Core Bariatrics
Episode 17: What Tammie Wish She Knew
Ever felt a chill after a hearty salad, or craved Brussels sprouts wrapped in bacon? That's the kind of unexpected shift in appetite and body temperature regulation Maria and Tammie are talking about on this episode, where they peel back the curtain on the life-altering journey of bariatric surgery. Their conversation serves up the raw, unspoken truths about post-op life, including why Tammie's water mug is now her most treasured accessory. Their narrative stitches together the fabric of lifestyle readjustments, unwrapping the delicate dance between treating oneself and adhering to a new health-conscious existence.
Social dynamics take a front seat as Tammie navigates the post-bariatric world, from the anxiety of standing out in a crowd to the emotional tumult of weight-loss compliments. Maria and Tammie dissect the influence of cultural and familial dining customs that clash with the new reality of smaller portions and the tactics to manage the ensuing social tension. And just when you think you've got it all figured out, they bring to light the post-operative surprises like gallbladder woes, urging open dialogue with your surgeon, and confronting the emotional impact of significant weight loss. Tune in for an honest, heartfelt exploration of the post-bariatric life that goes beyond the scale.
We want to gather with a purposeful intention to explore the world around us. ...
Listen on: Apple Podcasts Spotify
Ever felt a chill after a hearty salad, or craved Brussels sprouts wrapped in bacon? That's the kind of unexpected shift in appetite and body temperature regulation Maria and Tammie are talking about on this episode, where they peel back the curtain on the life-altering journey of bariatric surgery. Their conversation serves up the raw, unspoken truths about post-op life, including why Tammie's water mug is now her most treasured accessory. Their narrative stitches together the fabric of lifestyle readjustments, unwrapping the delicate dance between treating oneself and adhering to a new health-conscious existence.
Social dynamics take a front seat as Tammie navigates the post-bariatric world, from the anxiety of standing out in a crowd to the emotional tumult of weight-loss compliments. Maria and Tammie dissect the influence of cultural and familial dining customs that clash with the new reality of smaller portions and the tactics to manage the ensuing social tension. And just when you think you've got it all figured out, they bring to light the post-operative surprises like gallbladder woes, urging open dialogue with your surgeon, and confronting the emotional impact of significant weight loss. Tune in for an honest, heartfelt exploration of the post-bariatric life that goes beyond the scale.
We want to gather with a purposeful intention to explore the world around us. ...
Listen on: Apple Podcasts Spotify
Welcome to Core Bariatrics Podcast, hosted by bariatric surgeon Dr Maria Iliakova and Tammy LaCose, bariatric coordinator and a patient herself. Our goal is building and elevating our community. The Core Bariatrics Podcast does not offer medical advice, diagnosis or treatment. On this podcast, we aim to share stories, support and insight into the world beyond the clinic. Let's get into it. Disclaimer for all of your surgery, patients needs to be. If you live in the Midwest, you're going to be cold forever. Yeah, you are going to be cold forever. That's true. It starts a few months after and you are. I've hated socks. Now I have all the fluffy socks and I wear them to bed.
Speaker 2:Join the dark side.
Speaker 1:My husband also hates that. I want the flannel sheets. He's like I'm going to die.
Speaker 2:You know it's funny because you're right. Like everyone complains about being cold afterwards. Yeah, that needs to be the biggest disclaimer. Deal with it.
Speaker 1:You can always put clothes on.
Speaker 2:I guess you can. You can. It's hard to take body parts off, but clothes you can put on.
Speaker 1:Absolutely so with that that we want to talk about things that I wish I would have known before having surgery. Is there anything? Is there one that sparks.
Speaker 2:I think the thing is your appetite's going to change, yeah, and I think a lot of people they hear it, but do they right? Yeah, because a lot of, I think, come into it kind of expecting your appetite to change. But the crazy thing is your appetite is going to keep changing, yeah, and the kinds of things that you like to eat before you might not like A hundred percent, and the kinds of things that you didn't like before those might be an option now for you.
Speaker 1:Yes, yes, and so, instead of craving the ice cream, I'm craving some bacon wrapped. What are they? No, anything. Bacon wrapped, I will.
Speaker 2:Oh, what are they? Oh, I know what you're talking about Brussels sprouts. Brussels sprouts, brussels sprouts, yeah, so yeah, wow, okay, who craves Brussels?
Speaker 1:sprouts, Granted it had bacon on it, Enough bacon on anything. I'll crave a shoe, but I mean I feel like I crave more healthy foods now, especially because I know that they satisfy me longer.
Speaker 2:I think the food, how your body is going to change and what foods you like, what foods you don't like.
Speaker 1:Texture can be really different how you perceive texture.
Speaker 2:So that's one of the things I hear a lot. Yeah, a lot.
Speaker 1:And I think yeah, I'm open to trying anything now where I wasn't before. Yeah, I was very stuck in my way.
Speaker 2:Oh yeah, that's, I mean, the whole world is your oyster now? Yes, would you eat oysters?
Speaker 1:Oh gosh. The deep fried ones.
Speaker 2:Ok, I love it Right, wasn't that what you got, that one day, yeah, yeah, that, no, I think I think so. Yeah, don't you have to like right, I mean swallow that. Yeah, you have to swallow most of the food you eat.
Speaker 1:Tammy, that's okay, swallow it whole. Is that oysters?
Speaker 2:yeah, typically you don't chew them, right, you don't chew them, you just kind of let them go, let them have their way with you.
Speaker 1:I need to wrap my head around that.
Speaker 2:Yeah, I get it.
Speaker 1:Maybe that'll be an experience you give me and we video chat?
Speaker 2:Oh boy, yeah, I think maybe oyster eating. This podcast is devolving into our wishes and dreams very quickly, but, yes, all right.
Speaker 1:So I must say that the one big thing that I knew, could happen but didn't realize how much I would miss. It is chugging water.
Speaker 2:Oh so why? Why is that so important?
Speaker 1:I don't know. I need to quench my thirst like right, then yeah. Well, you've got your big.
Speaker 2:Stanley mug over here, and that thing is probably the size of your leg. Actually, it's massive 40 ounces.
Speaker 1:Yeah, so I'd leg. Actually it's massive 40 ounces. Yeah, and I'd bring it everywhere. It is my staple.
Speaker 2:It's your staple. So tell me a little bit more about that, like, why is it your staple? Why?
Speaker 1:is it?
Speaker 2:important Yep.
Speaker 1:So I have to, as bariatric patients have to drink throughout the day sip throughout the day You're going to be a sipping queen or king and because it's harder for us to yeah get big things of water in if we went a while without yeah, um. So, yeah, it's like my purse. I love it. I actually carry my stanley around more than my driver's license.
Speaker 2:That's probably sad no, it's so good because I'm thinking like me. You know, I don't really drink enough water throughout the day. No, you don't you know I drink my coffee. I'm really addicted. It's a problem, but okay. But here's the thing is. And there are some like side effects of going through this process that are really healthy overall. Yes, like actually thinking about drinking water throughout the day, or you? Know some fluids, whatever, but making sure that you're you're taking care of yourself, yes, keeping hydrated. So I'm actually really proud of you.
Speaker 1:Thanks For having your Stanley and taking it everywhere. Not being able to chug, it's tough. It's tough when you really just want to chug a bottle of water, and not so much just because you're like feeling dehydrated, it's because you literally just want it all. Right, you know that feeling you want it all in you right now.
Speaker 2:Yeah, it's a hot, hot day You've been working out?
Speaker 1:Yeah, I will say that, yeah, my water intake is much better now because it is something on my mind constantly. Yeah, which isn't a bad thing. Yeah, it's not debilitating.
Speaker 2:Well, you know and I've heard people say that the water like just getting that much liquid in you. You kind of feel like you're floating. Sometimes I actually had. I know I had a friend who had a jaw fracture, so unrelated to bariatric surgery, but he had to go on a liquid diet for a couple months because his jaw was wired shut. And I remember him telling me at some point that like he just felt like he was floating, like it was just tough because you go from not really thinking about your fluids and drinking that much and then all of a sudden, you are doing it all to survive, and it can be tough.
Speaker 1:I want to touch on only liquid diet for a hot second. People say it's you know, surgery is the easy way, right? I want to know how easy it is, or how easy people think it is, to not eat anything for however long. Luckily our program pre-op is a liver shrinking diet with food. With food, with like solid food not just like, but for one week post-op it's just liquids.
Speaker 2:It's just liquids and like just liquids can kind of suck.
Speaker 1:That is a mental.
Speaker 2:Yeah.
Speaker 1:F-bomb.
Speaker 2:It is because, okay, first of all, we're telling people like not to drink sugary things or sweet things, we're telling people to cut back on those things, but then guess what? Pretty much all liquids are sweet.
Speaker 1:Yes, yes, oh yeah, that first week I was sick of sweets, right, and I am a sweet fanatic. Yeah, I did not want to sweet and so when you told me I could eat a scrambled egg.
Speaker 2:I don't want to admit this, but the amount of salt that I put on it was pretty bad. I love it. Well, and you think about like in. Okay, so in American culture we think of sweet or like liquid as right. There's not that many liquids that are sweet. In other cultures there's a lot more like broths. You're so right, Right, so there's. I mean I think there is definitely something to be done about making the situation better, yeah.
Speaker 1:Yeah.
Speaker 2:For our people.
Speaker 1:I never ate egg drop soup. Oh yeah, I did then, right. Oh, actually I needed salt.
Speaker 2:One of our, yeah, one of the one of the folks that had bypass earlier this year afterward, but she got. She's a very creative person, a very ingenious person. Uh, she actually went to her favorite restaurant and asked for them to drain the soup, yeah contents, basically to make it a liquid, like take all the solids out and just have the base. And so she had. I think it was french onion soup. I think that first week, which I thought that was pretty brilliant, it's a lot of salt, whatever.
Speaker 2:Sure A restaurant's going to probably have some food that you know, yes, yes, whatever, but at the same time she got her liquids in and she actually had a good time doing it. Yeah, so there's ways, there's ways, there's ways. Yeah, but you're right, it's not easy. No, it takes a lot of planning.
Speaker 1:Yeah, and let's talk about what happens when you don't get your liquids in. Oh boy so, but even so, not so much the feeling of being dehydrated, or whatnot Sure but what happens when you don't drink enough water? You don't poop.
Speaker 2:That's true. Yeah, I understood the brown code was coming up. Very good, todd Brown, todd Brown. So that's a good point. So, like you know, to have BMs you have to have stuff in the tank bowel movements right bowel movement.
Speaker 1:I'm just making sure everybody's on the same page. That's fair.
Speaker 2:That's fair so if you've got it, yeah, to have a bowel movement, you've got to have stuff there, right? Uh-huh to have stuff in the machine in order to push it right out yeah so if you're not drinking enough water, you're setting yourself up for some miserable situations, including not being able to poop right, yes, and that will lead to you needing their medications or even feeling so miserable that you come into the hospital? Yeah, it's pretty bad so literally being full of crap. Wow.
Speaker 1:Dad joke.
Speaker 2:Yeah, sorry, that was pretty bad, but anyway. So, yeah, so if you want to get rid of that stuff, you got to put stuff in the tank.
Speaker 1:That is our first go-to. When people say like I'm not pooping regularly. It's like are you drinking enough?
Speaker 2:Are you drinking enough?
Speaker 1:Yeah, but then that brings up the topic of hey, did you know pooping every day is normal, right, I didn't. No, I'm serious, I didn't know that was a thing before surgery that's a thing. No, I would poop maybe once or twice a week. Wow, I'm dead serious. So, wow, we changed your life, tammy, a hundred percent.
Speaker 2:We changed your BMS, which okay, I laugh about this, but it's actually if you have like regular bowel movements, if your gut's working well. You're going to feel better. You feel better. You're going to feel better, I feel better. You feel so much better. It's a big one. It's a big one. So really, the constipation thing definitely can be worse after surgeries, but, but, but, but there's so many things you can do about it.
Speaker 1:Yeah, Right, yeah. And so there's times where I need to take a Miralax or Right Collase. Yeah, yeah, yeah, so there's so many.
Speaker 2:Oh, I really want to touch on because there's a lot of confusion about, like laxatives and stool softeners. So we're going to detour real fast and go there and go there just for a second. So stool softeners make the stool soft.
Speaker 1:Okay, I know that sounds crazy for me to break it down like that, takes the water and brings it into your stool.
Speaker 2:Yes, it makes your stool softer by absorbing water and it doesn't really help push things forward. That's what laxatives do right. So there are some things that are both stool softeners and laxatives, so Miralex is actually both.
Speaker 1:I didn't know that. Thanks for telling me that.
Speaker 2:And like Miralex, laxative. Hey, hey, terrible, not a JAD joke even, but anyway, yeah, just that's why it's called.
Speaker 1:Miralex.
Speaker 2:But Colase, Sacot, Docusate, all of those things are actually stool softeners only Okay. So if you are constipated, my first go-to is actually a stool softener after water. Okay, yeah, Right Because it's a little less intense than a laxative Right. Laxatives can push you over into diarrhea.
Speaker 1:Right, that's exactly right.
Speaker 2:Nobody wants that right. That's where I usually start, with the sun on Exactly.
Speaker 1:Exactly. And then there's a couple of other like natural ways to think about it too that aren't necessary Extra medication. So I think fiber.
Speaker 2:Yeah, yeah, I think hot Like hot tea, instead Hot tea oh yeah, I like that.
Speaker 1:That usually like I like that. Yeah, okay, I mean by the time it gets to your you know colon. It's not like the temperature's not making a big difference In my brain it works.
Speaker 2:But I mean, if it works for you, it's not hurting anything. That's fair. That's fair. It's a fluid. It's a fluid. Yes, there you go.
Speaker 1:That's probably what it is. Honestly, it's your placebo fluid.
Speaker 2:I like it, it's perfect. But no, but even things that have fiber in them, so like fruits, and fruit, has a lot of fiber. That's what he said dried fruit.
Speaker 1:Don't go overboard.
Speaker 2:Yeah, don't go too crazy, because those things are sugar bombs. It should be too many, but dried fruit's a really good one, and think of fiber the best way it was ever described to me. I love this. I love this. It's toilet paper from the inside. It's roughage, basically it's texture and roughage, and it's something that one helps to pull water into your gut. That's important because we already talked about that. That gut has stuff in the tank and then it also helps to sort of scrub things along as you go. So fiber really important.
Speaker 1:But you did mention something that I wish I would have known about. No, I didn't know about. So you said dumping syndrome, yeah, so I knew it was a thing. Obviously, right. But when we think dumping syndrome, I thought diarrhea. Yeah, that's it.
Speaker 2:Yeah, and it's not quite that, so let's okay. Dumping syndrome sounds as bad as it is to be honest with you. And dumping diarrhea. That makes sense right, like that's how we get the term, but it also is that feeling of like dizziness, lightheadedness, feeling really hot.
Speaker 1:I thought that was just my new way of my body telling me I was full nope, it was not, I was not in the right thing well, yeah so, yeah, I didn't realize that me being hot and flushed and just lightheaded was dumping syndrome, and I realized that in one of your appointments with a different person, totally interrupted, but I'm like the light bulb went off. But that's something that needs to be out there is that dumping syndrome is not just diarrhea.
Speaker 2:That's right, that's right and dumping syndrome. Let's talk about also how that happens and why. So it's basically your body responding in a new way to having foods that are high in fat or sugar. And why does fat and sugar matter? So sugar can trigger insulin release in your body and other hormones that are related to how we process sugar, and can do the same thing, because your body requires a lot of enzymes, a lot of like specialized, basically machinery, in order to process. And so for a person who's had a bariatric surgery, that changes yes, remember we talked about signaling changing and how things are processed, changes in your body after surgery. This is one of those ways.
Speaker 2:Yeah, so when you eat something that's really high in fat or sugar or both, you can trigger abnormal response from your body that will cause you to feel really lousy your body. That will cause you to feel really lousy, yeah, and will trigger dumping syndrome. So I will say, 100% of people have at least one episode of this, because you're going to overdo it or just eat something that doesn't agree with you as you go, at least once. But it's important to listen to your body. Yes, it is, yeah, and I think that's one of the things that it's both a good thing and a bad thing terms of yeah, exactly you.
Speaker 1:It's unpredictable, which makes it kind of challenging in the beginning, yeah, but then when you figure out what makes you feel poorly, you're gonna try to stay away from those things, and that's where surgery has helped me keep weight off.
Speaker 2:I stay away from some of those things exactly and so when we say like, don't eat high, like really things in sugar, high in fat after bariatric surgery, it's way less for weight control and much more to not feel miserable.
Speaker 1:Yes, dr Maria Ilyakova, over here one time at her house around Halloween, says Timmy, eat the Halloween candy. And I'm like Maria, you're my bariatric surgeon, you're not supposed to have me eat your, but no that. What another thing I love about you is you are this is a lifestyle. Right, you can have the piece of candy, because if you don't eat the piece of candy, you're gonna want a whole big candy bar, exactly so it's moderation, and moderation is so hard it is, oh, believe you me like.
Speaker 2:That is not something that we like. I don't think it's really something we can expect of ourselves or of anyone perfectly all the time.
Speaker 1:I think that's a topic we need to cover is because alcoholics or drug addicts, they can take that out, that addiction out of their lives.
Speaker 2:Oh my goodness, we actually were having a really good conversation a couple of days ago about appetite, like in our hallway, because we always talk about this stuff.
Speaker 1:We super obsessed in the hallway.
Speaker 2:Yes, in the hallway, that's all right, but appetite is so much more than like appetite just for food.
Speaker 2:We have appetite for feeling good or certain kinds of experiences or working out or you know, like, yeah, that endorphin rush or that feeling being satisfied can come from so many different things and and. For some people it's drugs, for some people it's alcohol, for some people it's food, for some people it's whatever relationship. It's a million different things. So there is a transference of how you feed that appetite after surgery. Right, if it's not food anymore, and not certain kinds of food anymore, it absolutely can become other things. Yeah.
Speaker 1:And those.
Speaker 2:so, knowing that ahead of time, I think that's another one that comes up for people I wish I would have known.
Speaker 1:Yeah, transfer addiction is real, yeah, and even our mental health person that we refer our patients to really digs into you know what your history of alcohol and drugs and even your parents' history. And her suggestion to me was I would not even touch alcohol after surgery because of your Risk factors maybe.
Speaker 2:Yes, yeah, yeah.
Speaker 1:But I told her. I said you know, alcohol has never been a thing for me. Sure, actually, whenever anybody drank around me, it made me feel uncomfortable.
Speaker 2:So, I know alcohol would Wouldn't have been your thing, but shopping is yeah, well also. I mean like shopping, let's talk about that real quick, because people change body shape and sizes sometimes really drastically and really fast after surgery. Yes, right, so is there. Did that kind of meet your expectations in terms of partnering with the shopping and the how, where and things like that?
Speaker 1:I don't shop for me, I hate that, ok, you need to take me shopping. I don't know if I'd address my body. You need to take me shopping. I don't know if I'd address my body. I am still boring, as could be. I have gone outside my comfort zone a little bit and things like just joggers. Well, those look good on you. I don't know I'm like these are my normal scrubs, but now I got like jogger ones that are like skinny.
Speaker 1:That's outside my comfort zone. I feel like I need someone to tell me how to dress.
Speaker 2:We should have a stylist on it, Right? I think yeah.
Speaker 1:But so shopping for me is my kids?
Speaker 2:Yeah, and just the rush of spending money, yeah, but you gotta get your kicks some way right and like there's gonna be some way, yeah, and it can be healthy. It can be unhealthy, but that's something to think about ahead of time.
Speaker 1:A hundred percent, yes, figuring out what you might transfer your addiction to yeah, and it's honestly.
Speaker 2:It's also possible for everything to be unhealthy, like anything can be healthy or anything can be unhealthy. I will say, like a drug addiction is never healthy. So that's maybe one thing that can't be healthy, right. But you know, working out can become an addiction, it can become unhealthy or eating well out can become an addiction.
Speaker 1:it can become unhealthy or eating.
Speaker 2:Well sex, sex can become an addiction. Yeah, everything can become an addiction. Yeah, so it you know, if it starts to interfere with your daily life exactly like that right. So, um, realizing that that's a risk for everyone and maybe trying to game plan that ahead and think about what you like.
Speaker 1:We had a patient who started knitting or crocheting. Yeah, right, and so she's like instead of eating that Twinkie I made. She makes a lot of hats for the NICU babies because we live in a big university town. Will that last with her forever? I'd be curious to see.
Speaker 2:Okay. One other big thing that comes up is relationships changing afterward. Do you think that's something that you were fully prepared for, that you really understood how that would work?
Speaker 1:Was I prepared for it? Did I research it? Did I think that I could battle it? Yes, because the divorce rate in the bariatric community is big. I did not want that. Bariatric community is big. Yeah, I did not want that and unfortunately, I planned for it. Did it work? No, how you planned, no yeah right?
Speaker 1:No, that's the name of the game Because, at the end of the day, even if someone says they are supportive of you 100%, that they don't look at surgery as the easy way out or any something like that, things just change Things change, things change.
Speaker 2:I think that's that's overall maybe the toughest thing.
Speaker 1:And I'm still battling that, I'm still trying to figure out what the change is, where the change, you know, but I feel like a lot of my friends have changed, because my friends were looking back like there was a lot of negativity. I will be honest, like I was 100 percent a negative person on myself, on the world, Like oh, no I think I was very judgmental. I was kind of a mean girl, yeah, like you said this before I have. Yeah, especially in high school. Why?
Speaker 2:Because I was insecure I want someone else to be the problem I don't want to be the problem. It's like projecting, projecting on other people.
Speaker 1:Oh, 100, yep. And so I think now that, um, I feel like I'm more positive than everybody around me like sometimes some of our co-workers complain about something or someone and I'm like hold up up. Are they having a bad day? Yeah, Did they do that on purpose?
Speaker 2:Like look at the positive stuff.
Speaker 1:So now, looking at some of my friendships, there's just too much negativity.
Speaker 2:Not enough Right, you're dealing with that, yeah, and being open to things, or you know, it's really hard to be vulnerable and I think when things change or when other people in our lives change, it can be a really big threat. Yeah, right, because it's like oh, I have this relationship with someone, I understand who they are, how they act, how my relationship with them is.
Speaker 1:And if they have a big change in their life, that can impact your relationship with them and it can right. I hate that like people say that I've changed and it's like, yeah, I have changed, I've changed for good, I'm prioritizing myself, I have dug into my work because I'm passionate about it, because I want to change someone else's life right, and I think, like now, that I don't have the time for certain people and things.
Speaker 2:Yeah, Like sure, I'll take the blame for that.
Speaker 1:That's fine, yeah, but the relationship definitely changed. Friendships have changed a lot, but then other friendships have blossomed a lot and I feel like my life is just happier now because I'm surrounding myself with more positive people, and so that's Sure, that's something.
Speaker 2:Do you still feel a loss, though, for the people that maybe?
Speaker 1:Every day, yeah, every day the ride or die.
Speaker 2:Yeah, that's tough, that's tough because for a lot of people it's their family, it's people that, and that's where I struggle the most, because my family dynamic is not there.
Speaker 1:My parents haven't talked to my mom in years. My dad's rarely. I don't have a family dynamic. I spent Thanksgiving with you and, even though it was fantastic, I could have cried because it was so great. Your mother is so great.
Speaker 2:We loved having you guys over. It was amazing.
Speaker 1:It's not family, it's not the same.
Speaker 2:It's not family, or it's not. It's not the same. It's not the same. It's not the same.
Speaker 1:At the end of the day, like your, mom can be like Tammy, you're like my daughter, but at the end of the day, if I do something to hurt you, she's your ride or die.
Speaker 2:It's your mother, that's true, and that's the thing is the ride or die thing is tough because sometimes when we're the most invested in people is when we also get the most hurt. Yeah Right, and especially when people are undergoing changes we don't necessarily understand.
Speaker 1:Yeah.
Speaker 2:Or we are worried for them or something like it can be. It can really be tough on your relationship. Yeah, that's something that comes.
Speaker 1:Yeah, and so outside friendships, my marriage my husband said that he doesn't think surgery changed me in any like um big way. Yeah but, he's like man, I was not ready for you to have as much energy. And he's like you always used to be the type of like no, we're not going anywhere because you don't have anything to wear oh yeah, that was me saying yeah, yeah and now I'm just like sweatpants, sweatshirt, we're going to dinner and he's like I wasn't prepared for all the energy that you have.
Speaker 1:But, then I have a lot of drive in me. Now I have a lot of I want. I do not want to be stuck in the same place, same whatever, and that has kind of torn us apart a little bit too. Because I have so much drive, I'm willing to move out of our small little town to just do bigger and better. Um, but he's content, yeah, so content, yeah, with change, want to go, go, go. Yeah, that's a struggle, we're, we're struggling, we're figuring that out. But open communication has been helping a lot and therapy has been helping a lot. So that makes relationship changes, whether you, yeah, whether you're the ride or die, yeah, it can change. It can change. It sucks.
Speaker 2:But it can change. Change and thanks, yeah, absolutely. Well, there are other things that we had talked about through all of this, which was stuff that you were missing, like stuff that you oh yeah. What I was missing when I was obese insecure and yeah yeah, like what kinds of things do you mean by that? Like what do you mean you were missing, like FOMO, like what?
Speaker 1:yeah, yeah, yo, yo I was missing. I was missing out on having normal relationships and like doing things and feeling normal. What I mean by that is me and you could go to a big conference one year ago. I would have felt sometimes I do still feel uncomfortable, but that's not because of my weight anymore. It's because I'm hanging out with a bunch of surgeons that are way smarter than me. Oh please. Like, that's not true, so that's where I feel like I don't belong sometimes. But now.
Speaker 1:I walk into a room and I am just like everybody else. That's right In my mind, that's right you know. And I am right before I was looking around being like am I the biggest person in this room? And honestly, yeah, people who are obese get treated differently, and that's a whole nother topic that. I am going to discuss because I have experienced that. But like going to an event and just enjoying the people and not worrying about if you're the biggest person in the room, if the person you're talking to is like wow, she is really fat, like I see these are things in my head.
Speaker 2:This is a me problem, well, but it's not a you. But because here's the thing, like I really struggle with this too, because even after, after people have had surgery, I'm like do I comment on how people look?
Speaker 1:because I do very strongly believe that people are worth same, yeah, the weight, no matter the body, no matter the things, and you really feel troubled about this sometimes I think, because you are, you are aware of that, I think you come off correct yeah, because I I do hear you getting your patients from the waiting room, yes, saying like, yes, you look great, but you also add on to that like your smile is right and so, because you're aware of it, I think you will always come off, as I'm not just commenting on your weight, I'm commenting on your overall that is not something, that it is very real.
Speaker 2:Yeah, and I think that feeling that way it's just awful and being made to feel that way is awful, yeah, and I wish I could just wave a magic wand and people didn't feel awful and so I wish I would have known that I was missing out on those things um sooner, because I would have went through with this sooner. I mean, I was years and years that I was contemplating doing this.
Speaker 2:So just having less anxiety of being in social situations and not being afraid of, I mean I still am afraid of like, am I wearing the right thing? But I'm not as much anymore, because, you know, the funny thing is, like, through all of this, I feel like it's almost kind of like when you become an adult and you're like when you're a kid. You're like, oh, all the adults do every and there's going to be a guidebook and it's all going to be really straightforward, and like everyone's going to tell me how to do things. And you become an adult and you're like, oh, holy bonkers, me being on the other side of walking people, like along the path with people, but not being a patient myself.
Speaker 2:Yeah, it is. It's really interesting, like what kind of things really matter to people as they're changing and to help guide people through change. Yeah, when you can't predict necessarily, like how that's going to change them right, it's really. I mean, it's really eye-opening, it is and it's really fun, but also challenging, challenging, very challenging.
Speaker 1:Yeah, have any of your patients expressed to you the why did I do this?
Speaker 2:Yeah. Reaction yes, oh yeah, yes, oh my goodness. So I? Oh my goodness, I didn't know that was a thing, though, but oh yeah.
Speaker 1:Like pre-op. I'm like why would anybody be like, why did I do this?
Speaker 2:Oh, no, no, oh no.
Speaker 1:Afterwards you're like why did? I do this when you are trying to get that ounce of liquid in, you're like what did I just do?
Speaker 2:Put it back, Take it all back.
Speaker 1:I literally had a patient the day of surgery like after surgery, called me to her room and she said take it all back.
Speaker 2:She literally said those words and I was like I can't Okay, and her post-op state, post-op state, post-op state.
Speaker 1:next day she felt a lot better, and then a week later she's like I'd never take it back.
Speaker 2:So, for the most part, actually I think 100% of the time. Yo, it's super normal. So that first night after surgery and, honestly, the first week can be really rough, and sometimes the first few weeks can be really rough, or sometimes you're going to have a few times that are really rough, that you're in yeah whatever it is, but no, that's super normal super.
Speaker 1:Okay, the why did I do this is super normal, but something that I did not realize was a thing um. One other thing is um. I don't finish my plate anymore, heck, 90% of the time.
Speaker 2:I don't even. You're not going to finish your plate, Klum. What is that? I almost want to. I'm sorry, no, I'm just kidding it has a joke. Obviously Because the mentality of that is so big.
Speaker 1:Yeah, parents or grandparents, you eat what's on your plate.
Speaker 2:I come from an immigrant family and I remember being made to sit at the table until I finished everything. I was eating and there would be stuff on my plate that I couldn't stomach you know or? Like just really didn't want to eat. So it is so common, yeah, so common. And, by the way, in my culture also, weight is a massive like all the girls are supposed to be skinny, all the guys are supposed to be like bodybuilders.
Speaker 1:That's what the culture is, and that's not possible if everyone's also in the finish your plate club, right. So we came to an understanding of OK, we'll just give them little smaller portions. Yeah, that way my husband can still have the mentality of they did finish what's on their plate.
Speaker 2:And then if you get extra, that's great, but honestly it gives me anxiety. That's tough and the other thing that that does that especially at restaurants I'm paying. Well, so a restaurant that's the tough part is like you go out and portion sizes didn't change just because you had surgery. No, it didn't.
Speaker 1:The whole world didn't change just because you went through this. An appetizer is too much.
Speaker 2:Right, and so when you're out there and the pressure is to not just finish your plate but like everything you order is too much and has stuff that you may or may not be able to eat very well, like that's, that's really a lot of pressure, yeah no-transcript.
Speaker 1:Struggle with not ordering a drink because they're going to be asked why are you.
Speaker 2:You know, and they don't want to express that they've had bariatric surgery right, because, like, the way that you eat is going to be differently, drink and eat is going to be different. Yeah, after surgery, no matter what. Right, and so are you not devouring it why are you putting?
Speaker 1:your force down every time. Why yeah?
Speaker 2:and awkwardly chewing an amount and like exactly, and like where we live, like going out and eating with people or drinking with people. That's like love, right? Yes, that's how relationships are built. That's how you keep your relationships and that's how relationships change after.
Speaker 1:That's how you keep your relationships and that's how relationships change after surgery, because going out to eat sucks yeah.
Speaker 2:And even like, but even feeding yourself. That's the other thing too, right. If you are just trying to go through a drive-thru or get something real fast, it's much harder, I think, to live in like, especially like the US, and take care of yourself on the go If you're traveling, if you're a busy professional you've got a big family like any family, really like it's tough, it's tough. There's ways around that and we'll definitely talk about that as well.
Speaker 1:Oh yeah, let's go, let's go. You gave me bariatric surgery knowing that there was a chance that you were going to cut me open again and take my gallbladder.
Speaker 2:I know, I know that's true.
Speaker 1:This is something I did not find in any of my research of that gallbladder. Gallbladder issues yeah, after surgery.
Speaker 2:Okay, so let me give you a little history lesson, actually as we go through this. So the gallbladder is technically part of the GI system. Think of it like a storage tank, a water storage tank, but it's a bile storage tank, so bile made by the liver, and it goes through these little plumbing tubes to get to your gallbladder and to get to your guts in order to help you digest cheesy, fatty, greasy foods, right?
Speaker 2:So important, important. You don't have to have a gallbladder, but a gallbladder's there in your body naturally to serve as a storage tank. That storage tank gets activated when you eat those foods and sometimes the gallbladder can go bad.
Speaker 1:Yes, it can, and Tammy experienced this. I'd rather have a baby.
Speaker 2:Right, and how does it go bad? Well, so a couple of ways, more than a couple of ways, but one of the main ways. After bariatric surgery or anything, not just surgery but any way that people lose weight, especially very quickly, can cause your gallbladder function to slow down. If that happens, you can start to form stones. You can start to have symptoms from those stones and develop like an infection or inflammation of your gallbladder and other problems. Guess what? That happens to about 10% of patients after bariatric surgery, maybe more. Yeah, didn't know that and that happened to Tammy about a year out.
Speaker 1:So yeah, and also didn't know, that back back, not even that long ago, people or surgeons were taking out gallbladders right when they did the surgery or even one of our other surgeons said that at his practice they would schedule the surgery and then six months out they would just automatically schedule the gallbladder.
Speaker 2:But then they realized that and I wouldn't say that common practice anymore. You're absolutely right, it used to be more common and there's a couple of reasons, because I used to have an attending. So attending is like a person who trained me, who's a really smart guy, and he said one patient, one surgery per patient per day. Yeah right, I was like, okay, cool, insurance says so too. Insurance says so too. That's correct. But no, but if you add like multiple surgeries together, you're ultimately increasing risk and time.
Speaker 1:And gallbladders.
Speaker 2:While it's really common to take gallbladders out, gallbladder surgery is one of the most common surgeries we do. They still come with their own risk and, if not technically, versus the general population, not that many more people who have bariatric surgery have gallbladder problems.
Speaker 1:They've found that.
Speaker 2:Exactly so. Risk versus benefit is for the most part. We're going to wait and see if somebody develops a gallbladder problem and then if they do, take the gallbladder, and what is the?
Speaker 1:symptoms.
Speaker 2:Yeah, because.
Speaker 1:I told you about, after I eat, having some like hot flashes and all that You're like is your gallbladder, I'm like.
Speaker 2:But actually gallbladder issues are. They actually do overlap a lot with dumping. Okay, yeah, because now that I'm thinking about this.
Speaker 1:I do not have the yeah, that issue really anymore after my gallbladder.
Speaker 2:Yeah so it might have been gallbladder?
Speaker 1:yeah, potentially, but it may, it may also have so talk to your surgeon, because I didn't tell her about these issues until after my first gallbladders right and we actually crazy enough we we had Tammy's get well for surgery and then her gallbladder got way worse over a weekend before that surgery so this is definitely something that can progress from bad to worse quickly, so definitely something to get addressed.
Speaker 2:But yeah, really quick gallbladder symptoms. If you're having problems with eating and that pain after you eat nausea, vomiting, bloating and the pain actually isn't just in the upper right part of your belly where your gallbladder is located, it can wrap around, yes, left side yes, to your back.
Speaker 2:Yes, it can go to your chest and your shoulders feel like acid reflux. Absolutely, you can get acid reflux symptoms from this. You can get chest pain from this um, and you can even have like diarrhea. And then, if your gallbladder is really sick, like infected or infl, and you can even have like diarrhea. And then, if your gallbladder is really sick, like infected or inflamed, you can get chilled, night sweats, fever, all those infection signs that people get too. Have it on your radar Exactly.
Speaker 1:Talk to your surgeon Talk to your surgeon.
Speaker 2:Get that taken care of.
Speaker 1:All right. The last thing yes, I crave plastic surgery now. I thought it would never be a thing, never, I've never had it. You want more surgery?
Speaker 2:huh no no, there is surgery addiction, by the way. Yes, there is, yeah, and that I.
Speaker 1:I watch botched often, yeah, and I see that people do get addicted plastic surgery yeah, but no, just the, just the thought of my breasts that they are pitiful.
Speaker 2:They are changed.
Speaker 1:They are changed.
Speaker 2:I mean yeah, Finds you a hundred people that would tell you otherwise, I think. But I hear what you're saying, I know.
Speaker 1:Yep, we're our own worst critics, but I think that's one of my biggest insecurities. And plastic surgery could change it.
Speaker 2:Yeah, well, okay, you know what A lot of people pretty much everybody who goes through a lot of weight change, especially through surgery one of the downsides to that is your skin doesn't really catch up to it. So a lot of people will ask about, like, can I tone, can I do certain exercises? It's pretty limited. Yes, some exercise can help and yes, you can definitely get some toning effect from some of the physical things that you do. But ultimately, if there's a lot of skin or there's a lot of change that you want, yes, and we can't predict it, unfortunately.
Speaker 1:No I wish I had like an AI tool to show people what that would look like.
Speaker 2:I never, ever thought I would have wanted plastic surgery, but it is a thing that I just didn't know Right, and there's a couple of things that are really important with that, because typically, plastic surgery is covered by insurance. It can be not under most plans, yeah, so especially if you're developing like rashes or skin problems or lipidema, which is like fatty deposits in your arms or legs that are bumpy kind of things, or I mean there's just a number of things If you're actually having symptoms more than just like oh, this looks different, having symptoms more than just like oh, this looks different, I would very strongly recommend getting that documented by your health care providers so that you can support getting insurance coverage for those reasons.
Speaker 1:Those are the things I wish I would have known. That's a pretty good list.
Speaker 2:I like this a lot, but this is the nitty gritty stuff that I will say. Like as a surgeon, I don't have a very good perspective on Right Except, except when people tell me that they've actually gone through these things and they wish they would, and sometimes you can't get that out of a 15, 30 minute appointment with a patient, exactly. So I'm really grateful when people share these things, so please do.
Speaker 2:Yes, I'd love to hear from anyone listening what your experience of this has been. What are the things you wish you would have known going through this? I promise this makes us better. Yes, on the surgeon side, on the provider side too, to know these things. Yeah, so don't be shy.
Speaker 1:And so other people know too. So make sure you're following us for our next episode and thank you so much for listening. Thank you.