Clementine Sky

It's been challenging to maintain my weight loss, but thankfully not as challenging as I'd expected it to be prior to surgery. During the first year when I was losing weight I was definitely more meticulous about tracking my food, limiting my carbs, and exercising than I am now, but part of it has to do with having developed habits. I used MyFitnessPal every single day, without fail, for the full first year, and that helped me to become very aware of how much I was consuming. Now it's more instinctive. I began to have more difficulties 18 months post-op, but that was primarily due to changing medication for endocrine disorders that I have, and experiencing a surge in appetite due to one in particular. It had been a "rule" to avoid carbonation, but since it's actually a myth that it will stretch your stomach out, it's one I've broken to my benefit. I drink a lot of La Croix and other carbonated water. It helps to give the sensation of being full without eating a ton. I weigh myself every week, and if I've gained more than five pounds, I become a bit stricter with myself.

It depends on the steroids and the reason for taking them, and whether they are imperative. I am dependent on steroids because my body does not naturally produce them due to Addison's disease, and even missing a single day's dosage can be catastrophic. My endocrinologist actually increased my dosage before and after surgery to compensate for the additional stress. Steroids definitely make weight loss far more difficult, but having the VSG was enormously beneficial to me. I'll still be ravenous at times, but can be satiated with far less food than prior having the surgery. I wouldn't ever advise taking steroids long-term unless it was crucial, because they are horrid in so many ways, but if you do not have the luxury of going off them, you don't have to despair.

I'm so sorry you've been diagnosed with shingles! They are agonizing, but hopefully you will recover from them soon. I had shingles a few years ago, during one of the calmer, less stressful times of my 20s, before becoming obese or having weight loss surgery. I have autoimmune issues that made me more susceptible, but another contributing factor was having a severe vitamin D deficiency. Many people are deficient in vitamin D, and it's even more common in those who are overweight due to how the body stores this vitamin. I definitely recommend that everyone have their levels checked and treat the issue if necessary before undergoing WLS or anything else that could be stressful. A new vaccine with a fantastic rate of efficacy has been developed, but most insurance companies will only cover it if you're older. It's possible they'd be willing to provide the coverage if your doctor could argue that you have an underlying condition that would put you more at risk. The vaccine that is currently available isn't as effective, though it does still help. My dad had shingles last November on his eye, and his doctors said it could have been severely damaging. He'd had the old vaccine, and though it didn't prevent shingles, it greatly diminished the severity of it. I hadn't realized I had shingles until the blisters had erupted, and started the antivirals late. Ice packs helped reduce the pain and itchiness a lot. I also got a cream from Whole Foods that was pricy but worth it for how it helped. I actually still have it in our medicine cabinet and can get the name when I'm home tonight if you think it might be of use.

I still would have hunger surges due to my medication, especially when I had to increase the dosage, but after having the VSG I'd become full much faster. I still gain weight rapidly but have been able to stay on top of it so it doesn't keep going up. It's usually about a 5-7 fluctuation. Even when I'm on the higher end of what's been my range for the past year, I wear a belt with size four jeans and comfortably wear XS dresses and tops. The surgery radically changed my life for the better.

I'm grateful to have defied the odds. I had the VSG in August of 2015, and though the first few months post-op were challenging, overall as I've become healthier so has my marriage. I had been very concerned prior to having surgery. I have Addison's disease and PCOS, both of which impact my physical as well as emotional wellbeing and can make it more of a struggle for me to calibrate my emotions properly when I'm stressed, and that is intensified even more when I'm hungry. I was worried I'd become unreasonable, intolerably cranky, and have difficulty reigning myself in because I'd be constantly ravenous, but I actually wasn't (yay!). I was scared I'd make him feel deprived and like he had to radically change his lifestyle to fit mine, but also that I'd feel resentful if he didn't, putting him in an unfair Catch-22. I was very worried that I'd lose all my hair and develop loose skin, but neither of those fears were actualized, either. My hair thinned a bit, but that's it. My skin is tighter and more toned now than before surgery. But I'd made my husband watch "skin" videos brave women who'd had WLS and a lot of loose skin had made and uploaded to YouTube, so that he could see that it could possibly happen to me. We talked about a lot, and made plans and compromises in advance.

Strawberry and rhubarb Icelandic yogurt (low carb, high protein, yum) and cold brew coffee with whole milk.

A bariatric surgeon named Dr. Matthew Weiner has several informative videos on YouTube, and one is about the reasons people regain after losing a significant amount of weight due to WLS. He was not my surgeon, but I found his videos to be very helpful. Besides lifestyle choices such as being sedentary and overeating, there are other possible causes of regain, such as certain conditions or medications. Steroids such as Prednisone can cause rapid weight gain. If someone injured their knee, as an example, and was prescribed steroids as part of the healing process, he'd have the double challenge of having to limit physical activity and taking medicine that will likely cause weight gain. Many antidepressants cause weight gain, as do various hormonal medications. Your stomach does not significantly stretch after having the VSG, but as your body heals and adapts after surgery you will be able to consume more than you initially did. There are many caloric "slider" foods that you can quickly consume without having the same level of restriction as with denser foods. I had the VSG in 2015 and have been maintaining a BMI on the low end of the normal range for over a year, but my weight bounces around about 10 pounds due to medical issues. I have Addison's disease which makes me dependent on steroids, which can cause my weight to rapidly surge. Anytime I'm going to be encountering a stressful situation, with work or even just something like a really long flight where I'll be sleep deprived, I have to take an increased "stress" dose, and I gain weight. I then just work to get that weight off again. But I can see how if someone was in a chronically stressful situation, that would be much harder.

Dr. Fernando Garcia in Tijuana.

My BMI was under 35 but rapidly creeping up towards it when I consulted with bariatric surgeons in LA. They were all pessimistic that I'd be covered even if my BMI reached 35, and even though I had high blood pressure at the time as well as PCOS and Addison's disease (which requires you to take steroids that make you pack on weight). I had Blue Shield of CA then (2015). They still would have performed the surgery on me, but I would have been responsible for the cost, which ranged from $29,000 to $35,000 at their offices. An insurance coordinator said that even if I was approved for coverage, my portion of the expenses would be around $5,000. I just went to Mexico instead. $4200 in total, which included two nights at the Marriott. I had no hoops to jump through prior to surgery. I picked the exact week I wanted the surgery, to fit with my schedule. I had a really positive experience and no complications. I exceeded my goal and have been maintaining at my "dream" weight for more than a year now. My BMI is 19.5. I think my surgery was just as successful as it would have been if I'd gotten it done by a local surgeon. So don't lose hope if your insurance denies you!

You're very welcome. No, I haven't experienced any major longterm side effects or any complications. The only thing I need to be careful with is having too much to eat (I won't be in excruciating pain or anything severe, but will feel unpleasantly full) or having hot liquids like coffee too soon after eating. I began drinking with meals a few months post-op, in moderation, without any issues except for hot drinks. And I also resumed drinking coffee, in moderation, a few months post-op. I normally have iced coffee, but when that hasn't been available, I've had it hot. When we were on vacation I had a larger brunch than typical, and my coffee had been forgotten about by the server and then finally brought right at the end of the meal, hot. I drank it all too fast and got sick for a couple of hours. That's it. I was ready to go zip lining by the afternoon.

I was just a bit younger and with a BMI a bit lower when I had the VSG in August of 2015, and it was one of the best decisions of my life. I also viewed it as a preventative measure to help reduce the risk of problems developing as I aged. I yo-yo'd throughout my 20s and let my weight control far more of my life than I should have, and I wanted to be able to thrive in my 30s and beyond and enjoy that time rather than receding as I did so often in my 20s. As a lower BMI patient, there are a few things you're probably already aware of, but I'll point out nevertheless. - You'll probably have to pay for it yourself. My insurance refused to pay for a cent of my surgery. I noticed that you're in Canada; it might be hard for you to get approved for the surgery there, too. Many Canadians and Americans go to Mexico for WLS, and so long as you chose a reputable surgeon and facility, it's safe. That's what I did, and I have absolutely no regrets. Even if my insurance had agreed to pay for the surgery, my out-of-pocket expenses would have come out to around $5000, and it would have been a far more time-costly route because they require years of documentation of weight loss effort, and months of seeing a nutritionist before they grant approval. My surgery was $4200, including a hotel stay at the Marriott, and I chose the exact week I wanted to have it done, to fit with my own schedule. I took on the responsibility of educating myself about the surgery, about common challenges following it such as stalls, and the post-op diet. You can find information on the websites for bariatric centers at Stanford, the Mayo Clinic, and other respected hospitals. - You will likely lose weight at a much slower pace than someone heavier. I've read so many posts from people on here who've lost more weight in two months than I did in two years, but that's fine since none of us are in a race. For me, losing weight slower has been beneficial in the long run even if it was frustrating along the way. I actually lost weight more rapidly on crash diets prior to having WLS, but always gained that weight back and then some even faster. By losing it slower, I've kept it off longer and more easily. It took a full year for me to reach my initial goal, and six months later I reached my "dream" goal. I've maintained that for over a year now. I have absolutely no loose skin. By losing weight more gradually, it also gave me more privacy. It wasn't as dramatic, so people never suspected that I'd had surgery. I'm not at all ashamed that I did, but I also don't feel the need to broadcast it. I'm very private by nature, and only told the people who actually needed to know about having the VSG. Best wishes to you!

It's sort of like I took the fabric and pattern instructions given to me, and then tailored them to fit myself. I have done things my own way, with success, but have followed the basic guidelines. The first couple of months out I was far more militant about adhering to the "rules" while I was healing. After that I would give myself more liberties, but within reason. I had alcohol for the first time four months post-op, at a Christmas event. It wasn't painful, but my tolerance was definitely much lower. I've only had a few sips of wine ever since. One of the reasons I avoid alcohol is because it's liquid calories that offer little in the form of nutrition. I also only have Coke, frappes, and other calorie-laden drinks on very rare occasion. It's easy to consume more than intended, and sabotage yourself.

What I like the most is your pose in the second picture. You look fantastic, but more importantly, you look so proud and happy. That made me smile.

I was a self-pay patient (my insurance would not provide any coverage due to my BMI being too low to meet their criteria), so I took on the responsibility of educating myself about the surgery prior to having it. I did not attend any classes, have any counseling, or meet with my surgical team in advance, but still felt reasonably equipped with knowledge and confident on the day of surgery. Several reputable bariatric centers - like Stanford, UCLA, and the Mayo Clinic - have information and instructions they provide to their patients available online. I read through it all, as well as published studies in journals and articles, and also found the videos of a bariatric surgeon named Dr. Matthew Wiener who posts on YouTube to be very helpful. I gleaned valuable information from online forums, too, so I was prepared for the "dreaded three week stall" and other common experiences. 1. Did your team discuss your post surgical diet with you in detail before your surgery? No. I received an email with a PDF of the post-surgical diet, and instructions for the 48-hour pre-op preparation diet in advance, but did not discuss it. Had I felt the need to, I could have contacted the surgeon's nutritionist prior to surgery. 2. Did your nurses go over your immediate diet with you in your hospital room? No, but I met with the surgeon's nutritionist the day after the surgery. 3. Were all stages of your diet given to you in written form? Did you understand when to start each stage? Yes, and yes. 4. Did anyone ever tell you not to eat or drink more than a certain number of ounces per hour? I most clearly remember Dr. Weiner's advice on his videos about being careful to avoid having too much liquid at once, but in the month post-op I really could not have tolerated copious amounts anyway. On my instructions it said "sip, sip, sip" to emphasize that you shouldn't guzzle back liquids. 5. Did anyone ever tell you what could happen to you if you ate foods that you weren't approved for yet? It's on all the information bariatric centers and my own surgeon's office provided, but what really captured my attention was reading on this forum about the horrible experiences people had when they ate solid food too soon. That was the best motivation to not deviate from the post-op dietary instructions. I also learned from my own body. It wasn't ready yet to advance, so I stayed on liquids and then soft foods for a little longer than the timeline given. 6. Were you allowed to order a meal in the hospital, and if so, what did it consist of? No. I was brought Gatorade and then broth. I was not at a hospital; I was at a clinic specifically for bariatric surgery, so they did not provide typical meals. 7. Did you have a clear understanding that the surgery was permanent? Yes. ---- I know doctors are all different and we all go to different groups that handle information differently....I just wondered how well these basics were covered for you. Did you feel well prepared to monitor your own Fluid and nutrition after surgery? ----- I made sure the basics were covered and felt prepared. -----Is a lack of basic instructions a common thing? ----- I think basic instructions are commonly provided, but we're all unique learners and have our own level of incentive to remember and follow instructions. I am grateful I didn't have to attend classes because I preferred getting the information on my own and making sure I was familiar with it, but that was a personal preference.

I really liked some of their flavors when I was on the post-op liquid diet, but haven't bought any since. At the time (fall of 2015) the Vitamin Shoppe carried this brand in single serving packets, which was terrific because I could buy a variety to avoid getting bored and to not be stuck with an enormous, pantry-hogging container of just one flavor. (Plus, they were more convenient for travel.) They discontinued carrying the single serve packets, and I never found them in other stores. I think Amazon sells the variety packs, and I'd recommend getting one instead of choosing just one flavor. I remember getting a peach one after someone on here said that was her favorite, but I disliked it. I liked the other ones a lot, though. My favorites were the dessert ones rather than the fruity flavored ones. I can't recall the exact name, but there was one that had a picture of a chocolate bundt cake or something similar on the front, and it was yummmmmm to the tum.

Being firm with a patient should not entail belittling her, which is counterproductive. A surgeon can be firm with a patient while still being reasonable and kind. I can't really give much of a pep talk about following a month-long pre-op liquid diet because I didn't have to endure it, but you do have my sympathies. I was a self-pay patient which meant I didn't have to jump through many hoops, and my BMI was low enough to not require any pre-op dieting. I definitely think being on a liquid diet prior to surgery would be significantly harder than post-op when you're healing and your appetite is radically reduced. It honestly wasn't that much of a challenge for me to follow the post-op dietary instructions without any deviations, even though I'd cheated on every diet I'd ever been on in the past. It's a medical prescription rather than a diet, and if you don't follow it the consequences are far steeper. It's imperative to view it that way. The silver lining of your pre-op diet is that you can go ahead and experiment with different shake recipes (the World According to Egg Face blog is a great resource), and the more weight you lose now, the less you'll have to lose after surgery. Best of luck!

I've never consulted with a nutritionist specifically for WLS, and the ones I saw for PCOS weren't particularly helpful. They basically gave the same advice as what's provided online about following a lower-carb but not ultra low carb diet. Since I went the DIY self-pay in Mexico route, I never had to consult with a nutritionist prior to having the VSG in August of 2015. I found ample information provided on sites for bariatric centers, like the ones at UCLA, Stanford, the Mayo Clinic, and also gathered ideas for meal plans and recipes on here, YouTube, Pinterest, and Instagram. That gave me guidelines about what to eat in each stage of post-op, and instructions on long-term eating. I did also receive information from my surgeon's office, but found it helpful to learn about eating in advance. It sounds like you're doing FANTASTIC on your own, so there's little reason for you to spend the money and time seeing a consultant about this point. The only point of possible concern is that from what you've described it sounds like you might be consuming too few calories at this point, especially at lunch. I noticed that my hair shedding lessened when I added in more calories. You may want to have a more substantial meal then and see how that impacts your weight. Otherwise, it looks like a strong meal plan, and quite obviously, it's working very well for you! Congrats!

No, but he was one of the surgeons I considered. I'm happy you had a fabulous experience! Dr. Fernando Garcia performed my VSG at the CER clinic.

I think many people are nervous in the time leading up to WLS, and those emotions can then amplify the feelings of being overwhelmed with other tasks. Even if you were a frequent flyer, chances are you'd have a little more anxiety about this trip than other ones, simply because it's different than travel for business or pleasure. What you're feeling is totally valid, and common. I was also nervous about traveling to Mexico for the VSG, even though I wasn't flying since I live in SoCal a drivable distance away. I actually had a surprisingly pleasant experience there. My surgery went very smoothly, I had minimal pain and no complications, the clinic was very clean and comfortable, the staff were attentive, the hotel was nice and everyone working there was friendly and attentive, and the transportation across the border was easy. I was worried I'd be in pain on the ride home, but I actually felt well enough to spend a few hours shopping at the outlet mall on the California side of the border, and to make touristy stops on the way home. The only discomfort was from a mild allergic reaction to the surgical tape over the incisions. Once I replaced it, I was fine. I'm sorry your husband isn't supportive. Mine wasn't at first either, but he did eventually get on board after I showed him medical research about the long-term benefits of WLS. I'd make a list of things you want to get done before the surgery, in the order of their priority, and then try to focus on one task at a time so you're not as overwhelmed. You'll probably feel more at peace once the travel is finalized. I recommend doing a search of VSG packing suggestions and gathering what you want to bring with you well in advance, so that you can have that sorted. The most important items for me were - a heating pad, Gas-X strips, slippers, comfortable clothing, slip-on shoes, and entertainment. Though I ended up sleeping most of the time during recovery, I'd brought my laptop and a HDMI cable to hook up to the TV in my room so I could watch movies when I was awake and not doing laps around the hall. I've read that people who have flown for the surgery feel more comfortable on the return flight with a small pillow, to place between their lap and the seat belt so it's not right on top of the incisions. I arranged for a house cleaning service to come a couple of times in the weeks post-op when I was recovering and not able to lift things like the laundry hampers, because with my husband's schedule already being full I didn't want him to have to do all the chores I usually handle, in addition to the ones he does. I also recommend making yourself aware of common feelings and frustrations people have post-op, so that you're prepared, and you won't worry something is wrong with you when what you're experiencing is normal. For example, most people experience the "dreaded three week stall" so it's good to anticipate it and know it's temporary. This forum as well as YouTube videos were helpful to me because I could read about what others went through and have a better idea as to what expect. Having the VSG changed my life for the better, and I'm so grateful for it. I am down to a size 2 now, which I never thought possible, and I am living my life so much more fully than before. This surgery can immensely improve your health and your quality of life. I think it could do wonders for you, too.

I find MyFitnessPal to be very helpful, because by being in the habit of writing down what you're consuming, you're making yourself more mindful about your choices. I don't follow a strictly low-carb diet because I find that it's too restrictive for me to sustain, but I do try to go for lower carb (under 100 grams a day), and by keeping track of what I'm eating, I can better stay within the range. There are other similar apps, but that's the one I use. If you do a keyword search of VSG on Instagram or Pinterest you can find a lot of posts, and many are meal plans or pictures of meals. I've gathered a lot of ideas and inspiration there. On YouTube there's also recipes, grocery hauls, and other videos of that sort by people who've had the VSG and are showing what works for them.

I'm not sure of the exact jeans / trousers size I was wearing when I had the VSG because they'd become so uncomfortably tight I started wearing skirts and dresses instead (in an XL). The highest size I ever owned was a 14, but I could barely squeeze into them. My favorite pair ripped in the thigh from the strain of being too tight. I've lost nearly 90 pounds over the past two years, and am now wearing between a zero and a four, depending on the brand. But........as others have mentioned, the sizes today are definitely larger than they used to be in the past. My aunt told me to help myself to any clothes I liked while I was helping to clear out a guest room closet that had sort of been where everything she was no longer wearing but didn't want to give away went, and some size 8s from the 90s or 2000s fit as well as the 2s and 4s today. I forgot to include top and dress sizes. I'm busty, so in more fitted dresses I am between a 6 and a 10. In dresses designed to be loose like ones by Max Studio I wear an XS. I wear anything from an XS to a large in tops depending on the fit. There's some that are XS but so huge it could be a XL in another brand, and some that are large but snug around the chest.

You're very welcome.

Coffee is one of the sweet, simple pleasures of life for many of us, and I'm glad you enjoyed your mocha. I think it's perfectly fine since you're well past the initial post-op stages where you have to be more careful while your stomach is healing. The stats on it are fine. I began drinking coffee again a few weeks post-op as part of my morning ritual. Then four months post op I actually broke a stall by adding in an afternoon latte or some other coffee that was reasonably low in carbs and sugar. I think I'd been consuming too few calories for the amount of exercise I was getting, and that little extra helped. I should try your drink. I'm cutting back on dairy (it's just not my friend) and am not fond of the taste of most almond milk, but with the mocha it might taste nice.

I had the VSG in Mexico in August of 2015 because my relatively low BMI disqualified from me receiving any coverage from my insurance, and it would have cost a small fortune to have the surgery in California where I reside. My total cost was $4200, which included a hotel stay at the Marriott and local transportation. I had a very positive experience there, no complications, and consider the surgery to be a tremendous success. My reproductive endocrinologist had recommended the surgery to me for my PCOS, and has done the follow-up blood work. I was initially very skeptical about going out of country for the surgery, but after researching it felt confident about the decision. "Medical tourism" has become an increasingly popular option for Americans and Canadians, and many of the facilities and surgeons outside of the US are equal to or even superior, but of course it's imperative to do thorough research before proceeding.

I really like Unjury, Syntrax Nectar, and Chike protein powders. There are fun recipes using them on Pinterest and The World According to Eggface blog.