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I was never given macros or calories just portion size recommendations & it came from my surgeon not the hospital. I was told to begin with 1/4 - 1/3 cup from purée stage gradually increasing to a cup at 6 months. I was also told 60g protein & keep low fat & low carbs. And I clearly remember my surgeon drawing a picture of a plate and sectioning it off to show the portion of protein, vegetables and carbs on a plate I would be consuming at a meal when I was in maintenance. If you think you’ll feel more comfortable with having more guidance, keep pushing your dietician or surgical team. It comes down to what you feel you need to be most successful.

I was given no guidelines *at all* after my sleeve. No permitted volumes, no suggested macros - I mean nothing. I learned everything I know here and managed to survive despite that! I did angst a lot in the first months too. Not nice to be set adrift after such life altering surgery and to be expected to navigate our own way. All the advice above is sound, and it's what got me though. I hope you do really well.

I was alone. My family all live in the US, I live in the UK. It wasn't possible for anyone to come stay with me. What I did before I went for surgery was set up a space near my bed that I would be able to put all my medications and vitamins, phone charger etc within arms reach so I wouldn't have to bend over or reach. When I came back home, ( I took the bus because I don't drive) I opened my medications and set everything out. They recommend you walk as much as possible. The pain meds helped and as long as you go slow, it's ok. After the first few days, I felt more normal and it was ok.

Yes - as Greentael (sp?) said above, your second set of photos give more context. Here are my before and afters. I forgot I had these on here.

Obviously you need to decide what's right for you. I was in the same boat as you in that they discovered inflammation during my EGD. I had already been leaning toward RYGB anyway, but that sealed the deal as far as I was concerned. My doctor stressed that even though I wasn't having issues with GERD, there was a strong possibility I'd develop issues if I insisted on SG. As far as risk is concerned, all surgeries carry some risk and since RYGB is a more complex surgery, you are correct that some studies show a marginally higher risk profile. Interestingly, other studies show no difference. Keep in mind that obese people are all going to have a higher surgical risk for ANY procedure than a normal sized person. Other factors that increase risk are things like heart disease, diabetes, smoking, etc. Also, surgical experience and the quality of the facilities play a huge role in overall risk. My point is that cross sectional studies showing risk are not equivalent to YOUR risks of surgery. In terms of "convertability", I think my opinion is somewhat the opposite of yours. Technically, RYGB is completely reversible, since unlike SG, nothing is removed from your body. This to me was a huge plus in my decision making process. When we look at revisions, keep in mind that revision of SG due to GERD is pretty common and those revision surgeries basically revise the patient to gastric bypass to alleviate the GERD. I can't speak to your malabsorption concerns since first of all, malabsorption in and of itself is potentially a good thing for weight loss. i can see a concern for malnutrition, but I was willing to commit to a lifetime of vitamin and calcium supplementation. I also try hard to eat a fairly healthy diet, thus also upping the chances that I have no issues with malnutrition. If you are not willing to commit you those things then yes, this may be an issue for you. Keep in mind that while it's less common, SG patients can also suffer from malnutrition. It's actually recommended that all bariatric surgery patients use supplements and eat a healthy diet and I think as long as you do those things, neither surgery is going to be an issue. Best of luck whatever you decide.

I was swallowing my normal pills the next day in the hospital but I was also drinking pretty good. And when I got home I could take my tablets just fine. If you are worried, though, order some bariatric advantage chewables. They taste decent and you can get them with and without iron. I actually took them the first month just cause they are a little lower iron than my SADI specific vitamin and I wasn’t eating as much to stomach the iron. It won’t hurt to have a couple of options on hand. Even if you have auto ship (which if you don’t have that you should look into it once you know what works for you because you save money and it’s one less thing for you to remember) you can skip a shipment anytime if you end up with too many vitamins. Also the bariatric advantage calcium chews are a good alternative to tablets and they are quite tasty (like candy). I still take them because I like them. They are a bit pricey but for the first month you don’t have to worry about swallowing issues and them being individually wrapped and not needing a drink is pretty convenient. I just keep a handful in my pocketbook and they are always with me when my alarm goes off. For the multi vitamin I use the procare health They are quite complete and reasonably priced. On their site you can do authorship and save some money. My labs have alway been great. Even now while I’m in the middle of chemo and have diarrhea everyday. That is one thing to keep in mind though. What works for me may not work for you. Whatever you do decide to go with take it with you when you go over your labs. You doctor may want to see how much of a specific vitamin is in there. They all have the same stuff for the most part but they have more or less of the different vitamins. If you end up being low in something you can always add that one vitamin but if you high you may need to switch to a different multi that has less a little less of that vitamin. I did the Pro care health multi with 45 mg I believe of iron after my sleeve and post revision I do their multi for the SADI which has higher ADEK and IRON that we need after DS or SADI. Ooh and it’s not a bad idea to eventually have one multi without iron on hand for days where you need to fast like lab days or if you aren’t feeling well and can’t eat enough to take it. I mean for twice a year you can just skip it but I’m doing a lot of labs and stuff right now that require me to miss it so I ordered an iron free and I feel better than I’m not missing all the other stuff at least. Also be sure to tell you Dr you take a BARIATRIC multi because some labs can be thrown off with the higher levels of vitamins. And if something is way off just google that and vitamins and see if that could be the issue to mention to your dr. I think it was biotin and cortisol that was my most recent one that was thrown off.

Your surgeon (or their team) should provide you with a list of the liquids you can consume during the pre surgery stage. If they haven’t yet, ask for a list so you can start to prepare. There are variations between surgeons as to what you can and can’t have at this stage. For example some are three meals of protein shakes a day & that’s all. Others are four shakes. Some are two shakes plus one meal of a lean protein & vegetables. Some are not shakes but milk. Mine was keto. So you can see we can’t really tell you what your surgeon may require for this diet or require specifically for you ( your current weight, pre existing health concerns, etc.) But as a help, start weaning yourself off caffeine, carbs and sugars now because when you start the pre surgical diet the withdrawals from those foods can be pretty tough (headaches, lethargy, irritability, poor concentration, etc.) It usually passes after five or so days but that first week wasn’t called hell week for nothing by my surgeon’s patients. All the best.

We went to visit friends this weekend in CO and I went snow shoeing for the first time! I don’t know that I could have done it at my starting weight. My legs are still sore cause you have to walk differently than you do normally, but we went over 3 miles and it was so much fun!

Thank you for your truths! It just proves that despite what non weight loss surgery people think its not the "easy way" out. It IS work and will continue to be so with constant diligence for our lifetimes! You've got this, I love reading your posts and get inspiration from them. Keep up the good work.

Hi back! I too am in NYC and my surgery is scheduled for for September 2. I also use Medicaid and Medicare. Medicaid won't cover shakes but SNAP/EBT will cover many of them and the meal replacement powders. You can use your SNAP/EBT card on Amazon and it will tell you which ones are EBT eligible. I would push your doctor to see if there is any prescribable multivitamin they can request. Medicaid will sometimes cover vitamin supplements if there is a medical need. When I was on dialysis, there was a renal multivitamin that was prescribed to me, but then once I had my transplant they wouldn't cover it. Medicaid has covered vitamin D, B12, and Iron when my levels are severely low-- but like, life threateningly low. There might be a multivitamin that is covered. Push someone at your clinic to try and submit a prescription for you. Your pharmacy will tell you whether or not it is covered. If it is not, try asking the pharmacist if there is a prescribable multivitamin that Medicaid covers. They often know. Then you can ask your clinic if someone can prescribe that to you. Good luck!