Weight Loss Surgery - FAQ

What type of surgery did you have?
There are three different types of weight loss surgery available today, and I chose the duodenal switch procedure.  You can read more about that procedure here, but basically they removed 80% of my stomach and re-routed my intestines.  In a very non-medically correct version, basically I can no longer eat as much as I used to and my body won't absorb as much of what I do eat.  Highly recommend reading the above link for more accurate information haha.

Is that surgery risky?
Of course!  All surgeries have risks.  The main long-term risk with this surgery is the possibility for malnutrition.  Because of this, I have to work diligently to get in 80-100g of protein, and at least 64 oz of hydrating fluid in every single day.  I will have on-going appointments with my medical team the rest of my life, including lab work, to ensure I don't experience this.

How much weight will you lose?
One of the main benefits of this surgery is that it typically provides a higher percentage of weight loss in patients when compared to the other surgery types.  My medical team expects that I will lose 80-100% of my excess weight.  Excess weight is calculated as follows:  pre-surgery weight - BMI ideal weight = excess weight. With that in mind, I can expect to lose around 140-175 lbs.  That number of course will vary from patient to patient, and will heavily depend on my ability to meet the diet and exercise goals throughout the next couple of years.

How much weight have you lost already?
To date, I have lost 46 pounds from my highest pre-surgery weight, which was between Thanksgiving and Christmas.  A lot of that weight was lost prior to surgery via the liver shrinking diet, but I have lost 27 of those pounds since my surgery date on February 6th.

How are you feeling? 
How I feel physically varies day to day.  Yesterday (3/4/20) I felt very strong, met my protein goals, and was more active than usual.  Today however, (3/5/20), I feel very sluggish, little to no appetite, and am very tired.  Both of these types of days are normal and will vary as my body continues to heal.

Can you tell a difference yet?
Not really, or at least not like I thought I would after losing 46 pounds.  I see the loss mostly in my ankles and feet as they've stopped swelling to the point I had to tighten my tennis shoes. Prior to surgery I had to go up in shoe sizes because my feet were so large.  Other than that, I've seen the loss slightly in how my clothes fit.  A pair of leggings that were tight prior to surgery fit comfortably now, and a few shirts fit a little looser. However, overall, my clothes fit almost identically to how they did prior to surgery.  This will all come with time, and they've told us often that it takes the brain the longest to catch up and realize how far a patient has come.

How much and what can you eat now?
Right now I am in the soft food diet stage.  The name of that is kind of deceiving, as there are a lot of foods that are allowed that folks wouldn't consider "soft", such as meats.  Right now I can eat about 1/4 - 1/3 cup volume of food per meal, and I'm eating 4-6 small meals per day.  Some items I'm loving right now are yogurt, scrambled eggs, 1/4 slice whole wheat toast, ground turkey, chicken, peas, carrots, peaches, applesauce, and mashed potatoes.  It is critical that I eat my protein first at every meal, and then if I have room I can add in veggies and carbs. At each meal right now, I eat around 2oz, or 1/4 cup, of protein per meal and then I can usually add in 1 tablespoon of a veggie or carb in depending on how full I am. I will be on this diet through the 3 month mark.   Some items that are not allowed right now are: pasta, rice, fried foods, stringy melted cheeses, processed meats such as sausage, raw vegetables, veggies or fruits with skins intact, any meat that requires a knife to cut it, nuts, protein bars, popcorn, etc.

Will that be your serving size forever?
No, but my servings will always be smaller than what many are used to.  One of the goals on my current diet is to slowly increase to 1/2 cup volume per meal by the 3 month mark.  At 3 months I can begin eating any foods that my body can tolerate, and the portion size over time will likely never be more than 1 cup volume per meal.

Are you hungry at all?
Surprisingly, yes.  Most days I feel hungry when it comes time for a meal (every 3-4 hours).  However, there are days where I don't feel hungry at all, and sometimes there are just random meal periods where I don't feel hungry. A lot of hunger can be confused for head hunger, i.e. craving food out of habit and not real hunger.  Because of this, I don't allow myself to snack between meal periods and make sure my meals are always measured out per the diet guidelines.  One of the common phrases WLS patients use after surgery is that "we now eat to live, not live to eat".  This has been a critical realization for me, as I do have to force myself to eat on the days where I don't feel hungry to avoid health issues.

If you're not hungry, how do you know when you're full?
I can ALWAYS tell when I'm full at a meal.  Always!  I will forever need to eat slow and chew my food very thoroughly, and my body tells me immediately if I've eaten too quickly or not chewed enough.  The most common symptom of that, for me, is feeling like the food is stuck in my chest.  When that happens, I intentionally stop eating, take a few deep breaths, and don't resume eating until that has gone away.  My body also lets me know when I'm full, which is typically just a very full feeling. They also taught us to watch for other signs such as, hiccups, runny nose, or sneezing while eating as these can be indicators of fullness.  I get hiccups a lot, and it's true it's an indicator that I'm full.  I never push myself to eat more once I'm full as I don't want to induce dumping syndrome.

What is dumping syndrome?
Dumping syndrome happens when a WLS patient has eaten too much, too fast, or eats foods high in starch, sugar, or fat. When this happens symptoms are often nausea, sweating, dizziness, abdominal pain, or other symptoms.  Thankfully I have no experience any of this since introducing solid foods back into my diet, but I'm also very careful to avoid it.

When can you begin an exercise program?
Technically I am allowed to exercise now, since I'm past the 3 week mark, as long as my exercise does not include anything that engages my core.  However, due to my slow recovery I have not attempted any exercise other than walking yet.  I will officially be cleared for all exercises at 6 weeks, and my lifting restriction of 20 pounds will be removed at that time as well.

When will you return to work?
As of right now, the plan is for me to return to work on March 12, 2020. If I'm cleared for that return date, I will have been out of work for 5 weeks.

How has your work responded with you being out of office for so long?
My company has been great about this entire process.  I filed for FMLA coverage, which was approved with no issue.  I was also able to obtain short term disability coverage for my time out of work, which ensured I didn't lose any pay.  I am VERY fortunate to work for a company that pays 100% short term disability up to a certain point, and my leave was covered in full. I am so grateful for that! My supervisor and coworkers have also been great about checking in on me over this process, and ensured my job responsibilities were covered while I've been out so I could focus on rest and recovery.

How have people responded to hearing you had weight loss surgery?
I have been blown away with all of the support I've received from everyone I've told about this surgery.  Initially I was hesitant to make my decision public, but thankfully everyone has been supportive.  My family in particular has blown me away with their support and words of encouragement.  I was also lucky enough to become friends with one of the girls in my pre-op class, and we talk regularly on facebook as a support system to one another. A lot of patients don't make their decision public out of fear of judgement or disapproval, but I can honestly say that has not been my experience.

What tips or advice do you have for others on this WLS journey?
1. Follow the plan provided to you by the team.  They truly know what they're doing and will set you up for success if you allow them.
2. Listen to your body.  You know if/when something is off, don't ignore it! Don't hesitate to call the medical team if you aren't sure what to do.
3. Drink, drink, drink! Whatever you do, don't let yourself get dehydrated. And take your vitamins!
4. Use your tool.  This journey is exactly that, use it to your benefit!
5. Don't force protein drinks after surgery if it's making you nauseas.  Contact your medical team and figure out a better plan.
6. Be patient with yourself.  The mental challenge of this process is not easy - talk to the medical team when you need it!
7. Real food is coming :) the liquid stage is only temporary! Try the pre-soft food items at the 10 day mark as the dietician allows.  You'll feel human again after some applesauce & mashed potatoes!

Have a question I didn't answer above?  Simply leave me a comment and I'll add them in!