Who is a "good" candidate vs. a "bad" candidate for surgery?

[Dragonsmate 107]

these are all good questions for your nutritionist.

as for Protein, for an adult, 2 things are important... lots of Water and dont go over 100 grams a day.

i think the psych was likely right, but since you havent done your nutritional counseling, how are you supposed to know? go get your nutritional counseling and then another psych eval. i think you might have put the cart before the horse.

With all due respect, the usual recommended Protein intake for an adult with a "normal" activity level is roughly 0.8-1 gram/kg of body weight. In obese folks, you would use your ideal body weight to calculate the amount, erring on the side closer to 0.8 grams if you are very sedentary and closer to 1gram if you are active.

Another source:

https://www.endocrine.org/~/media/endosociety/Files/Publications/Clinical%20Practice%20Guidelines/FINAL-Standalone-Post-Bariatric-Surgery-Guideline-Color.pdf

lists 60-120 grams of protein/day as the protein goal of post-surgery patients.

I just want to comment that as you become more active, start adding resistance training to your regimen, and begin a regular exercise program, protein will be even more important. Please keep in mind, protein is the most thermogenic of the macronutrients and because we are limited in the quantity we can eat at one time, we need to focus on making sure those meals are nutrient dense. Fluid intake is paramount in order for the body to digest, utilize and most importantly, process waste by-products from protein metabolism (your kidneys will thank you )

Edited June 19, 2014 by Dragonsmate

[VSGAnn2014 12,992]

Well, the big lesson here is ... don't go to your pre-surgery shrink evaluation appointment with a sugary Starbucks drink with whipped cream on top.

I think we can all agree on that.

Edited June 19, 2014 by VSGAnn2014

[moonlitestarbrite 902]

Well, the big lesson here is ... don't go to your pre-surgery shrink evaluation appointment with a sugary Starbucks drink with whipped cream on top.

I think we can all agree on that.

yeah, i think we all got the point across.

[FishingNurse 1,211]

@@Skywalker

As an RN that works with Psychologists and Dieticians everyday: I think your Psychologist has no business judging your "nutritional insight" He has a degree in Psychology not nutrition.

You will be required to see the Dietician before surgery and they will educate you. Problem solved! See the Psychologist that your Surgeon's use.

[Fluffnomore 1,235]

Skywalker, one other point. My husband has a well-documented diagnosis of bipolar disorder. He, also, hates having it "out there" and although he knows he has to mention it in these situations it makes him uncomfortable. But it does influence everything that happens medically: he is on certain medications that shouldn't be used with others; when he is in the middle of a swing his mindset and control are compromised; and people with bipolar have a tendency to go off their meds when they are either feeling too good or too bad. Again, it's not a reason for someone NOT to get the surgery, and in the end he wasn't approved for other reasons. But I had my worries throughout his approval process as well that he might not be as well-prepared for surgery because he had some magical thinking around what it would or wouldn't do.

My point is, any disorder, whether it is depressive or metabolic, needs to be thought about. In the end, my feelings about whether he was or wasn't ready for surgery were moot. If he had gotten the surgery, he would have had to figure out how to handle himself. Our friend, who didn't reveal the extent of her eating behaviors, had some very serious "come to Jesus" moments afterwards. She is doing okay, but it's going very slowly for her.

Again, I'm not making any judgment calls on whether YOU are ready or not. I'm trying to shed light on the other side of it.

[Forsythia 882]

My hospital only allowed psych evals from a very small list of vetted people. Before you turn that in, make sure that your surgeon's office does not have a requirement for that. When I went to see the psych, I passed right away, but a lot of people do not. They have to make follow up visits. But the whole point of the program is to progress and learn and change before going under the knife.

A lot of people get really quick approvals from their insurance. My insurance required 6 months of classes (which my hospital also required). So if your hospital or insurance requires monthly classes, don't think of it as an obstacle, think of it as a chance to learn and improve your habits - use that time to get your psych to change his mind.

[Miss Mac 6,262]

While you are still pre-op and walking around with your original birth stomach, here are some practical things you can do to give yourself a head start. These actions show up on nearly every bariatric program here:

Cut back (as in WAYYYYYYYY back) on sugary and starchy carbs. The limits our nutritionists have given us range from mimimal to maybe 150 grams of carbs per day. My personal experience through my first six months post-op, is that the lower I go with carbs, the better I do with my weight loss. Right now, I have gone commando with it. By limiting myself to -20 carbs, I broke a miserable seven week plateau. That few carbs means I am eating mostly "one ingredient" foods, not made in a factory, i.e. meat, eggs, cheese, nuts, non-starchy veggies, and 1/2 serving of fruit per day, ususally berries. But that's me. Your mileage may vary.

By eating more lean Protein, you will fill up faster and stay filled up much longer. Post-op my requirement was 60 grams, which is hard to do right away, and the Protein drinks really help if you can find one you like. At six months, my requirement is 80 grams......do-able, but I sometimes start or end my day with a Protein Drink.

Drink Water until your eyeballs float. The most recent adjustment I have made is to wean myself off of artificial sweeteners. They have been my go-to sweetener since I eliminated sugar, honey, and agave. Stevie has too much of a licorice taste for me. I counted a while back and I was consuming around thirty (30) per day. Now I make my morning cup of de-caf tea, take two sips, and dump the rest out. The rest of the day I drink Water with a splash of lemon, and lots of it. Most plans will recommend at least 64 ounces. Soda is not your friend, even if it is diet soda.

Move your body every day. This could be a walk, resistance training, swimming - really anything thing you are able to do. I have a lot of exercise DVDs, but hate the stupid music that goes with them. So.......I put the TV on a music channel and put the DVD in my laptop, and exercise that way. Sometimes, like today, I crank up the music and dance like nobody's watching, and I have orthopedic issues. On flare-up days, I do my exercise from a chair or on the bed.

Anyway, I am sure others have practical suggestions for helping you get a head start. And remember that packaged and processed foods and treats are not made to be healthy; they are made to make rich people richer. I wish you good luck and good health.

[VSGAnn2014 12,992]

This thread is really wonderful. Thanks to everyone who has contributed. And thanks to the OP for starting it.

[moonlitestarbrite 902]

Our friend, who didn't reveal the extent of her eating behaviors, had some very serious "come to Jesus" moments afterwards. She is doing okay, but it's going very slowly for her.

okay fluffnomore, i'll bite, what is a "come to jesus moment?"

[VSGAnn2014 12,992]

I'll explain "Come to Jesus moment."

It's when the clouds part, and "you see the light."

You hear. You see. You believe.

In other words, you experience a massive "Aha!" moment.

;=]

[Fluffnomore 1,235]

In my friend's case it was when, 6-8 weeks after surgery, after a particularly gnarly family party she found herself scarfing down an entire piece of cake and being resentful that she could no longer eat her feelings. Or that she could, I guess, but that it hurt like hell physically and it was what got her there in the first place. She called to talk to me about it and said, "You will not understand, until you go through it, how hard it can be to FEEL your feelings." To not leave the room after arguing with your spouse and pour a glass of wine. To not aimlessly eat late at night to make yourself feel less lonely or sad.

I was a wine girl. My husband is a night eater/binge-er, as was my friend. That takes a lot of de-conditioning. I still drink wine--not a lot anymore--and the funny thing is that I still have to think about it when I'm ready to order or pour another round. Along the lines of "Why? Do I really want this? What is happening?" I am far from perfect, believe you me. But I work hard not to ever kid myself about what I am doing. Last summer I was probably able to drink 7 bottles of wine per WEEK. This summer, that seems crazy to me…like it was a different person. And honestly, it was, in a lot of ways.

So that's my thing. For my husband, it's getting control of roaming the house and eating whatever is not nailed down. For my buddy, it was realizing that she could fix only one thing with the surgery, and the rest, not so much.

[moonlitestarbrite 902]

I'll explain "Come to Jesus moment."

It's when the clouds part, and "you see the light."

You hear. You see. You believe.

In other words, you experience a massive "Aha!" moment.

;=]

epiphany. got it. is this a southern expression? i have never heard it before.

[Fluffnomore 1,235]

Don't know. I'm as big of a Yankee as they come.

[woo woo 872]

This is a really good thread.

@@Skywalker I just wanted to mention that V-8 juice is VERY VERY high in sodium (which would explain the tastyness of it) and so not a good choice post-op, or for anyone with high blood pressure for that matter.

[blondebomb 580]

bikrchk--I haven't had the sleeve nutritional classes yet, but when you mentioned the Protein intake, how does your doctor(s) advise you to balance that? We have Protein powder in my house, and my daughter in particular loves it, but her PCP said no more than one a day or it's hard on her kidneys. I assume the same will be true for me for the long term post op diet....was just wondering if they tell people to fall within a certain Protein range post op for the rest of their life (not too much and not too little)

I don't no about others but mine said 70 grms a day for women an 80 for men.