Today was my second Dietitian visit. We discussed my progress on the pre-op goals. Overall. she was happy with my progress, but told me to work on getting more exercise and fluids. That came as no surprise since I knew I have been lacking in both. She was also pleased with my weight loss so far. That makes me happy too, because, frankly, I feel like it is never enough.
We went over some questions I had percolating since the last visit. For instance, I should be taking vitamin D3, not just vitamin D, because it has better absorption. This led into a talk about vitamins and the role they will play in the rest of my life. She even had cost estimates for me on the different versions of each vitamin. I asked her about Biotin for my hair and nails. She said I should begin taking 5000mcg because based on the input from the support groups it seems to give the most benefit. I have been a little worried about this; my hair and nails are just about the only parts of me I like nowadays.
She said it is true hair and nails will seem thinner, but this will reverse. She told me that my hair won't be actually thinning out, but rather it will get brittle and break easily. The hair follicles will probably synchronize their production pattern. Meaning that on average a person loses 100 hairs a day, while other are growing. After surgery, due to hormone changes, more may break all at once, so you will have a lot more shorter hair growing in. This will make it seem as though the hair is thinner, when really it is just shorter. So, while still not something to look forward to, it won't be a permanent change in my hair thickness.
I asked her if there were any other negative side effects I should look forward to. I was told that most people complain about their bat wings (floppy under arms). Also, the older crowd tends to have more pronounced wrinkles. They younger a person is the more elastic the skin is and the less likely this is to happen. I am 35, so hopefully I won't have a problem with this. I guess I could always start using a skin firming product.
Then I brought up bowel obstructions. She didn't know the complication rate, but explained to me in detail what happens. The doctor I am seeing does sew up the holes he creates when he enters the abdomen, but as the fat shrinks, sometimes a hole is left through which the bowel slips. She said if it were to happen, it would more likely be 1-2 years after surgery and I would know. There would be a lot of pain just after eating or when trying to go the bathroom. She said if at any time I have severe pain in my abdomen I should go to the ER. The sooner it is caught the easier it is to fix.
Lastly, I talked to her about the low fat requirement. I told her I couldn't bring myself to use margarine because I knew it was plastic. I asked if I could use the other healthy fats, like butter, coconut oil, and olive oil. The answer is yes by all means, but you have to use a very small amount. Keep in mind that a large amount of fat could cause dumping syndrome and will negatively effect my weight loss. The goal after all is to greatly reduce my caloric intake while upping my activity level. The surgery is a tool that will allow me to eat less and not feel hungry, but if I eat a great deal of calories, I will not lose weight. Case in point: she has a woman that is 4 months post-op and hasn't lost any weight because she grazes on food all day. She has admitted she isn't hungry, she just wants to eat. I cannot imagine going through all this and not losing any weight! Why give up the foods I love, and I mean I really adore the sweets, and not lose any weight? It boggles my mind.
She emphasized to me that I will have nine months to a year to get off as much weight as I can. After that I will plateau and it will be much more difficult to lose any weight. So I really need to keep my food intake down and my exercise up (30-40 minutes, 5 times a week).
Weight on Tuesday: 350.5 lbs
Weight on Wednesday: 349.5 lbs
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