Arabesque

Dr Matthew Weiner just did a post on his IG account (poundofcure) today about the pill trials - not that successful yet. Terrible nausea with one & consequently participants dropped out early. Yikes! There are a large number of companies developing them though.

This is terrible. What sort of aftercare is that. Send an email directly to the surgeon if you can listing the questions you have & didn’t receive answers about or didn’t have a chance to ask because you were pushed out the door. I had good follow up which is why I’m very surprised & disappointed for you at your after care. I saw my surgeon at week 2, 1 month & then the 3rd month. A colleague then took up my follow up appointments. I saw them every three months until my third year. I still see this doctor every 6 months. I don’t know for how much longer though. I guess my next appointment at my 5 year mark will tell.

Have you had a liver function test done? Excess copper is excreted from your body in your bile by your liver. While we’re losing, it’s not uncommon to have odd liver function results (processing our fat out of our body strains it). Maybe if your liver isn’t functioning effectively or being stressed by your weight loss may mean it’s not processing the copper out of your system & it builds up. I don’t really know either. Just wondering. Worth a deeper conversation with your doctors as to why it might be happening & what can be done to help reduce your levels.

Menopause is the worst. It’s when I gained my weight. Went from 60 to 75kg very quickly during perimenopause. This was my usual fluctuation so I didn’t worry that much. Then entered full menopause & bam another 15kgs. I swear I gained it overnight. Several of my friends were the same - gained 10-15kgs very quickly with menopause. Couldn't really shift a kilo of it. Drop a couple & put them straight back on. I had hoped that being on HRT might balance out my hormones & help me lose some weight but nope. Struggled for a couple of years. Wasn’t happy. That’s when I decided to have my sleeve. Why don’t you try getting in contact with a bariatric surgeon to discuss your revision options like to a DS. Does your surgeon who did your RNY still practice? Have you considered whether the new GLP - 1 medications might be an option? Certainly worth a conversation with a surgeon. PS Congratulations on your long term success with your original surgery. Such an achievement.

In most cases, your stomach growling is just your digestive system doing its job of digesting food and nothing to do with hunger (despite what we were always told). Your tummy is a muscle that contracts & expands as it digests what you are eating & moves that food through your digestive system. All that squishing & squelching is noisy. At the moment, it’s probably spasming to some degree too as a result of the surgery & the shock to your system. (All those cut nerves, cut tummy.) I’m 4.75yrs out & mine still rumbles & growls like my own personal poltergeist. It will grumble, rumble, whine & groan while I’m eating & even just drinking water for up to an hour or two after so certainly nothing to do with hunger. (It’s doing it now LOL!) My nieces & nephew think it’s hilarious. Sometimes they put their heads on my lap just to see if they can hear my tummy. Can be embarrassing at times though.

I echo the advice to seek help from a therapist to support you while you are experiencing emotional distress, anxiety, depression & support you to find strategies to manage your desire to turn to food during these times. The battle not to eat/ make the best choices is eternal. My brain whispering to me. It will be all right if you eat that. A small bite won’t hurt. It will make you feel better. You deserve it. Etc. It isn’t easy to fight your head/thinking though. And if there are odd times you just can’t argue your way out of it, forgive yourself. You are arguing against an intelligent person - you!

Remember that’s added sugar. Not the naturally occurring sugar. The naturally occurring sugar in milk (& other dairy products), fruit, vegetables, are fine. Keeping your added sugar under than 7g is easy. I do it every day & am 4.75 years out. I’d go further though & say stay away from as much artificial sweetener as well. It only feeds your desire for sweet/sugar, causes weight gain, affects your immune system, etc. it’s not easy cause they put that stuff in seemingly every darn thing. But at least try to keep it low.

I agree. Definitely contact your surgeon. It could be just swelling. It could be a stricture. But you really shouldn’t be experiencing strong pain a week out (except from the surgical gas pain but even that should be reducing each day.). Most of us throw away our opioid pain meds by day 3 or 4 & often don’t need any pain meds after then either. Yes, meeting those fluid & protein goals can be difficult in the beginning. I’m another one who struggled at first (one shake & a cup of soup each day from day 4 & really nothing before then except a few sips of water). As long as you are making an effort & slowly getting closer you’ll be fine. Be aware of possible dehydration though. All the best. And push to get a response from your surgeon asap.

I bought protein shake in powdered form & bought yoghurt drinks when I discovered them. (Be careful some have a lot of sugar/sweeteners & are actually low protein.) I didn’t realise I could make them myself so easily. LOL. I bought some supposedly flavourless pea protein to make my own smoothies but it was awful. All I could taste was peas (& I love peas but pea protein powder blah!). Some good tips I use when eating with others is not to eat while others are speaking. It slows you right down. And it means you give your full attention to others. Plus I put my cutlery down & lean back in my chair between bites even when eating alone. My last tip is to cut your food into small bite size pieces before sitting at the table. Of course you can’t do this when you’re out. I still do this at home. It’s like I’m prepping a meal for a toddler. lol! Use a small plate like a side plate for your meals (still do) to keep your portions small. I also used small ramekins. And I used a teaspoon initially & then a cocktail fork or spork instead of full sized adult cutlery to keep bites small. Some use children’s cutlery.

PPI are proton pump inhibitors which reduce the amount of stomach acid like Esomeprole (Nexium), Omeprazole (Prilosec), etc. I think you need a prescription in the States too for 20+mg doses. Over the counter ones of less than that usually aren’t strong enough. In most cases your stomach growling or hunger pangs are actually just your digestive system doing what it’s supposed to digest food. The PPI will help with that because at the moment your body is still producing enough acid to digest the amount of food you used to eat. Your head can mess with you bad at this time. It makes you want the food you can’t have at the moment even more Plus so many of us used food as a comfort & you can’t have it at the moment so aren’t able to comfort or soothe yourself like you usually would in a time of stress & emotional turbulence. Give yourself time to heal & recover from what is a pretty major surgery. It takes a good 8 weeks to fully heal & feel more like yourself. Be gentle on yourself.

Congratulations on your loss. Whoo hoo! Might be worth checking your calorie intake & what your body actually needs to maintain your current weight & activity level. What portion size are you actually eating? I eat pretty much what is considered an appropriate serving size in maintenance e.g. 3-4ozs protein & a cup of vegetables. Took me to about 18 +/- months to be able to physically be able to eat that. I had been snacking a lot in between to try to stop my continued weight loss until I got to that portion size. I actually still do have to snack just not as frequently. Might be worth a conversation with your dietician to see if there’s something you’re missing & what you could add to your every day eating to help. Also, a growling tummy is more often than not your digestive system doing what it’s supposed to - digest food. Mine is noisiest during & after I eat for up to a couple of hours. Remember you can’t be really be hungry as you’ve just/recently eaten. Your cup of tea is a great idea when this happens. PS - I snacked on combinations of cheese, multigrain crackers & hummus, protein bar, fruit, peanut paste, nuts, yogurt, chia pudding, etc. about 5x a day. Yes I felt I was eating all day long. Now I snack 3 x a day on basically the same things & also occasionally beef jerky & baked fava beans/chick peas.

Instead of snacking as you’re driving, try stopping & having a proper meal - salad, soup, grilled/steamed fish, etc. At three moths you'll have a few more options. Even picking up some yoghurt or pack some protein shakes & have them in a park. It may take you a bit longer to get where you’re going but it should reduce your desire to mindlessly snack in the car. Remember that’s just head hunger - eating out of boredom as you sit in the car. Travel safely.

Try warming the shake or using warm water to make it. Warm drinks are often more soothing & easier to drink & tolerate. Are you taking a PPI? They may help with the gas & belching as may GasX. Worth a try anyway.

I still can take up to an hour to eat though usually 30-45 minutes. It depends on what I’m eating. I stick to my appropriate portion size & stop if I don’t need any more. I don’t eat more. 4.75 years out & I lost all my weight & more & have maintained it. I can have a slow full signal so going slowly ensures I don’t accidentally eat past me being full & then only getting the signal at the oh my God I’m going to burst stage. It’s why I tend to eat until I’ve had enough & need no more & not rely on the full signal. However, the don’t eat for more than 20 or 30 minutes isn’t uncommon. I think it’s to stop you eating more than you need/too much. But surgeons have their own reasons for their requirements as we know.

Well so much for my dolloping Boursin on my steak. My batch had started to go green even though it had another week to go. Sigh. Went to a different deli & another grocery store that’s supposed to stock it & no luck. Will have to make my own again.

Oh yes, your remaining weight/fat does resettle in the months after you stabilise. Initially I was very straight up & down, no waist at all. I was a little upset because I’d always had an hourglass body shape even when obese & now it was gone. A few months later, with no weight change, I noticed I had a waist again & hips &, while my breasts were empty & saggy, I still had an E cup size so breasts. Sure I don’t have a butt but I had my hour glass shape back again - just much smaller dimensions ?. Where did you carry your weight? What body shape did you have? I wonder if you are naturally pear shaped so therefore slimmer on the top & you carried more of your weight around your waist, hips, butt & thighs. I’d say your saggy empty skin is being pulled downwards by gravity too. Are you thinking about skin removal when you’ve stabilised? I wouldn’t worry about having 30% body fat. This is a good result. According to the American Journal of Clinical Nutrition, there are healthy body fat percentages based on your age. For people aged 20 to 39, women should aim for 21% to 32% of body fat. For people aged 40 to 59, women should fall between 23% to 33% and men should fall around 11% to 21%. If you’re aged 60 to 79, women should have 24% to 35% body fat and men should have 13% to 24%. (From webmd) Why do you say you’re overweight with a BMI of 25? Love it or hate it, BMI does give us a bit of an idea & it’s how we’re defined by doctors, etc. You’re just on the borderline of healthy & overweight. And if you’ve built muscle you’ll weigh more so you’re really in the healthy range. Personally I wouldn’t define myself by my BMI & certainly not at your weight.

They pump you with a lot of fluids after the surgery so you’re probably still peeing that out. When I had my gall out the pumped me with so much fluid I gained a good 2 kgs. Thankfully I’d lost it two or three days later once I’d peed it all out.

Oh good you got a diet sheet some don’t. I remember some other UK people only being allowed milk. I’d still give your dietician or surgeon a call to see what other options you might be able to include like the shakes (which can be awful after the surgery texturally &/or flavour wise) or broths. Or if you could blend yoghurt with the milk to make a smoothie adding a sugar free flavour or vanilla. Can’t hurt to ask. I’m not a milk drinker (except in my porridge) so I’d struggle with only milk.

It will depend upon your surgeon. It may result in a delay depending upon how low your level & stores are. Has anyone gone through your blood work with you yet? They may require you to take some iron tablets to boost your levels. If you are very low they may want you to have a transfusion. Give your surgeon/ team a call & ask if there is a need for concern & what you need to do to boost your levels. Fingers crossed it will be an easy fix & your surgery will proceed as planned. PS - Avoid drinking coffee or other caffeine drinks immediately before, during or after eating. Caffeine reduces your body’s ability to absorb iron by 40 - 60+%. https://www.healthline.com/nutrition/coffee-caffeine-iron-absorption#TOC_TITLE_HDR_2

Were you given a diet & list of what you can & cannot drink/eat before & post surgery? If you didn’t ask for one. It’s really important to follow the plan you’re given. Surgeons can have different plans with different requirements. For example the pre surgery diet could be three protein shakes a day, or it might be 4 shakes a day. It could be two shakes & one meal of meat & vegetables (low fat, low carbs). Some even specify what brand of shakes to drink. I was on keto so lots of differences. Generally post surgery it’s protein shakes, bone broths, cream soups, consumes so protein, protein, protein. Some are allowed sugar free jello but again you should follow your surgeon’s plan. All the best.

I had the excess saliva thing for a couple of days. Carried a suck bag to spit in. It’s from your throat being irritated from the intubation tube. Your body produces the extra saliva to soothe the throat. The swelling made it difficult to swallow meds for the first two days too. You’ll likely find it improves every day. I started swallowing my vitamins when I got home so day 4. (I had an extra day as my back went into spasm & was in pain for that.) The swelling had reduced by then so I could take the capsules okay (one at a time of course). But check with your team as some like you to wait longer or to use patches, etc. not tablets. Aim for 64ozs a day of liquid but that does include your shakes & any soups, broths etc. you’re drinking. It’s not easy at first but as long as you’re close & working at getting closer you’re doing okay. Can be easy to get dehydrated if you don’t get the liquids up. Try drinking during the night too. I still do this. Drink every time I get up to pee which of course is often because, you know, drink a lot. LOL!

I’d be ringing my surgeon & requesting/demanding an appointment @timetoshine. Five months without any checks seems crazy to me. I’d had several appointments by then. Make a list of questions to ask them like your exhaustion, sickness, small portions. Out of curiosity how big are your portions? Are you eating slowly, taking small bites? Eating too much, too quickly & foods that are too coarse are renown for upsetting your tummy e.g. the foamies & then brining up what you ate. Keeping foods moist with sauces & gravies can help. Is there a reason you haven’t had your B12 shot yet or just life being too busy? I’d get that soon too as it will help with your exhaustion. Establish a routine with your daily med taking. It is essential not to miss your vitamins with bypass because of the malabsorption issues. Dense foods can cause issues for people. Chicken breast & steak tend to be the more difficult ones. How do you go with other cuts of meat like minced beef or minced chicken? Chicken thighs are more tender than breast too. Do you have a dietician? I’d ask them for some suggestions as to what you can eat to get more protein in. I relied a lot on high protein yoghurt & yoghurt drinks/ smoothies to push my protein up. It can take some people longer than others for everything to settle & to work out all your new tummy/digestive system’s quirks.

Week 5 was soft food for me. While it’s been 4.75yrs for me I remember making a lot of minced beef dishes: savoury mince, meat balls, bolognese with zucchini noodles. Also made a couple of slow cooked stews/casseroles & chunky soups.. So all had well cooked soft vegetables & its own sauce/gravy to keep everything moist. Omelettes & yoghurt/yoghurt drink were also on rotation & I had rolled oats & scrambled eggs for breakfast. I wasn’t eating much either (was told 1/4-1/3 cup from purée). I’d eat one golf ball sized meat ball. Two egg scrambled eggs took 3 days to eat. Doubt I was consuming 400 calories & barely reaching my protein goal - was much like @ms.sss in that way except I almost made 900 calories by 6 months. Check your plan as there can be a number of differences between what we’re advised to eat. And check with your team if you want to try something ‘off plan’ first. Listen to your body. There maybe foods your tummy can’t tolerate. Don’t give up on them though. Just avoid them for a week or so & then try again. Good luck.

100% pre made puff pastry @GreenTealael. No time (or desire) to make my own. ? Oh, yes shredded parmesan @Spinoza. I love caramelised onions so I might give your version a go too. I think the Boursin is why the zucchini tart went so quickly because generally zucchini isn’t that popular. But the pistachios & drizzled honey probably helped too. ? I’m thinking about trying a little dollop of the Boursin on steak the next time I have it. I tried a little Boursin on a cracker but I didn’t like it as much as when with other savoury ingredients. Glad your family enjoyed it too @ms.sss.

I hated that grainy taste too & they were so sweet. Shudder! I diluted my morning shake (doubled the water) which helped somewhat. Then I had soup for the rest of the day. Bone broths are very good, but consommés & cream soups are good options too. Make your own smoothie using yoghurt, milk, a little protein powder & a powdered flavour. Protein water is also a good option. It can be a challenge to hit that goal at first but as long as you’re making an effort, are close & getting closer you’re okay. It does get easier.