MacMadame

Well, my grandmother, who was taller than me was only 90 lb. But she had no boobs and hollow twigs for bones. I think I could get down to 110 and still be healthy. Anyway, I had an "ah ha" moment last night. I realized that when I first started swimming, I was burning 600 calories an hour and now I only burn about 300. I forgot that as I get smaller and more fit (and, in this case, improve my stroke efficiency), I won't be burning mega-calories when I work out. So I do think that things will stabilize eventually and I don't have to fight so hard to stop everything right this second.

I agree that you have to take what you are told by the office and see if it makes sense. My surgeon started doing sleeve in 2001 or 2002 (I have it written down somewhere but I can't find the exact year right now). So when he says he's done over a thousand sleeves and then how many procedures over all he does in a year, that number is believable. I asked for how many of *everything* he did and also his partner. That way I knew I wasn't getting the combined stats of the medical practice. When I added up all the numbers and divided by the number he does in a year, I got a number that was similar to the number of years he'd been in practice. So I knew the stats were legit. The thing I find interesting is that some docs clearly pad their stats while others seem to pick a lower number than they've actually done. The LapSF ads on OH say "over 1200 sleeves" which is true. But it's a LOT over 1200. It's closer to 2000 for the entire practice including ones done by a doc who left them to start his own practice. Lots of practices would include that doc's stats too, but they don't seem to be doing that.

I was! :laugh0:

Okay, I must have missed something. What happened to the live-in bf?

Even though I check "remember me", I am often not logged in if I come here from the main page. This means I can't find the User CP link and posts I've read aren't always marked as read. Just thought I'd report that.

Part of why there are different diets is that this isn't something that people do a lot of clinical research on. So the doctors look at related research and extrapolate from that. Since it's open to interpretation, they all interpret it a bit differently. Some take the approach of "if one of my patients has a problem, none of my patient can do it" (okay that's a slight exaggeration). These are the programs with a list of "rules" as long as your arm about what you can and can't do and can and can't eat and when. Things like "no salad until 6 months" and "you can't chew gum forever" and a bunch of stuff that is really rather silly. There are some "core truths" though. Like pretty much every program has you on some sort of liquid (clear, thin, full) for the first 2-3 weeks. Very few programs go faster than that in their progressions and this is because the danger of getting a leak is greatest during that time period. I am very happy with my program... once you get on regular food, there are no hard and fast rules -- it's all about "as tolerated". Things aren't forbidden outright either -- but there are things we are supposed to "avoid". I like "avoid" better than "forbidden" and "see what works for you" better than strict lists of when to progress to what foods based on the lowest common denominator. Dr. A. is more conservative than my doc (we don't do clears and go to softs at 2-3 weeks) but I think he mostly takes a similar approach and seems open to modifications of his instructions when they aren't working -- like Elisabeth being able to have that soy drink on clears. I like that. :laugh0: Btw, for all you former band people, my program is adamant that bandsters stay on liquids for *at least* 3 weeks even though the DS, RnY and VSG people can start to progress earlier if they feel up to it and they say that's to prevent slippage. I bet most people think sticking to the diet isn't as important for bandsters because nothing is cut, but Dr. A and LapSF's very low slippage rate make me think they have the right of it when it comes to bands and staying on liquids.

I guess I do South Beach. But I do 40% protein and 30% carbs.

A lot of people's understanding of science is very minimal, I've found.

Our stomachs are touchy early out and different people seem to react to different things. I couldn't drink straight milk at first. Now I can drink some, but not more than 8 oz. (It used to be 4oz. so I'm improving.) But I could have stuff with milk in it and made from milk. But some people can't do tomato Soup or OJ. And some people have trouble with eggs. It just seems to depend...

I want to tell them about the sleeve too. Not because I think *everyone* should get it but because I'm sure 90% of them only know about the band and bypass and so they are not really making an informed decision.

I started out thinking I wanted a band, but the more I looked into it, the more I realized it was a bad idea. I ended up getting a sleeve instead and I'm very happy with it. The problems I saw with the band included: -You don't get restriction right away so until you do, you are basically white knuckle dieting. I can do that without surgery -Not everyone gets restriction or keeps it once they get it. Without proper restriction -- finding your sweet spot -- the band doesn't work -The band has a high re-surgery rate. I am old enough that I didn't want to worry about having another surgery in 10 years when my band eroded or slipped or broke. Other concerns include: -weight loss stats aren't as good and weight loss tends to be slower. I thought I could live with that, but now I'm glad I don't have to -drinking with meals defeats the band's ability to keep you feeling satiety. I thought I wouldn't do that but now that I have a sleeve, I can see times where I might because I want to eat just a few more bites of something -the fill/unfill process require a lot of doctor's trips and I'm kind of bad about scheduling that sort of thing. For example, I'm overdue for a haircut and I really want one but I just haven't had time to call and make an appointment and I am supposed to call my doctor when I go under 120, which happened Monday and I still haven't had time to call him.... so would I be good about getting my fills? Hard to say and I'm glad I don't have to find out.

Or you could find a different surgeon who doesn't turn pre-op into some sort of test of your earnestness. :laugh0: I think it's horrible how some programs treat this period. Yes, it's good to lose weight and make your liver easier to work out with. But a good surgeon who operates on the SMO should be able to operate on you just fine if you fall slightly short of your goal. There is a surgeon in my area who not only requires a loss of 10% body weight (which is not really justified by the literature) but if you are even .5 a lb. short of the goal she sets for you the day before surgery, she cancels it. IMO that is not about medicine and what is good for the patient -- that is about being a control freak and showing them who is boss!

Lots of people love the Lean Dessert. I'm not one of them. :laugh0: but from the stuff you do like, I bet you'll like it.

Well, I can see why people blow the pre-op diet. But I can't see blowing the post-op diet as that isn't "dieting" but a medical issue. It's like not lifting stuff immediately after surgery or not eating certain foods when you are on certain medications.

People will believe anything, I swear. I got into it with someone on another board who claimed that all the nutritional experts agreed with her that natural Vitamins are the only ones that are absorbed and that stuff like Centrum is "crap" that you are just wasting your money on.

Well I didn't address the "compulsion" vs. "addiction" thing because I don't think it matters what you call it. Either way, tons of obese people haven't got mental issues as their primary motivation for why they are obese. If you cure the physiological imbalances, then the over-eating goes away. I think it's a chicken and egg thing. The obesity and underlying physiological conditions that cause it also cause the compulsive and/or addictive behavior. If the person wasn't obese, they wouldn't have that behavior. The behavior doesn't cause the obesity. Or, as my surgeon says to his pre-ops, "I'm not worried that I'm going to perform WLS on you and you'll turn into a drug addict or alcoholic." Yes, it happens, just like other complications happen, but it's not the norm, just as having complications is not the norm. But for the last one, I said that my triathlon training isn't an addiction but a hobby and your response was something about how "treatment proves me wrong" which ... um, makes no sense. :001_tongue: I think you must have misread that part.

Yes, some docs do that. Mine didn't. We were on something they call "thin" liquids which does not include pudding or oatmeal or yogurt (which are allowed on full liquids).

I love spin class! As for running, I have made my peace with it and that's probably the best it's going to be.

Monday is my planned rest day. Tues. I did a BRIC workout at the gym for 1.5 hour in the morning and a Track workout at (duh) the track for 1 hour in the evening. Tomorrow I have my first appointment with my personal trainer in the morning and a swim workout at night. I'm not sure what I'm doing Thurs. because my son has to defend his senior thesis to graduate that evening so I can't do my normal workout.

I think my Nike+ is broken. It never finds my sensor any more.

So I'm supposedly at goal. I wouldn't mind losing a bit more fat from my panus and boobage but I look fantastic in clothes and most of my problem areas are from loose skin, not fat. But I'm having trouble stopping the weight loss. I've been losing 1.5-2 lb. a week still and I'd be losing more but I've been actively fighting it. Should I? Some people say to "let my body decide where it wants to be" but I'm already a size 2 on top and a size 4 on the bottom and I'm getting kind of boney on top. Also, I've calculated my calorie requirements and I think I'd get down to 95 lb. if I don't start eating more. But when I eat more, I feel bloated and overly full. I forced myself to eat 1500 calories today and I hated it.

I'd kill for more of her body parts than her arms!

A stricture is scar tissue that blocks the food so people who have them have trouble keeping everything down, even liquids as WASa said.

Ugh, the whole detox craze drives me mad!

Here are some links I've collected when I was researching the sleeve. http://www.asbs.org/Newsite07/resources/sleeve_statement.pdf ASMBS position paper on sleeve - includes reports of early studies http://www.facs.org/education/gs2004/gs33lee.pdf LapSF Educational presentation to FACS - includes some 2 year results Vertical gastrectomy for morbid obesity in 216 pat...[surg Endosc. 2007] - PubMed Result LapSF Two Year Study SSAT - SSAT 2008 Annual Meeting Abstracts - Laparoscopic Vertical Sleeve Gastrectomy for Morbid Obesity: a Report of a Five-Year Experience with 750 Patients</b> LapSF Five Year Study - abstract only SSAT - Five Year Study - presentation (requires Windows to play) Deciphering the sleeve: technique, indications, ef...[Obes Surg. 2008] - PubMed Result Literature review on the sleeve - requires $$ to get the full text unfortunately http://www.lapsf.com/press/lapsf_study_6_2_05.pdf Sleeve best for over 50 crowd Vanderbilt University Medical Center Video of a sleeve with lots of education discussion Our Lady of the Lake Regional Medical Center Video of a sleeve that is more about the operation Weight loss, appetite suppression, and changes in ...[Ann Surg. 2008] - PubMed Result Ghrelin levels after RnY and sleeve http://www.bernhard-ludvik.at/download/pub/2005_ref61.pdf Ghrelin levels after band and sleeve SpringerLink - Journal Article Diabetes resolution in RnY vs. Sleeve Comparison Between Laparoscopic Gastric Banding and Laparoscopic Sleeve Gastrectomy Comparison of band to sleeve - literature review