Talking with my PCP

Gwen M.
on 7/24/17 9:51 am
VSG on 03/13/14

Hi all.

Today I had my pre-op appointment with my PCP. (I've got my second round of reconstructive surgeries coming up in, omg, 20 days.) This was the first time I'd seen her since my last surgery. She was super impressed with my results so far and admired my incisions/scars. Woo!

After she checked me out she started talking to me about weight loss surgery and told me that I'm her only patient who has been successful with it. This was mind blowing to me. First, I'm not yet at the point where I consider myself "successful." Sure, on some levels I do, but I'm not totally there yet. But then... I'm her only patient who has been successful? Is success really so unusual?

She told me that most of her patients do really well for the first 5-6 months and then quit and she doesn't know what to do. She tries to tell patients that WLS isn't a magic wand and that they'll still have to work, but then they think she's trying to talk them out of it. She said she has one patient who just cries every time she comes in due to her regain. :/ I gave my PCP the "surgery only changes your stomach and most of us get obese because of our brains" spiel. I can't remember if my PCP ever recommended therapy to me, but maybe she never needed to because I've been proactive about it?

I don't know. My PCP seemed pretty upset about it and seemed hopeful that I might have some advice that she could pass on. My advice would fill way more time than we had, though! I did give her permission to pass my email to any of her patients she felt might need someone who's been through this to talk to. We'll see what happens.

It was just a bit depressing to know that so many of her patients are unsuccessful with WLS. I'm sure most of them, like me, are having to go to DC for their surgery too, so I'd hope that those surgeons aren't all giving horrible advice. The information I got from my surgeon was solid.

Anyway.. just wanted to share that.

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

SallyCat
on 7/24/17 10:22 am
VSG on 10/17/16

Ugh. This scares me to death. I can't go back there. Just another example of why it's so important to be ever vigilant. Weigh every day. Drink the water. Get the exercise. Be accountable. Be mindful. Be happy.

That being said, 5-6 months seems super early. It seems like you would have to willfully try to sabotage at that point.

HW: 375 SW: 282 CW: 167 GW: 159

Gwen M.
on 7/24/17 10:28 am
VSG on 03/13/14

That seemed early to me too, but then I think about all the people who give up early since they're not seeing the results they thought they'd see as fast as they wanted to. Or they decide they can eat everything and do. I think a lot of people are expecting WLS to be a magic solution that won't require any work/change on their part. Which is either due to lack of education about WLS, stubbornness, or both.

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

CC C.
on 7/24/17 11:48 am

There's a person I've seen on another site who is less than 2 months out and is always using the site as a confessional about what she ate - fries, whoops! chicken fingers, whoops!, nachos, didn't mean to!, margaritas, was that bad? - eats 1500 calories a day, and whines about how she's not losing or losing too slow. And people chime in with "slow and steady wins the race!" and "it's okay, get back on the wagon!" All I can think is, this person is not going to be successful unless she smartens up fast. I have given suggestions, but they seem to get lost in the people giving her pats on the back. So I totally can believe that a lot of people fail even with wls.

Gwen M.
on 7/24/17 11:59 am
VSG on 03/13/14

I briefly joined a Facebook VSG group and had to leave because all the posts were like this. And if you told someone that they were making poor choices? All the wrath because "how dare you judge!!" Sheesh.

I've always been grateful to be told when I'm making poor choices. Whether I act upon that wisdom or not, it always makes me think, "Well... maybe I am, and I should consider this. What is this person seeing that I'm not?"

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

Dcgirl
on 7/24/17 10:26 am - DC
RNY on 12/16/13

Honestly, it's only because of the folks here on OH that I am successful. My program at Washington Medstar Washington requires the following before surgery:

An assessment with a psychologist

Six support group meetings (one per month for six months)

The psychologist didn't give me any advice. She just assessed my willingness to make changes in my diet, I suppose? The support group meetings are a JOKE. They are about 50 people, mostly pre-ops and some post-ops in a room, with a tiny nutritionist up front, and each month is a new "topic". It might be "Do Exercise" or "Cut Out Sugary Drinks". After they tell you very basic things (oh, soda has sugar, really??), they go through the room and people do introductions one by one. It was very normal to hear, "Hi, I'm Janet, I am 50, I've always been fat, my parents were fat, my siblings too, I don't wanna have a heart attack, I'm gonna have the sleeve". Then a post-op would introduce herself later on and Janet would be asking, "I love my grandma's German chocolate cake, when can I have that again?". It was seriously freaking absurd. I tried going when I could for the first 12 or 18 months after surgery but I literally couldn't sit through the stupidity. No one talked about WLS as a tool, no one talked about how difficult it was, although the NUTS talked about high protein and the benefits of Greek yogurt, no one preached about slider foods and how our pouches can hold unlimited amounts of popcorn...basically, if I hadn't had the resources and expertise of the vets here, I have no doubt I would have never made it to goal.

So yeah, as upsetting as your PCPs client experience is, I am not surprised. Based on how my Center of Excellence handles support pre and post op, I am not surprised at all. And it's super sad. Imagine going through surgery only to remain morbidly obese, or to lose it, and then have the shame and pain of gaining it all back. That would break my heart and leave me pretty devastated.

It's awesome that you've offered to talk to her patients who might benefit from the help.

I am thankful every. single. day for my RNY, and for the folks here who come back day after day giving advice and warnings. Heed them, people! Maintenance is a *****!

Gwen M.
on 7/24/17 10:33 am
VSG on 03/13/14

I also feel like a lot of my success is due to OH. My program required... nothing. My insurance required a psych eval with a psychiatrist. I had to meet with my surgeon's NUT a few times. But beyond that everything has been on my own. I found OH and stuck around, I tried a local support group, I found a local therapist, etc, etc. The information I got from my surgeon in the form of my packet and from the NUT were useful and fairly accurate, which is more than many people get, but there definitely wasn't anything to address the mental side of the process. I had to seek that stuff out on my own because I knew it would be important. SIGH.

Your support group sounds similar to the one I found locally that wasn't hospital-affiliated. I had to stop going because I couldn't handle all the self-sabotage that was almost.. bragged about? "Oh yeah, I don't follow any of the rules." said with pride. WTF, people?

I am also totally grateful for the people here who have shared their knowledge and experience. Both the ones who are role models and those who are cautionary tales. I also can't imagine how it would feel to have gone through all of this only to end up back where I started. :(

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

AggieMae
on 7/24/17 10:44 am
VSG on 10/25/16

I found the idiotic things people said at the classes very eye opening. And how many of the participants who toted quart size cups of surgery soda to the classes mind boggling. My favorite was the guy you explained how, when you want a full size meal you just need to drink with it so you can wa**** down to fit more food into your sleeve... His wife was sleeved 5 months ago and that's what she does... Yep.

It was mostly a "now NOT too" class. But I took so much away from it.

However the psychologist, PT and nutritionist where all helpful to me at our individual appointments. The pre op class was how I learned to access their services. I see the psychologist once a month and PT every 8 weeks.

AggieMae
on 7/24/17 10:33 am
VSG on 10/25/16

Gwen, I hope that some of the people your PCP gives your info to reach out. But please keep in mind that you can help but you aren't response for anyone but yourself.

The bariatric clinic at my hospital has a ~80% "success" rate at 2 years and ~40% at 5 years. And that is a huge improvement over 10-15 years ago.

My surgeon has (unscientificly) observed that people who "yoyo" seem to do better in the long run that those who have been obese for a long time.

It seems counter intuitive, since we yoyo dieters have repeatedly regained, but as I thought about it I realized that we are really good at losing and now we have a tool that will help us not to regain. I am thinking of suggesting a research grant.

Liz WantsHealthForAll
on 7/24/17 2:09 pm - Cape Cod, MA
VSG on 03/28/16

Hmmm... interesting (yoyo dieters having more success),0.

Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-123 CW: 120 (after losing 20 lb. regain)!

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