PatientEleventyBillion

There's really no way to gauge. If this were an administrative process with rigid timelines it would be one thing, but everyone's body is different. It's based on countless factors like how over one's normal weight they are, their metabolism, their caloric/carb intake, how long they take to heal, etc. There is absolutely no way to tell how long until you level out. I had an internist that sees hundreds of people for bariatric surgery say in an appointment today it can take up to 3 years for weight to level out. The first year should really be concern about healing. If one has made the appropriate lifestyle and dietary changes befitting a smaller person the weight should come off accordingly and eventually level out.

Since you seem to have your ducks in a row as far as the getting the surgery done goes, try and attend as many classes and gather as much information as you can surrounding pre-op and post-op nutrition, supplements, and if you take any medications how your surgery might affect those. Being aware of necessary lifestyle changes is part 1, implementing them is the next phase, and the most challenging. This must be partnered with the WLS for it to be effective at all. It's always good to be a step ahead and know whats coming.

It's time to rebel.. "You don't control me, weight loss surgery!" *shaves head* Now what'chu gonna do, huh?

Liquid calcium is overpriced for what it's worth (and causes me tons of heartburn) so I far and wide prefer chewables. There's a negligible difference in absorption so really it comes down to price, preferred method of intake, comfort, and taste.

I wouldn't find myself having any drink until I visit my buddy back in California next summer. So effectively a year after surgery. Even then considerations like, if my stage 3 fibrosis improved, how much I can consume and if I even feel like it will play a role in whether or not I have any drinks. Booze hasn't really something I must have so I don't prioritize it that highly. I just always liked the wrong kind of drinks evidently (soda-liquor mixers like Capn-Cherry Coke, Jack and Coke, Seven-Seven, Orange Crush/Slice and Vodka, etc.).

You're welcome dude, best of luck to you.

Well, let me tell you, as someone who uses the brand name Canadian version of your medication, Cipralex, that's exactly why. If you can get the generic of escitalopram, generally cheaper (especially if your insurance doesn't cover all of it), it tends to have the same potency. The apnea induces anxiety and panic attacks associated with obstructed breathing. These mimic a few symptoms of a heart attack, but rest assured, if your EKG is showing normal (make sure you get the long version of one if they didn't do that) your heart is fine.. for now. In the short term, apnea won't cause any problems with the heart, but over time the oxygen deprivation (even seconds of it is a shock to the body, hence the reaction) will cause significant heart damage, especially of the left side. So, your apnea goals.. the average person has 5 or less apneas per hour. In order to be on a CPAP I would hope you had a sleep study done. In my case, I had 55 apneas per hour. That's bad. My Fitbit watch also revealed this in "interrupted sleep" patterns. I will point out I'm not a doctor and cannot substitute for doctors advice, but as someone who suffers the same as you, I will give my advice as follows: Short term: - Use your CPAP - If you're a back sleeper, as I was before my weight gain, try sleeping on your side.. I personally find the right side easier on both apneas and anxiety attacks. - Elevation Long term: - Get your weight down, obesity causes this, you're doing great.. keep going - If normalizing your weight doesn't help obstruction, surgery on your airway to remove the obstruction should resolve - Given it's clinical significance toward preventing heart attacks in the long term, make sure your family doctors, physicians, and specialists related to this are aggressive in treating it as the underlying causes are treated A good idea to stay on the escitalopram until your apnea resolves. Its nothing to be terribly worried about as it's being treated.. just keep up the weight loss.

Whether solid or otherwise is irrelevant. High fiber diets tend to also be higher in carbs. Being on a low carb diet tends less fiber. Combined with high protein diet, and it's easy for you to get stopped up. I managed to avoid this for my 3 month pre-op diet until 2 days ago, where eating almonds caught up to me, and bam, bitch slapped with severe hemorrhoids. Funny thing is, I drink more than the 3.7L of water required per day (I drink virtually nothing else). Didn't help nearly as much as carb-laden fiber. So.. laxative it is. The only time where your body won't absorb the water from your diet is if you already have some absorption issue or you're eating slider foods (usually carb/sugar laden soft foods) where the body has no time to break things down and stuff just gets pushed through your digestive tract. I used to brag about not ever having stool problems despite gaining all that weight until I realized it was a dumb thing to be bragging about.

Do you have sleep apnea, OP? This is the likely culprit.

How do you think the liver shrinks? The body first consumes glycogen stored by the liver (it doesn't store a whole lot), then begins a digestive process of lipoproteins also in and around the liver, then other reserves such as adipose tissue, muscle tissue, and so on. When weight loss is occurring, barring other metabolic issues (such as the protein synthesis deficiency with, say, cirrhotic liver or other diseases), this is assumed to be the case. So yes, if you're losing weight and don't have any other major clinical issues with your body's metabolic structures, normal body function would indicate your liver is shrinking.

A whole swath of people in the Calgary medical community know of my pending surgery along with my pre-op improvements. Those who are close to me in my life, friends and family, know of it just because they're important people. I don't go out and just tell people, because its not their business, but at the same time, I don't care who knows because I don't give a rats ass what others think.

Dayum right at good Samaritan.. I used to drive by that every day for years.

It's funny, my surgeon is actually a huge fan of RNY (by admission of other surgeons and nurses that deal with him) yet virtually everyone I've met with him as their surgeon suggests lately he's recommended VSG far more often than not. Sufficed to say, if my reflux worsens, I know who I'm yelling at for a revision.

The high hBA1c is a very good justification for the surgery.

Depends on your body, dude. No one here can tell you.

I've come up with all sorts of stuff to say back to my stoner friends making fun of me being in surgery that day.. "you may be taking bong hits on 420 but I'm getting gassed/mainlining some liquid china white -- what now?"

I've known a few people who had this, but not from WLS, where it turned into cancer so I hope you get it done soon. From everything I understand about RNY is it tends to be good at resolving reflux/GERD. Wish you the best.

Fellow 420'er here. So many jokes to make.

Personally I wouldn't know, I've never smoked a cigarette in my life, and never will.

Question, is the initials of the dietitian in question "SC"? I wouldn't be surprised if this problem is systemic rather than with one megalomaniac. It would certainly be a good use of working at AHS to try and change things because I can't see how Ensure and Glucerna aren't counterproductive to the stated goal. Sounds like a fine diet.. I would make sure you're on 2-3k IU VitD in total, supplement what you don't take in with food. Make sure cal intake is lower than 1500-2000.. you'd likely be better off with closer to 1000. For now I take Jamieson Multi 100% complete chewable (has some fruits on the bottom right), available pretty much everywhere, and Jamieson chewable C+D cherry chewable tablets. I take iron with the MV and calcium citrate separately 3 times spread out through the day. They should give you a workup shortly before your surgery to have your vitamin levels checked out. When we take our next trip to the US I'll find myself having shipped to Kinek a bunch of iron and calcium chewable supplements from Bariatric Advantage. The shipping and customs are ridiculous (an extra 90 dollars on top of the initial shipping and exchange rate) but there's so few options in Canada it's sad. Sometimes I also get chicken nuggets from MLF.. the Janes ones have too many added carbs (probably the breadcrumbs). When looking at the carb amount on Wendys burgers or McDonalds McDoubles it's not so bad either. When eating their burgers I make sure there's nothing added at all and I eat the burger without the bun (totally unnecessary amts of carbs). I have some low sodium/cal ketchup at home.. I hate pretty much all condiments anyways.

Oh right. Dr. Ian Scott is an internist. He is a fantastic one as well. I saw him after I got approval from case manager+psychologist+dietitian, and right before I saw Dr. Gil. I even asked Dr. Scott to be our family doctor but because of his practice he couldn't. The guy is very aggressive at treating any other complications you have. For me, it was fractures in my L5/S1 vertebra. My ex-family doctor wouldn't do f**k all about my severe back pain, Dr. Scott took a very aggressive approach and I've been getting facet joint injections into my spine every 3 months (after X-rays and MRI), with a pre-assessment to getting the nerve ablation done which lasts much longer. Before him I had trouble doing more than 1000 steps a day due to immense back pain (like bring-you-to-your-knees back pain), and because of his treatment I now average between 3000-9000 steps a day. It's always fantastic to find the doctors/physicians/specialists who are as aggressive at getting you back on your feet as you want to be. Likewise we found a family doctor (when we moved from (NW/NE to SW) down the street from his home office who is extremely good too.

Agreed. When talking about this to my wife and saying I'll raise a stink post-op about this stupid diet (as only Americans can do) she said there would likely be more negative impacts than positive, so my wife is encouraging me not to cause any ripples suggesting to change this diet up. I went into my appt with my dietitian on Thursday being extremely quick and to the point. She recognized that wasn't my personality and kept asking me if anything was wrong. I told her "I'll tell you in my appointment with you post-op". It was clear she was flustered from then on out. I normally don't mess with people like that but that's what she gets for threatening to derail my surgery being an idiot. My surgeon won't stop any surgery with me dumping weight like this combined with fantastic liver function/fibroscan/blood sugar improvements. She stands no chance. By the time my OR date of April 20th comes around I'll likely be down 70-80 pounds instead of the 30 they wanted.

I'm mainly sticking to: - 2 cheese strings a day (any will do if they have 0-2g of carbs) - 5 chicken nuggets a day (16g carbs) dabbed with a tbsp of bbq sauce (5g) - wife making homemade meatballs entirely with ground beef, egg, substituting bread crumbs for almond meal (0-5g carbs for 5 meatballs, I believe the ones I buy are Black Diamond) - drinking probably 1/4 cup of Apple juice with my medications twice a day, one random cup of 2% milk (not that % matters for anything other than fat, all has decent amt of carbs) every few days for Calcium If the diet suggests 1400 cals, go with 1000.. Ensure likely has well over 100g of carbs too so staying well under 50 a day combined with lower cal intake (not too low) will dramatically help shrink liver and dump pre-op weight, take a decent MV (womens prenatal, Jamieson MV) that includes separate VitD, Calcium Citrate (not many options in Canada but there's a minty chewable from Jamieson at Walmart), sticking with chewable/liquid theme rather than large tablets or capsules. Key is sticking to low cal, low carb diet, very small portions, separated out well, not clumped together. Clearly AHS doesn't believe we can do this, thus sticks us on the stupid liquid shakes. Also remember it depends on your body as to how much you lose. In my case my excess weight was almost 200 pounds. That, I feel, is the overwhelming reason I've been losing weight so quickly on this diet.