October 2023 surgery buddies

[ChunkCat 728]

On 12/9/2023 at 3:07 PM, ukkodiak said:

Hi guys. Been a few weeks since I've posted here. Feeling a bit frustrated and puzzled right now. So my first six weeks weight loss was great. I lost 48 pounds in six weeks since my RNY on October 9th. However, since then I've pretty much stalled out and only lost 3 pounds in the past three weeks. I noticed my weight seemed to stall once my surgeon cleared me for solid foods.

I really hoping I haven't gone through all this time and money for nothing. My surgeon told me at my followup that I can expect weight loss to level out between 9-12 months post-op. And I can expect to lose half my total weight loss at 3 months. Have about another 75 lbs to go for my goal weight, so I feel like I'm on the clock here. Has anyone else out there experienced anything like this?

Your surgeon is a bit off in his ratios. Weight loss rate is different for each surgery and for each person. I think the 3 month mark for most surgeries is closer to 30% though, not 50%. I've never heard that for 3 months, only for 6 months. Have you run your stats through this calculator? https://www.facs.org/quality-programs/accreditation-and-verification/metabolic-and-bariatric-surgery-accreditation-and-quality-improvement-program/riskbenefit-calculator/ That is the calculator many bariatric surgeons use to calculate their patient's trajectories. I feel like I'm behind because at about 3 months out I'm only down 40 lbs or so since surgery, but 53 lbs since my highest weight. So I used that calculator, starting with my highest weight, since that is what the surgeon would have used. Turns out I am right on the mark, as their PA told me a few weeks ago! Everyone around me is losing faster, but that doesn't matter. For my body and my health conditions I am apparently right on track. I found that really reassuring. Keep in mind that site only tells you what it expects you to lose in the first year. I thought malabsorbative surgeries like the DS or Bypass can keep losing up until the 18 month mark, though it is much slower loss at that point? I know DS patients can even lose up to the 2 year mark, though again, it is much slower. You usually lose the last 20%-25% much slower because the body is closer to its set point.

I had a 6 week stall that started when I added solid food in. I kept gaining and losing the same few lbs. But someone told me to check my measurements, since usually when the scale stalls, our measurements go down. Sure enough, I was losing inches!! So I REALLY advocate people measure once a month and record it, the Baritastic app can even track it for you. It is really reassuring to see those inches lost when the scale has been acting like a d**k for weeks. LOL How are you doing now??

[Eva Greeff 10]

Congratulations losing 48 pounds in six weeks-that is great! As to the stall, I had the exact same issue. It is to be expected, I was warned about it by my doctor. I thought I was prepared, but when I didn't lose for over two weeks it really did mess with my head. I think I am out of it now, but I did extend my exercise a bit, drank more Water and tried to make sure I was eating very healthy. The stall between 3-8 (mine hit at 7.5 weeks) weeks is expected and normal, and you will have more stalls. I get it; I really do. I felt the same way you feel and was so frustrated about losing/gaining the same pound for 18 days. Measure yourself as one person suggested and just remember that it will pass. It is so frustrating, but hang in there. You can do this!

[Tanith 3]

Hi all, had surgery on 30th October and have lost 70lbs since then (a little extreme) although in general I feel very good….except for one thing. I still cannot eat solid foods. No matter how small a spoonful, how moist the food is, how long I chew and how long I take over a meal, I feel bad almost immediately. Uncomfortable and unpleasant. Drinking fluids is no problem and am basically living on Protein yoghurts, Protein Shakes, Soups, protein cheese and boiled eggs etc. not exactly very balanced despite all the Vitamin and mineral supplements. Has anyone else experienced anything similar ?

[Charlie21467 11]

Hi Tanith,

I too am in a similar situation. I have lost about 60 pounds since my Oct 3rd surgery. I can eat some solid food, but I have to be very careful. Most of the time after eating, I feel like I've swallowed a rock that is just sitting in my stomach (or what's left of it rather). I do get nauseous very easily and have gotten sick many times after eating. I also get heartburn very easy. I've been living on Tums lately. I told my Dr about this and he said just to eat smaller portions and very slow to eat. I wish it worked that easy. I'll be following to see what others say. Wishing you all the best.

[ChunkCat 728]

Sorry you guys are dealing with this! Are either of you on a PPI (proton pump inhibitor), this could be something like omeprazole. Typically the over the counter dose isn't high enough, so it is best prescribed by your doctor. Some people end up taking it twice a day. Omeprazole never worked for me, I take pantoprazole in the morning and Dexilant in the evening. Both are prescription. Bariatric patients typically need a PPI after surgery to protect their stomach from acid and help the sutures heal. Our new tummies are still producing the amount of acid we produced for our whole stomach, which is obviously too much acid for a little tummy. This can cause pain, nausea, vomiting, a feeling of not being able to swallow because acid is washing into the esophagus and irritating it. It can also cause that classic heartburn feeling... If you aren't on one, tell your doctor you want one. If you are on one, it's possible it isn't working, you may need a higher dose or a different medication (some people metabolize omeprazole too quickly).

In addition to this, it takes a while for our new tummies to heal the nerves that were cut and our fullness cues and stomach sensations can be different than they were before. Fullness may feel completely different and very uncomfortable. After I eat I feel pressure at about the middle of my stomach and a feeling of heaviness sitting there. It is my signal not to eat anymore. If I persist, I'll start hiccuping and sneezing aggressively, and sometimes vomit. I am very careful not to get to that point. But I can eat a normal bariatric sleeve portion for 3 months out...

Sometimes heavy Proteins like meat sit very heavily in new stomachs for the first year. It isn't unusual to not tolerate beef or chicken breast. Proteins should be moist (like chicken thigh in a sauce), with small bites and very thorough chewing. You'll probably eat a smaller portion of them than you would yogurt or eggs. Fish and other seafood are the easiest meat proteins for us to digest because they are lighter and softer, so try that if beef and chicken are too heavy.

If after a few weeks on a PPI you are still not able to at least advance to moist fish without pain or vomiting, I'd be requesting an endoscopy or other imaging to ensure there isn't a stomach stricture or scarring getting in the way of you eating. Strictures aren't super common in sleeves but they do happen.

Edited January 28 by ChunkCat

[Charlie21467 11]

On 1/27/2024 at 9:41 PM, ChunkCat said:

Sorry you guys are dealing with this! Are either of you on a PPI (proton pump inhibitor), this could be something like omeprazole. Typically the over the counter dose isn't high enough, so it is best prescribed by your doctor. Some people end up taking it twice a day. Omeprazole never worked for me, I take pantoprazole in the morning and Dexilant in the evening. Both are prescription. Bariatric patients typically need a PPI after surgery to protect their stomach from acid and help the sutures heal. Our new tummies are still producing the amount of acid we produced for our whole stomach, which is obviously too much acid for a little tummy. This can cause pain, nausea, vomiting, a feeling of not being able to swallow because acid is washing into the esophagus and irritating it. It can also cause that classic heartburn feeling... If you aren't on one, tell your doctor you want one. If you are on one, it's possible it isn't working, you may need a higher dose or a different medication (some people metabolize omeprazole too quickly).

In addition to this, it takes a while for our new tummies to heal the nerves that were cut and our fullness cues and stomach sensations can be different than they were before. Fullness may feel completely different and very uncomfortable. After I eat I feel pressure at about the middle of my stomach and a feeling of heaviness sitting there. It is my signal not to eat anymore. If I persist, I'll start hiccuping and sneezing aggressively, and sometimes vomit. I am very careful not to get to that point. But I can eat a normal bariatric sleeve portion for 3 months out...

Sometimes heavy Proteins like meat sit very heavily in new stomachs for the first year. It isn't unusual to not tolerate beef or chicken breast. Proteins should be moist (like chicken thigh in a sauce), with small bites and very thorough chewing. You'll probably eat a smaller portion of them than you would yogurt or eggs. Fish and other seafood are the easiest meat proteins for us to digest because they are lighter and softer, so try that if beef and chicken are too heavy.

If after a few weeks on a PPI you are still not able to at least advance to moist fish without pain or vomiting, I'd be requesting an endoscopy or other imaging to ensure there isn't a stomach stricture or scarring getting in the way of you eating. Strictures aren't super common in sleeves but they do happen.

Thank you for this information. This is very helpful. I was on omeprazole for the first weeks after surgery but not now. I do take the generic Zofran to help with nausea, but not every day. Lately the host stomach and vomiting has been in spells. One day in fine then the next I'm getting sick so easily.

I've been living on Tums which has caused some intestinal issues I believe. I only have a bowel movement about once every 4-5 days and when I do it's mostly mucus and no stool. It's been a real passion in the butt. Pun intended. Lol

Anyone else dealing with similar intestinal issues?

[ChunkCat 728]

3 hours ago, Charlie21467 said:

Thank you for this information. This is very helpful. I was on omeprazole for the first weeks after surgery but not now. I do take the generic Zofran to help with nausea, but not every day. Lately the host stomach and vomiting has been in spells. One day in fine then the next I'm getting sick so easily.

I've been living on Tums which has caused some intestinal issues I believe. I only have a bowel movement about once every 4-5 days and when I do it's mostly mucus and no stool. It's been a real passion in the butt. Pun intended. Lol

Anyone else dealing with similar intestinal issues?

Zofran can cause wicked Constipation, even if you are using it sporadically. So can Calcium, which is the main ingredient in Tums. If you are eating more than two a day, you could be causing considerable constipation, and the extra stomach acid can cause intestinal issues too. I'd definitely talk to them about continuing the PPI.

Have you tried using a stool softener daily for a while? It isn't unusual for bariatric patients to need them long term, but they can be especially necessary in the early months. For some it isn't enough and they have to add in a dose of Miralax daily. Miralax and stool softeners are safe even if you need to use them for a while, the ones that cause issues with bowel dependency are the stimulant laxatives.

I'd talk to the doctor about how your bowel movements are when you get a chance. I know some sleeve patients can end up not going for several days at a time, but usually mucus is seen when something is irritated in your GI tract. They might know of another cause though...

[SomeBigGuy 110]

For Constipation, my doctor had me take Miralax daily for the first month. If that didn't work, taking a tablespoon of olive oil 2-3 times a day seemed to fix the issue. It took about 8 hours after the first "dose" but it helped relieve my problems.

[walterblock1 32]

Had the same date I’m down about 87 lbs I’m food intake is very low I just eat Protein chicken and fish everything else upsets my stomach can’t eat a lot can only eat like a wing drumstick n I’m full other then then that’s everything is going well

[New To This23 102]

Hi everyone, My 3-month mark was January 27th, 2024 for RNY. I was cleared to eat regular food in the normal way (not liquid, puree) 2 days before Christmas. I just had my labs done today, and my 3-month checkup with the clinic is on Feb 12th, where we will go over labs and diet expectations. So I will know more then.

From my highest weight, I have lost 61lbs/27.69k so far, since surgery on October 27th I have lost 39lbs/17.69k. I feel like I should have lost more, but I am right on track. I was exercising at the gym 6 days a week since mid-November, up until 2 weeks ago when I got snowed in. I am hoping to get back to the gym tomorrow, but I am overwhelmed looking for a new job/career change and I would like to move to Nevada.

I have noticed that the exercise seems to help me with the weight coming off and I have been building muscle too, especially in my arms and legs (most excited about arms).

I take full body measurements every month on the 27th. I started doing this the day before surgery in October and I have found it very encouraging, especially since I struggle with feeling I should have lost more. I would suggest everyone do this, there are some great cheap templates you can download from Etsy.

The first month after surgery I lost 0lbs, nothing and I was super upset, how can no weight come off when all you get to eat is Protein Shakes, and it's a struggle to get them down? So I guess I hit my stall right out the gate.

My surgery did go very well. I only stayed one night in the hospital, and I was eager to get home, I did throw up the entire time after surgery (that day and the next day) but I did not have pain or gas and I was able to walk around easily. TMI but I did start my period the day before surgery, so FYI bring your own pads to the hospital, the ones they have are terrible, and no you can't use a cup or tampons.

I will let you know how my lab report turns out and what they tell me on February 12th. Oh and anyone living in Las Vegas or Henderson NV and can help with a job, that would be awesome I have a bachelor's in Business Management with an emphasis in Entrepreneurship, and I can learn to do anything quickly, but I would need to make enough to afford an apartment on my own. (it's worth a try)

[Wildflower Bohême 31]

On 2/7/2024 at 12:30 AM, New To This23 said:

From my highest weight, I have lost 61lbs/27.69k so far, since surgery on October 27th I have lost 39lbs/17.69k. I feel like I should have lost more, but I am right on track. I was exercising at the gym 6 days a week since mid-November, up until 2 weeks ago when I got snowed in. I am hoping to get back to the gym tomorrow, but I am overwhelmed looking for a new job/career change and I would like to move to Nevada.

I have noticed that the exercise seems to help me with the weight coming off and I have been building muscle too, especially in my arms and legs (most excited about arms).

I take full body measurements every month on the 27th. I started doing this the day before surgery in October and I have found it very encouraging, especially since I struggle with feeling I should have lost more. I would suggest everyone do this, there are some great cheap templates you can download from Etsy.

The first month after surgery I lost 0lbs, nothing and I was super upset, how can no weight come off when all you get to eat is Protein Shakes, and it's a struggle to get them down? So I guess I hit my stall right out the gate.

Great job on everything so far!! I applaud you on your dedication to moving your body!! I also take my measurements once a month, on the 1st. I totally relate to everything you said, including the early stall! I had a stall at 2 weeks and it lasted a month. I cried at my 3 week appointment, as I had gained 6 pounds. I thought my surgeon would think I was non-compliant, even though I was only getting 3-400 calories a day. She hugged me and told me that it was literally impossible for me to be non-compliant at this stage! It was just my body freaking out at itself, and the goal over time was to add a lot more calories.

I haven't been able to do much more than a little slow walking, even at nearly 4 months out and just short of 40lbs down from surgery weight. I think it has to do with sleep, about which I have huge issues. I feel like once I get better with that, I'll be able to add a lot more movement. I'm hoping that will help get me through future stalls, which I know are very likely to come and are super normal. Still doesn't make it easy!

Also having trouble getting my 64+ of liquids. It's a daily struggle that I don't always meet.

My surgeon chose to leave the hospital and physician's group 3 months after my surgery, because the powers that be were making decisions about the program that she felt compromised the program's (and her) integrity. She's moved to a more holistic private practice now, and even though they don't take my insurance, she offers a special rate for follow-ups to her former surgery patients. I'm totally going to go see her for my 6 month f/u and beyond, because the hospital has now ended their bariatric program, and I adore my surgeon and her holistic attitude. I feel really lucky.

Edited February 8 by Wildflower Bohême

[Wildflower Bohême 31]

I'm happy today because I have lost 109 lbs from my high weight! I downloaded a coloring page from Etsy to track my weight loss, and once I hit that goal (literally on New Year's Day), I downloaded another one with my next goal. It's fun to color with crayons (and kids Water colors, when I couldn't find my crayon box for a while) I keep them on my big magnetic white board. When I'm in a stall or gain a couple of pounds, I don't/can't remove any pounds, because they're already colored in. I just wait until I can color in new spaces. I recommend trying something like this, if it resonates with you!