Surgery questions

[FloridaJen]

Resident newbie with a million questions. I’m starting to think ahead to actually having surgery and will ask surgeon these things, but thought I’d pick your brains also.

Is it more or less typical to have gallbladder removed during DS?

With my previous band removal I would guess I have scar tissue and I also think I have a hiatal hernia. Is it possible to do all these things at one time?

Do most surgeons check your nutrient levels prior to surgery? What might I request checking beforehand?

I have fatty liver and last few tests showed elevated ALT and AST, is it heard off for people to get the liver biopsied while they are in there?

Besides trying to lose some weight and exercise, what can I do or take now to prepare my body for what’s to come?

How many people have you known or have seen die from this surgery or in the year following?

Thanks again for your continued guidance.

Jen

 

[DianaCox]

A few have died in the early days or weeks. They usually were the sickest of the sick - waited too long. There have been a few suicides further out - either unrealistic expectations that the surgery would fix everything in their life, or unprepared for the changes that it did. A very very few have died of malnutrition, which usually were the result of improper supplementation or eating, and not nipping it in the bud.

And some people just die. Cancer, heart attack, damage that didn’t get cured by surgery.

But - what would your life be like staying morbidly obese?

 

[DianaCox]

Oh, and most DS surgeons do a liver biopsy during the procedure - but it wouldn’t hurt to ask.

 

[FloridaJen]

A few have died in the early days or weeks. They usually were the sickest of the sick - waited too long. There have been a few suicides further out - either unrealistic expectations that the surgery would fix everything in their life, or unprepared for the changes that it did. A very very few have died of malnutrition, which usually were the result of improper supplementation or eating, and not nipping it in the bud.

And some people just die. Cancer, heart attack, damage that didn’t get cured by surgery.

But - what would your life be like staying morbidly obese?

Sad. Are those DS outcomes or WLS in general?

There is no question I can’t stay like this, but my mind goes to worse case and second guessing myself. I always land back on why can’t I do this without surgery?! I beat myself up about it because I’ve let myself get so bad I have to cut out my stomach and rearrange my innerds to live. Then I question how far I need to go to save my life, like is this surgery necessary or can I save my life with a less extreme surgery. But there is a reason I’ve come back to DS for the 3rd time in 10 years.

 

[DianaCox]

Why can’t you cure yourself of cancer by exercising and eating right?

BECAUSE IT’S A DISEASE!

 

[FloridaJen]

Why can’t you cure yourself of cancer by exercising and eating right?

BECAUSE IT’S A DISEASE!

I know. Thanks for the reminder.

 

[Munchkin]

Resident newbie with a million questions. I’m starting to think ahead to actually having surgery and will ask surgeon these things, but thought I’d pick your brains also.

Is it more or less typical to have gallbladder removed during DS? If you are fat and female chances are you will have problems with it. I insisted on getting mine yanked because I didn't want ANOTHER surgery 6 months down the road.

With my previous band removal I would guess I have scar tissue and I also think I have a hiatal hernia. Is it possible to do all these things at one time? Yes.

Do most surgeons check your nutrient levels prior to surgery? What might I request checking beforehand? Ask for at least iron and D.

I have fatty liver and last few tests showed elevated ALT and AST, is it heard off for people to get the liver biopsied while they are in there? Mine was but I have no idea if it's common.

Besides trying to lose some weight and exercise, what can I do or take now to prepare my body for what’s to come? Deep breathing. Practice getting up and down without using your abs.

How many people have you known or have seen die from this surgery or in the year following? Me personally, none. I knew one woman who died about 15yrs post and I think her death was related to extreme plastics and ovarian cancer. Over the years I have heard about others dying but I didn't know them. But I have been around DS world for almost 2 decades now and honestly I may have forgotten a couple. It is not common.

Thanks again for your continued guidance.

Jen

 

[Munchkin]

Sad. Are those DS outcomes or WLS in general?

There is no question I can’t stay like this, but my mind goes to worse case and second guessing myself. I always land back on why can’t I do this without surgery?! I beat myself up about it because I’ve let myself get so bad I have to cut out my stomach and rearrange my innerds to live. Then I question how far I need to go to save my life, like is this surgery necessary or can I save my life with a less extreme surgery. But there is a reason I’ve come back to DS for the 3rd time in 10 years.

I am not trying to be mean. But honestly, if you could take the weight off and keep it off, you wouldn't be here. This right here was my problem too. The hardest part was accepting the fact that I could not control my weight. My metabolism was broken and the DS was my best option to fix it. Willpower and diets could not fix it. Try hard to stop being so critical of yourself. Obesity is a disease, not a character flaw.

The reason why you keep coming back to the DS is because it works. It will fix you not just put a bandaid on the wound. It has the best results. It has the best quality of life postop. And nothing else you can get will give you a 95% chance of losing the diabetes.

When I had my surgery I discussed what was next in the world of weight loss with my surgeon. We both agreed it would be a matter of time until something better than the DS came along. He was convinced it would be a pill. But here we are almost 20yrs later and the DS is still the best shot at having a normal life postop. It will come. But not today.

 

[FloridaJen]

Thank you

 

[Webmommy]

It's very true that it is a disease and not a personal failing or weakness. Like many diseases it's suspected that obesity is genetic but we haven't identified the gene yet. When women find out they have the BRACA gene and a family history of cancer nobody says a mastectomy and oophorectomy is too radical or extreme of a surgery. They're just trying to avoid dying earlier than necessary. And so am I and I want to avoid living with some horrible conditions that run in my family.

But I get it. It took my time to come to a place of readiness and acceptance about bariatric surgery. I also experienced losing weight on my own and regaining it despite my best efforts. That helped me deduce there was something wrong with my body and should I undergo a super low calorie diet again I would probably lose weight but I would also regain it. So anything that mimicked a low calorie diet e.g. gastric balloon, lapband, stomach stapling or sleeve in time I would regain on that too. I needed something radical in order to make sure I lose all my weight, keep it off for life and avoid congestive heart failure, high blood pressure, diabetes and various other heart problems that my parents and uncles had/have. Watching my mom be on palliative care these past couple years was paradigm shifting for me.

 

[FloridaJen]

I am not trying to be mean. But honestly, if you could take the weight off and keep it off, you wouldn't be here. This right here was my problem too. The hardest part was accepting the fact that I could not control my weight. My metabolism was broken and the DS was my best option to fix it. Willpower and diets could not fix it. Try hard to stop being so critical of yourself. Obesity is a disease, not a character flaw.

The reason why you keep coming back to the DS is because it works. It will fix you not just put a bandaid on the wound. It has the best results. It has the best quality of life postop. And nothing else you can get will give you a 95% chance of losing the diabetes.

When I had my surgery I discussed what was next in the world of weight loss with my surgeon. We both agreed it would be a matter of time until something better than the DS came along. He was convinced it would be a pill. But here we are almost 20yrs later and the DS is still the best shot at having a normal life postop. It will come. But not today.

Nothing mean about it! It's what I need to hear because every single time I've revisited WLS I always tell myself I can do this without surgery. And maybe because I have had some short-lived success while doing whatever it is, I beat myself up because I stopped doing whatever it was to have that success. Most recently I did a dietetics program where I tracked my macros (every.single.gram.of.food), checked in weekly with a coach and had a personal trainer who kicked my ass twice a week for an hour. I dropped my A1C without meds from 9 something to under 6. SUCCESS. Except after 18 months, I only lost 25-30 lbs. (started at 309.) Then I couldn't sustain it (financially and honestly, weighing and logging every bite of food = not super sustainable) plus I needed more weight loss, so I bailed and declined VERY rapidly over the past year. I gave up, again. So to jump in from that to a DS is a hard pill for me and I start thinking about how if I just stuck with that, keep tracking macros, get my butt back to the gym I won't need surgery. But even when I was doing it I felt like I was climbing that mountain against wind and rain and biology. I never felt solid and could actually feel my body fighting me at every turn, every meal, every workout. Eat. Stay fat. Feed me.

 

[Webmommy]

Oh they did my bloodwork at my EGD appointment, my gallbladder is already gone, I believe they are taking my appendix too, and will also do a biopsy on my liver. I have non alcoholic fatty liver disease that showed up on a CT scan but not in bloodwork but that whole area hurts since my gall bladder was removed. I need a biopsy. Especially if I have future abdominal pain it will help rule stuff out.

 

[Webmommy]

Nothing mean about it! It's what I need to hear because every single time I've revisited WLS I always tell myself I can do this without surgery. And maybe because I have had some short-lived success while doing whatever it is, I beat myself up because I stopped doing whatever it was to have that success. Most recently I did a dietetics program where I tracked my macros (every.single.gram.of.food), checked in weekly with a coach and had a personal trainer who kicked my ass twice a week for an hour. I dropped my A1C without meds from 9 something to under 6. SUCCESS. Except after 18 months, I only lost 25-30 lbs. (started at 309.) Then I couldn't sustain it (financially and honestly, weighing and logging every bite of food = not super sustainable) plus I needed more weight loss, so I bailed and declined VERY rapidly over the past almost year. I gave up, again. So to jump in from that to a DS is a hard pill for me and I start thinking about how if I just stuck with that, keep tracking macros, get my butt back to the gym I won't need surgery. But even when I was doing it I felt like I was climbing that mountain against wind and rain and biology. I need felt solid and could actually feel my body fighting me at every turn, every meal, every workout. Eat. Stay fat. Feed me.

That seems quite punishing for very little weight loss. But the *good news is with the DS you can still track every bite, work with a trainer and exercise until the cows come home just as intensely and this time it will work! Even at half intensity it will work and you won't hate yourself in the process.

 

[FloridaJen]

Oh they did my bloodwork at my EGD appointment, my gallbladder is already gone, I believe they are taking my appendix too, and will also do a biopsy on my liver. I have non alcoholic fatty liver disease that showed up on a CT scan but not in bloodwork but that whole area hurts since my gall bladder was removed. I need a biopsy. Especially if I have future abdominal pain it will help rule stuff out.

I want all of these things!

 

[FloridaJen]

Another conversation with a surgeon's office trying to coordinate my next steps. This is basically the 4th person in my early part of this journey to try to scare me. I wish it didn't work. This was someone from the hospital system I work for, so I wanted to at least consult, but I told her I wasn't sure I wanted to waste their time since they don't do the surgery I'm leaning towards. Then followed a 10-minute scare lecture about how horrible the DS is and to be very careful because patients get really sick. I told her I had been researching off and on for 10 years and know how important it is to be diligent about vitamins and labs etc. She said over the 12 years she's been doing this she hasn't seen anything good come from DS. Such fun.