NickelChip

@LindsayT It's just amazing what a transformation you've had in less than a year. So inspiring! I am counting the days (11!) until my surgery.

You are looking absolutely amazing! So healthy and happy! I can't even imagine what it must feel like to go from a size 18 to a size 4. Lordy, I haven't seen 145 lbs since I was 17. Congratulations! If you don't mind my being nosy (because I am close to your same starting weight and height, and probably age too), how is your loose skin situation? Have you posted your before photos on here somewhere?

Oh yes, I've heard of Dr. Puebla. Great reputation and the prices in Mexico are incredible. My starting height and weight and end goal are really similar to yours, actually. I swear, I just can't picture how I'll look at the end at all. But I guess if there's a chance I'll want skin reduction surgery, I should get going on Duolingo! I wonder how much Spanish I could learn in two years...

Three bits of advice if you can manage it: 1. Curbside pickup for groceries 2. Takeout instead of eating in for your restaurant meals 3. Hotel close to your hospital for the night before if poor weather is at all a possibility. For many reasons, my mom and I are staying in a hotel the night before my surgery, and Mom will stay the next night while I'm in the hospital. Traffic, early call time for surgery, snow. I live about an hour from the hospital and there is a nice Courtyard Marriott about 1 mile from the hospital on a very busy road that is sure to get plowed 24/7. Plus my mom hates night driving, especially to and from areas she doesn't know well, and she wanted to be sure she could come see me in recovery and feel safe driving by herself.

Yeah, so I chose the RNY gp because I liked that it has a stronger metabolic impact than VSG while not being too malabsorptive like DS. Based on the risk calculator, there was a somewhat higher likelihood of addressing/resolving my hypertension and blood sugar issues, and I didn't want to risk developing GERD and requiring daily medications or a revision. I need this to be a one and done surgery if possible for financial reasons. Given that a full 20% of my surgeon's practice is revision (mostly to RNY, but they also do DS), this revision issue felt like something that is common enough with sleeve patients to give me pause. Also, my brother had the sleeve 15 years ago and while his overall weight is still well under where he began, his weight regain has been significant. I wanted the additional threat of dumping syndrome to keep me in line where sugar is concerned. And also, the more I thought about it, the more I preferred the idea of rerouting instead of removing parts of my organs. As for not telling people, I was tempted to do that, too. But the more I thought about it, the more I decided to just own it. A lot of people out there mistakenly believe obese people can "just" eat less and exercise more to lose weight and keep it off. How many of their real life examples are people who quietly got WLS and then credited their diet and exercise for their transformations? I don't want anyone using me as an example in the future to tell some other obese person what to do. Thankfully, I turn 50 in a few weeks and have therefore reached the age where I officially no longer give a fig about what anyone else thinks and am happy to direct naysayers to a wide selection of their own body orifices where they are welcome to stow their unsolicited opinions. Also, luckily, my close friends and family are very supportive, which helps immensely.

This is my fear, too! Good luck to you!

I've officially got the house to myself for the next 10 days! Since I have two kids in middle/high school and every illness known to humankind is running rampant, my parents have just picked them up and are taking them until I'm post-op. Let the self quarantine begin! I sent all the remaining food from the fridge with them, so now there's just yogurt and milk in there. And jello. I'm hoping to get a few organizing projects done while they're gone because it's so much easier to deep clean when no one is coming behind you to leave toothpaste blobs in the sink and drop their socks in the middle of the floor for some unknown reason. Seriously, why do they do that? I may start with cleaning the fridge shelves because now that it's empty, the grime is pretty obvious.

That is so wonderful, and I'm glad to hear you received such good care. Do you mind sharing which surgeon you used? Sounds like you found a great one. Speedy recovery, and enjoy that crop top!

I'm curious @catwoman7, how did you determine your 100g protein requirement? Has it just been trial and error, or were there tests involved? Also, this is why I added a scoop of plain protein powder to my smoothie every morning (I say this in past tense because I'm on my preop liquid diet now and smoothies seem like a distant, heavenly memory compared to protein shakes). I also got my teen daughter doing this because she's mostly vegetarian and I know the veggie meals at school are questionable in the protein department. My typical smoothie recipe packs in 40g protein so I felt good knowing I was knocking out a big portion of the protein for the day first thing in the morning. I imagine I'll return to that at some point when I have the capacity for them again.

Fun fact: the Bariatric Fusion chicken soup protein mix I thought was so disgusting I almost threw it out when I first tried it tastes surprisingly okay on the third day of a liquid diet. I'm glad I turned out to be too cheap to toss a $45 container of protein into the garbage without giving it another try. Pro tip: I used one of those plug-in coffee mug warmers with a small lidded travel mug to keep it just the right temperature for slow sips.

I'm on day 3 of liquids today and doing okay but trying to figure out what choices are working and which ones aren't. Oikos triple zero yogurt has been a life saver. I have learned I am not a fan of ready-made sugar free pudding. I'm going to try making a batch from a box instead, but if that doesn't taste any better, I'll cross it off my list. Jello, on the other hand, has been delightful. I may end up going through a box of sugar free Jello mix per day. Bone broth tastes nice but does not score high in the satiety department. I may save it for post-op. I'm averaging just under 900 calories per day, 130g protein, 10g fat, and 50g carbs. I get about 150 oz fluid per day.

There's a very high likelihood your weight stall has nothing to do with what you are eating, and it would definitely not have anything to do with too much protein. This is your body's natural reaction to severe calorie restriction. In a nutshell, when you are on liquids only, you rapidly lose mostly water weight as your body burns stored glycogen for fuel. Once the glycogen runs low, your body turns to burning fat, which is what you want it to do. This takes a few weeks. However, when you start to introduce solid foods again, and especially carbs, your body is very keen to restore those glycogen stores. So it burns fat while also replenishing glycogen. Glycogen is bound to water, which means the water weight you lost in the pre-op diet and right after surgery are regained, which is fine. You need glycogen. It's what helps us get through short periods of lower food intake, like when you have a bad cold and lose your appetite for a week. Your body is still burning fat because you have a major daily calorie deficit. It will show up on the scales in a few weeks when everything else balances out. My advice is to just do what your doctors tell you, stop tinkering with your diet, and don't weigh yourself for a few weeks. Your doctors have advised hundreds if not thousands of patients just like you. They know what they're doing.

How long has it been since you had the sleeve surgery? How much weight have you lost and how rapidly? How much food/calories are you able to consume daily, and also how much water? Are you improving slowly or getting worse?I think these details might help people with offering some advice, especially if anyone else on here has been through a similar situation.

I have my grandmother's silverware from 1938, which is so special even though it's just silverplate. The funny thing is, the cocktail forks pictured here were supposed to be in that pattern, but the seller on eBay sent me the wrong ones and I liked them so much, I offered to buy them too (she did end up sending me the correct forks, which I've put in the silverware chest). When I started looking for demitasse spoons, it turned out my grandma's pattern didn't have them, but the "mistake" pattern did. So it turned out to be a lucky accident, and they really complement the early 1900s china pattern (which is Bavarian, and not very expensive but looks gorgeous). I figured if I needed to use small plates and cutlery, I could at least make meals special by using the china that usually stays hidden in the cupboard. A way to shift from focusing on the quantity of the food to enjoying the overall aesthetic experience of dining.

Your figures from the other day seem spot on, just 1g over on fat. From what I understand, being over the protein goal is fine. But you might check your protein supplement and compare if you have more than one. For example, I discovered that one of the brands I have has 5g more carb in it than the other one, which adds up when you're having them 3x a day for a liquid diet. And even with the same brand, the chocolate flavor has more carb than the other flavors. But otherwise, I'd say you're doing really well with hitting the targets you were given.

Is sleeve your only covered option, or do you have reasons you've eliminated RNY as a possibility?

Oh no, so sorry! Mine was postponed back in December so I know how frustrating it can be. Hope everything is good soon!

I don't know if this helps, but when I saw the nutritionist last week for my last pre-op appointment, she suggested choosing three regularly spaced meal times, 4 to 6 hours apart. I've decided on 8:30, 1:30, and 6:30 because it works best with my daily work schedule. She said to eat what I could of "real" food at the mealtimes, but not to let myself keep eating beyond 30-40 minutes. My goal is 20-25g protein at the meal, but let's say I managed to eat 10g for breakfast. In that case, I would want to supplement 10-15g of protein shake at 11am (halfway between breakfast and lunch). If I managed to eat 20g of protein at lunch, then I could skip the supplement between lunch and dinner. But if I only got 5g protein at dinner, I should supplement with 15-20g of protein shake a couple hours after dinner. That way you're trying real food first, but not letting yourself get behind as the day goes on. She said it would take quite some time to ween off protein supplements completely and that was fine. Eventually, she wants me to be at 3 meals and no snacks with 60-80g protein per day. If you don't want to rely on protein shakes but you find you can easily eat something like a Greek yogurt in between meals, you could do that instead. But basically it's just going to take time, and even after you are at a point that you can usually get all 20-25g of protein in a meal, there still may be some days where you can't and you need a supplement.

I've done both. When I first started going to a nutritionist 7 years ago, I tracked religiously for calories as well as daily steps and lost about 40lbs. The problem I found was when I stopped tracking, I didn't have enough of a routine to keep eating the right way. When I was tracking calories with a 1500 limit, I would eat whatever and then stop when I hit the limit. Sometimes I was still hungry, other times I would have a glass of wine because I had "extra" calories at the end of the day. So it was effective for losing but not for maintenance. I also got really anxious having to track it all online for some reason. This summer, I started changing the basics of how I ate and forming a routine of the same foods almost every day. I would do a smoothie for breakfast, a big salad at lunch, and then a reasonable dinner, while minimizing the snacks and eliminating processed foods, added sugars, etc. I lost about 15lbs without tracking by keeping to this routine about 28 days out of every 30. The consistency worked for me and I didn't worry about the couple of times per month when I broke the routine and went out to eat or had a treat because it wasn't enough to outweigh the good stuff I was doing. Today, I've started my pre-op liquid diet and I am tracking again, but this time I decided on a notebook instead of an online tracker. I plan to track for several months because I think it's information I will need for my doctor and nutritionist if I encounter anything unusual during my recovery. I bought a Legend Planner Food Journal (pocket edition). It's not too big and it doesn't give me the anxiety tracking apps do. It has 6 months worth of pages, so I plan to track until the book is full and then reevaluate. I feel like if I can establish good habits and continue to track my weight weekly, I can stop tracking food. But if my labs come back bad or my weight starts going up, I will reassess.

In preparation for post-surgery, I recently bought a set of vintage cocktail forks and demitasse spoons to help keep my bites the size my doctor wants. I happen to love vintage china and went through my collection to find suitably small salad plates and bowls to use, too. I took a photo with the new plates and utensils with my "standard size" items (dinner plate, dinner fork and teaspoon) for comparison. (The bowl is a fruit bowl and holds about 1/2 c)

I've been told my eventual goal will be 3 meals per day, 20-25g protein per meal, which is equal to 3-4 oz cooked meat (palm size/deck of cards). After protein, I should prioritize non-starchy vegetables, followed by fruit, followed by starchy veg and grains, which are limited to 1/2 c portion. My program avoids giving specific macros because everyone is different and also I think to get away from dieting mentality. I was told to space meals 4-6 hours apart and avoid snacking (this is for after the early stages when you need to eat more frequently). Basically, when your appetite starts to return, stick with the limits of 20-25g protein and 1/2 c starch/grain, and eat as much non-starchy veg and fruit as you like until you feel satisfied (instead of taking bigger meat and starch portions as we might be tempted to do). Oh, and choose low-fat or non-fat options when available and stay away from added sugar. They're okay with stevia and sucralose but frown on sugar alcohols.

Generally I've never seen peanut butter on the approved list, but I did check on powdered peanut butter and was told I could add it to my protein shakes in the full liquid phase. The difference is the powdered (PB2 or similar) is significantly lower in fat than real peanut butter.

There's also a calculator Dr. Weiner has developed to predict how much weight you will lose (within a range) with each procedure. It does require you to give an email to get the results (which they send to you within a couple minutes by email), but in my experience they don't abuse this or spam you with anything. https://www.poundofcureweightloss.com/bariatric-surgery-weight-loss-calculator/

One more day before I start my 2-week liquid diet! It's starting to feel real, but surreal, too. One last day of "regular life" before it all changes.

Here's one other video I really found helpful (along with all of Dr. Pilcher's videos):