ChunkCat

Good luck with your surgery!! I was on liquids for 2 weeks post op and didn't tolerate protein shakes, so I drank mostly water with sugar free flavoring packets in them (plain water made me gag), broths, strained soups, Fairlife milk, and after about 2 weeks I could finally get in a protein water. My surgeon cleared me to eat fish and soft eggs at 2 weeks (much to the annoyance of their dietician), which interestingly was easier for me to digest than the protein shakes. I couldn't tolerate jello either. In the pureed phase I tried pudding and yogurt but they sat too heavy, so I mostly ate fish and soft eggs and all the liquid things. Plus I was able to tolerate cream soups. In the soft stage I ate anything that could be cut easily with a plastic fork, mostly fish, yogurt, and cheese. By a month out I was finally able to handle the feeling of a protein shake... My tummy was just really sensitive. Be aware you may have issues with lactose early on, so I recommend a lactose free milk like Fairlife if you are in the US. I spent a lot of money on protein stuff it turned out my stomach didn't like or my tastebuds found offensive. I HIGHLY recommend sticking with sample packets of things. Those will easily get you through a few weeks. BariatricPal has a good number of them, I liked Syntrax Nectars best. Seeq has a sample pack available and I really loved their watermelon flavor of protein water. You can get samples from Unjury too, they have some protein broth flavors some people like. I also spent a lot of time pinning recipes on Pinterest for the stages, but I never used any of them because my tastebuds preferred really simple things. I couldn't tolerate anything with cooked tomatoes/tomato sauce for at least 2 months and I wasn't allowed to add raw fruits or veggies to shakes or smoothies, but every surgeon's guidelines are different.

Great job, that is so exciting, and at 9 months!!

It is hard to say without seeing your specific policy details and talking to your insurance company. Even policies from the same company can vary dramatically... Your surgeon's office will know what your insurance requires and if it gets kicked back usually it is because a code is wrong or a paper isn't filled out properly and once remedied approval is then given. If the surgeon's office is preparing to submit to insurance or has already submitted your case to insurance, they must feel you've met the requirements given to them by the company. It is a waiting game after that!

Stories like this make me so sad... My condolences to her family and friends. She should not have been released to fly so early, the most dangerous post op complications usually show up in the first two weeks after surgery. It is absolutely ridiculous that people from countries like the US and UK are having to risk their lives going to places like Turkey for surgery because they can't get coverage for their surgeries thanks to **** insurance companies, or because they are on a waiting list that will take 5 years and require a crazy amount of hoops and delays. Obesity is a disease, not a moral failing. Bariatric surgery is life saving, life giving surgery that in the long run saves insurance companies and government healthcare a **** ton of money because patients who are successful with it often lose their pre-existing conditions, go off numerous medications, and avoid the complications of obesity in their lifetime... A good friend of mine recently had her company change insurance providers. She was in the process of getting her last appointments done for bariatric surgery. But the new insurance excludes all bariatric surgeries... She can't travel to Mexico even if she could afford it because of her complicated medical history. I'm so angry that ANY company or ANY insurance company can just decide not to provide coverage for these surgeries.

I went on a road trip for the holidays at 2 months out. I took a giant lunchbox with me filled with protein shakes and ice packs, cheese and some other cold snacks (I can recommend a fantastic lunchbox on Amazon if you are interested). Then I filled the top of it with some Powercrunch protein bars, Quest sweet chili protein chips, Paleovalley meat sticks (they weren't too dry) and water flavoring packets (I like sugar free lemonade and the Jolly Rancher sugar free ones because I love sour things). I stopped every 2 hours to walk around and use the bathroom to ensure I was hydrating properly. And we stopped for 2-3 meals a day in addition to my shakes and snacks. It worked really well!! I didn't feel deprived at all. In fact, I felt better than I did on road trips before surgery because I stopped more often and hydrated better! Plus I was making wiser food choices.

Lovely suggestions!! I'm an autoimmune patient and I incorporate these every day. I'd also suggest for the fatigue and mental fuzziness due to the liquid diet, add ELECTROLYTES. You can buy all sorts of sugar free ones. Often during the liquid diet our body is trying to shift into fat burning mode/ketosis. This can feel very unpleasant and we go through carb withdrawal. We are also low in calories. So electrolyte supplements once a day help give us the things the low calorie, sugar free diet is lacking and it often eases the fatigue and headache some... Good luck with your surgery!! ❤️ I have found mine has really helped my systemic inflammation and fatigue!

I am not familiar with that surgeon, I had my modified DS in NC. You might try posting in the Duodenal Switch Support Group on FB, there are a lot more switch/SADI patients there and the vets in the group maintain a surgeon list! https://www.facebook.com/groups/1799552573392212

Sorry you guys are dealing with this! Are either of you on a PPI (proton pump inhibitor), this could be something like omeprazole. Typically the over the counter dose isn't high enough, so it is best prescribed by your doctor. Some people end up taking it twice a day. Omeprazole never worked for me, I take pantoprazole in the morning and Dexilant in the evening. Both are prescription. Bariatric patients typically need a PPI after surgery to protect their stomach from acid and help the sutures heal. Our new tummies are still producing the amount of acid we produced for our whole stomach, which is obviously too much acid for a little tummy. This can cause pain, nausea, vomiting, a feeling of not being able to swallow because acid is washing into the esophagus and irritating it. It can also cause that classic heartburn feeling... If you aren't on one, tell your doctor you want one. If you are on one, it's possible it isn't working, you may need a higher dose or a different medication (some people metabolize omeprazole too quickly). In addition to this, it takes a while for our new tummies to heal the nerves that were cut and our fullness cues and stomach sensations can be different than they were before. Fullness may feel completely different and very uncomfortable. After I eat I feel pressure at about the middle of my stomach and a feeling of heaviness sitting there. It is my signal not to eat anymore. If I persist, I'll start hiccuping and sneezing aggressively, and sometimes vomit. I am very careful not to get to that point. But I can eat a normal bariatric sleeve portion for 3 months out... Sometimes heavy proteins like meat sit very heavily in new stomachs for the first year. It isn't unusual to not tolerate beef or chicken breast. Proteins should be moist (like chicken thigh in a sauce), with small bites and very thorough chewing. You'll probably eat a smaller portion of them than you would yogurt or eggs. Fish and other seafood are the easiest meat proteins for us to digest because they are lighter and softer, so try that if beef and chicken are too heavy. If after a few weeks on a PPI you are still not able to at least advance to moist fish without pain or vomiting, I'd be requesting an endoscopy or other imaging to ensure there isn't a stomach stricture or scarring getting in the way of you eating. Strictures aren't super common in sleeves but they do happen.

You are welcome!! I'm one of those people that really want to know WHY I'm being told to do something. The dietitians at our practice do apply a lot of rules to everyone instead of differentiating between the surgeries, which is annoying, so I'm glad they differentiated in this respect, because type of surgery makes a big difference in a lot of things!! And yes, it is frustrating when they have a mark on a paper you are supposed to reach, but they don't take into account where you were vs where you are and the improvements you've made! Everyone's restriction is different and this is hard for a non-bariatric patient to understand. Our fullness is not like the fullness pre-op. That fullness post-op can be painful and really exhausting if we ignore it and try to push to finish something! And each person's restriction relaxes at their own rate. Some people have high restriction all the time, others it depends on the protein. 3/4 of a cup is a lot of food for any surgery a year out, but especially could be uncomfortable for a bypass because your tummies are so much smaller than even a sleeve patient. And even for those of us with sleeved stomachs, some keep high restriction permanently... I'm glad in that respect you went your own way, You are the expert of your own body, no one else can know exactly what you feel. And you are the only one who can advocate for you in that way and if the doctors and nutritionists aren't listening, you just have to research and find your own best practices... You are the one who has to live with them in the end!

I am so glad they recommended you for revision!! It is sad that a lot of insurance companies have a "one bariatric surgery per lifetime" clause, or will cover revisions but make it near impossible to qualify for them. The sleeve surgery is the first stage in a classic DS surgery, it should always be up for revision to a DS/SADI if the results from it aren't lasting! I had a modified traditional DS done on November 1st. I'm so happy I did it. My diabetes and high blood pressure went into immediate remission. My weight loss has been slower than I'd like, but that isn't unusual for a DS because we lose for a lot longer than other surgeries (if we are lucky!). Your sidebar says you are pre-op, you should adjust it so it shows you post-op! How are you feeling?? I've heard the recovery from revision from sleeve to SIPS is not too bad since they don't normally touch your sleeve again unless it was improperly done the first time. Do they still have you on a strict post-op diet progression? I look forward to seeing how your weight loss goes, revision patients to this surgery usually do well! It just goes a little slower than before. ❤️

Wow, you look amazing!! What a stressful month though! I wonder why your body decided to kick out your implant. This isn't weird for people who have autoimmune diseases (our bodies are extra emo about foreign occupants), but I have heard of it in perfectly healthy people too. I'm glad the asymmetry isn't too dramatic, that gives you time to heal up and consider what to do next. You had soooo much done at once, I think given the complications you've faired pretty well all in all! I am so glad to hear you feel at home in your body now. That is a priceless win and well worth the pain. I hope you have a much smoother healing process from here on out!

Baritastic is a great app for tracking your food and it is made especially for bariatric patients!! It will track your fat for you as long as you enter everything you eat for the day! And it even has recipes in the app you can try...

I agree with this. At your starting weight you should have been offered a Duodenal Switch or a SADI procedure. If you weren't, I'm assuming it is because your surgeon can't perform those surgeries, so just offered you the sleeve? If you were offered these options, why did you opt for just the sleeve? My highest weight was 320. Two surgeons agreed I should have a traditional duodenal switch. I did the research and agreed with them, though originally I just wanted the sleeve. I was terrified of the switch portion of the surgery, especially because I've had ulcerations of the small intestines due to my autoimmune disease. So my surgeon called and consulted with my GI doctor and together they decided the DS was the best option for me and worth the risk because of how many benefits it would offer me. So I decided to accept my fear and go with the DS anyway. I'm so thankful I did and that it was an option offered to me. It has changed my life in so many ways for the better... The sleeve is the first part of a duodenal switch, that's where the sleeve operation actually came from. The intestinal part can be added at any stage by a surgeon qualified to do it, but only a small percentage of surgeons can perform it, as it can be rather complex. We see revisions from sleeve to DS all the time in my support group.

My dietician explained that there have been studies that show that pure liquids usually exit the stomach in 5 or so minutes. Everyone's transit time is different though. But he advised we stop drinking a few minutes before we start eating, to allow the fluids to drain out before we start adding solids. Once you add solids, those of us with a pyloric valve have stomachs that will close that valve and keep things in until the food reaches the ideal consistency to move on. This is why we shouldn't drink more than a swallow with our meals, because fluids will then take up too much room. For those without a pyloric valve, drinking with or soon after meals will wash the food out of their pouch and into the small intestines quicker because there is no pyloric valve stopping that process. But regardless of the surgery, the "wait 30 minutes before" rule has been disproven for most people. I know for a fact that my stomach works this way because I saw it do this with barium contrast during a GI fluoroscopy pre-surgery. It was really cool! So I always drink up until a few minutes before I'm ready for food. Even with snacks!

Ask your surgeon about the gummy vitamins. I was told no gummies, but we could take the calcium chews that are like a Starburst texture. Our vitamins had to be chewable powder tablets. Blech. I was sooooo glad to be done with those. LOL

Weight loss distribution is a funny thing. I have been tracking my measurements and it is odd to see where it is coming off, even this early on. I've lost an inch from my wrists at the 2 month mark. Why? How? I have no clue. Or I've lost nearly 9 inches from my waist just shy of the 3 month mark, but my protruding belly area, where I expected the weight to come off first, isn't budging. I've been told by a number of vets that it takes a year or two after you've dropped most of your weight for your body to get a clue and redistribute the fat you have left. So this means at times when you are dropping the weight you may look skeletal in some areas that you used to have padding in when you were that weight before. But try not to worry too much about it, usually within a year or two it rebalances as it redistributes. I'm sure that doesn't apply to everywhere, but it applies to most places... Also, most surgeries have a rebound once you reach your set point and stop losing. This is often in the 15-20 lb range. So conventional wisdom from the vets is to ride your weight loss down as low as it will go (unless you end up officially underweight by BMI), as you will rebound and then complain about that extra 20 lbs that came back. LOL

How much protein are they expecting you to get in? As far as I know, 60-80 grams is a typical goal for a bypass patient, with 80 grams being the excellent mark. And I agree, that is only 4 oz short of 64 oz, nothing to get bent out of shape over. Is more better? Yes, to a point, but my PA told me that to be getting 64oz of water in by 3 months is better than most patients are able to do... So it is odd they are riding you about it. You are doing great!! Most people cannot get their full requirement of protein in at 3 months, let alone at 6 weeks post op!! Give yourself some credit and ignore the complaints from them. I think it is generally good to follow our team's advice, but when they are making you feel bad for being within range of your goals (or very close to it) at 6 weeks post op, I think it is okay to set it aside and really appreciate for yourself how good you are doing... But that's just me, your mileage may vary. LOL

How is everyone doing now?? I'll be officially 12 weeks out tomorrow! I'll post my stats then and update you guys. I can't believe we are all getting to the 3 month mark...

Your surgeon is a bit off in his ratios. Weight loss rate is different for each surgery and for each person. I think the 3 month mark for most surgeries is closer to 30% though, not 50%. I've never heard that for 3 months, only for 6 months. Have you run your stats through this calculator? https://www.facs.org/quality-programs/accreditation-and-verification/metabolic-and-bariatric-surgery-accreditation-and-quality-improvement-program/riskbenefit-calculator/ That is the calculator many bariatric surgeons use to calculate their patient's trajectories. I feel like I'm behind because at about 3 months out I'm only down 40 lbs or so since surgery, but 53 lbs since my highest weight. So I used that calculator, starting with my highest weight, since that is what the surgeon would have used. Turns out I am right on the mark, as their PA told me a few weeks ago! Everyone around me is losing faster, but that doesn't matter. For my body and my health conditions I am apparently right on track. I found that really reassuring. Keep in mind that site only tells you what it expects you to lose in the first year. I thought malabsorbative surgeries like the DS or Bypass can keep losing up until the 18 month mark, though it is much slower loss at that point? I know DS patients can even lose up to the 2 year mark, though again, it is much slower. You usually lose the last 20%-25% much slower because the body is closer to its set point. I had a 6 week stall that started when I added solid food in. I kept gaining and losing the same few lbs. But someone told me to check my measurements, since usually when the scale stalls, our measurements go down. Sure enough, I was losing inches!! So I REALLY advocate people measure once a month and record it, the Baritastic app can even track it for you. It is really reassuring to see those inches lost when the scale has been acting like a d**k for weeks. LOL How are you doing now??

I highly recommend checking out A Bra That Fits calculator. I was recently pointed in this direction as I'm having bra fit issues as I'm losing weight. Band size I've always been spot on, but cups are always too small. Turns out I was wearing a bra 6 sizes too small in the cup!!! YES 6 SIZES TOO SMALL And I'm not the only woman that does that... I'm apparently a 44H right now, not a 44D/DD. Go figure. I went to the reddit for that website and the FB group, learned a lot about my breast shape, and ordered 6 bras through the "Amazon Prime Try Before You Buy" thing. 4 of them were too big and awful looking, apparently the calculator can overestimate cup size for my breast shape. I could see that the bra shapes would be horribly wrong if the cups fit correctly, it seems my breasts sit high and I have breast tissue under my arms that migrated there from wearing too small bras for 25 years...plus I have breast tissue way up high to almost my collar bones... I did eventually find one that fit amazingly! The women in the FB group advised me to go down one band size smaller and up one cup size (maintains the same cup volume) and to use an extender on it so I'll get 2 months out of my bras, as I'm currently dropping a band size a month, but my cup size isn't changing. I thought that was a great tip for making my bras last longer, since they are so damned expensive. In this properly fitting bra my shoulders don't hurt because there is no pressure on them! The band is actually carrying the weight of my breasts, like it is supposed to. And the wires are wide enough they aren't sitting on the breast tissue under my arms that I had just assumed was fat! As for other clothes, I've found the best way to stock smaller sizes is Ebay and Poshmark. I search for lots/bundles a few sizes smaller than I currently am. These are often listed by people losing weight and changing sizes, who want to clear out their closets fast instead of list item by item. I plan on selling my clothes this way too as I outgrow them! I recently got a bundle of 5 leggings in an XXL from really quality brands. Almost brand new. Since they are different brands they'll fit differently and probably last me a few sizes... I also found a tank top lot listed that way, and since I'm a leggings/tank/cardigan woman, these should last me a while. I have also picked up a few aspirational things on deep discount in a Large, so I can have some pretty things at that size for cheap, even if I don't end up staying at that size. I can't even fathom I could be that size by the end of this year! Anyway, this is how I'm saving money clothes shopping online!

Yeah, the dietician was a prick to mention your weight in relation to other patients. You were not unusually heavy and it is just plain unprofessional. I hope you have a word with the surgeon about it at some point, people need feedback on how their staff are carrying out their jobs. I'm sorry it is so hard to obtain this surgery in the UK, you should have been given ample support and encouragement on your journey, not criticism. As was said above, you may need the support of a dietician post op and going to one who was condescending to you pre-op is not a recipe for success post-op. You may want to seek out your own dietician for support. One you can feel free to fire at will. LOL I find dieticians assume by default we are all idiots about food, especially healthy food. And they tend to fixate on weird things, like pasta alternatives that are "just like the real thing!" that they have probably never eaten themselves. Or cottage cheese!! OMG I do not want to eat a bowl full of cottage cheese!! I think they should have to go through a 3 month staged bariatric diet, including an all liquids portion, so they have some lived experience and can be a little more human with their patients... Although I will say I've actually run into a few dieticians that have had bariatric surgery and while they don't say the stupid weight things anymore, they do still have a lot of biases from their training (like no protein supplements because they aren't "real food"). Your weight story is not unusual, as others have said there is more and more research pointing to obesity being a very complex disease and far from a moral failing or issue of willpower. There are a lot of stigmas around weight and weight loss surgery and unfortunately the medical community is a willing participant in much of that misinformation. I'd advise you to find a therapist or a mindful eating coach who can support you in changing your food choices early on, so by the time your hunger comes back your new habits are firmly in place and something you can rely on. I wish you so much luck on your journey!! You are doing great!

I wasn't allowed yogurt or fruit and veggies in my smoothies during the liquid diet pre-op OR post-op! Every surgeon is different. You'll have to call and find out, or play it safe and stick to strict fluids only. Since it is the day before your surgery I'm assuming it is just to make sure your digestive tract is empty the day of surgery, so I'd doubly stay away from anything thick... Good luck with surgery!!

OMG congratulations!!! That has got to feel amazing, even though things have been slow going lately! I'm so happy for you!! Consistency really does pay off with these surgeries...

OMG I'm so excited for you I teared up when I read your post!! I know how hard it has been and you've been so upbeat about it! I wonder if you were gaining muscle or maybe burning a bit too many calories with the exercise and now that you've slowed down on that your body feels it can let go of some of the weight?? My best friend loses more weight in the winter for some reason. Doesn't matter what she does, it seems to consistently come off better in the winter. Our bodies can be so mysterious sometimes... Whatever the reason is, I'm so happy the scale moved a bit towards your goal!! And I'm really glad you stayed consistent all summer, they say that's the best way to break a stall, even though it is so hard to keep the faith. I bet your body composition has changed a lot over the last 8 months even if the scale wasn't moving for a chunk of that time. Your experience is so encouraging because it shows that sometimes the scale can move months after you've thought it was done for good! You aren't the first person I've seen have a stall that has lasted for months instead of weeks...

I don't have MS, but I do have several autoimmune diseases along with Fibro and Chronic Fatigue Syndrome. I am almost 3 months out from a traditional duodenal switch. I have found my energy level and ability to exercise has increased a lot, I no longer get post exertional malaise. I also have less pain because the surgery causes your inflammation levels to decrease and as you lose weight, those levels will continue to go down. Since I am so early out, I have not had any nutritional issues. However, my surgeon did advise I go with a longer common channel than the standard 100cm cookie cutter length that most doctors go with, because I have a history of nutritional deficiencies. I went with 175cm. I'm really glad I had the DS, I'd do it again every year if I had to just for the fact it put my diabetes and high blood pressure into remission immediately after surgery!! Plus I have more energy than I've had in 2 decades. There is a different forum that has more DS patients on it, you might try posting there. It is www.bariatricfacts.org I'm not sure if anyone there has MS, but they are great with recommendations. There's also a support group for DS patients on FB called "Duodenal Switch SUPPORT Group" and there are a TON of DS patients there, you might try posting and seeing if any have experience with the switch and MS. As for surgeons, I had my surgery done with Dr. Pilati at WakeMed Bariatrics in Cary, NC which is right outside of Raleigh. We have a number of excellent DS surgeons in this area because of our world class healthcare centers. I don't know of any in the DE area but the women at bariatricfacts might, a lot of them are vets of the surgery for 10+ years!