ouroborous

The gold standard for treatment of PF is cortisone shots -- in your heel! If that sounds painful (it did to me), you can try to: Do some stretches specifically designed to improve the pain (google it) Wear orthotic inserts (that's what worked for me, a sole insert called SuperFeet and my PF went away for good) Lose weight!

My guess is that you'll be a little more gassy, forever. Your stomach is tiny now, and there's just not as much room to fit food and liquid and gas. However, it should dramatically improve with time (it has for me). The feeling of pressure is probably a warning that you're eating too fast or taking too big of a bite. Slow down and savor it. You're not going to jeopardize yourself by eating less, or eating slower, so if you feel any discomfort, that should be your warning sign that you're going too fast. It's a common problem that a lot of us formerly heavy people have -- we tend to wolf our food down. I know I do!

Carbonation fears are overplayed. It's important to remember that doctors tend to play a "better safe than sorry" role, especially when it's regarding non-essential, empty calories like soda pop. But as Tiffy pointed out, the part of your stomach that's left is the least stretchy, most muscular bit. It's supposedly similar in texture to football leather (don't know if that's true, but it's what I've read) -- think about how many sodas you'd have to drink to seriously stretch a pigskin! I had a glass of beer at 3 months out. Aside from having almost zero capacity (I went from a "can down a six pack easy" guy to one glass and I'm DONE!) and burping a LOT, like every two sips, there was absolutely no pain or discomfort or problem.

Bottom line is that some pain is normal. If you are vomiting (or blood is coming out of ANYTHING), or you have difficulties breathing, that is a medical emergency. A little pain, however, is normal, and you should adopt more of a "wait and see" attitude. It COULD be a staple line leak, but it's fairly unlikely at two weeks out.

I think that over the short term (2-3 weeks tops), being a little short on protein isn't going to hurt you. But in the long term, it can lead to muscle wasting and all sorts of problems. I DO think you shouldn't stress about it, though, because unlike, for instance, water, you really can just try to "make it up" when you feel more like eating.

Actually, Protein is measured by weight, not volume. Your target is 60-100g a day -- grams, which are a measure of weight. If you take 60g of protein and then only take what fits in 2/3 of a cup, that is less than 60g of protein. I'm sorry, but if your nutritionist said that you could eat less than 60g of protein (which you would be doing if you only took 1/2 or 2/3 of it) and still be eating at least 60g of protein, that's just wrong. It's basic weights and measures. That being said, I don't think we should freak out if we don't hit the target once in a while, and remember that there are other forms of protein that are easier to get down -- whole black Beans, for instance, are very protein dense, and chili or black bean Soup is relatively easy to get down. And of course there are Protein shakes.

Make sure that you're taking care of yourself -- in particular, getting enough Water, Vitamins, and Protein (you ARE seeing a nutritionist, right?), and getting enough sleep and exercise. If all of these things are in order, it's likely just normal post-operative "shock." If you get dizzy or have trouble breathing or begin vomiting (or a bunch of other potential issues including severe pain, high fever, yellow eyes, swollen abdomen), run to your doctor immediately. But if you're just run down and you're doing all the things you're supposed to do, that's pretty normal.

Um. You guys know that severe ketosis can ruin your kidneys, right? I worry about this sort of advice. A lot. Seriously, focus on limiting your calories to the target range (600-800/day, adjusted by exercise), keep carbs in a "reasonable" range, drink lots of Water, take your Vitamins, and exercise. That's ALL you need to do. Honest! That and a little patience and the pounds will just melt off. From the AAKP (American Association of Kidney Patients) website:

Don't worry too much about Protein, especially in the first week or two. You're not going to become seriously ill even if you're protein deficient for days on end. The only thing to be really careful about, especially in the first week, is Water. THAT can get you into trouble rapidly. If you were just sleeved on 8/9, focus on sipping water and walking as much as you can. The rest will take care of itself, trust me.

Actually, according to my surgeon, it IS possible to feel physiological hunger after lap sleeve. The mechanisms are complex, but apparently we shouldn't expect to "never feel hungry again." Some people are lucky and don't ever feel hungry again, but Dr. L said that "most people do regain some sensation of hunger, although much less strong than before."

So those who've read my posts know that I asked a lot of questions before surgery about post-op depression, and have had a few struggles since my surgery with the problem. I've had a lifelong history with depression and anxiety, and have at various points in my life done therapy and been on just about every medication known. None of those things worked, long term. Note: some people do suffer real physiological depression post-op. It is well documented, and you should always talk to your doctor if you're struggling. I'm just posting my findings so that some of you might have a head start in unraveling this ball of twine. What I'm finding is that my depression is almost entirely related to physiological factors. In short, when I take care of my physical needs adequately, I'm not depressed or anxious. In fact, when I'm getting enough sleep, food (especially carbs -- yes, the evil carbs!), Water, and exercise, my mood is very, very good. When I AM taking care of myself, I'm calm (not anxious), hopeful, and generally a pleasant person. However, any of the following will QUICKLY put me into a tail spin: Not getting enough sleep. I don't know how many times I'm going to have to re-learn this lesson, but for posterity, here it is: if I don't get enough quality sleep, I'm a wreck. This is getting more pronounced as I get older, and has gotten dramatically more pronounced since the surgery. It used to be that it took a week or two of crappy sleep (or not enough sleep) to bring me down. Now a day or two and I'm a wreck. Not getting enough exercise. This is intimately tied in to sleep; when I am exercising regularly and vigorously, I sleep better. But even if you take sleep out of the picture, exercise has worked better for me than any antidepressant I've tried, and it has worked quicker. Don't get me wrong, I'm a big fan of better living through chemistry; if you need AD's, take them, but for me, exercise is much more effective. It can nip an anxiety attack in the bud, and 15 minutes of brisk walking in the sunshine (or even in the gray... come on, this is Seattle!) can prevent an entire day of blue moping. Not eating enough. If I don't eat enough food, or good enough food, I am a mess. I get wobbly and cranky and prone to irritability and depression. Worse, I tend to compensate-eat later, and eat far more calories (and far worse calories) than I would have if I'd just forced myself to eat properly to begin with. Also, I've noticed a strong correlation between mood and carbohydrate intake in particular. I guess it makes sense; taking in far fewer calories means I have far fewer reserves to spare, but quite often snapping out a blue funk is as easy as drinking a glass of skim milk (which has both Protein and milk sugar -- a win/win combination of carbs and protein, according to my nutritionist). Not drinking enough. This doesn't make me blue, but it makes me feel ill and grumpy, and that often leads to OTHER bad behaviors that precipitate blue-ness. Drinking too much caffeine. Of course, overindulgence in caffeine is always a shortcut to feeling icky, but since my surgery I've found that my tolerance is much, much lower. One big cup of coffee can make we wired and jittery for hours, followed by a deep crash of exhaustion and depression and anxiety. It's almost not worth it anymore. Drinking too much alcohol. Similarly, alcohol is a depressant so this shouldn't be that surprising. What's surprising is how much stronger the effects are now. Particularly, unfortunately, the negative effects -- two or three drinks and I'm hung over, moody and anxious the next day. Just like caffeine, it's to the point where the "fun" is almost not worth the cost. None of this means that I can avoid other good mental hygiene, like keeping social contacts strong and so forth. But ultimately, I find that simply taking care of my body -- doing the things I should be doing anyway -- is the most potent antidepressant available. It's as simple as this: when I take care of myself, I don't get anxious or blue. When I don't, I suffer.

It's really, really important not to compare your process with others, as that will just discourage you. Make sure that you're losing, but over the long term -- don't weigh yourself ANY more frequently than once a week, and even that is pushing it (every other week or once a month would be better). Water weight gains can easily swallow week-to-week fluctuations. In the end, just focus on the fact that you ARE losing and it's a healthy loss. You'll get there, even if it's not right this instant.

I'm with the crowd. I've had a few drinks since my surgery (three months out). It affected me a lot faster, and differently. There's no way to drink enough volume to become really intoxicated (which is probably a good thing) unless you're drinking hard liquor. Plus, the two or three drinks that I did have made me mildly hungover the next day, which is a first (given my weight before surgery, I could have easily downed a six pack and not felt a thing the next day and only felt mildly tipsy at the time). All things considered, it's just not that much fun any more. Which, again, is probably a good thing.

I can't see anything specifically about helium that would be contraindicated for lap sleevers. That being said, hypoxia -- lack of oxygen, which helium inhalation can bring about -- can be fatal, so I'd still avoid inhaling too much of the stuff.

Look, let's be honest. It's not without challenges. But the fact is that there is simply no way that I could have lost 60 lbs and kept it off before surgery. Just losing 60 lbs has probably already added 10 years to my life. So, despite my griping and kvetching, would I do it over again? In a heartbeat.

Again, what people don't realize is that, while it is eminently possible to lose a great deal of weight "the old fashioned way," it is almost impossible to *keep it off* without surgery or some other kind of medical intervention. This has to do more with how our brains are wired than anything else.

100.3 isn't a huge concern in and of itself. However, if you present with vomiting or difficulty breathing then run, don't walk, to the ER.

From what I understand, it's a mechanical thing; if the NSAID pill pushes up against the wall of your stomach, particularly the staple line (which, being scar tissue, isn't lined with productive mucosa), you can ulcerate. So, as my surgeon recommended, it may be better to stack the decks: take a chewable, liquid, or sublingual preparation, where there isn't a risk of a pill lodging right up against the staple line for a period of time. Also, make sure you're on an acid blocker, and try to take it with food or Water (to increase overall gut motility). I am not a doctor, but the sense I get is that "once in a while" NSAID's are probably okay, but for regular use -- like arthritis, etc. -- you're probably better off with a non-NSAID, or at least a non-pill NSAID.

Thanks. I think I'm most excited about getting down to just one chin! Sadly, my belly is slower catching up than my face, but I'll get there. It's before and after pictures like this that remind me "yes, it IS working... you just have to be patient and 'keep on keeping on!'"

(Delayed response) This is useful information, particularly the higher numbers. I think it's very interesting that many doctors and nutritionists seem to take a "one size fits all" approach to nutrition. My suspicion is that my Protein needs are in the higher range, and I may need to drink one or more protein shakes a day to meet my needs. AFAIK, there isn't any real test for protein deficiency, right?

Danke schon!

Here's what three months looks like: 330 lbs to 270 lbs. 60 more lbs to go!

I had this exact same thing: an on-again, off-again, low-grade fever for about 4-5 days. By the time I hit about a week out, it went away and stayed gone. My surgeon said it is very, very normal, and only to worry if it spiked over 101 and stayed there (or if I started vomiting/bleeding/passed out/etc.) Don't worry about it. Just take your pain meds, drink what Water you can (sip, sip, sip), walk as much as you can, and focus on getting better!

Thanks I live with myself every day, and I tend to downplay my gains (er, losses). But the truth is that when I look at that picture of my face compared to even the old one from here (which is me at around 285) or especially the one on my work badge (which is me at 330), I can see a HUGE difference. My face is much less round. I need to update my weight ticker, too. Tomorrow is weigh day, and I'm hoping to (finally) be under 270. You're looking great too! Looking at your albums, your "then and now" pictures show an incredible improvement! What a difference a few months make, eh?

First of all, I am *not* advocating going against your doctor's advice, for two reasons. 1. All else being equal, your doctor probably knows better than you do, and better than some yahoo on the internet. 2. I could get in legal trouble if I advocated you ignore your doctor! HOWEVER, that being said, we all have to make choices and live with the consequences. I think that it's a given that: 1. Tylenol (acetaminophen/paracetamol/etc.) CAN lead to liver toxicity. It's extremely unlikely to damage your liver unless you OD or run at chronically high doses, but it's still a non-zero risk. 2. A lot of the literature is confusing, as Tiffykins points out -- a lot of surgeons take a "better safe than sorry" attitude, and much of the information is stolen whole cloth from RNY documents. 3. Different surgeons and doctors/pharmacists give different advice. That all being taken into account, you have to use your own judgment about the risks vs. rewards. Nothing in life is perfectly safe. Edit: my doctor responded to an email about this issue. I've omitted his name/email, but here's his response, verbatim: