Looking for all the information I can get...

So I recently got a new job with health insurance that covers bariatric surgery. I've been considering this for a long time now and finally in a position where I can get things started.

Even though I've been considering this for awhile, today was a turning point....the final straw so to speak. I had my follow up with my neurologist today who treats me for my MS. Well my blood pressure was super high. He was concerned because there seems to be a pattern now with my blood pressure being high for at least the past year or so. He also brought up my weight and how it has seemed to increase over the past few visits. I was up 6 pounds from the last appointment six months ago. :(

I told him my plan was to try to get weight loss surgery and he ageeed that would probably be a good choice for me. He also printed out records over the past couple years of my blood pressure and weight for me. And without even asking him he highly recommended a bariatric surgeon which just so happened to be the surgeon I researched and wanted to stick with. I actually had a consultation with this surgeon about a year ago to discuss my options. Things never went any further of course because my insurance at the time did not cover any kind of weight loss surgery. He did however recommend the gastric bipass for me instead of the sleeve which I was originally considering.

He told me though that since I've suffered with heart burn and acid reflux that the sleeve would not be a good option as it could make it worse. He also stated I most likely would not lose the amount of weight that I needed/want to lose.

Anyway, to make a long story a bit shorter.....I plan on scheduling another appointment with him to get things started and find out what all I need to do to get all this rolling. I plan on discussing all of my questions, concerns, fears etc. with him. However, in the meantime I'd love to hear all of your experiences/advice/words of wisdom etc.

I?ve been doing a lot of research online about the surgery and have watched a lot of Youtube videos of people's journeys with this surgery. I've seen mixed reviews. Lots of people say it?s the best thing they could have ever done for themselves while others advise against it. I have a co-worker who is completely against it as she states her cousin had the surgery and had major complications. I also have a good friend who had weight loss surgery (even though she had the sleeve) and highly recommends it! She's so excited about me getting this surgery and tells me every day not to be scared and how worth it it is. I know it?s all individual as everyone is different. At this point, I've pretty much made up my mind that I'm going to do this no matter what.

I just have some concerns and tons of questions that I don't even know where to begin. My friend who had the sleeve told me that the reason she chose the sleeve was because she couldn't stand the thought of having to give up sweets. Is that something that has to be given up completely? I mean it makes sense as I know it's a life style change and that eating these types of foods is what has gotten me in this place to begin with. How about hair loss? Do you really lose a significant amount of hair after this surgery? How about excess skin? I guess have to deal with a lot of that too. I know this is mostly cosmetic stuff and certainly doesn't persuade me against the surgery. I've heard it's difficult to get your water intake in. Also difficult getting enough protein in. That worries me. How many vitamins do you have to take?I also worry about cravings. Is it difficult not giving into your cravings? Or do you not have them as much? On one hand I want this so bad, but worry about failing because I'm so addicted to food.

I have so many other questions, but that's enough for now. Please share your experiences.....the good, the bad and the ugly? I want to hear it all. What would you tell me to calm my fears and also to prepare me?

Thanks in advance!

Ok I give up. I don't know why all my apostrophes turn into question marks. Sorry about that.

First, the best book for answering lots of basic questions which I read early in my journey was Weight Loss Surgery for Dummies.

Having WLS (sleeve or RNY) helps change metabolism for a while allowing more rapid weight loss (also due to restriction in the amount that can be eaten and malabsorption for RNY). After a period (1-2 years), metabolism tends to reset and we have to be much more careful with what we eat. The hope is that during that weight loss period after surgery we will develop good eating habits and support mechanisms to help in the long run. It is not a magic pill, but truly a tool to help in losing weight and keeping it off. Additional tools include therapy, group and/or online support, good eating habits, vitamin supplementation, food-tracking, weighing regularly, etc.

The rate of surgical complications these days is quite low compared to the past. There is the potential for some later complications, but most can be avoided or managed as long as you are aware of the potential and keep on top of them.

Sweets would not be recommended in the short or long term for anyone as they have a lot of empty calories and cause carb cravings. Some people do "dump" on them (more with RNY than VSG), but not all do so don't count on the surgery making you not want them. I have VSG and do not dump.

Getting water is the number one priority immediately post-op, but then we transition through foods gradually increasing protein from food vs. protein drinks. Keeping track of protein consumption is one reason for food tracking in addition to calories and keeping track of other nutrients.

Some people have hair loss after surgery, but others don't (I didn't). It generally comes back within a few months.

Excess skin is likely for most of us since we were significantly overweight, but some have more issues than others with it. It depends on where the fat was, genetics and age as to how bad it is. Generally it can be hidden under clothing if PS is not an option, and people still look better than when they were MO.

Reading the OH RNY and VSG menu threads (and other postings) daily will give you a sense for what people eat and how they are doing post-op. I feel that OH participation is critical for my ongoing success. I am 2 Years, 5 months post-op (maintaining below goal for 21 months) from VSG. It was the best thing I ever did for my health.

Best of luck to you. Suggestion: if you are considering either VSG or RNY, you may want to post your questions on the General Discussion forum.

Liz, I agree...that book was SO useful!

I can tell you that RNY was the BEST DECISION I EVER MADE IN MY LIFE.

10000% true.

Does weight loss surgery solve every single problem? Not in the least. But does it allow you to drop a massive amount of weight IF YOU PUT THE WORK IN so you can reclaim your health and be active and live longer? Totally! (capital letters not meant to be rude, but to provide emphasis).

At almost 5 years out I have had all of the emotions...the nervousness before surgery, the struggle to sip sip sip and reach protein goals immediately after...the compliments and awkwardness in the months immediately after...the excessive skin at a year after...and now, life is just life. I can easily eat enough protein to have more than 60 g a day and I still have great restriction when I stick to dense protein BUT more carbs have snuck in and I currently sit with 25 lbs to lose. Am I still a thousand times healthier and fitter than when I weighed 350 lbs? Absolutely. Am I a constant work in progress to overcome my mind wanting chips and popcorn? Absolutely.

In case it helps, here are my milestone posts from along the way (I pasted them at the end of this). Everyone's situation and experience is different, but mine personally is that RNY changed my life in a thousand incredible ways. I could go on and on about the positives (the airplane seatbelt has extra room! A normal sized towel wraps around me! I can walk 10 miles in a day and not worry about it!) but the biggest is just EXISTING as a normal-sized person. I no longer have to map out how far a conference is from the hotel. I don't have to stress about not fitting into a booth at a restaurant. I don't have to be fearful that our team-building activity at work will be something I can't do. I don't have to cringe when I spill over a seat on the bus and people give me dirty looks. Being normal sized allows you to just live, and not have to face day after day of morbid obesity. It's very freeing.

I am coming up on five years (in December) and while some people say you're a "vet" (ie veteran) after five years, I am a definite work in progress. Some people lose their hunger, and I am not one of them. I still have the urge to stuff my face and I have to consciously make good decisions and eat food that is good for my body.

Just a little side note - please make sure you check with your insurance company that your workplace doesn't have an exclusion or a limit. Mine was $10,000 and no one told me so I got slapped with a $12,000 bill after surgery. No bueno.

Good luck!!!

My posts:

Four year surgiversary: http://www.obesityhelp.com/forums/rny/6028857/Four-years-gon e-by-and-RNY-is-still-the-best-gift-I-ever/

having RNY was one of the best decisions I've ever made, and I'd go back and have it done every year if I had to! As DCGirl said, life as a normal-sized person is a zillion times better - better than I ever could have imagined!

and yes - your surgeon is right - if you have problems with acid reflux, you should go with RNY. The sleeve can often make that worse, and several folks who originally had the sleeve have had revisions to RNY because of it. You may be lucky and yours may not become worse, but having been a GERD sufferer myself, no way I wanted to take the risk.

most people experience some hair loss (I had very little - I just noticed extra strands in my comb when I combed it out after washing), but in most cases, it's not noticeable to anyone but you. And it does grow back.

Loose skin - yes, probably. For most people, it's easy to hide. I had quite a bit after losing over 200 lbs, but no one knew it was there except for me, my husband, and my doctor. It was easy to tuck into my jeans or hide under a slightly oversized, long top. I did eventually have plastic surgery (which you'll see referred to as "PS" on these boards), but only because I got tired of looking at it.

sweets - you can eat sweets with any surgery (although some - but not all - RNY'ers "dump" if they have too many. Lots of us have never dumped, though). In fact, once you're a few months out, you most likely will be able to eat pretty much anything. But because you can doesn't mean you should. I know if I quit paying close attention to what I was eating I'd start to regain weight pretty fast. I have to watch it like a hawk.

Complications - major ones are rare. These surgeries are much safer now than they were years ago. Some of us have had minor ones, like strictures (I had two of those), but those are easy fixes. Strictures are one of those most common complications, but they occur in only about 5% of RNY patients (in other words, not all that common). Some of us also deal with reactive hypoglycemia (can happen with any weight loss surgery), but that can be controlled through diet (i.e., following the bariatric diet rules). And then there's the risk of GERD with sleevers. I suspect you've read about major complications because people are more likely to write/post about those than they are to post that they've never had any issues, so it makes it seem like major complications are more common than they really are. You'll see very few people on here who have had major complications.

Vitamins - I take two multivitamins, vitamin B-complex, vitamin B-12, vitamin D, vitamin K2, calcium citrate, vitamin C, and iron. It seems overwhelming at first, but after the first few weeks, it becomes automatic. I don't even think about it anymore. I take a small handful before breakfast, then calcium spaced throughout the day, a couple before dinner, and then iron and vitamin C before i go to bed.

protein - you'll most likely be on protein shakes the first few weeks, so getting your protein requirement in probably won't be much of an issue after the first week or two. After awhile, most people can get their required protein in through their food intake and can give up the shakes.

cravings - yep - I suspect most of us deal with them. If it's a real struggle, there's therapy - several of us have worked with therapists to deal with that.

Weight loss surgery doesn't do the work for you, but it makes losing and maintaining weight possible. I worked hard to get where I'm at - and I still work hard to keep my weight where it's at - but I NEVER could have done this without the surgery.

I like to make lists, so I'm going to address all of your points in bullet list style:

• Staying away from VSG with a history of acid is a very smart move. We're seeing a lot of people need to revise to RNY because of reflux issues!
  
  
• You can lose just as much weight with the sleeve as the RNY. It's a tool, and your ability to lose weight is 100% dependent on how much work you put in.
  
  
• Complications happen with WLS, just as they do with knee surgery. In reality, they're pretty rare, and a few odd scare stories shouldn't sway your mind.
  
  
• Many of the people who advise against surgery have been unsuccessful with it-- and most of the time, it's their own darned fault. Surgery is not magic, and it takes a lot of hard work. You still need to track your food, eat healthy (high protein, low carb), and work on the mental/emotional issues that got you to this weight.
  
  
• Dumping, which is the reaction when RNYers eat sugar, does not happen to everyone. It may still be physically possible to eat sweets. But it's not a good habit to get into.
  
  
• Hair loss does happen. Google "telogen effluvium" for more information. Many people do see bald spots, starting at the 4- to 6-month point, but it stops by the end of the first year. There are lots of ways to disguise it, and honestly (in my opinion) it's absolutely worth the trade-off.
  
  
• Excess skin does happen as well, and everybody ends up looking differently. There's no way to prevent it, but some people have luck and good genes on their side and end up with less of the melted-candle look. Many of us wear good shapewear on a regular basis, and quite a few folks have plastic surgery done.
  
  
• It may be a little bit hard to get your water in for the first few days after surgery when you're swollen up, but you'll soon be able to drink pretty normally. Just keep a water bottle with you at all times and sip like it's your job!
  
  
• Vitamins are easy once you get in the habit. I fill a seven-day pill container with all my meds and vitamins, take them in the morning and at bedtime, and I've never had a problem.
  
  
• Cravings can absolutely be a problem, and learning how to handle them is super important. A very large majority of us were/are food addicts! Many people here work with a therapist or counselor to address their emotional relationship with food. It does take a lot of work, but you can learn how to handle it.

In terms of general advice? WLS has been the best thing I've ever done, and I say that having experienced quite a bit of regain. My health is so much better (no more high blood pressure pills or CPAP), I have energy, and I feel GOOD. I can do things I never dreamed of when I was SMO, like ride my bike halfway across Iowa or join the roller derby league. Thanks to my WLS, I had an easy pregnancy, a healthy baby, and now I have the energy I need to chase my toddler around. LIFE IS GOOD.

You can do this!!

Sorry for just now getting back to this! Things have just been so crazy busy these past few weeks. But I wanted to thank all of you for all the wonderful advice and tips!!! It is all much appreciated!

I am definitely going with the RNY as I don?t want anything to cause my acid reflux to get worse! At one point it was so bad that I would wake up in the middle of the night choking on my stomach acid and my throat on fire! I don?t want to go through that again!

Now that everything has gotten so real and I am finally in a place where I can actually have the surgery due to my new insurance covering it....I for a moment got a little scared and started having second thoughts. After today though I know that this is the right choice for me.

I went out for lunch with family today to celebrate my mom and my brothers girlfriends birthdays. Parking around the restaurant was all taken so we had to park in the parking garage nearby and walk to the restaurant. (My worst fear). It really wasn?t far at all, but it only takes a few steps for me to get winded. It was so embarrassing because there I was huffing and puffing like I had just ran a marathon or something. I even tried holding my breath to try and conceal all the huffing and puffing which only made it worse. And I was drenched in sweat....looking like I had just gotten out of the shower. My back hurt so bad and my legs felt like wet noodles ready to give out on me at any moment. I was humiliated and knew at that moment that I don?t just want to have this surgery, I NEED to have this surgery.

Not only that, but I realized there is so much I still want to do and accomplish in my life that this extra weight just won?t allow me to do. My brother and his girlfriend are planning a trip abroad....something I?ve always wanted to do is travel. My brother mentioned to me that I needed to get my passport so I could go with them. Other family and friends have asked me to go traveling with them....but I know there is no way in hell I can go in my condition. I can barely walk a few steps without feeling like my body is going to give out. I want to feel healthy again. I want to be able to walk to where I need to go without feeling like I am dying. I want to travel, land the job of my dreams, date, get married, start a family. And then there of course are the little things.....I want to ride a horse, fit on a rollercoaster again etc. I want to LIVE!

So without a doubt I need this surgery to help me lose weight. I have contacted my surgeons office and just received the packet I am required to fill out and I then will be contacted to schedule a consultation with the surgeon.

Thank you all again! I am excited to start this journey to a healthier lifestyle.

" just have some concerns and tons of questions that I don't even know where to begin. My friend who had the sleeve told me that the reason she chose the sleeve was because she couldn't stand the thought of having to give up sweets. Is that something that has to be given up completely? I mean it makes sense as I know it's a life style change and that eating these types of foods is what has gotten me in this place to begin with. How about hair loss? Do you really lose a significant amount of hair after this surgery? How about excess skin? I guess have to deal with a lot of that too. I know this is mostly cosmetic stuff and certainly doesn't persuade me against the surgery. I've heard it's difficult to get your water intake in. Also difficult getting enough protein in. That worries me. How many vitamins do you have to take?I also worry about cravings. Is it difficult not giving into your cravings? Or do you not have them as much? On one hand I want this so bad, but worry about failing because I'm so addicted to food."

Wow, you do have a lot of questions and good ones. I am a gastric bypass patient. I have lost 173 lbs in total and 123 lbs since my surgery almost a year ago. I have had moments of regret but as a whole, I'm so, so proud that I did this! My regret is always centered around my emotional eating and it does get a bit frustrating when I can't turn to food to ease those feelings. Now, if I'm completely honest and what I've realized is that the "binging" never actually helped and just left me feeling more miserable than I already was. So now, I just deal with stress differently and feel better in the process. As far as sweets go, there are alternatives. Stevia is my friend :) I eat pretty normally, just not as much. I do "dump" which is basically an over-reaction of the pancreas to sugar or fatty foods and is characterized by some or all of these symptoms, accelerated heartbeat, sweating, nausea and/or throwing up and diarrhea so I avoid sugar as much as possible. If I eat a protein bar as a snack I make sure that I get ones that are fairly low in sugar, no more than 6 or 7 grams of sugar.

Protein shakes and protein smoothies are great ways to not only get your sweet tooth satisfied but to get enough protein. Premier protein shakes are 30 grams of protein and I have one of those in the form of iced coffee each day. I often have a smoothie for breakfast and they have around 25 to 30 grams of protein per smoothie. Water can be a challenge but the farther out from surgery I get, the easier it gets. I think bypasses do better with "gulping" water than sleevers do but I have no proof of that.

I can't speak to hair loss, I was one of the fortunate ones who didn't experience that. I have used collagen (more protein!!!) almost since surgery (wish I'd know the 2 weeks I was on liquids after surgery about collagen) and I think between that, taking biotin and being sure I got sufficient protein has contributed to that success. Loose skin is a reality but there is plastics once your weight stabilizes and even with the loose skin, you feel so much better physically.

I am a binge eater and I have coped. Are there times when I want to do that? Yes. I find if I get my mind on something else, I get past the urge and besides, I can't. My little pouch won't allow it. You have no choice. You can learn to cook food that is scrumptious and appealing and that helps. I enjoy how I eat, to be honest and I don't regret my decision to have the surgery. It is a lifelong commitment but it is a lot more doable than before surgery! I promise!