[Sydenham]

Hello everyone and a Happy New Year to You All xxxxx
I would really appreciate your opinions on the following. Below is what I posted on a UK WLS site and the replies I had were supportive in every way. But I don't think us English are forceful enough when we are dissatisfied and I would love to know how you would handle my situation and what I should if anything be expecting my surgeon to do?
I saw the surgeon as planned and he simply asked me what I eat and drink and said that we can work together to hopefully resolve the problem. He now wants to see me monthly. The last time I had seen him in August I had gained but he just expressed his surprise and I stupidly didn't tackle the issue then. My surgeon has an excellent reputation but I feel intimidated by him.
The issue is for me though, is a really difficult one. After over 30 odd years of dieting, losing it, putting it back on etc, I had the Gastric Bypass as it was for me what I thought was going to be the solution. I now find myself in a position of having to "Diet" again and feel so confused its untrue. I took out a loan to finance the surgery (£9,000) and will not finish paying the loan off till July 2013 and yet I am not the thin person I expected to be by now and worse still feel as though I am once again in the cycle of feeling guilty and sad about the weight gain and now turning to food as a crutch.
This is my story that I posted:-

"I havent posted for a very long time but even in the early days of my surgery my posts always had the same theme to them. In a nut shell, I had my Bypass 7/4/11 and pre op lost exactly 2 stone. Post Op, I then went on to lose another 3 stone by July.
My issue was that I never felt I had anything in common with the other WLS patents on the Forums or that I met at groups or that I met up with individually.

They all talked about restriction or dumping etc and to give you an example, I went for coffee with a lovely lady that had the op two weeks prior to me with the same surgeon. We ordered a jacket potato with cheese and beans. Three mouthful's and she was done - but I ate all of mine with gusto, whilst she looked on in amazement.
My family have all asked "but I thought you had to eat differently when you had WLS?"
The point is - so did I, but I can eat anything and everything.

Now I am sure when this is read, I will be in for some tough criticism from a few but what I need to stress is that what I do have in common with those mentioned above is that I have the mentality of a fat person, so I am inherently greedy.
I have spent the majority of my adult life yo yo dieting and after several years of drumming up courage and deciding on a loan, I believed that the Bypass would be my answer. I required something to be in place that would deter me from over eating.

When I last saw my surgeon in August he was surprised that I had gained weight but neither of us said much about it, I was sent a copy of the GP letter and that was it. The weight gain has continued.

The straw that broke the camels back happened on Christmas Eve in the Supermarket as I was shopping. I was tapped on the shoulder by a woman I didn't recognize and she asked how I was doing. I was frantically
trying to put a name to the face but when she asked about my weight, I fell in.
She had the Bypass two weeks after me with the same surgeon but her 8 stone loss meant I just didn't know her. She looked amazing and we started to chat. I told her how unhappy I was and we compared our eating habits. She can eat bread but only just about half a sandwich - I could eat a whole baguette.
She eats from a side plate - I eat from a dinner plate and eat the same as the rest of the family and in the same quantity.
She never feels hungry and really makes herself eat - I do feel hungry and have done all along.

She said but you have to tell the surgeon so I came home and emailed him. I had felt too embarrassed to do so before as my weight gain had continued but was reassured when I had a reply.

I have an appointment tomorrow to discuss these issues and actually feel a bit better already as I have now taken the first step to attempt to resolve my difficulties."

Suzanne
xxxxx

[Butterfly312]

Although I haven't had my surgery yet, I believe the problem could be that you haven't been able to reset the mental aspect concerning food. You fixed the outer but the inner needs to be adjusted. You need to set limits for yourself. Are you eating small bites? Taking in a lot of protein and saying no-no to carbs? Tell your surgeon that you are having a problem with feeling full. I do wish there was more I could tell you. I wrote what I've read from others who have had the surgery. I thought posting something could possibly help instead of leaving you empty with no response. I do wish you luck on your weight loss. Don't be discouraged, you'll lose the weight.

[Sydenham]

Thank you so much Butterfly for taking the time to answer. I really do appreciate what you are saying to a point but surely if it was a case of reseting the mental approach to food - there wouldnt be a need for Weight Loss Surgery.
I have spent all my adult life trying and failing to do this, and that is why I decided on the surgery.
I also understand that the surgery is a tool that we are to work with but I dont feel "the tool", so have been left high and dry so to speak with only will power to prevent me from regaining all the weight lost so far. But this isnt what I understood Weight Loss Surgery to be all about.
Thanks again for your time.
Suzanne
x

[Butterfly312]

I'm sorry Suzanne that I didn't have the exact answers to maybe shine some light on this situation you are experiencing. The people here are usually very good in posting very good supportive replies. I'm sure someone with more experience on the matter will respond soon, even if it's to give you some support. I'm here for you...good luck.

[lastangelgrl]

Hi Suzanne, I had rny and I cant believe you're hungry and can eat these amounts with it...it makes me think that something was not done right! Did your Dr say what size he made your pouch? I would definitely be asking him a lot of questions. This surgery was too expensive and too much planning to just live with this and not get full benefit of it. Good luck!

[melanie6]

I really think you need a response from the doc...the one who moderates the board to see if she can give you some insight as to whats going on.

From reading what you wrote, it doesnt seem like you had surgery. I would definitely ask tons of questions and maybe even demand an xray to see proof of his work (im not in the medical field, but I believe you should be able to see the work on the screen if you indeed had the surgery...im sure someone will correct me if Im wrong). I can understand your confusion, if I put myself in your shoes I would be confused too. Something just doesnt seem right. Im only 5 weeks out but I cant eat more than 2 oz and my hubby who is more than 6 mo out cant eat more than 4 oz...and no bread (bread is the devil, lol).

Let us know what happens...Im curious how the doctor is going to address for concerns. (((HUGS)))

[jasmarie75]

Hello Suzanne, I would definately discuss the issues with your doctor. You also seem to not have changed your mentality. After I had my surgery I automatically started eating off a side plate. I measured my meat to 2 oz and used teaspoons to get any sides. I too sometimes feel that I'm hungry and know that I'm truly not (its the old fat girl in me still wanting to eat out of comfort). When I have that feeling I push liquids or drink a protein drink. How long are you taking to eat? Post surgery you should be eating your meals in at least 20 or 30 minutes. Take a bite, put the fork down chew and let it digest for a minute; its not a race to clean your plate (eventhough we grew up believing that). Personally I have never had any dumping and can really eat anything I want with no problems. Which ia a curse because nothing is off limits and I have had to teach myself that I don't need the cookies or cakes or cokes. I don't want to go back to the old me and stress when there is a gain or the scale. Are you exercising? That will also help in keeping the weight gain under control. You may want to think about going to a counselor to discuss the mental issues. You should not be ashamed to speak to your surgeon, they are there to help; I would also suggest to meet with a nutrientionist to go over your diet and to give you some other helpful pointers...good luck!!

[PookPook]

Suzanne,

I am five weeks pre-op, so I can only imagine the incredible distress, frustration, and disappointment you're feeling. What you've described simply shouldn't be happening, and my initial reaction is the same as Melanie's.

You say that you've felt hungry all along. Was there any change in your appetite when you were just released from the hospital and having only liquids and then soft foods? Did you feel any restriction in your digestive system if you didn't chew thoroughly enough? In short, is there any evidence that something was actually changed in you internally?

I certainly don't yet have the knowledge or experience of the post-ops on this site, but it would seem to me that if your current challenges with eating are indeed mental, it would be a gradual sinking back into old/bad habits after the initial inability to eat substantial amounts, and not - as you describe - feeling hungry all along.

Yes, it makes me wonder whether you'd do well to get a second opinion on exactly what was done (or not done) to you. (And if it turns out that nothing was done, then it's downright admirable that you lost 64 lbs. - more than halfway to your goal weight - on your own!)

Wishing you a satisfactory outcome on this in all cases.

[DocSanae]

First, a few things for you to check out.
1) Are you keeping the no drinking while eating rule? No drinking starting 30 mins prior to your meal, no drinking during your meal, and do not resume drinking at least 30 mins after your meal.
2) When you eat, is it protein first, veggies next, then carbs if you have room left? If not, you must change your eating pattern to this.
3) Are you getting in at least 60g protein plus 64oz (1.8 liter) water/fluids daily?
When you think you are hungry, do you get in some fluids first, then wait and see how it goes? (A lot of people who have been overweight for a long time confuse thirst and hunger, so what you think of as hunger, may actually be thirst.) Of course, once you've drank some water, you will have to wait 30 mins before you can eat anything.
The above 3 points are RNY rules that you need to stick to for the rest of your life.

Next.
1) The texture of food is important for keeping hunger away. The thicker the texture, and the more you have to chew throroughly, the longer it stays in your pouch, and keep you feeling full. Beware of *slider* foods. Foods with softer texture can slide through your pouch quicker than thicker foods, bringing back hunger.
2) Journal your food. Utillise online sites like www.fitday.com, www.sparkspeople.com, www.myfitnesspal.com and the likes. Chart your protein, carb, and fat intake, and the balance. Check out how many calories you are ingesting. At your stage--the time out since your surgery--your total daily intake should be no more thant 1200 kcals or so. In fact, most RNY post ops at the same time you are--6 months or so out-- averages around 900-1000 kcal daily.
3) Plan your food intake before hand. Plan and prepare daily, at the beginning of your day. Measure out your foods and make sure that the nutritional balance is good. More than 60g protein, while keeping your carb intake at around 100g or so, and keeping your fat intake below 30g, but not less than 20g. Do not depend on eyeballing the amount, do not depend on your *hunger* feelings, but eat the planned portions of the planned foods at the time you have set aside for your meals.
4) Read the labels of the nutrition information of all the food stuff you buy, whether processed food, seasonings, or cooking material such as flour, soup stock, dairy products etc. Make sure you are getting the best nutritional value for your money.
5) Not all foods are created the same--not all carbs are equal, not all protein are equal, not all fats are equal. There are good and bad carbs, in the form of complex and simple carbs, good protein from lean meat, and essential fat that are needed as lubricants for your body. Learn to avoid the bad stuff, which are usually large in number in processed foods, and low in home cooked foods made from scratch.

[pretty woman]

Hi Suzanne,
I could never eat what you are describing, and I am 11 months out. I know each of us are.."different-body reaction." But it doesn't seem that you have lost that much and now are gaining. I have no advice, just support. Please keep posting and tell us what your surgeon says. I would not be satisfied and think you have every right to stand up for yourself.GOOD LUCK.