SpartanMaker

My surgery was 9/20. I went back and looked at my log and I'm currently eating between about 500 and 800 calories a day. Like many, I was not told a specific calorie goal, mostly to focus getting in my protein and water. Since I'm at about 6 weeks now, I don't have any restrictions in terms of food, but getting to my protein goals is hard on food alone, just because I can't physically eat that much. This means I have to rely on protein drinks some still. It's been said a million times already, but your bariatric team is your best source for your concern. Plans are different and we all progress at different rates as well.

I 100% agree, but it's far beyond how badly obese people are treated in the grocery store. I can't speak for other countries, but lots of studies have shown that workplace discrimination against obese people is rampant in the US. Worse, it's not protected by law, unlike discrimination based on race, religion or gender. Those same studies have shown the odds of encountering discrimination is highly correlated to weight. In other words, someone that's merely overweight has a relatively low chance of encountering outright discrimination, while someone that severely obese will almost assuredly encounter it. In short, in the US, if you're obese you can be turned down for a job, denied promotions, or even fired due to your weight and it's perfectly legal. Most companies wouldn't admit to doing this, but if you doubt that it happens, look at the c-suite of any major company. The odds of finding an obese person is virtually nil.

I've seen it both ways. For my WLS, my bariatric team did all my labs and coordinated everything. That said, I was not self-pay. For a lot of my other surgeries over the years, it was more common for my PCP to do an ekg and labs, rather than the surgery practice.

My plan did have me do hibiclens both the night before and morning of. They provided two 4oz bottles as well as a lovely pink scrubbie. They also gave me a bottle of alcohol-free mouthwash and wanted me to use that instead of my regular one. Apparently they claim it's a fire hazard. News to me! I also had to self-isolate for 2 days between my covid test and surgery. I thought that one was a bit odd in that my wife was going to be my driver, would be allowed in the hospital room with me, and would be my helper post-surgery. If she just happened to have covid, isolating for the 2 days between the test and surgery wasn't going to protect me or the medical team.

Sounds a lot like mine! It was about a week before surgery and took about 4 hours total. Started with a pre-op review with a Nurse Anesthetist, followed by lab work, final weigh-in, as well as a BIA scan on their In-Body Scale. After that, I had another quick review of the post-op diet, and a review with the nurse educator on what to expect between then and my surgery date. We we also reviewed the general post-op plan, though she said she'd see me again in the hospital (I did), and that we'd review it all again at that time (we did). Finally I met with my surgeon and got to ask whatever questions I had.

I guess the way I've heard it is that strong relationships will get stronger and weak ones may not survive.

I think the things you read may be referring to type 1 diabetes? For type 1, your body produces little to no insulin instead of too much. Because there's no insulin there to signal your body to take up the sugar, your body instead starts to breaks down muscle and fat for energy, which would lead to sudden, unexplained weight loss. While type 1 is a remote possibility, it's a lot more likely your doctor is concerned about type 2. Type 1 used to be called juvenile onset diabetes because that's normally when it's discovered. It can also start in adults, but not very often. Type 2 used to be called adult onset, because that was historically when it would be seen. Now with obesity at epidemic proportions, even children sometimes get type 2.

Glad you both found something that's working for you! The data is pretty clear that WLS patients that partake in at least 200 minutes a week of moderate to strenuous physical activity are significantly more likely to maintain their weight loss. Not everyone will be able to tolerate running for one reason or another due to impact on joints, but there are lots of other activities that will work as well.

Oh how nice it would be if diabetes made you lose weight! People with diabetes don't respond correctly to insulin. The main job of insulin is to signal your cells to take up the sugar in your blood to use as fuel. Because that process isn't working like it should, people with diabetes have excess sugar in their blood. That excess blood sugar has to go somewhere. Where it goes is that your body converts it into fat and stores it. There's a reason why type 2 diabetes is strongly correlated with obesity. Being overweight can lead to insulin resistance on a cellular level, which can lead to more weight gain, which makes your body unable to as efficiently process the insulin, which can lead to more weight gain, and so on. Now just like any other potential hormonal imbalance, being diabetic does not make you gain weight. It just means that all other things being equal, it's more likely. To gain weight, you still have to eat more than you burn, regardless of any hormone issues.

I wanted to clarify something here: Bilirubin (the thing the OP asked about), is not a "liver enzyme", so elevation of just this would not at all be the same as what @kcuster83 mentioned. Elevation of ALT and AST especially, indicate potential liver damage. This is because these enzymes only are present in the liver. Bilirubin is not actually specifically related to the liver, though it's typically part of the "liver function test". The main purpose of bilirubin is to break down red blood cells and "recycle" them. Excess bilirubin is typically a sign that you are losing red blood cells faster than normal. That may or may not be a problem, but in the absence of elevated liver enzymes, does not by itself indicate a problem with your liver. As I mentioned, anemia is a much more common reason to see high bilirubin in the absence of other abnormal tests.

I think you hit on the issue there. I doubt this was sugar or fat content, it seems like you just drank too much too fast.

Hmm, I look at it completely the other way around. How I wish I'd done this when I was 44, or even better 34, instead of waiting to my late 50's. I think of all the opportunities to enjoy life I passed up on because I was too fat. How many opportunities to do things as a family did I pass up on because I was to heavy to do them. How many times did I stay home instead of go out because of my weight. I also think of the fact that I lived decades in pain that probably could have been avoided had I been healthier when I was younger. How many of the 15 plus surgeries that I've had could have been avoided? How many of the conditions like diabetes, coronary artery disease and congestive heart failure could I have avoided entirely had I done this decades ago? I think of the fact that I now see the same patterns of disordered eating showing up in my grown children and have to wonder if I'd addressed this obesity disease when I was younger, could I have modeled healthy living for them and perhaps have broken the cycle? I have to wonder if now it's too late for them to see me making health changes and make their own changes as a result. So yes, how I wish I'd done this while I was "awfully young".

I hate that "it's taking the easy way out" line. There's nothing easy about this. Plus, why in the world would that even matter? It's like some people think if we use a tool like surgery, we didn't pay our "penance" for being fat. "Nope, sorry, you're not worthy of being healthy, because you cheated your way to health. Do it the right way or not at all" Really? I sympathize with the position you're in as my wife was and still is very anti weight-loss surgery. Her line was always why would you permanently alter your anatomy when it's possible to do this without making so drastic a change? My response is I never had a problem losing weight, what I always struggled with was maintaining. After way too many yo-yo diets, I needed to do something else. Dieting alone was not working for me. I needed a better tool. That's what it is, by the way, a tool. The analogy I like to use is that WLS is like a shovel. I know that sounds odd, but bear with me... I've dug quite a number of holes on my property to plant trees. Most of those trees will be here longer than I will, but It's still worth it to plant them. I suppose technically I could have tried to dig those holes with my hands but wow, that would have been a challenge and I'm not sure I would have been able to finish the job. With a shovel, it became doable. The shovel still was a lot of work, but it made an almost impossible job, possible. No one thinks using a shovel is "cheating", we just think of it as a better tool. At the end of the day, the risk of early death for me was extremely high with cardiac issues, diabetes, liver and kidney problems, etc. I began to feel that I was living on borrowed time. WLS for me was life-changing and life saving. It immediately reversed my diabetes and high-blood pressure. I used the tool because I had reached the point where all I saw in front of me was an early death. For what it's worth, it would also seem that the medical community takes your side here based on the available medical evidence: https://www.bariatricpal.com/topic/442260-after-30-years-new-guidelines-for-weight-loss-surgery/ Best of luck whatever you decide.

Awesome job! You've been doing a fantastic job, and based on all the prep you're doing for surgery, I think you're going to do even better post-op.

I'm confused by this too? Something doesn't sound right here to me?

Sure, nothing wrong with pasta, especially if it's whole grain. The restriction returning is not normal and somewhat concerning? What does your bariatric surgeon say about that?

In all seriousness, I think @kaylee50 has given you some great advice. Foremost, talk to your team. You may not "really" be hungry (It may be what we call "head hunger"), though it's possible. Either way, they should be able to help.

I'm pretty sure it was aliens. That's my story and I'm sticking to it! 🤣

Are you working with a dietitian? When you're actually underweight and struggling to gain weight, all the things you learned about losing weight go out the window. For example, if you're avoiding carbs, you need to stop. If you're watching your fat intake, that too needs to stop. As @ShoppGirl said, this does not mean you should eat junk, there are plenty of healthy carbs and fats you can add to your diet. Do a google search for things like "healthy calorie dense foods". You'll see nut butters and avocados, but also dried and fresh fruits, whole grain breads, potatoes (sweet and white), oatmeal, full fat dairy, pasta, etc...

Most insurance plans require your participation in a "physician supervised weight loss program". These tend to range from 3 to 6 months. For example, my insurance only required 3 months, but like @kcuster83, my bariatric team required 6 months. The main reason for this is that surgery alone isn't all that effective long term. To truly lose weight and maintain, we have to learn to change our relationship with food. In addition to that requirement, you'll likely also have to complete a psych eval and may, depending on your program, have to have any number of other tests done like blood & urine tests, CT scans, swallow studies, an endoscopy, etc. Depending on if you have other health issues, you may also have to get other specialist doctors to give their okay, which means even more appointments. It took me almost 3 years to make it through everything, though obviously I'm the exception. You can read all about my journey here: https://www.bariatricpal.com/topic/441618-spartanmakers-long-and-winding-road/ Best of luck.

High bilirubin has been reported post-op in many patients. The obvious reason would anemia due to an iron deficiency. Other deficiencies such as vitamins B1, B12, folate, A, K, D, and E and copper may cause hematological abnormalities as well. I agree that checking your vitamin levels is a good idea. That said, it could be unrelated to any nutritional deficiencies and if you are asymptomatic, may not be cause for concern?

Keeping with the 80s theme: Survivor - Eye Of The Tiger Journey - Don't Stop Believin' Queen - We Are The Champions

I ate some crackers and was fine. Also ate some mango salsa (raw onions, mango & peppers), on top of salmon and was fine there too. I have not done any raw carrots or broccoli yet. I'll probably hold off on that for another week or two, but raw veggies with some humus sounds really good right now!

For sure: Queen - Another One (pound) Bites The Dust

Isn't it crazy the way we evaluate things like that? Pre surgery, 340 calories would have seemed really low to me, even when dieting. Now, I probably couldn't eat that much if I tried. I suppose there's nothing that says you have to eat a full serving if it doesn't fit your goals. The protein content to calorie ratio seems decent, so one regular serving might actually be two for me right now.