Worst Case Scenario?

Good Morning!

So, I am back on track after my post-approval freak out. Unfortunately, I was only able to lose 2 of the 8 pounds I gained before the Surgery Education Class (yesterday). The dietician said "Careful, watch that; surgeons have zero tolerance for weight gain." Message received and I'm already working on it.

However, when we got into class and she was addressing the group, she issued a very stern scolding for "those of you who've gained weight." I'm pretty sure the harshness of it was directed towards someone else, but regardless, it was applicable to me and I got the message. I screwed up but I am fixing it.

My file is going to be sent to St. Mike's on Thursday and I should get a phone call within a week for my meet the surgeon appointment. Obviously, I am going to keep working to take off the remaining 6 pounds, but what if I can't lose it all before the appointment? I got the impression that it was going to happen pretty quickly. What is the worst case scenario? I prefer to prepare for the worst and be pleasantly surprised than be blindsided with bad news.

UPDATE: Most of the 6 pounds are gone. Now there is just 0.8 to go, and I'm still on track to lose a total of 50 lbs. before I start OptiFast. Typical Jennifer ... freak out and get all upset, then everything is fine.

The dieticians in Windsor can be interesting...they gave the same speech in my surgical education class. I hadn't gained weight so I can't be certain but honestly I think you'll be totally fine. It's six pounds, not 20, and if you lose one or two pounds in the next week or two it'll be a minimal difference. I was at St. Mikes too and I had my surgical ed class on December 18th but with the holidays I didn't get my call until January 2nd. My appointment was then scheduled for January 9th. I think given the holiday period that was pretty quick. I'd guess you'll get a call in the next week and a half, giving you at least two weeks to lose a pound each week, you can do it! The surgeon mentioned nothing about my weight in the appointment and it was less than 10 minutes via video feed. Have all your questions written down, it goes quickly and you might forget lol.

Thank you ... I needed the reminder that it would likely be two weeks before the appointment. Sometimes I miss the obvious. They just made it sound like everything was moving so quickly (Toronto is begging for patients), that it felt like I had two days, not two weeks.

Don't chance it. I've been around here long enough to see people turned down for surgery. They want to know that you are really going to change your lifestyle after surgery. They are spending a lot of money and time on your surgery and they are trying to weed out who will be successful.

Not being mean, I want you to succeed. Join us on the What are you Eating Thread. It's not just for post-ops. Start tracking your food on an app. No more food funerals. There is nothing you can't eat once you get to goal. Ask yourself if you are self-sabotaging because you are afraid. Go lower carb (that will drop water weight quickly). Everything you put in your mouth is a choice. Please make choices that will support your long term goals, not satisfy an immediate craving. You've got this girl.

Do you know any details about the folks who got turned down for surgery? Was it the surgeon and/or anesthesiologist declining after they had been approved by the bariatric centre?

Yikes. I had stopped worrying after my appointment with the surgeon, but maybe I'm wrong not to worry.

Yes I have read where people were turned down during the process, before meeting the surgeon. Also there have been a couple of times here where they went into surgery and the surgeon didn't perform the surgery because their liver was too big. You should be fine. You are already on a presurgery diet. I am saving a comfy spot for you on the loser's bench.

The OP has only 6 lbs to lose, and that is doable in a healthy way. Carbs will help you retain water weight - carbohydrate is bound with water and stored as glycogen in the liver. Gaining a lot of weight during the nutrition counselling phase is a red flag to the Centre that you may not be compliant after surgery. Surgery only works on the stomach, not on the brain. Veterans here will tell you that the surgery is a jump start to getting weight off fast, but you have to do the hard work to keep it off.

Thank you, that makes sense.

The surgeon did warn me that my BMI increases the possibility of ending up with a sleeve instead of a bypass. I was a bit freaked out by that at first, but have calmed down since- no reason why I can't successfully work the sleeve, and if need be I can always modify to bypass down the road.

I had the opportunity to lose some weight during the past year and I didn't, so that's on me. Either way, sleeve or bypass, I'm grateful to be having WLS that is covered under OHIP. I certainly hope that by sticking to my pre-surgery diet, my liver will shrink enough for at least the sleeve...I swear I'm like doing visualization exercises every night (remember the visualization craze several years ago?)...I picture my liver, shrinking, shrinking

I'm with you on the carbs. I know from past experience that a paleo-type diet works best for me. I'm a flat-out sugar & starchy carb addict- I literally use sweet starchy foods like a drug. It really does take a lot of work to change the brain.

My surgeon told me that because of my BMI (63) that I would most likely get the sleeve, the consent form said Vertical Sleeve Gastrostomy with possible bypass. I emphasized that I really wanted RNY so if at all possible that would be my preference. I went to sleep at terms with getting either. My surgeon said he would do whatever was safe and the best option when he "had a look inside." I woke up and the nurse whispered "you got your RNY." My surgeon was awesome and he said I was a very tricky case and he was happy he could give me what I wanted. No regrets. So just go in with an open mind. Both surgeries work. Good luck!

I'm in Kingston, not Windsor, but my surgery is being done at St Mike's too. And I had an approx. 20lb weight gain this past year.

Last time I was weighed at the bariatric clinic was Feb/17, at my internal medicine appointment. I was already cleared by the dietician. Had my Pre-Surgery class a couple of weeks ago. I was scared about my weight gain. I didn't bring it up and of course we weren't weighed at the class.

Met the surgeon last week. Again I was scared I would be weighed for that appointment. I wasn't. The surgeon did not ask me about my weight, or whether I'd lost or gained weight, or anything like that. He just went over my health history and medications, and explained any potential complications from surgery. He did tell me that for patients with BMI approaching 60, there may be more chance of getting a sleeve rather than bypass because of abdominal fat, depending on how the fat is distributed etc.

Currently I'm day 6 into Optifast/special pre-surgery diet (had an allergy to the Opti). I'm currently about 4lbs heavier than the last recorded weight on my chart. I'm certain I'll lose those 4lbs during the next 3 weeks, though hopefully I'll lose more. I'm fully expecting to get weighed as part of my appointment with the anesthesiologist next week. If they question why I'm not losing much weight on the pre-surgery diet, I'll be honest and tell them I gained some weight last year but have been back on track and am sticking to the pre-surgery diet religiously.

Now here's the thing...Kingston really emphasizes how important it is NOT to get hung up on the scale, both before and after surgery. They emphasize habits and behaviour, and the fact that scale fluctuations are normal. So maybe the "culture" or whatever is quite different at different hospitals...but the funny thing is, we're both being sent to the exact same hospital for surgery. I suspect maybe your dietician was trying to motivate you by scaring you. Did she even record the fact you gained a few pounds? The surgeon won't even know.

I honestly believe you're going to be just fine. Whatever you do, don't starve yourself or take other drastic measures in an effort to lose those 6lbs, just keep eating healthy. You're going to lose 'em easy anyway while you're on Optifast.