I went for my doctor consultation today...and I have made the decision!

I have lived with being overweight most of my life, and I thought that I was doing ok. However, the last few years have proved that those extra pounds are going to do me in if I don't do something. I have been taking meds for high blood pressure and cholesterol and there is a lot of diabetes in my immediate family. I have worked very hard to lose the weight, but it doesn't come off like it did when I was 20! Anyway, I set up intake appointments for the last week in June 2007, and I will probably have the surgery sometime in the summer. I would really like to do it now, but I am a teacher, and I don't feel right about missing work. I've been reading some of the posts on the message board, and I am beginning to realize that I am going to need the support from others like me. I have never had surgery and I don't really know what to expect. I was especially interested to read that others feel reluctant to tell family, friends and co-workers about their surgery...um, this is where I am right now. I told my daughter and the sister that I am closest to, but I really don't want to have to justify my decision to anyone else. Actually, I feel that this is the most positive step I have taken in getting my health back. I would love to hear from you all, and thanks for being there.

First off, congrats to you. THis is not an easy decision to make, but it's a step in the right direction for many of us. I told only a few people along the way (mine was atypical and long) for two reasons. One, as you mentioned, I did not want to justify it and two, I wanted to make sure that I had insurance approval first. So it was awhile before I told many people. Even those that were supportive of me were not in agreement with me, luckily for me, they told me after I'd had the surgery and supported me throughout. I felt and feel that no one has walked in my shoes so they can't understand what I went through. I would never presume to second guess another person, so I didn't want that happening to me. I research everything so when I do make a decision, I've pretty much committed to it. I had initial problems but after 7 months, I've lost 120 lbs. Not only do I feel great, but my diabetes has gone, and my bp and cholesterol are normal. I know this because I gave blood two weeks ago and all my numbers were normal. I am truly grateful for this experience. Good luck on your journey, Sue

Wow, you sound like me - research everything first, then make the decision. I'm feeling encouraged already. I finally came to the decision because I don't want to have to take bp and cholesteral meds for the rest of my life. Also, my doctor told me that I am not diabetic, but my glucose levels are elevated. Even after making major changes in diet and lifestyle, I am always going to have these problems, unless I can get the weight off. I have so many questions about what to expect from the surgery and beyond. I try to do any major "me" stuff in the summers, since I have the time away from my job responsibilities. I am most curious about the first weeks and months and what I should expect. Also, what should I be doing while waiting for the surgery? Are there foods or habits I should wean myself away from? Anyway, thank you for your encouragement and kudos to you for your success!

I think what your going through is VERY normal, at least I can say I did the same thing. I didn't tell anyone I was going to do it (other then my son and fiance****il after I had a pproval. Even then I was upset when my fiance told his family, I just wasn't ready to deal with all the emotions with anyone who might not be supportive, let alone defend my decision. Luckily after I gave him hell for opening his mouth he made a point to let everyone know they WILL support me and not question this. It got me through the surgery. Now I don't even care about other's opinions. I am SOOO much healtheir. Only 3 months post op and I've lost 70lbs. I'm working out 3 times a week (water aerobics and weight lifting) and walking 2+ miles every morning. I could never have done this without pain before. I have much more stamina, can clean my house and walk the mall. I would never give this up for other's opinions. As far as prep work. Find a good therapist and meet with them regularly before and after. There are a lot of emotions you wouldn't predict, and it's good to have someone to bounce them off of that is objective. Also, get in the habbit of cooking low fat, no sugar soft foods. For at least 2 months you'll be eating very soft, high protein foods. I found my crockpot to be a godsend. Keep reading the boards, maybe take a look at the recent surgeries board, like the November or December 2006 boards, you'll see feedback from what folks are experiencing immediately after surgery and shortly thereafter. This was a tough decision to make. If you are as lucky as many of us, it is a 2nd chance at a life you thought was not available to you. I'm actually going to get out on skis and the snowmobiles this winter... there was no way that was possible for the last 10 years! Good luck! Renee

Thank you so much for your thoughtful response. I am going to take your advice! Congratulations on your success so far and God bless.

Joyce: I will send u 3 saved emails crammed into one long one here to read at leasure ok it summs alot up though..... ~~~~~~~~~~~~ Deciding to have WLS is a major, life-changing event and shouldn't be made on impulse (I am not saying this is you I am saying this for anyone thinking about it!). I recommend anyone be 110% sure this is what you want to do because it is PERMANENT! Things to think about: · How long have you been researching WLS?**Hopefully at least a good 6 months or so****for many it is years! · Do you understand the procedure, I mean really understand the nitty gritty of what they are going to do to your intestinal system! Not just it will help me lose weight but that they are going to cut your stomach in 2,make a small pouch, the old stomach hopefully is transected from pouch by staples and surgically cut in 2! Then the intestines are cut a few feet or so down and rerouted so you lose weight because the tummy is restrictive and bypassing the intestines decreases absorption....Know the risks involved with this!!!***(nutritional/metabolic/physical/psychosocial): ex B12 and vitamin deficiencies/protein deficiency/hernia/adhesions, risk of depression post op related to grief over loss of food and hormonal surge of estrogen/trauma of surgery, marital/relational difficulties/high divorce rate)... · Surgical risks: (not all inclusive.. Bleeding · Complications due to anesthesia and medications · Deep vein thrombosis/clots · Wound Dehiscence · Infections · Pulmonary problems · Spleen injury · Stenosis · Hernia · Depression possibly related to grieving the loss of food, decreased metabolism, and hormonal surges from estrogen being released into the body from rapid wt loss/fat breakdown.... · Gallstones.... · Long-term osteoporosis, vit./mineral deficiencies · hair loss (temporary due to anesthesia, trauma of surgery but will continue if you are protien/vit and mineral deficient!) · Food intolerances (possibly meats, esp. red meat, lactose intolerance, sugar, fats, fried food) · Dumping syndrome (Nausea/vomiting/diarrhea/chestpain/palatations/sweating/tiredness for minutes/hours/days) · EXCESS SKIN....OK my philosophy is you fit in your skin or you don't...Do say you don't want to feel bad after, ask yourself do you feel bad now? If yes are you healthy now as a MO person? Yeah many insurance companies pay for some plastic surgeries if medically necessary it may be a fight, but you can get some of it removed possibly....If though this will deter you I say the chances are great you will have some amount of excess skin, no one knows how much...Age, gender, prior diet/weight changes, pregnancies all affect this and the best chance on has to control this is (although limited) exercise, water and protein....So if this is a huge issue don't have surgery.....Perhaps join : http://health.groups.yahoo.com/group/ossg-plasticsurgery/ a great site and look at before pictures and after....Excess skin may be by far the most distressing side-effect for people as we already come with altered self-esteem/body image!!! · What type of research have you done? (Internet, in-person support group meetings, talking with others who have had surgery, surgeon consult, surgeon seminar, articles, books?????)***Knowledge is power and is the best tool we have for success and happiness afterwards**** · What are your present support systems? Friends, Family, co-workers.....**Although not 100% necessary if others are on board it sure as heck makes the ride all that much easier!!!*** · What are your current stressors? ***WLS is a time when you need to be as stable as possible, going through a divorce, bankruptcy, death of a close relative, job loss...well WLS may be a good option but pick the optimal time as it is stressful enough if everything is good, when you are going through something extra stressful you are hampering your success possibly and not having the old standby of food to rely on can be HELL!***This is not to say there ever is a right time and things can happen post-op but be kind to yourself and do what's best for you, waiting 3 months may make all the difference in the world! After all this is about forever!!! · What is your nutritional/obesity/diet history?***WLS is not for everyone, it is for the Morbidly obese (BMI above 40 or 35 with major comorbdities such as sleep apnea, Coronary disease, Diabetes....)This should be no ones first attempt at dieting (*I know this is not yours again just general guidelines)...Anyone who says this is the easy way out, KNOWS NOTHING about the surgery or the struggles you will endure and lifestyle changes necessary post-op for success! They are usually ignorant, jealous or both! Again your education and knowledge here goes a long way...Everyone seems to know someone who 'died' or had a 'terrible experience' with WLS...BUT no one seems to have a name or number to call that person!!! It is again based on hearsay alot of the time and their own fears and insecurities...You are doing this for you remember that, it is nice to have support, so educate friends and family, bring them to a support group!!! It can only help! Many programs require wt loss preop...I know many people disagree with this or don't understand why..IMHO I think it is a generally good idea to start instilling dietary, exercise and overall lifestyle changes preop, there is nothing magical about the surgery that makes u wake up and think like a thin person (*I WISH!!!!) So making small changes are helpful pre-op...EXERCISE is one of the biggest keys to success (IMHO again) and anything you can do preop will help you keep up with this and be healthier for surgery!! (and a better surgical risk!)...Start eating smaller portions, it is hard if you go from eating super sized fast food today to clear liquids for 2 weeks (*this is my equivalent of psychological hell/torture!!!) Start slowing down when you eat, put that fork down in-between bites, cut up your food to small pieces, stop drinking and eating at the same time (cant do it or shouldn't postop so start now!) Start taking in 64 ounces of fluid a day if u aren't already, will need to postop! Cut out carbonation, caffeine, sugar, alcohol and chocolate (these are 5 recommended things to avoid postop for many esp. in the first year) again make postop life easier on yourself not harder start ahead!!!!Try on new coping skills for size, they wont miraculously appear postop! Stock the house with clear liquids, crystal lite, diet kool-aid, broth, diet jello etc so u are ready when u get home!!!!Try and avoid the 'last supper syndrome' you will eat most everything again eventually, perhaps in smaller quantities, so don't have a feast each night of things u think u will never have again! · Ask yourself: What is my ability to make lifestyle changes? Be compliant with post-op recommendations??? This is only a tool....(*sorry can't say that enough!).... a. Need to exercise daily for health/wt loss and help with excess skin b. Need to supplement with B12, multivitamin, folate, Iron, Zinc, Calcium citrate, protein shakes possibly give or take things. c. Need for LIFELONG FOLLOW UP!!!! · Know that extended release medications may not be as effective or absorbed well (**esp. birth control pills in woman of childbearing age use alternative form of BC) I could probably ramble on all day about this..I hope some of this helps you! Any specific ? email us or me offline! Take care and good luck it is an awesome journey!! *not perfect and a positive attitude helps! DO this for you and only you!!!!Start journaling now www.obesityhelp.com is a great site, start your own profile there! Also if you haven't seen this document (pouch rules) print and read! A good basic guide to things that will help you use the tool and be successful as possible (*for most of us!!!) http://www.digitalhorsewoman.com/pouchrules.htm ~~~~~~~~~~~~~~~~~~~~~~~ The single BEST piece of advice I can offer being 4 yrs out is this to anyone: ***Disclaimer some may consider this a no-brainer, others a downer, some a new view, psychobabble, whatever thought it is just my opinion, so take it for what it is worth, and it is meant to be helpful/insightful and thought provoking at a time so many of us are caught up with the right vitamin to take, amount of water to drink, etc.. it is meant to challenge beyond those tasks to see the small stuff matters but that there is a larger and more global view as well to consider!!!*** Establish your mindset to accept that weight loss surgery is not a cure/quick fix for morbid obesity, it's a very effective/powerful/wonderful tool that can be used lifelong to combat the chronic/lifelong disease of morbid obesity that has NO *current* CURE (*So at 1 yr out when many say 100# gone forever I sometimes shudder, it is never gone forever it is gone for now but the work has just started at 1 yr out IMHO). The tool is flawed and can be defeated as well (emotional eating, grazing, drinking calories, eating/drinking together, alcohol use, high calorie dense foods, too many simple carbs, overfilling pouch, carbonation, no consistent exercise routine). Considered WLS as part of a life-long process & commitment to challenge your personal awareness/responsibility/consistency/accountability and that a life-long requirement to follow up with physicians, a regular exercise program, and healthy eating. Accept it will come w/ potential challenges & imperfections (risks, side-effects, complications, challenges such as plateaus, not meeting goal, regain, possible depression, grief over the loss/safety of food/obesity may of offered/invisibility it offered although may of been unwanted at the time/the new attention you get, possible anger or anxiety w/o comfort of food as it used to be/limits it may impose, effort it requires to be healthy etc.) that these frustrations are part of the process to make you healthier see them as challenges not difficulties, positive self talk helps!. Your mindset will be the most important tool for success, as all the challenges of traditional diets/exercise plans for health will be present after WLS as well *Yup so many say I will never diet again, well let me say diets don't work *because people go off them* correct but you will have to be mindful of food and pay attention to intake and exercise for life, so in a sense your dieting for life! Even after WLS.... The surgery won't make a person change, but the beauty is YOU HAVE COMPLETE control over those changes/choices needed after surgery for success, the choices are there and the best use of the mind/psychology will harness those. Surgery is such a drastic choice that so many are successful due to a recommitment to healthy living and choices that is one reason it works and we say it is a 'rebirth'. Changing habits pre -wls is the mindset that will keep you going, the surgery is a piece, the easiest/smallest IMHO. *It is however the milestone/landmark we set to focuses on. But truly the afterlife is the most challenging, the ever evolving challenges from things like getting in enough liquids to food introduction to vitamin taking, new ways of eating/drinking, introduction of exercise consistently to battling with the scale obsessions & disappointments as well as all the wonderful WOW moments. Have the support system needed to create the healthiest environment as well, willpower fades, the tools robust effects fades as well as the honeymoon closes...Harness your enthusiasm and mind for 6 months doing all you can to influence (not only wt loss) but the healthy lifestyle you want to adopt for maintenance, that elusive animal no one has mastered pre-wls. Exercise can become more routine after 6 months as well. Again the mind is just as/more useful than the pouch...it is the operator of the tool! Stress inevitable, so see each issue/stressful time as an opportunity to use your new tool/mindset! (Like I say use things as excuses or opportunities because holidays come and go each year as do parties, office food/celebrations, hurt feelings, sadness, losses, etc) I know this isn't one message it is a million crammed into one right! Anyone who knows me knows I am never brief, this is my PASSION (giving back), WLS saved me from myself. It isn't easy or fair, but accepting life is imperfect just as the world we live in, embracing that imperfection and controlling what I can has helped me get thru many issues. There is no perfection, I work on that daily. So what to do about all of this babble? Get a good journal, start writing today all the reasons you are COMMITTED to this change, what your expectations are (hopefully realistic for wt loss 50-80% of excess not an ideal body wt) and that the goals are not wt related alone, the functional ones how you can integrate into life easier, (clothes fitting, less medical co morbidities or risk of, less meds, less pain (physical/emotional) the benchmarks you are setting, take measurements and photos each month along w/ weights to document the journey. the mind is powerful but may be challenging to change so the photos/measurements help when the HUNKAMETAL doesn't register a loss. We are much more than a number on a scale, free from the numbers and see how much you are more than that as a person, your abilities etc....The journey is full of hills and valleys, some bumps and many more pleasures to see, it can be an awesome ADVENTURE! The letter you may write/journal entry today may save you from backsliding at your first plateau or at 1 yr out, a recommitment to those thoughts, and how you have grown over time. These are the things I recommend. I think everyone else has you covered w/ the 'physical items you need'. These are the ever-elusive psychological things you need LOL! OK if you have read this far thanks for hearing me out! I wish you well. ~~~~~~~~~~~~~~~~~~~~~~~ WT LOSS BEFORE SURGERY/MOTIVATION/AVOIDING THE LAST SUPPER SYNDROME In our program we are required to loose 10% of our body wt before surgery.... Loosing weight pre-op is required by many surgeons & for many reasons... and I am so happy I did! 1.. to show motivation, 2.. ability to adhere to a plan (as we will need to for life!), if you can't be mindful and able to follow restrictions pre-op how will you do it post-op? 3.. to increase your health even a modest 5-10% wt. loss is very helpful, the National Institute of health has even researched this...(hence why weigh****chers is so focused on the 10% wt loss) 4.. decreases surgical complications (by exercise and decrease wt your heart and lungs are in better shape for surgery, anesthesia and healing!)... 5.. Also psychologically it is tough going from a super-sized big Mac meal to clear liquids for 2 weeks post-op! 6.. ***MAIN ONE FOR PROTEIN SPARING or MEDIFAST DIETING***It helps shrink the liver and this eases their surgical procedure and decreases chance of nicking it.... 7.. exercising before helps you continue after! 8..The more you lose pre-op the less you will have to lose post-op and the closer to an ideal body-wt you will attain! I lost the weight by doing the food pyramid. That's it, I was eating so bad (fast food daily, large portions, consuming every high-fat/sugar thing imaginable and NOT exercising that just cutting down and walking 2 miles a day helped! For ME, it was "no one" was going to stop me from having this operation, it was my decision and all that was asked of me was to loose 30 lbs, I figured this is a small price for such a wonderful gift I would be given and the opportunity to have a healthier happier longer life....! I was so motivated/psyched; I dropped 30 pounds in 30 days and went on to drop 15 more before surgery! (Although this took me 2 months, as it got harder and I had a few last meals, we all do but you can't let this ruin your opportunity!) Exercise was another key; I faithfully walked 2 miles everyday..it helped that my mom went with me a lot! (a buddy is so helpful!) I followed the food pyramid given to me by clinical nutritionist Dr. Boham...I also wrote everything down (Many find www.fitday.com helpful for this) that went in my MOUTH!!! Or you can get food pyramid/bullseye version at: http://www.xenical.com/hcp/1400_Am_Beye.pdf I also had to remind myself how BAD I wanted this! Everyday it was/had to be more important to me to change my bad habits and lose weight to have this surgery than to continue to slowly kill myself with food/keep myself from the only hope I had!. I also told everyone about my plans and they helped support me, my friends/family and coworkers! I really can't give you any more guidance than this, it really had to come from within, it was a mindset with me, and I wanted this BAD real bad and I knew it was my last resort/chance! I felt invigorated and motivated by the end results...the long-term had to outweigh the short-term gratification of eating bad choices or overeating! It was a learning opportunity for me to change my habits and practice chewing well, not drinking with meals and eating smaller portions, giving up sugar/caffeine/carbonation/alcohol (if any of those are your issues, carbonation/caffeine/alcohol weren't issues for me)! So a few weeks/months of healthy habits to lose pre-op wt is not a lot if you frame it right! IT IS NOT FOREVER and it is about starting this journey! ~~~~~~~~~~~~~~~~~~~ I tolde veryone, why for me I was so educated I knew for me I was doing the right thing(at 29 YO I had HTN ^CHOl and wason meds and Diabbestes was a second away for sure!), telling is a personal choice for me the naysayers were just ignorant, scared or jealous that I was brave enought to make the decision. They can keep their naysaying ways, I am living in my body and I am in control of my decisions is where I was coming from, it freed my anxiety as I gained confiednecne knowing every ? asked I could answer so knowing I had inner peace w/ this was awesome too, but some stay alone w/ it and that is okay too we r individuals do what works! Ok longwinded Jamie will stop now! Take Care, Jamie Ellis RN MS NPP 100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY 320(preop)/163 (lowest)/174 (current) 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com http://www.obesityhelp.com/member/jamiecatlady5/ "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"