I'm a Newb!!!

I'm 29, just shy of 30... 3 great kids.....  I am prior Navy so you'd think I'd be thinner... so not the case.... have had some bumps in the road of health that have led to me being overweight along with my love of food....

I live in North Carolina working for a great company in Virginia. So I travel quite a bit daily.

I want this surgery.... I need to have this surgery as a bigger tool to help me be a healthier person for myself and my kids.  And right now, I am unsure if its going to happen.  I looked up the requirements of my insurance company and I don't meet one.... I have to have the 6mos min of physician guided weight management... I eat healthy, just no excercise....

How is that possible when I've been treated for lower back pain and foot issues when i started the process of working out...  This past June I had surgery on my right foot.... have been treated for that for about 5 months now. How can I get approval if I haven't had a chance to get the min time required.... I have also been treated for about a year for my lower back problem... I am now medicated but i couldn't do anything at first... I'm just scared and worried that I wont get surgery. 

My father had WLS and is doing great.... He went from 400 down to 180 in a matter of 2yrs. 

I am very proud of him!  Now, I just wish I can do the same thing.

Working out is hard for me at the moment because of my feet.   I have my WLS seminar on the 16th and I'll probably have a sleep study done soon since I've been told I may have it...

My story will change as time goes... I'm just in the beginning stages of this process.... just hope it goes the way I want it.

Any advise would be greatly appreciated.  

If you have chronic pain you understand the need for anti-inflamatory drugs (NSAIDs).  You know you can't take them if you have the RnY, right?

Now is the time to research ALL your Weight Loss Surgery options including the Duodenal Switch which allows you take NSAIDs if needed.

Visit www.DSFacts.com and the DS forum here on OH.  If you want more information about why the DS is the best weight loss option available today for everything they study in welght loss surgery (except for GERD) let me know and I can hook you up.

Decide on your surgery first and your surgeon second.  Think TWICE cut ONCE.  There is a whole revisions forum here for people who got that the other way around that you don't want to ever have to join.

~Becky

Thank you Becky!

Yup, thats what I've read.... I also take Hormone Replacement Therapy as well, which will not be absorbed if I have the RnY.  But they have patches for that....  :)

I'm hoping that this surgery will also take the strain off my back and I can get off Lyrica and be med free (except for my HRT). 

yes, I would like to further my knowledge on other surgical options.... 

Here's some links that I recommend you read (and bookmark):

www.obesityhelp.com/forums/amos/4391498/RNY-insulin-carbs-we ight-regain-Articles/#36305662

www.lenoxhillhospital.org/press_releases.aspx

www.dssurgery.com/procedures/compare-surgical-procedures.php

www.obesityhelp.com/forums/ds/4416755/Must-Read-Transcript-o f-Dr-Roslins-Presentation-to-ASMBS-on/

And of course read all of :   www.DSFacts.com

And read a lot on the 4 surgery forums here on OH, especially the Revision Forum (look to see what kinds of revisions people are getting ...from what surgery) and the Failed Surgery forum.

PM me if you ever have a question.

Good luck to you as you research.  I so remember being where you are.  I was headed to an RnY because I had only heard of it and the band.  When I first heard of the DS I thought "if it sounds too good to be true it must be a lie."  But I did my research and I made the best decision for me.  So I just try to pay it forward.  Most surgeon's don't do the DS so they don't tell you about the DS in their information sessions.  You have a right to know ALL your options.

~Becky

You should qualify on BMI alone. Most insurance companies require a BMI of at least 40, or 35 if you have two or more co-morbs. With a BMI of 50, I really can't see any way they can justify denying you. And even the more stubborn insurance companies usually cover the DS without question if your BMI is 50 or more.

I had the DS almost eight years ago, and I couldn't be happier. I eat well, and I eat guilt-free. I have what I think of as 'normal' hunger, not the all-consuming hunger I had pre-op. I take NSAIDs daily, for my arthritis, and I take vitamins and mineral supplements---but NO prescription drugs. My cholesterol is 112, even though I eat bacon nearly every monring---several slices, in fact.

Here are some pics of the various WLS procedures:

www.dssurgery.com/procedures/compare-weight-loss-surgical-pr ocedures.php


Edited because my pics didn't show up. Maybe this link will.

Welcome :-). My first and most important input is this: You need to learn about all the WLS options, including the ones your surgeon of choice doesn't do. I'm thinking in particular of the duodenal switch, since there are so few surgeons who do it.

Choose your procedure based upon your particular needs and what you can honestly live with for the rest of your life. THEN choose your surgeon.

You mention that you eat healthy. Would you mind giving some examples of how you eat much of the time? Are you eating a genuinely moderate-calorie, low fat, high veggie diet and still can't lose weight?

You mention being currently unable to exercise. What if you can never exercise again? How will that impact your ability to lose and maintain weight loss? Trust me, crippledness can happen FAST and have a heck of an impact.

These two issues are mega important in thinking about how to choose your procedure. If you are already eating a significantly calorie restricted diet, which is basically about anything under 1800 calories, you might not lose well or long term with only more calorie restriction. This means that a restriction only procedure would not be good enough.

If you can't lose or maintain without physical exertion that could exceed your realistic limits with injury/pain stuff, you need to be very honest with yourself about this. Don't build a plan based on hopes for the future that you'll get back to doing PT like you did in the Navy, cuz you are not that person any more. You're aging, not just fat :-). It might happen, but it might not.

So, with these things in mind, I want to urge you to consider the tremendous value of malabsorption in weight loss maintenance. Bands and VSG don't have any at all. RNY caloric malabsorption is GONE within a couple years and is never very much to begin with. RNY is primarily a restriction surgery with very mild malabsorption for calories but darned high malabsorption for certain micronutrients. There are also some late complications that are being reported more and more all the time as more long term postops get sick and come onto the radar of medical research.

For the person who needs both restriction and malabsorption, the DS provides the best of both worlds. You get a subtotal gastrectomy (VSG), possibly with a somewhat larger stomach than a standalone VSG, but still very significant restriction, plus an intestinal alteration that gives permanent and heavy malabsorption, particularly of fat and protein.

You have to learn how to eat to best benefit this arrangement, and it can be quite a mind game at first if you're an experienced normal dieter :-). The protein malabsorption has to be accomodated a whole bunch so that you don't lose all your muscle mass and/or develop protein malnutrition. This requires a love of animal source protein and not just dairy, cuz some people get permanently and badly lactose intolerant and must abandon all dairy. (Usually it's temporary though.)  You have to eat a minimum of 100 grams of protein a day, which equates to about a pound of meat, fish, fowl or cheese. Many people use protein supplements to make sure they get everything they need. Me, I eat more bacon and steak :-).

DSers tolerate different amounts of fat, so you kind of have to experiment to find a level of fat intake that works for you. We absorb about 20% of the fat we eat. A normal diet has a recommended daily intake of around 30 grams of fat. In order to get that 30 grams, a DSer has to consume around 150 grams of fat, which is something like a stick and a half of butter.

HOWEVER it is not REQUIRED to consume that much fat if your gut doesn't tolerate it well. Some people eat a lot less fat and others eat at least that much or more.

DSers MUST limit their carb intake, especially of things like grains, starchy veggies and fruit. We absorb most of our carbs and so can really gain weight if we move to a more carb heavy diet. The faster the carbs absorb, the more of them we absorb, and therefore the more calories we take in from them. They also tend to cause gas and other intestinal distress.

Just like with ANY WLS procedure, DSers must take supplements to make up for what's missing do to restricted diet and malabsorption. What kind of supplements and how many vary by individual and by surgery choice, but if anyone who isn't willing to diligently supplement shouldn't have any kind of WLS.

I'd like to invite you to come over to the DS forum to learn more, and take a look at www.dsfacts.com, www.dssurgery.com and www.dshess.com .

Thank you...

To answer your questions...  I eat probably a good (and I'll be honest) 2000 calories a day....  I eat low-fat, decent amout of protein and veggies and fruits.... some of my issue is that I graze during the day.... little snack here and there... and sometimes they aren't the best for me.  But my main issue is that I am not active. I'm ready and wanting to seriously change that. Food is my enemy.

My pain is temporary right now ... my feet will heal and the pain should go away.... its only been since early June when my surgery was. I dont forsee me being unable to excercise. The back pain is partially due to my weight, but when the weight comes off, I wont be putting as much pressure on my lower spine....

Would I like to PT like I did when i was in the Navy, heck yeah I would, but you have to realistically start small and build up after meeting a smaller goal first and then continue to meet goals alittle bit bigger than that smaller goal you met.  

I want to learn all i can about all thats available to me. 

You might want to really track what you put in your mouth for a week or so and see what you're actually ingesting. There are several websites that you can use for that. People talk about FitDay and Sparkpeople, among others.

Once you've done that and analyzed your intake, it's time to get brutally honest with yourself, because any changes you make MUST be livable for the long term. Not "what can I do to get the weight off?" but "How can I REALLY live?"

When you do this, beware of letting old lies creep in. The fact that you KNOW how to eat right (I assume, anyway) does NOT mean that you are capable of doing so forever. Trust me, I can organize a proper diet for just about anybody and I can estimate portion size within a tablespoon or two. Lack of knowledge was never an issue for me, and it really pissed me off when people would decide that because I was huge I didn't know how to eat.

There are loads of reasons why people eat the way they do. Some are physical. When I tried to eat a more vegetarian-friendly diet, I got sick. When I tried to really cut the fat, I got miserable. It was clear that I felt better when I could eat plenty of protein. This gets darned difficult if you try to super limit your fat intake. You wind up subsisting on chicken breast and white types of fish. UGH.

That brings me to the pleasure component of food. Food is NOT YOUR ENEMY. Get OVER that thinking. Eating is not just for fuel, it is the most basic and universally available sensual experience to humankind. It is normal and healthy to get pleasure from your food. People talk about food being ******ic for good reason. So don't bother to try to eliminate that pleasure from your life. Almost nobody can do that.

Chicken breast and white types of fish have very limited ways of making them pleasurable without adding fat. Fat is pleaurable and satisfying and NECESSARY.

A bacon wrapped filet mignon or an absolutely perfectly marbled ribeye is my idea of the best food in the world. You don't get to do that on a thousand calories a day.

For some people, a platter of linguini carbonara is heaven. This could be accomodated in various ways. For me it's less linguini and more absolutely fresh made by me carbonara :-). And I'll turn it down for a ribeye every single time.

See, these kinds of deliberations are important to choosing your surgery. If you truly ******ically love, oh I dunno, certain veggies, that figures into your choice. See how you can look at how you live and get clues about what could work for you?

If you have a pill swallowing phobia, this is really important to consider. (Phobias are very treatable btw.) If you KNOW it will kill you so much to swallow pills or possibly foul tasting liquids or chewables, you need a surgery that will require less supplementation. That would default to the VSG, because bands are evil and need to be outlawed tomorrow. Whatever you do, DO NOT GET A BAND. Be sure to read a LOT about band failures and complications. It's the very worst choice by every possible measure.

Regarding activity: Be realistic about how much activity your body now needs in order to change things. It's different than when you were doing PT :-). Do not assume that getting the weight off will fix everything. It improves LOTS of things. But if you have injuries now, they might not resolve with weight loss. I still have fibromyalgia, neck damage, low back damage and only about half a hip. I still have to do things to manage the pain and it limits some of the things I can do for exercise. No running, no stairs, no hilly hiking, no bicycle of any kind (well, a tiny bit of the chair style bike at the gym, but VERY little), limits on swimming.

You are never going to go back to the fit seaman you once were. You're older and bear the changes of childbirth and obesity. That doesn't mean you won't eventually become very fit, just that it's different now.

It's very important to make changes based on a conservative estimate of what you can accomplish. Give yourself a lot of leeway for what might intrude on reality, so to speak.

I'm reminded of Tom B. (Levittownloser on here). He wanted to run as he lost his weight. I don't think he planned to run marathons or anything, just to run for pleasure. But he's far exceeded any hopes anyone could have had, and does indeed now run marathons and is a very picture is skinny fit HAWTNESS :-). So yeah, that happens, and there are others who can share similar stories. But they are not common. They are the exception to the rule. Most people lose some of their weight but not all. They get considerably healthier but don't become superstars. They go on with their lives.

That's the norm with WLS. So plan very carefully to maximize your normalcy by being mega honest about your "short end" of what's doable, rather than reaching for the stars in terms of changes you've never been able to make or maintain LONG TERM before. If you can't imagine living on as little as 600 calories a day and never more than, oh, 1200 or so, don't screw yourself from the outset by getting a procedure such as RNY that is extremely likely to put you in that boat within a few years.

IMNSHO, the ONLY surgery options worth considering at all are the VSG for restriction only and the DS for restriction plus malabsorption, not to mention the 98% CURE RATE for type II diabetes.

P.S. I just saw that you are a grazer. The DS is the ideal procedure for a grazer, because you kind of HAVE to graze in order to get your protein in each day.

I'm 7.5 years post-DS, and I eat 2500-3000 calories a day---but I only absorb about half of them. This allows me to maintain a loss of 170 pounds. I eat about every three hours, all day long.