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@@northstar9148, having sustained concussion in mid-2015 (I was fortunate to have experienced only mildest and brief enough intellectual impairment) and doing volunteer work with people with TBI (independent of my accident), I sympathize. I hope your prognosis is good.

Whether your monthly appointment with the dietitian is part of the program, you may do well to take an alert friend or relative along to help ask the questions that need asking and to ensure that the appointments serve your interests. Your partner can also take notes for you. The RD's are accustomed to working with us in a pre-planned fashion, but you need some extra attention and have the right to get it.

Certainly ask the RD if you'll be getting written instructions for the post-surgery period. It's hard to believe that hard copy isn't standard in a practice. Get them farther in advance than they're usually given so that you have more time to read through.

That said, however, I hope you've considered your ability to safely follow the program after surgery. Will you have someone to help with meal planning and cooking if necessary? I also hope I'm too late to the party and that all this has been discussed in the surgery practice and you have arrangements in place. My own fear would be not having solid support lined up, going through surgery and then finding myself unable to follow through on my own.

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WLS - That was in response to this comment:

@sc101071 -- This means you.

WLSResources/ClothingExch, on 13 Aug 2016 - 18:16, said:snapback.png

Some of you posting in this topic have been here a short time. Give it a little more time and your eyes will roll, too. If they don't, you will not have been paying attention. More than a few BP users are and were poor candidates for surgery. No one considered their powers of comprehension or looked for evidence of common sense.

I appreciate the last you wrote. I'm not here to fight. That's why I deleted my keeper of the weight loss post. I'll stand up for what I think is right, but I'm not here to get into it with others.

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I really don't have any support. I think the t.b.i. may have led to depression as I keep to myself and don't have any real friends. I do worry what I will do after surgery for supplement and reminders. I have excruating knee pain and need a knee replacement, but the doctors won't touch it until I get the weight off. It's a vicious cycle. But, I do hope to get support on this website. So far, there have been a lot of caring, nice people, such as your self, that have offered support and advice. I really appreciate it.

Sent from my SM-J700T using the BariatricPal App

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@@Babbs

Amen sister!

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@@northstar9148, depression is a common development after TBI, especially if it's long-lasting TBI.

While I know nothing about your experience and treatment, I'll private-message you with some details of my treatment. It may be that a similar program is available at your rehab facility. If so, it could be helpful. I'll write later today or tomorrow, as I must get some things taken care of.

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BEHAVIOR is usually an indication of success or failure with anything, correct?

[...]

That being said, I sometimes see behaviors in these forums that are not indicative of success.

Only if the behaviors persists. Behaviors (or maybe "habits" would be more correct) only have an impact when done on a regular basis (well, unless you do something really dangerous). You could compare it with consuming alcohol maybe. If you drink a larger amount of alcohol daily, not good. If you drink a glass of wine now and then, it's most likely not causing a problem.

If these programs have a higher chance to help modify the behavior of these folks before WLS, I feel they would have a better chance at success.

Yes. If.

I mean there are patients participating in a 6 months long multimodal concept (PTs and NUTs and counsellors and whatnot) and they don't lose weight or only a few lbs. How can that be if these programs are supposed to be the cream of the crop?

I'm no longer sure it really works this way. Sometimes I think some people have what it takes to succeed, fancy programs and behavior modifications or not, and others don't. But maybe that is too much fatalistic thinking though.

Edited by summerset

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Yes. If.

If these programs have a higher chance to help modify the behavior of these folks before WLS, I feel they would have a better chance at success.

I mean there are patients participating in a 6 months long multimodal concept (PTs and NUTs and counsellors and whatnot) and they don't lose weight or only a few lbs. How can that be if these programs are supposed to be the cream of the crop?

It had registered in my head that these six-month class programs may become the usual. My sceptic side prompted me to enter this in the feed this past week:

What's with this new thing, a six-month, pre-surgery "class?" Is it going nation-wide? Who requires and conducts it -- the practice? the insurer? Is it out of pocket for the prospective patient, never to be reimbursed? If so, what's the price tag? Whose big, fat chipmunk cheeks is it filling? From what I've gleaned, the class has merits, but the whiff of greed is sulfurous. Or am I way off?

Beyond that, "cream of the crop" lacks relevance. It is the individual who loses weight [or not], not the program.

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Lol...I actually did as i pleased before surgery, had no nutritional plan or guidance, did the exact same post op, had no guidance then either. I made it just fine, will compare my results with anyone else's any day, and I continue to do as I please.

WLS is not one size fits all. Some people need the constant guidance in order to succeed and others get along fine by themselves. I have smoked anything I felt like smoking, not a big drinker but if I want it I have it, and I eat anything I please. I've never had a workout plan and I do not bother with things like Water consumption or counting calories, carbs, fat etc,

Not trying to impose my mindset on anyone and not saying I am always right. Just saying there's more than one way to be a success.

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Lol...I actually did as i pleased before surgery, had no nutritional plan or guidance, did the exact same post op, had no guidance then either. I made it just fine, will compare my results with anyone else's any day, and I continue to do as I please.

WLS is not one size fits all. Some people need the constant guidance in order to succeed and others get along fine by themselves. I have smoked anything I felt like smoking, not a big drinker but if I want it I have it, and I eat anything I please. I've never had a workout plan and I do not bother with things like Water consumption or counting calories, carbs, fat etc,

Not trying to impose my mindset on anyone and not saying I am always right. Just saying there's more than one way to be a success.

That's worth a full quote. ;)

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@@WLSResources/ClothingExch In Germany the insurance companies require all of this stuff. The thing that makes me mad about this is, that insurance companies can deny coverage even though the patient did as required. Like I said: it's like playing the lottery here.

The worst about it (IMO) seems to be the emotional turmoil the patient ist in when doing this program. The patient might be denied coverage if he/she doesn't lose enough weight on it and the patient might be denied coverage because he/she loses too much weight on it ("see, it works without surgery" which is of course BS because what is a time span of 6 months when it comes to weight loss and maintenance?).

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In Germany the insurance companies...can deny coverage even though the patient did as required. Like I said: it's like playing the lottery here.

emotional turmoil the patient is in when doing this program.

It's not so different here. Insurance companies exist not to spend money, not to spend it. Catch-22.

It's sad to think of people sitting through the preparatory programs in turmoil. They'd be so much better off in all ways if they'd focus on their confident and pride about having gotten serious about their health and well-being. Take each step as necessary, whether it makes sense or is fair or not, and don't fret until there really is something to fret about. All that in a perfect world.

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Hey wait.....and interesting thought just came to mind.

This is just a thought. Certainly not directed to any one person or group of people.

Perhaps the people who do not follow any advice at all are considered weak and dim witted.

Perhaps the people who need the constant advice and guidance from surgeons and nutritionists are equally weak of mind.

It is quite possible that everyone who gets WLS is dysfunctional in some way, which is why they let themselves become obese and need the surgery in the first place.

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Lol...I actually did as i pleased before surgery, had no nutritional plan or guidance, did the exact same post op, had no guidance then either. I made it just fine, will compare my results with anyone else's any day, and I continue to do as I please.

WLS is not one size fits all. Some people need the constant guidance in order to succeed and others get along fine by themselves. I have smoked anything I felt like smoking, not a big drinker but if I want it I have it, and I eat anything I please. I've never had a workout plan and I do not bother with things like Water consumption or counting calories, carbs, fat etc,

Not trying to impose my mindset on anyone and not saying I am always right. Just saying there's more than one way to be a success.

Yes, I do believe your approach is as worthy as anyone else's. That said, knowing you as I think I do, I know you are much more intelligent than the average bear. Somehow I doubt you were eating fried wings and drinking bear 3 days out. I also would bet cash money that you didn't try to eat a 20oz steak three weeks out of surgery or anything else foolish.

I do believe someone with an ounce of common sense and a bit of self control can do the research, behave appropriately with this surgery and be successful. :D

Hey wait.....and interesting thought just came to mind.

This is just a thought. Certainly not directed to any one person or group of people.

Perhaps the people who do not follow any advice at all are considered weak and dim witted.

Perhaps the people who need the constant advice and guidance from surgeons and nutritionists are equally weak of mind.

It is quite possible that everyone who gets WLS is dysfunctional in some way, which is why they let themselves become obese and need the surgery in the first place.

I think the people who ask ask ask for advice and then get offended when it is given to them are the most...uhm...entertaining.

I think those who are overly reliant on their surgeons may struggle with common sense decisions.

I do believe there is a middle ground and seemingly MOST people choose to take it. It's always the extreme that we hear from the most. :D

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