CrankyMagpie

I'm going for the sleeve (and I am over 300 pounds and shorter than you and also not male), because I need to be able to take NSAIDs and probably methotrexate for my arthritis. (Sometimes WLS clears up arthritis. That's why I'm seeking it, not the weight itself.) With the bypass, NSAIDs are off the table for, as I understand it, forever. And Tylenol does almost nothing for arthritis. (Also, I'm self-pay in the US, and the sleeve is less expensive; I have enough money in savings for the sleeve, but I do not have enough money for the bypass, I suspect--I didn't ask for a price, already having made up my mind. Also, the sleeve has a lower rate of complications. Not enough lower that that alone should be the deciding factor, but it certainly factored into my decision. The long-term difference in weight loss is only about 10% of excess weight, on average--50-60% for sleeve and 60-70% for bypass. I can live with that difference; it'll still be life-changing.) They'll know after they do the upper endoscopy whether you have GERD or not. I had a little damage on my esophagus, and they couldn't tell if it was esophagitis or GERD. (It may also have been due to the massive amount of NSAIDs I took for several years.) Since it was a small enough amount of damage, I'm still cleared for surgery and still planning on the sleeve; I'm just starting the PPI sooner than expected. I know they'll keep me on them for 3 months after surgery, but I'm OK with the fact that that could turn into a year or (I hope not) forever. Ultimately, everyone in this forum is going to be invested in their own choice, the same way that newly married people try to push all their friends to get married. (I can say that without getting in trouble. I'm married. ) We all had good reasons for what we picked, or maybe we didn't but now that we've picked it we need to believe it was the best possible choice. You probably knew that coming in. But just a reminder: this is up to you, and you've gotta do what seems right for your body, in consultation with your surgical team. ?

Sorry for reviving an old post, if that's a thing we aren't supposed to do. (Some forum communities really frown on it, while others are fine with it. I'm new enough not to know the norms, here.) I just wanted to see if anyone who has had the surgery since this went up has anything to report back. I did a ton of research about psoriasis and psoriatic arthritis (I have both), and in several small studies (aren't all the PsA studies small? it's so frustrating... but then, I guess it's not a very common disease!) the results were really astounding. Enough so that I'm surprised more PsA patients aren't being pushed toward the surgery, with its one-time cost, rather than biologics which can be something like $4k/month forever. Since I'm allergic to several of the biologics, and methotrexate isn't quite enough for me, alone, WLS is my best shot at getting my arthritis under control. That's why I'm doing it. I might talk, in some other threads, about things like fitting into airline seats and buying smaller clothes, but honestly? The pain is awful, and if I'm in the lucky group whose PsA is driven into remission, my life will be so much more amazing, even if I only lose like 10 pounds. If I'm in the unlucky group, but I lose a lot of weight, I'll still have a lot less pain in my feet and knees, even if the arthritis stays bad. So it seems like a good decision for me, either way. I have scalp psoriasis, too, so I'm hopeful that I can prevent massive hair loss. It's a risk, definitely. Anyway, thanks for any information any of you have! <3

Other pre-op people: do yourself a favor, and do not go read the forum I'm going to link. Just... look, we all have time before we have to think about that part, and it's not worth stressing ourselves out. Post-op people who want to start investigating plastic surgery: there is a whole forum on this site about this topic! https://www.bariatricpal.com/forum/393-plastic-reconstructive-surgery/ (To be clear: I'm not saying "get out of here with this discussion." I'm just making sure you're aware that there is a LOT of discussion happening already, in case it'll help you out! Carry on. )

Your family is hardcore! Mine would never be so direct. It sounds like you had all your facts and figures straight and were able to redirect a lot of their concern. I hope they are as active in supporting you through this as they were in expressing their fears, before you educated them! The advice to educate ourselves and really know what we're talking about, with this, is really good. I mean, it'll only help us, to know what to expect and to be able to really weigh the risks and the rewards for ourselves! ❤️

I use WonderSlim or ProtiDiet oatmeals (if the brand is important to you, I'm happy to double check -- I get them from Diet Direct, and they sell a whole variety of brands), and I've had a lot more luck with heating the water up, then adding it into the oatmeal and mixing it up than trying to microwave a mixed up bowl of oatmeal + water.

My nutritionists wanted me to do several things: 1) Focus on getting a protein as part of every meal. Ideally a lean protein, but they never balked at peanut butter on an apple as a snack. Low-sugar yogurts are good. Light string cheese is good. Eggs are good. 2) Get a fruit (up to 1/2 cup or 1 fruit) or a vegetable with each meal. 3) Switch from simple to complex carbohydrates. If you're going to have bread, make it whole grain--and after your protein. They weren't like "take away potatoes" (though they did encourage me not to count those as a vegetable :)), but they were like "switch from white rice to brown rice." 4) Take small bites, chew a lot, eat mindfully, put the fork/spoon down between every bite. No wolfing down food in the car, no open bags of chips in front of the TV. 5) Get 8 cups or more of water per day. If it has Mio in it, or it's an herbal tea or a decaf coffee, that's totally fine. Sugary beverages are a big no, and caffeinated beverages don't count. 6) Stop having carbonated drinks. (This is the one that I balked at the most, honestly. I knew I'd need to give them up post-op, but I had really planned to keep enjoying them until I had to stop.) If you really must have that diet soda, let it go flat first. And I mostly followed that -- I won't lie: at least two croissants, no small amount of Chicago style popcorn, and several servings of pizza crossed my lips over the course of the two months I mostly-followed these guidelines -- and lost 6 pounds each month. I need to lose a bit more quickly, so I've changed things around a bit -- doing a low-fat ketogenic diet which has me down near 1000 calories a day -- in order to meet my doctor's arbitrary weight goal in time to get my surgery this fall. But the rules above were pretty good, and the flexibility to break them--just a little, and only very rarely--was nice. (I hate keto. I hate that a single piece of fruit will wreck up my system for over a day. But it is a very efficient way to lose weight with mostly manageable hunger. And those refried beans in the mushy food stage will taste SO GOOD to me. I miss beans.)

Whew, I feel this post, friend! It's a bummer, feeling like you need to keep something like this from people. I have no idea how my in-laws will respond. They will probably have a bunch of opinions where I can't hear them, so I guess I can live with that. My blood family, though... they can be vicious. I know my mom opposes me taking this step, and I'm not sure if it's not wanting me to be healthier (probably a little; she has always seemed threatened when I lost too much weight) or if her entire problem is the part she actually expressed, which is fear of the risks of surgery. So I'm not going to tell her until it's done, and I'm past the liquids-only phase. And she'll be angry that I didn't tell her, but ... I'm an adult (and have been for about two decades)? This is my body? I have to live in it? And I can always fall back on "I didn't want you to worry." Which is a nice thing to say to anyone you neglect to tell before the procedure, which should probably be ... basically everyone you won't see day-to-day during the recovery period. Anyway, I'm really glad you have a good support network outside of that one person! That's going to help a lot. And if this person really bothers you, maybe some of your supporters can help run interference with them?

Thanks, @ellie123! It has been really frustrating for me, yeah. But it also sounds like you've had your share of frustrations, and you're getting through it! I'm glad you get your revision next week!

Probably not until late November. I can't pin my surgeon down, to get a date. They keep moving the goalposts. ("Lose 15 pounds by September, and we'll schedule you." "Ah, you lost 6 pounds between June and July; lose 6 more by August, and we'll get you in for late September/early October." "Oh, no, actually, Dr. Eid wants you to lose 20 more pounds, so if you lose 8 between now and your September appointment, we'll put you on the schedule for, let's say, the week of Thanksgiving." Ugh. Anyway, I'm at 7 out of those "8 more pounds," a couple of weeks after that appointment*, and well on my way to the "20 more total," so I'm going to do my best to get them to put me on the schedule, for real this time, so I can know when my surgery date is.) *I am cheating by doing a low-fat keto diet. ~5 of those pounds were definitely water weight from switching into ketosis, so as soon as I eat some fruit or something, they'll come back. Cheating or not, I'll meet their goals so that I can get in and get the surgery this semester. (I work at a college and take classes. My whole life is in semesters.)

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.