only like Italian food, or can't meet up at that time because you need to workout? Okay, I can be flexible! I'm turning 50 this coming year and it's only in the past few years I feel like I've started to learn to advocate for my own needs. And it's definitely a learning curve. It's so hard to remember that just because you could be flexible doesn't mean you always have to be. As for relatives and food, my strongest childhood memory is probably my very obese grandma, who seemingly passed down 100% of her genes to me (thanks, Grandma!), saying within the span of two breaths: "You know, you're going to be overweight like me and you have to be so careful with what you eat...want more Polish sausage?" I mean, bless her heart, she lived to 92 and was sharp and reasonably active until the last year or two, so if she passed that gene along to me, I'll take it. But you can't tell a person one minute that they have to eat healthy and the next minute present them with an entire family-size Tupperware filled with grapes as a snack because "grapes are healthy." Which I would eat all of even if I didn't want them so as not to hurt her feelings. Meanwhile, my mom was rail thin and always going on some sort of "eat grapefruit for a week and melt the fat off" women's magazine fad diet my whole childhood. Yikes. Family can do a number on you. And you're right, all that stuff will still be there to deal with emotionally even after the surgery...

I know in the US, our requirements for insurance to cover the surgery (if you have insurance that does) is generally a BMI of 35 with co-morbidities (blood pressure, diabetes, etc), or 40 without. I've had similar struggles to yours, weight gain starting in my 20s blamed on thyroid. With diet and exercise I could lose a few pounds, but never enough. I hovered in the 190s until my late 20s, 210s in my 30s, climbing to 225+ in my 40s. I went to my weight management center that was connected with my hospital network for 6 years starting at age 43 and started with nutrition and lifestyle changes, followed by medical interventions (Contrave, Saxenda, Wegovy when you could get it). I never got below 204, and that was with a strict 1200-1500 calorie diet that I tracked religiously and 10k or more steps daily for a year (I never missed a single day!). As soon as I relaxed even a little, the weight came back with a vengeance. This summer, I hit 251 and also have hypertension and prediabetes (A1c of 5.9) . That was when my weight management doctor (an endocrinologist) finally asked if I wanted to talk to the team on the surgical side. I'm awaiting insurance approval now. It should be covered though I have no idea about out of pocket expenses. I don't really care at this point. I'll make it work. If you are considering paying out of pocket and concerned at all about going to Mexico (although my brother went that route many years ago and it was fine), I did see a self pay option here: https://www.poundofcureweightloss.com/bariatric-surgery-cost/ I know it's frustrating, and if there's one thing I wish, it's that I had dealt with this when I was turning 40 instead of 50. Wishing you luck!

What a transformation!!! You look great and you must feel so much better.