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In a message dated 08/14/2001 7:20:25 PM Central Daylight Time,

hbstandard@... writes:

> So, you really think so? You think dieting makes the problem worse? I'd

> like

> to hear more about that theory. I have been laying a lot of guilt on

> myself for

> being overweight, and the idea that maybe dieting is not the answer makes me

> feel better.

>

Diets are what I believe (and know) got me to 267 pounds. I know I also was

on the road to being 300 pounds and beyond. I feel very thin (or normal)

now. I had a pair of slacks I wore in my senior high school pictures. At

the time I thought I was very fat and constantly tried to diet to reduce my

weight. I just tried to put the pants on the other day and they are too

small! I couldn't believe it!!! I thought I was so fat back then and

proceed to diet and gain my way to 267 pounds!! The typical scenerio with

dieting is take off 30 gain 40. Take of 20 gain 30 and so forth and so on.

Now for some the regain is a couple of months and others it is a couple of

year to start with, but it just gets worse. There are excellent books out

there about this like Seven Habits of Slim People, Breaking Free, Overcoming

overeating, etc. If surgery was not for me, I would do the approaches in

these books, not diet!

Dawn

Dr. Hess, Bowling Green, OH

BPD/DS

4/27/00

www.duodenalswitch.com

267 to 165

size 22 to size 10

have made size goal

no more high blood pressure, sore feet, or dieting!

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Thanks for your thoughts Suzy. My replies are below...

heather/ my thoughts.

> ** This is very personal.. it sounds like your current health

> situation is more complicated and dangerous than side effects of the

> surgery.. but you have to make your own decision and peace with this

> part.. is the other side of the fence truely greener?

True, true. I am not in the best of health. I wonder how much of that is due

to the extra weight?

** Most people have some vacation to use.. you need to discuss this

> with your employer, that you are having necessary surgery (dont feel

> the need to be too descriptive if you dont want) and you want to make

> sure your position is secure. Federal law prohibits employers from

> firing you if your out for serious medical issues, so dont worry about

> that part.. but the money is something you will have to arrange or

> save up for.. possibly a small loan to keep in your savings account in

> the event you are out longer than you thought. You pay back what you

> dont use right away and its there just in case.

You're right, I could use some vacation time. I hadn't thought of that. I'm

also glad to hear that if I get the surgery deemed " medically necessary " I will

not be able to be fired for being out of work.

> I dont

> know where you live, but generally takes at least 2-3 months to get

> approved and scheduled for surgery.. at least. Ive been waiting a

> year..

I live in Georgia, and I hear there is at least a 6 month wait for Dr. ,

who I am considering as the surgeon.

> ** you need to answer this yourself.. we all have a bad relationship

> with food, or we wouldnt be fat. .stop being so hard on yourself. You

> just dont have the right tool to fight the battle with, yet. You

> certainly do not put out a fire with gasoline, and that's excactly

> what traditional dieting does to our bodies.. makes the problem worse.

So, you really think so? You think dieting makes the problem worse? I'd like

to hear more about that theory. I have been laying a lot of guilt on myself for

being overweight, and the idea that maybe dieting is not the answer makes me

feel better.

> ** If you do what you've always done, you will get what you've always

> gotten..

If nothing changes, nothing changes. Right?! ;-)

> ** I have heard from most people that your appetite totally changes

> after surgery. You do not have the capacity to eat much after surgery,

> and your body will demand you feed it what makes you feel good...

> usually protein, then veggies, then carbs. Once you are full

> recovered, you can eat your carbs in moderation.

Oh I truly HOPE that would be the case for me!

> ** this is a huge decision that only you can make for

> yourself. I personally am comfortable with the 'what ifs' because I am

> so tired of being unhealthy and wearing circus tents for clothes.

OH GOD CAN I RELATE!!! Circus tents are no fun as clothing. That is for *damn*

sure. And my circus tents are getting larger and larger as the days go by. It

sure 'aint no " fun at the big top " like the circus should be, is it? Although I

sometimes feel like Bozo the Clown.

I

> used to be healthy and pretty and active and fun. I want that again.

> I am unable to maintain a diet and exercise program that supports a

> 150 pound me. I love food and I work on computers for a living, so I

> have a double whammy.

Me too! I love food (duh) and work on computers for a living too! What do you

do? I'm an Administrative Assistant/Desktop Publisher/ Phone

Answerer/Typist/Problem Solver. Heh heh.

Whatever the reasons are that im fat (bmi 51),

> I am choosing a new tool to circumvent the 'cavewoman' metabolism I

> have.

By " cavewoman " do you mean that our bodies are meant to exhert themselves a lot

more than we do sitting at a desk. Like hunting, gathering, etc. that cave

people did?

Nothing in life is risk free.. not driving a car, not eatin raw

> oysters, not having babies, not pracicing a religion that others find

> different from their own.. nothing is without risk. What makes the

> risks acceptable is what you will gain from taking that risk and

> winning. Reduce your chances of dying early from diabetes, heart

> disease, colon or breast cancer. Lose the weight the healthiest way

> you can.

True, nothing is without risk. I have watched my mom, who has struggled with

her weight her whole life, begin to exercise and eat well since she retired and

has more time to devote to that... and she has slooooooooowly lost weight and

trimmed up, but it has taken her 2 years of working out 3 days per week and

watching her diet to see a change of even ONE dress size. God, I don't have

that much patience! I am into instant gratification. Two YEARS?! Sheesh.

It's not worth it.

>We are here for you whatever decision you make..

Thank you Sue. You're a sweetie!

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You are welcome, .. Here's some more of my thoughts about your

questions.

> True, true. I am not in the best of health. I wonder how much of

that is due

> to the extra weight?

* Probably most of it.. its at the very least exacerbated by the

weight and the inability to be active. Lots of patients report much

lessening if not total alleviation of high blood pressure, borderline

diabetes etc. Yours would probably be greatly improved as well. :o)

>

>

> I live in Georgia, and I hear there is at least a 6 month wait for

Dr. ,

> who I am considering as the surgeon.

> ** I live in Florida, there is no DS surgeon here at all. I was

going to go to DR. , but as you say, he's six months out. I will

be seeing someon in Dr. Booth's office in Mississippi because I cant

wait that long.

>

> So, you really think so? You think dieting makes the problem worse?

I'd like

> to hear more about that theory. I have been laying a lot of guilt

on myself for

> being overweight, and the idea that maybe dieting is not the answer

makes me

> feel better.

** Without a doubt!! Humans have WAY too much capacity to eat.. Unless

you need to 'fatten up for the winter'.. there really is no need for

us to store so much energy. We have trained our bodies to be very

efficient at burning its beloved fat from years of evolution, progress

which has us driving our cars, refined foods that don't require our

digestive systems to do much for caloric and nutritional benefit, and

sedentary lifestyles in front of computers, instead of outside

fighting the harsh weather and rough terrain

>

>

> > ** I have heard from most people that your appetite totally

changes

> > after surgery. You do not have the capacity to eat much after

surgery,

> > and your body will demand you feed it what makes you feel good...

> > usually protein, then veggies, then carbs. Once you are full

> > recovered, you can eat your carbs in moderation.

>

> Oh I truly HOPE that would be the case for me!

> ** Meeeee tooo! lol

> Me too! I love food (duh) and work on computers for a living too!

What do you

> do? I'm an Administrative Assistant/Desktop Publisher/ Phone

> Answerer/Typist/Problem Solver. Heh heh.

** have been in customer service for a long time but am on sabbatical

now to go back to school and to have surgery. I will be trained as an

Oracle Database Manager.. :o)

>

> By " cavewoman " do you mean that our bodies are meant to exhert

themselves a lot

> more than we do sitting at a desk. Like hunting, gathering, etc.

that cave

> people did?

** You got that right!

>Two YEARS?!

Sheesh.

> It's not worth it.

** Chances are if she does lose all that weight, she'll gain it all

back.. :o(

>

> >We are here for you whatever decision you make..

>

> Thank you Sue. You're a sweetie!

** Thanks.. ;o)

>

Sue.

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You are welcome, .. Here's some more of my thoughts about your

questions.

> True, true. I am not in the best of health. I wonder how much of

that is due

> to the extra weight?

* Probably most of it.. its at the very least exacerbated by the

weight and the inability to be active. Lots of patients report much

lessening if not total alleviation of high blood pressure, borderline

diabetes etc. Yours would probably be greatly improved as well. :o)

>

>

> I live in Georgia, and I hear there is at least a 6 month wait for

Dr. ,

> who I am considering as the surgeon.

> ** I live in Florida, there is no DS surgeon here at all. I was

going to go to DR. , but as you say, he's six months out. I will

be seeing someon in Dr. Booth's office in Mississippi because I cant

wait that long.

>

> So, you really think so? You think dieting makes the problem worse?

I'd like

> to hear more about that theory. I have been laying a lot of guilt

on myself for

> being overweight, and the idea that maybe dieting is not the answer

makes me

> feel better.

** Without a doubt!! Humans have WAY too much capacity to eat.. Unless

you need to 'fatten up for the winter'.. there really is no need for

us to store so much energy. We have trained our bodies to be very

efficient at burning its beloved fat from years of evolution, progress

which has us driving our cars, refined foods that don't require our

digestive systems to do much for caloric and nutritional benefit, and

sedentary lifestyles in front of computers, instead of outside

fighting the harsh weather and rough terrain

>

>

> > ** I have heard from most people that your appetite totally

changes

> > after surgery. You do not have the capacity to eat much after

surgery,

> > and your body will demand you feed it what makes you feel good...

> > usually protein, then veggies, then carbs. Once you are full

> > recovered, you can eat your carbs in moderation.

>

> Oh I truly HOPE that would be the case for me!

> ** Meeeee tooo! lol

> Me too! I love food (duh) and work on computers for a living too!

What do you

> do? I'm an Administrative Assistant/Desktop Publisher/ Phone

> Answerer/Typist/Problem Solver. Heh heh.

** have been in customer service for a long time but am on sabbatical

now to go back to school and to have surgery. I will be trained as an

Oracle Database Manager.. :o)

>

> By " cavewoman " do you mean that our bodies are meant to exhert

themselves a lot

> more than we do sitting at a desk. Like hunting, gathering, etc.

that cave

> people did?

** You got that right!

>Two YEARS?!

Sheesh.

> It's not worth it.

** Chances are if she does lose all that weight, she'll gain it all

back.. :o(

>

> >We are here for you whatever decision you make..

>

> Thank you Sue. You're a sweetie!

** Thanks.. ;o)

>

Sue.

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True, nothing is without risk. I have watched my mom, who has struggled with

her weight her whole life, begin to exercise and eat well since she retired

and

has more time to devote to that... and she has slooooooooowly lost weight and

trimmed up, but it has taken her 2 years of working out 3 days per week and

watching her diet to see a change of even ONE dress size. God, I don't have

that much patience! I am into instant gratification. Two YEARS?! Sheesh.

It's not worth it.

Well, the surgery is for life. Yes, the weight will come off within the

first 18 months, but the aftercare is forever. :) If you feel that you can

and are willing to take supplements, get in protein, get regular bloodwork

(and that bloodwork is a doozy) as well as regular checkups with a PCP

(perhaps even educating him/her about the surgery, etc.), then I think you

are ready for the surgery. It ISN'T a quick fix, IMHO. Yes, the weight loss

is pretty 'effortless' (especially compared to previous dieting, etc.) but it

does change one's life (or at least it should).

The biggest problem I see is that people can get really complacent as

post-ops. They feel great, look wonderful --- who needs all those vitamins?

So, the bloodwork isn't done regularly - it was fine before, right? I think

people instantly think that if they feel great they are totally healthy.

Problem with many of the nutritional deficiencies is that they can take a

relatively long time to manifest and become severe enough to make one pay a

ttention. I'm NOT saying that everyone will get these deficiencies. With

proper aftercare and monitoring I don't see how a post-op really could get

them to any severe degree. I'm talking about becoming complacent about the

aftercare and I think every long term post-op has faced this at some time or

another.

Also, one cannot really predict how such things will affect them. WE're

talking worst case scenario here. People's bodies adjust to the surgery

differently. Some may have less malapsorption issues because of a combo of

great eating habits and higher body compensation. THey may not need as many

supplements. Others may.

I had a relatively 'lower' bmi at surgerytime (45) and I am very glad to have

had the surgery when I did. I think having the lower bmi helped my recovery

in that I was pretty 'healthy' before the surgery and could walk, get around

immediately post-op. I DID see myself as heavier in the future and with

serious co-morbidities (as my mother is now). I could envision losing weight

only to gain it back again (this has happened countless times in my adult

life). I didn't want to be at a comparatively worse point later on (health

and weight wise) and have to make the same decision...

However, since you have so many doubts about the surgery, perhaps it isn't

right for you now. Maybe there are other methods that can help you lose the

weight (such as Meridia, Xenical and other things). Good old eating right

and exercise works, too but you know better than anyone what your activity

level is now and whether you would benefit in the long run. I for one was

always pretty active and walked for a mile or so 2-3 times a week. I ate

well but too damn much. I had a bit of a sweet tooth but it went in cycles

and wasn't continuous nor was it related to emotional eating (ie - I didn't

eat sweets whenever I felt depressed, bored, alone, etc.).

I think it is good to try to figure out the reasons for being overweight.

However, I am SURE that laziness is NOT one of them. If you can lose weight

and keep it off with exercise and dietary changes, more power to you!!!! I

certainly wish I could have myself. But, repeated experiences with this lead

me firmly to believe that altering my digestive system was my only and best

choice.

I came into the surgery knowing that this was what I wanted and needed, so I

really didn't experience the level of anxiety that you have (I did have some

second thoughts immediately before surgery, though). However, I remember

mailing away for some information on bariatric surgery about a year prior to

the time I had my consult. It was for Bariatric Centers of America or

something like that (they only do the RNY). I remember reading the phamphlet

and saying 'well, maybe later' and putting it squarely away. I was not ready

at that time to consider surgery as my last option. When my PCP recommended

WLS about a year and a half ago, things just seemed to 'click' and I knew

that if I didn't take action I would be in a far worse place down the road.

Why not make the appointment with Dr. and use these months of waiting

to work through your feelings, research and prepare? If you come to the

decision that it is NOT for you or still have extreme reservations, then

cancel the appointment.

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

six months post-op and still feelin' fabu

pre-op: 307 lbs/bmi 45

now: 229

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