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DISCLAIMER: This FAQ is in no way intended to replace or undermine the advice of your physician. Every person is different, every surgeon has different guidelines, and no two situations are identical. Therefore if any of the answers below are unclear or contradict your physicians’ instructions, always follow your physicians’ instructions. The responses given are a compilation from multiple sources and references. How do I embed the weight loss ticker? There are many ticker generators you can use, but the majority of us use TickerFactory.com or MyFitnessPal.com – Once you create your ticker, embed the code into your signature via your “Settings” *Adding* liquid stage? During your clear liquid stage you can have anything that you can sip through a straw that is translucent, meaning see through. For instance: Water, juice, broth, sugar free popsicles, sugar free Jello, Isopure Protein drinks, Gatorade, Powerade, decaf tea just to name a few. Once you move on to full liquids you may add liquids that are not translucent. For instance: creamed Soups, soups with the chunks strained out, milk, Protein shakes etc… NOTHING CAFFEINATED When can I have coffee/soda/tea? Decaf coffee is typically OK about 30days post-op. Decaf tea is OK starting with your clear liquid diet. Soda is typically never OK, with the reasons varying from the carbonation causing painful gas to the carbonation stretching your sleeve. Regardless of the reasoning, it's generally a good idea to avoid sodas entirely, or to consume them in extreme moderation. When do I start mushies/purees? Every surgeon has different guidelines for the progression of your post-op diet. The majority of post-op diets progress as follows: Day 1-7 Clear Liquids Day 8-14 Full liquids Day 15-21 Purees Day 22-50 Mushies What’s the difference between mushies and purees? The major difference is that purees are anything that has been blenderized/pureed to a baby food consistency and has no chunks. These should not be watery, but instead a thicker pudding like consistency. Mushies are soft foods that have not been pureed. I'm on liquids/purees and I feel no restriction, should I be concerned that my surgery didn't work? Nope! You'll feel your restriction as you start to take in denser foods. In reality, you never want to experience that over stuffed feeling again because that means you've over stuffed your sleeve. There's much debate over whether or not you can stretch your stomach by over stuffing your sleeve, I for one am not trying to prove or disprove the theory. Best to play it safe - when you start to feel full, stop eating. Should I be counting calories or carbs or both? Both. Again, every surgeon is different, but the majority of sleevers will be on a 600-1000 calorie/day diet with carbs kept at 60-80g or less. The general guideline is this: When eating, protein is always first, veggies are second, and if you have room carbs/starch last. The majority will rarely have room for the carbs. How much protein should I be getting per day? The recommended protein intake may vary from 55 to 100g per day, depending on your individual needs and the bariatric diet provided by your surgeon or dietitian. The generally accepted minimum protein requirement for women is about 50 to 60g per day and men need at least 60 to 70g of protein per day. How much liquid do i need for the day? About 60-80oz When can I eat salad? Once you reach the point where you’re on normal solids you can try salad. Start with a small amount and see how your sleeve tolerates it as it can be difficult to digest. Best protein shakes? This one depends on your particular tastes, however most seem to enjoy powders?utm_source=BariatricPal&utm_medium=Affiliate&utm_campaign=CommentLink" target="_ad" data-id="1" >unjury. What else counts as a liquid? Anything that can be sipped through a straw or that will reduce back to a liquid. For example: Jello, sugar free popsicles, frozen yogurt/ice cream (these are generally no no foods) Why can't I tolerate plain water, is this normal? It’s called water nausea and it is completely normal. This is very common during the first few weeks following surgery and should eventually subside. What is sliming/slimes? Sliming or slimes occur when you eat or drink something and then regurgitate a slimy, foamy, saliva like substance, usually when belching. What is grazing? Grazing is when instead of consuming your standard 3 small meals and 2 small Snacks per day, you simply munch all day grabbing a handful here or a bite there. The rule is that your meals should take you 20-30 minutes to eat and should be about 3 hours apart with only fluids in between. What do all these acronyms mean? In no particular order: WLS – Weight Loss Surgery NSV – Non scale Victory (ie: smaller clothes, compliments, climbing a flight of stairs etc…) NUT – Nutritionist PCP – Primary Care Physician VSG – Vertical Sleeve Gastrectomy TOM – Time of the Month SF – Sugar Free WFL/WFD – What’s for Lunch/Dinner How much did you lose at 1 month etc.? How much can I expect to lose in what time frame? Everyone’s body is different and so is everyone’s journey. There is no set amount you should expect lose in a set amount of time, and you should never compare your journey or your progress to someone elses. As long as you’re sticking with the program and following your surgeons guidelines, the weight will come off. What is a stall? How long does it last and how do I break it? A stall is a point at which the scale stops moving for a period of time. The length of the stall varies from a few days to a few weeks and sometimes a few months. Non VSG’ers typically call it a plateau. Stalls are perfectly normal and to be expected. As we lose weight so dramatically, our bodies need time to catch up physically - this typically happens during a stall. While the scale may not be moving, you may notice an increase in compliments. This is because while the number on the scale isn’t getting any smaller, you are physically getting smaller. There are many tips and tricks for breaking a stall (increase your fluids and protein, increase your activity, up your calories…) but the reality is it will break on its own. When can I have sex? When you’re ready. Keep it simple for the first few weeks post-op and don’t attempt any tricky positions. Be careful until you’ve been cleared by your surgeon for strenuous activity. When can I start exercising? Typically right away, though the types of exercises you can do will be limited. Most surgeons restrict weight training/resistance training for about 3-4 weeks after surgery, but you should be walking/speed walking at least 30-45min daily starting from the day you get home. What do I do with flabby skin? What's the best exercise etc.? The severity of the flab will vary based on many different factors. While there’s no way to tell how bad it will be or whether it will even be bad, there are a couple of proactive measures you can take. Make sure you’re using a moisturizing lotion with Vitamin E and Keratin several times daily. The vitamin E will help add elasticity back to your skin and the keratin will add moisture, both of which may help your skin bounce back as the weight falls off. The best exercises to target your problem areas are resistance and strength training in order to tone and build muscle to replace the fat. Lastly, be patient. Just as your weight stalls while your waist catches up to it, your skin will sag until it gets the signal to shrink. While it probably won’t ever be as tight as you’d like, it will shrink. Will I lose hair? How much? What causes it? When does it return? Do Vitamins help? The truth is, yes, you probably will lose hair. Because of the drastic changes going on that are caused by the extreme reduction in protein and vitamins coming in as well as the hormonal fluctuations caused by the rapid weight loss, it takes our bodies a while to adjust. Don’t worry, as our hormones level out and our bodies get used to the new us, it will come back. There is no set time frame for it to do so however. I’m constipated - what is it okay to take, especially in the beginning when newly sleeved? Will it get better? Worse? In the beginning a simple stool softener like Colace should do the trick. You don’t want to take a laxative or anything that may irritate your new sleeve. While you’re in the liquid/puree stage, constipation shouldn’t be an issue, but as you reintroduce solids you may have to go back to your stool softeners. If you do find that stool softners are only offering temporary relief, try increasing your fluids and Fiber and decreasing your cheeses. I’m having very loose bowel movements, is this normal? Totally. You do need to monitor stools of this consistency to ensure they contain no blood, but very loose stools, even watery stools, are completely normal for a few weeks post-op. When in doubt – ask your surgeon. Will I feel fatigue? Will fatigue go away? Yes and yes. Your body has just undergone major surgery and it needs to heal. While it’s healing you will feel more fatigued than normal. Subsequent to having such a large portion of your stomach removed is the fact that you can no longer take in as much food (read: fuel) and therefore your body has to adjust and find a new fuel source. Your body will eventually begin to burn fat for fuel and some of the fatigue will subside. Your surgeon should also prescribe a B12 supplement which will also help with energy. When can I go back to work? How much time should I take off? That will be entirely up to your surgeon. Most return to work within 2-3 weeks. How many days in the hospital? Your hospital stay will depend on your recovery. When you are able to keep down liquids, are up and about and walking as directed, and your surgeon and nursing staff are confident there are no complications, you’ll be released. Your surgeon should be able to give you an expectation of the length of your stay. Do the staples dissolve? No. The staples used to close the stomach are titanium and do not dissolve. The stomach tissue will eventually grow over the staple line. Your staples do not make metal detectors go off or make you ineligible for an MRI. They are completely benign. Why am I always hungry? The most likely culprit is either head hunger or reflux/heartburn. Head hunger is a false sense of hunger triggered by boredom/emotions/the clock or any number of things which make you think you’re hungry when you’re really not. Heartburn is the most common culprit of constant hunger. Even though you may not feel as though you have heartburn, you may find that a simple antacid will eliminate that constant hungry feeling. What is dumping syndrome? Dumping syndrome is what happens when the contents of your stomach are rapidly dumped into your small intestine. It is characterized by cramps, nausea, vomiting, or diarrhea. Most people that complain of dumping syndrome associate the attacks with eating a certain type of food IE sweets, carbs etc.. It generally resolves on it's own once the offending food has left the system. What is a stricture? A stricture is what happens when scar tissue builds up in your esophagus (sometimes caused by reflux) that causes your esophagus to narrow and makes swallowing difficult. What is a leak and what are the symptoms? A leak is an opening along the suture line of your sleeve that allows bile and other digestive fluids to leak into your abdominal cavity. The symptoms of a leak vary but the most common symptoms are pain radiating across the abdomen, fever, rapid heart rate, shortness of breath, dizziness, vomiting, nausea, fatigue, and abdominal cramping. It is important to note that leaks are rare and only occur in about 1 out of every 100 cases. Can you get a leak any time after surgery? Or is it just immediate? Most leaks happen very soon after surgery, but there is still a risk for about 4-6 weeks after. Again, it is important to note that leaks are rare and only occur in about 1 out of every 100 cases. Some of my incisions are oozing - is this normal? If they’re oozing a green or yellowish Fluid, absolutely not. Green and yellow are the colors of infection and should be reported to your surgeon immediately. If your incisions are oozing a pinkish or clear watery fluid it’s your body’s way of keeping your incisions clean and isn’t usually a concern. When in doubt, ask your surgeon. I see a lot of people posting about drains - I don't have any. Should I be concerned? Drains are tubes that are temporarily placed in the abdomen that allow fluids to drain from your abdominal cavity in order to prevent infection. Not every surgeon uses them so if you don't have any, don't worry. It likely means your surgeon saw no need to place them. That being said, it doesn't mean you're immune to infection so you should still be on the lookout for fever or any areas that a red, warm to the touch, painful, swollen, or oozing any green or yellow fluids.
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DISCLAIMER: This FAQ is in no way intended to replace or undermine the advice of your physician. Every person is different, every surgeon has different guidelines, and no two situations are identical. Therefore if any of the answers below are unclear or contradict your physicians’ instructions, always follow your physicians’ instructions. The responses given are a compilation from multiple sources and references. How do I embed the weight loss ticker? Click on the liquid stage? During your clear liquid stage you can have anything that you can sip through a straw that is translucent, meaning see through. For instance: Water, juice, broth, sugar free popsicles, sugar free Jello, Isopure Protein drinks, Gatorade, Powerade, decaf tea just to name a few. Once you move on to full liquids you may add liquids that are not translucent. For instance: creamed Soups, soups with the chunks strained out, milk, Protein shakes etc… When do I start mushies/purees? Every surgeon has different guidelines for the progression of your post-op diet. The majority of post-op diets progress as follows: Day 1-7 Clear Liquids Day 8-14 Full liquids Day 15-21 Purees Day 22-50 Mushies What’s the difference between mushies and purees? The major difference is that purees are anything that has been blenderized/pureed to a baby food consistency and has no chunks. These should not be watery, but instead a thicker pudding like consistency. Mushies are soft foods that have not been pureed. Should I be counting calories or carbs or both? Both. Again, every surgeon is different, but the majority of sleevers will be on a 600-1000 calorie/day diet with carbs kept at 60-80g or less. The general guideline is this: When eating, protein is always first, veggies are second, and if you have room carbs/starch last. The majority will rarely have room for the carbs. How much protein should I be getting per day? The recommended protein intake may vary from 55 to 100g per day, depending on your individual needs and the bariatric diet provided by your surgeon or dietitian. The generally accepted minimum protein requirement for women is about 50 to 60g per day and men need at least 60 to 70g of protein per day. How much liquid do i need for the day? About 60-80oz When can I eat salad? Once you reach the point where you’re on normal solids you can try salad. Start with a small amount and see how your sleeve tolerates it as it can be difficult to digest. Best protein shakes? This one depends on your particular tastes, however most seem to enjoy powders?utm_source=BariatricPal&utm_medium=Affiliate&utm_campaign=CommentLink" target="_ad" data-id="1" >unjury. What else counts as a liquid? Anything that can be sipped through a straw or that will reduce back to a liquid. For example: Jello, sugar free popsicles, frozen yogurt/ice cream (these are generally no no foods) How long will my surgery last? Typically about 45mins assuming there are no complications or other procedures (ie: hernia repairs) being done at the time of your surgery. Every surgeon is different so for a more accurate answer you should consult your respective surgeon. Why can't I tolerate plain water, is this normal? It’s called water nausea and it is completely normal. This is very common during the first few weeks following surgery and should eventually subside. What is sliming/slimes? Sliming or slimes occur when you eat or drink something and then regurgitate a slimy, foamy, saliva like substance, usually when belching. What is grazing? Grazing is when instead of consuming your standard 3 small meals and 2 small Snacks per day, you simply munch all day grabbing a handful here or a bite there. The rule is that your meals should take you 20-30 minutes to eat and should be about 3 hours apart with only fluids in between. What do all these acronyms mean? In no particular order: WLS – Weight Loss Surgery NSV – Non scale Victory (ie: smaller clothes, compliments, climbing a flight of stairs etc…) NUT – Nutritionist PCP – Primary Care Physician VSG – Vertical Sleeve Gastrectomy TOM – Time of the Month SF – Sugar Free WFL/WFD – What’s for Lunch/Dinner How much did you lose at 1 month etc.? How much can I expect to lose in what time frame? Everyone’s body is different and so is everyone’s journey. There is no set amount you should expect lose in a set amount of time, and you should never compare your journey or your progress to someone elses. As long as you’re sticking with the program and following your surgeons guidelines, the weight will come off. What is a stall? How long does it last and how do I break it? A stall is a point at which the scale stops moving for a period of time. The length of the stall varies from a few days to a few weeks and sometimes a few months. Non VSG’ers typically call it a plateau. Stalls are perfectly normal and to be expected. As we lose weight so dramatically, our bodies need time to catch up physically - this typically happens during a stall. While the scale may not be moving, you may notice an increase in compliments. This is because while the number on the scale isn’t getting any smaller, you are physically getting smaller. There are many tips and tricks for breaking a stall (increase your fluids and protein, increase your activity, up your calories…) but the reality is it will break on its own. When can I have sex? When you’re ready. Keep it simple for the first few weeks post-op and don’t attempt any tricky positions. Be careful until you’ve been cleared by your surgeon for strenuous activity. When can I start exercising? Typically right away, though the types of exercises you can do will be limited. Most surgeons restrict weight training/resistance training for about 3-4 weeks after surgery, but you should be walking/speed walking at least 30-45min daily starting from the day you get home. What do I do with flabby skin? What's the best exercise etc.? The severity of the flab will vary based on many different factors. While there’s no way to tell how bad it will be or whether it will even be bad, there are a couple of proactive measures you can take. Make sure you’re using a moisturizing lotion with Vitamin E and Keratin several times daily. The vitamin E will help add elasticity back to your skin and the keratin will add moisture, both of which may help your skin bounce back as the weight falls off. The best exercises to target your problem areas are resistance and strength training in order to tone and build muscle to replace the fat. Lastly, be patient. Just as your weight stalls while your waist catches up to it, your skin will sag until it gets the signal to shrink. While it probably won’t ever be as tight as you’d like, it will shrink. Will I lose hair? How much? What causes it? When does it return? Do Vitamins help? The truth is, yes, you probably will lose hair. Because of the drastic changes going on that are caused by the extreme reduction in protein and vitamins coming in as well as the hormonal fluctuations caused by the rapid weight loss, it takes our bodies a while to adjust. Don’t worry, as our hormones level out and our bodies get used to the new us, it will come back. There is no set time frame for it to do so however. I’m constipated - what is it okay to take, especially in the beginning when newly sleeved? Will it get better? Worse? In the beginning a simple stool softener like Colace should do the trick. You don’t want to take a laxative or anything that may irritate your new sleeve. While you’re in the liquid/puree stage, constipation shouldn’t be an issue, but as you reintroduce solids you may have to go back to your stool softeners. If you do find that stool softners are only offering temporary relief, try increasing your fluids and Fiber and decreasing your cheeses. I’m having very loose bowel movements, is this normal? Totally. You do need to monitor stools of this consistency to ensure they contain no blood, but very loose stools, even watery stools, are completely normal for a few weeks post-op. When in doubt – ask your surgeon. Will I feel fatigue? Will fatigue go away? Yes and yes. Your body has just undergone major surgery and it needs to heal. While it’s healing you will feel more fatigued than normal. Subsequent to having such a large portion of your stomach removed is the fact that you can no longer take in as much food (read: fuel) and therefore your body has to adjust and find a new fuel source. Your body will eventually begin to burn fat for fuel and some of the fatigue will subside. Your surgeon should also prescribe a B12 supplement which will also help with energy. When can I go back to work? How much time should I take off? That will be entirely up to your surgeon. Most return to work within 2-3 weeks. How many days in the hospital? Your hospital stay will depend on your recovery. When you are able to keep down liquids, are up and about and walking as directed, and your surgeon and nursing staff are confident there are no complications, you’ll be released. Your surgeon should be able to give you an expectation of the length of your stay. Do the staples dissolve? No. The staples used to close the stomach are titanium and do not dissolve. The stomach tissue will eventually grow over the staple line. Your staples do not make metal detectors go off or make you ineligible for an MRI. They are completely benign. Why am I always hungry? The most likely culprit is either head hunger or reflux/heartburn. Head hunger is a false sense of hunger triggered by boredom/emotions/the clock or any number of things which make you think you’re hungry when you’re really not. Heartburn is the most common culprit of constant hunger. Even though you may not feel as though you have heartburn, you may find that a simple antacid will eliminate that constant hungry feeling. What is a stricture? A stricture is what happens when scar tissue builds up in your esophagus (sometimes caused by reflux) that causes your esophagus to narrow and makes swallowing difficult. What is a leak and what are the symptoms? A leak is an opening along the suture line of your sleeve that allows bile and other digestive fluids to leak into your abdominal cavity. The symptoms of a leak vary but the most common symptoms are pain radiating across the abdomen, fever, rapid heart rate, shortness of breath, dizziness, vomiting, nausea, fatigue, and abdominal cramping. It is important to note that leaks are rare and only occur in about 1 out of every 100 cases. Can you get a leak any time after surgery? Or is it just immediate? Most leaks happen very soon after surgery, but there is still a risk for about 4-6 weeks after. Again, it is important to note that leaks are rare and only occur in about 1 out of every 100 cases. Some of my incisions are oozing - is this normal? If they’re oozing a green or yellowish Fluid, absolutely not. Green and yellow are the colors of infection and should be reported to your surgeon immediately. If your incisions are oozing a pinkish or clear watery fluid it’s your body’s way of keeping your incisions clean and isn’t usually a concern. When in doubt, ask your surgeon.
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Steve The Sleeve Is Very Unhappy...
Lilee84 posted a topic in POST-Operation Weight Loss Surgery Q&A
I'm not really sure what's been going on, but I haven't really been able to eat for like the last week. Don't get me wrong, I try, but Steve rejects everything! I haven't been reduced to vomiting, thank God, but whenever I try to eat he expresses his displeasure by the 2nd bite and then of course I don't attempt to eat again for at least 4 or 5 hours when he feels normal again. I figured at almost 3mos post op that these things would be relatively non-existent at this point. Anyone else experience anything similar this far out? I'm pretty sure all the inflammation is gone so I'm really unsure what it could be. -
18 months post-op and I'm loving the healthy new me! had a blast at the park today with my munchkin and even made it across the monkey bars a few times!
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From the album: Lilee84
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From the album: Post-Op Progress
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I cant believe I fit! first time on a ride since surgery.
Lilee84 posted a gallery image in Before and After Gastric Sleeve Photos
From the album: Post-Op Progress
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From the album: Post-Op Progress
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Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
The simple answer is.. yup! The important thing to remember is that your stomach is still healing. Its still swollen and sensitive to being filled. Also, you should be sipping fluids regardless of how far out you are. -
Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
You're quite welcome!! The general consensus on caffeine restriction is that it can promote hunger and lead to over eating, and can also cause dehydration. -
Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
About 30% of sleevers will regain the weight. According to one surgeon (mine) those are the patients who don't follow the program, don't go to their checkups, and don't have a solid support system. I'd say everyone here should be pretty safe -
Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
The noisy tummy is totally normal - I think mine "talked" to me for a good 2-3 months post op and even now it talks to me occasionally, especially when I eat something it doesn't like. The always hungry issue you're having could be any number of things. It could be head hunger, acid reflux, or even thirst. I'd start by taking an antacid and drinking a glass of Water - if that doesn't take care of it the most likely culprit is head hunger. Hope that helps! I would definitely go back to your surgeon if you're having sleeve related issues. I know my surgeon's office is super busy as well, but if I call super early or email the nurse I usually get a faster response time, have you tried that? Your surgeon has been specifically trained to deal with any bariatric issues you may be having, and while I'm sure your PCP is great, they're not always aware of the minute details and intricacies of our new tummies. -
Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
Thanks for picking up my slack! Apparently VST has decided I no longer need to know when someone posts another question in this thread -
Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
Sorry to hear you're having so much difficulty! I hope things have improved since your post! Typically you should stick with bland foods for about 6 weeks out, or until you feel your sleeve can tolerate it. Essentially your stomach is like a baby's stomach: when they first start eating solid foods their little tummies can't tolerate spices so we give them plain meat, plain veggies, or mildly spiced foods until their stomach becomes more accustomed to solids. You slowly introduce more flavors and spices, and when you find something that doesn't agree with their tummy, you put it on the "not yet but soon" list. I know this isn't the list you were looking for, but hopefully by following the theory you should find some relief. And don't worry, you won't be eating this way forever - eventually your tummy will be able to tolerate most all the foods you used to enjoy, just in much smaller portions. -
Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
Well that's great that your surgeon had no restrictions! I know many who would kill to have such a lenient Dr. As stated in the disclaimer, this FAQ is in no way intended to undermine or replace the advice of your surgeon. It is merely for informational purposes and answers were compiled from multiple resources. That being said, isopure is pretty good! Tastes a bit like unsweetened kool aid! For those that can't tolerate their powder-based or rtd protein supplements, its a great alternative. Thanks for sharing! -
Alcohol and 2 weeks post op!
Lilee84 replied to sarahzamudio1091's topic in POST-Operation Weight Loss Surgery Q&A
I smell a muddy troll... No doctor in their right mind would sleeve someone with only 20# to lose, and at two weeks out your sleeve can barely tolerate water and protein shakes, let alone alcohol. If this is what you do for entertainment is start drama on a site intended to support those who need it I feel sorry for you. -
From the album: Lilee84
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Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
Try calamine lotion or benadryl... Even oral benadryl applied topically should relieve the itch. Try not to apply it directly to your incisions but rather around them - you don't want to do anything that could risk infection. -
Frequently Asked Questions
Lilee84 replied to Lilee84's topic in PRE-Operation Weight Loss Surgery Q&A
Check with your surgeon or insurance company for their requirements. Most insurance companies require a six month physician monitored diet unless thre are other wweight related comorbidities -
Frequently Asked Questions
Lilee84 replied to Lilee84's topic in POST-Operation Weight Loss Surgery Q&A
Sorry, I don't get on here much anymore so I never saw this question. Flax seed should be fine once you're back to a normal diet, but I'd avoid anything like it (including chia seeds) for a while after surgery until your staple line has a chance to heal. Check with your doc though, he/she may have a different opinon. You're quite welcome! "Onderland" is the magical place that only existed in fairytales pre-sleeve. It's that onderful amazing point at which the number on your scale starts with a "1" - hence the term "One-derland"