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Type 2 bariatric surgery advice needed ...

Joe Condron

Member
Messages
10
Type of diabetes
Type 2
Treatment type
Insulin
Hi all,

Thank you reading my message I have just signed up to the forum,
I was diagnosed with diabetes typye 2 in 2008, which suprised me as I
was always a guy who liked to keep fit, at that time I was 14.5 stone.
which was ok as my ideal weight is 16.5 stone as told to me by my diabetic
nurse, as I was a brawny man.

I have my regular medical checks and my cholesterol is 3.5 and I am
always congratulated by my GP and my nurse for the diabetic control
using novomix 30. (and like everyone else I am on a shed load of
medication including pioglitazone )

As my cholesterol and diabetic control is described by the professionals
as being excellent, I am saddened by the fact that I am gaining weight,
My weight today is 21 stone.

I exercise each day for at least a hour and after the GP looking at my blood
test results, He feels that I have gained weight due to the side effect of the
pioglitazone medication, as weight gain is a "more common" side effect.

I have LVF (left ventrical failure) in my heart, and also CKD stage 4,
my right kidney has renal atrophy, so I am only allowed certain diabetic
medication.

So, I need to lose weight for health reasons, also because I am so ****** off
with life at the moment, it's like carrying a 5 stone monkey on my back, it is
restricting my exercise routine, that I feel I need to do each day so that I can
deal with my PTSD.

I am wondering if anyone has had bariatric bypass surgery, and if anyone can give me
positive feedback on there operation, as I am going to ask my GP for this op. any
other advice, will be very much appreciated.

Thank you for reading my post.

Best Regards from Joe in Liverpool
 
Last edited by a moderator:

Hello Indy51,

Thank you for your helpful reply, I appreciate your time and effort.

If my GP and/or Diabetes nurse approves and supports me on this journey,
would three ready made slimfast drinks at 200 calories each ...
and 200 calories of these be ok

Amaranth or Chinese spinach Artichoke Artichoke hearts Asparagus Baby corn Bamboo shoots Beans (green, wax, Italian) Bean sprouts Beets Brussels sprouts Broccoli Cabbage (green, bok choy, Chinese) Carrots Cauliflower Celery Chayote Coleslaw (packaged, no dressing) Cucumber Daikon Eggplant Greens (collard, kale, mustard, turnip) Hearts of palm Jicama Kohlrabi Leeks Mushrooms Okra Onions Pea pods Peppers Radishes Rutabaga Salad greens (chicory, endive, escarole, lettuce, romaine, spinach, arugula, radicchio, watercress) Sprouts Squash (cushaw, summer, crookneck, spaghetti, zucchini) Sugar snap peas Swiss chard Tomato Turnips Water chestnuts Yard-long beans.

As I don't know where to get the Optifast meal replacement sachets from?

Regards Joe in Liverpool
 
I believe Prof Taylor said any reputable meal replacement shakes are fine to use - the study used Optifast as Nestle offered them for use by the study. One additional factor mentioned at the Optifast site but not mentioned in the ND diet notes is to add at least a teaspoon of olive oil to the diet to avert gallstone issues, which probably goes well with the veggies. I believe there is a list of suitable veggies at the website: http://www.ncl.ac.uk/magres/research/diabetes/documents/StudyRecipes.pdf

There are also handouts you can print to give to your doctor:
http://www.ncl.ac.uk/magres/research/diabetes/documents/Informationfordoctors_revised_April14.pdf

Since you are taking medications, it's definitely wise to do this under the supervision of your doctor.
 
Hello and welcome. I can read the despair in your message and can feel your pain. I was (a few year back) 20 stone got diagnosed at 18 stone and then shed 6 stone over the next few months. I was surprised I could do it. I, personally didn't use shakes I just used real food but very small amounts. The shakes are easier in a way as the nutrients are balanced and a defined amount. The veg you listed are fine. Personally I stuck with raw carrots but I was never a veg person.

I wonder if your doctor understands the action of insulin on the body. Insulin makes you store fat it is that simple so you are on insulin. As for Pioglitazone and all other drugs of its class (thiazolidinediones), these are absolutely contraindicated in patients with heart failure so I am surprised you are on it.

Luckily for me I did not have any medical reasons not to starve myself back to normality and it worked. I returned back to normal blood glucose levels within a month and my 3 month HbA1c returned to the normal range from the 90s. As I have continued and lost more and more weight things have only improved to the extent that I do not have to worry about what I eat now (however, I do and always rob peter to pay paul). You can read my 3 month journey from the link in my signature.

Given all of the other conditions and the amount of medication you are on you will need to get the assistance from your GP. Note I did not say approval as it is your body and life not his/hers. I am pretty sure that people going for bariatric surgery have to go on a low calorie diet for a few months before as well. The reason you need their support is that as you start the journey you will rapidly have to reduce your medication. You will need regular check ups because of your other conditions.

As you start downn this route the first few days are really hard (bloat yourself on water and just occupy your mind) then it gets easier. I then found I went through what people term carb flu. It is in fact your body moaning that it needs fuel as it hasn't yet switch from glucose burning to fat burning. Drinking lots and lots of water helps (this lasts a few more days just keep going). As you come out you will be fully fat burning and just think you have about 400,000 calories of reserves to go through so at a deficit of lets say 1600 calories that is 250 days. You will not maintain the low calorie diet for that period of time but it will get you on the way and then look at a diet that is not going to raise those insulin levels too high and manages to continue to allow you to reduce your weight further.

Good luck with whatever you decide to do, print of all the material if you decide to go down this track and give them to your doctor (including the research as I expect he hasn't read it).
 
Joe Condron said:
...
If my GP and/or Diabetes nurse approves and supports me on this journey,
would three ready made slimfast drinks at 200 calories each ...
and 200 calories of these be ok
...
as I don't know where to get the Optifast meal replacement sachets from?
Click to expand...
Other, less sugary and more nutritionally balanced replacements are available I used Exante products. Others have used Shake that Weight.

See this thread for the experience of people following a Newcastle Diet earlier this year.

Good luck.
 

Wonderful post Andrew.

I must admit I had read @Joe Condron 's post last night, but was too weary to write a sensible response.

Joe - I think sometimes bariatric surgery seems like a quick fix for weight gain, and a means of reducing your appetite, but like all other treatments, it doesn't always work out as intended. I have posted before about a friend of mine who had a gastric band fitted, in the States, and she certainly lost a magnificent amount of weight, and looked fabulous. (Her motivation was looks, as opposed to health.) But, she did it by consuming liquidised Mars bars, chocolate, curries and so on. She didn't change her diet at all, just picked out her favourite bits and learned how to pulverise them into a state she could manage, then eat.

In the end, she had to have the band released, as she was losing too much weight and suffering ill-health as a result. As soon as the easing occurred, she kept eating the same diet, only it didn't have to be liquidised any more! Bang came back the weight. She wasted a lot of money and a lot of her life; never mind the risks of undergoing any surgical procedure when morbidly obese.

Of course, she is an extreme, but that was all about mindset, and her looking for an easy way out of something she didn't like.

Whether doing the Newcastle by shakes, proper food, or just finding a way to drop some weight, it strikes me that reducing your weight is likely to have a positive impact an every medical condition you mention. But, as Andrew says, it is imperative you engage with your health professionals to ensure your medication can slide down, as your weight and conditions improve.

There is no mention of what you currently eat, but if you could give us an indication of a typical day's consumption, we may be able to help you consider some interim dietary steps that could be helpful.

Good luck with it all. 46 is too young to be juggling this lot of medical issues.
 
@Joe Condron , can I suggest as you are from Liverpool, you ask your GP for referral to the weight management service. It is provided at local health clinics throughout the area by a team from Aintree hospital.
I would be reluctant to suggest a way forward for you, as your other health issues are of concern. However, the Aintree Loss team is a multi-disciplinary team of health professionals, specialising in obesity , (doctors, physiotherapists, psychologists, dietitians etc). They will devise an individual treatment plan with you. If together you decided bariatric surgery is right they make the referral, and support you before and after.

Weight Management Service - Aintree University Hospital
www.aintreehospitals.nhs.uk/HospitalServices/.../Pages/default.aspx
Welcome to Aintree's Weight Management website. Here you will find ... Aintree Liverpool Obesity Support Service (Aintree LOSS) A level 3 service for patients ...
 
Good Evening everyone

First of all I'm sorry for my late acknowledgement of your
kind encouragement, support and advice

I decided to try a few things out ths week, the first was to
alter my diet to 1000 calories a day but unfortunately I had a hypo,
I had a slimfast for Breakfast and Tea, and the other calories were used on my Lunch,

so I upped the calories to 1500 a day, and the same thing happened :-(
Again I had a slimfast for Breakfast and Tea, and the other calories were used on my Lunch.


My daily script of Novomix 30 is 50-45-50 units a day,
Maybe I am eating to match my insulin, rather than the
other way around ??? I feel ready to face my GP in the morning
( August 3rd ) to act on Pipp's adice, and ask him for a referral to the weight management service.
which is provided at local health clinics throughout the area by a team from Aintree hospital.

Thank you all so much for everything, I will keep you informed about my journey.

Regards Joe Condron
 

A wise decision, @Joe Condron .
I had a lot of help from the Aintree team, even though I did not have bariatric surgery.
Good luck, and please do keep posting here to let us know how you are.
 
Hi Joe

I think bariatric surgery can be a good choice for the very obese, ie those over 160kg... some who have it are double that and more. For those people the risk:benefit ratio is more favourable. 21 stone converts to 133kg, which is only a smidgeon above the 125kg threshold where I understand the risk:benefit ratio starts to kick in. It sounds like you will be able to find ways to lose the weight without it, which would be great.

I was a little surprised to read that your nurse said 16.5 stone was a target ideal weight for you. This would make you very tall (which is possible, I admit). The top figures on the Body Mass Index (BMI) chart I have in front of me are a BMI of 26 at 97.7kg/215lb/15.3st weight and 193cm/6'4" height . You can google it yourself but to give you an example, if you are 6'4" then your target ideal weight (BMI 22.5) would be approx 84.1kg/185lb/13.2st.

Not sure what your BMI is now, but even getting it under 30 will likely see a big improvement in your health and comfort level.

It might also be a good idea to ask your GP about a referral to a sleep clinic for an overnight sleep study to check for obstructive sleep apnoea (OSA). It is common among overweight people with T2 diabetes, and especially if they also have high blood pressure (not sure if you have that or not). If you have OSA, treating it can really help with weight loss and other health issues.

Good luck and I look forward to hearing about your progress!
 
@CatLadyNZ , @Joe Condron has stated he will be asking for a referral to the local weight management team today. Not sure if this is a service available where you live, but this is a 'gold standard' service we are very fortunate to have in place here. Many people who have attended thinking bariatric surgery is the only solution for them are surprised to find that there are other ways. These are determined by a dedicated team of health professionals who consider, with the client, all aspects of their health, and the reasons for them being obese before deciding on the best course of action. If Joe does have OSA in addition to his other health problems they will identify and refer for appropriate treatment. It is probably best to leave specific advice and diagnosis to the doctors, dietitians, physiotherapists, psychologists, and other experts in weight management he will see through his referral.
 
It's great that he can access a service like that. Hopefully they will screen him for OSA. Please be aware that not all doctors treat it with the seriousness it deserves. There's no harm in him hearing about it from two sources. Who knows, they might leave it several months before dealing with it fully, and this way he has advance notice that if he has it, it should be prioritised. BTW I wasn't giving advice or attempting to diagnose him... I was giving information about a disorder and it's risk factors. One doesn't need to be a doctor to do that.
 
I was giving information about a disorder and it's risk factors. One doesn't need to be a doctor to do that.

I trust it was peer reviewed
 
My misunderstanding then.

The contradiction of the information on his ideal weight seemed like you were advising a lower weight than his nurse had. The charts on BMI can be very misleading and disheartening. Sometimes those of us who exceed the recommended weight despite countinous efforts to reduce become so disheartened that it makes sense to revise the standard recommended weight to a more realistic goal. Not the 'perfect' recommended level, but still an improvement and reduction in risk factors. Trying to attain the impossible can create all sorts of psychological problems.

I do have the advantage of first hand knowledge of, (and gratitude for) the multi-disciplinary team that Joe is asking to be referred to. He will be screened for many of the complications that can arise from being obese. As he has other health problems, all will be considered in an appropriate way. For any of us here to suggest other conditions is purely speculative. I would not choose to add to any members concern by doing so. Nor would I want to derail
this thread as that is the last thing the OP needs.
 
Mike D said:
I was giving information about a disorder and it's risk factors. One doesn't need to be a doctor to do that.

I trust it was peer reviewed
Click to expand...
It was, actually. Nothing I said about the disorder is at odds with the scientific consensus about it. I have read claims like "bananas cure sleep apnoea" though, and I don't think they've been peer reviewed
 
Rather than dissecting each other's posts can we please stop this thread being derailed. The OP is asking for advice rather than debates.
 
This link came up on my Twitter feed this morning. It's an infographic from the British Medical Journal, so hardly a comic sensationalising matters.

I have always posted the downsides of weight reduction surgery, but these potential side effects must surely put the extreme nature of the treatment into some form of context. I did note, thanks to someone else pointing it out, that there is no mention of post surgery RH on there, so not even this huge list seems complete.

Not the most edifying reading, but hopefully informative for anyone interested:

http://www.bmj.com/content/bmj/suppl/2016/03/10/bmj.i945.DC1/moom024533.ww1_default.pdf
 
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