PCP appt notes - back on the WLS train

Patty T.
on 10/21/08 5:42 am - Boalsburg, PA
While my new PCP congratulated me on weighing less than on my last visit, he's sceptical about my long term success on Medifast. Me too. It has worked, but I don't know how long I can keep it going. Lately I have been cheating. I have not updated my ticker, but according to his scale, I have gained back 20 lbs from my lowest weight of 362.  ARGH.

We talked about how not being able to quit smoking is a barrier to having surgery. I asked honestly which was the most critical change to make, and my #1 priority should be the smoking. Then he wants me to go RNY.

I agree that I need a better tool. I don't know if the RNY is right for me. Hubby is gonna freak. Any input is welcome. Help!


Guate Wife
on 10/21/08 6:42 am - Grand Rapids, MI

Medifast is NO way to live your life.  It is a temporary fix, and once your body fights back for its survival, you will weight more than when you started.  I have nothing good to say about these 'diets', and research backs me up.

Patty, I agree that stopping the smoking is critical to your full recovery from any surgical procedure.  You need all the lung power you can get!  My surgeon refuses to operate on a smoker, and even pulled a surgery date from someone I was doing pre-op classes with -- on the morning of her surgery!  Some test came back that she had been smoking.  He won't risk the potential of death on his OR table, nor will he watch a patient get healthy in one area only to continue to undermine their health in another area.

If you are not interested in RnY (it simply was NOT an option for me), have you considered the DS?  Have you hung out on the DS forum at all to get a better understanding of our way of life?


       ~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight  =  370#  /  59.7 bmi  @  5'6"

Current Weight  =  168#  /  26.4 bmi  :  fluctuates 5# either way  @  5'7"  /  more than 90% EWL
Normal BMI (24.9)  =  159#:  would have to compromise my muscle mass to get here without plastics, so this is not a goal.


I   my DS.    Don't go into WLS without knowing ALL of your options:  DSFacts.com

Patty T.
on 10/21/08 7:35 am, edited 10/21/08 7:36 am - Boalsburg, PA
I have considered the DS, RNY and the VSG. At one point I really thought the DS was the one for me, but it is not covered by my insurance, nor is the VSG. I don't know if I have the energy to fight my insurance, or even which is the right choice for me. My Medifast period let me not make a decision. I'm back to researching.

I already have malabsorbtion issues with Vitamin D. I do love to eat - how else did I get so big!


Guate Wife
on 10/21/08 8:35 am - Grand Rapids, MI

If you insurance covers WLS of any kind, a fight will probably get you the DS.  Maybe not the VSG though, because long-term studies don't exist and it isn't backed up by the NIH.  Even though you might have to 'fight', the fight could be pretty painless.  And, the sooner you start, the quicker you will get an answer.  If you are interested in the DS, come over to that board and ask specific questions about insurance, denial, the fight, etc...  MANY people there will be willing to help you.

As far as Vit D goes, yep, that can be an issue for us.  I tell everyone to load up on mega-doses pre-op.  The DS board can help you with that as well!

Good luck with all of you research.  It is sometimes daunting, but lean on others that have already struggled with the same decisions and fought some fights -- so many people will be willing to extend a helping hand.


       ~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight  =  370#  /  59.7 bmi  @  5'6"

Current Weight  =  168#  /  26.4 bmi  :  fluctuates 5# either way  @  5'7"  /  more than 90% EWL
Normal BMI (24.9)  =  159#:  would have to compromise my muscle mass to get here without plastics, so this is not a goal.


I   my DS.    Don't go into WLS without knowing ALL of your options:  DSFacts.com

Guate Wife
on 10/21/08 9:02 am - Grand Rapids, MI

Patty, here is a current thread going on at the DS forum about fighting the insurance company -- almost everyone wins!  Thought you might like to follow the thread to understand what you might be in for and see how helpful others will be in your struggle:
www.obesityhelp.com/forums/ds/a,messageboard/action,replies/ board_id,5357/cat_id,4957/topic_id,3761756/

       ~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight  =  370#  /  59.7 bmi  @  5'6"

Current Weight  =  168#  /  26.4 bmi  :  fluctuates 5# either way  @  5'7"  /  more than 90% EWL
Normal BMI (24.9)  =  159#:  would have to compromise my muscle mass to get here without plastics, so this is not a goal.


I   my DS.    Don't go into WLS without knowing ALL of your options:  DSFacts.com

Moj_ Patti
on 10/21/08 7:39 am - Where the Jackalopes Roam, CA
I think you should get some kind of award for doing Medifast as long as you have.   

It's hard to stay motivated when you have a long way to go. I was 400 pounds in 2000. I lost 140 at Weigh****chers in about 2 years. Then the meetings got to be totally unmotivating for me and I quit. I've gained back most of it.

I'm not a smoker, but I've lived with them. My ma, a 50-year smoker, was able to quit with the patch. I've known other people who used the nicotene gum after smoking for years and years. And I've read here on OH about Chantix being a great help to those that have to quit. You may want to look into some help to quit smoking.

I'm preop and I've used the 6 months I've had to wait to see the surgeon to do a lot of research on the different weight loss procedures.

I initially thought I wanted a lapband. My medical group doctor nixed that and I've read lots of stuff here on OH that supports his viewpoint. It's not great for people with higher BMIs.

He recommends RNY. I'm not entralled with that because I'm not sure I can handle eating more supplements than food during the course of a day for the rest of my life. But lots of people lose a lot of weight successfully with it.

I'm going to talk to the surgeon, who I see in 7 days, about a vertical sleeve gastrectomy. It's a newer procedure where they just make your stomach smaller. No dumping. Not as many supplements. I'm worried that my insurance won't cover it. So RNY is my backup plan.

Everyone is different. Spend some time comparison shopping.

Hang in there!!

Hugs,

Patti
One food makes you larger, and one food makes you small... 
(deactivated member)
on 10/21/08 8:53 am - San Antonio, TX
Curious, by supplements are you referring to vitamins or to protein supplements? There are successful people on this board (Jandell off the top of my head) who do not use protein supplements AT ALL as per the recommendation of their doc. I just thought I'd mention that - many of us subsist on food alone or do protein supplements by choice rather than by requirement.

Vitamins yes, you have to take a lot of vitamins.
Moj_ Patti
on 10/21/08 9:09 am, edited 10/21/08 9:10 am - Where the Jackalopes Roam, CA
Extra vitamins, calcium, iron, biotin, silica? (stuff to keep your hair from falling out), meds to reduce the acid in your stomach, medicine to keep your gall bladder happy, and more that I'm probably missing. I saw one post where a woman said she takes 46 pills a day.

Between the real world support groups I've attended, and some of the posts I've read here on OH, it sounds like RNYers and DSers have to take a lot of pills to stay healthy because of malabsorbtion (sp?). Of course, everyone is different.

I wasn't talking about the protein. It looks like everyone has to get their protein in. And some level of vitamins.

I'm not trying to slam anyone's WLS -- this is just my newbie view of what I've gleaned. Everyone is different. RNY and DS have worked for lots of folks.

But I think VSG is a good fit for me. But if my insurance doesn't cover it (and they have for some people), I'll probably end up with an RNY anyway.

Patti

One food makes you larger, and one food makes you small... 
(deactivated member)
on 10/21/08 11:37 am, edited 10/21/08 11:38 am - San Antonio, TX
Your hair will probably fall out no matter what. I am not saying VSG is a bad choice I just wanted to clear up what you meant by supplements. I took an acid reducer for the first 6 months, but no longer. Unless you are prone to ulcers that would probably be the case with all 3 surgeries. Your vitamins will be most with DS, least with VSG (edit)

Just to give you an idea what my regimen is as an RNY patient: I take 6 Bariatric Advantage multivitamins per day (their capsules dosages), 1000mg calcium citrate (4 caltrate plus), 4 colace stool softeners, 10,000mcg B-12 3x per week (1 sublingual lozenge each time) and 1 iron pill per day. So yeah, its quite a few pills. I separate it into 4 doses - iron when I wake up, B-12, 3 multis, 1 calcium, and 2 colace with breakfast, and then the same with lunch. I take the last two calcium before bed. It works fine for me but you have to be willing to keep up with it and people who don't are definitely endangering their health.

DSers often take even more supplements, and additional supplements may be needed based on blood work. I did not take anything for gall bladder because I don't have mine.

I'm sorry if I bothered you, I didn't think you were slamming anything, I just wanted to clarify what you were talking about.

All the best,
Jennifer
Patty T.
on 10/21/08 12:09 pm - Boalsburg, PA
Thanks for the details on your regimen. Exactly the sort of info I am looking for. I know that any surgery is a comittment to a lifetime of vitamins and supplements. In trying to educate myself, I've read horror stories of folks who did not follow their supplement plan - or even worse, had a doc prescribe Flintstones chewables.


Most Active
×