Top 10 Mistakes WLS Patients Make

Sep 18, 2007

I saw this on the "Over 50" board and am saving it for posterity.

1st Mistake: Not Taking Vitamins, Supplements, or Minerals

Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist. Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results. Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include:

Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning.

Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible. 

(Search WebMD for more information. Cy)

2nd Mistake: Assuming You Have Been Cured of Your Obesity

A "pink cloud" or honeymoon experience is common following WLS. When you are feeling better than you have in years, and the weight is coming off easily, it's hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back.

A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don't change what you've always done, you're going to keep getting what you've always gotten -- even after weight loss surgery.

3rd Mistake: Drinking with Meals 

Yes, it's hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating.

4th Mistake: Not Eating Right 

Of course everyone should eat right, but in this society eating right is a challenge. You have to make it as easy on yourself as possible. Eat all your meals--don't skip. Don't keep unhealthy food in sight where it will call to you all the time. Try to feed yourself at regular intervals so that you aren't as tempted to make a poor choice. And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your "absolutes" based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you.

5th Mistake: Not Drinking Enough Water 

Most WLS patients are at risk for dehydration. Drinking a minimum of 64 oz. of water per day will help you avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too.

6th Mistake: Grazing 

Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It's one thing to eat the three to five small meals you and your doctor agree you need. It's something else altogether when you start to graze, eating any number of unplanned snacks. Grazing can easily make your weight creep up. Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing. Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement.

7th Mistake: Not Exercising Regularly 

Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest!

8th Mistake: Eating the Wrong Carbs (or Eating Too Much) 

Let's face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, which have beneficial vitamins. For example, if you can handle pastas, try whole grain Kamut pasta--in moderation, of course. (Kamut pasta doesn't have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as "condiments," rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies.

9th Mistake: Going Back to Drinking Soda 

Drinking soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we know it does is keep you from getting the hydration your body requires after WLS--because when you're drinking soda, you're not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there.

10th Mistake: Drinking Alcohol 

If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it.

Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious. Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations.

If you think you have a drinking problem, get help right away. Putting off stopping drinking doesn't make it any easier, and could make you a lot sicker.,messageb oard/action,replies/board_id,5495/cat_id,5095/topic_id,33769 33/

I am approved!

Sep 17, 2007

After all the hard work and the changing surgeons and going through the psychiatrists and so forth and so on... I Am Approved! Yay!

Somehow, I half-anticipated a longer wait and an appeal or two. But one week after being submitted for insurance approval with United Healthcare, I am approved and scheduled for surgery on October 18th. 

OMG! I've got so much to do! Where do I start???

Melissa F. is my Angel. I love her.

A prime example of "If you don't have anything nice to say..."

Sep 16, 2007

[email protected] @~~ posted this in response to a thread Maureen wrote, complaining of the lack of support she is experiencing with her DS board.

I'm just trying to count here... but this makes what FIVE "Goodbye Cruel Forum" posts that you have made in the last 2 weeks?  You just don't tire of the attention, do you?

I'm pretty sure the reason that you didn't get any responses to your PMs is that you were quite public, nasty and hateful about your leaving the agony of the DS board and becoming an RNY wanna be ninja or some such garbage!

Something about reaping what you sow?

Now that you are home with your RNY sisters, I'm hoping that you will finally get that DS to RNY revision that you are so hoping for.  But if they ever tire of your never ending need for attention -- there's always the lap band board.... hmm... wonder if you can get a revision from DS to RNY to Lap Band?

Now, call my crazy, but that's a very rude thing to say to anyone. My momma taught me to keep my unkind things to myself. Words DO hurt a lot more than physical wounds because they stick around in our minds and play with us long after the physical wounds have healed.

Once we've lost the weight and gotten some control over our eating and exercise, we still have those words circling around, telling us we're not worthy.

Please, choose to build someone up instead of tearing them down. A kind word goes a long way in making someone feel good about themselves. Wouldn't you rather be remembered for your kindness than reviled for your venom?


Sep 14, 2007

I meant to post this a couple of days ago, but OMG! I checked my file on the surgeon's website, which I do every day. Every day, nothing new; no progress. 

Until Tuesday! I log in and see "submitted for insurance approval" OMG! OMG! OMG!

Yay me!

No further word on approval, but now I'm on my way! I'll call the insurance company on Tuesday. I'd do it Monday, but I have my therapist appointment.

Is patience REALLY a virtue?

Aug 25, 2007

I saw my therapist last week and she had a copy of the psych evaluation. I have been approved! The psychiatrist wrote that I needed strong boundaries and someone to hold me accountable. Gee... Tell me something I don't know. Otherwise, it was all good. Said I was well informed about the surgery, was making positive lifestyle changes pre-op, and seemed very committed to a major lifestyle change.

At this point, I know the surgeon's office has ALL of my paperwork, including the B-12, PTH and the H-pylori. Good on the B-12 and PTH, negative on the H-pylori - not even a trace of it in my system. They've had everything for a week, at the least. I'm going to make a phone call Monday to get a status report. I called on Friday, but they had their "office closed" voice mail running at 3 pm, even though the message says open til 5 pm on Fridays.

My 'task list' on their website hasn't been updated, so I'll mention something about that when I call. If it was updated, I'd not be calling, would I?

I thought I'd list all of the pre-op tests my surgeon requires:

B-1 - lab
B-12 - lab
CBC - lab
Comprehensive Chemistries - lab
Contract signed for support person
Endocrine/PCP History and Physical 
H-Pylori - lab
Mammogram - Female Pts. (Age 40 or >) - I didn't have to do this one
Nutritional Eval - I chose the optional 1 year nutritional counseling package, $500 out of pocket
Pap Smear - not fun
Psychological Evaluation
PTH - lab
Roux En Y Video 
Cardiac Stress Test 
TSH - lab
Upper GI
Vitamin D 25 OH - lab

My surgeon gave me the list to give to my PCP and have done. I actually had to complain of reflux and heartburn in order to get the Upper GI ordered. They were honest complaints, the stress of this whole approval procedure has weighed heavy on my tummy.

I don't know of any more hurdles to jump before approval and surgery. We'll have to see...


Aug 08, 2007

Ok, I know it's been a while since I updated. Sorry about that. Work and life have been hectic and I've been lax.

Ok, I met the new psychiatrist and took the stupid tests. The psychiatrist gave me a qualified approval pending the test results. It's been over two weeks and my therapist hasn't gotten her copy of the evaluation. 

Time to make more phone calls!

I've got to get to my PCP to get the scrip for my last labs to be drawn. She forgot to put the B12, PTH and H pylori tests on last round of labs. Should have gotten it done last week when I found out I needed them, but car troubles have kept me from it. Car is a little better, so I'll be making the hike to the PCP tomorrow or Friday and get the labs done. (Might be tomorrow but the office closes at 12:30 and I might not wake up in time.)

BUT... Once all this is done, by end of this week, the surgeon's office should be ready to submit to insurance. Yay!

Keep your prayers going for me. I need all the help i can get!

Square two - better the second time...

Jun 02, 2007

I know I've been gone for a while. Things got rather weird with my last surgeon and I became extremely discouraged. I couldn't visit the boards without getting upset, so I took some time off. Please know, I thought about y'all regularly.

I'm sure you've heard of my misadventures in Psychiatryland. When I tried to discuss the situation with Dr. Duffy, she became very defensive and wanted to see me again. Oh, yeah! Like I'm going to pay you $125 to justify yourself and your poor judgement. Not happening.

So, I call the surgeon coordinator and explain my situation. The first psych office won't return my calls and the second psych thinks I'm a liar, when I was honest and forthright. She referred the situation to her supervisor and the ultimate decision was I have to clear the first evaluation before we can proceed. 

After a big ol' pity party with lots of my favorite food friends around, I realized that I had to persevere. I picked myself up, dusted myself off, and had an epiphany. Obviously, if the universe is consipring against me, I'm not meant to have this surgery with this surgeon.

I called the Dr. M's office and told them as I was unable to get any support or resolution, to remove me as a patient and send me a letter stating that fact.

I found a new PCP that is awesome and much closer to my house. I'm also a patient with Carolina Weight Loss Surgery under Dr. Pirello for the Fobi Pouch. Already, things are falling into place much easier. The clinic is a Center of Bariatric Excellence, the which my first surgeon was not certified. 

Dr. Pirello is awesome and I feel very confident in his abilities. He feels I'm a great candidate for surgery since I have successfully kept off 100+ pounds for over three years.

I'll be starting the optional nutritional program this week (which is really intensive and is for a year) and will be scheduling the Upper GI this week. I meet the new psychiatrist for an evaluation in two weeks. 

I've not mentioned the previous surgeon and my travails to the new doctor. I want to be judged on myself, not on the issues I had in the past.

If all goes well, I could be having my surgery before the end of summer. (Happy dance!)

Yep, back to square one it is...

Apr 22, 2007

Have you ever had events conspire against you? They have for me when it comes to this surgery and Dr. Melkonian.

I've reached an impasse with the psych eval - I MUST clear up the first evaluation and that office won't return my calls. I've asked to be formally released from Dr. Melkonian's care and for a copy of my medical file. 

Another friend is going through Dr. Pirello and I have a call in to schedule a consultation. He is listed a Bariatric Center of Excellence, where Dr. Melkonian was not. Hmmm... Dr. Pirello does the Fobi Pouch and is the only surgeon in my area to offer it. My understanding is it's something like an RNY with a band on the pouch. I like the statistics with maintaining weight loss 5+ years out vs standard RNY.

I told my PCP, Dr. Garuba, to take a hike. The way his office staff treats their patients is rather bad and I refuse to take that treatment anymore. Dr. Garuba is good, but he really needs a complete overhaul of the staff who come in public contact.

I'm now seeing Dr. Zoret and she is amazing! My first visit and we covered a lot of ground - I really felt like she gave me her undivided attention. She approves of the WLS, gave me Chantix to quit smoking, gave me something for the joint pain I've been having, also has taken a 'wait and see' attitude with the athlete's foot. She says I probably have a resistant strain. There is marked improvement, but there are some small areas on the soles of my foot that persist. Dr. Zoret wants me to take a sleep apnea test, but I'm resisting. At least the doctor understands my reasoning. Her staff is wonderful and friendly and fabulous!

I've started Chantix to quit smoking. I've completed my first week and have officially quit smoking! Yay me! I will say, this stuff really does help; it's unlike anything else I've ever tried. Yes, I have cravings, but nothing like before. My only complaint is that I have become RAVENOUS! I'm trying to control it, but you know how it goes sometimes. It doesn't help that I'm PMSing, on top of it all.

Anyway, back to the beginning and I hope and pray the universe guides me smoothly with Dr. Pirello.

I think I'm back to square one...

Apr 05, 2007

Ok... I'm starting to get the feeling that I'm not fated to have Dr. Melkonian as my surgeon. 

The psych he referred me to has totally screwed me. Unbeknownst to me, they DID send in an evaluation pending release upon quitting smoking. I'm being told that there are now TWO evaluations and I have to clear the first one. HOW am I supposed to do that when the psych quit and I am being screwed by the practice? I tried to explain it all to the insurance coordinator, but she didn't listen. I don't like dealing with her. I get the impression that she's way too busy to pay complete attention to everything.

The coordinator also has my second psych evaluation, which I've not seen yet. She said it did NOT release me, and i'm just wondering WTF??? I meet with the psych on Monday afternoon and I am going to have to seriously restrain myself from an outburst if she gives me some b.s. explanation.

On top of that, my PCP's staff is horrible. Four times since January, I've requested for my nutritionist evaluation to be faxed to the surgeon. The last time was two weeks ago and I spoke to the head nurse personally, instead of leaving yet another voice mail. Surprise, surprise, the surgeon's coordinator has not received it.

So, I'm starting over. From scratch. I'm changing PCP tomorrow. I'll be calling for copies of my records from my current PCP to take when I start with the new one.  I think the doctor is awesome and tells it to me straight, but having to deal with his staff is an awful experience and I dread having to call to make an appointment. On the downside, my current doctor has an excellent nutritionist on staff and is part of my visit with him. Now, I'll have to pay out of pocket. If it's the price I have to pay, I'm ok with it.

I've scheduled myself for a seminar with Dr. Voellenger on April 16 and have requested the day off so that I can attend. I'll take Momster with me, too. I like that Dr. Voellenger offers several different options and am going to inquire on the DS in addition to the RnY. I still think the RnY is the way to go, but I like the idea of having a completely working stomach.

I'm four days out on quitting smoking. I was a pack and a half a day. So far, I've slipped every day and had a couple, but ONLY a couple. I strive to do better every day and I will be able to get this monkey off my back.

I feel so defeated right now, but I'm not giving up. I'm seriously taking all of this as a sign that I'm not on the right track with my surgeon. I'm just going to change tacks and try to move forward. 

But first, I'm going to have myself a nice little pity party.


Mar 29, 2007

First, I have to say that PK rocks!

I've seen a new psychiatrist - Dr. Sally Duffy. She seems very nice, and our visit was more like a conversation - I liked that and was very comfortable. Since I was referred to her by my therapist, she knows that I'm already taking action with my issues. I've even asked that a copy of this evaluation be sent to my therapist so we can take action on any issues that arise.

I had to take a true/false test with 120 questions. I asked how long the test usually takes and was told between 20-30 minutes. I was done in 15. I don't know if that's good or bad... When I take these kinds of tests, I get in this stream-of-consciousness state where I take my first answer; I find it's usually right. Dr. Duffy was a little surprised at my speed, but I didn't feel like I rushed through it.

I told her about the problems I've had with getting my psych evaluation done. She surprised me by calling what the first practice did "patient abandonment". I'm seriously considering finding a lawyer.

When she asked me why I wanted the surgery, I told her my health was starting to take a turn for the worse and that I really  want a family and kids, I want to be active and go hiking and camping and kayaking again. I loved being outdoors as a child; you could barely keep me inside. Dr. Duffy said something like making the life you wanted. I agreed.

At that point, I got a bit teary-eyed and choked up. When Dr. Duffy asked why I was like that, I told her because I finally felt like I was making some progress toward my goal.  I've never really had a goal before and that I was feeling very frustrated about the process.

Dr. Duffy complimented me at the end - she said I was very articulate. Yay, me!

I've got an appointment April 9th, to discuss the evaluation. I got the impression that everything went well, but you never know. I'm not going to worry about it until we meet. At this point, I'm going to assume the worst and go from there. Not to be pessimistic, but I've had nothing but problems with this whole psych evaluation. Talk about testing one's determination!

A work friend is going through the steps to get surgery, too. We're comparing notes. She's going through a different surgeon and is heavily considering the Fobi Pouch. I've heard different things, but it sounds interesting. I'll do some research on it and I may make a consultation appointment to examine my options.

OK, enough about me... For now! Mwa ha ha ha ha ha ha ha!

About Me
Charlotte, NC
Surgery Date
Jun 18, 2006
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