learn2cook

Start by adding more non-starchy veggies to every meal. At least, this is my plan for further down the road. I think the temptation is to increase portions size across the plate when we're hungry, but if you have been getting your 60-80g Protein per day already, you don't need more. So keep the meat and starch or carb servings the same as your plan suggests but add a baby spinach salad or more cooked veg to your plate. It will fill you up but not cause your body to increase your set point the way processed food and simple carbs would.

I did a lot of walking from a couple weeks after surgery until I was down to about 100 pounds overweight. By then I was walking 6-8 miles 3 days a week, along with non-planned outings.
At about 100 pounds overweight I challenged myself to complete a C25K (Couch to 5K) program that gets you running 5k in 30 minutes in a month. Having completed this, I continued running, increasing distance until I was up to about 90 miles a week. I ultimately ran 5 marathons.
Of the two, I enjoyed running more. I did my running first thing in the mornings, when I could contemplate the day and listen to audio books. Very enjoyable stuff.
Walking and running burns about the same number of calories per mile.
I would recommend doing what you enjoy and can sustain. It's hard to sustain something you dislike.
Good luck,
Tek

yep - I think a lot of us how are a few years out can relate to this. I, too, thought I'd conquered all this. It's a lifelong battle.

Yes it’s a forever thing. And yes, I think there are behaviours we have to also adopt forever. Like tracking for you & weighing myself regularly for me. But it’s easy to get complacent, or life throws crap in our way, old eating habits return, health issues & medication changes, etc, can get in our way.
I’ve been a little complacent lately. Not sure why except weakening & testing things to see if I could be a little less narrow in my choices & how it would affect me. Learnt some things like I still can’t eat bread - hot cross bun sat like a ton weight & made me constipated - not Easter fun!
I’m a proponent of adopting the small changes approach. Easier to adopt & adapt to one or two adjustments at a time than diving in the deep end. The pouch reset is a fairy story. You can’t reset your pouch but you can reset your thinking. Won’t be easy but we’re used to the hard work around losing & maintaining our weight. You got this @MandoGetsSleeved.

Gastric bypass for GERD developed from a sleeve surgery is considered the gold standard of treatment. However, it is not 100% effective... A number of studies, like this one https://www.nature.com/articles/s41366-022-01072-9 show that up to 30% of people still report post-operative GERD symptoms to some degree after gastric bypass. You are not experiencing the impossible, nor are you imagining it. Unfortunately these occurrences have not been well studied, so it is good you are having an endoscopy to check things out. Hopefully it will show something that can be easily corrected!! In the meantime, elevating the head of your bed when you sleep can make a big difference. You can do this by elevating the actual mattress, or sleeping with a wedge pillow.
As an aside, when you developed GERD with the sleeve, did they do studies to prove GERD due to stomach acid reflux? I ask because some people with GERD actually have bile reflux, which can produce the same symptoms but has a very different treatment path. It is worth ensuring they've tested for bile reflux just to be sure they are treating the right condition.

I'm so glad you tried the muffins and liked them!! I really enjoyed mine, they kept well in the fridge and warmed up really well with a quick zap in the microwave.
Regarding the nutritional needs of a SADI patient. We don't really know, honestly. The SADI is too new to have some of the longer term studies that have been done on the sleeve, bypass, and DS. But it is commonly thought by most surgeons that the dietary needs of a SADI are more than with the bypass because SADI patients are thought to malabsorb more than a bypass patient. And their needs are most likely a little less than a traditional DS.
That said, I attended nutrition classes with all the different surgeries in one group, so we had to learn everybody's requirements!! Most good surgeons recommend that SADI patients follow the dietary requirements of a DS patient to be on the safe side. That means 80-120 grams of Protein, less than 50 TOTAL carbs while in the active weight loss phase (the dietician said "net carbs" is not an official measurement, but if you want to follow net carbs you'd need to keep under 30 net carbs since they get counted differently, most DS patients introduce a bit more complex carbs into their diets once they reach maintenance weight) and the fat grams recommended by the ASMBS is 60 grams of fat by 1 year post op.
However, SADI and DS patients malabsorb a good amount of fat, so veterans of the surgeries will tell you that you need more fat than that. I seem to feel best around 80-100 grams of fat a day, but there are veterans of the DS surgeries that eat closer to 150 grams, or whatever alleviates their Constipation and eases their symptoms of low fat like dry eyes and dry skin.
According to most studies, a DS patient only absorbs about 20-30% of the fat they consume, around 60% of the protein they consume, 60-80% of the complex carbs, and every single calorie of simple carbs!! That's why simple carbs are so important to restrict post surgery (besides the digestive drama), you can eat your way around any surgery with simple carbs... And this is why counting calories is pretty useless for DS and SADI patients.
We don't yet know exactly what the percentage of absorptions is for SADI patients as they haven't done a breakdown study (as far as I know) but it is safe to assume SADI patients absorb a little more fat and protein than a traditional DS patient would. The best way to find your own perfect macros post surgery IMO is to aim for 80-120 grams of protein and then watch your protein labs. They will tell you if you need more protein or if you can back off a little. And for me at least, I find my skin, hair and eyes are highly sensitive to when I have too little fat in my diet.

But I knew I needed to do this for me, to save my life. So I guess to answer your question I knew all the risks, the rare complications the benefits that WLS entails. I just gave all my fears to a higher power and took the biggest step forward I have ever taken in my life!! Fortunately, I have had zero issues and have followed the Drs orders faithfully. It is the answer to my prayers, the help I needed. Now at 54 I am healthier than I have ever been!

My surgery was a “virgin” surgery. I did my research and felt the SIPS/SADI was the best surgery for me and my health. It was not covered by my insurance (it was around 16k) it is so frustrating that insurance won’t cover this surgery that will literally resolve T2D but will pay for metformin, insulin and dialysis.

I hope talking to them about it will help! It's funny because everyone knows right now I can barely eat anything, but they all catch themselves offering me food because it's "polite." I'm eating dessert, want some? I made this big meal full of stuff you can't even look at right now, can I get you a plate? And then I see it on their faces, it's like oh, wait...
But since you're dealing with regain, it's good that you are figuring out your triggers and asking others to help you avoid them now so you can have the best chance for success the second time around.

I agree with NickelChip, your PCP not knowing about the surgery is not a big deal IMO. What is most important is that YOU understand your surgery and whatever anatomy you end up with, and that you are able to communicate that to emergency responders and ER doctors in an emergency. Everyone close to me knows what surgery I've had done, knows the technical term for it, and it is in my phone's health info that emergency responders can access. A lot of SADI and DS patients carry a card illustration of their surgery in their wallets or on their phones.
When I was considering the SADI and two surgeons recommended I do the DS instead I had reservations. I live in North Carolina and we have some really stellar bariatric surgeons here in Raleigh. But I plan on moving back to New Zealand in the next few years and DS surgery is really rare there, there are only 2 surgeons I know of in the country who can perform it and they are both in Auckland. My surgeon here told me as long as I planned on having the first few years locally here in Raleigh, and as long as there was one surgeon that could be consulted about my care in the area I move to, I should be fine with the DS... The same applies to the SADI. What we tend to forget is that people have surgery on their small intestines for a variety of reasons besides bariatric surgery. Cancer, Crohn's, etc... Many people have designer insides and while not every gastro doc is trained to do a DS or SADI, they have the technical skill to find a surgeon to consult with about your surgery should they need it.
In terms of your PCP what she most needs to know is that it is vital to order a FULL panel of bariatric labs for you at least once a year, as well as at any point if you start having symptoms of a Vitamin deficiency or Protein deficiency. She'll also need to watch your Iron levels. These are things a PCP can do. She also needs to be in good communication with your surgeon if she has any questions. Doctors act like they can't talk to each other, but they can. I have an autoimmune GI condition that causes ulcerations sometimes (like Crohn's) and my bariatric surgeon actually called and consulted with my GI doctor to ensure they were on the same page about the surgery and to ensure it was a safe surgical option for me. That made me feel SO well cared for!
My PCP has a sister who had the sleeve done so she's familiar with the bariatric surgery options. She is well read, researches what she needs to, knows how to consult when she needs more info, and trusts me to tell her what I need when I need it. For me, that's the perfect PCP. I don't need her to understand the complexities of my surgery. I just need her to know when she's out of her depth and needs to refer out to a GI doctor, my bariatric surgeon, or the ER.

I take a lot of vitamins, more than that list. My advice is to buy these containers, enough for a month, and dose out all your vitamins for the month. https://www.amazon.com/gp/product/B08QR78YP3/
I spend about $200 every other month. You could do it a bit cheaper depending on the brands you buy (for instance, Citracal Petites are more cost effective than the bariatric calcium chews and both are Calcium citrate) and which ones you take. I take a lot because I had some deficiencies pre-op. But they all fit in those cases! I just grab my little container for the day and carry it around with me. I set alarms to remind me to take them. I put my meds in with the vitamins. The way I look at it, my junk food budget is now my Vitamin budget, and I feel a lot better taking those vitamins than I ever did eating junk food! LOL

Hi ShoppGirl, I replied to you in the DS forum. You'll probably find the answers you need in the Facebook group I'm in. It says it is for the Duodenal Switch, but we also have plenty of SADI patients in the group and we have veterans of both surgeries in there. https://www.facebook.com/groups/1799552573392212 I highly suggest joining that group and posting your questions.
Regarding gas, yes, the SADI can have gas issues if you eat too many simple carbs. And eating too much junk food may make your bathroom visits rather unpleasant. I had the DS done about 4.5 months ago and I don't usually have any gas issues and my bathroom visits are pretty normal except my stools are pale colored now due to the fat malabsorption (perfectly normal). But I stay below 50 total carbs per day and eat about 120 grams of Protein a day and about 100 grams of fat. With the SADI or DS surgery you are more focused on your macros than calories because we malabsorb a portion of everything but simple carbs.
If you keep your carbs low after the SADI you will lose weight better and maintain weight better...and you should minimize the side effects. You'd also want to stay away from sugar alcohols and you might find that some foods digest differently, like lettuce or other leafy greens. Usually most SADI or DS patients learn within the first year what their trigger foods are and learn to eat them at home at night or not at all.

there have been people on here who had the SADI (some might still be on here). It's sort of an altered, new-fangled version of the DS. There would be more potential complications with that than with the RNY or VSG, because it's a more complicated surgery, but on the other hand, I think that like the others, major complications aren't that common. And like with all the WLS surgeries, you'll hear about horror stories because people are much more likely to post when they have problems than if everything is hunky-dory. It's because they're usually looking for support or advice.
one thing to think about is that regular (PCP) physicians are all pretty familiar with the RNY and sleeve since they're so common, but you might come across some who aren't familiar with the SADI - so if you have issues in the future, you MAY have to see a specialist, but then that might not be a big deal for you. On the plus side, people tend to lose more weight (and maintain their loss more easily) with that one than the sleeve and RNY, so there's that.

Thanks @MiniBypassDude I didn’t even know what a MBP was supposed to be and I was pleasantly surprised! My favorite parts of your posts were “start loving yourself,” “forgive yourself,” and “you are worth it.” Honestly this WLS journey really really teaches those important lessons. Thank you for giving back important information and being honest. Congratulations on your healthier life!

Great suggestions above. I’d suggest taking an electrolyte drink with you or sachets or tabs you can add to your Water when you top it up. It will give you extra boosts of energy. Just be warned they can be sweet so dilute them by adding extra water to the mix.
Enjoy the hike - how lovely to share in your daughter’s field trip.

I agree with ShoppGirl. That sounds unrelated to your surgery.

I’m wondering if it really has anything to do with the surgery at all. My primary dr told me that immediately post surgery if I had issues that I would call the bariatric dr and ask if I should see them or go to my family dr. Maybe try giving them a call and see if it sounds like something of concern.

I looked at my journal from my 6th month time. My weight loss slowed significantly. I kept loosing but I was lucky if it was 4 lbs every other month. Stalls and plateaus were more common than actual WL. I just kept to my original plan and weight kept coming off even past the 2year mark. Instead of my scale obsession, I started measuring inches/centimeters and thrifting highly structured clothing made out of thick denim and leather to see my progress. A stiff pair of jeans with no stretch can show true WL because they get too big. I find they keep me honest with myself in maintenance too ; j

I haven't been told this personally but it's something I've heard can happen. I would suggest trying to increase calories without increasing volume if you can't eat more. You could add a small handful of dry roasted or raw nuts, which are very calorie dense. Or choose low fat instead of non fat dairy products. Even just adding a Protein Shake in between Breakfast and lunch or before bed could give you another 200 calories without making you feel too full.

I read the whole thing. That was great sharing, I felt like I was there! Honestly you should think about writing a how to book of your adventures. This was/is a great chapter of success!

If you find food getting stuck at the 4 month mark then reach out to your doctor. There could be something wrong going on. Before that point keep taking small bites, chewing thoroughly, and using sauces to help the slide. If you had GERD before surgery it takes time to heal. If you have GERD afterwards talk with your doctor sooner, like today.

Yes, I had back pain due to reasons the above posters said. I went to yoga for a year to help with the transition. I needed to tuck my but under my spine more and drop my shoulders down and back. I noticed the swing of my arms and legs changed. All of it was building new muscles and increasing range of motion. The floppy skin was even moving to a different tempo than the rest of me and I had to learn how to accommodate that!

Side note; when I had Covid they x-rayed my lungs to check for pneumonia. They then told me I have significant arthritis in my spine. The pain there reduced significantly with stretching and strengthening exercises.

If you find food getting stuck at the 4 month mark then reach out to your doctor. There could be something wrong going on. Before that point keep taking small bites, chewing thoroughly, and using sauces to help the slide. If you had GERD before surgery it takes time to heal. If you have GERD afterwards talk with your doctor sooner, like today.

Yes, I had back pain due to reasons the above posters said. I went to yoga for a year to help with the transition. I needed to tuck my but under my spine more and drop my shoulders down and back. I noticed the swing of my arms and legs changed. All of it was building new muscles and increasing range of motion. The floppy skin was even moving to a different tempo than the rest of me and I had to learn how to accommodate that!

Side note; when I had Covid they x-rayed my lungs to check for pneumonia. They then told me I have significant arthritis in my spine. The pain there reduced significantly with stretching and strengthening exercises.

I didn't dare give myself goals. I had my heart broken too many times. Every sure fire diet got my hopes up and then it failed and I crashed.
I had hopes of loosing 70lbs because I had done this before three times.
When I began getting NSV's these really boosted me. I had rid myself of diabetes, blood pressure and Water retention. These meant so much more than the numbers on the scales.
I doubled my expectations and I love my saggy skinned old woman body now. For the first time since I was six years old, I fit in this world.