Wheetsin

Put simply: if your metabolism has shut down, you are dead. You cannot live without metabolizing. Your metabolism is also elastic. You can slow it down by reducing calories and being sedentary, but you can also speed it up. The two best ways to raise your metabolism (and they're related - even better) are exercise, and adding lean muscle mass. Aerobic exercise, specifically. Frequent small meals (although I understand not usually advocated post-op), making sure not to skip a morning meal, etc. all help too. Medically speaking, starvation mode may or may not exist. It's heavily debated, and more people disbelieve than believe. Or they use it colloquially (just like we use the term "socialist country" even though I doubt there's really a completely/truly socials country out there). E.g.:

If you want a kick start, I would suggest doing something similar to the induction phase of Atkins, and then following through with a reduced carb diet. I know a lot of people follow strict diets, and I know a lot try to eat "normal," just less of it. I would NOT advocate exceptionally low carb meals as a long term weightloss strategy, but for "kick starting" loss and something maintainable while you're slowly adapting to a new eating lifestyle (lower carb) it is generally effective. More so with males (if you're a HS FB Coach I'm making the assumption - perhaps with a bit of sexism - that you're a male). For whatever reason, guys just rock low carb diets. A lot of people who have had WLS and need to reach those final pounds find it's almost impossible to do unless they follow some type of diet other than portion. Low carb seems to be among the more effective. The induction phase of Atkins looks something like 20gm carbs a day, no more. Limited amounts of a few lower carb veggies. meats, cheeses, etc. as long as they fit within the 20gm guideline. About 2tbl of cream cheese or heavy whipping cream allowed. Adding in healthy fats like olive oil whenever possible - e.g. stir some into tuna salad, use it as salad dressing, etc. In fact, on induction, the more fat you eat then typically the more weight you lose.

I would say -- let's gently lay the concept of pounds on the ground, and turn the other way. Are you seeing any difference in how your clothes fit? Have you been taking body measurements, by any chance? A stall around the 2 - 3 month mark is almost a guarantee with WLS. I don't know why, but I've seen a LOT of people go through it (A LOT as in almost everyone who has shared with me). If it helps, if the information you've given is accurate (calories, types of foods, etc.) there's really no way you're going to go for a long time without losing some body fat. It may not be detectable on the scale, and it may not be constant. Keep it up and you will see a change.

Did you tell her that you could not comofortably hold that much food? If she understands the volume is the hard part, she should be able to make adjustments for you. Unfortunately lots of the "affiliates" of WLS (everyone who is not the patient, really) don't understand how individualized all of this can be, and tend to give out generic instructions. WHen I had my lap-band put in, the nutritionist gave me an instruction sheet for drinking. Following her isntructions, it would have been physically impossible to drink the amount of Water she was telling me to drink. Not because I couldn't hold it, but because the guidelines were something like "2oz an hour, sipping, no fewer than 64 oz a day." Well even if I stayed up all night to drink, I couldn't get in 64oz at only 2oz per hour. So I called and she treated me like I was stupid, very "Well duh, those are just guidelines..." so I told her that maybe she shouldn't have titled the page with RULES...

With my AGB I got to within about 30 lbs of a normal BMI and still felt huge. I would see myself in a picture and think I looked ok, but my mental model of myself never changed. To be fair, it never changed on the way up, either. I was only ever able to "see" myself as a certain level of fat. Anything over that fat didn't register mentally, nor did anything under. I COULD, though, pick up a normal sized shirt and tell from looking at it that it would fit me (I hate to try on clothes and would rather just eyeball them, hold them up, and bring them back if they don't work). So I did have a concept of my size, at least relative to other items. I COULD NOT see someone on the street, and determine whether I was a similar size to them. So that concept of size seemed not to apply to other people. My husband must've been so sick and tired of me saying, "Am I her size? Am I bigger than her? Am I smaller than her?" But it was just me trying to understand what I really looked like.

Loose skin is such a subjective thing and varies completely from person to person. Just going to paste from a previous post: The are(s) fat is lost from matter, too. I have a stomach so saggy you can't even see my bellybutton. And honestly, you can't really find it either. I've tried, in my attempts at stellar hygiene. I can stick an entire medical (the ginormous ones) qtip into my "belly button" and never actually reach it. It's like a bottomless pit, right in the middle of my abdomen. My elbows look melted. But my hands/forearms are fine, my face and neck and chest are ok, etc. BUt I lost 175 lbs, and wasn't even at goal - so I had a lot of skin to start with. odon't just consider your age, size, height, etc. Those are factors, yes. Are you scarry? (e.g. do you have a lot of stretchmarks?) What shape is your skin on overall? What about your prents' skin? Are you fair skinned? Do you have sun damage? Etc.

Alright guys, help a sleeve researcher out. I don't want to make assumptions. Sorry if this makes any of you uncomfortable. What is "bathroom episode" a euphemism for? Vomiting? Diarrhea? Gas? All of the above? Gotta just say it like it is with me.

When I had my AGB (similar or same incisions) I slept the first 4 nights in a recliner. It took that long to be able to get into bed comfortably, even though I was walking around fine by then. When I first slept in bed I used a mound of pillows behind me. I'm a side sleeper, and can't stand to lay or sleep flat on my back, but it was still too uncomfortable to sleep on my side. The mound was the most omfortable compromise I could find. It was 2 or 3 nights of the pillows. Then after, I could side sleep using a pillow under my pannus. I have a really hangy one, and it would pull on my incisions. The pillow stopped all that nonsense. WHen my stitches were removed @ week 2, I was bak to sleeping normal.

With WLS in general, removing liquid protein and going with solid/dense proteins is a pretty well known stall breaker. Everything the nurse told you is correct. I have AGB but am still supposed to target the same 60gm of protein a day. I'ts not THAT hard for me, but does require me to eat small, frequent high protein meals. I'm far enough out that I don't count grams any longer, or pay too much attention to it, but I did for 3 - 4 years. If I don't eat tuna, or my cooked turkey pepperoni chips I have a hard time getting 60gm in.

It's interesting to see how many of us relative "oldies" have made their way over to this thread. I'd love to see a poll of how many of us have either lost our bands, or need to lose them (as in my case - I'm working on approval for a revision). Or are having complications that aren't yet being properly diagnosed -- I was treated as someone who first needed a series of unfills, then who needed to change eating habits, then who was just "one of those" responding unfavorably. OP is more generous than me. I'm going on 6 years out, and would have to cite the failures I've seen upwards of 75% - 80%. I've seen it at abou t95% or higher for women who have had babies with a band. I do not have much faith in the lap-band (or any other brand of AGB) as a long-term solution. I'm just not seeing enough people keep their bands. I was diagnosed with a slip last month. I believe it happened in 2008 (when I had an onset of stnrage symptoms, that didn't seem to add up to a "slip"), but my body is tolerating it. As in - I still have moderate restriction, I am not getting sick, etc. But my slip was described to me as "profound" and options such as unfill for self-repositioning, or surgical repositioning are not an option. My options were "live with it like this, and since you're tolerating it, maybe you can even get a fill some day" or "removal." I'm going removal, and revision to a sleeve. Years ago my surgeon told me my band would slip if I didn't follow the rules. I'm not a model bandster - I eat carbs, I'm not a rigorous exerciser... but I followed the rules, and even better than rules if it worked out better for me. I don't hate my band. I'm sad to see it go. I didn't have constant misery or pain, I didn't hate the consequences it enforced, or intolerances, or a lot of the other "baddies" people often experience. It helped me lose 175 pounds and if it hadn't moved, I would still be happy keeping it. Though I would be more and more wary that it's probably gonna have to come out one of these days.

I may be able to help, a little... Last month I was diagnosed with a "profound" band slip. Yet oddly enough, did not have many of the typical symptoms (I believe it slipped in 2008, when the symptoms I do have started appearing). I am currently pursuing band removal, and revision to the sleeve. If you are self-pay, band removal is just another operation. If you are going through insurance, you will need to have documentation verifying that the removal is medically necessary. That is assuming the removal procedure (there is a CPT code for removal of lap-band and associated parts, but I don't have it on hand) is approved. You can find that CPT code and verify with your insurance. I'm at the "proving it's medically necessary" stage. We have the xrays that show the slip. I have almost 3 years' worth of off and on documentation of the same complaints (because I didn't have "typical" symptoms, I was first treated as an overfill... until we got down to less than .25cc... and then I was treated as someone who just needed to eat differently... it was ridiculous.) My insurance company requires an EGD as part of the proof of medical necessity -- I'm scheduled for that next week. From what I've been told, that's pretty much the last step prior to approval. They are also submitting for a revision to VSG (vertical sleeve gastroectomy - or "the sleeve") at the same time. Because of the nature of my slip, my surgeon is not considering my a candidate for re-banding. And with the laughable re-banding sucess rates, I would not consider it an option for myself. I'm not jumping with joy at the thought of a sleeve, but I need something... I can't be rebanded... I do not want a malabsorptive procedure... I do want something with some history of good success... well, the sleeve definitely wasn't my first choice but options are few. NYC_Gal, from what I have read & been told (by sleeved people) the recovery is not that much different. It's the same 2 - 3 weeks as the band, with some people returning within a week. It seems like most people perk up on day 3 - 4. I was OK the day after my band, and fine day 2. If it takes me 4 days instead of 2 days, I won't really think twice about the difference. Also, unless your self pay, there really is no approval from your surgeon - unless you just mean he agreed to do your surgery. Your approval will need to come from insurance (again, moot if you're self pay). Band - sleeve revisions are quite a bit risker than "virgin" sleeves. Adhesions and scar tissue can cause some complications. The pain afterward can be significant -- our ports were sewn in so as not to come back out, and sometimes have to be dug out a bit. Some surgeons will revise in one procedure - others require a waiting period (usually because of swelling and the way it can "hide" leaks). I haven't yet spoken with my surgeon so I'm not entirely sure which way he goes. HTH

Unless your surgeon's plan specifically indicates a caloric goal so soon after surgery, don't worry too much about not getting enough calories. I wouldn't even be too freaked about Protein at this point. I personally would be focused on ounces of Water. More than anything, your body needs to be hydrated right now. You will not heal adequately if you are significantly dehydrated. You will not function properly, head to toe, if you are dehydrated. (Most people function day to day wth some small degree of dehydration). Make that #1 priority. Everything else can wait, and will come with time. What's enough, anyway? At the end of the day, you want a calorie balance that's lower than your BMR. Maybe that's 1, maybe that's 900. (OK, I'm not saying to aim for 1 calorie a day, but you get my drift...) BTW, BMR (basal metabolic rate), in case you or other readers are unfamiliar with the term, is the number of calories your survival costs you. In other words, your body needs a base number of calories just to be alive: to circulate your blood, to breathe, to digest, etc. That doesn't count things like movement, or rigorous cognitive processes. Just laying there, doing nothing. To lose weight, you somehow offset that number of calories - eating fewer, burning some, etc. There is no number of calories required to survive, unless you have absolutely no reserves to draw on. Then "enough" = BMR + your activities. BTW... each gram of protein contains 4 calories. I'm guessing you've been guided in the neighborhood of 60gm protein per day. That's 240 calories, just in the pure protein you're consuming (if you're consuling 60gm, if not, adjust accordingly).

Wow, great job. And good grief -- how tall are you? I'm between 5'10 and 5'11, and when I last weighed 185 I was still in a M or L shirt. And I have a big frame (your frame looks tiny in your pics), and small boobs, and a large rib cage. I'm guesstimating to EVER see a Small, I would need to weigh like 130, which just isn't going to happen (my "normal" BMI weight is about 175 - 185). You boggle the mind.

I don't have Celiac, but a good friend of mine has two chuldren with autism who are on a very rigorous, casein and gluten free diet. Here are some blogs she uses: http://glutenfreemommy.com/ http://simplyrecipes.com/recipes/food_blog_spotlight_-_gluten-free/ http://www.food.com/recipes/gluten-free I believe she just makes the adjustments for casein as needed.

BTW Bryn - something that really helped me the first time around was focusing on the (almost surreal) concept that I would be ale to maintain my weight loss. I'd lost those same freaking pounds so many times over that maintenance was pretty much mission impossible. But this time, it will stay off! And it did, until I got pregnant. And even then, it mostly did. I'm not really a psyching up, hype, ra-ra kind of gal. I just kinda get sh*t done because it needs to get done. But that little voice in the back of my head telling me that this time it will be gone for good really was the difference between just thinking about it, and actually doing it. Think of how good it will feel to lose the weight and not really have to worry much about it coming back. Crimeny -- just the mental break of not having to beat myself daily with chants of, "I really need to do something about my weight..." was worth more than I can express. The first I was able to think back to myself, "I DID, and it's awesome" was such an amazing moment. If I ever had a defining "A-ha!" moment where I just absolutely knew I had made the right choice, that was it. This time around it's different. I'm not facing the unknown of WLS, or surgery, or freaked out about the "little" things -- I'm just facing the unknown of what's different between my lap-band and the sleeve. That's a much calmer mental struggle. Now instead of "will it work," "can I do it," "will I be able to adjust," etc. I'm wondering, "with the band I feel this, how will that translate with the sleeve," and "with the band it does that, what will it do with the sleeve?" That's a different place than where you're at, but just remember -- lots of people who are much bigger wimps than you have been there, done that. (Or so I told myself when I was in labor...)

Just got a call from my surgeon's office. My insurance apparently requires an EGD. The lady called me on my cell, which gets horrible reception, so I didn't hear everything and didn't have much opportunity to ask. I'm going to call her back as soon as I have a chance. I don't know if the EGS is required for the band removal part, or the revision part. Or if it's required b/c my chief symptom from my slip was reflux. Or if it's standard to check for hiatal hernias when doing a sleeve-type procedure. Or... who knows. Just curious if it was "standard" for band -> sleeve revisions. Hope to have more info soon.

Hmm... my port incision is located pretty far away from my actual port. Port incision is right around my xiphoid process, my port is about 3" down and an inch or so to the right. I get pain from the scar tissue near the incision, and the actual port area "glitches" sometimes (e.g. I bend just right, or wrong, depending on how you look at it... I swear I can feel it *thwap* even though it's still sewn down good and tight... so I don't really know what's going on there). When I lay flat on my back, my scar tissue makes a very obvious knot under my skin. Sooo painful if my daughter happens to press on this or kick it when we're playing. If your incision is right over your port, I would guess you're feeling the effects of the surgeon having to actually cut the port out. If your incision, like mine, is not really in the same area as your port, then definitely watch it closely for any redness, swelling, hardening, discoloration, etc.

anonynurse - do you know how long it takes for reflux damage/ulcerations to heal to the point that it can't be visually detected? I'm curious about this. I have only had reflux twice since getting a total unfill (early last month), and both times were within a week of the unfill. My fills/unfills apparently now take about 8 days to kick in - I know that's not unusual, but it is for me. Prior to that, I was having severe reflux (severe as in the degree, not frequency -- only 1 or 2 times a month, but all night long, as soon as I would doze off, even if I was sitting up, 1 - 3 nights in a row. That had gone on for at least 2 - 2.5 years that I can remember... I got tired of hearing "need more unfill" and actually started thinking it was dysmotility, especially since it was so intermittent... with 20/20 hindsight I should have connected the dots, but I didn't have much in common with other slips I had read about. Also because I knew 100% when I would have the spells... it was a weird feeling that I thought was the food not passing thru... I just attributed that feeling to yet another change (since it was my 3rd or 4th complete change in band sensations). I also had at least one case of aspiration pneumonia, but it was just documented/diagnosed as "pneumonia" (but when I'm not sick, and no one around me is sick, and I have no fever, and 4 days prior I woke up to acid in my lungs... I never finished med school, but I'm comfortable taking a somewhat educated guess...) I'm wondering if that damage would still be visible, since I (hopefully) won't have had any reflux for about 5 weeks by the time of me EGD.

Italianlady13, do you have family or close friends here? I ask just because having someone buy something here, and ship it to you, would probably be cheaper and would give you a lot more selection -- and you'd be a lot more liekly to have it whenever you needed it. We do this for my husband's family in Europe all the time. Someone could easily take the powder out of the bulky container, seal it using any food saver machine, and shipped reasonably using the USPS flat rate boxes. I'm guessing it would be about $55 to ship a box that would hold a few months' worth of Protein powder (that's just a guess). Otherwise, the one you have found sounds good. I've never heard of that company, but that doesn't mean anything. As someone else mentioned - don't expect unflavored to have 0 impact on taste. Lots of things are unflavored (no flavor added) that still have plenty of flavor.

I didn't get a binder (had AGB) but for about 4 - 5 days, moving around wasn't 100% comfortable unless I held a pillow against me. It had more to do with helping support the weight of my pannus that with the compression, but it made a heckuva difference. It also helped to sleep with a pillow tucked under my saggy stomach, so it didn't hang. It's nice that you were givena binder, I can imagine it will really do wonders for your mobile comfort level.

BTW, I'm trying (still) to adjust to one of thoese silly ergonomic keyboards. My typing accuracy has gone down significantly. I should take the time to edit out my misspells/misstypes, but I'm just not gonna.

Bryn, I had those same doubts before my forst WLS. Here was my defining thought: The next 12 months is going to pass regardless of what I do. Time doesn't care, and isn't going to stop. So 12 months from now, I can be exactly the way I was, or I can be better. After those 12 months, if I'm the exact same, will I regret it? Haven't I regretted it those same exact 12 months, 10 times over? The time's passing... only I can control what happens during that time. I had fears. I still do, and considering I need a revision - many of them came true. But that's ok. It's not "the worst thing ever," it's just my reality... it's something else I need to deal with. I'm analytica to a fault. I always overthink things, but I'm glad I do. If I didn't overthink, I wouldn't be "ready." I don't think decisions can be as easy as a pro/con list, and you one-for-one your way down it because things can very in severity or consequential weight. But try looking at it that way for starters... Like 'what if it doesn't work': I have researched this a lot and have not found any instances of it not working, as in someone cannot lose weight. I have found people who have regained their weight. I suspect those people did not make the more holistic changes necessary for any sustained weightloss. Just make sure that mentally, you're ready to work and are not expecting a freebie. You may very well get a freebie, but don't prepare for it. 'what if I'm miserable for the rest of my life': WLS is extreme. I have to think that anyone seriously considering it is already miserable, and already expects they will be miserable for the rest of their lives unless they do something differently. Misery has many forms, so what kind of misery are you afraid of as a result of surgery? and 'what if I'm always nauseated': Does this happen very often? I don't have that particular concern, but if I did I would probably be trying to see how often it happens, what medication solutions to long-term nausea were available, and asking myself if I would rather live miserable because I'm nauseous, or miserable because I'm fat (and everything that comes along with being fat). Remember my comments above that some things carry more significance than others, and that misery comes in different forms? Here you go. What's worth more? Which is more significant? Which would you better tolerate? and 'what if I can't eat solid food' and what if, what if, what if...: Then you will adjust to mushy foods, liquids, soupy foods, etc. I've had my band about 5.5 years. There are times when I cannot eat solid foods. I may go through spells of 4 - 6 days where I can't eat solids. I go through spells of a day where I can't comfortably drink liquids. Pre-op, these things were unthinkable... I couldn't imagine what I would do if I couldn't eat solids anymore. But once I was in that position, it doesn't bother me. I'm still feeling a swallow of orange juice I took about about 3 hours ago. I will probably stay away from solids today & tomorrow. It doesn't bother me, it's just how it is. In regards to that last idea, I'm not sure I can explain this very well, but perhaps others -- especially those who have had their VSG a while, or those who have had other procedures first -- can chime in. When you're "living the reality" none of the silly (as you come to see them) things that scared you really matter anymore. You become very resistant. I would have been terrified at the thought of not eating for 4 days. I couldn't possibly conceive of not feeling hungry. Getting full after 3 bites was so abstract, you may as well have been asking me to conceptualize the boundaries of the universe. Possibly having to give up foods I liked seemed like such an ultimate sacrifice. But when the time comes and you (if you) have to face any of those concerns, you just do it. And it's easy to do it because you're getting something out if it. I'm gladly going to skip food today, because it beats the hell out of feeling anything I eat just sitting there. I'm perfectly happy to not feel hungry, because I don't have to stop what I'm doing to eat. Not eating solids for a week or so is ok, because the liquids and mushy stuff is just fine, and wellw orth the avoided discomfort. Hope that makes sense. I know it's hard to "pretend" what things are going to be like, and some of these things probably seem impossible... but when you're there, they are simply your reality and you cope. and 'what if I'm miserable for the rest of my life' and 'what if I'm always nauseated' and 'what if I can't eat solid food' and what if, what if, what if...

Didn't you guys also feel awkward getting attention fat, though? Maybe it was different attention, but still attention. I know I did/do. When I get attention, I never assume it's positive attention: e.g. I think someone is looking at me because I'm so large, or because the way I'm sitting - my stomach must look really gross, or... Other than the type of attention you're getting, it sounds kinda the same. "People stare at me because I'm fat, and it makes me uncomfortable" or "People stare at me because I'm attractive, and it makes me uncomfortable." On a fundamental level - not much difference. You are - and will be for a while - having to make one hell of a culture shock adjustment. Long ago I was working on an MS in Clinical Psychology. I studied a lot about the different motivators for becoming and/or remaining obese. I ran across a book called, "I want to be thin, I want to be fat..." Especially for those of you dealing with the changes that your new body is brining (both external and internal changes) it might be an interesting read.

Good point on the sister. You can tell I am an only child. I kinda just skimmed past that whole "sister" part... Does your sister know you are having surgery? That, too, might change the dynamic.

I haven't had VSG but I have had laparoscopic WLS. The sorest for me was the largest incision, which was used to insert my AGB and attach the port. I'm guessing you guys have a similar deal where one incision is the "main" (removal) incision and quite a bit larger than the rest. Some of the other incisions -- I didn't even know I had them until I saw them well after getting home. But that main one, ouch. Overall my pain was very tolerable, but what I did have definitely came from that larger incision (and did for a few weeks). A few years ago, after my AGB, I had my GB removed and the surgeon re-used the same incisions and added a new, tiny one by my belly button. Once again, the main incision is what hurt. And there had been just enough time between the two procedures for my slightly keloided scar to calm down and flatten... just in time to have it re-cut... and it's now flattened again, right as I am researching VSG as a revision option. SIgh...