Pckeys

This is very often the result of the vagus nerve being over-stimulated after eating to limit. The vagus nerve runs very close to the sleeve and is responsible for all sorts of things from hiccups to the vomiting reflex, sneezing and so on. Can also cause a vasovagal response (fainting). Try cutting back slightly on the amount you eat and see if the symptoms lessen.

egg? chicken? beef? pork? fish? beans? cheese? yogurt? milk?.. you're gonna need to be a lot more specific.

Well said, I'd also argue that the OP has likely already reached this magical 19-24.99 range when factoring in the extra weight of any lose skin they may have. BMI is also a pretty poor metric, I think it's a little silly to be so stringently exacting with such an inaccurate measurement to begin with. If people want to be splitting hairs over whats a healthy body composition, you'd need a DEXA scan

That's Jason Fung and very different study and different metabolic pathways

All of the studies on this, many done from 2012 to as recently as feb this year, show a better preservation of REE with very low carb on calorie restriction (regardless of the calories) when compared to moderate/higher carb intake with equal calories. I'd also bet your nutritionist will spout the traditional rubbish for the conventional "SAD" guidelines (which are ludicrous)... the "permanently" lowered REE is a myth too If you're interested, do a search for REE preserved on VLCKD ... you'll get plenty of results.. read the studies, not the stupid magazine summaries that often miss the point entirely.... another interesting take-away with these studies is the lead time to adapt. The preservation of REE was best expressed with people who are already keto adapted (that is people whose bodies are already able to use ketones as a fuel). Dosnt take long. and of course, permanently elevated insulin levels with frequent meals throughout the day with carbs will always shut off fat burning... I dont understand why people dont get that. Insulin is the fat storing hormone

Although 800 cals isnt going to break the bank, you dont mention your protein intake. Getting too little protein can keep you feeling deprived/hungry all the time. I'd first start adding more protein (either with shakes or real food or combo of both) before worrying about upping calories/carbs. Other thing I'll say, and I'm sure to get flack over it, some interesting studies coming out suggesting a low calorie keto diet will preserve BMR (Basal Metabolic Rate) better than a higher carb intake of equal calories.

Jason Fung and Peter Attia and many others in the field have spoken extensively about this over the past few years. Both have used fasting as part of treatment options for 1000s of patients for metabolic diseases such as obesity/diabetes/kidney disease/alzheimers etc.. Patients that lost considerable weight over short periods of time DID NOT have lose skin when using longer fasts (3 days or more) as part of their strategy... this did not include "time restricted feeding" like 16/8 which is generally not long enough to reach needed levels of autophagy. I should add, once the nutrient sensing pathways for autophagy is understood, it is very easy to see why this happens.

I find it fascinating that those that shed comparable amounts of weight at that same rate as WLS patients by extended fasting (3 - 5 days or more) have NO lose skin. Jason Fung, Peter Attia, Satchin Panda ( the godfathers of true fasting) put this down to autophagy.

I'd also add that it's entirely possible the OP is carrying around some excess weight in lose skin which has nothing to do with health outcomes/BMI etc.. this can be as much as 15 - 30 pounds!

That is hilarious, I thought I was the only one who did that. I did that for years to keep my German Shepherd from getting at stuff... till I moved to a place that had a different door on the oven that he worked out how to open...

I think you should be talking to your surgeon about this, I'd be amazed if this was permitted, especially with all the gas in your abdomen.

and did you have the other issues checked? Hypoglycemia, Hypocalcemia ? B12 is only part of the picture. Numbness (especially in tongue and in calf) is almost certainly nerve related. Eating more is not going to solve that, if you really wanted to up your calories you could drink coconut cream for crying out loud... is this Dr your surgeon? sounds ridiculous to be suggesting stretching your pouch unless he's actually done an endoscopy to confirm there is an issue.

this has less to do with weight loss than it does a drop in baseline insulin levels. It happens exactly as you describe when some people start a keto diet too... when you drop high GI carbs, your baseline insulin drops, your kidneys start excreting sodium instead of holding onto it and your blood pressure drops. Since you're not eating anything at the moment, you're in the same early stages of psuedo ketosis If you return to carbs during/after weight loss, your high BP may well return (although weightloss will certainly help), but it is the high fasting insulin - which causes the kidneys to re-uptake sodium - which will contribute to hypertension. If you're on BP meds, you'll want to watch this over then ext 2 months.. many of us get off the meds within the first month of so.

Hypoglycemia, Hypocalcemia (low calcium levs) and Vitamin B deficiency (particularly B12) are the 3 most common causes of paresthesia of the tongue after weight loss surgery. If you haven't been strictly taking your vitamins (or even if you think you have) I'd have your levels checked as soon as possible.... if you dont get to the bottom of this you risk permanent nerve damage.

If this is only happening on Tuna/Chicken, then I'd probably drop these and try them again in a week or two. Many have different foods that give them issues at various stages post-op but seem fine later on. Mashed avocado does the exact same thing to me.

Bupropion has a half-life of up to 30 hours.. with that in mind you can probably go a day or two without a full dose until you are able to get them down again. I was able to do full pills 3 days post op... I couldn't do crushed pills at anytime, tasted bloody horrible. As noted above, should be fine with cutting them up into smaller pieces first.

sounds great... the 2 options that seem most cost effective are DHL eCommerce and DHL eCommerce Plus. One provides tracking to delivery point whereas the other provides tracking only on entry to destination country and is then handed over to that countries national postal service.

I'm aware you are not responsible for the shipping costs, I did not infer you were making them up. But the options are severely limited because your choice of carriers is limited. FedEx for international shipping is possibly the most expensive option I've ever seen (42 USD to deliver to Thailand for a product worth 32 USD with a weight of under 1 kg) is the cheapest option. DHL on the other hand have tiered rates of between 9.95 and 4.95 for the same product/weight on other sites. I'm not having a go at you, just pointing out that buying anything instore is just not possible at those rates to Thailand

Unfortunately, your shipping costs to places outside the US are absolutely ludicrous, more than I've seen anywhere else with any other online store. More often than not, shipping is much more than the product itself, this is a shame since there are many items my friends and I would be interested in trying.

Agree with all suggestions above but wanted to add this: Mountian Dew Zero uses acesulfame potassium, aspartame and sucralose as sweeteners. acesulfame potassium and sucralose have a massive effect on insulin at the pancreatic level (they dont raise blood sugar, but will act on your pancreas to raise insulin levs - which is worse than raising blood sugar levs).. it will be next to impossible to mobilize fat in that state.... crystal light is the same but uses them in less quantity when looking for something to replace it, find something that does NOT use either acesulfame potassium or sucralose.. otherwise you may as well just be eating sugar.

Welcome and good luck. Let us know how things go

Sounds great. It looks like you had a slightly lower BMI to start with (around 37/38? ) Might be worth remembering that those with a lower starting BMI tend to lose slower than others with a BMI above 40, so dont freak out if your rate of loss slows a little after the first 6 -12 weeks.

100g would be just about spot on for your height. You can do nitrogen tests to get an idea of your protein requirements. The idea is to be in barley positive nitrogen balance.

this is a brilliant breakdown of the recommendations. You can take these values and add 15%-20% for sleeve (since we absorb slightly less) > https://examine.com/nutrition/how-much-protein-do-you-need/

you said it "feels" like fat pain and not muscle or organ pain, I'm explaining that is not a thing. So...