ouroborous

It's something folks swear by to break stalls. Basically you re-run yourself through all of the early eating stages (liquid, full liquid, mushy, regular, etc.). Honestly, I think it's just a way to feel like you're DOING something while time passes -- the body is complicated, and stalls will eventually end (if you're doing the right thing).

Yeah, that 6-8 week stall was a killer for me, but just have a little faith in the process, and your body will start burning the fat again. Oh and don't forget to drink lots of Water, eat enough Protein, exercise, and get lots of rest (as if you didn't have anything ELSE to worry about

You beat me to it... I'm pretty sure that the muscle teardown/repair/rebuild cycle requires you to retain water for a few days. Even when I wasn't losing weight, I was losing inches; I started this wearing 48 inch waistband jeans, and now I'm wearing 40 inch waistband shorts (they're elastic in the waist, so that's probably like a 42 inch jean, but still). For reference, in my 20's when I was working at a very physically demanding job (UPS, unloading boxes, 6 hours of dripping sweat every day), I was wearing 38 inch jeans, so I'm getting within sight of being near or at the lowest weight I've had in my adult life (which is sorta sad at 276 pounds, but still!) I haven't started going to the gym yet (I got overeager a few weeks back and pulled a triceps, but I think that's healed), but I think now it's time!

Well, my stall is officially over. At the 6 weeks point, I had two weeks where I lost zero pounds, and now I've lost 3 pounds a week for two weeks, finally putting me over the 50 pounds lost mark since this journey began. And for the record, I didn't change anything -- didn't change my carbs or my Protein, didn't change my quantities, I didn't do a pouch reset. I was just patient and reminded myself that I was doing all the right things and that eventually my body WOULD lose weight again (at <1000 cals a day, it HAD to!). And... it did. YAY! 250 lbs, here I come!

Oh, one other thing. WRT to carbs, I've been eating 80g-100g all along. My stall right now has nothing to do with increased carb intake, since my carb intake has been pretty steady for the entire time since surgery, including some weeks when I lost 7-10 pounds in a single week. Basically, the idea that I'll speed up my weight loss by eating less carbs just makes no sense, when you look at the evidence. This is just my experience... you all should listen to your doctors, not me, of course. But I think that the moral of the story is that I'm going to try to "lighten up" and not weigh myself as frequently, and eat more carbs (good, healthy, complex carbs) and eat them more frequently (rather than a single carb-heavy meal, eat little Snacks of Protein and carbs on a regular basis... which, incidentally is what my nutritionist told me to do last time... I should listen to the "experts" instead of making it up as I go along -- I'm not always the brightest bulb in the batch!)

Again, not to be confrontational, but there's a lot of science indicating that carb restriction can lead to depression and lethargy. Additionally, although simple carbs can lead to insulin spikes/troughs, we're not talking about simple carbs here (I don't eat sugar and white flour anymore, pretty much at all, and my fructose intake is always in the form of whole fruit). I think we have to remember that what applies to the general population isn't always going to be applicable to WLS patients, because our nutritional needs and intake are very different (even our metabolism is slightly different if we're digesting in a less acid-rich environment). The bottom line is that a 6'1, 280 lb. man who's taking in 1000-1200 calories a day (which is, again, 50% more calories than my nutritionist recommends, but I'm using it as a "high Water mark" of my cheatiest of cheat days) is going to lose weight, given enough time. I don't recommend skimping on any other essential nutrient, of course, but I think that extreme carb restriction is not going to net gains (losses) as impressive as claimed (in fact, I've yet to see a study that shows that carb-restricted patients do better than non carb-restricted patients post WLS). And what I do know is that it will make you feel miserable. Well, maybe not you, but it does for me. I can literally feel the difference within minutes of eating a few grapes (ooh, scary, complex carbs!) And the real bottom line, of course, is that I'm going to listen to my nutritionist and doctor -- this is ultimately what we should all be doing, listening to our doctors. And she's telling me to eat more carbs and trim my Protein down slightly. Edit: thinking about this, I really should have chosen a different thread title. I'm ultimately less concerned with stalls (which I KNOW will happen and are inevitable -- the body has a billion homeostatic mechanisms designed to prevent rapid weight loss; we're literally fighting a million years of evolution when we try to shed pounds rapidly) than I am with feeling crappy all the time. I'll happily accept a slightly slower weight loss if I feel good. My girlfriend is the example I should have been paying attention to; she happily munches on wheat crackers (in moderation) and fruit and vegetables and mashed potatoes and rice (all in moderation), and has been steadily losing weight for 8 months now. And her mood and energy level have been great and getting better every day. Basically she never watches her carbs, only her calories and exercise, and she's doing great. So again, I'm sorry if I come off as confrontational, but it's really starting to dawn on me that everyone is in agreement -- my surgeon, my nutritionist, my girlfriend's experience, and my own body and instincts. The only reason I've been trying to limit carbs is because (again, sorry, but let's be honest...) "some people on the internet" told me to. I should learn my lesson! Also, I think I'm going to start weighing myself every other week or once a month or so. I know I'll lose the weight, and if I stop anxiously hovering over the scale I won't stress out so much about the inevitable plateaus.

Thanks for the reply! But nope, it was nutritional. I wasn't eating enough carbs. I think I'm going to stop listening to the folks here who say "ohhhh noooo, 60g of carbs! You're going to get fat!" and start listening to my nutritionist who keeps telling me "don't worry about carbs -- stick to your Protein, Water, calorie, and exercise goals, and you WILL lose weight, and feel so much better while you're doing it!"

Okay, I just heard back from the nutritionist (I'm so lucky to have highly-skilled nutritionists who actually answer their email). She told me to eat more carbs. Basically, we need carbs for energy, mood regulation, and all kinds of stuff. Basically at >100g of Protein per day, I'm not leaving enough calories in my calorie budget for carbs. So she told me to eat less protein, and eat more carbs. I'm putting this in bold because so much of the "folklore" that circulates around here is that "carbs are bad." However, my own experience is that long-term, very low-carb diets can be hazardous to your well-being! She also responded that it's not as important to be low-carb as it is to be low-calorie. With regards to the plateau I'm experiencing, she said what you all are saying: plateaus happen, and as long as I'm doing all the exercise and stuff I'm supposed to be doing (I am), I will eventually start losing weight again (I asked her about the "sleeve/pouch reset" and it was her opinion that this is basically just a placebo that keeps you occupied during the time that it normally takes for you to get out of a plateau -- in other words, it just keeps you busy, it doesn't actually DO anything as long as the calories are the same). But with regards to feeling blue, down, lethargic, sleepy, and low energy, she was very emphatic that I need to eat more carbs, more complex carbs, and restrict my protein if necessary to do so. So to anyone who's going through this same thing, post-sleeve blues, talk to your doc or nutritionist, but please don't just buy into the common folklore that "carbs are bad." Maybe for some people, maybe sometimes, but for the rest of us, carbs are important for maintaining mood and energy. And as we all know, when you're too exhausted to go to the gym or make good food choices, your weight loss will suffer. (Note: if you couldn't tell, I feel better while writing this. I ate some grapes -- again... evil, evil carbs!)

Yeah, I've considered that. My next bloodwork isn't scheduled for a month (actually it'll be close to two months before I get the results). When you're feeling cruddy, two months is a long time! Here's what I do know. Before the surgery, my bloodwork showed that nutritionally I was fine in almost every area. My folate and Iron were a little high, but that was about it. Because my iron was high, the nut. recommended that I not supplement with iron, however since I was nervous about going to basically zero iron, I'm taking one bariatric iron chewable per week. I talked to the nut. about that and she's fine with it. I am not diabetic, nor have I ever been. I was worried about it (my dad has diabetes, under control, and given my weight it was just a matter of time), so I bought a blood sugar tester, but my sugar has never even been close to bad. My doctor's bloodwork confirms this. So I'm definitely not diabetic; however, that doesn't mean I can't be temporarily hypoglycemic or whatever. Every day I take two Bariatric Advantage chewable multis (morning/night), one sublingual B12 (don't know dosage), one 1000 IU Vitamin D (hmm, just realized, I've cut my D in half since the surgery, maybe I should add another D in the evening), four 250 mg chewable Calcium citrates (split over the day), and four 125 mg chewable Omega 3's (split over the day). I also take a male support supplement that contains some herbs and basically lots of zinc and Vitamin E (not toxic doses, but high doses). I take 40 mg of omeprazole per day, and some antacids as needed. My eating is sporadic, I know that. During the work day, my schedule is much more structured. On the weekends, I can go 3-4 hours (or longer!) between meals. It's not wise, I know, but I forget. Also lately I've been sort of neglectful of my Water. I don't think I'm dehydrated, but I have had a few days where I've only gotten about 20-40 oz of water in. I've been good on Protein, usually 90-100 g per day. Carbs have averaged around 80-100 g per day (per the nut. I shouldn't bother counting them, but still, LiveStrong counts them for me). Calories during the work week are pretty constant, from 600-800 net calories per day (800-1000 gross, but my nut. says to subtract out my exercise calories, so I do). On the weekend, calories vary wildly, from maybe as low as 400 if I forget to eat, to 1200 or so if my girlfriend and I go out for dinner. I'm not feeling nauseous or anything. I get a little dizzy when I stand up, but I think my blood pressure is MUCH much lower than before my sleeve (I used to run a resting BP of around 130/90, now it's about 120/70, and my resting heart rate has gone from about 90 bpm to about 60 bpm (!)). The feeling I get is just sort of run down. I feel tired -- physically tired... fall asleep in the chair tired -- in the middle of the day. I never used to have that happen. I also get blue and depressed, but it tracks *exactly* with my fatigue; if I eat and the fatigue goes away, the blues go away instantly (which is why I'm not taking the antidepressants; I'm not convinced that general depression is the root problem, and I don't want to sign on for a six month course of Wellbutrin if this is just a nutritional thing). My sleep is okay, but not great. My sleep doc has prescribed a new auto-titrating CPAP that should be better able to track my pressure needs so that I shouldn't have to get a new sleep study every month. I will pick that up tomorrow. Because I'm a sorta geeky guy, I purchased a recording SpO2 meter (the finger clip thing that measures your blood oxygen; it's a cheap way to look for apneas/hypopneas during the night). During my tests so far, my O2 sat hasn't dropped below 92-95% (which is fine), and my pulse rate never spiked above 80 bpm during the night. An apnea attack would show elevated pulse rate with oxygen desaturation, so I don't think I'm having clinically significant apnea (of course, this doesn't mean I'm getting restful sleep; you can have "partial arousals" that don't much spike your BPM/SpO2 numbers, but which still ruin your REM sleep). We'll see if the new fancy auto CPAP machine helps. I'm somewhat at a loss. I'm going to email the nutritionist and see what she thinks. I'm seeing her in a week, but I feel crappy NOW, and I'm not losing weight NOW, so I'm hoping for answers... I'm convinced that ultimately this is nutritional. I just don't know what it is that I'm missing. My suspicion right now hovers around carbs; I know that everyone on here afears the carbs, but I'm noticing that eating carbs (especially complex, good carbs -- fruits, whole wheat crackers, etc.) seems to help a lot. I think I have to switch away from such a protein-heavy diet and start incorporating more fruits and whole grains in my diet.

So from last week to this week, I lost -- nothing. It's very frustrating, because even when I'm NOT tracking my calories, I'm still eating less than half of what I used to eat. I know, I know, it could be a plateau, it could be Water weight, weekly weigh-ins are probably still too frequent. What makes it more frustrating is that I've been feeling really sick lately. There's something... off... about my food schedule. Some of you may know that I had been really tired and a little depressed, and complaining about that. I even got the doc to prescribe an antidepressant. But I never took it because I am still sort of convinced that the problem is sleep-related (my apnea is acting up) or nutritional, NOT general depression. Yesterday, I discovered that it is definitely nutritional. I've been trying to go about 2-3 hours between eating, but I discovered that when I do that, especially by the end of the day, I get sort of lethargic, sleepy, and blue! However, if I eat every hour or so, I feel much, much better. My girlfriend even commented that it was like turning on a switch... I was tired and grumpy and unpleasant, and then I had some apple slices with Peanut Butter, and woke right up to my normal chipper self. So SOMETHING is amiss nutritionally. But that's frustrating, because I'm not losing weight! It's not like I'm pigging out. Even if I don't track my calories at all, because of the sleeve's restriction there's no way I could eat more than 1200-1300 calories per day (and that would be really pushing it, it's probably closer to 1000-1100). Most days last week, at work, I stayed at 600-800 net calories. For reference, before my SWAG is that I was eating around 3000-3500 calories per day, and maintaining around 330 lbs. Now, at "only" 48 lbs down, apparently I'm maintaining at significantly less than half those calories. It's just not fair! So now I'm stuck, not losing weight, and discovering that in order to not feel sick and lethargic and sluggish, I have to eat more. ARGH! I want to at LEAST cross the 50 lbs mark. Is that too much to ask for a guy who was technically at least 130 lbs. overweight? Can you tell how frustrating this is for me? Edit: I'm about 7 weeks postop. I don't know when the usual "stalls" happen...

Stomach Hormone Ghrelin Increases Desire for High-Calorie Foods, Study Finds ScienceDaily (June 20, 2010) ? The "hunger" hormone ghrelin, which acts in the brain to stimulate hunger and increase food intake, heightens the appeal of high-calorie foods over low-calorie foods, according to a study being presented at The Endocrine Society's 92nd Annual Meeting in San Diego. [...] Stomach hormone ghrelin increases desire for high-calorie foods, study finds

The gurgling is just a side effect of the mechanical restriction. Your stomach is tiny now, and from the surgery it is probably practically swollen shut. The gurgling sounds are very, very normal at first and some amount of gurgling will persist, probably forever. Some folks have suggested warm/hot beverages relax the sleeve a little bit. Try a cup of hot chamomile or spearmint tea; it used to really help me relax my sleeve! The good news is that now, about six weeks out, most of those issues are behind me. It doesn't last forever!

Congratulations! Even when you trim down, expect your head to take a long time to catch up. I'm about 50 pounds down now, and my head STILL hasn't caught up, even though my clothes are just falling off me.

I think that pre-op jitters are very normal, especially considering that this surgery is irreversible. However, I take comfort in facts and statistics: the data on this procedure, as new as it is, shows that it is an extremely safe and extremely effective to lose weight. And it's "durable" weight loss -- which is medical jargon for "the weight comes off and stays off." That's the magic -- that's why we get ourselves "mutilated" and remove 3/4 of our stomachs instead of just doing diet and exercise; diet and exercise can and do lead to weight loss, but almost nobody -- literally 5% -- can keep the weight off. And each cycle of loss and regain is very hard on your body. And all this time of diet and exercise and deprivation and shame and discomfort is precious days and years of your life that you'll never get back. As to being on medicine for life -- aside from possibly an acid blocker, you'll be on far, far fewer medications post-sleeve than you would be as an obese person. Trust me. And most of the "medications" we take are Vitamins. Who do you know who doesn't pop a Multivitamin? So how come when we have to take vitamins it's shameful? These are some of the questions I've had to ask myself. With the sleeve, yes, you do something irreversible. But that's half of the appeal. You can never go back to eating enormous portions. You can never go back to wolfing your food down. And if you listen to your doctor, and follow some simple directions, the weight will never come back. That's why we do this. To me, when I looked at it like this, it was crazier to not get the surgery than to get it. Edit: I should add one more thing. Almost every single person I've talked to who's had the lap sleeve done has said that it was the best decision they'd ever made, and that they would do it again in a heartbeat. Now, that's not scientific, but to me it was pretty impressive. I can't think of many other elective surgeries with a customer satisfaction rate that high...

It gets better over time, but my understanding is that it will be with you, occasionally, for life -- that tight feeling is your restriction! If it's excessively unpleasant, talk to your doc, but honestly I suspect that a certain amount of "lump in the chest" feeling is normal for all sleevers, and is part of re-learning how to eat.

Again, your mileage will vary. My nutritionist basically told me to not bother tracking carbs at all, but she did say the same thing the others here are repeating: eat your protein first, the vegetables (complex carbs), then anything else (including simple carbs -- rice, potatoes, sweets). If you follow this recommendation and stay within your calorie target, I suspect you'll lose weight regardless of how many total carb grams you consume.

So, I gotta say, I bought an OTC supplement to help that particular issue and... no help there (it was mostly lots of Zinc and Vitamin E... I was careful not to get toxic since these are fat soluble). Hopefully when I'm closer to my goal weight, this issue will resolve (cartoon image of a dust cloud coming out of... well, you get the picture).

It's bizarre how different everyone's advice is from their docs. My nutritionist specifically told me not to go longer than 2 hours between mini-meals. The only limitation is not to go over on my calories, and to make sure I get enough protein/water/vitamins.

I would highly recommend moving back to mushy/slushy foods, at least for now. I'm not a doctor, but 12 days to solids sounds scary to me. You may be setting yourself up for complications.

I second what Tiffykins wrote (as always!) Slider foods I can consume with almost no feeling of restriction whatsoever. Solid foods, on the other hand... my girlfriend and I went out for dinner at a local Mexican joint, and we split three tacos. I was able to eat 1/2 of one taco and a couple of tablespoons of black Beans and rice, over about 45 minutes. And I was STUFFED. Moral of the story: the density and consistency of the food make a HUGE difference.

food -- particularly carbohydrates -- is a powerful mood-altering substance. This isn't just the case for people with food addictions, it's at least partially how the body works. Carbs, for instance, have been shown to have strong connections with serotonin levels, and other foods (notably chocolate, but there's more... just can't remember them all) have strong affinities for dopamine. The bottom line is that going to food for comfort is very normal. Without this crutch it can be very difficult to self-soothe. Again, this isn't just "addictive behavior" -- anyone who is low-serotonin will feel stressed and anxious and blue. Tiffykins' recommendation to get a massage is spot-on; you have to find other behaviors that help to soothe you without being unhealthy. A hot bath and a glass of milk is another method; the heat relaxes your muscles and lets metabolism byproducts like lactic acid get released, and the milk is full of tryptophan, which is a natural serotonin precursor. Exercise is also a good choice -- exercise ALWAYS makes me feel better -- but you have to be careful not to overdo it, because if you're feeling stressed and anxious because of "low reserves," then burning up the LAST of your reserves with exercise isn't going to help. The best medicine is a good night's sleep! Protect your sleep time fiercely, because consistent sleep deprivation is an almost sure way to lapse into low-grade depression and anxiety. Mild exercise is good as a sleep aid, as are the relaxing effects of a hot bath or shower. Also, milk and its tryptophan-explosion. So maybe the ideal thing is: exercise mildly to moderately (around midday when it won't affect your sleep time). In the evening, drink a tall glass of nonfat milk and take a long, hot shower or bath. And then, sleep like a baby. The odds are that you'll wake up feeling right as rain! The thing to NOT do is to "relax" with something like alcohol or marijuana -- these things will further deplete neurotransmitter levels, and while you may feel better in the short term, over the long run you're just digging yourself in deeper!

Focus foremost on Water at this point. Two reasons: it's more immediately dangerous to be dehydrated than it is to be low Protein, and two, mild dehydration can cause lightheadedness, especially with folks on BP medicine. And yes, I'd talk to the doc and get him/her to check your blood pressure regularly.

The first few days can be rough. I had some real issues with post-op fever -- it was mild; not an infection, but apparently a very normal post "trauma" thing your body does. The surgery itself is so easy, that I think we get blindsided when our bodies remind us that "hey, you did something pretty major down here!" Just focus on getting enough Water. That's really your number one goal in the first week. Then focus on Vitamins and Protein. Then, once you've got those licked, you can focus on everything else. Oh, and KEEP MOVING. I know that when you feel like crap the temptation is just to lie down and sleep, but trust me, walking and moving is a life saver.

Well, you're SUPPOSED to be eating small meals (100 calories or so) every 2 hours or so, so I'm not sure I see the problem! Just make sure you're making healthy eating choices, and your calories aren't going over, and otherwise listen to your body!

Absolutely; the depression HAS set in, but I'm trying to use it as motivation to make even healthier choices to "take care" of myself (and a lot of the depression, for me, may be a low-carb diet plus a bit of sleep deprivation from my apnea going haywire). And you're absolutely right; all of the habit changes the sleeve is requiring are changes I've been needing to make for years now. Change is never easy, and seldom pleasant. But it is necessary and inevitable, so I might as well be the one making the changes rather than the one who gets blindsided by them, right?