Arabesque

I was fortunate as I had a friend who had undergone the surgery & then another did it the next year. Their friendship & support was very helpful. I also made some lovely friends through this forum too. We’re of a similar age, share interests, had our initial surgery within a couple of years of each other.We chat & share what’s happening in our lives (& not just weight related) via our own private group chat now & there is another with whom I email. So you never know who you may meet & click with here.

I wondered gall stones too which can cause pancreatitis. As can high cholesterol, diabetes, obesity & abdominal surgery (though like catwoman7 I can’t recall any mentions of it here either). Gall stones are common with obesity & high cholesterol & can form as a result of rapid weight loss & high. Often cholesterol levels increase with weight loss too (releases into your blood as you lose fat). So it seems your chances for it occurring are probably higher at the moment. Hopefully this is just temporary & it responds quickly to treatment.

Your experiences are quite common at this stage. I wasn’t hungry or interested in eating either and I too just sipped my shakes & soups for hours in the liquid stage. I got in less than 300 calories in the beginning. I only ‘ate’ two meals during the liquid stage & from purées started to eat to a routine so I could better get my nutrients in. However, I was never given a caloric goal only protein & fluids & portion size recommendations. And it took a while to regularly reach those goals & that was okay. You can only physically eat what you can especially this soon after surgery. Doesn’t matter how much someone tells you you should be eating. If your tummy can’t tolerate more then you just can’t. I was barely eating 900 calories by 6 months. My surgeon & dietician were okay with this because I was eating a variety of nutrient dense foods & my blood work never showed I was lacking or low in anything. It was almost my 3rd year before I could eat 1400/1500 calories. Many eat more but this is fine for my age, height, gender, weight & activity level. That was my experience but others will have very different stories because we’re all different. Keep working at getting in your protein & fluids. Try explaining to your dietician that your surgeon is okay with what you’re doing. That you physically can’t eat that many calories at the moment while you’re still healing but you’ll keep working at it. If they won’t listen maybe try to find another dietician who is more understanding & willing to be more flexible for you & your needs. No one way will completely suit everyone. Plans should be flexible enough to be modified so it works for you whether it be your calories, portions, activity level, specific nutritional needs, medical needs, progress timelines, etc. PS - Try diluting your shakes, broths etc. & count the extra towards your 32oz water goal. Fluids don’t have to be just plain water. Try green or herbal teas, squeeze some lemon, lime or orange juice into your water, protein water, milk, yoghurt drinks, electrolyte drinks (an little boost of energy too) & then rotate the ones you enjoy throughout your day.

Some foods just don’t sit well for a while (or for the long term - for me it’s still pasta, rice, bread, quinoa, potatoes, etc. as they just sit heavily & fill me quickly.). Your tummy is still healing & still sensitive (fussy like a two year old). There will be foods you’ll tolerate one day & not the next. It may take a couple months for this to settle occurring less & less frequently. If a little sip of a fluid helped, I’d think as others have, that what you ate wasn’t moist enough. Even though your on soft foods they still need to be moist. Think stews, braises, slow cooked dishes, etc. I ate a lot of mince dishes with gravies in that stage. And yes, you may need to take it a little more slowly as you introduce soft foods back into your diet. We all heal differently and what you’re experiencing is not uncommon. It’s okay to be concerned - everything you’re experiencing is very different & new to you. Better to ask questions than sit & worry something is wrong.

Everyone recovers differently & can or can’t tolerate different things at different times. Not everyone experiences temporary changes in their senses taste &/or smell. Some can drink cold drinks easily while others find warm or hot drinks easier & more soothing. Some people are advised (by their surgeon) to progress through the stages more quickly while others need to stay at a stage longer. You won’t really feel your restriction (a tightness across your chest) until you’re eating more solid foods & the nerves that were cut during the surgery are healed. The pain you initially felt would have been from stressing, straining or irritating your healing tummy. You shouldn’t use your restriction or discomfort as a signal you’ve eaten or drunk too much or too fast. Not everyone dumps. Less than 30% with sleeve & less than 40% with bypass. But it is easily managed by avoiding those foods that cause it (fats &/or sugars) which you should be doing while you’re losing weight. In time even those who do dump may find they can eat a small amount of these foods without issue. It is important to follow your plan. Remember all because you can doesn’t mean you should. The plan is in place for a reason. Initially to protect & support your healing tummy (think of all those sutures & staples holding your tummy together) & then to support your weight loss (awareness of portion sizes, calories, nutrition, food choices, reflect on old eating habits & establish new habits, etc.) Conversations with your surgeon & dietician would be of benefit to ensure you are making the best choices - behaviours & foods. If your surgeon feels you are healed enough to progress more quickly, they’ll let you know what you are able to do & eat now. I am worried you chose to eat cake at 4 weeks post surgery. It was your choice but was it a self sabotaging behaviour? Cake at week 4? What will you eat in subsequent weeks? Only you know the answer to this. Maybe a conversation with a therapist will help. And yes you will lose weight while your calorie intake is in deficit even eating cake but your focus should be on the nutritional value of what you are eating when your intake is low. Protein, protein, protein then vegetables & eventually some fruit & complex multi/whole grain carbs.

The surgical gas is in your abdominal cavity not in your digestive system (not inside your tummy or intestines). Burping, farting & gas X won’t work. The gas rises & sits behind your lungs putting pressure on nerves causing the upper body & shoulder pain. It is absorbed into your lungs where it breathed out. Walking, marching on the spot, pumping your arms up & down forces the gas up & out (because you breath more heavily with the physical activity). Slow & deep breathing exercises can help too. It usually takes about a week for it to fully dissipate

This is one of the negatives of artificial sweeteners. Because your body tastes sweet it reacts as if sugar is being consumed & available to be used as an energy source hence the insulin reaction. The body also reacts by storing calories because there actually wasn’t any sugar which results in weight gain. (There are academic papers on this if you’re interested.) And of course artificial sweeteners continue to feed your desire for sweet. Your body needs some sugar (as glucose, fructose, lactose, etc.) as an energy source. Look for natural sources not ‘added sugars’. I get mine from fruit - blueberries predominately - and keep my added sugar intake to less than 10g a day total (usually only 5g). But it has been my choice to continue this from maintenance.

Another factor to consider is that your muscles & tendons & sinews are relearning how to move & hold your now much smaller body. Your centre of gravity & posture has changed because they’re no longer compensating for that extra weight you carried before. Aches & pains in hips, knees, back, etc are quite common for a while too. You may also find your balance is off too. My friend & I realised we were slouching because we didn’t have a big tummy to hold up our upper body anymore. And I had upper back pain (though a better fitting smaller bra helped with that 😉).

There is no right or wrong rate of weight loss & it fluctuates week to week (or even day to day) as well. There isn’t a timeline in which you must lose your weight. We are all so different physiologically, psychologically & emotionally. We’re different ages, gender, heights & builds. We have different weight loss/gain histories as well as medical histories, health status. If your team is happy with your rate of loss you have nothing to worry about. Celebrate every pound you lose.

It does get better when you’re eating more & a more real food balanced diet. But when it will happen for you ant be predicted. There’s no specific timeline. And you may find it happens randomly for a few months after too.. Mine persisted for a couple of months. I found an electrolyte drink helpful & would take one with me if I knew I would be doing a little more that day or when I’d have to be more active. (I drank hydralyte & would dilute it as I found it too sweet.) Generally look at it as a sign to take it easy while you’re healing & your body is coming to terms with the changes.

I’m surprised you haven’t been prescribed any anti nausea meds. Also wonder if it’s a sensitivity to something you’re eating. What if you try sipping a protein shake on your way home to help offset the afternoon nausea. Grazing is fine. Many do graze or eat several smaller meals. It just depends what you’re grazing on & if you’re still keeping to your daily total calorie & portions sizes & meeting all your goals. For example you make an appropriate meal and eat it over two or three sessions.

Oh damn. Let’s hope this is the last of it. But look at those achievements. How wonderful.

As I said above your weight loss is never consistent. If you graph it you’ll notice it zigs & zags. If you weigh every day you may gain one day & lose the next. You’re still losing so it’s not a stall. Most likely just a slower loss period. Stick to your plan & try not to worry about how much you lose each day or over a week (not easy I know). You will lose the weight. There’s no hard & firm date you must lose your weight by. You’ll lose it in your time & that’s fine. if you find how much you lose each day or week is making you anxious or frustrated, some people find it helps to only weigh once a month. As long as you’re making an effort to hit those goals and are close or getting closer you’ll be okay. It took me ages to consistently hit my goals every day & I still reached my goal & even lost more.

Watched an interesting British medical program recently that talked about how caffeine restricts your absorption of iron (by up to 65%). This is a concern because low iron levels & anaemia can be a side effect many experience after surgery. I too was a no caffeine after surgery. I drink green tea which I was allowed so it didn’t bother me. My surgeon is a no caffeine proponent because it can be harsh on your sensitive tummy. There are some who have coffee in hospital so you can never tell. As @Recidivist advised this is a conversation best had with your surgeon.

Yes the shoulder pain is from the surgical gas which is pumped into your abdominal cavity. It rises & settles behind your lungs putting pressure on nerves & causing shoulder pain. It takes about a week +/- to be fully absorbed into your lungs & breathed out. Best advice is always follow your plan. It is in place to protect your healing tummy & support your recovery. I always say: all because you can doesn’t mean you should. It’s not a race. There isn’t a prize for doing more or doing it sooner. You’ll be okay but don’t push your luck by continuing to do more than what is recommended - even though you may get frustrated.

Two bonuses of the surgery are a reset of your metabolic rate & of your body’s set point (the weight your body is happiest at). As others have said your pre surgery BMR will have no impact on your maintenance BMR. Before surgery, I’d struggle to lose a kilogram eating 800 calories & would gain weight eating 1200 calories. Now I eat about 1400/1500 calories to maintain my much lower post surgery weight. I am also an almost 58 year old woman, with a smaller frame, only 5’3” & not very active.

Most of us have been where you are now. Hair loss is common with weight loss (& during pregnancy & stressful periods too) . Your natural hair loss cycle has been accelerated as a stress reaction to the surgery, weight loss, hormonal changes, etc. The hair you are losing you would have lost anyway but over a longer time period. That hair is dead so you can’t save it. Your new hair is still growing though at it’s usual rate. Supplements won’t help your dead hair but may make your new growth stronger. Yes, three months is generally how long it lasts +/-. Hair grows slowly & you don’t usually notice your new growth coming in but a couple of months after you stop losing your new hair may be long enough for you to start to notice it (short fluffy strands)

It does seem a lot of calories if you’re still trying to lose. But if it is what your team advised based on your body & needs, activity levels, etc. that’s fine. You may be in maintenance. With a BMI of 27 & at your goal, this may be at your new set point (the weight your body is happiest at & is easiest to maintain). To lose more weight you’ll have to be more active & consume fewer calories but to stay at the lower weight you will have to continue to do more & eat less than you do now. My restriction kicks in more quickly if I eat food that is too dry, coarse or dense or if I eat too quickly. If a food is dense, like certain meats, it will feel heavy in your tummy & feel like you’re full more quickly setting off your restriction. Sometimes I feel it but can’t work out why - just a quirk of my tummy.

Stalls will break when your body is ready. You can’t really force it to happen. If it broke when you did that before it is more likely because your body was ready to start to lose again & not because of dietary restriction or increased activity. Stalls are an important part of your weight loss as it is when your body resets itself in response to your weight loss to date (metabolism, hunger & satiety hormones, etc.). Stick to your plan & don’t stress your body more.

You’d know if it was dumping. Cold sweats, heart palpitations, nausea, cramping, dizziness, etc. More likely just your tummy reacting. The potatoes could be too heavy/dense because of their starch content. I wasn’t allowed potatoes (for the starch reason too) until maintenance though I know many are allowed them from purée. I still can’t eat them - too heavy in my tummy. Could have been the mayo too. Lots of trial & error as your tummy is healing & recovering. The taste, smell or texture of some foods can set off your tummy.

I wonder if it’s an internal switch. I believe some surgeons use one to help tether the tummy. But keep ringing your doctor until you get a response. Pain is never okay.

Seems like you’re doing well on all fronts. I’d be celebrating. As to how well you’re doing & if there are red flags or things you’re missing that’s hard to tell as we’re all very different. Our bodies are physically, emotionally & psychologically different & have different nutritional needs & capabilities. We have different health situations, lifestyle demands, etc. Only you, your body, your surgeon, GP & dietician can best make that call. 180lbs is a possible goal but whether you’ll get to that weight or be able to maintain is unknown. Your final weight depends on many factors. The most influential is what your new set point is. This is the weight your body is now happiest at & is easiest to maintain. Lifestyle choices, medications, genetics, sustainability of your final eating style & activity regime all influence your final weight too. Remember not everyone reaches their goal. Not sure what the average weight loss stats are for mini bypass but it is about 65% for sleeve & bypass. (That is 65% of the weight you have to lose to put you at a healthier weight.) Of course some exceed that stat & some don’t reach it. Celebrate every pound you lose. Celebrate how much healthier you are. Celebrate how much stronger you are & how much more energy you have. And not so much the final number on the scale (though we’re all guilty of doing that 😉).

Yes, very likely. Your digestive system is healing from a pretty major surgery (think of all those sutures & staples holding your tummy together) so swelling & inflammation is to be expected. You’ll find that you’ll randomly experience these types of symptoms for a while. First because you’re healing & recovering & then because you’re system is relearning & generally can be sensitive & fussy. Some times you eat something one day easily but the next it’s no way & then next week it’s fine again. Of course the how long, when, why & what of this is different for everyone but it gives you an idea of what you may experience. Best advice is go slowly & gently. Follow your plan. Sip leaving a few minutes before the next sip then same with bites. If something disagrees with you avoid it for a few days & they try again. Are you allowed juice? Many of us aren’t but plans are different. Are you on a PPI to help reduce your stomach acid production? Water can almost seem heavy to drink at first especially if you drink it cold. Try warming your shakes, water, etc. or hot drinks (herbal or green teas are great) as they often are more soothing.

Yes to the high protein yoghurt. And you can make it into your own yoghurt drink by blending with milk. Cheese & boiled eggs are also handy. Like @Spinoza, I try to avoid medium & high processed foods & I love leftovers. My freezer is full of them. Easy meals - just add vegetables. Made a 5 egg omelette yesterday (with mushrooms, tomatoes, celery, capsicum, mozzarella, basil, prosciutto). Ate a third for lunch & will eat the rest today & tomorrow. Just reheat in the microwave. I do have a packets of baked fava beans & chick peas in my cupboard. I rarely if ever eat them except they are handy if travelling. I always throw some in my bag when I stay with my mum though I still don’t always eat them. Make up a batch of the savoury egg muffins. Dice vegetables, cheese, meat (chicken, bacon, tuna, etc.) or whatever of your choice and add to a half cup muffin pan. Whisk up 8 eggs, salt, pepper. Pour over the meat & vegetables. Bake moderate oven about 30 mins. Freeze & reheat in a microwave. Easy. These are the ones I made with home made caramelised onion, feta, mushrooms, pancetta. Eat two for a meal or one as a snack.

Some people lose quickly & some lose slowly. It’s just how it is. The only thing you can rely on is that your weight of loss will slow over time. Not sure what weight you started at, but if you have more to lose you often lose more in the beginning. If your doctors were concerned they would have said something so enjoy your loss - it’s worth celebrating.