SteveT74

Well, there's pluses and minuses. Although I am sure I had a little excess fat all over (definitely my face), most of it was in my abdomen (a lot of if the bad visceral fat). That's the sign of insulin resistance and T2DM. So, while it's all coming off in one place (and I may be looking a lot thinner faster), having T2DM, high blood pressure, high cholesterol, triglycerides and generally being a high risk for stroke and cardiac disease is not cool at all!! Hence, the reason I got this surgery. Women may carry the weight in their arms, legs, thighs, butt and some subcutaneous fat in their stomach--they usually don't get that bad visceral fat that is so dangerous. So, it may take women longer to see the results of their weigh loss (since it's coming from all over their bodies), it's still a better way to carry your weight than they way I am/was. I still have 40 pounds to go to reach my goal (although 30 would still put my at the weight I was when I was a trainer in college 22 years ago).

Shanza, it looks like you're losing at around the same pace. I guess we started around the same surgery weight and you're a week a head of me and already in onederland. :-) I hope a I can say the same thing a week from now!!! 9 pounds in one week might be a stretch though, but ya never know.

I just hit 209.4 today. So, yes--twins at that!

There are good surgeons all over the world and you can get a great surgery in many countries. The issue is follow up. If you have a complication sometime down the road, do you have a doctor near you that can care for you and understands the procedure you had?? I know of plenty of people who went to Mexico for their surgery and it's worked out great. The sleeve is a pretty simple procedure as far as the actual surgery is concerned, so it might be something doable abroad--just do your homework so you sure you're working a doctor and hospital with a good reputation and lots of experience. However, when you start getting into more complicated procedures like a duodenal switch, I wouldn't go far from home.

Thanks!!! Same to you!!!!!!! Sent from my SM-G965U1 using Tapatalk

Me today (one month surgiversay) (sorry, just took it in the office bathroom): Sent from my SM-G965U1 using Tapatalk

Me on the day of surgery: Sent from my SM-G965U1 using Tapatalk

Me in August 2018 (in the light colored shirt): Sent from my SM-G965U1 using Tapatalk

I added a p.s. in my response to you above--but then you posted this. I am all for the green smoothies like the ones Dr. V talks about on YouTube. Also, if you're not able to eat 750 or more calories in real food a day, it would be hard to meet your protein goals without the shakes (so shake away!). For better or worse, I can definitely eat 800-1000 calories a day at this point and was just cleared for solid foods without restrictions (except for raw veg) at this point. Since today is my one month surgiversary, it's a good day to answer this question. On 12/17 (surgery day), I weighed 232.5 and this morning I weighed in at 210.2. That's a 22.3 pound loss in exactly one month (or an average 5.5 pounds per week). Of course, I had a one week stall when I hit 222 and another 4 day stall when it hit 214--so it's all bits and spurts. However, during this same time period I also gained 4.5 pounds of lean muscle (according to my BIA scale). My body fat percentage has dropped from 28.6% on 12/17 to 23.2% today. and my waist is down six inches!! I went from size 42 dress slacks to size 36 in one month!!!! I actually am wearing a fitted shirt today!!!! I didn't think I would ever wear a fitted shirt again in my life!!! More importantly, I really feel great!!

First off, stalls are totally normal. You just lost 27 pounds--you're body needs time to adjust. It's normal for your weight loss to take a one week pause along the way (sometimes even longer). Also, don't cut back on your calories. Stick to your diet plan--even with the stall. Remember, this isn't a calorie counting diet. It's a healthy eating diet, provided you hit your protein goals and drink your water!!! You don't want to eat too little or you'll have issues with your metabolism. When you hit a stall it may sometimes help to eat more calories--in the form of health fats (avocado, extra-virgin olive oil, Ghee etc.) and good proteins. Stay away from carbs if you can--they are the devil's food!!!

I am sure everyone of us eats too fast at times. It happens--and it sucks. At least twice in the past two weeks I ate to fast and then had to run to the garbage pale or toilet to throw up. Only usually not much in the way of food comes up, but the foamies--ugh. It can suck for an hour or so for me. It's not always predictable either. I can eat to fast at one meal and feel totally fine--but a few meals later the same pace will have me bent over the toilet. What can ya do??? You can practice all you want, but unless you have 45 minutes to an hour to eat every meal (which I certainly don't!), you just have to take it in stride. Break up your meals, so you have a few small meals instead of two or three big ones. Make sure you weigh out your food (which becomes more important when you're eating solids [I was just approved for solids]). This will help ensure you're not eating too much volume. For me, the biggest issue isn't with overeating--it's freakin' constipation. Eating too fast is my fault and the consequences last an hour or so, but the constipation can last a couple of days!! Even so, I'll take all the issues and then some because the weight loss results are totally worth it!!!

Awesome job!!!! You look terrific!!! Keep up the great work!!!!

Usually, people get resleeved when there is an issue with the way the first procedure was performed. Even if a sleeve stretches out, the benefits from a second sleeve operation aren't that signficant (not enough weight loss to justify the procedure). I would agree with the other who suggested considering other procedures. A RNY is one option, but I think the better option for someone that already has a sleeve is the SIPS procedure (which is a modified duodenal switch). It's a lot more effective than a resleeve (unless your sleeve wasn't done right in the first place) and it's a much easier recovery from what I have read--your stomach isn't involved do you don't have the same issues with pre-op and post-op dieting etc.

Hey Lolo, I am jettisoning shakes (to a point)! While they are really important for getting your protein in right after surgery (when it hurts to eat anything), they are still processed foods. Most of them are made up of some combination of soy or whey protein, which is ok--but this processed protein triggers a significant insulin response. I am able to meet my protein goals with whole foods as part of my regular intake, so the shakes are no longer necessary for me. That said, I still have my shakes handy. If I am having a day where I might be missing the mark on protein--or right after a workout (if I don't have time to eat), I may have half a premier shake. However, to the extent I can avoid them, I will. I was doing this on instinct, but my surgeon actually recommended that I cut them out at my one month follow up yesterday--so, great minds must think alike. I told him what and how I have been eating and he's totally on board. Apparently, he's been eating Keto for a few years. P.S.--when I say I am jettisoning shakes, I mean the premier shakes and muscle milk stuff etc. If you're doing healthy shakes with kale, etc. in a blender, those are great. I am not having those personally at this point, but not for any particular reason. Maybe I'll go that route in the future. It's hard to do a true Keto diet after WLS. If you're doing Keto correctly, you're eating close to 1,500-2,000 calories a day with 60% or more of those calories coming from good fats (hopefully). With that many calories, you can still meat your protein goals. Also, people who are successful on Keto also mix in intermittent fasting, where they will skip breakfast and go 18-20 hours without eating and have maybe 4-6 hour window of opportunity to eat. That won't work for someone with a sleeve (at least within the first few years following surgery). We can't consume that many healthy calories, so we need to make sure we are hitting our protein goals first. We can then consume the rest of our calories in the form of healthy fats. On most day since surgery, my macro will look something like 45-55% protein, 45-55% fat and 10% or less carbs. One month post-op, I am eating between 750-1000 calories per day of protein and good fat foods. Good fats will get your calorie count up, but neither sleeve nor keto require real calorie counting. I just keep track of calories to make sure I am not going off the rails and to set a limit (I don't want too much of a good thing, if ya know what I mean). I have been doing a little intermittent fasting--but not as long as most Keto adherents. I am usually asleep by 9:30 and I am up somewhere between 4:30 and 5am to hit the gym. I don't eat before my work out (you burn 20% more fat doing cardio in a fasted state in the morning). I may skip breakfast altogether and wait until lunch to eat (or I might have a small high protein snack after my workout, if I am really hungry--which I am usually not). I consume most of my calories between 12pm and 7:30pm. I also make sure to him my water goals--which is important no matter what diet/lifestyle you follow. This is as close to Keto as I can safely get at this stage in my recovery. It's working for me. I feel great and blood sugar is great for the first time in years. I am still only 3 weeks into "Keto" or should I say "Bariatric Keto", but it's awesome so far. Since I have been in ketosis (which happens to a lot of WLS patients anyway shortly after surgery), I am losing weight at a very rapid pace (for me). I have loads of energy now. I do feel hunger, but I am satisfied quickly. I enjoy the foods I am eating a LOT. Moreover, the diet I have been following is doctor approved for me. I had my one month follow up yesterday with my surgeon and I went over my diet and workout regimen with him. He cleared me for all activity and had no issues with my diet choices at all. Cutting out processed foods and carbs and eating a high protein,, high fat (good fat) diet melds is like rocket fuel for your VSG in his opinion (with the modifications I described). I am not sure what you mean? In terms of age, I am 44. I am doing full 60 minute spin classes 5 days a week (with 2 in a row on Wednesdays (5am and 6am classes). I am probably overdoing it, but I feel really good after my classes. I have also just been cleared by doctor for all activity--no restrictions. So, I am going to start weight training again, starting tomorrow morning.

Sounds like lots of good advice. On top of all the potential false alarms for hunger, there's also a chance you're actually hungry. Most of us didn't get obese because we ate when we were hungry. The problem was we ate when were not hungry, when we were hungry we ate to excess. When feel really hungry, drink at least 8oz of water. If you're still hungry 15-20 minutes later, then eat something healthy--preferably with healthy fats and protein (way more satiating than carbs). If you limit your carb intake to the minimum (for me that's 20 net grams of carbs per day), I find that I have less hunger throughout the day. I'll also point out that I am a new newbie having just been sleeved one month ago today, but I have not lost any feelings of hunger. That doesn't happen for everyone--grehlin isn't the only hunger hormone. Anyway, just because you feel hungry again doesn't mean you're about to blow it and eat yourself into obesity again. The fact you're worried about it is a good sign. Just continue to stick with the program and it will all work itself out.

I had reflux starting around 2 weeks after surgery. It presented as a persistent sore throat that lasted over two weeks. I thought I was just getting a cold and then thought it might be strep. Turned out to be GERD. I was taking pepcid, but that wasn't getting the job done. My surgeon gave me a prescription for protonix and the sore throat was gone within 48 hours. As for preventative advice, give yourself two hours between your last meal and bed time. Also, drinking 2 tablespoons of apple cider vinegar mixed with 8oz of water seems to help a lot too.

I haven't read much on Paleo, but I have been essentially following a ketogenic diet since surgery. I am eating less than 20g of net carbs per day, between 90-150g of protein a day and around 30-40g of fat per day. Following a true Keto diet would require that increase my caloric intake, in the form of good fats, and probably maintain my current protein intake or even reduce it a bit. As a one month post-op VSG patient, that's not going to work for me--so this is the best I can do at this point in time. Nevertheless, I have been in ketosis for about 2.5 weeks (which is the point of keto, right???). It got me out of my first big stall and I have been on the happy train since. Also, I am probably eating more calories that most VSG patients that are 4 weeks post-op since I am having a great recovery. Liquids go down like pre-op, so I have been able to hit the gym hard and without any discomfort. I am working out about 2 hours each morning before breakfast (on a fast), which burns 20% more fat than after eating. My workouts have been most moderate to high intensity cardio. I am just starting to add strength training--slowly and gently--into my routine. I had my surgery on 12/17 and I am currently consuming between 750 and 1050 calories per day (most often between 850 and 950). I am eating some foods, like avocado, that are high in good fats (but are also high in calories), along with smoked salmon, eggs etc. I have cut back on protein shakes--trying to get my protein from whole foods. I weigh out all my food on a scale so I can input my food intake into MyFitnessPal app, which I use religiously. I don't trust myself to guestimate (that used to get me into trouble in past diets--like Weight Watchers). MyFitnessPal isn't perfect, but it gives you a very good idea of your caloric and nutrient intake and you can review your macros to make sure you're on track. I do get very hungry at nights--which was a big problem for me pre-op (and appears to remain a problem). I have been drinking apple cider vinegar (2 tablespoons, mixed with 8oz of water and a little lemon juice and splenda (quarter packet)), which seems to kill the hunger and is supposed reduce insulin sensitivity. As for results, I am now down 21 pounds since surgery (12/17) and 32 since my pre-op diet (12/3). I have also gained 6.5 pounds of muscle (mostly in my legs from Spin Class)--according to my BIA scale. Although my total numbers lost won't blow anyone away, I was a low BMI patient (had lots of nasty co-morbidities)--so those are impressive for me (I think). I am really thrilled though, since I have gone from wearing a size 42 (which were snug) on 12/3 to a size 36 pant as of today (and they look nice on me!!!). That's 6 pant sized in 6 weeks. This is the thinnest I have been in at least 12 years and I am just getting started. I still have 40 pounds to go, but I honestly feel I can get there for the first time in my life!

I found that warm fluids, chicken broth for instance, really helped with spasms. They were a blessing that first week. Anything really cold did not make my tummy happy.

Uhhhh... I know I am doing this wrong, because I am still kinda wolfing down my food. I can eat 4oz of roast been in about 5-8 minutes. I also don't feel an worse for the wear afterwards. If I don't measure out my food though and I eat fast, I can out pace my sleeve and then I am not a happy campy and its vomit city. There's no way I am going to eat one bite every one or two minutes. I don't have the time when I am busy feeding the kids, getting them ready for school, working etc. Everything is always a rush. I just have to find a happy compromise.

As for the hydration issue, that's true. Caffeine is a diuretic But if you're getting plenty of water (more than 64oz a day), hydration is not going to be an issue for you. You just don't count coffee towards your hydration amount and you might want to add extra water 8-16oz of water per day for 8oz cup of coffee you consume. Personally, I have been having issues with constipation, so I added one 8oz cup of coffee to my diet per day (with some premier shake in it instead of milk). It has definitely helped get things moving to the point where I am not taking stool softeners! As for your doctor's advice regarding caffeine stimulating hunger, that's absolute NOT true. In fact, it may be just the opposite. At best, caffeine is hunger neutral. In particular, at least one study was conducted to determine whether hot caffeinated coffee reduces hunger. In that study, the study, the subjects were given hot beverages and asked to rate their hunger. Each group was given coffee, tea, decaf coffee, decaf tea or just plain hot water. The study found that any hot beverage reduces feelings of hunger--regardless of caffeine content. In short, caffeine does not increase hunger and the debate is open as to whether it helps reduce hunger. It's ok, my surgeon did a great job for me, but I know some of the info his office gives his patients is pure BS. For example, the crap about never drinking from a straw and never drinking carbonated beverages against because they stretch your sleeve is total BS. You don't drink with a straw or drink a carbonated beverage because you will probably major gas pains if you do. Not a good thing!! However, later on neither a carbonated beverage or a straw is going to hurt you. Nevertheless, for many people carbonated beverages are trigger for drinking sugary drinks or diet chemical drinks loaded with artificial sweeteners that are bad for you. If you're going to have sparkling water one year post-op, you'll be just fine.

Why are you guys avoiding caffeine??? My post-plan discusses staying away from coffee, but nothing about other caffeinated beverages and there's even a suggestion for some water that has caffeine added. The issue isn't caffeine--it's coffee, which can be irritating for your stomach (at least that's how it was explained to me). Do what your doctor says, but I have been having caffeine (in moderate quantity) and I am not seeing any downside to it so far.

I have been doing spin classes 6 days a week (2x on Wednesdays). Once I am approved to weight train, I am going to begin immediately (although I sort of started already, but very light weights and high reps). I also plan to join orange theory and probably do that twice a week in place of spin and usual weight training. Anything that will get my heart rate up to around 80% max will work in my book. I blessed in that I always enjoyed the gym and working out. I always felt the cardio and strength benefits from the gym, I just never saw any real weight loss as a result of my efforts. As a new sleever, I am starting to imagine the possibility of getting those strength and cardio benefits while actually losing weight!!!!

It was the same for me... nothing to worry about!! Consider yourself lucky that you can get your water in. It also bodes well for your ability to handle purees/softs. The procedure is NOT designed to restrict fluids--just solid foods. Even purees will pass through with relative ease. I am about to move on to solids, which I hear is when you really notice the sleeve. I had 4.0 oz of thinly slice roast beef for lunch with 1/2 a slice of cheddar cheese and I was full (not to the point for feeling sick or in pain--just comfortably full). It was nice since that would have been an appetizer to me in the past!!

I am a sleeve, not a bypass--but my surgical uses the same post-op diet plan for both procedures, with only minor differences in terms of supplementation. It's really hard to look at one person's macro and diet and use that as a basis to determine what's best for you. We all have our own issues and challenges to deal with. We also all have issues with stalls, although I agree that a month and a half is on the long side. The fact is, however, you started off at 311 when you had surgery in late August 2018 and you're now down to 235 as of today. Since you've been stalled for one and half months, that means you lost 75 pounds in a 4 month period. That's a LOT of weight in a very short period of time. Shorter than I think is common. Maybe a long stall isn't entirely unusual in these circumstances. That said, if you're eating less than 600 calories a day 5 months out of surgery, that seems really low. I am just finishing up my soft/puree phase and I am consuming between 700 and 900 calories per day. I expect that to go up to 1200 calories or so per day over the course of this year--maybe even 1500. I have been essentially following my doctor's guidelines, which means eating three meals per day that cause me to consume at least 70g of protein per day. I am also drinking more than 64oz of fluid per day, which maybe one of the most critical ingredients to weight loss. While my post-diet (at least for this phase of my recovery) doesn't limit me in terms of macronutrients (provided I hit my protein goals), I have chosen to limit myself to 20g or less of net carbs (which does not count fiber or sugar alcohols consumed). I have also chosen to eat only foods that have good quality sources of fat--like avocado, fish (and fish oils) etc. As a result, I have put myself in a state of ketosis, which seems be really helping me make the most out of my sleeve (at least for now). I would NOT say that I am following a Keto diet, since more than 50% of my food intake is coming from protein and maybe 35-40% is coming from fat, with less than 10% coming from carbs (it varies day to day, but carbs are always under 20g). I am also trying to exercise daily--not just take a walk, but really work up a good sweat and get my heart rate of to 80% max. I am not suggesting you do what I am doing--everyone needs to find their own best path--but if you're in a prolonged stall it's best to change things up. If I were in your shows, I would try hard to get in more protein and fats (to the extent you can tolerate them) and get your calories up closer to a 800 a day. I get that you might not be able to eat the fat at this point depending your sensitivity to dumping, but you can't continue doing the same thing that isn't working for you at the moment. You need to change a couple of things up to restart your weight loss engine. If that means drinking an extra protein shake or getting in an extra little meal to reach a new calorie/protein goal, then do it. See how it goes for a couple of weeks. Also, if your nutritionist isn't helpful, is there another bariatric nutritionist you could speak to???

I don't think you should be anymore worried about the sleeve than you were with the band. Even though the sleeve seems more radical, from a surgery and risk standpoint, the sleeve is probably safer. You're not installing a foreign body that could slip, dislodge or cause significant injury. For me, the recovery from surgery has been a relative breeze (not the case for everyone), but I honestly had very little pain after surgery and no nausea. I was drinking normally (without restricting) after 3 days and I haven't had an issue with eating at all. Obviously, there is an adjustment to the new restriction, but that's probably something you're already familiar with after the sleeve. After any surgery, there's always going to be something. My aunt has a band and, frankly, I think my recovery from the sleeve was easier than hers. I was expecting to be in a lot of pain, with terrible gas issues etc. I know everyone's experience is different, but I recall having a little pain and nausea when I first came out of anesthesia (which you can barely remember anyway). I know I told them I had pain and nausea when the attending nurse was talking to me--but I also recall thinking, give me the good stuff now because I don't want to feel pain and nausea (if it does happen). They gave me a little something and I went back to sleep. I woke up a few hours later and all I could think about was how badly I needed to pee--which isn't easy after being under general anesthesia. Aside from needing to pee, I had no nausea and no pain. I had some gas and bloating (to be expected), but it wasn't terrible at all!!! I was on the floor with a women who got a lap band the same day I was sleeved. She had the same gas etc that I had. I don't think that part of the experience really differs much between the procedures. I had gas-ex chewables that I brought to hospital with me and that really helped. I slept sitting up the first couple of nights (get a good travel/neck pillow), which was more comfortable for me. Keep walking--it helps. Longer term, I really snapped back quickly. I could drink normally after a couple of days. My program had me start on the puree/soft food stage right after I was released from the hospital (which is different from most). After a couple of days, I could eat relatively normally as well. Obviously, I can't eat large quantities any more, but I can definitely eat a 4-6oz piece of tilapia (stuffed with lump crab meat and a little ricotta) and I feel very satisfied. In the beginning you can feel everything you swallow all the way down into your stomach. I haven't felt that in a week or two. I was frankly worried that my doctor didn't make my sleeve small enough or that the surgery isn't working right--since I was able to drink so easily and eat without feeling pain or discomfort--but I think I am just lucky. I have had issues with constipation and GERD, but these are all manageable. Most importantly, the weight is coming off!!! I have lost 18 pounds since surgery (and 30 since I started my pre-op diet). I have dropped 6.5 inches off my waistline since the day of surgery. As of this week, I have been taken off all my diabetes medications. Obviously, my initial concern that the surgery wasn't going to work for me, was misplaced!!! That said, I am highly motivated to loose this weight and live a healthy lifestyle. This is the first time in 15 years that I actually believe and know that I can have the body and good health I deserve. I am also not relying on the surgery to do all the work for me. I am sticking very closely to my doctor's post-op diet guidelines. The only modification that I made was to cut carbs down to 20g net carbs per day and to focus on eating my protein first and then good fats along with it (like avocado). I have also been hitting the gym--treadmill, elliptical and spin classes (I haven't been cleared for weight training yet). In short, having this operation was one of the best decisions of my life. I have no regrets (other than not doing it sooner)!!!! Don't be nervous!!! It's going to be worth it!!!!!