Mhy12784

It's elective surgery. Patients are expected to be optimized for surgery, and risks minimized. If a patients blood sugar is out of control its for a reason (sometimes controllable, sometimes not) for both optimizing patients outcomes and minimizing legal liability. Sometimes an A1c can't be lowered, and in those cases they (should) like documentation from a specialist stating that they tried to optimize the patient and this is the best they can do.

Well it's not necessarily deny you so much as postpone. However it's far enough in advanced (close to a month) that there's plenty of time to address any issues. It'll depend entirely on the policies and procedures of the groups involved with your care, but I have to imagine an endocrinologist should be in order. Has your primary care physician already sent you to an endocrinologist at any point ever about managing the diabetes?

I'm extremely lactose intolerant. Originally I started off only buying whey protein isolate as it's lactose free (there's a million brands pick and choose). But they're generally more expensive and taste poorly. As far as ready to drink protein shakes go my two favorite lactose free ones were Labrada Lean Body and Oh Yeah! Protein proteins. I found muscle milk disgusting. However I recently tried premier protein shakes and found them delicious, as well as being healthier and cheaper than everything out there. So now I just use those and take several of the lactase enzyme pills with them. You can get cheap generic brand lactase pills from Walmart Sam's club Costco etc. Personally I think just buying the lactose pills and taking 3 with a premier shake (or whatever shake you enjoy the most) is the way to go. But if you want the naturally lactose free ones then the options I mentioned above are the best i am aware of.

And just to be on the safe side I would give your surgeons office a call telling them about your blood work and asking if it would be an issue. Maybe they won't care, maybe they'll have you jump through some hoops. If you have an appointment soon you could bring it up there, but if you don't have an appointment until very close to your surgery I wouldn't wait. But an A1C of 10 is a big deal and they could expect things to happen. I know that my hospital (not even the bariatric group but the entire hospital) now has a new policy in place where patients having certain elective surgeries are mandated to see an endocrinologist before surgery if their A1C is over a certain amount.

Where I work all bariatric patients have an A1c done with their preoperative blood work. An A1c of 10 would absolutely have you canceled with the group I work with. As this means your diabetes is extremely poorly controlled putting you at high risk for complications, infection, and poor recovery times and outcomes. Hell I've seen patients with an A1C in the 8s get canceled HOWEVER there is an exception to this. If your diabetes is truly complicated and uncontrollable (and it's not just a matter of you being non compliant with your diet exercise and medication) they would send you to get a preoperative endocrinologist consultation/workup and have the endocrinologist say how they've tried everything your case is complicated blah blah blah and that an A1C of 10 is the best they will be able to do prior to you having surgery. I would be shocked if a surgeon and anesthesia (hell and a hospital) allowed a patient to have elective surgery with extremely poorly controlled diabetes without proper documentation (an endocrinologist consultation etc) covering their ass. Because not only does it put you the patients health at risk, it also puts the surgeon anesthesia and hospital at a financial risk (eating the cost of complications, lawsuits etc) as well as possibly even legal risk.

Has anyone tried pure protein? (they come in a can) Hows the taste compare to premier protein

You're taking miralax ways too often, which can cause your body to become dependent on it (this is a real thing). I had the same problem as everybody else, and I have seen substantial improvements with the following. Colace 3x a day (this you CAN do often) Metamucil 3x a day (I love the pink lemonade flavor of Metamucil weight control. It has some other stuff in it, but I just buy it because I love the pink lemonade flavor) Fiberchoice tablets 2-4 times a day (they taste yummy, and contain inulin fiber which doesn't do much but add bulk) And sometimes I'll eat some fiber gummys as well (they contain polydextrose, which is another cheap crappie fiber that serves little purpose but adding bulk). I have no idea how often you should take laxatives but my surgeon strongly recommending avoiding taking them more than once in a blue moon as it will cause dependency and cause real problems. And with fiber supplements you wanna build up your dosage slowly over time otherwise you'll get super bloated and gassy. I probably get around 35g of Fiber a day on a 1200-1500 calorie a day diet and that barely cuts it. That's not counting the additional fiber I get from fiber tablets and sometimes gummies as those are inferior sources of fiber. But I strongly encourage anyone with constipation issues to get ahead of the fiber game, before your unpleasant issues turn to hemorrhoids and then you'll be dealing with an extremely unpleasant situation

Scrambled eggs Protein powder in sugar free pudding Baked or air fried fish (with almond or coconut flour if you want it be like fried) Ground beef (this is probably end of month 2 more risky) Protein mug cakes

I know premier protein seems to be the most popular protein drink, but many people are lactose intolerant and more are so after surgery. Has anyone experimented with opening their shakes adding the lactose treatment drops, and letting them sit for a day/few days to go work before drinking? I know that lactose treatments are hit or miss (usually miss) and that premier protein has a ton of lactose in it. Thanks for any input!

I do, but it's also about twice as much cost wise as regular milk. And it also doesn't address the protein part (which has ton of lactose) and the lactose free protein alternatives tend to cost substantially more while tasting substantially worse

My issues with the pills (especially the chewables) is they were never hundred percent effective. But with the drops (or even the powder) you can open a drink put it in there, and it'll work constantly until you drink it (ie you can drop it in 2 days in advance and it'll break down all the lactose over 2 days) I've done this with milk in the past but never tried on protein shakes or anything complicated

The surgical group I work with routinely uses a disposable 36fr bougie. However on complicated cases they have been known to use an endoscope instead of a bougie as it provides direct visualization. Is it common, no. But it's not unheard of. Of course this is very often on revisions or patients who have had/have a lap band in at the time of their procedure

Congrats, where are you having yours done? Had mine in Port Jefferson a few months ago. Terrific experience

My favorite coconut flour recipes "fried" chicken or fish. Works best in an air fryer but could be baked. Basically dip it in egg wash, throw some coconut flour on a plate and season it. Dip it throw in an oven or air fryer with VERY VERY little oil and you have a healthy fried chicken/fish. Other easy recipe is a protein mugcake. 1 scoop protein powder, 2 tablespoons coconut flour. 1 teaspoon baking powder. Mix all in a coffee mug add some milk stir until a THICK batter. Add some vanilla extract or flavoring of choice. Microwave 30-40 seconds and done. Personally I love coconut flour, tastes fantastic low calorie filling and high in fiber

Try different protein powders. Whey, whey isolate, casien, egg, beef, soy. I find it incredibly difficult to imagine they're all an issue (especially if you can have milk and yogurt which contains both whey and casien so....) You could also try using things like Greek yogurt and cottage cheese as protein supplements. Trial and error is the best way

Has anyone noticed a substantial change in hunger around this point? I feel like the past several weeks my empire has come roaring back. I've been sticking to my basics (high protein high fiber low calorie) but it's been a world of difference lately. I'm hoping it's a temporary phase or something

My hair really started falling out much more than usual in recent weeks (although I'm a guy) However I did start using thickening conditioner and thickening shampoo . It hasn't made my hair loss slow down at all, but I do look like I have more hair...

Damn I wish I could stay under 1000 calories. That ship sailed almost as soon as I started eating solids. I'm probably averaging 1300-1500 a day and I get pretty hungry. Although I'm still losing (I think), but I have to get to the gym at an unreasonably high rate, and being able to eat an extra meal a day (I eat an extra meal whenever I go to the gym) is certainly a motivator for me to do cardio

Protein mugcakes is my go to protein recipe (Google it there's tons of them) My personal favorite is 1 scoop of protein powder (syntrax matrix) 1 tablespoon coconut flour, 1 teaspoon of baking powder and a little skim milk to get it all mixed (until it's dissolved and a thick mix) Microwave 30-60 seconds based on preference. Now your protein is hot and cakey. Plus it's delicious, and it's not sweet at all

Unless you love the taste (which is a totally legit reason to buy it) you'd almost certainly be better off making your own protein drinks from a price/protein standpoint. But if it tastes great, there's nothing wrong paying a premium for that

I mean on the flip side you could use it as an opportunity as well. You'll have some amazing before and after pictures. Plus people tend to take fitness products/supplements more seriously when the person advertising them is thin/fit. I think ultimately a thin fit you would be more beneficial to your career even if it becomes known you had WLS and it'll greatly outweigh the negatives.

I think 64 oz thing is hogwash. Early on when you're in the liquid/puree phase I think 64 oz is a good number for most people to aim for. But once I started eating solid foods and a relatively normal diet again (around 2-3 months post op) my fluid intake is close to half that possibly even slightly less. And I pee non stop and it's always clear, so I'm not particularly concerned about my fluid intake. If I was drinking 64oz + of fluid a day I would probably be peeing in excess of 20 times a day which is in no way appropriate or healthy

Makes even less sense when you factor in Skim milk is a decent source of carbohydrates and contains no fiber.

I was sleeved the week after you (11/13} and my numbers are very similar (70 is pounds since then) and my weight loss has certainly come to a trickle at this point. I don't have much left to lose, but things slow down enormously. I think 75 pounds since November is great, but more importantly is which direction you're trending

Theoretically yes, in practicality no. If you have reflux after a sleeve lifestyle adjustments, medications, minor surgery (Linx, stretta), and conversion to bypass are your major options.