Debs ramblings about her NHS sleeve...

[Debs!]

Hi Debs, how did you find the patient support meeting, I'm seein knock out man lol 31st Keep smiling x

Did you go honey?

We met a man who was 46 stone and is now 13.

You are seeing knock out man a week later so I expect out journey will be very close - I'd love to be surgery buddies

It was ok. Mainly post op so felt their needs were a bit different but everyone was very welcoming

It's a long day. Left home at 6.15. Back well after 10 as I live so far away!

See your Thursday!!

 

[Debs!]

Today 5/3/15 I went to Walsall Manor for the group session from the dietician, nurse and pharmacist. Every team has a slightly different process. Walsall say LSD is 3 weeks for patients with BMI under 50 and 6 weeks for those over! LSD is a choice of 2 diets. Milk and yoghurt or a very scripted food diet - basically 20gms sugar free cereal and milk or an egg on thin toast; lunch is single slice bread or a small pitta and cottage cheese or cheese spread. Evening meal is 80gms meat or fish or veggie equiv. and a single potato no bigger than an egg or 2 tablespoons rice/pasta. Plus a pint of milk and a low fat yoghurt.

Post op is 4 weeks of liquid only, 4 weeks of purée and 4 with of getting lumpier mash. Seems longer than the recommendations of some post op teams - but it is what it is!

 

[dellam760]

Hi Debs, I have got one more obstacle in my way before I get a date for surgery. I need a camera down into the tummy and then my surgeon should be contacting me for the sleeve date !!

How excited ??

I am 53 and like you ~ ever the jester.

Have you been nominated to a surgeon yet?

Keep strong and time ticks by and you get one day nearer !!

 

[Debs!]

Hi Debs, I have got one more obstacle in my way before I get a date for surgery. I need a camera down into the tummy and then my surgeon should be contacting me for the sleeve date !! How excited ?? I am 53 and like you ~ ever the jester. Have you been nominated to a surgeon yet? Keep strong and time ticks by and you get one day nearer !!

Yes I have my surgeon and everything now. I see the anaesthetist on 24th March then I will have my surgery date! Eek!!!!

Scary but exciting all at once!

 

[clairemp]

Wow Debs,

How exciting!

Can't imagine how you must be feeling!

I'll be watching your journey very closely.

Congrats!!!!

 

[Debs!]

Monday 9th March saw me back at Walsall Manor for my pre-op appointment with the nurse.

This was very straightforward and not peculiar just to bariatric patients. The lady before me was there for a forthcoming knee op! She was friendly in the waiting room till I disclosed my forthcoming op was bariatric surgery. She said she doesn't agree with those being on the NHS. She wasn't rude. Just 'cooler'. It was interesting to see how her character changed. In fairness it is apparent to me that subject bariatric surgery appears to provoke extreme views unlike any other surgery. All part of the journey!

My pre op tests with the nurse included bloods, weight, blood pressure, a visual inspection of my mouth, swabs from my nose and groin, and the customary urine test.

Thankfully my body, for once, cooperated. BP was 118/78. Weight was 116kgs and I remained 170 cms tall.

Next thing is the final pre op with the anaesthetist on the 24/3/15. They have confirmed that I am now approved and on 'list' but cannot give an indication, as yet, as to when that means the operation will go ahead. There was an abstract suggestion it might be April/May but this could be effected by school holidays/bank holidays as even surgeons have to have a little time off!

I am taking my vitamin D supplements religiously since they were prescribed - my levels were under 29 and need to be 50 or higher apparently. I've resume my a-z vitamins and an additional Zinc one. I have no idea why, but I decided I needed the zinc for me hair. I am a bit batty!

As its getting closer now I am 'testing my decision' often. I've come across two prior patients whose experiences were more challenging that the normal. One lady's pouch leaked and she contracted septicaemia and was in hospital for 6 months. She is ok now, but was seriously ill for such a long time. As a single mum that's a unimaginable outcome and whilst slight, it's a risk. So I explore issues all the time - which I think is exactly how one prepares for something as huge as cutting out 80% of a healthy, if overused, body part!

 

[sjtmay05]

Hi Debs,

Well done you....your getting so close to your op
I'm back there tomorrow ( Friday 13th March) so praying that it's not bad news as its on 13th lol....2nd appointment with Mr kendrick.

So Is your next stage, starting the LSD. .??

Wish you well, all the best with your journey
Keep smiling xx

 

[Debs!]

Hi Debs, Well done you....your getting so close to your op I'm back there tomorrow ( Friday 13th March) so praying that it's not bad news as its on 13th lol....2nd appointment with Mr kendrick. So Is your next stage, starting the LSD. .?? Wish you well, all the best with your journey Keep smiling xx

how did it go on Friday? I was wondering if all was well. My next appointment is 24th March and then just wait for a date for LSD and operation. It's all a bit surreal really x

 

[clairemp]

How's it going for you Debs? Have you been asked to lose a certain amount up til now and how has that gone..?

 

[Debs!]

How's it going for you Debs? Have you been asked to lose a certain amount up til now and how has that gone..?

Hi Claire

I had to lose 5% in tier 3 - which I was at between July 2012 and October 2014 and I had to keep it off. The target was 116kgs. I remain at 116kgs though I can fluctuate by a kilo up or down. In fairness the dietician in tier 4 at hospital said as I had spent over 2 years in tier 3 with at least monthly visits and my weight had never really gone up - it wasn't a critical issue in tier 4. It seems it would be if had been directly referred from GP and she would have then asked for a % of weight loss. Purely to look for a commitment to change I guess????

I've been prescribed gabapentin which I didn't get on with and now I am on pregablin. Side effect of both is weight gain. I was also on a hormone injection for 6 months which also has a common side effect of weight gain. All this once referred for bariatric surgery. It's been a difficult 4 months trying to stay level.

They do expect me to lose weight during the liver shrinking diet. They said that (and what they see on surgery day) is the only indicators that I have followed the LSD. Other places say weight loss during LSD isn't the issue. It's so confusing!

Thanks for asking xx

 

[clairemp]

Well done you for maintaining that over such a length of time! That must have been a nightmare. You must be so relieved to see the end in sight. What a commitment!

I have to say I'm so confused. I don't even know what I've been referred for!?!

Some Tier 3's are in hospital and some seem to be run by private companies.

I've been referred by my GP straight to the hospital to see the Bariatric Nurse and Dietician so what does that mean?!?

I can't wait to get there next week and find out. My impatience is killing me

 

[clairemp]

Forgot to say that I've been on Pregabalin for years for neuropathic pain. Hope it's working for you..

 

[Debs!]

Well done you for maintaining that over such a length of time! That must have been a nightmare. You must be so relieved to see the end in sight. What a commitment!

I have to say I'm so confused. I don't even know what I've been referred for!?!

Some Tier 3's are in hospital and some seem to be run by private companies.

I've been referred by my GP straight to the hospital to see the Bariatric Nurse and Dietician so what does that mean?!?

I can't wait to get there next week and find out. My impatience is killing me

So the week has passed - how did it go??

My (limited) understanding is that if you have co morbidities and a certain BMI there is no need for a 12 months or greater tier 3. That you can be referred directly to tier 4 at the hospital who will provide dietry and psychiatry support and testing for around 6 months to 'speed up the process'

I found wading through the NICE advice on bariatric surgery was really helpful - at least it outlines what should happen - even if it is a million miles from what sometimes does happen.

I can only say it is like knowing the rules in cricket - doesnt mean the game makes any sense in practice!!!!

 

[Debs!]

I have an awful cold and as result no taste. I am afflicted with the munchies as I am at home and weight gain is the result. Have slapped my own face today (metaphorically) whilst shouting get a bloody grip. I realise I am very very lucky to be possibly soon given treatment on the NHS and so for once, I like to not wreck things for myself.

Head hunger and self pity/food rewards are the devil!

 

[clairemp]

Hi Debs, thanks again for your explanation. I have been going through NICE guidelines but there is so much to read that I can tie myself up in knots! My appt is on the 27th so another week to wait

Sorry you're not feeling great. Something's doing the rounds again. Hope you manage to stay on top of the hunger pains.

It really is within touching distance for you. Looking forward to hearing all about it..

 

[Debs!]

Few days now before my last appointment before I am given a date to start pre op. All I can focus on now when I read forums and support sites - its the side effects and risks! Its like I am inexplicably and unhelpfully fascinated about reading all about the bad bits! Doesn't help the nerves!

I found some 'thin quick' shakes (not sure if we can include the proper brand name!!) on 3 for 2. I know they are not good for bypass folks - but I am to have a sleeve and they are on the post op diet sheet. My hospital have all the patients on 4 weeks of liquids after the diet - they provide via prescription Fortimel Regular which is classes as a food for Special Medical purposes for use under medical supervision. Its a 200 ml bottle which is 200 calories but contains 20g protein per bottle and taste horrible!!!! But as for 4 weeks its milk, squash, juice, weak tea, clear soups that has been strained and the shake thingy - I guess hate it or otherwise - it will be consumed! I have also bought loads of little plastic food boxes so I can make my food and freeze some as opposed to always cooking in tiny portions.

I have 9 days of being employed left - so weird having been there since 1983 - all my adult life. I am a little anxious about managing on my pension - but once the surgery is done, with luck, I will get a little part time job.

I am suffering with gurgling gut a lot at the moment. My gastric system has been fairly rubbish since I had acute pancreatitus and gall bladder hell in 1999. I closed that year with having the damn thing out. No one told me pre gall bladder surgery that whilst the pain goes - there is a side effective for some of having no gall bladder. For me that is that certain foods make me sleepy, nauseous, sometimes sick and in need of urgent access to the loo. Cream and fat is a huge trigger - having read about WLS now, in particular dumping, it sounds like my post gall bladder 'issues' are along those lines - though on a milder scale - usually!

Its been a difficult week as daughters dad (my ex) was recently diagnosed with bowel cancer and we have been running his around since he had his op as he can not yet drive. Just adds to the stress - stress of my own making!

I am trying whilst feeling ok, to crack on with getting ahead with some 'jobs'. Trying to get the garden sorted after winter, and spring clean the house and such the like. I've even promptly tried to sort all my bills and such so that I have a little less to fret about once the time comes.

Despite lots of tier 3 counselling - 2 years of it - I keep thinking that my normal coping strategy for stress, pain, lack of control - is to eat. Soon that option will be removed, at least until the surgery is fully healed - I worry low mood is inevitable as a result along with post op regrets. I am writing this now so when I am depressed /regretful in the early post op days - I can remind myself that this is quite normal and should be relatively short lived.

Roll on Wednesday - last hurdle before LSD starts.

 

[CONSIE70]

Catchy title eh?!?

I am indulging myself with a pre op diary. I suggest potential readers skip this as it's bound to be either boring or a some what depressing series of moans by me as I crawl towards my sleeve!

I am person with a facade of confidence which masks low self esteem and I use food as a crutch/weapon/shield. I am the one who tells the jokes, who can be loud and appears confident and the one who mercilessly pokes fun at herself. The 'fat jester' would be an unkind but accurate label.

I am now 47 years old and allowed my self abuse with food to turn to self loathing whilst always maintaining that fat, funny and fabulous facade! If only people knew....

Journey so far?

Well I got very big back in 1989 after I got married aged 21 and the marriage failed very quickly - a matter of weeks. Never really got a grip of dieting in a sustained way. Yes I went to slimmers world and had a card filled with shiny sevens and yes I went to weightwatchers and got a key fob, and certificate to say I was at goal with lots of 'well-done'. Didn't fix my head and I ate my way back to the start weight and more each time.

Losing weight is a very public thing - you cannot hide the losses and gains. Great on the way down - taking your ill fitting clothes to the charity shop or passing them on to your friends who remain a little larger. Fairly awful when you wished you'd kept that big coat and work suits as you gallop back up the scales spending £££'s to lose and £££s more as you gain!!

In 2012 my GP referred me to a Tier 3 multi discipline team in South Yardley, Birmingham. I saw a dietician, doctor and psychologist each month for just over 2 years. With a BMI of 41 my local PCT (Worcester) would not fund WLS as they imposed as BMI of 55 for funding.

My luck changed when NICE changed the guidance in 2013 which led to funding not being PCT controlled but being paid for by NHS England. The Tier 3 team agreed I was suitable for WLS back in September 2014 and referred me to Walsall Manor Hospital - initially my referral was lost - so I did not hear from them till January 2015.

I saw the first round of people there on the 23/1/15. I then had appointments for the Surgeon and Psychologist for April 2015 - but rang on the off chance of a cancellation and due to a threat of snow they had cancellations for the next day so I was able to see both those guys on the 30/1/15. It was a minor miracle.

I now have a group session focussing on liver shrinking diet and post op diet, a pre op with the nurse and the pre op with the Anesthetist - all in March and then as long as they say I am ok – with luck, I will be listed for surgery - waiting list permitting it could be as early as April-May.

I have opted for the sleeve. I spent years researching and I feel this is the right decision for me - I am acutely aware that everyone is different and I would never knock another's choice. I just feel this, whilst not necessarily being the 'gold standard' will give me an outcome which will transform my life.

Of course I am scared. You'd have to be fairly unusual to not be scared of cutting out 75% of your stomach on a forever basis! But I am also excited and looking forward to being kinder to myself at long last.

I really hope I do not muck this lifeline up!

Good luck with your forthcoming op, i personally was going to do the sleeve but as you rightly pointed out you loose the cut stomach on a forever basis, i opted in end for bypass, because if i were to ever get ill or personally wanted to reverse my surgery i would without a doubt, i new on the bypass scene and although i lost over a stone in six days, when your 6ft 3 and 40bmi that really hits you, the illness point being if you were to get ill and required long term higher rate of nutition than the sleeve could give you, then the only option is tube feeding, thats why i went down the bypass route,
goodluck x

 

[Debs!]

Good luck with your forthcoming op, i personally was going to do the sleeve but as you rightly pointed out you loose the cut stomach on a forever basis, i opted in end for bypass, because if i were to ever get ill or personally wanted to reverse my surgery i would without a doubt, i new on the bypass scene and although i lost over a stone in six days, when your 6ft 3 and 40bmi that really hits you, the illness point being if you were to get ill and required long term higher rate of nutition than the sleeve could give you, then the only option is tube feeding, thats why i went down the bypass route, goodluck x

Hi Consie

You make a valid and important point. And your explanation of your decision making process as I compare it with my own does support my initial assertion that we all make our informed choices based on what we personally feel is what we need. I went for the sleeve to avoid malabsorption which is what a bypass is clearly designed to do. I feared that this might lead to superb weight loss but other unwanted issues. The sleeve is totally none reversible as you say. That's a huge step. When people say what's the wackiest thing you've done to loose weight - I will always reply - chopping out my stomach!!

I've not done enough research into bypass reversals to see how common it is?

I read a lot of sleevers after 2 years or so don't feel the restriction and thus, like all surgeries, they regain. I guess my mind felt that meant it was possible, even with a sleeve, to eat more than is needed.

That said, the variance with outcomes is fairly immense! I read some sleevers can't eat bread. Others can much through a loaf! Some sleevers dump and can only eat tiny meals - others feast like every day is a Christmas Day.

That's why I am will endeavour to make clear - the best surgery for anyone in my mind is the one they want to go for. I wouldn't want anyone to follow my balmy logic but to decide what they feel most comfie with

When did you have the bypass? It's good to read it's going well

 

[Debs!]

Well tomorrow at 9 am is the last hurdle before I am given a date to start the liver shrinking diet - indeed I may know that date tomorrow I guess.....by 10am the appointment will be over so the mystery will be cleared up!

I am still full of a cold but hoping I can at least appear well and match fit for major surgery.

My steel focus is being battered. I have mentioned to one or two my intentions and boy have the 'don't do it' started. All well intended - all commenting that surely I can manage to lose weight without such a drastic step as cutting out the stomach - well 80% of it.

I agree - it is bloody drastic. But I have got to the 'it has to be drastic' place. I am worried about being ill being the 0.4% who develop serious post op complications. I figure we must all worry about that?

So far I crawl on and push out the negative thoughts and inch towards the surgery.

It is a bit surreal that its almost my time.

 

[Jacwat]

Well tomorrow at 9 am is the last hurdle before I am given a date to start the liver shrinking diet - indeed I may know that date tomorrow I guess.....by 10am the appointment will be over so the mystery will be cleared up!

I am still full of a cold but hoping I can at least appear well and match fit for major surgery.

My steel focus is being battered. I have mentioned to one or two my intentions and boy have the 'don't do it' started. All well intended - all commenting that surely I can manage to lose weight without such a drastic step as cutting out the stomach - well 80% of it.

I agree - it is bloody drastic. But I have got to the 'it has to be drastic' place. I am worried about being ill being the 0.4% who develop serious post op complications. I figure we must all worry about that?

So far I crawl on and push out the negative thoughts and inch towards the surgery.

It is a bit surreal that its almost my time.

Aw Debs, I can totally understand your thoughts, I am in the same place myself. It is so natural. You have to think about all the positive posts on here in relation to the tiny minority that have had issues. Also think about what could happen if we didn't have the surgery. It is an exciting time getting your date, hopefully I will get mine on Friday. I want to do this so I can live a better and a longer life! Good luck today Debs, keep us informed xx