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JessiL--I'm writing to you as Brian88ss' wife. I'm 14 months out from my VSG (sleeve) surgery. Your post has struck a major chord in me. I've lived with anxiety my entire life, and it became acute in 2012. I sought help through I psychiatrist and counselor. I also live with chronic arthritis pain that I was told would be greatly reduced by several physicians (hasn't happened), which has really ratcheted up my anxiety. One of my friends, who is a psychologist (not the one I see) said, "when you live with anxiety, there's good news and bad news-the good news is you're going to live. The bad news is, you're going to live." I am working on something called mindfulness meditation (living with the anxiety and pain, but putting it in the back of your mind-like the needle on the record is down, but you don't have to always listen to it." I also switched from Xanax to clonazepam (which is like a longer-acting form of Xanax). That being said, I know that our population (bariatrics) is at a huge risk for cross-addiction (alcohol, pills, shopping, gambling, etc.) and I struggle with tension headaches, for which I take a medication that has a sedative in it (I have noticed myself using it more recently, so I know the anxiety is ratcheting back up ). What I do know, is there's hope. NEVER give up hope. You had this surgery to improve and extend your life (I have to tell myself that lots). I also know that one of the best anti-anxiety exercises out there is exercise. I'm not even talking anything hard-core, even getting outside for a walk can help (I know this because I use it as one of my tools to deal with what my friends and I call "the big A." When my husband read me your post, my heart totally went out to you. Please know there are people out there who care about you (and they are people you may not even know!). This is going to sound really weird, but I'm going to try something new-adult coloring books (you can find them on Amazon and if you have a Prime membership, you get a discount and free shipping. My online anxiety group has been raving about them, so I thought it would be worth a try. Remember that you are special. You have a purpose in this life. And you are the only "you" in this world. Thinking of you and sending you hugs and good vibes. If you want, you can message me through my hubby-I'm trying to limit my time online right now, as that might be a contributing factor to the increased anxiety. Please do take care and know that you are not alone. Julie

While I am not a healthcare provider, I work in liver disease. The goal of the pre-op diet is to help shrink the liver and alcohol is the worst toxin for the liver (and causes inflammation of the liver). I hate to tell you this but I'm worried that drinking could affect your liver and therefore the ease of surgery. I'm not saying I was perfect on my preop, but I was really careful the last two weeks and my surgeon said that he could tell by my liver. I don't envy you, this would be a tough decision for me as well. Best of luck

Have you ever been to an AA meeting or are you worried that showing up will risk your reputation? I would suggest at least trying it once. It may help you to talk about your struggles as you go through your transition into sobriety. Don't be afraid that they will judge your weaning process. It's not something you have to share. Sometimes it helps to take what you find useful and leave the rest. I've always found group settings to be more useful than talking to a therapist. Cognitive Behavioral therapy is also useful for people recovering from any addiction (food, alcohol, illegal substances) because you learn preventive strategies. You need to have a plan in action in case severe stress, anxiety, or depression arises and it becomes terribly challenging to turn away from alcohol.

This was sent to me in a private message by one of our members who wanted to stay anonymous but thought the information might be useful to other BariatricPal members: "Alex, I realized my drinking was getting excessive. Particularly when I woke up with my hands shaking. It was quickly going from drinking after working out, to wanting to take nips to quiet the nerves during the day. There are two schools of thought out there when it comes to alcohol - the AA/total abstention model and Harm Reduction model. In my typical fashion, I started researching it and realized that sudden withdrawal could be very dangerous. Just stopping drinking if you have been doing for an extended period of time can create bad withdrawal symptoms, the worst being known as Delirium Tremors (DT's), but it also can spike your blood pressure, elevate heart rate, night sweats. If I went into a medically supervised system, my options all involved sudden withdrawal with benzos and other anti-anxiety drugs. And at the same time you risk loss of professional licences, reputation, gun rights etc. Not a great solution to a problem. And it is a problem. Not only is it stalling my weight loss, but if I was in a accident, the hospital is not going to bring you a bourbon as medicine, instead you get to go through DT's. So I didn't want to risk being dependent on alcohol, the dangers are too great. Then I found these articles: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0022994 https://hamsnetwork.wordpress.com/2010/10/09/more-on-tapering-off-alcohol/ One of the benefits of controlled tapering of alcohol is avoiding a syndrome called "kindling." Some people who have repeatedly gone through cold turkey withdrawal without tapering off become more and more likely to have bad withdrawals from even small amounts of alcohol. This phenomenon is referred to as "kindling". People who have undergone kindling can suffer withdrawal seizures from drinking as little as a six pack of beer. Some decades ago some detox facilities forced clients to undergo cold turkey withdrawal to "teach them a lesson". Not only did this fail to stop people from drinking, it resulted in many people suffering from kindling. I used this system over three days and the result was a controlled landing. I've now been able to go through the last week alcohol-free without really bad withdrawals. Can't say it wasn't without discomfort. It did goof with my sleep and I have been agitated and muscles are a little sore, but it was bearable. Used a portable breathalyzer to monitor my BAC and home blood pressure monitor to make sure nothing spiked. My goal is to stay alcohol-free for the next month and re-evaluate. I need to re-learn my relationship with drinking, and make sure I bring my BAC down to 0 between drinks so I don't get back to that level again and make sure it is not an everyday activity. But that is my goal, not a recommendation."

Was wondering the same post sleeve. Not a heavy drinker to begin with, but it would be nice to have one here and there when I go to happy hour with my girlfriends...but fortunately I haven't craved alcohol one bit. I would, however, like to know. My doc suggested not to do it for one year, but I got the vibe that this was more about forming bad habits than causing damage to the sleeve/pouch. Although I know some bypassers can dump from alcohol, so in that case I would probably avoid it just to avoid the embarrassment of something going wrong in public. If you do venture out, maybe try at home first so you know what to expect.

Hey Molly! I did have my psych appointment today. Really no big deal. I had to answer some questions on paper that were looking for eating disorders and drug or alcohol problems. Also a couple questions on mental health stuff and how you have felt in the past week/month. Easy peasy and she approved me with no further psych stuff.

I had the psych eval and it seemed to go well...he told me to go to a support group meeting and call in when i lose the last few pounds. One thing that was a surprise is that he asked to speak to my therapist to ask about: 1. drugs and alcohol 2. eating disorders 3. contraindications to surgery I am completely fine with it, but didn't expect him to ask. Apparently it's policy if you have seen a therapist in the past 6 months. For the ladies who have had the surgery--- how long did the tiredness last? I'm 2 lbs away from pre-surgery goal weight and am trying to consider my clients when I schedule the surgery.

Sure some rules are pretty standard (crackers 4 days after surgery) but MANY vary by doctor and nutritionist simply because there are no controlled studies to back a lot of it up. It's what that doctor has seen provide their patients with the most success. Some plans advance faster than others. Some allow alcohol at a certain point. Some allow flavorings in the Water. THATS why we refer people back to the doctor and nutritionist that they chose, hopefully because they trusted that doctor enough to have surgery with them so hopefully they are motivated to follow the advice/plan of the doctor they trust.

Great thread. Here's my answers: What type of weight loss surgery have you had? Sleeve 1. How long have you been in maintenance mode? 7 months 2. What's your current height and weight? 5"2 120 lbs 3. How many calories do you eat daily (on average) to maintain your weight? I don't count or measure my food but I would guess around 1500 on a normal day 4. What kind of focus do you put on protein -- number of grams or anything else you want to say? I always have protein first and at least 60 grams but I don't measure it. I still have shakes and bars but only the one's I like. You still need to plan ahead and have protein snacks handy. 5. What kind of focus do you put on carbs - number of grams or anything else you want to say? I eat whatever is not processed in any amount. ie fruits and veggies I don't worry about. I do eat oatmeal almost everyday but I put in a scoop of unflavored protein. I find having the oatmeal keeps me regular. I don't do refined carbs unless it's a treat. I think someone else put on here they'd rather have a cookie than white bread. That's exactly how I am. Not wasting the carbs on rice or pasta. 6. What other nutritional tips / tricks are working for you that help you maintain? I try to stick to the basics. I take my vitamins, get enough sleep, workout, drink water, eat my protein first. 7. Which foods, if any, do you avoid altogether? Bread, rice, pasta, fast food, pop, alcohol 8. What exercise regimen (exercise types and frequency) do you follow? I workout everyday. It makes me feel so much better to start my day. I run 2x, spin 2x, weights 2x and do yoga once. I just did my first half marathon. I had the same workout program before surgery. I do it to be healthy not thinner. 9. What role, if any, has counseling or therapy played in your WLS success? Not much. I go to my sessions as part of my surgeons plan. I do love these boards that give me lots of advice and tips. It has helped me be successful. 10. What advice would you offer WLS patients to help them be successful? I don't weigh myself everyday but every few days to make sure I am not gaining. I stay within a 2 lb. range Be mindful of your weaknesses. Mine is sweets. I don't deprive myself but I also make sure to limit what I have or what's in the house. If it's going to be hard for me to resist it then I try to get rid of it. For example: I am fine with the chips ahoy cookies being in the pantry but if I make fresh baked cookies I usually put as many of them as I can in my kids lunches to get rid of them before I eat them all I think one thing that has really helped me is to truly think of this as a life style change vs a diet. I have to because 80% f my stomach is gone. In order for my body to run smoothly I need to eat this way. Remember none of us are perfect and none of us are the same so you need to find what works for you and stick with it. ~LA

Warning: this is more or less a variation on the never ending ‘should I tell a guy I’m dating’ & ‘how quys react to WLS’ theme, so if you are tired of that jibber jabber, move on to something else. I’m just 1 month out. I’ve recently met a guy and although I’m not exactly into dating at the moment, we immediately hit it off. So we went on a couple of foodless, decaf, non-alcoholic dates, and surprisingly had a lot of fun. Apart from me constantly having to come up with reasons for my unconventional dating behavior while still giving the impression of a sane person, of course. I hate lying on dates (not that I have moral issues, it just makes me more nervous), so coming up with answers that were truthful but wouldn’t expose the fact I had WLS has been EXHAUSTING. This is just a sample dialog: ‘Does 6 pm work for you?’ ‘Can we make it 7?’ ‘That’s fine. What do you do at 6?’ ‘I’m having dinner’ ‘Couldn’t we have dinner together?’ ‘I don’t think that’s the best idea’ ‘Why, do you have celery for dinner?’ etc. So yesterday he invited me over and it was all going very smoothly, except he kept offering me something to drink, and I just got tired of excuses, so… I told him I recently had the surgery to help me lose weight and I was in recovery, following a special diet. After a minute or two of what seemed to me like an awkward silence, ‘Ok. So are you allowed to have sex yet?’ Am I crazy to think out of all the answers he could have given, that one was actually pretty good?

@Amylou I'm with you! When they told us at Mayo - NO alcohol for a year, we knew there was research to back it up. These things are not said for no reason. That's why so many people regain their weight, say their surgery didn't work and go back for additional surgeries, etc. If we revert back to our old eating/drinking habits of the past, even in smaller portions, what results should we expect? It's a whole lifestyle change

FYI - Women are 2 x more likely to have addiction transfer to alcohol after WLS than men. My mom is a recovering alcoholic and she knows many, many women who had WLS and ended up alcoholic after surgery. Because I know I still have some addiction issues from my food addiction, I am in absolutely no rush to try a drink. I have no desire to go down another addiction to overcome.

The older I get, the longer it takes me to recover from drinking any amount of alcohol. I always feel like crap the next day. I'm inferring that RNY will just make all of that worse. Not sure it's worth it.

When counting carbs you subtract the sugar alcohols and the Fiber from the total carbs listed on the serving. And the fairlife skim milk is 80 calories 13g Protein and 6g carbs. And the whey protein only has 3 g carb per serving. Or course you could modify this as you choose. And only use one scoop. What I am trying to say is that adding even just a half of scoop and putting it in a blender takes away from the whey protein taste and offers an alternative. My mini meals never add up to more than maybe 200 calories so for Breakfast this is for me a great alternative. I still want to aim to get at least 800 calories a day as I'm not looking for a super fast weight loss..I have done competitive weight training in the past and am desperate to not lose muscle mass. So this is just a guide for those who are struggling. But all in all its still under 400 calories.

I ran across these tips a while back. Hope they help. Get my FREE eBook - The Top 10 WLS Fears and How to Kick Their Butt! Empowering Weight Loss Surgery newbies and veterans with confidence and knowledge to lose weight and keep it off for life 1. It is easier to get distracted from signals of physical hunger and satiety at social gatherings, especially if food is the main event. Make an effort to pay close attention to your body's signals. 2. Be a food snob. Skip the store-bought goodies, the dried-out fudge and the so-so stuffing. If the food you select doesn't taste as good as you expected, stop eating it and choose something else. Think of how much less you'd eat if you only ate things that tasted fabulous! 3. Think of your appetite as an expense account. How much do you want to spend on appetizers or the entree? Do you want to save some room for dessert? Go through this process mentally to avoid eating too much food and feeling uncomfortable for the rest of the evening. 4. Pace your eating prior to the event so you’ll be hungry but not famished at mealtime. But please, ignore the old diet advice of "eat before you go to a party so you won't be tempted." That is absurd! You want to be hungry enough to enjoy your favorites. 5. Socialize away from the sight of the food. People who tend to overeat are "food suggestible" so just hanging around food causes them to eat more than they need. 6. Survey all of the food at a buffet before making your choices. Choose the foods that you really want most at that time and remind yourself that you can have the other foods at a later time. 7. If the food is so special, give it your full attention rather than eating on autopilot. Eat mindfully by reducing distractions and sitting down to eat - even if it's just a cookie. Appreciate the appearance and aroma of your food and savor one small bite at a time by putting your fork down. You'll eat less food but enjoy it more. 8. If the food doesn't taste as good as you expected, stop eating it and choose something else. 9. Since the duration of the meal tends to be extended at social events, you may need to have your plate taken away (or put your napkin on it) once you are satisfied to avoid nibbling unconsciously. 10. Be aware of the effects of alcohol on your food intake. And don't forget that many beverages contain calories too. 11. Be cautious of "obligatory eating" - avoid eating just because it is on the table, on your plate, because you paid for it, it’s free, or because someone made it. Deal with Food Pushers with a polite but firm, "No thank you." If you're concerned about hurting their feelings, ask for the recipe or a small portion to take home with you for another meal. 12. It's common to have candy and snacks lying all over the place this time of year. Avoid indulging in food just because it's there. Grazing unconsciously leads to extra calories that you probably won't even remember enjoying. 13. Before having a cookie, a piece of fudge or other holiday treat that was laid in the break room, check your hunger level. If you’re hungry and you choose a favorite food to satisfy you, remember to sit down and eat it mindfully – no guilt. 14. At restaurants, the portion sizes are usually huge - almost always "two for the price of one." Request appetizer portions, co-order and co-eat with your dining partner, or have the server package up your meal to go as soon as you feel satisfied. Remember, "super-size" is no bargain if you didn't need that much food in the first place! 15. Look for opportunities for physical activity - take a walk after dinner to enjoy the lights, take a few laps around the mall before it opens to do some window shopping or take guests to local attractions. http://www.bsciresourcecenter.com/proddetail.php?prod=FAHolidayEatingMMay

I see so much variation on here with different surgeon's post-op liquid/food phases, it's incredible actually. My surgeon is very conservative. Phase 1 - Clear liquid diet (days 1-14) Phase 2 - Protein drinks, creamed Soups (week 3-8) Phase 3 - Full liquid/Blenderized (week 9) Phase 4- Soft to Regular Foods (week 10) Foods to add after 11 weeks: Shrimp, scallops, lobster, salmon, halibut, soft cooked vegetables, cold cereals less than 3 grams of sugar, toasted bread Foods to add after 12 weeks: Soft bananas, apples, melons, peaches (no skin on fresh fruit), plain lettuce, low fat dressing Foods to add after 13 weeks: chicken or turkey without skin, chicken or turkey salad, ground turkey, chicken meat, fajita meat, soy products, refried Beans, Peanut Butter, Pasta, untoasted bread Foods to avoid for 6 months after surgery: red meat, pork, raisins, grapes, nuts, seeds, popcorn, corn, alcohol Next week I enter phase 2 and will be there for 5 weeks....sigh...going to have to google some good creamed soups. Compliancy is not an option for me, this was a HUGE surgery and I get one shot at it. The good news is that in 2 weeks, I'm down 22 pounds. That's crazy, right?

Mines with a licensed social worker (like myself) at the Bariatric Center. I might look into this as a career move some day. I do assessments now for drug and alcohol related problems at a Rehab.

For details on the methodology and demographics, read the full article from the Feb. 2011 issue of the JACS here: http://www.journalacs.org/article/S1072-7515(10)01090-2/fulltext The link I provided in my initial entry was for the abstract press release on the study, not the full study itself. I suggest reading the whole study for more information. I know there were 19 test subjects, so I assume there were a mix of male and female, with different body weights. The results shown were of course a statistical result across all of the patients. The statistical probability of these values being correctly representative of the expressed population is excellent (p values all < 0.001). Of course, individuals will vary somewhat. Note that while this study has a subjective component (the questionnaire about how the subject felt after the test), the results were described in objective terms (BAC levels). It is definitely possible for one person to "feel" intoxicated while another does not, but for both of their BAC levels to be the same; objectively, they are both as inebriated, and with the same loss of function, even though they might not feel that way. Obviously one study is not conclusive, no matter how good the statistical sampling. All I provided was one study. If you can find an alternative study that refutes these findings, it would be very good to see. In my (albeit quick) research, I found a few more studies, but they all seemed to suggest the same things as these findings. I don't have time to sort through it, was just wondering if you knew offhand. I have the sleeve so it's not the same, so it's not applicable to me. It's just as a statistician my first thought is always correlation is not causation and losing weight in general is a reason for alcohol tolerance to decrease so I wondered how much of this was on top of the normal decrease in tolerance. Just something to think about when reading.

@@brittneywlsj At the appointment I filled out some paperwork to give to the nurse. The nurse took my vitals and just asked me some questions like if I smoke and how often I drink alcohol. She also gave me a true and false quiz to do to make sure I understood the surgery and what I need to do afterwards. Then I met with the case manager. She just asked me if I had any questions and gave me her card if I wanted to reach her. The nutritionist came in after that and verified what vitamins I was taking. She also went over the pre-opt liquid diet and recommended I buy a book called The Emotional First Aid Kit: A Practical Guide to Life After Bariatric Surgery by Cynthia L. Alexander. She said it's written by a psychologist and the book is supposed to have other people's stories and what you should expect to happen after the surgery. I'm definitely going to buy it. It sounds like it will be really helpful. Then Dr. Mcarthur came in and asked some questions about medications and health history. She went over what medications to stop before the surgery and what not to take for a certain amount of time post-opt. She also went over the risks and possible complications (what they went over at the seminar) and drew a picture explaining how the surgery will work. After that she did an examination of my stomach and felt around. She also went ahead and put in all the prescriptions that I will need, expect for one that I'll need to drop off. That is pretty much it. I'll see her again before the surgery at the end of October.

I was still thinking of canceling it the night before surgery! The first 10 days post-op are no fun, but the surgery is SOOO worth it. I am almost 5 months out and feel no negative residual effects, but I can tell you: 1. I can work in the yard in the summer time all day and not get that tired 2. I can fit in an airplane seat with no discomfort 3. I do not have to take ANY medications anymore 4. I wake up every morning at 5 AM with plenty of energy 5. I do not snore anymore The list goes on and on. For me, it was short term discomfort for what has so far been pretty easy weight loss. I have only had one incident with my sleeve and it really was my own fault, too many sugar alcohols at once (atkins bars), at week 4. Best of luck to you.

So some people asked for information on "Why Alcohol Is Bad" post surgery. (Particularly directly after) Most of it has to do with wound healing. As people have said, your stomach has a large 'wound' in it from the surgery. There are many studies which describe the effect of alcohol, however this is one of my favorites. For those who don't have time to go through it all: "In summary, acute ethanol exposure can lead to impaired wound healing by impairing the early inflammatory response, inhibiting wound closure, angiogenesis, and collagen production, and altering the protease balance at the wound site. As mentioned previously, the host response to chronic alcohol exposure appears to be different from that of acute alcohol exposure. Analysis of clinical data indicates that chronic alcohol exposure causes impaired wound healing and enhanced host susceptibility to infections, but the detailed mechanisms that explain this effect need more investigation." Do what you want to do. We are all big girls and boys here, however know the risks and benefits of all of your actions.

There was a study of alcohol after RNY surgery published in the "Journal of the American College of Surgeons". You can read the whole thing here: https://www.facs.org/media/press%20releases/jacs/gastricbypass0311 Note that the study shows we become MORE affected by alchohol as we heal from RNY surgery (effects are more pronounced at 6-months than at 3-months). One 5-ounce drink of wine was enough to raise the BAC over the legal driving limit. To put it in perspective, one drink after surgery approximately affects us like 4 before surgery. Also, they continue to warn that in RNY patients, there is a higher chance of abusing alcohol due to transference. Here are some excerpts: "The results of this unique demonstration of alcohol metabolism changes in gastric bypass patients showed that patients who underwent a Roux-en-Y gastric bypass (RYGB) operation had considerably higher breath alcohol content (BAC) and took significantly more time to return to a sober state after drinking, compared with BAC levels tested prior to having their procedure." "During the study, alcohol metabolism tests were performed on 19 morbidly obese patients before their RYGB operation and then measured again at three and six months post-operation. Patients also reported symptoms experienced when drinking and answered a questionnaire about their drinking habits." "The results showed peak BAC percentage of patients after drinking five ounces of red wine was significantly higher post-operation. BAC was 0.024 percent at pre-operation and 0.059 percent (p = 0.0003) at three months. Tested again at six months post-operation, the patients’ BAC was 0.088 percent (p = 0.0008) which is more than the legal driving limit of .08 percent. Additionally, it took 49 minutes for patients to reach a zero BAC prior to their operation compared with 61 minutes at three months and 88 minutes at six months post-operation." "RYGB patients need to understand that their body will respond to alcohol differently after their operation and they need to exercise caution if they choose to drink alcohol,” said Dr. Morton. “Our recommendation to all of our RYGB patients is never drink and drive and to limit consumption of alcohol to one standard drink (one 12-oz beer, 5-oz wine, or 2-oz liquor) for every two hours."

When I decided to stop losing, I was still food journaling everything on MFP so I calculated my BMR using the tools form that site and added a few hundred calories until I stopped losing. Did that for about another 6 months and finally (and purposefully) let go of the journaling in favor of a more natural lifestyle. For me, the habits are are there... exercise 5x per week, small, high protein meals, etc. I eat what I'll call "righteously" 85%-90% of the time, stay active and have maintained within 5 pounds for the last year and 1/2. If I creep up, I adjust out some of the junk, (alcohol and treats) until I'm back in the zone. Typically takes less than a week.

Hey everyone, I'm 2 1/2 months out from bypass surgery, and I'm really curious to know a couple things about drinking after surgery... Also, I should mention I'm only asking because I got an OK from my doctor to be able to drink on a special occasion: my birthday, just would like some ideas, thank you in advance ! -How fast does alcohol hit you, and how much does it take before you feel it? -How long do you feel the effects for ? -Is it over fast, if so, do you drink more ? -What kind of drinks do you have ? -Any cocktail suggestions that don't make you dump ?

@@Oregondaisy how are you doing? has the surgeon told you what activities you are allowed to do? I think you should view it like I did recovery from plastics. Not an excuse to get fat, but not a time to severely restrict either. I emphasized Fluid, Protein and no junky food, no alcohol etc. I maintained during that time. I went to a Mariners game yesterday my friend had suite tickets - with buffet and everything. It was really fun. We did a bunch of selfies and I admit I didn't like how I look. People say they can't tell that I have regained, but I look so much bigger then my "thin" friends it was a reminder why i need to stick with what I am doing and even if it takes me a year, to get my weight back down....