FluffyChix

Baloney. mr fluffy and I have been Keto for about 90% of the last 18 years. Good news! We still have all our kidneys and have totes normal bun/crest levels!! Even despite my chemo and tons of contrast media! Lol. https://www.renalandurologynews.com/nutrition/high-fat-low-carb-diet-beneficial-for-ckd-patients/article/314032/

Why did I read this in his voice 😂😂 I love DR. Now. Ikr!!!! Followed by "you have one munt to lose tirdy pount."

I was not meaning it seriously. It's like my popcorn eating emoji. I think any Dr. Now meme is hilarious.

Oh this should be good.

Yes, if necessary, go back in this week to re-weigh. Why? Cuz they use THIS weight as your start weight. And just pretend you lose a crap ton of weight the next 6 months leading to surgery...the insurance "could" theoretically deny you for that. That's not as big a worry when you are at your weight. But if you were in the 240-250 range, yeah, you could lose yourself right out of surgery if you don't have an insurance recognized co-morbidity. So call the office and INSIST on being re-weighed for the records and then make them prove they changed your original chart starting weight.

Ok guys! This is so helpful to us newbie losers! Please tell us how many weeks/months/years out from surgery you are and what kind of surgery. If you can, list your portions and nutritional averages. Please post what a day of food looks like to you including any meal with calories (i.e. real food, protein drinks, protein bars, snacks, etc). OK! So excited to see what y'all post!!!

So so sorry to hear this Kathy! ((gentle hugs)) I'm adding you to my prayers for healing (and a new kidney asap)!!! Hope the dialysis starts to make you feel better soon and you remain strong in thoughts, spirit and body!!!

Yes, quite a lot really. I still have my hip pain but it's now mostly from a joint I won't let him inject (deep at the bottom of my pelvis). LOL. So I just have to lump it. I think my injection helped the SI and hip bursa although I think my other doc's injection on the left hip was better for the bursa than this doc's. It's a give or take. I negotiate with myself if the payoff for being active is more than laying in a recliner and having a very similar pain. I take the activity as much as I'm able now. I know it helps emotionally for sure and also think it helps the arthritis pain too.

Cool. My RD never beat me up about anything and was always positive. Log your last 3 days into MFP, print them out and bring them. It will take maybe 5-30 minutes. Then she can get an idea of what you've been eating.

Yes. Not with the loggin, but with missing a month of visits. It's 3-6 months of CONSECUTIVE visits for most insurance companies--no gaps between months (I think?)...but you need to go and make sure!

Mr. F. is a T2 diabetic and at dx his sugars were about 290. Within 3 weeks of going on his Met/Januvia and dropping his carbs to no more than 30g whole carbs per day, his fasting bg is in the 80s and 90s and his A1c is now in the 5's. So if you go to a low carb, protein adequate (for you that's about 70g/day as a female around 5'4"), lowish fat fat diet, your triglycerides will fall rapidly, so will your bg and insulin needs. So be ready to cut your meds pretty quickly.

I honestly think the thing that tickles and offends me the most about this topic is the title from a medical professional: "Help!!! Need advice on telling people they are fat..." When I first read this my knee-jerk response to this was, "Well, my honest opinion is that none of us need to be told this--Newsflash! We already have very personal knowledge and awareness of our fatness." Like, what a strange way to broach a subject to a room full of people in various stages of trying to change their personal reality. But @nibble and @Orchids&Dragons I know this avoidance so well. I also ducked my well-woman's exam for years--only going to my GP when I had severe infections. I almost died from BC because of the shame of my own personal knowledge of being fat and my embarrassment to have a gyno exam while super morbidly obese.

Is it a magic bus by any chance?

Happy Birthday!!! (You're drivin' the bus to hell...hehe)

It sure sounds like more than "sweet tooth" as others have said. Please be sure to mention to the doctor about GI bleeding/blood in poop. This is a serious and can be a potentially life-threatening situation. What color is the blood? Dark tarry black/brown? Or bright red? Also, the intense deep pain you describe that doubles you over is not normal. So please please bring these up. At the very least I'd ask for an EGD, and even more, maybe an upper and lower GI or MRI? I'd especially do all of this before doing another surgery. And the GERD symptoms being so bad after the VSG, that alone would merit a revise to bypass or DS. But I'd worry about having a DS being as light as you are going in. Hope you get it figured out soon! Hang in there and you might see if going back to low carb and ditching any wheat/sugar will help at least improve the GERD a little and also improve the insatiable hunger a little in the interim?

Thanks. Good to know. My niece is in PA school and they're working on cadavers right now among other things. I'm told she has 3 years of study. To me that feels like med school without doing a residency program--hence me describing as mini med school. Sorry.

I'm telling you from a patient perspective how I received this suggestion/discussion. My two primary care people are my oncologist and the NP. The NP is a nurse who basically went to mini med school for 3 years. She and the doctor alternate visits on their patients. They are AUTHORIZED to discuss this stuff with me. Sorry but I wigged out then with their conversations. I would have totally gone nuts if a practice nurse had brought this up. They are NOT docs. They are not NPs. There is an implicit authority and level of magnitude. There is. I'm just tellin you straight up from a patient perspective or at least MY patient perspective. I would not go to my nurse for WLS advice/recs. I go to someone with the authority to prescribe and that's the doc and the NP. The only thing my NP can't do is write a narc script. You asked: How should a doctor tell you to lose weight? Or should they just not say anything? Who can you help by ignoring it? Sorry, but as a nurse you are there to answer questions from the patients and carryout doctor treatment instructions, not make care decisions and care suggestions. If my doc didn't care enough to have the conversation with me and instead palmed it off on his nurse? That would be the last time that doc saw me.

A PT absolutely! A PT Assistant? Not in my lifetime...

If a physical therapy ASSISTANT talked to me about weight, I would give you such a poor review and mention your name on every survey the facility sent me. I would take it to your superiors. And it would be the last time I saw you. It's noneya as in "noneyabusiness." My PT ONLY talks to me about my weight when I ask her direct questions about it related to my diseases she is seeing me for--and she's has a doctorate. Dr. Lindsey is her name. LOL. My oncologist and NP at the oncologist who see me as a patient, talked to me about WLS for 2 years before I was mentally ready. It took me 2 YEARS! At first I was mad, then horrified, then sad, then I actually got to work thinking and researching. It was THEIR responsibility to do it because I have a fat mediated cancer that is in remission. They are both normal weight. First, if you have a doc talking WL with patients, honestly, he needs to do the whole physician heal thy self thing first. It is NOT a nurse's place to have that discussion unless the patient opens that door and asks for information from her or him. And I can't imagine that would happen very often. If I had wanted WLS info, I would have asked my physician who went to school for 10 years to tell me that kinda stuff. Sorry. No offense meant to any allied healthcare professionals...but bottom line? This is a doc to patient issue.

I will tell you, if I was eating a puree of chicken, green peas, and pumpkin--I'd be a Starvin' Marvin all the live-long-day. Rinse and repeat. I was starving after my RNY despite pretty strict adherance to my diet--until I was able to advance to soft food/purees. And then I still didn't feel full until I was able to progress to more dense proteins. BUT, I did not add insult to injury like I see so many on here do. I did NOT eat refried beans, nor mushy peas, nor pumpkin/sweet potato/butternut squash/lentils or any other legume. Had I done that, my insulin (which was still in the teens--way too high) would have stayed up and my BGs would still have been bouncing all over the land. Instead, my soft diet mostly consisted of these items which helped keep my BG spikes to a very small even keel. I COULD tolerate eggs--we are all different. My pouch is called Iron Will. 1. Flaky white fish (cooked in foil or softly pan sauteed in olive oil)--think tilapia, pangasius/basa, sole, haddock, John Dory, red mullet, haddock, pollock, cod, salmon 2. Canned salmon, tuna, chicken whizzed in a small mini chopper with Greek yogurt and a tiny bit of mayo/mustard and dill relish, s/p/gran garlic 3. Poached eggs/soft scrambled eggs (scrambled eggs that are cooked past 160 but are not set-up and rubbery) 4. Egg salad with cottage cheese 5. Cottage cheese with a dollop of greek yogurt and some peanut butter powder (low carb, low fat), and Walden Farms blueberry pancake syrup (zero cal, zero carb, zero fat) 6. Chili/soups made with slow cooked ground turkey and low glycemic veggies (no potatoes/root veggies/beans or legumes) 7. Veggies: Roasted smashed cauliflower (to replace mashed potatoes), frozen broccoli steamed until mushy then mushed with a wedge of Light Laughing Cow Cheese, green beans cooked with onion and chicken bouillon, sliced avocado, seeded and peeled tomato, frozen spinach cooked until mushy and then combined with a little Light Laughing Cow Cheese or low fat cream cheese or chevre Those were my foods for the "puree" phase until I was able to eat a normal diet at 4 weeks. My BGs were routinely in the 80s and low 90s after eating. They never spiked more than 10points after a meal from pre-prandial numbers. And my hunger was kept to a minimum. When I HAD to eat something I would drink fluids and that would help meet fluid intake and keep from snacking. I ate every 2-3 hours, just a tiny amount until my tummy could handle more. I had 6 meals a day spread about 3 hours apart. I supplemented with only 1 protein drink per day and got off of them as soon as I could--that's what my doc wanted. I still have 3oz of protein drink in coffee each day. Now I eat 3 meals + the protein coffee a day. If absolutely necessary to make a protein goal, I will add a snack in--or if it's a random Starvin' Marvin day. I do have those--usually right before a big losing phase. But they aren't every day. They are very random. Otherwise, I have little hunger and eat by my scheduled planned meals. Hope this helps. Your hunger is partly cuz your blood sugar and insulin is still crazy and cuz you then inject MORE insulin into your body. You're on the BG roller coaster from hell. The only way to break it is to reduce your bg/insulin response to meals and bring that into control. You can cut your insulin in half the second you decide to live that kind of life, then continue to reduce it until you're off of it. It may only take 2 weeks. Your hunger also comes from trying to transition from being a carb/sugar burner, to being a fat burner (which normally happens as a result of us going so low in calories (and often carbs)). Your hunger is ALSO coming from the types of food you are putting in your body (last night's meal) AND because you are not eating dense proteins yet. If you give it half a chance, this surgery will work for you and will help limit your food. But you are still in control of your choices of food. The surgery is only a mechanical limitation. You're smart and rationalize like nobody's beeswax. So if you want to figure out how to fu*k your new tool, you WILL succeed and either quit losing or regain to beyond starting weight. Then you'll really be fu*ked.

With your insulin jumpin' all over the place and your sugars spiking I'd be amazed if you had a thimble size tummy and weren't still starving. In short, there is ZERO bariatric surgery that is going to help you. Zero. Sorry. Don't mean to harsh your mellow. I'm only pre-diabetic with an A1c at last check of 5.3. Whah??? Yep, cuz I control it with my diet and now with exercise and it continues to go down. If I ate like you, it would not be long before my A1c was back well over my 6.9 that was when I quit low carbing for a while and started back eating SAD. It would probably be a lot higher, more toward the 8's. I would want to sacrifice small animals and people to satisfy my ravening hunger and appetite. So you have two choices. You can either start being part of your solution, or you can let this "magic bean surgery" help you about as much as it can/will...which may not even meet the national or international averages. You can allow the tool to help to its capacity, but more, you have to adopt a proper diet and not that BS diabetic diet spouted by the ADA or whomever you listen to...if I were in your position, I'd get this guy's book and read it, then internalize it and live it. Within 4 days to 2 weeks you will turn your life around. Your hunger will diminish so much and start to come into alignment. And finally, you will be maximizing the opportunities provided by your new tool. This is one of the smartest diabetologists I've ever seen. He pioneered the concept of eating to your meter, and pioneered and helped develop the home glucometer. http://www.diabetes-book.com/

BLD (breakfast lunch dinner). I get fiber from my leafy greens and low glycemic veggies and fruit. I also get it from whole psyllium husks I add to brewed iced tea in the afternoons. I still struggle with constipation.

I follow a "protein adequate" low carb, low fat whole foods protein forward diet. I'm only just now re-experimenting with adding a small 2oz serving of berries a day--not every day. My RD instructs for men and women are 60-80g prot/daily. My personal script for protein is 74g and I'm a 55yr female, 5'4" tall. I exercise at least 6 days a week (some days that's just walking) for 30-60minutes or more. I eat on average, about 25g net carbs. My protein averages 65-75g/daily. Healthy fats (avo, nuts/seeds, olive oil, KG butter) fills out the rest of 650-750 cals per day. I eat almost a pound of veggies/tiny amount of berries per day. I eat B-L-D and if necessary to make macros, will have a snack (but that is a rare occasion--if I feel snacky at night, I will allow a sf popsicle for 15cals and 2g net carbs). I also have protein coffee at the start of my day to fill out my protein reqs. I have 3oz of Premiere Protein + 3oz Silk Cashew Milk mixed together, spread over 3 cups of decaff in the wee early hours of the day. I have to eat the by the clock cuz I'm rarely hungry. Hope that helps. I think you're a guy, so you may or may not need extra cals? If I add cals right now, my monthly loss gets cut in half and I'm way too impatient for those shenanigans. If I was gonna die from sweet cravings, I'd first try for a couple of berries or an ounce of Granny Smith apple with a tsp of peanut butter on it. If that didn't work, I'd cut an Atkins Bar into 8 pieces -- freeze them, then only have 1. I would still dump from that 1 piece.

How many grams of protein is that? How many carbs? How many daily cals total? That seems like a crap ton of protein you don't/may not need? I count about 10oz of protein from food + Premier Protein + 1 Candy oops Atkins Bar = eleventy billion extra grams of protein you may not need? 10oz protein x 7g/ounce (on average)=70g protein just from your food. For most people that's almost there. I'd just add 1 extra ounce of protein per meal for Lunch and Dinner, and MAYBE add a couple of oz of Premier Protein in coffee and you're one and done. Ditch the Atkins Bar.