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I had the Duodenal Switch, which is different than the most common two surgeries being discussed here. I picked it because I had type 2 diabetes, high blood pressure, high cholesterol and triglycerides, sleep apnea, etc... I also picked it because I knew a purely restrictive surgery wouldn't work for me. Portion has never been my issue. Pre-op I was eating about 1000-1200 calories a day, for about 10 years, and did nothing but steadily gain weight. My surgeon said it was obvious I have a metabolic disorder, so I needed a metabolically strong surgery. I also didn't want to risk gaining weight back and the DS has the lowest rate of regain. But as a trade off it can cause more vitamin and protein deficiencies if not managed well and the diet is a bit different than the others post op because of our malabsorption. However, diabetes was my biggest concern and the DS puts about 95% of T2 cases in remission, and most stay that way. Post op my blood sugar dropped to 82 within 24 hours of surgery and my high blood pressure normalized, so they took me off of my diabetes meds and blood pressure meds. I'm 3 months out and my a1c is 4.8 without medication!! My blood pressure continues to be normal without meds. My cholesterol and triglycerides are also normal without medication, which hasn't happened in decades! All this to say---consult with a surgeon who offers ALL the surgeries if you can find one in your area. Talk to them about your reasons for wanting bariatric surgery and consider your options carefully. The sleeve surgery is amazing for a number of people, but it isn't right for everyone. The bypass is a fantastic surgery for certain patients, but again, it isn't for everyone. And the DS is a powerful surgery, but it definitely has a specific patient profile. All are great surgeries, but not all of them will be the best surgery for you. Only you and your surgeon can decide that. And don't be afraid to get a second opinion. I went to two surgeons before deciding on one (though both recommended the same surgery). I needed that extra reassurance I was picking the right surgeon and the right surgery. I'm so glad I did this surgery, I just wish it had been an option available to me when I was younger.❤️

My two word response to anyone who comes at me with anything other than less than 100% support... f**k off. It's not my job to educate you or seek your approval. Get on board, or get out of my way.

Homemade purees should be completely smooth, like yogurt or pudding. No bits, no lumps, no bumps. I was advised to take bites no bigger than my thumbnail and yes, use a baby spoon! Most of us use smaller utensils, at least at the beginning. Even with bites that small, and even though it is pureed, you should chew it just to ensure it is smooth before swallowing. Then set down your spoon/fork and give it time to work its way down. The advice to eat a 1/4 cup is the MAX you should do, NOT the minimum. Most of us could only do a few tablespoons of food to begin with, if that. Don't eat more than your tummy can handle. Give food time to move down your throat and into your stomach before you eat more. Relax, eating should be slow and deliberate. And it should take a lot of time to eat, like 30 minutes or more. Don't drink within 30 minutes of eating. 20 minutes is too soon. Some have to wait a little longer than 30 minutes, it depends on how long you personally need to give digestion to complete and move the food out of your stomach. In the beginning I needed to wait 45 minutes. For many of us, yogurt was considered a puree, it is a heavier texture than a liquid. So if you can do yogurt without thinning it down, you are doing good! It is fine that it was in your full liquid stage, but it is still good to have in pureed stage. Try the above suggestions and see if that helps. It really sounds like you are eating too much too fast. Take the amount of time you think is slow and double it! Take the bite you think is small and half it, at least! Your tummy is very brand new, purees are heavier than shakes, it is normal for them to take longer to make it to your stomach, and longer to digest. ❤️ Good luck!!

Choosing a surgeon and Days 1-3 It's Sunday night and my surgery was Friday morning (1/12/24). My gastric sleeve was 3/24/23. I lost almost half the weight before my Gastric Sleeve surgery. I chose to have my surgery in Tijuana, Mexico because of the cost and I have a friend who lives about 45 minutes away in Mexico and my father lives about 2 hours away. I started my research reading about medical tourism in general to get advice on what to look for and what questions to ask. I started my search with Realself.com and chose surgeons with 4+ stars,10 or more years experience, and who said they were part of the American Board of Plastic Surgeons or the American or International Societies of Aestetic Plastic Surgeons. I read all the reviews I could find, noting all the bad things said, and verified they were actually listed on the board or society sites. One of them wasn't. I made virtual appointments with 3 and chose Dr. Rodolfo Casillo Calderon, who is listed on both the American and International Societies. He originally told me I had to wait until a year after my surgery, but I reached my goal and my weight stabilized in early October so I was able to move the date up. I uploaded a bunch of pictures to myTouchMD and when we did our call he explained in detail what he would do, complete with drawings on my pictures. He explained possible problems and what could be included in my package and that I would have a patient coordinator to walk me through it and answer questions. I had told him I wanted a 360, breast lift with gummy implants, and a BBL (i've always had dents in my butt and got called board butt in high school). He told me he didn't think I had enough fat in the area he was working for a BBL, especially since some of the transferred fat would die, but he would see what he could do. I asked for the best medicine package and told them I didn't need transportation to/from the airport since my dad and friend would provide that). I also told him in the future, I wanted my inner thighs, maybe my arms if I could get a good price at the same time and a face-lift. He told me that was too much to do in one surgery, that the face-lift would be one and the thighs and arms another, and they had to be at least 6 months apart. He sent me a quote for the 360, breast lift with implants and lipo and said it included the mons reduction and lift but not the BBL. The quote included the surgery, labs, cardiology evaluation, compression garments, meds, hospital stay of 1 night, and 6 nights in a recovery home that has 24/7 nursing staff and food. $12,699. I paid a 20% deposit and paid the balance during my pre-op lab appointment. I also filled out paperwork and met my coordinator. When I talked to Dr. Castillo in person, he took the pre-op pictures and told me again that he didn't think I had enough fat for a BBL, but he would see what he could do. I was disappointed, but trusted his judgment. I woke up after surgery in recovery, and they took me to a room and bolstered me well with pillows. I had a catheter, so I didn't have to move. My right toes felt numb and I couldn't feel my left toes, The nurse said it was from the anesthesia and would wear off and it did. I could feel and move my toes again. I had good service ar CER Hospial and spent the evening eating, drinking and watching TV. I asked for a snack and they got me some crackers (the cafeteria was closed and I didn't want jello). The next morning (Saturday) Dr. Castillo came in and talked about my surgery. He put 320cc in my right breast and 240 in my left and explained it would take a while for them to drop. He also told me he did a little fat transfer to my butt and gave me instructions to reduce death of the fat and stressed that there wasn't enough fat for a ful BBL, but he did what he could and it mostly came from my hips. Then his nurse came in and gave me my meds and instructions for aftercare. My patient coordinator from his office also came in and told me I'd get picked up by Casa by Linda's driver at about noon and asked if I have any questions. Shortly before noon they took my catheter and IV out and the nurse helped me sit up and helped put the compression garments on me, then I got dressed. The drive was a bit scary. The driver said it was like driving in New York with people pulling out and changing lanes without enough room. He told me interesting stuff about Tijuana and prohibition, how the margarita came to be made, and about Rita Hayword's history, getting discovered, and changing her name. I was helped out of the car and to my room, which has a queen hospital bed. The head was inclined and my space was pre-padded. I got in bed and they explained the remote and how to call them and asked if I had questions, needed anything, and if I was hungry. They brought me lunch and my friend came with my backpack and snacks. I was able to get out of bed and put my stuff away. My laptop, tablet, and snacks are all in reach. Sitting up is the most painful. Lying down in my nest of pillows is not as painful, but hurts pretty bad. To get up, I put the foot of the bed down, the head up, and roll to the side, then use my arm to push myself up. To get back in bed, I get on the bed on my knees and position my knee at the far side of my nest, then lower myself sideways and roll into the in the nest. My breasts aren't hurting at all. The compression garments has an open crotch, so you don't have to mess with it to go to the bathroom. The staff here respond quickly to requests and bring me my antibiotics and pain meds, and so far the pain is tolerable and I've been able to walk. You walk hunched over and slow. Linda has come in several times to check on me and see if I need anything. She is originally from Canada and is a US citizen, married to a local. This morning, after breakfast, I took a shower. One of the staff helped me with my compression garments (it hooks down both sides) and got the water ready. There is a seat in the shower with the shower head within reach. I hosed myself down and she handed me a washcloth and put soap on it. I didn't have to ask her for help as I was able to bring my legs up to wash them (it wasn'teasy). After I rinced myself off, she put antiseptic on gause and applied it to my incisions. I dried myself and got into bed to wait for the return of my compression garments (they washed the blood out). When she returned with my compression garments, she put gause in my new belly button and over the incisions in the back that had bled, then she helped me hook the garments up, putting a square of gause over my nipples. Nothing else to report. Unlike Friday and Saturday, I slept most of the day.

20+ years later, I never tracked a thing related to food. Good luck, Tek

it really depends on what ur goals are... rapid weight loss? sustained weight loss? maintenance? muscle building? fat loss? carb reduction? fats loading? anyway...i used the following calculator to determine my optimal macros based on a modified keto diet (kinda like Atkins II, sorta). it worked for me until it didn't...the macros i was aiming to maintain was really not sustainable (for me) in the long run. im 5+years post op now and don't look at macros anymore (haven't done so since year 2)...now i just keep an eye on total calories (no matter how they are comprised). i've been able to maintain below goal weight this entire time just on maintaining a caloric limit alone....but thats just me...ymmv. but anyway, here is the calculator: https://www.ruled.me/keto-calculator/ good luck! ❤️

I've been told my eventual goal will be 3 meals per day, 20-25g protein per meal, which is equal to 3-4 oz cooked meat (palm size/deck of cards). After protein, I should prioritize non-starchy vegetables, followed by fruit, followed by starchy veg and grains, which are limited to 1/2 c portion. My program avoids giving specific macros because everyone is different and also I think to get away from dieting mentality. I was told to space meals 4-6 hours apart and avoid snacking (this is for after the early stages when you need to eat more frequently). Basically, when your appetite starts to return, stick with the limits of 20-25g protein and 1/2 c starch/grain, and eat as much non-starchy veg and fruit as you like until you feel satisfied (instead of taking bigger meat and starch portions as we might be tempted to do). Oh, and choose low-fat or non-fat options when available and stay away from added sugar. They're okay with stevia and sucralose but frown on sugar alcohols.

Normal. We lose weight in "stair steps" .... not a downward slide. ( I wish it was just a slide !!! )

I actually did the math and took it to my surgeons office asking exactly how did they expect me to do it!? I further explained I'd have to drink right up to bedtime and sleep was just as important in the healing process, so if I drank just before bed..I'd be getting up several times in the night. I was told they "know right out of surgery there is no way to get in the entire water requirement." They just want you to try. My math (basic because I suck at math): Average "day" (excluding time for activities you can't be actively drinking water i.e. driving, showering, different tasks at work): 12 hours No drinking water 30 mins before and after and during a meal: 90 mins+- 90 x 3= 270/60 = 4.5 hours per day you aren't allowed to drink 12 hrs a day +- - 4.5 can't drink. = Leaves you 7.5 hours to get down 60+-oz each day 7.5 hours to get down 60oz each day @ 2oz. max each "drink" = .12 to get your sip in. In other words not real easy or possible if you also add nauseous! This isn't taking into consideration snacks (which I didn't do and still don't). Needless to say they found me funny. I wasn't going for "funny!" Said they'd never had a patient break it down before. I told them I'm a Histologist who manages a laboratory measuring in microns/millimeters/centimeters etc. everyday what did they expect?.. Perhaps they should have done the math before asking patients to do something! I asked who has time for that!? That's when they said to work up to it, its not expected for awhile, to just try..its a goal to shoot for. Eventually you'll be able too. So no worries, just do the best you can! 😆

My newest NSV. Life is so tough now. I have just caught myself complaining that there is too much choice in the clothing sites online. I used to rage when I could not find clothes in my pre op size.