SpartanMaker

Adding another one:

I'm curious how much you're exercising? This may sound counter-intuitive, but, getting regular exercise may actually help you have more energy. Also, I think you'd be better off getting a bit less protein and more water. Dehydration can really sap your energy, but 70-90 grams of protein may be more than you really need at this point?

Bottom line, no. Keto is a high fat, moderate protein, low carb diet. Post-surgical diets vary a lot, but almost all of them emphasize protein first. Most also emphasize low fat and low to moderate carbs. In maintenance, lots of folks eat a more normal diet, eating a balance of protein, fats and carbs.

I agree with @GreenTealael 100%. Your bariatric team is in the best position to help. We here on the forums really know nothing about you. To start with, your profile isn't filled out, so we don't even have basic info. Beyond the basics like starting weight, goals weight, current weight, age, gender, and height, I'd ideally need to see your food log, and would have your percentages of body fat and lean mass. Finally, I'd want to understand what you mean by "I work out 6 times a week for over 50 mins". Exercise type and intensity make a ton of difference here. Even those things might not be enough though and that's where your bariatric team can help. There is one universal truth if you're not losing weight: You are eating about the same number of calories as you're burning. Without some potential metabolic and endocrinological testing that your doctor can do, it would be hard to know if this is due to Eating more than you think Burning less that you think in exercise A slow metabolism due to the loss of lean body mass Maybe even a hormone imbalance As pointed out, the simplest place to start is making sure your are logging your food accurately. It's really easy to be off by several hundred calories and this can easily be enough to make a huge difference in how much you lose.

Current recommendations vary a bit, but most suggest that to lose weight and prevent re-gain, 250 to 300 minutes of moderate physical activity per week are needed. Of that, at least 150 to 180 should be aerobic activities such as brisk walking, running, swimming or bicycling. Moderate by the way, is defined as attaining a heart rate of 50-70% of your max heart rate. The easiest way to estimate you maximum heart rate is to subtract your age from 220. For example, if you are 50, your max heart rate would be 170, so 50% to 70% of that would be 85 to 119 BPM. In addition to the aerobic activities, strength training should be included. The recommendation would be to perform 2-3 sessions per week for 30-60 minutes. Detailed recommendations are beyond the scope of what I can add here. For beginners, bodyweight training would be my recommendation. Doing so you'll be at a much lower risk of injury and IMO, bodyweight training should be the foundation of all other strength training. Google "bodyweight training for beginners" and you should see some recommendations. Just make sure the website is from a reputable source. there are lots of "fads" out there and some of them could be harmful. The reason strength training is so critical is that muscle is significantly more metabolically active than fat. By gaining muscle, you'll actually increase your overall metabolic rate, meaning you'll burn more calories even when you're not exercising. This means you'll be better able to lose weight or maintain weight at a higher overall number of calories than you would otherwise. In addition, strength training can help you age gracefully by reducing the risk of osteoporosis, improving mental acuity, improving balance and physical functioning, and helping manage pain. Finally, in addition to the aerobic and strength training recommendation, I also think it's a good idea to participate in functional fitness that helps improve balance, coordination, and flexibility. There are lots of options here, but yoga and tai chi are good choices if you need recommendations.

I want to clarify something here for those that are following along at home. A random blood sugar test can be used to indicate diabetes, but just because your blood sugar is less than 200 mg/dL, does not mean that you don't have diabetes. An analogy would be this: if you weigh over 600 pounds, you are definitely obese. Just because you weigh less than 600 pounds does not mean you are not obese. I'm diabetic, but my blood sugar was never over 200 mg/dL any time I checked. As I mentioned, it's much more common to use A1C and fasting blood glucose tests to diagnose diabetes. Fasting is good because blood sugar fluctuates throughout the day. It should be at its lowest point after an 8 to 10 hour fast, so for most people, this is first thing in the morning. The other common test most diabetics are asked to do is "postprandial". This means after a meal. Now timing after that meal is subject to some debate, but typically 2 hours after eating is used as the "standard" for diabetics. For everyone, even non-diabetics, your blood sugar will start going up roughly 10 minutes after starting to eat. While this is heavily dependent on what and how much you ate, in a non-diabetic, your postprandial blood sugar should peak within about an hour of eating and should be back to normal in 2 to 3 hours. For diabetics, this normally does not happen as fast, so the peak blood sugar concentration is typically closer to 2 hours after eating. In short, most type 2 diabetics are asked to take a postprandial reading 2 hours after eating. Both fasting and postprandial readings are used to determine how well the disease is managed. For example, a high fasting blood glucose test might indicate that your diabetes medication needs to be adjusted. Another example might be if the post prandial reading is actually lower than the fasting number. If this is a consistent trend, it might indicate reactive hypoglycemia.

So I think the answer is... It depends. If you take the MFP recommended calorie counts, it should ask you if you wish to adjust your calories down for every 10 pounds you lose. If you miss changing it when it asks, you can always change it later yourself. (Though see below, as you may now be in "manual mode".) If you don't take the recommended calorie numbers and use your own numbers, then this "manual mode" won't ever ask if you you wish to change it. It says the same until you change it yourself. As far as Fitbit, if you have MFP and Fitbit linked, calories burned should be adjusted down as you lose weight. When they're linked, Fitbit should pick up your weight from MFP and will use that as part of their calculations. FYI, it bases the calories burned on heart rate, as well as height, weight, sex, and age. It might be a good idea to double check your fitbit app to make sure it's showing your latest weight. I have seen them get out of sync for some reason? Keep in mind that it's up to you if you want to add in those exercise adjustments from Fitbit to your MPF calories or not. You can change a setting to add them, or ignore them. I normally don't add them in since I think it overestimates calories burned, but the counter argument is that by adding them in, you give yourself permission to eat more on days when you really need to. For example, if you had a hard workout, or really active day.

I don't claim to be an expert here, but a few thoughts come to mind for you to consider: MGB is extremely rare in the US. (It's much more common on other parts of the world, especially Asia.) Part of the reason it's so rare here may be due to the fact that it's not an endorsed procedure by the American Society for Metabolic and Bariatric Surgery. I would suspect revisions are even less common, so there's probably not a lot a data on success rates? Because there's not a lot of data, it's a bit unclear if MGB will even address your GERD issue? I'm seeing a few studies out there, but results are unclear. Roux-en-Y GB is actually sometimes performed specifically to treat GERD due to its effectiveness in alleviating those symptoms. I would think if GERD is the main reason for the revision, this may be an important consideration?

Well, obviously I'm in the minority here, and that's fine. I do feel like corn tortillas may be getting a bad rap? While they certainly aren't the most nutritious food in the world, they are a whole grain complex carbohydrate that contains fiber, as well as several vitamins and minerals. They are typically low in calories (roughly 50 per tortilla), low in fat and are especially high in zinc. Compared to plain flour tortillas, corn tortillas are definitely the better choice. Note that some of the most protein rich dinners I'm eating right now are tacos and enchiladas, so I don't see a problem with them at all as long as you eat them with protein. I also don't get the safety concern. They are made from ground hominy (typically finely ground), and are pretty homogeneous. They are also easy to chew. Also, unlike wheat flour products, they don't tend to "gum up" in the guts. Maybe I'm missing something there, but these should be fine? For the record, at 4 weeks, my plan said to: "focus on low-fat solid foods". A corn tortilla is certainly a low-fat solid food. I was also supposed to eat "protein first, then vegetables and fruit, and limit grains and starchy foods". No foods were specifically off limits at 4 weeks or later. Tortillas definitely fall into the "grains and starchy foods" part, but I probably only eat a few tortillas a week. I'm pretty sure that qualifies as "limiting them". As far as I'm concerned, it's all about balance and these work for me.

Great post! Thanks so much for sharing. I think this is exactly what I needed to hear today as I deal with some debilitating chronic pain issues. There is always hope, but sometimes it's hard to see it.

There doesn't seem to be a lot of studies regarding this, but I found one that claimed the pharmacodynamics of dextromethorphan in bypass patients was not really any different from the general population. I think the moral of the story is don't take too much and don't take an ER version and you're probably fine.

Apparently dextromethorphan, a common ingredient in OTC cold medicines can also cause hallucinations in high enough doses. Enough so that it's even a commonly abused medicine? The more you know... If this was the cause, I have to think the poster took more than the recommended dose? It's also possible that this was an "extended release" medication and I think we've all been cautioned not to use those post WLS due to the fact that we can have issues either absorbing too little or too much of these meds.

Ah, maybe that was related to the alcohol content? Alcohol seems to affect people differently post WLS and maybe she wasn't ready for it?

Not saying this was the case here because of course I have no way to know, but I think it's human nature to "blame" things like this on WLS even though it would be impossible to prove. We as humans don't like it when we don't understand something. That makes us look for reasons, even if they're not completely rational. Seeing nothing else, it's easy to convince ourselves that "it must be due to "xyz", with xyz being weight loss surgery. Now to be clear, I do think there's an outside chance of some possible correlation. Changes in the gut microbiota have been known to be correlated with development of a new allergy or insensitivity. The point is that while unlikely, I suppose this is possible: WLS > Dietary Change > Change to Gut Microbiome > Development of an Insensitivity to an Ingredient in that Specific Medicine Reading back through this, I feel like i'm trying to rationalize a very tenuous link, but weirder things have happened. I'm trying to keep an open mind here, but even if this were related, I can't imagine it would be at all common.

I eat them and have no issues. Typically I heat them on a cast iron pan first if I'm doing something like tacos or making enchiladas. One taco or enchilada is all I can eat right now. I also try to limit how often I eat higher carb options like this just to make sure I'm getting my protein in. What I have not done yet is whole corn, or tortilla chips. Those just seemed like a bad idea until i'm a little further out from surgery. Edited to add: I made posole recently and had no problems with the hominy, just FYI.

I guess I'm the weirdo that found the pre-op diet easy and struggle more now post-surgery. Let me explain my theory on why: I actually started a restricted calorie diet about 4 months pre-surgery. I then started substituting a shake for one meal a day about a month before the pre-op diet. I feel like doing both of these allowed me to ease into the pre-op diet without missing a beat? My pre-op diet, by the way was full liquids. No meals. I knew from previous experience with drastic dietary changes, I'd likely regret it if I didn't ease into it, so that's why I did what I did. The biggest challenge for me pre-op was actually just dealing with my emotions. I was constantly worried something would delay the surgery I'd been waiting so long for. Now that I'm ~6 weeks post-op and "allowed" to eat anything, I find my head-hunger talking over sometimes. I didn't have this pre-op because it was so restricted. I basically had no choice in what I was eating then. Now however, I find myself sometimes making bad food choices. I'm not actually hungry at all and so when I do feel like eating, I gravitate toward things that sound good, rather than are good for me.

Congrats! Like you said, there are definitely some things that make your pregnancy higher risk, but in other ways, you are actually in a much better place. For example, you're much less likely now to end up with gestational diabetes. You probably already know this, but the things your doctors will be most concerned about will be your ability to eat enough, as well as the potential for vitamin and mineral deficiencies. These can all be overcome with your doctors help. If it's available to you, going to a multidisciplinary hospital system where they have more experience with pregnancy post gastric sleeve would be a good idea. In most states, this would be large teaching hospitals or the like. Maybe talk to your bariatric surgeon for an OB referral to someone with experience with post WLS pregnancy?

Sorry you're going through that and sorry you missed that goal (it was a nice goal), but at least you're better prepared for understanding stalls than a lot of folks. That said, even when we intellectually know the reasons these things happen, our emotional selves still get frustrated! I've written a few times on here why physiologically stalls happen, but I still had the same emotional reaction when, like clockwork, I hit the dreaded week 3 stall.

It's not actually "soup", but one thing I really appreciated having at that stage was "Millie's sipping broth". It's basically like a tea bag, but instead it's herbs and spices. Maybe a little pricey for what it is, but they are very tasty. I mostly just used them to help me get my liquids in, but if I was also needing a protein boost, I also added them to my homemade bone broth. Both ways worked well. My fave was probably the Pho, but the Spicy Tortilla is also very good. Edited to add: They are available here on the bariatric pal store, as well as Amazon, etc.

I've never had to do anything like that and never heard of doctors doing such a thing? Here's are a couple of basic rundowns of types of blood sugar tests: https://www.cdc.gov/diabetes/basics/getting-tested.html https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis Honestly, the A1C is probably most used, along with a fasting glucose test. (FYI, clinical standards typically require at least 2 different tests, or 2 readings of the same test separated by time, before a positive diagnosis of diabetes should be made.) Both of these tests are easy to do, since they can be part of a regular blood draw. Some docs also like to see a glucose tolerance test, because this will show the swings in your blood sugar the others won't. For example, A1C is an average, but just like 5 is the average of 4 and 6, it's also the average of 1 and 9. Knowing just how big those swings are may help with a treatment plan. I doubt many do that up front, though. Typically they.ll do the A1C and fasting blood glucose and then decide if additional testing is needed. The problem with what your doctor is proposing is that it's not standardized. As you hinted at, your blood sugar levels could be different if you ate a carb heavy meal vs. a protein heavy meal. Without a way to control or account for that, I personally can't see the value in this non-standard test.

Yep, that's similar to the ones I have. Much better than the old-school ones with the little clips.

Don't have any experience with plastic surgery, but I've worn compression bandages enough for other things. Here are my thoughts: You may need more wraps than you think? I've worn one on my knee a lot (post knee replacement), and I would never use just one. I'd often use 2 or 3 on just my knee. If it's slipping, it may need to be tighter? Obviously not too tight, but unless you're moving a lot (which I suspect not immediately post surgery), it shouldn't just slip off while you're still. It may not make a ton of difference, but I found that starting at the top and working my way down the limb seems to help as well. Make sure to wrap it several times around the top before moving down. If you think it's tight enough, but it's still slipping, you may have to "fix" it in place by wrapping it around other body parts. For example, maybe try starting the ones for your arms by wrapping your shoulder first, then moving down the arm. Refer to point one above though. This will absolutely take extra wraps. If none of the above helps, you could also consider using some cohesive wrap to hold it in place? Be a bit careful if you go this route though. Cohesive wrap doesn't give like the compression bandage, so it would be easier to cut off your circulation. Hope you find something that works for you.

Ask 10 nutritionist if popcorn is "good for you" and you'll get 11 different opinions. Here's some of the reasons I've heard bariatric patients should avoid it: I honestly think this one is more urban myth, but some people claim popcorn kernels or pieces can get stuck in the staple line and cause issues. If true, this is obviously a bigger concern the closer you are to surgery. Even if the popcorn itself can be an okay choice, we tend to add toppings that aren't so good for us. It's easy to overeat since it feels like there's not much there. This can catch up to you though. Also, because it has very little protein, eating too much popcorn may prevent you from meeting your protein goals for the day. Popcorn is high in insoluble fiber, meaning it will draw water into it and swell in the gut. Now normally fiber is a good thing for a healthy gut, but especially for bariatric surgery patients that are not used to it, you run the risk of the popcorn swelling while it's still in your stomach and causing significant discomfort. This risk is probably reduced if you eat it slowly. Eat it too fast and you may regret it. Anything you eat in a mindless way (as we all tend to do at the movies), could lead to you eating too fast or too much. See #3 and 4 above. No question that alternatives such as those suggested above may be better for some people. The concern for me is that especially while at the movies, I have to make sure I don't fall into that "mindless eating" trap. That's so dangerous for me. I'm trying to learn to stop associating "movies" with "snacking". (I even do this at home, so Netflix is no relief.) I think at least for me, that may be the better option long term?