Arabesque

I had no gas pain with my sleeve but after my gall i did. But it wasn’t a throbbing aching pain more discomfort. A bit like strained muscles after a hard workout. My back hurts way more when it goes out. The gas pain took about a week to disappear. Really had no surgical pain after three/four days with either surgery. But of course everyone is different & we tolerate different levels of pain. For gas pain, walking is best. You don’t have to walk miles - even lapping your yard a few times a day helps as does going up & down steps, marching on the spot & lifting your arms up & down. A heating pad can alleviate pain too. The gas is used to fill your abdominal cavity not your tummy so very little escapes through your digestive system (burping & farting). The gas is actually absorbed by water in your blood stream & is breathed out. Which is why walking, marching in the spot, etc. helps as you breathe more heavily with the activity. The excess gas rises & often gets caught under your upper lungs which causes the upper shoulder pain.

How low is low? How tall are you & what’s your BMI? I was 200lbs but at only 5’3 my BMI was 35. I lost all my weight and more. Got to my goal in 6 months & lost another 11+kgs over the next 11 months or so. I maintained at about 49kgs for a year. I put on 2kgs in a month because of a necessary dietary change & a change of a med & have been sitting at about that 51kg for almost 10 months There have been posters here who started with BMIs of less than 35 & had the surgery because of existing health issues & they were able to lose weight. The main difference between people with higher starting weights & those with lower is that those at a higher weigh lose more quickly at first. But their rate of loss slow as they lose weight just like everyone else. Recovery is an individual thing - just how your body reacts to the surgery & heals. Nothing really to do with your weight as such but existing health factors may influence your recovery. Some people who carry a lot of weight in their abdominal area sometimes struggle with more discomfort when getting up & down & generally moving as the weight around their tummy pulls at the internal & external surgical sites. A binder is often helpful as it supports the tummy & abdominal muscles.

Fear of the unknown is real & an understandable reaction to something like this surgery. Mine went all so quickly, that I really didn’t have time to worry about anything: 6 weeks from initial GP’s appointment to meeting the surgeon, the dietician, doing the pre surgery diet & then the surgery. Though I’m also not a big worrier. If I have questions I’ll ask or research it myself. Knowledge is power. Think I was more concerned about telling my mum. Lol! A friend had recommended her surgeon & on meeting him I was confident about his ability. I was going to a good hospital. I had a supportive GP. And, after years of watching my father suffer with cancer, treatments & complications, I sort of learnt you can’t worry about something that MAY happen. It’s a waste of effort & emotions. Be aware of possibilities but you can’t be certain of what will happen until it does & then you can plan to move forward.

Best check with your surgeon & dietician because plans have different requirements. Plus we can only do what we can do within those guidelines. I was advised only 1/4 - 1/3 cup to begin slowly increasing to a cup over time but that was my plan. I remember it took me three days to eat two scrambled eggs for months. At about 8 months I could eat one egg. That was all I could do. I was able to eat two scrambled eggs for the first time last weekend & I’m more than 3 yrs post surgery.

Made Jamie Oliver’s ricotta fritters & rich tomato sauce yesterday. Of course I made some changes to the sauce like no chilli, added onion & celery & used button mushrooms instead of porcini. Shame is only about 10g of protein. But tasty. The fritters would be good for breakfast with a poached egg.

I had put on weight with menopause pushing me from 75kgs (always my highest bounce back weight) to 91kg very quickly. Could not shift it at all and after three years I woke one morning & said that’s it. Enough! Rang my GP straight away for an appointment to get a referral to a surgeon & not quite 6 weeks later I had my surgery. Had a friend who had surgery a good year before, but it wasn’t really on my mind until that morning. I didn’t have any comorbidities (except for my feet which would get sore from carrying my weight if I stood for a couple of hours or wore heels). I knew it was likely they were ahead of me though.

Me too. I used a fine mesh tea strainer.

I agree. And the surgery would remove fat cells as well as loose skin if that was a concern. Plus fat cells don’t make you gain weight & become overweight. We do that to ourselves by overeating & making poor food choices. (It’s a lot of why I said I have to work harder than friends & family who’ve never carried weight - too easy to slide to bad habits again.)

HRT! (That’s likely what your mum was on too @ShoppGirl.) I was menopausal before my surgery. It was the reason of the sudden 15kg weight gain I had that pushed me to the surgery. The hormonal flush from the oestrogen released from my fat as I was losing was fantastic. No menopausal symptoms at all. Once my weight loss slowed they came back though. ☹️ I’ve had symptoms since about 2016 & still do. Still have breakthrough hot flushes even on HRT though they’re not as bad as when I’m not on it. And I’m not as ‘feisty’ on HRT. My 82yr old mother is still on HRT - if she goes off it all her symptoms return & you don’t want her feisty! I wonder sometimes if I might end up being the same. Lots of benefits. Good for supporting calcium absorption & therefore your bone density. Can reduce the risk of heart disease & strokes too if you start before you’re 60. Certainly worth a conversation with your GP &/or gynaecologist.

There are lots of exercises you can do seated which wouldn’t impact the healing of your ankle. Google is your friend. Resistance bands are really useful too. Sure won’t stretch you from a cardiac perspective but will work your upper body muscles. And yes, exercise only contributes to about 10% of any weight loss you have to lose. Have 50lbs to lose then exercise will be responsible for about 5lbs. Unless you start running marathons! If your calorie consumption is less than your body needs to function, you will lose weight even if it is a little slower with your reduced activity. Maybe check in with your dietician to ensure you’re on the right path. Sometimes a small tweak can be helpful. Am a little surprised you’re being advised to still be getting protein from shakes instead of real food alone this far along even if you have weight you still wants to lose.. I didn’t have another shake once I began purées. My calories were still low & I got my protein in. Even now I get in 70g of protein & consume about 1300/1400 calories a day in maintenance. Oh & I didn’t really exercise while I was losing & apart from some stretching exercises I still don’t. Wouldn’t burn 40 calories a day. Hope your ankle heals quickly & you’re up & moving easily soon.

So sorry you are experiencing this. Your PCOS is the likely suspect or at least a contributing factor to your struggles. Also check your medications. Many common meds are renown for resulting in weight gain. There is not one diet/way of eating that works for everyone. So your nutritionist saying you eat healthily & gave you no other help is pretty poor. Like @Sunnyway, I made changes to what I eat. I did lots of reading. And as I was slowly introducing foods back into my diet, there were some I didn’t start eating again, some I started & dropped again. I really listened to my body & what it needed. There are foods/food types I avoid, others I restrict or reduce my intake. Much like @Sunnyway, I cut out a lot of added sugar, artificial sweeteners & sugar alternatives (so no desserts, cakes, biscuits, sweets, etc.), little starch (no potatoes, bread, rice or pasta). General keep to fairly low processed foods prepping most of what I eat myself which allows me to control the ingredients & how it’s cooked. I eat some carbs - about 2 serves a day but whole or multi grains. But I found this is what works for me. I feel better: no bloating, less gas, more even energy levels, etc. Don’t really miss anything. Eating this way works for me. It may not work for you. Question the nutritionist further - they are there to help you. You may benefit from a eating plan that incorporates aspects of anti inflammation diet, or to reduce foods naturally high in hormones (soy products, lot fed beef & chicken, etc.) There may be additives in more processed foods that are fighting your ability to lose weight too.* Again the nutritionalist should be able to advise you. *- Watched a great documentary earlier this year which showed that a high processed food diet actually increases the hunger hormone in your body & decreases the hormone that tells you you’ve had enough. Gracious knows what they do to your other hormones.

There are things you can depend upon. Stalls happen & you can experience several of them. Our rate of weight loss slows as we progress (as our calorie intake slowly increases & gets closer to the number of calories our body needs to function & maintain our weight). Our weight loss is never a straight downward line on a graph. It zigs & zags, up & down. And everyone’s weight fluctuates & women fluctuate more thanks to our hormones. It can be fluid, constipation, what we are, how much we drank, or just your body. Not sure how much you want to lose & what your weight currently is but it’s likely you’re in a stall. But chat with your dietician. You may need to tweak your diet or activity.

Once your weight stabilises you should be ok to get your rings resized. I had one resized but it turned out to be too early as I continued to loose. Can’t get it any smaller though because of its design (I got it down to a H but it needs to be a F.5 now). I use those clear spiral resizers (got mine from Amazon) as I still have rings, which had been small, I haven’t resized - can get expensive if you have a few to do. Good interim solution to loose rings. As a side note, I recently had a monogram ring made & sent my mum a pxt. She said she liked the ring but went on & on about the loose skin on my hands - as if I didn’t know! Sigh!!

Aah the foamies. For me they happen if I eat something too coarse, too dry, too rich or too fast & it gets ‘stuck’. I don’t vomit as such any more but I regurgitate. The offending bite or two of food sort of bubbles up - sorry sounds a bit gross. But there’s no real clenching of the stomach muscles because the food hasn’t really got down into the stomach yet. The only good thing is once you spit up the saliva or regurgitate that last bite you feel better pretty quickly after (unlike dumping). It doesn’t necessarily happen when I’m eating though. It can slowly build up over a little time afterwards: restriction, coughing, saliva & then sometimes regurgitation. Salmon can be too rich because of how naturally oily it is @Hazel40. I can’t tolerate oily fish now though I wasn’t great with it before either. Try poaching it in milk (add herbs of choice) as a lot of the oil will go into the milk & give it a milder taste.

I agree with the suggestion to go back to liquids for a few days. It’s not uncommon for people to do this - we heal in our own time. And yes certain foods like eggs can be difficult to tolerate for some. I’d also talk to your surgeon just to be sure especially because of the pain. Oh, and being able to feel water go down, I get that at times & I’m three years post surgery. Only with water though & especially if it’s cool/cold. I also gurgle a lot - a very noisy digestive system.

My also gall less sister-in-law & I both experience the too much acid diarrhoea attacks. It comes on us more quickly than usual diarrhoea & the cramping feels a little different. Doesn’t hurt to ask if it could be contributing. I also over produce acid so if I don’t eat regularly I can have issues too.

I think they would. I have to keep my protein high because of the protein absorption issue - hence the dietary change to counter the increase in calories from the increased protein. I hate protein shakes & I can taste even the flavourless protein powders making going back to a low calorie diet using shakes challenging. Plus the med is hormonal & my weight gain was always strongly linked to my hormones. I actually did reduce my calories initially to try to lose the kgs but it didn’t do anything. Sounds like what happened most of my life - ha! When I see my GP in a couple of weeks, I’m going to see if I can go back to a lower dose HRT & see if that helps. I’m actually experiencing more hot flushes & acne - boo - on the higher dose. Of course the gain could just have been my body settling again. It is only 2kg & I’ve been stable at this weight for 9 months.

Actually I was advised to increase my salt intake to help boost my low blood pressure. You are eating so little at the moment & wouldn’t be adding additional salt to your diet, that any salt intake from the broth you are consuming would be minimal. Your daily intake would be considerably less than the general recommended level anyway. Why not ask how much you can have on a low sodium diet (& ask about the reason for it) & then do the maths & adjust your food choices accordingly. Our bodies need some salt, more if you live in a hot environment, exercise heavily & sweat a lot. (My uncle’s cardiologist put him on a low salt diet but didn’t take into consideration he worked outside in central Queensland. He collapsed because his levels were too low.)

What has your doctor recommended? If your bone loss & calcium absorption level is poor they should have you on appropriate meds, etc. to help you better manage it. A friend was put a high calcium diet (including more dairy, oily fish, tinned fish with soft bones -salmon, mackerel, beans, etc.) to support hers. She walks a fine line though as she also has a heart condition & too much calcium cause heart issues. How are your vitamin D levels? Your body needs D to help absorb calcium. Not sure if you drink alcohol but it impedes the body’s ability to absorb calcium & vitamin D. I was prescribed Creons (pancreatic enzymes) to help with my protein malabsorption issues. I believe they can help many malabsorption issues. Worth asking your doctor.

While constipation is more common, some suffer more with diarrhoea. It could be from excess acid in your now smaller & still healing tummy. (I get it because I don’t have a gall to regulate the acid entering my tummy - too much acid & a get an attack.) Plus you’ve changed how your digestive system works & your body may need more time to get used to it. The liquid & then runny purée diet doesn’t help either for some. Have you tried Imodium? It was on my list of meds to have on hand post surgery if needed. They may give you a little more confidence if socialising, travelling, going to work, etc. But it is certainly worth a chat with your surgeon.

There seems to be a few different requirements as to whether you can swallow meds after your surgery or not & when you can start. My surgeon didn’t have any restriction on swallowing meds. I was swallowing meds in hospital 24hrs after surgery. Wasn’t the easiest thing to do because of swelling & discomfort but it certainly got easier over the next couple of days. Otherwise, it will depend upon the meds you have to take I guess in regards to delaying when you resume taking them. If you have to crush them, make sure you mix each one in tablespoon of your shake or milk or drinking yoghurt to mask the taste a little. Capsules are easier to swallow & thankfully my vitamins were capsules. Some, who aren’t allowed to swallow tablets use patches for vitamins

The stats are averages & based on your weight after three years. With sleeve or bypass the average weight loss at that point is around 60/65% of the weight you had to lose to put you in a healthy weight range. It reflects factors such as bounce back weight gain, lifestyle changes, complacency, health changes etc. It’s not necessarily the lowest weight you’ll reach, or even where you’ll settle. It’s just gives you a bit of an idea. Some exceed it others don’t reach it. And as @ShoppGirl said your new set point will most inform of where you settle. Personally, I chose my goal as this was the weight I always dropped to before gaining again. It also put me in a healthy weight range (if you use BMI as a guide). Most choose a weight that was where they once were or think they’d like to be. No scientific reasoning at all. I passed my goal but I’m an outlier - someone who doesn’t fit the stats. I didn’t work at losing that much it was just where my body settled. My lowest was 48.2 but settled at 49kg. A medication change & a needed dietary change & I’m at 51kg & have been there for about 9 months. (Would prefer to be 49 but … you know life.) I think setting benchmarks for along the way like you’re doing is a great idea. If you set a final goal make it a ‘it would be nice if I got to that but I accept I may not & that’s okay’ goal. Congratulations on what you’ve achieved so far.

The scales will quickly tell you if it’s too much. I checked out recommended portion sizes of foods & recommended daily serves per day as a starting point. These are about the portion size you should be looking at. Some eat a little less, some a little more. It depends on lots of factors like age, gender, height, frame, weight, activity, etc. For example, if you are very active you likely will need to eat more across a day. The other considerations would be calories & the nutritional content of what you eat. If your meals are higher in calories you’ll likely have to cut back on the portions you eat. Generally about 4oz of meat & a cup of vegetables but it does depend upon the meat & the vegetables. But it’s all reliant on what your body needs to maintain your weight & for your body to function effectively because that’s our real goal.

You can always depend upon a couple of things post surgery. Everyone loses at their own rate & every rate is okay. The heady faster rates of loss of the first weeks don’t last. Everyone’s’ rate of loss slows & it will be even slower as you get closer to your goal or your maintenance point. Sure you may have a week when your loss is a little more or a week it’s a little less. Your weight loss is not an even straight downward line on a graph. It zigs & zags, up & down. If anything it almost curves a little as your rate of loss slows. As long as your general trend is downwards your golden. I lost almost 70lbs in 6 months but that was me. Generally men lose more quickly but there are other factors that may influence your rate of loss (age, amount to lose, genetics, health status, medications, etc.). Celebrate every pound you lose. You’ll get where you are meant to be in your time.

Don’t be hard on yourself. Life sometimes throws crap at you & health issues & related pain stress are big ones (mean your back not your pregnancy of course). And one you have little control over. Stumbled across this article a little while ago about the pouch reset diet. https://emergesurgical.com.au/does-the-pouch-reset-test-work/ Maybe better to go back to your post surgery diet - meeting protein & fluid goals, watching portion sizes, looking for more nutritionally sound food choices, etc. All the best.