CrankyMagpie

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.