Tiffykins

For me, the key was long term risks, higher regain rate with RNY, and the issues of vitamin/nutrient deficiencies are much higher with RNY/DS vs. VSG for the rest of my life. As for this particular study, this statements stood out to me: So, let's see there are 2 risks factors, Age and Higher Rate of co-morbidity that can skew the results of this study. It's not really comparative when there are increased risk factors with the study subjects that are being reported. For it to be a fair, and just assessment, all of the factors would have to be equal. Unfortunately, it's not going to happen in the world of bariatric studies/stats.

None of the surgeries beat carbs. Not even the heavily touted DS. There are several DS failures out there, and RNY has the same consequence with carbs just like VSG and the band. I only dieted through my losing stage. In maintenance, I do not diet, and had zero issues maintaining my loss for a year before pregnancy. The malabsorption of calories/fats/sugars with RNY/bypass only lasts around 2 years. It might not last that long. So, the bypass only gives you an out on carbs/sugar/fats/calories for so long and then the body adjusts and starts to absorb everything that is consumed except for certain vitamins/nutrients. Being prepared for any weight loss surgery is essential, committing to making a lifelong change in eating habits and behaviors is the only guarantee. Bypass, DS, VSG, the band all have failures. If people do not change their eating habits, even malabsorption will NOT help them.

My bp hangs in the 95/60 range. Never hypertensive, but was diagnosed with hypotension last year, mainly postural/positional. It's not been a concern for any of my doctors once it stabilized with increased fluids, sodium intake and taking care when standing quicly. My obs are ecstatic with my lower bp especially this late in the pregnancy. I think you are just rocking ! ! ! BUT, of course, the disclaimer of "check with your docs" is gonna be thrown out there!

It really depends on what you consider a complication. Leaks, death, blood clots, anesthesia issues, general surgical complications can occur. Those stats are specific to each surgeon. As for complications post-op, those range by patient. Some, not all, experience the following; 1) Difficulty drinking/sipping the recommended clear Fluid levels (you'll find this is most likely to occur the first 2 weeks when swelling from the trauma of surgery is most common) 2) Progressing through the food stages (some take longer, others are able to progress faster) 3) Fatigue 4) Lactose Intolerance (can occur shortly after surgery and last for several months with varying degrees of intolerance with milk products) 5) Nausea/dehydration

No baldness. I've only seen a couple of ladies that already had female hair thinning have issues of true bald spots. I lost half of my hair by volume. It's all grown back. The only major change is that my hair used to be semi-curly, super wavy, but it's grown back in stick straight. And, now in pregnancy, it's getting pretty wavy again. Most start to seeing the heavy shedding begin around 3 months post-op. It seems on average that it last 3-4 months.

I'm over 2 years out. Check out my profile for TOPICS I've posted, and updates. Also, pull OregonDaisy, *susan*, Suzannesh, Luck, are some here that are further out. If all else fails, check out this group on obesityhelp.com http://www.obesityhelp.com/group/VSGM/

Nothing will prevent it. About 85-90% of WLS patients experience it. No amount of Protein, Biotin, special shampoos, snake oils, supplements will stop the losing if you fall victim to it. However, you can help regrowth by making sure you get enough protein, adequate fat intake, and other supplements like your multi with Iron, zinc is supposed to help with regrowth as well. I used Folicure shampoo that helps clean your scalp to promote hair growth. http://www.obesityhelp.com/forums/vsg/4347455/Hair-Loss-in-Weight-Loss-Surgery-Patients/ http://www.aocd.org/skin/dermatologic_diseases/telogen_effluvium.html

Main reasons: 1) Empty calories- inhibit weight loss, leads to dehydration/water retention 2) Our livers are already working overtime in the rapid weight loss stage, why put more crap in there for it to process??? Your body has been through hell and is going through so many physiological changes that alcohol can contribute to even more issues during your weight loss phase. 3) Transfer addiction- Take away the ability eat through your emotions, pick up a bottle and start drowning the issues in a bottle I was only required to wait 3 months. However, I didn't drink until I was at goal. I knew going in that I was not willing to suffer any consequences from having alcohol early out. I was too focused on getting to goal, and getting healthy. However, many people start drinking earlier, and suffer no ill effects. We trusted our surgeons to amputate the majority of a major organ, I figure we should trust them on what we put in our bodies post-op. Here are some other topics that have been shared over time here on this subject: http://www.verticalsleevetalk.com/topic/22739-another-alcohol-question/page__p__191944__hl__alcohol__fromsearch__1#entry191944 http://www.verticalsleevetalk.com/topic/22435-alcohol-carbonated-bevs/page__p__189205__hl__alcohol__fromsearch__1#entry189205 http://www.verticalsleevetalk.com/topic/19240-sugaralcohol/page__p__162127__hl__alcohol__fromsearch__1#entry162127

From a medical standpoint, your body is going through so much right now, and that is why it is recommended to wait until your weight is stabilized. You won't be able to stay in ketosis since it causes fetal brain damage, your hormones are raging and causing a hormone dump of estrogen into your system which can cause issues in your pregnancy. As for being able to have a healthy pregnancy, it is possible, however it is NOT recommended for many reasons.. You are still considered obese, the risk for gestational diabetes is quadrupled, the risks of miscarriages are tripled, the risks of other fetal complications are doubled. Your body, and your baby deserve the very best environment for growth and development. I have seen far too many early miscarriages from women on obesityhelp who get pregnant while in the losing phase. I'm not saying it's not a natural occurrence, but why risk it with your body already going through so much. First pregnancies are extremely difficult, and you'll be adding risk factors while being obese. If you were have a loss, are you prepared to deal with that, and the emotional turmoil that comes with those events. I had 2 chemical pregnancies during our 14 months of TTC. I was devastated each time, and felt so extremely guilty. Those emotions, and situations took a major toll on my marriage. I was 8 months out when cleared for TTC. I was below goal, my labs had remained stellar, and I felt fabulous. We were also facing a looming deployment, I was 33 years old, I have other health issues that throw me into high risk, so my surgeons agreed that we could try, but they prepared me the possibility that I might not get pregnant, or have difficulties conceiving because of all the factors. While I understand, and completely empathize with your desire to conceive, I refused to get pregnant as an obese woman. I was over 200lbs with my 13yr old son, and I was miserable. I delivered him at about 240lbs, was induced, had a horrific c-section, and overall, I hated being pregnant while fat. I can tell you that you would probably continue to lose weight through the pregnancy because of your starting weight. The baby will pull from you what it needs. The amount of Water and food required for me in this pregnancy is difficult to fit in, and I'm over 2 years out. Throw your concern about getting to goal out the window. The most important factor to consider before getting pregnant is; Can I give that developing human the very best environment for growth and development while NOT compromising my own health? I can tell you that even being a small, petite woman during pregnancy after VSG is NOT easy. I struggle a lot to meet food intake requirements some days. The physical changes, hormone rages are horrific. I never, seriously never had head hunger before surgery like I have now. I've gained a solid 20lbs, my body aches, my cravings are absurd, and it's a mental battle that I have shared on a couple of times. Physically, myself and Tatum are doing fabulous. This weekend Tatum has moved up into my abdominal cavity, pushing everything up into my stomach region. I have puked up nearly every single thing I put in my body, not because I'm nauseated, not because I'm sick, but because of her positioning, my stomach literally can not accept food. Even the softest of foods have come up, it's not a wrenching puking, it's more like a regurgitation of what I have eaten. It's not pleasant by any stretch of the imagination. She is breech at this point, and I have done every yoga stretch, move, every position to get her to move just a little and nothing has worked. All I've been able to get down is bready type foods, gummy Snacks, chewy granola bars, and Peanut Butter. Life has not been pleasant this weekend, and it's simply because of how my stomach is shaped now, and how Tatum is laying right now. I wanted pregnancy more than anything in the world. It was the biggest driving force to me choosing WLS from the beginning. BUT, more than my selfish desire to have another child, I wanted my pregnancy to be healthy, and for me to be able to provide the best outcome possible for my body and the baby. For me, and I'm not saying this is for every woman out there, this is my conviction, I find it utterly self-centered and beyond harmful to conceive children while obese. I just refused to put my body, or a baby through a pregnancy while obese. I know that sounds harsh, but it's how I really feel about it.

Yes, at 4 months out, I was still super restricted. The adding bread, potatoes, other mushy foods to my meat really changed well after a year post-op. A lot of it was "how" I ate the food on my plate. I would only eat the meat first, add nothing to it. Once I got into maintenance, and eating more varied diet, I started eating differently. A bite of meat, a bite of veggies, a bite of meat, a bite of potatoes. Those mushy foods helped the food go through faster, and didn't take up space. I didn't touch bread for months, and for the first year, it was really difficult for me to eat breads. Now, they're a bit of a slider food. I still feel restriction with breads, but I can eat it without discomfort at this point. Just like, if I decide to drink wine before a meal, I can eat more. Sometimes, I'll have coffee or a hot tea (like at the Japanese restaurant we frequent) before my meal, I can fit a few more bites in. The alcohol and warm liquids all relax my stomach. Another reason why alcohol is so discouraged early out. Snacking and drinking go hand in hand especially in social settings. We drink, we snack, we drink some more, we snack some more etc etc. That's what led to my gain over the holidays last year.

This is just my opinion, and from years of reading around the boards so I hope no one takes offense to this: Surgeons that push RNY over VSG typically do not have the high volume of experience with the sleeve that they have with RNY. Also, RNY costs almost double the sleeve when it comes to surgical charges. As for high BMI patients, check out obesityhelp.com I can name at least 5 members over there that are less than 3 years out, and have lost a tremendous amount of weight, Jimbo has dropped 330lbs in 20 months, MissEye dropped 200lbs in less than 18 months, Frisco has dropped 190lbs in less than 18 months. While you're there, check out the revision forum, and see just how many RNY patients are seeking revision because of 2 main reasons 1) Significant weight regain (I'm not talking 30-50 lbs, I'm talking 100+ pounds) 2) Major complications with Vitamin deficiencies and stretched pouches and stomas. They are getting revised to DS. Converting their RNY Pouch to a Sleeve with the switch part for the malabsorption. The long term stats on the VSG vs. RNY for long term weight loss staying off, and keeping it off at 5yrs out, are within a 3% difference. You have to decide with what you are willing to live with for life. The assisting surgeon tried to convince that I "needed" RNY as I lay in the holding area of the surgical floor about to head back for my revision to VSG. There is NO way I'd live with RNY. It's not for me, my lifestyle, my wants/needs out of a surgery. I've added my standard reply when people ask why I chose the sleeve over RNY:

For those following the pregnancy, super quick update. Tatum is perfect, I've gained a solid 18-20lbs, and the ob told me today that I needed to hide the scale, focus on getting my Protein only because I told him I was having mad cravings for red velvet cake, and then told me to indulge in as much red velvet cake as I could get my hands on. I still struggle with the physical changes, and to some degree weight gain, but it's getting better every month. I also get a lot of questions about my skin after losing 140-145lbs so I decided to be brave today, and share some fully sleeveless pics. Personally, it doesn't bother me. I have an aversion to armpits so I don't wear sleeveless shirts. I think armpits are repulsive, and I have zero desire to show mine off. Plus, I suffer from Brandilynn's razor line of random underarm hair that I miss occasionally. My home glucose monitoring was perfect, textbook numbers, zero chance of gestational diabetes WOOT WOOT ! ! ! I go back in 3 weeks, a growth scan will be done, and we'll get new pics of Tater Tot then, she's stubborn, and is not cooperating at this point for pictures. As you can see, I have flabby arms, but considering the amount of weight I lost, they could have been worse. Also, remember I've gained back over 10% of my weight lost, and some of that has gone back to my arms, my arms are normally thinner at the top. If you notice, my ass is still flat, my hips have widened, but I'm still wearing a size small maternity pants, or a size 4/6 in maternity pants. I have one pair of 8's that are "skinny" maternity crop pants, but I'm having trouble finding a good fit in maternity pants since I'm carrying so much of the weight in my stomach, but I'm still narrow in the butt and thighs. Cheers everyone. . . 3 more months, 3 more months, 3 more months ! ! !

Are you on a PPI(acid reducer)? I went through the same thing except it was caused from overproduction of acid. I went on Prilosec 20mg once daily, and at over 2 years out I never experience true physical hunger.

I read a story of a vet sleeve patient that I could relate to all too well. I leaned on her for support as a mentor. She posted her reflections and it clicked for me. She told me that her choice to have surgery was like ending a toxic marriage. Kind of like divorcing that abusive, inconsiderate, doucehbag of a husband who was a person she loved to hate. The relationship was toxic, but they had good years similar to the good years we have with dieting/exercising/doing it the "old fashioned" way, and then those toxic behaviors, issues in the marriage would pop up again, and the marriage would go to pot, AGAIN. That made perfect sense to me, I could lose weight, I could diet and exercise, I knew the cause of my weight gain after each diet attempt and why I couldn't keep the weight off. I had a toxic relationship with food, quantity and my love of food with no consequence other than being fat were my issues. I wasn't an emotional or compulsive eater, volume was my issue. I just knew that I couldn't do it without surgical intervention. Just like some people can not leave a marriage/relationship without intervention from family, or a major trigger to make them see that they need to get out. I hope all of that makes sense. I never had any issues post-op with the acceptance of having to have surgery to be successful. I'm not one of those that believe this is the easy way out, it's easier because I had surgery, but so is driving to the store instead of walking.

Have you had any labs pulled lately??? Low Vitamin D and D3 can contribute to cravings for sweets. I would just stock up on Protein packed foods when you want to reach for other junk.

I was already married when I had my surgery, but I can tell you that I didn't change as a person just because I lost weight. I'm still the same girl I was at 270lbs. Not every single person changes because of weight loss surgery. The only difference will be your pant size, and your eating habits. Unless those 2 things make up your entire personality and character then you'll still be the same guy, just smaller clothes and appetite. You might find her to be your biggest cheerleader and support system. She might not sabotage your efforts since she will be with through the process. My husband tried to sabotage my efforts, but I don't think he did it on purpose. He just wasn't used to me saying "no" to his offers to eat some of his Desserts so it took a few months for him to quit offering me little treats. Maybe someone will chime in that was in the same situation, but I wouldn't throw out the possibility of a wonderful relationship just because I was going to have surgery. You might not like her in a year because, well, it's been a year. People change through the seasons for different reasons. I eat out all the time, and have since being just a few months post-op, and it didn't sabotage anything about my weight loss. I do agree that you'll have to focus on you, and making your goals, but I would have not been able to do it without the amazing support I received from my husband. At first, he didn't like all the physical changes, he did embrace all the food changes, and we are better off today because I'm better today than I was at 270lbs.

I want to add that most of us are "not" normal. The 1200-1400 calories per day is a standard "diet' for someone that has less than 30lbs to lose. It's a textbook nut answer for how to lose weight. I barely ate 1200-1400 calories a day in maintenance at 125lbs. If I hit 1400 calories, it was a really good day LOL. If you read some of the vets out there, from 2-5 years out, we were all on very similar post-op plans. More and more new surgeons are doing sleeves, more and more send you to nut that is NOT trained or experienced with bariatric patients with metabolic issues that can hinder weight loss. I can honestly say that the people that I've been following for the last year of so that follow a less stringent plan, and just eat smaller portions, post twice as much about stalls, slow weight loss and/or taking forever to get to goal. I know it's not a race on getting to goal, but taking advantage of that first 5-9 month honeymoon period seems to really help people get to goal, and be prepared to get into maintenance a little easier.

Restriction for me stayed pretty consistent for the first 3-4 months. I started eating more higher fat foods to get my losing to slow down because I was already within 25-30 pounds within my goal weight. I noticed I could eat more slider foods, but dense Protein was still only about 3oz. Around 8-9 months I hit my sleeve capacity, and it's remained the same since then. I still max out at 3-6oz of dense protein foods. Scallops, soft meats like duck, I can get in about 5-6oz, steak about 4-5oz, chicken I'm still pretty restricted to 3-4oz. NOW, with all that being said, if I add any type of condiment (commonly called food lube) I can fit a bit more in. Add anything bready, like a wrap, or some of a dinner roll, some mashed potatoes in between bites of my meat, cheese, I can fit in a few more bites. The first mushy meals I was really restricted to about 3oz of stuff like yogurt, sugar free pudding, refried Beans, etc etc. But, I was able to move up to less liquified mushies within a couple of weeks, and tolerated them well. It just takes time. Drinking warm fluids, especially herbal decaf tea, was a major help with relaxing my sleeve before eating.

The main issue with RNY regain is that once their malabsorption wears off, it's called intestinal adaptation, they are NOW metabolically challenged to keep the weight off. We have simple restriction only to keep us in check. For all the sleeve patients I've seen gain weight is that "life happens", and emotional eating creeps back in. Also, choosing the wrong foods, getting back into bad habits/behaviors that led to their obesity in the first seems to be the culprit. I've said since hitting maintenance that losing was super easy. Maintenance is where the hard part comes in. I'm a firm believer that behavior modification is the biggest contributor to long term success for any weight loss surgery patient. Trying to find a balance of a new "normal" and remembering what contributed to my obesity is what helps me tremendously. I do live a pretty extreme life of moderation, and I accept a 5lb bounce. Anything more than 5lbs, be it Water weight from alcohol, and carbs, or if it's a true gain from several weeks of just eating what I want (which I experienced last holiday season), and I go right back to Protein, protein, protein. Knock on wood, I was not compulsive or emotional with food. I just ate a lot of it. I have only recently been dealing with head hunger, and absurd cravings that I can only contribute to the pregnancy. I honestly can not wait for the next 3 months to fly by so I can get off this rollercoaster, and back on plan with my eating. It's been an emotional twist for me that I've gained weight, and that I can not get into ketosis.

I'm not calling anyone out on their morals. I could give 2 poops about someone's morals. This is not about morals, or convictions to drink. This is about the sheer medical facts and statistics of drinking soon after major surgery, and the risk of transfer addiction. I believe it's reckless and hazardous behavior not only to do this to your body early out from major surgery. And, you're right, whoever will only live ONCE, but there is NO reason to rush to the end of it. Many obese people self-medicate with food, no different than self-medicating with alcohol. If you've been around the forums long at all, done any amount of research, you take away a fat person's ability to eat, the risk for a transfer addiction is quadrupled. It's called educating someone, not judging, nor worrying about someone's moral compass. I care more about what this poster is doing to their body and that others might follow suit because of this one experience. It's detrimental to the liver to drink this early out. Bottom line, it's ridiculous and absurd.

I followed a very basic, low carb/high Protein meal plan. I ate 4 meals per day, each meal had a minimum of 15gr of protein. This accomplished 2 things; 1) kept me within my calorie/carb/protein guideline 2) kept me from snacking which is heavily discouraged. My plan stated 600-800 calories, NO more than 30-40gr of carbs (and this is ALL carbs, good/bad, white/complete/whole grain etc, a carb is a carb), and at least 60gr of protein. I ate lots of meat, cheese, greek yogurt, and eggs once I got to regular food. Carbs are my enemy when it comes to weight loss/gain, and like I said, I don't care what source of carb they are classified in. I had a totally boring meal plan, but a little creativity and recipe tweaking made things much easier.

Are there any foods you can't tolerate with the sleeve? Pork sits a little heavy in my sleeve at 26 months out, as do scrambled eggs, but both are doable, just eating slower than normal if I "really" want them. I don't "really want" them at all. It's been well over a year since I've eaten pork chops, and don't miss them. I'll try an egg sandwich on occasion, and it works as long as I have some cheese and meat on it as well. Did you have acid reflux with the band? Do you have it with the sleeve? No to the band portion, but I didn't have it pre-band either. I didn't fully develop reflux with VSG either, BUT I choose to stay on my PPI. Too many stories of people's hunger returning, and dealing with breakthrough reflux. I have had several flare ups in the pregnancy, and I'm miserable for hours if I have reflux. I'll gladly take my PPI forever to avoid feeling that way. Did you have any complications during your sleeve surgery? Yes, I had a leak. It was directly related to the damage the band did to my stomach tissue. Get a complete unfill, allow your stomach to relax for a few weeks before surgery. My port was completely inaccessible as it had migrated, and was surrounded by hoards of scar tissue. Can you swollow pills now? I have been swallowing horse pills since around 6-7 weeks out without issue. Do you still get "stuck" on food? Nope, none. What is the best thing you can say about your sleeve? Constant permanent restriction, the ability to eat a varied, nutrient dense diet, and the lack of physical hunger at 26 months out. I still forget to eat. What is the worst thing you have experienced with your sleeve? Honestly, nothing. I had a hell of a recovery, and I'd do it all over again to live the life I have today. Every struggle, hurdle I endured was worth it, and I'd glad do it all over. Would you do it again? Without hesitation!

Get your medical records with op reports including the release forms you signed before surgery.

This just screams TRANSFER ADDICTION WAITING TO HAPPEN. I'm so whatever about all of it when people choose to make absurd decisions especially after going through such a traumatic surgery, and all of the changes that occur. Enjoy whatever you choose, and why even bother asking if you're clearly going to disregard not only medical advice, but other's experiences, don't b*tch about stalls and not being able to lose weight, or why your body is not recovering all that great, or you damage your liver by shoving alcohol in there too early.

It's water weight. As much as we'd like it to be fat, at this stage in the game, it's just water. It'll slow down to some extent based on what type of post-op guideline you follow.