DLCoggin

I shoot for 30/40/30 P/C/F and track it daily in MFP. The actual numbers last week were 33%/33%/34%. The week before 33%/35%/32%. My surgeon requires 100g a day for Protein for the guys and I seldom fail to meet that primary goal. As you can see, I struggle a little to hit the 40% carb mark. I don't worry too, too much about fat since the numbers can be deceiving because of the malabsorption associated with RnY. Like just about every other aspect of WLS, I think it's important to remember that there's no "one size fits all" formula for macro nutrient ratios. Lifestyle, activity level, genetic variables, medical history - lots of variables. To say nothing of where you are at in your weight loss journey. These are the numbers that I use for maintenance. They've worked well for me but as you can see, others have had great success with other variations.

Shortly before my surgery I asked my surgeon if the pouch could be stretched by liquids as well as solids. Her response - "Absolutely". In the case of gastric bypass, the pouch is often equated to a funnel. Wider opening at the top with a narrower opening at the bottom. Since the pylorus (the valve at the bottom of the former stomach) is no longer in the path that food and liquids take, it is true that liquids pass through more quickly. But as is the case with any funnel, it is possible to put liquids in faster than they are going out. In the case of a funnel, it overflows. In the case of a pouch, it stretches. That does not automatically mean that it stretches beyond its ability to return to its original size. It is highly unlikely that one instance of "overdrinking" will result in any significant detrimental effect. But it does mean that the possibility of over stretching exists if someone were to make a habit of drinking too much too fast. In the case of the sleeve, the pylorus is still present. The pylorus opens and closes periodically to allow food or liquids to pass through to the small intestine. So again, the possibility of drinking too much too fast could result in the sleeve stretching. And again, it is highly unlikely that one instance of "overdrinking" will result in any significant detrimental effect. And once again, it does mean that the possibility of over stretching exists if someone were to make a habit of drinking too much too fast. I am not aware of any analytical studies that have been done to determine the statistical incidence of stretching of a pouch or sleeve. I suspect that it may be less common than some folks believe. That said, why take the chance? Whether eating or drinking, portion control along with slowing down are always good habits to develop.

I simply cannot find a way to get into the gym thing. Pack the "gym bag", get in the car, do the gym thing, pack the gym bag, drive home...just not for me. That said, I lost 130 lbs in just under fourteen months. My exercise of choice - just plain old walking. First on a treadmill but that quickly got boring so I moved to walking in a park near my home. I started with 20 minutes a day and worked my way up from there. Today I do at least three miles, three times a week. I enjoy it almost as much as my black Lab. And my equipment cost was a $15 pair of tennies from costco. More recently, I purchased a Total Gym and have started doing strength training three days a week. Love it. Probably never going to look like Chuck Norris but that's OK. I enjoy it, I can already see the difference and feel even better than I did before. Whatever it is, perhaps the most important thing you can do is find an exercise routine that you e n j o y. That's the one that you'll stick with and you'll be thrilled with the results!

Lisa, it's not uncommon at all for patients to actually gain weight immediately following the surgery. Just hang in there and follow your plan. Rest assured that as long as you follow your plan there is not the slightest doubt that you are going to lose weight and lose it more quickly than you ever thought possible. The laws of science and the universe cannot be denied. Apprehension following the surgery is perfectly normal but it passes quickly and then the real fun begins! Stay positive, stay patient, follow your plan as closely to the letter as you possibly can, stay away from the scales for at least a week and two would be even better,maintain a food log and, when cleared by your doctor, start exercising at least three times a week . You're gonna love the new you!!

My team also says that shakes do count as fluid along with decaf coffee, decaf tea, Crystal Light, flavored waters (you might want to try Nestle Pure Life Splash), Mio - there are a surprising number of options.

It's a common misconception that there is a long list of things you'll never be able to eat again following bariatric surgery. That simply is not true. With a short list of exceptions, I eat anything I want to eat. Once you graduate to a regular diet, it's not about what you "can't" eat, it's about what you "choose" to eat. Or not eat. That's where the all important lifestyle changes come into play. It's all about control, not denial. The miracle of weight loss surgery is that it puts you in control. You're gonna love the new you!!

Yup - me too! Joe has a lot more zippity in his doo-dah! Lol!

So yesterday was not a good day. We're talking a particularly not good day. The problems had nothing to do with wls but it would be fair to say that the day would have had to improve just to suck. So I get up this morning still feeling a little down in the dumps. Then I'm checking my email and I run across this. Pretty sure that I could NEVER do this but I gotta say, the sheer fun of it put a smile on my face that is still there. I think I've watched this thing three or four times. Hope it puts a smile on your face as well!!

The Nameless Dance Walk Guru Master has been found! The video in my original post now has almost 2.3 million hits on YouTube. Now meet Joe, the guy who started it all...

I've never been "diagnosed" but there is no doubt that I occasionally experience hypoglycemia. I've measured my blood sugar several times in the low to mid 30's. Hypoglycemia following bariatric surgery is pretty much synonymous with "late stage dumping". It normally occurs three to four hours after eating but can occur 24 hours or more after a meal which would make it appear "random". I’ve been able to trace the cause several times. One time was from eating white rice (aka simple sugars), another from eating a handful of red grapes, still another was from eggnog (nectar of the Gods!). Another time was popcorn (that is so unfair!) The message is pretty clear – too much sugar or carbs triggers an abnormal insulin response and the blood sugar crashes. In my case, the good news is the symptoms invariably disappear quickly (within 15-20 minutes) after I eat something with a little sugar or carbs. That sounds counter intuitive but anything that raises your blood sugar relieves the symptoms relatively quickly. For example, a couple of times I ate a single Hershey's Simple Pleasure (23g of sugar) or half of a Protein bar. More recently I tried a single Babybel Light cheese round. Both options worked like a charm. As of now there is no specific therapeutic option for treating the condition but research is being done. The University of Cincinnati very recently published their results of a study done with 65 bariatric surgery patients who experience hypoglycemia. Here are two links to articles on that study. http://medicalxpress.com/news/2014-03-exaggerated-insulin-response-subset-bariatric.html http://www.healio.com/endocrinology/diabetes/news/online/%7B570bedca-38a7-46bc-8cb9-9a5b97379fb2%7D/islet-function-insulin-clearance-affect-patients-after-gastric-bypass The bottom line is that hypoglycemia can usually be avoided or "treated" with diet. Based on my experience, you don't want to wait too long once you notice the symptoms. The sooner you get your blood sugar up, the better. It isn't common, but in severe cases it can result in loss of consciousness (stay away from eggnog!). I've made it a practice to never leave home without something (usually a protein bar) I can eat to raise my blood sugar - just in case.

I'm two and a half years out and get cold all the time unless I have my new best friend - a sweater. You're absolutely right - less insulation. I don't like being cold but I now have a collection of jackets from lightweight all the way to parka. Since I live in So. Cal. I don't need much besides the sweater until we go camping in the mountains. More sensitivity to cold is pretty common but I gotta tell you, it's a small price to pay in return for: type 2 diabetes, hypertension, sleep apnea, high cholesterol, four or five medications, back and knees pain and 130 lbs - all g o n e. Cold? I ain't worried about no stinkin cold! You're gonna love the new you (cold and all)!!

Forecast highs/lows in L.A. for today through the weekend are 72/55, 73/57, 72/54, 64/54 and 66/55. For San Diego 68/57, 68/59, 65/56 and 62/56 (rain), 64/58. Little cool but you should see lots of sun!

Awesome ! Could you please sent me the spread sheet. I'm at pescareno1@gmail.com Thanks so much Just emailed!

Nanny's Grammy a yahoo.com hannysgrammy @yahoo.com. Can I get a copy too? Gixxergirlrny@gmail.com On the way guys!

In the interest of full disclosure - I've been using MFP for two and a half years and would be lost without it. That said, I would be very interested in what options that you find that will allow you to track things like B12, omega3's and zinc. The apps that I have seen (which is not extensive, maybe three or four) are developed around the information the law requires for nutrition labels. Sometimes a manufacturer will include additional information for a nutrient(s) that are not required, but it's hit and miss. MFP has a total of sixteen options that can be tracked (but does not include any of the three you have named). You can configure MFP to track different options from their website - after you login click Settings > Diary Settings and under "Nutrients Tracked" you can see the options in the drop down boxes. Good luck in your search and I hope you will share your findings!

Countless folks have felt exactly the same way you do when they hit that first stall - "I feel like I am going to be the only gastric bypass to fail!". Nonsense!! Take a deep breath and try to relax. As you have seen, it's perfectly normal. There is no schedule for stalls. They are impossible to predict with any accuracy other than the fact that they will occur for almost everyone. Keep doing exactly what you're doing. Stay away from the scales for at least a week, two or more (if you can resist the temptation) would be even better. When you are in maintenance, daily weigh-ins are a great tool. When you're in the rapid weight loss part of your journey, daily weigh-ins can be frustrating, stressful, discouraging and even self-defeating. Stay away from the scales. Trust the process. The laws of science and the universe cannot be denied. Trust your body. Allow your body to find its own way in its own time. Do those things and you'll find your journey so much less stressful, so much less frustrating, and so much more fun!! You're gonna love the new you!!

One more thought for you Phil. When you are at home, measure everything you eat. Measuring cups are great for liquids and I bought a digital scale from Amazon (it's been awhile but I think it was in the $25-$30 range) for weighing solids. After a few months you'll get quite good at eyeballing portion sizes with surprising accuracy. I eventually graduated to eyeballing first, and then measuring to see how close I was. It takes a little practice but it's another great confidence builder and you'll soon be able to estimate portion sizes quite accurately!!

Phil, perhaps you're over-thinking it a bit? I've been using My Fitness Pal for two and a half years and would be lost without it. But that said, I don't always know everything that went into every dish I eat. For example, my daughter-in-law cooked a green chile quiche for a function at her church today. I happened to be at their house early this afternoon. She had some left over and offered me a piece. Since I hadn't had lunch (Lol - to say nothing of the fact that I love quiche!), I gladly accepted. A couple of hours later I was back home and went to enter the quiche lunch into MFP. I did a search for "green chile quiche" and MFP returned many results. About the fourth or fifth one was a, "Crustless Green Chile Quiche, Homemade" with a serving size of "one wedge/square (4oz)". Close enough! I've repeated the same process many times for restaurant meals. Are those entries precisely accurate? Certainly not. Are they as accurate and honest as I know how to make them - without fail. Is that good enough? My answer would be an unqualified, absolute "Yes!" Perfection is not realistic, sustainable, and most importantly, it's not necessary. Special occasions sometimes result in my exceeding my average daily calorie goal. I can see that in MFP. And usually on the scale the following morning. So I make a mental note to reduce my calorie goal by 100-200 calories for a day or two. Again, I can see that in MFP and subsequently on the scale. There is no other tool that I know of that gives you the ability to manage your weight better than a food log. Next to the surgery itself, it is the most powerful tool that you can have in your arsenal. Commit to logging for 90 days, make your entries as honest and accurate as you can and you'll see the results for yourself. Your confidence will go through the roof! You're gonna love the new you!!

Here's a link to a National Institutes of Health article that covers just about all things "gas". There are also references there for additional information including MedlinePlus (an NIH website produced by the National Library of Medicine). All are very good sources for a wide variety of topics including WLS. As you have noted, gas can be quite uncomfortable. The good news is that there are a wide variety of options for minimizing it (starting with dietary choices) and if necessary, some excellent over-the-counter products for treating it. If those don't get the job done there are a number of Rx options as well. http://digestive.niddk.nih.gov/ddiseases/pubs/gas/#food Congratulations on your weight loss and a fabulous job of maintenance!! I love to hear from folks who are five plus years out!

Just emailed!

With one exception, just keep doing exactly what you're doing and you can get to any weight you want (within reason). Sooner or later, eating 800-1100 calories a day, you will lose weight. The laws of science and the universe cannot be denied. We all know how tough it can be but commit to refusing to allow your mind to cloud what you know to be irrefutably true. That 165 is a slam dunk. Just acknowledge that your idea of timing is a little different than your body's idea. It's pointless to stress over it since your body is going to find its own way, in its own time, every time. And when all is said and done, our bodies are pretty smart! Every day that you continue to follow your plan is an unqualified success and reason to celebrate! The one exception? Stay away from the scales for at least two weeks, even more if you can resist the temptation. Congratulations on the great job so far! I'm betting you're lovin the new you!!

You're going to have a great time Terry! San Diego is a great city for tourists - Sea World is terrific and the San Diego zoo is one of the best in the world. Forecast high (in L.A. where I am) for the 24th is 72 with a low of 54. San Diego tends to be just a little cooler. I suspect that should compare favorably with New England. Please pass along my sincere thanks to your son for his service and my best wishes for a speedy recovery!

On the way!

Erica, I also suffer occasionally from hypoglycemia but in my case it is usually easily avoided with diet and on those occasions that my sugar does drop too low, it has been easily rectified by eating something (exactly what does not seem to make much difference as long as it has some sugar). Here is a link to a very recent study from the University of Cincinatti - http://medicalxpress.com/news/2014-03-exaggerated-insulin-response-subset-bariatric.html . And this link refers to the same study with a slightly different approach toward explaning their findings - http://www.healio.com/endocrinology/diabetes/news/online/%7B570bedca-38a7-46bc-8cb9-9a5b97379fb2%7D/islet-function-insulin-clearance-affect-patients-after-gastric-bypass . I would be very grateful if you could share links that you have identified from your research to other sources of information on hypoglycemia following gastric bypass. As they say, "knowledge is power"! Thanks so much!!

There is no schedule for stalls. They are not uncommon in the time frame you're in but it's impossible to predict stalls with any degree of accuracy. Just keep doing what you're doing. Regardless of what your weight is doing - follow your plan. Forget about second guessing yourself. There are going to be times when your weight drops quickly, times when it drops more slowly, and times when it just refuses to move at all. Regardless of what your weight is doing, your response is a l w a y s the same - follow your plan. Every day you do that is a success worthy of celebrating. We all understand the temptation but judging your success by the number on the scale is always a bad idea. It's frustrating, discouraging, stressful and can be self-defeating. Trust the process, allow your body to find its own way in its own time, follow your plan and you're gonna love the new you!!