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Sunday, November 2, 2014

8 Years Post Op RNY

Wow. I'm 8 years post op RNY already. Often I have people ask what life is like post op as a long timer and so this post will be a wrap up about my life, the good and bad, post op.  I can finally say that I'm getting the "hang" of this whole maintenance thing finally. It's taken a while for me to get the hang of it.  I didn't realize until I was around 2 years out that I was a binge eater and had an eating disorder. That's why now, I highly suggest that everyone preop examine the reasons they eat.  It made life quite difficult past the first few years but now I feel like I am getting the hang of it finally.  Let's just say that getting off the weight of surgery is EASY PEASY.  There you go, I've said it.  Yes it can be full of struggles - I remember being terrified of drinking and eating initially as if I was going to burst my pouch - but after you get past the first couple of months, it generally becomes much easier.  But long term, it is a challenge to keep off the weight. Your metabolism becomes far more sluggish and it takes way more work to lose even a simple pound long term. Again, that's why I say so often to use your first year well and get to goal with no regrets!

At 8 years out, life is pretty good.  Like everyone I have my great days and difficult days with food.  I battle my FATHEAD every day trying to make healthy choices and to CHOOSE to exercise.  It's a choice.  Everything is a choice now.  I either get off my butt or I watch the scale creep up.  If I get off track with my eating, I see the scale creep up, and back I go, down to a back or basics eating plan. I still suck at moderation most days and if food is there, I will eat it.  There's no magic to keeping it off. I know what works - lots of protein and exercise, very low carbs.  Hard to sustain.  

Medically no big issues other than the ones that I've known for years. Osteopenia of the spine that developed at year one (wrong form of calcium - we need citrate friends) but has stayed the same since.  Anemia - always battling ferritin but haven't had it bottom out yet with hemoglobin.  Always supplementing.  Low vitamin D (Hello? I'm Canadian) and of course, Reactive Hypoglycemia (which I've managed well the last few years).  That's it.  They sound scary but other than watching my sugar intake and taking a few extra supplements, they really impact my life very little.

Positives - Life is GOOD.  I fit in normal clothes.  I range between a M-L in shirts, 9/10 or 11/12 in pants.  I   coach basketball and still walk like crazy.  I did 5 half marathons and am calling a break until maybe Spring when I might consider taking up running again. Always undecided lol.  I could end up doing bellydancing instead...who knows? Lol.  I fit in backseats of cars, am not afraid of turnstiles or passing by groups of teenage boys, I do fit in one size fits all, I can shop in virtually any store, I can easily do all physical tasks and well, life is normal :) 

The biggest change for me this year has been my attempt at resolving my body image issue. Although I know at times that I'm normal sized, I'm also at times very critical of my body.  So well, it was time to pursue plastics.  My tummy really has bothered me forever.  It was time to fix this.  So I finally decided to go for my tummy tuck.  I was lucky enough to get OHIP to pay my panni portion and so out of pocket, it cost me $4080 to upgrade.  I had a fleur de lis tummy tuck which includes a vertical incision in addition to the horizontal hip to hip cut.  (This helps fix skin above the belly button as well).  Dr. Matic in London removed four pounds of skin from my abdomen.  I'm very pleased with results and hope that this well help me like my body a little more especially when it comes to summer time.  It will also alleviate rashes and prevent hernias hopefully from happening in the future.  

There's my life in a nutshell.  Any questions? Just message me diminishingdawn @cogeco.ca (no spaces)

Saturday, August 16, 2014

Treating Reactive Hypoglycemia

Hypoglycemia After Gastric Bypass Surgery

What is hypoglycemia?

Hypoglycemia refers to low blood glucose or blood sugar.  While "dumping" is a result of too many sugars and makes you sick 20-30 minutes after eating,  low blood sugar caused by reactive hypoglycemia can make you feel bad and it can be dangerous, since your brain requires a certain amount of glucose to function normally. Severe low blood glucose levels can cause passing out (loss of consciousness), seizures, car crashes, or other more serious outcomes. In people without diabetes, glucose levels are typically above 70 (3.8 Canadian) first thing in the morning, before eating and usually range from 70-120 (3.8 to 6.6) at other times of the day.  (although it spikes shortly after eating). 


The main organs in your body that are important for maintaining normal blood glucose levels are your pancreas and your liver. The pancreas makes and releases insulin into the blood stream. Normally, when you eat a meal, the pancreas makes insulin and the insulin helps to keep blood glucose levels from rising above normal.  People who have high blood sugar, often having a problem with their pancreas.

The liver is also very important to help maintain blood glucose levels. The liver makes glucose, particularly between meals and overnight when you are not eating, so your vital organs can get the glucose they need to function normally.  The liver ships out glucose to other body parts and is the distributor for your body.

There are two broad categories of hypoglycemia:

(1) Fasting hypoglycemia - refers to low blood glucoses in the morning, or when no
food has been eaten for many hours.  You may wake up hungry, moody or feeling faint.  Some people have to keep something by their bedside to consume before getting out of bed (but this is rare)

(2) Postprandial hypoglycemia (also called after meal or reactive hypoglycemia) - refers to low blood glucose levels within a few hours after eating.  It is "reacting to food".  The food is what sets off the chain of events for your blood sugar to go up and down like a roller coaster.  It's "what you eat" that is usually the problem and so, you must take steps to eat differently with your RH in mind.


Postprandial hypoglycemia is also referred to as Reactive Hypoglycemia.  It is a result of how your body is adept at processing sugar.  If you eat something high in sugar or carbs, a lot of insulin is released in response to eating, and the insulin removes too much glucose from the blood.   The insulin's job is to bring blood sugars back down but because it is getting all the sugar in the blood stream at once it is pumping out too much and bring blood sugar further down than expected.  (When you had your pyloric valve sugar was slowly released and then insulin was also slowly released).  Because the valve is gone, the sugar spikes you up fast and the insulin is released too fast.  In some cases, this may be very severe i f the pancreas is making too much insulin.

Most often, reactive hypoglycemia shows up around the 1-2 year mark post gastric bypass...but can occur anytime really after the first 6 months, when the sugar response in gastric bypass patients becomes 20x as strong.


Symptoms:
You may feel some or all of the following syraptoms within 1 to 4 hours after eating:
Weakness
Racing or rapid heartbeat
Nausea
Extreme hunger
Headaches, especially first thing in the
morning (may indicate a low blood
glucose has occurred overnight)
Dizziness
Sweating
Difficulty concentrating or thinking
Nightmares or bizarre dreams - may
indicate a low blood glucose while you
are sleeping
 Importantly, you may have no
symptoms, but others may notice that
you are staring, not paying attention,
seem less attentive, or are "not looking
quite right."  Much like a brain fog. 
Some also have a numb mouth or tongue. 

Treating Lows:

It is critical to treat a low blood glucose quickly so that your brain has enough glucose to
fimction normally and to prevent you from passing out.  An important tool is a glucose meter or blood sugar metre used by diabetics.  They can be costly but if you have the coverage, get one.  It will make it much easier for you to figure RH out.  Keeping a journal with blood sugar readings and foods, will help you greatly to learn what affects you and how it affects you.  Most patients have a dropping point when their blood sugar starts to drop and will eventually become critically low.  You need to know when that point is by testing at the 1 hour mark and every 10-15 minutes there after. 

 When your blood glucose is toolow, you need to eat food with sugar in it to bring your glucose level up quickly. You need to eat food with sugar, even though you may experiencing dumping syndrome (abdominal
cramping, lightheadedness and diarrhea),

1. Stop what you are doing - sit down.
2. Test your blood glucose, i f possible, to make sure that it is low.
3. Eat 15 grams of sugar in the form of one of these "hypoglycemia treatments":
a small juice box works great)
- 3 tsp sugar
-3 tsp jelly
-small box of raisins
-3 glucose tablets or 4 dextrose tablets >
- 7-8 lifesavers (chew and swallow)
-5-15 jellybeans (sugar content varies from 1-3 grams per bean - check label)


4. Retest your blood glucose after 15 minutes. Repeat treatment if glucose is under 80.
5. After you treat the low glucose, eat a protein food (but not low fat ones) to prevent
the low from returning - this is a critical step.  You want protein to keep it sustained.  Otherwise you will keep going low, high, low, high.  Always carbs plus a protein:

Some examples of protein foods to have are:
a. roast beef (1 ounce).
b. regular cheese (1 ounce)
c. regular cottage cheese (1/4 cup)
d. regular ricotta cheese (1/4 cup)
e. peanut butter (1 tablespoon)
f. nuts (1 ounce)
g- whole milk (1 cup)

6. Keep glucose tablets or glucose gel with you at all times. These are available at any pharmacy and do not melt or require refrigeration. Keep some in your pocket or purse, next to your bed, and in your car for emergency use. You don't want to take the time to search for a sugar food when you are having a low blood glucose! You may also find that 4 ounce juice boxes are convenient for the car.  Honey packets work well too.  Never ever drive when you may be feeling like you are having an issue.  You could easily cause an accident and kill yourself or others. Stop and pull over if ever you feel like your blood sugar may be affected.  Eat and test. 



Being Proactive

It is really smarter to be proactive rather than reactive to lows.  Every time you pass out from reactive hypoglcyemia it may lead to permanent brain damage. You must treat it seriously.   Working to prevent a low is always better than to reactive to contant highs and lows.  Plus, being reactive rather than proactive can also lead to cycles of eating when you are not supposed to and can easily lead to regain!

1. Modify your diet.  Chances are that it was a food that caused the problem to begin with.  What did you eat?  Learn what  your marker time is for your blood sugar to dip.  For instance, for me it is at the 1 hour, 15 minute mark.  If I dip, I need to know that is when I need to eat preventatively.  But again, if you can avoid a low by changing what you eat that's always better. 

• At meals, eat controlled portions of low glycemic carbs.  Add fat to your eating.  Many protein foods have fat in them and the fat in the protein food also slows the digestion of the carbohydrate. This will lead to less of a "spike" in blood glucose after you eat and result in less insulin secretion (which is what you are trying to avoid).
• . Carbohydrates that are high in fiber are typically slowly digested. Read labels and look for whole grains rather than "enriched" flour, which has much of the fiber removed.
• Avoid high glycemic carbohydrate foods 
• Avoid eating only carbohydrate at a meal or snack   Always eat a carb with a protein. Always!
• Avoid eating carbohydrate in excess amounts (stick to 25 garms of carbs per meal.  Remember, it's not just sugar --but it's also carbs because carbs turn into sugar!). 

AVOID some fruits: bananas, pineapple, • • • •
watemelon, raisins, cantaloupe, grapes, plums
all finit juices
refined cereals, such as Corn flakes. Rice Krispies
regular pasta and rice rice cakes or popped com
Refined crackers, such as Saltines, Ritz,
white bread, rolls, bagels
pretzels
starchy vegetables: potatoes, corn,
winter (orange) squash
sweets: candy, cakes, cookies, ice
cream, syrups, soda
alcoholic beverages

• Avoid sugar alcohols, such as sorbitol or mannitol.
Include a high protein food with each meal and snack. High protein foods
include fish, chicken, turkey, meat, eggs, cheese. Look into paleo/primal eating.
• Include healthy fats with each meal, such as soybean oil, olive oil, canola oil,
olives, nuts, nut butters, seeds, soybeans, and avocado. Fish, such as mackerel,
salmon and blue fish, not only contain high quality protein, but healthy fats also.
• Include high fiber, non-starchy vegetables with most meals. Examples are
romaine lettuce, broccoli, asparagus, summer squash (yellow, zucchini & spaghetti
squash), tomatoes, carrots, turnip, spinach, kale, collards, cauliflower, eggplant,
green beans, cabbage, and cucumbers.
• Try eating 6 small meals a day, rather than 3 larger meals. If you eat snacks
between meals, choose non-carbohydrate foods, or select a snack from the attached
snack list.
• Before exercise, eat carbohydrate with protein, such as whole-wheat crackers
with whole milk, regular cottage cheese, or peanut butter.
• Drink liquids primarily between meals. Water or decaffeinated, unsweetened
tea/coffee are best.





Many reactive hypoglycemia patients have had excellent results with a paleo or primal diet.  You can google the terms for a shopping list.  Mostly, you need to cut out the carbs and focus on proteins.  If you bake, use alternative flours (coconut, almond etc) and add fats.   These types of baked goods will affect you far less than goodies made with traditional white flour and sugar.  Read and learn.  marksdailyapple.com is a good source for information!

Mix-and-Match Snacks
Remove all tough skin and chop seeds and nuts

1. Hummus and pita
1 oz whole-wheat pita with 2 TBS hummus
2. Extend Bar (www.extendbar.com)
These are made with uncooked cornstarch, a very slowly absorbed carbohydrate,
and can prevent low blood glucose levels. It may be useful to eat one at bedtime (to
prevent low blood glucose in the middle of the night) and one in the mid-morning
(to prevent low in late afternoon).
3. 4 oz light low fat yogurt topped with 1 TBS chopped nuts
4. 1 medium apple and 1 TBS peanut butter
5. Toasted cheese and tomato on wheat
Top 1 slice whole wheat bread with 1 oz cheese or avocado and 2-3 slices tomato.
Toast in toaster oven.
6. Cottage cheese and berries V2 cup strawberries or blueberries and V2 cup cottage cheese topped with 1 TBSchopped soybeans. Sweeten with Splenda if desired.
7. Veggies with dip1-cup raw baby carrots or broccoli florets and 1/3-cup cottage cheese vegetable dip
8. Top an 8-inch whole-wheat tortilla with cup refried beans, V4 cup shredded
cheese, and 1 TBS salsa. Microwave for 15-20 seconds and roll.
9. Celery and peanut butter
4 - 3 inch raw celery sticks and 1 TBS peanut butter

10. Ricotta cheese dessert
cup part skim ricotta cheese mixed with 1 packet sugar substitute. Sprinkle with
cinnamon and 1 TBS almonds.
11. String cheese and crackers
1 mozzarella string cheese and 1-2 RyVita or Wasa whole wheat crackers
12. Tuna salad pita
1/2 (loz) whole-wheat pita filled with V2 cup tuna, 1 TBS mayo, and alfalfa sprouts
13. Tomato and cottage cheese
1 small tomato cut in wedges topped with V2 cup cottage cheese and sprinkled with
chives
14. Smoked salmon and cream cheese
1 slice whole-wheat bread topped with 1 TBS cream cheese, 1 thin slice red onion
and 1 oz smoked salmon
15. Egg and spinach salad with chick peas
1 sliced hard cooked egg, 1-cup baby spinach, cup canned chickpeas, 1 TBS
olive oil and balsamic vinaigrette. Toss spinach with vinaigrette, place in serving
dish, sprinkle with chick peas and place sliced egg on top.







Sunday, August 3, 2014

8 Years Post Op RNY

I know that when reading many blogs for RNY, people get upset because the journey ends at a year out or two, and many don't write posts on how they are doing after many years.  For that reason, I like to update my blog so that people can get an idea of what life is like many years post op RNY.  Now, I've always been a bit abnormal in some ways - easy peasy recovery, very few issues....but we all know that the experience of surgery is different for everyone.  So here, I'll update you about how things are and tell you about anything new I've learned or experienced:  

The Good:

-Life is pretty typical - I continue to be very active and to walk 5 to 10 miles a day is not unheard of for me.  I am active and busy and still enjoying life without having to worry about turnstiles, getting in the backseat of a two door car, that one size won't fit all, and all the typical stuff of morbid obesity.  I can say that I've sideswiped many possible health issues and I can confidently say that I know that I won't ever go back to being morbidly obese.  While I definitely have my challenges most days with my eating, I am pretty confident that I understand how to manage my weight now.  Hopefully there won't be any obstacles with this and I can keep doing what I'm doing.  
-My deficiencies seem to be okay.  Not much different than before.  Not improving much, but not getting terribly bad either.  I'm still osteopenic (since year 1) but it is the same - no worse/no better and I'm okay with that.  Iron still sucks but not enough that I need infusions.  Still vitamin d deficient (aren't most Canadians? yes!).   Other than that I'm holding my own and that's a good thing!
-While I go up and down on the scale (I can be as close as 5 lbs to my goal weight or as high as 20 lbs over - and then I get my act together and work on it) I'm staying fairly the same.  That's a good thing even though I can really beat myself up over it.  
-The clothes in my closet are one of two sizes.  I've bumped up one size from my lowest so I guess in the scheme of things that isn't too bad.  I am still working on getting down. 

The Bad:

-I beat myself up over regain constantly.  
-There are days that my eating is out of control.  I am still a slave to sugar.  Some days sugar wins, and some days I win.  It sucks.
-I still want to get back to goal and it's a bugger to control the eating most days. 


The Ugly:

-The skin.  Hoping to get a tummy tuck come Fall/Winter.  I have OHIP approval for a panni so I'm just having to save money for the upgrade.  
-Some days my reactive hypoglycemia kicks my butt but I'm far better at managing it now.  I had two pass out incidents but for the last few years manage it fairly well without problems.  I understand it much better now.  

Really there's not much in the way of ugly to be honest.   No big complications or problems.  Have never been in the hospital overnight since my surgery.  No horror stories at all.  

Dawn


Wednesday, March 12, 2014

WLS is Like Baking a Cake

"Please help me!  I'm only 2 months out and I've ONLY lost 30 lbs."

I see these posts all the time on just about every board that I read.  A sense of panic that someone has not lost all their excess weight in a manner of minutes, hours and days.

*sigh*.  Big giant sigh!

You need to wrap your head around realistic expectations.  You did not gain 50, 100 or 150 lbs over night.  You will NOT lose it over night.  This takes time.  This takes the right ingredients.

WLS is like baking a cake.

When you decide to bake a cake, most of us just can't go into any cupboard, grab ingredients and within a matter of minutes, have a cake baked, done and frosted.   Weight loss (even with wls) takes time, balance and the RIGHT ingredients.

Before we decide to bake a cake,  most of us have to read and find the right recipe.   We might have to research a bit before something seems to be "just right" for us to make.  We have to find a recipe for success.   It may take lots of consultation, lots of reading, talking to experts until we find the right recipe for the occasion.

Then we have to go shopping for all the right ingredients.  We have to make sure that we have all the right food ingredients as well as pots, pans and utensils.  Measuring cups guarantee success.  Without that careful measurement, our cake may not rise or may be a total disaster.  Planning is key.

We might even take a "dry run" and practice that recipe before we actually make it for that special occasion.  We know that skills are not innate, they are practiced.  We might even find that the recipe needs a "little something" so we may consult others for advise.  We may talk to other baking experts about that one missing ingredient.  We may even tweak the recipe accordingly and find that our recipe is better than the original!

The day of the big event, we are prepared in all ways for the task ahead of us.  We know that a good cake will take some time.  We give ourselves plenty of time so that we can slow down and be exact with our measurements.  We know that being rushed won't help make the cake better.  It's about exact measurement and precision.  We don't just throw together ingredients.  That doesn't work.  It takes time.

Once we carefully measure, mix and pour, we wait.   We wait some more.  We wait some more.

Even the best cakes don't come out of the oven in 60 seconds.

That time waiting is precious.  It's exciting anticipation of what is to come.  We know that it will be totally worth the wait.  We know that the cake is worth waiting for.  Even though we have to wait, we don't question that we will have a cake when the process done.  We know that we've prepared the cake the way we need to.

We know that we are set up for success.  We added all the right ingredients.  We know that we have had good practice.  We know that we have all the ingredients and all the right tools.  We know that in 40 minutes our cake will be done and it will be a success because we've set it up that way. 

And even, when you take your cake out of the oven, there is more time to wait before you can frost it.  Patience is required.   It will take time, more time and even more.  

Stop thinking that your cake will be baked in 3 minutes. If you've done all the planning, followed the rules and set yourself up for success, you have nothing to worry about.  Everything worth waiting for takes time. 

Know and believe that it will be worth the wait.

Saturday, January 11, 2014

Realistic Expectations

I put this on my webpage7 years ago and it has made its way through cyberspace on many, many blogs.



REALISTIC EXPECTATIONS!

While you will lose weight in the first few months after bariatic surgery, you reach your maximum weight loss in 12 to 18 months.  Here is what you can expect to lose post op!

For patients weighing 200 to 250 lbs.
10 lbs. in first 10 days
15 to 25 lbs. in 6 weeks
25 to 35 lbs. in 3 months
35 to 45 lbs. in 6 months
60 lbs. or more in 1 year
70 lbs. or more in 18 months


For patients weighing 250 to 300 lbs.
10 to 12 lbs. in first 10 days
15 to 25 lbs. in 6 weeks
25 to 35 lbs. in 3 months
45 to 60 lbs. in 6 months
80 lbs. or more in 1 year
90 lbs. or more in 18 month



For patients weighing 300 to 400 lbs.
10 to 30 lbs. in first 10 days
25 to 45 lbs. in 6 weeks
35 to 55 lbs. in 3 months
50 to 80 lbs. in 6 months
100 lbs. or more in 1 year
120 lbs. or more in 18 monthsee


(The error above is often copied on pages lol).

 For patients weighing 400 to 500 lbs.
10 to 30 lbs. in first 10 days
25 to 45 lbs. in 6 weeks
35 to 60 lbs. in 3 months
50 to 90 lbs. in 6 months
120 lbs. or more in 1 year
150 lbs. or more in 18 months







Sunday, December 1, 2013

The Phrase I Hate

There's not a lot that irks me in the online world.  I spend much of my free time lurking on OH and reading and admining various wls specific groups on Facebook.  I understand the differences between newbies and oldtimers like myself and the different ways that we see the world.  There's generally not that bothers me, but there is one phrase that bothers me and I'll explain why today. 

When people post their weight loss, I often see the phrase "100 lbs gone forever".  This is the phrase that bothers me.  It might seem strange but I feel that when we engage in talk of forever that we are taking something for granted.   We are taking our weight loss for granted.  Early out in the honeymoon period, we get this sense of invincibility because life is smooth, temptations are low and hunger is low.  We think that life is going to be that way forever. 

Tis not so for most of us.

I've gained back 10 lbs.  15 lbs, 20 lbs, 25 lbs.  I know that it is not necessarily FOREVER.

This is DAMN hard work.  It is hard to keep our mind always on what we should be doing. It is difficult to keep our demons away.  It is hard to stop eating emotionally when you've done so for 10, 20 or 30 years.  It's not all rainbows and unicorns.

Eventually you realize that this is WORK.  For the rest of your life nonetheless. 

And it is easy to slip into old habits.  Very easy.

It's very easy to become unfocused, to be unaccountable and to avoid the scale.

This is FOREVER, not just for one year.

And hunger returns.  And life goes on.  The compliments stop coming.  Motivation wanes.

I want to scream and shake people and say "Don't say FOREVER.  You don't know how EASY it is to do!!".

Don't take anything for granted.  Don't think that you can just do "moderation" when you sucked so badly before at it.  KEEP THE TRIGGERS OUT. 

I want to say that dessert shouldn't even be in your vocabulary at 4 weeks out.  You shouldn't be having a cookie! If you think it's a challenge now, wait until year three or four or eight or twelve.  Keep it out. 

When you are a long timer, you see so many people struggling early.  You see people that are failing. You want to reach out and say "Don't go there!!!!".  Stay the course. Don't give in yet!! Get to goal.  You want people to succeed.  You want people to do better than you and not to struggle with food demons.  It's hard.  You know what it's like when after a year, you started having goodies again.  You see people digging into Pandora's box far, far too early. 

But then you shut up because you know that newbies won't understand.  They'll think that you are just being mean and not letting them enjoy a "small bite" of everything because they think that their small pouch will keep them in line forever.  *sigh*. 

It's a different mindset. 

At 7.5 years out, and around 15 lbs up at the moment over my goal, I'm frustrated.  I'm angry. I'm pissed that I have to get back to all the incredible hard work it takes to lose the weight now at this juncture.  It's not the same as the first year.  It's a huge ass kicking to even lose a lb or two now.  It blows the mind how much effort it takes to lose when a gain can be acquired from a bad weekend.

Feeling a little down...but I've done it so many times before - pick myself up, dust myself off and begin again. It gets a little tiring though to be honest.  I just want to know how to do this whole damn moderation thing successfully after many years of yo yo-ing up and down the same 5, 10, 15 etc pounds. 

What a pisser :(

Ah well.  Here's to new beginnings yet again....

Thursday, July 11, 2013

Things To Do While Waiting For Gastric Bypass

 A question on the OH Ontario board today has lead to this post today....

Here in Ontario, we have typically a wait of anywhere from 9 months to 2 years for surgery.  Most patients get through in just over a year.  Often I hear "how can I fast track through the process?".  I had a very honest lady in my support group spend a meeting discussing how she was one to think this and now that she's gone through the surgery, she realizes that she was the one who held herself back.  Rather than embracing the help from the Bariatric centre, she thought she could "talk her way to the front of the line".  She realized that this is what actually held her back in the process and made her wait even longer.  I admire her for her courage to tell the group about this and how her thinking has changed now that she's had her surgery.   Kudos to her.

The things is (and I know this all too well) you become somewhat obsessed with surgery once you've decided that you are going to go through with it.  It's understandable because we know that it's going to be an amazing change especially after seeing so many of our friends go through this surgery.  Quite frankly, we are also a society where we have very little sense of delayed gratification - we want what we want NOW.  So I'm here to shed a little understanding on WHY the wait is crucial.

You need to reframe your thinking on the whole process. This is not merely a set of hoops to jump through.  To be a success with gastric bypass you are going to need to make some drastic changes BEFORE surgery.  There's so much to learn, to know, and to understand that there needs to be a process.  Recently I've seen some turnarounds for surgery at 3-6 months through Humber River Hospital and to be honest, I'm SCARED for most of these patients.  This is a HARD road.  This is not brain surgery people.   That's the problem.  We get our bodies rerouted but we still have the same fat brain.  That fat brain will want to sabotage us along the process.  We have to outsmart it with education and by establishing some positive habits now. 

We have SO much to learn through this process in order to be a success that I often suggest to people that they EMBRACE the time as preparation time for what is going to be the most amazing (but often challenging) time of your life.  So start preparing now:

Prepare your Resources:

Begin by preparing your resources for surgery.  I would suggest that most people read at least two good books on surgery to understand the basics.  I've seen so many people not read a thing other than the handouts given by the surgical centre.  There's barely any information there to be honest.  The best resource I suggest is Weight Loss Surgery for Dummies.  Truly I think it should be mandatory reading for anyone preop.   Some other ones I like are the Real Skinny on WLS (Janeway)   and the Complete Weight Loss Surgery Guide and Diet Program by Sue Ekserci.

Start a binder with ALL your resources given by your hospital.  If you can get a copy beforehand, get a copy of your eating plan through your surgical centre.  Start creating meal plans according to each food stage.  Make a shopping list.  Know your eating stages like the back of your hand.  Try a few shakes but don't get carried away as your tastes may change.  If you see any samples, buy them to try after surgery.  Remember protein is key.  Learn what makes a good quality protein shake.  Don't get fooled by people you know that might want to try and sell you their inferior shake that "worked for them".  Learn and read! Collect recipes and calculate nutritional info if possible. 

Write down a list of complications and what to watch for.  Learn and read your message board on OH every day.  See what it is like as a new post op after surgery.  Learn the differences between foamies, things getting stuck and dumping syndrome. 

Research your hotel options and travel options for your spouse.  I did this months ahead for my hubby so that I knew where we would stay, routes and even shopping areas in Guelph.  Loved ones will benefit from your thoroughness. 

Document every visit to your dietician, social worker etc.  Keep your homework.  Write down your responses and document what you've learned as you go through.  You'll appreciate your thoroughness later!

Oh did I mention that you could go in expecting to get a Roux En Y (If you are asking what that is, you need to research!) and you may come out with a VSG.  Again research!!  You need to know these things.  Learn the difference between dumping syndrome, foamies and things getting stuck.  Read about a stricture, hypoglycemia, slider foods, plateau/stall,  NSAID (we cannot have them), malabsorption, restriction, why carbs matter, vitamins, etc.  Read and read and then read some more! (Seriously!). Read about what dumping syndrome is and why you cannot count on having it.  Learn what the expected loss rate is.  Learn about things that you can do to increase your rate of loss.  The bariatric centre won't tell you all things.  Some people lose 50 lbs, other lose 150...find out the differences to their level of success. 

Prepare Your Mind:  

I have always said that the mental aspects of this surgery are the hardest.  While the six months to a year are fairly easy (albeit the first 6 weeks can be TOUGH), after that this surgery is going to be hard.   Explore the issues that have lead you to this point.  Look into whether you have an eating disorder,  learn about what your patterns are and why you've gotten here.  What are you replacing with food?  Are you a binge eater? Emotional eater? Boredom eater?  Start working on these issues now because some time after a year, it is no longer going to be a constant high and the amounts that you'll be able to eat will be greater.  I'm going to be honest here and say that there is a failure rate for surgery.  Some people do gain all or most of their weight because they have not dealt with these issues.  You need to know that and really start to explore your eating issue.  Do you just "like food"?  Is it instant gratification? Then it's time to start teaching yourself about delayed gratification.  Yes, it's going to be about willpower again certainly after a point.  Start to teach yourself about discipline, putting off a craving, finding other outlets for emotions and stress.  I know this sounds preachy but my surgical centre did nothing about this and I really wish they'd did.  At 2 years out I had to find therapy in community and was lucky that I had it.

Utilize your centre's dietician and social worker for these changes.  Start making big changes now.  You can only benefit from this.  Start exercising. Start getting rid of all the negatives in your life.  Time for a positive change. Get rid of the baggage.

Prepare Your Family or Spouse:

There may need to be some changes in your house.  Although you cannot DEPEND on your family to go through all the same changes as you, you will need their support and their help especially for the first 2-4 weeks.  Time to prepare everyone about what you'll be needing and what they'll need to do to pitch in to make your recovery smoother.   Remember too - if you are keeping your surgery a secret, you need to draw boundaries with your family as often the "secret" gets out.

Track other people's journeys:

As you see some people preparing for surgery that will have surgery before you, watch their journeys.  Read how they manage the first month out.  Look at what they struggle with, how they solve their problems and record and write down what you learn.  You'll only benefit from what you learn.

Find Mentors: 

Find a mentor - whether online or in person.  Find someone that wouldn't mind you emailing them if a question should arise.  You might be feeling panicky after surgery or you might not want to post everything to the masses online.  Find that person who you've learned from and respect and who will give you quality, sound advice.  Find someone who is stable and secure.   If they seem flighty or highly emotionally charges, stay away.  Find someone who seems to give helpful advice and is willing to answer your questions.  Find someone you relate to.  Actually, if anything, find MORE THAN ONE mentor.  Sometimes people fall off the face of the earth or they might get to a point that they are struggling themselves and might not respond.  Always nice to have a backup.

Find a Support Group:

Look for a support group in your area.   Many communities have them.  If you can get to one in a nearby community, I think it is just as valuable and worth a trip. Bring your spouse if they are a bit leery of surgery or bring a friend who is willing to support your surgery.  Face to face contact is important.  You have to be careful who you trust to be a mentor and seeing people in person may help you find someone.   Don't be hestitant to email someone in your support group, they probably will be more than happy to help you.  Even go out for coffee if they are willing.  It helps to settle the nerves when you have a one on one talk.  Go to meetings.  Sometimes newbies feel a disconnect from the people in their support group.  To quote one of the members in my support group, "Suck up every bit of information" from people that you can learn from, especially from people that have been there, done that.  Experience is an amazing teacher.  Taking advice from someone who has not gone through the surgery can be iffy at best.  Learn from others.  This is by far the most valuable piece.  Make connections of support.  Some times that means "putting yourself out there" and it is worth the risk!

I wish you well in your journey.  Embrace the time you have now.  You may find that before you know it, you'll feel a sense of panic because surgery "has come so soon!".   It can be a funny thing!

Good luck, my friend!

Dawn