Sparklekitty (Julie), Science-Loving Hag

Which surgery is right for me?

Oct 02, 2017

"Which surgery should I get?" This question pops up on the forums ALL THE TIME. And it's a big decision to make!

The default answer is: talk to your doctor and consider your medical history. Your surgeon has dealt with thousands of patients and can help make the decision based on his/her experience and your particular health situation.

That said, here are a few considerations about the different surgeries that you may want to think about as you do your homework.

 

RNY:

  • Has been around longer, so there's more data on long-term success rates
  • A slightly more complicated procedure than sleeve
  • Surgeons may be more familiar with the surgery since they've been doing it longer
  • Best choice for patients with diabetes, because there are excellent rates of putting diabetes in remission
  • Has the benefit of malabsorption, though it's not permanent
  • Some patients (but not all) experience dumping syndrome when they eat sugar, so it can be a good choice for people who have problems with sweets
  • No NSAIDs allowed because of ulcer risk

VSG:

  • Slightly less risky as a procedure
  • Less data on long-term success since it's been in common use for less time
  • No malabsorption, which may be a plus for some people
  • No risk of dumping (could be good or bad)
  • Can be converted to a DS if additional loss is needed for high-BMI patients
  • May reduce hunger due to temporary ghrelin removal, but this doesn't happen for everyone. Can be a good choice for "grazers"
  • Less risk of nutritional deficiency, but supplements still required
  • NSAIDs *might* be allowed-- old recommendations said they were OK, but newer research says no
  • Can cause reflux in some people, so definitely don't go for sleeve if you have any history of acid problems
  • Weight loss may happen more slowly than RNY, but final loss amounts seem to be about the same

Both surgeries have similar outcomes for total weight loss and possibility of regain. They're both a good tool for losing weight and keeping it off. Which one you choose is ultimately up to you and your doctor.

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Julie's foolproof jerky

Sep 19, 2016

You'll need:

  • London broil
  • Small bottle habanero sauce (I use Yucatan Sunshine)
  • Large bottle cayenne sauce (I use Louisiana sauce)
  • Half bottle pre-mixed Montreal Steak seasoning, regular or spicy
  • Dehydrator

To make:

  1. Trim the fat from the london broil and slice it into thin strips, about 1/4" wide (or the width of your knife blade), at a 45-degree angle.
  2. Put the meat in a plastic zipper bag, and set the bag into a mixing bowl.
  3. Add sauce and seasoning to the bag. Zip it up, pushing out as much air as you can, and shake until everything is mixed well and coated.
  4. Let the bag marinate in the refrigerator overnight.
  5. Lay the strips of meat in an electric dehydrator so that nothing overlaps. Run on "high" for 8 - 10 hours, depending on how crispy you like your jerky.

One 2oz serving contains roughly 75 cal, 12g protein, 0 carbs.

 

4 comments

Research: slow metabolism and portion sizes

Sep 08, 2016

Two great articles discussing some of the reasons why we become obese. Hint: it's all because of what we're eating.

http://www.acaloriecounter.com/blog/why-am-i-not-losing-weight

http://physiqonomics.com/eating-too-much/

 

 

2 comments

Knocked up

Jul 24, 2015

One of my major goals for post-op life was to have a baby, which would be much safer at a healthy weight. 3 weeks after having my IUD removed, I had my wish!

I'm now 25 weeks pregnant with a totally healthy little boy, and hopefully he'll show up around November 5th. Hooray!

My health is great, but it's been a bit of a mindf!ck trying to wrap my head around some things. Transitioning to eating more (1200 cal/day in maintenance, and my OB wanted me to up to about 1800 for pregnancy) was hard, especially with constant nausea in the 1st trimester. I have a very difficult time with meat, and I'm eating LOTS of carbs compared to before. But the logic is that I should eat what I can and "don't be dumb about it" (OB's words), and Little Dude will get what he needs. Thank goodness I'm craving peanut butter sandwiches and not potato chips or ice cream!

I'm up to 169lb, which is scary. I'm on track to gain about 30 - 35lb, which my OB says is right on. Seeing the numbers go higher than my first goal weight (160lb) was frustrating. but I know this is for a good cause. And if I could lose 140lb after surgery, losing 30 afterwards-- including 10+lb of baby and fluid and whatnot-- will be no problem.

I definitely have moments where I look at my body and feel like I'm out of control, or I'm afraid that I'm going to go back to the way things were. But then I remembered that before, I could have eaten two or three PB&J, plus chips, plus a huge glass of milk. Now, I have half a sandwich and I'm done.

This "before" pic, taken with my dad 9 months before I had surgery, really reminds me that things ARE different.

Compare that to now, even at 169 and rocking the maternity pants:

I look different, I feel different, and things are good. How can it not be when there's a junior geek on the way? :)

2 comments

One year, victory, and the future

Mar 01, 2015

I'm 15 months post-op and finally navigating the treacherous waters of "maintenance." Secretly, it's kind of kicking my ass, but if I could lose that much weight in a year then anything else should be manageable, right? I mean, after all, I've pulled off a lot of great things since Surgery Day, and this is just one more thing to go for.

Good things since surgery:

  • In November, I rode 40 miles in el Tour de Tucson, the big city bike race, and finished in 3:08. I was worried about being able to finish in the allotted 7 hours, but I totally kicked butt! My dad flew in from WA to ride with me and it was a blast, and I never could have done it pre-op.

  • I'm also going to do a 5k! I signed up for one that's probably a bit too soon, since I'm not a runner and my knees hurt when I do too much time on the training. But even if I have to walk, that's totally OK. There's a UV color run next weekend, and I'm signed up for a mud run at the end of the month, and I can at least try, even if I don't get a super-fast time!

  • I now wear a size 2/XS, when I started in a 22. Mind-blowing! I'll admit that I have trouble looking at myself and believing that I'm that small, but it's getting better over time. I have the weird problem of being able to shop in some places because things don't run small enough-- good luck finding cheap yoga pants at Wal-Mart! I still have a serious muffin-top from the loose skin around my middle, but it's something I can live with when I (apparently) take up so little physical space.

  • I've received the all-clear from my surgeon, GP, and OBGYN to begin Operation Respawn! Husband and I are hoping to add to our family for the first time, and the surgeon says my health is in tip-top shape to get going on that. It's going to take a while, but I'm still looking forward to it.

Granted, it's not all happy peachy good times. I'll admit that I'm having some trouble; finding the right balance of what to eat in maintenance is HARD. I eat more carbs than I should, so I'm trying to reign that in. And even though the scale reads what I'd like it to, it bounces around within a 2lb range and that makes me super nervous after watching it so closely for a year and change. I'm happy where I am, and even if I gain a few back I can make peace with it. But it's not magically easy when you hit the finish line!

Overall, though, I feel awesome. I have energy, I can do things I never expected, my bloodwork and stats and whatnot come back in great shape. And I'm SO incredibly glad that I did this. Even though the watching and measuring and mindfulness is never going to end, and sometimes I feel like being smaller (I don't ever think I'll be able to use the word "thin" or "skinny") isn't going to last forever, it's absolutely been worth it.

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9 months

Sep 02, 2014

Next week marks 9 months since surgery day. Before I went under the knife I wasn't even sure if this would work, but 120lb and 6 (soon to be 7) pants sizes smaller, I guess I've put that one to rest.

I feel like I've got things pretty well figured out, food-wise, but I've had a few days lately when I'm just sick of making what I can and can't eat such a big part of my life. I understand that's what "thin people" do, but all of that obsessing is draining. How much protein, how long until I can drink more water... I just want to feel normal again!

Normal is something I'm still grappling with as I adjust to being smaller. I haven't been this small in my entire adult (or teen, for that matter) life, and it's been a head trip. Example headspace: My thighs are squishy. Are thighs always supposed to be jiggly? Is that something normal people are used to?

I have no idea what normal is or should be at this weight-- or lower. My surgeon doesn't believe in weight goals, which is a good thing, but it's odd to have no clue where I'll end up. 160 is a good "first goal" that I never thought I'd meet. 150 sounds like a nice number in my head that I could totally live with and it would drop me smack-dab at a BMI of "normal" 25. The middle of "normal" would have me at around 130... but I think that would look weird, nobody believes I weigh as much as I do (more than one doctor has joked about my bones being laced with lead) and maybe that would be too small.

I'm almost in a size 6 from Old Navy, where I get all of my jeans, and my size medium tops are a bit baggy. If I lost another 30lb, I wonder if I might run out of sizes, then what?? Heck, I'm so used to buying new clothes a touch on the snug side since I've been shrinking out of them quickly enough, I don't even know how pants are supposed to fit. Do "regular" women have them baggy in spots? What am I supposed to aim for?

Finding a new normal has gotten easier when dealing with food, and way harder with my body. I really didn't have any body issues at 285lb, or perhaps not as many as I could/should(?) have, and I never thought there'd be any weirdness as I got smaller.

But honestly, those are problems I can deal with, since I've put a lot of problems behind me. This weekend, I wanted M&M's (whoo hormones plus changing psych meds!) so I got a package and ate less than half over the span of two hours. Before surgery, I would have picked up a king-size bag, eaten it a handful at a time, and still go looking for another snack an hour later. But a dozen M&M's as a "once in a great while" treat... I never would have imagined that I'd be fine with that, much less LIKE it!

So even though the scale has slowed way down-- like it usually does, like it's supposed to-- and maybe I haven't lost as quickly as others (and I know comparing is bad), but I think I'm doing a damned good job so far.

2 comments

Thumbs-up from the doc, 4 months out

Apr 04, 2014

I had a check-in with the surgeon yesterday, and he says I'm doing great! My blood tests came back fabulously, though my good cholesterol is low-- not a surprise because I've been SO exhausted that I can't do more than walk about a mile a couple of times a week.

Sadly, he didn't have any good solutions for why I've been absolutely exhausted lately. I was the last appointment of the day, and they were running late so I was in at a bit after 5, and I almost fell asleep in the waiting room! Fortunately my iron, B12, and whatnot aren't low, so those aren't the cause. I'm supposed to up my protein and water, which makes sense since I fight to get 60g protein most days, and see if that makes a difference, otherwise we'll get my thyroid tested to rule that out, too.

Overall, though, he's really pleased with my progress. I'm down by 63 pounds between surgery day and my office weigh-in, which is "right on track," even though my loss has slowed way down lately. (Probably due to low protein and not a whole lot of exercise). So I'm supposed to "keep doing what [I'm] doing," and come back in 3 months. The next visit is when he does the standard apnea and blood-pressure evaluation, so apparently I'll do a home sleep study and maybe go back to the cardiologist to see if I can go off the CPAP and/or the blood pressure meds, which would be AWESOME.

So even though I feel really weak and woozy today (I actually had to stay home from work, ugh, trying to rest up and push the fluids and protein this weekend) I think the results from yesterday are reason to smile. Hooray! :)

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Progress and lessons, 3.5 months out

Mar 23, 2014

103 days since surgery, and I'm feeling pretty darn good if you ask me. As of yesterday, I am officially 60lb below my morning-of-surgery weight... holy crap, how did that happen??? I started out in a 20W pants, 44C bra, XXL top, and I'm down to pants in a 14, 42/40C bra, and shirts in size L. My husband got this pic of me the other night (wanted to send my Iowa State pride to my folks... Go Cyclones!), and even though it's at an odd angle-- he's taller than me but at least it makes me look busty-- it does show some progress!

(Bonus points for some corgi love, that's my buddy Lloyd!)

Good stuff:

  • Smaller clothes. Hooray! I'm still trying to wrap my head around it, and the most recent trip to Old Navy took three trips back to the dressing room before I ended up with things that actually fit, but I'm not about to complain.
  • I think I'll be able to get off my CPAP soon (I see the doctor in two weeks). I've been getting a head rush in the morning and I think it may be from too much oxygen, so I'm trying a nap or two without it and it seems to be going OK. Hooray!
  • I've been having periods where the scale doesn't budge for days, or it goes back and forth, up and down, but I'm being patient and sticking with it. It's hard, but I'm becoming much less obsessive about it.
  • I'm getting the hang of eating out, which is helpful because it's one of the ways my husband likes to spend time together with me. Check the menu in advance, find options, don't be afraid of taking home leftovers, I can definitely do that.
  • My mom, who's been my biggest supporter through this whole process, is absolutely PSYCHED that I'm doing so well. It's a little odd, because I don't feel like it's worth making a fuss over, I don't think I look all that wonderful, and I feel really weird being fussed over, but I'm glad she's proud of me.
  • Because of how well I've done, my uncle-- who is quite heavy and at risk for a heart attack-- is seriously looking into having RNY surgery. He's even talked to my grandma about it, and that makes me proud that he's serious about it; my grandpa passed away after heart trouble and at least one stroke, so I'm really glad he might be able to help his health that way.
  • I have some AMAZING buddies here on OH, and I don't know what I'd do without them. ::hugs::
  • Despite all the stories about hair loss, I'm not really shedding too much. Probably because I wear my hair so short and I don't do much more than run a comb through it in the morning. So I've got that going for me, which is nice.

Not-as-good stuff:

  • Digestive issues... constipation leading to hemorrhoids and/or a fissure. Ow ow ow ow OWWWWWWWW. After dropping some cash on probiotics, miralax, some extra vitamins, and eating half of a whole-grain english muffin with peanut butter on it (fiber + fat, neither of which I'm getting much of right now) things are finally getting better, but the past two weeks have been SERIOUSLY painful.
  • I've been really tired lately, partly because work has been busy, and partly because I'm still having a hard time eating enough. As a result, I'm napping a lot, and that leaves my husband alone in the evenings and he feels lonely. That makes ME feel terrible, and even though we're fine together, it's still stressful.
  • Still having a bit of trouble wrapping my head around the possibility of getting smaller than this. A size 14 is where I've spent the majority of my time while off my psych meds (high school, college, etc.) and 200-210lb has been my long-term average. The thought of actually, permanently being smaller is kind of scary, and part of me says "I'll deal with it when I get there," but I'm not sure how well that's going to work.
  • I haven't posted anything other than an updated headshot with my new glasses as a profile pic on Facebook yet because I don't want to feel like I'm bragging-- gotta love the concept of being "Iowa nice," huh? All of my friends are super-supportive, and all of my offline friends are very encouraging, but... I dunno, it just feels awkward and I don't know how to handle it.
  • I'm having a hard time getting all of my protein in, which is probably because I'm just not hungry. (Not complaining there, but still.) Protein bars help, and so does the "Protein Plus" milk I've found, but it's still a struggle. And when I eat nothing but lean dense, protein all day to hit my targets, I don't have room for veggies or anything like that, and that gets me plugged up, and it's just plain not fun. That's definitely a question for the next visit to the surgeon.

Overall? I'm definitely glad I had surgery, and I know I've made a lot of progress. There's a long way to go, both physically and in my head-space, but I feel pretty good about the journey so far. And honestly, I can't ask for more than that.

4 comments

5 week update

Jan 15, 2014

I'm a little more than a month out of surgery, and I'm a little amazed at all that's happened. Here's a bit of a recap, as much for my recollection as anything.  
  • It feels odd to have no sense of hunger, yet it feels like I need to be eating all the time in order to get my protein in. I need to eat a fourth meal in the evening, around 8:30 or 9, in order to get close to where I need to be, even though I'm still often falling short of 60g... definitely need to work on that.
     
  • I'm officially wearing smaller jeans, down from a 20W to a misses' 18, and smaller undies. I got some new shirts, too, and a misses' XL seems to be hit or miss on the fit, but hopefully that won't be the case for long.
     
  • Several people at work mentioned that they've noticed my weight loss. While wearing a new top the other day, 3 people commented that "I'm melting," which is pretty cool to hear! 
     
  • Yesterday, I successfully had my first dinner out. For our wedding anniversary, Husband and I went to Outback Steakhouse (classy, huh?), and I had a 6oz steak and broccoli. I ate about 1/3 of the meat and half of the broccoli and did just fine. It's too weird that I can eat that little and feel as though I've had an entire Thanksgiving meal-- but I can definitely tell that those nerves are growing back and I can feel the sensations of fullness now.
     
  • I'm starting to get sick of eating the same things. Grilled chicken breast, baked fish, plain shrimp, and string cheese, over and over and over. Time to start figuring out how to change it up a bit, but that shouldn't be hard now that I've got some energy back.
     
  • Boooo hormones! I've heard that it's to be expected with weight loss, but it sucks to finally have a "shark week" after about 2 years without them (hooray IUD!), not to mention a bit of PMS. I've also had to tweak one of my psych meds, which gets kind of screwed up by estrogen changes, but that should help things even out in general.
     
  • I've joined a walking team at work, which is good encouragement to get my butt moving. We do group walks a few times each week, hitting up the loop around the office park. Husband and I have also ordered a treadmill to be delivered tomorrow (we actually ordered one from Sears before Christmas but it never arrived and I'm still fighting for a refund), so I can log some time on that every night and that will help as well.
     
  • Protein bars are awesome. My current favorite is the "Think Thin Brownie Crunch," 230 cal and 20g protein with no weird protein-powder texture. I ordered a whole bunch of flavors from an online vitamin shop, so I've got more flavors to try, and half of a bar makes a great breakfast.
2 comments

To share or no?

Nov 30, 2013

I am deliberately open about health-related stuff, particularly my bipolar disorder. I think that it's important to show that I, and others, can live a (mostly) normal life despite the hand that genetics/etc. has dealt us, and that by publicly saying, "Hey, I have this diagnosis, but I'm not crazy/scary/violent/etc. or fit any of those other stereotypes," I might help fight some of the stigma against mental illness, and maybe even help others seek help when they're hesitant.

Despite all that, I'm finding myself VERY hesitant about opening up about surgery. I've mentioned it to my coworkers, since I'll be out for a few weeks and I've already had to deal with CPAP stuff and such in the past. I work in a healthcare-related field, and the workplace is very wellness-oriented, so I'm not concerned at all. But for some reason, Facebook is a whole different jungle, even though everyone on there is always friendly and supportive.

What on earth am I afraid of? It's not as though I'm doing this for vanity's sake; I'm absolutely doing this because I want to get healthy and because it's my best chance at doing so. I know that nobody I'm friends with would judge me for that. So what else? Is it fear? Shame? Embarrassment? I've gotten over that with my mental health, but I guess I'm still working through it with my weight.

I'm ashamed that I can't just accept my body as it is. Does not embracing my fat make me a bad feminist? I know that's not the case because I actually have a pretty good body image; the only exception is when I see photos of myself, and if anything, that's because I'm embarrassed about ruining other people's pictures with my appearance (like family photos for my brother's wedding this summer). I'm not doing this for vanity, I'm doing this for health, but the shame is still there, though it's sort of silly.

I'm embarrassed that I couldn't do this the "old fashioned way." I've certainly tried, and I wouldn't be doing this unless I felt that there wasn't any other long-term option. But could I have tried harder? Will people judge me for that?

I feel awful that I've gotten to a state where I NEED to have this surgery. Yeah, I don't eat as well as I should and I could stand to get a LOT more exercise, trust me. But the big factor, oddly enough, is my bipolar. Psych meds are notorious for weight gain, and every time I switch pills-- starting from the first time I started medication at 17-- I gain weight. Sometimes a little, other times as much as 50lb. And when I stop taking one pill, the weight doesn't go anywhere, fight as I may. For a long time, I told myself (and my doctors agreed) "sane first, skinny later." But that can only last for so long when the weight affects other parts of my health.

In the end, I'm having this surgery because I want to take care of myself, and statistically speaking, it's the best way to lose weight, keep it off, and handle these long-term health issues. It's my body, my choice, and if anybody else has a problem with it, that's too damn bad. And maybe sharing a quick update on FB will come down to that, since I'll probably mention something about surgery or recovery offhand while I'm healing up.

"So just in case I post something about crazy medical issues this month, I'm going to be in the hospital for bariatric surgery next week. It's been a big decision with a lot of research and careful thought, and I think it's going to be a good thing for my health in the long run. I'm very hopeful, a little nervous, and secretly a teeny bit embarrassed (but working on it). Good thoughts appreciated!"

Yeah, I think that will work.

3 comments

About Me
32.6
BMI
VSG
Surgery
12/10/2013
Surgery Date
Aug 11, 2013
Member Since

Before & After
rollover to see after photo
At my brother's wedding, several weeks before attending my surgeon's info session
290lbs
My first triathlon!
180lbs

Friends 31

Latest Blog 12

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