Question:
Please help....I feel very afraid and so sad right now

I had RNY on 6/26, In the hospital I weighed 296 and at my first consult in March I was 280. I am down to 220 lbs. and I felt so great, I am in jeans I never thought I could wear again and I can go into a store and buy a size large sweater, people think I am melting before their eyes. I saw my Dr. today for my 4 mo. post op and he said he was not to pleased with my 60 lb. weight loss (he goes by the 280 lb. starting weight)in 5 months..I corrected him and said it's only 4 months, he did say well then I take it back, your doing ok a little slow but ok. I do feel I'm kind of a slow loser but what the heck I am so grateful for the 75 lbs. He then explained after my asking a question that my pouch could stretch and that I could gain...I thought that being he transected that it would not stretch too much, I also asked how much he bypassed ( I was part of a study and could either be 100 cm or 150 cm), and until now did not want to know the answer, well he said I was the standard and it was 100cm, I am devistated and wish I had never asked, now I feel doomed. I know that this operation is just a tool, but I am so afraid of going back to my old habits being my pouch can stretch so much....we all have the graetest intentions, but as so many of you know it'so so easy to get back off track. Anyone a long term post op with only 100 cm bypassed and are you doing ok....I am so sorry I went to the Dr. today, I'm afraid of going back into a depression...a place that I havn't been to in a long time. Thank you for listening.    — jane O. (posted on October 20, 2003)


October 20, 2003
I had my rny on 6/24 and have lost 72 pounds and feel wonderful! You are doing great! I hit a lot of plateaus, losing the majority of my weight one week a month, but I feel so much healthier than I did at 313 that it's incredible. I got really depressed too the other day, when I realized that I had about 90 pounds more to goal, but then I realized that I havn't been this weight in 10 years! My self esteem is so much higher. People say that I'm glowing. So we are in it together. Think about how much you have lost (it really is incredibly fast!) and maintain your health. Email me if you want. I think that we will do fine!
   — Holly M.

October 20, 2003
Jane, Shame on your doctor!!!! You are doing wonderfully! 60 lbs is ALOT of weight and your 'tool' appears to be working perfectly. It is so frustrating for me to see people (& now a professional!) compare one case to another. We are all individuals, losing weight at our own pace...some more quickly, some more slowly. You are doing TERRIFIC! You are losing an average of 2 lbs every other day. THATS AMAZING! You said it yourself: You feel great! Isn't that what this surgery is all about?!! And as for your tummy stretching ~ stop worrying about it!! We as WLS patients know what are limitations are and what we should be eating.....you're doing all the right stuff!! Keep up the good work!! *HUGS*
   — chelle3081

October 20, 2003
I think your doctor should be tortured. What a terrible way to treat someone who is doing so well. Being transected doesn't mean that the pouch can't stretch - it does mean you won't have a staple line disruption. If you continue to eat small portions, you won't stretch your pouch - avoid carbonated beverages - they can stretch the pouch. And my surgeon says that popcorn can stretch the pouch so I avoid it. Keep your chin up - you will do great and the difference in whether you have 100 cm or 150 cm bypassed is really a matter of how fast you lose. Try to get past this and keep on using your tool to your best advantage.
   — Patty_Butler

October 20, 2003
Sweetie you just hang in there , you are really doing great! believe me , if you have lost 60 pounds in 4 months what will you be at in a another 4 wow you are doing really good, keep your chin up! most of us are bypassed at different lengths an i do remember my doctor said i was about the same as you. i was 238 to start and 18 months later i still wear a size 0 or 2 and go between 118 to 120 so don't fret about your doctor just follow the rules , keep a positive attitude. and yes this is only a tool you must follow the rules you can gain it back if you don't eat healthy and smart , you will do fine, we are all here for the support and that is one of the biggest things , is support through this surgery.
   — rhondan

October 20, 2003
Don't feel doomed! I was only bypassed 25 cm and at 6 months I have lost 83 lbs and only have anoterh 25 to goal. The less bypassed, the less problems with malabsorption you'll have. There are many of us who have succeeded with 110 cm or less bypassed. Are you getting enough exercise? You should try to get in at least 3 30 minutes of cardio activity each week. Hang in there - you're doing just fine!
   — Barbara C.

October 20, 2003
I am only bypassed 75 cm and I am a "slow looser" too BUT it is STILL coming off! NO WORRIES ...you will be okay! RNY 8/12/2003 262/230/125
   — E. V.

October 20, 2003
My Dr. did the same thing at 4 mos. At 6 mos I was declared as a "fast loser" the next month by the same Dr. and I really hadn't lost much more weight. Each Dr has their own opinion, sometimes it is influenced by how their day is going in general (they are human). Don't let the Doc get you down. YOU ARE doing good!! At 6 mos I am stuck (for 6 weeks now) at 205 from 283... know what? I feel great, my labs are great and that's what counts!!! Also, if you go to the AMOS website weight planner you will see that compared to averages - you aren't doing bad either!
   — M B.

October 20, 2003
Only 100 cm??? Only 60 lbs??? Sheesh, do you think the doctor be ANY MORE discouraging? Sweetie, that's what I had and I've lost 100 in 5 months. However, 60 lbs in 4 months is still awesome. 100 cm bypassed is a good amount. I know lots of proximals that have only 75 cm bypassed and lost just great and have kept it off. Do not let the man discourage you. We all get to goal at our own rate. Sounds like he said some pretty heartless things to you. I know there are others here just exactly like you who will encourage you. I would like to throttle the dang doctor that doesn't have encouraging words for the wonderful people who's lives they have altered. God bless you, and know you are NOT alone and you ARE doing just fine and YOU WILL make it to your goal. Hugs... Lisa
   — Happy I.

October 20, 2003
I think you have done great!! My surgery is scheduled for Friday....4 days away and I only hope I do as well as you have. Keep the spirit up!
   — Deb S.

October 20, 2003
If it makes you feel any better, your body will start to adapt and "learn" to reabsorb calories regardless of how many inches are bypassed. What the surgeons have done is given us a level playing feild by restricting our food intake and providing some malabsorbtion...We can now do what slightly overweight and average size people do to stay/get into shape. ..Eventually, it will be like taking off training wheels. Your pouch will stretch (not so far as to allow you to eat what you could pre-op..however what would probably be considered a small to average woman's portion size)and your body will work it's darndest to learn to absorb nutrients and calories. HOWEVER, you will be given a "break" for the first 18-24 months...you won't feel as hungry, cravings will subside....forget about how many inches you are bypassed, and use this time WISELY to learn how to make healthy food choices and understand what a reasonable portion is...that is truly the hardest part in my opinion (has been for me, anyway)....you are doing FABULOUS with the weight loss..don't sweat that part....just use this time with your "training wheels" to learn what eating healthy and exercise is *really* all about. Don't psych yourself out...you will succeed! -Kim open RNY 7/17/01 282/140/125
   — KimBo36

October 20, 2003
By 4 months, I was 61#. And I have more like 400cm bypassed! As distal as you can get. Your wt loss is fine! What is the worst that can happen? Not reach goal at all? Not stay there? OK, if that was to happen, despite your best efforts, what is the worst thing you face? Revision to distal. That's all. Not complete annihilation. I've seen many people do well on LESS than 100cm bypassed, IF they have a good program.
   — vitalady

October 20, 2003
The pouch is built to stretch, though it is usually made out of the relatively tougher, less stretchy part of the original stomach. You don't gain from "stretching" your pouch due to overeating; you gain from constant grazing, from eating lousy foods that flow easily through the pouch instead of filling it, from eating and drinking at the same time (thus washing the food and feeling of fullness out of your pouch), and from drinking high-calorie beverages.<P>The study behind the "Pouch Rules for Dummies" found that long-term posties in that study had pouch capacities ranging from six to ten ounces, and yet their success relative to each other did NOT depend on pouch capacity. You might think the six-ounce pouch-holders were better at keeping their weight off than the people with ten-ounce capacity pouches, but that wasn't true. It all boiled down to who was eating right and who wasn't, pouch capacity aside. I'd hazard a guess that the same would be true if you lined us up by bypass length. Your success is not a function of whether your pouch is stretched to four ounces instead of six, or a matter of how long your bypass is. It all depends on how you use the tools you've been given.<P>I think 75 pounds lost in four months is a far-above-average loss for a "lightweight," and I think your doc is nuts for suggesting you are a "slow loser." JMHO.
   — Suzy C.

October 20, 2003
Your doctor sounds like an idiot. My doctor NEVER complained about my weight loss. He wasn't happy because I was losing too FAST!! I have a friend who was heavier then you and it's taken her over a year to lose 100 pounds and our doctor is always happy when she just loses weight and doesn't care how much. He says that some people are slower losers then others. If you KNOW you are doing everything in your power to eat right and exercise, then your doing all you can do. Keep up the good work and don't worry about what he says.
   — Patty H.

October 20, 2003
A couple of thoughts here: First, many surgeons are excellent in the technical aspects of their work, but just don't have the "bedside manners" of other doctors. Heck, most of the time their patients are unconscious, and they are in their element then! Second, success with weight loss surgery is not necessarily measured by the scale. How about your labs? Blood pressure? Are you generally in better physical condition than before surgery? That is success! I have only lost about 60lbs after nearly a year. But, I am healthier and have more energy and I am in better physical condition than at any other time in my adult life. What matters is not whether your surgeon is happy with your weight loss - what matters is YOU and how YOU feel about it! I think you are doing fantastic! And, it doesn't really matter how much intestine was bypassed; the surgery is a tool, and your body adapts no matter what the surgeon does.
   — koogy

October 21, 2003
I can only aggree with all those that have responded to you question. This surgeon is a fool, he should not say such things, he clearly know nothing of the after care of WLS patients. You have done marvellous, you have steadily lost weight, not too fast, as we all know that too fast is not good for us. Be very proud of what you have achieved, the man is a fool and although he may be an excellent surgeon, he has a lot to learn about his patients DON'T LET SUCH A FOOL KNOCK YOU DOWN, FOR KNOW REASON Carol
   — Carol C.

October 21, 2003
Jane, your pouch will stretch over time and it susposed to do so (see Suzy C's comments below). And 100 cm bypassed is a normal amount for a proximal. In fact, I think the less bypassed the better. The more bypassed, the more malabsorbtion of the good nutrients our bodies need to stay healthy. The less bypassed, the better. In fact, the distals, over 150 cm bypassed, should be saved for the super morbidly obese and used sparingly. The more bypassed, the more supplementing you have to do...there is no reason why you cannot lose all your weight in your own time with what you have bypassed. Everyone loses at their own different rates. Slow losers still get there! Your doing well. The most successful post-ops are those who follow a program and adhere to the pouch rules. Do so, and you will make it...
   — Cindy R.

October 21, 2003
First let me say - YOU ARE AWESOME and just try to forget about being depressed. I think my surgeon is wonderful and I owe him so much. Because I feel this way about him I have never, ever posted one particular experience I had with him but I feel it would be appropriate to post it now. When I was 3 months post op I had lost about 35 or 40 pounds. I thought I was doing GREAT! I had been on a long plateau which I attribute to two things - 1. Being normal 2. Not supplementing protein. Anyway, I asked my surgeon how to break a plateau. He proceeded to tell me there was no such thing as a plateau. He had been pleased with my weight loss until I told him I hadn't lost anything in 3 weeks. Then, it suddenly seemed as if my loss wasn't enough. He told me I must be eating too much a really berated me. He finished up by saying "Rona, you're just eating too much if you haven't lost any weight in 3 weeks. Look at it this way, there's no fat people in concentration camps. No food - no fat." I thought I would die. I was totally devastated. I went home and sobbed and sobbed. When I went back for my next visit (it was pretty amazing that I even went but I just had to confront him) I told him how badly he'd hurt me with his comments. I told him that I'd been eating properly, that I'd never deviated from my eating plan and that I'd never given him any reason to think I'd be dishonest with him. To my surprise, he apologized over and over. He said he'd heard another "old school" weight loss surgeon use the concentration camp comment so he thought he'd try it. He said he knew he'd said the wrong thing as soon as it came out of his mouth. I could tell he was sincere so I forgave him and still think the world of him now. I figure he's human just like me. Having said all that, I think you should tell your surgeon how he wounded you. It will force him to show his true colors. Either he made a terrible mistake or he actually is an idiot. Whatever the outcome, don't let this man steal your joy. You are doing wonderfully and should be so happy with yourself. I am only 100cm bypassed and have been at goal for over 2 years. There are photos on my profile page if you want to check them out. There's even one of me with Carnie Wilson. I was horrified a year ago when I gained 10 pounds but I seemed to level off and that's where I've stayed. I eat the foods I enjoy. Some days I'm well behaved and other days I'm not as good as I ought to be yet still I am a normal size. You are an amazing success story already and you're only going to do better as time passes. Chin up - big smile - move forward! We're all so proud of you.
   — ronascott

October 21, 2003
I started out 1 yr ago at 175 the day of surgery. My surgeon only bypasses about 33cm. He transects the stomach and makes it approx 4oz. The end results are the same as far as weight loss goes. His patients have a great deal of success and very little malabsorption problems where vitamins and minerals are concerned. I was concerned myself in the beginning, but 1 yr later I am at 23.0 BMI and down 140 pounds from a starting bmi of 44.1. I am typical as far as his patients go. So I wouldn't let the amount of bypass concern you. Sabra
   — Sabra_D

October 21, 2003
Hey we had the same surgery date! I have to say I am disappointed in your doctor. You are in the normal range of loss. 20-30 1st month 7-14 after that makes 48 pounds for 4 months a normal low-end loss. Since you lost 60, you are perfectly normal to me. This is why I hate what society does to fat people. We feel bad we are overweight and when we finally lose, we never think we are losing fast enough. You are fine.
   — mrsmyranow

October 21, 2003
I feel your sadness I had my surgery July 16,03 and my goal (set by the dr) for 3mths was supposed to be 51lbs I lost 43lbs; he was a little nicer than yours he told me I am doing good but a little slow. And it does get discouraging when you sit in the waiting room and people who had surgery around the same time as you have lost 60 - 70lbs. Hang in there because that's what I am gonna do.
   — Liza H.

October 22, 2003
I can totally relate to what you are feeling. I had my surgery 6/24/03 and I've lost approx. 65 lbs. When I saw my surgeon for my 6 wk check up he said he was disappointed with my progress. I was about 15 lbs behind where he wanted me to be. I probably wouldn't have felt so awful if he HAD been a jerk about it - but he is very kind, and has wonderful bedside manner. I just felt like a failure. But I have since spoken with my pcp and she has been thrilled with my progress. I have continued to lose, have not gained at all, and haven't experienced any problems since surgery. She says she prefers that I lose slow to give my system time to adjust, to give myself time to learn and maintain better eating habits, and to give my skin a chance to regain some if its elasticity. My stats were very close to yours, and I take great comfort in the fact that I went into surgery at a BMI of 46 and am now at 37. Also, when I feel really down, I go into the closet and try on something I haven't been able to wear. 9 times out of 10, it'll fit. It seems like I'm "redistributing" faster than I'm losing, and as long as this continues - even if it's only a few lbs a month, I'll be happy. Hang in there. You're doing fine!
   — Patti S.




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