Gotta get my BMI down quick

I've been nursing a surgical incision wound since December after emergency surgery for small bowel strangulation. It was an ordeal, I almost died, and left the hospital after 10 days with my incision wide open with 3 super-infections...MRSA, Klebsiella & enter****al.

Eight months later, after a CT scan, I find out that the muscle under the still open wound has split and I have intestine bulging out. My wound hadn't healed because I have a massive pannus from being 456 losing down to 302---and most of my weight was in my belly---and the pannus pulls at the wound, not allowing it to heal properly. I've tried binders, support garments, etc. Doesn't help.

I saw a general surgeon and he wanted me to play the waiting game. So I found an abdominal reconstruction specialist for a second opinion.

She was awesome. Really went to great lengths to evaluate me, took photos, measurements, and is gathering a team to do a combo fleur de lis tummy tuck, which will completely eliminate the wound and a retro-rectus hernia repair. I couldn't be happier with this course of action.

The only requirement she asked of me was to watch the documentary Fat, Sick, and Almost Dead by Joe Cross and follow the principles in the documentary to lose as much weight as fast as possible to lower my BMI further and to be able to remove the maximum amount of flab. She said forget about protein, forget about wound healing diet, just lose weight.

The documentary promotes juicing, mostly green plants. No problem. I eat a mostly plant based diet anyway, with the addition of fish, a little chicken, yogurt, eggs and cheese. If I eat sugar I suffer from reactive hypoglycemia, which is common for distal RNY people after 2 years out. Even just the greens, without the fiber/cellulose, triggers the hypoglycemia. I can't do the juicing. I get very ill.

So I went to plant based soups. Broccoli, greens, okra, tomatoes, beans cauliflower, carrots, onions, garlic No added salt. I've been doing it for 10 days, along with a piece of fish or some Greek yogurt now and then. I haven't lost much weight. I know I'm getting enough calories---I track everything.

I also take prednisone for rheumatoid arthritis, but I don't take it every day. I wonder if it s making me hold onto the weight.

I don't drink sodas, use artificial sweeteners or eat processed foods.

I want to make this work, but I am afraid that my protein will be extremely low for healing by the time I do have surgery or that I won't lose enough weight. I can't seem to get below the 302. My weight has great fluctuations every day---one day I will be 307 and the next I'll be 322 and the next I'll be 317. It HAS to be water weight. I already take a diuretic every day.

I just needed to "talk" to people who understand.

First off, I am so sorry to learn that you have had to endure all of this.  It's great news that you have what sounds like a workable solution with a competent surgeon. 

Re the wild fluctuations in weight, are you sure your scale is in good working order?  Do you weigh at the same time every day in the same outfit (or no outfit, as I now do)?

My understanding is that prednisone can cause bloating/swelling.  My sil was on prednisone and took a diuretic to combat that side effect. 

Have you discussed any of these issues with your bariatric surgeon?  Or was he/she the one who did the emergency surgery?

My bariatric surgeon doesn't take my insurance anymore and I am 7 hours away anyway. I see another bs for followups and blood work. He just pushes the protein--saying I need 140 daily to heal. It ain't working, and I have to go over calories I'm comfortable with to get that much protein.

My scale is fine. I do weigh without clothing and at the same time every day. Other family members use it. No fluctuations.

Soups are probably going to cause you to retain water with the sodium....

if it were me, Id stick to literally dense protein...it's low calorie, no carbs, no sugar, and you get full and get protein. Or if hunger isnt an issue, protein shakes with little sugar/carbs (like Ispoure). I know WL is the top priority, but honestly, you do want to get the protein....it can help with healing but you don't want your body to start eating muscle tissue while you're inactive (Im assuming you can't do much with an open wound). If its like a very short term thing like 2-3 weeks, you'd be fine but if you're talking 1+ month, you'll need protein. 

The quickest way to lose weight is little to no carbs (bc then your body is forced to burn fat for energy). 

Im so sorry to hear youve been through all this but Im glad to see you pop up here! I hope you'll be able to get this under control quickly!

My soups are home made, no added salt. I quit refined foods awhile back. It is cheaper and healthier to cook from scratch.

ACB, you'd be surprised at how active I can be with a big bloody belly hole and a vental hernia. I'm just not allowed to lift over 10 pounds.

I think, instead of trying to crash diet over 6 weeks, I am just going to eat as clean and healthy as possible, tracking my caloric intake. Ihaven't had to count calories the last 10 months because it takes so much more to heal, and even eating more than normal, I lost weight. Slowly, but still lost.

6 weeks---now 5. That is how long she wanted me to juice. I don't have a surgery date yet. I missed Christmas last year in ICU on a ventilator. I want to have Christmas this year, so I want to get it done asap.

Yay that's soon!! Eating clean is great. I did paleo for 2 months and my body loved it. 

If you feel like eating something bad - just look at your stomach and imagine it being gone :)

Im sorry that you are going through all of these problems...i havent had my wls yet but when i had my hysterectomy in january my incision came wide open because of the size of my belly and when i was getting in the vehicle to come home it came open... Im not sure if youve tried it yet but what my husband did is after he would clean and pack it he would put like that really good thick tape on it over top of the gauze it helped hold it together while it healed i didnt do much of anything for a whole 3 months straight...i also used a binder and a girdle at the same time until it healed more...i do understand what your going through with the wound i couldnt even wipe my own booty for awhile because it felt like it would rip open more...i really hope you get better soon and i will keep you in my thoughts...i did look at your pictures and you look amazing!

Thank you for your kind words, Molly. I see a wound care specialist every other week. I was plagued by infections, spent months on a wound vac, nothing has healed this thing. There is no way taping it together would work, but thanks for the suggestion.

You'll be on your way, soon. If I had to do it again, I would. Even with the problems I have now, it is NOTHING compared to being a prisoner in all that fat. I will get down to my goal weight. I might have to jump some hurdles, but I KNOW I can now.

I remember how I would sit and look at before and after pics for hours. Now I am this close from becoming one of those afters

does your hospital or another near you have a wound center , they specialize in wounds that don't heal , im not a doctor but i would think doing major plastic surgery when you have a major infection would be dangerous , my vsg was put off 1 month because of a small skin infection on my neck

prednisone will make it harder to lose weight maybe you doctor can give you something else

I am currently cleared of all infections. I see a wound care center every other Friday, am under the care of an infection specialist, a rheumatologist, a PCP, a abdominal reconstruction specialist and a plastic surgeon. I think I have all my bases covered on docs.

I'm thinking the prednisone is what is keeping me from losing any weight. I have rheumatoid arthritis, but I can't take any of the regular meds with an open wound. I only take the prednisone when I have to, but without Enbrel for almost a year, having to is more and more common. I guess I'll just suffer through the pain. Prednisone isn't good before surgery, anyways.