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Liver Shrinkage Diet struggles
xKirstenx replied to xKirstenx's topic in Gastric Sleeve Surgery Forums
Thank you for sharing your experience, it really helps seeing that other people are being honest but still fighting through the preop diet! Yes, my partner eats away from me, we don't discuss food other than me venting about my diet, and I have nothing in my PC room other than shakes and glasses of squash etc. It's helping a lot more but still sucks being able to smell the food in the house or on my partners clothes. Sounds silly I know! Hahaha! That's so interesting how you sat and watched most of it before realising! The things we do eh? I am avoiding all food/drink related media too, scrolling as soon as I see something or switching channels etc. Thank you for the wonderful suggestions, I'll look into them and see what I can do. Thank you! x -
Liver Shrinkage Diet struggles
NickelChip replied to xKirstenx's topic in Gastric Sleeve Surgery Forums
Just wanted to say I'm starting Day 13 of my 2 week preop liquid diet and it's not so bad at this point. I mean, I wouldn't recommend it to friends, but my energy levels are good and the hunger isn't terrible. The first few days I was tired and cold all the time, but it is winter and I live near Boston, so cold comes with the territory. 4 weeks would be hard, but you can do it! I suggest getting any source of temptation out of sight, and keep yourself busy. Also, if you're like me, you will start thinking of the most random food-related things, like a food you like or a restaurant you went to one time 10 years ago, just totally out of the blue. Avoid cooking shows. I stupidly was halfway through an episode of Great British Baking Show before I realized what I was doing! OMG, why am I watching someone cook a tart right now?!? If you're allowed it, get the chicken soup flavored shakes (I know Bariatric Fusion, Unjury, and Celebrate have versions, if those brands are available to you). That has been such a life saver as I'm really tired of everything being sweet. Sugar free jello is lovely and only 5 calories, so it should be fine for you to have. It's almost like chewing, sort of. Good luck! -
Liver Shrinkage Diet struggles
Arabesque replied to xKirstenx's topic in Gastric Sleeve Surgery Forums
Apparently they called the first week of the pre surgery shake diet hell week at my surgeon’s office. There’s a lot of withdrawal symptoms associated with it (sugar, carbs, caffeine). Your cravings go crazy - you always want more the things you can’t have. Your emotions are all over the place which often makes you want to comfort yourself with food. On & on. Round & round. I was vey relieved I was placed on keto for the pre surgery diet. I had done the shake diet before. Two shakes & one small portion meal of steamed vegetables & plain cooked protein. Did it for 8 weeks & then again for 6 weeks a couple of years later as another diet I was trying. It ain’t easy even with one meal. Check with your dietician regarding swapping out a shake for a broth/soup. Some companies do offer them as well as shakes but they’re still going to be low calorie & go through you quickly being liquids. You’ve got this. You can do it. -
6 month blood labs..question.
catwoman7 replied to BlondePatriotInCDA's topic in Gastric Bypass Surgery Forums
I honestly don't think I've ever had my hydration level tested, so I have no clue about that one! Have you been eating any high sodium foods? Or started doing strength-training recently? Both can cause some water retention. Other than that...??? high WBC usually means you're fighting an infection - although I just googled albuterol, and you're right - it can increase white blood cell count. That could be what's going on. I would imagine that if you were early out of surgery and your body was trying to heal, that could cause an increase as well - but since you're six months out, then no - probably not that. More likely water retention or the albuterol. Let us know what they think...I'm curious. -
Cold feet b4 Surgery time sensitive.
Arabesque replied to Joe Brown's topic in Gastric Sleeve Surgery Forums
For life? Not true at all. Stage two of the post op return to eating is purée. It usually is weeks 3 & 4 so two weeks only in the first month. The staged return to eating (usually a two week cycle of liquids, purée, soft then solid foods) is to protect & support your healing tummy. It takes about 8 weeks to fully heal. Some surgeons recommend chewing well before swallowing to help during this time too to ensure nothing too coarse or fibrous is swallowed that could impact your healing. It also makes you stop & think about your eating. I wasn’t told to do that. A couple of weeks on the solid food stage (probably early start of month 3) I was eating chicken thighs, steak, lamb chops, pork loin, etc. Yes we are advised to eat slowly. It takes a good 20 odd minutes for the message to get through that you’re full. If you eat quickly you’ll easily eat too much & be over full. It’s about being mindful when eating too. Putting your cutlery down between bites & really thinking about if you need the next bite yet or just want it is a good habit to get into. It’s actually a good practice for everyone not just bariatric patients. So many people just shovel in spoonful after spoonful of food in their mouths & before they know it they’ve eaten copious amounts of food & are groaning & uncomfortable because they are overfull. Something to be aware of is eating too much, too fast or food that is too coarse or fibrous can result in the foamies. Thick foamy saliva rises to protect your oesophagus & to help you bring up the excess food or food that is causing a blockage. I still have the foamies at times. I think my oesophagus is more sensitive. Char grilled meats & vegetables & sometimes fibrous vegetables can cause me grief. But I feel fine once I’ve bought up the offending thing, I feel fine. Last time I had an episode it was because I hadn’t trimmed my sugar snap peas well & there was string left dangling & it irritated me. Most people rarely experience it & not in the long term. There’s lots of misinformation & scary horror stories online many not based on any truth or vey little or posted to drive likes (the scarier the story the more clicks). Go to reputable medical sites & forums like this one. Generally a good idea to avoid social media too. Highly recommend the you tube videos of Dr Matt Weiner (A pound of Cure) & Dr John Pilcher. Straight forward, practical information, clearly explained. -
February 2024 Surgery Buddies?
Sandee01 replied to NickelChip's topic in PRE-Operation Weight Loss Surgery Q&A
Had surgery on 14th. My anxiety was insane during Pre op worrying about what is coming aftersurgery and i had to lie on a tiny stretcher for 3hrs before going in. Pain conrtol was terrible after surgery and i didn't get relief til i got to my room and on dilaudid. Then the first day was great and relatively pain-free and stress-free. I insisted on the overnight because I knew with my anxiety it would give me a good Kickstart to recovery. Went home next day and I still took some hydrocodone that day but didn't take any more after that. I couldn't believe that these incisions hurt less than my gallbladder and a colon resection so recovering from the surgery pain is fast compared to other laparoscopic surgeries I've had Struggling really hard with the eating. I can't seem to figure out how you can get all the protein you need and all the water you need in a day when you have to pause between meals like you do and you can only drink so many ounces an hour. My Cravings are huge. I was really hoping I wouldn't feel hungry anymore but I feel like I feel hungry all the time. I was psyched to get to the full liquid diet only to find out that I couldn't have cream soup or pudding more than once a day. Have to mix protein powder in with everything I'm definitely going through my doubts about why I did this. I mean I know why but looking at food and realizing I can't just reach over and take a little bite of something is really hard. I am adhering to the diet because I don't want to be sick but I feel like I might be drinking too much through the protein meals or water because I seem to get that full feeling quickly after just a sip but then it releases itself through burps I'm also psychologically in a bad place because my psychiatrist did not change one of my meds over from extended release to normal release and so this weekend has been really rough and I can't call him till tomorrow. I am definitely very low about all of this right now -
Cold feet b4 Surgery time sensitive.
Joe Brown replied to Joe Brown's topic in Gastric Sleeve Surgery Forums
An the other hand i want to be 200 pounds and ive had a hard time maintaining that I snore heavily and buy a lot of food out and on general want to stop being crazy about running after food im seriously confused surgery in three days feel like cancelling -
Cold feet b4 Surgery time sensitive.
CelticSoul replied to Joe Brown's topic in Gastric Sleeve Surgery Forums
Hi Joe, I am almost 8 weeks post surgery. While I can't speak for everyone, I did not experience this. Yes, you have to chew your food well (if it needs chewing), but it is not as onerous as it seems. Sure, the first time I had solid food I made sure that it was well chewed and I ate it slowly to make sure it was not going to present a problem. I've done that with every new food I've tried. But it has NEVER taken me 10-15 minutes to eat 2 tablespoons of food. In fact, I have to make sure I don't eat too fast! It is like drinking water after surgery... at first you struggle to take a sip at a time. Then you notice you are taking bigger sips and then a large swallow. I can drink 8 oz of water in a couple of swallows now. I know that thought of the changes this surgery may bring to your life can be scary, but does it really matter if when you are past the initial stages of the process it takes you 15 minutes longer to eat your dinner than it did prior to surgery? That you can't get your money's worth at an all you can eat buffet? If you look at the surveys of people who have had WLS, their most common regret is that they didn't have the surgery sooner. BTW - I'd always been a "healthy" fat person until I wasn't. I can't count the number of times I lost a little weight only to gain it back; Weight Watchers should have been giving me frequent flyer rates. Today, I went under 300 lbs. for the first time in 19 years and I'm 35 lbs away from being a weight I haven't seen since 1984. Yeah... I'm good with it all! -
Cold feet b4 Surgery time sensitive.
Joe Brown replied to Joe Brown's topic in Gastric Sleeve Surgery Forums
I read online that after surgery even long term it will take 10-15 minutes to eat 2 tablespoons and eat extremely slowly chowing until all food is equivalent to mash potatoes thickness before swallowing is this true signing up my life for this?? -
Did you have a gastric sleeve leak and if you did what was the reason?
FifiLux replied to KII's topic in Gastric Sleeve Surgery Forums
I had one as a complication after sleeve surgery and it was found a month later when I collapsed at home and had to go by ambulance to hospital. The cause was suture failure. My symptoms then were weakness (could barely stand), fever, nausea with vomiting and abdominal pain. It is a rare occurrence so if you are not suffering with any of these I think you don't need to worry, you are just causing yourself unnecessary stress when you are already going through enough to deal with following surgery and coping with food planning etc. I also had other complications post surgery with pancreatitis and abdominal abscesses so basically anything that could go wrong did, I ended up spending three months in hospital over a period of four months. They closed the gastric leak by using clips and mesh via gastroscopy but that failed, twice. I now have a tube coil like thing that was inserted in order to drain fluid and hope that the hole will then have time to heal and close. The only information I was given in advance of the surgery about it was that it could happen but the surgeon did not go into detail and just said she had never had a patient have a leak, guess I am her exception if she will admit it to others in the future. No other details given to me such as cause/effect/symptoms. -
Did you have a gastric sleeve leak and if so what caused it ???
FifiLux replied to KII's topic in Gastric Sleeve Surgery Forums
I had one as a complication after sleeve surgery and it was found a month later when I collapsed at home and had to go by ambulance to hospital. The cause was suture failure. My symptoms then were weakness (could barely stand), fever, nausea with vomiting and abdominal pain. It is a rare occurrence so if you are not suffering with any of these I think you don't need to worry, you are just causing yourself unnecessary stress when you are already going through enough to deal with following surgery and coping with food planning etc. I also had other complications post surgery with pancreatitis and abdominal abscesses so basically anything that could go wrong did, I ended up spending three months in hospital over a period of four months. They closed the gastric leak by using clips and mesh via gastroscopy but that failed, twice. I now have a tube coil like thing that was inserted in order to drain fluid and hope that the hole will then have time to heal and close. The only information I was given in advance of the surgery about it was that it could happen but the surgeon did not go into detail and just said she had never had a patient have a leak, guess I am her exception if she will admit it to others in the future. No other details given to me such as cause/effect/symptoms. -
Liver Shrinkage Diet struggles
SleeveToBypass2023 replied to xKirstenx's topic in Gastric Sleeve Surgery Forums
4 weeks?? I honestly haven't heard of that. When I started, my bmi was higher than yours and I had to do 2 weeks. I feel like 4 weeks is a bit excessive. Did you ask why you have to have no food for a month? I know every surgeon's office is different, but that really seems excessive to me. What does the dietician say? -
Hi everyone! I have my surgery date scheduled for the 16th of March 2024. Due to a high BMI of 61 I have to do 4 weeks of the liver shrinkage diet. I started on Friday the 16th and I'm really struggling. I'm on total meal replacement shakes x 3 daily with just sugar free squash and water to drink alongside these. My total intake per day is 800 calories or less. How did you guys do it? I know I HAVE to do it, but it's so hard. I cry daily because I'm hungry and I want food. My stomach constantly growls, my stomach hurts and the shakes never feel like they satisfy any of that hunger. My partner is so supportive, he eats away from me and hides food so I don't feel any further distress and jealousy. I know why I'm doing this but I don't know how I'm expected to do this for a whole 4 weeks. Any advice or support is welcome. If anyone is doing the same atm for their March surgery please let me know, maybe we can buddy up! Thank you all ❤️ xKirstenx
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Cold feet b4 Surgery time sensitive.
BeanitoDiego replied to Joe Brown's topic in Gastric Sleeve Surgery Forums
I can really only share what the experience has been like for me, and the positives that have come into my life. I was in a very similar spot as you, both mentally and physically. The doubts and fear doubled, trebled, quadrupled to an infinity even as I was being rolled into the OR for surgery. I am now six months and two weeks post-op. I can pop off for a 2 mile run if I feel like it. A 10 mile hike. A long yoga session. I am signed up for getting an open-water SCUBA certification. My cholesterol is normal for the first time in my adult life. My mental health has improved. I've also enjoying seeing my physical transformation. Attaining a high level of fitness remains a strong motivation for me. But eating small portions, managing supplements, timing my water intake, and tracking food? It has gotten easier and easier. I truly wish you well on your journey, no matter which path you decide to take. -
6 Month Post-Op Update Revision Sleeve to Bypass
Chel1 posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Sleeve in 2017 to revision Gastric Bypass Aug 2023 - Update Hi All! I can't believe how fast time has gone! I will be going to my 6 mth check up tomorrow 2/20/24. Everything is a lot better! As of today I am 173lbs, I'll update my ticker it's still at 183. I am able to eat more varieties that I cook at home. Can't tolerate beef to well but I was never a big red meat person. I am still on the fence with salads/raw vegs though I can tolerate raw onions and tomatoes. I CANNOT eat take out! Purchased chinese for my son as he was going back to college... tried a little and was bringing it back up the rest of the night! If I eat out it has to be at a place that actually cooks food like salmon, veggies, no added anything. Food prepared at home is MUCH beter because you know what's in it. I am not doing too well with my multi because I purchased capsules that I open to put in my protein smoothies (Unjury Vanilla) which I don't take every day anymore. I just purchase the multi-vitamin patch from the bariatric store, I'll update you on that later My food is mostly a diet consistency of pescatarian due to the low cal/high protein and the ease of my system digesting the food. I would occassionally eat chicken as well (ground, poached breast etc), turkey hardly ever because the meat is not as soft as chicken. My veggies are fine steamed, some legumes & beans (occasional), as far as grains or potatoes etc I try to not do carbs at all or keep them at a bare minimum (jasmine or basati brown rice) with an occasional meal...I've really gotten into sweet potatoes as I didn't eat them a lot before. Swelling is gone, skin is good, and I can visually see the difference in pounds and inches loss especially from a side view lol. I still have work to do (vitamins, eat more, move more) and I am working on it. BTW!!!! I am back in the health & wellness field as I start my new position next week. I took a pause last summer. Now as I am on my health journey I'll be helping my patients with weight loss and adopting healthier lifestyles. My goal is to lose 13 more lbs and as you all know after running so long and you can see the finish line in sight....your legs get weary and that last sprint is the hardest. It is good to move from "morbidly obese", to "obese", to now "overweight"...do you guys feel the same? Let me know how you all are doing! -
4 Days Post Op - Revision Update
Chel1 replied to Chel1's topic in Revision Weight Loss Surgery Forums (NEW!)
@newbegining2024 Hi All! I can't believe how fast time has gone! I will be going to my 6 mth check up tomorrow 2/20/24. Everything is a lot better! As of today I am 173lbs, I'll update my ticker it's still at 183. I am able to eat more varieties that I cook at home. Can't tolerate beef to well but I was never a big red meat person. I am still on the fence with salads/raw vegs though I can tolerate raw onions and tomatoes. I am not doing too well with my multi because I purchased capsules that I open to put in my smoothies which I don't take every day anymore. I just purchase the multi-vitamin pack from the bariatric store, I'll update you on that later My food is mostly a diet consistency of pescatarian due to the low cal/high protein and the ease of my system digesting the food. I would occassionally eat chicken as well (ground, poached breast etc), turkey hardly ever because the meat is not as soft as chicken. My veggies are fine steamed, some legumes & beans (occasional), as far as grains or potatoes etc I try to not do carbs at all or keep them at a bare minimum with an occasional meal...I've really gotten into sweet potatoes as I didn't eat them a lot before. Swelling is gone, skin is good, and I can visually see the difference in pounds and inches loss especially from a side view lol. I still have work to do (vitamins, eat more) and I am working on it. BTW!!!! I am back in the health & wellness field as I start my new position next week. I took a pause last summer. Now as I am on my health journey I'll be helping my patients with weight loss and adopting healthier lifestyles. My goal is to lose 13 more lbs and as you all know after running so long and you can see the finish line in sight....your legs get weary and that last sprint is the hardest. Let me know how you all are doing! (this will be posted in a new thread as well) -
What do you eat 2 months post op
ChunkCat replied to DanielleQ's topic in Gastric Sleeve Surgery Forums
I was definitely a deviled eggs person!! They are so easy to pack in a snack box with some cheese, deli meat, and when safe, some cucumber and cherry tomatoes! I think I did pickles until I was cleared for raw food. I did not do chicken well unless it was chicken thighs in a sauce. I ate mild thai curries, shredded pork bbq with a no-sugar sauce, salisbury steak, turkey in gravy, meatloaf, pho with no noodles, just the meat and veggies, deviled eggs, tuna, swordfish, etc... Honestly by week 8 I was cleared for most foods so I ate whatever, within reason, protein first, then a little veggies, maybe a bite of starch if I had room. Lots of whole foods, as little processed food as possible. My fat requirements are higher than most people so I was more generous with the cheese and eggs than someone else might be. I ate a fair bit of deli meat at first because it was soft and easy to eat in small portions. Poached meat would be good too. -
Did you have a gastric sleeve leak and if you did what was the reason?
Arabesque replied to KII's topic in Gastric Sleeve Surgery Forums
Didn’t have one but I understood if you are to experience one it usually occurs in the first few days. While you need to seek help as soon as possible if you suspect a leak, they are usually repaired fairly easily via an endoscopy. You’ll likely be on antibiotics after to ensure any infection is cleared. I have three friends who’ve had sleeve surgery too & none of them at one either. They’re pretty rare I think like 1%. And even rarer if you have one in the years post surgery. Leaks occur because of a suture/staple failure, tissue decomposition, patient health prior to surgery affecting healing like a history of smoking or high blood pressure, food choices (not following your plan), excessive activity to strain & cause trauma to the area. -
Cold feet b4 Surgery time sensitive.
Arabesque replied to Joe Brown's topic in Gastric Sleeve Surgery Forums
Nerves & feeling anxious before surgery isn’t unusual. You are doing something that requires many changes to you physically, psychologically & emotionally. And you don’t have any experience with any of it. I didn’t have any co morbidities at all before my surgery but I knew they would be in my future simply because I was obese. Being generally in good health bedside surgery puts you in a stronger place for your surgery & recovery so a plus. The very small portions are only in the beginning during the staged return to eating. As you progress you are able to eat more until you are eating what is a recommended & appropriate serving size. Not those large servings that are two, three or more times we been acclimatised to think of as normal but the portion size we should be eating. Doesn’t mean you won’t ever eat your favourite foods ever again either. In time you work out how much you can eat of that food & how often. Or you may make changes to the ingredients or the cooking method to make it a healthier & more nutritious choice. We talk about having to do the head work while we are losing. This is the most important step. Working out the why, what, when you eat & changing your relationship with food. Reflecting on what drives you to eat & the food choices you make so you can mange those cravings & work out a way of eating for the future that is sustainable, doesn’t restrict or limit you & allows you to enjoy your life as you want. This is the difference between the surgery and every other diet I’ve been on (& I was almost 54 when I had the surgery & had been on a lot of diets). I’ve never been able to lose weight & maintain it for any length of time like I have after the surgery. Yes, I work on it every day but it doesn’t mean I don’t or can’t enjoy my life or miss out on anything. A lot of it is routine & I look at it as not being on a continuous diet (so many negative connotations) but this is just my way of eating. Like how people who have food allergies or may be vegan or vegetarian eat & the food choices they make. Ensure you have access to a supportive therapist you can call on if needed & a helpful dietician who listens. This isn’t something you can really do completely on your own. Best decision I ever made. All the best whatever you choose to do. -
February 2024 Surgery Buddies?
LisaCaryl replied to NickelChip's topic in PRE-Operation Weight Loss Surgery Q&A
If you don't already have it, the Baritastic app is pretty handy. So far, I'm only tracking food (well, liquids) and my weight, but there's more fun stuff, too. The bariatric nurse at the hospital recommended it during my pre-op appointment. -
Nervous and need to be affirmative!
Possum220 replied to Alligator23's topic in PRE-Operation Weight Loss Surgery Q&A
The lactose in the shakes can cause people to poop badly. There is something to take to help with lactose intolerance but I dont know what it would be called in the US. This might be something to ask at your meeting. There is also another preop diet to follow for those who are lactose intolerant. But that would normally be suggested by the dietician. Not sure why it wasnt suggested for you. Again another question for the meeting. I was not allowed fruit in my preop. If you have IBS you may find that certain fruits/foods may not agree with your tummy. Its all trial and error to find out what the culprits are that are affecting you. Fruit/vegies that have a high seed/fiber content were a no no for me before my RNY. Kiwi fruit, Zucchini, stone fruit, grapes etc are a bit of a problem but after you have the bypass you may find that you have the opposite problem and these fruits/vegies will help things to move along. It is all a bit of a learning curve. If you were to go an do it on your own these are issues that you would have to face anyway with having IBS so there no point is ditching the op at this stage. It is not part of their remit to even say "well if you cant handle it you may become malnourished". This statement smacks of shaming. It is their job to educate you in navigating it all. The RNY job is to make our bodies less capable of absorbing nutrients/calories from the food. This process is called malabsorption. This is the reason that you will be taking bariatric vitamins for the rest or your life. You will require blood tests on a yearly basis for the rest of your life to check that your body is being given the correct amount nutrients and head off any long term issues. Eating well and taking care of your body is something to focus on. I have been listening to the podcasts of The Bari Chronicles. You may find the Vitamin episode helpful. https://podcasters.spotify.com/pod/show/the-bari-chronicles/episodes/Multivitamins-Nutrition-For-Weight-Loss-Surgery-e2eduqv (Also available on apple podcasts. I hope it all goes well at the meeting. -
February 2024 Surgery Buddies?
RonHall908 replied to NickelChip's topic in PRE-Operation Weight Loss Surgery Q&A
Update: 10 days after surgery. The one thing you should do if you're not doing is taking stool softener. Yesterday was NOT fun. Even taking MiraLAX everyday, I hadn't gone #2 in two days. Yesterday, I couldn't go and was hurting from not going. After an enema and trying to free the compaction myself, I had to go to the ER in order to get it free. After being violated and a large enema later, I was freed from the beast. Never had an issue like that in my life. I've been getting 64 oz of water or more a day. I went ahead an started the soft foods, because the ER Doctor said I was only intaking protein and not getting fiber that allows better bowel movements. Be sure to get in water and take stool softner. Constipation isn't fun, being compacted is something I hope never happens again. -
February 2024 Surgery Buddies?
Bariover54 replied to NickelChip's topic in PRE-Operation Weight Loss Surgery Q&A
Hey Ron! I had my BP on the 6th. I’m doing pretty good as well. I don’t start vitamins until Tuesday a full two weeks after surgery. I guess they want to make sure I’m eating something to protect me from getting nausea. I saw my nutritionist yesterday and he said I can ease into soft foods with yogurt and cottage cheese. Luckily I love both! I was able to have about 1/2 a cup without feeling uncomfortable. I just stopped eating and I wasn’t hungry or wanting more. A few hours later same thing with a Greek yogurt. I’m so ready for eggs, tuna, cheese etc. I also was told to wear my binder for 4 weeks. It definitely makes me feel more secure. My glue is still on my incisions. I guess they put a super deluxe hospital grade glue on me. I’m not scrubbing it off or peeling it off until it comes off naturally. I’m too scared to open something up. So, good luck my friend. And everyone else hang in there with your liquid diets. It’s definitely worth it. It will make your surgery go smoother and recovery easier. 💖💖💖 -
January 2024 surgery buddies
AmberFL replied to Pink fridge's topic in Gastric Sleeve Surgery Forums
same! I am on soft foods as well, and I found that if I eat the soft chicken or turkey. I eat 1oz I feel so satisfied for a long time too. So I think incorporating those protein rich foods will help us. -
Bypass patients are supposed to take B12 supplements (either by injection or sublingual tablets) because our new stomachs lack intrinsic factor which is needed to digest it. You likely won't absorb the B12 that's in your multi or food. So keep taking it unless/until your clinic advises you to stop. As everyone said above, high B12 isn't dangerous. I wasn't told to cut back on my supplement until mine went over 2000.