Considering Bariatric Surgery

DeidreB
on 7/13/11 12:01 am
Hello everyone
I am considering gastric bypass surgery.  I have attended the mandatory orientation at TWH and am scheduled to meet the NP and SW in August.
I didn't hear anything from the time of my referral (December 2010****il this past June despite several attempts from my GP.  I began WW at the end of April and have lost 25 lbs to date.

I found the orientation helpful in describing the procedure but poor in terms of the stats - they stated a death rate of 1 in 300 (European study) but my research shows its about 1 in 1000.
They did talk about vomitting, dumping, foamies.
There was no information about hair loss or absorption issues related to medications i.e. antibiotics

I have been lurking on this forum for about a month and read DiminishingDawn's blogs (thank you Dawn!).  it seems to me that the surgery helps one take off about 80% of the weight one has to lose in the first year or so.  But after 2 years there is the same tendency to gain weight as there is with any other weight loss.  

I haven't seen any posts about the emotional aspect of restriction - I predict tears for me - does anyone have this or is it a non issue because you aren't physically hungry and are losing so much, so quickly?
Does anyone on the board regret surgery?
Much appreciation in advance for your thoughts/comments...
D

    
Leslie W.
on 7/13/11 12:32 am - Cobourg, Canada
Welcome to OH D!
I am going thru TWH too.
My referral went in in August last year and I did not hear anything until April this year.
When you get to your nutrition class you will get more info.

From those that I have met the regain has to do with your metabolism as well as your choice of what you put into your mouth. If you follow the guidelines set out with diet and exercise the regain should be minimal.

Good luck in your journey.
    
Referral: August 2010 Orientation TWH: May 25, 2011  NP: June 8/11, f/u sleep clinic June 7, abd u/s June 14, SW: June 28/11  Nutrition Class: July 5/11, Dietician Aug 09, Psychologist Aug 25 Surgeon Sept 16th Surgery Date: Oct 11/11 HW:287, Opti wt: 260 SW: 242
My Angel is Sheri TK   
Derek C.
on 7/13/11 12:54 am - North Bay , Canada
Welcome D
I too am with TWH - and am getting read to meet with my surgeon on July 22nd.  I think the biggest thing for me is knowing that multiple attempts at weight loss albeit successful in the short term , have been unsuccessful in the long run.  I think that the surgery combined with educational compnent of TWH and more importantly knowing that with the surgery complete , you get a second chance and when you push the food envelope your body reminds you you had the surgery (ie dumping) is motivation for me to keep going .  Focus on the positive - the things , activities that are unable to do now.  Congrats on your weight loss through WW - and ill end with a fine quote from the nutrition class at TWH , After surgery , you eat to live , not live to eat

 

 

 

 

 

 


 

Surgery Date - AUGUST 22, 2011 - Ran first 5KM Race - Oct 14, 2012 (28 min)  - Currently maintaining a healthy 190 lbs and training for my first half marathon in the summer of 2013

 

 

 

 

 

 

 

    
Gabygee
on 7/13/11 12:58 am - Canada
I certainly do not regret a minute of the past 4 months.
(I am only 3 months post-op, but I'm adding the OptiFast time into the equation).

As for dealing with hunger - naw - I have little or no hunger.
And my appetite issues (akin to addiction) haven't really been a problem.
The occasional "Oooh, wouldn't a Dairy Queen cone be nice?" but that's it. Fear of dumping helps to squelch those temptations.

Of course, the time will come when my fear of dumping lessens and I will then have to resort to Plan B, which is
to visit the psychologist I have retained.

She is now familiar with Head Hunger and she has helped to treat addicts of all kinds before. So she understands when coping with 5 minutes of unbearable need is all you can handle - much less contemplating a lifetime of deprivation.

In fact, that seems to be the key for me - coping with small increments.
Example - yesterday was an upset tummy day. No matter what I ate or how slowly I ate it, it wanted to come back up.
So I coped by slowing right down and eating slightly less than has been my recent habit.
Today I'm back to the "regular" intake.
And no Foamies.

I too struggled mightily before the surgery with these doubts and concerns about my ability to manage long-term. I hope that the tools I have put in place will be up to the task.
But I deemed the whole process so worthwhile vis-a-vis my continued health and impact on longevity, that I went ahead with a glad heart.
And am very pleased thus far with the results.
        
Diminishing Dawn
on 7/13/11 1:04 am, edited 7/13/11 1:07 am - Windsor, Canada
Welcome and "you're welcome" too! 

You'll find that the statistics vary according to what study any particular group or person is quoting. Typically the quote of 1in 200 is the stat that I've seen thrown around the most often. Then take away pre-existing factors for certain people and the result can be lower.  Remember though that as obese people, the statistic of death is around the same just undergoing any kind of surgery - even something simple and routine such as a tonsillectomy, hysterectomy etc.  Just going under anesthetic puts us at risk to begin with.

The Bariatric surgery centres use different statistics for loss. Some say 50-60% percent of excess weight off is considered a success. Others quote 70% of excess weight loss gone etc.  The thing is that different people will lose different amounts depending on body size, metabolism, how much they work "their surgery", genetics, how much is bypassed etc. There is no hardcore answer as to what you will lose. 

For example, you might be 280 lbs and lose 100 lbs to go to 180.  You might lose to 140 lbs. It's hard to say - everyone has such different results but statistically we have to use this knowledge about the fact that not everyone is going to lose 100% of their excess weight and go in with some fairly realistic expectations.  Not everyone is going to be a size 0, 2 or 4.  Some people get to goal and are a much bigger size...but generally regardless of whether they get to a normal bmi or not, they are going to be generally be healthier than they were before.  Some people going into surgery are 400+ lbs, and they may get into the 200s and stop.  They are not necessarily going to be a size 4 when all is said and done and that's not necessarily because of what they do or don't do after surgery.  So there is a range and I think that is why the bariatric centres generally err on the side of caution and quote the lower numbers, so that people will have some realistic expectations going into surgery.  

There are also people that go to town, become involved with weights and body building and do get to that size 2...so again, everyone is different. The main reason for surgery is to always go in with health in mind and everything after that is a bonus.

Ah the great vitamin/hair debate. As for the hair loss/absorption issues, there is often no "hard core" science on many aspects of surgery.  This is the reality.  They do their best guess as to what we absorb and don't absorb.  For instance, the duodenum is bypassed with surgery and some of the jejenum.  Some people swear by the supplementation of biotin after surgery for hair loss, but then we also know that biotin is absorbed in the duodenum (which is not part of our intestinal tract as it is bypassed after surgery) so many people think supplementation is useless for that fact.  As well, there is also the belief that the reason we have hair loss is not necessarily due to biotin deficiency but rather that it is the "protein pulled from our hair and nails" that causes the loss...so again, with no hardcore scientific data on this, you'll find varying opinions.  Vitamins are a topic that is very very individual. The Bariatric centres will tell you what the basics are for supplementation (they are taking their best guesses based on statistics) but they don't know for sure what you will need. Part of why getting bloodwork done is so important.  Every body is truly different.

As for medications, again, not a lot of hard core data on that.  Just best guesses.  That's why you'll hear use more than one method of contraception a lot.  We do know about long term use of NSAIDS - that has been studied so that is the one that you'll hear the most -- and that data is even before having WLS (meaning that NSAIDS have been studied in non-pouch people and that's where much of the ulcer/NSAID data comes with in the first place).  

Statistically most people reach their lowest weight at the 1.5-2 year mark and then have bounceback or regain.  It is often quoted somewhere as to the 10-20% of EWL as being what to expect.  It is thought to be due to malabsorption diminishing over time.  That's not to say that everyone is going to put on weight, but by far and large, most people do experience (or fight with) the tendency for regain.  It does not necessarily mean that one is doing anything wrong but that the body has compensated very well to the surgery.   As well, in addition to this, some people do have a hard time later on because of emotional eating and all that fun stuff. Realistically after few years, people can eat quite larger portions, become unfocused, and have stresses return in life.  It is much harder to make perfect choices over time so that is definitely a part of it too.

You'll find though that to lose 120, 130, 150 lbs ....and then to have a 10-20 lb regain is not the end of the world.  Even if you do have regain, chances are that you'll still be a fairly healthy weight. You might not be a size 2 but you are mobile, healthy and living life as a fairly normal sized person and life is good.

As to the emotion aspect of restriction - yes it can be tough for many. Some people go through big time buyer's remorse after surgery because they are losing their best friend. Social eating will be different as well.  For most people though the first year they are not hungry.  This doesn't apply to everyone and also, we have to learn to tell the difference between head hunger and stomach hunger (which many of us have confused over the years).  Most people find though that once they get to the 50 lb loss mark and higher that these feelings disapate and they feel amazing.  I know very few that regret surgery even in my support group which has hundreds of people in it and for most that's usually just in the first year mark. Some people though have medical issues - often that exist before they have the surgery - and those are the people that tend to have issues of regret.  You'll find that most people on here have only one regret - that they didn't do it sooner! 

Dawn :)

17+ years post op RNY. first year blog here or My LongTimer blog. Tummy Tuck Dr. Matic 2014 -Ohip funded panni Windsor WLS support group.message me anytime!
HW:290 LW:139 RW: 167 CW: 139

PatXYZ
on 7/13/11 1:23 am
Hi Deidre,

I am also going through TWH. I can give you some idea of the stats from the most recent research on RNY. You can expect to initially lose around 75% of your excess weight and at 3 years out to have a loss of about 60-65% of your excess weight, this is the average. Of course there are people who lose 100% of there excess weight and keep it off and people who outright fail and lose 25% or less, but these are outliers.
Some of  this will depend on your own habits (exercise, getting adequate protein, avoiding simple carbs, etc) and health issues (metabolic issues, need to take meds that promote weight gain, etc.), but also potential complications - many people with significant regain actually have reactive hypoglycemia, which can cause a cycle of hunger every hour or two and a significant increase in calories (this is currently being studied by Dr. Roslin in NY and it is believed to much more common than previously thought and be caused by the lack of the pyloric valve in RNY). The best thing you can do to lose, and avoid regain, is avoid carbs - for some this is easy and for others very hard.
You will probably go through a period of mourning food, your life will be significantly different after surgery, but many of the vets here and at the TWH support group describe not ever feeling hungry, so your feelings about and relationship to food may be quite different post-op and there is a great need to work at changing the habits you're used to to have long-term success.
Think about checking out the TWH support group. It meets every 3rd Wednesday of the month from 7-8:30pm on floor 6 room 103, the same place where the orientations are held.
PatXYZ
on 7/13/11 1:28 am
Two quick things I forgot...

1) TWH has not yet experienced a death in their bariatric program - you are in good hands. The stats I've seen are usually around 1/300-ish, I wouldn't worry about that. If you have particular operative risks, they will address them with you ahead of time.

2) If you use the pill for contraception, you'll need something different post-op as it won't absorb properly. Many people use Mirena IUD or the Depo-provera shor instead.
Mary A.
on 7/13/11 1:47 am, edited 7/13/11 1:50 am
I am not going to provide my long winded response..because most of my points have been covered by others already…

what I will say is that it is a constant work in progress at 29 months post-op..I still watch the carbs, sugar and my protein intake..it’s a choice…sure people can regain weight..but those fortunate enough to be approved to have surgery have been a tool… a tool that works…or doesn’t work..that is totally up to EACH INDIVIDUAL person.

I don’t believe I have been deprived of anything…our issues with food are as unique as each individual is/…sure there are daily struggles and challenges and CHOICES….again CHOICE.

 never cried or had any negative emotions about the surgery..that being said there were times I thought "what the heck have I done to myself"..but being 29 months post-op and maintaining a 100-114lbs weight loss…I feel great an only wish that I would have had the surgery several years earlier. For me it wasn’t about reaching a specific number and for myself…I lost about 15-20lbs less than I had anticipated…BUT……I figured if I was where I was happy..I would concentrate on keeping that weight….and my only piece of partying advice was (don’t be a slave to your scale..it will drive you CRAZY

regrets..not a single one...challenges..many.

but worth every minute & every struggle along the way

prior to surgery 323lbs....4 years post-op maintaining between 108- 114 lb loss. 

life is AMAZING when you continue on the right path~!.  Use your surgeons gift to the fullest~!

Mary
surgery done in Duluth, MN

Diminishing Dawn
on 7/13/11 2:26 am - Windsor, Canada
Awesome post Mary and very, very true. 

Dawn

17+ years post op RNY. first year blog here or My LongTimer blog. Tummy Tuck Dr. Matic 2014 -Ohip funded panni Windsor WLS support group.message me anytime!
HW:290 LW:139 RW: 167 CW: 139

Joyce J.
on 7/13/11 2:50 am - Scarborough, Canada
Hi there

Welcome to the forum
You will find lots of support and encouragement here, the odd butt kicking when you need/want it as well

As usual, Dawn has done an awesome job in her post

I had my surgery Aug 1, 2005. I lost 120 pounds and have been able to keep it off. I didn't lose all the weight that I needed to lose, lots of emotional stuff happened in my life and
I haven't given up, but I am so happy to have lost the weight I have, it has made a huge difference in my life

Take care

Joyce----Today is the first day of the rest of your life

 

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