The Wait! the good, bad and ugly

The wait...is really hard! I have a surgery date of Feb 1, 2016 with Dr Starr, which is good....but it leaves way too much time for "stinking thinking" I end up doubting myself and the procedure. I change my mind about every 3 days as to whether I can go through with it or not. This is the ugly bad part. I get myself anxious about possible complications, the difficulty of life style changes etc. I am driving myself and dear hubby crazy! I am just wondering if anyone else is going through this kind of struggle. I talked myself out of the surgery in 2012. Some days I find myself in that old thinking mentality that maybe just maybe I can do it with diet. Gees, who am I kidding! Anyways thanks for reading....Going back to waiting...

It will be over before you know it! 

Yeah the waiting is very tough and it certainly sounds like you have had more than your share.  Perhaps if you keep your mind very focused on all the reasons you DO want/need the surgery.  Also, is it possible for you to ask the clinic to have your date moved up? That date sounds crazy long way away.  

I think most of us have thought hmmm...I seem to have this under control do I really need WLS ?But if we are really honest with ourselves we could not maintain the ridgid dietary lifestyle in the long term without the tool.

I also have Dr. Starr.  This is where Dr. Starr is booking. Must not have a lot of OR time. I will be lucky to be sometime in March 2016, or hope for a cancellation!!!

Hi thanks for your reply...I am now focusing on the Do want...need the surgery. That little tid bit really helped me to refocus. It is my understanding that the waits are crazy long right now because of HRRH moving into a new hospital this fall. They have halted a number of elective surgeries....I just hope the new place is finished so the wait doesn't end up being even longer. Thanks again

I feel the same way. I really want the surgery and feel like I need it (hence, the reason I want it). But, I keep going back and forth over whether or not it is the right choice. 

I have stopped visiting the forum so much and try to put it at the back of my mind. I find when I allow myself to dwell on it too much my anxiety takes over and then I just drive everyone crazy (myself included).

I too was surprised that your surgery date is 7 months away, especially if you have been through all the other steps in the programme.

The wait and the weight. 14 months from the time I was put on the programme - surgery 2 weeks from now and I am still very ill at ease.  I run out of breath getting dressed and I have to pluck up courage to walk more than 2 blocks. It's pathetic. My weight has seriously impacted my career and I am not in a position to retire (nor do I want to).

Hard to keep up momentum all this time, but I ask myself what will happen if I don't do this?

 

What keeps me moving forward is seeing posts from so many patients who say this is the best thing they have ever done. I also know that there are hundreds of people waiting behind me. I am at an age (61) where if I don't do this now, I don't think I would qualify later. Do I want the surgery - no, do I need it? I think I do.

Decide what is right for you, but know that you are not alone when it comes to being overwhelmed with doubt.

I can totally relate to the back and forth thinking as well.  One thing that's helped me to stay the course is doing my research.  Reminding myself that diets don't work (at least for me).  The people that diets work for, are the people who have completely changed their lifestyles so that they eat/sleep/breath their new way of life.  They are the ones who have quit their jobs and taken up new careers in the fitness or nutrition industry, or they are the ones that don't have familys at home demanding their time and so they have unlimited time to focus on their health, and/or they're the ones who have started smoking again and starving themselves etc.  Since none of these options are realistic for me, I have to make something work within the limitations of my lifestyle/family/career.

Through my research I've learned that diets don't work for the masses.  When we lose weight, our bodies' biological processes do absolutely everything in their power to sabotage these efforts and make us regain the weight.  First our metabolism becomes more efficient, meaning we burn less calories to do the same activities, both resting metabolism and active energy consumption.  Second, our appetite increases - we have an increased fasting desire to eat, more intense hunger, higher consumption of food etc. (this is related to highter levels of fasting cortisol).

Then, our basal and post-meal ghrelin levels increase, which leads to increased calorie intake (because we feel hungrier) and less energy expenditure - a biological process to preserve energy

After that, our Leptin levels, which are supposed to tell us "I'm full" become dysfunctional, we become leptin 'resistant', so it doesn't work as well as it's supposed so we lose that 'satiety' signal.  Many of us have killed that Leptin switch years ago simply by our choices of food (but that's another story I won't get into here).

Basically our body launches a coordinated attack against us when we diet, that multiplies and gets worse with each subsequent diet.  Our bodies hoard fat and our mind magnifiies food cravings in an obsession (as the brain's reward pathways become over active). And in addition to food becoming more rewarding, cravings to eat them increases and will power to hold back decreases as areas of the brain involved in restraint become less active. Weight loss makes it harder to exerciese self-control and resist tempting food.  Mechanisms are in place to preserve our energy use by slowing down our metabolism, thus slowing down calorie burning; and mechanisms that make us eat more, crave more, get more reward from food, and neglect to tell us when we're full, all work to increase calorie consumption.

The more people diet, the stronger the effects become.  When people who 'are' successful at weightloss manage to maintain their lost weight, they find that to achieve the same weight as a non-dieter, they have to consume 3-400 calories less/day and typically have to exercise 1-2 hours/day as opposed to the standard 30 mins 3x/week - just to maintain the same weight that a non-dieter would.  For example, me and my BFF both grew up the same size and shared clothes our whole lives until I got big.  Now for me to get back to normal size (her size), I'd have to eat way less than her and exercise way more than her, just to be her size again.

This is why surgery is so beneficial and has a much higher success rate than dieting.  When the upper portion of the stomach is removed, it creates a modifiying effect on the dietary hormones, almost like putting them out of commission for a year or so.  This is why people talk of the 'honeymoon' phase, where people admit to losing weight regardless of what they eat.

Unfortunately, this behaviour will come back to bite them in the butt when the honeymoon phase is over and the effects of ghrelin/leptin/cortisol/insulin/NPY/peptide YY etc all start kicking back in again.  Although I too am still waiting for surgery, I am using this time to learn all I can, and what I'm learning, is that going back to a diet is futile (for me), I will need the honeymoon phase where the effects of the dietary peptides and hormones are at their weakest to overcome my cravings and addictions from a psychological and behavioural stand point, I will need to build muscle (something I am starting now), not only for asthetics, but building muscle will create new muscle fibers, with more insulin receptors, helping the insulin to become more effective, and I will need the smaller pouch to help with the decreased calories that will be needed to maintain the weight loss forever. Only with sustained weight loss will I be able to get more physically active to the level I want to be.

Hopefully some of these points will help you too if you are swaying back and forth and questioning your decision.  They really help me.  Diets just make things worse unless you are ready to do a 180 on your life and give up everything about your life as you know it now and become a new person.

"Diets just make things worse unless you are ready to do a 180 on your life and give up everything about your life as you know it now and become a new person."

Is this not, in effect, what we do once we have weight loss surgery? Allow this to become our lifestyle and commit to change.

To be successful in the long term, I think it is.

Yes Karen, I think after WLS we do completely change our lives (our food choices, food amounts, and hopefully activity levels as well), but I'm not convinced that we have to change our lives to make WLS work for us, to the same extent that we would have to in order to make diet work for us - otherwise, most of us would have been successful at diet right? I mean we've all admitted that diet doesn't work for us if we have or are contemplating WLS.  To be successful at diet would require climbing mountains (analagy, not literally), which most of us based on our careers, family, time-committments etc., cannot do,  That's not to minimize the changes we will have to make with WLS, relearning how/what to eat, what our pouches can handle, adding exercise etc.  - but the battles we face with WLS are a different set of battles and are a consequence of not being able to overcome the battle with dieting to begin with. Neither are easy.