Arabesque

Actually I was advised to increase my salt intake to help boost my low blood pressure. You are eating so little at the moment & wouldn’t be adding additional salt to your diet, that any salt intake from the broth you are consuming would be minimal. Your daily intake would be considerably less than the general recommended level anyway. Why not ask how much you can have on a low sodium diet (& ask about the reason for it) & then do the maths & adjust your food choices accordingly. Our bodies need some salt, more if you live in a hot environment, exercise heavily & sweat a lot. (My uncle’s cardiologist put him on a low salt diet but didn’t take into consideration he worked outside in central Queensland. He collapsed because his levels were too low.)

What has your doctor recommended? If your bone loss & calcium absorption level is poor they should have you on appropriate meds, etc. to help you better manage it. A friend was put a high calcium diet (including more dairy, oily fish, tinned fish with soft bones -salmon, mackerel, beans, etc.) to support hers. She walks a fine line though as she also has a heart condition & too much calcium cause heart issues. How are your vitamin D levels? Your body needs D to help absorb calcium. Not sure if you drink alcohol but it impedes the body’s ability to absorb calcium & vitamin D. I was prescribed Creons (pancreatic enzymes) to help with my protein malabsorption issues. I believe they can help many malabsorption issues. Worth asking your doctor.

While constipation is more common, some suffer more with diarrhoea. It could be from excess acid in your now smaller & still healing tummy. (I get it because I don’t have a gall to regulate the acid entering my tummy - too much acid & a get an attack.) Plus you’ve changed how your digestive system works & your body may need more time to get used to it. The liquid & then runny purée diet doesn’t help either for some. Have you tried Imodium? It was on my list of meds to have on hand post surgery if needed. They may give you a little more confidence if socialising, travelling, going to work, etc. But it is certainly worth a chat with your surgeon.

There seems to be a few different requirements as to whether you can swallow meds after your surgery or not & when you can start. My surgeon didn’t have any restriction on swallowing meds. I was swallowing meds in hospital 24hrs after surgery. Wasn’t the easiest thing to do because of swelling & discomfort but it certainly got easier over the next couple of days. Otherwise, it will depend upon the meds you have to take I guess in regards to delaying when you resume taking them. If you have to crush them, make sure you mix each one in tablespoon of your shake or milk or drinking yoghurt to mask the taste a little. Capsules are easier to swallow & thankfully my vitamins were capsules. Some, who aren’t allowed to swallow tablets use patches for vitamins

The stats are averages & based on your weight after three years. With sleeve or bypass the average weight loss at that point is around 60/65% of the weight you had to lose to put you in a healthy weight range. It reflects factors such as bounce back weight gain, lifestyle changes, complacency, health changes etc. It’s not necessarily the lowest weight you’ll reach, or even where you’ll settle. It’s just gives you a bit of an idea. Some exceed it others don’t reach it. And as @ShoppGirl said your new set point will most inform of where you settle. Personally, I chose my goal as this was the weight I always dropped to before gaining again. It also put me in a healthy weight range (if you use BMI as a guide). Most choose a weight that was where they once were or think they’d like to be. No scientific reasoning at all. I passed my goal but I’m an outlier - someone who doesn’t fit the stats. I didn’t work at losing that much it was just where my body settled. My lowest was 48.2 but settled at 49kg. A medication change & a needed dietary change & I’m at 51kg & have been there for about 9 months. (Would prefer to be 49 but … you know life.) I think setting benchmarks for along the way like you’re doing is a great idea. If you set a final goal make it a ‘it would be nice if I got to that but I accept I may not & that’s okay’ goal. Congratulations on what you’ve achieved so far.

The scales will quickly tell you if it’s too much. I checked out recommended portion sizes of foods & recommended daily serves per day as a starting point. These are about the portion size you should be looking at. Some eat a little less, some a little more. It depends on lots of factors like age, gender, height, frame, weight, activity, etc. For example, if you are very active you likely will need to eat more across a day. The other considerations would be calories & the nutritional content of what you eat. If your meals are higher in calories you’ll likely have to cut back on the portions you eat. Generally about 4oz of meat & a cup of vegetables but it does depend upon the meat & the vegetables. But it’s all reliant on what your body needs to maintain your weight & for your body to function effectively because that’s our real goal.

You can always depend upon a couple of things post surgery. Everyone loses at their own rate & every rate is okay. The heady faster rates of loss of the first weeks don’t last. Everyone’s’ rate of loss slows & it will be even slower as you get closer to your goal or your maintenance point. Sure you may have a week when your loss is a little more or a week it’s a little less. Your weight loss is not an even straight downward line on a graph. It zigs & zags, up & down. If anything it almost curves a little as your rate of loss slows. As long as your general trend is downwards your golden. I lost almost 70lbs in 6 months but that was me. Generally men lose more quickly but there are other factors that may influence your rate of loss (age, amount to lose, genetics, health status, medications, etc.). Celebrate every pound you lose. You’ll get where you are meant to be in your time.

Don’t be hard on yourself. Life sometimes throws crap at you & health issues & related pain stress are big ones (mean your back not your pregnancy of course). And one you have little control over. Stumbled across this article a little while ago about the pouch reset diet. https://emergesurgical.com.au/does-the-pouch-reset-test-work/ Maybe better to go back to your post surgery diet - meeting protein & fluid goals, watching portion sizes, looking for more nutritionally sound food choices, etc. All the best.

PCOS isn’t enough of a medical reason?? This is awful. Your insurance sucks the big ones. So sorry.

Best test for calcium is a bone density test. I had one before my surgery (rock hard bones apparently) & am going to ask for a referral for another one soon. It’s been three years & I’m female & in my 50s so danger group. I consume way more calcium now than I did before surgery plus on HRT so I don’t expect any change. Heard recently that there are more men having bone density tests these days due to low calcium consumption & alcohol consumption (affects absorption of calcium & vitamin D).

Niece #4 had a sleepover last Friday. We went to see a performance of niece #1’s first choreographic work. Made her scrambled eggs & bacon for breakfast. I made some for my dinner on Saturday night without bacon after I took her back to the coast (was beautiful day). No pxt of mine just hers. First time I’ve been able to eat 2 eggs since surgery but I was starving. Hadn’t really eaten much of the day.

That’s a good idea. I just usually eat it as is. Let us reduce so it gets pretty rich. Been thinking of adding some white beans next time to boost the protein & fibre.

Always remember, we all lose at our own rate. Some are slow losers while others lose more quickly. There’s no right or wrong rate of loss. Sure there are generalisations & averages but you should never use them to judge if you’re failing. It really is impossible to compare your loss in pounds or inches to anyone else. So many factors influence your loss. Body shape, skeletal frame, age, genetics, starting weight, where you carried your weight, general health, genetics, etc. As you lose more weight you’ll notice you’ll drop sizes more quickly. Sizes tend to differ by 2 inches. It takes a loss of more pounds to lose 2 inches around your body when you’re bigger than when you’re smaller. That lose ‘10lbs & drop a dress size’ only applies to people who are pretty much in a healthy body weight range to begin. Took me a good 10/15kg (30lbs) to drop a dress size & a bit when I first started losing. How much exercise you do is really personal. Yes, there are lots of benefits but, for most, exercise only contributes to about 10% of the weight you have to lose. Have 100lbs to lose, exercise will burn 10lbs. I didn’t really exercise at all & I lost all my weight & more. All I do now is some stretching, & use resistance bands. I wouldn’t burn 40 calories. Ha! But that’s me. You’ll get there but in your time.

My nose drips a lot & has for years. No real cause but sometime my reflux can make it worse though mostly at night when my PPI wears off. I find temperature is the worst cause. The colder I feel the more my nose drips. And I feel cold most of the time. It runs like crazy when I go to the grocery store, the cinema or the theatre. We’ve had some lovely spring days here lately & my nose has been pretty good. Today it was much cooler & drip, drip, drip. My mum has a lot of mucus in her throat but it’s from her compromised breathing (scaring from a lifetime of bronchitis & pneumonia & a curvatures of her spine). She used a puffer for a while but now uses a nebuliser which she says helps a lot. If it’s not allergies or reflux, have you checked you don’t have a (low grade) infection or even scaring in your lungs? Just a thought. PS - Some say they’ve discovered their nose runs when they’re full which is a new post surgery realisation. Might not be the cause for you but may be adding to it.

Pork sausages with fresh tomatoes, celery, onion & mushrooms in gravy. I cheated & used Gravox - LOL! Only use the fat pork sausages from the butcher in my home town. They are the best. Every so often I buy some when visiting my mum then freeze them in packs of two for when when I want to cook them.

Any scale that goes to small increments (0.1ounce) works well. You can get them for less than $20 on Amazon.

As I said I think I kept losing until my body got to its new set point - thank you surgery. for me my new set point was at a lower weight than I’d expected (my goal was the lowest weight I would always bounce up from). Your set point will strongly influence your final weight. You can eat yourself above it but it takes a lot of effort to eat & exercise yourself below it. People often talk about getting too thin & looking gaunt but, apart from a couple of months while everything settled, I don’t look like a lost too much nor am I bony, I just look small. But then I am short & have a smaller frame & believe me I still have body fat. I’m talking to you thighs, hips & tummy! 😉

How much is it going up? The reality is weight loss is never a straight downward line. It zigs & zags & goes up & down. A gain could be fluid retention (as you said you have), constipation, hormonal fluctuations, your usual weight fluctuation, etc. as long as your general trend is downwards your doing fine. Do you weigh less today then you did three weeks ago? And yes stalls happen. The first often around week three ( yes, I did say first) & they can last 1-3 weeks. They are just your body shutting down (needing a break) in response to the stress of all the changes (to your diet, reduced calories, surgery, weight loss, etc.). They always break & you’ll start losing again when your body is ready.

I am one to say follow your program because there are differences as well as similarities. Though I often also say, if the program isn’t working for you, speak to your surgeon or dietician. I recognise there are weaknesses in the American health system & the ridiculous power of insurance companies: If you don’t do what they say & get all the right boxes ticked you can’t have your surgery power. Through reading posts here, there also seems to be many medical practitioners who do not look at each individual case & don’t make adjustments to their program to suit the individual patient’s needs. And dieticians often seem to promote their own ideologies & current fads. I saw a documentary a few years ago that spoke about the influence of large food production corporations on the curriculum in schools & in medical courses at colleges/universities - scary stuff. Things aren’t perfect in Australia, & I’m sad to say, we’re slowly going down the US path, but my experience was much different. I’m sorry yours has been so negative. My surgeon & dietician did consider me, my needs & circumstances. For example, my surgeon puts different patients on different pre surgical diets. A friend was on all shakes while I was put keto. He said I didn’t need to see a therapist (he gave me the name of one if I wanted or needed) but he sent her for several appointments before her surgery. My dietician, though not perfect, was at least open to my preferences & needs. She advised the keto diet only for the two weeks pre surgery saying it should only be followed for the short term to kick start weight loss (something I already believed). She didn’t give me specific macros to reach (apart from protein) but only recommended low fat, low carb (multi or whole grain low processed only), low sugar. I did a lot of my own reading & discussed my thoughts & what I wanted to do. I eventually devised my own way of eating & what foods I wanted (& needed) to eat, avoid, restrict or reduce. She’d make suggestions about alternatives & things I could add to make sure I was getting in my nutrients (she always checked my blood tests). I guess the big difference was my surgeon & dietician wanted to support me & help me achieve my goals. If yours aren’t supportive, don’t listen to your needs & are simply following a genetic ‘one program suits all’, find a new team (if you can). And especially in your case, if they don’t recognise you are an intelligent, well educated & are highly knowledgeable in the medical field, give them the boot. All the best.

I reached my goal & was happy, so I started to increase my intake to find my maintenance point. But I kept losing. More & more slowly of course. By the time I did stabilise I was a good 11kg less than my goal. I was eating three meals a day & 4-5 snacks. I settled around that quite happily for about a year. But with a medication & a dietary change I gained 2kgs & have been there for 9 months. I eat around 1300-1400 calories a day. Still have to snack a few times a day to reach those calories (& get in the extra protein I need) but not as many as initially. I think this is about the weight my body is happy at too - my body’s set point. Maintaining at that lower weight wasn’t/isn’t an issue. How I eat doesn’t impact how I want to live & enjoy my life & doesn't require me to run miles or spend hours in the gym (a big positive to me - LOL!). And I guess they’re the real factors to consider. Are you happy at the weight you reach & does maintaining it allow you to live & enjoy your life as you want without feeling you are missing out or making sacrifices? And is it sustainable? I say this a lot but it is what is working for me.

Hormones are the worst. My weight issues began with puberty. I bounced between 60 & 75kgs most of my adult life. When I began peri menopause, I gained weight & hit 75 more quickly then ever before When I began menopause I put on another 16kg even more quickly - felt like overnight - & suddenly I weighed 91kg. Couldn’t shift a gram of it. It’s why I turned to surgery. Interestingly, the 49kg I settled at for a good year after surgery was about what I weighed when I was 12 & puberty hit. Then, in late November last year, my GP upped my HRT dose & yep, weight gain: 2kgs in that first month. I modified my diet as soon as I realised & while I I haven’t gained any more, I haven’t been able to lose those kgs either. I wonder if starting with your hormones & maybe trying to sort those out maybe a better place to start.

I’ve read of people fainting with their orthostatic hypotension post surgery but it does usually only occur a few times & then resolves itself. A few of us have persistent low blood pressure but I know I always had a tendency & it is a genetic thing in my mother’s family. Is there a history of low blood pressure in your family at all? At my higher weight my BP sat at 120/80 with random drops. So my obesity kept my BP in the normal range. Now, at a much lower weight it’s always low & I live with it without issue - just know what to do to manage mine when it happens. Have never fainted though. I have a slow heart rate too but my doctor isn’t too concerned. Not slow enough I believe to consider bradycardia. I recall someone posting here they had to get a pacemaker too but can’t recall who either. Will be interested to hear what your cardiologist says.

I agree with the others. Speak with your surgeon & dietician & see what your blood tests show is lacking. Of course this may change as you progress & are eating more & a wider variety of food. I have not taken a vitamin since 8 months post surgery because I get all I need from what I eat. (Though I do take Vit D in winter when my levels drop - too cold to go outside t get some sun 😉.)

A bypass is usually revised to a sleeve if the bypass fails: weight gain, unmanageable vitamin malabsorption issues, excessive dumping complications,... Much like a sleeve can be revised to bypass because of weight gain, GERD, etc, As others have said, any weight loss surgery can fail if you don't make permanent changes to how, what & why you eat. Post surgical benefits like loss of appetite & your restriction don’t last. They should help you to kick start your weight loss & give you time to assess your eating & establish new eating habits. Sounds like you relied on the side effects of your bypass to influence what you ate. I’d expect your bypass would have failed sooner if you didn’t experience dumping (50-60% don’t with bypass). You mentioned your tummy has stretched. It does because it is a muscle & stretches & contracts. Can’t believe any doctor would say it can’t. Consistently eating larger portions will cause it to stretch more & contract less. But is your tummy as large as it was before you had either surgery or about the size of someone who never had a weight issue? The success you have with either surgery is dependent upon you, with consideration of any complications you may have of course. We all have our reasons for choosing the surgery we did & the effort we put in to make changes are reflected in the success we have or didn’t have. Excluding the life changes that can sometimes sabotage our intentions. I chose sleeve because of the lower risk of malabsorption & dumping. I lost all my weight & more. I don’t eat like friends & family who carry weight. I don’t eat exactly like friends & family who never carried weight either. I have to work a little harder & listen more carefully to my body (what it needs, how it reacts, etc.) because it’s easier for me to gain weight. I’m sorry you are unhappy with your revision.

I only received blood thinners for 24 hrs after surgery & no more so much like @catwoman7 & @SpartanMaker. Just told to walk: little & often & I had to wear compression tight/leggings for a week. But the length of time you are prescribed blood thinners post surgery would be strongly influenced by your specific situation & needs. If you can’t contact your surgeon, maybe speak with your GP. And maybe get some compression tights/leggings if you haven’t any.