Manuel Lopez Ganoza

That's exactly my problem, he said that we would talk about Vitamins in the next appointment, and it's 3 weeks away. He only said to take a Multivitamin, but I see most WLS patients taking multiple Vitamins and I guess I get anxious.

Hi MariaVSG!! Thank you for your comment and wishes. Compared to the pain I had the first 12 hours after VSG, the MGB was a walk in the park. I think I have mentioned it before, I 'm an M.D. (Psychiatrist) and I think I took the decision of having a VSG to soon. I'm convinced the MGB it´s a better procedure (at least for me). Be prepared to have more gas then expected, forget about the GERD and Constipation. Everything will be alright!!

TeacherMommy,
Sorry to hear about your struggles – it’s tough! Try not to get down on yourself, although I know it’s easier said than done. The problem with getting down on yourself is it encourages you to give up…and that never helps! It only makes things worse. Know that all of us have had (or will go through) multiple stalls.
The advice I always give is to go back to the basics…back to the very beginning when you just had surgery, when you were so scared to take a bite (or sip) because you didn’t know how it would affect you, or if your surgery was going to help you lose weight, so you didn’t want to overeat. Go back to counting every single crumb. Be brutally honest with your calories.
And do what your doctor and the others say: go for Protein, do (but not overdo) your exercise, stay hydrated. And be patient. The weight has to come off if you’re eating fewer calories than you burn – it has to. There’s just no telling when. But it will.

Hola Manuel! I had my VSG back in November 2011, lost about 52 lbs and a year later I got pregnant with baby number 2. I gained every single pound back during pregnancy. Is been 2 years since my baby was born and I'm about 6 lbs shy of reaching my pre-op. I am devastated! I have GERD, hypertension and I'm pre diabetic. My doctor said there is nothing to do and suggested gastric bypass. Reading your post gives me some hope. I am very scared of another procedure that seems a lot more drastic than the vertical sleeve. I'm happy to see you are doing well.
Greetings, Maria.

Hi! Sorry about my writing/grammar, English is not my first language.
I had a sleeve gastrectomy done on April 25 2015. Things went wrong after surgery, I couldn't drink enough fluids, I couldn't´t sleep and I regurgitated every and all the night. I ended up in the ER on may 10, and on may 13 my bariatric surgeon did a Mini Gastric Bypass. I´m a few days post-op but I feel much better, I can tolerate Clear liquids and my progress is steady an headed to recovery.
Well, I just wanted to introduce myself to the group, I have been studying a lot about the MGB, I´m an M.D. so I think it helps. I have a couple questions for the experts:

1.-Sleeve gastrectomy + MGB = better results?
2.-What do you think about juicing....I´m thinking about buying a Nutribullet and use it for Breakfast

WLS Do’s and Don’ts

DO remove the word ONLY from your vocabulary. Ex: I’ve ONLY lost 10 Lbs in 2 weeks… Now let’s look at this again without the word ONLY: I’ve lost 10 Lbs in 2 weeks!! See what I mean? Perception is reality folks!!

DON’T assume you’ll never eat all of your favorite foods again. This is just an excuse your brain has designed to allow you to indulge. You WILL eat all your favorites again someday, just much less but find it to me more enjoyable. Which leads directly into the next:

DON’T do the “last meal” syndrome. You will only sabotage your weight loss you might have pre-surgery or set you back further from your ultimate goal post-op. This surgery is very serious and is for the serious minded. Use this time wisely to get the feeling of how life might be like post op.

DO learn all of the rules pre-op that you will endure post-op. Such as, no drinking with meals, using smaller utensils and plates, engaging in some type of workout routine, limiting your sugar and sodium intake, joining as many WLS support groups as you can.

DO Celebrate every single pound lost! Imagine one pound of butter. Yeah… that’s gone from your body forever. It is noteworthy and worth every bit of a pat on the back as any others that may go along with it.

DON’T compare your successes and losses to others. Chances are very high that you will only come out on the short end and only find yourself disappointed. Everyone’s journeys are their own…

DO keep track of your losses in many different ways than just the scale! Examples:

DO keep one set of your largest clothes you’ve ever worn. Make it a point to try them on, especially when you’re having a down moment. You will find this will really pick up your spirits! This is a real rollercoaster of a ride, and anything that will keep you positive is what you should do!

DON'T keep any other fat clothes around. Get rid of them ASAP. You're never going to fit them again, right? So... off to donations they go.

DO take photos of yourself just before your surgery. Keep them close. Again, having a bad day? Look at them and compare them. As a matter of fact, take photos of yourself often. You will also find that the more you lose, the more you will want to take pictures. Nothing wrong with that!!! That goes with celebrating your losses.

DO take measurements of yourself often. Keeping track of all your inches lost will really keep you on the right track when your scale is being stubborn!!

DO reward yourself every time you hit a mini goal. Make some more worthy than others. I like to go shopping when I hit a goal, it is my favorite thing to do now.

DON’T let the scale define you. Great majority of us will endure many fluctuations and stalls in this journey. It is what it is… patience is the key here. Meditate and envision yourself months down the road at your goal. Smile, then move on!!

DO find out about measuring body fat! It’s more than just weight loss, FAT LOSS is the real goal here. Keep in mind that the BMI scale is greatly inaccurate and most Health Studies do prove this. According to the American Council on Exercise (ACE) our body fat % ranges should be average: 25-31% for Women and 18-24% for men. Any higher is considered obese. However it does go more in depth, according to ages and more. Everyone has different genetic make ups, frame sizes and fitness levels... even a different ethnicity can post differences.

DO have many goals in sight. Having only one, especially a simple weight goal you will find can be difficult. Have many MINI goals along your journey, and more than just ones that involve the scale. Such as, clothing size goals, body fat% goals, fitness or workout goals, dietary goals, etc…

DO challenge yourself always!! Whether it’s a global challenge with others, or personal challenges... It will keep you motivated and always willing to go further than you ever thought you could!

DO have a mentor! Find someone that you can trust and confide in, and that you know has “been there”. Preferably someone you know in person. You will find many folks in your life who have been there, for obesity is worldwide now and there are so many who have been able to defeat this demon. It’s not easy! It quite literally is the toughest feat I’ve ever had to endure. I can say this too, my job will never be done. This is for life!
DON'T believe the myth that your tool has an expiration date. Yes, it's true you will lose the most weight in the first year and it's also true that the further out you are and the closer you are to goal, the harder it is to lose. However, as long as you keep up with your healthy eating and fitness routines you will continue to lose weight and / or keep it off in the many years post op. It all boils down to calories in vs. calories out.
DON'T believe the myth that having WLS will keep the weight off forever. That is our individual responsibility.

And finally…

DON’T ever beat yourself up! We all make mistakes, and dare I say not one person on this Earth is perfect. I try hard to be, no doubt! I always admit that I’m a perfectionist – but I’m far from perfect. I just try to be… The only thing you can do is pick yourself up, give yourself a pep talk, perhaps contact your mentor for reassurance and move on!!! Again, this is for life. Every day you wake up is a second chance.

DO look for solutions to your problems. Otherwise they will just become excuses.


DON’T EVER GIVE UP! I don’t think any explanation is necessary here.

DON'T expect the scale to post a loss every single day. As a matter of fact, don't expect it to move that much even weekly! Just keep doing all the right things and the scale will move in the right direction when it needs to.

DO expect to see fluctuations on the scale, both down AND up. DON'T lose your head over it either. This isn't a miracle cure and the weight isn't going to magically disappear in a few weeks. You have to keep pushing with healthy eating, some type of workout and getting plenty of Fluid.

DON'T let the scale define your journey when there are so many pieces to that puzzle!!!



Good luck to all of you. This journey is a tough one, but if you are here, then you believed in yourself enough to give yourself the life you’ve always dreamed of. YOU WILL BE successful. Always keep that in mind.

Add-ons by other experienced sleevers:

DO keep a list of NSV (Non scale victories) to reflect on when times are getting hard. Can you walk up 2 extra flights of stairs before getting winded? Cross your legs?" and

"DO NOT be afraid to change things if they aren't working. Stalls happen even gains happen. If you are on a long stall look at your eating and decided if changes need to be made. Utilize your tool!" -- Southern Sleever

DO: Keep a food diary of what you eat and drink. This is a great learning tool as to which foods have what amounts of fat, Protein and carbs that add up to your daily intake goals. There are many ways to diary your food - from old fashioned pen and notebook to many options via smartphone apps. Keeping one is the important thing - however is right for you. I use mine now to look back for meal ideas when I hit a blank as to what to prepare for a day or a week.

DO: Realize this is not a diet to be followed for a while then set aside. This is a permanent lifestyle change. Yes, the amount of food you eat will increase as time passes, but your relationship with food will be forever altered. How you Celebrate your joys, successes and holidays will be different. How you mourn your sorrows will be different. Some people need outside help to get through the sometimes overwhelming mental changes this process brings. If you need help with this part of the deal- reach out and get it. -- SKCUNNINGHAM

DO roll with the punches!! -- fern

One of my favorite things to tell our newbies is this:

Stalls are like lovers. Your first will probably not be your last.

Trust in the process. It works. It just is a fickle crazy maker.

I have found that even though I have been successful these last 17 months, I still investigate every new diet that comes out. I have my 18 month follow-up appointment on 6/11 and will confess to my bariatrician that I have this anxiety and a tendency to have "exercise bulemia". I feel like if I eat anything, I have to go exercise off the calories right away.

So, just stay on point with Protein first, then veg, then limited fruit.< br />
I had to give up Peanut Butter and cheese to move my most recent stall. maybe I will try those again after my panni at the end of the year. (I have to be two years out.)
Remember these basic concepts that many of us follow with the variety of plans our bariatric teams give us:
Drink no calories.

Drink Water until your eyeballs float - 64 - 80+ ounces per day.

Don't eat anything made in a factory. You can do this by shopping the perimeter of the supermarket and avoid the aisle unless you need a spice or paper towels...that kind of stuff.

Eat at least 60 ounces of Protein per day, and at any meal, eat your protein first - then veg - then fruit.

Dessert should be something like an apple, not apple pie with two scoops of ice cream.

Avoid sugar, grease, and salt as much as possible. Eating clean will help you discover the real taste of natural food. If it weren't for sugar, grease and salt, McDonald's would have no business. When I gave up candy bars and started eating dark chocolate, I realized that it wasn't the chocolate I missed - it was the sugar.

Try to wean yourself off of soda and diet soda. Many bariatric plans discourage soda pop and anything with bubbles post-op.

Reduce starchy carbs like bread, flour, sugar, rice, noodle, biscuits, white potatoes, macaroni, spaghetti etc.


So what is left to eat? meat, eggs, cheese, Beans, Peanut Butter, yogurt, cottage cheese, nuts, and fresh fruits and non-starchy veggies. You can adjust your current recipes to reduce carbs. The World According to Eggface is a good place to start. We have a forum here for recipes. Also, Sparkpeople.com and Myfitnesspal.com.

Many of us use Myfitnesspal.com for logging our food every day. It is really an eye-opener if you are honest with yourself about what you eat.

Weigh and measure your food to accurately acknowledge your actual portion size. There is a scientific principle that says, "You cannot control that which you do not measure."

Exercise where you can. Move your body every day. Don't become part of the sofa. Good luck, and get going!

I take nasal B-12 once a week and everyday I take calcium citrate that has Vitamin D3 and mangnesium in it. I take Iron that has Vitamin C in it, and I take a multivitamin everyday.

When you have a RNY, much of your stomach is altered and your body no longer produces vitamins from foods, therefore it is extremely important for RNY patients to consume a variety of vitamins. I don't think MGB works that way, so I think it may not be a requirement for your type of surgery. If you are concerned contact your doctor or nutricianist and have them clarify your requirements. Most individuals on this board are not familiar with MGB, so you may be unnecessarily getting alarmed.

manueljlg73 You indicated that you had a mini gastric bypass (MGB). This is not the same operation as a RNY or sleeve. It is a different type of reroute. I do not think that your Vitamin requirement is the same as those with the conventional gastric bypass. It is important for you to follow the Vitamin regime recommended by your doctor. He should have laid out that regime in great detail.

@@manueljlg73 loss of hair comes from rapid weight loss and particularly not getting enough Protein.

Remember with all surgeries they are a tool and not a magic wand. I believe one can choose any surgery and the onus is on the individual to make it work. Anybody can regain weight after surgery.

My Delightful first VSG turned Nightmare @ "resleeve"
7 years ago I had a VSG with the wonderful now deceased Dr. Aceves. He was the most caring gentle sweet man and absolutely brilliant,no scars, he was there with me when I woke. He spent untold time with me personally. I loved him and the surgery was so successful. I lost 105 pounds, came within 3 pounds of my goal weight and was ECSTATIC.

A year and a half ago I had to leave my home state and move to rural NorCal to care for my aging parents. My active lifestyle screeched to a halt.. nothing to do here. The move was very difficult as I had lived in AK all my life and developed an amazing network of friends, had a booming business and a home i loved. I went through a terrible depression and a very sedentary lifestyle. Needless to say I began to gain weight. More depression. More weight. More depression, more weight. 40 pounds later I looked for a solution and found Dr. Almanza who proposed a 'resleeve" I did not know because I did not research that any reputable doctor would NEVER do a resleeve over a successful sleeve.. I does not work because the side of the stomach does not expand evenly.

With no research and desperation I made appt with ALMANZA. My first impression when I met him was he is terrible narcissistic. He paid NO personal attention to the patients... quick promises and all talk about HIM, his 6 pack abs, his good looks, etc. It was too late for me. I was THERE. I awoke to the most horrible scars... and I have experienced absolutely NO feeling of reduced appetite. I believe in my heart that he opened me up, ran into scar tissue from a previou Lipo job and said to heck with this and sewed me back up. A veterinarian would have done a better job at putting me back together. My scars are hideous and I have had NO weight loss. All he did was appear to the 'group once to extol his own virtues and we never saw him again. Now his staff blames my meds which are the SAME meds I was on with Dr. Aceves during the original surgery. SO if my meds would prevent weight loss....WHY oh why would the even take my money, promise my goal and do an ineffective surgery??? I asked for 1500 dollar back and they wont refund anything. I pegged him as a blowhard narcissist the night and the only time we met him... but it was too late. NEVER buy into the "resleeve"... it isnt "a real thing' done by any reputable doctor, but rather just a RIP off. Almanza is a quack and ripoff in my opinion. (unless it was a botched sleeve to begin with)
Almanza is an absolute cocky, self absorbed, swindler, and fraudster. In my opinion and experience. I would advise avoiding him completely. I made a terrible mistake and lost a good amount of money. I so wish Dr. Aceves were still alive. I just dont know what to do now. WHAT do I do now?
I have now done some research and the only reason a 'resleeve' is usually done is to fix an original sleeve that was botched. (not my situation). At this point, someone in my situation needs a Mini Gastric Bypass. It has been suggested to me once that a plication would apply but I dont agree.
I have been beat to crap on the message boards ... expressing my feelings and experience... even accused of being a 'ruse' working for another doctor and trying to steer business his way, OMG it breaks my heart to share the awful weight (no pun intended) of being an obese person with others who share the same but are so judgemental and cruel. I must grow thicker skin. so now i am looking for a safe and reputable place (my beloved Dr. Aceves has passed) and his clinic is just too expensive for me... after the $$ I wasted with Almanzo. Ohhhhh my gawd this is just such a dilemma. I was never happier than when people were telling me i was too thin. Superficial?? Maybe ... but the feelings are REAL. and i know there are a few of you who 'get it'. And the others want to bash the crap out of me. yes, my happiness revolves around my weight and size. so kill me.

I did one week of Clear Liquids, one week of full liquids (protein shakes and cream Soups, yogurt) then a week of purée like apple sauce and really runny mashed potatoes and then a week of cottage cheese, refried Beans type foods before moving onto soft regular foods.

Hi there ! Wow, you've been through a lot in a short time !! I'm glad you are doing better. I had my MGB on 4/23 I was a revision from the sleeve which was a revision from the band (yep, 3 for me). Your first question is hard to answer because your sleeve was so new and also because the first part of the MGB is basically the sleeve. In other words your experience will be different than mine because I was a sleeve patient for 2 years. I would guess your experience will be exactly like that of an MGB patient since essentially that's what you had only in a 2 step process. In fact I once read that Dr. Rutledge commented that he if had performed 100 MGBs then he had performed 100 gastric sleeves. My experience is different because restrictive procedures are not new to my body and my portion size is much larger than yours will be. As far as juicing, I'm a huge fan !! I have a breville and I love Joe Cross ! Just be aware of your fruits, too much sugar even natural sugars may not agree with your new insides and could cause dumping. The other thing is you won't get much Protein from juicing and it may not keep you full long so I would prob supplement with it and not make it a primary form of nutrition. Hope this helps !!

Everyone is a little different, but don't judge it while you're on liquids and puréed because usually those go down easier. You will notice more restriction when you move on to real foods again. Just go slow because chances are you will be numb for awhile and not really feel full so just go with a couple ounces every few hours and work your way up from there. Staying hydrated is the most important thing right now and then Vitamins and Protein, also watch your salt intake as in you will need to add salt or some even lick it off the palm of their hand to be sure to get enough. Gatorade is a great option too for electrolytes. Don't rush too soon into advancing foods though, your body's been through a lot. My support staff isn't great either because I had surgery in Mexico this last time but I worked with a bariatric surgeon for over six years and I had my band in 2007 so I'm no stranger to weight loss surgery. I'll try to help if you have questions.