sastexan4u@yahoo.com

115 Kgs.... wow...really? Maybe 6 real diet attempts per year..multiply that by let's say....the last 20 years (I'm 37)...that is a lot of FAILED attempts....and what do I have to show for it? 115 kgs....and absolutely NO photos. I actually physically tackle anyone who tries to take a photo. My poor 4 year old and 5 year old already know the golden rule..... NO PHOTOS OF MAMA!!!!!
 
There are so many reasons why I want/need to lose weight...but..my sons are the biggest reason. Need to make them the happiest kids ever...AND need stay alive to see my grandchildren!!!! Ok, so it would also make me happy to sit comfortably on the airplane and not struggle to do up the seatbelt. It would be nice not to eye the chair before I sit to be sure of its' strength. It would be nice not to hear "fat" in every sentence - even if it's not being said. My reasons are endless.
 
With my husband's amazing support (he told me he's supporting me, but he doesn't care if I do it or not - he loves me for me), I will be getting "sleeved" on June 16th in Egypt. I am the most excited person ever - so excited, that even though my doctor didn't instruct me to go on the pre-op diet, I'm doing it anyway. Couldn't hurt right? Anything to help the good doc out on the operating table!
 
I am going to try and blog consistently throughout this process (my first blog EVER!) because I know how important they are - I have spent hours and hours viewing endless blogs and youtube videos. Needed the encouragement....and the not-so-encouraging ones, I learned from.
 
Wish me luck everyone, and I wish all of you the best of luck as well. No one understands more than we do how much we need this. For those of you who made a success story out of this....you are my idols!
 
Ma salama.

I am currently six weeks post op, but only losing a pound a week. I had complications with my surgery resulting in a 10 day hospital stay. Once I came home and shed all of the extra IV fluids, I lost 20 some pounds. However, now it is a painfully slow 1 pound a week average loss. I spoke with my surgeon about my frustration, the obvious negative calorie balance resulting from a drastically reduced caloric intake, And he told me that some of his sleeve patients may be carb sensitive. Have any of you been told you were carb sensitive? I know some people talk about going through phases of not losing weight, but I am truly concerned. I am a band to sleeve conversion patient. The band really did not work for me, and now I'm really fearful that the sleeve will not work either. All I keep thinking is I know I did not have two WLS only to be virtually the same size. Of course, the question from the doctor, nurses, and dietitian is, "have you been working out? " As if that is the reason why my weight loss is so slow. Grrrrrrr....

Well, I am 6 1/2 weeks out. I have really increased my exercise and today I did 30 minutes on the treadmill most of it in zone two. (I use a heart rate monitor to record my data). I have started noticing I can fit into close one size smaller, and I have a lot more energy! So whether the pounds are coming off or not, I am feeling good about myself and my level of energy!! I weigh in at the doctors on June 3. I don't know whether I am excited about it or not...

Just put some masking tape over the number part of the scale. On the tape write down your goal weight. Now EVERY time you step on you will ONLY see your goal weight and are forced to either wait until you see the Dr. or bend over and remove the tape (which you KNOW will be wrong)

Need to to mix up your protein shakes and try something different?
 
There is a clear liquid protein broth from Unjury called Chicken soup and it REALLY good.. BTW you can eat this one warm, and it taste EXACTLY like how you would want homemade chicken soup to taste.
 
 
If you like chocolate, try Syntrax's Nectar in Chocolate Truffle. With water it tastes like a YooHoo, with milk it tastes like a Wendy's milkshake.
 
I also have The Nectar in Vanilla Bean torte (23gm protein) and I mix it up with 2 oz of blueberry kefir and 4 oz of milk (9gm protein). Kefir is 99% lactose free and has just as much protein as milk.
 
If you like fruit juices try Unjury's Strawberry Sorbet. Mix it with water, lemonade, or milk and yogurt (strawberry cheesecake). I have made this one so many ways even into ice pops!
 
Of course all of these items are 0 carb and 0 fat too. Samples of the Nectar can be purchases at Vitamin Shoppe and Unjury through Unjury.com
 
Looking for sleeve & bypass recipes from someone who actually had it AND tastes YUMMY?… go here… http://theworldaccor...e.blogspot.com/

Have you experienced a stall in your weight loss? Has it been 2 weeks or more since the scale has moved? If so read on.
 
Chances are really good that IF you are following the Dr's guidelines you are most likely having small body adjustments and have lost size. Start by measuring your thighs, upper arm, forearm, neck, waist, hips, chest. I encourage everyone to do this twice a month. It a true stall is when all of your numbers, including the scale doesn't move. That is something you can show the Dr and NUT and you can work on figuring out how to solve the issue.
 
The scale can give discouraging (and misleading) numbers, but cover up the numbers with a piece of masking tape and put your goal weight on the tape. Only find out your true weight from your Dr. at check ups because that is the weight that is going to matter when it is jotted down in your record.
 
It is stressful enough trying to readjust to life post op and enjoy foods one at a time, why add more by constantly worrying about stalls?
 
In addition to measuring yourself I found out in my San Diego support group that many have experienced stalls/plateaus. Almost all of them swore by eating avocado with every meal for a week to break the plateau. View the .pdf file that explains a bit more about this and the science behind how this works.

As some may know, I have been trying for WLS since August of 2005. Finally my time came and I was sleeved. I was a very active member on ObesityHelp until I found this site. Enjoy the info and videos...
 
The word bougie means "candle" in French. "F or FR/Fr" following a bougie size=French
 
Its just a guide that the surgeon uses to butt the stapler up against, when forming your VSG. The closer s/he gets to the guide the 'tighter' /truer to guide the sleeve is. During surgery the bougie is inserted into your mouth down your throat, towards the end of yer stomach where it meets the pylorus via an esophageal dilator. After the new stomach is formed, the bougie/guide is removed out of your mouth, possibly why some VSGrs complain of a sore throat post op.
 
 
Some surgeons will use an endoscope or other "guide" to size ones new stomach. I read an OH post of a VSGr who's surgeon explained an endoscope is the same size as a 32F bougie...Im not sure.
 
Bougie size determination is between YOU and YOUR surgeon. Discuss size, rationale for size chosen, type bougie and technique used when sizing your new stomach........ PRE-OP!!
 
Some surgeons may "oversew" the staple line giving one a 'tighter' than bougie sized sleeve.
In order for an "oversewn" staple line to affect stomach size it MUST be running or continuous oversewn suture line across majority of staple line not intermittent oversewn nor merely at intersected "junctures" where the surgeon has reloaded the staple gun as majority of "oversewn" techniques (to prevent leaks) are done today. Make sure your surgeon explains what his/her "oversewn" technique is. Do not assume because a surgeon "oversews" you have a tighter than bougie sized sleeve.
 
A bougie is 1/3 mm PER french. i.e to calculate ~ inches 40F bougie 1/3 x 40 = 13.33mm convert to inches = ~.52 inches or ~1/2 inch in diameter.
 
Below are diameters of bougie/ "guides" in inches
 
32F = .40"
 
34F = .425"
 
36F = .45"
 
38F = .476"
 
40F = .5"
 
46F = .576"
 
60F = .75"
 
 
Video 1
 
This VSG surgery video shows a 'red' 34F bougie, one technique in sizing stomach, exised stomach, testing for leaks etc
.http://www.orlive.co...eight-loss-surg ery-gastric-sleeve
Red bougies are older mercury filled ones. FDA is tryin to ban em because of disposal issues (mercury).
 
 
More surgeons will use SINGLE USE disposable sized bougies
 
Video 2
 
In this surgical video Dr. Alvarez shows a disposable 32F bougie and use/technique
 
 
~9-2012
In another Forum, this member's bougie pix is from hospital she works at 1st: 36F, 2nd: 38F on left, 32F on right

 
 
General/ crude comparison chart created by another Forum member


 
 
Standard sized bougies in the US and Mexico are 32F. 32F is the smallest guide a bariatric surgeon in the US may safely use in forming your sleeve. Your surgeon may prefer any size bougie from 32-50F, based on YOU, your height, weight, or perhaps the need for a malabsorptive procedure in the future, inc. 1st step of 2 part DS. Discuss what to expect, rationale for size chosen with your surgeon if this is a concern.
 
LapSF/Dr. Criangle on their routine use of 32F bougies in VSG "Optimal weight loss may require the smallest possible pouch, which may yield the highest leak rate" .
 
Some surgeons will welcome discussion and your input on bougie sizes. After reading a published journal on the higher incidence of VSG surgically induced GERD (acid reflux/heartburn) in use of 28-32F bougies, it may be wise to request a higher bougie size. However, like all surgeries, we will need years of data to support whether or not this claim is actually true.
 
The History of using Bougies
 
In 2000 the use of 50-60F bougies were standard for VSG when it became a stand alone WLS, as they were the standard sizes of DS bougies, which VSG was modeled after. As the years went by, bariatric surgeons thought..smaller bougie, better restriction, less regain. So in ~2005 an adopted 32F bougie became the VSG standard. Rarely, if ever are 28-30F or 50F and over bougies used in the US for VSG as stand alone anymore. Many many VSGrs do EXTREMELY well with 40F-48F bougies as the guide to sizing their new stomach, losing all the weight they need to.
 
In 2008 study (small poll 135 pts) on Bougie Sizes in VSG seems to indicate at 6 mos and 12 mos post VSG .... 40F and 60F bougies with no significant difference in EWL (eventual weight loss) 2008 Bougie Size Comparison
 
In 2009 study (a large poll) on Bougie Sizes in VSG seems to indicate at 5 years post VSG ... 32F and 44F bougies show exactly the same EWL (eventual weight loss) 2009 Bougie Size Comparison
 
In 2012/13 study (a very large poll) on Bougie Sizes in VSG seems to indicate at 3 years post VSG, a LESS than 40F bougie and GREATER than 40F bougie show no difference whatsoever in EWL (excess weight loss) 2012/13 Bougie Size Comparisons
 
 
VOLUME/GASTRIC CAPACITY in VSG:
 
PRE VSG: Average stomach holds 32-48 oz or 4 to 6 cups per meal
POST VSG (~6-8 months out FOR LIFE) ..new stomach holds 8-12 ozs or 1 to 1.5 cups per meal
(depending on weight/density of foods you eat! can be much less or much more)
 
The length of an adult stomach is 10-12 inches. DNA affects the length of our stomachs, as well as variations in shape. Tall people, for instance are known to have longer stomachs..so makes sense they have a bit more capacity, short people have shorter stomachs therefore less capacity.... so volume/capacity can be influenced by the length and physical anatomical variations of an individual's stomach.
 
Dr. Alvarez explains in this You Tube video about length of an individual's VSG stomach and how it relates
to volume.
 
This limited 2009 study is interesting in looking at gastric capacity in VSG,
just 3 days post op (120 ml=~1/2 cup) compared to 2 years post VSG (250 ml=~1 cup)
http://www.ncbi.nlm.nih.gov/pubmed/19533260
 
At the end (8:28 mark) of this LapSF VSG surgical video shows 1 DAY old (pod) sleeve Xray and a sleeve Xray at 4 years out. It is not clear to me if same pt. or solely to impress the new "normal" sleeve size. Note the "new normal" 32F tightly formed sleeve has dilated/stretched naturally to perhaps triple in size...The video also shows one technique of sizing the sleeve, as well as reinforcement of the staple line (to prevent leaks)
 
This VSG video shows the speed with which LIQUIDS/FLUIDS empty from the sleeve. In normal stomachs fluid empty rate is 5 minutes or less due to space creating a reservoir for large volumes of fluids. In VSG stomachs: fluid empty rate looks MUCH faster than that... youdecide!
 
The COTTAGE CHEESE TEST /CCT (link following) may be helpful to VSGrs that are curious about their new stomachs capacity. It was developed for RNY but an effective tool in VSG as well! I'd suggest waiting until you are on a regular diet before checking. When doing this test PLEASE eat to sensation of satiety - no longer hungry, and absolutely not full.
 
A simpler method, following the basic guidelines and time frame in the link provided... is to place 1 level cup (8oz) of small curd cottage cheese in a bowl and eat from that. Using a measured tablespoon to eat any remaining cottage cheese from the original container. Add or subtract any cottage cheese eaten or not finished using the measured tablespoon. 2 TBS=1oz. Total...the amount consumed = your sleeve's capacity.
http://www.bsciresourcecenter.com/proddetail.php?prod=A4
 
 
STRETCHING in VSG:
 
YOU CANNOT STRETCH/DILATE out your sleeve to anything remotely close to its original size.
 
From LapSF/Dr. Criangle: The removed section of the stomach is actually the portion that stretches the most. The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food.
 
The fundus (inc. majority of stomachs 'body' up to pyloric canal) of the stomach is ALL but removed with VSG.
The fundus is the upper most part of the stomach's greater curvature. The fundus is:
1) the stomach's stretchy/expandable tissue, capable of expanding 2-3xs its resting 'unfilled' size
2) the pre-op 'mass quantities' of food, waiting to be digested, storage section
3) where 70% of the body's grehlin a "hunger hormone" is produced.
 
 
 
Stretching, due to overeating is most common in RNY because more of the stretchy fundus part of the stomach is retained to make the 'pouch', and is usually NOT covered by insurance to correct. Re-sleeving or a need for a malabsorptive surgery post VSG may or may NOT be covered by your insurance plan.
 
Anecdotally, Ive read from select OH VSG members, or according to a/their particular surgeon..overeating will cause your sleeve to stretch out. Ive read/found no scientific data, published or otherwise, to date that says this is a TRUE statement.
 
Since food stays in our stomach less than ~ 3 hours after a meal..common sense tells me food doesn't stay in our stomachs long enough to create 'stretching'. Food once ingested, immediately begins to be churned into a liquidy sludge called chyme through peristalsis in the stomach. This liquidy sludge must be small enough to pass through our very small pyloric valve and into the small intestine for further digestion /breakdown and absorption of 'micronutritents' ...so there cannot be enough pressure for long sustained periods of time in our stomachs to cause it to stretch.
 
 
Post op VSG ... depending upon the amount of swelling/inflammation you have..even a little 'thick/er' dense liquids or pureed foods/mushies may or may not feel restrictive, as you pass through the progression of texture dietary phases ( to promote healing) and onto your regular diet ~2mos post op. ... swelling/inflammation has naturally reduced. Density of meals becomes a key player in restriction. By 1 year out you'll find you can eat more than you could at 2 days post op, at 2 weeks post op, 2 months post op, and 6 months post op. Your sleeve has naturally and fully matured.
Depending on the food..you can eat more or less than the 8-12 oz capacity of a fully matured sleeve.......at any particular meal.
 
Toleration of a food, does NOT make it a good choice!
"just because I CAN...doesn't mean I DO"
 
---------------------------------------------------------------------------
The bougie size controversy/wars are ridiculous imo.. 'get a smaller one, you can stretch it out, you're not going to have any restriction, that bigger one is all wrong, you'll re-gain easily years out, my surgeon made mine smaller and I got to goal in 6 months'
...all nonsense DO NOT PAY EM NO MIND!! This is YOUR story! YOUR journey!
 
 
ALWAYS REMEMBER THIS TRUTH:
 
YOUR WEIGHT HAS NOTHING TO DO WITH THE SIZE OF YOUR STOMACH, altered or not!
 
Most important is the quantity and quality of the food choices you ingest post-op

To the weight loss surgery patient slider foods are the bane of good intentions and ignorance often causing dumping syndrome, weight loss plateaus, and eventually weight gain. Slider foods, to weight loss surgery patients, are soft simple processed carbohydrates of little or no nutritional value that slide right through the surgical stomach pouch without providing nutrition or satiation. The most innocent of slider foods are saltine crackers, often eaten with warm tea or other beverages, to soothe the stomach in illness or while recovering from surgery.
 
Understanding Slider Foods
The most commonly consumed slider foods include pretzels, crackers (saltines, graham, Ritz, etc.) filled cracker snacks such as Ritz Bits, popcorn, cheese snacks (Cheetos) or cheese crackers, tortilla chips with salsa, potato chips, sugar-free cookies, cakes, and candy. You will notice these slider foods are often salty and cause dry mouth so they must be ingested with liquid to be palatable. This is how they become slider foods. They are also, most often, void of nutritional value.
 
For weight loss surgery patients the process of digestion is different than those who have not undergone gastric surgery. When slider foods are consumed they go into the stomach pouch and exit directly into the jejunum where the simple carbohydrate slurry is quickly absorbed and stored by the body. There is little thermic effect in the digestion of simple carbohydrates like there is in the digestion of protein so little metabolic energy is expended. In most cases patients in the phase of weight loss who eat slider foods will experience a weight loss plateau and possibly the setback of weight gain. And sadly, they will begin to believe their surgical stomach pouch is not functioning properly because they never feel fullness or restriction like they experience when eating protein.
 
The very nature of the surgical gastric pouch is to cause feelings of tightness or restriction when one has eaten enough food. However, when soft simple carbohydrates are eaten this tightness or restriction does not result and one can continue to eat, unmeasured, copious amounts of non-nutritional food without ever feeling uncomfortable.
 
Many patients turn to slider foods for this very reason. They do not like the discomfort that results when the pouch is full from eating a measured portion of lean animal or dairy protein without liquids. Yet it is this very restriction that is the desired result of the surgery. The discomfort is intended to signal the cessation of eating. Remembering the "Protein First" rule is crucial to weight management with bariatric surgery.
 
Gastric bypass, gastric banding (lap-band) and gastric sleeve patients are instructed to follow a high protein diet to facilitate healing and promote weight loss. Bariatric centers advise what is commonly known among weight loss surgery patients as the "Four Rules" the most important of which is "Protein First." That means of all nutrients (protein, veggies, complex carbohydrates, then fat and alcohol) the patient is required to eat protein first.
Protein is not always the most comfortable food choice for weight loss surgery patients who feel restriction after eating a very small amount of food. However, for the surgical tool to work correctly a diet rich in protein and low in simple carbohydrate slider foods must be observed. The high protein diet must be followed even after healthy body weight has been achieved in order to maintain a healthy weight and avoid weight regain.

I had my sleeve done on March 30, 2013. This is my story so far… even though I feel like I am eating like a bird, my weight loss has come to a halt! I am upping the exercise a bit to see if that helps. The lack of weight loss is frustrating, however, I am fitting into smaller clothes! It is the best decision I have ever made regarding my health. At first I felt very sad - I missed chewing - doesn't that sound weird? But then after a few weeks I was allowed to have soft foods and the desire to chew up some meat was fulfilled! Now I find that I don't even really enjoy food - it is a chore to figure out what I want to eat. I make sure I get my protein drink in each day and a V8 along with the vitamins and calcium citrate; the rest is just filler. Nothing tastes as good as it used to before the surgery. If this keeps up, it will be a breeze to lose more and keep it off for life!
Food was my best friend that I turned to whenever I needed to calm myself, soothe my mind, celebrate an occasion, and so on. The surgery has severed this relationship - it's been like losing a friend that I depended on for moral support. But now I realize that food was not my friend – it was a crutch that was bringing me down – not holding me up. I am learning new ways to cope with life – it is wonderful. I think anyone who has struggled with weight should consider this surgery. The recovery is painless and the scars are minimal. I can’t wait to uncover the thin person that is inside this chubby body – what a treat that will be! Good luck to all!!

So, I went for my 6 week follow-up visit on Thursday, and also saw my primary care physician the same day.
 
First, the follow-up. My surgeon was very pleased with my progress. I've mentioned about the scale discrepancies before. The first visit with the doctor, his scale and my home scale showed the identical weights (274), so that's what they had as my starting weight. Every visit since then, their scale has been 5-6 lbs higher than the home scale. So according to them I went up to 280 before the surgery, but they still have 274 listed as my starting weight. This last visit, they had me in a different office than usual, and that scale was 7 lbs higher than the home scale. So according to them, I have lost 36 lbs, even though at home I know it is 43. I'm not going to argue, they are still very happy with 36, and I would be also if I didn't know it was actually 43.
 
Now for the primary MD visit. He was amazed at the difference in how I looked, and my weight loss. My blood pressure was 110/80, and he said that in 2 weeks I can start cutting my BP pills in half and he would evaluate me again in 6 weeks. This is huge for me, getting off the medication was one of the major reasons I did this surgery.
 
Also, big news - on Friday my wife was sleeved! That's why I haven't blogged about this other stuff until today. She is doing pretty good now, her recovery has been much different than mine. She has had a bit of a rougher time than I had, but I know she will get through it.

So I had 4 appointments yesterday...3 revolving around my sleeve and the other one was my dentist. My appointments were with my nutritionist, fitness trainer (part of my weight loss program), and my sleep specialist.
 
Good news is I weighed in at 257 pounds! I don't have any complications and it seems I might be able to stop taking my nexium.
 
Bad news is my premier protein shakes that I have had to drink twice a day have been staining my teeth! Ugh. So I guess I am going to have to switch from my chocolate version to a lighter color when I'm done with the 3 boxes I just bought from costco.
 
My nutritionist appointment went fairly well. She doesn't have any real concerns. I learned that I have, once again, not been getting enough calories in. I average around 600 calories a day. According to her, others at this stage are already up to 1000 calories. I was concerned and asked her if this is going to affect my metabolism because it has been 3 months, basically, since my body has been in a severe calorie deficit. She recommended that I try real hard to get my calories close to 1000, but no more than 1200 so I don't hit stalls etc.
 
I think if I could manage to eat that many calories, then I would lose weight more consistently and hit less stalls.
 
My other appointment with my fitness trainer went well. She was impressed and very supportive about all the steps I am taking to be more active. I expressed a little disappointment with how "slow" my weight loss has been considering all the effort I put in and the first thing she asked me was, "are you getting enough calories?"
 
So, right now, my calories are my main focus. I don't think I am a slow loser, but I think the weight should be coming off quicker considering my age, bmi, and activity level. I have always, in the past, lost weight fairly quickly so I feel something is just a little bit off.
 
I am putting every effort into eating more calories. This is a daily struggle for me. I feel the only time I can manage upwards of 800 calories is if I eat slider foods, fried foods, or high sugar foods...all of which I want to try and avoid. I am still figuring all this out and am extremely frustrated!!! I never would have thought that I would be frustrated because I am having difficulty getting enough food!!!
 
I want to do everything I can to keep the weight coming off at a consistent pace with no stalls. The only issue right now is that I am not eating enough calories to support my intense workouts.
 
Yesterday, I tried real hard. I basically ate from the time I woke up until I went to bed. As soon as I could eat something...I did. I even let my husband take me to Ruby Tuesday's thinking this could help up my calories. At the end of the day, I did reach 1200 calories, but I felt crappy and overly full. I actually felt extremely tired like I was going to pass out...I think from eating too much. I don't like how I felt yesterday!
 
Today, I wasn't hungry ALL DAY. I drank most of my meals. So I am sort of at a loss. If I stuff myself just to get my calories in, but am not hungry the whole next day, then what?
 
All in all, I don't want to stuff myself. I want to just eat normally when I'm hungry. I guess I just need to find higher calorie foods or make them. I am extremely dedicated in upping my calories because I truly feel that my weight loss will be better and more consistent.
 
Oh and I am definitely losing some hair. No one can tell, but me because I have soooo much hair! My brush has extra hair in it, my rubberbands, and the hair catcher has extra hair. I hope it doesn't get too bad, but it was still worth getting my sleeve.

Insurance approved on the first try...YEAH!!!!!!!!!!!!!!!!!!!!!! 3rd day on 2-week liver shrinking diet. Not so bad, but only 3rd day. Surgery date March 28. I cannot wait...very excited. The butterflies have not shown up quite yet.

I recieved my pb2 w choc in the mail... looking for recipe ideas!!! I start soft foods Monday. Is it too soon to use??? Any recipes/ feedback would be nice! I am down 26 lbs yay! Blessings
 
TD41

Hi,
Just curious how everyone eats their meals.... Are you using adult or children utensils... I find myself at times eating to fast or too much im not sure if I should use a smaller utensil so that I am eating less food and filling up faster.... Any advice would be appreciated. Thx
 
TD41

Finally 8 weeks out, feeling pretty good.
 
Went to endo this morning and am now on a U100 insulin in my pump. This is so exciting to see progress. Down 70 lbs and kinda on a stall but that's ok, as long as I see progress. Went from size 20 down to 14. Working for size 8.

One of my favorite Mexican foods. I've been eating this stuff for about 4 weeks straight.
 
I got all the ingredients at Walmart. It cost about $4 for 2 days worth of meals (4 - 6 meals in my case). It's very filling and sticks with me.
 
1 lb of chicken breast.
1 pkg of Taco Bell Taco seasoning.
(I tried other name brand taco mixes and the store brands, Taco Bell tastes the best and is just as cheap. There is a Taco Bell chipolte version as well, but I liked the regular version the best. )
 
1 can of gebhardt refried beans w/fat.
(I tried the non-fat version and I like the fat version better. It only has 2grams of fat per serving.)
 
Salsa or Picante or Taco sauce to taste
1 pkg of your favorite shredded cheese.
 
 
I grill the chicken breast and run it through my food processor.
Mix the taco seasoning with about 1/2 cup of water and mix it thoroughly. I mix it in my protein shake shaker.
Toss the chicken into a pot or pan and add the taco seasoning.
Bring it up to a boil and then reduce the heat to a simmer. Let it simmer for about 20 minutes.
 
Mix the chicken and beans in a bowl. Add some salsa if it's too thick for your taste.
 
 
Spoon some of the mixture into a bowl and top with cheese and salsa.
 

So, I had my 1 month follow up appointment today with my doctor. It wasn't a good visit, in my opinion. He didn't understand why I haven't lost any weight since my last visit 3 weeks ago. I told him that I had the same concern. I explained that I had in fact gained weight and just lost that weight this last week. It was really a depressing visit and I just wanted to cry while talking to him. I know he didn't mean to, but he really made me feel like I'm failing at this. I'm trying my hardest. I still can't eat more than 600 to 700 calories a day, I don't snack more than once or twice a day, and I get most of my protein in. I try to get all my fluids in, but it's been hard. I have even given up coffee (which has been really hard for me) because I know that if I drink coffee, I won't drink water as I tend to sip my coffee most of the day. Sometimes I feel like I'm crazy the way I read every damn nutrition label making sure that I don't eat something that has too much of the wrong things in it and choose something that has all of the right things. He kept talking about liquid calories and I just wanted to yell and tell him to shut up about that because the only liquid I even drink is water. I miss juices and I can't stand adding those crystal light flavors to my water because of the after taste I get from them. I know he wasn't trying to be cruel, but after this visit, I just felt so defeated. I had to fight my own thoughts. I kept thinking about going out and buying the most unhealthy, greasy, fattening thing I could from a fast food restaurant on the way home, but I couldn't bring myself to do it. Of course, the one thing I have always had my entire life is wheel power of not eating what I know I shouldn't be eating, so I didn't stop. I just went straight home and started working again. I'm just really worried that the weight won't come off.

After dropping 20 lbs in total from the pre op diet and first few days after surgery, I've weighed exactly 254.7 for the past 3 days. A stall during the first week post op? A bit discouraging. I spent a couple hours last night reading these forums about people's stalls. I guess I need to not obsess about the scale, and let things happen in their own time. I believe it's physically impossible not to lose weight with the small amount of calories I've been taking in.
 
I am very moody and irritable today, even getting annoyed if my kids try to talk to me. I'm not sure what that's about, that's not my normal. I guess I'll attribute it to the diet.
 
I've progressed to the stage 2 of the the post op diet, mushy or puréed foods. I went to the grocery store to pick up some things that sounded good from the list - low fat cream soups, instant grits. I also went to GNC and picked up a case of the Isopure bottles. Expensive, but I like them better than the powdered shakes which seem too sickeningly sweet to me now. 40 g of Protein and 20 oz of liquid simultaneously? Win-win. I got the Alpine Punch flavor, really only because it was the only one there was a full case of, and it's not bad. There are some other flavors I'd like to try also. My first mushy food was the instant grits. I only was able to eat 4 spoonfuls, and I put the rest into a container for another time. I will probably try a soup at dinner time. I'm finding it very difficult to eat and drink enough, especially since I can't drink for 15 minutes before, or 45 minutes after eating something. That takes 3 hours out of the day where I can't drink anything. I was more thirsty than hungry at lunchtime, even after taking a couple hours to drink the 20 oz Isopure. So I drank instead of eating.

So it's 2 days before my 7 month sleeve anniversary- and it's blowing my mind... I remember thinking, I'm losing to slow, etc. But wow- the before and afters are speaking for themselves. Today I'm weighing in at 153.9 lbs from my heighest pre-op weight of 216 for a total loss of -62.1 lbs and I'm -18.9 lbs away from my ultimate goal of 135, and I'm only a few pounds for my second optimal goal of 145 (doctors original goal for me).
 
A lot of the reason I haven't posted in my blog lately is this funny thing called life. I've been living it. I wasn't before. Plain and simple. I hid behind my computer, I was socially done- I had no motivation to go out, or even go shopping. I had to force myself to interact and get dressed up. Well, a few months ago a met a nice guy, and we started casually dating. In January he asked me to make it official the day before his parents flew in for a visit so he could properly introduce me as his girlfriend. Life has been amazing ever since. He moved a couple of weeks ago and now we are doing the long distance thing while I finish my PhD for the next year or so. I'm getting back on the wagon and tracking my calories and carbs and protein like crazy on Myfitnesspal.com (screen name DLMeekie if you want to follow me). It's only been 7 months since my surgery, but it already feels like a life time ago. I can't believe I will be at goal or near it at my 1 year surgiversary. I'm so happy now, that I struggle thinking it could get any better.
 
My weight loss has slowed down tremendously, but I'm okay with that as long as I know I'm doing my best to eat right and work out. Since I stopped swimming last semester I joined a women's only gym with onsite daycare and I've been going at least 3 days a week, and walking at a steep incline for 3 miles, then I rotate the weight machines (upper body versus lower body) for at least an hour. So basically, I'm in the gym 3 days a week for 2 hours.I miss swimming a lot, and I don't enjoy the gym as much, BUT I'm getting it done. And it's not nearly as hard as it use to be. It fits into my schedule and my life with my son.
 
My only regret still remains. I wish I would have done this surgery sooner. I wish I could go back and reclaim my 20's. But I can't. So I must embrace my 30's when they arrive in 6 months or so.... Life is good.
 
Height: 5'9
 
Highest (Surgery) Weight: 216
 
1st Primary Goal Weight: 169 (Achieved 11/27)
2nd Optimal Goal Weight: 145
 
Sleeve Journey:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 8/17/12- PreOp/Surgery Day w/Pics Posted in Blog
Week 1 (8/24): 204.8 (-11.2)
Week 2 (8/31): 200.6 (-4.2)
Week 3 (9/7): 196.8 (-3.8)
Week 4 (9/14): 193.5 (-3.3)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 9/17/12- 1 Month Anniversary w/Pics Posted in Blog (-22.5 lbs)
Week 5 (9/21): 191.6 (-1.9)
Week 6 (9/28): 190.1 (-1.5)
Week 7 (10/5): 187.0 (-3.1)
Week 8 (10/12): 181.9 (-5.1)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 10/17/12- 2 Month Anniversary w/Pics Posted in Blog (-11.6 lbs)
Week 9 (10/19): 181.4 (-.5)
Week 10 (10/26): 177.9 (-3.5)
Week 11 (11/02): 176.8 (-1.1)
Week 12 (11/09): 174.7 (-2.1)
Week 13 (11/16): 173.3 (-1.4)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 11/17/12- 3 Month Anniversary w/Pics Posted in Blog (-8.6 lbs)
Week 14 (11/23): 173.1 (-.2)
Week 15 (11/30): 167.3 (-5.8)
Week 16 (12/7): 168.1 (+.8)
Week 17 (12/14): 164.6 (-3.5)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 12/17/12- 4 Month Anniversary (-8.7 lbs)
Week 18 (12/21): Holiday Break/Vacation- No Scale Available
Week 19 (12/28): Holiday Break/Vacation- No Scale Available
Week 20 (1/4/13): 164.5 (-.1)
Week 21 (1/11): 161.5 (-3.0)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 01/17/13- 5 Month Anniversary (-3.1 lbs)
Week 22 (1/18): 161.7 (+.2)
Week 23 (1/25): 158.7 (-3.0)
Week 24 (2/1): Out of town- No scale Available
.2Week 25 (2/8): 157.2 (-1.5)
Week 26 (2/15): 157.2 ( .0)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 02/17/13- 6 Month Anniversary 157.2 (-3.3 lbs)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 03/17/13- 7 Month Anniversary 153.9 (-3.3 lbs)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 04/17/13- 8 Month Anniversary
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 05/17/13- 9 Month Anniversary
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 06/17/13- 10 Month Anniversary
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~> 07/17/13- 11 Month Anniversary
 
ONE YEAR SURGERY ANNIVERSARY~~~> 08/17/13- 12 Month Anniversary

I'm feeling really good today. Like I've said, every day is better than the one before. I had my follow-up visit with the doctor this morning, and he's happy with how I'm progressing and how my incisions are looking. I'm down 15 lbs according to their scale, 20 according to mine. 15, 20, whatever it is, I'm on my way. I just got back from taking my daughter Chloe for a walk to the library. Felt good to get out for a walk. I walked around the block a couple times yesterday, but it was chilly and raining so not too pleasant. Much nicer out today.
 
Well, I bit the bullet and posted a note on Facebook about the surgery. I woke up at 5 am and couldn't sleep, and all I could think about was getting it off my chest. I spent the next 2 and a half hours working out what I would say. I created the note, then shared it to my wall with the following statement - "Dear friends, please read the attached note in its ENTIRETY before passing judgment. I hope for your support. Thank you, Joe"
 
Here is what the note said:
 
On Friday March 8, 2013, I had a surgery called 'vertical sleeve gastrectomy'. This is a bariatric weight loss procedure. This was not a decision that was made lightly, or hastily. I will try my best to outline my reasons for doing it, what it is, and reasons for not telling anyone.
Reasons for not telling people
First, I want to say that I was originally planning on only telling a very select few people about this. But I realize that this is probably not very realistic, as the changes will probably be pretty significant, and pretty quick. I've even outright lied to some people, including some of my coworkers and bandmates, which I am very uneasy about. I hope they will forgive me. Please don't be offended if you were not one of the people I chose to tell beforehand. My main reason for choosing not to tell people beforehand was that I didn't wish to invite any negativity, or have anyone trying to put doubts in my head as I had already made the very difficult decision and none of that would have been helpful to me. Every person I did choose to tell had the exact same comment - "you're not THAT big." I appreciate the 'compliment', and suppose I got pretty good at hiding it. Before surgery, I weighed 274 lbs. I'm sure this number will probably shock most of you, as that seems to be the universal reaction. Another comment I heard was "you could do that yourself". There have been times I've been able to shed decent amounts of weight, only to put it all back on, and then some. And each time I would do this, would make the next time even harder. I also REALLY didn't want to hear anyone say to me that I was 'taking the easy way out', as no doubt some of you reading this might be thinking right now. This would have done nothing but anger me, and would have jeopardized our friendship. Believe me, there is nothing easy about having surgery. I'm still recovering, and wouldn't ever want to relive the first 24 hours. It is still going to take hard work and exercise to get to my goal and maintain it. This is only a tool to help me achieve that goal.
What it is
There are basically three main types of weight loss surgery. There is the gastric bypass. This was never a consideration in my mind, as I view it as being a last resort for extremely overweight people, and there can be a lot of malnutrition involved. I was actually scheduled for the lap band procedure, as I know a few people who have had it done, with varying degrees of success. After hours and hours of further research, I decided against this. Basically, the lap band is a device that is implanted and placed around the entrance to the stomach. The band gets filled with saline so that it inflates and restricts how much you can eat. The 'temporary' aspect of the band (the fact that it can be removed if any issues arose), was the biggest plus to me initially. The more I read online, the more I saw people not happy with the lap band, and having it removed and getting the procedure I had, the vertical sleeve. Some issues with the band include slippage, erosion, and the long-term maintenance (you have to go periodically for 'fills' to adjust how much the band is filled). Some people just could never find what they call their 'green zone', the perfect level of restriction where they are restricting enough to lose weight but not so much that they are vomiting after 2 bites. Also, insurance concerns crossed my mind - would insurance cover the fills forever? What if I moved or had to change doctors? All of these things pointed me in the direction of the vertical sleeve. The vertical sleeve is the newest of the three types, and is basically a laparoscopic procedure where up to 85% of your stomach is removed, leaving you with a sleeve about the size of a banana. Basically, you are then restricted to eating between 3 and 5 ounces at any meal. You can eat pretty much what you did before, only MUCH less. Some people find that they don't tolerate certain foods after surgery, or don't like the tastes of some foods they liked before. It is a permanent solution. The weight loss results are comparable to the bypass, typically very good. Another benefit of this surgery is that the part of the stomach that is removed is the part that produces the hormone grehlin, the hunger hormone, so feelings of overwhelming hunger go away. People say that they go from eating extreme amounts of food and never feeling full before surgery, to having to remind themselves to eat so they can get in enough calories after. The fact that the lap band was 'temporary' and could be removed at any time, was what made it more attractive to me initially, and seemed less 'drastic'. But the more I thought about it, the more I realized that I needed a permanent solution that would help me make the lifelong changes I needed to make. Wanting something because it was reversible, enabling me to go back to the way I was, no longer made sense to me.
Reasons for getting surgery
First and foremost, I did this for my wife and kids. I don't want to leave them without a husband and father. Sure, I'm not happy with how I look, but looks were at the bottom of my list of reasons. I would have been perfectly happy to continue to eat 5-6 slices of pizza and being upset that there wasn't any more because I still didn't feel full, and watching my weight continue to rise every year. I 'know' what the right things and right amounts to eat are. But 'knowing' and being able to stick to it because you never feel satisfied are two very different things. I never smoked or drank or did any drugs. Food was my drug, and it was negatively affecting my health. Besides weighing 274 and growing, I had a BMI of 36, which is considered obese. I have high blood pressure, high cholesterol, erosive GERD (acid reflux), shortness of breath, a leaky heart valve, and what my doctor says is the second worst case of sleep apnea he's seen in his office. If you don't know, sleep apnea means you stop breathing for significant periods of time, which lowers your blood oxygen level, and the 'jarring' that occurs when your breath comes back could cause your heart to go into a deadly rhythm. So basically, I was a ticking time bomb that could die in my sleep at any time. I have a machine called a CPAP machine that helps me breathe at night, but I've tried it and find it impossible to sleep with it. I'm actually getting a new one today that my doctor says is easier because the air pressure level automatically adjusts based on what you need at any given moment, instead of being set at a fixed level that sometimes seems like too much and would wake me up.. I plan on giving it a try, and hopefully once I lose a significant amount of weight the sleep apnea will disappear. I also hope to be off my medications. Most people who get the sleeve are able to get off their medications and are cured of their sleep apnea. I've seen stories of people being cured of type-2 diabetes (which I thankfully did not have, yet) the day of surgery. Amazing. The apnea and medication for blood pressure, while being the result of being overweight, also become self perpetuating problems. They limit my energy level, which in turn limits my activity level, further adding to the obstacles to weight loss on my own.
How I'm doing
The surgery went well on Friday. The surgeon found a fairly large hiatal hernia, which he repaired while he was in there. The first day was basically Hell. I was in pain, discomfort, had a hard time taking deep breaths, and was extremely tired. All I wanted to do was sleep, not only because I was tired but because I wanted to avoid the discomfort. They pump your belly full of air during the procedure to maximize the space they have to work, and this air leads to gas pain which radiates to your left shoulder. This gas pain is no joke. Every day gets easier than the one before it. I am on a clear liquid diet for 1 week, basically limited to water or crystal light, broth, sugar free jello, and sugar free ice pops. I also need to drink protein shakes until I can start eating foods with protein. They want you to get between 60 and 80 grams of protein in every day, and if I can't get all of that in from food I will have to continue with the shakes. At first, it was very hard to get in the fluids, due to swelling. Very small sips. That is getting easier by the day. After 1 week, I progress to a few weeks of a puréed diet, eating mushy foods. A blender will be my friend for this phase. After that, I can start introducing some 'real' foods, slowly to see what I can tolerate. They still want you to concentrate on getting most of your calories from lean proteins and vegetables, limiting sugars and starches. I welcome my new relationship with food. It will no longer be something that I do for pleasure, consuming unlimited quantities. Instead it will be something that I will have to be conscious of, sometimes reminding myself to eat so that I can get in enough calories to sustain good nutrition and fuel my body. It will be a big change, for sure. I continue to feel better every day. The pain is basically gone, limited to what I would describe as a 'tightness' feeling at the incision sites. I had 7 small incisions, which should leave minimal scarring. The first step out of bed or off the couch is the hardest, because of this tightness, and my fear of twisting or stretching anything the wrong way. I'm walking well, just a bit slow at the moment. The tightness also makes it impossible to sleep on my side or stomach right now, limiting me to my back, which is the worst position for my sleep apnea. To counter this, I've found that sleeping upright on the couch with my feet up on an ottoman is the best for me. I tried piling pillows on the bed to elevate my head, but found that it was pushing my head forward, further restricting my airway. I will get my new CPAP machine today, and look forward to sleeping in bed with my wife again tonight. As of this morning, I've lost a total of 20 lbs, including 9 lbs lost during a strict one week pre-op diet.
In conclusion
I am a very private person, who doesn't like divulging personal (potentially embarrassing) information, as I've done at length here. I only just decided to write this after waking up at 5 am and not being able to fall back asleep. I hope for all of your understanding and support, and 'friendship'. I welcome any questions or comments, either under this post, or in a private message, or in person. I do not welcome any criticism or cruel comments or jokes (even lighthearted ones, as I might not view them this way). If that is your inclination, please refrain from commenting, or go ahead and remove me from your friends list. I apologize for ending this on such a down note like that, I just want to make it clear how serious I am about this. Thank you.'
So far, I've gotten all positive comments from people, except for one person. He used to be a close friend, but we grew apart in recent years, but are still friends on Facebook. It's been years since we've talked, even on Facebook. He said he was hurt that I didn't contact him, because he had weight loss surgery also and could have helped me in my decision. I had no idea he had surgery, and told him that and asked him how I would have known. We sent messages back and forth, and he still was upset, saying stuff about how he's sick of putting himself out for other people only to get nothing back (paraphrasing). I told him that I was disappointed that he chose now, a time when I'm reaching out for support and understanding, to make it about him and his hurt feelings that our friendship isn't what it used to be. Whatever, I can't worry about that now. I need to take care of myself at this point in time.

Hello All,
I was sleeved on Tuesday March 5 2013 and boy o boy has the past 5 days been rough.
 
Day of surgery: I was poked 6 times before a usable vein was found for my IV. On the lighter side I had a great surgeon and she assured me that everything would be fine as I drifted into lala land but when I woke up I felt like I had been run over by a train. The recovery room nurses were very attntive and kept giving me pain meds until I was comfortable. A few hours later I was up in my room not much pain but when I was finally completely coherent I was greeted with the dreadful gas pains....I truely had no idea that the das pains would hurt more then after surgery. The only thing that helped was walking around and more pain meds....this summed up day 1.
 
Day 2: I have not passed any gas at this point and only had little baby burps. After going down for my leak test I came back up to my room and a few minutes later I begin to have a rumbling in my stomach could this finally be the big one so that I am over this gas feeling??? WRONG! I have diarreha this went on for 3 hours...all I could think to myself is how is this possible I havent eaten anything in 2 weeks. I was later released in the evening and estatic becasue I thought to myself I will feel much better at home becasue I was home!
 
MAJOR MISCONCEPTION!
 
Day 3: The gas pain was out of this world and I am still not passing it but I am also begining to have some other pains, after reading VST I find that these are stomach spasms...at this point I can not decipher gas pain from hunger pain or either of these pains from incision pain. I began to feel like this was the worst decision of my life and all I can think about is how hungry I am and how bad I want to get out of the house even though it is snowing outside. My vision in my left eye is blurry and I dont know why. The day goes on and my gas pains get worse. I just decide to go to sleep and pray that I dont die.
 
4am Day 4! I log on to VST to see if anyone is having the same relentless gas pains and I find out about Gas X strips...although I know I shouldnt have I drove myself to the local Walgreens and purchased 2 packs...where had these strips been for the past 3 days what a relief and I am now begining to let the air out. I wake up and told my daughters I want out of this house and thy drove me to the mall under the premise that I would walk the perimeter of the mall to get in some excercise, I was only able to walk about 1/3 of the mall and had to sit for about 10 minutes before walking back to the car. I feel like I am losing the muscle in my calfs. We came in from the mall and I had to take a nap. I attribute the fatigue due to my lack of nutrition.
 
Well it is now day 5 and I am finally able to pick up my laptop and share my experience with you all. Today I feel like the page is turning, still having some stomach spasms, not much gas pain and not much cabin fever anymore. I am looking forward to tommorow because I meet back with my surgeon to have my drain removed and hopefully she will allow more variety into this very bland clear liquid phase that I am currently in. My drain today does not have much fluid in it and I stepped on the scale and for the first time in over 8 years I am under 300 pounds!!!!! Today I am feeling much better and looking forward to the rest of my journey.
 
I can wait to share with you all the rest of my journey.

Hi guys...
 
As you are starting to see, I really like to find natural ways to help my body. I really don't like all the chemicals and unnatural things people put in and on their body's. Over the past few weeks before surgery I have wanted to start taking care of my skin. Mainly because I am worried about the loose skin thing after I start loosing weight. I am sure I can't escape it all, but I figure if I start now I can at least get a jump start on it. I can make it better than it might have been without the effort.
 
So through my research, I stumbled upon "dry skin brushing"
It is said to help with
~ Removes toxins from your body
~Tighten your skin
~Help exfoliate dead skin cells
~Help with aging
and half a dozen other benefits... I am adding a link to one of the main articles I found helpful.
 
http://www.pureinsideout.com/detox-skin-brushing.html#
 
I figure if I add this into my daily life of keeping my skin hydrated, taking skin helping vitamins and staying fully hydrated, maybe I can get some of the elasticity back in my skin.
Give it a try or at the least look into it. I know I am going to try it.
It can't hurt

This is my first blog entry, so I will give a brief synopsis of what has happened so far.
I am 9 days from my surgery, on March 8, and will be starting my pre-op diet tomorrow. It's getting very real for me now, and I'm FINALLY starting to feel a bit nervous (and excited of course). Dr. Karl Strom will doing the procedure at Bayshore Community Hospital in Holmdel NJ.
My wife and I are taking this journey together, although I will have a month and a half head start on her, due to her not being able to get out of work until the end of April. We had originally decided on getting the lap band surgery, but after doing lots of reading and research decided that the sleeve was the better option for us.
I've gone for all of my pre-op testing, except for one last thing tomorrow. My surgery was scheduled so quickly, that some of the doctors were booked up and I had to wait for dates for pre-op stuff. I went for my bloodwork and chest X-ray on President's day, did an EGD 2 days ago on Monday, and a cardiac stress test yesterday. This morning I had the final consultation with the surgeon. Tomorrow I have my second and final Nutritionist visit, and a Pulmonary stress test. Then I should be done with all of my pre-op stuff, yay!
That about sums up where I'm at now, I'm sure I've left out a lot of details, but now that I've started to blog I hope to keep up with it.

For those of yolu worried about getting protein in and calories and even basic vitamins YOU WANT THIS APP!!!!. You can make your daily calories what your dr sets. You can scan the barcodes on all foods or just search for them. Makes life easy. I am supposed to be between 500-600 daily. come to find out I was only getting 400! which can cause a stall. It will track your weight and even measurements.
 
Oh and add friends ---asifitsthelast.

Day three of my liquid diet and it's been going pretty good. I don't trust my scale at all cause it's saying I'm 258 and yesterday at the doctor I was 263. I don't think it's possible to lose THAT much in less than a day? O_O
I dk. But whatever. lol I'm not complaining. I've been obsessing with looking at people's before and after's. That's seriously all I've been doing since like 7am. I like finding younger people around my age and seeing how they've done. Especially those who've had the sleeve.
 
12 more days to go!