ChunkCat

I agree with @NickelChip, this seems quite off. I've seen 800 calorie plans for bypass patients in the active weight loss phase, but most people are in the 1200 calorie range for maintenance... And your portion size will naturally increase a bit over time as you are able to eat more as your pouch heals. It won't be as much as a "matured sleeve" can eat, but it won't be a few tablespoons either. At the bariatric clinic I go to I attended nutrition class with sleeve patients and bypass patients, even though I'm a DS patient. We were all told to keep each meal to 10 grams of fat or less (general aim at 1 year out is 60 grams of total fat as per the ASMBS guidelines for a year out), and 10 grams of carbs or less, for less than 50 total grams of carbs a day, as they want us in ketosis during the active fat loss phase (this amount will double to about 100 grams of total carbs in maintenance). And protein varies for each group but bypass was to aim for 80 grams of protein a day, since they malabsorb some compared to the sleeve patients. NONE of us were given a calorie goal, only macro goals. We were ALL told to aim for 5-6 small meals a day for consistent energy, aiming for 4-5 meals if we go to bed early or get up late. So we were encouraged to eat about every 3 hours, allowing 2-3 hours between our last meal and bed. And told a fair amount of our carbs should come from high fiber, low carb vegetables and low sugar fruits, with a fiber supplement (SunFiber is amazing and non-bloating) and Miralax as needed to maintain regularity.

Hahahaha!! I eat a little bit of dark chocolate a few times a week for my mental health. I save it until after dinner and only have a bite or two, so it takes forever to finish a bar or bag of chocolate chips. But man, saving those carbs for that dark chocolate is worth it! 😂 I recently discovered freeze dried strawberries. OMG *swoon* I can't eat any raw fruit yet, it sends me right to the bathroom. But apparently freeze dried is fine and eating 1/4 cup of freeze dried strawberries easily fits into my macros. They are delicious crumbled on top of greek yogurt too! But they have to be freeze dried, the regular dried variety has sugar added and is waaay higher in carbs.

Yeah, you should have been given either macro goals, or a calorie goal, or ideally, both with the sleeve surgery. It isn't odd to not be able to digest heavy carbs like noodles, pasta, breads, and rice. And they really aren't the best things to be eating in the weight loss phase anyway. Pork can be quite dense, my stomach doesn't like it too much and it hates chicken breast. LOL When you eat things that your stomach is fine with, do you keep it down easily or does it cause vomiting and nausea? If you drink fluids other than water (like milk or a protein shake), does it cause the spitting, or is it just with plain water?

Even though you are a revision, your digestive system is still full of swelling and sutures from a major surgery! Hydration is king for the first two weeks, then protein, and both of these needs can be met with fluids... If you are experiencing nausea don't be afraid to ask for meds, it should help you be able to drink more. I agree with the others, sounds like a possible UTI. Best to go be tested at the doctor. Be sure to let your surgeon know approximately how much fluid you are getting in a day. Low fluid intake not only causes dehydration, but it can increase your risk for a UTI, especially in the first few weeks after surgery. ❤️

If you are counting total carbs you need to be under 50 grams total carbs to maintain ketosis. If you are counting net carbs you need to be under 30 grams net carbs to maintain ketosis. They aren't interchangeable. Some believe fiber and sugar alcohols don't impact blood sugar so they can be subtracted and net carbs followed, but that doesn't apply to everyone. I can't eat any of the high fiber "keto" products like breads. For me, carbs are carbs and keto bread will knock me out of ketosis just as fast as a chocolate bar. 🤣 I am not the norm, but it is incredibly annoying!! And I know others like me. Regardless, my dietician said we should count total carbs because net carbs are not a recognized measurement by whatever association decides these things. LOL Most fruit is high in carbs, yes, and so most people watching their carb count choose coconut and berries as opposed to citrus or bananas. Same with veggies, green beans would be a better choice than a sweet potato. Keep in mind this state of ketosis is not intended to last forever, so what might not be the best item to eat right now will fit perfectly later on in your nutritional picture when you can increase your carb count.

I'm so sorry you are experiencing this!! This isn't a you problem!! If you aren't losing sufficient weight you are either being given poor advice from your nutrition team, poor medical support from your surgeon, or it is possible your body is under significant stress for whatever reason and isn't losing weight. There are rare cases when someone with a sleeve doesn't respond but often those are people who have low starting weights. If they had a high starting weight and don't respond to the sleeve surgery, these people generally end up revised to bypass or a DS/SADI, and then lose weight, but again, that should be a convo being initiated by your surgeon as a future possibility if food modification and medications don't work. Some people take GLP-1 meds to help jumpstart their weight loss if the surgery hasn't triggered it, but again, at the 6 month mark this should be something the surgeon initiates conversation about. You shouldn't be living in fear of your appointments with them. If you aren't feeling supported you might consider getting a second opinion from another bariatric surgeon in the area not affiliated with this practice. I strongly believe in second opinions when talking things like surgery... It may sound like I'm being harsh on your team, but lets be clear. They made a nice chunk of money off of your surgery. You deserve good aftercare!! Some surgeons, like my own, believe that the best way to lose weight in the first 6 months to a year after surgery is through being in ketosis. This involves a good protein intake (60-80 grams with the sleeve) and carbs below 50 total carbs or 30 grams net carbs. You can get pee strips to test if you are in ketosis. Once in ketosis you should go through regular periods when you lose some weight, followed by periods where you lose none as your body stabilizes from the previous loss and recalibrates. If this doesn't happen, I'd definitely be communicating with the surgeon about it! What dietary advice did your team give you? Hydration is important for weight loss. If you aren't able to eat enough calories or drink enough water your body will go into starvation mode like @summerseeker mentioned. This is a huge stressor to the body!! And huge stress will cause weight loss to stop. Sleep is also crucial to weight loss, often more important than exercise. If you aren't getting regular sleep for enough hours per night, this can stall your weight loss. Physical activity of some kind is important, but it accounts for less weight loss than proper nutrition and sleep. And if you are under calories and under hydrated exercise will just further stress out your body.

Hey!! You are a little over 2 weeks post op. Burping and feeling bloated are quite normal. As the internal swelling goes down these will ease (unless you chug water, then you'll feel bloated for sure! LOL). It isn't unusual to feel like things are creeping up your esophagus, right now everything is very swollen in there and that leads to a pressurized feeling. It can feel like water and food take forever to go down, or that they go down a bit and then start trying to crawl back up, before going down again. I had all these issues. I also had this thing where every time I drank something I could feel the fluid displacing air in my digestive tract, causing burping and then this trickling, gurgling feeling AND sound as the fluid tracked down into my stomach. It sounded like liquid going down a drain you just unclogged. It was weird as hell. LOL It lasted for the first month until the swelling went down enough inside to make more space. Fluids for another week are not going to hurt you. When you say fluids do you mean strict liquids only like milk and water? Or are you including shakes, pudding, yogurt, and so on? I was on strict fluids only for 2 weeks, no yogurt or puddings and I wasn't even able to stomach a real protein shake for the first month. I was not able to get any protein down the first two weeks without intense stomach spasms. The surgeon said that was not unusual at all. After the first two weeks we were supposed to introduce thin purees for the third week, and he told me I could have really soft fish and soft eggs. I hated purees. Yogurt sat too heavy. I still couldn't do jello. Sugar free pudding was a no too. I could do protein water, milk, a little bit of soft pureed egg, and weirdly enough, a little soft fish chewed well. At the 4th week we were told to progress to soft solids, but it took me another week before I was able to consistently. I had to be very gradual about my food progression. My team said that was perfectly fine, everyone's pace is a little different, just be sure to keep them posted on your progress as you go and follow their advice, but without forcing yourself to eat things your tummy doesn't feel ready for. You sound like you are right on schedule. ❤️

I like roasted edamame as a vegetarian protein snack. Not sure if they sell it on BariatricPal, but I know they have a variety of roasted beans and most of them are pretty tasty done that way. I also like the Quest protein chips in the sweet chili flavor, they are vegetarian though not vegan. My favorite vegetarian protein sources are tofu in all its forms (I married a Chinese person so I am quite familiar with the many forms of tofu!), as well as beans, and I like products with wheat gluten. Tempeh is nice too and certainly high in fiber. My favorite vegan shake is the ones made by Four Sigmatics. They have medicinal mushrooms in them, though you don't taste them. The plant protein sources are really nice and the shakes actually taste great, especially the peanut butter one!! OMG I don't use them now because I actually need whey protein isolate with the DS surgery, but they were nice in years past and give a great energy boost thanks to the medicinal mushrooms.

Yes! I had debilitating back pain that was causing muscle weakness in my legs. I could barely walk up 2 steps, I couldn't do a flight of stairs. Every time I stood for more than 5 minutes I'd start to get intense spasms all across my lower back radiating down into my butt and the only way to stop them was to lay down. I got them when walking too. It severely limited my mobility... I noticed a few weeks after surgery that the pain wasn't as bad. By 3 months post op the pain was gone!! I can walk as long as I want to now. I'm working on rebuilding the muscles that were weakened by the pain and inactivity. I'm so, so, SO grateful for my surgery and the pain relief. I was having to get injections into my SI joint every few months and I was still having the spasms every day... So glad to be free of those, man were they painful! I am starting to get the hyperextension pain @ms.sss describes from sleeping on my stomach too. I guess because my spine has to curve in the other direction now that my stomach is going down! LOL

2 lbs a week is considered "rapid weight loss". I know it doesn't seem like it, especially when comparing to others progress, but it is true... By 3 months you want to have lost 25% of your excess weight to be "average" and right on target, though even if you aren't at 25% lost there is still hope, because some people lose very slowly the first 3 months, then pick up the pace. If your surgery weight was somewhere around 286 and your goal is 150, your excess weight is 136 lbs. 25% of this would be 34 lbs. You have lost 43 lbs. So you have actually lost 32% of your excess weight! That is excellent!! You are ahead of schedule... Percentages IMO are much better to use than actual lbs lost because it is the percentages that really show you where you are! And on a funny note, I was exactly where you are at 3 months--43 lbs lost, 137 lbs excess weight, so 32% towards my goal weight! LOL Your team should be thrilled! Sorry your boobs are going south too... A good bra does help, I am losing fast in the band size for some reason, I have to buy a new bra every month! LOL

HAH! I would have gone over his head too. Liver biopsies are not pleasant, the liver hates them. Why do something invasive when you can do an MRI first!?

I had stomach spasms post op for several weeks and couldn't tolerate anything heavier than a thin shake or protein water, not even jello... Spasms are one of the rarer side effects of surgery but they normally regulate on their own in time. Still, it is good to talk to your surgeon about it. There is a medication that occasionally works for stomach spasms (it didn't work for me) but I'm not sure if there is one for esophageal spasms. Since you had the bypass, there is also a small but distinct possibility that you may need the connection between your esophagus and stomach stretched a little or you may have a stricture somewhere. These are all very treatable things, usually done with just an endoscopy! ❤️

I think that is a reasonable ask given your history and your past MRI-spectroscopy... Hopefully they can get insurance to cooperate!

Honestly I think this is one of the reasons therapy is so helpful when going through this experience. Even if you don't go every week, having a person who has both perspective and understands the ins and outs of abusive relationships and how they echo through us for years after can be immensely healing. You are changing a LOT and it is normal to have feels about that. And he will have feels about it too, because he loves you and as you change, he will have to change in some ways too, to accommodate and appreciate the ever-changing being that is you! My partner doesn't care what weight I am. I gained 100 lbs since we were first married. We've been together 17 years. They look at me with just as much, if not more, desire than they did when I was young and smaller, which is hard to wrap my head around! They have always encouraged me to dress in ways that feel good. They prefer curvy women, always have. I have been worried that as I lose weight they might lose some of that attraction to me because in time, I will be smaller than they've ever known me, smaller than I've ever been in my adult life! But they assure me that while they aesthetically like the look of curvy women, they LOVE me in all my forms and my health and wellbeing is more important than anything else and no matter how I change, I will still be beautiful. If they loved me at 200 and they loved me at 320, they will love me at 170 or wherever I land. I've done enough work in therapy with the abuse I dealt with in the past to be able to trust what they say. But it still gets to me sometimes... Today I noticed my boobs have become visibly flatter. This is really hard for me because I LOVE MY BOOBS. 🤣 I have always been booby and I like it! Last year I found out I carry the CHEK2 mutation and with my cancer history combined with it I have a much higher risk of developing breast cancer than I'd like. The specialist I saw advised I consider an elective mastectomy after my weight loss stabilizes. I understand the logic, but I've already had to bid goodbye to my reproductive organs thanks to cancer, I wasn't expecting to have to consider saying goodbye to my boobs too. So I was standing in the bathroom today having the feels about my flat boobs and my partner came in so I pointed out the change. They admitted they could see the difference but very stubbornly said "These are my favorite boobs in the whole world. They are the best boobs ever, no matter what size they are." FFS, really?? Am I not supposed to cry at that?? They said something similar when we talked about a mastectomy. I feel very lucky to have a partner that can abide all the changes that I've gone through in this life and still look at me through the eyes of love. I hope I succeed at giving that back to them...

I'm pretty sure most of us were a combination of excited and nervous! LOL It is an exciting time, waiting for surgery, but it is also a bit nerve wrecking because, well, you are waiting for surgery! And you are waiting for this big new change in your life... Good change usually makes me both excited and nervous!

Yeah mine generally stays close to 50 and everyone seems to ignore it. I think if yours continues to track upward they may want to do some imaging just to be sure nothing is wrong. Is your AST elevated at all? Or is it just the ALT?

I think doing a comprehensive set of body measurements is much more accurate than a number on the scale. I do use my scale, but when I was in a 6 week stall it was those ever decreasing body measurements that showed me I was still making progress! I do them on the monthly anniversary of my surgery, which for me happens to be the 1st of the month so it is extra handy. LOL I measured everything. My wrists, ankles, calves, neck, upper arms, thighs, hips, overbust, bust with and without a bra, and underbust, plus my waist and the area where my stomach protrudes the widest. I have lost everywhere, even in my wrists. 🤣 Pictures once a month in the same/similar outfits against a door in your house in clothes that fit close to the body are great too. The door helps your brain see the scale of things better IMO.

Hi Nancy! I've had a high ALT value since my 20s. They said it could be from fatty liver, but I also have arthritis and the bone/joint degeneration from it can cause levels like that too. How high is high? Are we talking a little bit out of range or quite a large amount out of range? I highly recommend you go over to bariatricfacts.org I post over there regularly and there are a number of vets there who are 10+ years out from DS surgery who will probably be much more helpful about this than anyone here. There just aren't many DS people here who post or read the forum... Also, there is a FB page with a ton of DSers, including a number of 10-15 year+ vets who could might have some experience with this. https://www.facebook.com/groups/1799552573392212

I'm a little confused. According to your sidebar you've lost almost 100 lbs in 3 months?? How much were you expecting to lose? I'm guessing your surgery weight was different than your starting weight. To put this in a bit of perspective, I had surgery almost a month before you (Nov. 1st), my highest weight was 320 but my surgery weight was 307 and I'm currently at 251!! And my weight loss is considered quite a good pace and certainly within the realms of an excellent result thus far. That change in clothing size is way more important than a number on the scale! Feelings with these surgeries are tough because for some reason our brains expect years of weight to take a few weeks to come off. LOL Everyone thinks they need to lose faster, even the fastest losers among us. Everyone thinks they should be further along, even if they are quite far. We have really high expectations of ourselves and our bodies, probably in part from years of everyone else having unrealistic expectations of us and our bodies. This surgery is an opportunity to give ourselves a bit more kindness and compassion, and maybe recalibrate our expectations. Healing takes time. Even with surgery, weight loss takes time. And the entire process is SOOOO frustrating! I get it, I experience frustration on a regular basis. Today I was lamenting the fact that suddenly my boobs have flattened like pancakes. 😢😂

Andrea, have you lost just the 4 lbs from your surgery weight in November? Or do you mean in the last week/month?

Yeah, I either had to have drinks very cold and icy, or very warm...nothing in between. It was interesting and I was super grateful for my thermal cups. I got in a lot of decaf tea, broth, and iced flavored water. I couldn't stomach any protein other than milk for the first two weeks, but after that, the first protein I was able to get in was a clear protein water. I went with MyProtein Sour Watermelon clear whey mix because it is cheaper than SEEQ but tastes very similar. MUCH better than the bottled protein waters I tried! And I was able to water it down so the taste wasn't so strong. They sell sample packs on their site, never buy their tubs at full price, you can usually get them 40% off! Anything sweet for me had to have a sour component or I couldn't get it down. It took almost a month before I could drink a regular protein shake, and even then it sat heavy and was best thinned with milk. I couldn't get down the Unjury protein broths. I still have containers of them in my pantry!

I'm glad it helped!! Oh yes, I forgot to mention that, moving to soft foods will help some, purees just don't have as much solidity to them. There is a huge difference between a 1/4 cup of pureed food vs 1/4 of a solid protein, even if it is a soft protein... At 8 weeks I was cleared for most foods and I think that is part of the reason why my hunger started to ease off around then. If your PPI is omeprazole it is possible it isn't working as well as you need it to, sometimes people need something like Pantoprazole or Dexilant, so if that gnawing hunger at night continues you may want to ask your doctor about it at your next appointment! ❤️

Did your surgeon discuss Gastric Bypass or the SADI or Duodenal Switch with you? With your starting weight, you might want something that gives you more than the restriction of the sleeve. Especially if you only lost 100 lbs with the band... All three of those surgeries have varying degrees of malabsorption which help you lose weight for longer and the SADI and DS are usually used in patients with a high BMI. But, not every surgeon is trained to do these surgeries. If your surgeon didn't offer them to you, I'd highly recommend finding a surgeon that will. The convo is worth it. Unfortunately I can't comment on how the sleeve feels vs the band, since I never had the band. I have a sleeved stomach (as well as rerouted small intestines) and for the most part it feels normal. Do NOT believe anyone who tells you that you won't be hungry post op. Some are lucky enough to lose their hunger for the first year, a few lose it permanently, but some of us never lose it at all. I woke up in recovery hungry and boy was I mad! LOL But my surgeon had warned me that not everyone loses hunger. The portion of the stomach that is cut out contributes to a number of hormones that can affect hunger and satiety... The rerouting of the intestines that the Gastric Bypass, SADI, and Duodenal Switch do controls a whole host of hormones too, some different than the ones in the stomach, this is why these surgeries are more effective at helping with comorbidities like diabetes and high blood pressure, and why they are a bit more effective for higher BMI patients.

Genepro has unflavored protein powder and it dissolves pretty well into things and it doesn't really have much of a taste. It is my favorite plain protein powder. You can put it in flavored water or tea or milk or whatever... Just be sure to count the protein count on the nutrition label, don't believe the "nano absorption" bull crap they advertise. LOL

Did the hospital give you the little 1 oz cups to drink out of? If so, fill them and try to get in 2 every 15 minutes. If not, get a few shot glasses and line them up, fill them, and try to drink 1-2 every 15 minutes . I know, it sounds crazy, but it works. 8 oz an hour means you'll have 64 oz in 8 hours! This way I was able to hit 64 oz by day 3 post op. Some people drink certain temps better than others, so try warm tea, iced drinks, and room temp to see if it makes a difference for you. My nutritionist suggested drinking out of the little cups and then graduating to an actual cup instead of using a water bottle because we gulp less air when we drink from a cup. I found this to be very true. I had to flavor my water to get it down post op. The sugar free Jolly Rancher water flavoring packets are my favorite. I had to water them down a good bit, but they helped a lot. I also kept an insulated cup with hot broth in it to sip on. Broth, milk, sugar free popsicles and shakes all count towards your hydration goals!