PatientEleventyBillion

Just keep doing cardio, visceral fat is a combo of cardio and especially diet. I've been doing situps and pushups with decent success, even though they don't specifically target visceral and subcutaneous fat in that region. Hiking helped me as well once upon a time.

On 6/10/2017 at 7:03 AM, Ance said:

My 20yo has been struggling with her weight since middle school. She's 5'7" and 255lbs now and has successfully gone through all her pre-op. She has a 6/21 date for her sleeve surgery. Her dad and I are not supportive of her choice. We feel she's too young to take such a drastic step when other than her weight, she's a healthy young lady. She has been up and down with her weight but she also gives up too easily on the lifestyle change required to keep a healthy weight. We fear because of previous behaviors she'll do the same and not stick to this commitment.

As her mom, I won't let her go through this process alone and will help her with her healing process but, this decision has caused friction and stress at home. It breaks my heart. We've asked her to hold off and we'll work with her to go the healthy route with seeing a nutritionist, a physical trainer and a therapist to guide her through this journey. She said no that her minds made up. She's under our insurance and the thought has come up to mention to the company that we don't approve this surgery but don't know if that may back fire. Another thought is to remove her and encourage her to get a job with insurance and she can do it and pay for it on her own. I'm conflicted and scared.

20 years old is not too young.

Have you or our child ever seen hepatologists or endocrinologists? They will point out a common epidemic.. kids in their teens and twenties in western nations (especially the US) are coming at record pace for advanced liver disease (fibrosis, cirrhosis) and endocrine problems (diabetes, metabolic syndrome, heart disease, etc.) at an age which these diseases were only seen by the elderly beforehand. It's a very serious problem that one wants to tackle early rather than late.

The key to this process isn't merely the surgery but more importantly making important lifestyle choices -- being a smaller person means living like a smaller person. For many of us obese people our endocrine system is out of whack, we eventually become at the behest of our brain, psychoactive effects of carb-laden foods, and the physiological hormonal results of our body telling us we're hungry when we shouldn't be. While lifestyle plays a huge role in breaking the body's endocrine system, once it's broken sometimes it takes serious intervention beyond lifestyle to see positive changes.. but if those underlying causes aren't changed, permanently, the tool which is the surgery becomes useless.

I'd say you're on the right track of support, support good choices here on out, and medical research is always a plus. Get multiple opinions, talk with your child to see the best course of action. Don't ever take the advice of one person or overly rely on one person for information.

34 minutes ago, lizpuller said:

Thanks so much billion. Great info. Getting this peanut size brain to use it is next lol.

We were all there at one time. Not even just the peanut brain for me but being too depression prone and stubborn.

- Go to store

- Look at product and nutrition labels

- Read reviews and buy ones that seem best fit to your goals/needs

- Go to register, purchase, take home, and enjoy

1 hour ago, lizpuller said:

So, i guess a food journal, scales, bs , and how ifeel over a longer time will sorta dictate my path. Avoiding processed carbs #1 regardless.

Avoiding processed anything is best.

The more important thing regarding fat vs Protein is how to utilize the energy you get from it.

The only benefit of carbs is the immediate availability of energy. There's no question that this is the fastest way to get it due to not only how quickly it moves through the body and bloodstream but how quickly the muscles utilize as well.

Fat and protein take longer to digest, take longer to be utilized, but no question the next thing that the body goes for after carbs are depleted is fat available for energy. Protein is necessary to prevent muscle weakness but to even get the muscles to burning up the Proteins within the muscle need to burn through carbs and fat. For those of us who are overweight that's why it's essential to get protein first and foremost, because the muscles will rapidly burn through it's energy stores and need replenishment, or else is burns the muscle proteins and makes one weaker, which has a doubling effect on those of us who are overweight.. makes us weaker and more prone to injury. The fat is merely for more sustained energy utilization.

8 hours ago, Joann454 said:

Ooh that's awesome! I wonder when they'll test mine again. I was right at 6 so no meds but I was headed that way. Congrats!!
I'm hoping this new generation of women raising girls will teach their daughters to raise up and empower each other. I see it with my nieces raising their daughters.

Thank you. Everyone has been congratulating me.. I see a myriad of doctors/specialists regularly. It's hard to feel like I accomplished something given I've been fighting off the health effects of being a dumbass for years, and only now am I on the verge of finally being perfectly healthy. But being realistic, I think I'll be happy when I'm off my last medication.. metoprolol, beta blocker for heart rate and BP. Post-op it's been 100-120/60-90, but I think my doctors/specialists want to see it on the lower end of that permanently before taking me off this. RHR has regularly been 50-80.. so I don't think that's much an issue anymore.

As far as my daughter goes, and our future kids, definitely being aware of what they eat, and minimizing the junk carbs from the diet. My wife has PCOS and has been losing weight seeing me lose a bunch of it, and from all those months of me begging her to stop eating so many carbs so she doesn't go through what I did with my enormous weight gain in such a short timespan. Women seem to have a tougher time losing it.

HBa1c 4.9 and completely normal now..

Was on 2 diabetes meds pre-op, Forxiga and Metformin (1000mg twice a day), peaked at 7.9 last year.

Last several standing order A1C results:

- September 2016: 6.5

- December: 6.1

- March 2017: 5.7

- June: 4.9

Stopped Forxiga day before surgery, and stopping Metformin as of today.. starting to be normal again.

The truth isn't "God-forward" enough?

As clergy, or rather, in a general sense, as someone who is trying to be a role model for others, it seems more logical to be honest and forthcoming, if you're trying to tailor your experience to others.

6 hours ago, MSinger said:

I don't want to frighten you, but I had severe nausea and violent wretching from the moment I woke up from surgery. I had a scopalamine patch, compazine IV, zofran IV, tigan injections, and I was inhaling alcohol prep pads that were held up to my nose - believe it or not, they actually helped some. I was taking all of my nausea medications as soon as they were available and the nurses did an outstanding job of watching over me and reminding me as soon as I could take my next med. I couldn't eat or drink at all my first night. Compazine and tigan helped me the most. The good news is that as the days passed it gradually got better. When I was discharged, I had some lingering nausea when I woke up in the morning that I took zofran for. I'm a little over 2 weeks out now and don't need nausea meds at all.

My experience is really an outlier here. Most of the stories I've read here have been very mild, but everyone reacts to surgery and anesthesia differently.

I'd say thats an outlier too.

There are also things that contribute to nausea people may not be aware of.. especially taking medications or supplements on an empty stomach.

If we look at Calcium for example.. calcium carbonate, the most popular version of calcium supplement, shouldn't be taken on an empty stomach or else it might cause nausea - which is why calcium citrate is recommended over carbonate and others. Some medications are the same way. Of course, right after surgery we can't really have a lot of stuff, yet we must take our meds and supplements anyways, so.. that's just one of the many juggling acts we have to put up with as part of the process, and that's on top of situations like yours where each person's body reacts differently.

Best of luck to you.

I felt nausea at first when first getting back on meds and taking chewable supplements the following morning after discharge.

Since then, the only time I've felt some nausea was when I overate.

Yet to actually throw up though. I wouldn't call myself fearful of throwing up I just have a very high aversion to it so I do all I can to suppress it unless I have no choice.

I haven't, and sorry to hear your experience was this bad.

Crossing my fingers the rest of your journey is a lot more successful.

5 hours ago, Berry78 said:

I think you meant pancreas. The pancreas makes insulin.

Many of us have chronically high insulin levels preop due to years of insulin resistance.

Hopefully your system will figure out that you don't need so much insulin anymore and will stabilize.

Definitely work closely with your team to work through this.

Good luck!

Edited to add:

I read the article about the increased activity in the pancreas. Not sure what would cause such a thing, but this screams keep sugar in the diet under a super tight control to me.

Think about it. You drink some orange juice because you are trying to fix a low blood sugar. But now you've just signalled the pancreas to increase insulin!

The constant sipping of Protein Shakes sounds like a reasonable solution for right now. As your diet expands, you'll have a job figuring out what to do...

Yes, that's what I get for posting when tired.

The juice thing does make sense due to how quickly simple carbs pass through the body. During my liquid phase I'd constantly be feeling lows because my liver would send the signals to make more insulin but because the drinks I had were already through me the insulin was there unnecessarily. OP did say they had lows before taking the juice though. Interesting situation.

Regardless of the surgery, norovirus had me hospitalized for days one time -- the only time in my life I've ever taken an ambulance. I'd have definitely went to the ER.

22 minutes ago, Apple1 said:

From my research though, the stretchy part of our stomachs was removed during surgery. What we have left should not have much ability to grow in size.

As I just cited, it's not a permanent change, the stomach stretches -- it's a muscle. It's all part of how people manage themselves afterwards.

For example, someone that maintains an infrequent diet and doesn't consume much food, will remain having a smaller stomach, and the hormones leptin and ghrelin will be activated less -- this is not merely for VSG but also for RNY patients -- the answer to the question of "how much?" is up to them. This also directly affects peristalsis in the intestinal region, something activated by those hormones, which has a doubling effect of creating hunger. This is no different for thin people like my sister who have no hormonal (and thus metabolic) issues.

I think people need to understand that having your stomach cut is not the primary function of why the surgery works well.. it's the hormonal changes. If cutting the stomach merely was all there was to it, people would find themselves with a plate of food in front of them at all hours of the day because they'd be starving all the time.

The idea that the stomach doesn't grow after VSG or RNY is false. Even our bones grow/shrink (due to Wolff's Law), so why wouldn't muscle?

The surgery metaphorically starts the stomach anew, which especially includes hormones. The emphasis on lifestyle changes is because the surgery is rendered useless by those who do exactly what they did to get themselves in trouble in the first place. The physical restriction is not a life-long savior. Anyone who believes this needs to get it out of their heads immediately. It's lifestyle choices in the long run that is what keeps the stomach smaller.

10 minutes ago, Misha42000 said:

I'm confused how does it grow back?

http://www.obesitycoverage.com/weight-loss-surgeries/gastric-sleeve/gastric-sleeve-will-my-stomach-stretch

Quote

YOUR STOMACH CAN AND WILL STRETCH AFTER SURGERY

Our stomachs have the amazing ability to stretch and expand as a result of our food intake. The walls of our stomach are made up of folds of tissue called ‘Rugae.’ These are folds in the stomach wall that expand and contract as a direct response to food entering and flowing through your stomach.

Anyhow, my post was directly related to the fact that restriction gives way later on, and the hormone ghrelin returns to normal levels. This is why they say you can't rely on the surgery forever. People's intake increases, and as a result, the stomach grows. People can eat more. In the beginning it's a mixture of swelling reduction and stomach growth, later on it's related to diet, which most people increase. The stomach will retract as well to accommodate those who eat less as well.

The main function of the surgery is related to hormones. Most of us who have issues with overeating, it stems from busted hormones constantly telling us we're hungry, and doing ourselves no favors by eating bad food. The surgery is a tool to help change those things.

If you're not on medications and are hitting lows like that, that's rather worrisome.. it does sound like it's possibly some type of overstimulation of the kidneys, either by some kidney malfunction or by the liver pushing it to produce too much insulin. Ping-ponging blood glucose around OR date isn't that uncommon, but generally there's an easy explanation that involves meds like Metformin. Please update us OP on what's going on.

2 hours ago, kejamess said:

Hello! So I was "sleeved" 8 days ago. Today I binged... badly. I'm supposed to be on liquids only as I am still in stage 1. I ate food, and not just food but junk food--chips and candy! I attribute this ill behavior to hormonal imbalance. Unfortunately, I have not had any negative side effects (yet) of my conscious-less gorge; but obviously this is a behavior I must terminate immediately. What are some of the consequences I have put in my path as a result of the overeating I did today? Any advice on how to stop myself from repeating this horrific behavior?

My advice is stop blaming anything other than your conscious choice for what you did. I can't see how you won't do this again and again if you aren't being up front with yourself.

10 minutes ago, Daenerys Targaryen said:

If I eat carbs in veggies and fruits, I still continue to lose weight. If I eat bread, Pasta, sugar, etc. my weight loss stalls and then starts creeping up.

Pretty much. Even some complex carbs (potatoes, breads, rice, etc., something someone mistakenly called simple carbs earlier) have a negative effect on certain people. Me, I just avoid them in near entirety.

2 hours ago, itstime4me123 said:

Sounds like you dodged a billet with that one. You will find a genuine person that realizes everyone has a journey. Hang in there.

I second this.. a blessing in disguise.

9 hours ago, jiminy_cricket said:

Hi everyone,
I'm from Philadelphia and my Doctor put me on a 2 week 1,000 diet instead of a liquid diet. I was so confused when he told me this because everyone else does the liquid diet.< br />

It's not liquid that makes the liver shrink, so don't worry about that.

2 hours ago, Newme17 said:

I didn't think of anything other than veggies, legumes, and fruit being complex. Is there some other kind? Never heard of junk science healthy carbs.

https://medlineplus.gov/ency/imagepages/19529.htm

Complex carbohydrates are found in foods such as peas, Beans, whole grains, and vegetables.

Quote

Complex carbohydrate foods provide Vitamins, minerals, and fiber that are important to the health of an individual. The majority of carbohydrates should come from complex carbohydrates (starches) and naturally occurring sugars, rather than processed or refined sugars, which do not have the vitamins, minerals, and fiber found in complex and natural carbohydrates.

How this is relevant to many of us, especially those of us who are diabetic, is complex carbs, entering the bloodstream slower, tend to be better on the glycemic index, and have more nutrients. If one is going to have carbs, these are the ones to have as priority.

2 hours ago, GrrlAnn said:

After being stalled for weeks my nutritionist upped my carbs to 120g of carbs a day in addition to 100g Protein while staying under 1500 calories. It's not easy and I frankly don't like it. She said I need the carbs because I do 5 intense 45 minute Bootcamp workouts a week.

I am very, very tempted to forgo her advice and go low carb since it has worked so well for me in the past. It also seems like most bariatric nutritionists recommend low carb to their patients.

Has anyone else gotten similar nutrition advice (high Protein, low fat, moderate carbs)?

Sent from my XT1585 using BariatricPal mobile app

Intense exercises justify the increased calories, and getting more of that from (complex) carbs if need be. Carbs represent more immediately available energy, which is important if doing that kind of exercise.

On 5/28/2017 at 8:32 PM, Ladybug_rny said:

I'm not on the liver shrinking diet I'm on the diet the dietitian put me on while I meet my three visits required by insurance. I think I would do better on the liquid diet to shrink my liver than this because I know that's major. Some people say have funerals during this time but I really would like to lose as much weight as possible before the operation. I do good during the day and I slip at night time I think it's making dinner for the family. But I just read to eat before I cook for the family.

What diet? The whole premise of the pre-operative diet is to shrink the liver.. so it would be an utter surprise not to be on a diet that's viewed to accomplish this.