ouroborous

The spray was awful. I was sorta half-awake the whole time they were scoping me... I actually *remember* the feeling of the scope down my throat and gagging a little at one point. Unpleasant! However, the rest of the day is full of little "blackouts"... I guess I'm just challenging to anesthetize. All things considered, however, the EGD is nothing to be afraid of. Even though I wasn't completely "out" during the procedure, I was so doped up that they could have been feeding me my own liver and I would have happily chowed down. Better living through chemistry, baby!

I'm envious. I have Aetna, but I was told that due to the corporate plan we had, there was no way that WLS would ever be covered. 20 grand I wouldn't mind keeping, but oh well... health is more important than money.

Sorry! Didn't mean that to come across as brusque or anything :thumbup: Sometimes when I'm at work and "sneaking a break" I don't have a lot of time for a response (and then an hour later there's absolutely nothing to do and I write a novel! It's the nature of my work, I suppose...)

Thanks for all the tips and information, fAiTh! You've got lots of good advice. I'm hoping to pick up some sports that I like. I can deal with SOME boredom at the gym, as long as that's not the only way I can get fit. I'm hoping to get into some "guy" things to do; being the perpetual overweight geek, I've never really had much "guy" stuff in my life -- rock climbing, martial arts, hiking, and I find myself oddly missing that part of my life. Also sex, well, at my weight and not feeling so hot about my body, I haven't had much of a sex drive for a long time (which is kinda tough as a 39 y.o. guy, since we're expected to always be the ones to "get things started!") -- hopefully that will change too. What I'm MOST hopeful for, though, is the sleep thing. I've struggled with sleep all my life (literally... one of my nicknames as a little boy was "sleepy"). With my sleep apnea, I feel like I haven't had a really GOOD night's sleep in AGES, and I'm really really looking forward to that. I'd almost be willing to have the surgery if that was the ONLY benefit. I'm also looking forward to feeling good about my body again. It's really hard to explain, but when I'm overweight and doughy, I just don't feel super manly or confident about myself. I have had various times during my life when I've been lifting weights pretty hardcore (I have a body that's naturally built for it... and what do I do? sit on the couch all day!) and during those times I've felt way more upbeat about my appearance and masculinity. I'm hoping to get some of that back if I can shed some flab and build up the muscles. Honestly though, I've been fat for so long now that I almost don't know WHAT to expect. I'm just hoping to build some new, healthy habits that can last me a lifetime!

Well, I've already attended an orientation meeting, and I'm not super big on support group type thingies. So not really.

I have loved ones who have lived in Canada and the UK, and I have to say that anyone who says that "we have the best health care system in the world" here in the US is full of it. We have a lot of great docs, and we have access to all the most wonderful and expensive machines and devices. But for most "average people" who have to just put up with whatever their crummy insurance will provide for them, the situation is far from perfect. My sister recently moved from Oregon to London and she RAVES about how great the NHS is. Note: I don't mean to imply that our individual practitioners here in the US are unskilled -- far from it. But our system is broken, very very broken. It's sad that we should be relieved when we find someone who is willing to treat us like a human being and actually listen to our concerns, but that's how it rolls here -- in a system that's driven purely by profits, the patients have become, to many people, simply a commodity at best, and a nuisance at worst. The fact that we have real lives, real fears, and real questions never seems to factor into the equation. If you got the impression that our broken, inhumane health care system here in the States makes me hopping mad, you're right. First in the world in costs, 37th in the world in patient outcome. I'll shut up now because this is verging on politics (which is one of those conversational black holes).

So, with fitness, I need to develop new habits. My whole life, I've been a fairly cerebral guy, and I've never been one for sports or fitness. My career -- as a computer programmer -- is both mentally and financially rewarding, but it is very sedentary. Being the guy who was usually "picked last for the team" (due to obesity; by nature I have the build of a football player, but since I'm so sedentary, my body was always soft and unformed) I never cared much for organized sports. So, I'm facing a fairly large hill to climb trying to change a lifetime of sedentary habits into one of good habits. I have a few weapons in my arsenal that I'm going to try to use, however. I have always had problems with depression and anxiety. Most of these stem from poor sleep (when I sleep well, I have NO problems, but I almost never sleep well due to sleep apnea!) and too much caffeine (which, again, I abuse due to being tired all the time). One thing I've discovered in the last ten years or so is that nothing will calm me down and "level out" and improve my mood like some hard cardio work will. So I'm hoping to use this to combat the inevitable post-surgery blues. Boredom. Let's face it, I get bored easily, and I have often tended to eat out of boredom. I won't be able to do this (as much) after surgery, and I'm going to need something to replace eating with. I'm hoping that I can replace eating with exercise to entertain myself. One problem is that I find traditional gym-style exercise very, very boring. Weightlifting is okay (because you can try different machines, and different weights) but machine cardio is the most boring thing on earth. So hopefully, I'll be able to find some entertaining ways to keep moving and keep fit. I've always enjoyed martial arts, but since my 20's I've been too heavy to really get into it; I'm hoping to take it back up. At almost 40 I will probably be the oldest one in the class, but what the hey, it's good for me. Understanding how habits work for me. I've realized that it's really hard to quit a bad habit, and almost as hard to start a new habit out of the blue. From what I know about myself, what works best is substituting one habit for another, worse habit. I'm hoping to use this to learn how to substitute healthy fitness habits for older, unhealthy, sedentary habits. I would LOVE to hear any advice people have on these topics. I really, really, really have to make fitness and exercise a habit now, and make it lifelong. I'm not just doing the sleeve to lose the fat; I want to really make a turnaround in my whole body health and learn how to stop being my body's enemy, and start seeing it as my friend, my vessel, and my ally.

So, I'm a little over three weeks out from my surgery (5/6/2010), and a week out from my two week pre-op diet. I know I have fatty liver (diagnosed) and I'm going to be super rigorous following the pre-op diet since I don't want to risk injury to my liver during the surgery! It will be hard, however, since I love, love, love carbs -- the breadier and doughier the better. I'm already trying to prep myself somewhat for the surgery by weaning off of carbonated beverages (it will be hard to say goodbye to my beloved Diet Cokes, but in return for being a more "normal" weight... okay!) and cutting back on carbs when possible. My girlfriend had the lap sleeve in November of last year, and her tremendous success (going on 60 lbs lost with very little work on her part, and almost no cravings) has been my inspiration. Plus, it's very comforting to have someone around who "knows the ropes" and can reassure me that what I'm experiencing is normal. I'm a worrier, you see -- I comfort myself with facts and figures. I know that leak rates are less than 2%, I know that mortality in this surgery is around a tenth of a percent, and I know all of those things mean that, statistically speaking, the bad things almost certainly won't happen to me. I know that at 39 (which isn't a kid, but is still fairly young), with no diabetes, heart disease, or other comorbidities, and with a very uncomplicated surgery (no hiatal hernia, no gall bladder issues, "virgin" stomach -- not a revision), I'm very safe. But still, I worry. I'm somewhat concerned about my mental state following surgery. I'm predisposed to depression and anxiety. Much of that has to do with my poor sleep (I've strongly tied my depression to lack of sleep) and the amount of caffeine I use to function despite being so tired. But still, I have to admit that I'm nervous about my mindstate after surgery, considering how common post-surgical depression is, and how I'm predisposed. I'm guessing that the first week post-op, where I'm scheduled to be back to work but "working from home" (so, no coworkers to distract me and lighten my mood, etc.) will be the hardest, as I'll have time to dwell and wonder "what have I done?" and mourn all the things I can't have anymore. I'm not a religious person, so I don't have faith to strengthen me, but I have friends and families and the wonderful community here. I figure that I can survive a week or two of anything, and the payoff should be SO worth it. So that, in a nutshell, is where I am today.

If you're post-op and having persistent headaches, you may also be dehydrated. The docs are all pretty much insistent that post-op your primary concern shouldn't be what you eat as much as how much you drink. I keep hearing people say "sip, sip, sip!"

Thanks for the words of encouragement. It's true that the main reason I'm getting WLS is because I've been unsuccessful with diet & exercise and the health risks of remaining obese into my 40's and beyond are unacceptable. But that doesn't mean I would be upset at feeling a little better about my appearance! Yes, I'm terrified of the surgery (just being honest here :mad: ) but I'm VERY ready to be done with being a porker.

I'm scheduled to be sleeved on 5/6. I'm expecting the first couple of weeks to be hard, especially mentally. My girlfriend was sleeved in November of last year, and honestly her recovery was pretty easy and she's had very little unpleasant effects. One time she ate some chicken that was too dry, and it got "stuck," but otherwise she's been happy with the outcome. She hasn't mentioned nausea or stomach spasms at all. I've had problems with depression in the past (mostly due to my sleep apnea, which is never more than partly controlled), and I'm expecting that my first week or two after surgery, I'll have to deal with a lot of depression and anxiety, and more than a few "holy crap, why did I DO this to myself" moments. I say all of this because I think it's better for me to be prepared for the worst, and pleasantly surprised, than expect the entire process to be a walk in the park and then get floored by the inevitable setbacks. As Tiffykins said, this IS major surgery, and we can't expect to just "walk it off" without a little readjustment period (although, ironically, walking may well be my best friend post-op to fight the blues and speed in healing!)

I think we're about the same general demographics (I think I'm a little lighter than you at 330-ish, and I'm just guessing that I may be a few years younger, but that's hard to say!) I'm hoping that I have anywhere NEAR as amazing of a transformation as you!

What are the odds that I'll be able to get to a point where I'm comfortable with my shirt off WITHOUT surgery? For the record, I'm 39 y.o. male with a BMI of 42. I have a big tummy, but it doesn't droop down over my waistband. I have some stretch marks from a rapid weight loss/regain in my teens. What I'm HOPING is that with sufficient exercise (and eventually weight lifting) I can avoid most of the super-invasive plastic surgeries. However, I'm trying to figure out how realistic my hope is, or if I should set my sights a little lower... The odds of me having tens of thousands of dollars for plastic surgery any time soon are... slim to none.

The irony is that I (a man) got into a lot of trouble for doing this same thing (dating two women, sleeping with neither) many years ago. Some women friends told me that I was being deceitful and "stringing them along" (even though the situation was almost identical, we'd never explicitly *said* we were exclusive, but they might have assumed it). A lady friend of mine completely chewed me out, saying that I was lying by omission and rationalizing it. I don't know who's right, but the really funny thing was that this same woman, some years later, was doing the *exact same thing* (and sleeping with the guys, to boot) and when I (gently) called her on it, she got all defensive and told me it was no big deal. My rule of thumb these days is that if I'm doing something I wouldn't want my romantic partner to know about, I probably shouldn't be doing it. Following that rule has kept me mostly on the straight and narrow. Of course, I'm a lot less wild at 39 than I was at 25!

Ah, a fellow Diet Coke addict! I'm actually having a fair amount of success kicking the soda habit, but caffeine... I need that! My sleeve is 5/6 so I have a little while before I have to give it up for good.

Congratulations, brother. I'm having my sleeve op on May 6th, and I'm hoping that I can have anywhere near your level of optimism, and success!

Oh yikes. That's good to know, before I have one glass of red wine and think "I'm okay to drive" (I actually don't drive after ANY alcohol, but still, good to know). As to your other post, that's me to a Tee: "no off switch." I don't obsess over food, in fact I can go long periods without any food whatsoever. It's just that when I DO eat, I can (and do) easily eat until I feel ill. There's never a "that's enough" stage! So hopefully lap sleeve is the perfect surgery for me, too (I'll know in about a month)! Edit: just did a little research, and it looks like the science proves you correct. I always thought that alcohol was absorbed by the stomach, but it appears that it's actually the small intestine where most is absorbed. Since lap sleeve doesn't affect that, and in fact increases the transfer rate from the stomach to the small intestine, alcohol could conceivably be MUCH quicker in effect. Source: http://www.intox.com/about_alcohol.asp

Okay, this is exactly what I'm hearing from all sources, so it rings true. 1-2% is not really something to worry about, since I think that's about the same as the general anesthesia complications rate. So if you're going to worry about THAT... Ahh, this makes sense. I was under the impression that real liver "shrinkage" just couldn't really happen in two weeks. The slippery liver thing makes more sense. Yeah, this will be the hard part for me! I'm naturally a worrier :lol0: Thanks for the info, as always!

Thanks for that, Tiffykins! This whole "20g of Protein max" thing had the smell of an urban legend about it. It's sad that doctors and nutritionists are repeating it, but even there I've found that not all medical practitioners keep up to date with the research. My primary care doctor pooh-poohed WLS because he said it had a very low success rate compared to diet and exercise (!)

Dr. Jossart, there's a pretty strong current of belief around here that after lap sleeve, it's "impossible" to absorb more than 20g of Protein at a time. This is often used to say that high-Protein shakes, for instance -- say 50g or 60g of protein -- are a waste of money. Many people claim that their doctors and nutritionists gave them this fact. Also, I DO find some reference to protein malabsorption on the net -- for instance, a consent form I found referenced it. However, I searched the medical databases and couldn't find ANY reference to lap sleeve significantly altering protein metabolism (intake, yes, but not basic metabolism). From what I understand, one of the primary "selling points" of the lap sleeve is that it is not malabsorptive. I guess if the smaller, scarred stomach is unable to produce sufficient gastric acids or pepsin or whatever, protein metabolism might be challenging, but that seems a stretch (and I believe it would be noted in literature). I'm starting to think that the "20 grams of protein in a sitting" meme is an urban legend. One possibility is that since the lap sleeve used to be just part of the lap sleeve plus DS procedure, which unless I'm mistaken IS malabsorptive, there may be old data floating around masquerading as current truth. I'd appreciate it if you could shed any light on this, because a lot of people are giving a lot of other people a lot of potentially incorrect advice :lol0:

Here's what Dr. Jossart had to say: Re: question about Protein The VSG does not have significant malabsorption and protein deficiency is essentially unheard of. Any Protein Drink will be fine. Make sure the carbohydrate count is low(usually less than 10gm) as you don't want to consume alot of sugar. Most health food stores sell good quality Protein drinks as well as grocery stores, etc. The general rule is more than 15gm of protein and less than 10 of carbs.

So, immediately after posting this, I found a LOT of articles on the net referencing Protein deficiencies after VSG. Deficiency due to restriction in intake makes sense, however my understanding is that stand-alone lap sleeve is NOT supposed to alter your basic metabolism. The only thing I can come up with to explain any supposed protein malabsorption would be if the increasingly rapid stomach emptying prevents sufficient pepsin secretion (and overall acid breakdown) for proper digestion. However, I believe that lap sleeve patients would be noticing this and having very noticeably difficult times digesting protein. One possible explanation for the "protein absorption" myth is that lap sleeve used to be just one part of a two part procedure -- and that procedure DID change absorption (of Proteins and other macro- and micronutrients). So perhaps what we're getting here is a confusion between the old procedure (which was malabsorptive) and the new procedure (which is not). Also, if the body could NEVER absorb more than 20g of protein at a time -- in other words, if this isn't something that changes w/lap sleeve, then that's another matter. However, I'm dubious of this. So, I believe that this may be something of a medical "urban legend." I'm STILL trying to track down ANY scholarly evidence that protein absorption changes in ANY way after lap sleeve. Since I'm about to get the surgery myself, it's kinda important to me (I want to be able to get enough protein to not only be healthy, but also build muscle).

I am not a doctor, but from my understanding, Protein is not absorbed by the stomach, period. It is broken down by the stomach and bile acids, and absorbed in the small intestine. Protein (nutrient) - Wikipedia, the free encyclopedia "Digestion typically begins in the stomach when pepsinogen is converted to pepsin by the action of hydrochloric acid, and continued by trypsin and chymotrypsin in the intestine. The amino acids and their derivatives into which dietary protein is degraded are then absorbed by the gastrointestinal tract. The absorption rates of individual amino acids are highly dependent on the protein source; for example, the digestibilities of many amino acids in humans differ between soy and milk Proteins[6] and between individual milk proteins, beta-lactoglobulin and casein.[7] For milk proteins, about 50% of the ingested protein is absorbed between the stomach and the jejunum and 90% is absorbed by the time the digested food reaches the ileum.[8] Biological value (BV) is a measure of the proportion of absorbed protein from a food which becomes incorporated into the proteins of the organism's body." Note the phrasing: "between the stomach and the jejunum." This jibes from what I remember of my physiology classes: the stomach is NOT primarily an absorptive organ; instead, its job is to churn up food and mix it with acid and enzymes for absorption in the intestines (primarily the small intestine for nutrients). As another case in point, consider that lap sleeve is considered a restrictive, but not malabsorptive procedure. The duodenal switch, on the other hand, is a malabsorptive procedure. All of this goes to my (educated) guess that the figures about how much protein you can "absorb" in one sitting after lap sleeve being bunk. It's not so much how much you can absorb, because that hasn't changed. Instead, it's literally about how much you can consume -- that's the only thing that's changed (unless you also had your gallbladder out, which DOES affect protein digestion, to an extent).

Will this change w/time? Broccoli is about the most "good for me" vegetable that I actually LIKE. I think eggplant and squash are disgusting. Hopefully this is just a temporary thing! Or maybe I can put it in a blender...

Actually, from what I understand, up to 30% of people who have WLS (or, in general, lose lots of weight fast) get gallstones. That's effectively 1 in 3, so it's pretty common. I'm not sure about the stats on pancreatitis.