Is WLS right for me . . .

Jun 03, 2011

 . . . or am I right for WLS?

Sometimes when replying to a post, I wax on . . . and on, and on . . . and forget to wax off.  Here is a probably too long reply to someone's recent post, but it may be helpful for those trying to decide if WLS is right for them:

Like most everyone here, I chose the DS after much research and as I was above 450lbs (500 at my highest) I knew I would need both the restrictive and malabsorptive part for long term.  I do understand your concerns as I had the same ones.  I settled on the DS because I finally understood that it was ONE TOOL that I would use with many others to achieve the loss and health I wanted.  In a nutshell, it was the tool I chose because biologically it made the most sense to me, was geared for those with higher amounts to lose and would leave my digestive system working most closely to the way it should. 

To me, the key is recognizing that WLS is not THE answer, but one tool to choose from  Let me put it to you this way:

First and foremost it is imperative that you recognize that there is NO SURE-CURE, NO QUICK-FIX for long-term weight loss!!!  The ONLY thing that works is a COMPLETE LIFESTYLE CHANGE, which includes re-thinking and modifying three things:

   ++   Food & Nutrition
   ++   Exercise
   ++   Monitoring your body & Diagnostics (Doctor Support)
          (getting to know your body and what it needs to be healthy).

There is no getting around this.  There is NO OTHER WAY to achieve substantial, healthy, lasting weight loss.  Now, anyone must incorporate different tools while making these lifestyle changes for the greatest success based upon your personal needs, preferences and starting health condition.  It may be something as simple as finding the right running shoe, choosing water aerobics over traditional for less impact - or choosing hardcore weight lifting over using bands, finding lower carb, sugar alternatives for your favorites foods and even developing new tastes, trying new foods and adjusting your nutrition based upon what your body needs (you may try avocado for the first time and realize you're allergic . . . no'mo avo for you.

Bear with me, I promise I have a point . . .

Now, for us, that lifestyle change ALSO included WLS (specifically the DS).  Having WLS will not under any circumstance replace any part of the complete lifestyle change.  Each of us took stock of ourselves, our personalities, our habits, our current health and physical condition and recognized that we needed an extra strength tool that would allow us to maximize the effectiveness of a complete lifestyle change.  That TOOL was weight loss surgery.  And like screwdrivers, there are different ones out there . . . even for lefties and righties, battery powered, manual . . . all different depending upon the user and the job being done.

WLS is the same way.  Each procedure has it's pro's and con's and while we can promote the one we chose, only you can decide which is the best for you.   I can tell you that while each is different, the things they have in common are:

Supplements for life, regardless of which procedure.
Whether solely restrictive (like Band) or including malabsorption, you're taking in less and will have to supplement.  HOW much supplementation will depend upon the procedure (DS requires more because the malabsorption is stronger) as well as how your body currently processes (different for every single individual).  For many, supplements to maintain health are replacing numerous prescriptions to try and improve failing health . . . I'll take THAT trade.  If you knew the truth, you'd find that many who have never had WLS and could be considered healthy by their doctors, would be found to have some type of vitamin/mineral deficiency if they had a full lab panel.  But because they are considered to be healthy, it's not checked unless something serious and mysterious happens.

Nutritional Behaviour Modification
Protein heavy, then leafy greens and nutrient rich complex carbs (like healthy veggies) with limited simple carbs and last (but definately least) your refined sugars and sweets.  This isn't a diet it's just a healthy lifestyle.  The difference is that WLS is far less forgiving on poor eating habits . . . when you stray from healthy eating, you WILL feel it, you WILL NOT be able to ignore it.  But then, that's one of the purposes of the tool as well.

Exercise
Exercise is not just about burning calories, it's also about building/maintaining physical strength, bone health, cardiovascular health and healthy metabolism.  Naturally, with WLS, you can lose (and will initially) without exercise, but you will not lose as much and you will sabotage your health without some regular exercise/activity.

Monitoring Your Body (Diagnostics)
While this can be as simple as discovering a previously unknown avocado allergy (nothing against avocados, just never tried one before), it can be as serious as being diagnosed with anemia and making the necessary changes to manage it for life.  With WLS, this specifically includes labwork to check your levels.  Of course preventive maintenance and testing with your doctor should be done by everybody, but because of our modified systems, deficiencies affect us more quickly and more severely than those who have not had WLS.  So it requires being MORE diligent about testing, follow up and acting on the findings.

Choosing to have WLS requires a major personal commitment to your health, the danger of surgery and, more importantly, the LIFE-LONG changes that you MUST make.  You must decide if you can and will make those changes.

Forgive me for lecturing, I think I'm going on so because I'm resurfacing after too long underground and off the wagon.  I'm telling you things that I'm having to tell myself as I make my way back.  I've gained and am dealing with less than optimal health (though nothing serious yet) because I've gotten away from these principles.  Life will pull you away from focusing on your health and I'm thankful that I've finally got my head back in the game.  I've learned about myself that I must always be diligent.  "Winging it" for me is dangerous.

That being said here's my .02 on your specific questions:

Cost of vitamins - What would you do if you received a diagnosis (or  more) that required multiple prescriptions and without them you would die?  You'd find a way.  Supplementing is not an option and if you have WLS, you must determine a way to budget for it.  You may even start a "Supplement Fund" and by the time you have surgery, you will have accumulated enough until you find the most cost effective regimen for you.  In time your costs will go down as you plan, buy in bulk and refine your supplements based on your labs.

You can also make it fun.  If you feel comfortable to let your friends know that if they ever want to give you a gift (for birthdays, christmas, special events, or just a thank you), make it a GNC gift card or Amazon.com (you can order all kinds of supplements from them) or wherever you get your supplements from.  A friend of mine got me a generous one for Amazon as a thank you and I went crazy with books, but if I'd realized I could get my supplements from there, I would have used it more wisely.

Bloodwork - Also not an option.  Work with your doctor and/or surgeon.  They can probably find a way to code it some at least some can be covered.  At the worst, find out what it would be, figure out a way to budget it and add to your Supplement Fund each month so when it's time you'll have the funds.

Pregnancy and Childbirth - Okay, can't talk to that as I haven't experienced it, but I know there are quite a few women on here who have gone on to have healthy children after.  Even without WLS, prenatal care requires adjustments in your nutrition and routine.  The difference after WLS is that you have to be more mindful of it and more diligent about getting the nutrients you need a keeping your levels at an acceptable . . . umm, level.

Protein vs Carbs -  Okay, again this is a component of healthy eating anyway, just moreso after WLS.  If (I said IF) you have already decided you can't handle restricting your carbs, you're not mentally ready for the commitment of WLS.  At the very least be open to learning alternatives (for example, I love pizza and have indulged too much in recent months . . . okay 2 years . . . and I'm going to try Brok's pizza recipe - I never would have considered mixing cheese and eggs to make a crust in the oven - and the picture looks scrumptious).

A lot of your hesitation regarding the perceived (I say perceived because the reality is that we're not as limited post WLS as it appears) food limitations may be solved by NOT thinking of this as temporary.  Usually when you start a diet, you're in the frame of mind that eventually the diet will end and you can go back to indulging in the forbidden - which is how many give up.  Remember that, whether you choose WLS or not, the lifestyle changes necessary to lose weight and maintain the lost and optimal health are LIFE-LONG changes.  Acknowledging that up front if half of the battle.

As far as whether DS or VSG . . . first I'd recommend letting go of the "100% right" thing.  Regardless of how much research you do beforehand, post-op life is a learning experience.  You will falter, you will have bad days . . . that's the nature of life.  I don't think there's a person on this board who hasn't had a less-than-picture-perfect WLS day.  The key is NOT letting it get to you or make you give up.  Next the question is the malabsorption.  In my mind the key to answering that is being honest with yourself and saying, "Can I make primarily good choices  Do I have the discipline to stay away from pasta's breads and cereals and be open to alternatives?"  If this is something you feel you truly cannot do, then you need the malabsorptive part.

I think you're headed in the right direction as far as research, maybe just a little more soul-searching necessary.  I wish you the best in whatever you choose to do, but for now . . . I think I've said enough.

 

2 comments

Got Iron???

Jun 03, 2011

I wrote this reply to a recent inquiry about Iron Infusions . . . thought I'd add it here:

I'm sorry, I don't know what type of iron I had, but I've had an infusion about once a year since surgery (and actually 2 within a month's time beforehand).  I was diagnosed with severe iron-deficient anemia prior to surgery and my mother also had life-long issues.  Others' experiences may be different, but I'll tell you about my first one:

They usually want you there around the 9am hour.  They gave me a couple of Tylenol horse pills and then got the IV line in (be sure you drink plenty of water during the day and night prior.  Not enough and your veins will have difficulty with the IV, the vein will "blow."  It's not overly painful, but can cause problems - more below)

Next was a 1/2 hour bag of Benedryl.  (My understanding was the Tylenol and Benedryl guard against the reaction to the iron, plus the added benefit of a nice nap).

For my first visit, they did a test dose of iron (a large syringe full).  Once given, they wait 30 minutes to see if you'll have any reaction - I think they're specifically looking for signs of an allergic reaction because your body WILL react to the iron (talk more about that below).  If no reaction, then they start the iron bag.  The iron IV itself lasts about 2-2.5 hours depending upon how slowly they drip.   Learned the hard way mine has to be pretty slow because my veins are apparently very sensitive and it hurts if too fast.

You can bring snacks with you, but my office usually has some available.  The IV is on a pole w/ wheels so you can run to the restroom if you need to (helpful considering the water you drink before hand and the saline which always seems to be a part of IV's).

You'll probably doze off and on during most of it.  After my first one, I tried bringing a book, but usually about 15 minutes into the iron, I start to drift.  I can stay awake with extreme effort, but it's easier to just enjoy the ride.  Starts to wear off for me about 10 minutes before the bag ends.

You may hear beeps during.  The machine will beep if anything stops the flow (a blown vein, a kink and sometime the IV is not in a good position.  It will also beep when the Benedryl bag ends and when the Iron bags ends.

Once the iron is done, they'll flush your IV with a little saline (to be sure the last of the iron still in the hose has gone in), remove the IV, plug your stick with cotton and tape and you're good to go.  Even though it only takes a half day (now about 3.5 hours for me) and there's no problem with driving afterward, I usually take the whole day off because it is taxing on the body.  I go home and sleep off the rest of the benedryl and relax.

I was supplementing in between (with Proferrin ES) but for me it was a waste of money, because I still had to have an infusion once per year.  My doctor suggested I try Integra.  So far it's working.  I'll no more at my next quarterly check-up.

Hope this helps.  If you're interested, more about hydration and possible reactions below.

Hydration and Blown Veins
I have occasionally had a vein blow during an infusion.  What it means is that the vein literally blows at the insertion site and the IV is no longer going into the vein, but under the skin.  Not life-threatening.  Becomes tight and a little painful, but not overly so.  The alarm may not go off immediately, so if you suspect a vein has blown, let them know.  It can be very worrisome because if you're not well hydrated and veins blow, they wrap your arm in a heating pad and keep trying in different places, switching arms  . . . it can become frustrating.

Reaction
Okay, this is just my experience, don't know if this is "the" reaction, but it's the one I had.  With my first infusion, my vein blew early on into the Benedryl bag and I didn't realize it initially because I'm paranoid about IV's and they are always a little uncomfortable for me.  When the discomfort reached a level I knew wasn't right, I let them know.  They re-did everything, but I had not much Benedryl in my system because it had gone under the skin and they said it was too dangerous to give me more. 

About 10 minutes into the iron bag I started having difficult breathing.  Nothing extreme, it just took more effort to breathe and I couldn't do it well laying back in the chair.  I sat up but it got worse and worse.  I got the nurse's attention and told her I was having real difficulty breathing and my chest felt tight.  At this point, I was having to sit with my back as straight as possible and my hands on my knees so I didin't relax my chest at all.  I explained to her that I could breathe, but it took a lot of effort and concentration.  She said that is indicative of the reaction and if possible, just be patient.  If I began to feel at all like I couldn't breathe, though, to let them know.  It never got to that point, but I was sitting in that uncomfortable position, working for each breath for over an hour.  Eventually, it began to subside slowly and over about a 30-45 minute time period I was able to sit comfortably in the chair.  The iron bag ended about 15-20 minutes after I was finally able to sit back in the chair and breathe comfortably.

It's my understanding that this is the body's typical reaction to such a concentrated dose of iron.  It's not life-threatening, but very uncomfortable which is why they give the Tylenol and Benedryl.  I can't imagine what I would have felt if I hadn't had at least the Tylenol.

Now at my last infusion, another young lady was getting her first and had a very quick and severe allergic reaction to the test dose.  The team reacted very quickly and got things under control.  They stopped the iron, but continued the saline to help push through what was already in her system.  They wouldn't do an infusion that day, but after a couple of days would have her come back and try another iron.  I'm not sure exactly what she was feeling, but it was a bit frightening to witness.

Hope this helps.
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About Me
Atlanta, GA
Location
49.4
BMI
DS
Surgery
02/16/2006
Surgery Date
Jul 05, 2005
Member Since

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