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Any thoughts on the findings below would be greatly appreciated. I've inserted my thoughts on the recommendations at bottom. Thanks! Position: The patient spent most of the night in the lateral position. sleep Latency: The patient’s sleep onset latency after lights out was 27.5 minutes. The REM sleep latency from sleep onset was 178.0 minutes. Total Sleep Time: The total time in bed was 363.0 minutes with a total sleep time of 219.0 minutes. Sleep efficiency was 60.3 %. Sleep Architecture: The patient had 30.0 minutes of REM for 13.7% of TST, 55.0 minutes of Stage 1 for 25.1% of TST, 103.5 minutes of Stage 2 for 47.3% of TST, and 30.5 minutes of Stage 3 for 13.9% of TST. The arousal index was 51.2 per hour of sleep. Respiratory: The patient was observed to have had a total number of 16 respiratory events with an AHI index of 4.4 per hour during total sleep time. The REM AHI index was 0.0. The normal AHI index is less than 5 per hour. There were 0 obstructive apneas, 0 mixed apneas, 0 central apneas, 16 hypopneas, and 108 RERA’s. The total RDI (A/H + RERA’s) was 33.97. Moderate to loud snoring was noted for 91.2% of TST. Oxygenation: The patient had an average oxygen saturation of 95%. The minimum oxygen level was 86%. Cardiac: The average heart rate was 65.3 beats per minute. The patient had a normal sinus rhythm with PAC’s noted. Other/EMG: Patient had no evidence of periodic leg movements during sleep. Diagnosis and Impressions: This patient has evidence of mild obstructive sleep apnea syndrome independent of sleep stage. Although her total AHI was 4.4, her respiratory disturbance index was considered moderately elevated at 33.97. This indicates significantly elevated respiratory effort related arousals which contributes to significant daytime fatigue as a result of upper airway resistance. The patient was also noted to be snoring for 92% of the total study time. In addition she had evidence of oxygen desaturation events as low as 86%. The patient remained in sinus rhythm and had evidence of frequent atrial premature contractions. She did not have evidence of periodic limb movements. Sleep architecture was markedly abnormal with extremely poor sleep efficiency of only 60.3%. She had difficulty falling asleep with a sleep latency of 27.5 minutes, delayed REM latency of 178 minutes, and decreased total REM of 13.7% of the study night. The total arousal index of 51.2/hour indicates severe sleep fragmentation in general. Recommendation: 1) Based on the patient's history of daytime fatigue and evidence of significant respiratory effort related arousals, persistent snoring, and oxygen desaturation events, a CPAP trial is certainly warranted. (Scheduled) 2) weight loss efforts can help reduce the severity of sleep disordered breathing events. (evaluating lap-band procedure) 3) avoidance of alcohol and sedating medication is indicated as these can worsen sleep disordered breathing events. (rarely use alcohol; never use sedatives) 4) suggest avoidance of driving while sleepy. (rarely drive while sleepy) 5) would check TSH to rule out hypothyroidism if not already performed. (this is Greek to me):confused2: 6) if there is evidence of nasopharyngeal crowding, consider surgical evaluation.(this is Greek to me):confused2: 7) suggest improvements in sleep hygiene.(this is Greek to me):confused2: 8) if the patient continues to have significant daytime fatigue despite appropriate treatment of OSA syndrome, consider referral to a sleep specialist. (not sure what sleep specialists do but will get referral from my primary care physician). 9) consider cardiac evalution. (will get referral from my primary care physician)

I don't have Barrett's but know of someone that does. Are you on any meds to control the stomach acid? As for alcohol and being able to eat. If I drink, I tend to be able to eat more than I normally can. Not sure if the alcohol just relaxes us more or what but I have definitely been able to eat more when I drink any alcohol.

Our nutritionist discussed this at one of our support group meetings. Her advice is not to ignore the fiber and sugar alcohols because each of us absorbs them differently. And even if the calories are not extracted in the stomach, they can still be absorbed by the body on the way out. I think the ADA recommendation is a good rule of thumb. So your drink was 3 full carbs and 15 half carbs or 10.5 all together.

You need the two weeks off from work so leave the date as is. You should be fine to get around.for the superbowl. At six weeks post op, you will be on a regular diet, but nutritious and small quantities. Keep ready to drink protein in your room as a back up to make sure you get in your 64 grams. If you feel the diet options are not there with traditional football game food on the menu, you can always opt for a small grilled chicken salad. Remember, no bread, alcohol, or desserts. If asked about your diet choices and quantities eaten, just say that eating healthier is your New Years Resolution.

I think you are doing a great job, and your doctor was treating you a little rudely! I work full time with a doctor and he says your liver (or mine) is probably not that big, at least to be felt like that. I can't see your ticker, (they are blocked at work) so I am not sure about your starting weight. I am 28, 5'4'' and my high weight was 262, and ate out almost 100% of the time for meals and I have a lean liver according to my ct scan. The big fatty liver than can be felt like that is usually from being an alcoholic or being older and obese, and and having comordidities like diabetes. Were any of your liver function tests elevated? LIke AST, ALT, etc? You are 22, and you probably have nothing to worry about, keep up what you are doing. Be pround of your preop weight loss. :-)

So I'm 4 months post sleeve surgery and down 40lbs. My unsupportive husband decided he wasn't in love with me and we are in the process of divorcing. The divorce was no surprise. Unfortunately he didn't want the marriage or work for it like I tried. Anyway I'm looking forward to dating later this year and meeting new people. I'm 30 yo. But food and alcohol are often part of the dating process. Luckily I never was much of a drinker. I can only imagine going out and eating 4 bites and being full. How do you deal with this? What about the scars? When do you tell your sleeve story? I'm excited but scared of dating. Any advice from fellow sleevers is appreciated.

I stayed an extra day in hospital because I could not get past liquids without nausea . When I got the wave they put an alcohol prep near my nose , kind of squashed the feeling imidiately and gave me zofran iv push and out it went. But in the hospital they told me if I needed I could take a script home with me for the zofran so I am sure its available in pill form, call your syrgeon you shouldnt have to suffer like this. And by some alcohol preps they work wonders. Good luck to you I hope your better soon.

I am not a big drinker but here and there I do like one ,When is it ok to have something and then what are the best choices?? I know we cant have any carbanation or juice anymore..So..... What are some of the better choices out there? What has been everyones experience with the first adult beverage since surgery?

@@MiaLynn I had the sleeve surgery 11 months ago and I've had none of the issues you say you are fearing. I can only speak from my perspective....my experience. I can have anything I want to eat.....I just choose not to. I've never experienced the dumping sensation unlike my little sister who had bypass. The only thing even remotely close to the dumping sensation that I've had is If I eat candy or sweets.....they tend to upset my stomach and give diarrhea. I attribute this to the refined sugar being a rarely injected food by my system. I'm fairly certain that this wouldn't occur if I ate that type of stuff more often. I hope that I never do ! I can drink anything I want.....but I prefer staying away from anything caloric or carbonated. My exception to this is on the nights where I'll enjoy an adult drink.....even then I stay low calorie on the mixer. I find that alcohol impacts me stronger only due to the fact that I don't have food in my stomach when I'm drinking like I did in past life. Outside of that....it's the same. I lost a nice chunk of weight on my own......and regained it....several times in my life. I feel confident that this time, however, I'll get it right......and maintain. The only times I've thrown up were due to actually being sick.....would have likely thrown up even if I was pre-op. Once was a stomach virus and once was from a sinus infection and the drainage in my throat was too much to handle and I hurled. Only you can make the decision for yourself. Get the best information you can as you make your choices. I wish that had the sleeve surgery sooner.....but am very relieved that I finally did. Life is very straightforward and easy with it. The sleeve will prevent you from eating large quantities of food at one time.....but, for me, at least....it doesn't prevent me from eating any type of food.

I drink wine, I gave up beer completely, I believe any carbonation stretches the stomach (but thats another thread). When I was trying to lose my last 15 pounds I was drinking a glass of wine at night (200 calories) and I couldn't lose it, but then I stopped drinking wine and replaced those calories with food and I lost it pretty quickly. So I believe the alcohol affects your weight loss in more ways than just the empty calories. Now that I am at goal I have started drinking my wine again and I have not regained any weight.

Have you ever considered beer might nowt appeal to you in the same way as pre-sleeve. I'm just saying this because that happened to me. Several things I enjoyed pre sleeve like alcohol, sugar, salty foods, highly processed foods and other foods no longer appeal to me. It is like the surgery flipped a switch inside me and j have no reason to flip it back, especially since a healthy lifestyle has improved my life in so many ways.

Like Iggy my Dr. allowed me to have some wine somewhere around 8 weeks, it was the holidays and he told me have some if I wished, if went down fine but hit me a lot quicker then before surgery. Now though alcohol don't really effect me like that, its almost like pre-op, I just get sober quicker! I've had a few sips of beer here and there but not a full one, I was thinking of waiting till my 1 year surgiversay, boy how I have missed beer!

I havent been banded yet..but im pretty sure that alcohol might not be too good so early on in bandland....might cause ya some pain....but i could be wrong

seems like she said splenda was the last ingredient and that theres not a lot in there. but we did talk about the artificial sweeteners and that they cause ppl problems. i just have a problems with sugar alcohols i think. i drink juice made with splenda and it doesnt bother me but sugar free coffee at starbucks and sf pudding did!

I had a few sips of scotch around 3 months out or so to test the waters. I've since had a few glasses of scotch (2 or 3) and a number of beers, one night I consumed 8 bottles at a club. Not that I'm advising anyone do that though. Best to feel out your tolerance at home (and to make sure you don't dump from the alcohol). I can say that I'm a little disappointed that I can drink... just one more thing I shouldn't really be able to do, but can. So it's going to be more will power now since I know I can drink if I wanted to.

I have found that my tolerance is a bit lowered, but I can drink alcohol without a problem. I drink a glass of wine or a beer about 3 times a week, but I usually don't even finish it!

Once you're finished with the post operative healing period I would think you could enjoy those glasses of wine as you did before. BUT remember that they are loaded with extra calories and be prepared to work them into your caloric intake for the day. Your absorption of the alcohol or the calories hasn't changed at all.

I am a wine/martini/margarita drinker. The first couple of months after surgery, some did not taste so great - like the margaritas. But now 6 months after surgery, alcohol is not a problem at all. As a matter of fact, red wine has been my saving grace when I could not eat - it relaxes me enough to be able to try the food again. For me, it seems to have the same effect as warm drinks on the band. It also helped when I could not get my calorie count up high enough to reach the 1200 to be able to lose. I find that it takes much less quantity to be able to reach the same buzz - where as before surgery, I had a high tolerance.

Hello, I find my tolerance is really low (and it was pretty low to start with) with the band although I enjoy an occassional glass of wine with no probs. Had a huge bad episode with an irish coffee (probably from having it too soon after a PB) which was DUMB but I'm still a newbie and learning mostly thru hard knocks. Had a margarita (sip or two) and just found i didn't like it or want it and didn't even come close to finishing it. It's also somewhat of a challenge when following the no drinking with or after meals 'rule'. Alcohol is also an irritant to the stomach so I don't like to do to much of it and it definitely slows/stops weight loss for the week!

Never counted carbs or fat or calories. I make sure I get in 60-80g protein, 64oz fluid and my vitamins. I try to eat veggies and fruit every day. I still eat sweets, pancakes, bread, pasta, rice, alcohol, etc, but in moderation and certainly not every day. Passed goal in just over 7 months and have maintained 10 pounds below for about 8 months.

I'm sold on fatsecret.com. If you wants to be my buddy on there we can see each other's food logs (I just switched from fitday so today is the first day). Search Donna4545. I bet you can get down to 900 calories/day--get rid of the sausage,alcohol, potatoes, bread and eat more like you did 6 months out (that's not a flame, it's advice). If you have a sweet tooth, don't eat that cookie! Instead make something lowcal and sweet from the Bariatric Foodie blog--she's got Protein cheesecake, bon bons, tons of stuff. You can do it! You are almost there. Donna

I found that I could not tolerate much, if any, of the Protein supplements, shakes, ready-made or not. I was a bit panicky, but finally found 2 that got me through. I rarely, if ever use now. Just one note - don't let your Water (milk, etc) get above 105 degrees or the Protein powder will clump. Believe me - if you have a hard time getting down well-mixed protein, you don't want to try clumped protein. YUCK!!!! Any whey from Amazon - [ame=http://www.amazon.com/Optimum-Nutrition-Instantized-Protein-2-7-Pound/dp/B000GIUQOG]Amazon.com: 100% Any Whey Protein: Health & Personal Care[/ame] I add this to yogurt, oatmeal, hot cocoa, etc Serving size: 1 scoopAmount Per ServingCalories70Calories from Fat0Calories from Saturated Fat Amount Per Serving and/or % Daily Value*Total Fat0g (0%)Saturated Fat0g (0%)Polyunsaturated Fat Monounsaturated Fat Trans Fat Cholesterol0mg (0%)Sodium30mg (1%)Potassium Total Carbohydrate1g (0%)Dietary Fiber0g (0%)Soluble Fiber Insoluble Fiber Sugars0g (0%)Sugar Alcohol Other Carbohydrate Protein17 (34%)Amount Per Serving and/or % Daily Value*Vitamin A0 (0%)Percent of Vitamin A present as beta-carotene Vitamin C0 (0%)Calcium0 (8%)Iron0 (0%)Flavor0 (0%) unjury chicken Soup - https://www.unjury.com/store/protein/reg/chicken_soup_flavored_protein.shtml

My sister had gastric bypass 10 years ago her recovery was much different than my lap band in recovery....I know she eats a lot less at a setting, She has dumping syndrome with sweets & can not drink alcohol at all. I didn’t have any of those issues with my Band in. So whether it’s sleeve or gastric bypass I know it will change my life more significantly even the band. I hope those have gone through it already can give you more insight after June 5 I’ll be able to tell you more :-) I hope the best for you!

I couldn't have coffee right away after surgery, but now I drink a cold brew coffee everyday. I also eat fruits and veggies; no where near what you eat now, because my smaller belly won't allow it, but I do eat them. I also drink alcohol occasionally, again, not much and not right away, but I can. I haven't really had to give up much after having the sleeve. If I want a piece of chocolate, for instance, I have it, but just a small amount, and I'm sure to track it. It's all about moderation, and the sleeve helps with that.

I'm 36- I weigh around 240 and I'm 5' 6". I was this weight at the age of 12. I managed to lose 100 lbs when I was 17 or so with an extreme diet where I would just eat a can of soup and a nonfat yogurt and that would be all my food for the day. A bit disordered. I kept off 80 lbs of that for around 10 years and then it came crashing back on in a 3 month time period and there was nothing I could do to stop it. I manage to lose 30 lbs or so, but, then it creeps back on. I have one kid, I gained 80 lbs while pregnant due to preeclampsia but was back to prepregnancy weight in just three weeks, so, just water weight. I know that I really have to do some kind of weight loss surgery. I know how to lose weight, I've done it before and maintained it for years, but,it just doesn't work anymore. I'm thinking I should do a real gastric bypass since I've lost the weight before and kept it off and now can't lose, so, probably can't get away with the less drastic procedures. My insurance will not cover it. My work got a new plan a couple years ago and they did include gastric bypass. You just had to have the insurance for a year. So, I met with a doctor, did my monitored diet and all that crap and then by the time the year was up the insurance company dropped weight loss surgery. I was furious because I did all the preapproval work just waiting on my year to be up and then they pull that crap. I will be doing this in Mexico. I have no comorbidities other than slightly elevated liver numbers. Cholesterol under 200, glucose under 100, a1c was normal. My doctor hates it because she has to tell me my labs are perfect after lecturing me about the health concerns of being a fatty. But, you all know exactly how that is..lol Here are my concerns. I love fruit and vegetables. I eat around 800 grams of them per day. The UK does fruit and veg servings easier, 80 grams is a serving and thus 800 grams is 10 servings. I'm guessing that's why my lab work is good despite being obese. Obviously, I won't be able to eat ten servings of fruit and veg a day after surgery. What will I still be able to eat? I've already mostly dealt with my food demons, gave up soda in my 20s. I'm still drinking coffee. Will I still be able to drink coffee after bypass? My life sucks as it is. I can't get promoted at work and I know a big part of that is my weight. I'm the person that gets phone calls from other locations on how to do things. I work at a level three pay grades above my current level but can't get promoted to that level. I'm married and my husband is a normal weight vegan, so, that whole relationship sucks too. Everyone assumes that I'm lazy. I had a well-meaning friend invite me to go walking with her, a one mile loop. Seriously? I walk 5 miles everyday. Will my life suck less after bypass? I've mostly given up alcohol, but, weight loss surgery will have to be a secret from my local relatives. I will have to occasionally be able to drink a little alcohol. I will have to be able to drink a little coffee. I want to be able to eat fruit and vegetables. I just don't want to make my life worse than it already is. I'm lucky, never really had a binge disorder or anything like that.