I have had a really hard time managing my diabetes (type 2). My A1c climbed to over 14 and now is back under 10 and going down, but I had an eye appointment this morning, and moderate retinopathy was found in my left eye. It's not serious enough to require treatment, but I do worry very much about the damage long-term high blood sugar levels have done to my eyes and the rest of my body. Improving my diabetes is second only to improving mobility as a motivator for having RNY in the spring.

My main worry in this process is my depression. I have had pretty serious depression for most of my life. I have been in the best place in my adult life over these last 18 months, which is by far the longest stretch I haven't been in despair. There have been some low periods, but I've been able to come out of them more quickly and manage through them. I have the best combination of medications I have been on and have a good therapist and psychiatrist for medication management. Coming up for air like this is what is enabling me to envision a better future and start the path toward surgery. However, I am worried about relapse. When I am very depressed, I devote what very little energy I have to work, and self-care becomes a mighty struggle . Exercise or moving at all is sporadic at best, and anything more than opening a package to prepare a "meal" (even microwaving) is often too much (which leads to things like an A1c of 14).

I understand that many people experience depression after surgery, and that was in fact one of the first things my surgeon told me at the consult. I am very concerned about going down the hole and what will happen if I can't care for myself in the way I will need to. Right now, in preparation for surgery in the spring, I am eating three relatively healthy meals, taking my vitamins, keeping a food diary, drinking fluids, exercising, even cooking a little, and things are going well...it's like a different world. I'm not sure what will happen if I become depressed again. I am really working on mindfulness and a meditation practice to keep me grounded through tough times, but I do not know if that will be enough.

If anyone else has had similar struggles, how are you coping?

I cannot help you with the depression fear but I will talk about diabetes.

I had RNY gastric bypass surgery almost 4 years ago. I had Type II diabetes prior to surgery and took 2 prescription medicines daily but these were still not keeping my diabetes under control. My doctor was recommending that I transition to insulin shots but I refused. I had the surgery instead. I was in the hospital for 2 days. When I left, I was off all my prescription medicines for diabetes and I have not taken any since. I periodically (around once per month) check my fasting blood sugar levels and they are fine.

The surgery does not solve everyone's diabetes. For some, they only see a reduction in the amount of medication they take. This seems to be a function for how long they were diabetic. I had diabetes treated by medication for around 5 years prior to surgery. It seems that from reading past threads, that individuals that suffered for many years with diabetes and transitioned to insulin did not experience complete remission from this disease. So the sooner that your get this problem under remission the better.

Some individuals that have surgery experience a hormone flush. Chemicals and hormones are stored in fat cells of your body. As you lose weight these hormones are dumped into your body and individual can experience mood swings. Generally this tapers off when you transition from the weight loss phase to the maintenance phase.