Madam Reverie

I did have a sizeable dinner.. I am only 4.5 weeks out and during the day I can eat little. During the evening, the capacity seems to increase. This capacity worries me...

Hmm.. you may be onto something there.. I have IBS and have always know that bread is not always good for me. Thing is, I can't imagine life without bread. Its my most favourite thing in the world

I, personally, have never wanted to be looked at/pitied/observed/cross-examined/analysed/evaluated/held up as some sort of bariatric circus freak or wheeled out as the novel conversation topic du jour (however 'well' intentioned). Which is why, only two people in my world know what I've done - my fiance and I. My sparkling personality <coughs> is enough to raise peoples interests levels in me, all by itself. I, personally, do not need a badge that says 'I am now officially 'interesting', because I've mutilated my body, of which I now offer up to you all as part of my identity for your consumption, titillating dissection and ultimate judgement.' Its everyones own path to choose. As LV says, there's no right or wrong approach - each to their own. If you need to talk about it with people in your sphere - then that's cool and i totally understand it. As for spreading it to the four winds? Hell no. I'm pretty good at keeping my own counsel and will subsequently keep it that way.

Tonight and for the first time in, ooh, 8 months, I had a spoonful of Ben & Jerry's Phish Food, with three mini Amaretti biscuits. I must say, I nearly passed out with the level of unadulterated pleasure it brought me... Feeling guilty? HELL NO!!!!!

You got in there before I did! Drat and double drat!

'You can have a million dollars.. I have 200 million in an offshore account.. sadly, I need $350 dollars to process the paperwork to receive the money. If you send that to my bank account, I will send you a million dollars on release of the funds.' ........ Gotta love the 419......

Are you serious?! Oh no! I wish I hadn't reported it now.. I could've have some serious fun! BOOOO!

I was told by my nutritionist.. 'you would really have to go some to stretch your stomach to its original size and regain all your weight'. As for my surgeon - he said 'yes, there is flexibility in the organ (that is what the stomach is designed to do) so if you overeat every day, you will, over time, stretch it out a bit. Conversely, if you eat little, it will shrink.' Consequently.. and my advice? Listen to your pouch and when it says stop - stop. Asking for absolutes on the 'average stretch of a pouch', is, although i'm sure that this is not your intention, like asking 'how much to the millimeter of alcohol can I consume before i can't drive a car'. There are guidelines provided us, based on average consumption levels and associated performance. Some people can drink more and process it more quickly, like some people can eat more and process it more effectively. Asking for any further specificity than that, is pretty futile. Only you know what your stomach tells you in comparison to the guidelines offered you. None of us know exactly the amount we can eat - because each food type has a different effect on us and this also changes day by day. For example, some days I can eat bread and some days, I'd rather gouge my eyes out with a rusty spoon than put bread in my belly. I just eat what I fancy and stop when I feel a fullness below my sternum. That feeling that if I ate another mouthful, it'd be up into my esophagus. That's the only gauge I know and that's all I have to go by. Best of luck in finding yours and being comfortable with it. More importantly; try not to freak out. You're not going to put all your weight back on overnight and if the scales do start going the other way, you know what you have to do.

You go girl!

Its the food and the Iron.. headache is probably due to insufficient Fluid. Unless you're vomiting a lot or have pain/swelling in and around your wound sites/stomach coupled with a bit of a fever- I wouldn't worry. However, if you're concerned after a couple of days - see your quack.

'Cause I knew I wouldn't be able to eat a man-mountain of food at every meal. Which, considering I don't really have a sweet tooth, preferring mountains of savoury, was, on evaluation, going to work in my favour. You can't stuff a mountain of lasagne down your gullet when your stomach is the size of your thumb! From what I see/hear, people with very sweet teeth, have the hardest time. Primarily because the sweet stuff can constitute 'sliding' foods. Small stomach or not - to avoid those things still takes dedication and will power - just like a diet.

Depends on how you want to play it.... 1) The combative method - walk into the directors' office and tell them, 'any more speculation in front of the whole office about my personal medical business and I'll have you before a tribunal quicker than your legs can carry you (not very good for the career prospects, but fundamentally, they are in the wrong on many levels.) 2) The jokey method - Say in front of all the staff 'Oh, yeah, about my surgery, I'd just like to announce that I'm having a brain transplant. Reason? The medical community cannot believe I actually work here!'. Any follow up, smile and say 'with the greatest of respect, it really is none of your business.' 3) Ignore them entirely. They'll get bored of the speculation eventually. 4) Ham it up. Wait until some bozo chooses an inopportune and public moment to make a direct enquiry - promptly run away crying. They'll be scared shiteless that they've said something terribly wrong and after initial attempts at saying 'there there', will leave it be and probably avoid enquiring again like the plague. Best of luck!

They're not too bad, thank you for asking. Some days I'm good, some days I'm like 'uh oh.. maybe need to take a food break for a few hours'.. I have not had a repeat performance of the awful bile inhalation in the morning - so I guess the nil by mouth for 3 hours before bed and the elevated sleeping position, must be doing its thang.

I wouldn't say 'disappear', but despite being on Cerazette contraception pill (which stops your periods), I decided to spontaneously have a period - and I'm 4 weeks out of surgery. Hormones must be going crazy!

<shakes her tail feathers>

To be blunt and to not waste anyones time.. Asking a surgeon for a detailed response about the effects of bariatric surgery on an individuals metabolic rate (particularly as we're all different) is like asking a baker to fix a rare sports car. In short, you need an endocrinologist. As for the impeded weight loss. You sadly had a bit of a rough trot of it immediately after your surgery - so this would definitely have short-circuited the system - giving much credence to the points made by our learned friends on this site, that you may have to wait it out and see how your body normalises. As far as references for current academic research go, please see below. As you'll know, academic research is normally very narrow in its focus, so you'll have to go through quite a few of them in order to assimilate a potential 'ground truth' for yourself. However, there are some articles which offer the generic information you seek which might at least allay your current fears. Naturally, this comes with the caveat that without full knowledge of the endless subtleties and nuances the endocrine system plays on our bodies, it might appear attractive to propose one hypothesis for your current predicament, for it to then be incorrect because of a previously unidentified and unevaluated interaction. Consequently, if you want your rare sports car fixed? Go see a specialist mechanic Hope this helps. Any questions or queries, please do not hesitate to ask. Best of luck, Daydra x Bariatric surgery in obesity: Changes of glucose and lipid metabolism correlate with changes of fat mass Original Research Article Nutrition, Metabolism and Cardiovascular Diseases, Volume 19, Issue 3, March 2009, Pages 198-204 F. Frige', M. Laneri, A. Veronelli, F. Folli, M. Paganelli, P. Vedani, M. Marchi, D. Noe', P. Ventura, E. Opocher, A.E. Pontiroli Show preview | PDF (216 K) | Recommended articles | Related reference work articles 2 Effect of bariatric surgery on liver glucose metabolism in morbidly obese diabetic and non-diabetic patients Original Research Article Journal of Hepatology, In Press, Accepted Manuscript, Available online 20 September 2013 Heidi Immonen, Jarna C. Hannukainen, Patricia Iozzo, Minna Soinio, Paulina Salminen, Virva Lepomäki, Ronald Borra, Riitta Parkkola, Andrea Mari, Terho Lehtimäki, Tam Pham, Jukka Laine, Vesa Kärjä, Jussi Pihlajamäki, Lassi Nelimarkka, Pirjo Nuutila Show preview | PDF (808 K) | Recommended articles | Related reference work articles 3 Dramatic Reversal of Derangements in Muscle Metabolism and Left Ventricular Function After Bariatric Surgery Original Research Article The American Journal of Medicine, Volume 121, Issue 11, November 2008, Pages 966-973 Joshua G. Leichman, Erik B. Wilson, Terry Scarborough, David Aguilar, Charles C. Miller III, Sherman Yu, Mohamed F. Algahim, Manuel Reyes, Frank G. Moody, Heinrich Taegtmeyer Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 4 Bariatric surgery and its impact on sleep architecture, sleep-disordered breathing, and metabolism Review Article Best Practice & Research Clinical Endocrinology & Metabolism, Volume 24, Issue 5, October 2010, Pages 745-761 Silvana Pannain, Babak Mokhlesi Show preview | PDF (355 K) | Recommended articles | Related reference work articles 5 Progressive Regression of Left Ventricular Hypertrophy Two Years after Bariatric Surgery Original Research Article The American Journal of Medicine, Volume 123, Issue 6, June 2010, Pages 549-555 Mohamed F. Algahim, Thomas R. Lux, Joshua G. Leichman, Anthony F. Boyer, Charles C. Miller III, Susan T. Laing, Erik B. Wilson, Terry Scarborough, Sherman Yu, Brad Snyder, Carol Wolin-Riklin, Ursula G. Kyle, Heinrich Taegtmeyer Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 6 ESR1 gene and insulin resistance remission are associated with serum uric acid decline for severely obese patients undergoing bariatric surgery Original Research Article Surgery for Obesity and Related Diseases, In Press, Corrected Proof, Available online 14 November 2012 Weu Wang, Tsan-Hon Liou, Wei-Jei Lee, Chung-Tan Hsu, Ming-Fen Lee, Hsin-Hung Chen Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 7 American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient Review Article Surgery for Obesity and Related Diseases, Volume 4, Issue 5, Supplement, September–October 2008, Pages S109-S184 Jeffrey I. Mechanick, Robert F. Kushner, Harvey J. Sugerman, J. Michael Gonzalez-Campoy, Maria L. Collazo-Clavell, Safak Guven, Adam F. Spitz, Caroline M. Apovian, Edward H. Livingston, Robert Brolin, David B. Sarwer, Wendy A. Anderson, John Dixon Show preview | PDF (1294 K) | Recommended articles | Related reference work articles 8 Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient—2013 Update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Review Article Surgery for Obesity and Related Diseases, Volume 9, Issue 2, March–April 2013, Pages 159-191 Jeffrey I. Mechanick, Adrienne Youdim, Daniel B. Jones, W. Timothy Garvey, Daniel L. Hurley, M. Molly McMahon, Leslie J. Heinberg, Robert Kushner, Ted D. Adams, Scott Shikora, John B. Dixon, Stacy Brethauer Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 9 Bariatric surgery and the gut-brain communication—The state of the art three years later Review Article Nutrition, Volume 26, Issue 10, October 2010, Pages 925-931 Maria de Fátima Haueisen S. Diniz, Valéria M. Azeredo Passos, Marco Túlio C. Diniz Show preview | PDF (156 K) | Recommended articles | Related reference work articles 10 Postoperative Metabolic and Nutritional Complications of Bariatric Surgery Review Article Gastroenterology Clinics of North America, Volume 39, Issue 1, March 2010, Pages 109-124 Timothy R. Koch, Frederick C. Finelli Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase Bariatric surgery has become an increasingly important method for management of medically complicated obesity. In patients who have undergone bariatric surgery, up to 87% with type 2 diabetes mellitus develop improvement or resolution of their disease postoperatively. Bariatric surgery can reduce the number of absorbed calories through performance of either a restrictive or a malabsorptive procedure. Patients who have undergone bariatric surgery require indefinite, regular follow-up care by physicians who need to follow laboratory parameters of macronutrient as well as micronutrient malnutrition. Physicians who care for patients after bariatric surgery need to be familiar with common postoperative syndromes that result from specific nutrient deficiencies. 11 Update: Metabolic and Cardiovascular Consequences of Bariatric Surgery Review Article Endocrinology and Metabolism Clinics of North America, Volume 40, Issue 1, March 2011, Pages 81-96 Donald W. Richardson, Mary Elizabeth Mason, Aaron I. Vinik Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase Obesity is a disease state with polygenic inheritance, the phenotypic penetrance of which has been greatly expanded by the attributes of modern civilization. More than two-thirds of obese persons have comorbidities, many of which are characteristic of cardiometabolic risk syndrome (CMRS) in addition to other life-quality–reducing complaints. The CMRS is associated with increased cardiovascular events and mortality. Individuals with a body mass index greater than 35 infrequently achieve or maintain weight loss adequate to resolve these metabolic and anatomic issues by lifestyle or pharmacologic strategies. Data suggest that some of these patients may be better served by bariatric surgery. 12 Secretion and Function of Gastrointestinal Hormones after Bariatric Surgery: Their Role in Type 2 Diabetes Review Article Canadian Journal of Diabetes, Volume 35, Issue 2, 2011, Pages 115-122 Alpana Shukla, Francesco Rubino Show preview | PDF (1234 K) | Recommended articles | Related reference work articles 13 Cirurgia bariátrica: como e por que suplementar Review Article Revista da Associação Médica Brasileira, Volume 57, Issue 1, January–February 2011, Pages 113-120 Livia Azevedo Bordalo, Tatiana Fiche Sales Teixeira, Josefina Bressan, Denise Machado Mourão Show preview | PDF (548 K) | Recommended articles | Related reference work articles Open Access 14 Tratamiento quirúrgico de la obesidad: recomendaciones prácticas basadas en la evidencia Original Research Article Endocrinología y Nutrición, Volume 55, Supplement 3, March 2008, Pages 1-24 M. José Morales, M. Jesús Díaz-Fernández, Assumpta Caixàs, Albert Goday, José Moreiro, Juan José Arrizabalaga, Alfonso Calañas-Continente, Guillem Cuatrecasas, Pedro Pablo García-Luna, Lluís Masmiquel, Susana Monereo, Basilio Moreno, Wilfredo Ricart, Josep Vidal, Fernando Cordido Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 15 Micronutrient deficiencies after bariatric surgery Review Article Nutrition, Volume 26, Issues 11–12, November–December 2010, Pages 1031-1037 Padmini Shankar, Mallory Boylan, Krishnan Sriram Show preview | PDF (376 K) | Recommended articles | Related reference work articles 16 Xeroftalmía bilateral por déficit de vitamina A secundario a cirugía bariátrica Endocrinología y Nutrición, Volume 54, Issue 7, August 2007, Pages 398-401 Beatriz Alonso Castañeda, María Ángeles Valero Zanuy, Paula Soriano Perera, Francisco García Ruiz, Roberto López Lancho, Susana Perucho Martínez Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 17 Metabolic surgery and gut hormones – A review of bariatric entero-humoral modulation Review Article Physiology & Behavior, Volume 97, Issue 5, 14 July 2009, Pages 620-631 Hutan Ashrafian, Carel W. le Roux Show preview | PDF (403 K) | Recommended articles | Related reference work articles 18 Bariatric surgery in duodenal switch procedure: weight changes and associated nutritional deficiencies Original Research Article Endocrinología y Nutrición (English Edition), Volume 58, Issue 5, 2011, Pages 214-218 Francisco Botella Romero, Marta Milla Tobarra, José Joaquín Alfaro Martínez, Llanos García Arce, Angélica García Gómez, M. Ángeles Salas Sáiz, Antonio Soler Marín Show preview | PDF (188 K) | Recommended articles | Related reference work articles 19 Alteraciones del metabolismo óseo en la cirugía bariátrica Review Article Medicina Clínica, Volume 136, Issue 5, 26 February 2011, Pages 215-221 Virginia Ruiz-Esquide, Pilar Peris, Laia Gifre, Nuria Guañabens Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 20 Bariatric surgery in patients with late-stage type 2 diabetes: expected beneficial effects on risk ratio and outcomes Original Research Article Diabetes & Metabolism, Volume 35, Issue 6, Part 2, December 2009, Pages 564-568 E. Renard Show preview | PDF (212 K) | Recommended articles | Related reference work articles 21 Reversible neurologic dysfunction caused by severe Vitamin deficiency after malabsorptive bariatric surgery Surgery for Obesity and Related Diseases, Volume 2, Issue 6, November–December 2006, Pages 656-660 Michael M. Rothkopf Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 22 What can bariatric surgery teach us about the pathophysiology of type 2 diabetes? Original Research Article Diabetes & Metabolism, Volume 35, Issue 6, Part 2, December 2009, Pages 499-507 F. Andreelli, C. Amouyal, C. Magnan, G. Mithieux Show preview | PDF (245 K) | Recommended articles | Related reference work articles 23 Seasonal changes in serum 25-OH-Vitamin D3 after bariatric surgery e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, Volume 3, Issue 5, October 2008, Pages e208-e210 F. Granado-Lorencio, A. Simal-Antón, I. Blanco-Navarro Show preview | PDF (176 K) | Recommended articles | Related reference work articles 24 Decreased dopamine type 2 receptor availability after bariatric surgery: Preliminary findings Original Research Article Brain Research, Volume 1350, 2 September 2010, Pages 123-130 Julia P. Dunn, Ronald L. Cowan, Nora D. Volkow, Irene D. Feurer, Rui Li, D. Brandon Williams, Robert M. Kessler, Naji N. Abumrad Show preview | PDF (640 K) | Recommended articles | Related reference work articles 25 Nutritional Deficiencies in Obesity and After Bariatric Surgery Review Article Pediatric Clinics of North America, Volume 56, Issue 5, October 2009, Pages 1105-1121 Stavra A. Xanthakos Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase

Have a look at your paperwork first. It seems they have done all the tests without finding anything, but it still hasn't resolved your wife's issues.. So as far as negligence goes, their bases are pretty covered. The best I can suggest is that you sit on their doorsteps until they do something which resolve the issues. Ideally, your wife would be taken in and observed for a few days... Continually make a lot of noise until they do something.. That would be my advice.

I'm 4 weeks out and average about 800-1000 calories a day. I don't know what has happened, but it seems like overnight I've gone from not being able to eat much, to being able to stomach 3 inches of Mousaka, roast meat in gravy with Veg, Beef ragu, two roasted chicken drum sticks (although that took 2 hours to consume), meatballs, deli meats, tortilla stuffed with deli meat and lettuce and tomatoes (half at a time), chicken kiev. lamb shank, pork fillet, lamb kebab with hummus and salad, sambusek (which aren't very healthy, but oh so good), salad, dim sum, prawns, steamed fish fillet. I'm having all sorts of things now. My diet is varied, balanced and becoming tastier by the day. I'm probably not doing as well as I could be on keeping it 'fat free', but I think my body needs the good fats to help it repair more effectively from the surgery. I'm also moving away from the Protein shakes. They're a good back up, but I can get a lot of my nutrients from food. Not hitting the 90gr or Protein a day - but I'm working on it. I'm certainly eating more protein now than I ever did before the surgery. I'm hoping that stands me in good stead for the hair loss issues... As for things I can't eat...I struggle with cheese, red and white wine, sometimes tomatoes, raw onions and bread sits in my stomach a bit like a brick - but I can eat it if I want, but it's not really clever to...Same deal with Pasta. Which, I used to love, but is almost a waste of space in my stomach. I also don't tolerate rich, sweet sweets all that well... So cream based products are out.. chocolate... I don't have a major sweet tooth though, so it's all good and doesn't bother me. Can't wait to be able to add some spice back into my food though. I'm craving a mushroom bahji with extra roasted whole chili! Feeling good

and for the record.. Extreme vomiting is NOT the norm... not in any way shape or form... Get that paperwork and get on it.

I would be demanding the paperwork she signed for the surgery, going through it with a fine tooth comb to see what they have to cover post-operatively. They have already determined there was a stricture - else they wouldn't have attempted to stretch her stomach. However, these are often repeated as it takes time to achieve it. Have they done a leak test? Have they x-rayed her to see if her stomach has twisted (become volvulus)? Personally and if it was me and based on the paperwork and symptoms? I'd be parked on their doorsteps until they did something. If they still resisted, I'd be seeking legal representation. A simple blood test will tell them how malnourished she is.. which is not acceptable for as far out as she is... This smells a bit like palming you off until the 'cover' for the procedure has expired... I'm sorry for your troubles, but get your legal eggs in order and then get some representation.... I wish your wife a very speedy recovery.

http://action.sumofus.org/a/coke-russia-lgbt/4/3/?sub=fb If you feel so inclined, please sign and promulgate - if you haven't already done so

I am 4 weeks out and had something similar - but it was only on one side. I have had kidney stones before and I sincerely thought it was that. In concert with the pain, my left side, around where the incisions were made, also became swollen. It comes and goes now, but when i spoke to my surgeon about it his response was 'that's a first - pain radiating out from where you're saying it is..Sure it's not gas?'... Well, I upped my gas meds and added cranberry concentrate to my water for good measure. So far so good. Gas or not, the pain felt different - but it didn't give me the full malaise that kidney stones gave me originally.. I'm putting it down to 'sluggish tubes' and have seriously made an effort to consume more fluid. Sorry you're feeling rough. Maybe try the cranberry concentrate or cranberry tablets from your health food shop?

No one will condone it - 'cause you know you're not supposed to. But, its a very minor slip and as long as you aren't making a habit of it, you should be fine. (says the woman who had pizza, chicken tenders and a coke the night before hers!)

Okay slightly off topic (and knowing me, I'll be breaking a million rules by posting), but this will be coca-cola's dirty, not so 'little' secret if they go ahead with it. If any of you feel so inclined please have a look at the following, sign and promulgate. For those that are against, indifferent to this cause; no need to comment or kick up a fuss. Please just walk on by. Many thanks http://action.sumofus.org/a/coke-russia-lgbt/4/3/?sub=fb

So, I'm in reasonably nice food hall, which belongs to a major brand in the UK; picking up a couple of nice bits to munch on for the weekend. Noticing that my food bill has been slashed dramatically in the process and since this thang.. Anyway, I decide to exit through the clothing bit and spot a dress on sale. I think 'hmm, that's nice. Do I really 'do' lace though? Besides, is it be big enough?'. I ummed and ahhed over it for about 5 minutes - purely because I didn't want the embarrassment of getting it stuck over my shoulders cause it was too small. Anyway, after lots of mental debating, i decided to try it on. It fit. I didn't get it as it happened, because the lace aspect did my head in.. But as I left and trotted on down the high street, I couldn't help but walk into another lovely dress shop. Found a jacket I really liked. Lady approached me and said 'May I help you?'. I replied with 'Umm, yeah.. Do you have this jacket in a size 20-22 please?' She looked me up and down as if I'd come from Mars and replied 'Erm, you don't need that size my dear. You need a 16-18.' I have been neither of those sizes for nearly 15 years... I can see that THIS might be a problem in the future. I could be a size 14, but will still see a size 22-24 in the mirror.... I may have to work on that. In the meantime... size 16-18?! I'll bloody take it! Yipppppppppppppppeeeeeeeeeeee!