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9 month follow-up appointment - success?



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I had my 9 month post-op appointment yesterday. Nothing special, just a routine follow-up. The only thing I wanted to talk to my surgeon about was the continuing saga of Constipation and whether I should still be on a 1300 calorie goal. I was thinking that perhaps I should up it to 1500 to see if it helps with the current plateau I appear to be on.

First thing he does when he comes into the room is break into a huge smile and shake my hand. He had me stand and turn around so that he can check me out. He had me lift my shirt so that he could see how much excess skin there might be and what my BMI might be before calculating anything. He then asked for my log printout that I always bring in with me. Here is where my surprise came.

He called me one of his best success stories.

Success? But I am not done yet. Am I?

According to him, since my ribs are now visible as well as my xiphoid process (pointed bottom of the sternum) and that my knees touch when laying down, and just general visibility of muscle and joints that I am already pretty lean. There may be a layer of fat still attached to the inside of the skin, but not a lot of reserves. I pointed out that I still have a belly and he said that it mostly skin and of course with constipation I am a sticking out a little, but he is happy with where I am. I thought I still had 20-25 lbs to go. My original goal was 220, but I thought I would bottom out at 200 and maintain at 220. I am currently at 225. Don't get me wrong, it feels wonderful to be here from 330, I just didn't think I would have "finished" already.

I asked if I could continue to try for the 200 lbs mark, and he said it was fine, but it would only be for personal satisfaction. Health wise, he was happy where I am now. He liked the muscle that I was able to maintain and wants to ensure that I do not sacrifice it for a number on a scale. I totally understand that.

He then went on to praise my record keeping. Said not only did he wish more patients did it, he wished he was able to do it. I have logged every bite I have eaten since I started logging food. I didn't start it because I wanted to log it, I only started doing it so that I would know how close I was to my Protein goal. I have since come to appreciate the data aggregation and analysis that I can do with it. (kind of a nerd here). He also said that I should be consuming anywhere from 1200 - 2000 calories! Woah there chief, not ready for that just yet! But I think I will go ahead and change my goal to 1500 and see if that changes anything. I also think I am going to change my categories from:

Breakfast

lunch

dinner...

to time ranges:
06:00 - 12:00am
12:00 - 05:00
05:00 - 09:00
I think that would be a better way to track it. anyways, I wanted to put this information out there because I know some of the men are wanting more topics relevant to them. I have also attached part of my log in case anyone was curious as to what I do. This is only an example, I have several different analysis tabs going on.Paul MyFitPal 2015-11-19.pdf

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I had my 9 month post-op appointment yesterday. Nothing special, just a routine follow-up. The only thing I wanted to talk to my surgeon about was the continuing saga of Constipation and whether I should still be on a 1300 calorie goal. I was thinking that perhaps I should up it to 1500 to see if it helps with the current plateau I appear to be on.

First thing he does when he comes into the room is break into a huge smile and shake my hand. He had me stand and turn around so that he can check me out. He had me lift my shirt so that he could see how much excess skin there might be and what my BMI might be before calculating anything. He then asked for my log printout that I always bring in with me. Here is where my surprise came.

He called me one of his best success stories.

Success? But I am not done yet. Am I?

According to him, since my ribs are now visible as well as my xiphoid process (pointed bottom of the sternum) and that my knees touch when laying down, and just general visibility of muscle and joints that I am already pretty lean. There may be a layer of fat still attached to the inside of the skin, but not a lot of reserves. I pointed out that I still have a belly and he said that it mostly skin and of course with constipation I am a sticking out a little, but he is happy with where I am. I thought I still had 20-25 lbs to go. My original goal was 220, but I thought I would bottom out at 200 and maintain at 220. I am currently at 225. Don't get me wrong, it feels wonderful to be here from 330, I just didn't think I would have "finished" already.

I asked if I could continue to try for the 200 lbs mark, and he said it was fine, but it would only be for personal satisfaction. Health wise, he was happy where I am now. He liked the muscle that I was able to maintain and wants to ensure that I do not sacrifice it for a number on a scale. I totally understand that.

He then went on to praise my record keeping. Said not only did he wish more patients did it, he wished he was able to do it. I have logged every bite I have eaten since I started logging food. I didn't start it because I wanted to log it, I only started doing it so that I would know how close I was to my Protein goal. I have since come to appreciate the data aggregation and analysis that I can do with it. (kind of a nerd here). He also said that I should be consuming anywhere from 1200 - 2000 calories! Woah there chief, not ready for that just yet! But I think I will go ahead and change my goal to 1500 and see if that changes anything. I also think I am going to change my categories from:

Breakfast

lunch

dinner...

to time ranges:
06:00 - 12:00am
12:00 - 05:00
05:00 - 09:00
I think that would be a better way to track it. anyways, I wanted to put this information out there because I know some of the men are wanting more topics relevant to them. I have also attached part of my log in case anyone was curious as to what I do. This is only an example, I have several different analysis tabs going on.attachicon.gifPaul MyFitPal 2015-11-19.pdf

First, a HUGE CONGRATULATIONS! I can understand your hesitation to shout off the rooftops about reaching your Dr.'s goal, when you feel you haven't gotten there yet. I would probably react the same way. But that said, you obviously did things right and he appreciates your effort. I think our surgeons see so many people come and go over the years and when they see someone put in 110% to track, make good food choices and work on their fitness, they have to applaud it. I bet less than 5% of their patients do what you did and took it as seriously as you do. So, again, HUGE CONGRATS! Hopefully a you can implement a few changes that you are comfortable with and maybe see some more progress. I bet you have 20lbs to lose just by having extra skin removed. That could get you to your goal for sure!

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Congratulations!

As far as whether you "need" to lose more, one thing it's helpful to remember is that your surgeon has seen ooodles of bariatric surgery stories - yours is the only one you have to work with, so to speak (yes, we all know folks who have had it). Our internal critical eye sees us differently than others see us. Usually, ours is the only post-op body we see in the mirror, unclothed, dressed only in the messages we've internalized about the way we look.

Own your success - and continue to set and meet your own personal goals. Well done!

Edited by 2goldengirl

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Congrats!!! I guess it takes our brains a while to catch up to what we have done. But it's good to enjoy what you have achieved and how you got there. I understand where you are coming from, however. I look in the mirror and I recognize that I have lost weight, but I feel I have a long way to go. My wife and doc can't understand how I don't see my progress. I do, it's just that I also have a goal in mind and that is what I am striving for. Congrats on how very far you have come and good luck in achieving your goal!

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one of his best success stories.

@@BigViffer

doc wouldn't lie to you about the above

accept his nice compliments

you are a success!!! :lol:

you've worked hard

logging, tracking food and drink

following all the rules

if you feel like you want to loose a few more lbs - go for it

doc gave his "blessings" to go forward

don't go overboard now

you don't want to go the "other" way, with loosing tooooo much weight :o

i am NOT a medical person, here are my thoughts from a laymans/MY perspective

you've been loosing weight successfully these past 9 months

you've been heavy for a long time in your life

maybe you want to keep loosing out of "fear"???

you "might" be scared to see life in a different way

NOT having to deal with weight loss anymore

concerned - "Now What Do I Do??"

remember no shrink here

just my thoughts above

weight loss is over - you've done terrific

now its time for maintenance

this is usually harder than your initial weight loss

(we've all lost weight in the past, hard to keep it off)

you must keep up all the rules you've learned while you were loosing weight

forever and forever and for...........

i have confidence in you that you will continue to do great

for the rest of your healthier, happier, longer life :rolleyes:

you've lost 105 lbs!!!

you ARE a success

keep up the good job

good luck bud

kathy

congrats

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Maybe seek a second opinion?

-RC

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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