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"Ready" for surgery? How much were you able to change before surgery?



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Hey folks,

I'm pre-op, will be submitting for insurance approval in December. I've been struggling with my pre-op diet for a while and wanted to know how much you were able to change about your eating habits and such prior to surgery. I go back and forth between feeling really down on myself, wondering if I should postpone surgery since I "can't do it" and maybe that means I'm not ready, and then also feeling like all bariatric patients struggle with changing eating habits and if it was that easy we could just do it without surgery so I shouldn't be too hard on myself.

What do you think? Were you still struggling with eating unhealthy foods before surgery or did you have a pretty good handle on things?

I've been in weekly therapy for over four months trying to deal with issues around food and I thought I would have made much more progress between then and now. It's pretty discouraging and makes me worried that I won't be successful after surgery. My bariatric team and therapist are all super supportive and have told me they are behind me whether I go with surgery or not. I definitely still want to have surgery but I'm just constantly second guessing myself.

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It was SUPER HARD keeping the food quantity down during the 2 weeks of pre op. I had to force myself because I wanted to shrink the liver for surgery. After surgery, keeping quantity down is effortless (because you get a stomach ache if you Don’t!). But during pre op I was starving . Now I can eat low cal and I’m fine.

Probably the best thing you can do now is to go low carb. Get used to no sugar, no fake sugar, no breads and pastas, and focus on Protein and veggie Soup and fruits. Eat natural starchy carbs every day like potatoes, sweet potatoes, root veggies. After a couple weeks not eating sweets your gut bacteria change to the k8nd that don’t make you crave sweets any more. This will prepare you for a post surgery HEALTHY diet. Of real foods, not sugar free Jello . Getting off sweet tasting things is going to help you. Good luck.

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@GotProlactinoma thanks! I'm not quite to the liquid diet stage yet. Just curious about the 6-month (or however long) process prior to getting a surgery date. If people were able to make changes and eat healthier consistently during that time.

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[mention=319018]GotProlactinoma[/mention] thanks! I'm not quite to the liquid diet stage yet. Just curious about the 6-month (or however long) process prior to getting a surgery date. If people were able to make changes and eat healthier consistently during that time.

I didn’t change much before my liquid diet. On day 10. My doc said loose half a pound per month. The hospital said I could gain a pound. My insurance only required 90 days, and I was approved quickly. My understanding was that I needed to go through the motions but not be too successful. I guess all plans are different.


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8 hours ago, GotProlactinoma said:

It was SUPER HARD keeping the food quantity down during the 2 weeks of pre op. I had to force myself because I wanted to shrink the liver for surgery. After surgery, keeping quantity down is effortless (because you get a stomach ache if you Don’t!). But during pre op I was starving . Now I can eat low cal and I’m fine.

Probably the best thing you can do now is to go low carb. Get used to no sugar, no fake sugar, no breads and pastas, and focus on Protein and veggie Soup and fruits. Eat natural starchy carbs every day like potatoes, sweet potatoes, root veggies. After a couple weeks not eating sweets your gut bacteria change to the k8nd that don’t make you crave sweets any more. This will prepare you for a post surgery HEALTHY diet. Of real foods, not sugar free Jello . Getting off sweet tasting things is going to help you. Good luck.

I agree limiting carbs really does help. Especially when you do get to the liquid diet phase (I'm in that phase now). I really didn't have headaches or anything by eliminating these foods prior. Also, it's good to hear that you are in therapy as well. Therapy has really helped me - my therapist recommended "The Self-Esteem Workbook" to read and honestly its been helping me work on thought patterns I have. I tend to stress eat or eat when I get bored so it was something I began to recognize and have been cutting it out slowly. Make sure you are tracking all your foods. I noticed I would eat more when I wasn't paying attention. I also try to keep busy. You sound like you are making really good steps in the right direction. Just remember no one is perfect. Best of luck to you!

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You didn't really give any specifics of what foods or behaviors were at issue.

Eating fast foods? Soda? Sweets? Grazing all day? Nighttime eating? Not eating vegetables? Pasta, rice, bread? Not drinking Water?

You asked if we struggled and if we changed habits. Yes to both. But change one habit permanently and build from that - I stopped all soda and drank ice tea - no sugar, but used tiny amount of sweetener. Then cut out all fast food, etc.

After surgery the healing time and restriction force a change of habits, but it will not fix your head and will be much harder unless you work on changing ahead of time.

It's good that you are in therapy. I wish you the best on this journey.

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I am pretty much forced to make changes and this is really a good thing. I have to get my A1C below 8% and my blood sugar was not well controlled. As of my last test, it was 10%.

When I first got the news, I moped around. Then, I got my butt in gear. At the beginning of this month, I began carefully tracking sugars and eating the right carb to Protein ratio. Now my average reading on the meter is 129 which puts me well below the 8% threshold. If I can maintain this momentum through December, I think I can meet my goal. I'm glad that I have to do this. Otherwise, I might have continued to gain weight and just said to hell with it.

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I’d also like to add that sometimes the physical takes a while to catch up to the mental. I had a “relaxing” mentally some months prior to surgery but that didn’t change my physical approach to food at all. I continued to eat as before and didn’t lose a single pound prior to surgery. Call it a long goodbye or just a balancing act between the two (mental/physical) but up to the day prior to surgery I can’t really consider my habits to have changed. My understanding of the process as well as how I’m eating certainly did and I think that’s helping me now. (I’m 5 weeks out).
Oh, therapy is great, I’m all for it if you have the right therapist.


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I started this journey to WLS in May of this year. I've mostly been low carb since 2000, with periods of utter recidivism. Prior to starting in May, I was on the straight Whataburger chicken Strips dinner with Cream Gravy diet. (Um, not recommended...just sayin') I was a total mess and had basically checked out and was in WTD status (WTD=waiting to die). I developed a staff infection in my foot and amazingly it saved my life. I realized I still had fight left in me. I didn't actually want to die yet. But I also knew I could no longer live in this body with its present incarnation. I was in raging pain all the dayum time 24/7, slept very little, hardly moved out of my recliner, and was very isolated. Poor Mr. Fluffy was at his wits end!

So when I started this pre-surgery weight loss game, I was deadly serious that things would change. I was going to be very strict and focused. I WAS going to start feeling better, lose weight, or die trying. So yes, I have changed dramatically. I am pretending I'm post WLS with the exception of the quantities. Because I was losing too much weight, my surgeon made me up my calories to 1500cals/day, so I end up eating a crap ton of healthy food to make that number every day. Much more than I would normally eat--6 times a day! But every meal is planned, tracked and logged prior to putting it in my mouth. My food is very KISS right now. NO sugar of any kind. No diet or soft drinks. No caffeine. 3 square low carb meals + 3 Snacks eaten on a schedule. No drinking with meals or for 45 minutes after a meal. Eating Protein first at every meal. I'm in it to win it now and am fully vested. I've come down from my 287lb weight (regained up from 218lbs over the last 5 years) to 233.4lbs this morning (up 2lbs from WurstFest this weekend).

I want to try to adopt as many behaviors as I can now. I want to be prepared and done with carb withdrawals, sugar withdrawals, and caffeine withdrawals now--pre-surgery. Cuz getting over surgery is going to be hard enough without going through the Keto flu that you have when you first enter ketosis.

If I could recommend only one thing for you--it would be to start from here forward with doing Atkins. It's like a gateway, easy to follow roadmap into a ketogenic or even a low carb lifestyle. Will there be slips along the way? Of course! Nobody's perfect! Will you cheat? Maybe. But doing it now will make things soooo much easier. Slips will have lesser consequences now. But the low carb can help you gain control over your food issues.

((hugs)) and sorry you are struggling right now!!!

Edited by FluffyChix

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I have never been more thankful for the 6 month lead up to surgery. In the past, the 6 months always caused me to give up and decide not to proceed with surgery. I was indignant about it and I let it piss me off to the point of raging against the surgery machine for 8 whole years. When I finally reconsidered, it was after my dad died. In the lead up to him dying, I put myself on the "If the people on My 600lb Life can do it, so can I liquid diet" ( not the actual name, but what I actually called it) Before I knew it, I had followed that diet for 3 whole months and at the end thought "Damn...I could be halfway to surgery." So when my dad died, I actually called the surgeon and started the process. I went on modified Keto which for me was eating a 1400 calorie keto diet Monday through Friday. On the weekends, I ate what I wanted, but I stuck to 1400 calories. I also started a walking regimen which by the day of surgery I was walking 5-7 miles per day. I really made changes in that 6 months mainly because I wanted post surgery to be as easy as possible. Truth be told there were still many changes to be made post surgery. I stick to the program and I work out 5-6 days a week. I run now about 20 miles per week.

I'm totally living my life now. No weight struggles. No complications.

Life is about evolving. Every change you make now will have an affect on your future and you never stop changing.

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I think the thing that helped me most was not beating myself up for every mistake. I was certainly not perfect during the 6 months prior to surgery, but I acknowledged the mistakes, and made improvements. Don't focus too much on the scale, do the best you can and improve on 1 thing at a time. I started with diet soda. I was a Type 2 diabetic, so I had already been drinking diet soda for years, but I chose to cut out soda completely when I started this journey. I then started to track ALL my food intake. I was amazed to see which foods were problem foods. It was not always the ones I thought.

CARBS, get them out. Protein is key to curbing your hunger. I started focusing on the protein, in many forms, and found that the cravings disappeared and I wasn't as hungry all the time. Focus on the protein and it will get easier.

Perhaps the biggest change for me was Water. Drink it all the time. I finally purchased a 40oz HydroFlask and started focusing on emptying it 6-8 times a day. If your stomach is filled with water, you won't feel hungry and eat things you shouldn't.

One last note, find what works for you. The things that worked for me may not for you. We all slip up at some point, but we can't beat our selves up for it. We need to learn from it, and change what we are doing till we find what works for us. You are making a big change and it won't happen overnight, take your time, change one thing at a time, and then add another. Before you know it, you will meet your goals, and feel amazing. Keep at it and stay strong!

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I changed it all because waiting after the surgery would most likely be a nightmare, like being the surgeon and not ever going to med school. Learning as you go is too much stress and this is a serious surgery. I even did a mock post op of 3 days w/o solid foods, it's what you would have to do newly post op. It took me 3x to be able to go three days on a freshly RNY post op life... that was the last lesson for the "for life" signaling to me "I can do this!"

That was what I did and YTD I am glad I did it. No rushing through pre-op training and being honest about this being for a life time made the difference for me.

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@Little Green - you didn't develop all the habits that got you to where you are in six months, so trying to erase all of them in six months is kinda crazy. Pick one thing and for a solid week - work on it -- e.g. this week I will not drink diet soda. I will drink seltzer with a wedge of lime (or whatever). Or this week, I will not eat any white flour - if I eat bread it will be whole wheat.

Probably the thing that helped me get my head in the right place pre-op was tracking every bite I ate. I mean absolutely everything. No cheating on the list. Doesn't matter how you do it - little notebook, My Fitness Pal, or some other app. Be honest because not being honest with ourselves about what we were consuming was part of what got us into the problem in the first place.

It was hard and there were times when i felt like I was failing and over the last year I have had those feelings post op as well - but that has more to do with my issues about being an over-achiever and my need to succeed at everything. I was worried going to my 1 year appointment that I was going to be told I wasn't doing enough and didn't do well enough because I had convinced myself of that. WRONG! They asked me to be a motivational speaker to the pre-op support group as a "success story" and I don't feel like I'm quite done yet.

The most important thing, in my mind, to learn in your pre-op is to get back on the wagon after you fall off and to write it all down honestly. Because then you have data you can look at and post-op it will matter -- sometimes an increase or decrease of 10-50 calories a day can break a stall.

Be gentle with yourself. You are a work in progress. You've got this.

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