Feeling a bit flat, freaked out and confused!

Howdy fat-to-fit,

I am sure that your sister in law would have metabolic syndrome/Syndrome X as well - obesity is a symptom!  Ad we all here would have had, to one degree or another.
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Metabolic_syndrome  (this is pretty basic).

I was sleeved with a BMI of 30.4 2nd Feb this year.
Yup.
Long history of dieting, with Mum putting me on my first diet aged about 13 (I was 51 when sleeved).
Victim of the "low fat, high carbohydrate" diet as I am sure that we all are/were.
Endometrial hyperplasia.
Moderate sleep apnoea requiring CPAP with Severe Upper Airway Resistance Syndrome (still have, poxy small nose canals!)

I ate a pretty healthy diet before hand, with occasional carb blow outs (well, most of December 2014 when I put on 4 kg c/o the Coles Finest Christmas Pudding - lots of!), but obviously ate TOOO much!
Thankfully, due to my upbringing - frugal parents and takeaways just weren't available in NZ (except for "fush and chups") - I remember the first McDonalds coming to Auckland in 1981, the year I started my nursing training!!! - I have never been in the habit of having takeaways.

Yes, I have had episodes of 'addictions' prior to sleeving e.g. chocolate, liquorish allsorts, and don't forget the Christmas Pudding...
and I'd guess that I had an eating behaviour disorder "disordered eating" (http://www.nedc.com.au/disordered-eating ).

Since 2002 I have been (mainly) doing a higher-protein, lower-carb diet.
And this is what my surgeon, his off-sider, and dietician encourage.
Not only that, it is coming back into 'mainstream' after sliding into disfavour from the badly scientifically researched with shocking statistical analysis (wouldn't pass peer-review these days!), Government pushed low-fat diet.

I am too shy to post photos of "before" with my c**p selfies and "now"  - better phone lol!, but might pm you.
If you look at the posts, I have put a lot of info on low-sugar etc diets on the "Resource" section, and want to move one post off the post-sleevers onto "Resource".
Carbs you also need to be wary of are also high GI such as potato and rice.

I have no hankering now for sweet stuff.  Not even interested.
Gone off all those Quest bars, no added sugar protein bars etc etc that I had stockpiled...
Remember, if you eat it - ie chocolate (and don't buy it in the first place lol!) it just keeps the addiction/blood sugar ups and downs/insulin releases going...hence developing insulin resistance/metabolic syndrome/Syndrome X etc.
If you don't have refined/high GI carbohydrates, these cravings pass.
I BELIEVE that the sleeve has helped me to stick to a more natural diet ie no added sugar in any form, no refined/high GI carbohydrates.

Have I achieved good results weight-wise, BMI and body fat%?
Yes.
Do I have saggy, baggy skin?
Yes, but I am 52, and your skin loses collagen/elasticity as you age - that's why we get wrinkles lol!

Date	Weight kg	BMI	Body Fat %
2nd Feb 2015	70.48	30.5	42.5
28th September	43.8	18.95	20.9

I HOPE that your S-I-L does end up having the sleeve done - just for convenience more than a anything else, and all the best for yours!
She may be interested in looking at bandingtogether.com; there are a lot of happy banders there.
I am on there also - they have  section for sleevers, as well State, etc etc.  My blog is on there, I have the same 'username' - 'denzel'.

Happy for your SIL if she is going to be sleeved instead on having the band. I thought about the band before I knew much about the sleeve, but I am so happy I never went with it, it just didn't feel right for me and now I have read so much more about it I know that I was right.

I wish the best for both you and SIL and it is cool that you will have each other for support.

So very excited, my SIL had a follow up appt with the surgeon, and he has reassessed after a dietitian appt & food diary (& she, like me, has put on more weight since last year) I'm so excited for her, and relieved for me - i was feeling a little guilty that he'd said yes to me... anyway, we'll be going through it together, which is s awesome !!!

                    

Fantastic news luv! Roll on November!

Thanks Sutika  - and thanks for the mermaid !!!

I've spoken to my SIL, and she was very gracious, and happy for me, but I could feel the hurt & frustration , I really hope she gets an answer soon, she is vehemently opposed to the band, she wants the sleeve. Anyway, we shall wait & see. She has a follow up with the surgeon in a couple of weeks.

Yep, I always like to be well informed & prepared, greenfrog - I think he was quite impressed when he saw my little book of scribble & print offs !!! :-)

Thats what you want, to be well prepared.
Good Luck with it!

Well done ftf!!! That is great that you have a diagnosis and a way forward. I am really happy for you, your patience and efforts have paid off.

I am sure your SIL won't blame you for the advice of the surgeon. She will know you support her wherever her journey leads. I can understand you being apprehensive though :)

Go you good thing!!!!


And have a mermaid too!

Ok, I can now change the title of this post to "Feeling excited & impatient for my date to get here " !!!!!! Turns out I have Metabolic Syndrome, and with that and my family history, my surgeon said the sleeve is a totally appropriate  choice, as it's a 'metabolic' operation, and he feels that the  potential health benefits outweigh the risks. Just worried about how my SIL will react, I really feel for her - and she's the one who got me thinking about WLS again, and who referred me to this clinic, so I can understand if she feels a bot hard done by :-( 

I am SO excited - and relieved. I had gone  a bit nuts in the research after SIL's appt, but I don't regret that, I feel like I am in the best position to have the sleeve done now, well informed and mentally prepared for what lies ahead. Bring on November !!! :-D

Thanks for that, Beeby - good to know! I'm really not keen on a band, either. I feel a bit grossed out by the thought of the portal bit, in particular. I know I have to be prepared for that option to be offered to me, I think I would really try to fight it, though!

So, my SIL got a text from the clinic nurse yesterday to say the surgeon was happy to go ahead with the lap band on the same date she was scheduled for sleeve surgery. She's not sure how she feels about that, but at least it's a positive step forward, so she was feeling a little better, and plans to call & discuss it on Monday, when she's really had time to process last week's appointment, the aftermath, and what is being proposed. I just hope she is genuinely happy with whatever happens.

Meanwhile, I'll  just bide my time until my appointment rolls around .....

Hi , I was sleeved one month ago and my BMI was 32.5. The first surgeon I went too offered me the lapbband , which I'm dead against . My Aunty and cousin had there's out this year due to problems with it . My Aunty has been sleeved and my cousin next month now , also my uncle last week !  I got another referral and saw another surgeon who was happy to sleeve me . I was previously 10kg heavier 8 years ago and have poly cystic ovarian syndrome which makes it very hard to keep my weight down (put on 13kg since last year 😢). I have always struggled so much to lose weight and put it back on so quickly . I did a lot of research on my surgeon first tho , he's been in the business a long time and has never had a leak . Why wait till my BMI went even higher again , I think surgeons should be sleeving people with a lower BMI more readily if they have a long history of weight problems , why wait till people get even bigger and have more co morbidities , and serious problems . Also sleeving people with a lower BMI means less loose skin afterwards needing more high risk surgeries . Anyways, this is my view ,and I'm happy with my sleeve and looking forward to a healthier life , 7.5kg down , 18kg to go . Good luck with your appointment , hope it goes well for u

that sounds like a great plan of attack to me! Who is your surgeon?

My plan is to go in, be honest, but confident in what I believe is right for me. I have no desire to be dishonest, or stupid about this. I'm not a 19 year old who wants to look good in a bikini, I've done the diet roller coaster too many times now ! I do have co morbidities and a pretty scary, relevant family history. I have no doubt he will discuss the lap band, but the standards for that are the same as the sleeve. I have noticed people on this forum have been sleeved with lower BMIs than me, so I think there's still hope. I guess I'll have an answer when I see my surgeon!

Personally, I don't think your chocolate addiction is an issue ( I mean to prevent surgery).
I could be totally on the wrong track, but I think your major problem is your BMI.  I thought I was going to be knocked back with a BMI of 38.  I had mild sleep apnoea and need a knee replacement (trying to keep the one I have for a few more years).
I'm not a doctor, and it has been over a year since I did my surgery.  I think at the time the guidelines then were something like BMI of 40+ , as long as you understood the risks.  But it was up to the surgeon to assess each individual patient with a BMI over 35 with co-morbeseties (I think that's the right word, I don't know what the word is, sorry).

I remember one Surgeon whose talk I went to, said flat out wouldn't operate on anyone with a BMI under 40.  He did scare me off the surgery for a while.  So 2 years later when I started thinking about it again, he was totally off my list! I  didn't even attempt to make an appointment with him! hehe 

But I suspect, even he has changed in the way he thinks and on who he operates.  When I heard him speak he was pushing the lap band for everyone.  Now I have heard he hardly ever does them (talk was over 4 years ago).

You can only go in and tell the truth and see what happens.  I suspect the guidelines have and will change as people have the sleeve for longer and Doctors learn more about the long term benefits (or risks) of sleeve surgery.

I guess if he does offer you the band, you could just say straight out I'm not interested.  You only want the sleeve, and see how that goes.

Good Luck!

I can understand how frustrating and even frightening this must be for you at the moment, but try not to stress luv. When you see your surgeon, just present your case as you've done here and I'm sure you'll be heard. They do have to put people through their paces prior to surgery to ensure a good outcome but I think with your comorbidities you can offer a compelling argument for going ahead.

I forgot to say, my appointment isn't till Sep 21. Also, I think I might go back to the GP who referred me & get a mental health plan, then book in with the psychologist again - at least then the surgeon will see that I'm committed to working through my chocolate issue !!! Yum.......

Thanks for the love, ladies !! I REALLY appreciate being able to vent and get some valuable opinions, too .

I know, Sutika - I thought the ankle weights was a bit extreme - and what if she'd been 'caught' ?? I'd die of embarrassment , if nothing else lol!

My SIL is feeling extremely disappointed, but she sounded better than I'd expected this morning. I think she's just going to have a good think about the lap band option, and work towards that next appointment in 3 weeks. As I said, she does understand that the surgeon has to cover himself, and that he needs to make sure there are no other underlying issues, etc. and she is ok with that.  I just feel for her so much, she really has battled since she was 12, and she also feels that she's being almost punished for trying so hard to at least stay as healthy as possible (she does a lot of exercise, always has) Oh, and she has already thought of going to another surgeon, which I think she will if this all goes wrong!

I'm struggling to understand exactly what  "ideal" criteria are for this surgery. I know my chocolate addiction is a red flag, but people with a higher BMI than me also struggle with food addictions. I feel like I am a good candidate, and I'll do well with a sleeve - even the psychologist said that to me !!!! I'm just nervous he's going to say a lap band is a better option. I wouldn't bother with a balloon - you can only have that for 6 months, and that's a 'diet' for me - I've dieted for that long plenty of times and regained the weight  (& more!) I feel like I'll just keep gaining if I don't have this surgery....in which case I'll 'qualify' for the surgery pretty soon , anyway - 4 more kilos and I'm at BMI 35 !

My plan is to do what I did at all of the other appointments - go in & be honest, calm , but confident. As I said, I have some health issues in my immediate family, my cholesterol is high , insulin quite high, fatty liver. I am actually the heaviest I've ever been. My BMI is 33.5, so it's not right at the bottom end, but it is low for WLS. I feel enormous for ME, my knees & feet hurt & I have carpal tunnel syndrome back again .I would not have gone this far into this process without being completely confident that this is right for me. 

Thanks for listening, girls 

Hi ftf

Firstly, I agree with Lisa and aussiearies on their comments. And hugs :) Big hugs to you.

Secondly, that ankle weights lady has some serious issues that no surgery gonna fix, far out!!

Gee, your SIL must be feeling pretty bad, poor thing. I get the risks and the need to weigh up options, sometimes even to say no I am not comfortable to do the surgery, that's valid, but I agree: why make someone jump through all those hoops first, and why make them feel bad? What is her plan now?

As for your visit I know you must be dreading the same thing happening, but try to go in feeling calm and with an open mind. You are a different person and must be treated as an individual.

Lastly, he is not the only surgeon around. I am not saying don't listen to him or take his advice seriously, but if you don't feel you've been given a fair hearing before a decision is made (which is all most of us want really) you can seek another opinion with someone else. More money, yes, but you want to feel comfortable with someone who will be operating on you.

Run yourself a nice bubble bath and try to relax :)

Hi FTF

I can understand how you feel. You have co- morbidities which surgeons generally take into consideration, especially if you BMI is not as high as it has been.

If I have read your posts correctly you are like many of us, up and down with your weight, and if your BMI is lower now than it has been perhaps that is something else to stress to the surgeon, that you have lost weight as you have done before, but you know from your own history that you will end up putting it back on and probable more as well.

A low BMI currently, might auger well for having the surgery now with it being less risky than if you end up back there with it being higher.

The balloon appears to be a very short term weight loss procedure and even though I thought about it years ago I decided not to have the lap band, and after reading the comments on this and other sites I am glad I went with my gut on that (pardon the pun)

Sadly I didn't have your problem of a lower BMI as mine was very high but I do wish you well in your journey 

I do understand doctor's being cautious and not wanting to perform major surgery for someone they think might be able to lose the weight themselves and keep it off, but if that is not you or your SIL then you should get the help you need, if the surgeon can see you are knowledgeable about the process and understand the good, the bad or the ugly and are going into this with your eyes open, he might feel differently.

Not being from Vic I don't know of any surgeons that are less strenuous re the BMI level but others may be able to comment.

Hey FTF, 

I'm not in your shoes (sad to say I have a BMI of 48 - which I truly can't believe, but I digress...) and as you know I'm yet to go to my surgeon's appointment so I can't offer you any advice, but I just wanted to give you a virtual hug and show some support. It's clear you've done your research and know what you're in for, so perhaps the surgeon will not have any problem in saying yes, especially since you have a large number of other health considerations.

When is your appointment?

I wasn't sure where to post this, but I decided Pre Sleeve is appropriate, seeing as I am Pre Sleeve....and may be staying here for a bit - I don't know!!!!

I haven't started a diary yet, as I wanted to wait till after my surgeon's appt, so I have it all locked in and definitely going ahead.

My SIL and I have been on this journey together - we are both Low BMI for WLS, we've both had our surgery booked in since last Nov, but we both had to wait the 12 mths for PHI to kick in. Our weight struggle stories are a little different, but we've sort of both arrived at the same point, & we're only 5 moths apart in age, too. 

We were both booked in by the clinical nurse, and we both kind of assumed that we were going ahead, that the various appointments were a requirement, but not something that would potentially rule us out . S it turns out, my SIL was 'flagged' for psych appt first, and was told at that appt that the surgery 'may not be right for you', so she scheduled her surgeon's appt earlier, as he is the one who makes the ultimate decision. 

I have had dietitian, GP and psych appts, all seemed positive, but certainly didn't say "See you after surgery", obviously they aren't legally allowed or medically qualified to confirm that. 

Anyway, SIL had her appt yesterday, and the surgeon made it all sound very scary, stressed the risk & implications of a leak, etc - which, of course, he HAS to do, gave her the third degree, and then said he thought a lap band was probably a better option, but wouldn't guarantee that, either. 

She was, obviously, really upset and frustrated, and is feeling in limbo. She works, and she very much needs to tell her employer how much time she needs off, and exactly when that will be. She absolutely understands where the surgeon is coming from, and that this is not some quick fix thing you do on a whim, but we both feel that we were not fully informed about the process. I am so worried they are going to say the same thing to me!! I will be furious - I really think their process is flawed - with Low BMI patients, I think they should schedule all appointments early on after the initial nurse's consult , so you know where you stand ! I have a slightly higher BMI, I also have pretty high cholesterol, high insulin, fatty liver,  and a history of heart attack, insulin related cancer & high blood pressure in my immediate family, so I know those will be taken into consideration, but I'm feeling  quite flat and disappointed for her and freaked out about my appointment!!!

This is something I've thought about and researched a LOT and I feel like now is the best time for me to have it done, and that the sleeve is the right procedure for me. I wouldn't have increased PHI, nor waited all of his time if I wasn't serious about this. I don't want a balloon and I don't want a lap band (and I wouldn't even consider a gastric bypass, which I'm sure no surgeon would , either!) I'm not being stupid or deceitful about it (someone on another forum said she was low BMI, so she wore ankle weights to her surgeon's appt !!!!! ) I've been honest at every appointment. I feel like I'm a good candidate, I know it's going to involve a lot of commitment and that I'll face various emotional and physical challenges , but I'm motivated to make this work for me,  I'm just really nervous now - I really feel like I'm in limbo and just want to know that it's going ahead.

Sorry for the rant,as I said, I'm feeling flat & freaked out and I just want my surgery confirmed !!!