ouroborous

Congrats on your surgery, Tiffany! Oh, and to the Seattle fans: hello from Seattle (I'm sitting listening to the cars driving in the rain along Elliott Ave. right now :thumbup1:)

Well, actually, my nutritionist said that for the two weeks before surgery, I'm supposed to limit myself to no more than 40g carbs per day from all sources except green vegetables. After surgery, I'll probably spend much less time counting carbs!

Surprising things I'm learning about carbs. My scrambled eggs and cheddar cheese in the morning is about 1g of carbs. Most of that comes from the splash of nonfat milk I use to make the eggs fluffier. I was surprised that, per the nutrition information, milk contains carbs but cheese doesn't. Who'd a thunk it? My coffee was a whopping 12g of carbs! Black coffee has zero carbs, but I use two small scoops (about 15g) of sugar free cocoa to sweeten it, and that has a surprising 10g of carbs in it. Then I use two Splenda packets, which each have 1g of carbs (apparently from the fillers that they use). So, I'll be skipping my morning coffee (unless I can learn to choke it down black). That's okay, though, since I'm supposed to be weaning off coffee anyway. It's sorta amazing how many carbs there are in various foods. I realize that I can't really just eat something without checking it out first, or I might be sabotaging myself. I just poured my coffee down the sink :thumbup1:

Yeesh... pick breathable fabrics!

Yes, spot reduction absolutely IS a myth; you cannot induce where your body loses fat. However, it's VERY possible to spot "tone" -- to build up the muscles in a trouble area. And post WLS, I would wager that most complaints come from lack of muscle tone, not from fat.

Good luck! You'll be fine!

Thanks for the info. I'm hoping to avoid having to take medication for life. I have moderate reflux right now, and no hiatal hernia. Bottom line, however, is that obesity is worse and more dangerous than acid reflux, so if I have to take acid reducers, so be it.

Of course, if the doctor orders it, do it, but I am still curious as to WHY you'd need this done. Is it to check for gallbladder issues? From what I understand, at 3 months out it's almost unheard of to have a leak. The only other thing I could think of would be esophageal issues due to reflux. Anyone know?

Guys, I can empathize with not wanting to comply with the diet, it can be hard. I love me my carbs, the breadier, the better (as you can tell by looking at me). However, I cannot emphasize this enough: do what your doctor tells you to do, to the letter. Do not take the advice of people on the Internet over your doctor. Do not decide that you know better than your doctor. I know it can be frustrating, and we wouldn't be here if we didn't have problems with a healthy diet. But I know from my research as well as my own personal experience that the best outcomes are those who do what the doctor says, even when that's hard. They don't just make this stuff up for fun, I promise. Tiffykins has some info on why the pre-op diet is necessary, and apparently it isn't just about shrinking the liver, it's about making it less "slimy" and slippery and easier to retract during the surgery. Trust me when I say: you don't want to get liver damage just because the pre-op diet seemed too "hard." I'm sorry if I seem a little unsupportive, but this is sort of the "dark side" of medical support groups, in my opinion: you run the risk of people taking the advice of, let's face it, random strangers on the Internet over the advice of trained, experienced medical professionals. This group is great for support and general advice, but please, please, if in doubt, ask your doctor. Edit: re-reading this, it seems a little harsh. I don't mean to disparage anyone; we all have good intentions. It's just that I get worried for people who seem all too willing to be non-compliant with their doctor's orders. That can get you dead.

Congratulations, Midwest! That's tremendous progress. With a positive outlook like yours, I bet you'll get to your target weight!

My girlfriend had a really sizable hiatal hernia repaired during her surgery. I know how big it was because the surgeon and basically everyone on his team kept commenting on how huge it was. The only real side effect she noticed during her recovery (which was very, very easy, according to her) was that when she'd take a deep breath there would be a little "hitch" that felt weird (and hurt a little at first). She said it could be alarming if you didn't know what it was. So maybe, if you're aware of it going into surgery, it will help you be prepared for it after the surgery. And honestly, it will really help your quality of life afterward to get it repaired :biggrin0:

I believe that even if your insurance is in flux, you can just get the surgery done (if your doctor decides you need it), and work out payments. Then you can fight with your new insurer to get them to cover it. That's better than living with a bad gallbladder!

This is going to be really hard for me, too. I'm so used to having a glass of water or a diet soda with my meal!

So, I dug up some research on obesity and hypogonadism (low testosterone, for men), and the numbers were pretty eye-opening. I've lost the link, but basically for men who had low testosterone (I'm borderline), having weight loss surgery caused the free and bound testosterone in the blood stream to basically DOUBLE. In short, for these men, losing weight via surgery was more effective than exogenous testosterone (shots, creams). I thought there would be some change, but not THAT much of a change. For me, if that ratio holds out, it would basically put me squarely in the middle of the "normal" range instead of perpetually hovering near clinically low testosterone. So, I'm excited! Edit: here's the study: http://www.endocrine-abstracts.org/ea/0002/ea0002p79.htm And here's the abstract: IMPROVEMENT OF MALE HYPOGONADISM IN SEVERE OBESITY DURING WEIGHT LOSS AFTER BARIATRIC SURGERY M Monteiro1, H Cardoso1, G Vargas1, P Mendes1, A Sergio2, M Santos3, C Santos3 & H Ramos1 1Dept of Endocrinology, Hospital Geral Santo Antonio, Porto, Portugal; 2Dept of Surgery, Hospital Geral Santo Antonio, Porto, Portugal; 3Dept of Pathology, Hospital Geral Santo Antonio, Porto, Portugal. Objectives: To evaluate changes in gonadotrophins, total (TT) and free (FT) testosterone, SHBG, insulin and c-peptide levels during weight lost after bariatric surgery. Material and methods: Seven (n=7) patients submitted to bariatric surgery for treatment of severe obesity were followed-up over time. Before surgery mean age was 32,857 (19-56) years old, mean weight was 170,571 kg (? 37,362) and mean BMI was 58,824 kg per m2(? 14,211). Results: After a mean follow-up of 13 months (min 6, max 25), mean weight and BMI decreased respectively to 126 kg (min 97, max 196; ? 33,872) and 43,767 Kg per m2 (? -13,845). The mean analytical values before (:thumbup: and after (A) surgery were: FSH (mUI per ml) B:3,245 ? 1,380 A:2,330 ? 0,948; LH (mUI per ml) B:3,142 ? 0,780 A:2,700 ? 1,009; TT (ng per ml) B:2,050 ? 0,825 A:3,653 ? 1,452; FT (pg per ml) B:6,028 ? 2,377 A:13,400 ? 5,702; SHBG (nmol per l) B:21,237 ? 15,329 A:26,666 ? 10,366; Insulin (microunits per ml) B:44,528 ? 39,321 A:17,716 ? 12,1598; C-Pep (ng per ml) B:6,833 ? 2,320 A:4,116 ? 1,621. After surgery all patients improved their weight and BMI in a significant way (p=0,001). Weight loss attained with bariatric surgery resulted in significant increase of TT and FT (p=0,019 and p=0,026), and decrease of c-peptide (p=0,034). Gonadotrophins and SHBG increased and insulin decreased, with weight loss, but not significantly. Conclusions: Weight loss in men with severe obesity and hypogonadism, attained by bariatric surgery, improved hypogonadism with increase of TT and FT levels.

Tiffykins has a good point, and I would also make sure it's not general protein sensitivity (when you feel nauseous, do you experience any pain in the right upper quadrant of your abdomen? Especially, does it radiate to the back?) If so, it could be the beginning of gall bladder issues, which are very common in WLS patients.

I think pnw may be on to something, too -- even if you're not diagnosed w/sleep apnea, us heavy people always have poor sleep. Sleep quality has many, many documented connections to memory and overall cognitive function.

Here's a bit of advice: keep your receipts. You can deduct the sleeve costs on next year's tax returns (in fact, I believe you can deduct all medical expenses above $500, although I'd check with your accountant to be sure). My girlfriend did that with her sleeve, and this year she got back almost $8000 instead of the usual $1500 or so. It didn't quite "pay for itself," but that sure takes away some of the sting!

Oh, those cocoa dusted almonds are great if you're craving sweets (particularly chocolate). I still have to be careful on volume, since there's 6g of carbs in only about 20 almonds. But still, in moderation, they're great. And yes, almonds are insanely good for you in terms of Protein digestibility and essential fatty acids.

I'm not sure if men are allowed to post, and I don't know if this will help, but... The "you're great, but... [you're too fat]" thing goes both ways. I can't count the number of times that I -- naturally a fairly shy man -- finally got the courage up to ask out a girl I was attracted to, and was told something like "I like you, like a brother" or "let's just be friends." It's more polite than the "radio silence" you mention, but still the message is the same: you're a great person, but because you're so fat, you're unacceptable. It even goes further, for me. When I was a good deal younger -- but still pretty heavy -- there was a very beautiful girl who, for some bizarre reason, seemed fairly fixated on me. In retrospect, she was sending me EVERY sign that she wanted some kind of intimate relationship with me, but I was so sure that I was fat and unattractive, that I "froze up" and didn't reciprocate, and the opportunity was lost (one of my "normal" weight "friends" swooped in on her). In retrospect, it turns out that she wouldn't have been good for me, but still, it makes me wonder how many experiences I missed out on because I didn't think I was good enough. In a weird way, I sorta get why we don't get picked for the mating dance when we're fat. Despite all the Disney films in the world telling us that "it's what's inside that counts," the bottom line is that in many ways dating and marriage are about breeding and genetics. On many unconscious levels, we are attracted to someone because we think we would make good, strong, smart, healthy children with them (well, maybe not explicitly, since that wouldn't explain homosexuality, but you can't deny that basic health is almost always a prerequisite for attraction). So, it's unsurprising that we obese people might not get "picked" because let's face it, who'd want unhealthy, obese kids? But even knowing all of this evolutionary psychology stuff, it's hard to be the one who's constantly waiting by the sidelines in life. Even knowing that there's a biological basis for it, that doesn't make it any easier when you feel like you're defective because you're fat. And that may be the worst part -- not just the rejection from society, but the internalization of it. Once you start to buy into it, once you start to buy into the idea that you're defective and undesirable because of your weight, you really start to live your life differently -- you stop taking chances, and you avoid situations where you just "know" you won't be accepted. And that may be the biggest tragedy of all. Ultimately, it would be great if society didn't reject fat people, but like I said, I think a good portion of it is wired into our biology. And with the sleeve surgery, we finally have a chance to escape the physical trap; it's up to US to learn how to escape the mental trap.

(Cross posted from the forums.) So, my lovely girlfriend took a number of pictures of me standing around in just my boxers, and, yeah... now I remember why 1) I never go shirtless, and 2) I don't like pictures! I believe that, under all the flab, I'm still a basically good looking man. But I have let the fat pile up, in roll after roll, until I'm almost unrecognizable under it. I think I've never really let myself accept just how very fat I've become. I have this bizarre mental image of myself as much more "normal" weight than is reality, but I also live in constant apprehension of someone seeing just how large I am. It's a bizarre mental double-image, and the photos today (which are in my private profile, and are going to stay private until I have some real progress to show!) were... a shock. My weight looks... ungainly, unhealthy, and just unsupportable, long-term. In some ways I think I haven't been fully committed to the surgery until this moment, just now, when I realized "man, if you stay like this, if you don't change something, you are going to die, painfully, and soon." I really understand now why... My back almost always hurts. If it's not my back, it's my shoulder from lying on my side to read or sleep (all that weight on my shoulder causes problems). I almost never sleep well, and fight constantly with apnea. I'm sick so often. I hate exercise so much -- if I walk long distances (or even stand up straight for too long), something is always chafing or rubbing or constricting. It's not surprising... with that much flab to move around, who would be comfortable? I have such a hard time finding clothes that fit. I buy huge, tent-like clothes to try to fit into and "hide" my flab, but let's be real... I'm not fooling anybody. I feel so awkward in social situations -- I'm very body-shy, and it's very difficult for me to avoid the belief that someone is "judging" me for my body. Some years ago, I had LASIK surgery because I was very nearsighted. I had to wear thick, coke bottle glasses (or contacts, but they were killing my eyes). I was very frightened of the surgery, to be honest -- I was worried I would go blind or something. But I got through it; I did my best to follow the surgeon's instructions TO THE LETTER, and when my eyes had fully healed, I had better than 20/20 vision (20/10 in one eye, 20/15 in the other). It wasn't entirely a positive experience; I had to shell out five thousand dollars of my own money (LASIK was still new). It was a little painful and a lot frightening, but I still consider it one of the best choices I've ever made. I still just stare out on this beautiful world, sometimes, and marvel at how nice it is to be able to really SEE without thick lenses or frames chafing my ears or getting smudged or slipping down (and making everything look small, that's one odd effect of glasses that they never mention -- everything looks so SMALL). It was totally worth the money, and I would do it again in a moment. So that's how I'm thinking of the weight loss surgery. I've done the research; on almost every single metric, this surgery will improve my life. It will add years of life expectancy, and (maybe more important), it will likely be QUALITY life, not years spent in sickness and decline. It will restore my mental image of myself as a "normal looking" guy to reality. It will hopefully ease my constant anxiety that something is Dreadfully Wrong with me, health-wise (I'm fortunate that almost all of my anxiety is, for now, ungrounded -- but how long will THAT last?). YES, there will be some initial pain, but apparently not much. YES, I'll have to likely deal with some nausea or "sliming" or whatever, but that's a small price to pay. YES, I'll have to re-learn how to eat, and make good food choices every single day, but to be honest, I should have been doing that anyhow. I'm hoping that, like the LASIK surgery, I'll look back on this in a few years and say "would I do it again? Absolutely, yes. In a heartbeat." Because after looking at myself in all of my non-glory today, I don't like what I see. That much fat just can't be sustained. This kind of life of pain, embarrassment, discomfort, and always waiting for the "other shoe to fall," health-wise, just can't last. I have to do it. I think, now, I may finally WANT to do it.

So, my lovely girlfriend took a number of pictures of me standing around in just my boxers, and, yeah... now I remember why 1) I never go shirtless, and 2) I don't like pictures! I believe that, under all the flab, I'm still a basically good looking man. But I have let the fat pile up, in roll after roll, until I'm almost unrecognizable under it. I think I've never really let myself accept just how very fat I've become. I have this bizarre mental image of myself as much more "normal" weight than is reality, but I also live in constant apprehension of someone seeing just how large I am. It's a bizarre mental double-image, and the photos today (which are in my private profile, and are going to stay private until I have some real progress to show!) were... a shock. My weight looks... ungainly, unhealthy, and just unsupportable, long-term. In some ways I think I haven't been fully committed to the surgery until this moment, just now, when I realized "man, if you stay like this, if you don't change something, you are going to die, painfully, and soon." I really understand now why... My back almost always hurts. If it's not my back, it's my shoulder from lying on my side to read or sleep (all that weight on my shoulder causes problems). I almost never sleep well, and fight constantly with apnea. I'm sick so often. I hate exercise so much -- if I walk long distances (or even stand up straight for too long), something is always chafing or rubbing or constricting. It's not surprising... with that much flab to move around, who would be comfortable? I have such a hard time finding clothes that fit. I buy huge, tent-like clothes to try to fit into and "hide" my flab, but let's be real... I'm not fooling anybody. I feel so awkward in social situations -- I'm very body-shy, and it's very difficult for me to avoid the belief that someone is "judging" me for my body. Some years ago, I had LASIK surgery because I was very nearsighted. I had to wear thick, coke bottle glasses (or contacts, but they were killing my eyes). I was very frightened of the surgery, to be honest -- I was worried I would go blind or something. But I got through it; I did my best to follow the surgeon's instructions TO THE LETTER, and when my eyes had fully healed, I had better than 20/20 vision (20/10 in one eye, 20/15 in the other). It wasn't entirely a positive experience; I had to shell out five thousand dollars of my own money (LASIK was still new). It was a little painful and a lot frightening, but I still consider it one of the best choices I've ever made. I still just stare out on this beautiful world, sometimes, and marvel at how nice it is to be able to really SEE without thick lenses or frames chafing my ears or getting smudged or slipping down (and making everything look small, that's one odd effect of glasses that they never mention -- everything looks so SMALL). It was totally worth the money, and I would do it again in a moment. So that's how I'm thinking of the weight loss surgery. I've done the research; on almost every single metric, this surgery will improve my life. It will add years of life expectancy, and (maybe more important), it will likely be QUALITY life, not years spent in sickness and decline. It will restore my mental image of myself as a "normal looking" guy to reality. It will hopefully ease my constant anxiety that something is Dreadfully Wrong with me, health-wise (I'm fortunate that almost all of my anxiety is, for now, ungrounded -- but how long will THAT last?). YES, there will be some initial pain, but apparently not much. YES, I'll have to likely deal with some nausea or "sliming" or whatever, but that's a small price to pay. YES, I'll have to re-learn how to eat, and make good food choices every single day, but to be honest, I should have been doing that anyhow. I'm hoping that, like the LASIK surgery, I'll look back on this in a few years and say "would I do it again? Absolutely, yes. In a heartbeat." Because after looking at myself in all of my non-glory today, I don't like what I see. That much fat just can't be sustained. This kind of life of pain, embarrassment, discomfort, and always waiting for the "other shoe to fall," health-wise, just can't last. I have to do it. I think, now, I may finally WANT to do it.

Well, my girlfriend (who is also a sleever) and I went out for a "farewell" dinner tonight. I ate my last meal (ever!) where I won't be thinking about protein grams or carb grams. I had a big ole cheeseburger, with fries. I drank two large mugs of beer since that will likely be my last beer. I had two big glasses of Diet Coke. It was glorious, but I was also saying goodbye. For the most part, I don't think I'll miss it. But I kinda needed to do it so I didn't feel like I'm getting a raw deal. On Tuesday, I'm going to start my pre-op low-carb diet, which I'm actually going to informally begin on Monday. Edit: oh, I also took some "before" photos of myself just in boxers. Jeesh, it's mortifying. I guess I didn't really want to admit, even to myself, just how fat I've become. Well, that's going to change...

I'm with you. It's nobody's business except for those I choose to tell, and those people have been overwhelmingly supportive.

So, does acid reflux get worse after surgery? I know that obesity can cause acid reflux, and I have it. According to the endoscope, I don't have a hiatal hernia. Is my reflux likely to get worse after the surgery?

So actually, the science points to obesity causing memory loss: Obesity is associated with memory deficits in youn... [Eat Weight Disord. 2006] - PubMed result Obesity Tied to Memory Loss | Psych Central News