Zom B

38 minutes ago, Latanya said:

I'm struggling with my BM's as well. My nurse says I should be going every three days.

Hi Latanya,

What was your surgery type and when did you have it?

Every 3 days? Are you going more or less? Today alone I’ve gone 3 times and they’ve been crampy and uncomfortable.

Rough couple of days. STILL dumping😞Starting to feel thirsty, not quite dehydrated. I follow this diet in my binder, plus the meds and Vitamins. Yet every morning I dump.

Tonight....I dumped while contemplating dinner. I’ve only had omeprazole, 2 calcium’s, 3 oz of chili w/beans, and a premium Protein vanilla today plus about 29 oz of Water. I’m so frustrated. I don’t cheat and I’m mindful and I haven’t rushed. This is starting to get to me. I’m hungry, yet not. While my physical pains are healing, I worry I’m not mentally capable to handle this bathroom + food anxiety. I have to go back to work in a week and a half where 45 teachers share 3 bathrooms and my usage is frequent and urgent!
I felt pretty upset at dinner time so I made shrimp scampi with no fat, no carb brummel and brown margarine and garlic cloves. Am I in for some garlic pain? I haven’t had a veggie besides mashed potato and those were very bland and low fat. Now I’m just sniveling. Help and insight appreciated.

On 8/30/2020 at 6:34 AM, Addicted said:

My. first slip was pizza the first week post op. Adding spicy Condiments followed. I was arrogant thinking that I could handle it. I may have thought I was getting away with it but I started to have really bad reflux and had stopped my reflux med. I also had that terrible feeling you experienced from overeating. When I had my follow up appointment, I was told that it was possible that I had damage with the spicy foods and not sticking to my full liquid diet.

I have digestive issues anyway so ignoring the "rules" made no sense. My brain now talks to me when I think I can have something that does not comply with my soft foods diet. I analyze everything and find that so much it would seem like I can eat is a "no". It's like, "you can have fruits but it can't have skin or seeds", "you can have vegetables but they have to be cooked, soft and watch out of gas producing vegetables. You can have Beans though." go figure. I no longer scoff at the rules though because I only have another week or two before I go on regular foods. I made it this far, why blow it.

I would think that we all have pushed the limits at some point and lived to regret it. Don't be discouraged by the mistakes you make. You are awesome!

“I would think that we all have pushed the limits at some point and lived to regret it. Don't be discouraged by the mistakes you make. You are awesome”

An awesome mindset! 💜🙌🏻

On 9/14/2020 at 4:39 AM, xFatBoy007 said:

You are on the right track! Trust the process and continue doing what you are doing. See if you can fit in more Protein in for more energy. I’m taking in about 78-80g of Protein a day and my energy issue went away. I had surgery on 8/26 also with a cpap. My weight has some what stalled but I’m trusting the process and putting my head down to continue moving forward. Hope things get better for you soon😊

thanks FB007. What Proteins are you enjoying? I’ve tried deli turkey, eggs (scram and boiled), chili, Soup and shakes. I tried tuna and it didn’t go well.

The only thing that I look forward to is the chili and I think that may be where my disconnect is. The proteins are old hat.

On 8/26/2020 at 4:55 PM, MoominMan said:

😮 How odd that my surgeon reckons it's fine to have soft (non pureed) foods now. He even said things like curry are okay. Maybe I should play it safe and follow other, more strict, guidelines.

Could you be prepared for those cravings and tailor some “cheat” foods that aren’t fried or as processed? There are lightly breaded dinosaur nuggets and other chicken items that have low carb or even veggie crust. Freeze some thin beef patties with tasty seasoning to grill when you want that burger and instead of bun, try lettuce or slices of Tomato. I know about those cravings. I’m a vivid dreamer and I have dreamt about grilled cheese, steak, toast and preserves, cheddar cheese cubes, pancakes. You name it, I have woken up groaning about it. I know it’s a mental game. Mental cravings/withdrawal . I get my Protein and Water in so this is old habits and possibly stress talking in my head. Don’t berate yourself. Make a plan and do your best to stick to it.

1 hour ago, RickM said:

"Gold standard" is a marketing term used in selling a procedure (cynically, it has been said that it applies to the surgeons themselves, as that is where they make the most "gold") and as such is basically meaningless.

Here in the States, there are four mainstream procedures that are routinely performed, and approved by the ASMBS and the US insurance industry - lap bands, RNY, VSG and DS.

The bands are falling out of favor owing to their high longterm complication rate and low effectiveness, but there is still a lot of marketing push for them by their manufacturers.

The RNY has been around for forty years or so, based upon procedures that had been first developed 100 years before to treat gastric cancer and other gastric maladies (Billroth II). It was an improvement over the existing malabsorptive procedures such as the JIB (jejuno ileal bypass) but it still had the longstanding tradeoffs of its basic configuration - bile reflux, marginal ulcers (aka, the "NSAID problem"), dumping syndrome and moderate nutritional deficiencies. Bile reflux has largely been eliminated in the RNY WLS procedure via tailored limb lengths, but the others remain as common side effects and are largely controlled by diet or medication restrictions and supplements. It is overall a very good and mature procedure that works well with tolerable side effects, but it is far from perfect, which is why there is been an ongoing effort in the industry to find a replacement (this is how progress is made.)

The duodenal switch (DS) was developed in the mid to late 1980's, which combined a moderate level of malabsorption with a moderate level of restriction (compared to the RNY which is more highly restrictive and minimally malabsorptive) that takes care of the RNY's problems with bile reflux, dumping/reactive hypoglycemia and marginal ulcers. In exchange, it is more technically challenging for the surgeon (which is why most don't offer it) and is a little more fussy on its' supplement regimen. On the plus side, it is more effective in treating diabetes, somewhat more effective on overall average weight loss, and much better at resisting regain. It should certainly be on the radar for anyone in the high BMI ranges and/or with a history of yoyo dieting. The main thing that has held the DS back from being more popular is its complexity, which often doesn't fit in with either surgeon's skill sets or business models (can't do as many procedures in a day.)

The VSG came out of the DS as it is the first phase when the DS is done in two steps. Typically the VSG stomach is made smaller, about half the size, than the DS sleeve. It overall yields similar weight loss and regain characteristics to the RNY but without the dumping/reactive hypoglycemia or marginal ulcer predispositions and is also quicker and easier for the surgeon to perform, which is why it has been gaining popularity. The primary downside is the predisposition toward acid reflux owing to the stomach volume being reduced much more than the acid producing potential, to which the body doesn't always adapt.

Nothing is perfect, and they all have a place for different circumstances. Getting beyond marketing fluff, hey are all the "gold standard" when used appropriately.

The next new thing that is working its way through the industry is the SIPS/SADI (sometimes called the "loop" or simplified DS) that shows some good promise of having effectiveness somewhere between the RNY and the DS, with surgical complexity on the order of the RNY (it is being promoted as being "almost as good as the DS" while being more "accessible" - simpler so more surgeons can do it. It is still usually considered by most insurance to be investigational, and has yet to gain approval by the ASMBS, but there's a good chance that it may become that RNY replacement that the industry has been looking for.

Wow. Thank you for taking the time. An amazing read. I’m in Seattle and wanted a sleeve but my acid test and gerd numbers were too high according to my team. I informed them that I only began experiencing heartburn/reflux after my abdomen got larger and tight plus I have a small frame, 5’0. They refused, it was bypass or nothing. If I can get my belated dumping under control I believe I will be on track to hit my goals and can start exercising soon. That is, when the West Coast smoke dissipates. Thanks Rick

24 minutes ago, tarotcardreader said:

I have the same concerns about work im thinking maybe preemptive med every morning

I’m equally scared of the other way. When I was on liquids only for 2 wks I had only 2 BM’s. Upside was after them my weigh-ins felt accomplished 😂

On 12/19/2019 at 9:32 AM, RickM said:

In general, we should follow our program's instructions; however, if you are being held up by scheduling issues rather than their progression calendar or individual problems, then I agree with livdacovich and give them a call - 2 months on purees is insane (as a general rule - some rare individual circumstances may require it.) We were on a puree diet, including eggs, in the hospital, so there is a huge YMMV thing going on between programs - some will allow steak at the same time that others are still on liquids.

This is one of the things about these different programs that is really interesting (and a bit concerning) to me - are the ones with slow progressions doing so from experience (they tried going faster, but their patients had problems) or inexperience ("that's the way we've always done it..." and they never bothered trying anything else)? Is there something about the techniques that a surgeon uses that requires a slower progression, or conversely allows for more rapid progression? As patients here, we don't really know. There are lots of stories and urban legends on the internet about someone's sister-in-law knew someone who died from something they ate ahead of time (and some doctors or staff may repeat them to encourage compliance.) I have noted that several of the legacy DS/VSG programs are similarly quick progressing to what I went through - is there a difference between a sleeved stomach and a pouch in that regard (I don't know if my program differs any in that regard with the RNY as they rarely do them anymore.)?

Give your doc's office a call when you would normally be scheduled to advance and ask about it.

Good luck

Hey Rick, do you happen to know why your Dr/program rarely does RNY any more? I’m on the West coast and my team calls it “the golden standard” But I do wonder if that’s because trends tend to start on the East coast and slowly make their way up ver here.

I was August 20th for g. bypass. Also have a CPAP. My loss is good but I’m also living off like 350-500 cal, 50 G Protein and about 40oz Water daily. I can’t fit much more in me and I’m so tired I don’t have the energy to care much.

I go back to work soon and I’m scared.

I’m 3 weeks out and am on the purée stage. Have followed it to a T and still dump occasionally. Although, for me, it is delayed. Usually in the morn, before my omeprazole or any foods/fluids. I get gurgles, chills and have to hobble quickly to the loo. Sometimes it lasts an hour sometimes 10 mins. I usually end up feeling queasy from the chills. I really hope my body acclimates as it is not something I can easily avoid when I’m back to work.