Putting Down The Cheeseburger

(Mmmmm....food porn.)

Yesterday, Lor told me a delightful (/sarcasm) tale about a lunch date with two friends that hadn't seen each other in quite a while. One party spent the majority of the luncheon complaining bitterly about her sister, who had recently had weight loss surgery because "she was a lazy ass who doesn't want to put down the cheeseburger and exercise." Towards the end of the meal, the complainer asked her friend how she was managing to stay so trim and fabulous looking.

"I had bariatric surgery, because I am a lazy ass who won't put down my cheeseburger." was the reply.

I would guess that lunch ended soon thereafter.

This story, paraphrased from a tale Lor found on a bariatric social web site, highlights the ongoing issues that we have relating socially after we have gone through bariatric surgery. The great misconception still exists that we have somehow created a trap door in our digestive system that allows us to eat whatever we want and suffer zero consequences from it. 

Can I let you in on a little secret? I have to work twice as hard at maintaining my diet and exercise as a "normal" person. Every single thing I eat is analyzed, weighed, measured, and logged. My daily regimen is closer to that of a professional athlete than that of someone who just wants to stay fit. I live on supplements, protein shakes, and meals that would not pass muster as a salad on a child's menu. And a single dietary mistake lands me locked in a bathroom for hours, expelling the material my rearranged digestive system didn't agree with from both ends. 

Those who choose bariatric surgery are accused of doing this because we want to be more attractive, as a sop to our poor self-esteem. But, the truth is, bariatric surgery did not turn Lor and I into Malibu Ken And Barbie.  I will admit, I no longer suffer from feeling unattractive due to my size. But I now feel unattractive due to the huge piles of deflated skin covering my body like flesh-colored Play-Doh. I don't recognize my face in the mirror, which gives me some real existential crises. I had to shave my head due to hair loss, for goodness sake. (And, yes, the happy accident is that I actually like my shaved head. Thank goodness.) 

And, through it all, I still deal with the lingering suspicion that I am somehow "not doing enough." I should eat less, exercise more, hydrate better, sleep longer. Bariatric surgery has given me many of the symptoms that we would equate with an eating disorder.

Do I wish I hadn't done it? Not for a moment. Societal mores had nothing to do with my decision. I took ownership of my own health, and control over my own body, by going through with surgery. But I still find it very frustrating that our society not only is focused on size as a metric for determining the worth of a person, but is even willing to judge those of us who strike out toward health via the method of bariatric surgery. In a nation where over 50% of the population suffers from obesity, calling those of us who required surgery "cheaters" is disingenuous at best, hypocritical at worst.

Yes, I "put down the cheeseburger". Bariatric surgery was one of the tools I used to help me do so. The idea that this is somehow "cheating" is held by those who have not spend years (or decades) trying and failing to defeat obesity. To those who have not walked a mile in these shoes, I can only say the following:

Get Over Yourselves,

- Hawkwind

Playing Santa

As Christmas grows ever nearer (23 days as of this post), I have been fielding a few questions about Christmas gifts. What, people are asking me, does one get for a pre- or post- bariatric surgery patient? In the service of Christmas Gifts That Don't Suck (TM), I would offer up the following suggestions:

1. Clothing: You've seen the complaints here on almost a weekly basis. As the weight loss starts happening, the clothes stop fitting. So quickly that many patients (myself included) just stop buying clothes entirely, out of frustration with the concept of wearing something once then giving it away. This eventually leads to sagging pants, tent-like shirts, and underwear that falls off. Some even suffer from the issue of shoes no longer fitting. (Not a problem I have had, but one that is driving Lor crazy, for example.) So, pay attention! Buy a piece or two that is a size below what your patient should be wearing currently. It will be snug for a bit, then it will fit for a glorious week or two, then it will sag and eventually be donated. If you are afraid to guess at sizes, a gift certificate to an inexpensive clothing store like Old Navy might be your best bet.

2. Supplements: It may not occur to many, but the post-surgery life is flooded in supplements. I, for example, am taking a Multivitamin, an Iron supplement, Biotin, and Osteo-Biflex (a joint health product). That is, like, every single day. Though the grocery bill does diminish a bit after bariatric surgery, the supplement bill goes right through the roof. So, get your patient a month or two worth of one of their supplements. If you aren't comfortable picking brands, grab 'em a gift card to a local GNC or even a CVS/Walgreens type of store. This is the one time that buying a gift certificate to a drug store will not be viewed as a lame last-minute gift idea.

3. Dining Out: Our lives after our surgeries are filled with cooking 3 meals a day, every single day. We no longer go out to eat much, because we are afraid of wasting food. Also, the majority of the places we used to go are what made us obese in the first place. So, take your patient out for lunch or dinner - but take them somewhere they would have never gone before. No burger joints or salad bars, please: try places like seafood and sushi restaurants (sashimi is 100% allowable under most nutritional plans), steak houses, and barbecue pits are all great ideas for high-protein, low-carb dining. Your patient will get a meal with a loved one, plus leftovers to take home. (Trust me, there will be leftovers.)

4. Adventures: The great majority of bariatric patients are recovering from sedentary lifestyles where very little time was spent trying new things. Both physical health problems and embarrassment over their size kept them at home, on the couch. Now that they are taking steps in the right direction, help them out! Get them a hot air balloon ride. Take them to an ice skating rink. Buy a month's worth of dance lessons. If you ever heard them wistfully wish they could try an activity while they were overweight, now is the time to strike - get them through the door of that studio/dojo/museum/whatever. Better yet, go with them - nothing defeats fear of the unknown like having someone to share new experiences with.

Hopefully, somewhere in here is an idea or two you can use for the friend or loved one that has gone through bariatric surgery this year. As they are trying to come to grips with this new life, free from the bonds of chronic obesity, you can show them you support their life-altering decision with nothing more than a thoughtful gift. But act quickly - you only have 22 shopping days left!

No Fruitcakes, Please,

- Hawkwind

Big Brother Speaks

Chaos and Mayhem in 2008

We've talked a lot here about what family support means to a person who goes through bariatric surgery. Getting some family members or friends "on board" with you dramatically increases your chances of long-term success - just like a lack of support frequently translates into a lack of focus and eventual regain. But, what does family support mean, really?

Though it may come as a surprise to you, it turns out that the great majority of the readers of Misdirected are not current or potential bariatric surgery patients. But most of my readers have someone in their lives who is severely obese, and who is maybe tiptoeing around the concept of bariatric surgery. For the great majority of you, you want to know how to best support the person you care about that is considering tackling this journey, without feeling like you are pointing fingers and shouting "You are SO unhealthy! Have surgery!"

I have spent very little time talking about my family here (excepting Lor, of course) other than obliquely. As I say frequently, those are not my stories to tell. But major changes take place in the lives of those whose loved ones have gone through this process. My brother has been a rock throughout this process for me. He has been a source of encouragement, a fountain of exercise and nutritional information (he is a personal trainer), and someone to whine at when this all seems to be too hard to continue anymore. And, he has recently asked for the opportunity to address the Misdirected audience. 

His unedited comments follow. 

"An open letter to family and friends.

Jeremy, Lor, and I  met as teenagers,  I am mentioned in the blog as Jeremy's brother. His family adopted me as a teen for reasons that don't matter here, but I use as a reference to set the tone. 30 years later, we are still standing through thick and thin. water flowing bright and clean, and dirty and turbulent at times,.Jeremy and Lor have been a part of me through all of it.

The past year has amazed me though. The decision and life changing choice the two of them made has amazed me, and made me so proud. They stepped outside of fear and judgement and made a life for themselves that is so very different from before. I cannot begin to say how this has changed the both of them. I won't say for the better, because, through all of this I have had the honor to see the rough parts of their hearts. Thank you both for everything, and I pray that your journey keeps going forward. 

The reason this is an open letter though is because of this. I saw new smiles on my brother and sister at the party he talked about. I saw that his blog had brought people together. I saw smiles and gleams in the eye that offer new hope. I wish everyone well and wanted to take a moment to applaud you all and offer my congratulations. This is hard work and a  hard line to tow.

I am lucky to have these two in my life. Because of that, I appreciate the people who have taken this journey with them. 

Thank you to all, Jeremy and Lor I love you both and will never be able to convey how impressed and proud of you both that I am."

In case anyone was wondering: this is what supporting your loved one looks like.

Humbled And Lucky To Have Such A Brother,

- Hawkwind

The Fear of Tofu Casserole

Image of Tofu Broccoli Casserole courtesy of kirstenskitchen.blogspot.com.

As we get ever closer to the holiday season, the phone calls are starting to come in. Well-meaning family members, working on their holiday meal planning, dial us up, wanting to know what exactly we can eat.

Them: "Do you need anything special?"

Us: "Any high-protein items are usually fine, so are fresh veggies."

Them: What kind of protein? Anything special?"

Us: "Oh, you know - turkey, ham, beef are all fine."

Them: "And what kind of veggies?"

Us: "Anything not white is probably safe."

This is followed by a short pause as they digest (Ha!) this information. I can actually hear the disappointment in their voices when they say "Oh - so the same things we make every year?"

I just know my family was hoping to prepare quinoa cakes and tofu surprise in order to show their support.

Now, I am just teasing here - Lor and I are extremely lucky that both sides of the family are so supportive of our surgeries that they care enough to ask - many bariatric patients do not enjoy this kind of help from their families. But, the fact of the matter is, bariatric surgery does not prevent you from eating most things (carbonated beverages aside.) It just forces you to eat really small amounts.

At the end of the day, it will be Lor and I who have to monitor and control our intake over the food-filled holiday season. The rest of the time as well, of course, but the holidays will be tricky, just like any event where there is a whole lot of calorie-rich and nutrient-poor food waiting to be sampled. We've been getting in some practice with all the social gatherings we've been attending recently, so I am thinking the holidays shouldn't be too bad.

I am already planning on falling off the wagon in a few spots, admittedly. I will not go through the holidays without at least one tamale, for example - I do not care that they are 90% corn meal. If a pecan pie puts in an appearance, I will likely have to have a (very) small piece. Same for the infamous Chile Relleno Wontons at the Superbowl party - I will have one, and that will have to do. The watchwords will be Sensible Eating.

As much as I love holiday food, I love the idea of being down 100 pounds by January 1, 2017, even more.

So, let's skip the Tofu Casserole, and let me at those Green Chile Chicken Enchiladas instead!

Err...in moderation, of course.

Because A Life Without Tamales Is Not Worth Living,

- Hawkwind

Uncomfortable Answers

In the weeks leading up to and following our surgeries, Lor and I have become the friends and family ambassadors representing the nation of bariatric surgery. Sometimes the questions are asked in front of everyone at public gatherings, sometimes whispered as soon as no one is around, but the requests for more information keep on coming. The procedure itself is somewhat mysterious, and people are filled with curiosity.

For the most part, this is excellent - clearing up misconceptions about the procedure and the lifestyle changes that accompany it is probably the best way Lor and I can "pay it forward" for an experience that has had such a positive life-altering affect on us. We have friends and family members who are either considering or going through bariatric surgery and being able to help them along is awesome. Heck, I even write a blog about it, to get the information out there. We want this info to be spread far and wide.

But...there are a few questions that come up (and frequently get repeated) that demonstrate the misunderstandings surrounding bariatric surgery. And the answers admittedly don't feel real good when we know that someone is hoping that our answer will be exactly the opposite of what the truth is. It always makes me sad that someone who is considering bariatric surgery asks me a question that I know will immediately turn them away from looking into it any further. But, in for a penny, in for a pound - here are a few of those uncomfortable answers:

"Aren't you hungry all the time?": No...and yes. Let me explain. If I allow myself to dwell on thinking about food, I will crave it. It is as simple as that. Smells are an especially strong trigger for me - I can't smell pizza without wanting to eat one. Like, a whole pizza, I mean. But if I walk away, and think about something else, within 5 minutes or so I am no longer hungry. The hunger is not being generated by my digestive system at all (which is remarkably quiet if I don't expose myself to pizza), but by my mind. It is pretty weird, admittedly.

"If I have the surgery, when can I get back to eating normally?": By FAR the most common question we get asked. And the short answer is: Never. The surgery does not create a black hole in your abdomen that allows you to eat whatever the heck you want without consequences. The Lap-band, Sleeve, and Pouch all perform varying degrees of the same effect: negative reinforcement. There is less available space in your stomach, so you eat less. I personally find the sleeve superior (for me) because it also removes the majority of your ghrelin-producing stomach from your body completely. No hunger hormones mean no constant craving for food. (Something that plagued me for years before the surgery - I was literally hungry 100% of the time.)

"So, when can I start drinking Cokes/drinking alcohol/eating Krispy Kreme again?": Whatever the trigger food, we all want to know when we can start hitting it again. For some, it is soft drinks, for others ice cream. I, for example, will probably crave beer for the rest of my life. And the probable answer is "Never." Cokes and beer can't be had due to the side effect of carbonation expanding the area in the pouch, creating more room for food. But those Krispy Kremes and McDonald's french fries? They should be avoided as well, because it is so easy to vault off the rails and eat way too many of them at one sitting. They pass through the digestive track so quickly that you will never get full - leaving you eventually with an empty box of donuts and a feeling that you have just done a really bad thing.

"Really? I have to quit drinking?" Alcohol is no longer taking a pleasant 20-30 minutes to work its way into your system. It is no galloping through the stomach straight to your liver and then to your brain. One or two drinks is all it will take to get you very, very inebriated. And here is the real danger - we became obese because of addictive elements in our personality. It is so very easy to switch addictions from food to alcohol. The numbers of alcoholic bariatric patients are extremely high for this very reason.

"Will I have to exercise, like, every day?" Yup, afraid so. There are many stories of failed bariatric surgeries out there, each with their own sad tale about why the patient fell off the wagon and ate themselves back to obesity. Those stories all have one common element - these people stopped moving, and started eating. Exercise is critically important to the success of bariatric surgery - it not only keeps your metabolism up, but it also reminds you on a daily basis that you are doing this for a reason. As soon as you stop exercising, you will start regaining. It is as simple as that.

"Man, it sounds like your life sucks. Why would anyone have this surgery?" The saddest question of all - the questioner has given up on the idea of surgery now that they have been convinced that it is not going to be easy.

And, they are right - it isn't easy. But giving up the foods I loved was not something I could do on my own. It required external intervention to push me over that hump. And now, I may never have a Guinness or a chocolate cream pie again.

Instead, I can touch my toes. I can sit down without waiting for a chair to break. I can (almost) keep up with Lor and Vixen on our daily walks. I have spent more time socializing in the past 6 months than I did in the previous 6 years - once food ceased being the #1 priority in my life, room for a whole lot of other priorities was created.

Now, my life no longer sucks due to obesity. And that is why I had bariatric surgery.

Heck, I Might Even Get To Drink Real Coffee Again,

- Hawkwind

3 Decades (And Counting)

Melissa in 1986. Someone should have warned her what she was signing up for.

It has become a regular feature on my blogs to have a little chat about my relationship with my wife (Lor/Melissa) every year on our anniversary. Many people find it charming or romantic, she finds it embarrassing, I find I am simply compelled to do it by the urging of my inner voices.

This year is a little different for a lot of reasons. The last several months have brought us both through bariatric surgery, not because either of us was concerned about our physical appearance, but because we both wanted to extend the potential time we had together. The experience has brought us even closer together than we were, as we have become one another's partners through this process - each acting as a combination of cheerleader and drill instructor for the other. Every member of our surgical team was delighted to hear that we would be going through the process together, because couples enjoy a much higher long-term success rate from bariatric surgery than others. Now, I can see why.

However, this year is also special because it represents a landmark year for our relationship. You see, in 1986, I took a gorgeous 15-year old out on our first date. Within a couple of weeks, we were "going out", as we used to call it back when we were in high school. This year, 2016, actually represents our 30th year together.

When we were married 2 years later, in 1988, I had just turned 18 and she had only been 17 for a few months. We were so young that we spent the next decade or so raising each other. I still can remember the conversation with her mother when Melissa turned 35, when my Mother-in-Law congratulated me on having had her daughter for longer than she did. And, while many couples lament not getting to spend enough time with each other, my illnesses and Melissa's caretaking has placed us in close proximity to each other almost 24/7 for the past 9 years. I can safely state that I have spent more time with Melissa than with any other human being - by a pretty good margin.

Today, we have a very different future to look forward to than we did a year ago. Her diabetes numbers remain very low, and she may be in remission completely. Weight loss has improved my seizure control. We have bought a house. Slowly, we are emerging into what most of the country thinks of as a "normal" life. And none of it would be possible if not for her unflagging patience and self-sacrifice over the past 30 (!) years.

Thank you, Melissa, for everything you are and have done for us over the past 3 decades. I wish I knew what I did to deserve you, because I would do it again in a heartbeat. And here's to the potential of loving you for another 30 years.

Best 30 Years Ever,

- Jeremy

Showtime!

Lor and I on July 23, right before my surgery. I am at 248 here. She is at 188. She got a 6-week headstart. Cheater.

At the point in time when this is posted, I am getting prepped for surgery.

However, when I am writing this, I still have a few hours to go. I had been getting increasing frantic as the days went by. Lor finally had all she could handle on Saturday, and decided to force me out of the house.

Here's where we went:

This, my friends, is what we call "The Valley". A little tiny town in the Northern part of New Mexico, sitting alongside the Rio Grande. It also happens to be where I grew up - as did 4 generations of my forebearers. 

When I was younger, I was convinced my hometown was the ass-end of the Universe. The moment I had the chance, I got the heck out as quickly as I could. No small town life for me, nope. I was destined for bigger things - a bright and glorious life that could only be achieved in "The City". And, over the years I have grown to love Albuquerque, and come to consider it home. I certainly have no regrets about moving here.

But...there is something about the place where your roots are. I am forever spiritually invested in the place that gave me birth and acted as my home until my twenties. The graves of my grandparents and great-grandparents are all within a few miles of The Valley. While spending just a few hours up North on Saturday, I could feel myself growing more centered - my anxiety sloughing off like a snake shedding its skin. Sure, I can do this, I was able to say to myself. Northern New Mexico produces self-reliance and toughness. It was a glorious reminder, and yet another demonstration of Lor's wisdom in hauling me up there and then stepping back and letting my ancestors do their work on me.

The end result? I am back to feeling great about the surgery and the changes that will result from it.  By the time you read this, I am probably already done with my surgery, and watching the pretty lights in recovery, or possibly getting settled in the room that will be my home for the next two days. 

Tomorrow I should be back behind the wheel of Misdirected, and will let everyone know how it all went. Thanks for tuning in, and for all the support you have provided the two of us with over the past few months!

See You On The Other Side,

- Jeremy (aka Hawkwind)

Patient Zero

Photo Credit: Small Creatures via Compfight cc

(This special Saturday edition brought to you courtesy of Friday getting away from me!)

Since the beginning of Misdirected's conversion to a full-time weight-loss surgery blog, I have attempted to keep track of everything. How I felt, what I thought, what was happening to me both inside and outside. It was a journaling experience of sorts, that has gradually turned into a journal that gets shared with several hundred people every week.

However, now that we have had a real, live surgery in the family, I have stopped paying a whole lot of attention to what is going on in my life, and am almost totally focused on what is happening to Lor post-surgery. Pain, discomfort, and diet have all been dutifully logged. Her times of energy vs. her times of exhaustion. Her doubts are measured against her optimistic periods. All carefully cataloged, and much of it recorded here.

It is no secret why I am doing this, of course: My own surgery is exactly a month from today, and I want to know what to expect. Our nutritionist laughed during my last visit, and told me I would be the best-prepared surgical patient ever, thanks to my observations of Lor. It seems kind of heartless, really, sending my wife into the trenches before I ever get there. We had a pretty well thought-out plan for why we scheduled things the way we did, but every day I wonder if we chose the correct order. I just know that I am glad to be 100% healthy and able to care for her while she is recovering from surgery and settling into her new life. And if I get to pay close attention to see what is coming down the road for me, surely that is an unintended "bonus", and not my nefarious plan all along, right?

As it turns out, I am not alone in carefully watching this process.

Members from both sides of the clan, Lor's and my own, check in on a regular basis. They are, of course, concerned about her health and recovery. But they are also watching this process very carefully. Obesity is not uncommon in either of our families. Lor's success (and how hard she has to work at it) is being used as the measurement by which many others will decide if they are going to investigate surgery as a treatment option for themselves. "It is like there is a new drug treatment being tested, and I am 'patient zero'." Lor quipped yesterday. Her success will be what convinces a whole lot of people that there is something to this whole weight-loss surgery thing.

In that sense, Lor was the right person to go first. She is a practitioner of alternative medicine, so agreeing to have surgery in the first place meant that she really believed in the process. Everyone who knows her is aware that she is a meticulous researcher, paying special attention to what could go wrong, and never over-estimating positive potential results. ("Counting chickens" is her favorite phrase for being overly optimistic.) If she chose to do it, goes the family logic, there is really something to this.

The surgical prep and surgery have been so successful for one reason: she is stubborn. There is a reason she had already lost nearly 50 pounds before she ever had surgery - once she makes up her mind to succeed, she refuses to fail. She never set a "goal weight" exactly, talking more about the health benefits of losing (and keeping off) about 50 pounds. She already blew through that goal like an oncoming train. Next stop, 60 pounds down. Give her a day or two.

A better ambassador for the benefits of weight-loss surgery could not have been picked. But we will have to give her a few days before we start asking her to make public appearances. kissing babies, cutting ribbons, etc.

The weight of everyone's expectations has kinda worn her out.

Recording The Success Of Patient Zero,

- Hawkwind

The Post-Birthday Hangover

Birthday Card designed and created by Kristina Daniels.

...you know, the one when you wake up and realize you not only have a mile-long list of stuff to do today but also have to catch up on all the stuff you didn't do yesterday because you were busy goofing off? Yeah. that hangover.

It should have been a great day, really. Due to unexpected circumstances, I got to see my parents and my brother, as well as one of my best friends, who made me the card you see above and brought me a bouquet of flowers as well. (Yes, men are allowed to like flowers. I checked.) I got an awesome lightweight laptop from my in-laws, who wanted me to have something to write with while I was in the hospital and recovering from surgery next month. I had dozens of birthday wishes from friends and family all over the country.

So why didn't I enjoy my birthday more?

In a word: food.

I wanted to go have a beer or three to celebrate. I couldn't.

I wanted to go out to dinner somewhere, like I've done for my birthday every year that I can remember. Not only was this a bad idea from a diet perspective, but I couldn't exactly go by myself. (Lor is still recovering and on a liquid diet besides.)

I wanted a birthday cake and ice cream so bad it almost felt like physical pain.

I got through the day successfully, managing to stay under my daily max of 105 grams of carbs with room to spare. But I was miserable all day. I smiled while visiting with everyone, did my best to be nice to Lor, and spent most of the day trying not to think about food. It was hard - probably harder than any day I have experienced since the first week of our low-carb diet switch. As a result, I was probably not as friendly as I should have been, and my nursing care for Lor definitely suffered. As did all the stuff that I should've been doing around the house. Which I am getting to do today. Which is not making me very happy.

See a pattern here?

At the beginning of this pre-surgical process, I was really worried about being restricted from various foods, because fat men love food, right? (And no, I am not afraid of the term "fat", political correctness notwithstanding. That is probably a whole other post.) These days, I am beginning to resent my attraction to food. These overwhelming cravings just drive me crazy - they make me feel like an addict in recovery. Ok, ok - I am an addict in recovery. But that doesn't make me like it any better.

Many post-bariatric surgery patients talk about how their entire relationship with food had changed. They no longer want to eat, but now look at food as nothing more than fuel - the body has to be "gassed up" every once in a while, but otherwise they do not enjoy eating. And that whole idea makes me sad, too. Because deep down, I don't want my love of food to be removed from my life.

Because I love eating so much that it has made me obese.

Someone help me off this carousel - it is making me so dizzy that I want to throw up.

Looking For The Nearest Trash Can,

- Hawkwind

Another Appointment Closer

Patient Progress: Lor managed a half mile walk last night (logged above by Map My Walk). 5 days out from surgery, mind you. She is setting the bar impossibly high for my surgical recovery, I have to tell you.

In the midst of all the commotion surrounding Lor's surgery and recovery, it has been pretty easy to forget that I am going through this process as well. For example, last week when Lor dropped a whole 8 pounds around her surgery? Yeah, I gained 2 pounds. I am not holding it against myself - I ate more fast food last week than I had eaten in the previous 2 months or so. Hard to make good food choices when you are shuttling back and forth from a borrowed room in your parent's house to the hospital. In defense of the hospital, they did have high-protein, low-carb items available, like omelets and salads. They even had Muscle Milk protein shakes! I should've just stuck with eating there.

These are the lines I am rehearsing, as today I have to go into meet my nutritionist for my final dietary meeting. After today, I will have seen her a total of 6 times - 3 visits with Lor, and now a total of 3 for me. I am not sure there is a heck of a lot left for her to say to me at this point that we haven't covered in the previous 5 meetings in one way or another. But, it represents one of the final 2 steps before I begin my 2 weeks of liquid-only diet to prep for surgery in July, so I want to make sure I make it to the appointment, even though I do have a surgical patient recovering at home.

Luckily for me, another one of our friends has stepped up and offered to come hang out with Lor during the hours when I will be gone today. What we ever did do deserve the support we are getting from our friends and family members, I do not know. I am constantly reading horror stories about bariatric patients being forced to go this alone, due to lack of support from those closest to them. I honestly do not know how they succeed at this, and my hat is off to them.

Tomorrow is also my 46th birthday, which makes me feel a little weird. Why? Because I will weigh less tomorrow (267) than I did ten years ago on my 36th birthday (285). I am reminded of the Bowflex commercials from a few years back: "I am 44, and in better shape than I was when I was 24!" Heck, for that matter, next year at 47 I may very well be in better shape than I was at 27.

How's that for a brain bender?

No special plans for the birthday either, despite all the emailed coupons for free pancakes, free stir-fry, free ice cream and free pizza. This year I will just stay home with my lettuce wraps and chicken salads, and try to work off the 2 pounds I earned last week. I don't want two weeks in a row of bad dietary choices, right?

Mmmm....Lettuce,

- Hawkwind

Post-Surgical Reflections

The guest room is empty, the phone has stopped ringing, and calm has descended over the house once more.

Guess we'll call this one a successful weight loss surgery, right?

After a week of chaos and worry, hundreds of communications passing back and forth, and more activity than Misdirected has ever seen, Lor is resting comfortably in bed, binge-watching Heartland and managing almost a whole protein shake a day.  Her color looks good, her bruises are (mostly) fading, and she is doing laps around the house regularly to get back into fighting trim. We might even try walking up and down the driveway this afternoon, just for giggles and grins.

The post-surgical changes are pretty remarkable already. She has no interest in eating at all - her mother and I have been having to remind her to drink water and protein shakes. She has deemed us "water Nazis", and not looked kindly on our attempts to keep her from being re-hospitalized due to dehydration.  Now that her Mom has gone home to catch up on all the sleep she has missed this last week, I am the sole arbiter of hydration and nutritional discipline in the house, a position that has not made me very popular. Lor has vowed revenge when it is my time to go under the knife next month. I tremble in fear.

Her weight is also already dramatically responding - with a total weight loss of 8 pounds in the last 7 days. It is quite humorous to watch her clothes falling off her as she walks back and forth down our main hallway. Next week, when she intends to return to "civilization", I am sure one of our first stops will be at the thrift store to pick up some new clothes. No point in buying brand new, full price stuff just yet, right? This rapid weight loss can last up to a year after the surgery.

Most importantly, her blood sugar levels dropped to normal and have stayed there since the surgery. We continue to hope for a full remission of her Diabetes but won't get official confirmation of that happy state for another couple of months. But so far, so good.

There have been lots of discussions between the two of us about lifestyle changes from here on out. Lor had expected to maybe lose a few pounds, but was mainly concerned about addressing her Diabetes. However, at this point, she is already within shooting distance of her weight back in high school! Similarly, I had hoped to maybe get back down to around 250 pounds when everything was said and done.

Today I am at 267 - and I am still 5 weeks out from surgery.

We are no longer dealing with questions like "Will this work?" We are now moving into "Where will this stop? and "Who the heck will we be when this is all over with?" Neither one of us has any clear idea of what our lives are going to look like 50, or 75, or even 100 pounds from now. It is tremendously exciting and completely terrifying, all at the same time.

One last time - thanks to everyone who stayed plugged in during Lor's surgery. It meant more than you can ever know to have so many people so interested and concerned about her status and well-being. We will keep you all updated with her progress now that her time in the trenches has truly begun.

Able To Breathe Again,

- Hawkwind

It Is Still Friday, Right?

2 PM in Albuquerque, NM. The recovering patient is asleep in her own bed, my mother-in-law is cleaning my house from stem to stern, and I am hiding in my office, "working."

It has been a hectic 24+ hours since I last posted here. Lor was walked around the hospital floor several times last night, discovered the reduced capacity of her new stomach pouch the hard way (no room for error on drinking just a little too much anymore!), and been awakened by hospital staff asking "Are you sleeping?"every two hours.The hospital staff members have been great, but anyone can tell you that a hospital is no place to get well.

So, by 6 AM this morning, Lor, her mother and I were all sitting around the hospital room, waiting for her release. A doctor showed up promising freedom at about 7 AM, and by 11 AM or so (you know, hospital time) Lor was finally out the door and on her way home. She arrived here at noon or so, and is now resting as comfortably as you can with 5 new holes punched through your abdomen, and the MIL and I are doing the best we can to avoid interrupting that rest. 

Lor is actually doing pretty well today, all things considered. Her mobility is good, she has had little interest in pain meds, and her biological functions are slowly returning to normal. Once the post-surgical inflammation recedes a bit we will get a "real" idea of what her new stomach capacity is. Right now she can only have a couple of sips of anything before she is forced to quit for half an hour or so. It seems slow to us, but she is right on target according to her medical team. We are doing our best to not get in the way of the folks that do hundreds of these a year, even when certain things seem weird. Not easy for control freaks like Lor and I.

For this weekend, we plan to just let her recover, walk her around the house (slowly), and get this healing process underway. I continue to hope for a steady recovery for her, but knowing her tendencies it may be necessary to apply the brakes now and again. If she had it her way, she would be ready to run a marathon tomorrow.

I will let everyone know how the process is going on Monday morning. Enjoy your Father's Day weekend!

Very, Very Tired,

- Hawkwind

There's Got To Be A Morning After

6:00 AM. So early that even the nesting birds are wanting to know "What the heck are you doing up so early, man?" as I walk by their nests.

The good news, since I know you have all been waiting for it, is that Lor came through the surgery 100% successfully. Her surgeon nearly gave us all a collective heart-attack when she emerged after only 45 minutes of surgery, but, no, the news was nothing more significant than that the surgery was completed, and we could see Lor shortly. There was much rejoicing, Facebook posting, telephone calls, etc. Others in the waiting room probably thought we were celebrating an ethnic holiday.

There isn't any bad news exactly. But there were some...surprises.

Post surgery, I think we were expecting a glowing, healthy person who was now totally committed to weight loss. What we got was someone who was in major amounts of pain, and suffering from the effects of anasthesia. Stupid of me to expect otherwise, but I was taken aback by the fact that the preson who went in for surgery was not the person who came out. Though she had returned to normal within a couple hours, it wasn't something I was mentally prepared for, and maybe should be included in the pre-op "training" - "Dont take anything said in the first couple of hours after surgery seriously."

A little later on yesterday, I got to see the reason that Lor was in so much pain. My first glimpse of her post-surgical abdomen gave me a serious shock. She looked, bluntly, like she had been in  a knife fight.

I know, I know - what the heck was I expecting after she had scopes inserted into her abdomen in 5 different locations? What ever I was expecting, it wasn't this. Big bruises surrounding obviously punctured tissues, all across her tummy. I don't know how she is carrying on conversations, or breathing for that matter. I have a certain amount of experience with knife injuries (how is not important here), and these ones look like they are no fun at all.

So, next time someone asks me if bariatric surgery hurts, the answer should be an emphatic "yes". Got it.

We also had some administrative snafus that wound up with Lor finally getting comfortably settled in her bed, just in time to be informed that she had to move to a different room. On a different floor. Of course. Out came the wheelchair, the dance of disconnecting cables and monitors and leg-squeezers, and she was shipped up one floor, to the room literally directly above the room she had already been in. Administrative logic never ceases to confound me.

Lor's Mom took the overnight shift last night, and they are both currently still asleep 5 floors above me. I have camped out here in the cafeteria to jot all this down after sneaking out of my parent's house at 5:30 this morning to drive the 5 miles over to the hospital Lor is at. Thank God for our families - this would have been a nightmare without all the familial help and support we have received.

Thanks also to all of you - Lor was the subject of prayer chains, the focus of positive energy flows, and the receipient of remote healing energy from across the country. I can't thank everyone enough for your care and interest in the well-being of the person who is the center of my life. My heartfelt thanks to all of you.

Wondering If 7 AM Is Still Too Early,

- Hawkwind

PS - No pics for the next few days, my poor Kindle isn't the best tool for blogging.

Scary Stories

Photo Credit: Magda's Maggots via Compfight cc

I spend a LOT of time (probably too much) hanging around on message boards and forums relating to obesity surgery. I don't input very much - after all, I am not a "vet" yet, have not earned my surgical scars and all that. Every once in a while, I will put up a link to here on Misdirected if I feel it is especially relevant, but other than that - I lurk.

There are quite a few encouraging tales to be found out there. Formerly 600-pound men who are now avid wilderness hikers. A previously obese woman fitting into her wedding dress for the first time in 25 years. A grandmother getting into a swimsuit for the very first time in her life. The stories can be really heartwarming and encouraging to those of us just getting ready to take the plunge.

But I have recently been paying a lot more attention to those "other" stories": 

• "I lost 100 pounds but gained it all back..."
• "I am going through a bad time in my life and can't stop eating..."
• "My husband just left me and all I want to do is cry and eat..."
• "After 5 successful years, I am regaining again and I don't know why..."

Entry after entry of people whose surgery is not working out for them for one reason or another. Scary stuff.

I have not gone out of my way to look into relapse numbers. Normally this is the type of research I would be all over like stink on expensive cheese, but here I have held myself back. I couldn't tell you exactly why, only that it didn't feel right to be investigating failure before I have even started the process. I have been wanting to prepare myself for success, not for failure.

But the truth is out there: relapses happen. And it is scary to think that all this work, (and rearrangement of my innards) could go down the drain if I don't watch my step.  So, I have been carefully reading these relapse stories, and looking for common elements. I keep finding 3 common themes coming up time and again:

1. Lack of accountability. Most of the desperate pleas of those I see talking about their failures online are for someone to "straighten them out" or "tell them off." At home, these individuals are not getting the support they need. Maybe they live alone, maybe their family is disinterested, or maybe (most frightening) their support system is working actively to sabotage them. But they need someone to call them out, and tell them to get back on track.

2. Lack of exercise. This seems to be a major issue. I have yet to read anyone's story about how they are suffering from massive regains while they are still exercising regularly. Just about all the horror stories I have read talk about how the pressures of life, or exhaustion, or just laziness have kept them off the street, away from the gym, and placed them on the couch.

3. Emotional turmoil. The big push that starts the plummet of the cliff of a major regain seems to frequently be an emotional trigger of some kind. A lost job, the death of a loved one, the breakup of a long-term relationship (sadly common for those who have gone through bariatric surgery) all seem to be things that have forced these individuals to seek comfort where they have always gotten it in the past - from food.

Lor and I are lucky. She has me to hold us accountable to our diets, and I have her to push us when it comes to exercise. As far as emotional turmoil - we have each other to rely on if something goes wrong in either of our lives. It isn't like we're going to get divorced again. Been there, got the T-Shirt - it didn't fit.

For anyone else, I would encourage them to find a family member, community,  or friend to act as an accountability partner. My other advice would be to do it now - while things are still going well. Looking for help while you are desperate leads to bad, bad choices. Get someone in your corner right away, and keep them there - when the storm clouds roll in, you'll have someone to run to before things get out of control.

This lifestyle change that we have undertaken is hard enough without handicapping ourselves by trying to go solo. Do it with a friend, find a support group, get plugged into a relationship with a trainer - anything you can do to make sure that one bad day doesn't turn into one bad week, or one bad month, or a disastrous relapse to obesity. One thing we know about life - bad times will show up. Make sure that you have planned ahead, and have the tools you need to come out the other side with your "new self" intact.

Being Prepared Aint Just For Scouts,

- Hawkwind

Lead Me Not Into Temptation

The Gathering of Cousins. I am the one with the beard.

This weekend was a special occasion in the family: two of my cousins are hitting their 50th birthdays this year, so a party was organized to get as much of the family as possible together to celebrate. It was wonderful - family members came in from as far away as Georgia to be there, and I got to see people that I hadn't seen in years. It was so nice to see uncles, aunts, and cousins without everyone wearing black for a change.

The problem came when it was time to eat. The aunt who organized the event was very concerned, wanting to be sure that there were items that fit into my diet. I assured her that I could eat most anything that came off of the grill. relieving her concern. No, the problem wasn't that there was not food available for me.

The problem was that everything else look so good.

There were huge bowls of potato salad. Tortilla chips with my mother's family-famous salsa. A beautiful marbled birthday cake with butter cream frosting. There were 3 coolers filled with different kinds of beer!

And here I was, without Lor, who couldn't come thanks to the effects of her pre-surgical diet. Alone and unsupervised, in a wilderness of food. 

I knew I was going to fail somewhere. I am no stranger to my own nature. So, I adapted. I made sure there was always a bottle of water in my hand, so any time someone offered me a beer (which was frequently - my family has watched me in action at get-togethers for 45 years now) I could just wave my water at them to show that I was supplied. I couldn't possibly live without some of Mom's salsa, so when items started coming off the grill I put a healthy dose of it on my burger instead of using chips to eat it. And I did have a single serving (about 2 Tablespoons) of potato salad, which I ate as slowly as I possibly could after I had finished both a lettuce-wrapped burger and bratwurst.

 I didn't go anywhere near the birthday cake.

All things considered, I didn't do too badly. It worked out to only about 10 grams of Carbs (almost all from the potato salad.) This time last year it would have been a couple of fully loaded burgers, a couple of bratwursts, a pile of potato salad, and a bowl filled with chips to go with Mom's salsa. This would have all been topped off with as big a slice of cake as I could've managed interspersed with half a dozen beers.

And I wonder how I got to 302 pounds?

The visits with family members were gratifying, though. Those that don't follow Misdirected all commented on how good I looked. Several that do look in here from time to time thought I had already gone through surgery, on the basis of my appearance. I actually laughed and joked and visited, instead of hiding in a corner, hovering over a plate, hoping no one would talk to me. I even participated in family photos without trying to hide in the "back line", behind everyone else.

Though it was nice to have everyone tell me how good I was looking, it wasn't the 33 pounds I've lost so far that made the difference for me. It was knowing that I was finally making changes in my life and sticking to them. At our next family get-together, I will have been through surgery, further committing to this new lifestyle of not being shackled to obesity. I will not have regained every ounce plus some extra pounds from failing on my latest fad diet. And looking forward to success, rather than anticipating failure, is making all the difference in the world for me.

Looking Forward To The Next Family Gathering,

- Hawkwind

The Pre-Final Countdown

Photo Credit: ryanredward via Compfight cc

Procrastination is a living, breathing animal that eats your best intentions and leaves you with the remains of wasted time.

I had every intention of producing a blog yesterday morning. When I sat down to write it, it occurred to me that the momentous events of the day were coming up later in the morning, so surely I should just write later, right? But later came and went, and left me in such a dither of emotions that I could never actually get anything coherent down to be published. So, here we are, 24 hours late, with the news that we've all been waiting for.

The day has come, the die has been cast, etc. - I go under the knife (the scopes?) on July 25th, just a hair under 6 weeks from Lor's surgery date. I do still have to pass muster with a psychiatrist, but that evaluation is scheduled for 2 days from now. Barring any catastrophic failures, this thing is a go.

I am not exactly ambivalent about the whole thing. The meeting with the nutritionist yesterday was extremely positive. I've lost a total of 30 pounds since we started the process in February. Lor and I are exercising every day, dietary changes have been made successfully - I've received a glowing report on my pre-surgical prep from the team over at ABQ Health Partners. It seems like I am prepared to succeed at this.

But...(there is always a but) I am still having trouble wrapping my head around where this is all going to wind up. My loved ones are cautioning me to not be overly optimistic about the final results of my surgery -  high blood pressure and sleep apnea, for example, have been a part of my family genetic makeup regardless of size or weight. Thanks to my currently over-sized body I will probably never be built like Hugh Jackman, but will instead be left with an apron of left-over skin reaching down to my knees. I mean, I am happy to accept all those results if it means I can finally walk without being in constant pain. But I was kind of hoping for more dramatic results than what I am being cautioned to expect. No one is trying to talk me down off the ledge, but I seem to be receiving plenty of warnings that the landing won't be as comfortable as I was hoping for.

I am left looking in the mirror now, trying to figure out what (if anything) will be different about me when this process is all said and done. My surgeon airily informed me back in March that the surgery would "Get me down below 200 pounds". I am 30 pounds down now, and I am just not seeing it in the mirror. Granted, I already feel better - I can walk two miles now and carry on a conversation afterwards. This from a guy who 3 months ago couldn't carry groceries out of the car without gasping for air during the process. I guess I was just hoping for something more tangible, and I am kind of afraid that even losing over 100 pounds post-surgery is still going to leave me looking like a deflated balloon. A deflated balloon with high blood pressure, sleep apnea, and excess skin hanging off me everywhere.

Later today is our bi-weekly "measurement" routine. I am hoping for some positive results there, because right this second I could use a win. I am not nearly as pumped up about having a date for my surgery as I had thought I would be.

Curiously Ambivalent,

- Hawkwind

The Memorial Day Minefield

Photo Credit: smartvun19 via Compfight cc

Since it is the "official" kick-off for summer, we tend to spend some time with our families over Memorial Day weekend. In both of our families, get-togethers mean food - lots of carbs, lots of sugar, lots of alcohol. For Lor and I, this meant that this weekend was going to be a series of excellent chances to really screw things up. Here's how we did.

Saturday was the combination Mother's Day/Father's Day/My Birthday get together at my parent's place. Mom was out of the country on Mother's Day, and both Father's Day and my birthday this year will be taking place during Lor's first week post-op. We decided to place all our early summer holidays into one giant Memorial Day basket. 

Alongside the usual burgers and brats (without buns they work out perfectly for a low-carb diet), I had requested two special things - beer, and Chili Relleno Won-Tons. What the heck is that, you ask? Take a won-ton wrapper, fill it with spices, ground beef, and cheese. Add a seeded and roasted green chile to the center of the mix. Wrap and deep-fat fry. Heaven. These little bombs have been the centerpiece of the High Holy Day of my family's religious observances (that is, the Super Bowl) for years now - my Dad usually has to make 30 - 40 of them, and we wiped them out every year. Obviously, they will be vanishing from our diet after our surgeries, so Dad made us a dozen of them. I managed to only have two and bid them a fond farewell.

We had also planned on bringing one of Lor's homemade sheet cakes, but sanity prevailed at the last minute. We baked a dozen small cookies instead of a birthday cake. I had two and called the whole thing a win. I had been planning for this party to be my final beers ever as well, but 2 beers escaped and made their way into my fridge. Since Lor doesn't drink beer at all, I felt I would not be sabotaging her liquid diet by having them at some point in the future. I decided to hang on to them and drink them later...maybe during the first week of Lor's pre-surgical liquid diet. Everyone I talk to that has gone through the liquid diet phase tells me that I might need them.

Sunday was our gathering with the Lor half of the clan. Same burgers and hot dogs (just wrap 'em in lettuce and your carb levels are perfectly safe), and a metric ton of fresh fruit. Lots of forbidden foods like enchiladas and Rice Krispy treats and potato chips, but we managed to get through without injuring our diets. Well, Lor may have had a 1-inch by 1-inch Rice Krispy treat, but cut a lady some slack - she goes on a month of nothing but protein shakes starting on Wednesday. 

We also got to spend LOTS of time talking about the upcoming procdeures. I described the Vertical Sleeve Gastronomy so many times that I started thinking I should carry a banana around with me to demonstrate the size and shape of the remaining stomach post-surgery. We did hear quite a bit of "I could never do that!", but we also got a few "Tell me a little more about this surgery..." conversations. I am beginning to think we should take this show on the road, trying to bring this whole "surgery to correct obesity" thing out of the shadows and into the light where it belongs. Maybe after both our surgeries - we'll have a lot more energy then.

Nutritional visits, pre-surgical evaluations,  psychiatric appointments, and the beginning of Lor's liquid phase are all taking place within the next 5 days. We have arrived at where the rubber meets the road!

Kinda Happy I Saved Those Last Two Beers,

- Hawkwind

A Bittersweet Birthday

Normally what is happening over on Lor's side of the journey to bariatric surgery is closed off from public view: as I have said before, it is not my story to tell. But, this last weekend was significant enough that I have asked for, and received, Lor's blessing to talk a little bit about what I saw over Lor's final pre-surgery birthday.

Lor's journey to bariatric surgery is significantly different than mine. She is active. She is proud of her looks and her shape. She is a fabulous cook, and especially enjoys baking - bread, pies, cakes, you name it, she is the one that gets the call when someone in the family needs a dessert for a special occasion. She is nowhere close to where I am on the BMI scale, and would be perfectly content to stay there. So, why, then, go through the huge life changes that surgery forces a person through? Why give up freedom to choose her own path, and instead be forced into the regimented lifestyle that she will live with for the rest of her life?

One word: Diabetes. It runs rampant in her family, it has killed several of her loved ones, and despite her youth, she has been struggling with it for years. She has taken the high road and chosen a more difficult lifestyle recommended by her doctors (and her family) so that she can remain healthy and vibrant for decades to come.

She was treated to two different birthday meals over the weekend, one by my parents, and another by her best friend. From my parents, she received a life-saving gift: a new digital scale for us to use in food prep. Our old postage scale had been returning suspicious results for quite a while, and verifying weights between the two demonstrated that we had been WAY off in many of our food measurements in daily prep. (2 oz of Kale does not fill a small child's cereal bowl, for example. It overflows the bowl and creates piles on the counter.) Lunch was filled with encouragement and speculation as to how different her next birthday would be. Though she smiled and laughed, 25+ years of experience with her showed me the tension in her shoulders and her face - her surgery does not represent freedom like mine does. 

Dinner was at a local sushi house, and was a whole different experience. Her best friend also suffers from pretty severe dietary restrictions, and here the conversation was able to deal with fears and doubts realistically - with a pro who has been there and done that in having to make changes to her life that were forced upon her by health issues. I am sure the bottle of sake didn't hurt the spirit of full disclosure much. Here, too, was another comforting thing: this was not the last time Lor would ever be able to eat at this particular restaurant. Though California rolls will vanish from the future menu, many other things (sashimi, for example) will not have to. For the first time in weeks, we were not having a "food funeral" at a restaurant. The difference in atmosphere was huge: here was a place we would be returning, not another thing we were waving goodbye to.

All weekend long she was deluged with messages from friends and calls from family members, all saying the same thing: we are proud of you and we support what you are doing for yourself. And, by the way, happy birthday. It was amazing to watch. I am always proud of her, but this weekend I was really proud of the community around her - admiring, encouraging, uplifting. You have made me very proud to also be a member of the "Loralia Fan Club."

Wishing Everyone Had Friends And Family Like Lor's,

- Hawkwind

Not Living, Just Surviving

We've had quite a few conversations with friends and family members in recent days, talking about the nuts and bolts details of the upcoming surgeries. While the great majority of these conversations have been strongly supportive, a few have been...less so. One recent conversation with a family member springs to mind.

The family member in question had lots of questions about what I was going to be giving up as a bariatric surgery patient. "So, no more beer, ever?" he asked at one point.

"No," I explained, "no carbonation at all. It makes the stomach pouch expand, and you wind up right back where you started."

"So, like, no Cokes either?"

"No, none. I need to avoid coffee too - caffeine is a diuretic, and staying hydrated is super important after the surgery."

"No coffee!" he exclaimed. "I need coffee in the morning to wash down my breakfast!"

"Yeah," I explained, hanging on to my patience with both hands. "Can't really wash things down while eating anyway. You can't drink while you are eating at all. You need all the space in your stomach at meals for food."

He leaned back and crossed his arms, clearly disgusted. "No beer, no coffee, can't even drink when you want. That's not living, That's just surviving."

Now, I personally have a strong opinion on survival - I think it beats the alternative. And, I understand that the relative in question isn't suggesting I should bite the dust in the name of drinking beer. It is a question of quality of life that is being raised here, not life vs. death. And, as it happens, I have a certain amount of experience in evaluating quality of life. Over a decade of dealing with Epilepsy has had me questioning many times: Is this really worth it? And, despite all the things that Epilepsy has forced me to give up, I have always come back with the answer that life itself is worth continuing, even without the various components that I used to previously enjoy.

And, here's the thing: Bariatric Surgery may not only extend my life, but it also has the potential to give back many of the things I have lost previously. Reduced weight could increase my activity level enough so that I could start weight lifting again. It could remove my dependence on a machine to help me breathe at night while I sleep. It could mean a reduction in my arthritis symptoms, meaning I am no longer in constant pain. Heck, it even has the potential to reduce the dosage of my anti-seizure meds - meaning that the "brain fog" I am constantly in might be lifted somewhat. Sounds an awful lot like a new lease on life, where I am currently just surviving.

Is that worth giving up Starbucks and Samuel Adams? Yeah, I think so.

Considering Switching to Bushmill's,

- Hawkwind

PS - If you have a family member who is considering bariatric surgery, be supportive - a good support structure is a necessity to be successful.