PolkSDA

"Most WLS programs"? No offense is intended, but as others have pointed out, it's frequently the opposite of what you state. Both my surgeon and nutritionist said they want me to be eating at least 4 times per day if not 5-6, but small amounts spaced evenly throughout the day rather than dedicated "meals". Snacking is important IMO.

Glad to see I'm not the only one... after being morbidly obese for 4+ decades and ALWAYS running hot (to the extent that frequently in the winter I wouldn't need to wear a coat due to sufficient internal padding), these first 4 months following surgery have been very different when it comes to temperature. No more constant sweating. In fact, I think I've felt cold/chilled more times in the last 4 months than in the last 10 years... and I *STILL* have another 60+ pounds I want to lose. At this rate, I'll be wearing a parka and mittens in July!

NOTE: Lest people be triggered, most of this should not be construed as advice. It's what works FOR ME, and we all have different habits, predilections, experiences, and psychological and physical responses. I'll fly counter to typical advice and say that while a conscious effort to control hunger is important, I also don't deny myself pleasure, just keep it limited. Unless my doctor/nutritionist has told me that I MUST avoid cheese (which I don't understand), I think it is perfectly fine to have a portion of cheese as long as the calories are factored into daily intake. I get pre-portioned cheese as opposed to cutting it from a bulk block. Personally, I like the packs of pre-portioned 80-calorie pepper jack. For me, having things portion controlled is critical. Far better that I satiate enjoyment in some small capacity than depriving myself entirely. IMO that has negative psychological repercussions; the whole "forbidden fruit" syndrome. I'm going to say a bad bad thing: I'm eating complete garbage. I like my bacon burgers. I like my spicy chicken nuggets... but I'm just eating a whole lot less of it than before I planned for surgery. I've been candid about this with my nutritionist and her response was "We can make all the recommendations in the world and lecture you, but ultimately you have to do what works for you... as long as the results stay on schedule." Which they are. I'm still continuing to lose weight and am at my lowest weight in over 30 years. I know my limitations... and eating without enjoyment doesn't work for me. I keep portion size small, focus on proteins, and avoid the carbs whenever possible. For example if I feel the need for fast food, it's likely JUST the above... no side dishes (fries, onion rings, etc.). I get what I enjoy without the excess baggage. I'm sticking within 900-1400 total calories per day. I don't necessarily recommend this for anyone else; it's what has worked for me given my habits and psychological makeup. Others are free to disagree.

Same. Between Wal-Mart and Amazon I got everything I needed at a fraction of the cost, with emphasis on the former when it comes to foods, protein, and supplements.

I came out of anesthesia at about 1:30PM the day of my surgery. That afternoon, night and following day were absolutely dismal. I think I maybe slept an hour that first night. The pain and discomfort were overwhelming. I had been fighting severe constipation the last 2 days before surgery, and I believe that exacerbated everything. I went home the afternoon following surgery, and the first several days everything was tentative and ginger. However, it steadily improved and by day 10 I felt completely back to normal, as if I'd never had surgery. No soreness or pain at all. So it does get better. Hang in there! EDIT: I just noticed that mine was a different procedure, sorry about that. General principle still applies though; gotta just forge ahead.

I realize there's unlikely to be a one-size-fits-all equation to measure one's weight loss progress objectively, but are there any guidelines, i.e.: With a starting weight on date of surgery of N, if I am weight Z at X days post-surgery, am I on target, ahead of schedule, or behind schedule? In other words, where am I? My medical team really hasn't given me any guidelines. When I entered the assessment program in June of 2019 I was 382. I was 337 on date of surgery July 13, 2020. So 6 weeks post-op I'm now at 311, a subsequent loss of 26 pounds since date of surgery, and a cumulative loss of 71 pounds since start of journey. I know that I'm prone both to diet cheating and being lazy, so I like to keep a bit closer tabs on progress than others might need to, so if I see myself falling behind, I know that I need to go back to shakes & soups for a while and/or get off my fat *ss and go for some extra walks. Thanks.

Lectured? No. But at my 1-month post-op meeting with the dietician, she did say that over time she wanted me to reduce my reliance on protein shakes for my daily protein intake and to be getting it from other food sources. She never implied that 2 per day was somehow "bad".

As with every profession, there are those that are at the bottom of the class. I recall a doctor-mandated consultation with a dietician about 15 years ago. She was extremely fit but weighed about as much as my shadow, and had ZERO frame of reference about what it was like to be overweight, let alone lifelong morbidly obese. I recall her saying "well, maybe the next time have 1 slice of pizza instead of 2!" all satisfied with this glowing wisdom she had just imparted. I replied "Lady, if the problem was 1 piece of pizza vs. 2, I wouldn't be in the shape I'm in. It's more of a question of 1 PIE or 2." She just couldn't fathom what it was like to be an overeater. Needless to say, that went nowhere. My dietician this time around, however, is aces. She too is a diminuitive slender fit women, but the persona is completely different. She asks questions, doesn't try to lecture, tries to find healthier alternatives to fit my lifestyle, food preferences, and cooking capabilities (or lack thereof). She doesn't berate me if I tell her that I've tried certain foods that aren't on the regimen or had something more or less frequent than I am supposed to. She's not judgmental, so I don't feel the need to hide things from her; I can be candid with the good, bad, and the ugly. Do you have the option of requesting a different dietician from the same hospital/system?

I scheduled 2 weeks off, but realistically I could have gone back after 1 week. Then again, my job is sedentary computer work, so less demanding than for many others.

I frequently find Crystal Light and other "water bottle portion" packet mixes to be too sweet or "syrupy" for my tastes, so I find myself more frequently using TrueLime, TrueOrange, and TrueGrapefruit with a single packet of artificial sweetener. It's still refreshing with a hint of sweet, but not as "heavy" for lack of a better word. They're available in 500-packet cases which make them very economical.

Yeah, she had to have meant temporarily. When I discussed with my nurse having V8 or spicy hot V8 a week out, she said that was fine as long as my system tolerated it, but once I moved to the pureed stage, she would prefer I get my vegetables that way, so that they're unprocessed, retain fiber, etc.

Very interesting... I think the post-op diets may be similarly variable as the pre-op diets. In your case, yogurt is part of the pureed stage, but in my post-op diet staging, yogurt was part of the full liquid phase. I've been eating yogurt and no-sugar-added applesauce since 2 days after surgery without issue. Go figure... I agree that jerky would not be good due to its texture and consistency. Still, regardless of what the "infraction" is, I don't think it's worth feeling guilt over. Perhaps I have a different perspective, in that while I fully intend to comply with the phases of the diet progression, there's also the safety net in that if you proceed too quickly or eat something you shouldn't, your body will let you know pretty darned quickly that you shouldn't have done that. It's like a child and a hot stove... once you burn yourself, you'll know not to touch it again. I've been lucky thus far, in that nothing I've yet ingested post-surgery, whether type of food or amount or pace, has triggered any nausea, let alone vomiting, dumping, etc. The only negative has been if I eat or drink something too quickly, I'll feel a bit of heartburn-like pressure. That's my signal to put on the brakes. Thus far it's passed in about 10-15 seconds. I presume that as I add more food types to my diet, I'm likely to encounter combinations/types that my system will not tolerate, but thus far (knock on wood) I've been lucky in that regard.

Better meat than carbs or sweets, IMO. Lean meats won't kill weight loss, and protein is important. EDIT: How the heck have you lost 88 pounds in 9 days?... or is your starting weight prior to surgery? I set my starting weight to my weight on day of surgery; is that not what we're supposed to do? Or is starting weight what we weighed when we made the decision to have the surgery?

The only people who know about my surgery are my immediate coworkers. I've not told anyone else: family, friends, nada... precisely for this very reason. People who may be well-intentioned but don't realize that we don't need the lecturing or coaching. I figure I'll let the results speak for themselves, and they can bring it up as they notice I've lost weight. At that point, they don't really have a leg to stand on, whereas talking about it before the fact or in the early stages leaves you open to recrimination at worst or "helping" at best. Note: That's my personal approach; others' will vary.

Why feel guilty? It's not like you went out and devoured an entire 16-inch pizza. Occasional lapses and eating TINY things that aren't in the prescribed diet phase isn't something to get twisted in knots over, IMO. I'm supposed to be on liquids until Monday when I can go to pureed foods. Let me tell you a secret: 2 days ago I was so hungry, I microwaved some turkey sausage, pureed it, added some V8 and pepper for flavoring, and it was absolutely delicious! There was no discomfort or side effects. Do I feel guilty? No. I'm just ahead of schedule by a few days. I'm keeping an eye on my caloric intake and I'm still sub-600 calories per day. The last 2 days I've gone out for 45-minute brisk walks, so my daily caloric net is negative. I've done plenty of things in my life that are worthy of self-flagellation, but eating a piece of chicken jerky wouldn't be one of them.

The preop diets (or lack thereof) appear to be all over the map. My Dr. explained that the point of my 2-week preop diet was shrinking the liver, not weight loss, so it was no fats and low to no carbs. As such, I was allowed unlimited steamed or raw non-starchy vegetables (no corn, peas, or lima beans). So my go-to was steamable packages of frozen vegetables, either cauliflower or broccoli + cauliflower, with salt, garlic, and pepper for flavor. The day before surgery was clear liquids only. If you cheat, just get back on the horse and don't beat yourself up over it... we're all human.

Per the title of the thread we're talking about the first post-operation visit, not the exploratory or fact-finding visits leading up to the decision.

I had my 1-week post-op appointment on Monday. No discussion as to weight loss, just pain, discomfort, healing of incisions, any digestive system issues, dealing with fluids, and going over transition to pureed foods this coming Monday. They weighed me as they do at every visit, but that was it. The fact that weight loss wasn't discussed doesn't surprise me, as this close to surgery individual weight loss is likely to be all over the map, and not necessarily indicative of sustained weight loss, which is the ultimate goal. It's not (IMO) the amount you lose in the first week or two that dictates the success or failure of the surgery.

Thanks for the feedback. Day 8 post-op. I'm down 9 pounds from last Monday. Appetite is a nonissue, however I do find myself wishing for something to actually *eat* rather than drink, but I've got another week on full liquids before I can proceed to pureed. I'm having no problems drinking copious amounts of liquids, so dehydration is not an issue. Surprisingly, even acidic drinks like Spicy Hot V8 are not causing me any discomfort, even if I drink them relatively quickly. I had my first post-op visit yesterday and we talked about V8 (since it's not on the list of approved liquids), and they said as a substitute for a meal or snack, that's fine but not to overdo it, and once I proceed to pureed foods, they prefer me to have actual blended vegetables for fibre rather than juices. In terms of calorie count, I'm at about 450-600 per day. So at this point, things are chugging along as hoped.

I had a sleeve gastrectomy on Monday and had to go through the approval process with Health Alliance. My hospital handled all of the paperwork and there were never any hitches or questions. Then again my hospital has a very good rep, so it may be as much a question of how thorough and diligent the personnel are at your hospital, as opposed to Health Alliance itself. When I first embarked on this journey late last year my doc told me up front that Health Alliance will want to see long-term weight loss during the pre-surgery program and no major weight gain at any point. They never gave me any specific numbers. I was originally scheduled for surgery in April, but of course that had to be canceled due to COVID. When elective surgeries opened back up in June, I did not have to get re-approved; everything was still in place. So no sage words of wisdom, just a singular data point.

No such instructions here. If I'm told I can't have any sugar *OR* any artificial sweeteners, I'll be a in a world of hurt...

I'm incredibly shocked how well things are going right now (knock on wood), given that things didn't start incredibly well. I had my sleeve done Monday morning. They tell me I was under just a bit over 4 hours. It was a robotic-assisted surgery. I'm not gunna lie, Monday afternoon through Tuesday afternoon when I was discharged were miserable. I had been suffering with severe constipation the last 2 days of my preop diet, and that continued through the recovery period, with the abdominal pressure and distension pushing back upstream, which made ridding my system of the excess gas from the surgery extremely difficult. I hadn't slept a wink the night before surgery, and only got about an hour Monday night after surgery, so by Tuesday afternoon I was running on empty. The gas proceeded to work it's way out of my system, and by mid-day yesterday I was back to some semblance of normal. Luckily I did not experience any gas being trapped in joints, under shoulder blades, etc. The only real side effects I'm feeling are soreness... more discomfort than pain I would say. They sent me home with Oxycodone, but I've avoided it, not wanting to go down that road, and luckily Tylenol has been sufficient. I just need to be careful when turning, twisting, picking things up, etc. I can't sleep on my sides, and sleeping on my back is not natural for me, so that's an issue for the moment, but that will resolve itself in time. I've had no problem keeping full liquids down. I've not even had the remotest urge to vomit even once, so I must be pacing myself well. My biggest problem is not wanting to eat. I'm forcing myself to get in at least 3 protein shakes per day, but that is more than sufficient for me right now. I don't feel the need to eat more than that. I am, however making sure that I get all my vitamins, and am drinking copious amounts of water/Crystal Light/etc. throughout the day. I went out for two 15-minute walks at a brisk pace today, and they were lovely. I'm down 6 pounds from Monday preop, so I'm quite pleased thus far... I hope this portends the future.

... but not for the reasons you might think. I questioned whether I should make this post in the preop section or here, but since it's my first post on the forum, it might as well serve as an introduction as well. My apologies in advance for the verbosity, as I have a tendency to ramble. At age 54, I've been morbidly obese since I was a teen. I have no personal frame of reference as to what it means to be fit or eat healthily. Sure, there's the cognitive recognition of what those concepts are and what they should mean, but nothing in my own life experiences that are relatable. I'm 6'1" and at my heaviest weighed 410. Five years ago I was diagnosed with high blood pressure, which medication has fortunately kept under control. In June of 2019, when I weighed 385, I was diagnosed with Type 2 diabetes. It was at this point, that I realized I actually needed to do something about losing weight beyond paying lip service. I've been feeling it more in my knees and ankles the last few years, and the notion that should I ever need a knee replacement or other major joint surgery, that I would likely be denied due to my weight wasn't an enticing prospect. I've made token efforts at points in my life to dieting and exercise, but nothing consistent; nothing that "stuck". So I spoke with my primary physician about bariatric surgery options and started down this road. After consultations and doing my own research, I decided on the sleeve gastrectomy. Over the several month "trial period" (not sure what the technical term is), meeting with dieticians, the surgeon, the psychologist, etc., my surgery was approved and scheduled for mid April of this year... well, you can guess what happened. Thanks to COVID-19 everything was put on hold. I freaked out a bit at that point. My work schedule is such that certain times of the year are no-go as far as being away for extended periods. What if my recovery takes longer than expected? What if due to the quarantine and stress eating (believe me, it's a thing), I gain weight again and they kick me out of the program? Having all this uncertainty on top of all the uncertainty going on in the world... being in a high-risk group for COVID, the business I work for having to completely retool how it does business, the financial market crash (at the time), the civil unrest in an election year, etc.,put my head in a not very happy place. I'm also stressed by the fact that I have no immediate support structure in the event things go wrong (either medically or if I slip with respect to eating habits). I have no family, no significant other, and I live alone. Under normal circumstances, I'm perfectly fine and dandy with all three of those things, but for the first time in my life, I'm faced with the prospect of not having support when I might need it. I've never head surgery in my life, outside of two colonoscopies, which all things considered, I've been blessed in that regard, but again I have no frame of reference of what to expect and what to do in the event things don't proceed as planned. I've avoided reading many of the threads here simply because I don't want to read about worst-case scenarios, as I know that my mind will tend to drift there, and I don't want the negatives of what *might* happen to dominate my thoughts right now. So back to the present... at the beginning of June things started to open back up in the state, at least as far as allowing elective surgeries to be back on the docket. I'm scheduled for surgery on July 13. The 14-day preop diet (which I started on June 29) that my hospital prescribes is more restrictive than many others. No meat in addition to no carbs or fats. It's a 1000-1150 calorie per day diet. As someone who normally would eat 3000-5000 calories per day, that's effectively a snack. So I'm in the middle of day 6... and everything is fine. And I have no idea why. I *SHOULD* be frothing at the mouth, hangry, threatening to eat the neighbor's cats, etc., but for some reason I'm not hungry at all, and this cognitively makes no sense to me based upon my "normal" eating habits. I've been actually eating less than 800 calories per day, not even up to the recommended 1000-1150 calories. Breakfast: protein shake (30g protein, 140-160 calories depending on brand) Morning snack: Yoplait light yogurt (90 calories) Lunch: 12-oz pouch of steamed vegetables with garlic and pepper (80-140 calories depending on what mix I use) Afternoon snack: apple slices (50-80 calories) Dinner: Another protein shake (140-160 calories) Evening snack: another yogurt (90 calories) I'll mix in sugar-free jello (5 calories) throughout the day or some celery sticks as needed, and if feeling peckish will do an extra pouch of steamed vegetables. What's freaking me out is why I'm not freaking out... if that makes any sense. It shouldn't be this easy, and I worrying that I ma be lulling myself into a false sense of security/complacency. Or is my brain somehow making this easier on me, as somewhere deep down in the depths of my subconscious I fundamentally realize that I *have* to make this work? I don't know; it's hard to convey. I was at 351 on Sunday prior to starting the diet (and yes, I pigged out on Saturday and Sunday knowing what was ahead) and am now down to 339 as of this morning, which is a good thing. Just trying to get a handle on why my brain is operating the way it is... At any rate, good to be aboard.