CrankyMagpie

I've had kefir, and it reminded me not even one little bit of drinking alcohol. It's like really tangy, thin yogurt. If you're worried, you could just have yogurt. Chobani has a pretty good mix of happy yogurt bugs in it. (And Light 'n Fit is absolute junk, probiotically speaking. They don't list what strains they include, which makes me suspect they don't really include any.)

There was a study that found that people who used lavender aromatherapeutically (which just means "they smelled lavender," but that seemed like weird phrasing) after surgery were better able to tolerate pain. And, I mean, just generally it is also a nice scent and a calming, grounding herb. I'd recommend having a lavender sachet with you, or dropping a little lavender essential oil on a small piece of cloth, to have with you as soon as they'll let you (in the recovery room? I dunno, but certainly in your hospital room!). I plan to do that. I'll be real: I am stressed about the pain. I deal OK with modern anesthesia, based on how my last two outpatient procedures (one of which was the endoscopy) went for me. But I've never noticed that pain meds actually dull any pain for me? They just force me to sleep, which is a way of escaping pain, but I already know my team is going to have me up and moving around, maybe as often as every hour, which means very little sleep-escape for me. I'm worried it will be nearly unbearable, and I am clinging to lavender and breathing exercises as two tools to help me get through it. It's temporary. It might be awful, but we'll get through it, and we'll be better and healthier after the fact. We've got this. 👊

I'm pre-op, but I've done a lot of reading. Still, take my opinion with the appropriate amount of salt. You may not be in that much pain, but you're going to be pretty tired as your body heals and adjusts to a significantly decreased calorie intake. You won't be able to drink as much liquid as you ideally should, yet. It's even possible that your throat will be a little scratchy from the breathing tube, still. (Most people aren't that scratchy on day 3, but still.) If you can push it back another week (or better: get it to a full 2 weeks out from your surgery date, if possible), I think you'll feel a lot better, both physically and emotionally, about the whole thing.

Yeah, I feel that. It'd frustrate me, too.

Do you have a before picture in any of those dresses? Because I bet, while they still fit, they fit differently now, at least. (Also, I don't know about the rest of you, but some of my clothes that "fit," pre-op, are ... probably smaller than my, uh, actual size.)

Pretty much the only good thing I will ever say about Weight Watchers is that their app for food tracking was fantastic. I'm not sure I'm willing to pay $15/month (or whatever) to a corporation that makes money off of the suffering of fat people--especially now that we have more data on the futility of "diet and exercise" as a weight loss approach, without surgical or other major intervention--but, man, that app. Everything had both grams and ounces, plus volume measurements. It was so good. MyFitnessPal is ... not as good, but it's not horrible. Sometimes they have gram/ounce conversions and multiple measurements. Sometimes not. In general, food tracking makes me a Crazy and Very Cranky Magpie. As an approach, it really bothers me, because it disincentivizes cooking with multiple ingredients and choosing small, local eateries over big chains when we go out -- because tracking those things is so much harder and more full of guesswork. But I try to work past those incentives and do what's healthy and just give things my best guess. (At non-chain restaurants, I always put in the highest-calorie version of the dish I'm trying to add. You wouldn't believe how much butter and cream and salt goes in restaurant dishes.) For recipes that I make a whole lot (and with fairly consistent amounts of ingredients :)), I'll actually go to the effort of putting them in SparkPeople's Recipe Nutrition Calculator, so that I can add them in to MFP as complete servings. (Of course, you still have to know how many servings the recipe gives you. So, even with a recipe calculator, there's a little bit of estimation, for most of us.)

This is a nice idea. I don't know if I'll do a bunch of rewards, though my grandmother did a charm bracelet when she lost a bunch of weight. That kind of appeals to me. I might do that. I do have a couple of milestones in mind, though: when I hit 250 lbs - get myself a bike (or maybe I will wait until 220 and get myself a folding bike!) and then I train on that bike until I can do one of those bike tours around another country! no specific weight, but surely by next summer - go kayaking at the local kayak rental place because my butt won't be too big anymore somewhere under 200 - actually go to that other country Hmm. I feel like there were other things I wanted to do that had weight limits attached. (Like maybe going on a hot air balloon ride or a zipline/ropes course. Then again, even at a lower weight, I'll still be a chicken.) Honestly, though? At 250, I think I'll be able to do almost everything I want to, except for being able to fold up a bike. Any loss beyond that is just ... some non-food metaphor that means "super great and very welcome, but not strictly necessary." I might need to lose a bit more than that to feel really comfortable going to an amusement park, say, but that's usually more about size than weight. (I Googled, and Cedar Point has 1-2 adult rides with a weight limit of 220; most rides with limits are much higher.) If I ever want to go snowshoeing, weighing less would be super helpful, to get women's snowshoes. ? But, yeah. Maybe a bracelet charm every 10 pounds. That seems really nice.

My doc requires that we lose 10% of our initial weight before surgery. I'm 60% of the way to that goal, with a probable surgery date in November. (I'm also doing keto, but also trying to keep it low-fat, which makes it pretty seriously low-calorie as well. It's awful, but at least it's fast! I'll meet my surgeon's goal before the liquid diet and, assuming that's also very-low-carb, I'll probably lose another little bit from that, too.)

Mint tea is fine if you can tolerate it (and if your team didn't tell you not to): it's good at fighting nausea, but it will increase the chances of acid reflux. I'm pretty sure my team said not to risk it. Avoid at first: I saw a doctor somewhere explicitly suggest avoiding ginger, which is a bummer: that's good for pain and nausea. But it's also a very "hot" herb, and I could see it irritating the staple line. Also it is potentially dangerous to combine with blood thinners. I definitely plan to hold off on that. Ginko biloba and Asian ginseng are potentially dangerous with blood thinners, in the same way as ginger, so they'd also be good to avoid for at least until you're off those. Dong quai, fenugreek, horse chestnut, red clover, sweet clover, sweet woodruff, meadowsweet, wintergreen, willow, poplar, and reishi are also worth avoiding while on blood thinners. (I don't know this all off the top of my head; I have a book of herbal and medicine interactions. It's a few years old, so there are almost certainly other herbs I haven't listed.) After you're off the blood thinners, gingko biloba and Asian ginseng would both be fine to add back in if your doc OKs it; they may even support healing. Meadowsweet, wintergreen, willow, and poplar contain a similar substance to aspirin, so I plan to avoid them until I'm cleared for NSAIDs again. I also plan to avoid licorice. It can mess with the digestive system (usually in good ways, but I'm not sure what mixing it with the PPIs would do), and it can raise your blood pressure. I have to avoid it for other reasons, but for the two weeks before and after surgery you'll want to make sure to avoid St. John's Wort, which affects the absorption of medicines. It's not a tea thing (unless you're a lot more hardcore than I am ), but it's a good idea to avoid garlic for two weeks before and after surgery. A website I was looking at for suggestions of teas to drink after surgery also said to avoid Kava and Ephedra (OK, that second one seems obvious) for two weeks before and after surgery. Nice possibilities: If you aren't allergic (I am, which is a bummer), chamomile would be a nice tummy-settling and mentally soothing herb that might also help you sleep while you're in the hospital. (It has potential interactions with chemotherapy drugs like methotrexate, but no other class of drugs or medicines is listed alongside it in the book I'm using.) A tea blend with lavender in it would be really nice if you're into floral tastes at all. It helps a tiny bit with pain and with fighting off unwanted bacteria. One study found that just smelling lavender helped people cope with pain after surgery, too. (No known drug interactions.) Because getting proper nutrition is a tricky thing immediately after surgery, I plan to drink teas made up of nutritive herbs like nettles, oat straw, raspberry leaf (or not, note below), and maybe rose hips. (I'm going to play with the amounts until I find something I like the taste of.) (The only interaction listed for nettles is diclofenac, which is an NSAID. That said, nettles are also a very, very gentle diuretic--gentle enough that they aren't even contraindicated with medical diuretics in this book--so I might add a little marshmallow leaf to help balance that.) Hibiscus is a nice tea and also contains some vitamins and minerals. (Nothing is listed about it in my book, good or bad.) Echinacea would be nice, though like chamomile, it has potential interactions with some chemotherapy drugs. After I'm off the "good pain meds," I'll probably add in more raspberry leaf, some red clover leaf, keep doing the nettles, add in some mullein (good for the lungs, as well), and keep balancing that formula with marshmallow leaf. If your main pain med contains codeine: You may get a little less bang for the pain med buck (fancy medical term: "reduced drug absorption/bioavailability") if you're drinking green tea, black tea, raspberry leaf tea, uva ursi, or anything else that contains tannins. I'm not saying "don't," but maybe just "mix it up a bit with other things."

Seconding the Leslie Sansone recommendation! Here is her YouTube channel: https://www.youtube.com/channel/UCVl6ZdslZz2Zj-34bMJFPbg This is probably her easiest video: https://www.amazon.com/Start-Walking-Home-Leslie-Sansone/dp/B003HC9JIW She has a big range of difficulties--some of them get pretty hardcore--but even in the harder ones, she's very reassuring during them and says things like "if you can't do the fancy steps, it's OK to just walk to the music!" People who don't like her generally feel like she's a little saccharine--just too chirpy and upbeat--and while usually that kind of thing annoys me (I mean, I am a very cranky magpie), she hits just the right level of pep and positivity, to keep me going. I have pretty bad plantar fasciitis right now and can't do her videos without messing my feet up. I'm looking forward to starting back up with them after I've lost enough weight that my feet aren't so messed up!

Statistically, this surgery is safer than joint replacements or gallbladder removals. And both of those are also considered safe. Like... do people sometimes not make it? Yes (0.08% for the first 30 days, or 8 out of 10,000 people), but that's why we have to do so much pre-op screening and the pre-op liquid diet: to give us the best possible chance. Also, take some comfort: the gastric sleeve is safer than the gastric band or the gastric bypass. You picked the safest option, and you will feel so much better soon. We're all cheering for you!

My last meeting with the PA and nutritionist (my third of four), she said if I can lose 20 pounds between now and then, I can have my surgery the week of Thanksgiving. More specifically, if I'm down 8 pounds by our next meeting (9/5), she'll actually schedule it. Since the surgeon said in June I only had to get to "15 pounds down [from SW] by 9/5" (I'm ahead of schedule for that!), and in July the PA said "if you lose 6 more pounds by our August meeting we'll schedule your surgery in September" (and I did, and they didn't--the surgeon had changed his mind and decided to stick with his initial "lose 10% before the surgery" demand), I'm trying not to hold my breath too hard. But I'm holding up my end of the deal, anyway. I've started a low-fat ketogenic diet (I'm following the Ideal Protein protocol, but with alternative products... partially because it's less expensive than doing it for real, but mostly because I hated going into their offices and being weighed every week; I have my own scale, and lots of IP's "nutritionists" are just chiropractors, anyway). So far it's probably all water weight that'll come back pretty much immediately as soon as I drink some fruit juice, but I'm down 5 pounds this week. It's a low-cal enough diet that I'll be able to lose a real 1.5-2.5 pounds per week for the next couple of months (more early on, less as I get closer to November), which should guarantee my spot in November. I'm really anxious, though, because like I said, it'll take very little carbohydrate for me to gain back the water weight. I'm worried that the liquid diet, that last week, might contain too many carbs, and the surgeon won't listen to me and will throw me out for "gaining weight" when I didn't, really. I'm also worried that the anesthesiologist will refuse to work with me if I'm in ketosis at the time of surgery--it's not that different, but it's different enough that they have to watch some extra gauges, as I understand it. So, I have a few questions for my next appointment, I guess! Anyway, hi, other hopefully-November folks!

Just seconding Sosewsue61's comment: I've been told (by nutrition professionals, if not actual doctors) that hormones get stored in small quantities within our fat, and losing a lot of fat quickly can do a real number on our hormonal systems because they're all released at once. It's a little unpredictable. For me, in my early 30s, on a low-fat keto plan, that looked like some skipped periods, some longer-than-average periods, and a few extra cramps--and I'm ready for that again in my late 30s, after the VSG. I don't know what that would look like for me on menopause, or for anyone else, though. The one reassuring thing I can say is that it's temporary. Your body adjusts. The really rapid weight loss tapers off, and you go back to some kind of homeostasis. (I don't want to say "you go back to normal," because it's generally a new and better normal, right? Like you said, there's less inflammation when you weigh less, and that has positive impacts for every body system.)

I just googled Fairlife, and that might be an option for me. I'll look at soy milk and rice milk, too, but iirc they're a little too high in carbs for me right now. (I've voluntarily started a low-fat ketogenic diet, so that I can reach my doctor's 10% weight loss goal for before my surgery. After the procedure I plan to be a bit more moderate in my approach to things. The irony that I'm more restricted now than I will be a month after surgery has ... not escaped my notice.) They make peanut milk, now, too, which I know literally nothing about, except that it exists. I'll also have a look at that. I vaguely recall coconut milk won't work, but I might be mixing up keto and WeightWatchers in my head? I'll look. I'm only really invested in using up the Quest powders because I have them in my house right now, you know? When I replace them I'll try something else. People seem super into the Syntrax Nectar, so that's a possibility. And I liked Muscle Milk OK in the past. (I liked Premier Protein, too, but my team won't allow it because the first ingredient isn't protein isolate. Other kinds of protein are, in their minds, inferior. Since there are so many options out there, I'm not going to fight with them about this.) Anyway, thanks for the suggestions! And also, I'm with you on avoiding Amazon!

I'm pre-op, so just reporting things I've read elsewhere, but there are apparently lots of people who can't stand the sweetness of standard protein shakes, post-op, and have to water them down to be able to drink them. I sort of hope I'm in that boat; my sweet tooth is a problem for me, right now. And right now I don't like the Quest protein powders unless they're mixed with milk (plus I have a nut allergy, so I can't do almond milk); it'd be great to be able to have them plain and not hate them.

My doc is very experienced (one of the first two to have performed the gastric sleeve operation) and insists on a one-week liquid diet before surgery. He also makes his patients lose 10% of their body weight before the surgery. (And, I mean, he's popular--booked out for months in advance--so I guess he can afford to cherry-pick patients so that his stats stay good, too.) I have read some of the studies about this, and there is a noticeable change in the size of the liver when patients are put on a very low calorie or ketogenic diet before the surgery takes place. It isn't total bunk.

I dunno, the nutritionists I have to meet with work with the bariatric surgeon, so I had kind of assumed they were bariatric nutritionists. I've never asked, though. (And honestly? I am not impressed with all of their levels of knowledge. The one seems pretty cool, and I at least like and trust her. The other two just have a bunch of rules memorized and don't listen and don't seem to know how to adjust to patients with different needs. I am having a lot of trouble separating their useful insights from their dogma.) Anyway, it's reassuring that snacks can be a part of a healthy post-sleeve lifestyle, so thank you! Really, knowing what I do about the amount of food that'll fit in a post-op tummy, I had kind of imagined protein shakes would be needed to hit the protein goals. Maybe these nutritionists just aren't counting those as "snacks."

My surgeon allows coffee. "You can have it the day after surgery if you want!" said the PA. I pointed out that I'm not going to want it that day (because nausea), and she agreed. I don't want to have to fight the headache on top of all the other pain, so I'm choosing a week between now and the surgery and going cold turkey. (I'll cut down on caffeine a little between now and then, too.) One other benefit is that cutting out caffeinated coffee will also help me get enough water in, since that's one less non-hydrating beverage that I can replace with hydration. I dearly love coffee, though, so I'll probably drink decaf when my stomach is calm enough for it.

My surgeon's nutritionists would tell you your problem is that you're having snacks. They are very hard-line opposed to snacks; I'm pre-op (don't even have a firm date yet), and I already have heard them repeat "three meals per day and no snacking" multiple times. (I kind of hate these nutritionists. But that's my issue, and we're talking about you.) Lots of other teams seem to be more moderate in their approach, and ultimately, as long as you're doing what your doctors and nutritionists tell you and making progress (at whatever speed), I feel like that's a good definition of success! 37 pounds down must feel really good! Are you having an easier time getting around? Wearing loose clothes that used to fit too tight before the surgery?

For folks who are on protein-only or protein-and-veggies-only diets for a while before the surgery, you can manage your symptoms with some of the suggestions on this list: https://www.perfectketo.com/keto-flu/ You don't need to take ketone salts (bleh, keto bros can be the worst), and you can't very well add extra fat to your diet, but the other tips--hydrate well, have bone broth (if allowed), and do what you can to replenish electrolytes (even if it's just drinking sugar-free gatorade or putting a pinch of salt into your water) are good ones. It won't fix everything--you're still starving your body (deliberately), and that's always going to be unpleasant. But it'll take care of some of the nastier side effects. Also, if you're allowed fruit juice, this isn't you. You're just hungry. But stay hydrated anyway.

My SIL had amazing results with a lap band years ago, and when I (rather rudely, in retrospect) asked how she did it, she said "diet and exercise," and I felt like a loser for not being able to do the same. Just ... as a data point. (Obviously, I found out, because my family is into gossip, and eventually the band failed and she gained a lot back.) Being several years older and wiser, of course, I now realize that it is super duper rude to ask people about their weight or comment on their food choices, so with people who are close enough to me that they get to ask rude questions, I'll probably tell the truth. (It helps that I have some complicating medical issues that make this surgery a bit more necessary, which will slow their roll on the judgment front. I'm also happy to point out "this is my body, and since I'm the one who has to live in it, I'm the only one who gets to decide.") But coworkers? And randos I just kind of know? I'm still working on a set of scripts, but it's going to be something along the lines of "That's a very personal question" or "I don't believe in food-shaming one another" or ... just ... blatantly ignoring anything rude they say and changing the subject outright. (I'm working on my quelling stare, for if they try again after I've changed the subject. ;)) I'm not willing to make someone feel like I felt, not if they're well-meaning and generally not a jerk. But I also don't owe anyone any answers, you know? So this is my happy center line. Ultimately, I hope we'll each find what works for us.