VSGAnn2014

Uh ... reality check .... I'm not the OP. And I'm not crazypants. And I'm not a troll. I'm 19.5 months post-op. I've lost 100 pounds and weigh 135 pounds and have been maintaining well for nearly a year. And yes, I can eat a whole bagel with cream cheese. Maybe not a huge bagel, but a whole bagel. I've done it maybe three times while staying at a budget hotel where they serve continental Breakfast. And it doesn't trigger a carb-fest for me. And I haven't gained weight from it. It's just calories, people. And carbs aren't poison for everyone. And when you're maintaining -- trying not to lose anymore -- it's just food. And if you don't eat it 3 meals a day for a week, what's the big deal? If you're still in the weight-losing phases, it's not the smartest thing to eat. But in maintenance ... chillax.

Once again ... cannot understand why anyone watches that schadenfreude fest. Most "patients" on that show are severely bananas, with family members who are just as nuts. The "stars" of that show are recruited / cast for their outlier physical, intellectual, and social issues. I don't think their massive challenges are at all typical of most WLS patients. I doubt any of the 600-pound *stars* would have qualified for WLS surgery at my surgeon's practice. As we all know, WLS alone doesn't resolve obesity.

LOL! I think that's it ... the perfect affirmation! Love it. Really.

I'm 19.5 months post-op (sleeve surgery). I am a woman and a social drinker, defined (for women) as having no more than one alcoholic drink (1.5 ounces of spirits or 5 ounces of wine) a day and no more than 7 drinks in a week. I have one drink most days, but not every day. Earlier this week, I brought up the subject of social drinking to my psychologist whom I've been seeing for the last 24 months. Like the OP, he has a Ph.D. in psychology. Although he has a general practice, his practice includes many bariatric patients and others who have medical conditions and need to improve their self-care. He also delivers day-long pre-op bariatric surgery orientation and educational classes, so he's very well versed in the latest research re WLS patients' nutritional challenges (which vary considerably according to the specific WLS they undergo), emotional challenges, medical complications, the potential for transfer addictions and pre-conditions and correlates related to those transfer addictions, and anything else you'd expect someone who teaches that class and consults with bariatric patients to know. I raised the subject of social drinking with my psychologist to invite his perspective about my current use of alcohol because a few months ago my husband's cancer reappeared after being in remission for less than a year. In addition to being my husband's primary care giver, I don't want to do anything to jeopardize my own self-care as a recovering obese person. Specifically, I asked him if he thought I should be drinking at this time, if he thought I was drinking too much, and what red flags around alcohol could appear in circumstances like mine. We had a great discussion. He repeated several things which I had learned from studying research studies available online as well, including: 1. Transfer addictions with alcohol do happen, but not to the extent that this topic is discussed in the lay literature. He said that most people who have trouble with alcohol post-op had trouble with alcohol pre-op. 2. He said that there is a smaller percentage (5% or 6%) of WLS patients who did NOT have alcohol issues pre-op who do develop problems with alcohol post-op. 3. He said that my continuing social drinking is something I should keep a mindful awareness of -- about not only how much I'm drinking but why I'm drinking and what benefits I derive from it. He asked why I drink, and I answered that I enjoy the ritual of it and the tastes of it -- either a scotch before dinner or a glass of wine paired with the meal. He asked if I ever drank to inebriation, and I said no, that's not why I drink. 4. He said he would be concerned if I were to use alcohol to medicate or manage my emotions in times of stress. I'm not doing that -- even now. Alcohol has never been my go-to drug to medicate my feelings. I'm in the camp of @@CowgirlJane and others here in that of all the things I worry about wasting calories on, the 100-135 calories spent on a pre-dinner single malt scotch or a glass of wine with dinner is the least of my worries. (My current maintenance calorie budget is 1,800/day.) However, the substance I do struggle with in terms of portion-creep that challenges my discipline is chocolate -- specifically, dark chocolate with sea salt. About six weeks ago I had to declare a moratorium on that stuff. Over a period of three months, I'd edged up from one square of chocolate after dinner to two squares to four squares to (gulp!) six squares ... every damn night! I seriously doubt that dark chocolate is a toxin, but it was sure about to make me its b***h! So for me, mindfulness, moderation and common sense will be the keys to my maintenance success. But total abstinence and perfection -- not so much. EDIT: P.S. I've lost 100 pounds and now weigh 135 pounds. I reached my initial weight loss goal (150 pounds) 8.5 months post-op. I've weighed at or below that weight for the last year.

So you're anti-alcohol of any kinds for WLS patients and think all WLS patients should be or become tee-totalers ... right? Do you feel the same way about alcohol for patients a year out (and in maintenance) as during the weight-losing phases? Do you also recommend no-Cookies for WLS patients? Ever? Even in maintenance? What about cake? Barbeque (and all the sugar in those BBQ sauces)? Chili? Breads? If not all breads, which kinds / brands? What about coffee? Tea? Marijuana? What about sweet potatoes? White potatoes? Fruits -- with or without sugar?

I have used this phrase here before. I'm sure, at least some folks think I'm being rude. But I think it and say it to myself a lot. It expresses exactly what I need to do to care for myself and rise to the occasion, whatever that is: "Buck up!" Not sure that's an affirmation. But it's certainly instructions.

I assume y'all know this, but if not ... the sleeve doesn't restrict slider foods like chocolate, sweets, popcorn and ice cream. Those are the foods found in the Sleeve Handbook in the chapter called: "How to Regain Your Weight Fast." (joke, but not really) I also assume y'all know this, but if not ... the more sugar you eat, the more you crave it. And the only way you can kill that monster is to cold-turkey sugar. Here's another tip -- if you go back to eating a high, high, high Protein diet and a low, low, low carb diet and drink at least 64 ounces of Water for a week or so, you will be shocked at how tight your stomach will feel and how little you will crave sugar. In a month or two you can lose the ten pounds you've regained. And you'll also have learned some things you needed to learn about maintenance. But here's the challenge you will face: To kill the cravings and get your stomach feeling like a sleeve again and get your head back on straight, you have to make these changes in a very disciplined way. No exceptions. Good luck. EDIT: I'm not saying that you can't ever eat sweets, but in moderation and only if sugar is not a terrible trigger food for you. Only you will know that.

@@Kindle ... I don't have any experience with Wellbutrin. I'm just sending you a big ole hug. I hope you feel better soon.

@@jenn1 ... you're a WLS cover girl. And I hear you on the Project Queen transformation ... ditto here.

@@cdsjjotn ... I bet you would enjoy shopping. Have you considered shopping?

I do eat Pasta -- but I've been in maintenance for a year. It certainly wasn't a "food group" while I was losing weight though.

@@SamBwaR3 ... "Kicker" is a more polite way to say "s**t-kicker." In other words, kickers are those who work around animals, e.g., cows, horses, sheep, chickens, and other animals raised in groups, that leave a lot of s**t laying around. Some synonyms are cowboys, cowgirls, ranchers, farmers, country folks, etc. . The term is also used pejoratively by those who wish to appear superior to people who live and work in rural settings. But those of us who regularly or even occasionally wind up with s**t on our shoes don't agonize over those mis-uses of the term and often use the term to refer to each other.

Maurice's is not at all high-end -- caters to young people, casual dressers, and probably kickers and rednecks. I've bought only their jeans and jeggings, which truly are designed to give you some serious a**.

Uh ... cereal is pretty worthless stuff. Read the labels -- how much Protein? How much sugar? How many carbs? Frankly, cereal is pretty pitiful stuff for a WLS patient who's trying to lose weight. Yes, the rules vary, but these rules are pretty universal: 1. Eat 70-100 grams of protein. 2. Eat your protein FIRST. 3. When your capacity increases, add colored, low-glycemic vegetables. 4. When your capacity increases, add a little fruit. 5. When your capacity increases more, add whole grains. You'll find very little protein, no veggies, no good fruits, and very few whole grains in most cereals. Oh ... and since you're asking this early, I'm betting you loooooove cereal. And that means it's probably a trigger food for you -- something you could eat a lot of and graze on. If so, it's yet another reason not to eat any of it while you're trying to lose weight. Later on, in maintenance, you can eat anything you want to as long as it doesn't make you gain weight. But until then ... nope.

I don't think any of these are addictions or obsessions, but just activities that please and entertain me: Hanging with my hubby Cruising Travel Socializing with friends Clothes and "primping" Writing Becoming a domestic goddess (this is a helluva lot easier to do 100 pounds lighter) My Fitness Pal (weird, but true -- I love understanding which foods are nutritious)

@@bayougirlmrsc ... I love Maurice's jeans, too. Very inexpensive, but great shapes and fits!

This morning I did another closet cleansing -- moving out more clothes that no longer fit and no longer look good on me. At the back of the closet I found the literal fat suit -- a navy, boxy Pendleton wool suit, the outfit I'm saving forever to remember, really remember, how fat I used to be. I put it on. It was huge. The jacket wrapped around me twice. The pants are so enormous I had to hold them up with my hands. Feeling that garment against my 135-pound body brought back the terrible heaviness, physical pain and grief that were with me constantly and the awesome toughness I summoned to survive every day when I weighed 100 pounds more than I do now. For those of you who haven't lost all your weight yet or who haven't thrown away all your fat clothes, please save one outfit to remind you of how far you have come and of the respect you owe to the person you once were for having the fortitude to survive the burdens of morbid obesity. One day, you will appreciate more than you can imagine right now that fat person's courage.

I'll give your surgeon the benefit of the doubt and say she/he's a brilliant surgeon. But she/he's spouting nonsense about 1100 calories being a proper maintenance calorie budget. Trouble with surgeons is they get a "fact" in their head (from God knows where or when) and then classify it as correct and immutable. Here's an actual fact: The maintenance budget for sleeved patients varies by multiples, depending on gender, age, activity level, maintenance weight, muscle mass, and other things I don't know about. Human bodies are similar, not identical.

The difference between "sleeve" and "pouch" is not a big deal. But ... as I understand it, per medical nomenclature, a "pouch" is a food container created from the upper portion of the stomach during RnY (gastric bypass) surgery. During RnY surgery, the surgeon staples the greater portion of the stomach separating it from this smaller portion of stomach. This smaller portion of stomach does not include the pyloric valve at the bottom of the larger stomach, which regulates the flow of food from the stomach to the intestine. This new smaller stomach area (without a pyloric valve) is now called a "pouch." The surgeon then stitches the bottom of this pouch to a portion of the upper intestine that's lower down than the natural length of the intestine above it, giving food less intestinal surface and length along which it can be absorbed. Without a pyloric valve, food that's eaten flows directly (without restriction) from the pouch into the intestine. The banana-shaped sleeve created during VSG surgery still operates just like the larger stomach did (with valves at both ends -- the hiatal valve up top and the pyloric valve at the bottom). With both valves, the sleeve offers food restriction that an RnY's pouch does not. And with the stomach fundus removed (not just stapled off), VSG surgery removes ghrelin (the hunger hormone) from the equation altogether. In short: 1. RnY (gastric bypass) uses intestinal malabsorption to help patients lose weight. 2. VSG (sleeve) surgery uses restriction and greatly reduced ghrelin to help patients lose weight. Anyway, that's how I've understood the major distinctions between these two procedures. (I'm a sleeve patient.) EDIT: Here's a picture of the new gastrointestinal connections found post-RnY surgery: http://www.bariatric-surgery-source.com/image-files/ximg-med-rny-gastric-bypass.jpg.pagespeed.ic.bt9H0OYtw3.jpg

Here's how I look at WLS: This journey is tough in many ways. It's certainly not "cheating" and not "the easy way." It takes commitment and an eye focused unblinkingly on the prize. WLS has been an amazing tool for me. I bet that almost everyone has to be committed to make it to the finish line (however you define that) and to stay there. Even then, the deck is stacked against some committed folks who suffer from metabolic and auto-immune diseases, meds that slow their weight loss, surgical and other complications, and other issues. I don't assume anyone finds this journey to be easy. But the reality of WLS is that it's our actual behaviors that determine what our rewards will be. That's why everyone who's had WLS who's trying to lose weight or trying to maintain their weight should consider this: If you don't like the results you're getting, consider whether you need to change your behavior. Some (including me) benefit from counseling / therapy. Some have to eat less than others. Some have to exercise more than others. Only you know what you're eating / drinking and how you're exercising and can figure out which behavior changes you should make your WLS a success for you.

Sounds like a good plan. Remember this: Many thousands (hundreds of thousands) of people have had sleeve surgery. And many, many of them have reached their goals and maintained their weight loss. WLS complications are not typical -- but UNUSUAL. And to answer your original question -- no, your stomach won't shrink beyond what it was immediately post-op. In fact, your stomach is astonishingly smaller now than it will ever be again -- just a sliver of things can get through it (Water doesn't count -- it and other liquids just slide on through, not challenging your tiny, swollen, inflamed, newly operated on sleeve at all). Over the next six months your sleeve will heal. As it heals, the swelling and inflammation will subside, and you'll be able to eat a lot more than you can now -- as you SHOULD. FYI, I'm 70 years old, have lost 100 pounds, now weigh 135 pounds and can eat at least 1,800 calories/day and not gain weight. It's amazingly liberating. Astonishingly so! Focus on the positives and the bright future, as much as you can. Your thoughts will shape your emotions and both will shape your behaviors.

Sometimes I have to make road trips 100 - 200 miles from home each way. So in those instances I stick with fast food that I know -- and that's very often McDonalds: Egg McMuffin with egg, cheese, Canadian bacon - 300 calories Breakfast burrito - also 300 calories Cheeseburger - also 300 calories Each of those items has enough Protein to satiate me and get me through to the next mealtime. On those trips I always carry bottles of diet iced tea and Water in the car.

@@Angie74 ... you go! You're doing so great.

I had no idea there was such a thing as "Easter holy food." Hallowed ham? Holy chocolate bunnies? Deviled eggs (but with a name like that, maybe not)?

At that stage, I was augmenting my pureed foods with Protein drinks and had no trouble getting in 60 grams of protein. If you can do that, I'd say try to do that much protein. In any event, the first month or two is definitely a time of many transitions. So many things happening -- your stomach healing, your throat / esophagus healing, the behavioral changes required, possibly some emotional upheavals, just getting used to the idea of having a permanently much smaller stomach -- you've got your plate full (so to speak).