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TPN is Parenteral Nutrition. It is nutrition through an IV. There are also forms of nutrition that can be given through the stomach. I agree that focusing on hydration and sleep are important for you at the moment, but you can't totally ignore protein at this point. You are 6 weeks out, not 1 week out. Right now you really SHOULD be relying on protein shakes! Shakes count towards your fluid goals and will give you enough nutrition to combat the fatigue and weakness that comes from not eating enough. Most patients rely on protein shakes for the first 6 months after surgery to help them get enough protein in. I'm 3.5 months post op and I eat just fine, but I still need a shake in the morning to get 120 grams of protein a day! At the stage you are at, you should be drinking some protein shake every hour in addition to your water/electrolytes, so you keep a steady supply of nutrition up. Of course you can and should try eating too, as the nausea eases eating will be easier. But shakes will actually help your hydration goal, not hinder it. ❤️

Thanks everyone for the messages! Hopefully someone will find message when they run into the same situation and help ease their mind as well. I did get a call today from my doctor. They also said they like my B12 to be over 1000. If I don’t feel well because of it I can take my B12 3-4 times a week. They assure me everything else that is showing red is fine, because of surgery and my body is recovering. My wounds are still healing etc…That’s why they don’t do blood work till 3 months after. It just so I needed blood work done for other reasons and it freaked me out.

I am the same with the jeans, feel like I am buying a new pair every fortnight. I also had to get a new swimsuit within a couple of weeks of starting aqua aerobics as the one I bought a short while ago was holding too much water. I also like that I can now sit comfortably on a bus seat and not worry that I am taking up a seat and a half. I am able to get the seat belt on a plane closed without any issues where as a year ago I had to get an extender piece (was mortified).

I agree with Arabesque, this sounds like a post viral syndrome. I'm so sorry you are going through this! You were doing so well!! What many people (and doctors) don't understand is getting any sort of virus that hits the body hard can result in a number of conditions afterwards, some caused by trying to recover from the virus, some caused by opportunistic viruses showing up when your system is low from one virus already, and some can actually be autoimmune conditions that are triggered to show up from a viral infection. Any of these could be contributing to your condition. A few years ago I got cat scratch fever (that's what I get for fostering litters of kittens! LOL). I was sick with it for a few weeks. My immune system had already been behaving badly that year, I have an autoimmune disease that flared so bad it effected my digestive system, my eyes (I was having vision problems), as well as my joints. But the virus kicked my butt royally. Then a few weeks later I started spiking high fevers at night out of the blue. I was so exhausted I started sleeping more and more every day until I was sleeping about 18 hours a day. My doctors were absolutely useless and said it was probably chronic fatigue syndrome caused by the autoimmune flare and started putting me on courses of steroids. My bones started aching so bad I would cry. I could barely walk to the kitchen to get a glass of water. My GP made out I was pain med seeking so I fired her, her lack of support was appalling. I started fainting when I tried to shower. I had vertigo all day. After fainting twice with temps over 104 I ended up in the ER where they did labs and said nothing was wrong, it was probably a virus and to go home and sleep it off. A week later I ended up in the ER again where a wonderful doctor said I was experiencing acute kidney damage from dehydration due to the fevers and that I was NOT leaving the hospital until someone figured out what was wrong. I was in the hospital for almost 2 weeks, two different hospitals where I continued to run fevers at night up to 105, it was absurd. Then suddenly one day the fevers and pain stopped. The infectious disease doctor was baffled. But when my advanced labs came back they finally understood what was going on---I had atypical Epstein Barr Virus. Atypical because mono didn't show up when tested for in the ER and I only had one lymph node swollen on my whole body, a tiny one behind my ear. Apparently atypical presentation doesn't show up on mono tests, only the two week test. Epstein Barr Virus is notorious for showing up with other viruses and generally making a pain of itself. It took me another two months before I could reliably get out of bed, and honestly my body took several years to return to a new normal. They thought I had POTS but turns out it was just severe physical deconditioning from the virus and bed rest. All this to say--if you still can't figure out what is going on after a couple of months, you might want to consider talking to an infectious disease doctor or immunologist, whoever is in your area that can treat long Covid and can test for other viruses that might be complicating the picture, as well as autoimmune conditions. Your symptoms sound so viral or autoimmune in origin. My Dad ended up with post viral arthritis. Viruses are such weird things and they can really give our bodies a hard time! Oh and one suggestion. You might want to give this device a look, it was made by two guys, one who had long Covid. https://www.makevisible.com/ I've considered getting one as I love that it helps track your activity in relation to pacing which is shown to help with post viral recovery, and in managing autoimmune conditions, chronic fatigue, fibro, etc...

My band size keeps changing every few weeks! Bras for big boobs are expensive. I'm sure the boobs won't be big for long at this rate but still, it is a funny problem to have. I have no clue why my body has decided that my bra band area is the best place to lose weight post op. 🤣

I had nausea until about 8 weeks out. It was constant and impacted my ability to eat, drink, and take my vitamins. A few things helped me (and others like me) that may help you: 1. Ondansetron only takes the edge off of nausea for me. It is rather ineffective for my body. I have much better results with promethazine, it actually manages to eradicate the nausea for a number of hours. I'd ask about a prescription to try it, at this point it is worth trying something else for the nausea and they have a number of meds out there that can help with this. I took it several times a day. 2. My surgeon told me to be gradual with my addition of vitamins. I had to take the chewable B complex everyday, and the little B1 pill because my complex didn't have enough B1 in it alone. But these were pretty gentle on my stomach. The actual multivitamins though he said are rather activating for the stomach and some people can struggle to incorporate them early after surgery. It could be these are contributing to your stomach pain and nausea, especially if your multivitamin contains iron, as it can be a little hard on a new tummy. So talk to your doctor about this, perhaps they can switch you to a bariatric B complex and let you try adding in the multivitamin closer to 3 months than all at once right now. 3. When my stomach would hurt I'd massage it in clockwise motions with firm, but not painful, pressure. I got twisting stomach spasms for the first few weeks with any food or water and this was the only thing that helped ease the pain of them. 4. My PPI needed an extra dose and for me, omeprazole is worthless. Some people metabolize it fast and for some it just doesn't work as well. Have they considered switching you to Pantoprazole? It is often used in the hospital because it is so effective. It might be worth switching to it to see if it is any more effective for you. A lot of bariatric patients end up having to switch around to find the most effective one for them. 5. Hydration is crucial early out of surgery. They should have had you exclusively focusing on hydration for the first two weeks along with the B complex. It sounds like your electrolytes are off, probably because you are chronically dehydrated. Nausea is made MUCH worse by dehydration!! You are 6 weeks and still struggling. Unfortunately at this point you DO need to be trying to get in some protein with your hydration to prevent malnourishment. Greek yogurt is great for this, but there are other options too. Have you tried any protein water powders like SEEQ or Syntrax Nectars? These are easier to stomach and come in nice flavors. SEEQ watermelon is seriously tasty. LOL Try some sample packets!! It is okay if you can't hit your full protein goals yet, every little bit helps. If the change in meds doesn't help you at all, I hope they consider doing some imaging and a scope to ensure you aren't experiencing something like a stricture. They are rare, but they do happen, and they can cause issues with progressing the diet. 6. Water flavoring packets can help with getting in more water, as does sipping it around the clock out of those tiny cups until you get the hang of getting more water in. It can and does feel like a full time job and you will feel like you are floating! This is normal. Electrolyte powders are a great addition to water at least once a day because they really help you get minerals you are missing since you aren't eating them in food! And try a variety of things and a variety of temperatures. Some hot broth or tea, some flavored water over ice, something room temperature, sometimes the tummy has an opinion about what the best temp is! I am so sorry you are dealing with these issues 6 weeks out. It sounds like your team needs to be more proactive in trying different meds and doing some testing to figure out what is going on. Honestly, some do struggle like this for a while. On occasion some end up with TPN for a while to help them get the nutrition they need. It sounds like you aren't quite at that point because you are keeping some foods down, but it is an option if you continue to struggle and end up in the hospital repeatedly for low vitamin levels. Some find a month or two of TPN can get them past the roughest part and then their systems are able to handle food and water without issue. It really depends on the person. But you don't want to go that route if you can avoid it... ❤️

My gastric bypass is 2/21. I had a sleeve back in 2012. I gained weight back except that golden 25 I like to say not a total failure but not feeling great about it. I still do not have a large appetite but it was wrong choices. I been through breast cancer and I have reached a place in my life where I have had enough of self harming as I say. The surgeon puts me on pre op diet for Two weeks. I am having a bit of trouble with all the fruits and veggies. I have IBS. I stated this from beginning to all. Today I get the poops badly and called office to see if I can take imodium. I told them I was having a tough time with to much fiber. They say well if you can’t handle it you may become mal nourished from bypass. I’m like wtf. We would like you and your hubby to come in Tuesday a day before my surgery to ask any questions you may have and then a decision will be made to go forward or not. I’m saying the decision was made already. You never had an ibs patient before. In a way I think there being careful and in a way why now? I gotta be on a liquid diet only on Tuesday. Now I feel is this going to be to much for me. I don’t want to stay fat. Maybe try on my own. I went to class I did everything that I was suppose to do but I can’t help if my tummy get sick if it’s just to much fiber. It’s like 20oz of fruit and veggies combined a day. All advice is welcomed

I am at the end of week 3 post op, and I had my bloodwork done 1 week again from primary care for other reason. However because he knew I had surgery done, he order to check vitamins and urinalysis. I don’t know if I am freaking out? But it has more red in the result than before the surgery. Hope to see if anyone of you had testing done post op and maybe can explain a little bit before I get a call from my doctor. It show I have too much B12, then there is protein in my urine, and bilirubin is high. I hope my liver is ok! Maybe all this is normal after surgery.

I'll start! I just bought jeans almost two weeks ago and they are already getting baggy....think I might need to sport the mom/ boyfriend jean look for awhile

Eight days after surgery, the only soreness I have now is directly on the incisions. The gas pains subsided by day 3 after surgery. I see my surgeon next week for the two week post op visit. Getting fluids in is no problem. I can get 70-80 oz down daily without issues. I can get 4 protein shakes in as well. Which is what my Dr. recommended for me. Though, I do feel full at times with broth and protein shakes. I still feel like I need more, even though I take a multivitamin and B-50 complex. I'm ready for the next phase which is the puree' / soft food phase. I can start that in 5 days. I feel like I can do it now, but I'm not going to get ahead of myself and follow instructions. I really don't want any setbacks. If anyone has questions feel free to ask. Just for advice, the body wrap they put you in after surgery, wear it as much as you can. It really helps with soreness. Also, it helps if you start coughing.

Day 9 on the liquid diet. My greatest disappointment so far has been a batch of "natural" jello that didn't remotely taste like lime. My biggest treat has been tropical flavored Popsicle brand sugar free popsicles. I literally yelled at a robot when I had to call FedEx after they mis-delivered an order from Celebrate that had three new flavors of meal replacement shakes in it. Do not mess with me when I'm hungry and sick of fake cappuccino flavored shakes that don't actually contain caffeine! The robot transferred me to a human and I was much nicer.

make sure you're sticking to your plan and stay off the scale - maybe just weigh yourself once a week. also, keep in mind that the closer you get your goal, the harder it is to get the pounds off. It took me 20 months - and after the year mark, there were months when I only lost a lb or two.

If you don't already have some bariatric cookbooks, I can highly recommend these three of the several I bought: Bariatric Meal Prep Made Easy by Kristin Willard The Bariatric Diet Guide and Cookbook by Dr. Matthew Weiner The Easy 5 Ingredient Bariatric Cookbook by Megan Wolf All three have sound nutritional advice as they are written by bariatric experts, as well as some really nice recipes. They talk about portion sizes and what to aim for nutritionally as you go through the honeymoon period and into maintenance, and even give you different portions for different phases. None of the books give specific calorie goals, but that's rather standard with many programs. The focus is often for you to discover what works for you and not get sucked into a dieting mindset by counting everything so closely you drive yourself crazy. But the basics are generally to fill one half of your (small, child or luncheon sized) plate with a 3-4oz portion of lean protein and no more than a 1/2 cup serving of starch/grain, and the other half with non-starchy veg. Consume 60-80g protein. Drink at least 64 oz water. (Apologies for not having the metric measurements). Using a small plate is a really great visual cue. Check out the Portion Perfection plates, which are 8-inch melamine and printed with exactly how much of each food goes where. If you need to retrain yourself, this is an easy tool to use. They have bowls, too. (All the books and the plates can be found on Amazon in the US). Going back to liquids is extreme. I would think it would be sufficient to go back to three meals per day as described above, and either no snacks or only fruit and veg or a protein shake as a snack if truly hungry, and make sure you weigh your portions and get all your water in every day. The other thing is to look for processed foods that have crept back into your diet and get them out of your house. You can't be tempted by what isn't there. Good luck to you!

There are some good dieticians & there are some … well… lousy ones. Is there any way you could find another dietician? Telling you to go to back to shakes is a bad suggestion like @summerseeker said. They should have gone through what you’ve been eating & make suggestions from there. The goal is to be eating real food not highly processed synthesised shakes loaded with artificial sweeteners & such. Stalls are frustrating. No way aground that but they are an important part of your weight loss when your body takes stock of your new needs & adjusts digestive hormones, etc. Best advice is to stick to your plan. Don’t make changes & stress your body more. The stall will break when your body is ready. Good advice from @summerseeker too about going back to the basics of protein first, then vegetables & then low processed complex multi/ whole grain carbs if you can eat more. Make cause you’re hitting your protein & fluid goals. Calories are a bit of a touchy issue at the moment in the medical world. Some are anti some are pro. A lot is around a calorie is a calorie regardless of what the food source is versus nutrient value. Plus, caloric needs differs so much person to person - age, gender, activity, metabolism, general health, hormones, etc. all affect how many you need. Personally I think if you are eating nutrient dense food, having an idea of calories can help you stay on track & guide you if you’re sliding.

I’m starting my pre-op diet in one week! I’ve been planning this for so long, it’s kind-of hard to believe I’m getting close. My preop diet includes two protein shakes, two snacks, and a healthy dinner daily for two weeks. There are some adjustments in the days before surgery like dropping one snack and adding in a special protein drink. I have my pre-op appointments next week and have a long list of questions, tho I really thought I’d asked them all. 😄

I am shocked that she said go back to liquids, that seems like really bad advice. You would be hungrier than ever as they just go straight through the pouch. I once had a stall of over 2 months, it was so tough but then I dropped 5lbs over night. I was only on roughly 800 cals a day then. Stall are the pits I have 5 small meals a day. It works for me. Just find what works for you.

Thanks! I did get evaluated for Orthostatic Hypotension and POTS with my primary care doctor doing the tilt table test and with the balance specialist, but both tests were negative. I used to have the Orthostatic hypotension previously but it was caused by my blood pressure medicine. Since I've been off of it, that particular dizziness has gone away. Now its more of a persistent feeling of motion, almost like its someone jiggling my glasses. It's just frustrating because I keep trying walking to exercise, but I'm stuck to using the treadmill or sidewalk and not going too far from the car. I'd prefer walking in the woods on trails, but I don't want to get stranded where my wife couldn't help me back. The brain fog is no joke. I had a lot of trouble with it before the surgery, had a one month or so break, then after covid, it came back even worse. Regarding other viruses and vertigo, I'll check back with my doctor when I go back next week to see if they can prescribe anything for that. Hoping you're doing well and feeling better yourself! Thank you again for replying!

Have you seen a bariatric dietician? If not, perhaps it may be timely to do so. If I have understood correctly, you are eating 1/2cup of food at a time, many times a day??? You don't say what you are actually consuming...are you eating calorie dense foods? Nuts/seeds, cheese, full fat yoghurts/milk, avocado, salmon and other oily fish, eggs? Have you actually calorie counted your daily intake over a week or so? What exercise are you doing on a daily basis?

Had my surgery on 1/25 and I’ve been off work for a full 3 weeks. Tomorrow is my first day back and I’m DREADING it. My energy levels have been low. Since I’ve been off, I’ve been waking up around 8am after a good 10 hours of sleep and I’ll do a few things around the house. Nothing strenuous. I don’t work a desk job and am constantly on my feet from 7am to 7pm. All this week I’ve been trying to wake up at 4am which is when I would normally get up for work, but I just end up napping. I work the next 3 days in a row. It’s gonna be rough!!! Wish me luck!

It will break soon! I had my stall at week 2 and the stall lasted 2 weeks for me. The stall stopped at the last day of week 3 and I’m on week 4 now. It shall pass very soon, hang in there.

Hi Fifi0523 from FifiLux I am in a similar situation to you, 8 months post surgery and between January 11th and February 12th I only lost 4lb. On Jan 11th my surgeon said my goal was to lose 10kg (22lb) during the rest of the year so I guess he based that on his knowledge that my loss would slow down. My goal is to lose 17kg (37.5lb) and that seems way off, if not impossible, given the stall I have now. This is even after I have upped my exercise, not by much due to suffering from exhaustion, but certainly by more than I was doing pre-op. I have started to track my food and drink to see if there are places I am slipping up and it has already helped me highlight areas as I was eating more carbs that I realised and I hadn't been counting my protein correctly at times. I also have started to go into menopause in the last couple of months and I am not sure if that is impacting the weight loss as I know it is already impacting my energy and sleep. I hope and think it is just our bodies recovering from rapid loss and now that it will continue but at a slower pace - I just hadn't expected it to be this slow!

if you've been following your plan and haven't increased your eating lately, then yes, you may be in a stall. Mine tended to last longer the closer I got to my goal. I'd give it a couple more weeks. If your weight hasn't started dropping by then, then you may be in maintenance (at 11.1 st, you're almost at a normal BMI). You can always lose more by dropping your calories or increasing your exercise (or both). But I'd give it a little more time.

Hi I’m 8 months nearly 9 month post gastric sleeve . I’ve posted my weight below . Am I in a stall ? My goal is 9.6 stones 15th Jan -11.1st 22 th Jan -10.13st 29th Jan -10.12st 5th Feb -11.0 st 12th Feb -11.1 st I’m so worried 😭

It appears I'm also experiencing a 3 week stall. At 2 weeks post op (surgery 1/24/24) I had lost 10 lbs. It's now 3 weeks post op and I'm still the same weight. I sure hope this stall doesn't last a month! I have been discouraged a bit, I think, because any time I've tried to lose weight in the past it has been agonizingly slow and not permanent. I had hoped that I'd lose faster after VSG and I found myself thinking this morning that I did this drastic and permanent thing just to have the same result I have always had - no weight loss for weeks at a time despite my best efforts. Reading about this "infamous" stall gives me a little hope, although I don't understand how I'm not losing weight when I'm consuming 500 calories a day or less, mostly protein and no fats/sugar. I appreciate the topic and the comments, and I'm hoping the stall breaks soon!

I think everyone does in some form. Doesn’t mean it will happen though. Yes, a bounce back regain of 10-20lbs is a real possibility but it doesn’t happen to everyone. Whether you regain or not I think depends on a number of factors. Some you can control & manage & some you can’t. Complacency - letting the new good eating habits slide. Not dealing with emotional & psychological issues behind your eating habits. Health & medications - some medications are renown for increasing your appetite or a health situation may arise that limits you in some way. Unsustainable way of eating to maintain - too restrictive & stops you from enjoying & living your life as you want. Life - sometimes throws crap at you & good intentions are the first to go. Commitment - accepting the changes you make have to be forever. I had 40 years of losing & gaining weight. Every diet, dieticians, medications, exercise plans, you name it I did it. I’d stick to it, lose weight & as soon as I stopped I would start regaining again almost immediately. Simply because I went back to eating the exact same way as I did before. I had a low & a high weight I bounced between until the last 4 or so years & my weight exploded. Nothing worked then so surgery was my only solution. Am nearing 5 years & have basically maintained my initial stabilised low weight. Never have been able to keep weight off like this ever. I had a medication glitch but we sorted that & I lost the 5ish lbs I’d gained without doing anything. I work at it every day. I established a way of eating that was sustainable & works for me, my needs & my life. Same with my activity. Don’t exercise as such just do four x 5 minute sessions of resistance bands & stretches 6 days a week - wouldn't burn 20 calories. I’m okay with that because it works for me & I’m happy to do it You have to be mentally ready for this because that’s where a lot of the battle is. Sure the surgery gives you some tools, but for me, the time it gave me while those tools were at their most effective was the biggest win. It was when I examined my relationship with food (the why, what & when I ate) & worked out what I needed to do make be the most successful. I wouldn’t stress about something that may happen because it simply may not. Just be aware of it. You never know what the future will bring & you’ll have built a wealth of knowledge & strategies & have a support team (doctor, dietician, therapist) to help you get on top of it. All the best.