wjgo

Prepare your sleeping arrangements for after your surgery. The incisions will be a bit painful for up to a week whenever you bend at your stomach /abdomen. You can lessen this by pressing a pillow against your stomach whenever you sit or stand.

But, it can be a bit painful getting in and out of bed. Plan on using a recliner to sleep in. If you do not have one, arrange the space around your bed so you can lay down the easiest without having to bend.

Sent from my XT1609 using BariatricPal mobile app

Carbs, and fats too, really, are pretty much irrelevant to us at this early stage. If your calories are low enough to promote the desired weight loss, courtesy of your WLS, and your Protein is high enough to maintain your lean body mass, you will by default be on a low carb and low calorie diet. This is one reason why WLS has been the most successful weight loss therapy for the past few decades, irrespective what diet fads are "in"with the weight loss industry.
At this point, you really shouldn't be looking at how to get in more fats or carbs, but how to get better overall nutrition within the limited diet. My basic plan was to get the best nutrition that I could in the non-protein segment of my diet within my tastes and caloric budget. On average, it worked out to be a rough split between fats and carbohydrates, but that wasn't a specific goal, but just how things worked out.
If you get into being more active as you progress, then a specific concentration on adding specific carbs may be appropriate is you find yourself running into energy limits - the body can only convert fat to the needed glycogen so quickly, so the balance may have to be shifted if that occurs. At around 4 months, I found myself running out of gas when I was swimming beyond an hour, so I shifted the meal balance some before the workout to favor complex carbohydrates and problem solved.
By feeding my body appropriately, my loss rate kept stable rather than continuing to decline as typically happens - so much for those silly diet myths that "carbs make your weight loss slow or stop" or "carbs make you gain weight".

After much thought I got gastric sleeve surgery at 21 years old after dealing with weight issues my entire life. I was still young and I wanted the tool to gain my life back. I lost 60 lbs and then broke my ankle which halted further progress because I was non-weight bearing for 10 weeks. I also started vet school and did a lot of stress eating, however I was still able to maintain my weight pretty well. I've gotten a second wind to reach my goal and even 3 years post-op I'm still able to manage CICO easily thanks to my tool. I'm slowly but steadily reaching my goal that I once thought was unobtainable. What I do - CICO CICO CICO! I watch where my calories are coming from (more Protein & Fiber preferably). I would like to have the time to exercise, but that might have to wait until after graduation lol.

A large percent of pre-op weight loss surgery candidates feel that once their waistline changes, so will their thinking, and their dead wrong.




Today, during one of my pre-op psych evaluations, I heard a woman say “I just feel like once I start losing weight and start feeling so much better about my self- I will stop doing all the destructive things that got me here. Don’t you think?”
My response was “no I don’t agree.” I went on to explain that hers was a common assumption, a dangerous “magic-bullet” fantasy about what weight loss surgery can do.
Here’s why: The part of our brain that is responsible for the thought : “wow I look so much better, I better not mess this up,” or “I feel better than I have ever felt in my life, I am a changed person,” is not the same part of the brain that wakes us up in the middle of the night and says: “go on, finish that 1/2 pint of Chunky Monkey in the freezer, there’s only a little bit left anyway, and I have been so good here lately.”
We are dealing with two very different brains; the frontal cortex and the reptilian mid brain. The frontal cortex is the most newly developed (relative to other parts of the brain) part of the brain. It is the component that separates us from animals. It gives us the ability to think about consequences, plan, and execute. It is the “higher” part of ourselves, that often says “why do I keep on doing the same things I keep saying I won’t do anymore?” Or “I feel so out of control. This _______ (eating, smoking, drinking, gambling, pick your poison) is a temporary solution that produces long term pain. I have to find a different way.”
Our reptilian midbrain is the Commodore 64 to our MAC; it is the palm pilot to our iPhone; the horse and buggy to our Prius; the Tommy Lee to our Oprah. Our midbrain is antique equipment, long ago evolved to keep us alive and hence the reason it is still with us today- it keeps us alive. Our midbrain contains the parts of the brain that make us recoil at the site of a snake or a spider in our peripheral vision. It is hardwired to not have to go through superfluous channels of the brain that might otherwise say “hmmm what is that crawling over there? How do I feel about that? Oh its just a spider, my aunt had a collection of spiders, maybe I should collect things, etc etc.” We just jump, and process later.
That very system has helped humans survive for thousands of years. There is an adaptive quality to a brain that proverbially acts and asks forgiveness later. That very old structure once kept us out of harm’s way when a pack of tigers were first seen galloping across a horizon, or when a rivaling tribe could be heard in the far off distance, threatening to pillage our territory.
Our midbrain is associated with learning and reward. Learning what makes us feel bad, what eats us (in the past that would be in a literal sense- like tigers, but presently it might be a mercurial supervisor or unending debt), and even more relevant to this article- what makes us feel good. When our brains come across something that makes us feel good (ex: sex, drugs, food), we are then flooded with an influx of the powerful neurotransmitter- dopamine. Just like not everyone that is exposed to drugs will develop an addiction, not everyone that eats a Nutella crepe will develop a food addiction.
Much of the research on obesity currently, postulates that food addiction, no dissimilar than alcohol or drug addiction- is a reward system dysfunction or dysregulation, born out of genetic predisposition. It’s almost as if some brains think “if one slice of pizza feels good, how would four slices of pizza taste?”
To break these two very different parts up in a different, more basic way; our frontal cortex is the voluntary, while our midbrain is the involuntary.
This very dangerous fantasy, many people carry into weight loss surgery is a myth that I try to dispel quickly. This type of “magic bullet’ thinking is the very thing that gets so many gastric bypass and sleeve patients into trouble years down the road. No one wants to look at triggers. No one wants to sit with a therapist and devise a strategic coping plan. We want a pill, a surgery, a 16 minute solution to a 40 year old problem.
This is not to say that weight loss surgery is not a solution, just that its only part of the solution.

Despite our best intentions, we are still in some ways animalistic, hedonically-driven to feed our most basic impulses. This is part and parcel of why recidivism is the rule not the exception when it comes to recovery from most addiction. So what does this mean? Are all weight loss surgery patients destined for disappointment and disenchantment when the WLS honeymoon ends? No. But the answer to long term change lies more in two-pronged approach to long term weight loss success; surgery + behavioral change.
Simply thinking ourself slim is a fantasy. Think about your specific triggers for eating. For some it is that golden hour when all the kids are in bed and Narcos is queued up on your Netflix. For others it is that 2-3pm mid day slump. For some - it is when they are alone, the only time they can eat with abandon free from others’ judgement or their own embarrassment.
Whatever your triggers- the key is to identify what need is being met in that moment and to find a non-food alternative to meet each particular need ( many people have multiple triggers for over eating). If it is because its “your time,” after the kids are in bed- maybe you invest in a foot massager, or cultivate a self care space with textures, aromatherapy, candles, and books. If your trigger is that mid day slump, maybe you develop a yoga routine easily done in the office to help re-energize you. If it is the secretive quality to the trigger of being alone and eating, maybe it is finding another thing that is just your own that no one knows (going to a movie in the middle of the day, getting an overly priced facial on your lunch hour, playing hooky with your kid one day, etc).
The rule of the brain is : what fires together, wires together. So over time- if you have paired 8pm, Narcos, and nachos- you have created a neurological super highway. The moment 8pm rolls around, you are likely already getting the chips ready and didn’t even realize the thought pathway that just occurred. The idea is to repair our triggers with alternative behaviors and over time “clip those wires” or create “toll roads” to our superhighways (aka neurosynaptic pruning), so that we no longer experience such strong urges and can call upon the higher structures of our frontal cortex to guide the way again.
When we are in the midst of addiction, it is important to understand that our frontal cortex is not at the wheel. It has been duck taped and tied to a chair in the basement by our hedonic midbrain who is used to getting what it wants when it wants it. The closer we come to accepting this principle, the closer we come to being more mindful of our midbrain’s powerful rationalizations and sick contracts and see them for just that. We are better able to dis-identify from the thought, knowing it is not coming from our best self, but from our most carnal self.
Think of that distant cousin that only shows up when they need something, the Uncle Eddy that tells you he’ll move the RV when he leaves next month, indifferent to how it makes you feel. Except in addiction- that distant cousin has taken over, pretending its you until you can no longer tell the difference.
References
http://brainspotting-switzerland.ch/4_artikel/Corrigan & Grand 2013 Med Hyp paper (proofs).pdf
Blum K, Chen AL, Giordano J, Borsten J, Chen TJ, et al. The addictive brain: all roads lead to dopamine. J Psychoactive Drugs. 2012;44:134–143. [PubMed]
Avena NM, Gold JA, Kroll C, Gold MS. Further developments in the neurobiology of food and addiction: update on the state of the science. Nutrition. 2012;28:341–343. [PMC free article] [PubMed]
Gearhardt AN, Yokum S, Orr PT, Stice E, Corbin WR, et al. Neural correlates of food addiction. Arch Gen Psychiatry. 2011;68:808–816. [PMC free article] [PubMed]
Saper CB, Chou TC, Elmquist JK. The need to feed: homeostatic and hedonic control of eating. Neuron. 2002;36:199–211. [PubMed]
Stice E, Yokum S, Zald D, Dagher A. Dopamine-based reward circuitry responsivity, genetics, and overeating. Curr Top Behav Neurosci. 2011;6:81–93. [PubMed]
Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, et al. The D2 dopamine receptor gene as a determinant of reward deficiency syndrome. J R Soc Med. 1996;89:396–400. [PMC free article] [PubMed]
Comings DE, Flanagan SD, Dietz G, Muhleman D, Knell E, et al. The dopamine D2 receptor (DRD2) as a major gene in obesity and height. Biochem Med Metab Biol. 1993;50:176–185. [PubMed]
Noble EP, Noble RE, Ritchie T, Syndulko K, Bohlman MC, et al. D2 dopamine receptor gene and obesity. Int J Eat Disord. 1994;15:205–217. [PubMed]
Blumenthal DM, Gold MS. Neurobiology of food addiction. Curr Opin Clin Nutr Metab Care. 2010;13:359–365. [PubMed]
Volkow ND, Wang GJ, Fowler JS, Telang F. Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology. Philos Trans R Soc Lond B Biol Sci. 2008;363:3191–3200. [PMC free article] [PubMed]
Volkow ND, Wang GJ, Baler RD. Reward, dopamine and the control of food intake: implications for obesity. Trends Cogn Sci. 2011;15:37–46. [PMC free article] [PubMed]

The Numbers Task Force of the American Society for Obesity and Metabolic Surgery (ASMBS) has released its most recent numbers on the most common types of weight loss surgery in the U.S. The “ASMBS Bariatric Surgery Numbers Estimation 2016” shows figures for total procedures, plus a breakdown of each type. You can compare the values annually going back to 2011.


How many surgeries were done?
The data show that there were 215,666 total bariatric procedures done in 2016. That is a lot if you compare to 2011 – it is an increase of 36.5% over the course of 5 years, but it is not much if you compare it to the over 20 million Americans who are eligible for bariatric surgery based on criteria of a BMI over 40 or a BMI over 35 plus a related condition. In fact, only 1% of eligible Americans get weight loss surgery.
Why is the gastric sleeve taking over?
The gastric sleeve is gaining momentum, and quickly. It has leaped from 28,124 procedures in 2011 to 125,318 in 2016. It has jumped from making up 17.8% in 2011 of the total to 58.1% in 2016. Why has the gastric sleeve become so popular, so quickly?
There is a lower risk of nutrient deficiencies and dumping syndrome compared to gastric bypass. It helps fight hunger by lowering levels of the hormone ghrelin. It is relatively safe for higher-BMI patients. It has similar weight loss as gastric bypass, and lower reoperation and complication rates than gastric band. Why would anyone not choose the gastric sleeve?
The gastric sleeve may appear to be the choice du jour according to the numbers, but even so, not everyone chooses it. These are some hesitations with the gastric sleeve.
It is so new that there is no long-term research on it. We just do not know if it stays effective for years and decades. It is permanent. Done. There is no going back, even if the patient really, really begs. Some patients have trouble getting enough calories and Protein and continue to depend on supplements for a long time post-op. What are the non-sleeve choices?
While 58.1% of patients opt for the sleeve, the other 39.9% do not. In fact, nearly 1 out of 5 patients opt for gastric bypass, and biliopancreatic diversion/duodenal switch (BPD-DS) has held steady at 0.6%. These are some reasons to consider other types.
The gastric bypass has a long history. It can be successful long-term with weight loss, and it is famous for its ability to resolve diabetes quickly. The lap-band is reversible. Even though the band has dropped 86.93% since 2011, there were still 7,310 new bands in 2016. The BPD-DS may still be the best for higher-BMI patients. What does the research say?
Good news – weight loss surgery works! At least, that is what the majority of the research studies conclude, whether they are looking at the sleeve, bypass, band, or another method. All surgery types have a risk of complications, and all have a risk of mortality of under 1%. BMI can drop 7 to 14 or more kg/m2, and diabetes, sleep apnea, hypertension, and other obesity-related conditions can get better.
Is the gastric balloon going to be a factor?
Time will tell whether the gastric balloon is going to be a factor in the overall bariatric surgery statistics. The FDA approved it only in 2015, and it jumped from 0 in 2011-2014 to 0.3% (700 procedures) in 2015 to 2.7% (5,744 procedures) in 2016. The balloon is not a true bariatric surgery; it is not permanent, it leads to less weight loss, and it is intended for lower-BMI patients. This means that it may not be in competition with the true bariatric surgery procedures, although it is likely to become more common as it becomes better known.
What is the deal with so many revision surgeries?
If weight loss surgery techniques are always advancing, why are revisions becoming so much more common? They comprised 6% (9,480) of the total in 2011, but 13.9% (30,077) in 2016. It could be because some of the previous (failed) surgeries were done using older techniques, and are now ready for serious help – a revised procedure.
Why are 99 out of 100 eligible Americans not getting Weight Loss Surgery?
There are a lot of reasons eligible Americans are not getting Weight Loss Surgery. They include:
Cost. Fear of complications or death. Not knowing where to start. Lack of support from family, friends, and healthcare providers. Fear of failure. Lack of long-term commitment to lifestyle changes. What can health professionals and patients do to help eligible patients get the Weight Loss Surgery they need?
Surgeons and other bariatric professionals can help by making sure they reach out to eligible patients. They can explain their options, and promise to provide the nutritional and psychological support patients need for success and to feel confident in their success. They can organize support groups and provide additional resources for patients to get advice and encouragement anytime.
What can health professionals and patients do to help eligible patients get the Weight Loss Surgery they need?
Patients can do their part by asking questions to learn about their best options. They can express their doubts and fears to surgeons to come up with strategies for success. They can reach out to friends, acquaintances, and online groups for support.

thanks wjgo that's what I'm working on. trying different classes, I might take up swimming just to see how I like it.

Question; can I document an entire six months as it happens? The only way I can tell the journey is as it happens.
How I got here; Hi! My name is Johnnie, and I am morbidly obese, and I am also a food addict. 27-years ago, I was a dope smokin, cigarette puffin. soon to be alcoholic. This is when god sent me one of his purist angels, we will call her Elizabeth. This angel accepted me for who I was, but loved me for who I am. When my destructive lifestyle began to corrupt her, she gave me an ultimatum; lose the pot, or lose me... I cannot have both. 27-years ago I quit the destructive habit of smoking dope. Elizabeth and I were also married.
Retaining the other two bad habits of smoking and drinking, I had also started to pack on the pounds. My married weight some 27-years ago fluctuated between 195 to 200 lbs. Over thsee years I tried the Atkins diet, which worked initially, but not before the steadily gaining back the weight. Fast forward to 2002, my weight blew up to 260 pounds. This was also the time my doctor started me on my first of many high blood pressure meds. At this time I also wanted to quit smoking, so my doctor prescribed Welbutrin, and within a month I became a non smoker. This about the time that my drinking got worse, and my weight started to soar again. A brief try at Atkins again proved futile, as my metabolism was not as young as it used to be.
At 300 +/- pounds in 2008, I quit drinking and started dieting again; this time it was the 1600 calorie diet with a daily dose of Phentermine. I managed a measly 50lb loss, before reversing direction. I tried Phentermine a couple more times, and even tossed in the 1200 calorie diet. Nevertheless, my weight was now getting out of hand. I have been plagued with plantar faciitus, sore knees, accompanied by a (un-)healthy dose of low self esteem, it became clear, I need help.
2017 arrived, and I decided to change occupations. In April I started a new career as a professional truck driver. I do not need to describe a truckers lifestyle, accept to say, 2017 was not my best year for decision making. July I came off the truck with a kidney stone. It took 2-attempts to get the stone out, but that little bugger came out. Three days after the last kidney stone procedure, was rushed to the emergency room and diagnosed with multiple pulmonary emboli (blood clots). It was deduced that I got deep vein thrombosis from the truck driver life style, producing the clots that nested in my lungs. Weight in July and August was 298.
I should note here, that through all of the years I also suffered from acid reflux, which I treated with baking soda and Water. But the acid reflux became severe about 5-years ago, before I managed to get a grip on it. I have been reflux free for the last 4-years. This was about the time I was diagnosed with severe sleep apnea and put on the CPAP machine.
If you skipped ahead in this story, just know that I suffer like so many here, with many of the issues surrounding those two nasty words; Morbid Obesity.
Elizabeth, has never left my side, she has been my rock, my angel, my best friend for life, even now more than ever! With my background story out of the way, I can begin my journey now...

Look at peoples tickers or info on the side - that should give you some ideas

I lost all of the excess weight in about 6 months. On the last 15 lbs to goal

Unfortunately this is not an easy question to answer. Not because the answer is elusive, rather because it is varied. The posterior chain that is involved in walking and standing will be stronger in an obese individual by nature of having to haul the extra weight. Bone density is also increased for the same reason. As long as Vitamin D & Calcium intake percentage was commensurate with caloric intake, the femur, tibia, and fibula will be denser (hence stronger) than in a average weighted person of the same activity level.
The problem is that many of us that were obese for a long period of time either developed or already had injuries/ailments. Mine was a bad back, hips, knees, and ankles from a car accident. While the muscle and bone is fine for the most part, the joints were a mess. For people like me, that made us "weaker" as a whole. With joint pain and bad backs, we are not walking with an optimum gait nor proper posture. Over long periods of time, incorrect posture and positioning is no different than lifting weights with improper form. It exacerbates current injuries or creates new ones. That is why so many people have abdominal hernias, bulging or herniated discs, and deferred nerve pain.
I'm not even going to go into a discussion on what anyone should be doing in the gym. I am opposed to machine use personally. Sets, reps, and lifting regimen depend on what result you are wanting (raw strength or big, pretty muscles). There is a difference between being stronger and being bigger.
TL;DR - Yes, your leg muscles will be stronger than a person of normal weight but similar activity level.

The rules apply to Protein Drinks. Otherwise, you could be grazing - and that is bad. Much of the Protein digestive process is done in the stomach. So let your stomach do it job. Water can help, but you need to consume your Protein Drink as a meal so as to not disturb the insulin production cycle. Your Protein Drink should have plenty of Water already with it, so you won't need more. If you drink water while still disgesting, you can change the pH level in your stomach and slow down disgesting. Protein is also supposed to increase a hormone that slows down the stomach emptying food. So, just give your stomach the time it needs for the protein.
Sent from my XT1609 using BariatricPal mobile app

Find hobbies or activities to participate in that benefits by going to the gym or other training.
I've started Krav Maga and HEMA (sword fighting) martial arts classes and a Couch to 5k. Also decided to train for GoRuck.com obstacle course "races." I don't go to the gym to loose weight, or get stronger or bullk up, I go to the gym to enhance my performance on those activities. The Couch to 5k helps more for endurance. I know going to the gym and training helps loose weight, but the real end goal is for my activities. Even just going on 2-3 miles walks helps me in my photography club when we go on photowalks. I may be going to some of the cardio classes at the gym, and to me, that's so I don't get tired as fast in a sword fight bout, and will help me stay in a GoRuck course.
Find an activity you would like to do, that makes you want to go to the gym.
Sent from my XT1609 using BariatricPal mobile app

sugar free Jello pudding + Fairfield Milk + GENEPRO Unflavored Protein Mix



Sent from my XT1609 using BariatricPal mobile app

I am using Gummy pills with Fiber. For my diet, I just don't get much fiber. So I take 2.5 does usually daily, for a total of 7.5 grams fiber.

Sent from my XT1609 using BariatricPal mobile app

big do you still track your food? if so what is you fat percentage? Fat will provide that full feeling longer and will not spike your sugar/insulin response to the degree of the other macro's
also you can "train" your ghrelin response so over time if you eat more often you get hungry more often it is a viscous cycle but will pass if given time.
so if you fat percent in you food is low try to bump up the fat to help you go longer between meals.
watch those sugars and simple carbs they will start you on that cycle of hungry every hour as those highly refined foods hit your system hard but wear off real quick and just leave you starving after.

sugar free vanilla pudding then add PB2 Peanut Butter and youre in business

ate that everyday my first month postop

@wjgo you are ready to start jogging now. And yes, Compression gear is a must! Buy a size smaller than your current size though. Sadly, it's entirely possible that your excess skin will never go away on it's own.
Check out "Obese to Beast" on YouTube, this kid went from 370 to 200 (and lower for a fitness contest), he did it all naturally and it took him 5+ years and even with the slow weight loss, he's got a fair amount of excess skin that causes issues with his running. You can get some good compression gear cheap on Amazon (The Superman Compression Shirt in my Avatar was $19... By Red Plume, they can take a little bit to ship, but for the cost... it's well worth it, beats paying $50+ for Under Armour! (which I have as well and love, just not the price)

My surgery was Feb. 26th, so nearly 4 months out. But I've always been a big drinker and fortunately didn't have any trouble even within a couple of days of hitting the 64 oz. I'm also still using Protein Water to help get my protein in, so that's 20 oz right off the bat while I'm driving to work. If you're good with the 64, stay there. Just don't feel like you can't have more if you're thirsty. Hmmm, you just made me realize I'm 50g short on my protein today. UGH! Gotta go drink a shake.

@ wjgo maybe I should have not used the word " force" I open a bottle of Water, take a couple baby sips then set it down and don't finish it. That's what I meant by force, remember to drink the whole bottle even if it's in small increments. Then I end up with a line of lukewarm bottles and I don't like lukewarm, either cold or. warm tea temp, but not tinkle-warm anything. And its 90+ in Ohio so chilled tastes very fine.🍶

I feel the same way but I haven’t even gotten to my consult yet lol! I’ve gone back and forth with the idea for years now but I’ve ALWAYS gone back to yes; I will do this. The rationale that I have come to is simple; I may have serious complications from this surgery...but I also may have serious complications of being morbidly obese. I think that rationale has really helped guide me to make this decision. Best of luck to you 💜

I have a lot of comical Star Wars T-shirts. All sized 4xl and 5xl. I want to keep wearing them because they are funny and some stranger will always comment on it, like a sunset image of Chewbacca with a skateboard, Darth Vader swinging a lightsaber at a pinata, and a casual Friday of a storm strooper at a desk with a wall calendar with princess Leia on it. I have like 15 of them I collected.
Is there a place I can have them "professionally" resized smaller?
Sent from my XT1609 using BariatricPal mobile app

Right now, you should be on a liquid diet, like pre-op for a day or two longer, then transition to pureed foods for 2 weeks Then to soft/moist foods for another 2 weeks. All the while getting 60-80 grams Protein and 64+oz Water with 30 minutes after Water before meals, and 45 minutes after meals before water. Different programs have different variations of this.Sent from my XT1609 using BariatricPal mobile app

After surgery, you will have to permanently cut out ALL bubbly beverages, regardless of their calorie count.

Finding a great guy anywhere is tough, but stick to it if you really want one. I do and I will (though not in Columbus, Ohio--I'm in a small town in upstate NY, so maybe it's even harder?).
Good luck to both of us!!

Have you tried a tailored suit or dress? High end tailors can provide excellent fabric that can be retailored for a fee. Something to try out. Dress might be 3x cost, but use it 4x as long, plus you get a perfect fit. I'd talk to a tailor if you need clothes for work. I got a tailored suit for a wedding years ago. I was told it could be retailored many times if I was going to get smaller.
Sent from my XT1609 using BariatricPal mobile app

Many times I can get very, very hungry after drinking Water and while drinking Water. I admit that my meal/snack times are not ideal and can be erratic. All water I drink is near ice cold or cold and from thermos that starts out with ice if that makes a difference.


Is this normal, or is it time to eat a meal/snack? Usually I'll have a morsel of food if not near a meal/snack time and it does a good job or satisfying the hunger, and provides immediate relief.


And is this hunger mental or physical? I really can't tell what is mental or physical hunger.
Sent from my XT1609 using BariatricPal mobile app