learn2cook

Like others above, check with your team. I was to aim for 20 macros of Protein for each of three meals. I couldn’t do it but that was the goal. I ended up 20 for Breakfast, 10 lunch, 10 around 3pm, 10 around 5ish, and 10 in the evening one hour before bed. In my efforts to curb nighttime snacking habits, I started then (and still maintain now) 50% or more of my daily food should be consumed by lunchtime. It makes me go to sleep earlier and wake up refreshed, and mostly banished the nighttime munchies. Obviously this won’t work for everyone. I was never a morning person, nor a breakfast eater before surgery. You’re doing great, keep up the good work!

I am two months out and each program is very different. Follow the nutritionist. I had a two week stall and you just keep doing what they tell you. My Protein is 60-80 and Water is 64-100. I try to get closer to 100 because that is when I see more weight come off. Everyone is different trust the process! Congrats to you!

The PPI won’t cause hunger. It reduces the acid in your tummy. You’re ahead of the game if you can differentiate between head & real hunger. Yay! Those distraction activities will help when you are experiencing head hunger. If you feel hungry after you’ve eaten, that’s head hunger too. Try a warm drink instead of a shake. They’re a Meal Replacement not a snack. Many are advised to wait at least three or four hours between eating & only three meals a day & maybe a snack.
I still have times I can feel liquids go down. It’s a bit weird at first but now it’s just one of those things like my vey noisy, rumbling, grumbling tummy.
Your experience last night sounds like late stage dumping not the foamies. The foamies (frothy, thick saliva & bringing up what you ate that was stuck or too coarse or too much) occurs pretty soon after you’ve eaten the offending food. Dumping symptoms can include chills, weakness, light headedness, nausea, bloating, heart palpitations & vomiting &/or diarrhoea. Dumping usually occurs if you eat foods that are too fatty, have too much sugar. Even dairy can cause it. It occurs when these foods go through your tummy to your intestines very quickly (dumps through your system). About 40% of bypass patients can experience dumping. Once you work out what causes yours, you can avoid those foods. Some say in time they work out how much of those foods they can eat without experiencing dumping. Worth a conversation with your team to diagnose & management.

Liquids won’t fill you in the same way as more solid food simply because they pass through your tummy more quickly.
As for your hunger, yes there are some people who continue to feel hungry after surgery. You just have to work out if it’s real hunger or head hunger. If you’ve recently eaten you really would be hungry. If you are hungry for a specific food, taste or texture it’s not real hunger. If your tummy is rumbling (hunger pangs) that’s not real hunger either (just your digestive system working). Are you on a PPI? Tummy acid can make you think you’re hungry. The surgery is hard on us emotionally. Plus we experience hormonal flushes which can mess with us emotionally too. Many of us used food to comfort & soothe our self during emotional turmoil but you can’t. And of course you always want the things you can’t have more. It’s not easy to work all this out. It will take time & that’s okay. If you feel hungry, try distracting yourself. Play a game, go for a short walk, Water your plants, craft, read a book, ring a friend or family member, check your social media or this forum, etc.
Are you just sipping your liquids & leaving a couple of minutes between sips? Try a warm drink. Many of us found a warm drink like a green or herbal tea easier to tolerate as plain water can almost seem heavy in our tummy & for some cold liquids cramp our tummy.

I so agree with the above comment especially the “recovering Type 2 diabetic “ part. Anyone of us past 2 years out is there with you, I know I am. I definitely partook of the holiday cheer this year and I’m so “puffy” right now.

I’m concentrating on wellness for the new year. I do look for inflammatory foods that trip me up and eliminate them from my orbit for a while to get back to evenness. (Don’t know what else to call it?)

Aside from food and movement changes, I struggle with stress. I noticed if I journal, walk, talk to a friend, goof off on a guitar, extra Water weight just falls off. Sometimes I need an extra mineral or Vitamin (Magnesium and Vitamin D I’m looking at you.) I don’t know if any of this helps, but keep trying. There even could be a metabolic reason behind the weight creep. It doesn’t hurt to ask a trusted medical professional. You are not alone in this.

Oh, I’m sorry @LindsayT.
Is yours one of the genetic porphyrias? They say it’s one of those disease/syndromes that many have but don’t know. At least you do now know what’s been behind your symptoms all these years, as unpleasant as it is. Hope the treatments they’re offering help ease your symptoms. Do they think stem cells may help?
I first heard about it watching Buffy the Vampire Slayer lol! It’s known as the vampire’s disease & from where they believe the myth of vampires began.

I wasn’t required to track. I sort of did initially on random days for own curiosity. I did keep to the portion sizes I was given. I still do random checks to keep me on track & ensure I haven’t let things slide especially with new foods or recipes. I check Protein, sugars, calories but don’t keep a formal record. I keep a mental tally of my daily protein intake but only because I have a protein malabsorption issue.
It works for me & that is the key: finding out what works for you. If that’s tracking great. If it’s random tracking/monitoring or it’s none at all that’s great too. As long as it allows you to maintain, is manageable & not consuming you, all is good.
I put on a good 2kgs/5lbs at the two year mark but didn’t know why. We worked out I wasn’t absorbing my HRT after my gall removal (why I don’t absorb protein too). Was put on a HRT patch & I slowly lost half of it over about 6 months again without changing what I ate or my activity. I’ve pretty much lost another kilo and now, nearing my 5 year mark, am pretty much what I weighed at my initial stabilised weight depending on the day.
I should add I am very careful with what I eat & how much I eat. Still eat slowly. Still take small bites. Still eat to a routine most of the time around what & when I eat (I’m a clock watcher for my meals & snacks). Still very conscious of whether I am really hungry or just head hungry. Still very conscious of eating what I need not just how much or what I want to eat.

nine years later, and I still track my food every day.

Youre the main reason of my post, i was looking for people who have similar thoughts to mine and I wanted to know if I was overreacting since i'm sooooo anxious about everything. Reading you made my choice of the surgery a little easier and it helped me to believe that maybe it is actually what I need. The way I see it is that if I decide to change my lifestyle without the surgery, I'll have to make sacrifices but with the risks of falling back in my old habits. On the other hand, the surgery is my way to force myself to change my lifestyle because I know that my journey will make me not wanna go back to the past. Sometimes I need to put myself in situations to make me do things.. I don't know if that makes sense. But either way, i'll have to change my habits so I just have to decide if i want to do it with the surgery and have kind of a purpose of not making it worthless or without the surgery... Thank you so much for sharing your story..

k...im gonna go out on a limb here and assert that the decision to have surgery is yours and yours alone.
if you want to have surgery for health reasons, cool, go for it. if u want to have it for vanity reasons, cool go for it. if you want to have it for job opportunities, cool go for it,
surgery is not reserved for those that "deserve it", nor only to those that "really need it". if you have the means and desire and the mental stability, then by all means, have it done.
its your body, you decide what you get to do with it. dont let anyone guilt or shame you one way or the other.
with that said, you sound/read like you still have some thinking to do about which way to go? nothing wrong with that. it took me an extra year and 2 back-outs from scheduled surgery dates for me to eventually decide to get mine done.
you are ready when you're ready (or maybe you may decide its not for u at all). there doesn't seem to be any extenuating circumstances that requires an immediate decision in your post. take ur time, there is no rush.
good luck! ❤️

Hello
Just on this here - surgery is a very personal decision for each person, and my reasons for surgery may not match yours, and that is okay! Surgery would not be recommended or even proceeded with by a surgeon unless it were something that would benefit your health, regardless as to whether or not you're happy with yourself (and it is amazing that you are, we should all love ourselves regardless of our weight!).
I'd say that you are better off talking to your GP/surgeon again, be open and honest about your concerns and get some professional advice.

Surgery is a big step and it is a life-changing decision, so you need to be sure that it is what you want to do.
I am due to have my surgery in May this year, and it is something I used to be so against 2 years ago! But, I know that this is what I need to do for my health and my wellbeing.

If you like how you look, feel good, have good mobility, and have no health issues then there's no reason to get this kind of surgery. Doing it because you know you'll gain weight i the future isn't the right reason to do it. Maybe see a nutritionist about getting on a healthy eating plan, and move your body more. Walk, workout, go hiking, swim, do things that move your body. That will help. Pay attention to what you're eating and drinking. Consume 1800 - 2000 calories per day, prioritize Protein first, then veggies, then carbs. Reduce sugar and salt. Limit alcoholic drinks. These are all things that will help you to be healthier, drop a little weight, and ensure health as the years go on. Surgery is a last resort for those who have serious weight and health issues and have failed at everything else.

1). there are a lot more people who don't reach goal than there are who lose too much weight. Plus if you feel like you're losing too much weight, you can always increase your calories to put the brakes on it - or to start gaining. So I wouldn't worry about this one AT ALL.
2). fewer than 5% of people are able to lose weight and keep it off. You may be one of the lucky ones who can do that - and if so, and you're afraid of the surgery, it's not too late to pull out and try it on your own. I wasn't one of the lucky ones. I spent my first 55 years as overweight or obese. I gained and lost weight a million times and could never keep it off until I had weight loss surgery.
3). Hair loss, if you experience it (and not everyone does), is temporary. I lost hair during months 5-8 post-surgery (so...for three months). It wasn't much, though. I could tell because there were more hairs in my combs and brushes, but I really didn't notice it at all when looking in the mirror, so I'm sure no one else noticed it. Plus hair loss after surgery is more like shedding - not huge clumps of loss like one might have after chemo. For a lot of people, they're the only ones who notice it. It's usually more loss of volume than noticeable "bald spots" - and it does grow back.
to me, the risk of losing some hair temporarily vs. being morbidly obese for the rest of my life was a no-brainer. But you may think and decide differently for yourself - and there's nothing wrong with that. If you're not mentally ready for this yet, or want to try on your own to lose weight, then there's nothing wrong with canceling or postponing your surgery. You wouldn't be the first..or last.

I had the Duodenal Switch, which is different than the most common two surgeries being discussed here. I picked it because I had type 2 diabetes, high blood pressure, high cholesterol and triglycerides, sleep apnea, etc... I also picked it because I knew a purely restrictive surgery wouldn't work for me. Portion has never been my issue. Pre-op I was eating about 1000-1200 calories a day, for about 10 years, and did nothing but steadily gain weight. My surgeon said it was obvious I have a metabolic disorder, so I needed a metabolically strong surgery. I also didn't want to risk gaining weight back and the DS has the lowest rate of regain. But as a trade off it can cause more Vitamin and Protein deficiencies if not managed well and the diet is a bit different than the others post op because of our malabsorption. However, diabetes was my biggest concern and the DS puts about 95% of T2 cases in remission, and most stay that way.
Post op my blood sugar dropped to 82 within 24 hours of surgery and my high blood pressure normalized, so they took me off of my diabetes meds and blood pressure meds. I'm 3 months out and my a1c is 4.8 without medication!! My blood pressure continues to be normal without meds. My cholesterol and triglycerides are also normal without medication, which hasn't happened in decades!
All this to say---consult with a surgeon who offers ALL the surgeries if you can find one in your area. Talk to them about your reasons for wanting bariatric surgery and consider your options carefully. The sleeve surgery is amazing for a number of people, but it isn't right for everyone. The bypass is a fantastic surgery for certain patients, but again, it isn't for everyone. And the DS is a powerful surgery, but it definitely has a specific patient profile. All are great surgeries, but not all of them will be the best surgery for you. Only you and your surgeon can decide that. And don't be afraid to get a second opinion. I went to two surgeons before deciding on one (though both recommended the same surgery). I needed that extra reassurance I was picking the right surgeon and the right surgery. I'm so glad I did this surgery, I just wish it had been an option available to me when I was younger.❤️

Day and night 4.
I'm getting better at getting in and out of bed. As long as I am taking my time and remembering to bring the foot of the bed back down, it's almost painless. I've started getting back in bed by doing the reverse and it does hurt.
I haven't pooped since a couple days before my surgery, so I asked for stool softners twice. Morning of day 5 and still haven't, so will ask for more.
Adjusting position on the bed is challenging. By using both feet and my elbows and being careful not to use my stomach, I can move up, down, left, or right without pain. I can't sit up more or even pull the hair out from behind me without hurting though. If I want to add a pillow so I can sit up straighter to eat, I have to get up.
During the night the bra compression garment started cutting in painfully. I also have a couple spots that have begun to itch.

Choosing a surgeon and Days 1-3
It's Sunday night and my surgery was Friday morning (1/12/24). My gastric sleeve was 3/24/23. I lost almost half the weight before my Gastric Sleeve surgery.
I chose to have my surgery in Tijuana, Mexico because of the cost and I have a friend who lives about 45 minutes away in Mexico and my father lives about 2 hours away. I started my research reading about Medical Tourism in general to get advice on what to look for and what questions to ask. I started my search with Realself.com and chose surgeons with 4+ stars,10 or more years experience, and who said they were part of the American Board of Plastic Surgeons or the American or International Societies of Aestetic Plastic Surgeons. I read all the reviews I could find, noting all the bad things said, and verified they were actually listed on the board or society sites. One of them wasn't. I made virtual appointments with 3 and chose Dr. Rodolfo Casillo Calderon, who is listed on both the American and International Societies. He originally told me I had to wait until a year after my surgery, but I reached my goal and my weight stabilized in early October so I was able to move the date up.
I uploaded a bunch of pictures to myTouchMD and when we did our call he explained in detail what he would do, complete with drawings on my pictures. He explained possible problems and what could be included in my package and that I would have a patient coordinator to walk me through it and answer questions. I had told him I wanted a 360, breast lift with Gummy implants, and a BBL (i've always had dents in my butt and got called board butt in high school). He told me he didn't think I had enough fat in the area he was working for a BBL, especially since some of the transferred fat would die, but he would see what he could do. I asked for the best medicine package and told them I didn't need transportation to/from the airport since my dad and friend would provide that). I also told him in the future, I wanted my inner thighs, maybe my arms if I could get a good price at the same time and a face-lift. He told me that was too much to do in one surgery, that the face-lift would be one and the thighs and arms another, and they had to be at least 6 months apart.
He sent me a quote for the 360, breast lift with implants and Lipo and said it included the mons reduction and lift but not the BBL. The quote included the surgery, labs, cardiology evaluation, compression garments, meds, hospital stay of 1 night, and 6 nights in a recovery home that has 24/7 nursing staff and food. $12,699. I paid a 20% deposit and paid the balance during my pre-op lab appointment. I also filled out paperwork and met my coordinator.
When I talked to Dr. Castillo in person, he took the pre-op pictures and told me again that he didn't think I had enough fat for a BBL, but he would see what he could do. I was disappointed, but trusted his judgment. I woke up after surgery in recovery, and they took me to a room and bolstered me well with pillows. I had a catheter, so I didn't have to move. My right toes felt numb and I couldn't feel my left toes, The nurse said it was from the anesthesia and would wear off and it did. I could feel and move my toes again. I had good service ar CER Hospial and spent the evening eating, drinking and watching TV. I asked for a snack and they got me some crackers (the cafeteria was closed and I didn't want jello).
The next morning (Saturday) Dr. Castillo came in and talked about my surgery. He put 320cc in my right breast and 240 in my left and explained it would take a while for them to drop. He also told me he did a little fat transfer to my butt and gave me instructions to reduce death of the fat and stressed that there wasn't enough fat for a ful BBL, but he did what he could and it mostly came from my hips. Then his nurse came in and gave me my meds and instructions for aftercare. My patient coordinator from his office also came in and told me I'd get picked up by Casa by Linda's driver at about noon and asked if I have any questions. Shortly before noon they took my catheter and IV out and the nurse helped me sit up and helped put the compression garments on me, then I got dressed.
The drive was a bit scary. The driver said it was like driving in New York with people pulling out and changing lanes without enough room. He told me interesting stuff about Tijuana and prohibition, how the margarita came to be made, and about Rita Hayword's history, getting discovered, and changing her name. I was helped out of the car and to my room, which has a queen hospital bed. The head was inclined and my space was pre-padded. I got in bed and they explained the remote and how to call them and asked if I had questions, needed anything, and if I was hungry. They brought me lunch and my friend came with my backpack and Snacks. I was able to get out of bed and put my stuff away. My laptop, tablet, and snacks are all in reach.
Sitting up is the most painful. Lying down in my nest of pillows is not as painful, but hurts pretty bad. To get up, I put the foot of the bed down, the head up, and roll to the side, then use my arm to push myself up. To get back in bed, I get on the bed on my knees and position my knee at the far side of my nest, then lower myself sideways and roll into the in the nest. My breasts aren't hurting at all. The compression garments has an open crotch, so you don't have to mess with it to go to the bathroom. The staff here respond quickly to requests and bring me my antibiotics and pain meds, and so far the pain is tolerable and I've been able to walk. You walk hunched over and slow.
Linda has come in several times to check on me and see if I need anything. She is originally from Canada and is a US citizen, married to a local. This morning, after Breakfast, I took a shower. One of the staff helped me with my compression garments (it hooks down both sides) and got the Water ready. There is a seat in the shower with the shower head within reach. I hosed myself down and she handed me a washcloth and put soap on it. I didn't have to ask her for help as I was able to bring my legs up to wash them (it wasn'teasy). After I rinced myself off, she put antiseptic on gause and applied it to my incisions. I dried myself and got into bed to wait for the return of my compression garments (they washed the blood out). When she returned with my compression garments, she put gause in my new belly button and over the incisions in the back that had bled, then she helped me hook the garments up, putting a square of gause over my nipples. Nothing else to report. Unlike Friday and Saturday, I slept most of the day.

Just wanted to follow up on a few things from the post above:

1. DS patients do not typically experience dumping syndrome. We maintain our pylorus valve during the sleeve part of the surgery, so we dump at the same rate as the non-surgical population.

2. Bypass patients have about a 30% chance of dumping, lower if they avoid the food behaviors that trigger it. For all but a few it is a manageable phenomenon.

3. Diabetes goes into remission MUCH more frequently with Bypass and DS patients because of the alterations to the small intestines. As do most other co-morbidities.

4. I don't personally view my DS surgery as "punishing". My body has done nothing wrong. I feel no need to punish it. I personally don't have emotional eating issues but I don't judge those that do, nor do I think it is a reason to punish the body... Having my small intestines rerouted was not a punishment. It was a BLESSING! My fasting blood sugars normalized within 24 hours of surgery. So did my high blood pressure. I'm not on medication for either one. I'm currently 7 weeks post op. I consider remission of those two conditions to be a modern medical miracle... I didn't choose the DS to be harsh to my body. I picked it because it had the best chance of restoring my health and keeping the weight off long term. My surgeon put it best "You have a metabolic disorder. You need a metabolically potent surgery. The DS is the most potent one available..."

My bowels habits have changed, but nothing unmanageable. I have to watch my carbs, that's no different than before surgery. I no longer have to count calories because I malabsorb a portion of them. I'm at risk of Vitamin deficiencies if I don't take my Vitamins, that to me is no different than risking a blood sugar or blood pressure emergency from not regularly taking my meds pre-surgery. Nothing about this process is free. There are always trade offs. Any GI issues that occur with the DS can also happen with Bypass, including vitamin and Protein deficiencies. But protein and vitamin deficiencies are also possible with sleeve patients. They may happen at different rates, but they are unusual across the board. As are serious complications. Gallbladder failure can happen with ANY surgery. It is caused by the rapid weight loss and low fat diet many adhere to post surgery. It is not unique to the DS or Bypass.

I don't think DS and Bypass patients are choosing to punish themselves because they pick these surgeries. They pick these surgeries because of their own individual medical challenges and what they need out of their surgery. Most of us are working to heal various dysfunctional relationships with our bodies, or with food, or both. None of us are exempt from that. These surgeries are ALL support tools, not a punishment for past misdeeds.

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.

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.

I wouldn't hesitate to look into a revision. You had such great success with your first WLS. I've read the weight will come off slower second time around, but it beats developing later in life co-morbidities.
Many are going for the Ozempic shot nowadays in lieu of surgery, but recent studies show a lot of downsides to using it. I had a few people ask me why I didn't go that route with those shots available. It's the wave of the future they say. Maybe one day improvements will be made. I heard the other day they are working on a pill form. I hope for future generations they can perfect it and make it safe and available to all those who need it.
Believe me.. I did my research before getting my RNY. But for now, no regrets.
Good luck in your decision making.

It is a brain game for sure on those road trips. There are a lot of Protein Snacks that are good. My last road trip I took Quest Protein chips with me, they hit the spot for a snack. As far as restaurant eating, and there isn't a healthy option, most restaurants will give you a burger wrapped in lettuce, or a grilled chicken sandwich and hold the bread/mayo etc. There are ways to eat healthy on a trip even going to McDonalds. I typically will find a sit down place if I need to eat lunch/dinner etc, even if it means driving another hour to the next town. Gives me time to get that leg stretch in and find something that I can eat that won't break my weight loss goals. I will say I was super worried about hunting last year, we always eat all the junk non stop, and meals aren't exactly great. I was able to keep everything under control, only junk I had were chicharrónes, and some sugar free Jerky. I kept a Protein Shake with me every day as some days we hunt through meals.

I second the suggestion of a car cool box/fridge. Opens up so many possibilities! Don't go with processed food unless that's all you can tolerate (our stomachs tell us what to eat 3 months out)! If you can go for fruit, cheese, deli meat, raw veggies and hummus then that will get you far. Good luck!

I went on a road trip for the holidays at 2 months out. I took a giant lunchbox with me filled with Protein Shakes and ice packs, cheese and some other cold Snacks (I can recommend a fantastic lunchbox on Amazon if you are interested). Then I filled the top of it with some PowerCrunch Protein bars, Quest sweet chili protein chips, Paleovalley meat sticks (they weren't too dry) and Water flavoring packets (I like sugar free lemonade and the Jolly Rancher sugar free ones because I love sour things). I stopped every 2 hours to walk around and use the bathroom to ensure I was hydrating properly. And we stopped for 2-3 meals a day in addition to my shakes and snacks. It worked really well!! I didn't feel deprived at all. In fact, I felt better than I did on road trips before surgery because I stopped more often and hydrated better! Plus I was making wiser food choices.

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.

Lol, I had to look up incarcerated for hernias because I was picturing guys in stripes behind bars! I have had both with small intestines sticking out a muscle wall in my lower intestine (umbilical) that hurt intermittently for years until it became enstrangulated. US insurance often doesn’t pay for surgery unless there is complete blood flow stoppage. Hiatal hernia is a different beast that feels like a heart attack because the esophagus is turned inside out like a sock and jammed pulsating in your throat and chest. Both kinds, the doctors told me to walk when not in pain. What kept me sane, now and then, is knowing the pain is fixable, your response is management only. Sorry, I get a little Hermione Granger sometimes.