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Ahhh, the lovely tier 3 programme! It took an absolute age just to even be considered for that to begin with, I really feel for you. Then the added issue of thinking you would be aiming for a certain month or period of the year, to then be told last minute it's being pushed back, again and again, is genuinely the worst of it. Being completely honest too, as someone who is self-employed, I just don't earn enough regularly to commit to paying it per month. I was working 6/7 days a week between two jobs and I was barely earning more than 22-ish thousand a year salary until the end of last year. I do have the comfort of earning a little bit more now, but only in the right seasons unfortunately. I did put in a complaint yesterday to PALS, and they very quickly responded which was good of them, but it was conveniently not the woman who caused the stress to begin with. They've 'provisionally' (and I use that loosely!) let me know the 28th of March could work depending on how many others they have to schedule. Just a waiting game I suppose. Thank you for your kind words, I really appreciate it x

How hungry is everyone after gastric bypass surgery? One of my biggest fears is being constantly hungry since no food is actually making it through my stomach. I have a week to go before my surgery, just starting the pre-op diet tomorrow, and a bit nervous if i can make it through without feeling like I'm starving.

A final update for this thread: I had my gastric bypass on Feb 21! Check in went smoothly. I changed into my hospital gown, got my IV inserted, and was given a number of medications to take before being moved to a waiting area where I got onto a gurney. The various members of the surgery team came by to introduce themselves and check on various things. Finally, the anesthesiologist came by and gave me "something to relax" via my IV port. A minute later, I was being wheeled into the hallway, and that's the last thing I remember until waking up in my hospital room. I never saw the inside of the OR, and I have no memory of the recovery area afterward, either. The surgery itself took much longer than anticipated, about 6 hours. I was fine and safe the whole time, but the surgeon ran into some issues with my small intestine and a small abdominal mass (sent to pathology and was benign) that required additional steps. Because of this, I was surprised to wake up in my hospital room and discover it was already 9pm when my surgery began at 1pm! My poor mom had been so worried because we thought it would take maybe 3 hours max. The nurses checked on me several times that night. I was able to get up to use the toilet on my own, and the only real challenge was the IV pole having to be dragged along. I was very fortunate that I ended up with no roommate. It wasn't technically a private room, but no one else was assigned to it while I was there. In the morning, my surgeon came by and explained what had happened during surgery. He was concerned because some of the stitches ended up under more pressure than he considered optimal, so he wanted me to do a swallow test before I could have anything by mouth, including water. They got me in for that and it turned out okay, so about an hour after returning to my room, I was brought a bottle of water and a cup of red sugar free jello. I have to say, it was nice to have water because my throat was dry, but I really didn't care about eating. I did because they told me to, and I know at this point I hadn't had a single thing in my belly for over 40 hours, but I just didn't care. I felt zero hunger. But I at the jello, and later they brought me a popsicle, another jello, and a chicken broth. I ate it all over the course of about an hour. It was fine, but again, I just ate it because they told me to. Because I got such a late start on fluids after surgery, they kept me an additional night, just to be sure. But on Friday morning around 9am, I was discharged. I had a protein shake when I got home and worked all day on fluids. I was tired and a little sore, but my pain had been minimal enough that I was only on Tylenol. It worked well enough that I only had a few moments of real pain, mostly when shifting position that required the use of abdominal muscles. I was fortunate to have someone staying with me for the first few nights home, and my parents kept my kids (ages 12 and 15) with them for the first week so I wouldn't have to worry about all their activities and food. It took a few days to discover what worked best for me, which ended up being hot tea (decaf and herbal) instead of flavored waters as I'd been having pre-op. For the first week, I've met my 64oz fluid and 60g protein goals most days, but as time has gone on, I've become completely turned off anything with artificial sweetener and every protein shake except Syntrax Nectar Natural, which I can still manage. I definitely wasted a lot of money on shakes I won't be drinking, but I'm glad I had them for the 2 week pre-op diet and to take the pressure off finding things to try when I got home. Yesterday, I was allowed to start soft protein foods. So far, I've had tuna salad (2 Tbsp), refried beans with a sprinkle of melted cheese (1/4 cup), and 1 poached egg. No issues with anything so far. Tonight I will be cooking some haddock with pesto for dinner. I go in for my 2 week post-op appointment with my surgeon next Tuesday and hope by then my weight will be a little lower. I lost 15 lbs on the 2 week pre-op diet, but my weight was higher by about 5lbs when I got home from the hospital thanks to the fluids and swelling, and I'm only just back to where I was the day I went to the hospital. Still, 15lbs in three weeks isn't bad. As for other incidentals, I have been taking Benefiber daily in my morning tea and it really has helped. I had the first BM (very loose and not a lot) before leaving the hospital on day 2, and have managed to go at least every other day since, and daily the last couple of days, so I'm very grateful for that. My energy levels have been decent, but it's only today that I feel like I don't need a noon nap. Going without caffeine has been a struggle, but I'm getting used to it. After all the wait, I'm so glad to have this behind me and be able to focus on a healthy future!

Every doctor has different guidelines. My nutritionist provides net numbers case, and an overall range based on physical activity. Sent from my SM-S916U1 using BariatricPal mobile app

While I do soak my oats overnight, it’s not the traditional ‘overnight oats’ because I still cook it. I start with a microwave safe container. Add 1/4 cup traditional oats (half a serve & not instant which are more highly processed & has additives), 1/2 teaspoon dried cranberries, a tablespoon of mixed seeds & a cup of milk. I microwave it in the morning & then add 1/3 tub 20g protein yoghurt, additional milk for a runnier texture & blueberries. Gives me on average a good 22g or so of protein. You could add some unflavoured protein powder for an extra boost if you want. I eat it hot or cold. I always have a few spoons leftover (it’s very filling) which I eat as an afternoon snack. Be ware: don’t cook it after you add the yoghurt - it curdles - shudder! If you were wanting a quick grab & go breakfast before work, my version takes vey little time. Pop it in the microwave while you’re getting dressed. Stir in yoghurt, additional milk, berries & then go. The overnight recipes I’ve seen use half a grated apple & yoghurt, milk optional the night before & no cooking the next day. I think they use instant oats which is why it doesn’t need to be cooked. Traditional oats are a great complex whole grain carb. You get sweetness from the fruit you add so no added sugar. Great breakfast choice. I ate rolled oats & blue berries 3 or 4 days a week while losing & now eat it every day.

I can't imagine how this would be related to your sleeve surgery. That operation doesn't go anywhere near your spine. You can have temporary backaches post op from laying on that damned metal table, or from your muscles bracing in front to protect your abdomen, but those should ease as you heal and stop bracing. I suppose theoretically you could have some sort of nerve injury in that area from repeated surgeries, like scar tissue and adhesions, but I would think that pain would be felt in the stomach area or abdomen where they go in laparoscopically. A physical therapist can help manually massage out some of these areas if they can feel them. Sometimes in rare instances a person can get referred pain from another area, but I would hope that they'd have considered that before doing spinal surgery! Sorry you are still in such pain after so many treatments!

@summerseeker made a great list! I would add to make sure your surgeon prescribes a PPI (proton pump inhibitor) for the first few months after surgery. This is to help calm the acid production in your stomach because our tiny stomachs are still making enough acid for our big stomach at first! With lower acidity you'll be able to sleep better and heal better internally without acid irritating that tender healing tissue. And keep in mind that hydration is crucial for the first few weeks, more than anything else, because it is hydration that will keep you out of the ER for dehydration. Try different temperature fluids (ice cold, hot, room temp), different flavors (sweet water flavoring packets, savory broth, neutral lactose free milk, herbal teas, decaf tea), and different textures (protein milk, protein water, protein shakes, milk thinned yogurt when allowed, sugar free popsicles). All fluid counts at first, even shakes or sugar free popsicles. I ate a LOT of sugar free popsicles the first two weeks. BUT, if you can't get near those 64 oz be sure to let your surgeon know. There is no shame in going to get hydration infusions and usually if you let them know before it is critical, they can arrange for it at an infusion center instead of the ER. Oh and wear something loose to the hospital, preferably something that doesn't put pressure on your stomach. And shoes you don't have to bend over to put on! LOL

If you are counting total carbs you need to be under 50 grams total carbs to maintain ketosis. If you are counting net carbs you need to be under 30 grams net carbs to maintain ketosis. They aren't interchangeable. Some believe fiber and sugar alcohols don't impact blood sugar so they can be subtracted and net carbs followed, but that doesn't apply to everyone. I can't eat any of the high fiber "keto" products like breads. For me, carbs are carbs and keto bread will knock me out of ketosis just as fast as a chocolate bar. 🤣 I am not the norm, but it is incredibly annoying!! And I know others like me. Regardless, my dietician said we should count total carbs because net carbs are not a recognized measurement by whatever association decides these things. LOL Most fruit is high in carbs, yes, and so most people watching their carb count choose coconut and berries as opposed to citrus or bananas. Same with veggies, green beans would be a better choice than a sweet potato. Keep in mind this state of ketosis is not intended to last forever, so what might not be the best item to eat right now will fit perfectly later on in your nutritional picture when you can increase your carb count.

This is so awful, I am beyond sorry that you have had to go through this. I know most of us can completely empathise with how hard the waiting game is at the best of times, let alone with the added stress of the NHS and how badly run it seems to be with WLS! I had initially considered just staying on the NHS waiting list (I am currently on the Tier 3 Weight Management programme), but after hearing awful experiences like yours, and from reading about waiting times, I decided to look into going private with Spire. I think it may be worth just getting a second opinion in regards to what you were told before by a private surgeon! My surgeon, Simon Monkhouse, was amazing in the initial consultation. I have PCOS too, and an underactive thyroid, and he recommended a bypass and was transparent about it all. You can get a free consultation with him quite quickly, maybe this would be an option for you! simonmonkhouse.com I have everything crossed for you that you will get the surgery soon, and everything will work out. I'd definitely pursue putting in a complaint, too. Sending love and hugs x

My insurance approved me in 1 day. I have pre-op 3/7 and surgery 3/14. First follow up is 4/1.