2goldengirl

My stepdaughter is in her mid-twenties. When she was in HS, she became underweight - she feels stress as nausea and it did a number on her in those days. She now weighs 50 lbs. more than she did then and says (in much the same way she insisted that her weight was "fine" when she was younger) that she's happy with her curves. Both her parents are overweight and she has those genes. She's probably 20-25 lbs. more than would be ideal for her. The only thing I've focused on with her is wearing clothes that fit. I bought her some work pants and a couple shirts for working in the scene shop that really fit and that she can move and handle tools in. She nearly cried. Clothes made for looking cute just don't cut it for stooping, squatting, lugging sheets of plywood, and wrangling flats. I lay on the compliments when she looks nice, and keep my mouth shut when she doesn't. She knows I'm having surgery, and why. She's totally supportive. She comes to me for advice about fitness, as neither her mom nor her mom's wife are so inclined. If she asks about food/nutrition/weight, I'm there for her, but as a stepparent, I have to tred even more carefully than a parent.

Thank you so much for sharing your journey. Your post is both moving and thought-provoking.

Honestly, with a physically demanding job, I'd say more like 4-6 weeks, especially because of the lifting and twisting. What you'll need to do postop is work on your endurance for standing all day after you're cleared to lift.

How about something like a nice hot bowl of chicken broth? You could fancy it up by floating a lemon slice in it, or throw in a dash of hot sauce. So much of clear and full liquids are both cold and sweet, something hot might be a nice change of pace.

I'm still preop, but I'm trying something right now (well, it's on the stove right now). I'm cooking a heap of veggies in some homemade chicken stock with a can of diced tomatoes thrown in. I basically threw in things from the freezer (green beans, shredded zucchini) and stuff from the veggie drawer: kale, a bit of cauliflower, carrots, some cabbage, a couple potatoes, an onion, a leek, parsley. There's about 6 quarts of soup that I'll blend smooth, then add a bit of pesto for seasoning. If we like it (and I have when a friend made it), then I will have something that I can eat at any stage, really - depending on how thin I make it. I can add plain protein powder to it, husband doesn't have to, and we can both get our veggies.

This definitely sounds like reflux. Get thee to a gastroenterologist, pronto.

I think you're best off looking for an RD that works with a hospital that does bariatric surgery. But there is a lot you can do on your own, with help from the folks here. If you aren't tracking your intake in something like Sparkpeople or My Fitness Pal, I really recommend it. You will see at a glance what your calories and nutrients are. If you aren't tracking your activity, do that as well. A general rule of thumb is to shoot for a bare minimum of 60 gm Protein and 64 oz. of Fluid each day. Many people do more than this. My particular program focuses on protein first, veggies second, and fruit or other complex carbs last when you're at the stage you're in. Your new stomach has healed, the swelling from surgery is long gone, and this period is when you are likeliest to notice both the restriction that the sleeve provides, and to develop long-term habits that will mean long term success. Those habits include eating the fuel your body needs in appropriate amounts, eating to satisfaction, rather than fullness, and making exercise a part of your life. Like @@Babbs said, nobody is perfect 100% of the time. I'm betting that if you track the things you eat on your "off" days, it's much less than you think. It can take some trial and error to find your "sweet spot" - the place where you eat enough that you feel good and have enough energy for activity, and little enough that your weight loss continues. As your weight loss continues, it's normal for it to slow down as you near your goal. That's because you require fewer calories to maintain a body that weights 50-100 lbs less than it did. Many people find that they increase their activity over time, because they find a new enjoyment in activity without the burden of many extra pounds and the wear and tear on their joints from carrying them around.

This is why there needs to be a distinction made between "nutritionist" and "Registered Dietician". Anyone can call themselves a "nutritionist". A Registered Dietician often has a Master's Degree and and believe me, they know their stuff - though like anyone else, they have their particular points of view. Here is a link to the requirements to become a Registered Dietician: http://www.eatrightacend.org/ACEND/content.aspx?id=6442485467

First, you've lost 50 lbs. That's a huge achievement! You've lost nearly 10 lbs a month, which is fantastic. Own that! Second, the fatigue could be a number of things. Are you tracking your food intake? Are you tracking your fatigue? If you are, do you notice any patterns there? How many calories a day are you getting in? Sometimes fatigue can be not enough intake as well as a Vitamin issue. It can also be a sign of dehydration. Or, if you've been on medication for your blood pressure, after a 50-lb loss, your medication may need to be reduced. If you can give us more information, we can do more to help you.

I went through menopause ten years ago without any symptoms. Never had a hot flash. My estrogen level is practically a negative number, so my weight obviously isn't helping me there.

changing your routine is a great idea, and that's what you did. Your body got a bit more fuel and a chance to recover from your workouts. Moving forward, you might try adding another hundred calories to your day, and taking an extra rest day every other week or so. Dong too much can be as hard on your success as too little.

I think learning to see ourselves differently is a huge part of our process, and that also means seeing others differently as a byproduct. It isn't uncommon, for example, for someone recovering from addiction to alcohol to see anyone who drinks at all as an addict. That kind of oversimplification often doesn't last, it's part of the process. I agree that judging others isn't wise or helpful. We don't know the stories or struggles of others, and I don't feel sorry for other, either. That puts me in a place of presuming at least part of their story. The person I see at the grocery story who looks 100 lbs overweight and barely able to walk may in fact have lost 100 lbs and be walking today where they couldn't before. It's all too easy to think of ourselves as superior because we're making positive changes in our lives, y'know?

I promise, it will get better. You may find that warm liquids go down easier than cold ones. Try some warm broth if Water isn't working for you right now, SF popsicles can also help. I promise, each day will get better!

Your surgeon will probably want a duodenoscopy (EGD) and an upper GI X-ray. I had to see a gastroenterologist for the EGD. Your surgeon may want a final set of blood work and a preop clearance from your primary doctor within 30 days of your surgery. Good luck!

I've had a Tanita body fat monitor scale for about ten years, and I am VERY happy with it. It uses electrical impedance to measure lean mass vs. fat mass as a percentage. I usually show about a 10% difference in body fat percentage between first thing in the morning (when I usually weigh), and midafternoon (which is usually the most accurate in terms of the fat percentage). I chart the trends, and if I step on the scale in the morning and I see both a gain in lbs and a decrease in body fat %, I know that the gain is fluid.

I have to disagree. OCD can seriously affect a person's ability to be successful with the surgery. If I am reading the OP's post correctly, it's her own doctor who treats her OCD that told her she needed to delay. Threatening legal action is no way to get a positive psychological evaluation, or a positive reaction out of anyone!

Excellus Medical Policy.pdf Here is a copy of Excellus medical policy. You have to show documentation of obesity X 5 years and show: History of rigorous attempts at weight reduction. 1. There must be written evidence of a weight loss history, either by the bariatric surgeon, primary care physician or nutritionist. This documentation should include the name of the weight loss program, length of participation in the program and any weight loss achieved. At least one program must have been a supervised weight loss program; 2. Weight loss attempts need not be continuous, but a minimum total of six months is required. a. If the patient has had no previous attempts at medical weight loss, participation for a minimum of six months in a preoperative bariatric surgery weight loss program is required. b. If past prior attempts of weight loss are remote (greater than 5 years), then the patient is required to participate, for a minimum of six months in a preoperative bariatric surgery weight loss program I hope this helps.

I would find yourself a Registered Dietician who works with endurance athletes. Clearly, you will need to fuel your body differently than your average athlete for this kind of activity. Years ago, I was training for a couple 100km bike rides. Not racing, but distance. I worked with an RD who was a marathoner. It was tricky because I was on a weight loss program at the time. Each week we planned out my training rides, recovery day(s), and how to adjust my calories. I found that the harder I trained, the more my appetite just evaporated. I was having to make myself take a few bites of something every two hours after a long ride. I found I could handle liquids better than solids on heavy training days. Her advice was worth every penny I paid her.

It will clear up. Don't worry! Be glad to be rid of it, H. pylori causes stomach ulcers.

It depends on what your surgeon says. You will notice, whenever it is, that a little wine may hit you HARD postop. You are likely to be told to wait three to six months - alcohol can be a powerful stomach irritant. Of course you can live without wine and cheese for a while. I've cut way, way down on it preop. A few months ago, I couldn't imagine dinner without my glass of wine. But these days I skip it unless it's a special occasion, and I have managed to survive. I know I'll have to do without for a few months after surgery, and I figure it's a small price to pay for giving up my chances of developing diabetes

Not necessary to tell your surgeon. Gonna make that postop walking hard, though. Ouch!

The biopsies are routine, even if they don't see any inflammation. They do the biopsies to check for H. pylori, which causes ulcers. And the inflammation around your esophagus could definitely be reflux. You shouldn't have to wait more than a few days for your results.

HN medical policy is the same for B & G as any other member, what is limited is your network. Are you in the Bay Area, or Sacramento? I can check to see which facilities you need to use that offer bariatric surgery. Here is a link to HN's national medical policies: https://www.healthnet.com/portal/provider/content/iwc/provider/unprotected/working_with_HN/content/medical_policies.action The policy will open as a .pdf. Your medical group/IPA will actually be the ones reviewing and approving your surgery, but they have to use HN's medical policy. I hope this helps!

Fantastic! I keep wondering what 6 months postop will look and feel like. Hard to imagine, really. It helps to see posts like yours.

If you are having infections, your body needs extra nutrition to recover. While you are recovering, 900 calories for a 400+ lb person is VERY low. I'd suggest something more like 1200 calories, emphasis on lean Protein, healthy fats, and complex carbs. My surgery is three weeks from yesterday. I'm easing my way into liquids for the preop 10 days by doing Protein shakes for Breakfast and lunch, protein + veggies for dinner, and low-carb Snacks if I'm hungry. I'm gradually backing off on carbs to avoid the two-three day headach-y period that comes from doing that all at once. There's a balance to be struck by giving your body enough calories and nutrition to be healthy while trying to lose some weight preop.