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I'm moving ahead with weight loss surgery


ktgrok
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Just a weird question, but do you know your level of vitamin D?  If it's low, you might want to supplement a bit higher than normal before surgery to help prevent the usual drop.

 

It was tested about a year ago, and was well in the normal range. I do take a calcium supplement that has D in it, as well, and will probably add a D supplement before surgery.

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Tea has tannic acid.  Also, caffeine is a trigger for heartburn.  

 

Yup. I don't think I realized what a trigger it was for me, because I wasn't drinking a lot of coffee or anything. But it was enough, apparantly. Or, this was just a fluke, and I'll be refluxing again in a few days. It does come and go.

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Mini update: I had my appt with the nutritionist yesterday. It was a group thing, myself and three other people met with her in a classroom there at the surgeon's office. I really liked her. We learned about habits we need to create, preop diet plan, post op eating, the phases we will move through from liquid to solid foods after surgery, vitamin supplementation, etc. The plan is to meet again the week before surgery, then again at the hospital, then the week after surgery (I think that was the last one). Plus she has classes every thursday that I can always go to. 

 

In bigger news, my husband, after getting over the sticker shock, has said that we will pull money out of investments if we have to, to make this happen. I love him so very very much. He is amazing. 

 

He is worried about a few things, honestly, he said he worries I won't enjoy going out to eat on speical occiasions, etc. I explained I would, I'd just have to bring a lot of it home for the next day. He said he'd feel guitly eating so much around me when I can't, but we can work through that. 

 

The surgeons office is submitting everything to the insurance company today, so then we wait to see what they require. They may require a 6 month diet first, but I'm hoping not. That becomes a game of don't gain any weight or the will deny you, don't lose too much weight or they will deny you, etc etc. I know that I CAN still to dietary rules. I was a vegan for years, lol, not to mention the many months I was paleo, low carb, etc. I know about giving up things, etc. It's volume that kills  me, and this sx will be the tool to help me with that. 

 

So we shall see. 

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I am excited for you. Has your DR. decided which surgery is right for you?

 

not yet :(

 

I'm having manometry done on the 14th, that will be the deciding factor. The upper gi series didn't capture any reflux episodes, so we don't know how bad it is from that. The manometry will show how weak or strong the LES valve is, if there is any dysfunction in the esophagus, etc. Part of me says, to heck with it, lets just do the bypass to be sure, but the logical side of my brain knows that long term, the sleeve has less issues. So if sleeve will work, I should do that. 

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He is worried about a few things, honestly, he said he worries I won't enjoy going out to eat on speical occiasions, etc. I explained I would, I'd just have to bring a lot of it home for the next day. He said he'd feel guitly eating so much around me when I can't, but we can work through that. 

 

 

Well, it is very possible you will go through spurts of being less positive about eating at all, feeling like you're missing out, etc.  I had a hard time the other night, even and I'm 11 months out.  But MOST of the time, you're right.  I went out to eat about 2 months out, got something I never would have gotten before hand, but needed it.  It was *really* good and I had enough for FOUR meals, not just an appetizer. And most of the time, I can really appreciate getting a few meals out of going out.  

 

ALSO, he won't feel guilty, probably because it is going to take you just as long, if not longer, to eat that teeny amount as it does for him to eat a whole plateful (actually, if it doesn't, you need to consider that a bit more carefully as ideally you're eating about a dime size amount per bite, chewing extra well, and considering carefully if you actually need that next bite -- all which takes at least couple minutes per bite).  

 

The sleeve is so much healthier and fewer issues. If that is a good choice for you, you should absolutely do that one over the bypass.  

 

BTW, I went back on reflux medication this weekend. Though I didn't have any big issues, I can tell a difference using it.  Glad my gastroenterologist encouraged it and that I listened. But being on that still is pretty minor of an issue post-sleeve as is the gallbladder issue I hope to resolve next week <sigh>.

 

 

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I got insurance approval! They surgeon's office called yesterday and said the insurance has authorized the surgery! So now, the scheduling department will call me to set a date for my pre-op stuff and surgery. I still have to do my manometry testing and a gall bladder ultrasound, I'm not sure if they will call me before those are done. I may call today just to get a feel for how long out we are looking, so I can plan. My ultrasound and manometry are next week. 

 

Now, back to deadline hell with my writing!

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  • 2 weeks later...

So, I have my surgery date! June 12! They actually wanted me to do it in May, but my life is really hectic and June works out much better. Plus we will be on summer break so no worries about schoolwork piling up. 

 

Also, not sure if I updated, but I will be having the sleeve gastrectomy, aka gastric sleeve. It has less long term complications than the bypass. He will fix my hiatal hernia during surgery. We were not able to do the manometry test, as my deviated septum is so severe they couldn't get the tube up my nose. I worried about that test for weeks, snorted the numbing gel, and basically was quietly panicking. Only to have her unable to get the tube up there on either side. My mom has an S shaped septum, so it seems I probably do as well. He said that based on my history and the upper GI he is still confident that this is the right option for me. It also has a quicker recovery. 

 

I'll have surgery at 8am that morning and go home the next afternoon. 

 

thanks for all the kind words!

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Katie,

 

I'm so excited for you.  

 

Yesterday was my 1 year.  Surgery has been a great tool for me.  I still have so much to work on regarding my food issues, but the health results are worth having the surgery. 83.5 pounds gone.  Good numbers across the board (bp, sugar, cholesterol, etc).  Better mobility than ever.  

 

I wish you similar results and health :)

 

 

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  • 1 month later...

Just an update. I have started my pre-op diet, and surgery is on the 12th. The diet is to shrink my liver, as people who are obese generally have fatty liver issues which make it difficult to access the stomach during surgery. I'm to have two protein shakes a day and a dinner of lean meat and vegetables. I can snack on vegetables, sugar free jello, sugar free popsicles, and if I'm really hungry a slice of lean deli meat or similar. Day one was a bit difficult. I hear day 2 is worse, we shall see. It's about 1K calories a day, which I'm sure doesn't seem bad to someone of normal weight, but trust me, between losing the carbs and cutting back volume I was hungry a few times. Managed not to yell at people for the most part though :)

 

I've also paid the hospital which might have hurt more than the surgery will, lol. 1/2 up front and then arranged payments over 2 years. We have a high deductible, and it's a family deductible, not individual, so this is costing about 8K total. Very thankful I got that book contract as that's how I'm paying for it. And very thankful for payment plans, as some of my book money needs to go to other things right now. 

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I hope it goes wonderful for you. I'll offer sympathy with you on the diet, I think I might need to send my kids off to live with grandma for their own safety if I followed that regime :) Thankfully it isn't too long, although I'm sure it will seem long enough to you.

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More incentive, I just got access to my medical records via a patient portal they have. My ultrasound shows that I have fatty liver disease  :crying:

 

Mild, but there...liver is both enlarged and shows fatty deposits. So much for being perfectly healthy, just fat. 

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Katie, just make sure you follow the diet well afterwards also.  The fatty liver disease is very likely going to be compounded by the release of fat into your body as you lose.  I didn't have fatty liver before surgery yet have it now.  Still better to have it because of weight loss than weight gain, I figure.  And all the other health benefits far outweigh that issue.  But it is more of a reason to make good choices post-surgery.

 

I am going to get my act together....tomorrow...

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Katie, just make sure you follow the diet well afterwards also.  The fatty liver disease is very likely going to be compounded by the release of fat into your body as you lose.  I didn't have fatty liver before surgery yet have it now.  Still better to have it because of weight loss than weight gain, I figure.  And all the other health benefits far outweigh that issue.  But it is more of a reason to make good choices post-surgery.

 

I am going to get my act together....tomorrow...

 

Thank you, that is a good point. Actually, we see that in cats, in veterinary medicine. Fat cats that lose too much too fast get fatty liver disease. 

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What is fatty liver disease?  Can that lead to cancer?  I have a cousin who had weight loss surgery many years ago and now has cancer in his liver. 

 

Fatty liver disease is when you have more than 10% fat in your liver.  It impairs liver function. Yes, fatty liver disease is a risk factor for liver cancer.  Here's a link with some of the risk factors listed:

http://www.cancer.org/cancer/livercancer/detailedguide/liver-cancer-risk-factors

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And to clarify, for most people, the weight loss associated with bariatric surgery will lead to a resolution of fatty liver disease. But, it can't fix damage already done. 

 

As for my diet, right now I'm in the pre-op phase. Different sugeons have different protocols. In the UK it seems to often be just milk, nothing else. In other areas it is optifast, or an equivalent. Most places here do protein shakes, my surgeon has you do a protein shake for breakfast, one for lunch, and dinner is to be lean meat and vegetables. A little salad dressing/etc is fine, it doesn't have to be fat free, but nothing fried, heavy fat, etc. I am allowed to supplement with lean meat or vegetables during the day if I need to for hunger control. The goal is low calorie, low carb. This is for two weeks before surgery. (some surgeons base how long on how high your BMI is, mine does 2 weeks for everyone). The day before surgery is clear liquids/sugar free jello/etc.

 

After surgery I'll be on clear liquids for I think it is 2 days? Then full liquids, mostly protein drinks if possible to try to get 80grams of protein a day. That's for 2 weeks. Oh, and I think I can have yogurt in that phase as well, if I remember correctly, as well as say, apple sauce, etc. Then soft foods, like scrambled egg, very moist chicken or fish, etc. Then after a month or so regular food, but with the instructions to eat protein first at every meal. 

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More incentive, I just got access to my medical records via a patient portal they have. My ultrasound shows that I have fatty liver disease :crying:

 

Mild, but there...liver is both enlarged and shows fatty deposits. So much for being perfectly healthy, just fat.

Think of it as just one more good reason for having the surgery. :)

 

One thing, though -- you should seriously consider having a biopsy of your liver done while they are doing your surgery, because it will be far more accurate than the ultrasound at determining the extent of the fatty liver. It's a very minor procedure. (Ultrasounds are good at finding tumors, though, so please don't think I secretly suspect you have liver cancer or something awful like that! I just know from my dh's experience that a biopsy will provide better information about the condition of your liver, and you should have that information so you will be able to accurately monitor it as you lose the weight, to make sure the fatty liver doesn't get worse.)

 

Again, I'm not trying to scare you! I am only trying to help you prevent future problems because fatty liver can develop into cirrhosis over a period of years and I want to be sure your doctors don't take the "it's no big deal, it's just a little bit fatty" attitude that my dh's doctors took years ago when they told him he had a fatty liver, because for some people it can turn into a very big deal.

 

I am very glad you are having the surgery, and I hope and pray that it is a complete success and that your recovery goes very smoothly. :)

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More incentive, I just got access to my medical records via a patient portal they have. My ultrasound shows that I have fatty liver disease  :crying:

 

Mild, but there...liver is both enlarged and shows fatty deposits. So much for being perfectly healthy, just fat. 

What does this mean for you?

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And to clarify, for most people, the weight loss associated with bariatric surgery will lead to a resolution of fatty liver disease. But, it can't fix damage already done. 

 

....

 

I'm under the impression that the liver regenerates.  If you're otherwise healthy, eat enough protein and antioxidants, I think it can repair itself.  I could be wrong.  I have a lot more experience with kidney patients than liver issues.

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I'm under the impression that the liver regenerates.  If you're otherwise healthy, eat enough protein and antioxidants, I think it can repair itself.  I could be wrong.  I have a lot more experience with kidney patients than liver issues.

 

I should have been more specific. Mild stuff, yes. If you have, say, decades of issues and and cirrhosis, no, I don't think that would be repaired (but I could be wrong). Fatty liver disease can lead to cirrhosis, but at the stage I'm at I should be fine. It's just a sign my metabolism isn't healthy right now. Probably too many carbs/sugar. Sugar is processed in the body almost exactly like alcohol, but without the buzz. So it  causes the same kind of damage. Anyone with a BMI over 35 is expected to have some fatty liver disease. 

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I should have been more specific. Mild stuff, yes. If you have, say, decades of issues and and cirrhosis, no, I don't think that would be repaired (but I could be wrong). Fatty liver disease can lead to cirrhosis, but at the stage I'm at I should be fine. It's just a sign my metabolism isn't healthy right now. Probably too many carbs/sugar. Sugar is processed in the body almost exactly like alcohol, but without the buzz. So it  causes the same kind of damage. Anyone with a BMI over 35 is expected to have some fatty liver disease. 

 

I just looked it up, and this is exactly right.  Fatty liver is completely reversible, but if it turns to cirrhosis it's not.   Glad you caught it early.

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So, I'm down 7lbs in 10 days on the pre-op diet! It's not easy, and I'm getting used to be hungry, but I'm doing it. Calories are under 1,000 a day. Yesterday I was over 12K steps on my fitbit, and ate 840 calories. Myfitnesspal is angry with me, lol. It doesn't understand. 

 

And no, this doesn't make me think I should just forget surgery and diet to lose weight, as this is NOT sustainable long term. I'm HUNGRY. I am only able to stick with it because I know I only have to do it a bit longer. I'm looking forward to being able to have a wider variety of foods after the surgery - things like yogurt, applesauce, soup, etc that I can't have right now due to the carbs. 

 

Oh, and I'm terrified about the day of clear fluids only, on Thursday. That will not be fun. But I can do it. Oh, and I haven't been particularly bitchy either, which I was afraid of. Maybe the first few days, but now that I'm firmly in ketosis I'm fine. 

 

And...I am keeping up the blog! I didn't think I would, but so far I've posted at least once pretty much every day. 

 

 

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Do you mind if I ask, what is the diet like? Is it very digestible or high or low in fiber etc? Or is it super high nutrient? Or is it just low calorie to get you used to smaller portions later on? I am just curious about how they get you ready for what happens next. And I mean the general parameters, you don't have to type out a daily diet or anything like that.

 

 

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