May 9, 2024 • 40 mins
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.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to Core Bariatrics Podcast, hosted by
bariatric surgeon Dr MariaIliakova and Tammy LaCose,
bariatric coordinator and apatient herself.
Our goal is building andelevating our community.
The Core Bariatrics Podcastdoes not offer medical advice,
diagnosis or treatment.
On this podcast, we aim toshare stories, support and
(00:22):
insight into the world beyondthe clinic.
Let's get into it.
Disclaimer for all of yoursurgery, patients needs to be.
If you live in the Midwest,you're going to be cold forever.
Yeah, you are going to be coldforever.
That's true.
It starts a few months afterand you are.
I've hated socks.
Now I have all the fluffy socksand I wear them to bed.
Speaker 2 (00:41):
Join the dark side.
Speaker 1 (00:42):
My husband also hates that.
I want the flannel sheets.
He's like I'm going to die.
Speaker 2 (00:48):
You know it's funny because you're right.
Like everyone complains aboutbeing cold afterwards.
Yeah, that needs to be thebiggest disclaimer.
Deal with it.
Speaker 1 (00:55):
You can always put clothes on.
Speaker 2 (00:57):
I guess you can.
You can.
It's hard to take body partsoff, but clothes you can put on.
Speaker 1 (01:02):
Absolutely so with that that we want to talk about
things that I wish I would haveknown before having surgery.
Is there anything?
Is there one that sparks.
Speaker 2 (01:13):
I think the thing is your appetite's going to change,
yeah, and I think a lot ofpeople 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 yourappetite is going to keep
changing, yeah, and the kinds ofthings that you like to eat
(01:33):
before you might not like Ahundred percent, and the kinds
of things that you didn't likebefore those might be an option
now for you.
Speaker 1 (01:41):
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 (01:53):
Oh, what are they?
Oh, I know what you're talkingabout Brussels sprouts.
Brussels sprouts, brusselssprouts, yeah, so yeah, wow,
okay, who craves Brussels?
Speaker 1 (02:00):
sprouts, Granted it had bacon on it, Enough bacon on
anything.
I'll crave a shoe, but I mean Ifeel like I crave more healthy
foods now, especially because Iknow that they satisfy me longer
.
Speaker 2 (02:12):
I think the food, how your body is going to change
and what foods you like, whatfoods you don't like.
Speaker 1 (02:18):
Texture can be really different how you perceive
texture.
Speaker 2 (02:21):
So that's one of the things I hear a lot.
Yeah, a lot.
Speaker 1 (02:24):
And I think yeah, I'm open to trying anything now
where I wasn't before.
Yeah, I was very stuck in myway.
Speaker 2 (02:35):
Oh yeah, that's, I mean, the whole world is your
oyster now?
Yes, would you eat oysters?
Speaker 1 (02:39):
Oh gosh.
The deep fried ones.
Speaker 2 (02:47):
Ok, I love it Right, wasn't that what you got, that
one day, yeah, yeah, that, no, Ithink I think so.
Yeah, don't you have to likeright, I mean swallow that.
Yeah, you have to swallow mostof the food you eat.
Speaker 1 (02:51):
Tammy, that's okay, swallow it whole.
Is that oysters?
Speaker 2 (02:57):
yeah, typically you don't chew them, right, you
don't chew them, you just kindof let them go, let them have
their way with you.
Speaker 1 (03:02):
I need to wrap my head around that.
Speaker 2 (03:05):
Yeah, I get it.
Speaker 1 (03:05):
Maybe that'll be an experience you give me and we
video chat?
Speaker 2 (03:11):
Oh boy, yeah, I think maybe oyster eating.
This podcast is devolving intoour wishes and dreams very
quickly, but, yes, all right.
Speaker 1 (03:19):
So I must say that the one big thing that I knew,
could happen but didn't realizehow much I would miss.
It is chugging water.
Speaker 2 (03:29):
Oh so why?
Why is that so important?
Speaker 1 (03:32):
I don't know.
I need to quench my thirst likeright, then yeah.
Well, you've got your big.
Speaker 2 (03:40):
Stanley mug over here , and that thing is probably the
size of your leg.
Actually, it's massive 40ounces.
Speaker 1 (03:44):
Yeah, so I'd leg.
Actually it's massive 40 ounces.
Yeah, and I'd bring iteverywhere.
It is my staple.
Speaker 2 (03:48):
It's your staple.
So tell me a little bit moreabout that, like, why is it your
staple?
Why?
Speaker 1 (03:52):
is it?
Speaker 2 (03:52):
important Yep.
Speaker 1 (03:53):
So I have to, as bariatric patients have to drink
throughout the day sipthroughout the day You're going
to be a sipping queen or kingand because it's harder for us
to yeah get big things of waterin if we went a while without
yeah, um.
So, yeah, it's like my purse.
I love it.
(04:13):
I actually carry my stanleyaround more than my driver's
license.
Speaker 2 (04:16):
That's probably sad no, it's so good because I'm
thinking like me.
You know, I don't really drinkenough water throughout the day.
No, you don't you know I drinkmy coffee.
I'm really addicted.
It's a problem, but okay.
But here's the thing is.
And there are some like sideeffects of going through this
process that are really healthyoverall.
Yes, like actually thinkingabout drinking water throughout
the day, or you?
(04:36):
Know some fluids, whatever, butmaking sure that you're you're
taking care of yourself, yes,keeping hydrated.
So I'm actually really proud ofyou.
Speaker 1 (04:44):
Thanks For having your Stanley and taking it
everywhere.
Not being able to chug, it'stough.
It's tough when you really justwant to chug a bottle of water,
and not so much just becauseyou're like feeling dehydrated,
it's because you literally justwant it all.
Right, you know that feelingyou want it all in you right now
.
Speaker 2 (05:03):
Yeah, it's a hot, hot day You've been working out?
Speaker 1 (05:06):
Yeah, I will say that , yeah, my water intake is much
better now because it issomething on my mind constantly.
Yeah, which isn't a bad thing.
Yeah, it's not debilitating.
Speaker 2 (05:18):
Well, you know and I've heard people say that the
water like just getting thatmuch liquid in you.
You kind of feel like you'refloating.
Sometimes I actually had.
I know I had a friend who had ajaw fracture, so unrelated to
bariatric surgery, but he had togo on a liquid diet for a
couple months because his jawwas wired shut.
And I remember him telling meat some point that like he just
felt like he was floating, likeit was just tough because you go
(05:41):
from not really thinking aboutyour 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 (05:51):
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 howeverlong.
Luckily our program pre-op is aliver shrinking diet with food.
With food, with like solid foodnot just like, but for one week
(06:13):
post-op it's just liquids.
Speaker 2 (06:15):
It's just liquids and like just liquids can kind of
suck.
Speaker 1 (06:18):
That is a mental.
Speaker 2 (06:19):
Yeah.
Speaker 1 (06:20):
F-bomb.
Speaker 2 (06:20):
It is because, okay, first of all, we're telling
people like not to drink sugarythings or sweet things, we're
telling people to cut back onthose things, but then guess
what?
Pretty much all liquids aresweet.
Speaker 1 (06:31):
Yes, yes, oh yeah, that first week I was sick of
sweets, right, and I am a sweetfanatic.
Yeah, I did not want to sweetand so when you told me I could
eat a scrambled egg.
Speaker 2 (06:50):
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 likein.
Okay, so in American culture wethink of sweet or like liquid
as right.
There's not that many liquidsthat are sweet.
In other cultures there's a lotmore like broths.
You're so right, Right, sothere's.
I mean I think there isdefinitely something to be done
about making the situationbetter, yeah.
Speaker 1 (07:10):
Yeah.
Speaker 2 (07:11):
For our people.
Speaker 1 (07:12):
I never ate egg drop soup.
Oh yeah, I did then, right.
Oh, actually I needed salt.
Speaker 2 (07:18):
One of our, yeah, one of the one of the folks that
had bypass earlier this yearafterward, but she got.
She's a very creative person, avery ingenious person.
Uh, she actually went to herfavorite restaurant and asked
for them to drain the soup, yeahcontents, basically to make it
a liquid, like take all thesolids out and just have the
base.
And so she had.
I think it was french onionsoup.
(07:39):
I think that first week, whichI thought that was pretty
brilliant, it's a lot of salt,whatever.
Sure A restaurant's going toprobably have some food that you
know, yes, yes, whatever, butat the same time she got her
liquids in and she actually hada good time doing it.
Yeah, so there's ways, there'sways, there's ways.
Yeah, but you're right, it'snot easy.
No, it takes a lot of planning.
Speaker 1 (07:59):
Yeah, and let's talk about what happens when you
don't get your liquids in.
Oh boy so, but even so, not somuch the feeling of being
dehydrated, or whatnot Sure butwhat happens when you don't
drink enough water?
You don't poop.
Speaker 2 (08:11):
That's true.
Yeah, I understood the browncode was coming up.
Very good, todd Brown, toddBrown.
So that's a good point.
So, like you know, to have BMsyou have to have stuff in the
tank bowel movements right bowelmovement.
Speaker 1 (08:24):
I'm just making sure everybody's on the same page.
That's fair.
Speaker 2 (08:26):
That's fair so if you've got it, yeah, to have a
bowel movement, you've got tohave stuff there, right?
Uh-huh to have stuff in themachine in order to push it
right out yeah so if you're notdrinking enough water, you're
setting yourself up for somemiserable situations, including
not being able to poop right,yes, and that will lead to you
needing their medications oreven feeling so miserable that
(08:50):
you come into the hospital?
Yeah, it's pretty bad soliterally being full of crap.
Wow.
Speaker 1 (08:55):
Dad joke.
Speaker 2 (08:57):
Yeah, sorry, that was pretty bad, but anyway.
So, yeah, so if you want to getrid of that stuff, you got to
put stuff in the tank.
Speaker 1 (09:05):
That is our first go-to.
When people say like I'm notpooping regularly.
It's like are you drinkingenough?
Speaker 2 (09:12):
Are you drinking enough?
Speaker 1 (09:13):
Yeah, but then that brings up the topic of hey, did
you know pooping every day isnormal, right, I didn't.
No, I'm serious, I didn't knowthat was a thing before surgery
that's a thing.
No, I would poop maybe once ortwice a week.
Wow, I'm dead serious.
So, wow, we changed your life,tammy, a hundred percent.
Speaker 2 (09:29):
We changed your BMS, which okay, I laugh about this,
but it's actually if you havelike regular bowel movements, if
your gut's working well.
You're going to feel better.
You feel better.
You're going to feel better, Ifeel better.
You feel so much better.
It's a big one.
It's a big one.
So really, the constipationthing definitely can be worse
after surgeries, but, but, but,but there's so many things you
(09:50):
can do about it.
Speaker 1 (09:51):
Yeah, Right, yeah.
And so there's times where Ineed to take a Miralax or Right
Collase.
Yeah, yeah, yeah, so there's somany.
Speaker 2 (09:59):
Oh, I really want to touch on because there's a lot
of confusion about, likelaxatives and stool softeners.
So we're going to detour realfast and go there and go there
just for a second.
So stool softeners make thestool soft.
Speaker 1 (10:11):
Okay, I know that sounds crazy for me to break it
down like that, takes the waterand brings it into your stool.
Speaker 2 (10:16):
Yes, it makes your stool softer by absorbing water
and it doesn't really help pushthings forward.
That's what laxatives do right.
So there are some things thatare both stool softeners and
laxatives, so Miralex isactually both.
Speaker 1 (10:31):
I didn't know that.
Thanks for telling me that.
Speaker 2 (10:33):
And like Miralex, laxative.
Hey, hey, terrible, not a JADjoke even, but anyway, yeah,
just that's why it's called.
Speaker 1 (10:41):
Miralex.
Speaker 2 (10:42):
But Colase, Sacot, Docusate, all of those things
are actually stool softenersonly Okay.
So if you are constipated, myfirst go-to is actually a stool
softener after water.
Okay, yeah, Right Because it'sa little less intense than a
laxative Right.
Laxatives can push you overinto diarrhea.
Speaker 1 (10:59):
Right, that's exactly right.
Speaker 2 (11:09):
Nobody wants that right.
That's where I usually start,with the sun on Exactly.
Speaker 1 (11:10):
Exactly.
And then there's a couple ofother like natural ways to think
about it too that aren'tnecessary Extra medication.
So I think fiber.
Speaker 2 (11:13):
Yeah, yeah, I think hot Like hot tea, instead Hot
tea oh yeah, I like that.
Speaker 1 (11:15):
That usually like I like that.
Yeah, okay, I mean by the timeit gets to your you know colon.
It's not like the temperature'snot making a big difference In
my brain it works.
Speaker 2 (11:22):
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 (11:28):
That's probably what it is.
Honestly, it's your placebofluid.
Speaker 2 (11:30):
I like it, it's perfect.
But no, but even things thathave fiber in them, so like
fruits, and fruit, has a lot offiber.
That's what he said dried fruit.
Speaker 1 (11:42):
Don't go overboard.
Speaker 2 (11:43):
Yeah, don't go too crazy, because those things are
sugar bombs.
It should be too many, butdried fruit's a really good one,
and think of fiber the best wayit was ever described to me.
I love this.
I love this.
It's toilet paper from theinside.
It's roughage, basically it'stexture and roughage, and it's
something that one helps to pullwater into your gut.
That's important because wealready talked about that.
(12:03):
That gut has stuff in the tankand then it also helps to sort
of scrub things along as you go.
So fiber really important.
Speaker 1 (12:11):
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 dumpingsyndrome, I thought diarrhea.
Yeah, that's it.
Speaker 2 (12:26):
Yeah, and it's not quite that, so let's okay.
Dumping syndrome sounds as badas it is to be honest with you.
And dumping diarrhea.
That makes sense right, likethat's how we get the term, but
it also is that feeling of likedizziness, lightheadedness,
feeling really hot.
Speaker 1 (12:42):
I thought that was just my new way of my body
telling me I was full nope, itwas not, I was not in the right
thing well, yeah so, yeah, Ididn't realize that me being hot
and flushed and justlightheaded was dumping syndrome
, and I realized that in one ofyour appointments with a
(13:03):
different person, totallyinterrupted, but I'm like the
light bulb went off.
But that's something that needsto be out there is that dumping
syndrome is not just diarrhea.
Speaker 2 (13:14):
That's right, that's right and dumping syndrome.
Let's talk about also how thathappens and why.
So it's basically your bodyresponding in a new way to
having foods that are high infat or sugar.
And why does fat and sugarmatter?
So sugar can trigger insulinrelease in your body and other
hormones that are related to howwe process sugar, and can do
(13:34):
the same thing, because yourbody requires a lot of enzymes,
a lot of like specialized,basically machinery, in order to
process.
And so for a person who's had abariatric surgery, that changes
yes, remember we talked aboutsignaling changing and how
things are processed, changes inyour body after surgery.
This is one of those ways.
Yeah, so when you eat somethingthat's really high in fat or
(13:56):
sugar or both, you can triggerabnormal response from your body
that will cause you to feelreally lousy your body.
That will cause you to feelreally lousy, yeah, and will
trigger dumping syndrome.
So I will say, 100% of peoplehave at least one episode of
this, because you're going tooverdo it or just eat something
that doesn't agree with you asyou go, at least once.
(14:16):
But it's important to listen toyour body.
Yes, it is, yeah, and I thinkthat's one of the things that
it's both a good thing and a badthing terms of yeah, exactly
you.
Speaker 1 (14:25):
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'swhere surgery has helped me keep
weight off.
Speaker 2 (14:37):
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 bariatricsurgery, it's way less for
weight control and much more tonot feel miserable.
Speaker 1 (14:50):
Yes, dr Maria Ilyakova, over here one time at
her house around Halloween, saysTimmy, eat the Halloween candy.
And I'm like Maria, you're mybariatric surgeon, you're not
supposed to have me eat your,but no that.
What another thing I love aboutyou is you are this is a
lifestyle.
Right, you can have the pieceof candy, because if you don't
(15:12):
eat the piece of candy, you'regonna 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 (15:20):
That is not something that we like.
I don't think it's reallysomething we can expect of
ourselves or of anyone perfectlyall the time.
Speaker 1 (15:28):
I think that's a topic we need to cover is
because alcoholics or drugaddicts, they can take that out,
that addiction out of theirlives.
Speaker 2 (15:37):
Oh my goodness, we actually were having a really
good conversation a couple ofdays ago about appetite, like in
our hallway, because we alwaystalk about this stuff.
Speaker 1 (15:42):
We super obsessed in the hallway.
Speaker 2 (15:44):
Yes, in the hallway, that's all right, but appetite
is so much more than likeappetite just for food.
We have appetite for feelinggood or certain kinds of
experiences or working out oryou know, like, yeah, that
endorphin rush or that feelingbeing satisfied can come from so
many different things and and.
(16:04):
For some people it's drugs, forsome people it's alcohol, for
some people it's food, for somepeople it's whatever
relationship.
It's a million different things.
So there is a transference ofhow you feed that appetite after
surgery.
Right, if it's not food anymore, and not certain kinds of food
anymore, it absolutely canbecome other things.
Yeah.
Speaker 1 (16:24):
And those.
Speaker 2 (16:25):
so, knowing that ahead of time, I think that's
another one that comes up forpeople I wish I would have known
.
Speaker 1 (16:30):
Yeah, transfer addiction is real, yeah, and
even our mental health personthat we refer our patients to
really digs into you know whatyour history of alcohol and
drugs and even your parents'history.
And her suggestion to me was Iwould not even touch alcohol
after surgery because of yourRisk factors maybe.
Speaker 2 (16:54):
Yes, yeah, yeah.
Speaker 1 (16:56):
But I told her.
I said you know, alcohol hasnever been a thing for me.
Sure, actually, wheneveranybody drank around me, it made
me feel uncomfortable.
Speaker 2 (17:07):
So, I know alcohol would Wouldn't have been your
thing, but shopping is yeah,well also.
I mean like shopping, let'stalk about that real quick,
because people change body shapeand sizes sometimes really
drastically and really fastafter surgery.
Yes, right, so is there.
Did that kind of meet yourexpectations in terms of
partnering with the shopping andthe how, where and things like
(17:29):
that?
Speaker 1 (17:30):
I don't shop for me, I hate that, ok, you need to
take me shopping.
I don't know if I'd address mybody.
You need to take me shopping.
I don't know if I'd address mybody.
I am still boring, as could be.
I have gone outside my comfortzone a little bit and things
like just joggers.
Well, those look good on you.
I don't know I'm like these aremy normal scrubs, but now I got
like jogger ones that are likeskinny.
(17:50):
That's outside my comfort zone.
I feel like I need someone totell me how to dress.
Speaker 2 (17:56):
We should have a stylist on it, Right?
I think yeah.
Speaker 1 (17:59):
But so shopping for me is my kids?
Speaker 2 (18:04):
Yeah, and just the rush of spending money, yeah,
but you gotta get your kickssome way right and like there's
gonna be some way, yeah, and itcan be healthy.
It can be unhealthy, but that'ssomething to think about ahead
of time.
Speaker 1 (18:17):
A hundred percent, yes, figuring out what you might
transfer your addiction to yeah, and it's honestly.
Speaker 2 (18:24):
It's also possible for everything to be unhealthy,
like anything can be healthy oranything can be unhealthy.
I will say, like a drugaddiction is never healthy.
So that's maybe one thing thatcan't be healthy, right.
But you know, working out canbecome an addiction, it can
become unhealthy or eating wellout can become an addiction.
Speaker 1 (18:38):
it can become unhealthy or eating.
Speaker 2 (18:39):
Well sex, sex can become an addiction.
Yeah, everything can become anaddiction.
Yeah, so it you know, if itstarts to interfere with your
daily life exactly like thatright.
So, um, realizing that that's arisk for everyone and maybe
trying to game plan that aheadand think about what you like.
Speaker 1 (18:55):
We had a patient who started knitting or crocheting.
Yeah, right, and so she's likeinstead of eating that Twinkie I
made.
She makes a lot of hats for theNICU babies because we live in
a big university town.
Will that last with her forever?
I'd be curious to see.
Speaker 2 (19:13):
Okay.
One other big thing that comesup is relationships changing
afterward.
Do you think that's somethingthat you were fully prepared for
, that you really understood howthat would work?
Speaker 1 (19:21):
Was I prepared for it ?
Did I research it?
Did I think that I could battleit?
Yes, because the divorce ratein the bariatric community is
big.
I did not want that.
Bariatric community is big.
Yeah, I did not want that andunfortunately, I planned for it.
(19:42):
Did it work?
No, how you planned, no yeahright?
No, that's the name of the gameBecause, at the end of the day,
even if someone says they aresupportive of you 100%, that
they don't look at surgery asthe easy way out or any
something like that, things justchange Things change, things
change.
Speaker 2 (20:03):
I think that's that's overall maybe the toughest
thing.
Speaker 1 (20:07):
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 myfriends have changed, because my
friends were looking back likethere was a lot of negativity.
I will be honest, like I was100 percent a negative person on
myself, on the world, Like oh,no I think I was very judgmental
(20:32):
.
I was kind of a mean girl, yeah, like you said this before I
have.
Yeah, especially in high school.
Why?
Speaker 2 (20:37):
Because I was insecure I want someone else to
be the problem I don't want tobe the problem.
It's like projecting,projecting on other people.
Speaker 1 (20:44):
Oh, 100, yep.
And so I think now that, um, Ifeel like I'm more positive than
everybody around me likesometimes some of our co-workers
complain about something orsomeone and I'm like hold up up.
Are they having a bad day?
Yeah, Did they do that onpurpose?
Speaker 2 (21:02):
Like look at the positive stuff.
Speaker 1 (21:04):
So now, looking at some of my friendships, there's
just too much negativity.
Speaker 2 (21:11):
Not enough Right, you're dealing with that, yeah,
and being open to things, or youknow, it's really hard to be
vulnerable and I think whenthings change or when other
people in our lives change, itcan be a really big threat.
Yeah, right, because it's likeoh, I have this relationship
with someone, I understand whothey are, how they act, how my
(21:32):
relationship with them is.
Speaker 1 (21:43):
And if they have a big change in their life, that
can impact your relationshipwith them and it can right.
I hate that like people saythat I've changed and it's like,
yeah, I have changed, I'vechanged for good, I'm
prioritizing myself, I have duginto my work because I'm
passionate about it, because Iwant to change someone else's
life right, and I think, likenow, that I don't have the time
for certain people and things.
Speaker 2 (21:57):
Yeah, Like sure, I'll take the blame for that.
Speaker 1 (22:00):
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 likemy life is just happier now
because I'm surrounding myselfwith more positive people, and
so that's Sure, that's something.
Speaker 2 (22:17):
Do you still feel a loss, though, for the people
that maybe?
Speaker 1 (22:21):
Every day, yeah, every day the ride or die.
Speaker 2 (22:24):
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 (22:35):
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 youand, even though it was
fantastic, I could have criedbecause it was so great.
Your mother is so great.
Speaker 2 (22:51):
We loved having you guys over.
It was amazing.
Speaker 1 (22:54):
It's not family, it's not the same.
Speaker 2 (22:55):
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 (22:58):
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'syour ride or die.
Speaker 2 (23:08):
It's your mother, that's true, and that's the
thing is the ride or die thingis tough because sometimes when
we're the most invested inpeople is when we also get the
most hurt.
Yeah Right, and especially whenpeople are undergoing changes
we don't necessarily understand.
Speaker 1 (23:23):
Yeah.
Speaker 2 (23:23):
Or we are worried for them or something like it can
be.
It can really be tough on yourrelationship.
Yeah, that's something thatcomes.
Speaker 1 (23:31):
Yeah, and so outside friendships, my marriage my
husband said that he doesn'tthink surgery changed me in any
like um big way.
Yeah but, he's like man, I wasnot ready for you to have as
much energy.
And he's like you always usedto be the type of like no, we're
not going anywhere because youdon't have anything to wear oh
yeah, that was me saying yeah,yeah and now I'm just like
(23:53):
sweatpants, sweatshirt, we'regoing to dinner and he's like I
wasn't prepared for all theenergy that you have.
But, then I have a lot of drivein me.
Now I have a lot of I want.
I do not want to be stuck inthe same place, same whatever,
and that has kind of torn usapart a little bit too.
(24:15):
Because I have so much drive,I'm willing to move out of our
small little town to just dobigger and better.
Um, but he's content, yeah, socontent, 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 beenhelping a lot and therapy has
been helping a lot.
So that makes relationshipchanges, whether you, yeah,
(24:38):
whether you're the ride or die,yeah, it can change.
It can change.
It sucks.
Speaker 2 (24:43):
But it can change.
Change and thanks, yeah,absolutely.
Well, there are other thingsthat we had talked about through
all of this, which was stuffthat you were missing, like
stuff that you oh yeah.
What I was missing when I wasobese insecure and yeah yeah,
like what kinds of things do youmean by that?
(25:04):
Like what do you mean you weremissing, like FOMO, like what?
Speaker 1 (25:08):
yeah, yeah, yo, yo I was missing.
I was missing out on havingnormal relationships and like
doing things and feeling normal.
What I mean by that is me andyou could go to a big conference
one year ago.
I would have felt sometimes Ido still feel uncomfortable, but
(25:29):
that's not because of my weightanymore.
It's because I'm hanging outwith a bunch of surgeons that
are way smarter than me.
Oh please.
Like, that's not true, sothat's where I feel like I don't
belong sometimes.
But now.
I walk into a room and I am justlike everybody else.
That's right In my mind, that'sright you know.
And I am right before I waslooking around being like am I
the biggest person in this room?
(25:50):
And honestly, yeah, people whoare obese get treated
differently, and that's a wholenother topic that.
I am going to discuss because Ihave experienced that.
But like going to an event andjust enjoying the people and not
worrying about if you're thebiggest person in the room, if
the person you're talking to islike wow, she is really fat,
(26:13):
like I see these are things inmy head.
Speaker 2 (26:15):
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, afterpeople have had surgery, I'm
like do I comment on how peoplelook?
Speaker 1 (26:26):
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 feeltroubled about this sometimes I
think, because you are, you areaware of that, I think you come
off correct yeah, because I I dohear you getting your patients
(26:46):
from the waiting room, yes,saying like, yes, you look great
, but you also add on to thatlike your smile is right and so,
because you're aware of it, Ithink you will always come off,
as I'm not just commenting onyour weight, I'm commenting on
your overall that is notsomething, that it is very real.
Speaker 2 (27:04):
Yeah, and I think that feeling that way it's just
awful and being made to feelthat way is awful, yeah, and I
(27:24):
wish I could just wave a magicwand and people didn't feel
awful and so I wish I would haveknown that I was missing out on
those things um sooner, becauseI would have went through with
this sooner.
I mean, I was years and yearsthat I was contemplating doing
this.
So just having less anxiety ofbeing in social situations and
not being afraid of, I mean Istill am afraid of like, am I
(27:50):
wearing the right thing?
But I'm not as much anymore,because, you know, the funny
thing is, like, through all ofthis, I feel like it's almost
kind of like when you become anadult and you're like when
you're a kid.
You're like, oh, all the adultsdo every and there's going to
be a guidebook and it's allgoing to be really
straightforward, and likeeveryone's going to tell me how
to do things.
And you become an adult andyou're like, oh, holy bonkers,
me being on the other side ofwalking people, like along the
(28:12):
path with people, but not beinga patient myself.
Yeah, it is.
It's really interesting, likewhat kind of things really
matter to people as they'rechanging and to help guide
people through change.
Yeah, when you can't predictnecessarily, like how that's
going to change them right, it'sreally.
I mean, it's really eye-opening, it is and it's really fun, but
(28:36):
also challenging, challenging,very challenging.
Speaker 1 (28:39):
Yeah, have any of your patients expressed to you
the why did I do this?
Speaker 2 (28:45):
Yeah.
Reaction yes, oh yeah, yes, ohmy goodness.
So I?
Oh my goodness, I didn't knowthat was a thing, though, but oh
yeah.
Speaker 1 (28:51):
Like pre-op.
I'm like why would anybody belike, why did I do this?
Speaker 2 (28:56):
Oh, no, no, oh no.
Speaker 1 (28:57):
Afterwards you're like why did?
I do this when you are tryingto get that ounce of liquid in,
you're like what did I just do?
Speaker 2 (29:05):
Put it back, Take it all back.
Speaker 1 (29:07):
I literally had a patient the day of surgery like
after surgery, called me to herroom and she said take it all
back.
Speaker 2 (29:19):
She literally said those words and I was like I
can't Okay, and her post-opstate, post-op state, post-op
state.
Speaker 1 (29:22):
next day she felt a lot better, and then a week
later she's like I'd never takeit back.
Speaker 2 (29:25):
So, for the most part , actually I think 100% of the
time.
Yo, it's super normal.
So that first night aftersurgery and, honestly, the first
week can be really rough, andsometimes the first few weeks
can be really rough, orsometimes you're going to have a
few times that are really rough, that you're in yeah whatever
it is, but no, that's supernormal super.
Speaker 1 (29:42):
Okay, the why did I do this is super normal, but
something that I did not realizewas a thing um.
One other thing is um.
I don't finish my plate anymore, heck, 90% of the time.
Speaker 2 (29:56):
I don't even.
You're not going to finish yourplate, Klum.
What is that?
I almost want to.
I'm sorry, no, I'm just kiddingit has a joke.
Obviously Because the mentalityof that is so big.
Speaker 1 (30:10):
Yeah, parents or grandparents, you eat what's on
your plate.
Speaker 2 (30:15):
I come from an immigrant family and I remember
being made to sit at the tableuntil I finished everything.
I was eating and there would bestuff on my plate that I
couldn't stomach you know or?
Like just really didn't want toeat.
So it is so common, yeah, socommon.
And, by the way, in my culturealso, weight is a massive like
all the girls are supposed to beskinny, all the guys are
(30:46):
supposed to be like bodybuilders.
Speaker 1 (30:48):
That's what the culture is, and that's not
possible if everyone's also inthe finish your plate club,
right.
So we came to an understandingof OK, we'll just give them
little smaller portions.
Yeah, that way my husband canstill have the mentality of they
did finish what's on theirplate.
Speaker 2 (31:06):
And then if you get extra, that's great, but
honestly it gives me anxiety.
That's tough and the otherthing that that does that
especially at restaurants I'mpaying.
Well, so a restaurant that'sthe tough part is like you go
out and portion sizes didn'tchange just because you had
surgery.
No, it didn't.
Speaker 1 (31:19):
The whole world didn't change just because you
went through this.
An appetizer is too much.
Speaker 2 (31:22):
Right, and so when you're out there and the
pressure is to not just finishyour plate but like everything
you order is too much and hasstuff that you may or may not be
able to eat very well, likethat's, that's really a lot of
pressure, yeah no-transcript.
Speaker 1 (32:05):
Struggle with not ordering a drink because they're
going to be asked why are you.
Speaker 2 (32:10):
You know, and they don't want to express that
they've had bariatric surgeryright, because, like, the way
that you eat is going to bedifferently, drink and eat is
going to be different.
Yeah, after surgery, no matterwhat.
Right, and so are you notdevouring it why are you putting
?
Speaker 1 (32:21):
your force down every time.
Why yeah?
Speaker 2 (32:24):
and awkwardly chewing an amount and like exactly, and
like where we live, like goingout and eating with people or
drinking with people.
That's like love, right?
Yes, that's how relationshipsare built.
That's how you keep yourrelationships and that's how
relationships change after.
Speaker 1 (32:37):
That's how you keep your relationships and that's
how relationships change aftersurgery, because going out to
eat sucks yeah.
Speaker 2 (32:41):
And even like, but even feeding yourself.
That's the other thing too,right.
If you are just trying to gothrough a drive-thru or get
something real fast, it's muchharder, I think, to live in like
, especially like the US, andtake care of yourself on the go
If you're traveling, if you're abusy professional you've got a
(33:03):
big family like any family,really like it's tough, it's
tough.
There's ways around that andwe'll definitely talk about that
as well.
Speaker 1 (33:08):
Oh yeah, let's go, let's go.
You gave me bariatric surgeryknowing that there was a chance
that you were going to cut meopen again and take my
gallbladder.
Speaker 2 (33:16):
I know, I know that's true.
Speaker 1 (33:19):
This is something I did not find in any of my
research of that gallbladder.
Gallbladder issues yeah, aftersurgery.
Speaker 2 (33:27):
Okay, so let me give you a little history lesson,
actually as we go through this.
So the gallbladder istechnically part of the GI
system.
Think of it like a storage tank, a water storage tank, but it's
a bile storage tank, so bilemade by the liver, and it goes
through these little plumbingtubes to get to your gallbladder
and to get to your guts inorder to help you digest cheesy,
(33:48):
fatty, greasy foods, right?
So important, important.
You don't have to have agallbladder, but a gallbladder's
there in your body naturally toserve as a storage tank.
That storage tank getsactivated when you eat those
foods and sometimes thegallbladder can go bad.
Speaker 1 (34:03):
Yes, it can, and Tammy experienced this.
I'd rather have a baby.
Speaker 2 (34:08):
Right, and how does it go bad?
Well, so a couple of ways, morethan a couple of ways, but one
of the main ways.
After bariatric surgery oranything, not just surgery but
any way that people lose weight,especially very quickly, can
cause your gallbladder functionto slow down.
If that happens, you can startto form stones.
(34:30):
You can start to have symptomsfrom those stones and develop
like an infection orinflammation of your gallbladder
and other problems.
Guess what?
That happens to about 10% ofpatients after bariatric surgery
, maybe more.
Yeah, didn't know that and thathappened to Tammy about a year
out.
Speaker 1 (34:50):
So yeah, and also didn't know, that back back, not
even that long ago, people orsurgeons were taking out
gallbladders right when they didthe surgery or even one of our
other surgeons said that at hispractice they would schedule the
surgery and then six months outthey would just automatically
schedule the gallbladder.
Speaker 2 (35:09):
But then they realized that and I wouldn't say
that common practice anymore.
You're absolutely right, itused to be more common and
there's a couple of reasons,because I used to have an
attending.
So attending is like a personwho trained me, who's a really
smart guy, and he said onepatient, 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 likemultiple surgeries together,
(35:33):
you're ultimately increasingrisk and time.
Speaker 1 (35:35):
And gallbladders.
Speaker 2 (35:36):
While it's really common to take gallbladders out,
gallbladder surgery is one ofthe most common surgeries we do.
They still come with their ownrisk and, if not technically,
versus the general population,not that many more people who
have bariatric surgery havegallbladder problems.
Speaker 1 (35:52):
They've found that.
Speaker 2 (35:53):
Exactly so.
Risk versus benefit is for themost part.
We're going to wait and see ifsomebody develops a gallbladder
problem and then if they do,take the gallbladder, and what
is the?
Speaker 1 (36:02):
symptoms.
Speaker 2 (36:03):
Yeah, because.
Speaker 1 (36:05):
I told you about, after I eat, having some like
hot flashes and all that You'relike is your gallbladder, I'm
like.
Speaker 2 (36:18):
But actually gallbladder issues are.
They actually do overlap a lotwith dumping.
Okay, yeah, because now thatI'm thinking about this.
Speaker 1 (36:21):
I do not have the yeah, that issue really anymore
after my gallbladder.
Speaker 2 (36:26):
Yeah so it might have been gallbladder?
Speaker 1 (36:27):
yeah, potentially, but it may, it may also have so
talk to your surgeon, because Ididn't tell her about these
issues until after my firstgallbladders right and we
actually crazy enough we we hadTammy's get well for surgery and
then her gallbladder got wayworse over a weekend before that
surgery so this is definitelysomething that can progress from
bad to worse quickly, sodefinitely something to get
(36:48):
addressed.
Speaker 2 (36:48):
But yeah, really quick gallbladder symptoms.
If you're having problems witheating and that pain after you
eat nausea, vomiting, bloatingand the pain actually isn't just
in the upper right part of yourbelly where your gallbladder is
located, it can wrap around,yes, left side yes, to your back
.
Yes, it can go to your chest andyour shoulders feel like acid
reflux.
Absolutely, you can get acidreflux symptoms from this.
(37:11):
You can get chest pain fromthis um, and you can even have
like diarrhea.
And then, if your gallbladderis really sick, like infected or
infl, and you can even havelike diarrhea.
And then, if your gallbladderis really sick, like infected or
inflamed, you can get chilled,night sweats, fever, all those
infection signs that people gettoo.
Have it on your radar Exactly.
Speaker 1 (37:26):
Talk to your surgeon Talk to your surgeon.
Speaker 2 (37:30):
Get that taken care of.
Speaker 1 (37:32):
All right.
The last thing yes, I craveplastic surgery now.
I thought it would never be athing, never, I've never had it.
You want more surgery?
Speaker 2 (37:41):
huh no no, there is surgery addiction, by the way.
Yes, there is, yeah, and that I.
Speaker 1 (37:46):
I watch botched often , yeah, and I see that people do
get addicted plastic surgeryyeah, but no, just the, just the
thought of my breasts that theyare pitiful.
Speaker 2 (37:58):
They are changed.
Speaker 1 (37:59):
They are changed.
Speaker 2 (38:00):
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 (38:05):
Yep, we're our own worst critics, but I think
that's one of my biggestinsecurities.
And plastic surgery couldchange it.
Speaker 2 (38:12):
Yeah, well, okay, you know what A lot of people
pretty much everybody who goesthrough a lot of weight change,
especially through surgery oneof the downsides to that is your
skin doesn't really catch up toit.
So a lot of people will askabout, like, can I tone, can I
do certain exercises?
It's pretty limited.
Yes, some exercise can help andyes, you can definitely get
(38:33):
some toning effect from some ofthe physical things that you do.
But ultimately, if there's alot of skin or there's a lot of
change that you want, yes, andwe can't predict it,
unfortunately.
Speaker 1 (38:43):
No I wish I had like an AI tool to show people what
that would look like.
Speaker 2 (38:46):
I never, ever thought I would have wanted plastic
surgery, but it is a thing thatI just didn't know Right, and
there's a couple of things thatare really important with that,
because typically, plasticsurgery is covered by insurance.
It can be not under most plans,yeah, so especially if you're
developing like rashes or skinproblems or lipidema, which is
like fatty deposits in your armsor legs that are bumpy kind of
(39:10):
things, or I mean there's just anumber of things If you're
actually having symptoms morethan just like oh, this looks
different, having symptoms morethan just like oh, this looks
different, I would very stronglyrecommend getting that
documented by your health careproviders so that you can
support getting insurancecoverage for those reasons.
Speaker 1 (39:26):
Those are the things I wish I would have known.
That's a pretty good list.
Speaker 2 (39:31):
I like this a lot, but this is the nitty gritty
stuff that I will say.
Like as a surgeon, I don't havea very good perspective on
Right Except, except when peopletell me that they've actually
gone through these things andthey wish they would, and
sometimes you can't get that outof a 15, 30 minute appointment
with a patient, exactly.
So I'm really grateful whenpeople share these things, so
(39:53):
please do.
Yes, I'd love to hear fromanyone listening what your
experience of this has been.
What are the things you wishyou would have known going
through this?
I promise this makes us better.
Yes, on the surgeon side, onthe provider side too, to know
these things.
Yeah, so don't be shy.
Speaker 1 (40:11):
And so other people know too.
So make sure you're followingus for our next episode and
thank you so much for listening.
Thank you.
Welcome to Core Bariatrics Podcast, hosted by
bariatric surgeon Dr MariaIliakova and Tammy LaCose,
bariatric coordinator and apatient herself.
Our goal is building andelevating our community.
The Core Bariatrics Podcastdoes not offer medical advice,
diagnosis or treatment.
On this podcast, we aim toshare stories, support and
(00:22):
insight into the world beyondthe clinic.
Let's get into it.
Disclaimer for all of yoursurgery, patients needs to be.
If you live in the Midwest,you're going to be cold forever.
Yeah, you are going to be coldforever.
That's true.
It starts a few months afterand you are.
I've hated socks.
Now I have all the fluffy socksand I wear them to bed.
Speaker 2 (00:41):
Join the dark side.
Speaker 1 (00:42):
My husband also hates that.
I want the flannel sheets.
He's like I'm going to die.
Speaker 2 (00:48):
You know it's funny because you're right.
Like everyone complains aboutbeing cold afterwards.
Yeah, that needs to be thebiggest disclaimer.
Deal with it.
Speaker 1 (00:55):
You can always put clothes on.
Speaker 2 (00:57):
I guess you can.
You can.
It's hard to take body partsoff, but clothes you can put on.
Speaker 1 (01:02):
Absolutely so with that that we want to talk about
things that I wish I would haveknown before having surgery.
Is there anything?
Is there one that sparks.
Speaker 2 (01:13):
I think the thing is your appetite's going to change,
yeah, and I think a lot ofpeople 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 yourappetite is going to keep
changing, yeah, and the kinds ofthings that you like to eat
(01:33):
before you might not like Ahundred percent, and the kinds
of things that you didn't likebefore those might be an option
now for you.
Speaker 1 (01:41):
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 (01:53):
Oh, what are they?
Oh, I know what you're talkingabout Brussels sprouts.
Brussels sprouts, brusselssprouts, yeah, so yeah, wow,
okay, who craves Brussels?
Speaker 1 (02:00):
sprouts, Granted it had bacon on it, Enough bacon on
anything.
I'll crave a shoe, but I mean Ifeel like I crave more healthy
foods now, especially because Iknow that they satisfy me longer
.
Speaker 2 (02:12):
I think the food, how your body is going to change
and what foods you like, whatfoods you don't like.
Speaker 1 (02:18):
Texture can be really different how you perceive
texture.
Speaker 2 (02:21):
So that's one of the things I hear a lot.
Yeah, a lot.
Speaker 1 (02:24):
And I think yeah, I'm open to trying anything now
where I wasn't before.
Yeah, I was very stuck in myway.
Speaker 2 (02:35):
Oh yeah, that's, I mean, the whole world is your
oyster now?
Yes, would you eat oysters?
Speaker 1 (02:39):
Oh gosh.
The deep fried ones.
Speaker 2 (02:47):
Ok, I love it Right, wasn't that what you got, that
one day, yeah, yeah, that, no, Ithink I think so.
Yeah, don't you have to likeright, I mean swallow that.
Yeah, you have to swallow mostof the food you eat.
Speaker 1 (02:51):
Tammy, that's okay, swallow it whole.
Is that oysters?
Speaker 2 (02:57):
yeah, typically you don't chew them, right, you
don't chew them, you just kindof let them go, let them have
their way with you.
Speaker 1 (03:02):
I need to wrap my head around that.
Speaker 2 (03:05):
Yeah, I get it.
Speaker 1 (03:05):
Maybe that'll be an experience you give me and we
video chat?
Speaker 2 (03:11):
Oh boy, yeah, I think maybe oyster eating.
This podcast is devolving intoour wishes and dreams very
quickly, but, yes, all right.
Speaker 1 (03:19):
So I must say that the one big thing that I knew,
could happen but didn't realizehow much I would miss.
It is chugging water.
Speaker 2 (03:29):
Oh so why?
Why is that so important?
Speaker 1 (03:32):
I don't know.
I need to quench my thirst likeright, then yeah.
Well, you've got your big.
Speaker 2 (03:40):
Stanley mug over here , and that thing is probably the
size of your leg.
Actually, it's massive 40ounces.
Speaker 1 (03:44):
Yeah, so I'd leg.
Actually it's massive 40 ounces.
Yeah, and I'd bring iteverywhere.
It is my staple.
Speaker 2 (03:48):
It's your staple.
So tell me a little bit moreabout that, like, why is it your
staple?
Why?
Speaker 1 (03:52):
is it?
Speaker 2 (03:52):
important Yep.
Speaker 1 (03:53):
So I have to, as bariatric patients have to drink
throughout the day sipthroughout the day You're going
to be a sipping queen or kingand because it's harder for us
to yeah get big things of waterin if we went a while without
yeah, um.
So, yeah, it's like my purse.
I love it.
(04:13):
I actually carry my stanleyaround more than my driver's
license.
Speaker 2 (04:16):
That's probably sad no, it's so good because I'm
thinking like me.
You know, I don't really drinkenough water throughout the day.
No, you don't you know I drinkmy coffee.
I'm really addicted.
It's a problem, but okay.
But here's the thing is.
And there are some like sideeffects of going through this
process that are really healthyoverall.
Yes, like actually thinkingabout drinking water throughout
the day, or you?
(04:36):
Know some fluids, whatever, butmaking sure that you're you're
taking care of yourself, yes,keeping hydrated.
So I'm actually really proud ofyou.
Speaker 1 (04:44):
Thanks For having your Stanley and taking it
everywhere.
Not being able to chug, it'stough.
It's tough when you really justwant to chug a bottle of water,
and not so much just becauseyou're like feeling dehydrated,
it's because you literally justwant it all.
Right, you know that feelingyou want it all in you right now
.
Speaker 2 (05:03):
Yeah, it's a hot, hot day You've been working out?
Speaker 1 (05:06):
Yeah, I will say that , yeah, my water intake is much
better now because it issomething on my mind constantly.
Yeah, which isn't a bad thing.
Yeah, it's not debilitating.
Speaker 2 (05:18):
Well, you know and I've heard people say that the
water like just getting thatmuch liquid in you.
You kind of feel like you'refloating.
Sometimes I actually had.
I know I had a friend who had ajaw fracture, so unrelated to
bariatric surgery, but he had togo on a liquid diet for a
couple months because his jawwas wired shut.
And I remember him telling meat some point that like he just
felt like he was floating, likeit was just tough because you go
(05:41):
from not really thinking aboutyour 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 (05:51):
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 howeverlong.
Luckily our program pre-op is aliver shrinking diet with food.
With food, with like solid foodnot just like, but for one week
(06:13):
post-op it's just liquids.
Speaker 2 (06:15):
It's just liquids and like just liquids can kind of
suck.
Speaker 1 (06:18):
That is a mental.
Speaker 2 (06:19):
Yeah.
Speaker 1 (06:20):
F-bomb.
Speaker 2 (06:20):
It is because, okay, first of all, we're telling
people like not to drink sugarythings or sweet things, we're
telling people to cut back onthose things, but then guess
what?
Pretty much all liquids aresweet.
Speaker 1 (06:31):
Yes, yes, oh yeah, that first week I was sick of
sweets, right, and I am a sweetfanatic.
Yeah, I did not want to sweetand so when you told me I could
eat a scrambled egg.
Speaker 2 (06:50):
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 likein.
Okay, so in American culture wethink of sweet or like liquid
as right.
There's not that many liquidsthat are sweet.
In other cultures there's a lotmore like broths.
You're so right, Right, sothere's.
I mean I think there isdefinitely something to be done
about making the situationbetter, yeah.
Speaker 1 (07:10):
Yeah.
Speaker 2 (07:11):
For our people.
Speaker 1 (07:12):
I never ate egg drop soup.
Oh yeah, I did then, right.
Oh, actually I needed salt.
Speaker 2 (07:18):
One of our, yeah, one of the one of the folks that
had bypass earlier this yearafterward, but she got.
She's a very creative person, avery ingenious person.
Uh, she actually went to herfavorite restaurant and asked
for them to drain the soup, yeahcontents, basically to make it
a liquid, like take all thesolids out and just have the
base.
And so she had.
I think it was french onionsoup.
(07:39):
I think that first week, whichI thought that was pretty
brilliant, it's a lot of salt,whatever.
Sure A restaurant's going toprobably have some food that you
know, yes, yes, whatever, butat the same time she got her
liquids in and she actually hada good time doing it.
Yeah, so there's ways, there'sways, there's ways.
Yeah, but you're right, it'snot easy.
No, it takes a lot of planning.
Speaker 1 (07:59):
Yeah, and let's talk about what happens when you
don't get your liquids in.
Oh boy so, but even so, not somuch the feeling of being
dehydrated, or whatnot Sure butwhat happens when you don't
drink enough water?
You don't poop.
Speaker 2 (08:11):
That's true.
Yeah, I understood the browncode was coming up.
Very good, todd Brown, toddBrown.
So that's a good point.
So, like you know, to have BMsyou have to have stuff in the
tank bowel movements right bowelmovement.
Speaker 1 (08:24):
I'm just making sure everybody's on the same page.
That's fair.
Speaker 2 (08:26):
That's fair so if you've got it, yeah, to have a
bowel movement, you've got tohave stuff there, right?
Uh-huh to have stuff in themachine in order to push it
right out yeah so if you're notdrinking enough water, you're
setting yourself up for somemiserable situations, including
not being able to poop right,yes, and that will lead to you
needing their medications oreven feeling so miserable that
(08:50):
you come into the hospital?
Yeah, it's pretty bad soliterally being full of crap.
Wow.
Speaker 1 (08:55):
Dad joke.
Speaker 2 (08:57):
Yeah, sorry, that was pretty bad, but anyway.
So, yeah, so if you want to getrid of that stuff, you got to
put stuff in the tank.
Speaker 1 (09:05):
That is our first go-to.
When people say like I'm notpooping regularly.
It's like are you drinkingenough?
Speaker 2 (09:12):
Are you drinking enough?
Speaker 1 (09:13):
Yeah, but then that brings up the topic of hey, did
you know pooping every day isnormal, right, I didn't.
No, I'm serious, I didn't knowthat was a thing before surgery
that's a thing.
No, I would poop maybe once ortwice a week.
Wow, I'm dead serious.
So, wow, we changed your life,tammy, a hundred percent.
Speaker 2 (09:29):
We changed your BMS, which okay, I laugh about this,
but it's actually if you havelike regular bowel movements, if
your gut's working well.
You're going to feel better.
You feel better.
You're going to feel better, Ifeel better.
You feel so much better.
It's a big one.
It's a big one.
So really, the constipationthing definitely can be worse
after surgeries, but, but, but,but there's so many things you
(09:50):
can do about it.
Speaker 1 (09:51):
Yeah, Right, yeah.
And so there's times where Ineed to take a Miralax or Right
Collase.
Yeah, yeah, yeah, so there's somany.
Speaker 2 (09:59):
Oh, I really want to touch on because there's a lot
of confusion about, likelaxatives and stool softeners.
So we're going to detour realfast and go there and go there
just for a second.
So stool softeners make thestool soft.
Speaker 1 (10:11):
Okay, I know that sounds crazy for me to break it
down like that, takes the waterand brings it into your stool.
Speaker 2 (10:16):
Yes, it makes your stool softer by absorbing water
and it doesn't really help pushthings forward.
That's what laxatives do right.
So there are some things thatare both stool softeners and
laxatives, so Miralex isactually both.
Speaker 1 (10:31):
I didn't know that.
Thanks for telling me that.
Speaker 2 (10:33):
And like Miralex, laxative.
Hey, hey, terrible, not a JADjoke even, but anyway, yeah,
just that's why it's called.
Speaker 1 (10:41):
Miralex.
Speaker 2 (10:42):
But Colase, Sacot, Docusate, all of those things
are actually stool softenersonly Okay.
So if you are constipated, myfirst go-to is actually a stool
softener after water.
Okay, yeah, Right Because it'sa little less intense than a
laxative Right.
Laxatives can push you overinto diarrhea.
Speaker 1 (10:59):
Right, that's exactly right.
Speaker 2 (11:09):
Nobody wants that right.
That's where I usually start,with the sun on Exactly.
Speaker 1 (11:10):
Exactly.
And then there's a couple ofother like natural ways to think
about it too that aren'tnecessary Extra medication.
So I think fiber.
Speaker 2 (11:13):
Yeah, yeah, I think hot Like hot tea, instead Hot
tea oh yeah, I like that.
Speaker 1 (11:15):
That usually like I like that.
Yeah, okay, I mean by the timeit gets to your you know colon.
It's not like the temperature'snot making a big difference In
my brain it works.
Speaker 2 (11:22):
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 (11:28):
That's probably what it is.
Honestly, it's your placebofluid.
Speaker 2 (11:30):
I like it, it's perfect.
But no, but even things thathave fiber in them, so like
fruits, and fruit, has a lot offiber.
That's what he said dried fruit.
Speaker 1 (11:42):
Don't go overboard.
Speaker 2 (11:43):
Yeah, don't go too crazy, because those things are
sugar bombs.
It should be too many, butdried fruit's a really good one,
and think of fiber the best wayit was ever described to me.
I love this.
I love this.
It's toilet paper from theinside.
It's roughage, basically it'stexture and roughage, and it's
something that one helps to pullwater into your gut.
That's important because wealready talked about that.
(12:03):
That gut has stuff in the tankand then it also helps to sort
of scrub things along as you go.
So fiber really important.
Speaker 1 (12:11):
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 dumpingsyndrome, I thought diarrhea.
Yeah, that's it.
Speaker 2 (12:26):
Yeah, and it's not quite that, so let's okay.
Dumping syndrome sounds as badas it is to be honest with you.
And dumping diarrhea.
That makes sense right, likethat's how we get the term, but
it also is that feeling of likedizziness, lightheadedness,
feeling really hot.
Speaker 1 (12:42):
I thought that was just my new way of my body
telling me I was full nope, itwas not, I was not in the right
thing well, yeah so, yeah, Ididn't realize that me being hot
and flushed and justlightheaded was dumping syndrome
, and I realized that in one ofyour appointments with a
(13:03):
different person, totallyinterrupted, but I'm like the
light bulb went off.
But that's something that needsto be out there is that dumping
syndrome is not just diarrhea.
Speaker 2 (13:14):
That's right, that's right and dumping syndrome.
Let's talk about also how thathappens and why.
So it's basically your bodyresponding in a new way to
having foods that are high infat or sugar.
And why does fat and sugarmatter?
So sugar can trigger insulinrelease in your body and other
hormones that are related to howwe process sugar, and can do
(13:34):
the same thing, because yourbody requires a lot of enzymes,
a lot of like specialized,basically machinery, in order to
process.
And so for a person who's had abariatric surgery, that changes
yes, remember we talked aboutsignaling changing and how
things are processed, changes inyour body after surgery.
This is one of those ways.
Yeah, so when you eat somethingthat's really high in fat or
(13:56):
sugar or both, you can triggerabnormal response from your body
that will cause you to feelreally lousy your body.
That will cause you to feelreally lousy, yeah, and will
trigger dumping syndrome.
So I will say, 100% of peoplehave at least one episode of
this, because you're going tooverdo it or just eat something
that doesn't agree with you asyou go, at least once.
(14:16):
But it's important to listen toyour body.
Yes, it is, yeah, and I thinkthat's one of the things that
it's both a good thing and a badthing terms of yeah, exactly
you.
Speaker 1 (14:25):
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'swhere surgery has helped me keep
weight off.
Speaker 2 (14:37):
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 bariatricsurgery, it's way less for
weight control and much more tonot feel miserable.
Speaker 1 (14:50):
Yes, dr Maria Ilyakova, over here one time at
her house around Halloween, saysTimmy, eat the Halloween candy.
And I'm like Maria, you're mybariatric surgeon, you're not
supposed to have me eat your,but no that.
What another thing I love aboutyou is you are this is a
lifestyle.
Right, you can have the pieceof candy, because if you don't
(15:12):
eat the piece of candy, you'regonna 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 (15:20):
That is not something that we like.
I don't think it's reallysomething we can expect of
ourselves or of anyone perfectlyall the time.
Speaker 1 (15:28):
I think that's a topic we need to cover is
because alcoholics or drugaddicts, they can take that out,
that addiction out of theirlives.
Speaker 2 (15:37):
Oh my goodness, we actually were having a really
good conversation a couple ofdays ago about appetite, like in
our hallway, because we alwaystalk about this stuff.
Speaker 1 (15:42):
We super obsessed in the hallway.
Speaker 2 (15:44):
Yes, in the hallway, that's all right, but appetite
is so much more than likeappetite just for food.
We have appetite for feelinggood or certain kinds of
experiences or working out oryou know, like, yeah, that
endorphin rush or that feelingbeing satisfied can come from so
many different things and and.
(16:04):
For some people it's drugs, forsome people it's alcohol, for
some people it's food, for somepeople it's whatever
relationship.
It's a million different things.
So there is a transference ofhow you feed that appetite after
surgery.
Right, if it's not food anymore, and not certain kinds of food
anymore, it absolutely canbecome other things.
Yeah.
Speaker 1 (16:24):
And those.
Speaker 2 (16:25):
so, knowing that ahead of time, I think that's
another one that comes up forpeople I wish I would have known
.
Speaker 1 (16:30):
Yeah, transfer addiction is real, yeah, and
even our mental health personthat we refer our patients to
really digs into you know whatyour history of alcohol and
drugs and even your parents'history.
And her suggestion to me was Iwould not even touch alcohol
after surgery because of yourRisk factors maybe.
Speaker 2 (16:54):
Yes, yeah, yeah.
Speaker 1 (16:56):
But I told her.
I said you know, alcohol hasnever been a thing for me.
Sure, actually, wheneveranybody drank around me, it made
me feel uncomfortable.
Speaker 2 (17:07):
So, I know alcohol would Wouldn't have been your
thing, but shopping is yeah,well also.
I mean like shopping, let'stalk about that real quick,
because people change body shapeand sizes sometimes really
drastically and really fastafter surgery.
Yes, right, so is there.
Did that kind of meet yourexpectations in terms of
partnering with the shopping andthe how, where and things like
(17:29):
that?
Speaker 1 (17:30):
I don't shop for me, I hate that, ok, you need to
take me shopping.
I don't know if I'd address mybody.
You need to take me shopping.
I don't know if I'd address mybody.
I am still boring, as could be.
I have gone outside my comfortzone a little bit and things
like just joggers.
Well, those look good on you.
I don't know I'm like these aremy normal scrubs, but now I got
like jogger ones that are likeskinny.
(17:50):
That's outside my comfort zone.
I feel like I need someone totell me how to dress.
Speaker 2 (17:56):
We should have a stylist on it, Right?
I think yeah.
Speaker 1 (17:59):
But so shopping for me is my kids?
Speaker 2 (18:04):
Yeah, and just the rush of spending money, yeah,
but you gotta get your kickssome way right and like there's
gonna be some way, yeah, and itcan be healthy.
It can be unhealthy, but that'ssomething to think about ahead
of time.
Speaker 1 (18:17):
A hundred percent, yes, figuring out what you might
transfer your addiction to yeah, and it's honestly.
Speaker 2 (18:24):
It's also possible for everything to be unhealthy,
like anything can be healthy oranything can be unhealthy.
I will say, like a drugaddiction is never healthy.
So that's maybe one thing thatcan't be healthy, right.
But you know, working out canbecome an addiction, it can
become unhealthy or eating wellout can become an addiction.
Speaker 1 (18:38):
it can become unhealthy or eating.
Speaker 2 (18:39):
Well sex, sex can become an addiction.
Yeah, everything can become anaddiction.
Yeah, so it you know, if itstarts to interfere with your
daily life exactly like thatright.
So, um, realizing that that's arisk for everyone and maybe
trying to game plan that aheadand think about what you like.
Speaker 1 (18:55):
We had a patient who started knitting or crocheting.
Yeah, right, and so she's likeinstead of eating that Twinkie I
made.
She makes a lot of hats for theNICU babies because we live in
a big university town.
Will that last with her forever?
I'd be curious to see.
Speaker 2 (19:13):
Okay.
One other big thing that comesup is relationships changing
afterward.
Do you think that's somethingthat you were fully prepared for
, that you really understood howthat would work?
Speaker 1 (19:21):
Was I prepared for it ?
Did I research it?
Did I think that I could battleit?
Yes, because the divorce ratein the bariatric community is
big.
I did not want that.
Bariatric community is big.
Yeah, I did not want that andunfortunately, I planned for it.
(19:42):
Did it work?
No, how you planned, no yeahright?
No, that's the name of the gameBecause, at the end of the day,
even if someone says they aresupportive of you 100%, that
they don't look at surgery asthe easy way out or any
something like that, things justchange Things change, things
change.
Speaker 2 (20:03):
I think that's that's overall maybe the toughest
thing.
Speaker 1 (20:07):
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 myfriends have changed, because my
friends were looking back likethere was a lot of negativity.
I will be honest, like I was100 percent a negative person on
myself, on the world, Like oh,no I think I was very judgmental
(20:32):
.
I was kind of a mean girl, yeah, like you said this before I
have.
Yeah, especially in high school.
Why?
Speaker 2 (20:37):
Because I was insecure I want someone else to
be the problem I don't want tobe the problem.
It's like projecting,projecting on other people.
Speaker 1 (20:44):
Oh, 100, yep.
And so I think now that, um, Ifeel like I'm more positive than
everybody around me likesometimes some of our co-workers
complain about something orsomeone and I'm like hold up up.
Are they having a bad day?
Yeah, Did they do that onpurpose?
Speaker 2 (21:02):
Like look at the positive stuff.
Speaker 1 (21:04):
So now, looking at some of my friendships, there's
just too much negativity.
Speaker 2 (21:11):
Not enough Right, you're dealing with that, yeah,
and being open to things, or youknow, it's really hard to be
vulnerable and I think whenthings change or when other
people in our lives change, itcan be a really big threat.
Yeah, right, because it's likeoh, I have this relationship
with someone, I understand whothey are, how they act, how my
(21:32):
relationship with them is.
Speaker 1 (21:43):
And if they have a big change in their life, that
can impact your relationshipwith them and it can right.
I hate that like people saythat I've changed and it's like,
yeah, I have changed, I'vechanged for good, I'm
prioritizing myself, I have duginto my work because I'm
passionate about it, because Iwant to change someone else's
life right, and I think, likenow, that I don't have the time
for certain people and things.
Speaker 2 (21:57):
Yeah, Like sure, I'll take the blame for that.
Speaker 1 (22:00):
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 likemy life is just happier now
because I'm surrounding myselfwith more positive people, and
so that's Sure, that's something.
Speaker 2 (22:17):
Do you still feel a loss, though, for the people
that maybe?
Speaker 1 (22:21):
Every day, yeah, every day the ride or die.
Speaker 2 (22:24):
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 (22:35):
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 youand, even though it was
fantastic, I could have criedbecause it was so great.
Your mother is so great.
Speaker 2 (22:51):
We loved having you guys over.
It was amazing.
Speaker 1 (22:54):
It's not family, it's not the same.
Speaker 2 (22:55):
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 (22:58):
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'syour ride or die.
Speaker 2 (23:08):
It's your mother, that's true, and that's the
thing is the ride or die thingis tough because sometimes when
we're the most invested inpeople is when we also get the
most hurt.
Yeah Right, and especially whenpeople are undergoing changes
we don't necessarily understand.
Speaker 1 (23:23):
Yeah.
Speaker 2 (23:23):
Or we are worried for them or something like it can
be.
It can really be tough on yourrelationship.
Yeah, that's something thatcomes.
Speaker 1 (23:31):
Yeah, and so outside friendships, my marriage my
husband said that he doesn'tthink surgery changed me in any
like um big way.
Yeah but, he's like man, I wasnot ready for you to have as
much energy.
And he's like you always usedto be the type of like no, we're
not going anywhere because youdon't have anything to wear oh
yeah, that was me saying yeah,yeah and now I'm just like
(23:53):
sweatpants, sweatshirt, we'regoing to dinner and he's like I
wasn't prepared for all theenergy that you have.
But, then I have a lot of drivein me.
Now I have a lot of I want.
I do not want to be stuck inthe same place, same whatever,
and that has kind of torn usapart a little bit too.
(24:15):
Because I have so much drive,I'm willing to move out of our
small little town to just dobigger and better.
Um, but he's content, yeah, socontent, 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 beenhelping a lot and therapy has
been helping a lot.
So that makes relationshipchanges, whether you, yeah,
(24:38):
whether you're the ride or die,yeah, it can change.
It can change.
It sucks.
Speaker 2 (24:43):
But it can change.
Change and thanks, yeah,absolutely.
Well, there are other thingsthat we had talked about through
all of this, which was stuffthat you were missing, like
stuff that you oh yeah.
What I was missing when I wasobese insecure and yeah yeah,
like what kinds of things do youmean by that?
(25:04):
Like what do you mean you weremissing, like FOMO, like what?
Speaker 1 (25:08):
yeah, yeah, yo, yo I was missing.
I was missing out on havingnormal relationships and like
doing things and feeling normal.
What I mean by that is me andyou could go to a big conference
one year ago.
I would have felt sometimes Ido still feel uncomfortable, but
(25:29):
that's not because of my weightanymore.
It's because I'm hanging outwith a bunch of surgeons that
are way smarter than me.
Oh please.
Like, that's not true, sothat's where I feel like I don't
belong sometimes.
But now.
I walk into a room and I am justlike everybody else.
That's right In my mind, that'sright you know.
And I am right before I waslooking around being like am I
the biggest person in this room?
(25:50):
And honestly, yeah, people whoare obese get treated
differently, and that's a wholenother topic that.
I am going to discuss because Ihave experienced that.
But like going to an event andjust enjoying the people and not
worrying about if you're thebiggest person in the room, if
the person you're talking to islike wow, she is really fat,
(26:13):
like I see these are things inmy head.
Speaker 2 (26:15):
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, afterpeople have had surgery, I'm
like do I comment on how peoplelook?
Speaker 1 (26:26):
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 feeltroubled about this sometimes I
think, because you are, you areaware of that, I think you come
off correct yeah, because I I dohear you getting your patients
(26:46):
from the waiting room, yes,saying like, yes, you look great
, but you also add on to thatlike your smile is right and so,
because you're aware of it, Ithink you will always come off,
as I'm not just commenting onyour weight, I'm commenting on
your overall that is notsomething, that it is very real.
Speaker 2 (27:04):
Yeah, and I think that feeling that way it's just
awful and being made to feelthat way is awful, yeah, and I
(27:24):
wish I could just wave a magicwand and people didn't feel
awful and so I wish I would haveknown that I was missing out on
those things um sooner, becauseI would have went through with
this sooner.
I mean, I was years and yearsthat I was contemplating doing
this.
So just having less anxiety ofbeing in social situations and
not being afraid of, I mean Istill am afraid of like, am I
(27:50):
wearing the right thing?
But I'm not as much anymore,because, you know, the funny
thing is, like, through all ofthis, I feel like it's almost
kind of like when you become anadult and you're like when
you're a kid.
You're like, oh, all the adultsdo every and there's going to
be a guidebook and it's allgoing to be really
straightforward, and likeeveryone's going to tell me how
to do things.
And you become an adult andyou're like, oh, holy bonkers,
me being on the other side ofwalking people, like along the
(28:12):
path with people, but not beinga patient myself.
Yeah, it is.
It's really interesting, likewhat kind of things really
matter to people as they'rechanging and to help guide
people through change.
Yeah, when you can't predictnecessarily, like how that's
going to change them right, it'sreally.
I mean, it's really eye-opening, it is and it's really fun, but
(28:36):
also challenging, challenging,very challenging.
Speaker 1 (28:39):
Yeah, have any of your patients expressed to you
the why did I do this?
Speaker 2 (28:45):
Yeah.
Reaction yes, oh yeah, yes, ohmy goodness.
So I?
Oh my goodness, I didn't knowthat was a thing, though, but oh
yeah.
Speaker 1 (28:51):
Like pre-op.
I'm like why would anybody belike, why did I do this?
Speaker 2 (28:56):
Oh, no, no, oh no.
Speaker 1 (28:57):
Afterwards you're like why did?
I do this when you are tryingto get that ounce of liquid in,
you're like what did I just do?
Speaker 2 (29:05):
Put it back, Take it all back.
Speaker 1 (29:07):
I literally had a patient the day of surgery like
after surgery, called me to herroom and she said take it all
back.
Speaker 2 (29:19):
She literally said those words and I was like I
can't Okay, and her post-opstate, post-op state, post-op
state.
Speaker 1 (29:22):
next day she felt a lot better, and then a week
later she's like I'd never takeit back.
Speaker 2 (29:25):
So, for the most part , actually I think 100% of the
time.
Yo, it's super normal.
So that first night aftersurgery and, honestly, the first
week can be really rough, andsometimes the first few weeks
can be really rough, orsometimes you're going to have a
few times that are really rough, that you're in yeah whatever
it is, but no, that's supernormal super.
Speaker 1 (29:42):
Okay, the why did I do this is super normal, but
something that I did not realizewas a thing um.
One other thing is um.
I don't finish my plate anymore, heck, 90% of the time.
Speaker 2 (29:56):
I don't even.
You're not going to finish yourplate, Klum.
What is that?
I almost want to.
I'm sorry, no, I'm just kiddingit has a joke.
Obviously Because the mentalityof that is so big.
Speaker 1 (30:10):
Yeah, parents or grandparents, you eat what's on
your plate.
Speaker 2 (30:15):
I come from an immigrant family and I remember
being made to sit at the tableuntil I finished everything.
I was eating and there would bestuff on my plate that I
couldn't stomach you know or?
Like just really didn't want toeat.
So it is so common, yeah, socommon.
And, by the way, in my culturealso, weight is a massive like
all the girls are supposed to beskinny, all the guys are
(30:46):
supposed to be like bodybuilders.
Speaker 1 (30:48):
That's what the culture is, and that's not
possible if everyone's also inthe finish your plate club,
right.
So we came to an understandingof OK, we'll just give them
little smaller portions.
Yeah, that way my husband canstill have the mentality of they
did finish what's on theirplate.
Speaker 2 (31:06):
And then if you get extra, that's great, but
honestly it gives me anxiety.
That's tough and the otherthing that that does that
especially at restaurants I'mpaying.
Well, so a restaurant that'sthe tough part is like you go
out and portion sizes didn'tchange just because you had
surgery.
No, it didn't.
Speaker 1 (31:19):
The whole world didn't change just because you
went through this.
An appetizer is too much.
Speaker 2 (31:22):
Right, and so when you're out there and the
pressure is to not just finishyour plate but like everything
you order is too much and hasstuff that you may or may not be
able to eat very well, likethat's, that's really a lot of
pressure, yeah no-transcript.
Speaker 1 (32:05):
Struggle with not ordering a drink because they're
going to be asked why are you.
Speaker 2 (32:10):
You know, and they don't want to express that
they've had bariatric surgeryright, because, like, the way
that you eat is going to bedifferently, drink and eat is
going to be different.
Yeah, after surgery, no matterwhat.
Right, and so are you notdevouring it why are you putting
?
Speaker 1 (32:21):
your force down every time.
Why yeah?
Speaker 2 (32:24):
and awkwardly chewing an amount and like exactly, and
like where we live, like goingout and eating with people or
drinking with people.
That's like love, right?
Yes, that's how relationshipsare built.
That's how you keep yourrelationships and that's how
relationships change after.
Speaker 1 (32:37):
That's how you keep your relationships and that's
how relationships change aftersurgery, because going out to
eat sucks yeah.
Speaker 2 (32:41):
And even like, but even feeding yourself.
That's the other thing too,right.
If you are just trying to gothrough a drive-thru or get
something real fast, it's muchharder, I think, to live in like
, especially like the US, andtake care of yourself on the go
If you're traveling, if you're abusy professional you've got a
(33:03):
big family like any family,really like it's tough, it's
tough.
There's ways around that andwe'll definitely talk about that
as well.
Speaker 1 (33:08):
Oh yeah, let's go, let's go.
You gave me bariatric surgeryknowing that there was a chance
that you were going to cut meopen again and take my
gallbladder.
Speaker 2 (33:16):
I know, I know that's true.
Speaker 1 (33:19):
This is something I did not find in any of my
research of that gallbladder.
Gallbladder issues yeah, aftersurgery.
Speaker 2 (33:27):
Okay, so let me give you a little history lesson,
actually as we go through this.
So the gallbladder istechnically part of the GI
system.
Think of it like a storage tank, a water storage tank, but it's
a bile storage tank, so bilemade by the liver, and it goes
through these little plumbingtubes to get to your gallbladder
and to get to your guts inorder to help you digest cheesy,
(33:48):
fatty, greasy foods, right?
So important, important.
You don't have to have agallbladder, but a gallbladder's
there in your body naturally toserve as a storage tank.
That storage tank getsactivated when you eat those
foods and sometimes thegallbladder can go bad.
Speaker 1 (34:03):
Yes, it can, and Tammy experienced this.
I'd rather have a baby.
Speaker 2 (34:08):
Right, and how does it go bad?
Well, so a couple of ways, morethan a couple of ways, but one
of the main ways.
After bariatric surgery oranything, not just surgery but
any way that people lose weight,especially very quickly, can
cause your gallbladder functionto slow down.
If that happens, you can startto form stones.
(34:30):
You can start to have symptomsfrom those stones and develop
like an infection orinflammation of your gallbladder
and other problems.
Guess what?
That happens to about 10% ofpatients after bariatric surgery
, maybe more.
Yeah, didn't know that and thathappened to Tammy about a year
out.
Speaker 1 (34:50):
So yeah, and also didn't know, that back back, not
even that long ago, people orsurgeons were taking out
gallbladders right when they didthe surgery or even one of our
other surgeons said that at hispractice they would schedule the
surgery and then six months outthey would just automatically
schedule the gallbladder.
Speaker 2 (35:09):
But then they realized that and I wouldn't say
that common practice anymore.
You're absolutely right, itused to be more common and
there's a couple of reasons,because I used to have an
attending.
So attending is like a personwho trained me, who's a really
smart guy, and he said onepatient, 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 likemultiple surgeries together,
(35:33):
you're ultimately increasingrisk and time.
Speaker 1 (35:35):
And gallbladders.
Speaker 2 (35:36):
While it's really common to take gallbladders out,
gallbladder surgery is one ofthe most common surgeries we do.
They still come with their ownrisk and, if not technically,
versus the general population,not that many more people who
have bariatric surgery havegallbladder problems.
Speaker 1 (35:52):
They've found that.
Speaker 2 (35:53):
Exactly so.
Risk versus benefit is for themost part.
We're going to wait and see ifsomebody develops a gallbladder
problem and then if they do,take the gallbladder, and what
is the?
Speaker 1 (36:02):
symptoms.
Speaker 2 (36:03):
Yeah, because.
Speaker 1 (36:05):
I told you about, after I eat, having some like
hot flashes and all that You'relike is your gallbladder, I'm
like.
Speaker 2 (36:18):
But actually gallbladder issues are.
They actually do overlap a lotwith dumping.
Okay, yeah, because now thatI'm thinking about this.
Speaker 1 (36:21):
I do not have the yeah, that issue really anymore
after my gallbladder.
Speaker 2 (36:26):
Yeah so it might have been gallbladder?
Speaker 1 (36:27):
yeah, potentially, but it may, it may also have so
talk to your surgeon, because Ididn't tell her about these
issues until after my firstgallbladders right and we
actually crazy enough we we hadTammy's get well for surgery and
then her gallbladder got wayworse over a weekend before that
surgery so this is definitelysomething that can progress from
bad to worse quickly, sodefinitely something to get
(36:48):
addressed.
Speaker 2 (36:48):
But yeah, really quick gallbladder symptoms.
If you're having problems witheating and that pain after you
eat nausea, vomiting, bloatingand the pain actually isn't just
in the upper right part of yourbelly where your gallbladder is
located, it can wrap around,yes, left side yes, to your back
.
Yes, it can go to your chest andyour shoulders feel like acid
reflux.
Absolutely, you can get acidreflux symptoms from this.
(37:11):
You can get chest pain fromthis um, and you can even have
like diarrhea.
And then, if your gallbladderis really sick, like infected or
infl, and you can even havelike diarrhea.
And then, if your gallbladderis really sick, like infected or
inflamed, you can get chilled,night sweats, fever, all those
infection signs that people gettoo.
Have it on your radar Exactly.
Speaker 1 (37:26):
Talk to your surgeon Talk to your surgeon.
Speaker 2 (37:30):
Get that taken care of.
Speaker 1 (37:32):
All right.
The last thing yes, I craveplastic surgery now.
I thought it would never be athing, never, I've never had it.
You want more surgery?
Speaker 2 (37:41):
huh no no, there is surgery addiction, by the way.
Yes, there is, yeah, and that I.
Speaker 1 (37:46):
I watch botched often , yeah, and I see that people do
get addicted plastic surgeryyeah, but no, just the, just the
thought of my breasts that theyare pitiful.
Speaker 2 (37:58):
They are changed.
Speaker 1 (37:59):
They are changed.
Speaker 2 (38:00):
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 (38:05):
Yep, we're our own worst critics, but I think
that's one of my biggestinsecurities.
And plastic surgery couldchange it.
Speaker 2 (38:12):
Yeah, well, okay, you know what A lot of people
pretty much everybody who goesthrough a lot of weight change,
especially through surgery oneof the downsides to that is your
skin doesn't really catch up toit.
So a lot of people will askabout, like, can I tone, can I
do certain exercises?
It's pretty limited.
Yes, some exercise can help andyes, you can definitely get
(38:33):
some toning effect from some ofthe physical things that you do.
But ultimately, if there's alot of skin or there's a lot of
change that you want, yes, andwe can't predict it,
unfortunately.
Speaker 1 (38:43):
No I wish I had like an AI tool to show people what
that would look like.
Speaker 2 (38:46):
I never, ever thought I would have wanted plastic
surgery, but it is a thing thatI just didn't know Right, and
there's a couple of things thatare really important with that,
because typically, plasticsurgery is covered by insurance.
It can be not under most plans,yeah, so especially if you're
developing like rashes or skinproblems or lipidema, which is
like fatty deposits in your armsor legs that are bumpy kind of
(39:10):
things, or I mean there's just anumber of things If you're
actually having symptoms morethan just like oh, this looks
different, having symptoms morethan just like oh, this looks
different, I would very stronglyrecommend getting that
documented by your health careproviders so that you can
support getting insurancecoverage for those reasons.
Speaker 1 (39:26):
Those are the things I wish I would have known.
That's a pretty good list.
Speaker 2 (39:31):
I like this a lot, but this is the nitty gritty
stuff that I will say.
Like as a surgeon, I don't havea very good perspective on
Right Except, except when peopletell me that they've actually
gone through these things andthey wish they would, and
sometimes you can't get that outof a 15, 30 minute appointment
with a patient, exactly.
So I'm really grateful whenpeople share these things, so
(39:53):
please do.
Yes, I'd love to hear fromanyone listening what your
experience of this has been.
What are the things you wishyou would have known going
through this?
I promise this makes us better.
Yes, on the surgeon side, onthe provider side too, to know
these things.
Yeah, so don't be shy.
Speaker 1 (40:11):
And so other people know too.
So make sure you're followingus for our next episode and
thank you so much for listening.
Thank you.
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