Pre-op class #7, weekly weigh-in and serious contemplation

Boooo, I didn't lose weight this week.  I know that's okay, but I was a bit disappointed.  I'll keep trekking along.  It's hard to believe I already finished my seventh pre-op class ... they seem to be going pretty quickly.  Of course the process from the start of making the decision to having weight loss surgery up to now has been slow, but the anxiousness I had been feeling before is not with me now.  I find it difficult to make this huge, life-altering decision only to be told I would have to wait about nine months for that to happen.  Yet, I have found myself happy that Kaiser put on the brakes so that I could be educated during this time.  

The class last night was an opportunity to learn more about the difference between a gastric bypass and vertical sleeve, the two choices we are given through Kaiser.  Not one to be patient and wait for this particular week to learn more information, I have been doing a lot of research on my own.  I don't take this lightly and so I find a huge desire to be well informed.  The principal at the school where I work has called me a lifelong learner because I approach things like this as a student.  That's not necessarily a bad thing at all.

Bypass or sleeve, which way to go?  Oh, if only you could get in my head right now.  I cannot possibly describe the level of seesawing I feel inside.  In the beginning, I was all about the bypass.  People keep calling it the "gold standard", the one in which other surgeries try to emulate.  That makes sense since it has been around the longest and has a proven track record.  Then, as I was doing more research, I felt sure that I had switched and wanted to pursue the sleeve.  It simply is far less invasive and does not have the malabsportion issues prominent with the bypass.  I believe constipation is a bigger issue, which has to be a large concern for me since I had some major problems when I was on Optifast.  Of course, ninety percent of your stomach is removed, so there's that to consider.  However, after the discussion last night, now I wonder if perhaps the bypass is a better surgery for my situation.  The biggest issue is that I am a diabetic and most people who have that choice of surgery have diabetes resolved.  That's a big deal to me.  Of course, it does happen with the sleeve as well.  If I go with the bypass, I will have to be very committed to taking the supplements for the rest of my life because my body will not naturally be able to produce those essential nutrients any longer.  When I think about my commitment, I think about my brother.  He had a heart transplant years ago and while he does not take nearly as many anti-rejection meds as he did in the beginning, he must take pills every day.  The flip side of that is that he was given a new life, so a few pills in the big scheme of things isn't really a big deal.  He is committed to his new life, so this begs the question:  Am I just as committed?

Can you see now why I'm freakin' confused??  The facilitator did assure me that I will have an opportunity to speak with the surgeon and discuss my choices prior to the surgery so that we can make a decision together.  I have a feeling I will be told the bypass will be the surgery he will support for me because of the diabetes, but I also want to discuss the sleeve as an option.  On paper, it makes more sense to go with the bypass but my poor body has been through so much and to put it through the more invasive surgery as an automatic choice is something I fight. According to our patient manual, the weight loss is about the same with both procedures, although it will be a little slower with the sleeve.  When the possible complications with a bypass are 23 percent as compared to less than five percent with the sleeve, I'm sure you can understand my pause.

There are some questions that I will need to consider as part of all of this.  Instead of rushing through them in class last night, I want to spend some time really working on them this week and honestly searching my soul in terms of what is right for me.  Some of those questions include:

• Why am I contemplating bariatric surgery?
• Which type of surgery do I want and why?
• Have I honestly tried to lose weight non-surgically?  Why will surgery be different for me?
• Have I really considered the risks of surgery before now?  What risk level am I willing to accept?
• Have I considered the hospital portion of this process?
• How will the type of work I do affect my recovery?
• Am I willing to give up some foods for the rest of my life?  Am I willing to take nutritional supplements daily for the rest of my life?
• What level of weight loss will satisfy me?
• What will success be for me?
• How willing am I to commit to managing my food intake for the rest of my life?  How willing am I to deal with the underlying reasons for my past overeating?
• In what ways might I and my friends and family sabotage my program?
• Am I willing to stay on my program for the rest of my life?  What steps can I take to make sure I follow my program?
• Am I willing to minimize or eliminate eating high-sugar and high-fat foods for the rest of my life?  What steps can I take to make sure I remain compliant with all my post-operative instructions?
• Am I willing to remain vigilant regarding my caloric intake for the rest of my life?  What steps can I take to make sure I monitor my food and calorie intake?
• Am I willing to take the time I need to be sure my decision to have surgery is the right decision for me?  What do I need to know in order to make my decision?

Wow.  I can really see that the answers to these questions will be incredibly important for me.  Not

only are the answers important, but my willingness to be honest is equally as important.  This is more than just about which surgery I will choose but ultimately why I am choosing surgery in the first place.  I had a thought last night, fleeting as many of the thoughts I had, about maybe revisiting Optifast again.  I was able to lose 192 pounds through the program.  As fantastic as that was, I think my brain has forgotten all of the issues I had while I was on the shakes, though, especially towards the end.  I don't want to scare those that read my blog who are on the program right now, but I had a lot of medical issues going on after being on it for so long.  Truly, I think I thought about Optifast again because surgery is scary.  I gained a lot of my lost weight back after stopping Optifast and I can't forget that either.  Don't get me wrong, I'm not rethinking having the surgery (although that is okay if I choose to not forgo it in the future).  Surgery is just a tool, albeit a very important one, but I must give those questions serious consideration.  My life will change forever.  Forever.  I owe it to myself to spend some time in serious contemplation and answering those questions with my deepest level of honesty.  Heavy stuff.

Water Challenge Day 46:  Drank 182 of 182 ounces