Friday, November 30, 2012

Bariatric Betty - broken records

The last week has been a good one.  Thanksgiving went according to plan - I kept things simple and relaxed at our house and everyone had a good time.  We even got some good family pictures!  I really enjoy having my picture taken now, which still strikes me as funny after years of dreading it.  We got to see a lot of family, including one Aunt who is considering weight loss surgery.

My uncle asked me if I would feel comfortable talking about my experience with her.  LOL. Yeah, we don't talk much anymore, so he didn't know the answer to that question.  My main concern was if he or family members were pressuring her to consider surgery since mine has gone so well.  I am HAPPY to talk about my surgery with anyone, and encourage people who are interested, but so many people don't realize that the surgery doesn't solve the problem.  They think "If my loved one just does this, then in a year she'll have lost all this weight and we can go on with our lives with her healthy."  If only it was that easy.

First, you have to understand why you're obese to begin with.  Why do you eat what you eat?  Are you a volume over-eater? Are you a sweets junkie?  Are you a sugared soda or coffee addict?  Are you a carbaholic?  Do you drink alcohol often?  Are you an emotional eater?  When you've been on diets do you "cheat" often?  How active are you, and how active are you willing to be?  Are you trying to hide under your layers of fat - trying to make yourself disappear?  Are you trying to push people away with your size?  These issues have to be identified and addressed before surgery- yes, you can change how much and what you're going to eat, but if the reasons you got this way don't change then any loss will be temporary. 

Then there are the risks of the surgery.  People die.  Other people have serious complications.  Some of us have none (like me) but you can't expect that outcome.  Does your insurance even cover weight loss surgery?  If it does, can you afford your portion of the cost?  Are you prepared to be on a pre-approval medically supervised diet for 3, 6, or even 9 months before you even find out if your insurance will approve your surgery?  Do you have medical records documenting your obesity for several years?  Do you log/ journal your food - every bite?  These are things you will have to do.  There will be ongoing costs after surgery - you will be on supplements for the rest of your life - over the counter supplements that will not be covered by insurance.  Then there are the extra labs and doctor's visit you will need to pay for as well (again, for the rest of your life).

Are you ready for the scrutiny that accompanies the knowledge that you are a WLS patient?  The feeling that people are watching what you're eating (either out of curiosity or concern) all the time.  Sometimes they watch with judgement.  Are you prepared for "bad pouch days" when food gets stuck in the new stomach's stoma and makes you sick?  Can you give up drinking while eating (and for an hour afterword) for the rest of your life?  Can you limit yourself to eaing mostly protein for the rest of your life?  No, you will never eat like "normal" people do.  Yes, sometimes you will be able to fake it, but you will spend a large chunk of time figuring out how you will satisfy your nutritional needs and restrictions every day FOREVER.  Going out to eat requires pre-planning/ homework.  It won't feel fun and like a treat.  Going on vacation bring s similar planning and stress.  Eating at a friend's house can be uncomfortable because of your situation - imagine being allergic to gluten and dairy.  That's an example of how some people have to change their diet post-op - some can't handle wheat products at all but those who can eat it can't have much, and some become lactose intolerant.  There will be no more alcohol.  Your doctor may give you permission to drink a small glass of wine or beer after a year post-op, but most will say "No."  We are at high risk for alcohol related problems because of how our modified bodies metabolize the alcohol.

Family support can mean everything in the chances for your success.  If your spouse is supportive and encouraging it can go a long way.  But does your spouse have a history of sabotaging previous efforts to get healthy?  Encouraging you to cheat "just one little bite" or insisting on having snacks around for him or her that are too tempting for you?  Your new lifestyle will change your family's lifestyle as well, and while it will likely make them healthier they won't always like it.  Many people with rocky relationships see those relationships deteriorate after surgery.   The non WLS patient partner can feel jealous of the attention you get (especially from the opposite sex) and the time you are spending focusing on yourself that you used to spend on them.  If you have problems in your relationship your weight loss will not fix them.  I'm a firm believer that all WLS patients should seek counseling before surgery.  Sometimes couples therapy is also helpful. 

Are you prepared for the ongoing struggle both mentally and physically that will not go away?  This surgery fixes your stomach to a small size, but it does not fix your brain.  90% of our struggle is in our brain.  Sometimes I feel like a broken record talking about it, but it's true.  

Having gatric bypass surgery is one of the best things in my life, but it is not to be done lightly. 

Speaking of broken records, I had a couple this week.  I reached a new "low" on the scale, which is always fun.  My weight is fluctuating up and down +/- 2 pounds these days, but I'm losing about 1 pound a month on average.  My other broken record was a jog I did. 3.3 miles!!!  It felt great, especially because it was on new fallen snow and I felt like celebrating that I didn't fall once!  The adreneline from the fear of falling probably hyped my endorphins up a bit.  My 5k is in 8 days, and I can't wait.  I hope my 12 year old can keep up with me :)

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