SarahByNumbers

Throwing my anecdotal experience in the ring here, as well! I had a Vertical Sleeve Gastrectomy (VSG) at the end of November 2023. I was a "slower loser" the whole time, and then I hit a major stall about 6 months post-op, just bouncing around the same ~5ish pounds for months. I set up an appointment with my team for July 8th, discussed the issues I was having (mainly just being hungry and therefore eating larger portions), compared the different options, and we settled on trying out Phentermine. I did have to have a mobile heart monitor for 30 days prior to my surgery, as I had these weird heart "flutters" for YEARS and nobody could really figure out what they were (they ended up being PACs, or Premature Atrial Contractions, which apparently almost everyone has at some point and most people can't feel. I'm just unlucky! They are benign if they are not occurring in excess). My team had me do an EKG in-office that day, as well. They asked about any family history of heart issues, sudden death at early ages, etc. With a normal EKG, I was started on half of a 37.5mg tablet for 4 days, to increase to a full tablet after that if there was still residual hunger and I didn't have any major side effects. They said I'd know within those first few days if it was going to cause any issues. I did increase to the full 37.5mg after 4 days, and I've broken the stall (dropped 5lbs since July 8th, and part of that was spent at a music festival with few healthy food options), and I feel generally great! I do also have ADHD and Narcolepsy, so the stimulant properties are helpful for me. I'm feeling satisfied with much smaller portions and not experiencing cravings at all. I did have some mild insomnia the first few days, BUT I am already a night owl with a bit of insomnia due to the Narcolepsy, so it wasn't a big issue. Other comorbid conditions include depression and anxiety, which I am taking medication for, as well. The anxiety has not been exacerbated, which WAS an issue I had with previous stimulant use for Narcolepsy. Cost-wise, it ended up being roughly $7 USD with insurance. For me, trying Phentermine is definitely worth it, and I will follow up with my team later next month to see where I'm at. I had feared I was done losing after only 6 months post-op, and Phentermine has restored my hope that I can keep going to get to a healthier weight. It's important to remember that, while Phentermine will decrease your appetite, it does NOT cause you to burn any more calories than normal unless you also increase your activity. You have to decrease your portions - the Phentermine just makes it easier to do that, if it works as intended. So, your personal experience may vary, but it's worth discussing with your team if you feel stuck! EDITED TO ADD: My team said that I need to take a break from using it daily about once a month (like, not take it for a couple of days), otherwise I'll develop a tolerance and it won't work as well. This is pretty typical for stimulant medications in general.

Meowdy, friends! 😸 I had VSG on 11/22/23 (the day before Thanksgiving here in the USA 😂, almost 5 months ago), and I have not been a very fast loser. While some people may have dropped 20 lbs in each of the first two months post-op, I'm just at almost 40 lbs down since surgery. My Physician's Assistant (we don't meet with the surgeon at all post-op in our program) said I'm definitely a "slow loser" and am about 12 lbs higher than they'd expect me to be right now. Anyone else out there only losing about 1-2 lbs per week? Anyone who was in this situation and managed to kick things up a notch? And also, anyone who was a slow loser who eventually met their weight loss goal? I've always been awesome at getting in my water, protein, and vitamins each day. My program pretty much refuses to give us macro goals other than protein, but I know I'm generally under 100g of carbs daily (sometimes much less). Protein, I'm usually at 80g+. Calories, I float around 1000 per day. Water, I get a MINIMUM of 64oz. I took a week off of exercising (elliptical and weights) when I was sick with a cold, and I actually lost the most in that week, so I laid off the exercise for a bit, worried it was slowing me down. I'm going to start back up on it, just because it's a good habit to get back into. When I do the elliptical, it's usually pretty vigorous for 30 minutes, sweating profusely and burning ~400-500 calories. I put on some very loud heavy metal and take out all my frustrations on the machine 😅 I'm worried I'm going to be stuck at this weight and that I'm "wasting" this tool and opportunity, or that maybe I chose the wrong surgery. Granted, my current weight is way better than where I was before starting the pre-op diet, and my mobility and endurance are IMMENSELY better, and my IBS-D has basically disappeared (THANK THE LORDT), but it's still not where I'd like to end up. The PA told me that sleeve patients can lose for at least 18 months post-op, so hopefully it's just a slow-but-steady race for me. I guess I could just use some encouragement or advice or anecdotes from others who were slow but successful, or if someone sees something glaringly "wrong" with what I'm doing.

Small update, in case this is beneficial to anyone else going through the same stall & hunger issues in the future! I met with my Physician's Assistant (we don't see the surgeon post-op in my program - the PA does all the medical legwork) on July 8th since I was stuck in the high 240s for quite a while (roughly 112kg). The PA discussed what I was doing, agreed that I was doing almost everything right, minus somewhat larger portions at meals due to experiencing more hunger. We discussed GLP-1s (Ozempic, Wegovy, Zepbound, etc.), phentermine, topiramate + phentermine, Contrave, and other medication options. Since my insurance would not cover GLP-1s (I do not have diabetes) and they'd all be crazy expensive out-of-pocket, we decided to give the phentermine a try. Note that this is not a good medication to add if you have any history of heart issues - I'm not a doctor, so anything I say is personal anecdote and you should always consult a physician for any changes in your own medications, etc. Phentermine is a stimulant and an anorectic, which means it reduces appetite and can increase energy. It will NOT cause you to burn more calories without increasing activity, so reducing the amount eaten is critical (and increasing activity helps, too). The PA had me do an EKG in-office that day, and since it came out normal, I was prescribed half of a 37.5mg tablet for the first 4 days, to increase to a whole tablet daily if I still had residual hunger and was tolerating the 1/2 tab well. I did end up going up to the full tablet, as I had no side effects (except for some anxiety the one day I had a cup of coffee in the morning...don't combine stimulants!!). The result has been that I've dropped 5lbs in the last 2 weeks, and almost a week of that was spent at an outdoor music festival where the food options were far less than stellar (think "carnival foods" - I tried to stick mostly to all-meat options as much as possible, but I did help my spouse with some cheese curds and funnel cake...). I do have Narcolepsy and ADHD, and the addition of a stimulant has been a bit helpful for those conditions, as well. Another plus was that it cost me roughly $7 USD to fill at my pharmacy with insurance, so it was far more affordable for me than the GLP-1s would have been. My hunger has been curbed quite a bit, and this has helped me feel satisfied eating far smaller portions than I was eating previously. I have a check-in with my PA towards the end of August, and I'm pleased with my progress so far! I had an annual physical with my General Practitioner last week, and my A1C says I'm no longer pre-diabetic 😁

Thanks for checking on me!! About the same in terms of weight, unfortunately 😩, although I'm bouncing around the high 240s instead of the low 250s now, so there's been a slight change. I'm going to reach out to my team soon if things don't get moving again.

I attended a concert last week that was basically standing room only. In the past, I would have been DYING standing for 4 hours, but now apparently I can do it! My feet were a little grumpy with me, and I was a little sore the next day (over 40 here, lol!) but this is leaps and bounds better than it was in the past. Looking forward to seeing how I handle a 3-day music festival coming up this summer!

It's always good to ask stuff like this, because I guarantee there is someone else out there with the same question who is too shy to ask! 😂 Personally, I haven't had any issues post-op. It's entirely possible that it's something in your partner's diet that's making things taste off/funky to you, or just an "off" stomach week for you. Hopefully it resolves, otherwise SleeveToBypass2023's suggestion works! Good luck!

Someone's gotta tell my PA this! lol Thank you for the encouragement - this situation was at least a good motivator for me to re-evaluate what I'm eating (I was getting a little lax with keeping some of the less nutritious things outta my mouth), so if anything, my worries have put me back on track to sustain this lifestyle change longer term.

I absolutely had this, right around 4 weeks post-op from VSG. With laparoscopic VSG, there's one larger incision where they remove the stomach remnant (usually on the right side), and I know my surgeon said there's generally an internal stitch there that will dissolve over time (or pop, if you put too much pressure on it). In my case, I bent over pretty far to pick something up and felt a POP and a little pain, then it was fine. I noticed right after that my previously puckered-looking incision was now flat, so I was fairly certain it was the internal stitch popping. I asked the team about it, and they said that's exactly what it sounded like, palpated the area a bit, and had no concerns. Now, I'm not sure how this relates to RNY, but it's possible you also had an internal stitch that just finally let go. No pain following the pop is good. At 4 weeks out, your incisions should be starting to heal up pretty nicely, but it's definitely best to check with your team juuuuuust in case! Good luck!

Hi Carrielee - welcome! I had VSG surgery just about a week before my 40th birthday this past November. I had sworn in the years leading up to it that I would NEVER have any kind of WLS, but here I am! If I could have done it on my own, I would have - I needed help to improve my life, because nothing I tried on my own was working, and I tried it all. I had sleep apnea, insulin resistance, and bp that bounced back and forth between hypertensive and high-normal. I felt like I was going to die after climbing up a flight of stairs, and I was passing up good opportunities at my job because I didn't want to walk 5-10 minutes to another building and get all sweaty. I had never had surgery of any kind before (other than getting my wisdom teeth out, but it's not like I was intubated for that), so the thought of getting put under and having my innards poked at was rather intimidating. I would do it over again in a heartbeat. Like @catwoman7 said, I'd do it every year if I had to! I never needed to use my prescription pain meds post-op. I actually take the "long way" to my car at the end of my workdays now. My husband and I routinely walk to the front of our neighborhood and back, whereas previously, I hated just walking the 0.10 mile to our mailbox. My blood pressure has actually been almost LOW ever since waking up from surgery, my IBS-D has essentially disappeared (and I had days where I couldn't be too far from a restroom before), and I'm a little less sweaty. My knees feel INFINITELY better, and they're a little less noisy when I bend down. Now, you do have some health conditions that could make any surgery a little more risky (fatty liver, history of PE especially), but your doctor will review your history and will probably have you do quite a few tests and things to make sure it's safe for you to have surgery. I had some weird, random heart palpitations for darn near 20 years that were dismissed as "nothing major", but my doctor insisted that I do a 48-hour Holter monitor just to be sure. When that didn't show anything, they had me do a monitor for a whole month! They actually figured out the cause (occasional premature atrial contractions, or PACs, which apparently darn near everybody has at some point - some of us just feel them more than others), and cleared me for surgery. Ask your surgeon all the questions you can think of. I watched YouTube videos for months leading up to my surgery just to see what others' experiences were. I crawled through this forum extensively. I read the binder my program gave me over and over and over. I started following tons of WLS accounts on Insta. Do whatever you need to do to ease your mind a bit, and know that there is a large community to back you up! Trust your gut and go with what you know you need to do, be that surgery or something else. No matter what you choose, we'll be here for you.

Yeah, I honestly think that for a lot of us, keto or modified keto (at least in the beginning months or maybe even the first year) is the way to go. I know my program wants us to have a sustainable approach and incorporate all foods, but my body seems to love to hold on to carbs, and I want to get as far as I can in this first year before things REALLY slow down. Thanks for your input!!

Ding, ding, ding - we have a winner! You are correct - I went through UW Health, and their program is still very much focused on balanced meals and not restricting. They give amounts to have at each meal (e.g., 1/2 cup), but I always thought this was a little wonky because a 1/2 cup of beans is way different than a 1/2 cup of sugar. I had to BEG my Dietitian to give me some sort of maximum macros for a day, and some of those ended up being way higher than I'm comfortable with (150g carbs per day), so I'm just kind of going with what makes sense to me...hitting ~80g protein and at least 64oz of fluids, and then loosely monitoring carbs and calories. I'm going to get back to tracking every day, just so I can be sure it's not what I'm putting in my mouth that's slowing me down!

When I finally convinced my Dietitian to give me some sort of macros to follow, they actually said "150g per day" for carbs! I thought that sounded WAY too high, and even 100g seems like a lot to me. I've done keto before (and that was the only way I lost any weight at all, prior to VSG), so it's not too difficult for me to cut back there. Thank you for weighing in - I really appreciate it! :)

Yay!!! 🤩 I am so proud of you for how far you've come! You've worked hard to get here, and you've earned it! Also, your hair is *chef's kiss* 😙👌

Log in, click your username up at the top of the screen, click "Profile", and then click "Edit Profile" (for me, it shows up in the box toward the very top, right under the green banner selling things. lol) Hope that helps!

Hi Star! I had a similar issue (minus the spotting beforehand). I have a hormonal IUD (Mirena), so I don't tend to get more than a tiny amount of spotting at most every month. Usually I don't get anything at all! However, after surgery, I had what was basically a "regular" period - my first one in YEARS. Surgery stresses your body out, so it's normal for AFAB people with uteruses to bleed afterwards. Since then, I've had a light period every month. Like Summerseeker said, fat cells harbor estrogen, and we're dropping fat quickly, which basically frees that estrogen and causes our hormones to go wild and have a party! So, don't worry too much - your experience is pretty common. ❤️

Hey there! I have a WLS Instagram account, but I set it on Private (so I have to approve any follows and only followers can see what I post), set my profile pic as something random (not my face), and I've clearly stated on my profile that I only accept other WLS accounts as followers, just to keep it all semi-private. I still get a bunch of weird bots (and fake Keanu Reeves?? 😂) requesting to follow me, so I just run through and delete their requests every few days. There are a LOT of different hashtags you can use to find other WLS accounts to follow - just use words like "bariatric", "sleeve", "rny", "bypass", etc. and they should all show up. There's a pretty decent community over there, so even if you choose to never post anything, it's nice to see all the support and read others' stories! I don't post much either (I always figure I don't have much interesting to say).

I'm on Day 8 of 14 for my liquid pre-op diet, and honestly for me, it hasn't been all that bad! I didn't get "keto flu" or any of that, possibly because I've done keto diets before and knew to keep up with electrolytes. The only crummy part is when I can SMELL tasty things. I'm fine if I can see them, I'm fine sitting next to people chowing down, I'm fine watching YouTube cooking shows even, but if I walk past someone's office and smell something delicious, THEN I really miss food 😅 I'm starting to make myself anxious by reading about post-op infections (it feels like the only people I've read about getting them on my program's Facebook group are those who have the same surgeon as me...), "How will my cats EVER forgive me for not being able to sleep with me the night before surgery?!", "WHAT IF I CAN'T WIPE MY BUTT AFTER SURGERY AND MY HUSBAND HAS TO DO IT?!", etc. etc. etc. 😂 I think the big key is to always remember your "why" - Personally, I'm not just doing this to lose weight. I'm doing this because I have a family history of a number of different cancers whose risk is greatly increased with obesity (and I had a precancerous colon polyp removed earlier this year...I'm not even 40 yet). My "why" is that I want to be here a lot longer and be healthy and be able to enjoy that time doing fun, active things and not overheating and sweating my arse off while I'm at it. Today's my last day working in-office prior to surgery next Wednesday, and I'm really thankful for that. All my good savory liquids are at home! I hope everyone is doing fantastic and healing well, or having an easy time with their pre-op regimens! 💜

Contact your new insurance and see if they will allow you to continue with the same provider regardless of whether they are "in-network" or not, since you've already started a program with them at another covered location. I've been able to do that before - it just depends on your insurance!

@SomeBigGuy, I personally didn't go through Blossom, but there's a fantastic YouTuber named LoseWeightSara who did, and she has a ton of videos documenting her journey, including a few of her hotel & hospital stay. I highly recommend checking her out - she's a delight!

Welcome, Sharky, and congratulations on having your surgery scheduled! There's so much good information and support around here!

Apologies for the novel I'm about to write, and thanks in advance if you bother to read it all! 😂 TL;DR it took me ~7 months total to go from first appointments to surgery. I went through my local university's health system and am using insurance, so my timeline will likely differ from those who are self-pay or outside the USA! My program is roughly 5-6 months, with 4 group classes and two check-ins with Nutrition & Psychology where they determine if you're approved to move to the next part of the program (or send you for additional counseling or nutrition, if not approved). I also had to do 2 extra appointments with Nutrition & Psych to keep insurance happy, as mine requires that you have some sort of contact or follow-up every month until you get surgery. Here's what my personal timeline looked like: April 27th, 2023 - First appointments with Dietitian, Psychology, Surgeon May 2nd - First group class May 16th - Second group class June 6th - Psych check-in June 15th - Nutrition check-in July 5th - Third group class July 27th - Fourth group class August 1st - Nutrition check-in August 10th - Psych check-in **CALLED IN LATE AUGUST TO SCHEDULE! (see below) September 19th - extra Nutrition & Psych check-ins to keep insurance happy October 3rd - GP visit for physical and approval for EGD (the hospital mandated this due to high BMI requiring monitored anesthesia for the EGD) October 4th - EGD (scope of esophagus, stomach, upper bowel) November 8th - Started 2-week liquid only liver-reducing diet (LRD) November 9th - Pre-op Readiness Visits (basically meeting w/surgeon again, nurse practitioner, coordinator, etc. to make sure I have all the pre-op information, etc.) November 22nd, 2023 - SURGERY DATE! **So, they DID call me in late August to schedule my surgery. At my initial appointment with my surgeon, he wanted me to get an EGD to make sure I don't have silent reflux or anything funky going on, as I get occasional reflux with certain foods. When I scheduled my EGD back in April, they were scheduling out into OCTOBER 🙃, so I scheduled it for October 4th. In late August (after finishing all my classes and check-ins), my surgeon's office called to let me know the surgeon reviewed my file and was fine with skipping the EGD since I don't have a history of chronic GERD and asked if I wanted a date in September. Well, at this point I was used to the idea of having surgery towards the end of the year, AND I already had a big ol' wedding planned for October and wanted to be able to at least eat solid food for that and have my dress fit properly, so I told them I was fine with keeping the EGD appointment just to be safe and that I'd prefer a date in late November, as I had a HUGE thing scheduled at my work for this week (11/13-11/16) where I pretty much had to be there. They had no problem scheduling me out that far, so if you need a particular timeframe and need to push back for life reasons, I've heard the majority of programs have absolutely no problem doing so. Just know that your insurance (if you aren't self-pay) might want you to make an extra check-in visit or two so you have some kind of contact monthly.

@FabFab how did everything work out for you? I hope you're doing well!

Commenting in case anyone stumbles upon this thread in the future, as I'm guessing OP may have already finished their liquid diet! I've had good luck with ramen packets. Yes, the little powdered flavor packets that come basically welded to your 99 cent packets of cheap ol' ramen noodles. Definitely avoid these if you can't have much sodium 😂, but I was able to add Isopure unflavored protein powder to some boiled water with the ramen flavor packet and it was pretty darn good! Chicken and Soy have been my favorites so far. I didn't like the smell of the Beef flavor very much, but it tasted fine. My program allows us one 8oz cup of V8 per day as well (...or 3 dill pickles...so random, but love those electrolytes!), so I heated that up and mixed in the unflavored Isopure - it tasted a lot like a creamy tomato soup, and was great for breaking up the sweet-flavor overload from the protein shakes. I thought I hated V8 prior to the LRD, so I'm glad I gave it a try - it's not bad at all. I'm hoping I can find some basil in my spice cabinet and make a faux tomato basil soup! Finally, in the USA at least, there are these little "jars" of Better Than Boullion. Add a teaspoon of whatever flavor tickles you into some hot hot water until it dissolves, add unflavored protein powder if you want, add some pepper or other seasonings if it makes you happy, and you've got yourself a delightful protein "soup". 😁 Other items that are awesome are sugar-free Bomb Pop popsicles and sugar-free Tropical Popsicles, sugar-free Jell-O, Propel and Gatorade Zero, Crystal Light mix-ins for your water, Protein2O water, and there's even Gatorade Zero w/Protein these days - I found a pack of the mix-in sticks on Amazon! Most bone broth I've tried makes me want to gag, with the exception of the LonoLife mix-in sticks (found some at my local grocery store, but found more flavors on Amazon). Anyhoot, good luck to everyone doing their liver reducing diets, whatever your requirements may be! Mine's all liquid (and those 3 pickles...lol), I'm on day 6 of 14, and honestly it hasn't been all that bad. Just make sure you get enough protein spread out through the day, enough water, and get some electrolytes in (especially if you get leg cramps, nausea, headaches, or dizziness).

Hi Amber! My program requires similar vitamins (the only difference is, instead of B-1, they have us do a B-Complex). The explanation they gave me was that we'll need even more of quite a few vitamins after surgery, as we may not absorb certain ones (especially B-12) as well anymore. Vitamin D helps with healing, so it's good to have some extra (and deficiency is really common, especially in bariatric patients). The other reason for seemingly "doubling up" on some is that we're not getting any vitamins from "real food" immediately post-op, so they want to account for missing out on those when we're in the liquid & puree stages. Hope that helps!