RickM

My doc does it on an 'as needed' basis with his VSG patients, but does routinely remove them on his DS patients. He left mine in place as he could not feel any stones in there, or see any other signs of distress. I never had any problem with it thru the weight loss period or in the subsequent year and a half, so it seems like a good decision in my case.

I can't quite speak from direct experience, but binders and compression garments are standard fare after the reconstruction (tummy tucks, lower body lifts, etc.) that many of us go through to get rid of the excess skin after all the weight is off, so it seems like a reasonable bet. It sure seems like I'm wearing a corset much of the time!

Potatoes are about the best source of potassium on a per-calorie basis that we can find in real foods (and potassium is not supported well in our normal OTC supplements,) so they earn a place in my diet on that basis alone. In loss mode it's hard to afford much of them, (or much of anything beyond protein, for that matter!) but I did have some token amounts during that phase. As suggested, adding unflavored protein powder to mashed potatoes is a good early soft protein food, and is a classic suggestion in many plans.

These items should be in whatever program guide or booklet that they provide you, but it is certainly good to ask in case they don't provide much written instructions. The other major thing that I can think of, based upon reading of many others on these forums, is how much weight does the doc expect you to lose with his program (or what goal weight he might assign to you.) This can provide some valuable insight into your doc's philosophy - some will only expect averages, saying something like 'the averages say that you will lose 60% of your excess weight' while others will be disappointed if their patients don't attain 90-100% excess weight loss. This can help you decide whether to follow his guidelines strictly, or maybe be more aggressive on your efforts if you don't want to settle for "average". Exercise is another part of the equation, particularly in the long term, so you may ask about suggestions and progressions, particularly if you already have some activities that you want to resume, Good luck, and welcome to the loser's bench.

An Atkins style diet is one of the saner approaches to the pre-op diet for those docs who require them - much better than the all liquid type that some docs impose upon their patients (which has no particular rationale that I have been able to find.)

I recorded weekly and only had one week without a loss during the entire loss phase, up until the point that I started ramping up the calories to ease into goal/maintenance. I can't say if that was a function of guy metabolism, or not doing the low carb thing (glycogen deprivation is one of the primary stall mechanisms,) or what. It's a big YMMV.

Veg is another one of those big variables between people - some can go quicker on them than others, so try them a little at time to see how you do with them. Remember, protein first - I was doing well enough on protein that my doc was adding veg to my diet at day ten, and I was having small salads with leftover meat in them by the end of the first month. YMMV. Since you are getting along with the V8 juice, try the low sodium version as that as double the amount of potassium as the regular juice (which we need and don't get to any usable degree in our OTC supplements,) and is the best non-prescription source that I have found so far.

The general rule from my doc on this is to try small amounts of new things one at a time to test for your tolerance - if it goes down and settles well, then great; if not, try it again in a couple of weeks as such things can change quite a bit over time.

The typical recommendation is around 60-80g per day for the ladies and up to around 100g per day for the guys; if one is into some serious muscle building then one may use up into the 150 or so range (and no one who is going thru this weight loss is into that category, at least until they reach maintenance!) Anything more than what the body needs is just peed away, and little, if any, is stored day to day (except in our muscles and other lean tissues, and we don't want to be drawing from them!)

It all depends upon individual tolerances and surgeons' programs - some surgeons will still have their patients on liquids at that point, while others will allow them steak. I was in that second group and had no problem with some filet (which is often better tolerated than ground beef,) and some salad veg along with the more typical early proteins of dark chicken and tuna. Basically, I was at 90+% of what I was having at 6 months out and near maintenance. My wife, on the other hand, was a little slower to progress on the same basic program when she went through this some years ago. YMMV.

Typically, just until you can tolerate regular ones, though surgeons will have different opinions and instructions on this (along with everything else, it seems!) I never used chewable vitamins - only calcium supplements as those are typically are such horse pills - and I used them much longer than I needed to simply because I had a big bucketload of them from Bariatric Advantage to use up. I could only take pills one at a time with a sip of water each for a while, unlike the handful at a time as I could pre-op, but I was back to the handful approach (including the calcium horse pills) after a few months.

Yep - and one can get the same result (heart attack) by OD'ing on the supplement, which is why OTC potassium supplements are severely limited (to about 100 mg, or 3% of RDA) and why most effective treatments for it are under MD supervision. Potatoes are about the best real food source of potassium (on a per-calorie basis) but is off of many people's diets; bananas and avocados are also very good, but somewhat more caloric. The best semi-real food source that I have found is the low sodium version of V8 juice which has around 1100 mg in an 11.5 oz can.

There are two basic schools of thought on this topic within the bariatric world. Those docs whose practices have been based upon the RNY, which has some specific structural weaknesses that preclude the use of NSAIDs and other stomach irritating drugs, tend to transfer that experience to their recommendations to their sleeve patients. Those docs whose practices have been more biased toward the sleeve based procedures (primarily the duodenal switch and the VSG), which don't have the same structural defects as the RNY, generally have no problem with the use of NSAIDs; indeed, NSAID use is one of the major selling points for the sleeve and DS over the RNY. My doc, who has about twenty years of sleeve experience behind him, recommends NSAIDs for pain relief as soon as the normal post surgical prescription narcotic pain relievers are no longer appropriate. Even for normal, non-WLS people, NSAIDs are potentially problematic drugs, and consistent use of them (even the OTC versions) should be done under MD supervision as there can be potential organ damage resulting from long term use, Some docs recommending NSAIDs for their VSG patients often recommend that they be accompanied by a PPI, but that need is somewhat controversial. For the "typical" occasional use, there is little difference between a "normal" person and a VSG post-op. As usual, do take your surgeon's advice seriously, but consider that their current position on the topic will probably be changing over time, so should you find yourself in future need of NSAIDs, particularly on a chronic basis, check with your surgeon again for an updated recommendation.

OH has one, but it isn't very active (as in one post from early April that hasn't been answered, and the next most recent is from last December.) The next best thing (or maybe better,) is meeting other spouses at your local WLS support group. I've been on both sides of this equation as my wife had her WLS around eight years ago, and I'm two years out on mine. Between the two surgeries (and subsequent reconstruction surgeries) and the research/insurance battle phases before, we've been involved in the WLS and support group game for about ten years. Once past the initial healing/acclimation diet phase (which with our doc was not very long as we never had any extensive liquids-only stage,) our diets were very similar other than for volume. I've done most of our cooking through this time, and we typically had the same things for dinner, though she would have half as much as I did (and now we are pretty evenly split on portions.) Neither of us did any extreme fad dieting pre-op, post-op or in maintenance, but have concentrated on healthy long term eating that's fairly adaptable to either maintaining good health or weight loss. Breakfast, lunch and snacks weekdays are pretty much on our own due to work schedules, so our main shared meals are dinners and weekends. Eating out has never been a big problem as it is fairly infrequent (maybe once a week,) so the problem of the typically higher calorie restaurant fare is limited; my wife became disappointed if she was not able to stretch a restaurant meal into two or three meals with the normal leftovers, and I am now in that same boat, but the surgery has not had a big impact on any restaurant socializing; indeed, our local support group meeting are held at a restaurant, so we can all compare notes on our meals! You are right, however, that this is a change in our lives, and one that we all need to adjust to - both patients and spouses - but this is par for the course as we all progress in our lives and face the different challenges that life presents us over time.

Yes and no - yes from the perspective that I had various mushy and soft proteins during the first couple of weeks, but no, I didn't cheat in that I was following my doc's plan which combines the liquids, mushy/purees and soft proteins together in the initial phase from the hosptal on out for the first month (yogurt and scrambled eggs in the hospital along with broths and juices,) The over riding key instruction was to test new foods for tolerance one at a time and in small quantities as patients can vary widely in what they can tolerate and when. With some twenty years of sleeve experience behind it, I find it difficult to argue that his program is overly aggressive, risky or unwise.

It depends upon what's on your surgeon's program and what you personally can tolerate. I was having small salads with some leftover meat tossed in with some chopped spinach, tomato, avo, pepper and scallion after a month, but YMMV.

San Fernando Valley here, sleeved in May 2011. Now recovering from some reconstruction work (TT and manboob reduction). Good luck on your journey through all of this.

I wasn't really doing anything earlier than plan, but my doc's plan has a pretty quick progression built in, so things like scrambled eggs and yogurt were served in the hospital, and those things along with most soft proteins and liquids were acceptable as tolerated for that first month, so it is unlikely that you messed anything up. If you didn't feel any distress then it's unlikely that anything happened. Individual tolerances vary all over the map, so what is easy for some can be difficult for others. When my wife went through this a few years ago, her progression was a lot slower than mine, and even liquids offered a fair bit of restriction for a while, whereas I was downing liquids almost like normal (sip,sip,sip, but virtually no restriction on how long or much I could get down in a sitting) from the outset.

It is unusual to not have a stall at this point (though four weeks is on the long side, but not unprecedented,) as it is part of our physiology. Here is a great explanation of what is happening early in our weight loss journey - http://www.dsfacts.com/weight-loss-stall-or-plateau.html As you see from this, much of what's happening is Water hoarding to rebuild that glycogen supply, so keeping your water consumption up is helpful (sip,sip,sip!) and depending upon where you are, winter weather can be very dry which can further increase your need for hydration. Adding a bit of insult to the injury of a long stall is that you should also expect that when your loss resumes that it will be at a somewhat slower rate. That initial loss, as explained in that article, is mostly glycogen, (basically stored carbs,) which burns fairly rapidly at a rate of around 2000 calories per pound, while once you start losing again you will be drawing from your longer term stores of fat which burns more slowly, at a rate of around 3500 calories per pound - but its finally doing what you want to do, which is burning fat!

I can't speak from personal experience as my levels hover at the top, or just over the top, of the normal range, but B12 is a component in the making of red blood cells, so a deficiency tends to show up as anemia to one degree or another. It is also a regulating element for homocysteine levels which has cardiovascular implications but no immediately noticeable symptoms. But if you're feeling lethargic, B12 is one of the things to check (along with iron, protein and carb levels.)

While some people do go thru extended stalls, it sounds like you may have gone into an early maintenance mode between your lowered activity levels and whatever dietary changes that may have snuck in during your recovery from the hernia surgery. I had already been at goal for a few months when I had shoulder surgery last year, and I lowered my intake in anticipation of lowered activity levels during recovery (from around 2000 calories to about 1600, so a 20% drop) and then let it creep back up again as my activity levels rose from physical therapy back toward more routine workouts. I am starting to do the same thing again now, with a bit more of a Protein boost, ahead of a hernia repair and TT surgery next week. Depending upon what your intake levels are and have been, you can try cutting things back a bit, or increasing it a bit as feedyoureye suggests. Whenever there is a major change in workout or activity levels there is the opportunity for changes in hydration and Water retention, so make sure that your water intake is appropriate, or even on the high side (better to be peeing excess out than having the body go into hoard mode because the intake is too low.) Changing dietary composition can sometimes do the trick - adding a bit more protein, and sticking to the protein first rule, can give you the extra protein that your workouts may need while providing good sataity and the opportunity to cut calories a bit, or adding some complex carb before workouts can improve endurance and calorie burn. There are a lot of different variations that can be played with to find the one that your system is looking for. Good luck and keep up the good work - progress is already looking good!

The low sodium V8 is the best potassium supplement that I have found (and we tend to be real short on it since it isn't supplemented well without prescription.) It's not a replacement of eating your veggies, but it's a good supplement to them and helps to get more in than we otherwise would be getting with our limited intake.

It is likely ketosis which is a result of your diet being short of carbs; it will clear up as your diet broadens, or if one is intent on doing one of the low carb diets, when you get closer to maintenance and start widening your diet. Some take it as a good sign that "you are burning fat" (which is true - sorta; it is also a sign that you are not eating your vergetables!) but it is not essential to burning fat or losing weight.

Mine started in the hospital with things like scrambled eggs and yogurt. As to what can be tolerated is a very individual thing, beyond whatever the surgeon wants you to try and when. I had no problems with anything that I tried and progressed fairly quickly, trying new things a little at a time, getting progressively thicker, chunkier and less soft. Others have a problem progressing very rapidly and that's OK - there's a wide variation between what we as individuals can tolerate and when. When my wife went through this a few years ago, she had more problems with various food tolerances, and that's just the way she is - the doc had no worries about either of us, but just somewhat different responses within normal experience.

It is abnormal if you don't hit an occasional stall - the third week is a typical time for such things and then more randomly thereafter. I am one of the abnormal ones who only had one week during my entire loss period when I didn't show a loss; even a bit of gain here and there would not be abnormal - there are lots of things that can cause a bit of temporary water retention - hormones, variations in dietary sodium, medication changes, changes in diet or exercise/activity routines, phases of the moon (jk)....