Barry W

Hi there, sure, I can always use someone to share the road with... I think it's bound to be a little bumpy, but if we apply ourselves, it will take us to a better place.

Thanks Kathy - I gained about 10lb while going through the evaluation process, and they asked me to lose that before meeting with the surgeon and setting a date. I did what they asked and went in for a weight check to prove it, and after that I got the appointment with the surgeon, then at the meeting with the surgeon, Dr Jones, I got the surgical date (which was a little more than 3 weeks out) and some initial pre-operative instructions. Hope that is clear.

I have been using the new SlimFast Advanced Nutrition, High Protein shakes for my pre-op diet that I have voluntarily switched to early. They are palatable and I like their nutritional profile. These have just come out and are a "Meal Replacement shake", for which you'd like to see (1) A decent calorie count, not 100 calories, and (2) about 1/3 the RDA of important Vitamins and minerals. These are high protein (20g), and low sugar (1g), and have 5g added Fiber, which along with the protein, helps to stave off hunger. There is a good complement of vitamins and minerals, and 180 calories for an 11oz shake, in part due to the use of some healthy fats. I have been substituting these for Breakfast and most lunches for a month and feel fine. I have a small meal for dinner with a good portion of veggies that I continually vary included, and fruit now and then to ensure balanced nutrition. Have lost 20lb this way so far. Hope to be down 30lb by my surgery date. Have tried various flavors. For me the caramel latte is not great - just good enough to drink, and the vanilla is fair. I like the chocolate and the strawberry though. Your mileage may vary. They can be distinguished by the Advanced Nutrition / High Protein badging on the product packaging. Vitamin A 40% Vitamin C 110% Calcium 40% Iron 15% Vitamin D 40% Vitamin E 110% Vitamin K 25% Thiamin 40% Riboflavin 40% Niacin 35% Vitamin B6 30% Folate 35% Vitamin B12 35% Biotin 35% Pantothenic Acid 35% Phosphorus 45% Iodine 35% Magnesium 35% Zinc 15% Selenium 20% Manganese 35% Chromium 30%

Hi, yes, these are not the lightest shakes going. I prefer these as a meal replacement though, precisely because they have a little more calories - 180 is still super low for a meal, and they have a pretty complete panel of Vitamins and minerals, helping to ward off malnutrition. If you are focused on max protein and min calories, say if supplementing an otherwise balanced diet, these Pure Protein Shakes are easy to find in my area and pretty cheap at the supermarket. 23g of protein and 120 calories, and the vanilla and chocolate ones are not bad on taste either (in my opinion). http://www.pureprotein.com/products/23g-shake-rich-chocolate-4-pack/#

I have the Taylor 7506, which settles on weight quickly and reproducibly if I step on it multiple times. The displayed weight seems to match that on the scale in my bariatric surgeon's office, so it also looks to be quite accurate. It's also quite reasonably priced and looks nice. http://www.amazon.com/Taylor-Glass-Chrome-Digital-Scale/dp/B0000E2PEI

Hey, don't let it get to you man, some people are just jerks. if they respond inappropriately, just use that as a red flag not to listen to what they have to say - something wrong with them, not you.

Thanks for the positive wishes, Rio :-)

yes i am! im use to having a coke a day. :/ perhaps that is causing them as well If you only had one coke a day, not sure your body would miss it. If you drink half a dozen or more (or the same in coffees), you want to taper off gradually. Caffeine withdrawals for heavy consumers definitely occur and can be pretty bad at first - been there while camping coffeelessly, am normally a heavy coffee drinker. You should try to make sure you get enough hydration, as well as enough Vitamins and iron/minerals - take a good daily Multivitamin and if the plan allows it, eat a variety of vegetables, green leafy salads and fruits. Another question - Are you prone to migraines normally?

It is a fairly drastic remedy, so I don't want to actually try to "talk you into it". But I have decided to go with the VSG procedure after my own struggles with weight and associated health issues that have cropped up as I approach my senior years. Mine will be done at the end of this month. I looked into this very thoroughly, polling people here, reading of their experiences, plus a lot of literature research - I am a scientist. My own feeling is that it's not like it's something one should do lightly. There will likely be discomfort in the month following surgery, and there are risks of malnutrition and surgical complications. But these risks can be mitigated by choosing your surgeon carefully, and learning what you should do as a patient and complying faithfully. Then there is the fact that you still need to do a lifestyle change, just as you would if you didn't have surgery, and it is possible to "cheat" and not lose or gain the weight back if someone really does the wrong things, so it's not an easy answer. However, there is no avoiding that work, and I believe that having the surgery will improve my chances of accomplishing this change and sticking with it. The reduced hunger that normally accompanies the reduction in stomach tissue is one of the benefits of the VSG option for bariatric surgery. Plus you will have the greatly reduced stomach volume and (hopefully) a greater sense of gravity for the whole lifestyle change after going through surgical change to help get there. I think this should only be the last resort. However, if you have made numerous serious attempts to lose weight and failed each time to keep it off, and you have health issues looming in your future (or already), then I think that the risks of not having the surgery can be greater than the risks of having the surgery. That's where I am.

Last day of the month - Feb 29th, getting it into February thanks to the leap year

It doesn't have to be straight water, and if you are pre-op you don't need to be fastidious with caffeine. Hot or iced coffee or tea. For example Pure Leaf is widely available and they make some nice bottled iced teas, both green and black, and including unsweetened: http://pureleaf.com/pureleaf If you have a pitcher and want an all natural low sugar fruit flavored drink, mix a thin-sliced, peel-on lemon, lime or orange into some spring water and leave the fruit slices to steep for a few hours in the fridge at least - tastes very good and less than $2 per gallon. I first learned to drink that at a fancy Scandanavian hotel where they kept such pitchers out at meetings - the fruit flavor is subtle but really enhances plain water. Nothing wrong with a little fat-free milk either and you can get organic if you are worried about hormones.

Muscle Milk and SlimFast-High Protein, both in chocolate are both okay with me. Taste okay, and have 20g protein, just 2-3g of sugar, and also a little healthy fat mixed in to give 180 calories total in an 11oz shake - while this is about weight loss, you need to have *some* calories.

I have decided to try to go forward with the Sleeve Gastrectomy, and have begun the patient intake process at Beth Israel Hospital, which is local to me in Boston. There seems to be a lot of experience in the Bariatric Surgery program there, and I was particularly impressed with surgeon Dr Daniel Jones, who has written 2 books on patient safety, and serves on the nation accreditation board for bariatric surgery programs. Hope I am accepted as a candidate for the surgery. As things develop I will continue to ask questions here and assuming I get there, to share the experiences on my own journey so they might benefit others. Thanks for sharing your thoughts... Barry

Hi, I have done a fair amount of research at this point and see that the benefits of a Sleeve Gastrectomy can be great, but this is not a trivial change in lifestyle, there are risks and downsides, and of course it's not reversible. I am at the edge looking over the cliff now, have gone to the required patient info session at a local hospital where I would get the procedure. I know everyone's experience can be different, so I just wanted to do a simple poll: If you are at least 6 months post-op, please tell me three things: - How long ago was your procedure? - What was your starting BMI and what is it now? - if you could magically go back in time and revisit your decision, would you still get the sleeve procedure? Thanks for sharing your experiences! Barry

Real sugar has 23 calories per packet (like often distributed with coffee). It's really not that much, unless of course, you're swilling sodas, and grazing Cookies and Desserts - of course that's how a lot of us got here. Artificial sweeteners have little to no calories. But, they are not physiologically inert. They have been found to stimulate appetite and to stimulate adipogenesis (fat deposition), just like sugar does - so they are not truly "free" in terms of maintaining healthy weight. Large amounts of artificial sweeteners should be avoided just like the real thing. Personally, as long as they are taken in small amounts, I don't think there is much evidence to worry about the choice too much. In general, you want to minimize both sugar and low Fiber complex carbs like are found in white rice, white bread, Pasta and potatoes. High fiber sources of carbohydrates, like unsweetened oatmeal, whole wheat bread, legumes and fruits are actually a useful part of a healthy diet.

You could try your vegetables in pureed form, like in this "Winter Potage" soup. You are basically first boiling some super-healthy vegetables (edamame, peas, spinach and broccoli) in low sodium/fat free chicken broth, and then you puree everything in a blender until smooth. It is delicious and full of Vitamins from all the veggies, even has some Protein from the edamame. You might go light on the pepper if your tummy is not settled yet. http://www.myrecipes.com/recipe/winter-potage

Awesome - 48lb is very cool. I will bet that you feel that you move better and more comfortably as well. I agree it's good to recognize and Celebrate success - keep up the good work!

Just a follow up, today I saw my doctor and he prescribed me all the Vitamins I need I am also now drinking Protein shakes although they make me heave and taste horrendous. I am still looking for the right protein product that I will be able to tolerate a bit better. Thank you all for the info I'm glad I asked the questions as I would've still been going without if I didn't I'm really grateful thank you. ------------------------------------------------------------------- Hi - I see that you are having a lot of trouble with vomiting. I understand that complicates things of course. If the vomiting persists, I would see the doctor about that. Vomiting itself causes problems, and from what I have read, vomiting is common in the initial days, but if it persists, could be telling you something. Fortunately your diet should be transitioning in the coming weeks to allowing more options as your stomach heals, and you should be less dependent on the Protein Shakes. If a whole one makes you vomit, then try drinking just a half and throwing the other half out. You're better off keeping down half a shake than vomiting up a whole one. You likely got something like this, but if you'd care to have a look, here is a link to the post-sleeve dietary recommendations from Brigham & Women's Hospital. They are roughly a top-10 hospital overall, so very good. http://brighamandwomens.org/Departments_and_Services/surgery/metabolic-and-bariatric-surgery/pdfs/SleeveDietGuidelinesColor.pdf Hang in there! Barry

I have not had this surgery yet, but have been doing my homework. From what I have read, nutritional deficiencies, and their consequences, are common. See for example this research article: "The gastric sleeve: losing weight as fast as micronutrients?", Obes Surg. 2011 Feb;21(2):207-11. doi: 10.1007/s11695-010-0316-7, which can be read for free here: http://www.ncbi.nlm.nih.gov/pubmed/21088925 I plan to follow the guidelines to the letter. See for example this info from Johns Hopkins: http://www.hopkinsmedicine.org/johns_hopkins_bayview/_docs/medical_services/bariatrics/nutrition_sleeve_gastrectomy.pdf

Thanks people, for sharing your experience. I don't expect this to be any picnic, especially at first. Besides reading some abstract statistics regarding nutritional deficiencies and other post-op issues, I have seen the descriptions of discomfort and angst right in this forum from our members. This too is helpful, because it gives me realistic expectations about experiencing some "bumps in the road". I did notice though that these posts relating troubles and misgivings come largely from people in the first 3 months post-operation. That's why I wanted to hear from people at least 6 months past the procedure. It's really the long run issues balanced against the long run benefits that I would like to base my decision on. And based on what I have read here, I will be taking next steps. I am around 40 BMI now, so on the edge of the eligibility criteria. But I have tried and failed with lifestyle changes several times and I am only getting heavier, so I hope that I get accepted for this procedure by the insurance company and the hospital. Thanks again for taking the time to respond.

Here are some recommendations from Johns Hopkins for gastric sleeve patients. See the PDF linked below for full details. They are recommending: 500mg of calcium citrate (not calcium carbonate), with Vitamin D, taken 3x daily with food Vitamin B12 - 500microgram sublingual tablet or liquid formulation daily with Breakfast A chewable or liquid multivitamin with dinner - 200% RDA for Iron (36mg), folic acid (800mcg) and thiamine (3mg) and 2 mg of copper. Best also contains selenium and zinc. http://www.hopkinsmedicine.org/johns_hopkins_bayview/_docs/medical_services/bariatrics/nutrition_sleeve_gastrectomy.pdf

I have been using PATCHMD since 2 weeks post op. So, roughly a month or so. I have labs drawn mid October and I am very anxious to see if they are absorbing and providing the proper supplements. They are super convenient and 40% off when you use the coupon code PMD40. I will post once I have labs drawn.I only take Iron pill, omeprazole & Biotin orally now. Thanks for bringing these up - these patch vitamins are interesting as I know there are concerns about the bioavailability of some vitamins and minerals when eaten in pill form - basically how well they are absorbed into the bloodstream from the intestine. With these being administered through the skin, there will be a very different profile of bioavailability. As I look at the info on the Multivitamin from PatchMD, actually a concern of over-dosing arises though. Despite the fact that bioavailabilty here should be much higher than for pill vitamins, they still are formulating with aggressive dosing. If taken in too large an excess, vitamins can have toxic effects. The fat soluble vitamins - A, D, E and K are especially dangerous as they are not cleared quickly from the body; so there is the risk of accumulating too much, and even if you discontinue dosing, they won't leave your body rapidly.

I have been using PATCHMD since 2 weeks post op. So, roughly a month or so. I have labs drawn mid October and I am very anxious to see if they are absorbing and providing the proper supplements. They are super convenient and 40% off when you use the coupon code PMD40. I will post once I have labs drawn.I only take Iron pill, omeprazole & Biotin orally now. Thanks for bringing these up - these patch vitamins are interesting as I know there are concerns about the bioavailability of some vitamins and minerals when eaten in pill form - basically how well they are absorbed into the bloodstream from the intestine. With these being administered through the skin, there will be a very different profile of bioavailability.

You want to emphasize Protein content and Vitamins and minerals in the reduced portions you eat following bariatric surgery. So that would be lean meats, nonfat dairy, legumes/beans, low carb Protein shakes, as well as a spectrum of vegetables of all colors - to get a spectrum of vitamins and minerals. I am still on the fence but am doing my due diligence and the literature seems to indicate that nutritional deficiencies (AKA malnutrition) are common with such small portion sizes, when people are not receiving or following good nutritional advice. The less that you eat, the more important that you really eat the right things in what you are taking in.

I wouldn't panic, because people do get through this on a routine basis. I am not surprised that some people are experiencing hunger though, because: Even after you have been "sleeved", your body doesn't totally lose the ability to make the "hunger hormone" ghrelin. It's still expressed in the pituitary, small intestine, and your remaining stomach. So it is reduced, but not absent. The chills and light-headedness described as common symptoms in the first month, I believe are caused by mild hypoglycemia, since little is eaten at all at first, and what is eaten is pretty low-carb. Mild hypogylcemia does stimulate hunger as a natural response.