toasty

I am now about 2-1/2 months out from my surgery, and I am eating about 1/2 cup of food at a meal. If I go over that, up it comes. I generally have a Protein shake for breakfast (I'm used to that, been doing it for years), a rolled-up slice of deli ham and cheese with 6 Kalmata olives for lunch, and a small dinner (tonight I had two Swedish meatballs with a couple of broccoli florets). Finally, I have a cup of sugar free diet cocoa with a scoop of chocolate Protein Powder for dessert. I am generally in the neighborhood of 500-600 calories a day. The only thing in my diet that varies day to day is my dinner, everything else is exactly the same every day. I know it sounds boring, but I find it really convenient.

Sure sounds like a form of dumping to me. The symptoms of dumping syndrome are curiously like that of hypoglycemia. Feelings like you are going to faint, sweating, dizziness, cramps, nausea, and diarrhea, either one or more of those symptoms, are common. Since you are feeling faint, sounds like a form of dumping. You probably shouldn't eat sugar anymore. Even little bits.

First, I have never heard that there was more risk with RNY. In fact, I have heard on this very forum a number of times from people who had the band or sleeve and ended up getting a revision to RNY, because of the problems that came up with their other procedure. Gastric Bypass is the "Gold Standard". It has been around since the 1960s, and the medical community knows the most about the long term effects of it. Note that in the gastric sleeve, they actually remove a huge portion of your stomach, right out of your body! In RNY surgery, everything stays there (it's just re-routed). Now, it is definitely true that there are some increased restrictions with RNY. You can develop "dumping syndrome", where if you eat sweets or high-fat foods you may feel light-headed, dizzy, fainting, sweating, nausea, diarrhea, cramps, or multiple of these symptoms at once. Not a happy thing to go through. But guess what? You shouldn't be eating those things anyway, so it is a good training tool to keep you away from that stuff. Also, your pouch will be much smaller than the stomach left by the sleeve. You will be eating less. And if you don't chew your food completely, it doesn't get through the opening in your stomach and you end up throwing up. So, just remember to always chew your food. Vitamins? You have to take those with the sleeve as well. All in all, RNY is nothing to be afraid of. I've been living with it for 9 weeks now, and I've really embraced it.

As far as hot chocolate is concerned, I have some every night. It is part of my plan, my "dessert". I use the Swiss Miss Diet (it has 25 cals per cup), and I put a scoop of my dutch chocolate Protein powder in it (25g protein, 110 cals) and it is totally guilt free, 'cause I get in almost half my daily protein at the same time! My NUT loves this idea. In terms of the cake or pie, yeah you could do it, but why? I mean, we are talking about one or two bites, maybe, after eating the rest of your meal (remember to get your protein and veggies in first). Is it really worth it for those few bites? Speaking for myself only, it would be more torture to have only a bite of something I used to have a whole piece of (or two or three). And there's a chance that you will dump, which is sure to make for a "special" holiday or event I am sure. Personally, my Thanksgiving dinner is going to be turkey, pureed cauliflower fake mashed potatoes (even my daughter likes it as much as mashed potatoes), and 1/2 orange for dessert. Boy, that's gonna fill me right up, might not even have room for the orange. If I get a real need for a sweet treat, I use Russell Stover sugar free mint patties. One patty is 60 calories, so it isn't bad if you stick to one. I cut mine up into 4 pieces, and really chew it to get all the flavor. Really works for me. I have decided for me to stay away from all starches; no bread, Pasta, cakes, etc. And I try to avoid all added sugars in anything. You can have a great party or Thanksgiving or Christmas without the high fat and high sugar and high calorie foods. It is part of what we need to do in order to be successful long term. One final thing to consider. Right now, you are still in your "honeymoon" phase of weight loss (as am I). But the habits you develop now are going to be the ones you will use long term. After a year or two, your pouch will grow, and you'll be able to eat more. Your intestines will start developing the ability to process sugar and fats like your stomach used to. It will become easier to eat all those foods you used to. Remember that on average, after 5 years bariatric patients regain 40% of their lost weight. Now, that's an average. I intend to be much lower than that, so I am working hard to develop good habits that will enable me to keep my weight under control the way I want.

@@sarahbethemails I didn't see, how far out are you from surgery? @@glitter eyes At 17 months all of that sounds great, but for someone a few weeks out I can't imagine eating that volume of food. Maybe that's just me? I'm 7 weeks out, and I can eat about 1/2 container of yogurt, maybe 1oz of chicken or fish, 1/4 cup of chili, etc.

Dumping Syndrome. Pure and simple. The maple and brown sugar. Some of the symptoms of dumping are lightheadedness, fainting, sweating, cramps, etc. The symptoms are actually very similar to hypoglycemia. Don't do sugar!

@@Dallas Powell I hear you that you are losing weight, but it sounds like the only way that is happening is for you to do the same type of dieting that we all had to do pre-surgery. That's absolutely wrong. Like you say, that depends on willpower alone, which won't work over the long term. You're going down the right path to make your doctor accountable for this. Having him explain how you can possibly eat three lean cuisines at a sitting if your pouch is the size of an egg would be very illuminating. Its not so much about the calories (although I agree those are beyond the pale), but just the volume is impossible if your surgery was done correctly. If you can do that, why bother getting the surgery in the first place? If your doctor denies there is any problem, be sure and tell him you are not satisfied and are going to get a second opinion. Best of luck, and keep strong. If you are persistent, you will get to the bottom of it.

Back in 2007 I was diagnosed with severe sleep apnea. My pulmonologist put me on a BiPAP (like a CPAP, but different pressures for inhaling and exhaling). I have used it continuously, every single night (even on the rare occasions when I take a nap), since then. I even take it with me when travelling; I have used it on a long flight. That said, if I could get along without it I would be very happy. Going on camping trips is a hassle, getting authorization to use it on an airplane is a hassle, making sure I have power near my bed in hotels is a hassle, etc. So when I heard that after WLS some people stopped using it, I was very encouraged. However, I saw my pulmonologist last week, and he told me that I might be able to reduce my pressure as I lose weight, but I will probably never be able to get off of it completely. The problem for me is that the opening between my epiglottis and my esophagus is too small, and when I lay down it closes down so air has a hard time getting through. The pressure from the BiPAP keeps the opening...open. So, the answer is: it depends. You may be able to get rid of the CPAP if your physical characteristics allow it, but you also might not. You should talk to your pulmonologist to find out about your specific situation.

One more thing: obviously, the situation you are now in is totally different from any diet you have been on before. Before, having high-volume foods to fill up your stomach was the key. So, lots of veggies and high-volume (but low calorie) foods to keep you full (such as lettuce/salads, tomatoes, raw celery, etc.). Now, your stomach is tiny, so almost the opposite is true. You need mostly dense, high-protein foods (so they fit in your small pouch). BLTs are fine, but should probably not be a staple in your diet, because they keep you from eating the Protein rich foods. YMMV.

I have never heard of a NUT telling you to eat bread. I can imagine they would say you *can* eat bread, but not that you *should* eat bread. Maybe that's what you meant. As far as I am concerned, I tried a small piece of bread a week ago (I am seven weeks out) and up it came half an hour later. I've heard lots of people say that they can only tolerate bread toasted, so that's possible. I would suggest just trying bread by itself, to see how it goes. If you can tolerate it, then fine. Just remember to limit starches. Also, for myself, I tolerate lettuce fine (at least in small amounts), but I can't stand bacon. I used to love it, but now it just tastes like a mouthful of grease to me (yuck!). Lastly, given that your portion size at your point should be about 1/4 cup at a meal, you sure won't be able to eat more than 2 bites of the BLT before you are full (or at least, you shouldn't eat more than that). That doesn't equate to much Protein (only the bacon in that has any protein, and not much bacon), which is what your meals are supposed to be mostly. I would think a BLT would be more appropriate for 6 months or more out when you can actually eat more.

My first restaurant post-op was about 3 weeks out, I went to a Japanese restaurant that my family likes, and I got miso Soup. I took out the seaweed and tofu, and just drank the broth. It was kinda funny, because we have been frequenting the place for years, and the waitresses know exactly what we want (we are creatures of habit), so they were completely surprised when we didn't order the normal stuff. And they couldn't believe I was just eating soup. At 4 weeks I was cleared for soft foods, and we went back again and I had 3 pieces of salmon sashimi (no rice). At 6 weeks out I was cleared for solid foods so I went to Outback and had a kids plate of steak medallions, and had about half of it. Had to eat it really slow, and cut it into tiny pieces, but it was great to be able to eat some steak.

For my last meal my family went out to the Outback restaurant and I had a 20oz porterhouse steak with sauteed mushrooms, loaded mashed potatoes, a Caesar salad, garlic green Beans, and for dessert a chocolate Chocolate Tower with raspberry sauce and vanilla ice cream, and a Cadillac margarita. I was so stuffed I could hardly move. That was about nine weeks ago. At that time, I always had to ask for the "half-booth" (one side with a booth, the other side with chairs) because I didn't fit in a regular booth. Last Friday I went back to Outback for the first time since my surgery, and I ordered the kids plate with steak medallions, and ate about half of it and just a smidge of broccoli, and that was it. That was the first time having steak since my surgery, and it was great. And I sat in a regular booth with no problems!

I actually spoke with both my surgeon and my PCP about my weight, and both agreed that 190 was a good, achievable weight to shoot for (that would put me at a BMI of 29.8, just under the Obese category). They both agreed that once I reach that weight, we can review and determine whether I should try to lose any more. I am 5'7", so my ideal weight is 133-163lbs, which my doctors claim is ridiculous for me. Maybe, once I get to 190, I might shoot for 175, but I can't imagine myself below that. Before surgery (7 weeks ago) I was 300, and today I am 250, so almost half way there. I like this system. Choose an intermediate weight that feels achievable, and then once you reach it reevaluate where you want to be then.

I agree that as far as walking is concerned, you should start immediately (same day of surgery I was walking up and down the corridor in the hospital). I was up to 2.5 miles by the end of the first week, and by three weeks I was up to 4-5 miles a day. However, for weight lifting and other vigorous activities, my doctor said to wait 6 weeks. So I did. Last week he finally gave me the OK to do anything I want, so I immediately signed up for a karate class. It's great. I hate working out at the gym, and this gives me cardio, strength training, flexibility, and a sense of doing something useful (not to mention it is a social activity). I got lots of advice to not lift any weights over 15 pounds too soon or I might pull or damage something. I don't fool around with that. Six weeks is really not that long to be safe.

I don't really think that building muscle after surgery is any different than before surgery. You just have to wait until your doctor lets you start lifting weights. Until then, you can certainly do cardio exercise (walking, cycling, etc.) so long as it isn't too strenuous. After you are able to lift weights, then you should be able to do most anything, again as long as you don't overdo it. Get a personal trainer, let them know you had stomach surgery (you don't really have to say bariatric surgery), and you want a routine that builds muscle but that is careful about stomach muscles (also ensure you start with light weights, and only increase them very slowly, so you don't overdo it). You might want to consider yoga or karate as well. I have started with karate, and after an hour I definitely feel it. It is a whole-body workout. And I have spoken with my sensei, and he realizes what I am trying to do (lose weight and build muscle), so he is very supportive of that.

Problem is, after halloween, they have so much candy that they end up having candy for a week or more, not just on one day. With my daughter, last year I ended up going through the candy and throwing away half of it, and only letting her have one or two pieces a day. After a week, she got bored of it and we move on to more healthy Snacks. And I have always hated having lots of candy in the house. For those of you who it doesn't affect, bless you. But it calls to me something fierce, especially chocolate. Up until last year I used to buy a huge bag or two of candy from costco three weeks before Halloween, and then eat it all before Halloween and have to buy more for the actual holiday. Thank God I stopped that last year. I like the idea of giving out small toys or stickers. One of the problems with candy is that we end up getting older teenagers who come by (sometimes multiple times) to get candy. If I hand out small toys, those older kids will be less interested, while the young kids will be happy to have a toy they can play with. My $0.02.

I've sometimes unknowingly stumbled on a female-only thread (they show up in the trending topics list sometimes with no designation they are women-only). I've found often these end up discussing very female-oriented topics that I am certain females would not want me responding to (and might be less inclined to discuss in a mixed forum). There have been times I have been sorely tempted, such as when I see guy-bashing or stereotypes of male behavior. But I have decided women have a right to have a place they can vent with other ladies and not expect men to butt in on their conversations. So I kinda expect women to have the same consideration for men. Maybe a guy has a topic where he wants just male responses, or is very specific to men. Women should respect that need, and not post on those topics. Posting accidentally is fine, and most people will really be cool about it. But I do think it is a breach of etiquette to do this intentionally or frequently. Now, as for reading them, just remember all topics are readable by anyone.

@@beachgal2935 Yeah, I definitely enjoyed it in that direction. I'll try it again later when I am a bit farther along.

I think it also depends on what you mean by "dessert". I enjoy sugar-free Jello and sugar-free pudding, and almost every night I have a cup of sugar-free cocoa (with a scoop of chocolate Protein powder in it, very yummy). I make my own low-carb whipped cream by whipping heavy cream with splenda and vanilla extract. I have even found out you can make low-carb ice cream (although I haven't tried it myself). If you are talking about sugar-free cakes or similar, I think you need to be careful. As @@Djmohr says, if you are far enough out you can probably handle it, but you may not want to. My wife enjoys a sugar-free blueberry loaf, but if you look at the nutrition information on it, it is still loaded with fat and carbs (and sugar alcohols). sugar free definitely doesn't mean low-calorie. If you are talking about sugar-free candies, that's a good question. Russell Stover makes a whole line of sugar-free candies (not low-calorie, just sugar free), like mint patties and chocolate-covered peanut brittle. I have often wondered if I might try one of those, but I haven't yet. I'll probably wait until I am in maintenance before I try those.

I don't know that I have ever heard anyone indicate the maximum grams of sugar per day. And I know that not all sugar is created equal, so to speak. Generally, sugar found in milk (lactose) is not as much of a problem as say table sugar or high fructose corn syrup, so I wouldn't worry about the sugar in Nonfat Greek yogurt. Other yogurts may have added sugar, though. Also, although fructose and sucrose can be a problem, in fruits with a high level of Fiber (such as apples, for example) the sugar is not really a problem. So the answer seems complicated, and I don't really think there is a simple "no more than X grams of sugar" answer. Generally, I follow the rule of very little ADDED sugar, or very little sugar from low-fiber products.

I tried this last night, and oh boy, it did NOT agree with me! I am thinking it was probably the pumpkin or the pumpkin spice, since those are the only two ingredients I haven't tried before. But it sure tasted good when I ate it.

Of course I don't know your physician, but she may simply not be familiar with bariatric patients and how we lose weight. If you are still within a good range, then there shouldn't be any reason to worry. If you are at the low end of the range, and you are still losing weight, then there might be reason to be concerned. As far as her speaking with your surgeon, I would hope that she asked your permission to do so before she just decided to do it. Personally, I would happy to give my PCP permission to talk to my surgeon, but this shouldn't be something they take for granted. Given you are going for a f/u with your surgeon next week, I would have thought she would just ask you to talk with your surgeon about your weight loss and that the info from your appointment be forwarded to her.

Well, sounds like you are doing all the right things to take care of yourself. I can imagine how frustrating it must be to have these issues and not have any resolution on why they are happening. Hopefully you are able to get a resolution on your main issue (the chest pain) soon.

This is probably obvious, but if you are having chronic anxiety you should probably see a psychologist. They are really good at helping you to develop ways to manage your anxiety. If you are considering anxiety or depression medications, I would also highly suggest seeing a psychiatrist, rather than your primary care physician. Psychiatrists specialize in such medications, and have more training in treating those sorts of issues. I am by no means suggesting this is all in your head, but suggesting that there are other ways to manage your symptoms of anxiety. Certainly I would bring all of this up to your bariatric team as well to determine if there is a root cause to the continuing issues you are having. Sorry to hear you are having so much trouble.

@@jillofalltrades203 I checked into this extensively pre-surgery, and a number of sources (including my doctor) indicated that ER medicines (Extended Release) don't work very well with RNY patients. The reason has to do with our malabsorption of medicine. As a result of our surgery, we have reduced small intestine, so the ER medicines (which dissolve slowly) don't absorb as efficiently and tend to pass through the intestine before the medicine can be fully absorbed. Thus, ER medicines don't work very well, and are not recommended. See the following article for details: http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/Medication-Absorption-after-Gastric-Bypass-Surgery.aspx