CrankyMagpie

You can definitely do keto, but it might not be especially high fat for a while--most bariatric nutritionists seem to favor a low-fat, low-carb diet for new patients. And very few people get through the first few weeks without something artificial. (I relied on sugar-free jello, sugar-free popsicles, and SO MANY PROTEIN SHAKES.) If you're really dedicated, though, you could probably minimize most of that. For instance, Eggface suggests "double milk" (1 cup Milk mixed with 1/3 cup Nonfat Dry Milk Powder = 16 grams of protein per 8 oz. serving) as one option. Most plans won't force you to eat beans or fruit or high-carb veggies, though; the focus is very much on protein sources, mostly animal-based ones. If you're worried about dumping from high-fat keto, you might consider discussing the option of the sleeve instead of the bypass with your surgical team. (There are people with sleeves who experience dumping, but it's pretty rare.) But like Matt said, not everyone who goes bypass has a dumping problem from fat, either.

It took me about a week to make it to 64 ounces. Just keep trying your best, and mix up what you're trying if you feel any kind of pain. There is no shame in living off of Jello, if that's the only thing your new stomach will accept--mine was similar. Sugar-free Jello, sugar-free popsicles, and hot tea with premade protein shakes were all I could manage, the first few days. (I think adding the Muscle Milk to the hot tea and gradually adding more as I drank through the cup was my best bit of accidental genius, because the shakes were too thick for me at first. Building up to them that way went really well for me.) It gets easier. I promise.

The limited edition all red box of sugar free popsicles is my jam. I bought the sugar free bomb pops (red, white, and blue) on someone's recommendation, and they're OK? But all I really want are the red popsicles. I hope they're lying about this "limited edition" thing.

I'm not sure if one post on four topics is more annoying, or if four posts would be more annoying. Sorry if I guessed wrong. I'm not checking this site quite as often, now, and when I do come in, I mostly only ever look at this thread, to see how my October surgery friends are doing. Carbs: I wouldn't say it's exactly the whole truth that we "can't have bread or rice," as a blanket statement. Like, no, not right now -- at least not unless your team said toast was OK, as some do. But long term, yeah, most of us will probably reintroduce whole grain bread and brown rice in small amounts. Some people might choose not to, but that's a personal choice, not a rule we all have to follow. Some plans (Kaiser, for instance) have people eating mashed potatoes now, so the "no carbs" thing is just one school of thought that some of the veterans on this site (and probably some nutritionists who are really into keto) push, but it is by no means a universal bariatric surgery rule. Liquid: This wouldn't have worked for me right after surgery, but as soon as I was able to take normal-size drinks (as opposed to those super careful small sips immediately after surgery), I went back to using my favorite mugs with hot beverages that I really enjoy (decaf hot teas, decaf coffee). One is 20 ounces, and the other is 24 ounces, so I only have to drink three mugfuls per day to get to 64 oz. I find it a lot easier to get to my goal because it feels manageable ("three mugfuls" combined with "I like this beverage") than if I'm using smaller cups or forcing down plain water (which hurts, sometimes). Pre-op, I did the same thing with water bottles, sometimes with Mio or something in them, sometimes with cold herbal teas, sometimes plain. That's probably what I'll do next summer, when hot beverages are less appealing. 😁 I kind of expect my sleeve to be more consistently OK with water by then, too. Goals: Did your teams give you weight loss goals? Mine didn't, for which I'm grateful, though I know the average for the sleeve is 60% excess weight lost. (Take your weight on surgery day. Find your ideal weight--I use one of the higher numbers, since I've always been heavy and will have more bone structure to support that than someone who spent most of their life thin. Subtract your ideal weight from your surgery weight. That is your excess weight. Multiply that by .6 to get 60%, and subtract that number from your surgery day weight. That is how much you can reasonably expect to lose and keep off, long-term--but it's just an average: some people do better, and some do worse.) So I've got that number in a spreadsheet, a year out from my surgery, and I'm tracking my progress once a week to see if I'm on track for that, with a little chart that shows how I'm losing extra fast right now, even with stalls. (To be clear: not everyone gets there in 12 months, and I don't fully expect to, since I'm battling arthritis, which limits my activity a bit. Many people lose for the first 18 months or so--faster in the beginning, slower toward the 18 month mark. Weight loss tends to be about done, at that point, unless you are really working hard, either athletically or with an extra restrictive diet.) Motivation: I see people lamenting stalls. I wonder if the weight loss chart would help you? Because I had a week and a half stall, and I could still see clearly that my weight loss line was below a straight one year line to the average goal weight for where I started. Also, for your mental health, please stop weighing yourself daily if you are the kind of person who will be upset by a stall. Also, if you haven't already, take measurements. How many inches around is your calf at its largest point? Your thigh? Your hips? Your waist? Your neck? Your upper arm? Write all that down. When you hit a stall, pull out the measuring tape. Seeing those differences will help you see that you're still making progress. ❤️

I'm not even a full month past an invasive surgery. It's immediately visible to anyone who looks at my stats, and it ought to be enough that people give me a little bit of a break. And yet. I made a comment in a thread last night (my first comment in said thread), to correct a little bit of "what about the newbies" concern trolling (as a newbie, I'm qualified), and someone with a very high "reputation score" immediately jumped in and 1) lumped me in with the people they'd been heatedly arguing with for tens of posts, 2) misrepresented what I was saying, and 3) insulted my intelligence. Or at least my education level. When I clarified (angrily, because that's clearly what this person wanted from me, and I am honestly at the very end of my fuse for reasons that aren't relevant to the point I'm making), they doubled down, replying with one abusive post after another in rapid succession. It was awful. The thread has been closed, so while I guess maybe you could still go find it, please don't. If you witnessed it, please don't reopen that line of discussion or name the other person who behaved badly; that is not the point of this post. I'm not making a one-person call-out post; I'm talking about trends. Usually it's a couple of groups of veterans and near-veterans I see squabbling amongst each other, and if you go back in the archives a year, you can see a different set of near-veterans doing pretty much the same thing, about slightly different topics. (All that necroposting someone's been doing lately has accidentally surfaced a lot of ugliness.) And that is the behavior I'd rather focus on: people coming here to fight, being willing to bully newer members in the course of those fights, and still maintaining a high reputation. It's "people," plural, and it's a real problem. It makes reputation really misleading: we should lose reputation when we make the site more negative. And, yeah, the fact that I was provoked to the point of throwing insults back probably means I should lose a little bit of reputation for that, too. My point is, it would be nice to see some way for the community, or the moderators, to penalize bad behavior. Because without that, reputation is incredibly misleading. (I am, however, posting this in Rants & Raves and not Website Suggestions, because the details of how you build a fair moderation system are complicated. Done naively, it would just become another avenue for bullying and cliquishness; you can already see the ghost of that in the meangirl way some people use the "laughing" response on posts they disagree with. And I don't really expect Alex et. al. to put in that level of work, to learn how to do it fairly and then implement that. So this is just a rant. I'm angry that people get to behave badly, bully newer members, and still get little markers by their names suggesting that they are trustworthy. I'm of the opinion that removing reputation altogether would be better than what we have now, but I feel like that's not going to be a view that many share. So. Just a rant. Ignore me if you want; this isn't going anywhere, and I'm not going to pursue it now that I have it out of my system.)

@Kathy10/22 My surgery was 3 weeks before yours, and I don't think my team allows toast or crackers for me, yet. At two weeks, I was supposed to be eating soft foods. In rough order of "difficulty," my team's list went about like this: yogurt, ricotta, cottage cheese, refried beans, soft-cooked eggs, tuna in water (which I've only ever tried as a tuna salad with Greek yogurt), baked fish that "flakes" (still haven't tried that), thin-sliced deli meat, chicken cooked in a crock pot, ground turkey, other ground meat, and soups and chilis that haven't been blended. I don't remember if they explicitly listed hummus, but that's only a little bit more of a challenge than refried beans. Veggies that were really, really well cooked are also OK (no broccoli or cauliflower stems, but the tops are OK), as are canned fruits (in juice, not syrup), but getting in all of my protein with my allowed three meals is so hard, still, that I haven't had a lot of fruit or vegetables. I've managed all that, and I also do fine with chicken satay, hamburgers (no bread or veggies, just the patty), meatballs, and string cheese... but I only tried those things after I worked through the list my team gave me. I think they may clear me to move carefully into non-soft foods at my appointment this upcoming week. I very much want crackers, but I'm nervous about trying them. Maybe with something very soft on top.

I'm doing the Bariatric Fusion Multivitamin and Mineral Supplements (4/day), a sublingual B12 a couple of times a week (also Bariatric Fusion brand right now, but I have one of the more standard vitamin brands, Nature Made, for when those are finished), and now that winter's coming uphere I will add in a vitamin D3 a few times a week (D3 is a bit more absorbable than D2; conveniently, I have a bottle of Nature Made vitamin D pills in my cabinet! and they are small!) and some fish oil, when I have permission to add that. (I'm off blood thinners, so I could add them now, but they come in really large caplet form, meaning I'd probably have to break them open. So. I'll wait and not taste the fish oil, if it's all the same.) Since I'm supposed to go back on methotrexate any day now (read: two weeks ago, but I am afraid of what it'll do to my poor stomach), I'll add folic acid tablets when I do that, as well. But it seems like nobody besides autoimmune patients and pregnant people need to supplement that, so ... probably don't? How long after surgery were you able to take the one-a-day vitamins, @Kay07? I don't mind the chewables I'm taking now, but 1) I have an unfinished bottle of one-a-days, and 2) one theory as to why so many bariatric patients end up having tooth problems is our reliance on chewable vitamins. I figure I'd like to switch over once it's safe. The one-a-day vitamins are kind of huge, though. (I'll ask my surgeon's team, too, but anecdotes are welcome!)

I really like this guy's take on long-term eating after surgery: (Yes, he has a book, and I'm sure he'd love for you to buy it. But I feel like you can get the gist of what he's written about by watching his videos.) If you aren't into videos, he says once you can eat enough that getting enough protein isn't hard for you, you should move to a "veggies first" plan. Focus on getting lots of good, nutritious food. A month out, I am not able to eat enough that this is a reasonable plan for me, yet. But this is kind of where I'm heading, long-term, in consultation with the nutritionists at my surgeon's office. Oh! And he has a video just about diet, too. Here's a link to that. It covers immediate post-op through longer-term.

My doctor let me have pills right away (Prilosec and Actigal), and since Zyrtec comes in very small pills, I would just take it like normal. Or if you're super worried about a pill, Claritin comes in a dissolve-in-your-mouth form, and that's what I've been using.

I'm definitely at more than half a cup on the soft stuff like cottage cheese, too. (10/3 surgery date.) My nutritionists said to take small bites, to put the fork down between each bite, to chew everything to a paste, and to stop eating at half an hour, or when I feel full. So... that's what I do? My "properly full" mechanism still isn't really in place, but I can tell when I'm slightly over-full, anyway. Soups, I can eat significantly more than half a cup. Like, I really think soups might not be the best choice for me. Ground meat, it's less than half a cup, but still more than a quarter cup. My sense is that, as we move on to denser foods, we'll feel more restriction. So others on the forum have said, anyway. So I think we're OK?

Here's the recipe: https://www.bariatricfoodie.com/niks-protein-pumpkin-custard/ (It isn't mine, but it is one I've made and enjoyed. I also like this plain custard. I do half splenda/half xylitol, and people can't tell I didn't use sugar.) If you want a little fib to use to try to get off the hook, you could say you snacked too much while you were preparing dinner and now you aren't hungry? Or, since they'll eventually see you're losing weight, you can start with the "I'm watching what I eat--yeah, even on holidays" thing, maybe.

Could you get out of it? I know I'm not cleared to lift 10 pounds until my 1 month post-op appointment. That's enough reason not to be in charge of the turkey, right there. (You don't have to tell them what surgery you had, to say "I had surgery, and I am not up to this.") As family, they should understand. And what I mean by "get out of it" is flexible. Maybe you supplement the things you are willing to cook/can eat with some premade sides and a small turkey breast instead of the whole bird, but you still host. Maybe you don't host at all, and someone else needs to take up the slack, this one year. But I'd encourage you to find some solution along that spectrum that you can live with, rather than try to do the whole thing yourself and (entirely reasonably) resent it. My spouse and I are doing Thanksgiving on our own, and since neither of is is a big eater anymore, we'll either just eat normal food, or we'll mark the occasion with something really special like crab legs, which we almost never eat but both enjoy. I'm also going to make high-protein pumpkin custards (like pumpkin pie with some extra protein and no crust).

@Yvonne47 My team gave me a list of soft foods to try after my post-op visit and suggested I work my way down it. Eggs were not at the top of the list, and even working up to them, the first time I had them they settled pretty heavily. (I wasn't sick, but I wasn't in a hurry to eat more eggs that week, either.) I had cottage cheese, ricotta, yogurt, and refried beans before eggs. Really moist tuna salad (made with plain yogurt instead of mayo and squished up very thoroughly with a fork) also settled better, for me. But I don't ever do runny yolks or any of that--if you do, eggs might go better for you, sooner, than they went for me. Anyway, good luck at your post-op visit!

I'm only a pretty new sleever (1 month) and wouldn't usually comment, except that you said you're eating a Nourish bowl and just added flavoring to your water. I wanted to check: you're still keeping your eating and your drinking separated by half an hour, right? My understanding is that that rule is kind of a forever thing, not something we can really ever stop doing. Anyway, you've come really far in a year, and I know you'll figure this out and get it handled!

I haven't been cleared for non-soft foods yet, so I'm still not really getting enough fiber (though I'm eating refried beans as often as I can!). I'm trying to be patient about it--this initial stage, where I can't get enough protein unless that's all I eat, and I still have to supplement, will eventually end, and I'll be able to reintroduce vegetables for real. I don't have a great understanding of exactly how long that takes, but I can eat a little more each week; I think the end's in sight. (And I think they'll clear me to move on to non-soft foods at my appointment in a week and a half, because I'm tolerating all the soft foods pretty well.) I really liked chia seed "pudding" when I could have it, though! Oatmeal, too. Cauliflower "rice" or "mashed potato," snow peas and other veggies in stir fry, lettuce wraps for my sandwiches, crunchy apples, whole grain crackers... all things I look forward to having again, that should make for some decent fiber.

I wake up hungry (so I guess the opposite of nauseated), most mornings, @Oct517, but I end up a little nauseated after like half of my meals. Like you, I've never thrown up from it (though I was uncareful with some sliced roast beef last night, and it was a near thing), but it's awful. My body isn't consistently giving me a "full" signal, so I think I end up eating just a little more than I should, or something? Anyway, any other time I have nausea it's almost always dehydration. A sugar free popsicle often clears it right up. I wonder if getting a little beverage in you right after you wake up would help? I've heard people say they stick to protein shakes, or smoothies, or some other liquid for breakfast well after surgery, and I wonder if they're going through the same kind of thing you are.

I did the Bariatric Fusion Multi-chews (kind of like Starbursts; if it matters, I did the berry flavor), and at some point they started making me feel nauseated, morning and night. Since I didn't actually throw up, I just kind of ... toughed it out? until the end of the bag, and then I switched to their chewables (big, round, kind of chalky; I knew I didn't like the berry flavor, after sampling at my surgeon's office so I switched to orange). So you might do what I did: switch vitamin types, in case maybe there's a specific ingredient that's not working for you. Both kinds I've tried are available in the store here, along with a LOT of other options. My team gave me a "no" on the vitamin patches, but if your team allows them, a lot of people who find the vitamins hard on their stomachs seem to do well with those? (The science is out as to how effective vitamin patches are, in general, but anecdotally, I know there are people on here who use them and whose labs come back just fine.) Edited to add: not all of the Bariatric Fusion chewies (Starburst-shaped ones) are problematic for me. I do fine with their caramel calcium chews, and they're pretty good. You wouldn't mistake them for real candy, but I enjoy them.

I have multiple disabilities. A month out from surgery, I can assure you: a smaller stomach is not a disability. (The first few weeks, as your body heals, yes: you're disabled. You're a little extra tired. Maybe there's pain--though by the second week, it's really minimal for most of us. In my case, I'm still, for a few more days, not allowed to lift 10 pounds or more. But when that rule is lifted, I won't have any surgery-related disabilities anymore.) Also, with the sleeve, you can take NSAIDs after ... 6 months? I think? My doctor gave me a date, but it was far enough out that I don't remember. Anyway, they aren't off the table forever, so I wouldn't worry overmuch about potential future pain issues. This is a surgery, and like any surgery, there are risks. The risks of this particular surgery are lower than for gallbladder removal and for joint replacement. Only three people out of a thousand die within the first month, which is still not a number I took lightly, but I chose my surgeon carefully, as I assume you did as well. I'll be honest: I wouldn't have taken the risk if I didn't have a comorbidity that was going to continue to degrade my quality of life without this intervention. That's how my math worked out when I weighed all of the pros and cons, all of the risks and potential rewards. Only you can do that math for your own situation, and I hope that, whatever decision you make, it brings you a sense of peace and confidence that you're making the right decision for yourself.

I would be frustrated, too. My pre-op diet was a lot more bearable than what you're doing, in that it was essentially the long-term diet of a bariatric patient,* just ... more, because I didn't have the tool yet. Protein first, then veggies/fruit (fruit was limited to 1 serving per meal, but I could have it with every meal if I wanted), and I was allowed whole grains, as well (also limited to 1 serving per meal -- 1/2 cup brown rice, 1 wrap, and so on). Snacks were not encouraged, but I could have a cheese stick if I really needed it. Unlimited sugarfree jello and popsicles got me through a lot of night time hunger, since I was supposed to be losing 10% of my body weight on that diet. (And I did, just barely.) Keto's a lot harder for me to stick to, although if you've been doing it since April, I guess by now you've got your household and friends working with you (for instance: not doing meetups at pizza joints all the time). I wonder if you might want to take this time to switch over to something closer to what Kaiser will want you to do, long-term? You'll regain a little of your natural water weight, going back to eating fruit and higher-carb vegetables, and some people find that to be too upsetting, so this is just an idea for you to consider, no pressure. But once I settled into it a little, I found the normal long-term bariatric patient diet to be really doable, and that encouraged me a lot, in the time leading up to my surgery--I didn't have these "I can't do this diet anymore" feelings, so much (until the liquid diet, ugh). It didn't feel like a diet. I even had small cheats, from time to time (examples: a small piece of pie at my partner's birthday, a trip out with friends who wanted frozen yogurt--mine was heavy on the fruit, light on the yogurt, pizza with some veggies on it a maximum of once per month), and continued to lose weight. It felt good, for me, anyway. To be clear: I'd still have been frustrated to have the process take so long. Not in an "I can't do this" kind of way, but just because the anxiety of having it hanging over me, and having to hold off on some things I wanted (a new job, mostly) would have been upsetting. I just wouldn't have suffered any additional strain from the diet. Anyway, whether this is a good idea for you or not, your feelings are entirely justified. It's reasonable to be upset. *sure, sure, lots of bariatric patients do keto, post-op, but there aren't that many doctors that force it on you -- I know for a fact Kaiser doesn't

I think if they're supportive now, you won't have so many problems. The thing to be ready for, though, is that, after surgery, you will change. I mean, you'll still be you, but you'll be a more active version of yourself, right? Your habits will change. And that could affect your relationships. Some YouTube doctor says that you can't lose as much weight as WLS causes us to lose and not be a different person. I'm a little hesitant to believe that's entirely true. Some people become more outgoing, but do all of us make that change? I have doubts. Some people gain more confidence and are willing to stand up for themselves in relationships where they previously didn't, but do all of us do that? I don't know. That seems far-fetched to me, but time will tell. I can say, a month out, that the friends I trusted with the knowledge of my surgery have been very supportive. One pair I'd have trusted anyway, but I had extra assurance, because I know they stayed good friends with someone else who had it. The other pair was like "Cool, can we do anything for you?" and I was like "Do you like walks?" 😁 (And we went on an epic walk.) My spouse has been amazing every step of the way, so ... that was never a worry for me. I'm fully expecting to have some difficult roads ahead of me, with some of my other acquaintances and at least one family member. Maybe they'll surprise me and be awesome, and we will grow closer. Maybe they'll react worse than I imagine, and we'll part ways. I'm not even that stressed about it, right now, because I'm so focused on trying to build the best me I can be, you know? And I'm giving the bulk of my social attention to the friends I knew I could trust, too.

My team never made me quit caffeine, although I did for the week before and at least the week after surgery. Maybe two weeks? Then I started drinking caffeinated black tea now and then. I was probably at three weeks before I could handle any kind of coffee, and aside from drinking decaf just for the flavor (the BP store sells an acid-free variety), I really enjoy mixing a shot of espresso with a chocolate Muscle Milk protein shake. (My team doesn't allow Premier, but I remember the flavor from some fad diet or other when I tried them in the past: that's also really good.) I'm not quite a month out. Coffee's the best ☕️

I used to live above 60 degrees latitude. Here are some of my tips, gathered from folks when I moved there and from research and from my own experience: yes, a light box - Verilux makes nice ones, and the ones that are primarily blue (different brand) are bad for your eyes, so avoid them take a walk at lunch time, even if it looks overcast or it's cold - being in that natural light will do wonders for your mood you already are on top of this, I'm sure, but get exercise and enough vitamins, especially vitamin D find a winter sport you like - the folks who did this were the happiest among us grow plants in your house and at work, or if you really don't want to do that, get some nature photos and put them up in your workspace if you have the vacation time and can afford it, travel somewhere warm for a week I don't personally think this is a good idea, but other Great Northerners would use tanning beds and swore it made their winter more bearable

It's the 31st! Pretty soon, all of us October sleevers will be post-ops! Congratulations to all of us! ❤️ If people are looking for stats to compare to (though you shouldn't, for your own sanity; it's all so variable and so individual!), my surgery weight on 10/3 was 312.8, and I'm at 299.0 today, exactly 4 weeks later. Low to moderate, especially for starting out over 300. I expect I'd have done better if I'd managed to get more liquids in--we really need that extra hydration to lose the weight. But it's still pretty great--more than 10 pounds a month is a really mind-blowing amount of weight to lose, without feeling constantly hungry and dizzy. (At least, that's how I felt, every time I've lost that much weight in a month, before now.) And also without avoiding carbs like they are death ... I had (low sodium) chicken noodle soup last night.* Refried beans have been a significant part of my diet, as well. My team clears people to do ... uh, pretty much everything, as I understand it: lifting weights, swimming, and so on, after a month. I think that means I'm good after Saturday (11/3), but my one month appointment isn't until 10 days later. So I might try to be patient, we'll see. *Noodles are only OK this soon if they come in a soup like that, and even then, only if your team says they're OK. You don't want them swelling up in your tummy. Soup noodles are as swelled as they're going to get, so different teams vary on whether they allow them or not.