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I totally agree about the reactive hypoglycemia -- sounds like the classic symptoms. If your sugar is very low, also carry glucose tabs with you as that will raise your blood sugar straight away, then the nuts/protein bar can sustain it from there. I'm afraid the latter two don't have enough immediately available glucose to keep you from going so low you pass out. If there's not enough information on here about it -- you can also read a lot about it on Thinner Times. It's a relatively frequent side effect of RnY and DS, less so for VSG, but not unheard of. Good luck and feel better!!

I'm a banana or a rectangle. According to my stylists, I'm an inverted triangle cos my shoulders are so broad. Ugh. I'm also out of control, working too much, never fasting, eating badly, etc. I MUST GET BACK ON TRACK!!

NEVER lost my hunger!! Not even for a week or two LOL. But I'm here to tell you, you can still be successful!!!

Good for you, Sheryl, for pursuing your own peace of mind and mental health. It's way too important to ignore. Do what it takes to get you some happy again. I'm all for it! I am with you about the isolation thing. I'm very bad at it. I hate living in the countryside, I live in the center of town. I don't like working from home except on the occasions when I need to seriously focus on something uninterrupted. I enjoy working with and around a team of people and feeling like I'm in the mix, know what I mean? Any chance of switching to the office more -- or moving house? Good luck with the pursuit of happiness!! I think you'll find answers and epiphanies and feel awesome again soon... <3

Florinda...I've been through hell and back with work. I mean...really. If you can stick it out, it won't damage you any more than you feel it's already done, you'll have money in the bank, and a few months/years from now, you'll realise how much you grew from the experience. Just my $0.02... Sheila -- CONGRATS!! 4.0 is amazing. Well done you! I haven't had time to catch up with everything else. I miss it, and you all, and life has been insanely busy. Had my three-year post-op today (post-care is sooooo good here, I am in it for life) and dr this time told me not to lose anymore, despite weighing exactly what I did last year, when I said (and she agreed) that I could lose 3-5 kg more. ?? Anyhow, all labs good, but now low on B-12 and have to have injections every three months. I guess it's normal this far out, cos the thing that makes you absorb B-12 is produced by your stomach...and if you have less stomach... Apart from that, all good. I DO want to still lose 3-5 kg more, but likely what I need to do is get back to the gym and tighten things up again. Mid-section is all flabby. Have not fasted for months. Nor gone to gym. Been stressed and working too much. Net result? Not much difference... I am confused... But my trousers have a muffin-top for reals, and I'm not having it!! ETA: Oh and thyroid was high again (TSH), so I have to double up on the thyroid for a bit. I hope it helps with the fatigue...

I eat pizza toppings, not crust. And not very often cos I'm not so fussed about pizza anyhow. But yeah, I do eat it from time to time.

Ha! Seattle summers are the Best Kept Secret ever! No, controlling for weather, it's still a thing they haven't explained. It's just A Thing. Not for everyone, this is statistics...but it shouldn't be discounted or made light of. We don't know what's going on there... PS: It rains more in NYC than Seattle...

Hey. Take it super, super easy on yourself. End-of-life care, even with the best hospice, is super tough. Just live through this. And then take stock when you can. But seriously: LIVE THROUGH THIS. It's the toughest thing ever. I send you hugs and support. You'll be okay in the long run, don't worry about right now. Focus on the grace of saying goodbye the best way you can.

I'm not kidding at all...as a sociologist, it is a well-documented fact that Seattle and surrounding areas are more 'depressed' than many other cities (most others actually) in America. They are still trying to determine why...

First I've ever heard of this...anyone else? *********************************************************************************** Gut metabolism changes -- not stomach size -- linked to success of vertical sleeve gastrectomy Date:March 26, 2014 Source:University of Cincinnati Academic Health Center Summary: It's not the size of the stomach that causes weight loss after a specific type of bariatric surgery, but rather a change in the gut metabolism, say researchers. They have found that following vertical sleeve gastrectomy, there is a change in bile acids that bind to a nuclear receptor called FXR. In the absence of FXR, the researchers showed, weight-loss success and improvement in diabetes from vertical sleeve gastrectomy is reduced It's not the size of the stomach that causes weight loss after a specific type of bariatric surgery, but rather a change in the gut metabolism, say researchers from the University of Cincinnati (UC), the University of Gothenburg in Sweden and Cincinnati Children's Hospital Medical Center. The scientists, publishing their results in the March 26, 2014, advanced online edition of Nature, have found that following vertical sleeve gastrectomy, there is a change in bile acids that bind to a nuclear receptor called FXR. In the absence of FXR, the researchers showed, weight-loss success and improvement in diabetes from vertical sleeve gastrectomy is reduced. Vertical sleeve gastrectomy, VSG, is a bariatric procedure in which approximately 80 percent of the stomach is removed to create a gastric "sleeve," which imposes a physical restriction on the amount of food that can be consumed at one time. "There are very large debates over how small to make the sleeve," says co-principal investigator Randy Seeley, PhD, professor in the endocrinology, diabetes and metabolism division at UC and director of the Cincinnati Diabetes and Obesity Center. "Conventional thought is when you make the stomach smaller, patients lose more weight because they have less room to put more food and, therefore, eat fewer calories. But as it turns out, the reason why the surgery works is that you are changing the bile acids." This study, Seeley says, is the first empirical evidence that the therapeutic value of VSG is not a result of the mechanical restriction of a smaller stomach, but the result of increased circulating bile acids that are known to bind to the nuclear receptor FXR. That discovery, he says, was made in a mouse model by removing the FXR receptor in obese mice that had undergone VSG. Despite having a smaller pouch, or "sleeve," Seeley says, rodents without the FXR receptor didn't lose weight. Because bile acids and FXR receptors interact with gut microbial communities, the researchers also looked at gut bacteria after VSG. They found that the surgery also results in changes in the gut bacteria. "Importantly, we observed changes in several key bacterial groups that have been previously linked to the risk of Type 2 diabetes, and these changes were related to FXR and bile acids," says Karen Ryan, PhD, lead author and assistant professor of endocrinology, diabetes and metabolism at UC. "Manipulating the gut bacteria is another way we think that we might be able to mimic how surgery works without having to do the cutting and stapling," Seeley says. The significance of this study is in the exploration of future treatments for obesity and Type 2 diabetes, as bariatric surgery is proven to provide substantial improvements in obesity and obesity-related conditions. "There are not enough surgery tables or surgeons to treat the obesity epidemic, so we need to understand how bariatric surgery works so that we can offer more scalable solutions," Seeley says Journal Reference: Karen K. Ryan, Valentina Tremaroli, Christoffer Clemmensen, Petia Kovatcheva-Datchary, Andriy Myronovych, Rebekah Karns, Hilary E. Wilson-Pérez, Darleen A. Sandoval, Rohit Kohli, Fredrik Bäckhed, Randy J. Seeley. FXR is a molecular target for the effects of vertical sleeve gastrectomy. Nature, 2014; DOI: 10.1038/nature13135

Yes, I am I interested also. I also have a new laser treatment my boss and a couple of others did that DID really improve neck waddle. Only about 700-800 a treatment. My boss ( my exact same age and Man) took two for )1500. They zap starting about upper mid chest (below collar bones) repeatedly which draws up the muscles. Very interesting. Wait, WHAT?!?! There is something for neck wattles that isn't surgical? I MUST KNOW MORE RIGHT NOW!! I was actually crying about my neck wattle recently (lame I know).

A little over three years out, I'd say 1 on complications and/or regret. I didn't have too many mental/emotional issues along the way either. Or maybe work has been so overwhelming, I've not had a chance to worry about anything else LOL. I'd do it over again for sure. I don't regret the timing, though, as it was the right choice for me, at the right time.

This is a great book on exercise and depression, very well-researched and convinced me totally! :-) http://www.amazon.com/Spark-exercise-improve-performance-brain-ebook/dp/B000SFD21Q/ This is an awesome book about mid-life crises and the good that can come out of them... http://www.amazon.com/Finding-Meaning-Second-Half-Life-ebook/dp/B000P2A436/ I'm still working on both approaches...

I totally feel you, as you know. Have you read up on mid-life crises, cos it sounds like a full-blown one to me. I've got several under my belt now. :-( Yes, also, to the hormones. For sure. And lack of sleep. They are all additive. For whatever it's worth, I've always had super intense down periods/anxiety attacks that last from an hour or two to a whole day, almost always gone the next day though. I think it's called...life. I stopped trying to over analyse and 'fix' it and just try to roll with it instead. Most of the time, I tell myself it's not real -- it's hormones or lack of sleep or work stress just having its way with me, and I can ignore it enough to get through it. It ALWAYS ends again. <3

I'm so not fussed about sodium. I may be fooling myself, but my BP is low-normal, and I have bigger fish to fry. Life...it is deadly...

Reading all...responding little. Still recovering from pneumonia and the antibiotics that made me sick, then got UTI and had to take other antibiotics. Now feeling better mostly, but have yeast infection. God help me... I was down 3 kg, then up 4kg, then down 3 and etc. I haven't been to the gym since October, so my midsection is soft and squishy and muffin-top-y. :-( But still vacillating wildly weight wise. And also super work busy, like insanely so. Haven't fasted since 2013. Lost. Hoping I find my way out of this eventually. Love you all.

{{{{{Florinda}}}}} Go gentle on yourself, sweets. That's a lot of processing your heart and mind are doing just now. <3

Glad my 'cootches' were well-timed!! I would ask the doc about the thyroid numbers -- some people are 'fine' in the normal ranges and some are still in need of supplementation. There is a lot of more recent research suggesting that treating TSH till it's close to zero is a new best practice. But you can be as high as 5 (don't know the values or how they measure them in the UK -- just that the range is pretty broad) and still be 'fine' but badly in need of thyroid! So do a bit of research, maybe ask a second opinion. Give the HRT a try again -- do they have any bioidenticals or natural options there? Even the synthetic HRT could really help for a while. My friend slaps one of those Patches on per week and she says she can tell when it's even one day late...! My doc here gave me something called Premens, which is meant to treat PMT I think? But there are three varieties and one is for perimenopause, that's what she gave me. I have no idea what's in it...German is hard enough without trying to figure out the 15-letter ingredients... Point is, you must advocate for your health! You clearly need some supplementation of hormones to help you through this --so do your research, ask around, push your doc a bit, etc. I think a wee dose of thyroid and some HRT of some kind and you'd be a new woman! CWTCH!! xxx

I know I personally believe that stress (or rather the belief that stress is bad for you) can influence weight loss/gain, amongst other health outcomes. And a positive attitude (or even just a neutral one sometimes) does also influence outcomes. So naturally I found this piece interesting: Comes from this story: http://themindunleashed.org/2014/02/10-amazing-examples-mind-matter.html

Hi Georgia and Kim! :-) And anyone else I forgot...sorry! Sarsar, hello! Forgive me, I'm not super at remembering things...

I have had two dexa scans in my program so far and besides telling bone density, they also give accurate body fat %...if only I could remember what it was! LOL...I wasn't too fussed about fat % -- who cares anyhow? I work out a bit for muscle, I walk a lot, I keep fairly fit. Body fat % can suck it. I don't need any more numbers to bother about, weight is plenty for me. Re: The mid-life crisis thing. I do think it's very real and it's usually all about being plunged unexpectedly and unwillingly into the big questions of life and can leave you feeling super empty, scared, lonely, restless -- just like you want to get out of your own skin some days. The worst one I had lasted nearly three years. Torture. I did find this book to be quite helpful eventually... http://www.amazon.com/Finding-Meaning-Second-Half-Life-ebook/dp/B000P2A436 Still down 3-ish kg from the pneumonia/broad-spectrum antibiotics, but less nauseated now and able to eat. I've been trying to eat pretty healthy every day before I think about 5:2ing again, since my energy is still coming back. I do feel much more back to myself in the past few days THANK GOD. I am very bad at being low energy... My three-year surgiversary was on the 24th...and all is well I think. My three-year follow-up is in a couple of weeks, so we'll see how all the blood work comes out. I don't think they will do another dexa scan this year, but again next year. The program I'm in is annual after three years, in perpetuity, so unless I move, I will be at that clinic for the next X years. That's comforting to me, cos the care is so awesome. Denise -- did you ever add Queen of Crop in here? I do think she'd like it. And we, her. Bill sounds like a great guy, but I'm with you -- I hate having sleep disturbances of any kind. Still missing Cheri and Laura... Florinda, it's awesome that you didn't gain an ounce! I always am happy about that LOL. Coops -- I just posted in your tough love thread, so I won't belabor it again here. :-) Sheila -- so glad your puppy is okay!! My dogs are my babies... Chimera (forgot your first name!) -- that story about your college is heartbreaking. And work politics make me desperately anxious and frustrated too, so I feel your pain on that one. Here's hoping you personally find your way through to a better place!! Sheryl, I loved your dress, turned out so pretty! I can't remember if I posted since then, so I wanted to say... Wanda -- your attitude helps me. Seriously. Love to all... <3

I'm 110% with OD on this one -- you GOTTA get some hormonal support of some kind. Seriously. The hormones are probably behind nearly all your depressive symptoms (exacerbated by lack of sleep, also due to hormones) apart from the normal ups and downs of life. AND I think the inability to lose weight is also very hormonally linked. Do you take any kind of supplemental HRT? I'm telling you, I'd be on it like white on rice. I am only perimenopausal according to my GYN, but she still prescribes me some kind of natural supplement to smooth things out a bit. It's already starting to be not enough... So don't believe in your feelings, try to remember that it's your body messing with you, not reality. You don't need tough love, miz coops, just love. You're already the strongest one around. REMEMBER WHERE YOU'VE COME FROM!! And try to get some type of HRT support...that would be number one on my list. Number two would be thyroid... Cwtch!!

I'm with coops on this not being entirely weight-loss related. I do understand about the unbearable restlessness and emptiness/hole where your heart should be. FWIW, I have gone through a couple of MAJOR mid-life crises, both prior to WLS. One of the worst was about age 42-45. Read up on mid-life crises and the feelings they cause, how to manage them. They are TOUGH times, but you don't necessarily need to associate any of it with your weight per se. Might be easier to de-couple the two so that you're not overly stressing about weight when you're anyhow deep in the crisis feelings... Love to all. Been through the valley of the shadow of mid-life existential crises and lived to tell. Doubt they're all behind me yet, but touch wood, I'm not having one currently. <3

Have you checked into gluten and/or lactose intolerance?

Denise, I have an issue with guys who move too fast -- ask for your space, it's okay!! Sorry I've been absent, still trying to recover from the pneumonia and house move. The antibiotics made me super sick and I've been nauseated for two weeks now. I've lost 3kg, but I'm all weak and sloppy and loose, doesn't make me feel like I'm doing well or anything. I hate not having basic energy -- I suck at being sick. But I've been inadvertently fasting a lot...?