Attention ALL WLS Members >12 months post op - Need your input

As a post-WLS RNY 20 months ago, as well as an RN greatly interested in how long-term WLS members are doing, I need your INPUT! As you may be aware, most WLS programs really diminish the amount of support available (aside from support groups) once you've reached the 1 year mark.  I am researching and looking for programs out there that continue to stay closely connected to members who are greater than a year out (especially 2, 3, 4, 5 years, etc).  I need to hear from these members to better understand what your needs are as you move out past the 1st year following surgery.  What kind of support do you think would have been helpful to you or would be today?  For example, even though I am 20 months out, I still struggle with keeping motivated to work out regularly, yet feel amazing when I do.  Additionally, now that I can eat more food (common after about 9 months post surgically), I would have appreciated later staged nutrition counseling as well. Are there things that would make your experience more manageable today?  I would love to hear any and all suggestions that you have as I hope to help programs look to these expanded needs.

Our hospital/nutritionist sponsored support group meeting which is monthly meets at 6:30 pm.  Then at 7:30 pm the members who are more than 1 year out go into a separate room to discuss their issues or they can stay with the new post-ops or pre-ops - their choice.  This is a great option to have. I think the issues long-term are: labs (being sure to get them done regularly and tracking them yourself looking for trends), vitamins, regain and re-losing, exercise, motivation, plastic surgery, etc. Kathy

Keep stressing the need for taking your vitamin suppliments.  I became anemic and it has been a struggle to crawl out of that iron deficient hole.  I was taking vitamins but not enough iron.  A Nutrition course specifically tailored to 1+ years (2 years really because that ends the "honeymoon" period) post op would be also really awesome to have. Finding out more specific things about our plumbing.  Like how much of our mal-absorption plays a part in our vitamin routines as longterm post-ops.  What about caloric intake?  Is it the same as it was preop?  Does the mal-absorption still come into play with that too or has the body become more efficient and adapted as time passed? Things that longterm post ops still have to be watchful of in our health.  For example, intestinal strictures?  Adhesion problems that can happen years after surgery?  What you can do to utilize the tool you were given still even though it's been years since your surgery. Also, probably what some longterm postops would want to know is what if our worst nightmare happened and we didn't do what we should have and need a revision.  Is it possible?  What is the procedure?  etc etc One of the biggest things that may be useful is addiction transfer discussions.  Alcoholism is seeming so much more common to post ops than I would concider "normal".  As one of them... now sober for 9+ months... I had no idea until I came back to OH that so many of us have made that transfer.  Discussions on this would be very welcomed I think.  I don't know if knowing it was a serious possibility would have changed my actions regarding alcohol or not.  I didn't have any problems with it pre-surgery.  But, post surgery after about 1.5 -2 years I did.  Took me a while to kick that particular demon out of my life.  I wonder if I had known the propensity towards alcoholism post-op if I would have gone down the path I had with it.  At any rate, I think big red lights concerning the awareness of addiction transfers is something most definately that needs to be included in any post-op support group's itinerary. Thank you so much for asking us for input.  Those were just things off the top of my head. I had my Lap RnY on 7-22-02.  My weight has remained steady for the past 1.5 - 2 years.  I have 23 pounds still to go to reach my goal and now have to "work" at it just like everyone does. So glad you are asking these questions.

Trish, THANK YOU so very much for your excellent response and great suggestions.  All of these are being factored into the long-term post op program that I am helping develop so that once we get >2 years out there is appropriate long-term support for us. If you think of anything else, please don't hesitate to contact me directly at: [email protected]

My WLS team asks for a 5 year commitment to followup, support group, etc.  After the first year, followup appointments are every 6 months.  Support group is semi-monthly, IIRC. I stopped support groups after about 3.  It was dominiated by a couple women, everytime someone said something interesting, they took it and ran with it.  About the only useful thing I got from support group was new and exciting ways to cheat.  I didn't need that. Follow up appointments, I managed 2.5 years.  I blew off my 3-year appointment.  I keep up on my blood myself, so when something is low, I have the wherewhithal to deal with it... "Gee, my iron is a little low... what should I do?"  Uh... maybe I'll up my iron? Honestly, I don't think the 'needs' of longer term post-ops really exist.  My 'needs' are the same as anyone elses, Post-Op and Non-Op alike.  Staying motivated is not about being a post-op, its about being a human.  I think we need to move past being WLS Post-Ops (or "WLS Survivors" ugh), and move into dealing with life just like everyone else has to deal with it. No, I take it back, I just convinced myself the opposite.  Long Term WLS Post-Ops do have special needs.  They need to be taught to cope with life in similar ways as Non-Ops.  They need help transitioning from "WLS Post-Op" to "Just a person".

As always Tek, an added dose of common sense.  BTW I recently read your profile............I love it !!!!!

Patricia, Maybe drop this question on the Grads Board? At- http://obesityhelp.com/forums/wls_grads/

It’s a Forum for exactly the folks you are wanting input from. Sort of like Tek, ‘my needs’ are minimal. By Now, there aren’t that many things associated with WLS That are ‘news’ for me.  I’ve been at or below goal for just over 2 years, with no re-gain. I do continue going to my local support group And it is populated by a mix of ‘newbies’ and long-term folks. Several 5 year + post ops attend regularly. A Couple of 10 year out people. And then there are some of us 3 year + folks And then about half of the group are folks 1 year or less. There is a good bit of swapping “finds” either Recipes, Vitamin stuff,  “How cheap have you found_____?”, And some PS info Between the older post-ops. Some exercise stories are swapped-  “I just started doing pilates!  Wow!...” The WLC Clinic Program Manager hosts the meetings And usually has a guest in attendance. A Nutritionist, Exercise/Physical Therapist/Personal Trainer,

Usually the Docs will drop in every other month to get input back From their longer term patients to see if there are other things they should Be passing on to patients.  We’ve had Sales reps from Nutrition Companies, Even local Grocery Store Managers at one meeting, to ask about hard to find items That the group would buy locally if available. Our Program Manager is great at trying to keep meetings Interesting and Valuable. A great deal of the meetings are also just social gatherings, Because we’ve known each other for years now.   “Here’s my daughter’s graduation Photos,…”  “This is my grandson…” That sort of thing.  My surgeon’s clinic/group, makes the commitment a “For Life” thing. One month check ins for the first 6 months, 3 month check ins for the next year and a half, At two years out, we default to 6 month check ups, Or stay at 3-month or sooner IF lab-work or weight loss Has been off a bit at any of the check-ins. There is a good bit of ‘mentoring?’ from the older post-ops to the newer folks. We’re just “Normal People” with an interest in helping others to become Just “Normal People.” Hope you get some useful info! Best Wishes- Dx