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@SpartanMaker thanks for sharing I enjoyed this read and I'm glad you viewed happenings with a Renewed mindset. @Janina__sleevingitallbehind alright now 💪🏽💪🏽💪🏽. You go major win!

I don't know if this is a win, but there is a podcast called "isnt the stall the point" ... to me at some point weight stalls should be the point. I've noticed in the bariatric community that some are never satisfied and steady strive for more. I certainly won't be living my life like that. So my win is I stalled for six months, which I was fine with but at my breast augmentation appointment my weight had finally broke the STALL. I am finally 7 pounds from my goal weight in which the STALL and living my Life in Maintenance will be the point. 💪🏽

I had VSG in 2013. Lost 110 lbs. felt great! I was able to do things I hadn’t been able to do in years. I maintained my new weight for about 5 years. Then gradually started slipping back into old habits. Now here I am, 12 years later and I regained about 80 lbs. I feel so defeated. But your post and the progress you’re making gives me some hope and inspiration. I started doing the “pouch reset” and I’m going to try and immerse myself in the Bariatric community, like I did when I first had the surgery. The support is what helped me maintain my weight as long as I did. But I’m back now and ready to put the past behind me. Thank you for helping me to feel less alone in my struggle.

Wow so restrictive on the veg, did the doctor tell you why? I have never heard of that before, I was made have veg from day one on liquids by way of soup. If your bariatric team are not going to allow you veg (fruit I can understand being a no) then surely they should provide you with a bit of a menu guide, my team gave me recopies and food lists for each stage, and veg and even fruit were allowed throughout by way of a slow reintroduction. In the puree stage I had a homemade bolognese (though it had tomatoes and bit of carrot) and chili con carne (again has tomatoes but pureed right down so might be ok for you depending on why you are so restricted) and the kidney beans are a good protein, dhal. What about some hummus, can get different flavoured ones to kick up the flavour a bit? Omelets that you can then add seasoning/spices to?

For me, it may have been 5 or 6 days, but like you said, everyone is different. Also, in terms of the gas bubble feeling you have mentioned a few times, that IS NOT surgical gas. The gas used during surgery is not inside your digestive system. It's in what's called the peritoneal space. This is used to allow the doctor to help visualize all your organs. My point is that's not what's causing your gas bubble feeling. I can't say I actually experienced that feeling, but it makes be wonder, are you drinking with a straw? Typically using a straw is a no-no right after bariatric surgery because it can cause you to swallow air. Since you have such a limited amount of space right now in your stomach, We don't want any air in there.

Sorry you are in so much pain. I have a B12 deficiency (pernicious anemia) and a some of your symptoms are what I suffered from before my diagnosis and now when my level starts to drop, though I was diagnosed about 12 years ago so way before my WLS. My anaemia cannot be managed through oral supplements or food (as my body does not break down the B12 sufficiently) but the bariatric multivitamin I take daily and dairy products do help maintain my levels in addition to regular B12 injections (every four to six weeks). I think getting a B12 supplement and multivitamins should be top of your list, if you don't already take them but obviously that is not going to solve all the issues you are having with hernia and such. Make sure you get an appointment with the bariatric team to discuss everything with them and request full bloodwork and then also keep the appointment for the ultrasound etc. Hopefully you will get some answers soon that result in a course of action that will treat the cause and end the pain.

Oh wow, yes a serious B12 deficiency is a big deal, but I'm a little surprised for it to show up 11 years later? Also, did your other doctors not do any blood tests? A typical blood test called a comprehensive metabolic panel (CMP), is really common and should have shown a B12 deficiency if you have one. A B12 deficiency is fairly rare in most developed countries because B12 is found in high quantities in meat and dairy. For obvious reasons, it's more common in vegans, though most vegans know to consume foods high in B12 or to take a supplement. Speaking of supplements, are you not taking a multivitamin? Really everyone should take one since there's very little downside compared to the risks involved in vitamin & mineral deficiencies. Bariatric surgery patients especially should do so for a lot of reasons. If you really think this might be your issue, go pick up a multivitamin from the store and start taking it ASAP. You could just get a B12 supplement, but it's potentially possible it's something else, so a multivitamin should cover more potential deficiencies.

I called a bariatric place to try to get in with them. I think I might have a B12 deficiency. I have all the symptoms including pins and needles in my hands and feet. I read that its common with WLS to have that. I just didn't know it could cause so many issues.

Sorry you're having such a hard time. If you do have a hiatal hernia, that could account for the pain you're having? I think the critical thing is how quickly you can get in to see someone because if you have a hiatal hernia and it's causing you this much pain, it's probably going to require surgery to address it. That said, it's important to go through the process of differential diagnosis to rule out other causes. Gastroenterologist are well positioned to help you through the process regardless of what the issue is. On the other hand, a bariatric surgeon may also be able to accurately diagnose the issue and potentially even do the surgery, whereas a gastro will typically refer you out to a general or thoracic surgeon. It's a tough call, honestly. I think your instinct to seek out a bariatric center is a good one and the best course of action is to go down both paths for now until you know for sure what's going on and have a treatment plan in place.

I haven't had any issues with my sleeve. Out of the blue about a month ago I had what I thought was the flu, didn't throw up but had bad nausea and intestinal pain. Then I went to urgent care and they said I was dehydrated and gave me Zofran. I thought I was doing better. I was at work and had excruciating pain in the top right of my abdomen. And then it stopped. The next day I was so tired. Had brain fog. Could only eat soft bland food, lots of intestinal pain. I went to the ER 8 days ago and they said that I had a hiatal hernia and gave me more Zofran and bentl. And they just said to follow up with the gastroenterology department. They did a CT and found a teratoma on my ovary and my main dr said that that is what is making me so sick. I went to the gyn yesterday and he said no way this thing is making you so sick and said I should get a vaginal ultrasound which I can't get for three weeks. I had to apply for short term disability which isn't going to pay the bills. My main dr said to get in with the GI department and they sent in a referral. I don't live in the same city where I had my surgery. I'm wondering if anyone has had symptoms like this so far after surgery? If I eat or drink anything that is spicy or acidic or has a lot of fat or fiber it hurts so bad. My whole abdomen feels swollen. Even when I eat soft foods it hurts my whole abdomen. I'm fatigued, I have brain fog, I have a headache every day, it hurts to bend over to pick something up. I cry almost every day because I can't do anything and there are no answers. Maybe I should try to get into a bariatric practice here?

Not from the U.S. I'm from Canada. I might meet the criteria given my co-morbid factors but here they generally do it on a BMI greater than 35. I am currently trying to get a referral to a bariatric center.

I differ from what SpartanMaker says, I wouldn't try any more of the options that are out there. Obviously you first need to recognize that obesity is a disease and it never goes away. You tried to starve yourself to death and the body will automatically save every morsel you put into your body and store it as fat, especially on a 300 calorie diet. Increasing the calories is not necessarily the fix either, you need to look at the foods you are eating. Is it protein heavy or are you still eating salads, which are carbs by the way? Are you thinking that a baked potato is a veggie, it is not it is a carbohydrate, then add all the stuff you put on the potato. Diet wise, you may be choosing the wrong foods. And certainly the amount. You passed out probably because your glucose levels went into the basement with such a low calorie intake. I agree with SpartanMaker, and seek out a Bariatric center that has a whole host of options. Surgery is a tool that the obese person uses and it is a life long commitment to make lifestyle changes. You may need to see a therapist and nutrition expert both to help you, and maybe they have other options other than going straight to surgery, but for certain I feel you need better education on what is an appropriate "diet", and not all "diets" are really diets but ways to spend more money that is just wasted. You obviously have the willpower and stamina to take hold of a new life, it won't hurt to inquire. I would also urge you to watch some of the YouTube videos from BariNation, they have Podcasts with bariatric physicians and other healthcare providers every week and most recently there was discussion about Obesity being a disease and using something other than weight or BMI (Body Mass Index) to determine if someone is obese. My plan has always been to go the cautious or conservative route first. In my case I jumped right in and happy for it. I had an excellent surgeon and team that all worked together to ensure I had a good experience and did. Never had any pain with my surgery, and have had good results so far and today is Post op week 3, day 1. I wish you the best in your journey to seek out further information and a good bariatric group!!

At the end of the day, no one here can tell you if it's right for you. Keep in mind that obesity is a disease and it definitely needs a treatment plan, just like your other conditions. The right treatment for any given person varies based on a lot of factors, so don't automatically decide yourself what the right treatment should be. The best thing for you to do is seek out a GOOD bariatric center that has lots of options available to you and not just surgery. Personally, my gut tells me that it's too soon to go this route since obesity is such a recent issue for you. I'm not a doctor, and certainly not a bariatric surgeon, but just thinking through how recent this obesity disease is for you, I personally would want to try some more conservative treatments first?

I'm team both? My diet mantra is 80/20. What I mean is: I try to focus on getting ~80% of my calories from minimally processed foods. (AKA, I try to eat clean.) I don't really track this, I just focus on making good food choices when I can. I try to eat a wide variety of foods, so nothing's off limits. To me, there are no bad foods, there are just some that provide more nutritional value than others. Plus, the more variety i have in my diet, the better overall nutritional profile I'll have. I try to shoot for 80% of what I eat being things that have a bit more nutritional value. For example, most of the time, I might pick spinach or kale over lettuce. I eat carb centered. It's not quite 80%, so my mantra may be a bit off? I suppose between carbs and protein, it probably is 80%, so I'll settle for that. I know this one will be controversial here since the bariatric dietitians push protein so heavily (and don't misunderstand me, protein is critically important), but as endurance athlete at maintenance and 2.5 years out from surgery, I need more carbs than I did during the weight loss phase. Critical to the above is that I don't obsess over any of it. I guess my point in the above is that if you're trying to determine the "best" protein source, maybe the real right answer is there is no best. Once your body starts breaking down the protein you consume into the component amino acids, your body doesn't know where those amino acids came from. The advantage of not focusing on just one source of protein is that there are vastly different micronutrient profiles across foods. The more variety you eat, the better off you are nutritionally.

I got several boxes that are for Bariatric patients that have 3 compartments, one for the big protein and then the other two for veggies/fruits and carbs. I go to work with one for each meal every day I go to work and I have what I am allowed to eat and that's it. When it is gone, it is gone. If I get hungry later, I may have a snack and that snack is a Protein shake. I like Premier Protein, and through Amazon you can get the variety pack and they have "sweet" ones that curb the urge to go to any vending machine or reaching for the chocolate on your bosses desk. Or mine. I prep for the whole week on Saturday and Sundays. I will bake chicken and then weigh out the appropriate amount of chicken and put it in the box, then the veggies and then the carb. I have them stacked in the fridge so when I pack my lunch, I just grab one or two and 2 Protein Shakes and I'm set for my long day. Hope that helps!

Yes, I already have my food plan for my 2 week post-op period as well as the 6 week period after. My bigger worry is the full Bariatric diet while I go back to work and making sure I can stick to something tenable.

Did you have any psychological input during your Tier 3? (I don’t know if you had to go through Tier 3?) I had about 4 sessions with an NHS bariatric psychologist, but I believe I’ll still be having a Tier 4 psychological consultation to sign me off 🤞 for the MDT. Also, two weeks post-approval for the LRD! That is AWESOME! I think my trust tends to do the two-week milk diet. Even though I currently eat fairly low calorie keto, I think the milk diet would help lose a bit of pre-surgery weight at least. 💗

Hello, Wendyjane! The NHS is the National Health Service - socialised tax-funded medical care provided in the United Kingdom. The tier system is basically various levels of care for varying conditions. For those seeking weight management help through the NHS. Google AI summarised it really well for me: Hospitals are grouped into governing bodies (trusts), and each trust, I believe, decides how to invest in the tiers, which in turn impacts just how much and what kind of support is given. For example, when I went through Tier 3 in my trust, I was given 1:1 virtual support (zoom meetings) once a month for a year with a nutritionist to help me implement healthier lifestyle changes, and during that time, I also met with an NhS psychologist for 3-4 months to work through any issues I may have regarding food and mental health. I really enjoyed the support I received from my Tier 3 programme (“Weigh Ahead”). I was also held accountable for my weight, blood pressure, and body measurements. Tier 3 aims to help you lose 5-10% of your total body weight in order to be referred to Tier 4. The current Tier 3 service in my trust now allows patients to receive prescriptions for Ozempic and Mounjaro to help with weight loss. (I’m sure you can imagine I was sorely sad to find out I missed that opportunity! Whereas I think the injectables will be available to me only in Tier 4 and from the bariatric surgeon?) Also, in Tier 4, if you so desire to go forward with bariatric surgery, then you have multiple appointments with various consultants: the bariatric dietitian, bariatric nurse, bariatric psychologist, the anaesthetist, and finally the surgeon. Once your appointments with each of these completes, then they meet together as a “Multi-Disciplinary Team” to discuss each case and decide if that patient is a good candidate to go forward with surgery. If yes, you’re then placed in another waiting list. According to my trust, I am not meant to gain any weight from the time of my Tier 3 referral until surgery. This has been really, really challenging… and at times, frankly speaking, exceedingly discouraging. I hope this helps as an explanation. ☺️

Hi, NeonRaven! Thank you so much for your reply and sharing your experience! I find it so helpful to hear how other NHsers have experienced the process since it seems so much more elongated from the U.S. process. And you make such a good point about the London privilege - now it makes more sense why I’ve seen more internet presence and response from London NHSers. (And quite a few from the far north of England as well!) About three or four years ago during my annual diabetic review, my nurse had suggested bariatric surgery and that gave me a lot of hope - she was able to refer me for Tier 3. I had my dietitian appointment yesterday and it went really well! It was about 30 minutes and went over the Tier 3 lifestyle changes, continued lifestyle changes (balanced meals, regular exercise, blood sugar monitoring, weight maintenance, etc), medications, and then any questions I might have. She was very positive and said she would be recommending me to go forward for surgery when the MDT meeting happens 🥲 (once I meet with the next consultants - psychologist, anaesthetist, bariatric nurse, and surgeon - how soon? No one knows.) Needless to say, I am so relieved, so happy, and so excited to be moving forward even if it’s one step. I’ve found out that my hospital trust now does their “one-stop” clinic as separate virtual appointments, rather than in-person. (So, perhaps it will be quite some time before that MDT meeting?) And then the endoscopy and ECG will be done at the pre-op assessment once a surgery date is confirmed. I am so glad to hear your NHS experience has been so good and positive. I am so sorry to hear about your mother's complication and her passing, but it is so hopeful to hear she was able to put her diabetes into remission (that’s one of my big hopes!) Congratulations on your weight loss and wishing all the health and success! 💕 PS - funny enough, I have not had any group sessions whatsoever in this process. I am wondering if I’ll have a group session with the bariatric nurse?

I recently came across this expected weight loss calculator/predictor: SOPHIA Bariatric Weight Trajectory Prediction. Thought it was pretty neat! Sounds like you’re off to a great start!

Good point. People need to be careful when making comparisons. The good news is (at least in the US), as long as you look at the "Iron" content on the supplement label. it's all been standardized based on the elemental iron amount. In other words, if it lists Iron specifically, even if it has the source listed in parentheses (ferrous sulfate, ferrous fumarate, ferrous gluconate, iron carbonyl, etc.), one listing of 45mg is roughly the same as any other 45mg listing even if the sources are different. This is required by US law. Now there are individual differences between people in terms of how well we absorb iron from various sources and as I mentioned before, all bariatric surgery patients don't tend to absorb iron as well as the gen pop. That said, I'm not sure any of us will know how well we absorb iron from these different sources unless we're doing frequent blood tests and trying various forms. For most of us (as has already been said), the most important thing is to get regular blood tests and not to make any changes unless directed by your doctor.

For anyone that may be confused by this thread, here are some things to think about related to vitamin supplements: The most important thing is to follow your doctor's recommendations. All bariatric programs I've seen have specific recommendations and you would be well advised to follow these. The vast majority seem to recommend a bariatric specific vitamin supplement. Some may also recommend specific brands of over-the-counter vitamins as well. That said, at least from what I've seen, typically when recommending over-the-counter options, they will suggest taking these twice a day (AM & PM) instead of just once. There are a few reasons for the above recommendations. First of all, you'll be eating a very low calorie diet and thus vitamin supplements formulated for "normal" people may not be sufficient. Also, while malabsorption for bypass patients is a concern, sleeve patients aren't immune to reduced absorption. Some vitamins & minerals are dependent on stomach acid to be properly absorbed. Since all WLS patients will have reduced stomach acid production (at least for a while, if not forever), higher than normal amounts of some vitamins are needed. From a cost perspective, yes, bariatric vitamins tend to be more expensive, but if you have to take twice as many of an over-the-counter supplement, the costs aren't very different after all. Especially if you take advantage of subscriptions like those offered by sites like bariatricpal, the cost of a good quality bariatric multivitamin isn't that much. Keep in mind your food bill should also drop, so at the end of the day you should still be spending less per month. If for some reason you still think vitamins are just too much for your budget, please discuss this with your surgical team. They may be able to help you find a less expensive option that still meets your needs. It's never a good idea to make decisions that can impact your health simply based on things you may have seen on the web. Aside form the cost concerns I mentioned above, there is very little to no downside of taking bariatric specific vitamins, even though some have really high levels of certain vitamins. For some specific vitamins, there is no established upper limit, meaning there's no health risk in taking too much. If you take in more than your body needs, then you'll just safely eliminate the excess. Yes, there are established upper limits for a few vitamins & minerals and this is taken into account in the vitamin formulation. Iron, is an example. The established upper limit is 45 mg/day, which is also the max you'll see in most supplements. Keep in mind this upper limit was established because some people had digestive upset at higher doses. You'd have to take considerably more than 45 mg/day to actually have a significant impact on your body. Further, remember when I said that some vitamins & minerals need stomach acid to be properly absorbed? Iron is one of those, meaning that you're probably not actually getting a full 45 mg/day dose as a bariatric surgery patient. Regardless of which surgery you have, you should be getting regular blood tests for life that check for nutrient deficiencies. if you don't get these from your surgeon (for example, you went out of country for surgery), then please get them from your primary care physician. This is really important because some studies have shown up to 30% of WLS patients end up with nutritional deficiencies post-surgery. Don't be a statistic. Human bodies are not all the same, nor are our diets. This means one person may be successful stopping vitamin supplementation, whereas someone else that had the exact same surgery from the same doctor won't be able to do that. Please don't decide what you should do based on another person, even if it's your best friend, a family member, etc. Only with your doctor's blessing should you consider changing or stopping your vitamin supplementation routine. Regardless of which surgery you have, there is a real possibility you may need to take at least some form of supplements for life. The effects of nutritional deficiencies can be severe, so think of your vitamin supplements as insurance against potentially debilitating or even life threatening problems. Best of luck.

I have been keeping up with this thread and vitamin supplements can easily be confused. I can only tell you what I know. I took advice from my surgeon's team, including the nutritionist. Initially I was told to take 45 of iron, then later to take 18 due to my age and being post-menopause. I was also told that the over the counter medications for the multivitamin may not be enough as the bariatric vitamins. Bariatric vitamins are specifically made for the bariatric patient, so it follows the ASMBS standards usually, but you need to look at the "fine print" and look how many mcg, mg, IU, etc of each of the vitamins are in each of the multi-vitamins. Iron, B12, B50, B1, Calcium etc. should be based on your surgeon's recommendations. I have had the RNY Gastric Bypass 2 weeks ago, and I had options to choose from regarding my vitamins, but I followed what my surgeon's team recommended. At my 1 month appointment I am to bring my vitamins with me for the nutritionist to review, and to ensure that I am taking what I am to be taking. As for what is considered a by pass and what is not....Sleeve is not a bypass, but it is the first part of the SADI. That's all I know because a SADI patient told me this. Otherwise, I don't think it matters. I don't like to get into arguments online. I wish you well as you determine what vitamins that you should be, or not be taking.

First, remember that you're not on your own here -- it's your doctor's job to look at your test results and determine whether there's any cause for concern. It's also important to keep in mind that you are now a bariatric surgery patient as well as someone who is recovering from surgery. This means you have abnormal circumstances, so it is very common to have "abnormal" results for some tests. My surgery was almost 5 years ago, so I don't recall specifics, but I do know that I had some "abnormal" results after surgery that were expected because I was recovering from surgery. Another example is that my B12 levels are always sky high, but that's because I take a daily B12 supplement. I've found that ChatGPT can be helpful in explaining test results. You can upload a screenshot of your results and ask for an interpretation, and even give some background information (e.g., say that you had bariatric surgery 4 weeks ago) for more personalized results. It can also give you some questions to ask your doctor about your results. This should go without saying, but I'm going to say it anyway: obviously, ChatGPT is not a substitute for your actual surgeon, so you should only use it for information purposes, but it can still be really helpful to understand the implications of some tests and prepare you to discuss with your doctor.