Feeling like a complete failure! False hopes?

I've been so stressed about my weight and the possibility of me not making it to goal. I am so thankful for this surgery i really am but for everything i have went through and am still going through i feel like the weight loss should be much more. Pre-op i was hoping to be down 100 lbs at least by now. Here i am 6 months post-op as of Sept 5th and i am down almost 63lbs reality speaking i am losing 10 lbs a month which is less than i had hoped for. My window of opportunity to lose the most weight is slowing decreasing as i am now 6 months post-op. I am still 80lbs from where i want to be and 60lbs from where i would feel "comfortable at" I don't understand what i did so wrong that i only lost 63lbs and others have lost a lot more than me! Even people starting at the same weight as me and they are still losing 3+ lbs a week. I will lose 0.4 one day 0.8 the next and sometimes will stop losing completely or gain temporarily for 2 weeks. I am on time of month again so i gained a pound or so and once again have not lost in over a week. I have gone through hospitalization related to complications, gastritis, horrible constipation, dehydration, herniated disc, etc. Yet i am still not close to where i want to be yet.

To add to it my gastritis i think is coming back or i now have an ulcer. I am constantly getting sharp pains in my stomach again and barely able to eat and drink without nausea and pain. The constipation doesn't seem to want to resolve either. I am on a ton of vitamins now that i am on celebrate and not fusion so i am taking:

2 multis day
6 calcium chews
sublingual b12
chewable iron
wellbutrin
Synthroid
colace 2x day
biotin
Ambien

I am also taking zofran, pain meds again, carafate again the ER put me back on the carafate, and penicillin.
I have a tooth that needs to be pulled Tues
I also have a ton of other cavities
I have to meet with the pain clinic to help maintain my pain with my sciatica
My thyroid is all over the place i am having a hard time getting my levels where they need to be
Constant fatigue
I go to the gym with no outcome
I've gone through a lot i will leave it at that. I expected to see much more of a weight loss by now. Unrealistic expectations maybe idk?

Still don't regret the surgery my sizes continue to go down, ongoing compliments, better b/w, blood pressure really good but low, no more pre-diabetes, sleep study tomorrow night so possibly sleep apnea gone....

Yet i am still NOT HAPPY. Why???? I still can't accept me at my weight right now of 233 lbs. I don't want this to be the end of my journey i am not happy here yet. I hate when i have to remind myself i have only lost 10lbs a month with such a drastic procedure. I keep feeling like this is the end of the road for me and i just have to accept my weight staying where it is at right now like i am done losing. My body fat percentage is still high at 47% yet my bmi is obviously much lower. I lost 104 lbs pre-op in the 18 months pre-op. Why am i struggling now with such a powerful tool? It's depressing really... i don't feel like i am within normal weight loss at 6 months out.. and if i am then i would be on the low side percentage wise. Sorry for all the ranting i just am trying to piece everything together and understand where i am going wrong.. I have hanging skin to look at too every day i still feel fat! I know i need counseling but i have so much going on right now... Sept 30th i am also having another surgery not weight loss surgery related.. i have a ton of appts this month doctors appts. My daughters birthday this month, work, etc i am just so overwhelmed and depressed lately. Why am i feeling this way all of a sudden?? =(

What is your eating like?  You did lose a lot of weight pre-op.  I think that may be why you aren't losing as fast as you would like.  You already had the big drop so even though you are only 6 months post-op it is really almost like you are 2 years post-op.  I know how easy it is to be discouraged but you are doing great.  There is no law that says you only have a set amount of time to lose weight.  You can continue to lose weight for as long as you are taking in fewer calories then you are burning.

A sample of how you are eating may give an idea of why you aren't losing as fast as you like.

Breakfast is usually a greek yogurt or omelet

Lunch is salad with steak tips or chicken, lunch meat, leftovers from dinner usually consists of meat/beans always meat though
Dinner steak salad, chicken with veggies, or some sort of meal in crockpot sometimes wendys chili
 
Snacks during day consists of weigh****chers ice cream bars not every day
Almonds
Cheese sticks
Quest protein bars
Greek yogurt
Sugar free pudding
Cottage cheese

I usually have a skinny sugar free latte during the day too. Lately though i have been barely eating due to my stomach pain/nausea or my schedule honestly. I sleep a lot lately so by the time i wakeup sometimes noon i am so concentrated on fluids that i may not eat until 2-3pm unless i grab a greek yogurt since i can have that with my fluids.
I don't eat bread, pasta, rice, etc as it makes me sick. I always eat protein first.
 

Unfortunately, it sounds like you went into surgery with unrealistic expectations of how quickly you would lose weight, and you need to find a way to let go of those expectations and of the sense of disappointment and failure.  Please trust me when I say that by he time you are 2 or 3 years out, it will be hard to even remember what your losing pattern was or how much weight you had dropped by a specific number of months out. Everyone loses differently... Even if you ate exactly what someone else was eating, and in the same amounts every day, and did the same amount of exercise that they did every day, you probably would not lose in parallel with them.  Your metabolism may be the culprit, but there isn't a lot you can do about that.  When you say your thyroid is "all over the place", if it is way off, and you are significantly hypothyroid, THAT can slow down your weight loss (minor fluctuations wouldn't significantly affect weight loss, though).

FORGET ABOUT THE "WINDOW OF OPPORTUNITY"!  You will continue to lose as long as you continue to burn more calories than you consume.  Period.  It is true that you are slowly losing the caloric malabsorption, but even once it is completely gone, you will still lose... but you will lose just as slowly as if you never had surgery... As long as you burn more than you eat.  I dont know how tall you are or what your body type and muscle mass is, but maybe now would be a good time to re-evaluate whether your goal weight is realistic for YOU.

It also sounds like you are still caught up in a diet mentality.  This is NOT a diet, this is your NEW LIFE.  You eat the way you eat because that is what you have to do, regardless of the results.  Once you are done losing -- whether you ever reach your goal or not -- you have to KEEP doing what you have been doing in order to MAINTAIN the weight loss... And when you are in maintenance, there is no positive reinforcement in the form of compliments on how much you are losing and getting to buy lots of new clothes or seeing the scale move.  The only "reward" is the scale NOT moving up.  So I think you may continue to struggle with these feelings if you cannot let go of the focus on the speed of the outcome and of viewing this as a means to reaching a specific number on the scale.

It does sound like you have a LOT on your plate right now, and that alone may partially account for why you are feeling this way, but I really think you need to find a way to fit in some counseling so you can focus on the positive aspects rather than being consumed by feelings of failure at only 6 months out.   As long as you are doing what you are supposed to be doing in terms of eating, water, vitamins, and activity, you are NOT a failure.  You are only a failure when you abandon Tahoe things and go back to your old ways.

Lora

Lora, have I told you lately how much I value your sensible and to the point advice?

Well, if I haven't, I for sure am now.

This is a wonderful post -- I hope the OP is in a position to take this in (she may not be), but wow, it's a keeper, for sure.

*applause*

Marilyn (aka mmm)

I second Chipmunk's post as she said it so well!  Thank you Lora!

You are not a Failure!!! Period. You can continue to lose weight after the honeymoon period. Like Lora said it is up to you and the choices you make.

I have been harping on this situation for the last several months because I experienced a regain and had to figure it out. Check out my old posts if you are interested. Biggest issue I had was understanding what my post surgery lifestyle should look like. In a nut shell this needs to be individualized to you and you need to work your plan. I expect to reach my surgery "goal" of 240 in the next few days at just about the 3 year point. You might say I took a 18 month mental health day took me that long to get my head around what was needed. Happy to share if you want to hear more about my journey.

Chrispy

What/When are you taking all your meds and vitamins?  I might  be able to help some with the Thyroid Issues. With Synthroid, and most all other thyroid meds you have to take them on a empty stomach, and wait at least 30 mins before eating anything. Also its important to take it 4 hours before or 4 hours after any other meds. Since vitamins will mess up how much of it your body absorbs. 

For me this is what my vitamin schedule looks likes:

6am: when i first get up. Thyroid meds

7am I drink a protein shake

10 am, I take 1 mulit, 2 calcium (250 mg each), B12 (2500 MCG), Biotin, Dry D3 (10,000 units)--- All taken just before a morning snack, normally Greek yogurt

12 pm, 1 mulit, 2 calcuim --All taken just before Lunch

2 pm, 2 calcuim

4pm 2 calcuim

9pm, 120 mg of iron, 1000 mg of vitamin C

10/1030 pm, Ambien 2.5mg

How you take Synthroid is up to your physician.  Many people do take their meds around the same time as Synthroid.  The only label on your RX to mention a 4 hour waiting period is not to take antacids or products containing calcium or iron within 4  hours of taking  this medication. So yes you want to wait on your multi-vitamin, but unless otherwise instructed by your physician to do things differently, it is best that all  people on Synthroid get there instructions on how to take Synthroid from their physician.  Jane

http://www.drugs.com/pro/synthroid.html#Drug_Interactions

Drug Interactions

Many drugs affect thyroid hormone pharmacokinetics and metabolism (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to Synthroid. In addition, thyroid hormones and thyroid status have varied effects on the pharmacokinetics and actions of other drugs. A listing of drug-thyroidal axis interactions is contained in Table 2.

The list of drug-thyroidal axis interactions in Table 2 may not be comprehensive due to the introduction of new drugs that interact with the thyroidal axis or the discovery of previously unknown interactions. The prescriber should be aware of this fact and should consult appropriate reference sources (e.g., package inserts of newly approved drugs, medical literature) for additional information if a drug-drug interaction with levothyroxine is suspected.

Table 2. Drug-Thyroidal Axis Interactions

Drug or Drug Class	Effect
Drugs that may reduce TSH secretion – the reduction is not sustained; therefore, hypothyroidism does not occur
Dopamine/Dopamine Agonists Glucocorticoids Octreotide	Use of these agents may result in a transient reduction in TSH secretion when administered at the following doses: Dopamine (≥ 1 mcg/kg/min); Glucocorticoids (hydrocortisone ≥ 100 mg/day or equivalent); Octreotide (> 100 mcg/day).
Drugs that alter thyroid hormone secretion
Drugs that may decrease thyroid hormone secretion, which may result in hypothyroidism
Aminoglutethimide Amiodarone Iodide (including iodine-containing radiographic contrast agents) Lithium Methimazole Propylthiouracil (PTU) Sulfonamides Tolbutamide	Long-term lithium therapy can result in goiter in up to 50% of patients, and either subclinical or overt hypothyroidism, each in up to 20% of patients. The fetus, neonate, elderly and euthyroid patients with underlying thyroid disease (e.g., Hashimoto's thyroiditis or with Grave's disease previously treated with radioiodine or surgery) are among those individuals who are particularly susceptible to iodine-induced hypothyroidism. Oral cholecystographic agents and amiodarone are slowly excreted, producing more prolonged hypothyroidism than parenterally administered iodinated contrast agents. Long-term aminoglutethimide therapy may minimally decrease T4 and T3 levels and increase TSH, although all values remain within normal limits in most patients.
Drugs that may increase thyroid hormone secretion, which may result in hyperthyroidism
Amiodarone Iodide (including iodine-containing radiographic contrast agents)	Iodide and drugs that contain pharmacologic amounts of iodide may cause hyperthyroidism in euthyroid patients with Grave's disease previously treated with antithyroid drugs or in euthyroid patients with thyroid autonomy (e.g., multinodular goiter or hyperfunctioning thyroid adenoma). Hyperthyroidism may develop over several weeks and may persist for several months after therapy discontinuation. Amiodarone may induce hyperthyroidism by causing thyroiditis.
Drugs that may decrease T4 absorption, which may result in hypothyroidism
Antacids - Aluminum & Magnesium Hydroxides - Simethicone Bile Acid Sequestrants - Cholestyramine - Colestipol Calcium Carbonate Cation Exchange Resins - Kayexalate Ferrous Sulfate Orlistat Sucralfate	Concurrent use may reduce the efficacy of levothyroxine by binding and delaying or preventing absorption, potentially resulting in hypothyroidism. Calcium carbonate may form an insoluble chelate with levothyroxine, and ferrous sulfate likely forms a ferric-thyroxine complex. Administer levothyroxine at least 4 hours apart from these agents. Patients treated concomitantly with orlistat and levothyroxine should be monitored for changes in thyroid function.
Drugs that may alter T4 and T3 serum transport - but FT4 concentration remains normal; and therefore, the patient remains euthyroid
Drugs that may increase serum TBG concentration	Drugs that may decrease serum TBG concentration
Clofibrate Estrogen-containing oral contraceptives Estrogens (oral) Heroin / Methadone 5-Fluorouracil Mitotane Tamoxifen	Androgens / Anabolic Steroids Asparaginase Glucocorticoids Slow-Release Nicotinic Acid
Drugs that may cause protein-binding site displacement
Furosemide (> 80 mg IV) Heparin Hydantoins Non Steroidal Anti-Inflammatory Drugs - Fenamates - Phenylbutazone Salicylates (> 2 g/day)	Administration of these agents with levothyroxine results in an initial transient increase in FT4. Continued administration results in a decrease in serum T4 and normal FT4 and TSH concentrations and, therefore, patients are clinically euthyroid. Salicylates inhibit binding of T4 and T3 to TBG and transthyretin. An initial increase in serum FT4 is followed by return of FT4 to normal levels with sustained therapeutic serum salicylate concentrations, although total-T4 levels may decrease by as much as 30%.
Drugs that may alter T4 and T3 metabolism
Drugs that may increase hepatic metabolism, which may result in hypothyroidism
Carbamazepine Hydantoins Phenobarbital Rifampin	Stimulation of hepatic microsomal drug-metabolizing enzyme activity may cause increased hepatic degradation of levothyroxine, resulting in increased levothyroxine requirements. Phenytoin and carbamazepine reduce serum protein binding of levothyroxine, and total- and free- T4 may be reduced by 20% to 40%, but most patients have normal serum TSH levels and are clinically euthyroid.
Drugs that may decrease T4 5'-deiodinase activity
Amiodarone Beta-adrenergic antagonists - (e.g., Propranolol > 160 mg/day) Glucocorticoids - (e.g., Dexamethasone ≥ 4 mg/day) Propylthiouracil (PTU)	Administration of these enzyme inhibitors decreases the peripheral conversion of T4 to T3, leading to decreased T3 levels. However, serum T4 levels are usually normal but may occasionally be slightly increased. In patients treated with large doses of propranolol (> 160 mg/day), T3 and T4 levels change slightly, TSH levels remain normal, and patients are clinically euthyroid. It should be noted that actions of particular beta-adrenergic antagonists may be impaired when the hypothyroid patient is converted to the euthyroid state. Short-term administration of large doses of glucocorticoids may decrease serum T3 concentrations by 30% with minimal change in serum T4 levels. However, long-term glucocorticoid therapy may result in slightly decreased T3 and T4 levels due to decreased TBG production (see above).
Miscellaneous
Anticoagulants (oral) - Coumarin Derivatives - Indandione Derivatives	Thyroid hormones appear to increase the catabolism of vitamin K-dependent clotting factors, thereby increasing the anticoagulant activity of oral anticoagulants. Concomitant use of these agents impairs the compensatory increases in clotting factor synthesis. Prothrombin time should be carefully monitored in patients taking levothyroxine and oral anticoagulants and the dose of anticoagulant therapy adjusted accordingly.
Antidepressants - Tricyclics (e.g., Amitriptyline) - Tetracyclics (e.g., Maprotiline) - Selective Serotonin Reuptake Inhibitors (SSRIs; e.g., Sertraline)	Concurrent use of tri/tetracyclic antidepressants and levothyroxine may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. Toxic effects may include increased risk of cardiac arrhythmias and CNS stimulation; onset of action of tricyclics may be accelerated. Administration of sertraline in patients stabilized on levothyroxine may result in increased levothyroxine requirements.
Antidiabetic Agents - Biguanides - Meglitinides - Sulfonylureas - Thiazolidinediones - Insulin	Addition of levothyroxine to antidiabetic or insulin therapy may result in increased antidiabetic agent or insulin requirements. Careful monitoring of diabetic control is recommended, especially when thyroid therapy is started, changed, or discontinued.
Cardiac Glycosides	Serum digitalis glycoside levels may be reduced in hyperthyroidism or when the hypothyroid patient is converted to the euthyroid state. Therapeutic effect of digitalis glycosides may be reduced.
Cytokines - Interferon-α - Interleukin-2	Therapy with interferon-α has been associated with the development of antithyroid microsomal antibodies in 20% of patients and some have transient hypothyroidism, hyperthyroidism, or both. Patients who have antithyroid antibodies before treatment are at higher risk for thyroid dysfunction during treatment. Interleukin-2 has been associated with transient painless thyroiditis in 20% of patients. Interferon-β and -γ have not been reported to cause thyroid dysfunction.
Growth Hormones - Somatrem - Somatropin	Excessive use of thyroid hormones with growth hormones may accelerate epiphyseal closure. However, untreated hypothyroidism may interfere with growth response to growth hormone.
Ketamine	Concurrent use may produce marked hypertension and tachycardia; cautious administration to patients receiving thyroid hormone therapy is recommended.
Methylxanthine Bronchodilators - (e.g., Theophylline)	Decreased theophylline clearance may occur in hypothyroid patients; clearance returns to normal when the euthyroid state is achieved.
Radiographic Agents	Thyroid hormones may reduce the uptake of 123I, 131I, and 99mTc.
Sympathomimetics	Concurrent use may increase the effects of sympathomimetics or thyroid hormone. Thyroid hormones may increase the risk of coronary insufficiency when sympathomimetic agents are administered to patients with coronary artery disease.
Chloral Hydrate Diazepam Ethionamide Lovastatin Metoclopramide 6-Mercaptopurine Nitroprusside Para-aminosalicylate sodium Perphenazine Resorcinol (excessive topical use) Thiazide Diuretics	These agents have been associated with thyroid hormone and/or TSH level alterations by various mechanisms.

Oral anticoagulants

Levothyroxine increases the response to oral anticoagulant therapy. Therefore, a decrease in the dose of anticoagulant may be warranted with correction of the hypothyroid state or when the Synthroid dose is increased. Prothrombin time should be closely monitored to permit appropriate and timely dosage adjustments (see Table 2).

Digitalis glycosides

The therapeutic effects of digitalis glycosides may be reduced by levothyroxine. Serum digitalis glycoside levels may be decreased when a hypothyroid patient becomes euthyroid, necessitating an increase in the dose of digitalis glycosides (see Table 2).

Drug-Food Interactions

Consumption of certain foods may affect levothyroxine absorption thereby necessitating adjustments in dosing. Soybean flour (infant formula), cotton seed meal, walnuts, and dietary fiber may bind and decrease the absorption of levothyroxine sodium from the GI tract.