ouroborous

Focus on Water, Protein, and Vitamins. If you can get those under control, everything else will be okay. You can live for a good two to three weeks without consuming a single calorie, as long as you're not dehydrated. For an obese person like me, probably longer. Not saying that you WANT to do this, I'm just trying to help you settle your mind. If you have to, take tiny, tiny sips of water from a 1oz medicine cup. Whatever you need to do. Just focus on water and vitamins and protein (probably in that order). Of course, your doctor should be your primary contact, but still -- you'll be okay. It's rough at first, but it gets better!

If most of that is water, yes, it's (barely) possible.

Well, when I thought that every single day was going to be a battle with acid reflux, yes, I regretted my surgery. But it turns out that 99% of that was my fault -- I was eating and drinking too much, too fast. Now that I'm meticulously following the doctor's and nutritionist's guidelines, the reflux is much, much better and I don't have any regrets. I've already lost 30 lbs from my pre-surgery weight at 2 1/2 weeks out (15 lbs from my surgery day weight).

IIRC, rapid weight loss can lead to gall bladder disease, so if there are pre-existing GB issues, some surgeons remove the GB at around the same time as doing the surgery. Again from what I remember, the number of people who get gall bladder problems with WLS is about 1/3, and there are a few things you can do to "stack the deck" a little if you don't have your GB out at the time of surgery. I posted those in another thread, but they include coffee (obviously decaf at first), fruits and veggies (when cleared to eat them), low-fat diet, slower weight loss, and (oddly) moderate alcohol consumption. I'm not a doctor tho... talk to your doc if you have questions :cursing:

So, what are some suggestions for restaurant food that "keeps well" in the fridge (reheats okay, etc.)? My girlfriend (who was sleeved in November) said that her biggest challenge when eating out nowadays is knowing what will be a good combination of delicious at the time, and still reheat-friendly (since even "small" portions in the restaurant end up being more than a single meal's worth of food, for her). I'm just thinking ahead. To be able to have all the foods that I couldn't have before (because I had to watch my calories), just in smaller portions, has got me thinking about all of the "forbidden" food, and what will keep and reheat well Yes, yes, I know I should only be eating veggies and lean meat after surgery, but still. A guy can dream!

Okay... I just worry about people taking medical advice off the internet. If the doctor's blessing it then -- I'll shut up :cursing:

I'm not going to even taper off from 40 mg to 20 mg until 6 months or so. After a year, I may try removing it entirely, but if I have to take 20 mg omeprazole for life, that's a tiny, tiny price to pay to not have to worry about esophageal erosion, Barrett's esophagus, gastric ulcers, duodenal ulcers, and the overall misery of reflux. Yes, I know there can be some problems with Calcium and long-term PPI use. My doctor advised me about that. That's why I take a calcium supplement. Yes, I know that there's a drastic reduction in intrinsic factor post-surgery, limiting B12 absorption -- that's why I take a sublingual B12 every day. But to me, in my book, reflux and the associated dangers of acid overproduction are worse than simply having to take one tiny acid blocker every day. I may try switching to an as-needed antacid in a year or more if my reflux gets under control. But honestly? The risks are small, and I don't want to mess with success. The acid blocker doesn't make me "unhealthy" because I need to take it, any more than the Multivitamins I take do. It's just one of the changes that are necessary after the sleeve. On the grand scale of things, obesity and constant reflux are still FAR more dangerous than a slight chance of bone loss, and it's a sacrifice I'm willing to make. I guess I should wrap this up. I would like to encourage people, before they go tampering with meds that their doctors have prescribed all willy-nilly, to talk to their doctors about the risks and benefits, and get their doctors' recommendation about what to do.

Yeah Dr. Landerholm said that since Water is incompressible, and since the part of the stomach that remains is the non-stretchy, muscular part, apparently too much water (or any liquid) too fast can cause the acid to just back up into the throat. I was consuming EVERYTHING way too fast, but he really suspected that the water was the culprit.

Well, I just had a very informative nutritionist appointment, and I followed it up with a quick jaunt over to the doctor (one benefit of going to PSSC is that the nutritionist and surgeon's office are across the parking lot from each other!) First, the surgeon cleared me to take the OTC omeprazole. This is good because (1) the prescription capsules were a pain to get and to consume (the little grains went EVERYWHERE) and (2) I felt like the OTC version -- which has an enteric coating -- was much more effective. So far today I've had 20 mg of omeprazole (the doc wants me to take 40 mg/day for now, instead of 80mg/day) and I feel pretty good, acid-wise. Second, both the surgeon and the nut. agreed that I'm consuming stuff WAY too fast. Specifically I'm drinking too much water! Given that I'm consuming 100-120 oz day, both the nut. and surgeon agreed that that's likely what's causing the reflux. No room in the inn, so the water just forces acid to bubble back up. I honestly never even considered that; I drank water to SOOTHE my throat, but maybe it was making it worse. So now I'm not supposed to drink more than 80 oz/day, and I'm supposed to pace myself so that I'm not consuming more than 12 oz/45 minutes. I'm also supposed to stop drinking 30 minutes before and after a meal (thought I only had to do that on solids!) and stop consuming anything 1-2 hrs before bedtime (when my reflux is worst). So, I'm relieved that I may have a solution for my reflux that doesn't involve massive, massive amounts of drugs. I'm trying it out today -- so far, so good. I'm a little annoyed that my first nutritionist (who I won't mention by name, but with whom I'm currently attempting to cancel ALL of my followup appointments) didn't tell me ANY of this. Keep your fingers crossed. If I can tame this reflux, the sleeve will be a breeze! Oh, and yeah, I'm supposed to be targeting 600-800 calories/day. The first nutritionist didn't mention THAT, either!

So, I AM losing weight, just not very fast; in the past 5 days, I've lost about 2 lbs. I know that in the long term, they recommend dieters not lose more than 3 lbs per week, but I'm less than two weeks out from a sleeve surgery, and I'm on an all liquid/puree diet. My girlfriend is a sleever too, and she's astounded by the volume that I can eat without discomfort. A lot of this is due to the fact that I heal extraordinarily quickly, but I think also some is due to the fact that I'm larger than her -- my sleeve is larger. I still don't think I've felt hungry since the surgery. I'm just eating periodically due to a feeling that "I should probably eat something" and boredom. Boredom is a factor because I've been working from home for the past week (really unnecessarily; I could have been going in to the office probably by Tuesday of last week). When I'm bored, I graze! My sources of calories are denser than I thought, and they're all "slider" foods (by necessity, since I can't consume solids right now). I just did the numbers on my morning Protein blender smoothie, and it's about 500-600 calories (310 cals 3 scoops EAS Protein powder, 160 cals 2 cups of skim milk, 160 cals 1 cup frozen blueberries, pureed). That's an AWFUL lot -- I'm going to switch to the Premium Nutrition Protein shakes that we have, which are a little less net protein (30g vs. 40g total in the smoothie) but a LOT less calories (160 cal total). Also, my girlfriend bought some full-fat baked potato Soup from Safeway which is delicious (when pureed), but it's still about 400 calories per serving! Honestly, as I think about it, eliminating the blender smoothies (aside from once in a while as a snack or an "I need to eat a calorie" thing) and getting back to a routine at work should be all I need to kick start my weight loss. So... never mind! Edit: and I did the math. From my pre-surgery weight of 315.something (on the doc's office scale, which is about 2 pounds LIGHTER than my at-home scale), I'm down to 303.8, in 11 days. That's almost a pound a day. Probably a bit more than that if you adjust for the weight differences in the scales. It's not a race; I may not drop 100 lbs. in the first three weeks, but a pound a day is QUITE fast enough, thank you!

So far, so good. My water consumption is way, way down (I may not even make my 64 oz today at this rate!) but I haven't had reflux all day (on only 20 mg of omeprazole). So now the water consumption may be a new challenger, but at least the 800 pound gorilla -- the reflux -- appears to be doing better.

Well I'm only 15 days out, but so far I've yet to feel hungry, and I'm eating (at MOST) 1/2 of the calories I was eating before. More like 1/3 or less. Here's an example: I had forgotten to eat (when would I have done that before??) until 3:30, and did the math -- I'd consumed 280 calories all day long. I wasn't hungry at all, I just felt a little weak and suddenly remembered "oh yeah... food!" So yes, your mileage may vary, but at the very least I think it's safe to say that your hunger will be significantly diminished, if not entirely removed.

Welcome to the post-op side! It really does get better every day. Take a piece of advice from another recently sleeved dude: do EVERYTHING your doctor says. No matter how silly it sounds. I have been eating too fast and really paid the price. Don't do what I did! :thumbup1:

Congratulations! Focus on your liquids, keep walking, and take your pain meds as needed. That's what they're there for!

Well with today's "coming to jebus" moment at the nutritionist -- realizing that I'm eating too much, too fast -- I'm sure that the weight will start coming off faster for me. I'll be going from 1200+ cals per day wolfed down to 800 calories per day chewed slowly and carefully.

So, here's an actual question that my last "I'm not losing fast enough" whinge didn't actually touch on: how do I figure out what my target calories should be during my loss & maintenance phases? For reference, I'm a 39 y.o. male, 6'1 (and broadly built). I'd reckon that I've been eating around 1200 calories per day lately.

Heh. This is why weighing yourself too frequently is a bad idea... I'm going to see the nutritionist this morning, and they're going to weigh me. So, since I wanted to get my weight before eating Breakfast and drinking a couple of pints of Water and putting on all my clothes (that's a few pounds right there), I stepped on the scale. ARGH... still not below 300 -- 301.0. The big picture is that I'm still down 14 pounds in 15 days, so I shouldn't complain. It's just that I really, really wanted to be below 300!

Well, today was surprisingly tough. I've been dealing with the after effects of last night's acid extravaganza all day long, literally. My throat constantly wants to get sore and swell up. Fortunately I've discovered that hot tea soothes the soreness and I can pretty much drink as much chamomile tea (and Splenda) as I want. I took the advice of the MA who I spoke with on the phone, and at around 8:30 pm I took another 40 mg of omeprazole. That makes 80 mg for the day; that seems really high, but my acid is just out of control. (TMI coming up, sorry...) On top of that, my intestines have been in an utter uproar. I was having sharp pains in my side (and, being a hypochondriac, my first thought was "aggh! gall bladder!") but it was just gas. Still alarming and painful. My BM's (I've had 3 today) have ranged from full and healthy to... not so healthy. No blood in my stool, thank goodness, but I've been pooping so much acid that my bottom is raw and bloody. It seems like everything I take in causes my stomach to roil and causes gas and stuff. First I thought maybe I was getting lactose intolerant because my last gas outburst happened when I was drinking my evening Protein shake, but my next one happened when I was sipping Water after my omeprazole. What I think happened is: My acid has been barely controlled for a while. I've noticed that it's been building up, and I think I have to work with the doc to really control it. I've been eating too aggressively and too much; even though I'm cleared for "puree" foods and my handout from my surgical center says that mashed potatoes and melted cheese count as "puree," it felt ... too much when I ate it last night. I think it got stuck or irritated my sleeve or something. I didn't puke, thank goodness. Last night I had an apnea attack that triggered a LOT of stomach acid to come back up -- I woke up gagging on acid. I think that burned the hell out of my throat and caused it to be swollen all day. On top of that, the acid has been going out the other end, and it's been wreaking havoc on my digestive system -- causing my guts to be in an uproar, giving me gas, etc. I think it's a sort of "perfect storm." Here's how I'm going to address it: I'm going to really step up the omeprazole. I don't know what the maximum safe dose is, but while I'm healing, I'm more worried about the effects of the acid than I am of the PPI's. The omeprazole is not an instant fix, but it does seem to help long-term. I'm going to REALLY dial back on the food -- portion sizes are going to get smaller, I'm going to eat slower, and I'm going to go back to mostly liquid or super-runny food. I just don't feel like my sleeve is ready for heavier food yet, and it's sort of telling me that. I'm going to be drinking a CRAP-ton of hot tea. It seems to really help with the reflux, and it's the one thing in the mix that I'm not worried about the side effects of! I think what really blew me away was that last week was such a breeze! I had one minor incident of acid reflux (which upping the omeprazole seemed to help), but no real intestinal pain or anything. I was even sleeping better. And then BAM, last night and today was really rough! I'm not looking for sympathy, just relating my experiences so you other new sleevers can be prepared for it. At least I don't think I've done any permanent harm to myself (I'm not vomiting or in unbearable pain, nothing's bleeding, I've still managed to get all my water, Vitamins, and protein today). I think that just basically I went too fast. Lesson learned!

Sassie, I'm very sorry you're going through this. Knowing that folks like you are dealing so gracefully with REAL complications makes me embarrassed to be complaining so much about my paltry acid reflux. I hope you get better soon.

I'm glad that it's becoming more socially acceptable to be an unbeliever. Twenty years ago -- even ten -- people would assume you were a pedophile or something. Hope all of us infidel sleevers are doing well!

I second (third) this. Tell them that you've had abdominal surgery and shouldn't really be doing hard core work for a month or so. You don't have to go into details if you don't want to (although frankly I'm telling everyone since I don't have any problem with people knowing).

Oh I almost forgot. I have a Weight Watchers branded digital scale and it's very reliable and weighs up to 350 lbs. Highly recommended.

Posture and foot placement are surprisingly important with these scales, unfortunately. Try to make sure you always stand up straight (and you're not leaning to either side or forward/back), and try to always place your feet in about the same location on the scale.

Yeah, the regular sleep deprivation is probably the worst part of all of this. I could deal with the reflux if it wasn't keeping me up at night.

Well my doc's assistant told me to take 80mg/day for now. I figure that for the short term that's not too big of a risk. The Carafate doesn't seem to do much, but the doc says it helps protect the tissues from the acid, so I'm trying to take it to prevent the reflux from damaging my esophagus or sleeve/stomach lining. Yeah, I'm staying away from heavy food for a little while, but I can't skip the CPAP. I don't sleep at all with it. The question is what is the right pressure; I think it's a little high right now since I wake up with MAJOR dry mouth (when I sleep), but the problem is that if I lower the pressure, I wake up with apnea attacks. And my apnea attacks seem to trigger reflux attacks, so... It's a pain. I keep trying to remind myself that this is only a phase in my healing, and it will pass... but when it's 4am and I can't get any sleep and I'm scared that it's going to be like this forever, it's hard to be all calm and optimistic and zen-like about it.