Arabesque

I told very few people. My response was I was seeing a dietician (true), did a lot of research (true), my GP was supporting me, I wasn’t on a known diet as such but was working out a way of eating that worked for me (also true).

Try some different protein sources. Like 3ozs tilapia is 22g of protein. 3oz beef fillet, lamb, or chicken thigh is 20g. Pork loin will give you 23g. Chicken breast provides 26g. All of these require you to cook the meats yourself not processed or pre made. Your can of chicken breast may weigh 3ozs but there are other ingredients as well as the chicken in the tin. Then purée or finely dice, shred for whatever stage you’re at. It’s not easy to get all your protein in at first but it does get easier. As long as you’re making an effort & are close you’ll be okay. I never had another shake after the liquid stage. Was never my personal plan to rely on them. Plus they were disgusting!

If you take away the time you had a feeding tube, you’re probably more at about the four month mark compared to the rest of us. I think I was eating about 600 calories then so a little more. I was a low calorie small eater too. Didn’t stop e losing all my weight & more. So don’t give up. (So sorry you had these struggles.) and I would expect that is also why your doctor is okay with your lower food intake at this time & your eating routine. While yes it is important for you to be slowly increasing your caloric intake & increasing your portion size as you progress, I would expect t your path will be even slower. Out of curiosity what are you eating? Maybe there are some foods that are less dense & with higher calories you could be consuming. Do you regularly see a dietician to guide you on food choices with your specific needs? May be you could reduce some of your activity to take some stress off your body. Exercise only contributes to about 10% of your weight loss. I didn’t exercise as such. Just upped my daily every day activities. Parked further away from where I was going. Walked up escalators. Took stairs. Did single trips up & down my stairs instead of carrying multiple bags or whatever at once. Get some resistance bands. You don’t have to do a lot to see a change in muscle toning & building which ultimately will help you burn more fat. I’ve been doing about 4 x 5 minutes or so sessions across my day for about a year. Doesn’t burn a lot of calories. I say I wouldn’t burn 40 calories a day but my arms look great & I get complements & I had to buy new pants as my thigh muscles had grown. All the best. And yes, the stall will break when your body is ready.

I wasn’t allowed coffee pre or post either. Didn’t bother me as I stopped drinking it years before. Thankfully I was allowed my green tea which I’ve drunk for 20+ yrs & herbal teas. Was told the caffeine is too harsh on your smaller tummy especially while it is healing & so sensitive. But as with most things, follow the plan you’ve been given. If you are to give it up after surgery for a period of time, I’d give it up before as the withdrawal can be wicked.

The hormonal oestrogen flush was great for me. I was menopausal & my symptoms disappeared. Yay! They came back though once I lost the bulk of my weight. Sigh! But yes, heavier/lighter, more/less frequent cycles, more or fewer PMT symptoms & yes increased fertility are common. It’s actually often suggested that you double up on contraceptives for a while.

So loverly of you to do this @BigSue. Great advice. I did the colour thing back in the 80s when it first gained popularity. I am a winter & still wear predominately black. LOL! It makes it easier to put a practical & workable wardrobe together - things match (tops, bottoms, shoes, scarves, bags) & can be swapped about to switch up an outfit because of knowing the colours that work best on me also complement each other. It’s interesting how our personal style changes too. Pre surgery I wore a lot of architectural avant garde type clothing. Can’t now cause even though my height hasn’t changed (😉 still short) I don’t have the body to support the clothing anymore. I feel like I’m drowning in fabric & being overwhelmed. As someone who constantly gained & lost weight, the fear of getting something out to wear & discovering it wouldn’t fit was real & occured every day. Now it doesn’t even enter my mind. Bonus of actually maintaining my weight for more than a week for the first time ever.

2 weeks, 1 month, three months & has been every 6 months for the last 2 years. The next appointment I have to make will be around my 5 year anniversary in May. Don’t know how long this will continue but it’s reassuring that they’re keeping an eye on me & are there if I need them. I actually look for ward to the appointment as I get on well with the doctor who does these appointments & we always have a good chat as well as the follow up.

I wondered fluid retention too. And I hadn’t heard of hyper hydration either. I do know drinking too much fluid can flush vital enzymes & nutrients from your body which can cause many side effects. Were you told 64ozs/2L of fluids per day? This is the recommended intake for everybody. I do average about 2L every day & pee continuously so I must be well hydrated. Personally I’ve often thought it’s a little too much for me. I’m not tall, not active & on the smaller size. How can I need the same amount of fluid as say a 6’ tall man with a BMI of 30+??? I mean I can’t give blood because I weigh less than 50kg - simply because there’s less in my body. My pee is generally lighter (which is accepted as a sign you’re well hydrated) on the odd day I drink less (1.2 - 1.5L). Hence me wondering more that 2L is too much for me & I’m flushing out nutrients & enzymes. Got me worried now. Will be interested to hear what you're told at your appointment next week.

Apparently they called the first week of the pre surgery shake diet hell week at my surgeon’s office. There’s a lot of withdrawal symptoms associated with it (sugar, carbs, caffeine). Your cravings go crazy - you always want more the things you can’t have. Your emotions are all over the place which often makes you want to comfort yourself with food. On & on. Round & round. I was vey relieved I was placed on keto for the pre surgery diet. I had done the shake diet before. Two shakes & one small portion meal of steamed vegetables & plain cooked protein. Did it for 8 weeks & then again for 6 weeks a couple of years later as another diet I was trying. It ain’t easy even with one meal. Check with your dietician regarding swapping out a shake for a broth/soup. Some companies do offer them as well as shakes but they’re still going to be low calorie & go through you quickly being liquids. You’ve got this. You can do it.

Snoring & sleep apnoea affects many organs in your body. You are not breathing properly & often stop breathing while asleep. Your blood oxygen levels are often decreased. It strains & causes damage to your heart. Can damage your kidneys. Affects brain function, concentration. You become easily fatigued. Increases your risk of strokes. At your height & weight you are almost at a BMI that is considered morbidly obese. I know in your other post you said snoring was your only health issue but the likelihood of other comorbidities (high blood pressure, high cholesterol, diabetes, mobility issues, cardiac issues, etc.) developing soon is very high. I’m sure you’ve been told weight loss will benefit your overall health which to me is the most important benefit. We can become so used to & accepting of the limitations put on us physically, mentally, emotionally & on our life in general because of our weight it often is not fully realised until we lose the weight. Whether you do it via surgery, medication, dieting is your choice. But you have to want to do it & be ready to do the work associated with what ever you choose to do.

For life? Not true at all. Stage two of the post op return to eating is purée. It usually is weeks 3 & 4 so two weeks only in the first month. The staged return to eating (usually a two week cycle of liquids, purée, soft then solid foods) is to protect & support your healing tummy. It takes about 8 weeks to fully heal. Some surgeons recommend chewing well before swallowing to help during this time too to ensure nothing too coarse or fibrous is swallowed that could impact your healing. It also makes you stop & think about your eating. I wasn’t told to do that. A couple of weeks on the solid food stage (probably early start of month 3) I was eating chicken thighs, steak, lamb chops, pork loin, etc. Yes we are advised to eat slowly. It takes a good 20 odd minutes for the message to get through that you’re full. If you eat quickly you’ll easily eat too much & be over full. It’s about being mindful when eating too. Putting your cutlery down between bites & really thinking about if you need the next bite yet or just want it is a good habit to get into. It’s actually a good practice for everyone not just bariatric patients. So many people just shovel in spoonful after spoonful of food in their mouths & before they know it they’ve eaten copious amounts of food & are groaning & uncomfortable because they are overfull. Something to be aware of is eating too much, too fast or food that is too coarse or fibrous can result in the foamies. Thick foamy saliva rises to protect your oesophagus & to help you bring up the excess food or food that is causing a blockage. I still have the foamies at times. I think my oesophagus is more sensitive. Char grilled meats & vegetables & sometimes fibrous vegetables can cause me grief. But I feel fine once I’ve bought up the offending thing, I feel fine. Last time I had an episode it was because I hadn’t trimmed my sugar snap peas well & there was string left dangling & it irritated me. Most people rarely experience it & not in the long term. There’s lots of misinformation & scary horror stories online many not based on any truth or vey little or posted to drive likes (the scarier the story the more clicks). Go to reputable medical sites & forums like this one. Generally a good idea to avoid social media too. Highly recommend the you tube videos of Dr Matt Weiner (A pound of Cure) & Dr John Pilcher. Straight forward, practical information, clearly explained.

Didn’t have one but I understood if you are to experience one it usually occurs in the first few days. While you need to seek help as soon as possible if you suspect a leak, they are usually repaired fairly easily via an endoscopy. You’ll likely be on antibiotics after to ensure any infection is cleared. I have three friends who’ve had sleeve surgery too & none of them at one either. They’re pretty rare I think like 1%. And even rarer if you have one in the years post surgery. Leaks occur because of a suture/staple failure, tissue decomposition, patient health prior to surgery affecting healing like a history of smoking or high blood pressure, food choices (not following your plan), excessive activity to strain & cause trauma to the area.

lol! I did the reverse the larger I got in the before time: moved my rings down my hand to the smaller fingers so I could still wear them. 😂

Nerves & feeling anxious before surgery isn’t unusual. You are doing something that requires many changes to you physically, psychologically & emotionally. And you don’t have any experience with any of it. I didn’t have any co morbidities at all before my surgery but I knew they would be in my future simply because I was obese. Being generally in good health bedside surgery puts you in a stronger place for your surgery & recovery so a plus. The very small portions are only in the beginning during the staged return to eating. As you progress you are able to eat more until you are eating what is a recommended & appropriate serving size. Not those large servings that are two, three or more times we been acclimatised to think of as normal but the portion size we should be eating. Doesn’t mean you won’t ever eat your favourite foods ever again either. In time you work out how much you can eat of that food & how often. Or you may make changes to the ingredients or the cooking method to make it a healthier & more nutritious choice. We talk about having to do the head work while we are losing. This is the most important step. Working out the why, what, when you eat & changing your relationship with food. Reflecting on what drives you to eat & the food choices you make so you can mange those cravings & work out a way of eating for the future that is sustainable, doesn’t restrict or limit you & allows you to enjoy your life as you want. This is the difference between the surgery and every other diet I’ve been on (& I was almost 54 when I had the surgery & had been on a lot of diets). I’ve never been able to lose weight & maintain it for any length of time like I have after the surgery. Yes, I work on it every day but it doesn’t mean I don’t or can’t enjoy my life or miss out on anything. A lot of it is routine & I look at it as not being on a continuous diet (so many negative connotations) but this is just my way of eating. Like how people who have food allergies or may be vegan or vegetarian eat & the food choices they make. Ensure you have access to a supportive therapist you can call on if needed & a helpful dietician who listens. This isn’t something you can really do completely on your own. Best decision I ever made. All the best whatever you choose to do.

Oh, I’m sorry @LindsayT. Is yours one of the genetic porphyrias? They say it’s one of those disease/syndromes that many have but don’t know. At least you do now know what’s been behind your symptoms all these years, as unpleasant as it is. Hope the treatments they’re offering help ease your symptoms. Do they think stem cells may help? I first heard about it watching Buffy the Vampire Slayer lol! It’s known as the vampire’s disease & from where they believe the myth of vampires began.

You’ve just had pretty major surgery, your body is in recovery mode, stressed & you’re not eating much, so yes your labs will be a little screwy for a while. You want to be in Ketosis to burn fat so this is a good thing. High B12 could be you don’t need as many supplements. Like do you take additional B12 as well as your multis? Increased bilirubin levels are also common with weight loss. Ketosis & weight loss is hard on your liver (all the fat it’s trying to process out of your body). It will settle eventually. Probably better to discuss these results with your surgeon & their team though as they are more knowledgeable about what to expect after surgery while you are losing. In saying that, my GP used to run labs between my surgeon’s requirements (so I was getting them done every month or two). She was tracking & monitoring only so if anything unusual popped up we could be proactive. And they were sent to my surgeon & his colleague as well so they saw the results too. Bonus was my GP was a medical school friend of my surgeon’s colleague.

Stick to your plan. Don’t stress your body more by making more changes. Stalls are when your body takes stock of your current needs & readjusts things like digestive hormones, etc. The stall will break when your body is ready to move forward again. Also, your weight loss slows so much as you near your final weight (set point) it almost does feel like stalling. Consequently shifting the last pounds can be a b**ch. it’s because you’re eating much to what you’ll need to eat to maintain. Oh, & if you do cut your calories &/or increase your activity to lose more you’ll always have to eat less than you are now & do more to maintain the lower weight. Don’t give up yet though. You can keep losing vey slowly for months. I lost another 10kg over 12 months after reaching my goal.

It can be challenging when your taste buds are against you but it is a great opportunity to try things you haven’t before or give food you didn’t enjoy in the past another go. I wasn’t hungry or interested in eating either (for 8 months or so). So I ate to a routine to ensure I got on my required nutrition. It helped to change how I looked at eating - not for comfort, to make me feel good/better, if I was bored or …. but to fuel my body. Eating to live not living to eat. Was also when I began asking myself if I needed the next bite or just wanted it. Never forced myself to eat all my portion if I didn’t need it or thought nope, no more. At two months, I was eating only all real food & eating a wide variety of meats. Some vegetables were challenging but steamed green beans, cauliflower & cabbage were good. I could add tomatoes, celery, capsicum, onions, mushrooms to any slow cooked soup, stew, minced meat dish. etc. About a month later all vegetables were fine. Didn’t touch shakes from purées. Aim for three meals a day & maybe one snack. (I snacked on fruit or yoghurt.) Check with your dietician to see what they recommend for you. Try to avoid falling back into the old habit of eating if you have head hunger.

There are some good dieticians & there are some … well… lousy ones. Is there any way you could find another dietician? Telling you to go to back to shakes is a bad suggestion like @summerseeker said. They should have gone through what you’ve been eating & make suggestions from there. The goal is to be eating real food not highly processed synthesised shakes loaded with artificial sweeteners & such. Stalls are frustrating. No way aground that but they are an important part of your weight loss when your body takes stock of your new needs & adjusts digestive hormones, etc. Best advice is to stick to your plan. Don’t make changes & stress your body more. The stall will break when your body is ready. Good advice from @summerseeker too about going back to the basics of protein first, then vegetables & then low processed complex multi/ whole grain carbs if you can eat more. Make cause you’re hitting your protein & fluid goals. Calories are a bit of a touchy issue at the moment in the medical world. Some are anti some are pro. A lot is around a calorie is a calorie regardless of what the food source is versus nutrient value. Plus, caloric needs differs so much person to person - age, gender, activity, metabolism, general health, hormones, etc. all affect how many you need. Personally I think if you are eating nutrient dense food, having an idea of calories can help you stay on track & guide you if you’re sliding.

Unfortunately, nausea is not an uncommon side effect of multi vitamins. I found splitting my dosage helped a bit - I’d take one in the morning & the other at night. Yes, a different formulation or brand can help & is worth trying. Vitamin C, E, B9 (folate) & iron are usually the culprits behind the nausea so it can be worth checking how much you are taking of these. Like do you take iron & there’s iron in the multi. If so maybe take the iron at a different time. It’s also harder in the beginning as we have so little in our tummy there’s not enough there to protect it so nausea results.

Orthostatic hypotension is common after the surgery. That is your blood pressure drops on rising & then resettles again. Did they check your blood pressure sitting & then standing? I had a tendency towards low blood pressure before surgery now it’s something I experience every day & am almost 5 years post surgery. Periods of low energy while losing isn’t that uncommon either. I remember at around the 3 month mark suddenly feeling so tired again. At the time I thought I really should get more active & started to walk on my treadmill. But I couldn’t do it. Was so tired I worried I’d fall asleep as I was walking & I was wreaked after a couple of minutes. That nixed that idea. Plus the doughiness in the head & inability to focus can last well into the second month too. However, what you’re experiencing could be related to having had Covid. Back in the day it was known as a post viral response: lethargy, low energy, cold sweats, blood pressure issues, etc, I used to get burning on the soles of my feet too. Could last for months after having one of the more severe viruses like glandular fever, influenza A, etc. I’ve had two bouts after having pityriasis rosea & then human parovirus. I remember struggling to walk up the two flights of stairs to my apartment & I had a chair placed in front of the white board in my classroom because even standing was exhausting. Now of course everyone calls it long COVID but it’s the same thing. My last thought is you’ve picked up the vertigo virus. It’s a parasitic type virus that attacks when you’re run down post another virus. I got mine after influenza A. The vertigo, lethargy, etc. wasn’t pleasant. Occurred randomly for a couple of years after the initial bout. Generally over the counter anti nausea meds manages the vertigo otherwise a script for stemetil or similar helps. I carried it in my bag just in case I had a vertigo attack. Just some suggestions. Hope you start to feel better soon.

I think everyone does in some form. Doesn’t mean it will happen though. Yes, a bounce back regain of 10-20lbs is a real possibility but it doesn’t happen to everyone. Whether you regain or not I think depends on a number of factors. Some you can control & manage & some you can’t. Complacency - letting the new good eating habits slide. Not dealing with emotional & psychological issues behind your eating habits. Health & medications - some medications are renown for increasing your appetite or a health situation may arise that limits you in some way. Unsustainable way of eating to maintain - too restrictive & stops you from enjoying & living your life as you want. Life - sometimes throws crap at you & good intentions are the first to go. Commitment - accepting the changes you make have to be forever. I had 40 years of losing & gaining weight. Every diet, dieticians, medications, exercise plans, you name it I did it. I’d stick to it, lose weight & as soon as I stopped I would start regaining again almost immediately. Simply because I went back to eating the exact same way as I did before. I had a low & a high weight I bounced between until the last 4 or so years & my weight exploded. Nothing worked then so surgery was my only solution. Am nearing 5 years & have basically maintained my initial stabilised low weight. Never have been able to keep weight off like this ever. I had a medication glitch but we sorted that & I lost the 5ish lbs I’d gained without doing anything. I work at it every day. I established a way of eating that was sustainable & works for me, my needs & my life. Same with my activity. Don’t exercise as such just do four x 5 minute sessions of resistance bands & stretches 6 days a week - wouldn't burn 20 calories. I’m okay with that because it works for me & I’m happy to do it You have to be mentally ready for this because that’s where a lot of the battle is. Sure the surgery gives you some tools, but for me, the time it gave me while those tools were at their most effective was the biggest win. It was when I examined my relationship with food (the why, what & when I ate) & worked out what I needed to do make be the most successful. I wouldn’t stress about something that may happen because it simply may not. Just be aware of it. You never know what the future will bring & you’ll have built a wealth of knowledge & strategies & have a support team (doctor, dietician, therapist) to help you get on top of it. All the best.

I’m not excusing your grandmother, but older people tend to lose their filters & think they can say whatever they want. Not all of course but it seems a lot do. I spend a lot of time saying ‘Mum! You can’t say that’. She’s 84. Out of curiosity, did your grandmother also have dessert? My mother often comments on how large someone is while ignoring how big she is. I had enough one day & told her the person was considerably smaller than she is. Stopped her for a while at least. She was never like this before. Like she never said a word when I as nearing or at my highest weight. It’s probably why I get short with her at times because it’s not who she was. Yes, I do think we can be more sensitive about things people say because of our experiences with bullying & offensive comments. Consequently our immediate thought is that it is another rude & pointed dig. I often wish I was quicker with the pithy comebacks or could politely point out the impact of their words. I also wish I could breathe through or let my negative reactions to certain situations that arise because of my past experiences go.

It’s usually about four weeks before you can lift more than 10kgs/20lbs but please check with your team as to when you can introduce more strenuous activity. Requirements differ plan to plan & patient to patient. Nothing stopping you using some resistance bands at home in the meantime. You’ll tone muscles without straining your abdominal area. (Remember it takes about 8 weeks to be fully healed.)

2oz is equivalent to 1/4 cup of purée. My plan was 1/4 - 1/3 cup (2-3ozs), three times a day from purée so pretty much like your plan. Honestly I couldn’t eat any more than that but I was a no hunger & no appetite person. Sometime around purées I added a high protein yoghurt or yoghurt drink as a snack to boost my protein intake. But check with your dietician, maybe you can add a high protein yoghurt as a snack too. If you are experiencing real hunger. Never hurts to ask.