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Stalls happens to nearly everyone. Personally I suspect that the people who do not hit stalls also find valuable antiques at garage sales, win free cruises and never get traffic tickets. I stalled from week 3-7 (but did not know because I did not weigh myself except at the doctor), then I suspect I stalled multiple times after that too. I still made it to where I needed to be. Bariatric teams usually stress the importance of hydration over food at this point post surgery. There is usually more concern from the complications of dehydration vs low calorie intake - we are trying to use the excess stored fat after all. Ask your team if it is okay to only eat the amount you are comfortable with and at the frequency that works for you. The extended eating time frame is usually for when we start solids. Most of the time If we hold up our end of the bargain (mentally), our bodies will do the same. It will all come together eventually and life after WLS will not always feel like a chore. Good Luck!

Yes. I had a phone appointment for my 3 month and 9 month post op appointment. And... since my bariatric doctor is an hour and a half away I've had nothing but issues trying to get them to order my labs for my 1 year follow up post op appointment which is supposed to be next week. I finally gave up and called my PCP and am going to have her order the labs (she's on vacation so I have to wait until next week) so I have to reschedule my 1 year follow up because Covid has apparently sapped the bariatric clinic of their ability to do their job (I called them 7 TIMES and was told they would send my labs three of those times... guess what, I called the outpatient lab and they got NOTHING from them! The other four times I got their damned answering service and they never returned any of my calls... -_-")

Hello! Im just curious if anyone else has had a port placed in an odd spot? I had lapband in 2013 and my doc put my port right above my belly button. My new bariatric doctor has been perplexed as to why my previous doctor did that. I honestly don’t remember for what reason my original doctor did it for. My sister had gotten lapband about 2 years before me with the same doctor who did mine and hers was placed in a typical spot (upper side quadrant of the abdomen is how I can best describe it). My new doctor struggled to even feel for the port as it has seemed to migrate some and the first time he tried to check the fluid, he had to go into my bellybutton to get to the port. He expressed frustration as the bellybutton is difficult to anesthetize and just odd placement in general. I feel like this placement has caused me different issues. Anyone else have a port that was placed in a spot like mine?

Yep. I had the Loop Duodenal Switch (a.k.a SIPS a.k.a SADI-S) on January 23 2020. My stats: HT: 5'7 HW: 389 SW: 321 CW: 203. I went into the hospital wearing a 6xl (34-36) in tops and a size 32 in womens pants and right now I'm a large (12-14) in shirts and a 14 in womens pants. I'm currently irritated by a two week stall but... it happens. I technically AM still losing (I lost 0.2 pounds in the last week and 0.2 pounds the week before, so I don't really know whether to call this a stall or not, but I still count it personally. Two weeks ago I was 203.6 and I'm currently 203.2). My biggest advice is to stay on top of your vitamins and your protein and you'll be fine. Well, and hydrate yourself (I'm generally bad at that, but I try). Constipation can happen with SIPS, just be aware of that. Also the opposite happens. SIPS does interesting things to your bowel system... your body may take a while to adjust to a 'routine' but it'll likely level itself out (mine did). Vitamin deficiencies DO happen. Maybe not to everyone, but it's fairly common with this surgery. I had a potassium deficiency appear in my 3 month labs then disappear in my six month labs only to reappear in my 9 month labs and next week I take my 12 month labs so we'll see how that goes. I also had a Vitamin A deficiency in my 6 month labs and have been taking extra Vitamin A ever since. I take less iron then I started with as my iron levels are elevated (I only take 1 iron bariatric multi a day and two bariatric NON-iron multi's) and since my calcium levels are also elevated I take only 2 calcium citrate as opposed to the 3-4 that most take. I'm not sure what other advice to give you, but if you have any questions then don't hesitate to ask and I'll try my best to answer any questions that you have. Congrats on your upcoming surgery, and I wish you the best in your journey!

I don’t know if this is helpful or not, but I used to do swallowing with acute care and inpatient rehab patients as an SLP, and we saw strictures all the time with non-Bariatric patients (they were usually esophageal strictures). It might not be related to your surgery if it is this far out. Have you seen a GI? I do think that having an upper GI (barium ex-ray) would tell a lot. Hope everything turns out ok!

I have BCBSIL and they wanted updates to make sure I was actively participating in all the pre-op stuff and that it was working (they wanted photos to prove weight loss). I was at 43 BMI at my first appointment and at 38 when I went in for surgery (I think). The Bariatric coordinator said that losing weight once you start the program shows the insurance company that you are ready for the lifestyle changes that come after surgery and that they always go from the weight/BMI of your first appointment. Hope that helps!

whoever said some of the traditional advice on vitamins goes out the window when it comes to bariatric patients is right. Especially with RNY, since we malabsorb some nutrients. I'd go by your bloodwork and adjust as necessary. Going for three months at a dosage level that's a bit higher than "normal" (we're not talking 2-3 x more than normal - we're talking a few milligrams) shouldn't be toxic - they'd catch it before it became a problem. I have a similar issue with calcium. I evidently absorb it much better than most bariatric patients, because my endocrinologist noticed I was excreting gobs of it in my urine. She said I was at a huge risk for developing kidney stones at that rate. She had me cut my dosage in half, and then had me cut out calcium supplements altogether. I was a little freaked out about this because I have osteoporosis, but my levels on everything are fine. Balancing chemicals in bodies are an endrocrinologist's bailiwick, so yours should know what he/she is doing. And like mine, yours tests again after three or so months, so they can tell pretty quickly if the change is causing problems. and yes - different forms of iron are absorbed differently. Sounds like you're good at this point!

Meal plans post op vary depending on surgeon and bariatric team but i figured id post my team's plan in case that helps u[emoji6] Weeks 0-4: 1-2oz liquids every 15-30mins Weeks 5-8: 3 tablespoons(1.5oz) puree..no red meat no veggies..cottage cheese consistensy. Very moist very soft Weeks 9-6mos: 2-3oz (limit 1 oz fruit and veggies) ground beef okay now. No other red meat or starchy veggies (corn, peas, potatoes). 6months+: 4-6oz (1/2-2/3 of meal should be protein). All meat and veggies okay now. Limit starches to 1 oz. Sent from my SM-N960U using BariatricPal mobile app

hey hey! Sorry I missed you! I don't get on the computer often to check this site and for some reason I do not get notifications on my app of people responding to me. I am officially 175.8 lbs today and it is day 168 since surgery:) I see you still have not had surgery yet. I just wanted to encourage you. The fears of loose skin, complications, failing to reach goal, and wondering if bariatric is best for you are all very common emotions and concerns preop. There are truly no words though to explain how amazing this journey of self love is! I am not only losing physical weight at an incredible pace but I swear I am being healed from emotional baggage that has weighed me down for years at that same incredible rate as well. There's no way to fathom exactly what I am talking about until you experience it, but I hope you give yourself this opportunity because you deserve it! No more back pain, no more hip pain, no more sweating profusely, no more FUPA stickin out like an awning over my vag, no more getting creative about how the hell I'm gonna reach my hand to my butthole to wipe... LOLOL...seriously, I could go on but I may be a little too transparent for some folks lol. I have been the happiest that I have ever been in my life since surgery though so please update us when you have it and I hope to see the update at that time! I am cheering for you and am excited for you to experience this journey!

SAMMC Bariatric Clinic: Weight-loss Surgery, Nutrition and Hair Loss (whmcbariatric.blogspot.com Weight-loss Surgery, Nutrition and Hair Loss by Jacqueline Jacques, ND Original content: http://www.obesityaction.org/magazine/ywm22/wlsandhairloss.php Typically, about 90 percent of hairs are anagen (in a growth phase) and 10 percent are telogen (in a dormant or resting phase) at any given time, meaning you are usually losing a lot less hair than you are growing so you don't have noticeable hair loss. But sometimes this can change. A common fear and complaint of bariatric surgery patients is post-operative hair loss. While for most of us as people, our hair is an important part of our self-image and body image, it is not very important to our bodies. For this reason, nutrition can have a great impact on hair health because when forced to make a choice, the body will shift nutritional stores to vital organs like your brain and heart and away from your hair. Hair loss has many causes. The most common type of hair loss after weight-loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes. Growing and Losing Hair Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states; anagen, a growth phase, and telogen, a dormant or resting phase. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase which lasts for about 100 to 120 days. Following this, the hair will fall out. Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include: High fever Severe infection Major surgery Acute physical trauma Chronic debilitating illness (such as cancer or end-stage liver disease) Hormonal disruption (such as pregnancy, childbirth or discontinuation of estrogen therapy) Acute weight-loss Crash dieting Anorexia Low protein intake Iron or zinc deficiency Heavy metal toxicity Some medications (such as beta-blockers, anticoagulants, retinoids and immunizations) Weight-loss Surgery and Hair Loss Nutritional issues aside, bariatric surgery patients already have two major risks of major surgery and rapid weight-loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into the telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss rarely lasts for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight-loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back. Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One would be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if: Hair loss continued more than one year after surgery Hair loss started more than six months after surgery Patient has had difficulty eating and/or has not complied with supplementation Patient has demonstrated low values of ferritin, zinc or protein Patient has had more rapid than expected weight-loss Other symptoms of deficiency are present Nutrition Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40ug/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemia, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after bileopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high dose zinc supplementation as a therapeutic agent for related hair loss2 in patients with vertical banded gastroplasty. The study administered 200 mg of zinc sulfate (45mg elemental zinc) three times daily to post-operative patients with hair loss. This was in addition to the multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies, and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus we cannot say that zinc would prevent hair loss after weight-loss surgery, and further study would definitely be needed to make this connection. A further note: The Tolerable Upper Intake Level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60 mg/day. Information related to this study has made its way to many a support group and chat room – even to doctor's offices – with the message of "high dose zinc will prevent hair loss after weight-loss surgery." Patients should be advised that high dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen or prealbumen. Limited studies suggest that patients with the most rapid or greatest amounts of weight-loss are at greatest risk.3 With surgical reduction of the stomach, hydrochloric acid,4 pepsinogen5 and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion, rather than malabsorption, is responsible for most cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2 grams of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Many individuals believe that supplementing with or topically applying the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include vitamin A, inositol, folate, B-6 and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS) and is influenced by genetics. Conclusion Hair loss can be distressing to bariatric surgery patients and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is mostly likely caused by surgery and rapid weight-loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value. About the Author: Jacqueline Jacques, ND, is a Naturopathic Doctor with more than a decade of expertise in medical nutrition. She is the Chief Science Officer for Catalina Lifesciences LLC, a company dedicated to providing the best of nutritional care to weight-loss surgery patients. Her greatest love is empowering patients to better their own health. Dr. Jacques is a member of the OAC National Board of Directors.

This is the only WLS group I participate in here on the Bariatric Pal forum, so I have no other experience with it.

I find that the "corn" chips are way better than the "potato" chips. I can't wait to try these. I ordered a sample pack off of Bariatric Pal.

Thank you for your kind comments. It’s been a heck of a month. I’m Glad I verbalized what I was thinking because it seemed to open up a gate. After I posted, I downloaded a journal app and I made four huge entries. I’m seeing my surgeon tomorrow for follow up and I will address what happened with him and see if he has a therapist that specializes in both grief and Bariatric surgery follow up. I have been blocking my grief this past month because my daughter had become dangerously depressed and even expressed a desire to die. I was keeping myself from feeling everything fully in order to care for her. I will take care of myself from now on. I will also stay engaged here on the forum so I can stay focused on my own journey after surgery. I think it will help me a bunch. So appreciative for this place. Thank you all so much for the kindness.

Looking for recs for dietitians and therapists who specialize in bariatric patients in Austin, TX. Anyone like theirs?

I use BariatricPal Multivitamin ONE “1 per Day!” Bariatric Multivitamins from https://store.bariatricpal.com/collections/bariatricpal-multivitamin-one! BariatricPal has a special offer where it’ll cost you only $99 for an entire year supply! Check it out at https://store.bariatricpal.com/99 With just ONE convenient & affordable BariatricPal Multivitamin ONE each day, you can get the bariatric vitamins and minerals you need to stay healthy! BariatricPal Multivitamin ONE was designed and developed by a team of the world’s leading Bariatric medical professionals. Please take a calcium supplement separately to prevent interference with absorption of iron. You can view a large selection of bariatric friendly Calcium supplements at https://store.bariatricpal.com/collections/calcium. You can also find many other brands of bariatric multivitamins at https://store.bariatricpal.com/collections/multivitamins.

here are the American Society for Metabolic and Bariatric Surgery guidelines. They list what supplements all WLS patients should take, as well as those specific to each surgery (they call the sleeve "SG" or "LSG" here) you don't necessarily need bariatric-specific vitamins, although they do make things a bit easier. But any vitamin routine is fine if it fits into these guidelines. I've never used bariatric-specific vitamins. My multiple vitamin is just two Centrums (or the generic version of Centrum - both CVS and Walgreens have them - as well as some other places). I then take a few single-vitamin supplements that are required for RNY. https://asmbs.org/app/uploads/2017/06/ASMBS-Nutritional-Guidelines-2016-Update.pdf?/app/uploads/2008/09/asmbs-nutritional-guidelines-2016-update.pdf

I'm 4.5 years out and completely stopped taking my vitamins. I have no idea why, just a fact. I had the sleeve. The last time I got some they were different brands that I just picked up at Walmart. So not even sure if I got the right ones. I would like to purchase them through here so I know that I'm getting actual "bariatric" vitamins. But I don't even know where to start or which ones I need. I remember taking a daily, a B12, calcium and I don't remember what else. Any thoughts on where to start? Thanks!

Can we have protein soups in the first two weeks if we strain them? I tried a few from a bariatric liquid diet and I like them WAY more than shakes. https://www.nashuanutrition.com/collections/high-protein-soup/products/healthsmart-soup-chicken-bouillon-7-box

That is really helpful, thank you for sharing your experience. Over about a week my pains subsided and kind of moved around. After talking with a nurse and a few other bariatric patients I assumed it must be gas since it moved slowly. Now it's mostly gone, but im having a really hard time getting enough water every day. Different day, different challenge 😄 I hope you get comfortable and your gas pains fade quickly!

Any bariatric specific vitamin is a safe choice since they are formulate for the WLS community.

@rtl1234 Aw thanks! Today was better. Head hunger is a real thing! Woo. And to make you feel better, yes. I am still seeing what satisfied and full feels like. I’m not sure how to describe it, sometimes I’m like “Oh man, I have to eat now because I feel sick with hunger” or I will not feel hungry at all. Or I just feel like “Okay, so that was 1.5 oz” but I don’t feel full. That was until I accidentally drank some water then I felt that lump and kind of bad after I ate fast. I feel like most protein I eat sits kind of heavy. Not sure why. Do you have a hard time falling asleep? I do and my counselor (who is a bariatric counselor) said it’s normal. It even says it in my book from the hospital. I went from being sleepy all the time to not. My counselor said it was because our metabolisms are revving up. Not sure. Going to try to sleep now. :)

Hi I haven't been on one of these forums in a looong time. I had a sleeve done in 11/2010. It has gone well and MOST of the time I hovered between 185-210 (which was fine with me as I was nowhere near my high of 300). about 1.5 yrs ago I started having trouble keeping some foods down...I figured I was just eating too fast or too much. I was losing weight but not too fast. I had post-menopausal bleeding in 12/2019 so we did the whole cancer check thing (esp with the vomiting becoming more of an issue). Everything came out fine so I was referred to a GI who found a hernia. Had this repaired in 6/2020. Since then I have done well to keep anything but liquids down. I had an upper GI done and my stomach is the shape of a barbell. (1/3 normal sleeve, middle 1/3 severely narrowed, last 1/3 normal sleeve). Referred to another GI who did another EGD and colonoscopy and found I had almost a complete blockage in my stomach (11/2020) (he also got a good view of how I look like skin and bones without clothes which I think REALLY concerned him). He sent me straight to the ER to be admitted and I had surgery 2 days later which ended up being them taking the scar tissue that was wrapped around my stomach out. Still no improvement. My new GI had his nurse call me because he wanted to have an appointment (12/28) and see how I was doing post surgery (5 weeks out). He immediately ordered ANOTHER upper GI (12/30) which looked exactly like the one from October. We discussed going to a different surgeon and I picked a new bariatric surgeon (I tried a few but they wouldn't take me since they didn't do my original surgery in 2010 and the one who did is no longer in network). Once the surgeon saw my upper gi results he had his nurse move my appointment up a week. (1/5). My GI sent a message to the surgeon prior to my appointment so he had a heads up about me. First he wasn't happy I hadn't been referred earlier to him by my first GI. He said there is no fixing the middle part of my stomach and the only thing to do is revise to an RNY. He wants to do it as soon as ins approves. (Today I spoke with them and it is marked high priority and I should have an answer by tomorrow). I made sure they knew I could only keep liquids down and it had been thing way since June. I also mentioned I have gone from a size 14/16 in Dec 2019 to 4/6 now. (I just bought a size 4 straight skirt and it fits perfectly). I have a TON of loose skin but clothes hide it. In July I just bought a new bra 36 B now I am a 32A. The guy on the phone at Aetna took these notes to add to my file in addition to the ones my surgeon sent (the upper gi series, etc). Originally my file wasn't marked high priority until someone on the clinical team looked at it. SO, now you have my LOOONG backstory. I am kind of scared about the RNY. How is the recovery? This will be my 3rd surgery in 7 months. My body has not been getting the calories it needs for quite a while now (even protein shakes take a long time to get through). It's actually probably a miracle that I am still able to function as well as I have been at work. All of the covid changes have been kicking my rear but it has been a very productive year for me despite this whole mess. Thankfully I have an amazing admin assistant and colleagues who have been pitching in here and there to help when I absolutely needed it...but I am a workaholic so I have taken very little time off for recoveries. What can I expect of an RNY rather than the sleeve? Has anyone had any complications like this so far out from the original surgery? Obviously I am not doing this to lose weight...I am actually doing it to gain weight. This has really been crazy mentally after all those years worried about losing weight. sorry for the book. I would love input from anyone :)

Well, I did it. Instead of waiting for approval from Aetna, which I heard can take four to six months, I thought I would just do it now and see if I could get a jump start on my weight loss during Covid times. I booked today with Blossom Bariatrics for the end of February. I can't believe I am doing this! I have researched and researched but I just don't want to wait. Let's get this DONE!!!

I don’t have a history either. I believe He said Bariatric patients are more likely to have clots. He just called to check in on me. “All is well!!” So glad. No nausea after surgery bc I asked them not to give me gas. Makes me super sick. They just did IV drugs to keep me asleep. Think I’m the Anesthesia world it’s called TEVA.

This is what I posted in the post op section. I have to say, being day 3 after surgery I have asked myself a number of times what the hell have I done....then I have moments of comfort which removes all concern. It took me nearly 12 hours to come out of the anaesthetic properly, and I had the awful sweats and nausea, but no vomiting. I remember only the Ice packs put behind my shoulders and the cold towel on my head.....ooh it felt so good. The nurses were just smashing and I'm going to send a thank you hard to them at the ward. I came home the day after surgery. I've had two bad nights, but last night felt so much better and slept 8 hours straight. I am already 4kgs down since surgery so that gives me hope. My first night home I was worried about my intake of Fluid. I struggled to consume even one cup of liquid a day. Yesterday I got through an entire Optifast shake, one cup of warm coffee, and about 500ml of Powerade zero. What has worked for me through trial and error (haha that auto corrected to "terror") 1. Don't drink laying down. Try and sit upright as possible, it reduces the chance of pain. 2. Small sips mean exactly that. Wet the inside of your mouth, and don't do more than two at a time. 3. Room temperature liquid gives me less issues 4. Make a shake in the morning and aim to complete by midday. Same for the afternoon 5. Keep on top of standard pain relief. Here in Australia we have panadol which is safe for bariatric patients. I tried dissolvable ones but the contain effervescent bubbles... not a great outcome 6. When pain is felt, stand up tall, take s deep breath through the nose and slowly out through the mouth. At most it has been two breaths and the pain is gone 7. A cool shower, clean hair, clean jammies and clean sheets make everything feel better [emoji16] 8. My headaches are likely to be caused by coffee withdrawl. I added 1tsp instant (powdered) coffee to a choc or vanilla shake. Voila!! Headache gone Just my thoughts, and hope some of these ideas can help others just having had surgery. Day 1 I was 7/10 discomfort, and full of unfounded regrets. Today, day 3, 1/10 discomfort, totally happy with my decision to have taken this route. How are you all doing? Sent from my SM-G950F using BariatricPal mobile app