WLS GRADS >2 years, I need your VALUABLE INPUT

As a post-WLS RNY 20 months ago, as well as an RN greatly interested in how long-term WLS members are doing, I need your INPUT! As you may be aware, most WLS programs really diminish the amount of support available (aside from support groups) once you've reached the 1 year mark. I am researching and looking for programs out there that continue to stay closely connected to members who are greater than a year out (especially 2, 3, 4, 5 years, etc). I need to hear from these members to better understand what your needs are as you move out past the 1st year following surgery. What kind of support do you think would have been helpful to you or would be today? For example, even though I am 20 months out, I still struggle with keeping motivated to work out regularly, yet feel amazing when I do. Additionally, now that I can eat more food (common after about 9 months post surgically), I would have appreciated later staged nutrition counseling as well. Are there things that would make your experience more manageable today? I would love to hear any and all suggestions that you have as I hope to help programs look to these expanded needs.

I think I replied to this post on the Main? board. My surgical teams program asks for a 5 year commitment. Appointments every 6 months after the first year, support groups bi-monthly. I think there is even a specific group for longer term post-ops. The reason I am not sure of the support groups is because I don't go. The few times I did go, they were dominated by two or three individuals. The only thing I left the meetings with was frustration and new ways to cheat, which I didn't need. Really, after a year, perhaps two, I don't think post-op needs are different than anyone elses needs. I might draw that line at a couple/three months after the weight has stabolized. Up until that point, I could see post-ops having unique issues with losing weight quickly, and coming to terms with the new world and their new place in it. Once the weight has stabolized, I believe post-op issues are the same as anyone elses. Really, since for so many SMO/MO people, the weight was a symptom of other issues, it is those other issues that need to be addressed. Those root issues are as varied for WLS Post-Ops as for Non-Ops, and basing treatment on the one common symptom (SMO/MO) seems misguided. Probably the most useful thing would be to transition folks into the more direct issues they may face... Depression, Obsessive Compulsive Disorder, Addictive Personality Disorder, or what have you. Basically, even WLS is addressing, in many cases, the symptom rather than the problem. Once we've learned our new eating habits, and coping with the surgery, I think most of us would be better served addressing the other issues in venues that are focussed on those issues. To put it in more personal terms... Other that having once been SMO, I have little in common with, and few of the same issues as other WLS Patients. If I were going to go into a counseling situation, it would be in dealing with my OCD, dealing with marital issues, and coping mechanisms for the stress of work. A group situation with folks still focussed on food and weight would not be useful at all. Tek

My WLS doc moved to a different practice so I don't know what they do for support groups. It's an hour a way so I probably wouldn't go anyway. My surgeon sees you once a year for life. He is also available for any other problems that may crop up that might be related to WLS. I have blood sugar issues. Insulin resistance at best, diabetic at worst (still not diagnosed). My PCP put me on metaformin. My WLS doc took me off. I should have talked to him first. While my PCP tries really hard, he just doesn't have the experience that my surgeon has. My surgeon had the surgery himself so he really does know what it's like. I tried on 2 separate occassions to get some direction for nutrition. Both failed. One was totally clueless and the other wasn't much better and both supposedly worked with WLS patients. My WLS doc said I was doing fine and just keep eating like I was. OH has been the best support for me. Especially this board. I can come here anytime and ask a question and someone will have experience with it. Much better than a support group with newbies. I agree with Tek. I don't need to hear someone say they can't figure out why they aren't losing wt and then sit there and say they can eat a whole plate of spaghetti. It frustrates me.

In my area we have two kinds of support groups. One is the Bariatric surgery support group, which is exclusively for WLS patients. The second group is sponsored by a diet doctor who encourages anyone to come to the meeting, regardless of how you lost or wish to loose weight. This group aims to motivate patients and keep them on track. This may be the solution you are looking for. Lori

My surgeon's bariatric practice has only been around 2-3/4 years, so it is only this year that we've had folks >2 years. There is a surgeon's support group that meets at the hospital monthly. There is a monthly topic for discussion and sometimes a guest speaker. The attendance by some of the "oldsters" is spotty, unfortuantely. We try to encourage everybody to attend. The older post-ops I think have an obligation to assist the newbies. There is a regional WLS Support group, started several years ago by 2 women who where long-term post-ops who were looking for additional support. That group is open to anybody, and also encourages participation in your surgeon's group. Each monthly meeting has a main topic for discussion, sometimes a guest speaker. This regional group meets once monthly and also has an additional montly dinner meeting at various restaurants in the area. In addition, there is a Yahoo group message board. Sue O.

Hey neighbor! I agree with you ... there are several of "us" more than 2 years out that are screaming for help. I've never reached my goal ... actually, I never really set a goal (could have used some guidance there), so how will I know if I ever get there? Although the people associated with my program are all very nice, I'm a little disappointed in their after-care program as well. I am working with them now (after a 20 pound weight gain in a 10 month period), but, had I not gone back for my 2 year labs last year (which I wasn't going to do ... thats when I found out about my gain) they would never have had my stats on weight gain, depression, labs, etc. I do need to say that this program is trying to work with me now, but had I not gone back for my labs last year, I probably would never have heard from them again, which kind of suprises me because I would think that programs would particularly be interested in long-term studies. I also know several people who feel like they are failures and are embarrassed to go back to their surgeon or program because they've gained. It would be nice to know that no matter what, we'd be welcomed back (or how about a reminder that its time for labs, and here's a list of what should be done, and if you don't have it done here, please have the results forwarded to us? ... I know I get a postcard every year from my vet that my cat's shots are due.) I was also very disappointed in my own program's "support group", but as I started going more, and developing friendships, I realized that this was NOT my program's support group. This is MY support group. I think people in our group are also starting to take on that attitude, and while the program provides the space and the facilitators, it is up to US if this group works or not. Sure, I would have loved to have a class or something every 6 months or even annually to go over things like ... "ok, I'm not at goal at 2 years out, how can I get there?" (I think one of the probs there is that these programs consider you a "success" when you've lost 75% of your excess weight, and it often stops there), or, "how do I maintain once I am at goal?" I have been on a quest to find some good support groups, and I attend a few (and am still looking for more!). I'm basically trying to find what will "work" best for me. During this quest, I've come across several other people who are over 2 years post-op (although a lot of these support groups are geared more for people less than a year out), and between them and this forum, its helped. Talking about working out, getting back to basics, and even just comparing how much each other can (and should) be eating now, and shopping ideas, etc., some good friendships have been formed. SO, I do agree ... a more formal "further out" program would be appreciated by many, hopefully we'll start seeing that a little more (even if we have to create something ourselves). It's good to hear from you, if you're ever interested in hooking up for coffee or just a talk, please get in touch with me! Karyn

I am glad to see so much discussion on this issue. I am 6 years post op and consider myself a success story. I found there was absolutely no support for 1 year + post ops in Ft lauderdale Fla so I formed my own WLS Veterans group. I am a patient who works the program in order to maintain my success. I have found that is the only way to do it. I have a local plastic surgeon, Dr. Bernard Shuster as my group sponsor. He is wonderful. I run the group as I please and he helps with any expenses. I bring in speakers and vendors and set up discussion groups. I think it works. In the beginning the local bariatric physicians hated me. They thought I was a threat to them. Now they are sending their patiens to me. It is a lot of work. I merely created my own support network. Now I help put together local and regional conferences. There is one this weekend Sept 15-Sept 17th in Ft Lauderdale if anyone is interested. Let me know if I can help with your research. Regards, Paula