Too chubby for surgery

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Johnny Stevens

Johnny Stevens

Thanks, in deeper reflection of it today, I think he was way out of line, the appointment could have been used in a much better way. I would have appreciated him saying, here's where we are, without a weight loss and with the weight loss. He gave me lots of mixed messages.

I tend to move forward and it feels like pretty much without his help.
 
Nancy

Nancy

I moved up my PCP appointment so we can do just that, go over the tests the cardio guy didn't, he has been pretty good with working with me.
 
rachel-howard

rachel-howard

Some very good points, I appreciate so much hearing and learning this type of information because I have to make myself speak up sometimes, the used to doing for others in the family first condition. If it would be one of my kids, or my husband I wouldn't hestitate at all, so I have to think what this means to my family.
 
Lots of good stuff here...


For what it's worth:

I'd pay some close attention to the salt/sodium in your diet. nancy said before that water weight is often a problem for people who have heart conditions. I don't know what your situation is, but I wouldn't be surprised if at least some of the weight you carry is nothing more than excess fluids.

Finding another, BETTER cardiologist is definitely worth looking into. I'm suprized that your current one didn't offer to set you up with a program to lose that weight he said you needed to lose. I'm only about 20 pounds over my "BMI" and my cardiologist has twice offered to help me find a nutritionist or a dietitian who would be covered by my insurance...

On a side note, we discussed it and I'm doing OK on my own for the moment, though I'm still leaving the option open.

Some simple suggestions beyond the obvious stuff:

WeightWatchers and other freezer meals for dieting/low carb are nice, but you have to be selective about the sodium content if you have heart issues. Some of those things can have over half the US RDA for sodium. That, two slices of white toast, an egg, and two sausage links and maybe a ham salad sandwich (again on white) for lunch puts you over the limit before you've hit dinner.

A lot of people tout a "water" diet where you gulp down bottled water all day long instead of reaching for snacks. Well that might work for heart healthy folks, but probably not for us at all. Certainly not for me! I like my carbonated drinks, I'm kind of addicted. I also started drinking flavored seltzer water. The brand I've found is unsweetened, just carbonated water and some lemon (or raspberry, lime, plain, whatever) extract for flavor. I like it a lot and it's no carb, no sodium. Basically no nutrition really ( :D ) but it's probably a lot helathier for me than drinking Dr. Pepper all day...

Fruits and veggies are great for snacks and even meals. There's nothing that says you can't pick out on a veggie tray as long as you have a sensible dip if you like such things. Peter Pan now has a low sodium peanutbutter that's great on celery. It's the only time I can get my 4 y/o son to eat celery....


The other suggestion I'd make if you're really serious about losing weight have pretty much exhausted all other forms of diets and such would be jumping into the stomach reduction fad...

Mind you, I REALLY don't know what they'd say about working on someone with known heart issues, however I DO know that having an essentially life threatening condition that would be alleviated (at least in part) by a drastic reduction in weight is one of the qualifying marks such surgeons look for.

My sister-in-law had it done at the end of June this year when school let out for the summer (she's a teacher) and she's lost (over, I think) 100 pounds by now. She was teetering on the edge of diabetes and she and my brother have wanted to start having children, something that would be very difficult for her at the weight she had before surgery. She has to be picky for a while about what she eats and she does a fair amount of exercise, but as she recovers, her diet can include anything. The trick the the surgery is that by reducing the physical size of the stomach, one gets fuller much faster. Where she may have used to have two helpings of spaghetti at a meal, now she usually leaves a little of one helping behind, and she's FULL and satisfied. She's doing great.

It may be worth asking aobut if all other options have failed.


Ask around about cardiologists and talk to a surgeon or two. You should be getting help to get better, not being told you're going to die because you're too fat.
 
Harpoon

Harpoon

Thanks for the information, a very good point about the ready made meals, I will be taking that into consideration as well. Not sure I want to add another possible operation on to the list, I am glad it has worked out though for your sister in law.
I do have to get more veggies in the house, the raw ones are tasty, I did go fruit shopping today, although I know some can be pretty sweet too. I did look at drink options today, I am a long time Pepsi addict. Only vice that has been consistent in my life, that I can account for.
So far tonight I have not broken the eating after 7 rule and soon I will be pulling up the sheets so I will be happy with this one day at a time!
 
It's not for everyone, but I have been following a low carb eating plan for about 4 years now. I'm not as strict as I used to be and it is more a modified low-carb plan.

Here are just a few thoughts based on what I follow. If you find you eat a lot of pasta, rice, potatoes and/or bread, try cutting those things out and see what happens. Replace those things with vegetables to fill you up. If you get hungry in between meals, have some almonds or walnuts on hand to snack on, or eat a few cubes of cheese. If you like juice, try eating the fruit instead of drinking the juice. You get about the same amount of nutrition without all the concentrated carbohydrates.

If you aren't retaining water because of your heart issues or have pulmonary hypertension, make sure you drink 8 glasses of water a day. Most people are in a constant state of dehydration because we just don't take in enough fluids. A lot of back and joint pain is the result of dehydration. Once I started drinking adaquate amounts of water, my horrible morning back ache disappeared.

And as I said before - don't try to be too successful until after the holidays. ;)

And just because I'm giving some suggestions doesn't mean I've changed my mind on what the doctor said to you. He remains a class A donkey's rear end. :)
 
Just a bit concerned.

Just a bit concerned.

Karlynn, that comment about water is interesting. I did not realize that back and joint pain could be so exascerbated by dehydration. I never drink enough -- going to be more attentive to that.

Um. Breakingwaves, I'm not that experienced here, but I do know that each time my cardio listens deeply to my heartbeat, she is listening to make sure that the aortic valve is closing. There is a definite click, she says. She needs to hear that. If yours is NOT closing, then I think it is possibly time to consult a surgeon. If it were me, and I am somewhat in a similar condition here, I would definitely jump past the cardio and consult with a surgeon. Remember, the surgeons are knife happy and like to get on with things sooner. Even my cardio says that. When I asked her when she would send me to one, she said when I was ready. When the surgeon gets the nod from the cardiologist, the surgeon figures the cardio has deemed it time to operate. I think the pecking order is confusing and exasperating. But surgeons are very busy getting more practiced (which we want!!) so their time is very valuable. The fact that the cardio does not DO the surgery, it would seem to me that a surgeon should have a look at you personally and tell you whether he wants you slimmed down or not. Since you are making the appointment with the surgeon, he will not surmise that it is the cardiologists notion that you are ready, but rather that YOU are advocating for your own health and safety and need some answers and information about your condition.

Check with your insurance as to whether or not you can get an opinion from a surgeon. Get copies of all your recent tests, and perhaps fax them over to the surgeon prior to the visit as a courtesy.

Again, I'm just suggesting. I have a difficult time sticking up for myself also, and my cardio is so glib and personable, we chat and the time is gone!! But this is your life and health and you have a right and obligation to your family to push ahead. Many of us understand the denial of family members and the belittling of the condition by outsiders. It's rough. You have to decide for yourself that you want to get through this the best way possible. It's not easy to "put yourself on the front burner" so to speak. I'm a back burner mom and wife. Honest. I really know where you're coming from. But this is one time where you really don't have a choice. You need to do these things for yourself and everybody else will just have to get used to it!!

Well, I've sure said a piece! Guess you opened up a Pandora's box! I'll step down from the box now......... just wishing you a smooth road.

:) Marguerite
 
For all of you who are shy about advocating for yourselves, please know that everyone here has been that way at the beginning. After having stuff happen that seriously impairs your health, you DO become much more assertive.

Don't let the stuff happen first. Advocate for yourself at the next opportunity. The first time is the hardest, after that it becomes much easier. You won't regret it and you will find the best doctors that way.

Any doctor who is intimidated by an intelligent patient is not someone you want to stay with. You also don't want to be subjected to a patronizing attitude.

Go forth and advocate.
 
BW,

Know your enemies: There are several things that make weight loss more difficult for you at this time. You are under stress from personal concerns with the surgery. You are going through the holiday seasons. You may be carrying extra fluids (hopefully, your new diuretic can help some with that). And you are dealing with the extra fatigue that comes from your heart issues. When your body is tired, it can either eat or sleep to gain energy. We all know how much time we get to sleep with three kids, especially around the holidays. These are the things you must try not to let rule you.

Don't let it get you down. You're going to do fine. Once you know what you're fighting, you can focus better.

As far as your valve not closing all the way, I would have to think that the cardiologist is simply referring to aortic regurgitation. It's not surprising with severe stenosis to also have regurgitation persent, as there's usually some pretty good calcification by that time. It is a double burden for your heart, as it has to pump harder to get enough blood out of the ventricle through the stenotic (too small) valve opening, and then some of it leaks back into the heart at the end of the beat, because the valve can't close all the way (regurgitation). That wastes some of the heart's extra effort.

Usually, some of the calcification that is making the valve opening too small eventually starts also blocking the motion of the valve leaflets, keeping them from closing all the way. Mine was so badly calcified before surgery, that two of my leaflets were completely glued together, and the other barely moved. My interventional cardiologist (the one who does the catheterization, a.k.a. angiogram) was 99% convinced that I had a bicuspid valve because of it.

After cleaning my excised valve, the surgeon verified it was a "normal" three-leafer, but was astonished my heart was actually getting any blood through it. So, it can go quite a ways into horrible and still function enough to get by somehow.

My actual valve opening size was measured large enough that some cardiologists wouldn't even have sent me to a surgeon. This is why I caution against that as a solo criterion for surgery.

Best wishes,
 
Breakingwaves:

Good luck with the weight loss!

I am down 41 pounds since the day before my MVR. I lost 23 pounds post-op, regained 8 afterward. Joined Weight Watchers this past June and have lost 25+, for a total of 41 pounds lost since June 23, 2003.
My niece and her husband are lifetime WW members; she's lost 20-25 pounds, he's lost 65 (!!!).
I watch portion sizes like a hawk, fat/fiber/calorie content as well as sodium. I eat a lot of fresh fruit and veggies, no sodas of any kind even diet ones, grilled meat, homemade soups with extra veggies.
I do eat some pasta -- wholewheat pasta is kosher on WW's Core Plan, the plan I follow.
What I've done is change my eating habits, the way I think about food and my activity level.

When I snack, it's fresh fruit, natural applesauce, 94% fatfree popcorn, a skinny latte. I do eat 3 servings of skimmed milk daily (24 oz. of milk, or 4 containers of fat-free yogurt flavored w/ Splenda). Weight loss can cause some bone loss, particularly with women, so make sure you are getting 3 servings of milk (skim best) or milk products (low-fat cheese, yogurt, etc.).

For Thanksgiving, I made a pumpkin pie with evaporated SKIM milk, Egg Beaters, Splenda and the usual spices & canned pumpkin. I used a pie crust, but when I ate my piece, I ate only the pie filling. Tasted great to me. I added an extra egg white to give the filling some lift in the final product.

I bought a Trek 7200 24-speed bike this fall and am using it, along with doing a lot of walking.

My heart rate is great now, as is my BP. Can't wait for my next blood panel to see how my weight loss and increased exercise have improved my cholesterol levels.

Last night I bagged up 8 loads of clothes to give to a shelter for battered women -- some still have price tags on them. It's great to be able to fit into 10s and 12s now, instead of 16W-18W. I decided if I let my "fat" clothes hang around in the closet, it was giving me permission to put weight back on.

Good luck losing weight -- and finding a more sensitive cardio!
 
Marsha, interesting that you should mention the milk products. Recents studies have shown that weight loss is significantly increased and then maintained when dairy products are included in the plan - regardless of which plan you follow. I'm not certain, but I want to say that 4 servings a day was the standard, maybe 3. Taking a calcium suppliment doesn't seem to have the same effect.

I love cottage cheese and have that for breakfast just about every morning when strawberries are in season.
 
Pumpkin pie without the crust

Pumpkin pie without the crust

Catwoman:

I had that same pumpkin pie this Thanksgiving and with fat free cool whip on top, it was delightful. I didn't miss the crust at all.

Weight Watchers is a great plan
 
Karylynn

Karylynn

I have to force myself to drink liquids so I need to re discover the only liquid that my Mom used to have in the house. When we would ask what's to drink she would point to the faucet.
 
Catwoman

Catwoman

That is so cool, it sounds like you have developed a new lifestyle. You have really achieved something special!
 
tobagotwo

tobagotwo

Thanks for the advice, I really needed to hear what I was thinking, one of these days the words will meet my reaction. Its hard to imagine that a few short years ago, I was a spokesperson for a charity of people that couldn't speak for themselves when I am resistent to speak up for myself.

I think about what you have said in the past and it has already helped me a great deal.
 
Marg53

Marg53

You need to do these things for yourself and everybody else will just have to get used to it!!

So True!
 
Hi, BW. I'll join in the chorus by saying Dr. Insensitive was just plain wrong to chide you about your weight the way he did. If you need the surgery -- you need the surgery, plain and simple. I too have had good luck with a modified low-carb diet. I've banished the white bread and rice. I've traded baked potatoes for baked sweet potatoes, a nutritional powerhouse itself, and am really limiting the pasta (once per week or so). The water intake is also very important too, as everyone here has already mentioned.

Best of luck and please let us know what you find out with the new doctor.
 
Too Chubby?

Too Chubby?

When I had my TEE done a month ago, my cardiologist very nicely (I thought, or maybe it was the VERSED affecting my mood!) talked about my weight and that losing 10% of my body weight before I saw him next (in Feb) would be wonderful. I'm fortunate in that for the moment they're not rushing me into surgery, but I'm also looking at my results and timing and wondering if I should just get it over with. But I do know that my weight increases other risks associated with the surgery, such as pulmonary embolism, plus just the added stress to my heart from carrying the extra weight.
What is your diagnosis, BW? I have a good friend who lives in Red Lion, maybe we can get together some time if I go out there to see her. I have aortic stenosis, classified as severe, caused by radiation therapy I received for Hodgkin's disease in 1978-79.
Carolyn
 
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