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I hit a few Patches where I was so frustrated it was making me nuts. I stalled out for about nine weeks twice. I really thought I'd be at goal in nine months. I got down to 165 pounds, yes, about that size 12 and I was just..burned out. It's hard because we spend all that time pre-op and post-op daydreaming about being at goal, being thin, being able to do the things we couldn't do as seriously overweight people. And it's frustrating and disheartening to see that we still have SO far to go, to watch other people reach goal much more quickly and to have to readjust our expectations. The reality is that you'll get past this hump. You will lose more weight if you keep trying. I fell off a bit for about four weeks while stranded in the 160s. I didn't gain anything but I stopped trying to lose. I had to get to the point where I realized I was still a success and that a year earlier I would have daydreamed about being a size 12, not whining that I wasn't as small as I wanted to be! It stinks but the closer you get to goal the longer it takes for those last pounds to fall off, too. It took me six months to lose the last 20 pounds. Once they came off I quit trying to get smaller immediately and went right into maintenance, even though I had previously entertained the idea of dropping my goal down ten more pounds. It's a hard journey! You only have forty pounds left, though, and you've lost that more than twice over since surgery! Keep on going. It's too late to beat yourself up for letting yourself get heavy in the first place. You did something to change it, and you still have the power to do it. I've said it about half a dozen times in the past few days, but there is NO magic window of weight loss with this surgery. Your sleeve is getting close to it's final size and unless you put a lot of effort into it that thing isn't getting much bigger. It's still restricting you. The rest is up to you - making those good food choices and doing the right things, even when it's boring and feels like you're not getting anywhere on the scale. I never would have made goal if I hadn't kept on trying. There were weeks where I didn't see any change in weight at all, so if I had allowed myself to get discouraged and quit I'd still be in those twelves. Chin up. Keep going! ~Cheri

Pre-op or post-op? Some people are put into a program before their insurance will approve surgery and yes, sometimes that includes a weight loss goal to prove that you can handle the limitations of life after surgery. Post-op there is no magic window of time to lose weight with the VSG. There isn't any limited window of malabsorption like with the bypass. Your sleeve capacity will increase. It will become easier to choose to eat absolute junk food and therefore not see results. However, your restriction will remain such that you'll have to actually put effort into eating poorly to really gain weight. At least for most of us this is the case! I've seen a few people post here and there about having one heavy carb day and gaining on the scale the next day. I think the average result for VSG is 50-60% of excess weight lost. Please, someone correct me if I have that wrong! That said, I see very few people here on these boards (and I've been hanging around since early 2009, even though I didn't make a profile until late that year) that have lost less than 80% of their excess weight. With a sleeve, from day one you still have to choose to eat in moderation and to make good food choices. The only thing this surgery guarantees you is a drastically reduced stomach. Most people lose their hunger and desire to eat post op, but not everyone. But the sleeve stays restrictive, so the ability to lose weight beyond one year out is still there. I'm 19 months out and still can't eat more than a scrambled egg with cheese in one sitting. If I wanted to lose more weight I'd simply have to scale my calories back to the 800-900 per day range and it would happen. In fact, it took me 17 months to get to goal. While you'll see a number of people making it to goal in about 9-10 months, a larger number of people achieve goal sometime in their second year post op. I hope I answered your question. If you'll clarify, I bet you'll get more answers. ~Cheri

Even if you don't like it hang onto it until post op and try it again at that point. The shakes I loved pre-op tasted awful to me afterwards! I would get samples of a bunch of different flavors and keep them around so you can see what you really like. And even once you find something you love don't stock up on it too much because you might get tired of it, anyway! I still have a Protein shake each day to push up my protein levels and I've gone through three or four different favorites in the past 19 months. From the start I've liked several of the nectar flavors. My favorite unflavored protein is Integrated supplements because I can't even taste it in my morning coffee or chai latte. If I had more than a Tbs. of unjury in my Soup or drink I could taste it and smell it - I hated that stuff! Keep trying and don't feel obligated to go with a particular brand or force yourself to drink something you hate because other people do it or it has a good nutritional profile. Protein Shakes help A LOT in the first months post op, so you want to find something you like. A lot of sites offer sample packs and variety packs so you can try a lot of flavors, and Vitalady also sells samples - there's a thread somewhere on VST about protein samples that should give you a few places to try. ~Cheri

Keep up with the process and jump through the hoops. Either you'll come to terms with the idea of surgery or you won't, and it's easy to cancel or reschedule the surgery if you need more time. The entire process with insurance can be a long one, and I'd hate to see you drop out only to restart the process again in two months! I can't tell you what to do and I wouldn't know what to say to make you feel like this is the right choice, anyway. It's a deeply personal thing. A lot of people are scared of surgery in general, on top of their fears about VSG. My mom is one of them. She would benefit immensely but is too scared to have VSG be her very first surgery. I can tell you that it changed my life. I was scared to do it because I didn't want to leave my husband or my two year old twins to fly across the world for my surgery. I was scared that I'd waste my money. I was scared that all those failed diets in the past *could* have worked; maybe I just hadn't tried hard enough to do it on my own yet. It's frightening to know that you're not only making a life-changing decision, but that you're also risking your life to have the surgery in the first place. All surgery comes with risk, even if you choose a great surgeon with no leaks or fatalities, like I did! I cannot express how much I have changed, inside and out, all for the better. It was the very best thing I've done for myself. It's the only thing I've ever done only for myself. I'm happier and healthier and I wouldn't change a thing. Either you'll get there or you won't. If you opt not to have surgery, that's okay. Keep thinking on it and eventually the right choice will become clear to you. Best wishes, ~Cheri

You're lucky to be able to eat like that! Honestly, any dense dumpling type food (like gnocchi, spaetzle or knodel) are really hard on me, even now. My sleeve doesn't seem to care if it's made of flour or potato. Pasta is still hard on me and I mostly avoid it, though I have noticed that I don't have as many issues with rice or glass noodles so I eat some Soups that include those when I really want my pasta fix. Lucky you! Thanks for sharing with other people that might want to try this, though I'd caution them to do a few small bites first just in case they're like me and don't tolerate it well. And I still freak waitstaff out because they worry that I didn't like my food. It's a regular occurrence for the manager to visit my table just to be sure I enjoyed my meal because it doesn't look like I ate anything! ~Cheri

Sounds like you're doing a great job. I hit some Patches where I thought I'd never lose any more weight but like you, I kept plugging away and finally got past the plateaus. Keep your chin up if the last few pounds take longer to lose. It's normal! Enjoy your loss, you've done a great job so far. ~Cheri

Congrats on choosing the sleeve! It will certainly improve your life once you can get past this rough patch. If you're not on a PPI, you should be. And if you are on one, it sounds like it's not working and you need a new one. I started on Nexium and it wasn't working for me so I switched to Prevacid (OTC). That wasn't working, either, so I finally wound up on Prilosec (generic omeprazole) and the relief was almost immediate. I had the same issues you're describing and it was terribly uncomfortable. The good news is that somewhere between 6-8 months post op I was able to stop taking the acid reducer and the reflux/heartburn resolved on their own. I hope you have the same results. I had a lot of problems in the beginning with my bowels. TMI, but hey, you're asking, right? At first I had nothing like a normal movement. Turns out I had lactose intolerance. Once I cut out the dairy, I couldn't go at all. I've found that two things work like magic: either a cup of coffee each morning or a dose of Miralax every other day does the trick. I buy the generic version of Miralax, too, because it's a lot cheaper. Now that I'm 19 months out this is not an issue at all because my capacity has increased and I can eat natural sources of Fiber along with my Protein. Good luck. You're having great results so far, and I hope that once you get these two minor issues resolved you can keep on going until you reach your goals. I can't wait until your wife can join you on this journey. You guys are going to live longer, happier, healthier lives together and there's nothing in the world better than that. Best wishes to both of you, ~Cheri

Poor thing! I didn't have this post op but I did have it after I delivered my twins. I had so much swelling in my calves that I actually got stretch marks because they had me on a darn IV for nearly three days. I think it's totally unnecessary and I hate that doctors do it because it's convenient for them. It's overinfusion and it's not good for us. I left the hospital after delivering my twins weighing MORE than I weighed going in. In fact, the pants I wore to delivery were too tight when I went to leave. It was horribly upsetting, so I understand your fear and frustration. What worked for me? Exercise (lots and lots of walking), elevating my feet and taking a diuretic. I just used an OTC one for about four days until I was back to normal. If you're terribly concerned, call your PCP (not your surgeon) and see what they say. Best of luck, I hope you feel better soon. It's horribly uncomfortable to have your skin feel close to bursting. ~Cheri

I looked at your pictures and I would say the loss is significant. Yes, they're trained to look for facial features but in my opinion, you look like you're the sister of the girl in the first picture! If you have time and it's not too much trouble, I'd get the new passport done. If not, I wouldn't fret and I'd chance it. I sincerely doubt you'll be turned away from any country. At the worst I expect you'll have to explain that you've lost a lot of weight and show an additional ID to verify your identity. Enjoy your trip either way, and congrats on such a great loss! ~Cheri

The long post op liquid diet is hard. I had a reaction to sugar substitutes and don't bother with sugar free anything. At this point, I figure I eat so little at a time I want to make it count. I don't do low-fat, either. The diet link you were given is a good one. What are your surgeon's guidelines? I went to Dr. Aceves and he advocates a full three week of liquids before you can move on. It was really hard for me to make it that last bit - I wasn't hungry but the meals I was eating were boring and I just wanted to CHEW, even if I wasn't hungry. However, the guidelines he has are one reason he hasn't had any leaks. It may not seem like it but in just one week when you're on mushies and soft foods your complaint will be that you can't possibly eat the food you're supposed to be eating and that eating is a hated chore. You feel like you're starving now but wait until all you can get in is three bites of scrambled egg! ~Cheri

You know, I never worried about pepper or any other spices and I didn't have an issue. But if you're really concerned, shoot a quick email or make a call to your surgeon's office. ~Cheri

I'm with cattracks on this one. There is no magical window of time with the sleeve. Seriously - we do NOT have the same limited window of malabsorption that bypass patients have. Your sleeve is going to stretch but not enough to make losing a problem. You'll have to work at it to gain a real amount of weight. I stalled out around the mid 160s for close to nine weeks. I was sure I was done and would never see goal. I kept with it, fell of the wagon for a bit, and jumped back onto the right track after a while. And after plugging away I finally got a drop. A small one at first, then a big one. And here I am, sitting pretty at goal when I had been so sure before I couldn't lose anything else. Make sure you're not in denial about your food intake. It happens to us when we get lax. Exercise is important but unless you really bring it every day you're not going to lose weight from exercise alone. It will make your skinny, at goal body look better, though, and it's great for your heart and overall health. Keep with it. Some of us are slower losers. And let me tell you it took me better than SIX months to lose that last 20 pounds. I had two really long stalls and I'm glad I didn't give up or I'd still be wearing a size 12 instead of a size 6 - so please, hang in there. Best of luck, ~Cheri

I'd take it really slow on those eggs. In the beginning it could take me TWO hours to eat a single scrambled egg. It's a far denser food than anything you've had in your sleeve so far. I'd start with one or two bites of egg - with nothing else. Then I'd wait a bit and go back for more. You overdid it and it's totally normal until you learn your limits. I toss my food back up if I overdo it, too. Soon you'll learn those full signals (which are different than they used to be) and stop before you get sick. ~Cheri

Relax and wait for mushies. We all worry about this until we're faced with eating an entire scrambled egg and it takes two hours! Oh, those dense Proteins are HARD in the beginning. But liquids run right on through, even if we have to sip them all day long. You'll be fine. Stick to the plan and don't worry. ~Cheri

Yep, lesson learned, right? Bread took me forever and I still only eat a tiny bit of it when I do have some. Pasta and rice are my real no-nos, even 19 months out. I can only eat a few bites and I swear they swell in my stomach and cause me discomfort every stinking time. I always overindulge, forgetting that my limit on these foods is only a Tbs. or two, not half a cup. Guidelines are there for a reason, cheater cheater! No, it won't be this way forever. Eventually you'll be able to eat pretty much whatever you want but not in nearly the quantities you used to eat. Once you heal, it's a different story. I'm in the minority but I advocate eating a normal diet without restricting carbs or sugar down to Atkins levels. I suggest if you wish to eat this way to accept that 1) you'll have slower loss and 2) you'll have to track your intake religiously so you don't exceed your nutritional guidelines. I think too many of us approach the sleeve like a diet and get burned out. Restricting our diet drastically builds the expectation that we'll see a drop on the scale every single day. Not so - this is a lifestyle change. You removed most of your stomach. Be responsible and healthy and you'll reach your goals. But for now? Heal! Follow those guidelines and drink as much liquid as you can each day. ~Cheri

I think you're being too hard on yourself. Hold yourself accountable but don't be extreme about it. A variance of +/- 2 pounds is normal for me each day. So long as I'm not over 138 I don't beat myself up over my weight. Anything could affect us: pressure, humidity, salt intake, Water intake, time of the month. In fact, I regularly gain about 3 pounds during my cycle. So, I applaud your accountability. However, I think you shouldn't worry about the minuscule gain unless it becomes a habit. I'd also like to add that I really don't feel there is a "magic window" where weight loss becomes harder. We do not have the limited window of malabsorption that bypass patients have. Our sleeve does stretch a bit but certainly not enough for us to just start gaining weight or eating a ton of food - not without us really jumping off the wagon and running in the wrong direction! It took me 17 months to get to goal. Loss closer to goal weight is slower but it's just as easy to lose as it was in the beginning: you just keep on doing the right things and the weight comes off. I think this misconception people have is part of the reason half the posts on these boards are from people freaking out about a two week stall or a slower loss - they have this idea that if they don't drop the weight in nine months they'll be failures or have wasted their money on VSG. This isn't the case! You're doing a great job so far, and should have no trouble reaching goal. ~Cheri

Everyone's surgeon has different guidelines and many allow soft foods within just a few weeks of surgery. So long as you're following your particular surgeon's food guidelines I wouldn't worry. Eating was my most favorite thing in the world, pre VSG. Honestly, I think I enjoyed food more than my husband! (Kidding!) Post op it became a hated chore that required work and planning on my part. I had to make a food plan at the start of each day and log it into myfitnesspal to be sure I'd meet my nutritional goals. I often failed - at least for the first 4-6 months. Slowly but surely things will get more normal for you. Not only will you be able to eat more, but you'll start to lose that expectation that you'll clean your plate or eat at the same pace as the people around you. It's a hard mental adjustment to make but it really does get easier with time. As for how long it will be before you can eat that four ounces of fish more quickly? Who knows? You might be like me and have ridiculous restriction at more than a year out. I can tell you it would take me about thirty minutes to eat that tilapia, but if it were salmon I wouldn't be able to finish a whole four ounces as it's a denser fish - more meaty. Or you might be like the average sleever and be able to eat that four ounces along with some vegetables and maybe even a few bites of rice at one year out. Life will be easier for you if that's the case, I think! Enjoy it. It's hard at first and very frustrating. But honestly, I love that food no longer controls me. Once upon a time I'd have eaten twice as much fish along with a plate full of rice and vegetables and been hungry for dessert afterward. ~Cheri

Yep, no help from me, either. I didn't have to do the same type of workups as I self-paid. Best of luck to you, and I'll have my fingers crossed that it all works out and you can proceed with surgery soon. ~Cheri

It's been brought up on the boards here before and honestly it just varies by each doctor and what they prefer. I haven't yet seen a real difference in our recovery due to diets prior to surgery. The only big difference is that I have noticed that people that do an extended pre-op diet don't seem to have that initial big drop in the first month post op. They seem to lose a more reasonable amount of weight, more in line with what they'll lose each month for the first three or four months. I had Dr. Aceves and he required no pre-op diet but he does have one of the strictest post-op diets. Just do what your doctor says and you should be fine. Everyone is different but your surgeon has his/her particular diet plan for a reason, even if a different doctor disagrees with that approach. Best of luck. The time until your surgery will go faster than you think. Hang in there! ~Cheri

You're hearing the right things here. Stalls stink and they do happen. I'll be honest, I don't know that at your weight you really even needed the DS. I think you'll be able to reach your goals with the VSG if you keep plugging along. The vomiting is not normal. I'm sorry that your doctor isn't coming up with other ideas here! I developed lactose intolerance about six weeks out from surgery and didn't know it was the dairy making me nauseous all day long until I cut it out on someone else's suggestion. Is it possible for you to see someone else about this? Honestly - you HAVE to eat, and if you can't eat you can't expect to lose weight or be healthy. If I had to guess I'd say that the shock of the surgery coupled with your absolute inability to eat a normal, balanced diet is what's got your body totally freaked out and scared to let go of any weight. If you weren't having issues with vomiting I'd tell you to keep plugging along, record your intake and make sure you're eating enough. Stalls are normal and I honestly stalled out so much I stopped considering them "stalls" and just part of my regular weight loss pattern. And I was a slow loser on top of that - if you average out my weight loss from start to finish post op I averaged just over six pounds a month. If you subtract the big drop in the first month and average out the remaining sixteen months I lost about five pounds a month. So while your results right now aren't what you want or think they should be, they aren't bad results, per se. It's the vomiting that has me worried for you. I'd seek a second opinion and see if they can tie it to either a medication or something in your diet. Best of luck to you. I hope this gets resolved soon. ~Cheri

Best of luck to you on your journey! Life will be totally different in just one year, you wait. Heck, in six months you might not recognize yourself. On another note, I really hate that he military is so hung up on weight standards. My husband is active duty Army and over the years he has lost a number of really great soldiers and coworkers due to weight. I understand if they want someone to lose weight because the weight causes health complications and interferes with their ability to perform. But in a lot of cases, a guy is only a little overweight and fully able to perform and the discharge is based more on discrimination or appearances than a serious concern about his/her ability to accomplish the mission. A lot of times these are guys/gals that would stay in for another ten years otherwise. It's a shame. In any case, I hope that you find your apnea resolves itself and you really will be in a totally new place in just a few months. The liquid diet really stinks. I didn't have one pre-op but three weeks on liquids post op was a nightmare for me. I wasn't hungry, don't get me wrong. I just felt completely bored with my food options, not hungry in the least and totally frustrated that I had to sip 16 ounces over two hours. As with all things, the rough stage passes. Get through the surgery, rest well and heal and in no time you'll be back at 'em, good as new. Better, in fact, as soon as you start dropping those extra pounds. Oh, and black coffee works better than any enema at cleaning a person out. If that doesn't cut it, buy a bottle of Miralax and it will work, but not all day long like the Ducolax. Best wishes, ~Cheri

I don't think you're hearing something different at all. In my experience this has happened numerous times. I use Tricare, and whenever I visit doctors at a military treatment facility the issue is ALWAYS my weight. I seem to get more understanding care from non-military doctors I've seen off base but I see from this post that it can be an issue everywhere. I broke my right leg in 2005. I broke three bones in five places and completely shredded a ligament. I was in a wheelchair for four months and totally unable to walk. After moving to a new base, I went in for a referral for physical therapy because the humidity in our new location was giving me a lot of grief. I was refused a referral by a doctor that clearly didn't even bother to open my chart. I was told to lose 50 pounds and my leg would feel better. So yes, it happens. It happens all too often in an industry full of people that blindly repeat what they were taught: that weight loss is a simple matter of willpower and exercise, that a 1200 calorie diet is one-size-fits-all and that if the patient isn't losing weight they're either not trying hard enough or lying about trying in the first place. And heaven forbid you're on an Army post because doctors think the sun rises and sets on the BMI chart. The first thing they do is plop you on a scale and heaven forbid you're considered overweight or obese! I'm still right on the line between normal and overweight and just got scolded by my doctor - again, one who didn't even bother to look at my chart and see that I'm half the size I was two years ago. And while some of my heath issues are dramatically improved post VSG (namely, resolution of my diabetes) the other issues (back pain, endometriosis, occasional pain from that old leg injury) are still here and still bother me. I really dislike doctors, and because of the discrimination in the past I'm more inclined to nurse myself through anything other than a major problem or injury simply because I don't want to hear another lecture about my weight. ~Cheri

I wouldn't worry too much about the fat. Someone posted about fat grams per day recently and I shared my thoughts then, too, that it's less important to track fat than it is to track Protein and calories. We don't want to go all out and give ourselves heart disease but let's be realistic here: even on a day when we feel like we've had a lot of fat post op, it's likely nowhere near what we were eating pre op. We need the fat now more than ever because we're not getting it from other sources. It's very tough to go low-fat on a protein based diet! I relied heavily on cheeses when I first got here to Bishkek. We had no good source of meat so we were living the vegetarian lifestyle. I have no easy access to prepared or convenience vegetarian foods in this country. The best I could do was make my own soy milk and tofu, or order vital wheat gluten online and make seitan! And yes, tofu and seitan are good ways to get protein but let's not lie to ourselves and say they're as dense in protein as meat is - you have to make up that slack somewhere. There are only so many bean dishes or hummus spreads I can make and only so many ways I can prepare eggs before I'm tired of them! cheese was critical in reaching those protein goals. I even ate a lot of Peanut Butter, something I don't really care for normally. I still get one Protein shake in each day (two scoops of protein, about 50 grams) because I could not possibly hit my protein goals (90+ grams/day) otherwise. I eat as much cheese as I can. I'm still mad that my lactose intolerance makes cottage cheese impossible for me. I'd eat that day in and day out if I could! As it is I eat a few ounces of hard cheese each day. If you're really concerned about your fat intake, record your food on a site like myfitnesspal and be sure your fat intake isn't too high. So long as I'm not "in the red" on my fat totals when I track, I don't let it bother me much. The people that super-restrict their diets DO get results, but then they get to goal and have to figure out how to eat like normal people. Just eat a balanced diet now and save yourself the trouble. ~Cheri

I also stopped buying clothes once I made my appointment for surgery. I made do with what was already in my closet for two months and was fine with that. As I was losing, I made small purchases of a few shirts or a few pants as I needed them. I thought I wasn't going to get much smaller than a size M top and 8 bottom so I bought a lot of stuff in that size on sale. It turns out I was just going to lose that last twenty pounds incredibly slowly. I stopped buying when I hit goal, thinking that in maintenance I wouldn't lose much more. My shirt size is currently small, so I figured I'd never get smaller than a small. For the most part, I think shirts will be okay. However, I was in a size six pant and even though I'm maintaining and haven't lost but one more pound in the last two months my sixes are all getting big. I think the weight sort of rearranges itself even if you aren't still losing. Now it looks like I'll be okay with my sixes for a while but honestly, it wouldn't hurt me to buy some fours, either. So I guess what I'm saying is be careful. I thought I'd spend some time in every size on the way down but I skipped straight from 12s to 8s. I'd only buy what you need as you need it, because I didn't wear much of anything I bought for more than two months. I gave away tons of clothes that still had tags on it because I never had time to wear them before I got too small. And be careful even at goal! I bought an entire wardrobe of fall/winter clothing and it looks like I'll need new pants next year as these are already getting big. It makes me wonder how small I'll really be once I have plastic surgery. Sheesh! And did you know your feet could shrink? I've been a 6 1/2 most of my life, going up to a 7 during and after my twin pregnancy. Now all of my 6 1/2s are too big. It's completely bizarre. Shop sales and thrift stores when you can to lessen the blow when you find that your new favorite shirt only fits for six weeks. I never really realized how much expense/trouble went into clothing myself for a year, but I've had to replace everything from underwear and bras to shapewear to shoes to jackets. Even my nice leather gloves got too big for my hands! ~Cheri

Yes, check if you're really concerned but it should be fine. I don't look a bit like my passport photos or my military ID photo but I didn't have any problems traveling. One of the photos was taken back when I was about 250 pounds and the other two were taken about two months post op, so I've lost more than 80 pounds since then. I look enough like my photo to pass. I did get my drivers license updated when I was back home before traveling, just in case I needed to show an additional ID but it was never required. Doing the license was simple and only took 30 minutes of my time, not six weeks! I have no intention of updating any of my passports until someone brings it up as an issue or until they expire. I currently live overseas and regularly travel using my passport and haven't had a single person bring it up as a concern. ~Cheri