Berry78

If they mean by 9 weeks postop, that is a program I disagree with. If they mean at goal/maintenance, then that might be ok. Why I disagree is because at 9 weeks, you'll likely only fit in 3oz per meal. 9oz of food, if it were all meat, would only be 63g protein. You could fit a little fat with that, but no carbs, veggies, etc. They are trying to get you eating with normal dietary patterns, right out the gate, and it's just not do-able. So hungry that we cram food in and then vomit should NOT be the goal. Normal meals should come when we can meet our goals in 3 meals. Not before. I'm 7 months out and have to get my protein in 3 meals and a snack, then I add another couple meals of fruit and veggies. It was similar at 9 weeks. Some people's stomachs can hold 8oz right away. Those might meet their goals in 3 meals sooner.

So a whole bowl of oatmeal and only about 15g digestible carbs. You are a wonder woman! But, alas, please start doubling or even tripling the oat portion of your oatmeal

How about oatmeal with raisins? I hate for people to resort to white flour (pasta), but that is just me. There are whole grain pastas though. 2 cups of potatoes.. 1 white and 1 sweet would hit half your goal. So this is very do-able. Your nut may like seeing 50% protein, but may not be looking at it in relation to recommended calories. (50% of 1000 cal. would be much easier than 50% of 1500).

@Meryline... if you eat 120g protein, that's 480cal. 60g fat is 540 cal. 120g carbs is 480. Which brings you up to 1500 cal. Yes, this is less than 50% of your calories as protein, but this should get your nutritional status up where it needs to be. (In order to have 50% of your 1500cal as protein, you'd have to eat 187g protein a day.. 6 x 30g meals... totally wouldn't happen.) I think the 50% is about looking at your plate. 1/2 protein food, and 1/2 veggies, fruits, and grains. To give an idea what 120g carbs looks like: 1 cup beans and 2 pieces ezekial toast, and 1 whole piece of fruit, and 1 cup potatoes. Yep, you are gonna do nothin' but eat!

Gummies generally aren't digested well. Look for chews or powders.

Don't go 4 hours, it's too long. Every 3 hours is ideal this early out. This isn't "snacking", it's preplanned mini-meals that help you meet your goals. What will also help is to drink about 4-8 oz right before you eat. (Drink while you prepare your food). This takes the edge of hunger off so you don't eat as quickly. Most of us report liquid leaves the stomach within just a few minutes.. so it shouldn't make you overfull. (Just take your time, feeling it out).

I did find a study for vit. B-12. They said it isn't well absorbed through today's patches, but they used some micro needles to put the tiniest of holes into the skin, and that allowed the B-12 to get absorbed. So unless they start using micro needles, patches aren't the best way to receive B-12.

Right around the 3 week mark I had this happen. The food was still very smooth and slippery, but I got full after just a couple bites, and so my mind wasn't satisfied. This lasted a pretty short time. By 5 weeks I could eat a bit more and more solids, so it was better. Just time and experience makes a difference too. (I would see myself drink 8 oz of fluid relatively quickly, but that didn't translate to food, so it was a difficult transition).

I just want to caution everyone.. advancing too rapidly can potentially cause a leak. (Not picking on any of these examples specifically.. but just a general warning). While the stomach is healing, it is vulnerable. Better safe than sorry!

I agree, worth a call to your doc. Hopefully it's just part of the healing process...

I believe I saw a statistic that GERD is not cured in about 5% of bypass patients. There wasn't a hypothesis as to why this is the case. So what you read is correct. I went looking for a statistic about sleeves and GERD, and came across a revelatory article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579881/ Basically my takeaway is sleeves that have a hiatal hernia (that isn't repaired) are much more likely to result in GERD postop. If the sleeve is malformed, that also increases GERD. If neither of these is the case, GERD occurs in 5% or fewer cases... similar to RNY. This article is so important, in that the blanket statement we all make r.e. GERD = bypass may need some caveats.

I live with my hubby and MIL. While I was on the liquid preop diet MIL brought home no less than a dozen cakes, pies, ice cream, etc. She's one sick cookie. I considered it trial by fire... controlled myself.... and now I'm reaping the benefits because I'm not bothered by looking at sweets anymore. She is now on a diet herself, and I'm tempted to do the same thing back to her...

Ok, I got curious. Turns out my broad denouncement as to the efficacy of patch vitamins was hasty. So far I have turned up a study that shows vit. D IS effectively absorbed through the skin. Vitamin A (retinol) can as well. These are both fat-soluble vitamins, which probably has an impact. If your patch Vitamin A is retinol, then that makes sense...beta carotene still doesn't convince me. Is there a lotion, sunscreen, or something else you are using that has retinyl or retinol?... assuming you don't eat liver every week....

The bypass IS malabsorptive because lots of nutrients are absorbed in the first part of the intestine that gets bypassed. Over time, the intestines adapt and absorb more, (part of the reason regain happens). Bypass is better for Gerd and moderate diabetes. Dumping can be helpful against addiction to sweets, but not everyone with a bypass dumps. I have the sleeve and so far, so good. Still have to take daily vitamins. Lifestyle change is required for both bypass and sleeve. Exercise requirements are the same.

The vit A in the patch is beta carotene, right? "Eating excessive amounts of foods with beta carotene, such as carrots, can cause a person's skin to turn yellow-orange but it does not cause vitamin A toxicity. The body does not convert beta carotene to vitamin A when there is sufficient vitamin A present." https://labtestsonline.org/understanding/analytes/vitamin-a/tab/test/ Look somewhere else for your excess Vit. A. Liver, cod liver oil, multivitamin, etc.

Good news! Fingers crossed it gets better quick!

The skin is designed to be a barrier to chemicals from the environment. Not to absorb stuff. The mouth IS absorbant since it's a mucus membrane. There is some question whether sublingual actually gets absorbed in the mouth, or in the intestine once swallowed. Either way, oral administration is important. Think about it, if we could absorb b-12 through the skin, we could just go play in the dirt and get our quota.

Your wish is my command!

Ok, y'all, trying to get a sense where the carb wind blows these days...

People may be getting bored of the protein one.. how about asking how many carbs (and from whence they come)?

I think we figured out what is causing Meryline's hunger. She is a hair's breath from goal, and needed to increase her calories/protein/nutrition. Sometimes hunger isn't a bad thing!

The average response is people seem to notice losing about half their hair, evenly over their head. (same for me.. I'm 7 months out and have been losing since the preop diet... but it does seem like the losses are slowing down a tad). Usually the regrowth starts around 9 months or a year postop. (Fingers crossed for myself). Oh my gosh! How long ago was your surgery, and which procedure did you get? Do you have a plan for getting your levels back up?

Y'all run with a different crowd than I. People ask me "how are you?" all the time, but I just take it to mean the same as it ever means to anyone. It's a form of greeting. I've had all of two people comment on my losses. One was my daughter's boyfriend, and he ONLY said something because my daughter encouraged him to (she knew it would make me feel like someone had NOTICED!). The other one just asked if I'd lost weight, and that I looked good. I did have an interesting interaction with someone yesterday. She herself had a bypass 10 years ago, I know her because she worked with my teenage daughter back around the time of my surgery. She knows about my surgery, but hadn't seen me since I started losing weight. So I'm 98 pounds down, but she didn't say a peep about my weight loss. Instead, she started talking about how her daughter steals clothes out of her closet to wear. I admitted the shirt I was wearing came out of my daughter's closet! LOL!

Ok, I read a very interesting website that talked about how we absorb B-12. Essentially, our recommended daily intake is 3.5mcg. Most foods that are good sources of B-12 have this amount in one or two servings. There are two methods the body utilizes to digest/absorb B-12. One is the normal way, where "intrinsic factor" (a chemical created in the stomach) attaches to B-12, and ushers the B-12 out of the small intestine, into the blood stream. The second way is a "passive system", which doesn't require intrinsic factor. B-12 just slips out into the bloodstream by itself. BUT, this passive system is VERY inefficient, and so only 1/100th of the B-12 makes it into the blood. We sleevers, we had the portion of the stomach removed that makes intrinsic factor. So the first method doesn't work anymore. The second method works, but look at the numbers. If a serving of B-12 food has 3.5mcg, but you only absorb 100th of it, then you'd have to eat 100 servings of that food to meet your daily goal. Excess B-12 is stored in the liver, and if your liver is full, it can provide your B-12 needs for 5 or 10 years. Since your blood work is showing dropping levels, it may mean your liver isn't full anymore, so the supplements become more important. There is no proof the patch works, so don't count that in your figuring out how much B-12 your body is getting. Your pill has 1000mcg, so you are absorbing about 10mcg a day. But, that's statistically, and we don't know if the particular supplement you take is as easily absorbed as the ones used in the studies. So it's possible, you aren't even getting 10mcg. The shot, however, is the surefire way that you are getting this supplement, since it bypasses the digestive system completely. If your liver is running low, it could take a while before the shot fills it back up enough to reflect in a much higher number in your blood. Since your blood value did go up, the shot is definitely doing its job. http://www.b12-vitamin.com/intrinsic-factor/ Here's the website:

Fingers crossed you don't have compartment syndrome.. Let us know how it turns out..