ok folks so i went to see Dr. Ingram for me 5 wk post-op.. im disapointed

i weighed in and she said that in 5 weeks i lost only 20lbs.. but according to my calculation and my scale i  lost 33 lbs.

chris said that yet again my scale is wrong and their scale is right and i should throw out my scale.. (brand new 30 dollar one scale) and that she is always right! WTF!

i weigh my self everysunday in the am, after i use the bathrrom and shower.. and it said 186 her scale in the office said 189.. i had on jeans and a heavy shirt.. was cold yestrday.

i dont know what to make of it. Dr. I said that losing between 2-5 lbs a wek is good... but why did i have rny, just so to lose weight like the lap banders?

am i expecting too much? is my hopes to high?

she has cleared me for full foods, solid everyday foods. she says she has no food restriction, just dont eat raw bread, can have toast, crackers etc. no rice till next month.. and limit my fried foods, which is no prob since even smelling fried foods makes me hurl. ( thats even before wls)

oi vai, i guess im just gonna keep chuggin away like i have always been, up more protein, drinkmore.. and hope and pray i lose more than 2 -3 lbs a week. i will lower my expectations and just be happy im losing anything at all.

cant make myself crazy about food, vomiting issue or anything anymore.  im at peace now

Nanette:



Please share with us what your expectations of gastric bypass surgery are, and where those expectations (people/places etc) were derived from.
 

Can you clarify the wt loss differences as I am puzzled by what you wrote, first stating a 13# difference in home/MD scale then a 3# difference? (186/189 is 3# but you state 33# vs 20# wt loss for 5 weeks also?) Thanks.
 


Scales do differ, a 5# fluctuation is typical and time of day and clothes can also account for a shift up/down by same 5#. Realizing it can help us choose not react to this when it happens.
 


Realistic expectations is a topic I speak of frequently at support groups in person and online. For me WLS is not just about weight changing -- it's about life changing. It is in developing a healthy lifestyle that enables us to maintain the wt loss of the surgery. Reframing this as NOT A RACE but a journey, a process, an adventure filled with twists and turns it may help ease the worry or fear or frustration....
 
I propose it is MUCH, MUCH more important to focus on the LIFESTYLE you are forming because that is what will allow you to MAINTAIN the loss you achieve for a long time. If this journey is truly about health and developing healthy habits and a lifestyle..the hunkametal is ONE SMALL (and many times inaccurate) gauge of what is up w/ us..let success be how you feel, how you act, what your doing with your life; and take photos monthly, take measurements monthly etc other gauges ok!
 
Wt loss is so individual. This is why one patient loses more weight than another with surgery… For numerous reasons, including differences in calorie intake, energy expenditure, body habitus and body composition, basal metabolic activity, hormone profiles, genetics and much more. Because weight loss is regulated by such a myriad of factors, it would be highly unlikely that any two individuals would lose identical amounts of weight post-surgery, even if they were consuming the same amount of calories and performing similar amounts of physical activity. THERE IS NO NORMAL rate of wt loss, typical is RNY 2-5# week in first few months (Lap banders lose more like 1-2# a week or more/less)..we do not wake up thin as we may of hoped/dreamed, some lose faster others slower…
 
Remember most lose 2/3 of what they will in first 6 months, a successful surgery is not 100% of excess wt loss but 50%! Realistically we all want to be thin most will be thinner some remain obese depending on starting BMI, it is not meant to melt the fat away it is meant to give us a head start…good chance at changing ourselves and lives…..that is all. (We can accept it or not that is what is our choice making our journey a challenge or less so)
 
Therefore, it is important that healthcare professionals & patients alike realize that identical surgical procedures do not result in identical weight loss patterns and that weight reduction is regulated by far more than calories in and calories out. Furthermore, patients should not despair or feel unsuccessful if they have lost less weight than others, particularly if they have been honest in adhering to their postoperative dietary and exercise regimens.
 
Plateaus are also individual, some people get them every other week, others once a month and some never! Go figure...we are each individuals and our bodies are stubborn and are going to do what they want! LOL....As long as you are following your recommendations for food, vits, fluid, and exercise everything will take care of itself! Stay positive and don't get overly focused on the scale and numbers! Wt loss slows each month this is TYPICAL and EXPECTED…. fewer than 10 percent of patients achieve a normal BMI of 18.5 to 24.9 after WLS! Meaning the svelte ideal they’re aiming for may be a pipe dream in the first place. “Surgery is the best thing we have right now, but it isn’t the optimal cure,”
 


Many do not change their lives, use the tool and after the honeymoon regain wt and it is another failed diet attempt. I recommend people think about the first 6 months postop as a time to change their lives, focusing on the changes not the wt loss (which is a outcome of the lifestyle focus).
 
It is in this recognizing that the surgical ‘tool’ can help you to keep your disease (obesity) suppressed and enjoy long-term weight loss maintenance, provided you are willing to make lifestyle changes necessary for long-term weight loss success including:
o       1) REGULAR PHYSICAL ACTIVITY
o       2) GOOD NUTRITION AND APPROPRIATE VITAMIN/MINERAL SUPPLEMENTATION
o       3) ASSISTANCE IN IMPROVING EMOTIONAL STATUS
o       4) CONTINUED INVOLVEMENT IN A BARIATRIC SUPPORT GROUP AND IN YOUR CLINICAL PROGRAM
 
IF YOU DO THESE THAT IS A SUCCESS!
 
THE TRUTH ABOUT REGAIN *THAT NO ONE WANTS TO HEAR!
 
WLS is a tool, if you eat the wrong foods (carbs/sugar we NEVER EVER malabsorb, digestion/absorbtion of these substances happens starting in the MOUTH!), overfill pouch, graze all day, don’t exercise, drink calories, eat and drink together then we can/will regain wt. IT IS still about calories and you can regain wt. WLS is the tool to help us lose wt, PSYCHOLOGY is the tool to help us maintain that loss!






WLS is a tool that should lead us to a LIFESTYLE CHANGE…
 
Ø      How we see & use food. FUEL or SELF SOOTHING
Ø      How we keep our bodies active. EXERCISE or INACTIVITY
Ø      How we use our brain. EATING TO LIVE VS. LIVING TO EAT
 
Surgery was the easy part looking back although going through it I thought it was the hard part living the lifestyle after in a consistent, self responsible manner is the most CHALLENGING thing I have ever chosen to do, I did not realize preop the immense effort it takes each moment to be healthy!
 
Those that have goals that are health focused and functionally focused do the best (vs. those that are scale or weight/number focused). I am such a firm believer in not allowing the scale (or hunkametal that it is) to rule or dictate ones life/thoughts/feelings any longer, I agree we want to lose wt but gaining our health and ability to function in life are far more important than any number the scale can read; otherwise if it never reads the number we think, others say, a chart suggests we fail and that is simply not true!!!
 
 
For me I keep telling myself daily that***THE GOAL SHOULD NEVER BE A NUMBER*** If we focus on losing something we always seem to be trying to find it (i.e. wt regain), instead focus on what we are gaining!!! A LIFE!
 
I like this quote:
“ALTHOUGH I MAY NOT HAVE TOTAL CONTROL OVER WHAT HAPPENS IN MY LIFE, I CAN ALWAYS CONTROL MYSELF AND HOW I RESPOND TO WHAT HAPPENS”
(i.e. complications happen, plateaus, stalls etc but how I manage them if they happen is up to me!).
 
My belief is for too long many of us have used the scale with false beliefs it helps us be accountable when in fact we do that not a piece of metal. The scale can not measure our worth, it can not measure what is going on inside of us (emotionally), it can lead to being consumed by numbers and add to not living, not being present and in the moment. It can keep us in a victim mode, shamed with judgment. If this is you skip the scale a while and find other meaningful goals and measurements. In reality if we just are present and NOTICE we do not need a scale to tell us anything! If I am present I KNOW what I have been doing in my life eating, exercise and such, the scale is so inaccurate and shifts for many reasons we all know this. So choice for me is use it wisely monthly or weekly at most, and find other ways to be consistent accountable and responsible for my internal world, which affects my external being more than any hunkametal. This is my 2cents. For too long I believed I couldn’t be in control w/o the scale, how wrong that false belief was I have carried. This is my truth, although it is my opinion and can differ from others I respect that and just offer it up to consider!
 
Ending Scale Obsession
 
http://www.southbeachdiet.com/public/dailydish/dd_20060515.a sp
 
Do you weigh yourself every day? Or worry about even the slightest change in your weight? If you answered yes to either of these questions, you may be obsessing over the scale too much. This practice can be very discouraging if you're trying to maintain healthy habits.
 
In fact, your weight may change from day to day for many reasons. Shifts in water weight, constipation, and even the food you just ate can cause daily ups and downs that may register on the scale. These shifts can be misleading and worrisome if you don't understand them. For a more accurate measurement of your weight, you should only weigh yourself once each week and on the same scale every time — different scales may provide different readings. Or, instead, let the tightness of your belt be your guide. If your clothes fit better and you feel better, then you're getting healthier — even if the bathroom scale doesn't reflect it. Ultimately, it's up to you to stop scale obsession. Weight loss takes time and you need to be patient. Remember, if you're following a healthy lifestyle plan like The South Beach Diet™, the extra pounds will come off — whether you step on the scale a hundred times a day or never at all.
 
QUOTES that get me thinking:
 
“ In the Middle Ages, they had guillotines, stretch racks, whips and cahins.  Nowadays, we have a much more effective torture device called the bathroom scale.”  ~Stephen Phillips
 
‘Reality check:  you can never, ever, use weight loss to solve problems that are not related to your weight.  At your goal weight or not, you still have to live with yourself and deal with your problems.  You will still have the same husband, the same job, the same kids, and the same life.  Losing weight is not a cure for life.’  ~Phillip C. McGraw, The Ultimate Weight Solution: The 7 Keys to Weight Loss Freedom, 2003
 
“Gluttony is an emotional escape, a sign something is eating us.”  ~Peter De Vries


’’The best day of your life is the one on which you decide your life is your own.  No apologies or excuses.  No one to lean on, rely on, or blame.  The gift is yours - it is an amazing journey - and you alone are responsible for the quality of it.  This is the day your life really begins.’’  ~Bob Moawad


”If hunger is not the problem, then eating is not the solution.”  ~Author Unknown
 

thanks Jamie, i did/do have unrealistic expectations i guess. I will try to focus on a healthier lifestyle than weight loss. I guess being overweight all my life.. i kinda expected/dreamed of becoming my pre-preganancy weight of 130 again.. but thats probably not gonna happen, maybe it will.. i dont know. I have planned on excersisng more.. im not good with being on my own to excersise.. im a rule follower type.. so when i go back to college in sept.. i signed up for weight training, 3 times a week, and pilates once a aweek.

and i asked Dr. Ingrams office to find me a therapist.. caue i feel like i really need to speak to someone. But im scared to... does speaking to a shrink stay on my public records? im aiming to be a forensic nurse and i dont want me going to a shrink hinder me from being hired.

as a nurse.. what do u think?

Nanette:
Hello again, you are not alone in having unrealistic expectations. It is a common issue facing WLSers. Even those who are very educated and informed have challenges of wrapping their brains around this. We may intellectually KNOW we won't wake up thin, we may know that we most likely will not lose all of our excess and are HAPPY preop with ANY wt loss that is 'permanent' but things change over time, we see the wt come off erly on w/o needing to change anything and can get complacent with not doing our part (the huge part) of changing our lives. Then we sabotage oourselves because well if we don't lose it all then 'screw it'. Or many find the intense DAILY effort is quite challneging and do not keep it up and slowly let those bad old habits creeep in (if they had even changed them in the beginning)....

All I can recommend is continually working on developing exercise in your life, making it the same as breathing, brushing your teeth, eating, going to the bathroom...it becomes part of what you do...Not easy at all but it is possible and folks can overcome many issues/excuses that have gotten in their way before....When we feel like not doing it is when we just need to DO IT like the nike commercial...You may not be good on your own but you can be good on your own if you develop that trait over time..then you can say I used to not be good at....but I am working toward or I am doing it anyways....it is up to you what is more important?

As for therapy again we can choose to let thinks hinder our success that is up to us, be it fear, denial etc.
Therapy and personal growth work will not be helpful if we are not truly in it for ourselves. SOme hesitation and fear is fine but we again can find a 101 excuses or issues to keep us from investing in ourselves. Looking deeper into the past I say what is it that is holding me back from taking care of myself? Low self esteem, codependency etc are all issue to work on and getting help with them is a huge and brave step. Deciding to get help is personal and conficential. Although I do not personally like the word shrink, it seems to be a negative connotation of my profession I understand its origins/use.

IMHO if you want to be a nurse/caretaker you will be ill equipped to do so if you have not done some of your own work. This is very true in my field (psychiatry). Helping others is fine, but doing it as many do selfishly and not in taking care of themselves and doing it for their own unmet needs is not the positive that many think it is.

I beleive only in helping ourselves can we find inner peace, happiness and love and ONLY then can we have that to give to others.

The surgeosn office is a good reference for referral sources but know with therapists finding one who fits is very personal and it may take you a few times to get a match. Your insruance company as well as others in support groups can also be a good source of referrals for you. Going from not wanting to somewhat accepting of the need is a great step....when you are ready it will help, but until then you wil mot likely find a reason to not go (fear, cost, time, etc).....

I can not see how therapy would hinder you from being a nurse? Heck I think it would assist you in being a better nruse/caregiver...I wouldn't want a nurse to care for me who had not done her own personal work, same with a therapist. Let go of the shame for me helped. I am a better person, friend, wife, daughter, sister, nurse, nurse practitioner because of the work I have done IMHO! I let go of my shame and found happiness, success and inner peace. I wish that for you. Invest in your wellness and success. Think of how it can help you and those closest to you! Especiallyd uring this challenging time wih depression that can be common and if left untreated your honeymoon can be gone before you had time to use it! That would be sad.....

Gastric bypass is no quick fix

By Heather L. Connors
Times Herald-Record
[email protected]

Weight-loss surgery is not a magic pill.
That's a point doctors try to drive home to those who are looking for a surgical fix to their obesity problem.
"It's crucial they change their lifestyle, their eating habits," says Dr. Edward Yatco, a clinical instructor at Westchester Medical Center in Valhalla and a bariatric surgeon at Obesity Surgery Associates in Hawthorne.
"This is not the easy way out. It's a major surgery that comes with significant risks and possible complications."
Unfortunately, this message can get lost in the glow of success stories and miraculous "after" pictures.
In reality, a surgical procedure like gastric bypass (which retools the digestive system to allow for less calorie absorption) or the newer Lap-Band (which involves using an adjustable band to limit the amount of food the stomach can hold) is just the first step in a process that includes many lifelong adjustments.
And not just concerning food.
Prior to surgery, physicians like Yatco and fellow bariatric surgeon Dr. Dominick Artuso make sure - via seminars, nutritional counseling, one-on-one meetings and psychiatric evaluations - that their patients are prepared to handle all aspects of life post-surgery. Teens, which Artuso has been seeing a little more lately, will go to counseling for six months to ensure they understand what bariatric surgery means in the long term.
Social events, which are often centered around food, might become a bit awkward.
For gastric bypass patients, a lack of vitamin and mineral absorption might result in temporary hair loss.
Taking comfort in food will no longer be an option.
"Emotional eaters have to find other ways to deal with stress," Yatco notes.
And that's where another part of the weight-loss schematic can play a key role.
Support groups - many of which are offered through a bariatric surgeon - are really important, both doctors say. At these meetings, issues are addressed that go way beyond the loss of food as a friend.
"These people can experience stress in their personal relationships" as a result of the weight loss, Yatco says. "The patient's spouse may feel threatened by their newfound confidence. A spouse might also be jealous that the patient is now getting more attention from the opposite sex."
He's even had patients tell him that they've had friendships end because they were no longer the "fat friend," and thinner friends were resentful of having to share the limelight.
"All these other issues that popped up - we didn't predict them when we first started doing this," Yatco says. "Now they're becoming more and more prevalent in patients."
In the end, most patients adjust and are happy to watch the pounds melt off. And many of them are sorry for only one thing, Yatco says.
"Their only regret is that they didn't do it sooner."

http://www.recordonline.com/archive/2005/10/12/cover12.htm


This information while educational, is not meant to replace the advice
of a health care provider.

Also as in all weight loss programs, "results not typical"

--------------------------------------------
More info: http://obesitysurgery-info.com
--------------------------------------------

Realistic Expectations vs unrealistic expectations go hand in hand with Scale obsession and that dreaded "perfectionist" mentality.

It is a vicious circle. If your whole intent was to lose weight, than you will forever be the mental bolemic. You will be the type that constantly sees themselves as 40000000 lbs no matter how good you look.

that was me.....about 3 months ago. I was only worried about losing weight. Let me share with you....my lifestyle...it is better than ever. my endurance....like I was back in high school. My energy levels are going up. My health problems....going down. I have lost maybe 70lbs or so.....maybe more...maybe less. I dont know. I dont care about the stupid digits on a scale....unless they are my toes (lol). I have lost 6 inches off my waist. I am now into a pair of jeans I got 4 years ago with the intention of wearing them.....Today is the first time in lets say.....4 years that I have them on. And.....guess what??? I am CONTENT. If I never lose another pound...it was worth it all. however, I know I will lose more....because these pants are too big on me already! Yes I have problems with my severe edema. Yes, I am still morbidly obese. HOWEVR...It was worth EVERYTHING!

It was worth the painful memories of being molested and then coping with it. YES...it was worth my vein being cut on accident during my bypass. It was worth me almost dying. It was worth me having to be dehydrated and having to go to the hospital 2 weeks after surgery even after the church fire. It was worth not being able to keep food down for the first 3 months. It was worth it all. It IS WORTH it all.

My realistic expectations HINDER and even DENIES my "perfectionist" mentality that kept me obsessed over a scale number or a pant size.

The world wants us to think that we have to fit "a model" mould. I am not interested in what the world calls attractive, accomplished, talented, popular, or what they think what size is for me. I am not interested in what the world thinks. The world has nothing that interests me. I am not here to please the world...I am already found well pleasing to God. I am FEARFULLY and WONDERFULLY MADE! I am so valuable to God...that he purchased my soul with his own blood. He redeemed me from the "slave market" of this old world. The world tries to detract me from what i am....but thank GOD I am what I am. I am on the WINNING side!

oh tim, im so sorry to hear about that.. , im glad u are getting better and ur coping with it well. Ur right i do have issues.. and because of that issue i intentionally gained weight, cause i thought.. who would want to mess with a fat girl.... when my issue happened i was a very pretty, cheerleader, who weighed only 115 lbs.. then i thought wtf no one f'Ks with a fat girl and thats what happened.

i guess i didnt think about all the expectations/ expectations failures and issues that would come up with me losing weight/having RNY

im hoping i can overcome it, and focus on getting healthy.

thnaks both of u for ur support and posts

Have NOT seen you post in over amonth check in!

You aren't that heavy to begin with.  If you are under 200 lbs, weight loss is slower...the people who lose 20lbs a week are the ones over 400 lbs.  My doctor's scale is always different than the one I use.  Its probably all the clothes u wear and shoes too...at home when I weigh myself its in a T-shirt and boxer shorts, at my dr.s office its with pants, shirt, t-shirt,boxers,sox and shoes, keys wallet, cellphone, etc. 

I actually had the surgery on December 6th, 2007 and Dr. P in the same office did my surgery.

I was 338 lbs. before surgery, and as of today, I am 232 lbs.

Everyone is different. I still can't eat bread, crackers, rice or pasta. And ALMOST everything makes me sick.

Just relax and do what you are supposed to do and it will come off.  Dont' expect too much too soon.