It's all new

My first year felt like my life was taken over by my sleeve. I focused every ounce of energy on exercising, eating EXACTLY right, and losing the weight. I had plastics by the end of the first year and moving into the second year. I never lost my hunger after my surgery, so that initial eight months or so was really tough, I felt like I was balancing my desire for a healthier life with feeling like I was starving. At the end of the first year I was at my ideal body weight, in the middle of the BMI range. I could eat less than one scrambled egg at the end of the first year. My second year things seemed to fall in place. I was fit - really fit! I was cycling 40-60 miles regularly, working out about 10-15 hours per week. Life was good. I found that I had to eat a lot because I was so active. I maintained my body weight within 5 lbs. At the end of the second year I started unintentionally losing weight. I could barely finish a scrambled egg at the end of the second year - maybe with one or two cherry tomatoes. My third year has been tough. I became b12 deficient and had major medical issues as a result(take high quality Vitamins without fail - and start injections for b12 at the first sign of nerve pain in your hands or feet!!). I have had pretty severe hypoglycemia, too. It comes on without warning at times, and every time I exert myself, and does not seem treatable with diet. I spent most of the year underweight, although am slowly gaining back to a healthy range. I can ride my bicycle about 5 miles now, and am as exhausted as I was during year 2 when I cycled for 40-60 miles. I can now eat two scrambled eggs and two cherry tomatoes, with a tiny bit of room left in my sleeve. I eat salads, fruits, and veggies. I eat bread, Pasta, and rice without problems. I eat fish, chicken, and steak, although obviously in small portions due to their density. I eat ice cream, Cookies, popcorn, and candy - although I eat these foods in moderation! I never, ever, drink and eat at the same time. I never, ever, drink soda. Soda was a major trigger food for me previously, and I know myself well enough to stay away from it now. I don't eat out often, and do my own cooking at home. I don't eat low calorie due to my weight being low, but I do eat healthy, home cooked foods. I think I outlined the natural progression of increased capacity over time - and I can imagine how that could lead to problems. My advice is to take the bull by the horns initially and be prepared not to let go.

I had three separate surgeries: 1) brow lift/neck lift/lower eyelids 2) thigh lift/extended tummy tuck 3)breast lift and lipo for remaining problem areas. The tummy tuck/thigh lift was by far the most painful and restrictive during recovery. The pain came from my stomach muscles having been stitched up to tighten them. The neck lift was uncomfortable for the same reason - they sew up the muscle to keep it tight. The breast lift wasn't bad at all! My advice is to think about total surgery time - and don't go past your surgeon's recommendations of what you feel comfortable with. My surgeon put the limit at 12-14 hours. Consider grouping surgeries so that when you can't use your lower body/stomach, you can use your arms comfortably - and when you can't use your arms (breast or arm surgery) you are comfortable in your lower body.

@It's all new When you were in the weight-losing phase, did you eat very low carbs? If so, how low were your carbs? And for how long? Thanks in advance for your response. @VSGAnn, I ate low carb during the weight loss phase. If I recall correctly I stayed under 30 carbs for the first 7 months, and maybe 40 carbs for another month or two. I think I was around 600 calories until month 6, and maybe 700 calories until month 8 or 9. By month 9 I was down from 255 to 135 I think. I exercised a ton throughout my weight loss and once I was in maintenance. By one year out my problem was keeping up with enough calories for my level of activity. Over time my health deteriorated and I began losing weight for no reason - and despite increasing my calories. In the past two months I have gotten my weight up into a safe range for the first time in many months. It is a relief. After a year of constant worry due to being underweight, I still have these "what if's" pop into my head. As in, my weight has increased for no reason, what if it continues to creep up? I just tell my brain to shut up already and try to enjoy the fact that my weight isn't putting me at death's door anymore. I look at my face and that it is filling out and appreciate that I don't look so haggard - and try to let it go at that!

Year three was brutal - not for the reasons I have seen from any other sleever out there. In my third year I was taken off my b12 injections and moved to oral b12 - it turns out I don't absorb oral b12 even at high doses. I do not fully understand why, but the method of testing for b12 deficiency is highly inaccurate (if you are getting sufficient dietary b12 you get a falsely high reading, the test itself is accurate 40% +/- which is a huge variation, and it when your b12 level dramatically changes the test somehow "reads" the b12 in your body 6 months previously rather than the current level). Due to my undiagnosed deficiency I spent three months in a wheelchair, saw 9 doctors in numerous specialties, and was ultimately hospitalized for a week before a doctor figured out the correct test to order. The result didn't come back until I was home from the hospital because it takes two weeks to process, and during that time I was incorrectly diagnosed and told I would never walk again. For anyone wondering, the truly useful b12 test looks at MMA levels! I have permanent nerve damage to my hands and feet, have some level of constant pain, but am walking up to a couple miles on good days. The other development was constant fatigue, nearly fainting on a regular basis, and becoming underweight (of all bizarre things!!). I saw doctor after doctor, was in the ER a few times , and couldn't figure it out. Finally the nutritionist recommended monitoring my blood sugar based on the stats about sleever complications. It turns out I have very severe hypoglycemia. It isn't the typical reactive hypoglycemia that sleeves are prone to - where in response to food the pancreas overproduces insulin. Instead, my pancreas overproduces insulin day and night. My blood sugar never gets very high, and randomly drops low - in my sleep, watching TV, in response to exercise, etcetera. I spent a week on a 24 hour blood glucose monitor and found that my blood glucose drops below 55 every day repeatedly, and often drops below 45 and even into the 30's. I am still figuring out why. The important point for other sleevers is to be aware that reactive hypoglycemia occurs around 18 months post-sleeve in 18% of us. I am here to say that hypoglycemia can be a HUGE problem! My research says that most sleevers will have hypoglycemia unawareness, which means won't realize they have low blood sugar until there is a true medical emergency. I recommend to be on the lookout - that is 1 out of 5 of us, and the effects can be pretty severe. As sick as I have been in the third year I would still get the sleeve again. I am happily remarried. My relationships have improved with both friends and family. I know that I can conquer things that I never though possible, and where I would have given up in the past I have the confidence to continue today. I hold my head high, no longer look away when I see someone, and have stopped the negative inner dialogue that followed me everywhere. My preference is that year four is a year of health and healing - and if I could put on some muscle and gain a little weight I would be thrilled.

Yes, I now get white fingertips whenever they get cold. You can google Reynaud's to read about typical cases. There are different causes, normally it would not be related to the sleeve and to my understanding it isn't usually a health problem. In my case it was sleeve related in a roundabout way. I am almost three years out and was taken off my b12 injections. I do not absorb b12 from oral supplements - some people do not, even at high doses. As a result I had a severe deficiency that wasn't discovered until I had severe nerve damage to my hands and feet. The nerve damage from the malnutrition led poor circulation and my fingertips now go completely white in even mildly cold weather. Malnutrition can be a serious issue and is poorly recognized by medical professionals, particularly because the sleeve isn't normally associated with the same level of malnutrition as gastric bypass for example. In addition, b12 levels in your body don't reflect their true value at that moment - they reflect the value six months previously.

Yes, I tracked my food. Every day I get a minimum of 2,500 calories - although most days I stay up during the night so that I could get in additional calories, in which case I get in between 3,000-3,500 calories. And if that sounds ridiculous, IT IS!! I have spent most of the year too ill to exercise, and in the small time periods where I have felt better my weight has been low enough that cardio exercise has been totally off limits. Tomorrow I am getting connected to a 24 hour glucose monitor for the next week. The endocrinologist suspects hypoglycemia - a late stage complication of the sleeve, which can also lead to uncontrolled weight loss. I'm not sure what to think because the answer has been elusive thus far. Spending the last year malnourished and struggling with my health has been disheartening after the changes I made to get healthy. They have talked recently about putting in a JPEG feeding tube to get more calories through my system, but things have improved a little. I think that what helped is this 700+ calorie shake I have added each day - ensure plus, 1/3 cup Peanut Butter, 2 cups spinach, 5 strawberries, 1/2 cup blueberries.

My surgery was in May 2012, starting weight 255. Lost my excess weight in about 8 months, and had plastics shortly thereafter to remove excess skin. By summer of 2013 life was GOOD. I was biking 40-60 miles 5 days per week, and weighed between 130-135. I am 5'6". About 1 year ago my weight started going down. Nothing I ate seemed to have an impact and eventually I had to virtually quit exercising. I see bariatrics, a nutritionist, gastroenterology, and endocrinolgy - plus see a counselor. Overall my life is going great, but my health has been terrible! I have finally gained a few lbs recently and am up to 110. Maybe things are starting to turn around! I would love to hear from anyone else who has experienced similar issues.

YI am 39. I had a neck lift and brow lift. I was under 9 months post VSG but was at goal having lost over 100lbs - 5'6" and 145. That was back in December of 2012. I was very happy with the results, and my neck was 100% improved. My crows feet are pretty bad but I won't be doing any more to surgically "fix" anything at this point. I currently need to gain weight which would improve things all around. The drawback for some would be that I looked dramatically different with the brow lift - I didn't mind. With just the neck lift it would have been more subtle. No regrets. I felt too young for such an old face.

I am happy with my TT. My scar healed darker than anticipated, but I have no regrets. The scar is low enough that it would be indecent to wear anything that showed it - it keeps me from wearing a string bikini and that's about it. ...and frankly, I would feel silly in one anyway and would probably look ridiculous. Lol!

What you have described sounds quite normal at your stage. In fact, I think I could not finish an entire egg (without any additional food) until 6 months. At your stage I was stuck at appx 400 calories per day as getting liquids in was also quite difficult. I think your goal of three meals is appropriate... and at about 12-18 months past surgery you are likely to attain it. In the meantime, use shakes to increase calories. You won't be able to get your calories or protein sufficiently thru solid food for a while yet. It's true regardless the size of your sleeve as the swelling lasts for so many months. I wish you the best! You can do it with careful planning and it is SO worth the effort.

It is wonderful to read that your complications have resolved. The fact that your mind is not constantly distracted by pain must allow for vastly improved focus and concentration - not to mention the return of hope and joy! You have so clearly conveyed your excitement in having your life back. Congratulations to you and best wishes as you thrive from here forward! Mary

CGJ - it is with sorrow that I read of these things going on in your life, and to the people you love. I hope you lean on others, find strength in the things you love most (perhaps spending time outdoors, your horses, etc), and just put one foot in front of the other for a bit. Fueling your body so that you can tend to so many important issues is a requirement - hydration and food both. I have experienced a total loss of hunger under stress and didn't fight it properly... it sounds as if you are acting in a responsible and mindful manner. With caregiving, loss, and related issues, you will probably need time to recover, and possible more time than you expect. Be good to yourself. You deserve it. Mary

That is awesome! You have rocked your sleeve and had the success people dream about when they have the surgery. And despite your hunger, ability to eat more, and ability to eat anything you are maintaining your loss. Impressive! A couple things I think of: maybe you should try measuring some chicken breast ahead to see if you are really eating 8 ozs and a side. That is an unusual portion for a sleever, it makes me think that either your estimation might be off or that you've had some stretching. Also, I think with eating protein and your rapid return of hunger you could consider: reflux presenting as hunger (even if on a PPI it could be the wrong PPI or the wrong dose), or rapid gastric emptying, or head hunger, and undoubtedly there are other options too. Even that far out those are issues that can crop up or become increasingly problematic. Those were just some random thoughts that came to mind when I read your post! I don't think you were looking for advice so much as just letting everyone know what 18 months out looks like (and for you 18 months looks awesome) - whether or not those things are helpful for you I thought it was worth mentioning...

Ouch!! As you said, the weight gain is probably from the bruising. I read the thread initially hoping you had found a way to gain weight, fast. I am continuing to struggle with weight loss and poor appetite - six lbs in a matter of days sounded great, until I read the cause. Feel better! And Happy Birthday!

I was told that one major reason for less regain after plastics is that they remove skin and with that, what used to be fat cells. Many people have lipo at the same time for stubborn problem areas as well which removes even. My primary care doc explained it like this - we have shrunk the fat cells through the weight loss, but they never actually disappear unless they are surgically removed. That is why those of us who have been overweight or obese always tend to gain weight more easily - the fat cells are lying in wait just looking forward to plumping up again. With plastics, you remove cells and then have less chance of regain as a result. Plus, I think agree that the visual change is pretty motivating. In my before photos I looked as if I was carrying quite a bit of excess weight - after they removed 4.5 lbs of skin from my extended tummy tuck and thigh lift and it was a world of difference.