IncredibleShrinkingMan

Welcome to BP @betterlife7. The above post is absolutely correct about GERD. However, RNY has more complications in general and is far more notorious to what we all refer to as "dumping syndrome," which is a feeling of sickness caused by eating something that cannot be digested by the pouch, most commonly sugars. I would say that unless you have a serious problem with sugar and you feel that is primarily responsible for your weight gain, I am a strong advocate for sleeve (although you need to sit down and discuss this intensively at your consultation and also see what your insurance has to say). Eventually, we can eat just about anything we want with impunity, albeit with dramatically reduced portion sizes. Even years out, we will become full just on hors d'oeuvres, but eventually, the ultra-vigilance can stop, because the volume restriction helps us lose and maintain our desired weight. And, perhaps most important to me, the hunger hormone ghrelin, which is produced by the part of your stomach that is removed during a sleeve, no longer causes the unbearable hunger sensations that occur when you lose weight with diet and exercise.

@@JamieLogical it looks like I'm at your surgery weight today. I'm obviously a lot happier to be there than you were when you were there, and I'm not even half way to goal (though getting excited to possibly hit that milestone this weekend). Congratulations on your awesome job.

So, I am 4 weeks out and I still have more pounds lost than days since surgery. I expect this won't be true much longer, and eventually I'll just settle into 3 lbs/wk mode. What I told myself at the beginning is that if (God willing) I ever reach my goal weight, I will not attempt to halt it there. I want to have some reserve weight loss for the very common slight regain that happens in the second year, so that when all is said and done, I am comfortably at my goal weight with no complaints from my body. I think you should view every pound lost, even after goal, as a gift, and not be scared of it. Your doctor will tell you what to do if you overshoot it by too much. That said, if you really don't want to go lower, I would simply increase your lean, high-quality Protein intake so that you can continue to lose fat and simultaneously build some more healthy muscle. This will actually ensure that you don't start to creep back the other way by raising your metabolism. You will likely need to do this anyway since, inevitably, some of what all of us have lost is lean, desirable muscle, even if we followed everything to the T. Best wishes!

A Multivitamin is an absolute must. For the first 30 days you might need something chewable. I am 4 weeks now, and I get nauseated every morning from my One-a-Day, but that is partly because there is no way I can get down food in the morning. You should also be taking B12, D3, and Calcium. These do not give me anywhere near as many problems. Try Isopure whey isolate Protein drinks. It is a clear liquid, and has 40 g of protein, no carbs, and no fat. Ensure and the like makes me absolutely sick (both before and after). I hope that's not what you are drinking.

How far out are you? If it is any less than 3 months, that's a must even if your surgeon didn't say so. Those things will expand in your stomach and stretch your sleeve, not to mention they will put a halt on your weight loss and possibly reverse any you have achieved. Eventually, some surgeons say overcooked pasta is OK, but this stuff is one of the big reasons many of us are here in the first place. But here's some good news: you will likely have an extremely negative reaction to it and once you try it you will want no more than a trace amount in the future anyhow. Best of luck!

Not at all...4 weeks today and down 30 lbs since surgery. Cravings are limited and are easily silenced by protein. If he's talking about vigor of workouts or lifting...then maybe, especially in the early going, where those activities are generally off-limits. But even that should resolve quickly. I am starting to worry about muscle loss, but will be going back to the iron today to put an end to that.

This may sound petty, but I'll just tell you what I would do. Maybe you all are better people than me: 1) start spreading rumors about her at the gym and make sure she picks up on the fact that you are gossiping about her 2) deliver a KO comeback about her physical profile 3) tell each and every trainer and staff member about what she said so that she'll be on notice that she could lose her membership for acting that way again (actually not too petty...definitely do this) Just don't get yourself into trouble. You don't want to see this b*tch kick you when you're down.

The band causes all kinds of discomfort, less weight loss, and less permanent weight loss. People like it because it's "reversible," and sometimes even reverses itself by slipping, causing more trouble for the patient. It is also an extremely high maintenance instrument, requiring you to go into the hospital for filling every six weeks. I don't know what your schedule tends to be, but personally that sounds extremely irritating. Additionally, with your anatomy unchanged, your hunger hormone will respond to weight loss like it always does...increase your hunger and lower your metabolism when you lose weight. The sleeve is in no way reversible, but has minimal complication rates, weight loss similar to bypass, and arrests your body's efforts to block your weight loss, and is better in this area than even the bypass. This was a no-brainer for me, and from what I hear the band may not even be offered in another decade. Weight regain is still possible, as is failure, but the sleeve is a lifelong opportunity to get it right, as hard as it may be to adjust at first. Good luck with your decision!

Have you been going in for appointments? It's probably worth it to make sure something isn't wrong with your sleeve, because it sounds like you may not have the same restriction you had early on. Stretching may occur, and eventually re-sleeving could be a possibility, if not an RNY revision, as you seem to have trouble with carbs. Are you getting all the recommended Protein? Doing this is probably the simplest and most effective way to stave off carb cravings. Also, stop and make sure you aren't consuming slider foods as part of regular intake. Don't lose your confidence!

Also, @@byebyefat please never be ashamed of setbacks. They are part of this process and they will happen post-op as well. This is a very good lesson in picking yourself up and dusting yourself off so that a minor annoyance doesn't become a major problem. I've followed that advice way too infrequently in my life and I refuse to ignore it when it comes to my weight loss. Best of luck. The 14th is an eternity from now (I am visiting twelve different states just between now and then). You will make up that ground and do fabulously.

You are a very fortunate person not to suffer anxiety in general. That is ubiquitous among WLS patients, and in the days before surgery, it is nearly unavoidable. So I'd say even if your surgeon didn't instruct liquids, go ahead and transition to them, as post-op will be much easier that way if you do that now. That will help you make up the ground that might have slipped. Also, begin some exercise to help with those pounds and to help relieve stress. I know my anxiety goes down, however briefly, when I exercise and work up a sweat, and I think it should help you on multiple grounds. How did your pre-op diet go? Did you just get a low calorie plan or strict liquids?

T-shirts are nightgowns, and tank tops are t-shirts!

There is no cure for the anxiety associated with bariatric surgery. But I would encourage you to read up on the mind-blowingly positive safety statistics of sleeve, and the extremely low complication rate. I hear from people who have had it and started out in a much tougher spot than I did, and while I have a tendency in life to think I am going to be the unfortunate exception to general principles, it was very hard to slip into that mindset before my own surgery. Think of how positive and free people who have had the surgery are, and remember that in a very short time you will be among them. Anxiety that you know is going to end soon also lessens in severity. Best of luck!

All dates 2015 Final decision: March 27 Info Session: April 18 Surgeon Consult: April 29 Pre-op visits: June 11, July 7, July 17 (psych eval) Initial Surgery Date: July 30 (later moved to August 6 but only because the surgeon went on vacation) N.B. I was self pay and this will be very different if you are using insurance

I think it is reasonable to expect that the only people who will say anything until you are very near your goal will be people that know you've had the surgery. At a certain point (by percentage of total body mass), people will know it is obvious that you have done something. But early on, even if they notice something, they may not be sure whether it is intentional...you could be ill or otherwise not losing weight for a good reason. They all would rather be safe than sorry. Additionally, some of them are probably very familiar with weight loss efforts, either of their own or of people close to them, and therefore don't find it too remarkable a subject any longer.

If you can tolerate it, and if you are far enough out that you can consume it, just have a couple of bites and that should kill the craving. You can't possibly eat enough of it (unless it is high calorie liquid, which you must avoid at all costs) to seriously jeopardize your weight loss. But if you aren't advanced enough for a particular food yet, just eat your approved diet, and don't skip meals, and cravings should stay at bay. I notice that my cravings are the most intense when I go 8 hours or more between eating (not a good idea). I am dreading facing autumn...thankfully it's still 93 degrees in DC. When the highs dip into the 60s, all the usual fall and winter cravings come to town. I plan on partaking bite-size on cider donuts, potato dumplings, and various German dishes, but look forward to being happy with two or three bites. An added benefit is that I won't be thinking about it all day every day as long as I have some. If I don't like what happens to my weight loss, I'll come off of them right away and up the ante on exercise (much easier for me in the fall than in the heat).

There are things I gave up to have this done, and I occasionally mourn them, but the calculus never leaves the front of my mind...the benefits are worth so much more than a good ol' fashioned pigout and the memories of good times they conjure. 10 years from now, the memories you will have will be of looking fabulous and proud, and you'll have an addiction to eating healthy because that's how you will get there. It is important to never take your eye off the prize. Every day is better than the next, even during a stall. Just believe!

@@lakiaki You actually are just into the obesity range at 30 BMI. However, you don't meet the typical criteria (40 BMI, or 35 BMI with complication) for sleeve or RNY. There is a recent movement to perform lapband on lower weight patients like yourself who have far less to lose than, for example, I do. The question is, since that is a more conservative procedure that has far lower success rates, do you really want to go through the trouble? I don't actually know why they expanded the eligibility to 30-35 for lapband, since these are the patients least likely to see any benefit. You can probably find a doctor that will do it at 30 BMI, however, you may have to convince him that the DM2 prevalent in your family counts as a comorbidity, as even within this expanded category, a complication is typically required at 30 BMI. Do not...repeat DO NOT...attempt to gain weight to gain eligibility. The road you are facing right now is far easier than it would be even with a better surgical option.

I haven't had dumping (and I'm not convinced that sleevers actually ever experience it, being that it is a lapband/RNY thing), but I am 4 weeks out and any carb of any kind (starch in potatoes to a bite of a cracker) causes some kind of fever, lump in the throat, and nausea, but all passes quickly. While it lasts, it's brutal, and I'm therefore not eating carbs for another month, at which point I'll try again. I have some September weddings that I wouldn't mind looking my best for either.

If you're having trouble once you've hit pureed stage, try some Indian food. You will likely get back a more typical bowel cycle, as curry is a natural laxative. I am worried about all the extra oil they sneak in at take out places, but making it yourself at home should take care of that. Failing that, Miralax and water always do the trick. Additionally, watch out for the possibility that your multivitamin can cause constipation.

4 weeks out and not even at 500. I have to be reminded to eat. I have been as low as 170 in a single day in the past two weeks. The trick is, I know I won't have the energy to workout if I don't get the required Protein, so I used that as an incentive to get up to about 500 so at least I'll go for brisk walk/jog. Personally, I have been tolerating food well, but they fill me after a single bite. I had a 38 inch bougie, which is middling, but the restriction of anything but Clear liquids is still quite severe. However, this is nothing I would ask to have changed, as I am satisfied with my weight loss so far and have not yet hit a plateau. If I start to be able to eat more and then hit a plateau, I'll wish I had this back.

A couple things could be happening: 1) you could be building some muscle through exercising, and muscle weighs more than fat 2) you could be getting better and better with your Water intake, and some of the weight loss you experienced in the first four weeks may have been water loss and near dehydration 3) as you suggest, a stall is a stall. Your body will spend some time at a certain weight seeing what it can get away with, and hoping you'll provide it an influx of calories with which to stay there and/or restore the lost fat, but since you won't it will have to get calorie spending again very shortly.

I didn't have to do liquids for two weeks, just 1000 calories or fewer. Now I wish I had been put on liquids, and went there voluntarily two days before to have a soft landing into clear liquid phase of post-op. My surgeon visited my room at the hospital and I asked him how big my liver was and he said it was pretty fatty but nothing he couldn't handle. I had never been that hungry in my life. I know that if I had been more lax with the pre-op diet that I would likely have had my surgery cancelled. Fatty liver is real, and there's a very small chance that if we are in this category we didn't have it. The two weeks make a big difference. It doesn't completely cure it, it just makes it manageable for surgery. The lifestyle you lead after the surgery is what will restore your liver to normal.

My favorite clear liquid protein drinks are Isopure green tea and black tea. 40 g of protein per 20 fl oz bottle...no carbs or fat. Very filling, and even 4 weeks out, I feel like sometimes I can't even eat pureed foods very well, and so I resort to them (not ideal, but at least you stay on track with your protein). Trader Joe's chicken broth is good if you are into that stuff. I assume the surgeon drew the line somewhere as to when you can move from clear liquids to full liquids?

Congratulations! Go have a last supper and then work your way down to the pre-op diet starting ASAP so you don't have to go into it cold turkey (extremely difficult). You will have a much better time in the early post-op. Best of luck!