Gerty
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Post by Gerty on Aug 29, 2013 3:05:32 GMT -5
Hi Everyone, I’ve been lurking here for a few months. I’ve learned a lot, laughed and seen the support you give each other.
I’m introducing myself with a long winded, feeling sorry for myself story! I had RNY in 2000 lost 145lbs and have gained back 100lbs. I have a BMI of 51, reactive hypoglycemia, b12 deficiency, arthritis(hip, knees, back), pre-hypertension, depression, anxiety, blah, blah…It doesn’t seem that bad hearing others’.
I have been in treatment for the depression and anxiety for years and finally feel like it’s time to really get healthy again. I’ve been weight stable on my depression meds for over a year, and my psychologist and psychiatric nurse practitioner both support WLS.
I’ve been reading about revision to DS for about a year and started trying to get an appointment with a surgeon last May. I was nervous because the surgeon who did my RNY had been a partner in this office, but I took the seminar sent in my paperwork.
Then I got a call from the nurse asking what I wanted. I told her, and she said “So…You want a revision because you gained weight? I’ll have to ask him if he’ll see you.” I felt like crap. The next week I called them, he’d see me and someone would get back to me. A week later I got an email telling me what more they needed to make me an appointment. Two weeks later they called me to set it up, they usually have classes with the consultation, but they told me he wanted to keep me separate from his regular patients.
My appt. was a month out, that was fine. A few days before, they called and moved it out another month. In my logical mind I know it was because he was going to be in surgery, but that’s not what it felt like. A week before my appt. the nurse called me and we had the same conversation so...you want a revision blah blah! ?? Felt like crap.
I finally got to my consultation and he walked in gave me a lot of info…good, didn’t let me talk or ask questions…bad! Then he said I had to do a 3 – 6 month diet with a doctor in his office. I told him I’d already done a 6 mo diet and he said not in our office, and you’ve probably done opti-fast or something like that. He said they had a good Dr. to do it who just happened to be his wife! Holy @#$% unethical! Oh, and they don’t bill insurance for it.
I went ahead and made the appointments, but I left there angry and feeling like such a failure. I felt sick for days, I didn’t feel good about him and if I couldn’t talk to him, I couldn’t let him do surgery on me. My psych said I should turn him in to DOPL.
I found another surgeon in my area, actually got in with him the day after I called. He was great and does RNY to DS revision but will only do loop DS with a 300 cm common channel. BTW he has a staff psych and nut, but you can choose your own.
I went home talked to my husband told him the surgery was going to cost 4X as much as we planned because we were going to California. I canceled everything else. If Dr. K doesn’t think I’m ready, I’ll do what I have to do, but I’m not giving up or giving in! Okay, thanks for listening or reading, now I need something for heartburn.
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Post by duodenalswitcharoo on Aug 29, 2013 6:27:55 GMT -5
Whew, I have heartburn too after reading that giant paragraph haha (teasing you..but seriously...smaller paragraphs are easier on the eye) Welcome. I've heard lots of good things about Dr. K. So I think you are in good hands. Now I'm going to ask some hard questions. How did you regain? What old habits crept back in? (This is NOT a go at you NOR should you feel like crap...instead, face up to it) I'm only asking because you can regain with a DS. You can also not make goal with a DS. The DS is the best of the best and you are right to seek it out but use this time to understand what happened. Where did you slip? Was it lack of emotional support? Lack of dietary support? Using food as a crutch? Trying to push the boundaries of your RNY? I don't have an RNY so I am asking out of curiosity as those with an RNY cannot eat as much as I can with a sleeve. I also had no dietary advice or psych support but I have a little army in my head that kicks my ass now and then. If it makes you feel any better, Ive lost over 200lbs and kept if off but y bmi is still over 60! So you are not alone by any means. These ladies here (and a few gents) are top notch. A word of advice though: put on your big girl panties as everyone here, whilst supportive, tells it exactly like it is Welcome to the fold (haha!)
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Post by maggiesara on Aug 29, 2013 9:20:00 GMT -5
What is a loop DS?
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Post by larra on Aug 29, 2013 10:46:51 GMT -5
[quote author=dianacox Please provide the names of the surgeons to whom you spoke - it helps us to know either that someone is to be avoided, or possibly to help you know you misunderstood.
For example, I reread your post twice, and it appears that you are saying that Dr. Keshishian is going to do a loop DS on you - I'm 99% sure that isn't true, because I know Dr. K doesn't do that (or haven't heard that he does), and I'm guessing that somewhere in there you spoke to Gagner or Roslin (who ARE doing that procedure).[/quote]
She's in Utah, so whoever she saw is someone there. And my reading indicates she has not yet seen Dr. Keshishian and he was definitely not the one who only offered loop DS, but I don't know who was.
And to answer the next question, the standard DS is done with an RNY donfiguration. Unfortunately, we (and everyone else) generally refer to gastric bypass as RNY because it also includes an RNY configuration of the small intestines, but with very different connections from the DS and much less small intestine bypassed.
RNY looks sort of like a Y, with the small intestine divided and then one part attached to the duodenum (for DS) or stomach (for gastric bypass). A loop means the small bowel is just brought up to the duodenum or stomach, cut open and attached there without the Y configuration. Perhaps you've heard of the so-called "mini gastric bypass"? That's a loop gastric bypass that is not recognized as a standard of care operation and which very few surgeons in the USA do (for good reason that I won't get into here).
Did that help or did that add to the confusion? Your best bet is to look at pictures of the anatomy of the DS.
And to Gerty, who got lost in this post, I think you have made a great decision to head west to Dr. K, who will NOT make you wait months and months, will NOT insist on a completely unnecessary pre-op diet with someone in his pay and/or a relative (this sounds a bit unethical to me) and will NOT have a nurse who makes you feel like shit.
Larra
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Post by Deleted on Aug 29, 2013 11:52:50 GMT -5
Hi Gerty, Dr. Keshishian revised my RNY in December. I just wanted to welcome you and say I love your name. It makes me happy.
Whitney
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Gerty
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Post by Gerty on Aug 29, 2013 13:04:58 GMT -5
I was nervous posting, and I just needed to get it out. Sorry for any confusion.
I did really well with RNYGP for about 4 years and started to eat more carbs. That started reactive hypoglycemia and the circle went on. I got a very stressful job, I was feeling like a failure because I was gaining weight...got put on more depression meds...more weight gain...more depression...more eating. I also had a history of physical and emotional abuse, I'd been holding inside for years. One day I crashed, and it all came to the surface. I could no longer hold a job, I couldn't leave my house (except for counseling), and I stayed in my bed eating potato chips.
Knowing what I know now, I never should have had the first surgery. I thought it would solve everything. Life would be great. 13 years ago they gave me the surgery and a diet to follow and that was it. My personality changed, my family was angry at me, I had no support and I was lost with out food.
I'm not expecting DS to solve anything for me. It will help resolve the medical issues and if it I walk a little taller and talk to a few more people, bonus! I've talked to my family about the way they treated me last time and what I need from them. I told them what changes it could make in my moods and the very real risks. I have my PCP, my psych, and psych NP all ready to help. I've been learning how to deal with my food issues and have spent 8 years putting other issues in the past. I'm feel ready. I hope I have the chance.
The Dr. in Salt Lake requiring patients to go on a diet with his wife to have surgery is Dr. Simper. I've seen people on the OtHer board having to do it too. Her name is Dr. Joanna Erzinger, when I looked her up I found she is a Psychiatrist/Neurologist.
The other Dr. I saw was Dr. Daniel Cottom. I really liked him, and spent a lot of time with me. He will only do rny to ds revision as loop ds. I just can't take the risk. I know what I want and at 49 yrs old I finally won't settle for less.
Thank you all
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Post by amakram on Aug 29, 2013 13:55:16 GMT -5
Hi Gerty - Dr K is excellent and caring. Are you going to self pay for all of this? If not what does your insurance require of you to do? Mine did require 6 months of obesity counseling which my PCP thought was ridiculous so we talked politics for six months and a little about surgery to kill time.
Next time try putting more paragraphs in your post as it was kind of hard to follow along and I kept getting lost on the line on I was on.
As for the ladies and gents here, they're top notch and very supportive. I would definitely listen to their advice.
I have to agree with Duodenalswitcharoo that you probably need to figure out what caused you to regain in the first place. Address that issue first before surgery because I know of a few who have gained back even after this procedure and that would be very disheartening.
I can totally sympathize with the depression and can understand that completely. It's not easy to get away from depression. So maybe some new hobbies (not involving food), friends, volunteering, etc would help.
Wishing you all the best of luck. Amanda
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Post by larra on Aug 29, 2013 16:36:39 GMT -5
Gerty, whatever amount of extra money it costs you to go to Dr. K, he is worth it, and YOU are worth it.
Larra
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Post by newanatomy on Aug 29, 2013 16:57:51 GMT -5
I called Dr. Simper's office. I asked if I would have to participate in a supervised diet with his wife. They said no. It was only if your insurance required a supervised diet not for patients who are already approved or if their insurance does not require a supervised diet.
I did not use the recommended dietician for the nutritional assessment or his recommended psychiatrist either, no problem.
In addition, I have read great things about how thoroughly he answers questions and outlines the patients' options. There are a couple of his patients who post on here regularly, you can possibly speak to them. I have not met him yet but I feel pretty confident in my choice after seeing his reviews.
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Post by newanatomy on Aug 29, 2013 17:16:30 GMT -5
I am sorry you are going through a rough time.
I personal messaged a couple of Dr. Simper's patients. Hopefully they can offer their experiences with him.
I copied the following from an e-mail sent to me from Dr. Simpers' office:
Nutritional Assessment
We recommend making an appointment with Teri Lund M.S., R.D. at St. Mark’s hospital (801) 268-7479. For LDS Hospital patients, call You can call their office for additional guidance.
Psychological Assessment
The insurance company wants to make sure all patients are screened to rule out any psychological condition that might make compliance with the surgery impossible. If you do not have or know of someone, we would like to refer you to Dr. Larry Beall, Ph.D. This can be scheduled by calling his office at 801-263-6367. His address is 32 West Winchester (6400 South) Suite 101 Salt Lake City. Many insurance companies cover most of this evaluation.
They never even mentioned his wife.
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Gerty
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Post by Gerty on Aug 29, 2013 17:37:54 GMT -5
I called Dr. Simper's office. I asked if I would have to participate in a supervised diet with his wife. They said no. It was only if your insurance required a supervised diet not for patients who are already approved or if their insurance does not require a supervised diet. I did not use the recommended dietician for the nutritional assessment or his recommended psychiatrist either, no problem. In addition, I have read great things about how thoroughly he answers questions and outlines the patients options. There are a couple of his patients who post on here regularly, you can possibly speak to them. I have not met him yet but I feel pretty confident in my choice after seeing his reviews. Hi newanatomy, I've read that you're approved, I'm happy for you! I had read great things about him too. I went to the risks & benefits class that he taught and liked what he said. I started the jumping through hoops part. I had already done a supervised diet, and would have gladly accepted a list of suggested psychiatrists. He dismissed what I had already done and was requiring me to do it in his office. I have seen others in the same situation. I chose not to do it. My insurance requires failed medical weight loss.
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Post by newanatomy on Aug 29, 2013 18:17:42 GMT -5
I called Dr. Simper's office. I asked if I would have to participate in a supervised diet with his wife. They said no. It was only if your insurance required a supervised diet not for patients who are already approved or if their insurance does not require a supervised diet. I did not use the recommended dietician for the nutritional assessment or his recommended psychiatrist either, no problem. In addition, I have read great things about how thoroughly he answers questions and outlines the patients options. There are a couple of his patients who post on here regularly, you can possibly speak to them. I have not met him yet but I feel pretty confident in my choice after seeing his reviews. Hi newanatomy, I've read that you're approved, I'm happy for you! I had read great things about him too. I went to the risks & benefits class that he taught and liked what he said. I started the jumping through hoops part. I had already done a supervised diet, and would have gladly accepted a list of suggested psychiatrists. He dismissed what I had already done and was requiring me to do it in his office. I have seen others in the same situation. I chose not to do it. My insurance requires failed medical weight loss. My insurance required failed weight loss attempts, too. I provided copies of bills to weight watchers (online) and showed the fluctuations in my weight measurements which I obtained from my PCP. Can you provide them with a copy of any of your previous weight loss attempts? I searched on the OtHer site for any shenanigans regarding Dr. Simper's wife. I found about 25 posts written, highly recommending Dr. Simper as a surgeon for both virgin DS's and revisions, nothing about him making patients see his wife. As his wife works in his office, I am sure he recommends her to his patients if necessary but, forcing seems like something that would really hurt his practice. It feels strange to me to be defending a man I have never met. I just haven't experienced any questionable advice from his office. I think it's great if you feel more comfortable traveling to see Dr. Keshishian, I just had to clarify my understanding of Dr. Simper's reputation. I promise that when I meet with him for my consultation, if he tries to force me to meet with his wife, I will let the forum know.
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Post by Deleted on Aug 29, 2013 19:11:45 GMT -5
Hi Gerty, Dr. Keshishian preformed my revision in December. There are a few of us on this board. I know he saved my life.
He is a very skilled surgeon as well as a kind and compassionate human being. The minute I met him I knew I was going to be alright.
I am happy to answer any questions you have.
Best, Whitney
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Post by rickydeeswitch on Aug 29, 2013 19:56:15 GMT -5
Gerty, A few things from my personal experience. Those on mental health meds may lose more slowly and stop short of their goal. When that happens the disappointment and self negativity can awaken the Binge or compulsive eating pattern that has helped you to survive thus far. It no longer serves a constructive purpose. Other patterns like drinking or spending money can also re-enter or enter your experience and complicate your situation.
Social anxiety, panic and agoraphobia further take their toll. Reading through the lines of your account, I can see how you regained, and I have trouble with anyone, especially you, blaming and shaming you for the gain.
Try exploring and planning an alternative for that reaction which may well re-occur. Being prepared and giving yourself a break can help avoid the ultimate let down. Timing of your meds can make all the difference in your desire to eat.
Activity will definitely help you with both mood and wt loss, it's a win-win. OA can also help to find ways to understand where food stands in your life and how your eating can go so easily out of control... {:>}
P.S. Google DBT and Binge Eating. Lots of good skills to employ if u find yourself sinking...
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Gerty
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Post by Gerty on Aug 29, 2013 19:57:24 GMT -5
Hi Gerty, Dr. Keshishian preformed my revision in December. There are a few of us on this board. I know he saved my life. He is a very skilled surgeon as well as a kind and compassionate human being. The minute I met him I knew I was going to be alright. I am happy to answer any questions you have. Best, Whitney I think I've read more good things about Dr. Keshishian than any other surgeon. I've also been impressed that he is so available to people, even if they aren't his patients. I feel really calm about going to him. Right now my biggest question is where to stay down there, but it's a bit premature. I don't have an appointment yet. Thanks for your support, Gerty
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Gerty
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Post by Gerty on Aug 29, 2013 20:04:47 GMT -5
newanatomy,
I'm not saying he's making everyone go to Dr. Erzinger, but he is requiring it of some patients. I am saying that it's not ok.
Check the Utah forum on the OtHer site.
Gerty
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Gerty
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Post by Gerty on Aug 29, 2013 20:39:43 GMT -5
Gerty, A few things from my personal experience. Those on mental health meds may lose more slowly and stop short of their goal. When that happens the disappointment and self negativity can awaken the Binge or compulsive eating pattern that has helped you to survive thus far. It no longer serves a constructive purpose. Other patterns like drinking or spending money can also re-enter or enter your experience and complicate your situation. Social anxiety, panic and agoraphobia further take their toll. Reading through the lines of your account, I can see how you regained, and I have trouble with anyone, especially you, blaming and shaming you for the gain. Try exploring and planning an alternative for that reaction which may well re-occur. Being prepared and giving yourself a break can help avoid the ultimate let down. Timing of your meds can make all the difference in your desire to eat. Activity will definitely help you with both mood and wt loss, it's a win-win. OA can also help to find ways to understand where food stands in your life and how your eating can go so easily out of control... {:>} P.S. Google DBT and Binge Eating. Lots of good skills to employ if u find yourself sinking... Thanks rickydeeswitch, I've been on the BEDA website and learning about binge eating. I was shocked that it was real! I don't really meet the characteristics, but the uses of food fit. I have been working on finding new ways to deal with those things. It isn't easy. Sometimes you don't realize your even doing it. That too is something I'm working on. I hope I don't have to be perfect to have the surgery. The depression meds I'm on have been a good mix for a while now. I've talked to my provider about after wls. She wants me to have it too, and we'll adjust the meds if needed. I'm more prepared for the mental stuff this time. I have a mental health support team, and good info here. I don't drink, I do shop though! 2nd hand stores, yard sales...I love a bargain. I can't know what will happen, only do my best to prepare. Thanks again for your good advice. Gerty
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Post by Paula on Aug 29, 2013 21:08:47 GMT -5
I was a revision patient of Dr. Simper. I did not have to go through either a supervised diet nor was I required to have a psychological assessment to have my revision. This was not a requirement of my insurance company and therefore was not a requirement of Dr. Simper's to get him to perform my revision.
This situation you speak of honestly sounds to me like more of an insurance requirement than a surgeon requirement. The surgeons don't have control over the insurance companies or what those companies require. They, like us, have to jump through insurance company hoops.
This was merely my personal experience with the surgeon being spoken about.
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Gerty
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Post by Gerty on Aug 29, 2013 21:21:57 GMT -5
Gerty, whatever amount of extra money it costs you to go to Dr. K, he is worth it, and YOU are worth it. Larra Thank you! I feel really good about no matter how much more it is. Really my DH does too. Gerty
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Post by Deleted on Aug 29, 2013 21:24:24 GMT -5
Welcome Gerty. Your post tugged at my heart. I wish you well, honey.
I have a dumb question and hope it is ok to ask, but I've seen a few vague references to LDS patients over the years on WLS forums. I've always wondered what exactly everyone was talking about. Are there extra considerations because of garments and fasting? I mean no disrespect, but it's always puzzled me.
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Post by Deleted on Aug 29, 2013 21:25:25 GMT -5
Asking because in the email that New Anatomy posted above, there is a line about it.
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Gerty
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Post by Gerty on Aug 29, 2013 21:28:53 GMT -5
I was a revision patient of Dr. Simper. I did not have to go through either a supervised diet nor was I required to have a psychological assessment to have my revision. This was not a requirement of my insurance company and therefore was not a requirement of Dr. Simper's to get him to perform my revision. This situation you speak of honestly sounds to me like more of an insurance requirement than a surgeon requirement. The surgeons don't have control over the insurance companies or what those companies require. They, like us, have to jump through insurance company hoops. This was merely my personal experience with the surgeon being spoken about. Hi Paula, I have Medicare too. I know it's not required. When I called them before starting the process I was told my RNY was failed medical weight loss. Gerty
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Post by Deleted on Aug 29, 2013 21:29:48 GMT -5
Gerty, I did not need to stay in Glendale. I flew into Bob Hope Airport, rented a car, drove 20 minutes max, then flew ome same day. I did this 3 times. (Consultation, 1 sergical follow-up, 6 month check-in). He has a list of Hotels on is site. www.dssurgery.com/about/travel.php?subnav=0When you call you to make a reservation you may be able to get a discount if you tell them you are a Keshishian Patient. My surgery was in Delano near Bakersfield which is about a 4 hour drive for me. Flying into this tiny airport was pretty pricey. If you end up having surgery ther I can make recos when it gets closer to surgery date. Whit
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Gerty
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Post by Gerty on Aug 29, 2013 21:48:27 GMT -5
Welcome Gerty. Your post tugged at my heart. I wish you well, honey. I have a dumb question and hope it is ok to ask, but I've seen a few vague references to LDS patients over the years on WLS forums. I've always wondered what exactly everyone was talking about. Are there extra considerations because of garments and fasting? I mean no disrespect, but it's always puzzled me. It's not a dumb question! I'm probably not the best person to ask. I am LDS, but I have questions about garments with surgery. As far as fasting goes it isn't a requirement. it is asked that once a month you fast for 2 meals and donate the money for those 2 meals to the needy. It also about having control over your body. If you have a medical issue that makes it dangerous to go without food or water don't do it. I hope that answers your question. Gerty
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Post by Deleted on Aug 29, 2013 21:56:19 GMT -5
Thanks! I didn't know that about the fasting. That is really great. There are things I admire about many different faiths which are different than my own; I guess I'll add that one to (a long list of) things I admire about LDS.
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Post by newanatomy on Aug 29, 2013 23:31:58 GMT -5
newanatomy, I'm not saying he's making everyone go to Dr. Erzinger, but he is requiring it of some patients. I am saying that it's not ok. Check the Utah forum on the OtHer site. Gerty Gerty, I did, as you suggested, check the OtHer site again, specifically the Utah Forum. I saw one patient who mentioned a required supervised 6 month diet. This patient was seeing Dr. Erzinger. I understood this to mean that their insurance was requiring the supervised diet. I am sure Dr. Simper's office recommended Dr. Erzinger but, I am also sure that the patient would have been able to choose a different doctor to see if they wanted to. I wish you all the best with whomever you choose to have surgery with! I would not want to have surgery with anyone who made me feel uncomfortable either. I am a hoping for a good meeting with him for myself.
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Post by Leonie on Aug 30, 2013 1:28:28 GMT -5
Hi Gerty We also made major sacrifices to go with Dr K. Used our pension money. At least now I have a chance to live to pensionable age.
I had a (slightly irreverent) thought about fasting two meals: I have seven meals a day! Some days it feels like I am eating All The Time. Seriously, I am sure you will find a way to sponsor even more than two meals once you have all your health and energy back. Every meal, vitamin and movement fills me with gratitude and thanksgiving and worship.
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Post by duodenalswitcharoo on Aug 30, 2013 2:41:16 GMT -5
I was nervous posting, and I just needed to get it out. Sorry for any confusion. I did really well with RNYGP for about 4 years and started to eat more carbs. That started reactive hypoglycemia and the circle went on. I got a very stressful job, I was feeling like a failure because I was gaining weight...got put on more depression meds...more weight gain...more depression...more eating. I also had a history of physical and emotional abuse, I'd been holding inside for years. One day I crashed, and it all came to the surface. I could no longer hold a job, I couldn't leave my house (except for counseling), and I stayed in my bed eating potato chips. Knowing what I know now, I never should have had the first surgery. I thought it would solve everything. Life would be great. 13 years ago they gave me the surgery and a diet to follow and that was it. My personality changed, my family was angry at me, I had no support and I was lost with out food. I'm not expecting DS to solve anything for me. It will help resolve the medical issues and if it I walk a little taller and talk to a few more people, bonus! I've talked to my family about the way they treated me last time and what I need from them. I told them what changes it could make in my moods and the very real risks. I have my PCP, my psych, and psych NP all ready to help. I've been learning how to deal with my food issues and have spent 8 years putting other issues in the past. I'm feel ready. I hope I have the chance. The Dr. in Salt Lake requiring patients to go on a diet with his wife to have surgery is Dr. Simper. I've seen people on the OtHer board having to do it too. Her name is Dr. Joanna Erzinger, when I looked her up I found she is a Psychiatrist/Neurologist. The other Dr. I saw was Dr. Daniel Cottom. I really liked him, and spent a lot of time with me. He will only do rny to ds revision as loop ds. I just can't take the risk. I know what I want and at 49 yrs old I finally won't settle for less. Thank you all Hello again Hope you aren't so nervous now! It sounds like you are doing to internal healing that you so need. Well done. Most people like to skip that part and just fix the outside. It sounds like you are getting better at stating your wants and needs and that can be HUGE in a persons recovery I have heard endless things about Dr K, all of which were overly positive so if you can get to him, do so by any means necessary I'm glad you've shared and opened up. I think the DS is going to do you a world of good. I wish you all the luck in the world and look forward to reading about and seeing your progress
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Post by duodenalswitcharoo on Aug 30, 2013 2:46:03 GMT -5
Gerty, A few things from my personal experience. Those on mental health meds may lose more slowly and stop short of their goal. When that happens the disappointment and self negativity can awaken the Binge or compulsive eating pattern that has helped you to survive thus far. This times a MILLION!!!! So, I'm bipolar...and I WAS on meds which included risperidone. (a known weight gainer) I gained over 100lbs in 2 years because everytime I went to the shrink depressed about my weight, they upped my risperidone. It wasn't until after my sleeve and I stopped losing and started gaining less than a year out that I starting thinking it wasn't ME but something else. I stopped all my meds (something I do NOT recommend btw!!!) and my weight loss slowly started again. Now that I have changed GPs she can't understand why the shrink would even consider a weight gaining drug for someone already bmi 70+. ugh. Sometimes I feel like everything is against me, I am sure you can relate to that!
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Post by Deleted on Aug 30, 2013 11:12:10 GMT -5
Hi and welcome! Sorry I'm late to the party . I am very pleased to hear you have Medicare. Their requirements are oh, so much simpler than those of many other insurance plans. Your failed RNY is totally sufficient for them. My main suggestion is: If you aren't in regular therapy now, get there and stay there for the long term. I'm a survivor as well, and it took many, many years of intensive therapy to get to the point where I was ready to face WLS and the changes that would come with changing my body so dramatically. I also benefited greatly from sticking it out in therapy throughout the whole process, to this very day.
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