Considering cancelling my surgery. Really need advice!

[Roudoudou]

Hi, all. For those of you who have read my intro post, you know a bit about my story. I'm currently scheduled for the traditional DS with Dr. Srikanth on February 2nd. Srikanth kind of pushed me into scheduling it ASAP and it's scheduled for earlier than I would have liked. Had my endoscopy yesterday and also attended the pre-surgery seminar yesterday and am just having major doubts.

A few things:

1. I am objectively very healthy in spite of a BMI of 45! BP of 116/70, normal A1C, total cholesterol of 187. I move around fine, and just have some minor foot and knee pain which I'm sure is brought on by my obesity. However, it doesn't keep me from jogging about 4 miles three times per week. I am very concerned that this surgery is going to take me from a healthy person to thin, unhealthy person. The vitamin regimen worries me, as does all of the possibility for nutritional deficiencies. And I'm scared about losing my hair! My hair is already on the thin side (very fine). And, I'm only 39. Not a spring chicken, but maybe 60 years left of my life to live with a massive lifestyle change.

2. I know that deep down the major reason I want to lose weight is because I think it will lead to me finally having a boyfriend. I am convinced that my size has been the blocker for all these years, and am really hoping that things will change once I am at a more "societally acceptable" BMI. Yes, I hate thinking that way, but experience has shown me that at my size, I'm not meeting anyone. But my brain is telling me that just being a smaller size isn't going to result in me meeting a great guy who wants to date me!

3. The ARNP's talk at the seminar freaked me out with all of this "never again" references to anything white (bread, pasta, potatoes, sugar, etc). I have binge eating disorder and while I've made a lot of improvements, I am not binge-free and the thought of never having these things which have brought me so much comfort and pleasure is extremely scary.

4. I have lost weight previously, a lot of it (121 pounds) through modifying my diet. I know this doesn't make me unique, and that the problem most of us have is not losing the weight but keeping it off. Still, I keep thinking that I need to buckle down and try that again.

5. I've also been considering trying an intragastric balloon, like Obera or Reshape. I know these aren't designed for the type of weight loss I would need to get to a normal BMI and there isn't a ton of data on them. But I still feel like it's something that's worth a shot, perhaps in combination with an anti-binge eating medication like Vyvanase.

6. I have insurance approval. If I now decide not to have the surgery, will that affect my chances of getting approved if I wish to have it later?

Anyway, I am really struggling with the decision. I have insurance approval, almost have all of the pre-surgery tests completed (just need an ultrasound, bone density, and pulmonary function test, all scheduled for this Thursday), time off work is approved, and I have the surgery scheduled. Part of me thinks it's too late to back out now and I really don't want to come up with an explanation to my boss as to why I suddenly don't need to have surgery (I did not tell him the nature of the surgery). But I am having serious doubts and fears, and I do NOT want to make an irreversible decision that I will regret.

I'm not sure what I'm looking for in terms of responses. Support and advice, I suppose! I could really use it. Thanks for reading me pouring my heart out. I am frustrated with myself and feel like I'm being wishy-washy, but I really do have doubts.

Thank you!

Ann

 

[southernlady]

3. The ARNP's talk at the seminar freaked me out with all of this "never again" references to anything white (bread, pasta, potatoes, sugar, etc). I have binge eating disorder and while I've made a lot of improvements, I am not binge-free and the thought of never having these things which have brought me so much comfort and pleasure is extremely scary.

The ARNP is full of it. While there is nothing off limits forever, there are foods you will want to avoid or limit.

Example, I adore pasta but I know it's not good for me. I will eat it but very small amounts and not often. Pre-op, my dh and I had spaghetti about once a week (not including leftovers). Now, at almost 6 years out, I can not remember the last time I ate spaghetti. I don't avoid it, I just no longer find it palette pleasing. Peach cobbler...year before last I made one (I live next to one of the highest peach producing counties in SC). I not only fell of the tracks, I drove the train over the cliff myself...including gaining 4 lbs that week. This year, didn't even tempt me to make one.

Your body will let you know what foods is best for it. Many of us discover that carbs (and all those mentioned are carbs) cause gastrointestinal distress, the least of which are paint peeling gas. And then there are others who still have a cast iron sleeve...nothing bothers it.

Best way to handle carb cravings is
1) do not keep them in the house
2) make sure you meet or exceed your daily protein and fat goal before indulging.

There is nothing wrong with very moderate indulging and actually keeps us from feeling deprived. This is not a "never again" type surgery but a "after you meet your protein and fat goals first" surgery. Deprivation never works long term.

 

[harrietvane]

1. I am objectively very healthy in spite of a BMI of 45!

I was in the same boat until I wasn't. I'm also one of the younger people around here at 34, though this was my second surgery. (I had a lap band to start with.) I regret that I didn't know about the DS then, but my goal in revising to the DS was simply maximising the number of years of my life where I am able to fully enjoy them. I had only just started experiencing some comorbidities (hypertension and edema) when I decided to have the surgery.

2. I know that deep down the major reason I want to lose weight is because I think it will lead to me finally having a boyfriend.

Your brain is kind of right in this one. Surgery isn't going to make you a different person, but it may make it more likely that men will take the effort to get to know you or to consider you romantically. It's not a surefire way to get a boyfriend, though - spoken as someone who's just shy of a year out, ~100lbs down and still single. That said, while it would be nice if it happened, I didn't have surgery for *them*, I had surgery for *me*.

3. The ARNP's talk at the seminar freaked me out with all of this "never again" references to anything white (bread, pasta, potatoes, sugar, etc).

That's bullshit. You can eat things like that, but you'll probably find your desire to do so diminishes a lot. I ate the shit out of some sourdough bread I brought back from San Francisco! The difference was that one slice was more than enough.

4. I have lost weight previously, a lot of it (121 pounds) through modifying my diet. I know this doesn't make me unique, and that the problem most of us have is not losing the weight but keeping it off. Still, I keep thinking that I need to buckle down and try that again.

The statistics tell us otherwise. Your weight isn't a reflection of moral superiority or inferiority, and you are not a 'better' person if you lose weight through 'buckling down' or through having surgery. (To people who tell me surgery is the 'easy way', I ask...why would anyone want to do the 'hard way'?)

5. I've also been considering trying an intragastric balloon, like Obera or Reshape. I know these aren't designed for the type of weight loss I would need to get to a normal BMI and there isn't a ton of data on them.

Have you considered getting the sleeve to start with, which gives you restriction, leaving open the possibility to get the second stage of the DS (the switch) later on? As someone who had a lap band (which I know isn't the same), it was unpleasant and ineffective - and wasted years I could have been living with a more effective surgery to help me. The sleeve gives restriction - which it sounds like is important given your eating patterns - and leaves the door open for a simpler revision.

Only you can decide if you're ready for surgery. I have found the vitamins and eating regimen to be entirely manageable without too much thought on my part. I get regular blood tests, but other than prioritising protein I go about my life as anyone else would - which was the point for me. While there were risks and it sounded quite intimidating, I wanted to enjoy the rest of my 30s, 40s, 50s, 60s, and hopefully 70s and 80s, without an extra 130lbs following me around, making it harder for me to do the kinds of activities I wanted.

 

[hilary1617]

I regret not getting DS sooner.

In what I know now was really self-sabotage, I talked myself in and out of surgery for the better part of a decade. I convinced myself that even though diets and exercise fail 95% of the time and had never produced lasting results for me and even though my weight was making me miserable, that a year on a liquid diet (which I did and which didn't work) would be the answer, but it wasn't. I just lost more time. It would have been a decade much better lived had I moved forward.

My weight probably did lasting damage as well - heart, knees didn't bother me when I was younger, but probably won't forget the stress they endured.

It's a tough decision, but it is a good decision. Take care of you.

All the best.

 

[galaxygrrl]

10 years I ago, I was healthy and had a BMI of 45. 10 years later I had diabetes, high blood pressure, etc. To me the issue is whether you have the surgery now or later. And, the other thing is how much do you want to struggle with weight. The DS takes away the struggle.

So, I don't know how old you are, but if you are after a boyfriend - and I assume the next steps, love, marriage and kids - then do it now! Life is better thin from a social and career point of view. Much, much better. I feel the same way you do about the boyfriend thing based on experience. My biggest regret in life is not having kids. I just did not meet someone. And my weight was a big part of it. There is a biological clock on kids. If that is part of the equation for you, think about the life you want in 10 years and if you want a guy and kids as part of it.

By the way, you wont want to eat as much. And you will be able to eat bread, pasta, etc. Just not as much and you wont want too anyway.. And you will stop binge eating I bet.

Everyone is scared and it's a big decision, but everyone here is happy and glad they did it.

 

[Settledownnow]

It is a big decision. If you are not ready, it is fine to put the surgery on hold and think it through more. I would also encourage you to think back to what made you investigate WLS in the first place. The decision for WLS is very personal, but my guess is that you were motivated to investigate WLS not only because you wanted a boyfriend, but also because you are unhappy with your weight, the way you feel in your body, your appearance, and your sore feet and knees. I was someone who went back and forth on the DS idea and decided to work on making diet/behavior changes instead of having (revision) surgery initially. It helped me to change many habits and also convinced me that I needed to have WLS (again). Then you can move forward knowing that you are making the best decision you can.

Keep researching and reading. Having more information about the surgery and lifestyle can help you in your decision as well.

Please go not get the intragastric balloon or have any foreign object placed in your body to lose weight. You just have to read about lap band complications to know that is not a good idea.

Good luck with your decision.

 

[Clematis]

It's natural to be frightened of something so life changing. I spent the weeks leading up to my surgery looking in the mirror and hissing "if you just closed your damn mouth you wouldn't need the surgery." I had a lot of self-recrimination, and that lasted a month or two after surgery. I can say now that I wish I had done this decades ago.

I won't go over your objections point by point as the other posters have done a good job. But I will address these two points:

And I'm scared about losing my hair!

Hair loss is from weight loss regardless of the method of weight loss. But this doesn't happen to everyone. Did you lose your hair when you lost 121#? If not, you may be one of those lucky ones. I always lost hair when I lost weight and lost a lot of hair after DS, however it is all growing back.

an anti-binge eating medication like Vyvanase.

Vyvanse or Adderall only work (if they work, for some they don't) to suppress appetite for 10-12 months then, poof, you're right back to eating as before.

 

[galaxygrrl]

Oh, on the hair issue. I was freaked out too. But I did not lose my hair. I did not lose it when I lost 120 pounds about 15 years ago either. My Dr said eat lots of protein and take biotin. I read on other boards Biotin works. So far so good. I'm 4.5 months out from Surgery and down 75 pounds. So, make sure to look at Biotin.

 

[Larra]

So many good answers already!
I'll speak to the health issue. You think you are in good health now, only because your organs have reserves. Those reserves are being depleted every day that you remain MO. They just haven't reached the point yet where your sugars are elevated and your blood pressure creeps up and your knees hurt with each step. But one or more of these things, and possibly others, are going to happen at some point. I can't tell you when they will happen, different people start having comorbidities at different ages and different weights. But I guarantee you will not be healthy with a bmi of 45 at some point.
Do you really want to wait a few more years until the damage is more obvious?

You are right that losing weight doesn't change every aspect of your life. There is no guarantee that you will find Mr. Right, or have kids, or a better job or whatever. Weight loss doesn't solve every problem in our lives. But it sure does make it easier to deal with some of those problems, and rightly or wrongly it opens up avenues of friendship and employment that are not open when you are MO.
If the only issue is that you feel you were pressured into a surgery date that is too soon for you, change the date. Ignore that crap about never eating those foods again. I eat every one of them, just not as often and not as much as before. And those intragastic gadgets are experimental and not permanent. As soon as they remove it, what do you think is going to happen? For you to lose weight permanently, something about you has to change permanently, and that's what the DS is all about. Change is good! Scary, but good.

 

[Spiky Bugger]

If you are really not ready, don't do it.

Meanwhile...
DS--eat a Krispy Kreme, a few hours later maybe get bloated or other bowel issues;
RnY--eat a Krispy Kreme and almost immediately have a horrific dumping episode;
Sleeve--eat 1/4 - 1/3 of a Krispy Kreme and want more but if you eat more, you hurt and then barf...until this doesn't happen anymore and the regain begins;
LapBand--take a bite or three or two of a Krispy Kreme, feel it get stuck, feel your saliva filling up your esophagus, then barf;
No Bariatric Surgery--eat the box of Krispy Kremes and become disabled and then die of your comorbidities.

 

[Larra]

I tell ya, that @Spiky Bugger really knows how to put things into perspective, and in the least words of anyone.

 

[Roudoudou]

Thank you everyone for the thoughtful responses. I think I might have just been a bit freaked out because of the stress of having the endoscopy and then the seminar right after. Bottom line is I've been thinking about this surgery for years. I'm so close to having it that I think I just naturally am freaking out a bit. Still thinking, still praying, but feeling better. THANK YOU again for the support. Please keep adding your thoughts and advice should you be so inclined.

 

[DSRIGGS]

Do not even consider the balloon. It is not good science and will not work.

As the others have said, the ARNP is frankly full of shit. I am almost 3.5 years out and for dinner I had a sloppy joe with cheese and dill pickle on a bun. I ate all of it. Additionally I had macaroni and cheese plus green beans. Just and hour ago I had a cup of coffee with cream and sugar as well as 3 chips ahoy Reese's cookies. I am 6'2 and rang from 168-175 lbs. Now I am not a normal DS'r and I had nutrition issues because my virgin DS was with a standard limb guy gave me an absorbing intestinal track that was way too short. Had I done better research and met Dr Keshishian before my virgin ds I would not have had malnutrition issues.

The DS is the only bariatric procedure that has demonstrably great results after 5 years. Frankly none of the other procedures work. Yes you will have to commit to life long vitamin and mineral suppelmentation but it is honestly not a big deal.

Finally and I say this to be honest and with your best interest at heart. Do you really think that healthy people need a weight loss surgery? I recently found out that I have stage 3 liver disease and been told to cut out all alcohol for life. The cause of the liver problem? Being morbidly obese for 20 years and a type II diabetic for 10 plus years. It is very possible that your liver is in similar shape.

Please do all your research so you fully understand what you are signing up for and make sure you go a well respected DS surgeon who will measure your total small bowel length and make your Alimentary limb, Common Channel and Bilopancreatic limb as a percentage of the small bowel. It doesn't have to be exact Hess DS but you want to be sure that the limb lengths are such that you lose the weight you need to lose while making sure that you don't become malnourished because you have too much malabsorption.

Being nervous and having cold feet is normal but as long as you are a repsonsible adult who can commit to life long vitamin and mineral supplementation the DS is 100% the right choice for anyone needing to lose significant weight.

Best wishes to you.

 

[DianaCox]

What the Bugger said. You will never be younger and healthier than you are now - the longer you're MO, the more damage is done to your organs.

Living with a DS is not "set-it-and-forget-it" - you will DIE if you do that. But what you have to do is really really not all that hard. Much less difficult than any diet I've ever been on.

 

[bearmom]

I had a BMI as high as 49 at one point, and though I was relatively healthy I did see the changes happening in my labwork and tests. Others have already said exactly what I also would say (but more clearly and succinctly than I would have). I add my 2 cents mainly to let you know that those that have replied to you are not a narrow slic of DSers. Some of us simply aren't chiming in because someone has already perfectly summed it up.

I'm 9 years out and agree with every word above, and only wish I'd had the DS much sooner, because while I may not be causing continuing damage from morbid obesity, the damage that was done (even if I was young and healthy enough to not feel much of it) will catch up with age. Scans show damage to my skeleton, and I'm over 50 now and starting to feel it. I'm glad I'm not causing more, but wish like hell I'd stopped the damage much sooner.