theantichick

My understanding from my research is that it's necessary to slowly get your calorie intake up enough so you are properly fueling your activity. The weight loss will sometimes stall during this process, but it's important to not try to stay at 600, 700, 800 calories especially if very active. While the VSG seems to reset the "set point" so our bodies aren't driven to regain the lost weight, it's also important not to get your body back into starvation mode where it's trying to hang on to every resource it can. My surgeon said that by this point (I'm almost 6 weeks post op) she wanted me in the 1,000 cal/day range, and as I get more active more calories in. But she said it's important to make certain I'm hitting or exceeding my Protein goal every day, as the protein is what drives weight loss and maintaining a stable weight.

Former ER nurse here - for the VSG I can't think of any reason it would matter. Any tube we would be putting in the stomach would be smaller than the one used for the surgery. For lap-band or bypass, it could matter, since it could cause damage to try and put a tube through the small passage between the pouch and lower. I would suggest putting a card in your wallet with your drivers license and/or your insurance card with your relevant medical history. Someone at some point will be getting those things out of your wallet. I have several medical conditions including some drug allergies, so I wear a MedicAlert, and if they pull my record it has the VSG listed in my history, but it's not on the necklace/bracelet I wear.

LOL. My sis had VSG about 4 years ago, and my parents were worried about my having it. At first they were telling me how they were concerned that all of her health issues seem to be related to the VSG. When I let them know that they are not related (I'm a nurse), they backed off that track. The next time I saw them, they were worried that I'd become a downer and no fun to eat with anymore because my sis is one of those people who has to tell you about everything and how things work (even if she doesn't really know). I let them know that as far as I'm concerned, I'm not the food police so I don't speak about what other people are choosing to eat, and after a few months I'll be able to eat whatever I decide to just in smaller portions. And unless you ask me, I'm not going to go on and on about why I'm eating smaller portions or what you should/should not be eating. They finally decided to quit hassling me about it. LOL

but but but

Rough. I had decided to pursue nursing as a mid-life career change, with the goal of becoming a nurse practitioner. I loved ER nursing, but especially with my primary symptom being in my feet and making it incredibly painful to stand, and treatment compromising my immune system, I couldn't stay bedside. I miss the heck out of it. Luckily in my former life I was a data warehouse analyst, and a good one. So I changed my grad school track from NP to Healthcare Informatics (will graduate Dec 2017 god willing) and am back behind a computer. Where I didn't want to be, but at least it's an option that gets me off my feet, pays well (better than nursing), and with all of the assistive tech available, I'll be able to keep doing it as long as my brain works.

PsA/RA here too. My rheumy had me stop the sulfasalazine 3 weeks prior to surgery. I'm 5 weeks out, and see her next week to get my date to start biologics and see if I can start the sulfasalazine again in the meantime. I think she said I can't start biologics until 3 months after surgery, can't remember what she said about sulfasalazine. She and my surgeon both agreed that VSG was the only WLS open to me because I'll have to be able to take NSAIDs and steroids periodically. They are strictly prohibited for bypass and band. Some surgeons will say no with the VSG because of the increased risk of ulcers, but when the benefits outweigh the risks, they'll usually say it's ok. They'll likely require you to be on a PPI (omeprazole or the like) to try and prevent the ulcers. Interestingly enough, by day 3 post op my surgical pain wasn't nearly as bad as my arthritis pain, but without any meds or NSAIDs my arthritis pain has been decreasing. Rheumy said that both the stomach tissue and fat tissue increase the inflammatory factors, and the surgery should help decrease my inflammation as well as reduce joint stress with the weight loss. I didn't expect it to be this significant. So we may want to just try back on the sulfasalazine for a while and see if it does the trick, dunno.

Several of the RA boards I'm on call prednisone "Satan's little tic tacs". When we were getting my diagnosis and trying to find a med that worked, I begged my rheumy for steroids. Without going into the long drawn-out story, I'd been having symptoms for a year or more but they were atypical. One of my hellish symptoms was plantar fasciitis that turned into these incredibly painful knots in the arches of my feet. In a desperate attempt to figure out what was going on and get some relief as I was an ER nurse at the time, I got a doc to give me a round of steroids. I hadn't realized that my pain levels had gotten so high... I would tell people I lived at a 3 or 4 with all the joint issues I've had most of my life. The steroids brought my pain down to a 0 to 1 for the first time in decades. No telling how long the auto-immune was a factor. I had actually been living at a 6 to a 7. I didn't need a lot, just 20mg a day to get it under control and 10mg a day to maintain. I seriously considered black market prednisone. I understood what junkies feel for the first time. Rheumy held the line though, and it was a good thing because while on the pred, my bloodwork wasn't showing anything. Got me off the pred for about 2months, and my bloodwork popped. Methotrexate helped, but not enough. Now I wish we'd tried the shots. I don't have an issue with needles, and the pills were rough. I had what we think was an allergic reaction to mtx so now we can't go back to it. When we started talking biologics, I asked my rheumy about WLS. She was enthusiastically for it. The data isn't all in, but she said there's good evidence that the stomach fundus is responsible for a bunch of inflammatory factors. And of course all the fat tissues and the hormones they secrete is responsible for a bunch more. She said it wasn't likely to put me in remission, but it could really help. Going off my sulfasalazine (which was working some but not 100%) for the 3 weeks needed before surgery, I thought I was going to go nuts with the pain. My surgery pain by day 3 wasn't as bad as my arthritis pain. But it's been gradually getting better. I see my rheumy next week to get a date to start biologics (I think she said 3 mon after surgery) and see if I go back on Sulfasalazine in the meantime. And of course bloodwork. I'm curious to see where my factors are now because my pain is pretty much back where it was medicated. It's a roller coaster. I don't expect remission, but if the VSG helps the meds work better so I can function better (and get active again) then it's worth every bit of it. And of course I'd welcome remission if it comes.

A few years ago when I had a change in my migraine patterns, my neurologist ran every test under the sun. He found non-diabetic neuropathy in my feet and my B6 levels were through the roof. The only thing we could attribute it to is that I was taking a "whole food" multi-Vitamin that was very high in the B complex Vitamins. B6 is also known as pyridoxine and may be listed that way instead of B6 in some enriched foods. He had me stop taking any vitamin that had B6 in it at that point. We never determined if the high B6 was the cause of the neuropathy in my feet, but the neuropathy is mild. Subsequent testing has been normal, but my PCP and I keep an eye on it now. I think that so many things have the B-complex "for energy" now that it's hard to get away from too much supplement.

Sleeved 9/17. No gas pain, I don't know what my doc did different, but I didn't have any of that shoulder/back pain people talk about. First couple of days were rough trying to get in my fluids. But I have had no nausea, even post-op. Which was surprising for me because I have a history of severe nausea after surgery. My doc's anesthesiologist listened to me talk about it and did something with the IV mix and gave me a pill to take and that took care of all of it. The restriction made it hard for me to get to Fluid and Protein goals for a little over a week. I was super fatigued until I could start on soft foods and get my carbs up enough to get me out of ketosis (I get VERY sick on ketosis) so I haven't been able to start working out yet. I signed up for the gym on Friday and will start my Water workouts this week. But every day things got more comfortable and easier. I'm at almost 5 weeks now and am doing pretty good. I'm getting usually 800-1000 cal in a day and meeting my protein goals. I've got enough energy to move around more now and am feeling pretty good. The loss of cravings has been nothing short of amazing. After I got cleared for soft foods my hubby and I went to the store. I passed a lot of things that were binge triggers for me in the past, and part of my brain went "ooh, that would be good, and it would count as soft" and the other part of my brain would imagine eating it and go "eh. doesn't sound that great, actually". So I can walk away from pastries and sugary stuff with no problem. I'm loving my sleeve!!

Guidelines are what reduces complications including possible death! This isn't a trial and error kind of thing (for several weeks anyway). Eat steak - what's the worst case scenario?? Umm...blockage, leak, infection, death, failure... Oh, are we talking about eating choices BEFORE being cleared for a full diet? I think I lost track in the thread. I NEVER suggest rushing the diet advancement plan from your doc. I've heard some that I think are absolutely nuts, like zero Protein allowed for 2 weeks, but bottom line is that your surgeon is the one you've put your trust in for this surgery, follow their plan for advancing the diet, period. They have reasons for setting that. Now, once you're cleared to a full diet, I think that a cookie cutter approach isn't the best. ETA: But I will also say that it's a good idea to at least START with what your surgeon/team is recommending for a diet plan, and if it doesn't work, start researching and modifying from there. I've done extensive dieting over the years, and know from extensive experience that ketogenic diets make me very ill. I couldn't stay out of ketosis while on liquid and soft foods, and the experience just reinforced what I already knew. I will still refrain from simple carbs and sugars, and emphasize the protein in my diet, but I have to have 70+ carbs a day or I get very sick. That's what *my* body needs. Incidentally, I made sure my surgeon/team was on board with that before I chose them for my surgery. I didn't want to be fighting my team if they were going to be pushing a different program.

The NUT I had to see wasn't in the same practice as my surgeon. She didn't know what the surgeon's diet progression was, nor did she know what the surgeon's pre-op diet was. She gave me printouts of the standard 1,200 and 1,500 cal exchange diet. You know, the one we all started with in the 80's that hasn't changed a bit? She wanted me to get blood testing to show what foods I should be eating (to the tune of about $400) and wanted me to go on a low FODMAP plan. She went on and on at length about how I could "cure" my auto-immune arthritis with supplements that conflict with my treatment medications, and with an eating plan that has no scientific evidence behind it. NUTs aren't regulated in my state, there's no licensure or required certification. I could hang a shingle and call myself a nutritionist (though I think the state nursing board would have an issue). I repeat my statement that I have yet to meet one worth the oxygen. Every single one I've met had bought into one fad or another and several have given really bad nutritional advice. Registered dieticians are another group altogether, but I wasn't given an option to meet with an RD.

food cravings stopped immediately. I have told the story several times now where I went to the store after I got okayed for soft foods and walked by the pastries that used to rule my life. Part of my brain went "oooh, that would count as 'soft' food" and the other part of my brain that was imagining eating it went "eh. doesn't seem so good". Eating habits had to change immediately. Right after surgery, it's a chore to get all the Fluid and Protein in. I'm on a full diet now, but still can only eat 4-5oz of pudding consistency foods and only about 2-3oz of solid foods. So meal planning has to be a thing, so that I can get all of my protein and nutrients in. Hubby will dish what he thinks a small serving is, and it's still 3 times what I can actually eat. LOL. I had been worried about changing pant sizes too quickly, but I'm 4 weeks out and right now it's my tops that are starting to look like clown wear. That started by about week 2 but is getting full blown at this point. My pants are looser, and my "fat pants" have had to go in the giveaway box, but they haven't changed as fast as my tops size. I'm so thrilled with my sleeve. It makes some things about life a little challenging, like having to plan meals always. But it's so worth it.

I only had an option of a NUT. Dieticians are fine but most programs have NUTs. And I frankly have never met one worth my time. sent from mobile device

I'm a nurse and I have yet to meet a nutritionist who was worth a darn. The absolute nonsense I've heard from nutritionists would be laughable if it wasn't so serious. If there's a conflict between what your surgeon says and what your nutritionist says, go with your surgeon. I have declined to meet with the nutritionist further because it's a waste of time and money. There are decent resources out there if you as a patient have not learned about basic nutrition that will cost less and be real scientifically proven information. sent from mobile device

Ditto the neti pot. It's amazing how much it helps just to clear out the sinuses. Essential oils like eucalyptus can also help open up the airways, or some Vicks Vapo Rub.

VS sucks all the way around. Back in the day when I still fit in their crud, my sister went to buy me something for a birthday or whatnot. She was large, and the lady looked her up and down and told her in a very snooty voice that they didn't have anything that would fit *her*. I get my best fit (for now anyway) with LB. But I have friends who are very hard to fit (small ribcage, huge breasts) and they swear by Soma. Pricey, to say the least, but there's nothing like a bra that really fits. They say the Soma stuff lasts a really long time if you take care of it, too. As for food stuff, I just got released to full diet yesterday, so I haven't had much of the "caught out, must eat something" but I don't think that's too bad. When I got released to purees I was craving refried Beans, and the texmex fast food place we use doesn't have them alone anymore. So I got a bean burrito and ate the insides with a fork. I think there are acceptable fast food options if we just stop and think it through.

I'm trying to figure out where I come down on the "body positivity" movement and the "health at every size" philosophy in relation to WLS. It's caused me to really think deeply about this, and I thought I'd throw my thoughts out and see how others view it. For starters, I absolutely believe that people of all shapes and sizes deserve to be treated with respect and dignity. People should not be bullied for their shape or size. Physicians should not give different treatment plans for larger people than they do for thin people. The answer to strep throat is not "lose weight". I believe businesses should better accommodate people of all sizes with larger and more sturdy seating as well as better access for people who have mobility issues due to any cause. Airlines in particular. "Normal" people don't fit in those darned seats, for Pete's sake. I believe that people of all shapes and sizes should have access to good quality clothing at a reasonable price. I also believe the diet industry is bogus. The medical field should start telling the truth about the success rates both short term and long term of the "diet and exercise" prescriptions. If the success rates for diet and exercise were given for a drug, it would be banned by the FDA for sale. We need to learn a LOT more about what drives obesity and quit experimenting without full disclosure on people who are obese, especially children. We need to learn more about the damage done to our bodies by dieting, which is likely to be worse than if we just stayed heavy and never dieted. What we do know is that weight is a complex issue that individuals have very little control over. It needs to stop being viewed as a moral issue, with heavier people seen as moral failures. All of these things, I am in agreement with the HAES/body positivity movement. Then we get into the "health" discussion, and my stance starts diverging from theirs. HAES claims that there is no direct causation between body fat and ill health and that the path to better health should not involve any level of focus on weight. Well, not really. While there are some people who carry a lot of body fat and have no significant health concerns, there are also people who drink excessive amounts of alcohol and smoke daily who have no significant health concerns. No one would say that there is no causal relationship between alcohol and liver problems, or between cigarettes and lung issues just because not everyone who partakes is ill. The science is clear that excessive weight significantly increases the risk in a number of health areas. The body will compensate until it can't anymore, and then a cascade of health issues descends. I believe that to state otherwise is deceitful and damaging. And if your weight directly keeps you from being able to take care of yourself and move around, then there's no way you're "healthy", medically speaking. That is not to say that healthcare should be denied to larger people. We still treat lung cancer, even if the patient smoked for 40 years and "brought it on themselves". But we also encourage intervention for the addiction and prescribe cessation programs. We don't have a lot of good options to offer people who struggle with weight issues, and we need to be more up-front about how well they work, but we shouldn't quit trying. HAES/Body Positivity has and excellent observation about the health issues - it's no one's business. Unless I'm on your medical treatment team, it's not my business how much you weigh, and it's not my place to say you should lose weight. It's not my business what you do or don't eat. If I am on your treatment team, I should treat you with the utmost respect and not ignore symptoms and issues because you're larger. The whole argument about "my taxes pay for this treatment and y'all bring it on yourselves" is bogus. My taxes pay for sports injuries (caused by patient choice), car accidents (sometimes caused by patient choice), tobacco complications (caused by patient choice), and drug overdoses (caused by patient choice) and we don't see a large call for those people to go without treatment. Even if we were to start drawing lines, where exactly would they get drawn? HAES also pushes for healthy lifestyle choices, just without a focus on weight. I'm down with that. People of every size can take steps to improve their health: make healthier food choices, exercise, reduce stress, get regular medical care. Some of these will even have more impact than the actual weight loss. Many of these will result in weight loss. People should not be discouraged from doing these things until after they lose weight. I can even (medically) support an attitude of, "I'm going to work on these other things, and I don't care about the scale while I do." (And once again, if I'm not on your medical team, it's none of my business.) HAES has the right idea about much of this. And then I diverge again from HAES and the like when they say that being on Weight Watchers or having WLS or in any way deliberately focusing on modifying your size is AGAINST the body positivity movement. Everyone has different reasons for choosing these things, and not all of them have to do with hating your larger body. I loved myself at my highest weight and was generally okay with my body. I never looked in the mirror and hated myself. I have features I'm not crazy about, but it's at worst neutral, never a self-hatred. I didn't have VSG because I wanted to fit in a size 10 jean again (if I get there or even close it'll be a welcome side effect in my book). My decision was not swayed in the slightest by social pressures. I had VSG because I have physical health issues that are directly impacted by my weight and are reducing my mobility and taking my activity level down to practically nothing. I was lacking a quality of life and wanted to improve the things in my life that HAES talks about. Because of those health issues, I didn't feel like I had time to do it "the long way". I don't advocate WLS for everyone, and unless you ask me directly I'm not going to say whether or not I think it would be a good idea for you. But I'm not "body positive" because I "amputated a healthy organ" in order to change my size. Like so many things in our current society, the opposing sides would have you think that it's a binary situation - on or off, good or bad, this or that. I have never embraced a black and white binary way of thinking and am not about to start now. I want to support the HAES movement, but it seems like I'm not welcome and some of the concepts they propose as near-gospel I find to be scientifically questionable. Maybe I'm trying to justify my position against what I want to believe and it just doesn't fit, I don't know. What do you think?

I got a NutriNinja and love it.

Tylenol is generally approved for all of the WLS. However, I reiterate that if you're having to take *any* kind of headache medicine multiple times a week, you need to get with your doc and maybe even a referral to a headache specialist. It is not normal to have that many headaches and once they find the cause there are usually better treatment options than tylenol, advil, or excedrin. Too much tylenol can damage your liver.

The science says that long-term weight loss success is about 5%. Most of us are experts at getting weight off, we've been professionally dieting for decades. But it always comes back on, which is why we're here. And the weight yo-yo-ing on and off has been proven to be as detrimental if not more than being heavy by itself. While I hope that research continues and they find non-surgical ways to help weight loss succeed for my daughter's generation and future grandkids' generations, right now the best success rates are with surgery. That doesn't mean it's right for everyone, but it needs to be viewed as one of the best options medicine can give us at this point. My friends all expressed that they were concerned (based on people they knew with serious complications) but are supportive of my decision. They've all watched my health deteriorate over the years, and know what it's cost me to have to quit some of my favorite activities because I physically can't anymore. Some friends will be supportive, and others won't. If you've done your research and are steadfast in your decision, ignore the nay sayers. It's normal to have 2nd thoughts and cold feet, because it's a big life-changing decision. Bet if you're married, you had 2nd thoughts and cold feet before the big day. That's normal. Hang in there!!