Amanda Dutton LPC

With a sleeve, you may not have to adjust meds. As an RNY, I had to have mine changed from XR to regular because of issues with absorption due to not having access to stomach acid and because we lose those first few feet of intestines where things are absorbed. Since the sleeve became more popular BECAUSE those issues didn't happen (malabsorption), and the anatomy change wasn't causing the lack of access to stomach acid to break down medications, that is what makes me suspect that you won't need to change. Totally making an educated guess based on my own experience and that of my clients, though. ?‍♀️ Definitely still ask your doc. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

You cannot permanently stretch your pouch. Your stomach is an elastic organ. So, yes, it can be pushed to holding more than it should, but it shrinks back to normal size after the meal is processed. The only thing the "pouch reset" really does is get you to slow down and recognize that you only need a certain amount of food to actually be satisfied. See screenshot from article by Dr. Roshini Rajapaksa, MD, assistant professor of medicine at the NYU School of Medicine. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Especially the facility in Tijuana that BariatricPal setup. Those doctors chose to go work there because they support the need for affordable surgery and the US won't support it. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

It's definitely different for every surgical program. Generally, most surgeons say it's 60-80 because that is simpler than what the true recommendation is, which is about 1/2 of your goal or ideal weight. So since goal for women averages out to be around 120-160 (depending on lots of factors, but it's pretty much the typical range), that's where the 60-80g comes from. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Something that helped me in the pre-op phase to wean off caffeine was to start buying both diet coke and caffeine free diet coke. I would start fixing 1-to-1 mixed when I drank it and slowly switched over to just caffeine free. Same with coffee (bought regular and decaf and kept mixing in the decaf as I used up the big can so by the end of it, I was ready to fully go decaf. By then, I could switch out the soda for water, since I was off caffeine, and still have coffee, since it was decaf. At 14 years out, I'll get a diet dr pepper as a treat sometimes and I drink half-caf coffee (I buy one can of each), but I get in all my water, so it works. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

It's definitely a personal choice. I think it's totally appropriate for you to do whatever makes you feel comfortable. You may decide to not say anything for awhile and then one day change your mind - or not! Everyone in my circle knew because it had been a long decision process for me and I wanted the accountability. Eventually, the transformation was significant and it stuck, so it was something I was proud to share. Now, I've made my journey my life purpose, so I definitely share with everyone I encounter if the opportunity arises and it keeps me even more accountable (I'm a therapist and I coach bariatric surgery patients, too). ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

It sounds like you have a good grasp on the reasons why we slow down as we go (like having less to lose over all), so that's awesome, first of all. You're already ahead of many people that may not even realize that! Also, you're looking at the month rather than day-by-day, so kudos to you! Having slow and fast months is totally normal. Even a slow month is kind of a plateau. Being 4 months out, your body is still healing, so there is still going to be inflammation that causes your body to hang on to fat a little longer for fuel to heal. As long as you are moving, staying on plan with nutrition and vitamins/supplements and getting in your water, you should be fine. I remember having those same thoughts then suddenly having a loss shortly after. Keep us updated! [emoji175] ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

A 2 month old horse, a human head and a chihuahua! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

My waddle is just the motivation I need to drop my shoulders and lift my head in pics. Or figure out how to gobble. [emoji38]

In my experience, it seems like we have been in the diet mentality for so long that we're convinced that "thin=happy." That's such backwards thinking! In the media, especially diet commercials, we're shown pictures of larger people in disheveled clothes, eating terrible food and looking miserable while the thinner and more attractive (by society's standards) people are happy and doing exciting things. We are fed (pardon the pun) the idea that our self esteem and happiness is contingent on our weight when we are kids (being bullied, jokes by family, left out of teams) and it sets our expectations for the future. If we can wrap our brains around understanding that our self esteem is within our control and not dependent on the opinions of others, we can start feeling more determined to make changes that stick. THAT could be, and honestly IS the key to real, longterm weight loss surgery success. *steps off soapbox*

MJ shouldn't be an issue; however, like others have said: 1) depending on how far out you are from surgery, watch out for coughing 2) be aware of if you are prone to food cravings 3) possibly opt for oil, sublingual tincture, or canna coffee 4) there are also creams and lotions if you want to try topical. 5) check out if transdermal patches are available where you are I'm a daily user of CBD oil vaped or sublingual for RA and fibro, and I've had good luck with a couple brands. MJ isn't accepted in my state yet so ?‍♀️

Hey! I haven't posted on BP in ages, but got back on and came across your post, so I thought I'd offer an encouraging response. I'm 14 years post RNY and have RA & also take Humira. I've had no issues with it being effective, since it's an injectable and not oral. I also take Gabapentin for fibromyalgia and it hasn't been an issue either. My RA wasn't diagnosed until about 5 years ago, but I have had signs for years. I also use a topical NSAID with no issues (Voltaren gel), again, since it's not oral, but I don't use it often. Hope that helps! ~SW: 278, CW:168 & proud!~

What are you thankful for this year? Your home? Your job? Your family? What are the other people in your life thankful for? What about your family? Your co-workers? Your friends? Do you ever wonder if any of them are thankful for YOU? We often spend our lives working for others, doing things for others, helping others. Where’s the time for you? Taking care of ourselves and focusing on our own needs is usually WAY down on the list, if it’s on the list at all. It feels selfish. So, what if I told you it was actually self-LESS? Yep, you read that right. Self-LESS. Stop. Breathe. Read this very carefully: If you don’t take care of yourself, you can’t take care of anyone else. Go back and read that again. And once more. Think about it: What happens when you get sick? Or injured? Or have a nervous breakdown because you Just. Can’t. Even. Again: If you don’t take care of yourself, you can’t take care of anyone else. Are you hearing that? That’s not selfish, that’s self-LESS. If you don’t take time for YOU, you won’t be able to do anything for ANYONE ELSE. You will break, you will fall, you will crumble. Give yourself a moment to let that sink in. While you are doing that, take a look at a few suggestions at how to make that happen: Give yourself permission to say “no.” Let’s go ahead and get the hard one out of the way first thing. You aren’t responsible for making sure that everyone gets everywhere or that they get everything they want. Granted, young children have more needs than adults, but I’m betting that if you sit back and think for a moment, there are times that if you said “no,” the individual would either: a) just do without it, or find some other way to make it happen. Often, you’re the “go to” person because people realize that you’ll say YES. Set aside a specific time for your self care and treat it like an appointment you can’t miss. You know that doctor’s appointment it took you 2 months to get? And how you made sure that nothing stood in the way of you getting to that appointment? Yeah, treat your self care time just as special. Program it in your phone. Write it on the calendar. Let your family know that you have an appointment that you can’t miss and that you won’t be available. You need this. Expect others to push your boundaries. Especially in the beginning. They won’t be used to you being so assertive, so the attempts to make you feel guilty for not dropping everything to attend to their needs may ramp up for awhile. It’s okay! Remember, this is expected. You’re preparing for it now, by reading this, so when it happens you will already know that it is temporary. By sticking to your boundaries and not giving in, IT WILL GET BETTER. If you give in now, you have shown that if they push hard enough, they will eventually get there way. Don’t stop. Remember: we cannot be good caregivers if we don’t practice self care. It’s not selfish, its self-LESS.

Excellent job, VSGAnn! Planning is so important for us. Taking that time is an important part of staying on track and helping to derail bad choices during the day due to lack of a plan!

It is very hard when you are in a helping field, but even more important I feel. We are naturally givers and it's hard to make time for ourselves. Scheduling time for yourself takes some of the guilt away. I felt that guilt for such a long time until I started to "work myself sick." Then it became evident I couldn't fully be there for my clients if I didn't take care of myself. That really helped when I took this perspective.

That's awesome when you have the support of a spouse! So glad that you consider self care sacred and that you have the support to make it happen. Hope you and your husband continue to do well!

Yes! I completely agree! The dietitian that leads the support group I recently began helping just talked about making time for meals last night! A very important part of self care for anyone, but especially us!

That's such a great plan! I have my self care time between my agency job and my practice, about 30 minutes as well. Just quiet time to decompress and get myself centered. And a nice hot shower before bed REALLY is essential for me, too. I've never been a morning person, and showers always put me in sleep mode!

What defines you? Is it your home? Your job? Your family? Your weight? What about your purpose? Is it to make more money? To retire in the Bahamas? To run away and live in the mountains with a pet squirrel named George? Are their pieces missing from the puzzle that make it hard to see how you will get from where you are to where you want to be - to your purpose? We often spend our lives working for others, doing things for others, helping others. Taking care of ourselves and focusing on our own needs as a means to work toward our own goals is usually WAY down on the list, if it's on the list at all. It feels selfish. So, what if I told you it was actually selfLESS? Yep, you read that right. Self-LESS. Let me give you a scenario...see if this sounds familiar... Imagine that you wake up in the morning, your child is in the bed with you (laying sideways, foot wedged in your kidney, as usual) and as you're getting up, you realize you've overslept and that child is going to be late for school. You then rush to get him ready, grab some breakfast as you run out the door, call your boss (who of course, sounds frustrated), apologize and offer to stay late (again), and rush to the school. You get to work, apologize again, and are reminded that you are presenting at a meeting in an hour. As you scan through e-mails and vaguely hear your voice mails, there is a message from your mother reminding you about dinner at her house tonight. You make a mental note to call her. Rushing into the meeting, you apologize (again) for being late, but you handle the meeting like a champ. After the meeting, you continue your day, pausing every time someone asks you to do something and responding to their requests. That's what you do. Finally heading out the door at 7:30pm, you realize you've missed a call from your mother, and suddenly it hits you that you forgot to call her back. You call her back as you're rushing to her house, apologizing (yep, again) and thanking her for picking up your son (yet again). By the time you get home, there is barely time to shower and fall in the bed (with a precious foot jammed in your kidney), and hope that you set your alarm this time. Sound familiar? Where's the time for you? Not a moment of it anywhere. So what happens when you get sick? Or injured? Or have a nervous breakdown because you Just. Can't. Even. Stop. Breathe. Read this very carefully: If you don't take care of yourself, you can't take care of anyone else. Go back and read that again. And once more. Are you hearing that? That's not selfish, that's self-LESS. If you don't take time for YOU, you won't be able to do anything for ANYONE ELSE. You will break, you will fall, you will crumble. Give yourself a moment to let that sink in. While you are doing that, take a look at a few suggestions at how to make that happen: 1. Give yourself permission to say “no.” - Let's go ahead and get the hard one out of the way first thing. You aren't responsible for making sure that everyone gets everywhere or that they get everything they want. Granted, young children have more needs than adults, but I'm betting that if you sit back and think for a moment, there are times that if you said “no,” the individual would either: a) just do without it, or find some other way to make it happen. Often, you're the “go to” person because people realize that you'll say YES. 2. Set aside a specific time for you and treat it like an appointment you can't miss. You know that doctor's appointment it took you 2 months to get? And how you made sure that nothing stood in the way of you getting to that appointment? Yeah, treat your self care time just as special. Program it in your phone. Write it on the calendar. Let your family know that you have an appointment that you can't miss and that you won't be available. You need this. 3. Expect others to push your boundaries. Especially in the beginning. They won't be used to you being so assertive, so the attempts to make you feel guilty for not dropping everything to attend to their needs may ramp up for awhile. It's okay! Remember, this is expected. You're preparing for it now, by reading this, so when it happens you will already know that it is temporary. By sticking to your boundaries and not giving in, IT WILL GET BETTER. If you give in now, you have shown that if they push hard enough, they will eventually get there way. Don't stop. Remember: we cannot be good caregivers if we don't practice self care. It's not selfish, its self-LESS. Are there some specific ways that you already practice self care? Share in the comments and you may give a push to someone else!

Practice does not make perfect. Yep, you read that right. If you are hoping for perfection in the journey after weight loss surgery, you may be setting yourself up for disappointment. There are going to be setbacks along the way, so how do you prepare for that? Depending on how you approach this journey, you may enter it “gung-ho” thinking “I'm in this to hit my goal in the quickest time possible and I'm going to stay there no matter what!” That is an awesome attitude! I think it is great! However, when a setback occurs, it's best to be prepared so that it doesn't hit you so hard that you fall on your butt in shock and not know how to jump up and keep pushing forward again. Here are some key things to remember. You are not perfect. Sorry, but it's true. Neither am I. None of us are. It's a fact that we all have to embrace and accept. If we can come to terms with the fact that there WILL be setbacks, we will get a lot closer toward are goals than if we get discouraged by every bump in the road. There is something to be learned from a setback. So you gave in and had some of your “old” favorite food. Was it fabulous? Okay, cool. What did you learn from the experience? Did you dump? Have guilt? Feel disappointed? Take a moment to really listen to your mind, heart, and body to determine what you learned and go forward from there. Success is long term. You did not gain the weight overnight, and you won't REGAIN it all overnight, either! Don't beat yourself up over one setback. If you start being too hard on yourself, go back to #2 and check in again. Live through it, learn from it, and don't press the repeat button. Be kind to yourself. Take note of the small successes along the path of your journey. You chose not to partake in your “old” favorite food? Bravo! Do something nice for yourself that DOESN'T involve food. You came up with a new recipe that is a WLS-friendly version of something you love? Way to go! Share it with friends as you binge watch your favorite series. There are so many obstacles that you will face in your new life, don't overwhelm yourself trying to get everything perfect. There's no such thing. Just aim for “close enough” and you'll stay on track.

FocusOnMeNow, It's so hard to take ownership of the fact that we aren't perfect and that we are sometimes going to make mistakes. I'm glad that you've gotten to that point - it's definitely freeing, as you said!

Vulnerability is courage. That's awesome!