I am in full agreement with Larra here.
to start off, people who have had the surgery or just know a lot about it should be adamant that it is a high risk -high reward scenario. you are, as EN had said on PB, "medicalized for life". i remember the term medicalized scared the shit out of me when I read her post, and it caused me to make a thread asking if people with DS led normal lives at all, however they defined normal, or if they were able to travel and enjoy life etc. etc. lol.
"medicalized for life"
i read that as "the DS is limiting, and you will trade one set of limits of another." now, a year later, i see that it's not that the DS is "limiting" in that it limits your life, but it adds multiple non-negotiable commitments to your life -- vitamins, protein supplementation, yearly lab work for the rest of your life. it's why as a 20 something "lightweight" with so called "pre" diabetes, i was compelled to reconsider the DS given how daunting a commitment it is for the next, hell, 60 years of my life. it's not easy to accept that my multiple weight loss attempts ending in regain have to do with metabolic issues that the DS will best address. i'd much rather believe i have "full control", and can just low carb, diet and exercise an hour and a half 6 days a week to weight loss yet again. thyroid disease, pcos and insulin resistance-- btw- all of which predates weight gain-- will complicate the process for me for the rest of my life. i just have to accept it, and realize that i need surgical intervention, despite the "you are not sick enough or fat enough" for the DS messages i get, including one from within myself. it's not easy. ag
anyway, with the kind of care and financial commitment the ds requires, i think it's very rational to have these fears. it's good to have these, because it means you are not romanticizing the DS because of the weight loss results you see. i have hesitated precisely because i am aware of the life long non negotiable commitments, including one to learning more and more about nutrition, supplementation, the mechanics of the DS and associated complications etc. it's like a life long continuing ed course. it will keep you on your toes.
finances:
i also agree about income, because unless a person is planning on how they intend to change their financial situation, if it's not very stable, then it could turn out to be a poor idea to substitute one set of co-morbidities with serious malnutrition caused by lacking the funds to eat and supplement as you need to. i love what a member above said about their financial situation changing. that gave me a new perspective on this. perhaps, some people actively need the DS to get out of a financial rut because they are disabled or have other constraints due to weight that is holding them from getting the job they want. size discrimination is very rampant, and unless you are a highly qualified professional, it's likely going to hold you back a lot more. fat lawyers are less likely to be discriminated against than fat grocery store clerks. advanced education doesn't make it a level playing field relative to size discrimination, but it does make things easier.
so people have to weigh their own situation, and see where the DS fits in.
now for the "crazy bit".
that is an oversimplification, which i am sure Diana is aware of. it really depends on the type of "crazy". not all types of mental health issues are likely to led to noncompliance. i think people who are being treated for mental illness (non-psychotic fmp i'd think), successfully, and are compliant to their treatment and meds in other areas, are really not at any significant disadvantage relative to a neurotypical person. in my own case, while i have struggled with depression, ptsd and ocd, i am highly compliant to the treatment protocol that's been set for me. i am compliant to meds in every situation. i am a hypochondriac and a research fiend. i am deathly afraid of illness, so i am likely to go OTT with ensuring i am okay, rather than neglecting myself. i am, personally, hyperaware of how challenging ds life is going to be. i have never been suicidal. i have faced tremendous adversity, and i know how to make the most of less resources. i know how to take care of myself, and i have been shouldering major responsibilities since i was very young. despite mental illness, i feel intellectually and emotionally equipped to get the ds when i get it. when i decided to delay it, i was working through therapy, and i actively chose not to go through with the ds because i wanted to focus on healing emotionally.
when i do get the DS, it will be when, in my own critical assessment, i'd be ready for it. i am getting to that point, now, slowly and surely. i should also add that mental illness is such a complex and complicated subject, so i am only speaking of my own experiences, and i am in no way casting any judgment upon those who have had a more challenging journey re: mental health problems. whether a person is ready for surgery or not is really such an individual thing.
i'd rather have a smart, committed, rational person who isn't neurotypical but dedicated to their physical and mental well being rather than some vacuous irresponsible "normie" who has no idea what they're getting into.
lastly, i will say that the fiat analogy is a false one.
the DS is often the only choice for people suffering from multiple co-morbs. whether they are currently in optimum shape for it, intellectually, emotionally and financially, or working towards it diligently, another surgery may not be as interchangeable i.e. as conducive to critical long term goals such as weight loss maintenance and co-morb resolution as the DS. for some people, it's really their only and best option. revisions may not get insurance coverage etc.
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as a pre-op, who has struggled with some of the issues covered in the op, i would just say the following-
1. rational fear is your friend. you should be worried that you are about to make a decision that is going to seriously impact the rest of your life, and anything less than full commitment to your health and DS requirements is a veritable death sentence. don't replace one with another. mismanaged ds living is as much a death sentence as obesity is.
2. take a good look at your finances. if they are not how you need them to be, come up with a plan to change that. ideally, we should have a desire to change our financial situation and move towards financial stability for general quality of life reasons. the DS only makes it more dire. so, you must be willing to make the necessary changes so that you can accommodate the kind of financial commitment the surgery requires. i, personally, have faced financial setbacks that have caused me to delay the surgery. so, i am not talking out of my ass here or being condescending because i happen to be well off, and have never walked in the shoes of one with major financial constraints.
i know what it's like, and it's why i am working hard to make changes.
career change, in my case:
in fact, the DS is one of the reasons that has changed the course of my career. it's part of what has motivated me to pursue a career in the health sciences. one benefit is that the particular field i am going in to not only interests me but also pays well, and has a market for it that is projected to grow. the field isn't about to get saturated anytime soon. secondly, i have always had to be an advocate for the health of people close to me. i am a hypochondriac, as i said, and i do my best to stay on top of any health issues i have or my loved ones face. so, for me, a degree in the health sciences also provides me with the informational and intellectual tools to be a better advocate for myself post ds. knowledge is power.
do i think a professional degree is a requirement? absolutely not lol. but if i am going for it anyway, i know it will help me not just in a financial sense but also with being more intellectually prepared for the ds and for confronting physicians etc. who have not, historically, taken my concerns seriously, rubbishing them with the assumption that i am just "anxious" or that it's all because i am "fat". i have fought that for the better part of my adult life, but with a degree in the field i have chosen, i am going to be able to fight even more effectively. so, that's a bonus i appreciate.
the career example is just to illustrate that one has to be working towards greater financial stability. perhaps, the ds is the push you need to get there faster. it may be a blessing in disguise, for some. it really depends on your individual circumstances, but it's not impossible to find a silver lining and concretely work with it, if at all you can.
sorry, english isn't my first language, so i can be rather verbose for that reason. but there's my more than 2 cents lol.
