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I am what Kaiser calls a "reactivated case". I was in their bariatrics program years ago but dropped out and recently have been approved to go back. In the 4 years that I was gone, I gained 40 pounds. Kaiser wants me to lose that 40 pounds before surgery and they have given me approx. 4 months to do it... They gave me a meal plan and told me to exercise. I am going to have to BUST MY A** to lose this weight in 4 months and I need some serious suggestions...

Hi mariposa, Well, I did not have and eroded band, but my band simply never liked me. It never gave me proper restirction, even after 2.5 years and 20+ adjustments! It also gave me night GERD and I would wake up choking on my reflux all night long. It was no bueno!! When I started to seriously consider perhaps having the band removed and maybe getting the sleeve or even the RnY, I researched and asked a million questions to lots of people. I was finally convinced that I should just go for it, and I would be happy with my decision. Guess what...??? I AM!!! My sleeve has really saved my life!! I had so many physical issues, some life threatening that today are no longer but a distant memory. High blood pressure, possible future diabetes (it ran in my family and I would get hypo/hyperglycemic sometimes - though I do still if i eat something too high in sugar!) arthritis in my knees where I was SCHEDULED to have 2 seperate knee surgeries - but NEVER NEEDED TO HAVE!!! yayy!! I was so down and perhaps even depressed... but today I'm living the life I'd dreamed about for decades and I'm feeling SKY HIGH!! I know this can be you as well! Hang in there and once you get your surgery, you will be here before you know it. Xoxo

I just want to maybe clarify this for you: Translation, voice inflection can both get lost over the typed word. The sheer fact that we do not know you from Adam, we don't know that you are a nurse, we don't know you at all, we don't know what credit should be given, because let's be honest, after 2 years and seeing people post "I'm 10 days out, can I eat jelly Beans, cheetos, etc etc or I"m 4 weeks out, supposed to be on purees, do you think it'll hurt if I gnaw down on some beef ribeye this weekend at a barbque??? Do you see why these type of statements get some of the replies??? So, remember when you post something, we can not decipher what you NEED to know. You simply stated: I am 15 days out. I am still on a full liquid diet. Do you think an ice cream cone or sundae from McDonald's is okay to eat? I Have well over the amount of calories left. This is how it reads to some of us and this might clear up why you got the reaction/replies: I'm 15 days out, supposed to be a on full liquid diet, I want to eat ice cream because I have the calorie allotment for the day. NOT, I'm 15 days out, feeling very sluggish, need calories, and was thinking about having some fat free frozen yogurt/ice cream or no sugar added ice cream. Would these cause an issue with my new sleeve or did anyone else try ice cream this early out? Those 2 statements are vastly different. My reply would have been different although I would have suggested the same alternatives, but you asked about an ice cream sundae after having a huge portion of a major organ amputated so you can lose weight, and you wanted someone else to tell you they were fine after eating ice cream. That is NOT what you asked. Perception is 9/10ths of the law, you asked a pretty vague question, and apparently wanted a completely different type of reply. Replies are reactive to the question. Maybe now, you'll see why people replied the way we did initially. Your question was then followed by caloric justification. You're a nurse, you get this situation I'm sure in your daily job. For example (my aunt is an ob nurse) and she gets questions all the time, and they are not verbalized properly, or the patient can not communicate properly, or via email replies she says she just sits there and wonders how in the h*ll this woman was able to procreate. I'll drop it at this point. You took the replies as chastising and insulting. We simply read and replied based on what you asked. We aren't mind readers, and I dropped my crystal ball years ago so unfortunately, we can only reply based on what you give us.

Weight Loss Too much weight Loss Feeling cold all the time - was temporary only through the rapid weight loss phase. My body was in maintenance through the winter, minus 140lbs, I'm pretty sure it's okay to get cold easier considering I was half the woman I was pre-op Chronic GERD Take PPI never have refulx Strictures Only a 2% risk of this occurring(should be lower with an experienced surgeon) Leaks 1% or less risk Calcium deficiencies Taking the proper calcium supplement is essential, just like taking proper, high-quality adult multi-vitamins ensure this doesn't happen. Citrate is your best option Iron deficiencies not necessary, not common if anemia is not an issue pre-op. Multi with iron helps to keep levels normal Can't take slow release drugs Incorrect, there are zero medication restrictions with the sleeve No Aspirin Absolutely false, I take a baby aspirin every day and will for the rest of my life due to a rare, genetic clotting disorder, and aspirin therapy is the only treatment Issues from Surgery Could occur with any anesthesia procedure Twisting up the sleeve (There is a technical term for this but I don't recall it) Unsure of this condition would need to know medical terminology to reply intelligently Possible dumping reactive hypoglycemia is more common and is often confused with dumping, transit time has been studied some doctors believe transit time can effect dumping/hypoglycemia, others disagree Food tolerance issues Very minimal and usually resolve the further out you are from surgery Nutritional deficiencies Only if you do not take care of yourself and do not make good food choices Hair loss that grows back True gall bladder issues Ehhh can happen to anyone after weight loss, I lost mine at 8 months post-VSG Chronic fatigue until fully recovered Can be avoided with proper fluid, vitamin, protein intake. I napped a couple of times a day for the first month or so, but I had complications related to my revision from the band. B12 must be taken sublingually or by injection due to the intrinsic factor of the stomach being removed with the VSG. Lactose intolerance, or whey intolerance can occur making protein drinks limited. That's all I can think of at this point.

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My journey began around 3 years ago. I was under the treatment of a number of specialists most recently Endocrinologists. I received a diagnosis of Hypo-Pituitary and Hypo-Thyroid. I could not pursue weight loss surgery until I had a release from my endo. I received that approval in December 2010 and began my journey with Atlanta Bariatric and Dr. Christopher Hart. My insurance is Aetna and the approval I sought required 6 months weight loss consultations. I met with a primary care and a nutritionist. I was approved in August and my surgery to place on August 31, 2011. My highest weight was 567 with my endo and my weight before surgery was 479. I am sensitive to wheat and gluten, corn and potatoes. I was well aware of what I could not eat. I needed those six months to get a good idea and what I could eat and lose weight eating. In my teens and 20’s I had experienced some events in my life which caused me to want to alter my appearance. Believing that if I made myself unattractive I could keep myself out of harms way. In my 30’s I got the help that I needed and I realized that I myself was putting myself into harms way. But I struggled with ending this cycle of self-abuse. In my late 30’s I was married and lost my appetite with my second pregnancy. It never fully returned and I thought nothing of eating once a day. If I got hungry I knew the pain would eventually subside. So fast forward into my 40’s I commit to do a better job caring for myself, but my body refuses to respond. I start to get recurrent infections, my weight loss efforts plateau soon after diets start, and I just literally feel like I am slipping away. Maybe I waited too long. The weight loss Doctor told me that I needed to see a specialist because there was something going on internally that diet and exercise alone could not address. I went to Progressive Medical and they referred me to my first Endocronologist and after extensive testing I received my diagnosis Hypo-Pituitary and Hypo-Thyroid. You know when you receive medications that help in one area but can make you ill in others? Well that was my experience. We stopped the infections and lessened the fatigue. The trade off was weight gain and becoming Insulin resistant due to the medication. That was not an acceptable trade off for me. I changed Endo’s and was freed from the medication. My body was responding positively to the positive food choices and I was infection free. So here I am it is a new day and a new chapter in my life. I have learned so much about listening to my body and I have experienced so much love and support. I look forward to being apart of a community who happen to be headed in the same direction, Health and Joy and Peace.

I am hypothyroid and take Synthroid (100 mcg) daily. I normally take it first thing in the morning and I have been fine after surgery. I was recently given direction to take my Nexxium twice daily (morning and evening). My doctor said I can't take Synthroid with a PPI because it causes problems with absorption. So this morning I take my Nexxium when I wake up and figure I will take my Synthroid about an hour before lunch. By 930 AM I was sweating profusely and felt like I was having a hot flash! The RN who works with me asked if I had taken my Synthroid. I took it at at 10 AM and within 20 minutes the sweating and hot flash was back under control. Since I hadn't thought about it, I figured I would post for the other Hypo's out there after surgery.

Gem - I can totally relate..good bye Butterfinger, BabyRuth and Snickers!... so long Papa Murphys, pizza Hut and Dominoes....and toodle ooo to pastry, maple bars, and scones. Seriously I have found that getting my pantry ready for the "after" has helped and clearing out the Cereal and Pasta dishes satisfied my hunger and cravings. The new immediate challenge is they just built a Sonic and a Little Ceasars Pizza two blocks from my house. So I will do my best to visit before we start that lovely lardless luscious liquid lifestyle on August 29th. . I'm right up there with you but we can do this liquid diet thing. I just plan on not making mine all low-calorie because I am smart enough to recognize I will faint dead away faster than you can say hypo-glycemic! So do your best and leave the rest up to God! See you soon sleeve-sis. Reb

I think I have a blood sugar meter somewhere, and I'll try to dig it up. I guess I've been avoiding directly measuring my blood sugar because FWIK non-insulemic hypoglycemia is usually caused by problems with your pancreas, which I do NOT want to contemplate... For now, since the problem seems to be related to/worsened by my caffeine intake, I'm weaning myself (further) off caffeine, and trying to stick with the "many small, protein-heavy meals," and I'm going to try to have a protein-heavy "snack" before bedtime (probably just a Protein shake). Oh, and cardio exercise, since that seems to help people with hypo-g.

So, again with the bedtime hypoglycemia, although not as bad. It's 2:00am and first I was up with the shaky/wobbly feeling, which I dealt with with a small glass of skim milk. Now I have all kinds of aches and pains and bad gas. Almost feels like flu, but it's not. So instead of reactive hypoglycemia, maybe this is just nocturnal hypoglycemia? I don't have diabetes, so this is all really confusing. I can't wait till I can see a doc again...

I've actually been a diagnosed reactive hypoglycemic since age 14. I have kept it at bay for 15 years through my diet... even when I was obese. The secret to RHG is to never eat sugary foods alone. You must pair it with a complex carb and/or Protein. If I was to eat a candy bar alone my blood sugar would be in the 50s within a two hour window. However, if I ate a balanced meal followed by a candy bar then I would typically be okay. When you have an RHG spell orange juice is the best thing to ingest to quickly right your blood sugar levels. You can also purchase glucose tablets for these incidents (I keep a pack in my car). This is a quick fix though and must be immediatly followed by protein and/or complex carbs to stop the cycle. To be properly diagnosed for RHG you would need to see your doctor and chart your blood sugar levels and symptoms. Further testing would include scheduling a 6 hour Glucose Tolerance Test and possibly a follow-up 72 hour Glucose Tolerance Test. RHG is not something to be taken lightly. True suffers can pass out from too low of blood sugar- it's terrible, trust me. While I have lived with this issue most of my life and gotten pretty used to it, I have noticed an upswing in "incidents" since surgery. I had attributed this to having to learn how to balance my eating differently than I need pre-surgery. It never occurred to me that surgery may have exacerbated the issue. Thanks for the heads up! Amanda

Wikipedia states here http://en.wikipedia.org/wiki/Reactive_hypoglycemia that reactive hypoglycemia "is a medical term describing recurrent episodes of symptomatic hypoglycemia occurring within 4 hours[1] after a high carbohydrate meal" It also states "There are different kinds of reactive hypoglycemia:[4] Alimentary Hypoglycemia (consequence of dumping syndrome; it occurs in about 15% of people who have had stomach surgery)" So this it's saying that re-active hypoglycemia is a form of dumping, which I've experienced pre-surgery. You sound like your suffering from low blood sugar as eating relieves your symptoms, although wikipedia terms this as hypoglycemia and it's back to citing dumping again. I'd say you have hypoglycemia in the common usage sense and not the way it's most commonly used in the WLS community. See here for further wiki details: "Hypoglycemia (common usage) is also a term in popular culture and alternative medicine for a common, often self-diagnosed, condition characterized by shakiness and altered mood and thinking, but without measured low glucose or risk of severe harm. It is treated by changing eating patterns." http://en.wikipedia.org/wiki/Hypoglycemia It's something I used to experience more in my skinny teenage years due to not eating enough. The main things are to try and low carb/high protein it and to eat little and often (you have to be vigilant to not get into grazing though). I hope you can get into a better routine with your new job soon.

So after a couple of unpleasant incidents, I've done some digging, and as far as I can tell I have been suffering from reactive hypoglycemia (RHG). All of the symptoms I get are hypoglycemic (flushed/chills, nervousness, trembling, slight mental confusion, feeling like I'm going to collapse, etc., all coupled with a sort of panicky hunger -- "I have to eat NOW or I'm going to fall over!"), and it's relieved by eating (but only if I'm careful and eat high-Protein foods, carbs just make the swings worse). I'm curious if anyone else has gone through this with the sleeve. Incidentally, some call this or confuse this with "dumping syndrome" -- they're not the same, but they may be related. Eating in a way that leads to dumping apparently can dump a lot of blood-sugar spiking food into your small intestine at once, faster than your body can properly deal with. So part of the "eat every two hours" thing is to eat smaller meals and avoid dumping. The Wikipedia article (http://en.wikipedia.org/wiki/Reactive_hypoglycemia) mentions this. I am not diabetic, according to NUMEROUS tests by my PCP (given my weight and a family history, it seemed like a good precaution). Apparently, RHG is very common for WLS patients about 15-20 months out (I'm ~19 months out). It's made worse by not eating lots of small, high-protein meals, by not getting enough cardio, and by consuming too much caffeine. I'm guilty on all counts, but it seems like caffeine is really the worst offender for me. I don't do well with moderation, and I've discovered that when I really go overboard on caffeine, I get bad RHG, often at night. Also, it seems to be the combination of caffeine and carbs for me -- I don't drink caffeine at night, but my nighttime meals lately have been carb-heavy (spaghetti, for instance), mostly for convenience. And it seems like my RHG is happening mostly in the evening. So, I'm curious who else has struggled with this, and how you dealt with it. Unfortunately, since I changed jobs in mid-June, I'm not yet eligible for health benefits so I can't go see a doctor about this. That will be changing soon (next week, I think), but I really don't think this is an emergency condition, especially since I seem to be able to manage it by eating healthier, avoiding caffeine, and so on. Mostly I'm looking for support and advice

i have had hypothyroidism for almost 15 years...I had my surgery 13 months ago and I am down 148 pounds. My low acting thyroid has not slowed my weightloss down so far. I have 32 left to lose to reach my goal. I hope that it doesn't decide to kick in now! Have faith...I am one success story of someone with hypo!

CAN ANYONE TELL ME IF THEY ARE HAVING THIS PROBLEM? MY HAIR IS THINNING AND FALLING OUT. IS THERE ANYTHING YOU CAN DO ABOUT IT? I AM GETTING MY RECOMMENDED AMT. OF PROTEIN SO I DON'T UNDERSTAND WHY THIS IS HAPPENING. I AM HYPO THYROID THOUGH. ANY SIGNIFICANCE? I TAKE MEDS FOR IT. I DO NOT LIKE THIS AT ALL!!!!!!!!

I just love this thread! I am pre band and also have hypothyroidism. I have lost almost 40 lbs over the past year just trying to get approved for the band and it has been incredibly hard, but I haven't given up. I always come here and read all these posts from the "hypo bandster" and y'all keep me going! I just wanted to say THANK YOU ALL for sharing.

This is just my recommendation; when I very first had a sugary treat, I felt horrific. Not true dumping syndrome, but I did get the clammy, flushed feeling. Reactive hypoglycemia is common for some patients especially if you are low carbing, sugar free eating and then all of a sudden you throw some (all be it a small bite) of yummy buttercream frosting/cake into your system. I would suggest you having a couple of bites of sugary something the week before your wedding to make sure your body doesn't completely freak out. At 2 years out, even though I don't restrict any foods, and do not restrict carbs or sugar, I do not eat these things on a regular basis, and if I decide to indulge in cake, I feel pretty crappy. Cheesecake, candybars, Starbursts candies, pie, donuts do NOT have this effect on me, but buttercream or cream cheese frosting both make me feel weird. I'm assuming it's the fat content that does me in on the frosting. Many congrats on your upcoming nuptials and getting your sleeve date! ! !

I just went to my 6 month post op, and the NUT talked about reactive hypoglycemia. She said is is common among sleevers, and the symptoms are similar to dumping syndrome. What happens is that we eat more sugar/carbs than we are used to, and then our bodies respond by releasing extra insulin. For some reason, the body will release way more than needed, and then low blood suger happens. shakes, sweating, diarrhea, and light-headedness are some of the symptoms. Sounds like that's what happened.

thank you guys very much. i am very nervous. but i cant take another minute. i was always thick. but when i had my last daughter i gained alot of wait and began to have thyroid problems. i am hypo active and no matter what i do i cant lose anymore weight. @ sweetheart what is bandster hell. i havent heard of that one. lol

So ever since Friday i haven't been feeling all that great. I was feeling a bit swimmy in the head and my insides actually felt sore. It almost felt like I was coming down with something. Last week I found out my thyroid was way out of whack so instead of hypo i was hyper. My Doc changed my dosage and the swimmy feelings went away. I still felt sore inside and it hurt mildly to take a deep breath. I was thinking because I started taking Iron may be I was constipated, I took some miralax. Friday I felt so full and couldn't eat anything after my attempt at lunch. Well it doesn't appear as though I am constipated and I still feel sore inside and randomly without warning I get a pain in my left abdomen that makes me cringe. It really has me baffled. I don't feel full anymore and am able to eat normally. I am not one to freak out but I can't imagine what it could be. I will be calling the surgeon's office tomorrow. I am 11 weeks out. Does anyone have a similar experience? Just looking for clues.

Go Shirley, you are doing great with your weight loss! Hang in there hypo bandsters!

Just tried the calcium chewable from Bariatric Advantage today. It was raspberry flavored - SO YUMMY!!! It looked like a Starburst and tasted like one too!! I really like the liquid stuff I have now (Reviva) but these might be great to have for traveling or times when I have to leave home before I can take the first dose of Calcium. I take thyroid medicine (hypo) and can't take the Calcium for 2 hours after....so these might be good for my morning dose and I could stick with the liquid for my evening dose.

Oh thank you for mentioning that. I am actually hypo-thyroid and I am not taking any other antidepressants. I have in the past but they really started messing me up after a while. I started looking for whatever I could find to improve it naturally. I knew I was Vitamin or mineral or something deficient because my diet for many years consisted of doritos and Mt. Dew. You don't get very many nutrients that way but it sure was good while it lasted. I'm just paying for it now............giggle.