shriner37

I know many pre-op patients have questions about the process. Each one of us is different but I thought I'd share my experience around the surgery and recovery in case it is beneficial to anyone preparing to undergo VSG. Based on my BMI, my doctor put me on a one-week pre-op liquid Protein diet. This consisted of three Protein shakes a day and otherwise Clear liquids. The first couple of days were tough, but by day 3-4 my system had gotten over its carb withdrawal and I tolerated the diet fairly well. I also used this time to wean off of caffeine since my surgeon didn't allow any for 8 weeks post surgery. During the pre-op diet phase I dropped 8 pounts, from 285 to 277. On my surgery day, I arrived at the hospital fairly early. The nursing staff prepared me (IV, gown, support stockings, etc.) and I met briefly with the surgeon and anesthesiologist. I was wheeled into the very cold operating room. Shortly thereafter I was given the IV anesthetic and was fast asleep. I woke up in the recovery area. This was easily the most uncomfortable part of the process as I was coming out of general anesthesia, hooked up to everything and now had a wonderful (not!) urine catheter placed. As I came out of the fog, I remember trying unsuccessfully to negotiate with the nurse to remove the catheter as it was very uncomfortable. After 20-30 minutes in this area I was moved to a wheelchair (a surprisingly challenging endeavor) and was wheeled to my room. Once in the room the PCA pump was attached. This helped greatly with my comfort level. I was also allowed to start sucking on ice chips. I did experience some gas pains but they were manageable. The nursing staff got me up to walk within a couple of hours. My particular facility was absolutely wonderful. It is a small satellite surgery facility of a large hospital and is in the same building as the surgical practice. I think most of the patients are part of the weight loss surgery program. On my particular surgery day I think my nurse had two patients, so I was able to get as much attention as I needed. One key item they were monitoring was my blood sugar which was running low. This was surprising as prior to surgery I was a Type-II diabetic with a normal glucose of 115-120. They gave me IV glucose a couple of times and were monitoring it closely. I progressively felt better throughout the day and evening and walked a few more times. There wasn't much sleeping as it seemed like every 10 minutes someone was in the room to do something. The day shift nurse had been bringing me ice chips in a small medicine cup. The night shift nurse brought a large cup of them with a spoon (what an angel!) By about 3am I was able to get myself out of bed and move to a nearby chair, managing all of the lines and connections carefully. I found that the more mobile I was the better I felt. At 5am I was told that we needed to begin preparing for my discharge. This involved giving me a glass of ice Water which I sipped on. It also involved removal of the catheter and the surgical drain, both of which were momentarily painful. I did feel better after that though. One more walk, a visit from the surgeon and his assistant, and I was discharged a little more than 24 hours after arrival. We stopped at the downstairs pharmacy for the liquid narcotic pain medication. At home, day 1 post-op involved mostly sleeping and relaxing. I had to sleep in a recliner for a couple of days to limit suture pain. I used the narcotic pain med a couple times that day. I began sipping and walking, encountering a little pain but nothing unbearable. By day 2 post-op I was feeling much better. On day 2 I stopped the narcotic pain meds and switched to liquid Tylenol. I had been told I could drive as soon as I was off the narcotics, so switching to liquid Tylenol meant I wasn't tied to the house. By that evening I felt well enough to drive myself to a meeting of an organization I'm involved with. Moving slowly but without much pain, it was nice to get out a little. I noticed I had real challenges with capacity of my new stomach for the first couple of days. It seemed like it would only hold a couple of sips or maybe a teaspoon of broth. On day 3 this got better, and by day 4 I was able to drink liquids and even broth and Soup without much restriction. I think this was the post-op swelling going down a little. My surgery was on a Tuesday and I came home Wednesday morning. My first venture out was Thursday evening. I returned to work the following Monday without any real issues but I have a fairly sedentary office job. I have to say that my recovery was quicker than I expected with relatively few issues and no complications. I know this isn't the rule for everyone. I think it helped that despite weight and Type-II Diabetes I was in generally good physical condition which probably made things easier. I'm now about 10 weeks post surgery. I successfully transitioned diet from liquid to pureed to soft foods and then to regular foods. I've experienced two stalls (one early and one now). I've dropped two shirt and pant sizes and am almost ready for a third. I'm still learning how to manage my weight loss and diet while traveling extensively for business. I have yet to get locked into an aggressive exercise regimen but am trying to do so. But overall this has been a totally positive experience and a decision I am 100% happy with.

I would recommend that you discuss this with your surgeon (who from your profile looks to be the same as mine). I am sure that he can give you some insight into the long term success rates for his patients. What I've seen is that in general, bariatric surgery patients can expect to maintain a loss of 50-60% of their excess weight. But this number is an average across all patients, generally presented without any specificity about their overall adherence to diet and exercise programs post-surgery. I've read and been told that with appropriate adherence to nutrition and exercise goals a 70%+ EWL is maintainable.

@@BLERDgirl Thanks for the good suggestions. Planning for and preparing healthy snacks would be a big benefit, and is something I need to do. I also like your idea of using downtime to add in physical activity.

@@wannaBthinsoon Thanks for the information. You are right that grazing will probably be the biggest challenge I have, along with staying motivated enough to get in good exercise. I need to get back to see Tim as I'm overdue for my two month follow up. Can you tell me at what stage you were when you did the 5-day reset? I've been in what is basically a stall for a couple of weeks. I was traveling for a 10 day period which sort of got me a little off track with too many business meals plus some alcohol, and since then (I've been back over a week) I've only dropped a couple pounds. I'll talk to Tim or Laura about it but am wondering if a reset would help me get back on track for weight loss.

As I've progressed post surgery I have learned that the most challenging days for me are the days when I have less activity to keep me busy. If I have an active, busy day I have found that it's very easy to stick with my program and experience little actual hunger. The challenge, at least for me, are the days when I don't have much going on. Sitting around the house, watching TV in the evening, relaxing on the weekend. All of those end up prompting some serious head hunger. While the surgery may have helped me deal with actual hunger, it is still a battle to fight the urge to eat or snack out of boredom. As an example, Thanksgiving itself wasn't a problem for me. I was able to eat mostly turkey breast and green Beans and did just fine. Plus I was busy cooking, cleaning and preparing for a house full of guests. However I was off work the day before and day after and both of those days were very challenging, especially with snack or finger food items all over the place from the holiday. I did fairly well but still ate some stuff I shouldn't have. I've learned that keeping snack foods (slider type items) out of the house helps a lot as it reduces temptation. However, others in the household do occasionally bring in snack foods, so it takes a great deal of willpower to stay away from them when I'm just sitting around, watching TV, etc. Does anyone have any tips or tricks to help fight the urge to eat out of boredom and the associated head hunger?

Congratulations on being approved for surgery! As @@rking said every surgeon seems to have a different protocol so it's best to follow the plan given to you by yours. My surgeon did not allow caffeine for 8 weeks following surgery so I used the pre-op period to wean myself off of coffee. I'm back on it now but was able to consume some decaf after the first couple of weeks which helped. As far as post-op groceries, again I would refer to any documents given you by your surgeon or nutritionist (NUT). Every plan is different. Many doctors have patients progress slowly through the phases of Clear liquids, full liquids, pureed foods, soft foods and regular foods while others progress more quickly. For certain you will need some good choices for broth, Protein shakes, sugar free popsicles and then progressing to sugar free applesauce, fat free yogurt and cream Soups. The most important item, immediately post-surgery is to maintain your Fluid intake. For the first few days to a week after surgery hydration is more important than nutrition. If your experience is like mine you'll be challenged to get liquids in for a few days, then the post-surgery swelling will ease and liquids will be easier. I found that getting various flavors of Crystal Light helped a great deal rather than just drinking Water.

My discharge instructions said I could take showers starting the day I went home, but for the first two weeks I should stand mostly with my back to the running water. This was while the wounds were dressed and before the staples were removed at two weeks. After that I was free to do whatever.

Hi Mark! Congratulations on a successful surgery. My clinic counted days post-op so they considered "day 1" as the day after surgery. Good to hear you are able to progress to Protein shakes without issue. Everyone has a slightly different response to surgery. I personally had no pain drinking Water. It should hopefully get better soon, if not I'd sure ask about it at your first follow-up visit or ask the clinic.

Excellent post! I appreciate your perspective a year out and hope I have the same as I reach that point. I'm only a couple months out but already am starting to experience some of the things you mentioned. Your comment about the sleeve always being available as a tool is spot on. I had to travel for a 10 day business trip over the last two weeks and in the past that would have resulted in a 4 or 5 pound weight gain. Even though I wasn't able to totally follow my nutrition plan, because of the limitations of the sleeve I was still able to lose two pounds during that trip. I also agree with your thoughts about setting short term, achieveable goals. I've decided that instead of setting scale goals I use clothing sizes. Setting a target of reducing to the next lower size seems like a reasonable target. I've already been able to hit two of these and am just a week or two away from another. Keep up the good work!

I too did the 'food funeral' thing before surgery. I know I will ultimately be able to eat small, occasional portions of whatever I liked before, but as I've progressed back to regular foods after surgery I've found that many of the items that were really appealing to me before hold no appeal now. For example I used to love a thick, juicy cheeseburger, but now would much rather have some grilled chicken or baked fish. I was never a big sweets person, my attraction was to fried crunchy Snacks and high fat meals. I've found that the heavy, fat laden taste of these things holds no appeal to me now. Plus, I simply don't want to buy or prepare something so large that I can only eat a small portion of it so I naturally gravitate to better foods in smaller portions. This reinforces what we all have been told - the sleeve is merely a tool... to be successful we have to change our thinking and behaviors. My surgery seems to have helped both of those.

We all lose at a different pace, depending on our metabolism, environment, and compliance with diet and exercise targets. I'm nine weeks post-surgery and have been traveling extensively for the past several weeks. I've managed to lose at a rate of about 2 pounds per week during that period. That doesn't seem like a lot but given that I've not been able to totally control my diet (too many restaurants and business meals) as well as not being able to exercise regularly I'm happy with that result. As long as the scale is moving down things are headed in the right direction.

I think a lot of challenges folks have with their PCPs is that the regular doctors don't have a whole lot of experience with WLS patients. My PCP has been a friend since his Med school days and he's been in practice for 25+ years. When I consulted with him about my upcoming surgery he mentioned that he had one other patient who had WLS. He was supportive but I actually think I educated him more on the surgery and process than he did me. I'm not sure he was even aware of the sleeve gastrectomy procedure before I brought it up to him. Keep in mind that a PCP is basically a generalist; they have to know a reasonable amount about a lot of different medical issues. They are trained to refer to specialists for detailed diagnosis and treatment. Weight loss has it's own specialty - bariatrics. A smart PCP will refer an obese patient to a good bariatrician just like they would make an apporpriate referral to a gastroenterologist, oncologist or other specialist. Unfortunately too many PCPs abide by the old "eat less and you'll lose weight" mentality and don't recognize that bariatrics is a valid specialty practice unto itself.

It may seem counterintuitive but many have reported that raising your overall calorie intake for a while may help end a stall. If you are consuming 700 calories a day, you could try kicking it up to 900 or 1,000 for a few days and see if that makes a difference. It certainly wouldn't be enough to gain much and it may cause your metabolism to shift back into weight loss mode.

As you lose weight after surgery you will naturally feel more excited about yourself, your body and self image. You will be receiving more attention from many people as your body transforms. I'm not sure why a similar response from your husband would be seen as negative. It seems that would be positive and reinforcing if he were to react that way. Dealing with the effects of WLS is a challenge for not only us as patients but also for family and friends. It creates different responses in everyone. Some are very supportive and serve as partners to help us succeed. Some provide positive reinforcement by commenting on our success. Others may feel threatened that you are doing something positive to change your life or guilty that you are bettering youself while they are not. The key to remember is that you are doing this for you, for your health, and for your family by being healthier and living longer. Positive reinforcement from everywhere helps along the way but it may not be universal. Maintain focus on your goal and continually remind yourself the reasons why you are having the surgery in the first place. This will help you deal with any external issues along the way.

My surgeon told me that it was allowed but to make sure to consume with moderation because it is empty calories and can affect overall weight loss. Alcohol is absorbed in the intestines, so after gastric sleeve surgery the alcohol also reaches your bloodstream faster. I've consumed some alcohol on occasion and learned that I can drink a light beer or two, but I have to pour it into a glass and let the carbonation fully exit. Pouring fast for a large, foaming head helps that happen. I can also tolerate uncarbonated mixed drinks like a vodka with cranberry juice without any issues. So far I've stayed away from anything carbonated other than the beer. Three things to note: 1) there is still carbonation in the beer which can slow consumpiton and possibly make for some uncomfortability; 2) the alcohol does affect me sooner - the feeling I used to get after 4 or 5 drinks pre-surgery now hits me after 1 or 2; and 3) I've found if I have more than one occasional alcoholic drink it does slow down my weight loss, as it is extra calories and since they are liquid they don't limit my hunger or solid food intake. To me it is basically a moderation thing - if you can have an occasional alcoholic drink or two worked into your nutrition plan and still maintain the weight loss targets you seek then you should be fine. If you have challenges moderating alcohol intake then it is probably best to stay away from it entirely.

Had mine on September 15th. Very uneventful surgery and recovery. Have transitioned to regular food and still learning how to manage getting in all of the protein, fluids and exercise needed to maximize results!

It happens to all of us, but at different times. There is typically a stall at somewhere around 3-5 weeks post-op which is totally normal. I've experienced a second one at 7 weeks out as well, which has lasted about a week and the scale has just now started moving again today. As our bodies lose weight they periodically need time to reset. This will result in days, and sometimes even weeks without movement on the scale. However, your body is adjusting to the lower weight and though you may not be losing weight you likely will be losing inches. Your weight loss will pick up again when your body is ready, as long as you are following the diet and exercise recommendations of your doctor. Just keep taking in your Proteins and liquids and you'll be fine. I don't know how scientifically accurate this is but I've been told that as our bodies lose weight we are emptying fat cells, buring their contents for fuel. After good weight loss the body has to stop and tear down the empty cells which results in little weight loss but more inches lost. This happens periodically as the weight drops. One other thing I've noticed is that as my weight goes down, the stalls tend to be at the same general weights where I spent a good deal of time in the past. Not sure there is anything to that, but it does seem like an interesting coincidence.

You body is indeed in ketosis, which is a byproduct of fat burning metabolism. Your fat cells store glucose as well as Water and some other components. As your body burns off the contents of these cells, ketone bodies (metabolic acids) are released which can cause changes to the color and odor of urine, as well as changes in breath and taste. Eventually this should stabilize and you won't notice it as much. You can help minimize the impact by consuming as much Fluid as possible. In fact, proper fluid consumption is extremely important because if ketones build up in your system they can create toxicity and cause problems. This is why all doctors and nutritionists stress drinking the proper amount of fluid while in weight loss.

It takes some time. I'm almost six weeks out from surgery and still occasionally have problems knowing when I'm full. Generally I try to stop at what I think is the right amount, because for me I don't feel the sense of fullness until I've already had enough or maybe too much. With such a small stomach capacity the difference between satisfied and stuffed is only a bite or two. Everyone says to eat slowly - this is truly the key. Eat slowly, eat small bites and stop at the first sign of satiety and you'll be fine.

Hi and welcome to the forum. You'll find so much information here and so many folks ready to help that it is a great resource. That being said, the choice of procedure (sleeve or bypass) is one that should be made by you and your surgeon. Both are great procedures and provide excellent results. If you have already selected a surgeon or practice they should be able to help guide you through the selection process. If you haven't selected a surgeon or practice yet, I'd do my research locally. If there is one available, I'd be sure to check into those practices that are "Bariatric Centers of Excellence". These are practices and surgeons who specialize in the procedures and meet the criteria to qualify for this designation. Some insurance companies require that surgery be completed at a Center of Excellence before they will approve it. Good luck on your Quest.

I've been pretty consistently running 600-700 calories per day, tracking through MyFitnessPal.

Search the forums for the subject of stalls and you will read many, many posts about them. There is typically a stall at somewhere around 3-5 weeks post-op which is totally normal. As our bodies lose weight they periodically need time to reset. This will result in days, and sometimes even weeks without movement on the scale. However, your body is adjusting to the lower weight and though you may not be losing weight you likely will be losing inches. Your weight loss will pick up again when your body is ready, as long as you are following the diet and exercise recommendations of your doctor. I don't know how scientifically accurate this is but I've been told that as our bodies lose weight we are emptying fat cells, buring their contents for fuel. After good weight loss the body has to stop and tear down the empty cells which results in little weight loss but more inches lost. This happens periodically as the weight drops.

The first week after surgery I slept more than usual. I think some of it was catching up from the pretty much complete lack of sleep the night I spent in the hospital. Once I was caught up, though, I've found myself waking up earlier than before. I think it has to do with the fact that I was just on the edge of sleep apnea, and the weight loss from the pre-op diet program pretty much took care of that, so I'm getting better sleep, and thus waking up earlier.

I was in the hospital for about 24 hours. As a self pay technically I was an outpatient on a 23 hour observation.

At 12 days post-op I experienced my first NSV today. As my size has yo-yo'ed over the years I have all sizes of clothes in my closet, with shirts from (men's) size 16 1/2 up to size 19. I was very pleased to find that I now fit comfortably into an 18 1/2, and almost a size 18. My NSV was packing up all of my size 19 shirts to give to charity. Not quite yet ready to drop down a pant size but hoping that will come in another week or two. Anyway, the first NSV feels very good!