theantichick

I'm not surprised at a doc advocating lots of Beans and veggies and fruit. I AM surprised that there's not more emphasis on the Protein content of the foods, because protein is key to recovery and weight loss. That being said, it sounds like he's emphasizing high protein plants (beans), just not talking about the protein content.

Be VERY careful adding Tylenol/acetaminophen to pain medications - most narcotic pain killers are already mixed with it, and it takes VERY little beyond the prescribed amount to poison your liver. The abbreviation APAP indicates acetaminophen. The maximum dosage for healthy adults with no liver impairment is 4 grams (or 4,000 mg) a day. Most dosages of narcotic pain killers have 325 mg of acetaminophen. So just keep an eye on your total acetaminophen intake.

Made BBQ pork loin from frozen last night. Don't recommend from frozen for large chunks of meat like that, it took longer to get it to temp so it was a little crusty on the outside, but it was still super yummy and super easy. Will be trying some chicken tonight.

I don't watch network TV anymore. Almost everything I watch is Netflix or Amazon Prime. LOL. I didn't feel any real hunger for the first couple of months after surgery, which was both good and bad. I'm starting to have hunger and cravings again at almost 4 months out, but I'm able to tell what's real hunger and what's just cravings, so it's going well for me.

Starting around 3 months post, I started having huge amounts of shedding. My research says that it either happens or it doesn't, supplements don't make any difference. Getting enough Protein in is what lets it grow back fast.

The cardiologist is needing to get more information about what is possibly going on in your heart in order to make the surgery as safe as possible. I don't know how often they actually refuse clearance, I know with several kinds of heart issues, it just affects what they have to do for anesthesia, but it's possible to get cleared anyway. Unfortunately, there's no way to predict, you'll have to consult with the cardiologist after the test. Good luck!!

My surgeon said pretty much the same thing. You can't really exercise off the weight, but it's vital to keeping it off. It also helps to maintain muscle mass during the weight loss. sent from mobile device

Hugs. I went to RN school mid life while working full time. Divorced while doing my pre reqs. It took some time but I met the guy who is the perfect match for me and we're deliriously happy. Sorry this all came down right when you were dealing with surgery and all, but you made it through RN school you'll make it through this. Best of luck with the boards and the job hunt! sent from mobile device

I love my soda stream. I haven't tried it post op but the syrups don't have aspartame (which is a migraine trigger for me) and you can control the carbonation. I can't handle regular carbonation yet but want to try the soda stream soon. I've been craving a little soda taste. sent from mobile device

Melanie Hafford in Irving Texas. She's great, I'd recommend her to anyone. sent from mobile device

I'm still working on this one. I started therapy back in the spring about my food issues. I'm doing better, but it's a struggle. Food doesn't give me the emotional satisfaction it did before surgery, so I am having to find other ways to deal with my emotions. My therapist has me working on making lists of things I can do instead of eating when I'm bored, angry, frustrated, sad, or anxious.

Link in my sig to "The Easy Way Out" essay on my blog. If it's someone I care about, I take the time to educate them and assure them that I didn't do this on a whim. If it's someone I don't care enough about to take that time, I shrug and say "agree to disagree" and walk on.

One more thought. I think it's important to realize that everyone who is a "vet" and is posting on this board is very likely doing so because they want everyone on this board to be successful. I have yet to meet anyone here who has even a shred of malicious intent. Most of the vets are far enough out that they aren't really here for their own support. They're here because they made friends that are important to them, and/or they are trying to "pay it forward" for the help and support they got when they were newbies. It's also good to remember that they've answered the same questions, or posted the same content, hundreds of times. So sometimes their answers may seem short or impatient, but it's really just that they've typed it so darned many times. They're trying to share their experience and knowledge, period. They're not here to lord it over anyone, because trust me there's easier ways than spending time on this board to get a superiority fix. As someone who's only a little ways down this path, I deeply appreciate everything the vets share about their experience and how they're making this work. I believe it would be very short sighted and more than a little idiotic for me to blow off what they have to say. I give serious consideration to every post that a vet makes about successful WLS. Not all of it applies to me, but I consider it carefully. Assume good intentions, is all I'm saying. Because that is seriously all I've ever seen here.

Some advice from someone who's been on the internet practically since Al Gore invented it (that's a joke). Don't try to read "tone" into online postings. When you do, it's more about the voices in your head and your attitude than the intent of the person who actually wrote it. We get a lot of people on here who have been given incorrect information, and we try to set it straight when we see it. I'm a nurse, and my nurse educator hat is on constantly when I'm on this board. It's not a slam, or a lecture, or a "dressing down". It's sharing information, and trying to make sure the information out there is correct. A LOT of people keep calling the sleeve a "pouch" and while it seems like it doesn't matter, there are structural differences between the two. A pouch with a bypass is left with more of the stretchy tissue that can expand and stretch. A sleeve procedure cuts away most of the really stretchy tissue from the stomach, what is left will have some stretch, but nothing like an original stomach. A LOT of people have been given scare tactic information about carbonation, saying it will burst your sleeve (or pouch) or stretch it and make the surgery useless. I don't know as much about the pouch structure as the sleeve since I had the sleeve surgery, but I do know that the sleeves don't stretch much if at all. And carbonation will not burst the sleeve or stretch it. AT ALL. As for the soda question: Carbonation, especially early on, can make you bloody miserable. Some people never are able to tolerate carbonation. Then there's the empty calories if it's a sugared drink, which IMNSHO should be treated like candy. Once you're in maintenance you can probably do it occasionally if you budget the calories, but even then there's no nutritional value. And there's plenty of evidence that sugar free drinks drive hunger and cravings, so they're not a great option either, but better than full sugar if you just have to have a soda and the carbonation won't make you miserable.

I have three friends who are each 10 yrs or more out from RNY. They have all had incredible success long-term. Two of them did get WAY TOO skinny for a while, and had to re-adjust to get good nutrition in. They all have to take bariatric Vitamins for life. But they eat "normally" just small amounts, chewed really well, and they have to focus on Protein and nutrition when they choose their foods. That is not to say serious malabsorption issues don't happen. Just that it's not a given. And of course, if you choose the sleeve, malabsorption isn't an issue. If you don't take multis and eat healthy food, you run some risks of minor malnutrition, but stuff that's easily fixable and avoidable.

The old joke goes... What is the difference between a surgeon and God? God doesn't think he's a surgeon. sent from mobile device

Thank you- my surgeon has sucked with after care - I just get told whatever you can eat basically- Sent from my iPhone using the BariatricPal App That sucks. I'm hearing more and more reports here of surgeons that aren't doing a good job of educating their patients. That really concerns me. I know you directed this at the OP, but I will plug my surgeon. http://haffordbariatrics.com/ Dr. Hafford has been awesome.

Odd. All of those except the nutritional evaluation have to be ordered by a physician, and that one they probably have someone they want you to see. Not sure how they expect them to be accomplished before you meet with the surgeon. Even if you got your PCP to order them, it's a right pain in the butt to get a different doc cc'd on them.

Jello (sugar free) is important because it counts as fluids and is sometimes easier for newly post-ops to stomach.

My rheumy said that it wasn't a guarantee, but the stomach tissue that's cut away releases a lot of hormones that are part of the inflammatory process. So she expected a drop in inflammation from the surgery itself, and then more as the fat tissue goes away. Before surgery, we were talking about biologics. I had to go off my meds a month before surgery, and I was off a month after surgery. My factors were a little bit high, but not terribly bad. I had a flare for about 2 weeks after surgery, but since it backed off and I'm back on my meds, I'm doing pretty good. Some soreness in my wrists/fingers/thumbs, but manageable with salonpas Patches, still haven't needed NSAIDs postop. We have taken biologics off the table indefinitely. We may still need to increase my dose of sulfasalazine and/or add in plaquenil, but I'm happy about the improvement. And 60# off is making my knees happier.

That's another great slowdown tip! But what do you do when even after you have slowed down and are full, you're stupidly determined to finish your whole plate? This is such an ingrained problem for me. A few years ago, my husband and I had a big fight about my feeling guilty over throwing away things like a cup of leftover rice instead of saving it for another night's meal. I just REALLY struggle at throwing away anything edible. I wonder if this is something I can work on during my required therapy sessions. Trust me, the first couple of times you think "one bite more" and you take that bite, and you are MISERABLE for 20 minutes.... you start paying attention. That's another great slowdown tip! But what do you do when even after you have slowed down and are full, you're stupidly determined to finish your whole plate? This is such an ingrained problem for me. A few years ago, my husband and I had a big fight about my feeling guilty over throwing away things like a cup of leftover rice instead of saving it for another night's meal. I just REALLY struggle at throwing away anything edible. I wonder if this is something I can work on during my required therapy sessions. Get yourself a portable four legged garbage disposal. They are amazing at getting rid of the leftovers. Here is mine in action. Yeah, until the vet gets on you because the dogs each gained 15 lbs. LOL

Nope. "The remaining tube-shaped stomach has a limited ability to stretch and therefore, resists the amount of food you are able eat. This resistance to stretching creates feelings of fullness when you eat very small amounts of food and that feeling often lasts for an extended time." http://www.cpsh.org/services/Bariatrics/Vertical-Sleeve-Gastrectomy You'll hear a lot about stretching the sleeve, and it's true you can stretch it a bit, but the tissue that remains is not the kind that has a lot of stretch to it. Your capacity increases as the swelling/inflammation of the surgery goes down, and your body accommodates to the changes and your tolerance for the full feeling increases. At least according to my surgeon.

They even told me to transfer my Water to something like a shot glass to help with the sipsipsip. I did a couple of times because from my big water bottle, it seemed like I was sipping all day and never getting anywhere. Putting 2 oz in a container let me see that I really was getting some down, even if it was VERY SLOW. It gets better, hang in there!

Do we need to talk? LOL. Not really. I mean, I cannot restrict carbs the way most of you do. For now, it's fine. I don't know what it will mean once I get to maintenance. It could even prevent me from getting all the way to goal, but so far things are looking pretty good. I try to make it complex carbs when I eat them, but it's not always. Since I'm also working on food issues with my therapist, I have tried things if I got a craving for them. Oreos, ice cream, cake, pie at Turkey Day. For the most part, I've found that they just aren't as good as I remember them. When I find that it is something I still like, I just make sure it's what I used to consider a TEENY portion because if it's really sugary, my sleeve will only tolerate a little. So I'm getting used to just having a bite of something I think I want, and it's really and truly just a bite. I also have days occasionally where my stomach turns just thinking about drinking a Protein shake, and all I want are carbs. Those days, I try to find as much protein source as I can that doesn't turn my stomach, and I end up with more carbs that day than I normally eat. So I totally get that this is stuff I should probably be doing only after I hit maintenance if I really want to maximize the honeymoon period. Hence my statement. And therein lies the difference. I don't feel moved to confess my crimes here so I can "get straightened out" or gain some sort of permission or absolution. If for some reason I share how I'm eating (like right now), I am not going to get pissy if vets share with me that my choices may cost me in the end - not meeting goal, making maintenance harder, whatever. Your experiences are valid, and you guys are the ones who have been making this work. I'd be an idiot not to listen to what you have to say about it. I won't be able to say if my choices were good ones or not until I'm much farther down the road. I have the option to consider what you have to say, and use it or discard it as I see fit. That's called being an adult. I don't think anyone who criticizes my choices is being snippy or bitchy, and I certainly don't read any negative "tone" into it. I appreciate that everyone here wants me to succeed, and is just trying to warn me off of choices that might get in the way of that. And I *DO* consider what everyone says, even if I decide it's not the right fit for me. And I'm not violating anything my surgeon has told me either. I'm well past being released to a full diet, and my doc doesn't push low carb, she doesn't think it's sustainable for most people in the long term. She wants to see better food choices, focus on nutrition, and really good portion control. Ketosis makes me incredibly ill, so I have to find the right balance for carbs for myself. I am most definitely not there yet, but I've not given up either. And I'm not eating anywhere close to the way I was before surgery, so I consider that progress. I also try not to bash the low-carb thing for other people, or advocate that anyone else eat the way I am. I think for most people the low-carb diet is probably the most beneficial post-op. The vets with the experience are generally saying that it is, and many of the physicians are as well. So I don't know... do we need to talk??