ChunkCat

Looove the plates and silverware @NickelChip!! I don't have any fine china but I love the look of it. Once I'm not in an apartment or moving around the world anymore, I am determined to start a collection. LOL For now I just ordered some smaller plates, bowls, and tiny silverware to accompany the larger normal portion plates and bowls I have. It has helped immensely. If you have to eat small portions, they might as well look pretty!!

When you introduce foods in the soft food stage the brain can go through this panic when it sees a small portion in a big dish. It thinks you are starving it!! I found the smaller dishes really helped calm this voice and helped me be mindful of how much I was eating. Plus it helped me reprogram that "clean your plate" mentality so many of us had drilled into our heads from childhood. If you only put the appropriate amount in your tiny dish, it doesn't feel so bad if you leave that last bite...

It is different for everyone. I track and am 3 months out from surgery. I find it really helps to know what my macros are at the end of the day. I don't weigh my food very often because I'm really good at portions (I used to be a chef) but tracking keeps me accountable. And my surgery has a malabsorpative component so I really have to be careful I'm getting enough food.

I will say though that when I researched it, most studies show that people who track their food (at least for a few months) lose more weight in general weight loss attempts and maintain that weight loss better. I don't know how that translates to bariatric surgery, they probably haven't studied it, but when you have a carb limit to stay in ketosis (not every doctor requires this but some do), or a high Protein goal to reach, tracking your food can be helpful.

I sometimes take a break for a day if I've been out a lot or I'm traveling or away from the internet. I figure doing it most days is good enough for me. I trust that the habits it is helping me cultivate will kick in on days I can't write things down. Plus sometimes it really surprises me how I might think I'm doing well on protein or low on carbs and then I put things in and find what I assumed was true was not in fact true. LOL

Our tastes can change radically after surgery. Mine changed at about 2 weeks post op. I was SO mad!! LOL I didn't want to eat anything I had been eating. All my Protein supplements tasted awful. Soup I loved 3 days before was vile. I felt like a pregnant woman!! 😂 I think part of it is being in ketosis, it does funny things to the body. And part of it is the hormonal surge we get after surgery as we start losing weight. I've talked to some who say it eases up and others who had it throughout the rapid weight loss stage, but their normal tastebuds came back once they stopped losing weight.

I'm 3 months post op and right now I hate avocados (I used to eat them every day), and I can't taste sweet spices like cinnamon, nutmeg, and cardamom. I can't tell you how much this annoys me. LOL On the upside I like fish a lot more than I did before and that is great because fish is the gentlest meat protein you can eat and it packs a punch nutritionally!!

Catwoman7 is right, this could be hormones... Some stabilize after a few weeks, others it takes longer, it depends a lot on how your individual body deals with it! I felt like I had the worst PMS for a few weeks, I cried at the drop of a hat, I was angry and moody and down. But it has balanced out.

Also, major surgery all by itself can induce periods of depression post-op, this is not unusual and will fade in time.

I had nausea daily for the first two months, then it suddenly faded away. One thing my intuitive eating coach suggested is starting my day with a shake or Protein hot cocoa. This is because our tiny tummies can get a little dehydrated overnight and trying to put food in them first thing is uncomfortable. Easing into the day with fluids firsts rehydrates the tissue. Even with this I had to take nausea meds for 2 months twice a day. I found Zofran wasn't helpful so they gave me promethazine, it worked much better. And I never get much use out of omeprazole so I'm on pantaprazole in the morning and Dexilant in the evening. Don't be afraid to tell your team something isn't working if you try their medication adjustment and it isn't helping...

Oh and one last thing, if you take meds for depression, you might want to let the person who manages them know you are feeling down. Sometimes depression meds need a bit of an adjustment a few months after surgery. Our absorption of things can change. But if you aren't on meds for depression, the above reasons are probably why you are feeling rather down...

15 hours ago, AmberFL said:

So my targets are 60-80g of Protien Less than 40g carbs and less than 15g of fat. So I think I need to re-evaluate my food choices. It’s a learning curve lol

I would suggest maybe asking them why your fat target is so low? Is this a temporary target? Most studies now are showing we need 30 grams of fat for healthy brain function and more like 50-60 grams of fat for proper sex hormone function, regardless of our caloric intake. I asked my dietician about this and she said the ASMBS (American Society for Metabolic and Bariatric Surgery) suggests a fat target of 60 grams daily by 1 year post op. I can't find a reference to this on their site because there it is behind a member wall, but your dietician should have access to this and it is the guidelines most good programs follow.

By all means, follow what your team says, I'm not saying to ignore their targets, I'm just pointing out with fat that low you may experience brain fatigue, dry skin, dry eyes, and your meals may not feel as satiating since getting enough fat is a component of satiety.

But other than that your numbers look amazing for how early out you are post op!! Your surgeon should be thrilled you are able to get that Protein in, it is soooo good for wound healing!

I have to eat every 2-3 hours and have since I was post op, so I eat 5-6 small meals a day. I prefer this because it keeps me from mindless snacking, provides a rhythm to my day, and allows me to get in a variety of flavors and textures. I'm only 3 months post op, there is no way I'd get my daily macros in with just 3 meals a day. My stomach doesn't have that capacity and if I go past 3 hours without eating my energy crashes, I feel light headed, nauseous, shaky, and irritable. Each person's body is different, but by necessity I ascribe to the "eat less more often" method and I'm not alone in that need. My target macros are 120 grams of Protein, 100 grams of fat, 40 grams of total carbs, calories don't matter because I malabsorb a good percentage of fat and a moderate percentage of protein.

8:00 am Premier Protein vanilla shake

9:30 am 3 tablespoons hashbrowns, 4 cherry tomatoes, 1 1/2 scrambled eggs

12:00 Ratio Coconut Keto Yogurt and 2 tablespoons Diabetic Kitchen Granola

3:00 pm Espresso with 1/2 cup Fairlife Whole Milk, Quest Spicy Sweet Chili Protein chips

6:00 pm 1 grilled chicken thigh, no skin, 3 tablespoons green Beans

9:00 pm 14 Wasabi Soy Roasted Almonds, 1 Choxo Dark chocolate Coconut Cup

Total Macros: 116 grams of Protein, 40 total grams of carbs, 78 grams of fat, 1305 calories.

This is pretty typical for me. I don't always eat the protein chips, I was just in a hurry and they are one of my go-to Snacks when I can't have something perishable. Normally they'd be a protein and veggie.

Wow, you look great @Char V!! You have obviously exceeded his expectations of your weight loss!!

Yeah, I grew up pretty poor and finishing the food on my plate was a huge thing. My parents were excellent at food guilt and money guilt. But I've put a lot of hard work into letting that go because it just wasn't a healthy mindset for me... My fridge is full of leftovers like most bariatric patients, and we actually eat most of the leftovers (my partner too has weight issues and is diabetic). I try to order things that can be leftover and still taste decent. But every once in a while I set that aside and just get what I want, even if it won't be finished. My mindful eating coach challenged me to do that to teach myself that eating more than what I need is just as much a waste as throwing it in the trash... None of us can avoid food waste. It is fine to try and mitigate it as best we can while at home, if that is what our values dictate. But when eating out I need to sometimes practice leaving food on my plate and being okay with that... It was hard, but I'm working on it!! Still, I would be unpleasant if someone opted to point out my "wastefulness". 😂

Traveling all around AU working is definitely stressful on the body AND the diet! I recently opted not to go on a business trip with my partner because I didn't want to deal with attempting to eat for a week out of my hotel room without a fridge. Even I have limits regarding food wastage. LOL If we were driving there and I had a fridge it would be different, when we travelled for the holidays when I was 2 months out I was fine. I got a lunchbox that fit a fair number of shakes and Protein Snacks, cheese and such, and made sure to carry protein snacks wherever I went. But this gets considerably harder if you are flying around to places...so I decided to stay home with the cats. LOL Are you flying to various places or driving?? Sydney is such a lovely city, I really enjoyed my week there. Though it wouldn't be as much fun in a moonboot!!

I thought about this a lot when considering surgery. I talked to my surgeon about it and he said as long as I ultimately live in a city where there is at least 1 surgeon trained in my particular surgery (the DS), he'd feel comfortable doing the surgery. Fortunately I knew where I'd be moving in the next few years (New Zealand) so I can ensure that will be the case. I also tend to travel to major cities instead of obscure, out of the way areas.

But my surgery is rather rare, so it does limit my options some. You however are getting the bypass. This is a very common surgery the world over. We have members here from all over Europe (and other places) and they don't seem to be lacking in care. Though their post op diets can be pretty entertaining! LOL If you were looking to go to a rural area like a small village in Africa, then I'd have reservations. But these surgeries are commonly done in the UK, France, Italy, and Spain. I don't think you'll have an issue getting care in any major city in these places. Again, I can't really account for rural areas, but I have met people in the UK, France, and Italy that have had WLS and while their options for shakes and Vitamins may be a bit more limited than in the US (usually due to the artificial sweeteners allowed in that country) but they didn't seem to me like they were struggling to get care.

I'd scout out a few bariatric centers in the areas you are considering and see if they offer your surgery. When you pick a place you could consider emailing to ask what their aftercare looks like for a client that may be coming to that area post-op and in need of follow-up care. Then have a look at the travel medical insurance policy you are considering and check to see what (if anything) it says about bariatric care. Keep in mind the medical complex in other countries is structured differently. Some places (like the UK and NZ) rely very heavily on GPs to coordinate care and specialists, even moreso than in the US, so they may ultimately be the ones monitoring things like labs, and then refer you out if you need more specialized care.

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.❤️

The gas is probably from the carbs. Especially simple carbs, though complex carbs can cause it too. DS/SADI patients have altered small intestines and those shorter lengths digest carbs differently than the full length did pre-op. Things with sugars in them, like carbs, can cause gas to build up as part of the digestion process.

In addition to this, some people are sensitive to FODMAPS. That can happen with or without surgery. Onions are a huge FODMAP trigger food! Your gut may be reacting to these foods. You can try an elimination diet to see if it helps.

But really, cut the carbs if you want peace. DS/SADI patients need about 90-120 grams of Protein (120 grams is ideal, or whatever it takes to keep your protein levels at 7 or above) about 100-150 grams of fat depending on the surgery, and ideally we keep carbs below 50 grams during active weight loss, some go below 30 grams. But even in maintenance, we need to watch the carbs if we want to avoid gas and other digestive issues.

On 1/19/2024 at 11:38 PM, Clueless_girl said:

So the pain, discomfort and nausea will last a whole month? I have tried all of the meds the surgeons prescribed for those issues and I have to take them religiously everyday for some relief. But I am just now into my 3rd week. Sometimes it happens in the evenings, sometimes it's all day. I even sleep with a hot water bottle to ease the pain. I got the go ahead to go onto the soft diet, but after a few days, the liquid diet is easier to stomach. I don't think I've hit my Protein and Water goals once...

Everyone's recovery is different. I had no pain after a few weeks, other than some internal tugging of the stitches when I changed positions. But I am still on a PPI, those are wise to take for a while after surgery. My nausea eased around 2 months after surgery. I was taking meds for it every day (promethazine), twice a day. This isn't because of the DS, this is because any procedure on your stomach can cause nausea for a while. But again, for some it is brief, some it is longer.

Focusing on hydration goals is important in the first few weeks because it is hydration that will keep you out of the ER with dehydration. Our bodies have enough Protein stores to get us through those first few weeks. After that, protein is a slow, steady progress sort of thing. I was about 3 months out before I could hit my protein goals. I get about 120 grams a day now. But I hit my Water goal from day 2, because I desperately wanted to avoid dehydration!! How are you feeling now?

And yes, by all means, if you continue to have problems after modifying how you are eating, do follow up with the nurse. There are a few things that can prevent you from progressing your diet past liquids, but they are rare, and if you are getting down yogurt it is a good sign!

13 hours ago, Raevor85 said:

Now the other issue im having is eat pureed foods. I have threw up every time i try to eat the recommended foods and measured amount. I tried to puree the food myself but maybe im not doing it right. I called the nurse anyway and was advised to puree it more, take smaller bites ( i mean how small do i need to do really like a baby spoon? ) and if im still having issues in 2 days call back and they will figure out something from there. When i swallow it feels like its stuck in my throat and just sits there and it hits my gag reflex when i drink Water ( after 20 min of eating) so everything is just floating around in my throat and blam its coming back out. I feel the measurements i was advised to eat is still too much for me 1/4 cup i cant eat it. The only thing close to normal i can eat is yogurt and that is technically in the full liquid category.

Homemade purees should be completely smooth, like yogurt or pudding. No bits, no lumps, no bumps.

I was advised to take bites no bigger than my thumbnail and yes, use a baby spoon! Most of us use smaller utensils, at least at the beginning. Even with bites that small, and even though it is pureed, you should chew it just to ensure it is smooth before swallowing. Then set down your spoon/fork and give it time to work its way down.

The advice to eat a 1/4 cup is the MAX you should do, NOT the minimum. Most of us could only do a few tablespoons of food to begin with, if that. Don't eat more than your tummy can handle. Give food time to move down your throat and into your stomach before you eat more.

Relax, eating should be slow and deliberate. And it should take a lot of time to eat, like 30 minutes or more. Don't drink within 30 minutes of eating. 20 minutes is too soon. Some have to wait a little longer than 30 minutes, it depends on how long you personally need to give digestion to complete and move the food out of your stomach. In the beginning I needed to wait 45 minutes.

For many of us, yogurt was considered a puree, it is a heavier texture than a liquid. So if you can do yogurt without thinning it down, you are doing good! It is fine that it was in your full liquid stage, but it is still good to have in pureed stage.

Try the above suggestions and see if that helps. It really sounds like you are eating too much too fast. Take the amount of time you think is slow and double it! Take the bite you think is small and half it, at least! Your tummy is very brand new, purees are heavier than shakes, it is normal for them to take longer to make it to your stomach, and longer to digest. ❤️ Good luck!!

What surgery have you had?? It is much easier to find a support group for, say, a sleeve patient than for a DS patient. I agree with @Kri-star, check with the local hospital that does bariatric surgery. Austin is big enough to have a few support groups around, but a lot of the hospital support groups still meet online thanks to Covid!

I'm in a DS support group on FB that I love. So you might want to check around on FB and see if you find one you love. Often you can post in the big ones looking for people in the same area and plan a meet up!

Try thinning out the cream Soup with some chicken broth and eat only about 1/4 to 1/3 of a cup at most. Over time thin it out less until it is the normal consistency. Cream Soups sit heavier than broth and my stomach counts them closer to a pureed food than it does a Fluid. So I follow the food portions with them. I had to be very strict about this after surgery because just one bite too many and I'd be in the bathroom throwing it all up! So not cool...

I love when people name their tiny tummies. LOL Mine has not claimed a name yet!

Yes, make it clear to the doctor this revision is for treatment of your GERD and Tricare should go along with it. Reflux coming up your throat that far puts you at risk of aspirating it. I ended up in the ER with severe asthma attacks from that and got pneumonitis several times from acid burns in my lungs. It is NOT fun.

This wouldn't be a second weight loss surgery, this would be a revision due to a medical problem that the surgery will treat. So it won't conflict with their "once per lifetime" clause.

On 1/29/2024 at 4:29 AM, Char V said:

I have been busy with work(own business, work from home) but I have been staying 200km away from home 2 days a week as I have stuff on. Mostly immediate family stuff. That has interfered with my eating and drinking routine. I don’t feel happy/excited to eat out in public. Being judged for what and how much I eat. A friend complained I was wasting food.

Does this friend know about your stomach surgeries?? If so, I would have looked at them like they had lost their mind. And I would have told them if they ever voice their judgment about my eating habits again they'll lose the pleasure of sharing a meal with me. Yes, I can be a b***h. LOL But I grew up in a family of people with BAD boundaries. And this is a bad boundaries behavior. Our society is so preoccupied with weight loss and shaming fat people, then when we do something to change our bodies they judge us for that too. We can never get it right. I've decided people are going to judge me no matter what I do. So I do what I want. But I don't have to listen to their opinions of me!!

My partner loves eating out in restaurants so I've had to adjust to that post surgery. But in general I'm doing fine with it. Most people in the restaurant never notice how much I eat. I don't get weird looks. The wait staff doesn't comment. The only odd response I got was a confused waitress when I said I wanted my Thai curry without any rice--I can't eat it, so why waste it?? The sweet owner at our favorite pho place puts veggies in my pho now because I can't have the noodles! That made my heart happy... But part of the reason I don't get any odd looks I think is because I eat relatively slowly, put my utensils down between bites, and generally take as long to eat my small portion as it takes my partner to eat their normal portion! Then we take home lots of leftovers, which is convenient considering I eat 5-6 times a day! LOL

I'm sorry your friend opened their big mouth and said something stupid. I know you have struggled SO much with being able to eat, you would think they'd be celebrating the fact that you could eat ANYTHING at this point!! The best weight I have ever lost in my life has been the weight of other people's opinions, and sometimes, the weight of other people period! 😂

And here are my stats! I cannot believe I am 1/3 of the way towards my goal and that I've lost 76.5 inches from all over my body!! I definitely feel it!

Okay, so keep in mind I took these photos straight out of bed because I was rather cranky about taking them at all. LOL But I'm glad I've kept up with it!! The grey one is pre-op to 3 months post op, the green top is 1 month post op to 3 months post op! I love you guys but I am not posting my underwear photos. 😂

On 2/1/2024 at 10:01 AM, BabySpoons said:

I have lost over 100 pounds and have some loose skin, but I am getting cryo therapy twice a week. It helps to produce collagen and tightens my skin as the weight comes off. If I had waited till I hit goal weight, I don't think it would have been as effective. I also sit in an infrared sauna which has its own list of benefits. Rebounding helps too.

Babyspoons, do you get the cryotherapy on just your body or do they do your neck too? A very rude esthetician pointed out my turkey neck this week while I was roaming through the mall. I'm pretty self conscious about it because it is a hereditary thing in my family (along with jowls). I don't want to do a facelift in my early 40s so I am searching around to see what treatments might be available for me to do as I lose weight so I don't end up with quite as much loose skin there...

4 minutes ago, Arabesque said:

I even looked at prosthetics but they’re not right shape. Can’t believe no one has developed something yet because many women have the same problem after breast feeding, Not everyone wants to get implants or have a reduction.

I'm on a bra fitting FB group and this complaint gets posted ALL THE TIME!! Usually by post nursing moms and weight loss patients. I too am really surprised no one has targeted this market with a cutlet thing that helps fill in that space and can be transferred from bra to bra! The prosthetics don't work because they are for a totally different breast issue. And push up bras can only do so much and sometimes make it look worse!!

FWIW, dehydration will cause at least half the things on your list... I know it is hard, but you really have to hit that 64oz minimum as soon as possible. Dehydration is a major complication after WLS and it will do a number on your skin, make you tired and nauseous, contribute to dizziness, and worsen head hunger...

You are only a few weeks out from a major surgery, low libido can take a while to rebound and the rapid weight loss releases bursts of hormones that cause mood swings, sometimes impacts our libido, make our cycles weird, and caused a few meltdowns in our house early post op. 😂

For the Constipation try stool softeners combined with Miralax. These are non-stimulants so your system won't get addicted to them like it can the stimulant laxatives. Also, try increasing your fat a little. That might help with the dry skin and dry lips too. The post-op diets are extremely low fat, which made me super fatigued too.

You are 6 days post op?? You should be getting the bulk of your Protein from things like Protein Shakes, protein waters, fairlife milk, and other things like that. Your tummy is way too small and way too raw to be getting your protein from actual food yet. I know every surgeon varies and some do purees early, so I won't comment on that, but even then, you can't possibly get enough in on food alone to hit your protein goals.

Some soft things to try on the puree and soft food stages: very softly scrambled or poached egg, cottage cheese, ricotta cheese, greek yogurt, sugar free pudding, sugar free Jello (you can even get protein jello), some even include bean purees though I found those VERY hard on my stomach. You can also puree Proteins into a Soup base. I did a lot of cream Soups and strained soups. I was on strict liquids the first two weeks. In soft foods you can also try things like egg salad, chicken salad made with chicken thighs because they are more moist, and tuna salad, but don't add things like onion and pickle to it yet. Too rough.

ETA: Generally patients are encouraged to focus on their hydration goals for the first two weeks. This is because dehydration is the number 1 complication of bariatric surgery. Our bodies have protein stores that will last us the first few weeks after surgery. So focus on those 64 oz of Water and if that is going well, then you can think about getting some protein in as a bonus!

My favorite thing on the liquid diet was strained Soups. We just bought a bunch of Campbell's Soup flavors, strained them, and I drank the broth for "meals" to break up the sweet!! I especially liked the cream soup flavors, though you need to be careful to make those with a lactose free milk at first to be extra kind to your healing tummy. I also drank a number of broth flavors from Kettle & Fire. They are expensive but I figured they were worth it for that phase.

What really saved me though was ordering pho broth from the local Vietnamese shop and straining it...and hot and sour soup from the local Chinese shop and straining it. The contrast of flavors was HEAVEN. I did that a lot the first month.

Are you on a PPI like omeprazole? If not, you may need one... Many of us experience stomach acid issues post op, especially as we introduce solid food. Our tummies are still making acid for a normal sized stomach and that can cause a lot of discomfort. If you are already on omeprazole, you may need to take it twice a day or try a different PPI. I'd talk with your surgeon about that.

The pain you are describing could be from a number of things. I'd call your surgeon and discuss it. Strictures are unusual in sleeve patients, but on occasion they can happen and it is best to rule them out when experiencing pain with eating that suddenly appears weeks out from surgery. Good luck!!