New here and a little PO'ed

Hi I am new to this site, and forum.

My topic title might sound provocative...so be it.  I am a social misfit. For more than 5 years I have been fighting with the help of all my many doctors to get gastric bypass surgery.  At first my family doctor didn't even know who to refer me too!  Finally he found a doctor to refer me to, and I was put on a wait list where I would be then put on another waiting list.  Two years past, nothing heard.  During that time my Internal Medicine Doctor (I have diabetes) also recommended the surgery, as did the dieticiandietitian he referred me to.  My psychiatrist (I have many mental health issues as well) totally agreed.  After two years, the doctor whose name I had been referred to up and quit our province, and my referral was "lost".  Two wasted years. 

wawawwa, wa wa wa... after 5 years, seven doctors, I finally got to see a bariatric surgeon.  I thought I was on the way.  Did I mention I am 5 foot 11 inches with a 66 inch waist and 400 lbs?  Then out of the blue I am called and told I have to show up at a weight loss clinic .  Basically I am told I have to lose 10% of my body weight before I can even be considered for the surgery.  Furthermore I must jump through 1001 (exaggeration) hoops (such as attending seminars, join supports groups, and lose and unspecified number of inches around my waist, all with NO assurance this will even put me on the list for the surgery.

I do not do well in social settings.  I am a loner.  I don't even function in groups run by psychiatric workers...now I have to prove I myself by fitting into weight loss groups?  Also prove I understand nutrition.  I was / am a professional licensed chef, who cooked for the military for many years, and trained in dietary needs of ships crew etc...   Yes I am extremely obese...it is not because I don't understand food.  Drunks are not alcoholics because they don't understand booze...  I don't get it.

So anyway, I am new here.  I am not always a whiner, but I do tend to be more negative than positive.  I can lose the 40 lbs.  I have done similar "demand" loss tests before when in the military to pass physicals...but of course it isn't healthy and doesn't stay off.  My problem is the number of medications, (and my list is extensive including 2 forms of in metformin) make me ravenously hungry at times...It was only after the diabetes that my weight went from obese to monstrously obese.

GrumpyOldMan

Well, I'm just an average person so I really don't have a lot of experience with some things going on here. But I can tell you that I'm also somewhat of an introvert and can't stand some social situations...especially, those that are forced on you.

I'm probably only scratching the surface here, but in order to lose 10% of your weight, could you try walking? It might help you lose that weight and then prepare you for maintenance after your surgery. Also, it can help you clear your head.

As far as the social aspect of this, sometimes in order to get what you want, you just gotta face it head on. As a military man, I'm sure you know what sacrifice and perseverance is all about. Get to your seminars and meetings and you can eventually check it off your list. Ya' never know, you might meet one or two people that really click with and they can be your ally in your weight loss journey. Good luck and please keep us posted.

Welcome to Calorie Count and to the Weight Loss forum!! Have you checked out the Weight Loss Forum Reources thread at the top of this forum? Also have you seen that we have a New Members forum which has a great thread The Unofficial Guide to Calorie Count? Good luck and let us know if there is anything we can help you with!

It does sounds as if you are getting quite the runaround regarding your surgery -- but, many people here have found that counting calories and doing a little bit of extra exercise can make a tremendous difference to their life.  And the good thing about being here (at CC) is that the social aspect is minimized.  Many of us know WHAT we're supposed to do, but the carrying out part of it wasn't working -- that is where the CC tools come in handy -- especially the food journaling feature. Hopefully, we can get you where you need to be.

One of the biggest misconceptions about losing weight is that you must go hungry to do it -- not necessarily true, you just have to fill up on the stuff with better bang for the buck.  And I'm not talking "calorie-free, nutrient-free, (taste-free) diet" foods -- but real stuff.  So, even if you are ravenous, you could fill up on a salad focused on veggies, with some protein thrown in, and a touch of EVOO -- that will satisfy you without throwing in the calories towel.  The veggies help fill you, the protein and oil help to satiate you.

From your stats and using the tools, I get that you burn about 3700 calories per day -- with no added exercise.  If you cut just 500 from that and eat only 3200, you should lose a lb per week.  Add in activity to burn an addition 500 and you up that to 2lb per week -- at 400 lb, you could safely lose up to 1% per week -- I recommend you try that through exercise rather than calorie restriction.  Exercise can be the key, and something as simple as walking can be a great start.

Many, many people have had great success using CC to help them, from the member who has gone from 650+ to 350+ and is still trucking along, to that teenager who only needed to lose 5 lbs -- it is equal opportunity here.  If you use the tools, don't cut your calories too low, exercise some -- you should have success.

I have severe arthritis in both knees, and also my ankles.  Broke both ankles in the military, and am on disability for that and mental issues.  I do use a recumbant bike but even when I do NOT exercise, I often have to resort to Percocet to sleep, and even then only for a couple of hours at a time. 

This is one of the reasons the doctors feel I would benefit from the gastric surgery.  Too bad it wasn't done about 8 or so years ago, when there was still some cartalige in my knee joints.  I can walk maybe 100 yards with the help a cane.

I only eat about 2000 calories.  (used the CC yesterday to keep track as I was told and bought a food scale capable of measuring to the .5 gram)  I have lost 12 lbs since July (my last hospital admission).  At that time they did not believe I weighed 400 lbs.  (Mental ward, they thought I was overmedicated and drug seeking).  The had to find a special scale but found I was correct in my estimate (had not been officially weighed in 2 years) was found to be 397.5.  At my weigh in on Friday at the Weight Loss Clinic I was down to 384.4. 

One thing the shrink did was change one of my mood drugs, to one that has a side effect of weight loss (a nice side effect for a change).  What bothers me is that None of the doctors seem capable of talking to each other.  There is no continuity. 

I totally understand that gastic bypass is drastic surgery.  1:200 mortality rate on the table which is higher than quadruple bypass heart surgery.  I understand for at least 4 months or more I will be on a liquid diet, and my lifestyle will drastically change.  However, I also hope that with these changes come some positive effects, such as decreased pain, ability to have increased mobility, and less dependence on others. 

Thanks for the welcome.  I do better with online forums.  I run a mental health forum actually, small and cozy as it is.  There are a lot of reasons we are the way we are (not just MI but obese).  Doctors don't seem to get that sometimes.  Maybe times are changing, but when I was in the military being overweight was a sign of being lacking of moral fibre.  Heck, I gave up smoking, from going from a pack and a half a day to nothing...26 years ago.  Same with booze, from full blown black out alcoholism to stone cold sober again 26 years ago...doesn't that say something about moral fibre, guts, or willpower?  If weight loss is all about will power, they have it all wrong.  There is much more to it.  Mind you, you don't need cigarettes, or booze to live, you do have to eat to live.

Grumpy

I've lost weight with diet only, since I can't exercise due to a heart defect.  The best part of CC is the community interaction, which can be on your terms.  I get all the support I need from keeping my journal and having friends encourage me.  I didn't do very well with real life groups, like Weight Watchers - always felt like the odd gal out with nothing in common. 

There are a lot of CC members who have lost amazing amounts of weight and not all of them worked out or did the boot camp type thing.  You'll gradually learn who they are, and I suggest that you listen to these people because they know how to get it done.

Good Luck and welcome.

Hello, It sounds like you are determined and I don't think there is any lack of morale fibre.  Having grown up in a CF family, and spending 4 months in, I know what it's like to be constently judge (in my case it was lack of strength and cardio).  I have no doubt that you know all about nutrition, and that you implement that into your personal diet. 

As for excersice, try something that is low impact.  Swimming is an excellent way to get a good work out.  Lots of gyms offer personal swim training (one-on-one aqua-fit).  If it is still to social for you, schedule your sessions during a normal work time if possible.  (Swimming also makes me sleepy, but that's just me).

Are you wishing to get traditional gastric bypass surgery or the new adjustable ring thing?  Purely out of curiosity...

As for doctors...they don't communicate.  I worked in health care for 4 years and found that there was constently a lack of communication, not only between doctors but also with pharmacists.  And with having so many doctors, and they all having their own beliefs and perceptions of your situation, I think it would be very hard to ever get them all on the same page. I would just suggest keeping them all informed about everything to do with your health, even it means telling your Internal Mecidine doctor what your pychiatrist said.  You may get a blank stare but at least they can't accuse you of drug seeking if they know everything thats going on.  It also may prevent them from prescribing drugs that will interact with one another. 

Good luck with you weight loss!

I'm the same on all the social counts..

But I really recommend, however hard it is, to lose the weight without relying on surgery. People have done it even from the point of being over 600 pounds.. so if your life isn't immediately threatened, it's really best in the long run to avoid a surgery. I can't say I understand what it's like to be at 400 lbs, but I did hit 210 at an age when something more like 100 is the norm (And I'm really short to boot), and it's taken a long time but I'm losing it.

If you run a mental health forum, you might have heard of the MBTI personality types? If so, you're also INTP, right?

I tried swimming, but found to my dismay that at some time in my aging process I developed an allergy to chlorine at least the high level in the public pools here in Hamilton Ontario.  I was swimming a mile a day for about a month but the rash was so bad my family doctor made me stop.  Like I say I have tried, I seemed like every which way I turned there was yet another stumbling block.  Each new medication I was put on (and I am on something like 18 a day) had "Weight gain" as a side effect! 

I am not sure what the letters mean in the reference to mental health.  My mental health conditions have no "direct" bearing on my weight, though there is some corelation to sexual abuse and sefl-image problems that can and has been documented to be related to overeating and obesity...this explained to me by one of my PDOCs (psychiatrists).  I do not know if that is the case with me.  I am genetically predisposed to being large.  I was 200 lbs at age 18, had to lose 20 lbs just to join the military.  Mind you I was in great shape, played football, and baseball, and could run cross country all day, just not for speed.

The only form of bypass surgery covered by our health plan here is the full bypass where they bypass your entire stomach and about a foot or more of intestine.  They create a 'new' stomach which is about the size of a tablespoon, from part of the old one, and attach the intestine to that.  They leave the old parts intact in side because to remove them totally is too complex (too many connecting tissues and organs).  I feel it will be the only way to sustain long term weight loss. 

I have at times lost weight with diets, and medications such as Xenecol, but it never lasts.  Is that because I cannot adjust my lifestyle?  Perhaps.  I will admit to that.  But with a stomach the size of a tablespoon, the feeling of being full will be accomplished much quicker and require several small meals a day which should solve any oral fixation problems. 

I do not enter the concept of bypass with it being some sort of magic formula, but rather a rather drastic, but in my case needed aid.  What is so bothersome is the super long waiting lists, and lack of doctor's knowledgeable and caring enough to deal with me.  You get to a point where you get tired of trying to explain, especially when you are not especially easy going, or socially adept with people.  It would be nice if there was a central ombudsman or spokesman who could coordinate all the information that has been available about me, and my condition over the years, all the attempts, and efforts.  Instead I feel upset and irritated at having to "start over" again and again.  It never seems to end. 

I do appreciate the community support.  Thanks all

Grumpy

Hi,

I am sorry to hear about your trouble, but I hope you do not get discouraged.  I am sure that you can bear with the hoops for the time being and get to your goal.  It will be worth it in the end, even if it is extremely frustrating right now.  Try to remember that the red tape isn't personal--everyone has to do it who wants the surgery.  I know that any mental health issues are a "red flag" that they watch for for the surgery, so that is another obstacle for you, but try to keep stable and play the waiting game for now.

Best of luck!!

Not provocative at all, Grumpy Old Man!

Rather straightforward and to the point, actually!

Jumping through hoops... I know that story inside and out. I've been jumping through hoops for 25 years, just to get the surgery that my physicians and former shrink say will be better for me physically and mentally.

You get treated like you're a child, as if what you are asking for is something elective and arbitrary, like a facelift! The thing is, at our age, we know our own minds, we know what's going on with our bodies, we know what's right... and yet, they simply give you more hoops to jump through, or say you must get progressively even worse before they'll let you do it!

And then, even when you get close to the finish line, they tell you that even though you need x, they will only offer you y or z!

I do not do well in social settings.

I don't do well in enforced social settings, in which I cannot choose the company I keep, and cannot leave if I feel the need. PTSD + GAD + agoraphobia. I'm medicated slightly, but if I can't leave... no good. So, I certainly can understand that the enforced group setting can be something that is more of a negative than a positive, and can get in the way of the objective instead of clearing the space to get to the objective.

What you are saying, I don't see as whining. I think you have a legitimate beef. But it also seems that you have the fighting spirit and wherewithal to make what you need to happen, happen.

I think you need to befriend Duke3522 and read thru his struggles and accomplishments and sure he'd provide some great support and motiviation. 

I wish you much success in your journey

My diagnosis are Borderline Personality Disorder, Paranoia (mild), Dysthymia (long term depression), and Major Depressive Disorders.  Heavily medicated and spent six weeks in for Electro Convulsive Therapy (which did some good though it did leave major gaps in the memory department).

I keep fighting, but many days it just seems like the deck is stacked.  Lucky for me the latest round of hoops has my psychiatrist seeing red, and he is quite upset.  Whether that translates into his being able to actually talk to the surgeon, the weight loss clinic, the social workers, etc... who knows?

My trouble in social situations is I tend to create chaos without seeming to do so, until it all goes to heck in a hand basket, then they all point at me blaming me (and it is my fault, but I don't have the ability to sense myself doing it or stopping it, nor it seems do trained psychiatric staff).

Grumpy

Hi Grumpy!

I'm on the other side of all of this.....i'm a operating room nurse who has assited many surgeons with Laproscopic and Open Gastric bypass! If the doctors are saying you need to lose 40lbs....you need to lose 40 pounds....No i'm not heartless nor a bitch.....but i've seen "you" way too many times! The fact of the matter is that your too "sick" to be operated on! The doctors are afraid that the surgery itself will kill you....yes kill you..... That is why they won't preform it at this time! I'm sorry to be so blunt....but we are actually saving your life at this time! Please take it from someone who knows....someone who's seen.....someone whom really cares about you.....the facts are hard to swallow but it really is the truth! YOU NEED TO GET MORE HEALTHY IN ORDER TO HAVE THIS SURGERY!

Being Canadian too...living in Montreal....knowing the best Bariatriac surgeons around.... I know you can do this! Get healthier and then proceed! You are just too high risk right now! Trust me i care....i am a daughter/wife/mom/nurse who's seen and lost a few patients that i will never forget!

I get it, but if that is the case, then why in the appointment with the surgeon, did he not indicate this to me?  My wife was in the room with me.  He said "you will need to go on a liquid diet prior to surgery to shrink your liver".  He said nothing about a 10% body weight loss, nothing about referring me to a weight loss clinic, nothing about it at all.  Matter of fact, he told me my next steps were to make an appointment with his dietician, and social worker, as well as another doctor, not identified by specialty.  I made those appointments (all in March, a dissapointment in itself as he had indicated I was six months to a year away from surgery, but in fact at the time I was six months away from seeing the team the 'assesses' me, and that team hasn't seen me yet).  Out of the blue I get a call from a local clinic 'reminding me of an appointment'.  When I asked who made the referral (thinking that once again my ECT memory loss caused me to forget to write an appointment in my calender), they said it was my family doctor.  Confused I called my family doctor, only to be told he never made such an appointment.  When I showed up for the appointment I ran through the names of seven doctors I have seen in the past 3 years....turns out it was the surgeon who made the referral.

Would it not have been nice for the doctor to at least email me, call me, write me a letter, or in some way explain to me the rational behind what he is doing?  As it is the doctor at the clinic thinks I am "non-compliant" or "difficult".   He refuses to "speculate" on what is going on in the surgeon's mind.  Should the surgeon referring me to him not have given some idea of what the plan was? 

No while I have no fear of death, and thus the side effect of the surgery (most common two side effects cited by the surgeon are depression and suicide) is not a big deal.  My current and past psychiatrist know that my depression and suicide ideation are controlable with medication, and therapy, and will get better, most likely, not worse, with the surgery.  Yes I know they screen for mental illness, and such, but I have two psychiatrists who have stated catagorically that the surgery would be better for me than not having it and they should have a better idea of my mind and moods etc than a surgeon who has seen me for 20 minutes. 

By the way, I was told I would be done using the Minimally Invasive Procedure using 5 keyholes, though on occasion they have had to change to open procedure in some cases.  Like I have said, the surgeon gave a very thorough talk, answered all my questions, my wife's questions, and left us with the impression that my next step was to talk to Social Worker, Dietician, and other doctor (gas passer???) all on the same day in March, then see the surgeon the following week.  All those appointments have been booked.  Now what happens if I fail to lose 40 lbs in that time?  Start over?  No one can seem to tell me, and of course trying to get to speak to a surgeon on the phone is like getting a direct link to God himself.

Grumpy

Wow, so sorry to hear about these struggles.  Seems crazy.  I do understand the need to lose now, but you're totally right, the doc should have been upfront with you and given you a whole lot more detail about all of that. 

There are a group of us in the 300+ Countdown who do monthly log ins and support in the meantime.  I find that we fit into a different place than most of the other people in here.  We face different issues and have a lot of assumptions made about us.  I'm actually also a social worker, so I totally get how much your meds must be effecting you.  I get frustrated with it.  Here, you're depressed...take this pill that may make you gain a lot of weight and feel depressed about that too. 

But, you'll get there.  Hopefully sooner than later.  Sounds like you already have your part all figured out.  Just waiting on all the others.

Good luck!

Editted to add: Was going to say, I've actually heard of better results with the bypass since it forces the change in eating habits.  But, I've also heard of people who lost that 10% and realized that they would prefer to keep doing that instead of the surgery since it was about the same difficulty.  I have no personal opinion of surgery.  It's not right for me, but for lots of people it is the right choice.

It is just so befuddling.  I like things to make sense.  People who suffer from BPD (Borderline) tend to think in terms of black and white, they do not see, and cannot process in shades of grey.  Everything is and either / or equation or at least we wish it was.  When it isn't we have a great deal of difficulty, I do.

I will get around to checking some of these other mentioned community groups out.  I have a lot on my plate in the coming days.  I have to see my disability benefits worker to arrange for transport for all these weigh ins, and doctor - lecture - support meetings and tests at this clinic now, and I have two test tomorrow to undergo.  I also have to arrange for an ultrasound and lab work. (which is another waste of money as I just had the same lab work done for another doctor just last month, but hey who cares about saving money right).

Oh well I didn't mean to vent so much.  I am just so confused and upset by this.  I thought things were finally getting on track back in September, and now as October comes to a close I feel things slipping further away than ever. 

Grumpy

Don't give up, Grumpy. We're rooting for you.

Grumpy it seems like all is in place. That day you will see all the people that are involved in your surgery. It's called PRE-Operative Clinic in Montreal. Everyone will see you! Excluding the surgeon( ONE WEEK LATER LIKE YOU SAID). You may run into a resident though and he may answer a lot more questions for you. About the tests and having them repeated.....in Montreal you have a limit of three months. If your surgery date exceeds three months(from pre-op clinic to surgery date: someone will contact you and you'll have them redone probably the day before your surgery.) They need to compare results. The hospital will probably call you in and pre Admit you the day before the surgery. You said your appointment was in March....you'll probably be operated in April. 

Grumpy they won't cancell you if you don't lose 40 pounds...they want you to try...if you get 20 down good! Whatever you do will be good! They see that at least you are trying and want to change! I believe you can do this! You seem to be a very knowledgeable man. Hang in there and remember that you'll have good days and bad but stick to it! You can do this!

By the way...the wholes that you said(5) is Laproscopic Gastric Bypass. It is the least invasive way and yes they sometime have to open you....so many reasons for that! But keep positive! Keep your self strong. Let us know what happens!

Each bariatric clinic is different, but the first thing you should do is call your insurance company and see what their requirements are to qualify for the bariatric surgery. Some require just the medical testing (the "hoops") to make sure you can handle the surgery.  Usually you need to have a BMI >35 with co-morbidities (like hypertension or diabetes).  Or, you can qualify if your BMI >40.  Some insurance companies require a 6-month Dr. supervised weight loss program where the Dr and/or a dietitian will review eating strategies and exercise programs to aid you when you get the surgery (eat breakfast, drink more water, exercise as much as possible, etc..).  As for the support groups and such, there is generally no requirement for participation, you just have to show up.  But, with that being said, you might be surprised at the benefits you gain from each session.  Anyways, good luck in your journey.

Check your local area swimming pools as we have several that are salt water, no chlorine.

Hey kids...lets add grumpy to our friends. I think he needs lots of support. : )