Approaching my 4-year surgiversary

[BlackBerryJuice 349]

Hello all,

I recently logged back in after a two-year hiatus to ask some plastics-related questions and figured I might as well post an update after seeing a few familiar faces. I am not going to answer any questions about my surgeon, details of my post-op recovery, post-op diet, etc, since I think this information is readily available from other posters who are less far out from their operations. When I first joined here, there was a dearth of VSG veterans on the forums, so few of us had any idea what to expect after the honeymoon period is over. I am hoping my post will help people wondering about the long term.

PLEASE DO NOT PM ME WITH QUESTIONS. I am happy to respond to questions posted here. I don't really have time to address individual questions in private and I think it's best to ask and answer questions publicly so as many people as possible can benefit.

My stats: 25 at the time of my VSG, 5'5", highest weight 228 lbs, weight on day of surgery 208 lbs. Post-op goal 150 lbs (BMI 25), lowest post-op weight 136. That weight required significant effort to maintain. I settled around 140-13. I then started Crossfit and put on a lot of muscle mass. I am now sitting right around 150 lbs.

My surgery: Aug 9, 2010 in Mexicali, Mexico by Dr. Aceves. I self-paid, surgery cost around $8700 and then I had to pay for the flight. Laparoscopic VSG with no complications. Easy recovery. Reached goal weight in less than 5 months.

Thoughts about the long term:

Reflux: I occasionally have some, it's pretty minor. I don't take anything for it. Part of it is due to my penchant for coffee. I drink about 4-5 large mugs of coffee a day.

Complications: other than the mild occasional reflux, I've had none. No strictures, etc.

Foods: I can eat anything I want. After about a year out, nothing really upset my stomach anymore. I don't get nausea, sliming, or anything like that. I have always had a sweet tooth, and I still find many sweets a little too much for me. That said, I did go on a Haagen Dazs spree last week. But food just doesn't hit the spot like it used to. I don't really get major cravings anymore. I can easily keep ice cream and chocolate around the house and not eat it. When I do decide to have a treat, it's more like, "It's so hot now, ice cream sounds pretty good. Maybe I'll have some, it's pretty yummy!" rather than "I WILL SELL MY FIRSTBORN FOR A BIG MAC NOW, GET OUT OF MY WAY, NOTHING ELSE WILL SATISFY ME" like it was back in the day.

I can eat pretty decent amounts of food now. I still occasionally get comments about eating too little, but I think that has more to do with other people eating way too much, to be honest. For reference, I can eat a McDs cheeseburger and a few fries without a problem. I can force an entire Big Mac down my gullet, but some of it definitely sits in my esophagus.

Scarring: you can barely see the tiny divot from the scar where Dr. Aceves removed my stomach. I showed it to a few general surgeons (I'm a physician myself) and they couldn't believe the results, they thought it was just from a small mole excision. I don't think a layperson would even notice it. You can't see the 3 scars from laparoscopic instruments at all.

Esthetics: I have maintained the same overall bodyshape (pear). I have a very small amount of loose skin on my stomach that does not preclude me from having 6-pack abs when I closely watch my diet and exercise. It hangs slightly when I hold the plank position, but I honestly don't care. I think of it as insurance against stretch marks during pregnancy in the future! I have some loose skin over my butt and upper thighs. My breasts are still a D cup, but they are quite droopy, and when I really watch my diet, they get very flat and dumpy-looking. I worked very hard on my fitness the last few years and have come to the conclusion that I've probably gotten within 90% of what's achievable for my body with exercise, so I am having a breast lift with augmentation and lower body liposuction next week. I was originally curious about a lower body lift, but both plastic surgeons I saw felt that the improvement in my case would not be worth the scar as my situation is not that bad. The plastic surgeon believes he will achieve good results with Lipo, although of course I will never have a super-tight rear end like someone who's never been overweight at all. I can deal with that!

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[BlackBerryJuice 349]

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Relationships, Life, Emotional Issues: I used to be a major emotional eater. One of the reasons I had the VSG when I did was because of worrying about how big I would get during clerkship (I was in medical school at the time). I was probably the ONLY one of my classmates who actually got into BETTER shape during clerkship. I very rarely emotionally eat. When I do - maybe once every 3 months - I just acknowledge it and give myself a break. I can afford to have 1/3 pint of Haagen Dazs now and we all slip sometimes.

I still get occasional flack from my mother about my surgery, because she's an idiot, but overall, everyone who knows has been supportive since. Everyone agrees I look amazing regardless. After spending my childhood and teenage/young adult years being called "fatty," "BBW," fat cow" and having obscenities and insults yelled at me by men driving by, i's very weird to be known as "Six Pack Sally" at my gym and to have multiple people say things like "I wish I looked like you" or "What's your secret? I want your body!" I just thank people and tell them it's hard work (which is true!)

I get TONS of attention from men. That was a bit of an adjustment, remembering how poorly I was treated as a fat woman before. I was quite angry about it for a while, but now I just roll with it and use my appearance to my advantage. People treat me so much better and I can get away with all sorts of special treatment. I have to say that I was worried about women treating me poorly after my looks improved, but even women treat me so much better these days. I also carry myself with more confidence. I am a physician and am often in charge of a large team. I have no problem placing myself in the position of authority or confronting someone anymore and people respect me and follow my orders, regardless of what they might choose to say behind my back - I wouldn't know! Part of it is the weightloss, part of it is Crossfit. Interestingly, one of my supervisors recently wrote in my evaluation that I am "a strong advocate for a healthy lifestyle." Imagine that!

I was in a serious relationship at the time of my VSG. We continued to be together for about 1.5 years after. As I got into Crossfit and healthy eating, my partner who is a naturally skinny-fat but unfit person became quite upset with me. He would insult my girlfriends from the gym saying they looked like men (even though they are all quite feminine, IMO!), tell me things like "Live a little!" if I said I didn't want dessert, he behaved like an ass when I took him to my gym in an effort to have him meet my friends and hopefully get into exercising regularly, etc. I eventually broke it off because of that and other factors, but his attitude towards my healthy lifestyle and my goals was certainly a major consideration.

I am now married to a guy who is a bit overweight but quite built. He really likes exercise and I'm working on getting him to lose weight.

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[BlackBerryJuice 349]

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Weight maintenance: YES, YOU CAN GAIN WEIGHT AFTER THE VSG! BUT YOU DON'T HAVE TO!

About two years out, I noticed that I could no longer truly eat anything I want at every single meal even if I did work out quite intensely. Mind you, we are talking eating out constantly, Desserts, etc. I also became more performance-oriented, so I started to think more about fueling my body for exercise. Recently, I had a severe back injury that left me unable to exercise at all except walking for 9 months. I was also having major sleep issues due to pain and work stress and was away from my husband and very socially isolated and unhappy for a variety of work-related reasons. I love to cook and was certainly amusing myself by cooking lots. Normally, my husband would inhale most of my creations, but now I found myself eating less healthy and in greater quantities. Together with hardly any activity, this led to a weight gain of about 13 lbs in 9 months. Not the end of the world, but I was certainly worried!

Thankfully, I buckled up and once I was cleared to start exercising, I restarted couch-to-5K and then signed up for a 10K race. I lost the 13 lbs in about 2-3 months with only minor diet changes - basically, eating less crap and more fruits and vegetables. I still ate some sort of treat almost every day. I didn't follow any specific diet plan like low-carb or Keto, although I do try to limit my carb intake that doesn't come from fruits and vegetables. I am now closely monitoring my diet as I want to get as ripped as possible since I have Lipo coming up and will be away from the gym again for at least 4, potentially 6 weeks. I eat whatever I want within reason, but I count my macronutrients, so every day I eat a certain amount of Protein, carbs, and fat. I eat a fairly high-protein diet - 120-150 grams. I have had no problem losing fat on this plan while eating 2500-3000 calories a day depending on my exercise level.

SO YES, YOU CAN GAIN WEIGHT - BUT YOU CAN ALSO LOSE IT, AND YOU WILL ALWAYS REMAIN IN CONTROL! DON'T LET YOURSELF GO TOO MUCH! IT'S NOT HARD TO LOSE 5-10 LBS, BUT 25+ IS A PAIN!

LAST BUT NOT LEAST: PHOTOS

All these photos were taken within the last week.

These are my pre-op photos:

[Sassypants92201 76]

Wow thank you so much for all of this. I am so thankful and you have answered so many of my questions...a big one i have for you, is it difficult to consume as many calories as you need to for your workouts? I haven't seen that addressed at all on here. Thanks.

[mommaof3 39]

Wow you look great! You have really worked hard. You do not even need liposuction, in my opinion, but I wish you well on your upcoming procedure. Thank you for the update, very inspiring!

[TovaNJ 11]

Amazing transformation!!!

Thanks for sharing.

[BeagleLover 1,020]

You look awesome! Thank you so much for the hope.

[skinnygirlwithin 693]

wow! you look amazing! I agree it doesn't look like you need lipo.. Thank you for sharing

[Kindle 8,667]

Thank you so much for your post. It is very refreshing to hear about sleeved life as far out as yours, and thrilling to hear how confident and successful you are. Congratulations with all you've accomplished in your personal and professional life.

[thesuse2000 698]

Thanks so much for sharing your story! It was a fun read, and very inspirational. So happy for you for all your successes.

[Mrs Magoo 1]

So happy to read your candid story. I'm 8 months post and always wonder about the future. Thank you.

[BlackBerryJuice 349]

Wow thank you so much for all of this. I am so thankful and you have answered so many of my questions...a big one i have for you, is it difficult to consume as many calories as you need to for your workouts? I haven't seen that addressed at all on here. Thanks.

Yeah, that hasn't been a problem, as evidenced by some weight gain in the past, haha. It will be more difficult in the first year, but now, I don't have a problem. I would like to go through a bulking cycle this fall, which combines heavy weight training with overeating to help grow muscle, and since I find that my regular caloric expenditure is quite high (I maintain on about 3000/day when I do Crossfit), I suspect it will be a challenge for me to get 3500+ calories consistently with healthy foods. I'm planning to eat more foods like Protein Shakes with full fat milk/bananas/peanut butter or tuna melts with cheese and mayo. But not being able to eat enough to fuel my workouts certainly isn't a problem.

[Pookeyism 1,143]

Thank you for taking the time to post this. Very inspirational!

[I will what I want 271]

Thank you so much for posting this so we all can learn from your success. Do you have macronutrient goals for Protein and carbs? Did those goals change when you started Crossfit? Thanks!

[lambada 17]

Wow! Fantastic! I true inspiration! Thank you!