SpartanMaker

My surgery's not till the 20th, but I'm not really planning anything special? A "last meal" makes it sound like I'm dying or something, but I think of this as more of a re-birth. Is that weird?

Please, please talk to your doctor. Some issues with vitamins is normal, but the rest of what you're describing is not.

I actually bought several different vitamins, from several different companies, and in a few different forms (capsules, chewables, soft chews). I've heard some people have issues with one or the other post-surgery. I'd rather have them now so I have choices if I end up needing them. I figure eventually, I'll be able to use them, even if I can't stomach some of them early on. I doubt I'll waste entirely them unless they are just really terrible. One thing I have not done is compare standard off-the-shelf vitamins to these supposed bariatric ones. I really want to know if there's a difference?

So I just wanted to point something out here. GERD and an ulcer are not the same thing. Having experienced both, I can say neither is fun. Certainly someone could have both conditions, but most likely, what you are experiencing is one or the other. Ulcers are basically a place where the lining has been damaged. These are most common in the stomach, but can occur in the esophagus or small intestine as well. ALL bariatric surgery patients are at some increased risk of these occurring, but they can happen to anyone, including non gastric surgery patients. GERD is a chronic condition due to recurring episodes where excess acid enters the esophagus from the stomach. Almost everyone has occasional acid reflux, but GERD is when this happens repeatedly. In most cases of GERD, the valve at the bottom of the esophagus is damaged or not working correctly for some reason. (Note that long term exposure of the esophagus to excess acid from GERD can cause an ulcer in the esophagus, but I digress.) Bypass patients almost never have problems with GERD, because the small pouch has very few acid producing cells. Sleeve patients on the other hand are more likely to experience GERD than the general population. This is thought to be due to the sleeve putting extra pressure on the esophageal valve. Both groups (sleeve and bypass), are subject to ulcers and are at more risk of them than the rest of the population. How to know the difference? WHERE it hurts is the biggest tell. if you are having a burning sensation in your chest or throat, that's likely GERD. Ulcers typically hurt in your belly. If you are having this issue, talk to your healthcare provider ASAP. Both conditions can have serious complications and you should not tough it out or hope it will go away.

There seems to be some confusion in this thread and it's not clear from the original poster, what's meant by "Steroids". There are 4 things I suppose you might mean, so we should probably clear that up: Testosterone Replacement Therapy: Since the OP is female, I doubt you are on this, as it's typically prescribed for older males with low testosterone. Anabolic Steroids: I also doubt the OP means this as these are highly controlled drugs and only prescribed in very limited circumstances. That said, a lot of bodybuilders abuse these. (Ever hear of "Roid Rage"?) Corticosteroids: These are commonly used medications typically prescribed for inflammation. The most common oral example would be prednisone. It would be rare (but not unheard of), to be on this long term as the side effects can be worse than the inflammation it purports to treat. NON-Steroidal Anti-Inflammatories: As the name implies, these are NOT steroids, or even related to steroids. They got this name because they were originally developed as an alternative to corticosteroids. Common examples include the over the counter medications ibuprofen (Advil) and Naproxen (Aleve), as well as the prescription drugs meloxicam (Mobic) and Celecoxib (Celebrex). Typically this is a class of medications that doctors like you to be off of for bariatric surgery because they can cause stomach ulcers. I'm assuming the OP meant one of the latter two, but don't know for sure?

So, we’re jumping forward to May 2021. Picture this: I’m about to talk to my cardiologist at my 1 year surgery follow-up and am getting nervous. Mentally I’m going through all the things I’m going to say to convince him I’m fine, and that he should definitely approve me for WLS. Turns out, I was worried about nothing. He went through the standard checkup stuff and at just about the point that I was ready to go into my well rehearsed sales pitch, he actually asked me if I was still considering bariatric surgery. Imagine my surprise at that one! When I said yes, he didn’t hesitate to say he was fine with it and didn’t see the heart surgery as an issue at all. He just became my new favorite doctor. I walked out of his office ecstatic and ready to call the bariatric center to get the weight loss surgery scheduled right then. I mean if they would have taken me in tomorrow, I was READY. It was late in the day though, so I decided to wait. Turns out waiting was a bad choice. I woke up the next day with horrible back pain. I’d had back issues for many years, but it had been mostly stable for a while. Now I was experiencing a bout of sciatica that was so bad, I had little to no muscle control in my legs. Great, more health issues to deal width and once again bariatric surgery would have to wait. Let me jump forward a bit here. It took a few months, some new meds, some injections, and some aquatic therapy, but the back was feeling tolerable, at least. I was finally ready to call the bariatric surgeon’s office. Remember me saying I should have called sooner? It turns out they had a 2 month backlog for “new” patients. You see, because I had been out of the program for almost 18 months at that point, I basically had to start over. Fast forward to September 2021 and I finally get to meet with a PA and start the “intake” process. I then did the standard psych evaluation and 6 months of dietitian visits required by my insurance company. The surgeon also decided that I needed to do an abdominal CT scan with contrast. Not sure if this was typical, or something “special” just for me. Unfortunately, once again something wasn’t right. This meant the surgeon wanted a closer look, which meant more testing. Pro tip, if you ever get told you need to do a fluoroscopic swallowing exam, see if you can get out of it. Seriously. This was probably one of the top 5 worst exams I've done. I went in thinking it would be no big deal and was much more worried about the endoscopy they also were planning. Turns out, I had it completely backward. I slept through the endoscopy, but the swallow study just was miserable. After a few tense days of waiting for results, my surgeon’s office said they found a couple of issues, including a hiatal hernia, but I was okay to proceed to surgery! Now it became a waiting game for insurance approval and surgical scheduling. (Apparently they are still way behind and not able to accommodate a full surgical schedule due to a COVID-19 induced backlog.) After an eternity waiting, I finally, finally got scheduled for September 20th. I just thought I was anxious before. Now the waiting really begins!

LOL, my vote is for "nervited". Excivous sounds more like what happens when your surgeon gets in a hurry! Anyway, whatever it's called, I'm sure we're all feeling it!

Sounds like your program is more like mine. Best of luck and let us know your you're doing!

Once you create it, there's a button on the tickers page that says "Add to signature".

Hmm, that probably why my program actually doesn't want me eating fruit at all in the pureed stage. They even caution that raw fruits are not well tolerated early on and that they are best held until at least 2 months post-op. Seems like it would be a good choice, but bariatric tummies don't seem always fit our preconceived notions.

Great goals. I'm actually a big fan of bodyweight exercises and bands, but if that's not for you and you want to start with dumbbells, that's great too. Here's the thing, as a beginner, there is no wrong routine for you. Whatever you do will be beneficial. As far as what exercises to do, you can google stuff and find some great ideas there. Some of what you'll find is great, and some is not so good. To sort out the good from the bad, start by making sure it's from a reputable source. Next, look for routines that focus on these three things: Make sure they are working your you upper body, your lower body, and your core. Make sure there are both pushing exercises and pulling exercises for your upper body. For example, a chest press, matched with a bent over row. By making sure they have both, it gives you a better overall workout, helps prevent muscle imbalance, which in turn helps prevent injuries. If you see a routine that does not have both, that's a big red flag. Make sure they explain how to do the exercise and what correct form looks like. Most people that hurt themselves doing strength training, do so from bad form. Now that said, let's talk a bit about sets and reps. A set is when you do all the exercises for that session one time. Many routines have you do more than one set. Three is the most common, but depending on the goal, it could be one to five or even more. A rep is the number of times you do a single exercise before you move to the next exercise. The challenge here is that the ideal way to build muscle strength vs. muscle stamina are a bit different. Typically for strength, you want a really heavy weight and you'll do ~6 reps for 3-5 sets. If you're able to do all the sets at 6 reps, then the weight is too light and you should progress to a higher weight next time. For muscle endurance, you'd ideally use a much lighter weight and do maybe 3-4 sets at 15-20 reps. The same applies here as well, though. If you can do them all, it's time to up the weight, do more reps (maybe up to 25), or add another set. You should feel like you did real work when you are done. There is a sort of compromise that you could take as well (and honestly, this is what most people do), that doesn't strictly focus on strength or endurance per se, but is good for both. That would be to do roughly 3 sets at 6-12 reps. Once again, if you can do an exercise at 12 reps for three sets, it's time to up the weight. Keep in mind also here that what works for a while may stop working at some point. Every now and again, you need to change up the routine you are using and try a completely different program. I'd say probably every 12-18 week at most, move to something else. It could be dropping the dumbbells and moving to bodyweight, bands, kettlebells, barbells, or just varying the routine. For example, instead of 3 days a week, maybe you move to 4 days a week and separate out upper body from lower body work (2 days of each). This type of variation is key to long term success. Enough for now, but I hope this helps. Also, sorry for the novel, but I'm passionate about strength training and guess I got carried away!

Good on you! Way too many people (women especially), don't do any sort of resistance training at all. That's a shame since it's one of the best things you can do to keep your metabolism revved up as you lose weight. Before recommending anything in particular, it might help to know if you have any particular goals in mind? In other words, what do you hope to accomplish with your dumbbell routine?

It's automatic. BariatricPal, links keywords to their products.

Haven't experienced it as part of pre-op diet, but many years ago I did Atkins, which starts you out with <20 carbs a day. My recollection was I had about 3 days that I felt pretty lousy, but after that I moved into ketosis and felt fine.

For sure. It's actually surprising to me just how different they seem to be? Here's mine: Pre-op: Two weeks long -- Only 3-4 protein shakes per day and unlimited clear, sugar-free liquids (which can include SF Popsicles and SF Jello). Post-Op Stage 1: Days 1-3 -- Only Sugar-Free Clear Liquids Stage 2: Days 4-7 -- Add in Protein Drinks, Skim or 1% Milk. Can also use Unsweetened soy or almond milk. Stage 3a: Days 8-14 -- Add in Cottage Cheese, Yogurt and/or Ricotta Cheese Stage 3b: Days 15-30 -- Add in Pureed Meats, Beans, Low Fat Cream Soups, Cooked Pureed Veggies. Eggs allowed, but must be soft. Fruit not allowed. Stage 4: Days 31-60 -- Low Fat Solid Foods, focused on protein first and introducing only 1 new food at a time. Fruits and veggies okay, but should be cooked. Best to avoid nuts and seeds. Stage 5: Lifelong -- Add in Raw fruits and veggies as tolerated. How does that compare to everyone else?

You might want to consider that a lot of people have problems with eggs early on. It sounds weird to me because when I have tummy problems, it's one of the only things that I can tolerate. I'm also curious about the fruit? My program does not allow fruit until 1 month post-op. I assume due to the sugar content and the possibility of dumping syndrome. Anyway, I wanted to make sure you have some other options ready in the event some of your choices aren't well tolerated. One thing I figured I'd try is tuna or chicken blended with fat free mayo as a way to make "tuna salad" or "chicken salad".

Can share what you're finding challenging? Is it hunger, lack of chewing, thinking about food, loss of mental clarity or physical energy? Something else? Just trying to understand better what we can expect.

Honestly, it's not very intuitive. Click on your name at the top right and look for "My Surgery". Most of it's in there.

Welcome all! If you can, please update your profiles to help us know more about you, such as type of surgery, surgery date, starting weight, goal weight, etc. These will help all of us as we support each other through this process.

A couple of additional thoughts on this thread: First, as many have pointed out, averages are just that, averages. Some people will lose more and some less than those numbers. Whether of not you are on the lower side or the higher side depends a lot on you. Work your plan and you too can blow that "average" out of the water. Second:, avoid the temptation to select your target weight from the BMI "ideal weight" range. Some people don't realize this, but on average, 25% of your excess weight is not fat. As you might expect, it's made up of the additional muscle mass needed to carry the extra weight (much of which you'll lose), but it's also extra blood volume, bone mass, organ weight, excess skin, etc. Some of those things will continue to cause you to be "overweight" in terms of BMI, but in actuality, you might be in a very health place in terms of lean to fat mass. Get it checked if in doubt.

The others are correct, weight loss, especially after WLS is never linear. If you were to graph it out, it would look more like exponential decay (with lots of fits and starts and even deviations up). At one point. I even tried graphing out my potential loss based on a decay constant but realized it was all based on my previous experience losing weight in the past. The decay constant will undoubtedly be different than my past attempts. If it helps, I saw a couple of references in the scientific literature that suggest the AVERAGE across large population groups shows the weight lost at 2-4 months will be roughly 50% of that lost at 12 months. As an example using totally made up numbers to make the math simple, let's say you lose 50 pounds in 3 months post-op. Then the average above would suggest you'd lose another 50 pounds in the next 9 months. Again, these are averages. Your loss may be higher or lower than that depending on a lot of factors such as amount and type of exercise done, how compliant you are with your plan, total calories consumed, etc.

I use MyFitnessPal. Recipe creation is pretty easy on a desktop, but not quite as easy on the app, at least in my opinion. It's also very easy to copy a meal from a previous day, which I use more than the recipe builder. One word of caution. Because there are millions of users and anyone can add foods to the database, some common items have gotten out of hand. Always look for the green checkmarks on things, as these have all been verified by staff.

I hear you there! If I could provide one piece of advice it would be this: We have to start where we are. Forget about all the guidelines like "you must get x amount of cardio per day". While we all want and need to get to that level, some of us just can't do that right now. As long as this week I do a little more than last week, and next week I do a little more than this week, I'm trending in the right direction. I recently saw a video of a 700 pound man and his weight loss journey. For him, exercise was walking from one side of his very small kitchen to the other side. He literally started off with one "round trip". After a while, he made 50 round trips. Before long he was walking outside, which was a major milestone for him. Up to that point, he'd been house bound for years. Maybe for you, it's an extra trip or two up the stairs everyday, or walking to the end of the block and back. Whatever challenges you today, is where you start. Once you establish this, forget about "routines" and do this every day until it's no longer such a challenge. That's when you progress to the next challenge, either by extending the distance or intensity.

This is good advice. What you're experiencing is something called adaptive thermogenesis in the scientific literature. In effect, your body adapts to your restricted intake by also reducing the amount of calories you burn. As much as we hate it, this is actually a evolutionary advantage. When our bodies detect "lean times", they adapt to make sure you survive long enough to make it to the next time of plenty. This was important over most of human history because we we didn't always know where the next meal would come from. To break out of this adaptation where you body is "helping" you survive, you should try to do something different. Varying your macros as suggested above, varying your exercise routine, or potentially even upping the number of calories you eat for a while can all "reset" the metabolic changes that caused the stall. Now that said, even if you changed nothing, it's unlikely the stall will last forever. At the end of the day, your body can only slow your metabolism so much. If you prefer to wait it out, that should eventually work as well as long as you are sticking to your plan.

So it may be time to take a little break from the ongoing saga of why it’s taken me over two and a half years to get to surgery and instead talk about how I got to the point of wanting to have bariatric surgery in the first place. My lightest weight as an adult was while I was in the Army. Just sheer physical activity and regular PT had me lean down to around 175 from maybe 185 when I graduated high school. Unfortunately I was severely injured in a training accident while in the service and left the military with a bad limp and a knee brace as a constant reminder. Weight wise, things went downhill from there. Being somewhat disabled made it hard to exercise, but meanwhile I was still eating like I did when I was in the service. (Lots of food, very quickly.) This was obviously not a good combination. Several other health scares and life events later, I shot up to around 240. I managed to stabilize things at this point and was even able to get into strength training pretty seriously for a while. Most cardio was still out, though. Life went on for several years, until I got a new job that paid me very well, but also took it’s toll on me physically and mentally. Within 3 years in the new job, I was up to 285 or so and climbing. I knew I needed help, so my wife and I tried just about every possible diet program imaginable. Interestingly, I’ve kept logs of every one of those diets. For at least the past 15 years, the typical pattern was for me to be somewhere between 285 and 300 pounds lose 30-80 pounds, then yo yo right back to my starting weight and then some. In about 2017, I finally asked my Doctor for help. We did all the things you’re supposed to do: talk to dietitians, try medications of various kinds, and even do physician monitored diets. None of that worked any better. The problem was, they just assumed like everyone does that I was weak-willed or to stupid to know how to eat properly. That’s never been my problem. I actually eat pretty well overall, with lots of fresh veggies, and plenty of lean protein. The problem is, in addition to all the good food, I’m also an emotional eater that soothes with sweets. I knew I’d reached rock-bottom when I started hiding food from my wife. As an example, I might buy a box of donuts and plow through it in a matter of minutes. Or buy the boxes of chocolate intended for Valentines day and devour them all in a morning. No box or bag of candy or pastries ever had the dust settle on it around me! About this time, I got up to 330 (my highest weight), and knew I needed to take a different road or I would never live to see my grandchildren. (I may never actually have any grandchildren, but that’s a story for a different day!) This takes us to late 2019 when I discovered, quite by accident, that my new insurance plan starting in Jan 2020 would finally cover bariatric surgery. After about a millisecond of research (okay, maybe a little longer), I decided this might be the thing for me. I think you already know what happened in my saga in 2020, so we’ll stop there for now and start back up next time in the summer of 2021, when I finally got the cardiac clearance I needed to get WLS.