Real Talk: How to prepare yourself for bariatric surgery – Step 1

I’ve had so many people ask me how I got prepared for my surgery and how I’m dealing with it now. Did I have to do a pre-op diet? How did I make it through the pre-op diet? How did I mentally and physically prepare? How did I make it through the recovery period? What am I going through post-op? How do I deal with cravings? Do I have loose skin? If you have questions, seeking advice or just need someone to talk to through everything that you’ll be going through…(and trust me…it’s a lot); I’m here to help out as much as I can. This post can also help even if you aren’t having surgery. Changing your habits is pretty draining and you need to prepare yourself. I’m pretty sure many of you have had surgery before, but each one is different. I’ve had friends who wanted copies of my liquid and soft-food diets to shrink their stomach and get started on a weightless plan. In this series of post I’m going to try to cover everything step-by-step. Now surgery isn’t for everyone. I would only suggest surgery for people who have tried everything to lose weight or if you have health issues. Statistics show that people who get surgery only fr the quick fix aren’t as successful. The most important thing it to do is to mentally prepare yourself. Yes…you’re going to lose weight…a lot of weight. However, if you’re not mentally strong and disciplined you will fail. Regardless of what type of bariatric surgery you have, you still have to work on it.

What made me decide to get bariatric surgery stemmed from serious and on-going health and stomach issues. There was no question that surgery was much needed. The procedure that I had is extremely similar to the gastric sleeve also known as Vertical Sleeve Gastrectomy (VSG). The only difference was that instead of my stomach now being in the shape of an arm or sleeve (hence the name gastric sleeve), the part of my stomach that was damaged is what they removed…and it was a lot! Just know…it wasn’t an easy process at all. I’m going to keep it all the way 100. In a previous blog I spoke on how to find out what works for you. Find out what works for you! I’m going to assume that by now you’ve decided that surgery is what’s right for you. If you’re at this point, then I’m going to assume that you’ve thoroughly researched bariatric surgery and have attended the required information session or sessions at the hospital you’ve chosen to perform your operation. I would definitely suggest finding one that your insurance company is partnered with. You’re going to want to pay out of pocket as little as possible. These bills are no joke! I’m not going to get into all of the specifics regarding the different types of bariatric surgeries because all of the preparations are pretty much the same. You may have to do more or less pre-approval requirements than someone else has to do. Usually your insurance company sets what they want you to do. Your surgeon and/or family doctor may want other tests done as well. I didn’t have to do as much as other people had to do. I had to get an EKG, blood tests, ultrasounds, went to counseling, had a one-on-one nutrition session, attended a pre-op nutrition classed had a three month supervised diet. I only had to do three months because I had already lost some weight during this process. The tests are pretty explainable. They want to know if your body is able to handle the surgery. If it is…then you proceed on. If not…you will have a longer road to go until they see you’re able to handle it. If your insurance is paying for it they want to make sure that their money is being put to good use as well. Let’s not forget about that.

For me everything surprisingly went pretty smooth; it just seemed like it was taking forever, that was the most frustrating part. Once I finished most of the requirements set by my insurance company; I had to complete a three month pre-op diet. The time frame of these diets are usually set by the insurance up front and some could add time or take away time. I was in a nutrition class with someone who didn’t have to do a pre-op diet at all and then someone else said that they had to do a WHOLE YEAR!!! So my little three months were nothing. I wasn’t put on a strict diet or anything…I just had to lose weight. This was an opportunity for me to show how disciplined I could be. So many people fear the pre-op diet because it gives you a sneak peek at what you think you need to give up and can’t have anymore. If that’s not bad enough, people really freak out if they have to do a clear liquid diet before surgery. So many people depressed and start thinking about having to do this again after surgery. I only had to do the clear liquid diet 48 hours before my surgery. That was hard enough. The first thing patients need to understand is that on the clear liquid diet it isn’t just strictly water…there’s plenty of variety. Now after surgery…you will be hungry, but will hardly be able to finish a bottled water. More on that later. On the liquid diet you can have pretty much anything that originally comes in liquid form without sugar. There’s: water, water with the sugar-free singles (like the Crystal Light packets), sugar-free jello, broth (low sodium), Powerade Zero, Vitamin Water…I think you get the point. Things on that order. During pre-surgery the liquid diet is hard. Anything during this phase is hard to lose wight. Sticking with this you will show your strength and discipline and be able to keep it up post-op and going forward for the rest of your life. If you aren’t following the diet…your surgeon will know…believe me. (Dr. Now anyone) The biggest thing is just to lose weight…not to gain. Some people may be told they have to lose a certain amount of weight. Just know that you can do this! You NEED to do this.

The main thing about weight loss surgery is yes…to lose weight; and yes to get healthy. But you also need to attend pre-op counseling with a licensed psychologist or psychiatrist. This is another part of the process that people freak about. My suggestion is to complete the counseling requirement early on in your pre-op journey. Trust and believe this is definitely a necessity. For one…you’re about to go through a huge lifestyle change. Everything about you will change physical and mentally. You need to find out why you have this relationship with food. You need to talk through any trauma that has gone on in your life. How being overweight has made you feel? Why are you having surgery? What are your goals after surgery? These are things that I’m sure you’ve thought about before, but when you talk it out with someone you reveal so much more. Going to counseling was the best thing that I’ve ever done. If it wasn’t for the surgery, I don’t know if I ever would’ve went to a psychologist.

The waiting game! After you’ve completed all of your requirements, your surgeons office will then submit all of your results and paperwork to your insurance company for approval. If you complete everything and show that you can lose wight or that you’ve tried to…most likely you will be approved. If you aren’t approved…don’t give up. Talk with your surgeon so that you can appeal their decision. I finished my three month supervised diet in the middle of May and two and a half weeks later…I was approved. This was the best news that I’ve ever heard! Approvals will usually come back pretty quick. If you don’t hear anything after a month, contact your surgeons office and have them follow-up with your insurance company. Once the approval comes that’s a huge weight (no pun intended) lifted from your shoulders. However, the wait isn’t quite over with yet. After your approval the next thing that will happen is the surgeon’s office will call you to set up your pre-surgery screenings as well as your surgery date. The pre-surgery screening is usually scheduled within 15 days of your surgery. You may be waiting a little while to be scheduled or you may get a date of the following week. So you have to get ready quick.  You’re now anxious because you actually have official approval and know that you’re about to have life-changing surgery. While waiting for the date to come, this will be a good time to step-up the mental discipline to 1000. If you can find time, please go sit down with the psychologist again. This is one thing that I wish I would’ve done. Between my approval and surgery date it was almost a two months in wait. Surprisingly, I was pretty calm until the week before. That’s when I got nervous because I’ve never had major surgery before. At this point, I just had to wait it out.

Don’t do what they call a “food-tour” before surgery. This is where you just binge on all of the foods that you think you will have to give up altogether or things that you may be able to have for a long time. This isn’t smart. All it will do is mess with you psychologically and have you gaining weight. That would suck bad if you were losing weight. DON’T DO IT! Your surgeon will tell you, the nutritionist, the dietician and even the psychologist will tell you the same thing.

The last thing that I want to suggest is to buy everything you will need for your at-home recovery. At least for me…I was so nauseous that all I did was sleep. If I was out for too long I would get light-headed and sometimes I would throw-up. You won’t have to buy much food wise. Just try to get as much as you think you will need for at least the 2-3 week clear liquid diet. Some surgeons may have you on it longer, or take you off after your 2 week post-op appointment. To prepare yourself, be sure to stock up on water, any sugar-free flavors you want to add to the water, broth, sugar-free jello, sugar-free popsicles, protein shakes, 100% juice, and anything else you will need during recovery. At the pre-screening they gave us our prescriptions so I had those filled before my surgery. The only one that I couldn’t fill was the pain medication, but I ended up not needing it.  Also, get in the habit of taking supplements because you will be taking vitamins for the rest of your life. I didn’t want to take anything that was on the list except a multi-vitamin and biotin which was my choice. The reason why I started taking biotin was because I read after surgery your hair will thin out. I already don’t have any hair so I wanted to get that in my system before hand. It didn’t work, but at least I tried. I made sure to take them everyday to get into a routine.

This is pretty much the basics that you need in order too get prepared for surgery. If I think of anything else, I will add another post. Until then…research, research, research! Remember…DISCIPLINE! Next post I will get into surgery day through post-op right after surgery until to when you’re cleared for “normal foods.” Until then…GOOD LUCK and don’t hesitate to ask me questions.