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Ahhh, the lovely tier 3 programme! It took an absolute age just to even be considered for that to begin with, I really feel for you. Then the added issue of thinking you would be aiming for a certain month or period of the year, to then be told last minute it's being pushed back, again and again, is genuinely the worst of it. Being completely honest too, as someone who is self-employed, I just don't earn enough regularly to commit to paying it per month. I was working 6/7 days a week between two jobs and I was barely earning more than 22-ish thousand a year salary until the end of last year. I do have the comfort of earning a little bit more now, but only in the right seasons unfortunately. I did put in a complaint yesterday to PALS, and they very quickly responded which was good of them, but it was conveniently not the woman who caused the stress to begin with. They've 'provisionally' (and I use that loosely!) let me know the 28th of March could work depending on how many others they have to schedule. Just a waiting game I suppose. Thank you for your kind words, I really appreciate it x

Thank you for the response summer, The water has always been a problem since the very beginning. It ALWAYS causes the spit thing to happen and its awful. Even if it's just sips. I wish I could just live connected to an IV. At my last meeting with my nutritionist 3 months ago they seemed disappointed that I had only lost 20 pounds since the surgery and hadn't lost any more since then. It was disheartening and has led me to live in fear of my next appointment with them, I feel like they're just going to be disappointed and shame me again and make me feel not good enough. It sucks.

Honestly, this seems way off-base, with the exception of 60-80 grams protein, which is completely sufficient for most people (but not all!). Your calorie estimations are much too low for the vast majority of people in maintenance mode. So rest assured, you won't be on 650 calories for life! Also, 25g carb is extremely low carb and not a lifestyle most people are eager to embrace. If a doctor insisted on 25g carb for life as the only way to succeed, I would seek out a second opinion for sure. From what I see people saying around here, 1200 to 1500 is a much more realistic calorie range for the long term, although that is for maintenance, not for weight loss or for early days after surgery. If you eat to maintain your current weight right now, that would seem to go against your goal of losing 20-50lbs more. I have two suggestions. First, check out some bariatric cookbooks because they will tell you appropriate portion sizes for maintenance as well as give you some ideas for what types of foods to be eating. My favorite is Kristin Willard's Bariatric Meal Prep Made Easy: 6 Weeks of Portion Controlled Recipes to Keep the Weight off. She's a registered dietician specializing in bariatrics and every recipe has a gorgeous color illustration. Second, take a look at the Portion Perfection brand bariatric plate. It's kind of expensive, so you may not want to buy it, but the concept is really good. Basically it's an 8 inch plate (with a one inch rim all the way around, so a 6 inch circle of eating space). There are lines and illustrations to divide up the plate and show you where to put your foods and how much. If you're a visual person, this may really help. Other than that, you may want to check out some of the nutrition videos as well as the weekly podcast done by Dr. Matthew Weiner (Pound of Cure). I find them so insightful and he and his dietician, Zoe, are very keen on plant-based nutrition, which may be perfect for you. Edited to add: Here is a link to a dietician article about post-op goals that might help: https://www.mybariatricdietitian.com/mbd-blog/portion-sizes-after-weight-loss-surgery

I had VSG (2015) to RNY revision on January 18th due to GERD. I also had regained almost 70 pounds from my VSG post-op low weight. I've so far lost about 20 pounds since the pre-op diet & surgery. I need to lose another 20 pounds (for normal BMI) to 50 pounds (for calculated ideal body weight). I'm now on unrestricted food textures, and per my program's dietician, I'm supposed to be on my "maintenance" diet now. However, they refuse to discuss any calorie goals or macros other than protein. I'm someone who needs very clear goals and guidelines (thanks, long-undiagnosed ADHD), and I'm feeling very lost about what my diet should look like moving forward. The lifelong guidelines for my program, as I understand them: 60-80g protein per day Up to 4 oz. (1/2 cup) per meal, consisting of: Up to 3 oz. protein per meal Up to 1 oz. (total) veg, fruit, or starch per meal 3 meals per day 1 snack per day (the program guide I was given says 1-2, but per my surgeon I'm only allowed to have 1 snack per day and it has to be between lunch and dinner) - I have no guidelines for the amount I'm allowed for the snack. I assume it's not supposed to be as much food as the meals, but I don't know. Protein shakes/powders are frowned upon The only sample menu provided in my program guide is as follows: Breakfast: Egg omelet with sautéed peppers & onions Snack: Protein shake OR Greek yogurt with berries [removed per my surgeon's instructions] Lunch: Lettuce wrap with turkey and avocado/cheese [it is not clear to me if the / means avocado OR cheese, or avocado AND cheese, but I assume the former] Snack: Apple slices with 2 tablespoons nut butter OR carrots with hummus Dinner: Pesto chicken with spaghetti squash, sautéed spinach, and cherry tomatoes I plugged this menu into the Baritastic app to try and get a sense of what the calories and macros are supposed to look like. The sample menu gave no amounts other than the nut butter, so I used the 3 oz. protein + 1 oz. veg/fruit/starch rule. With the carrots & hummus snack option, here are the macros for the day: 593 calories 62g protein 32g fat 17g carbs (13g net carbs) 4g sugar 4g fiber And here are the apple & nut butter (I used natural peanut butter) macros for the day: 739 calories 67g protein 43g fat 21g carbs (16g net carbs) 8g sugar 5g fiber So from that, I'm extrapolating that I should be aiming for the following daily: 600-750 calories 60-80g protein 30-40g fat less than 25g carbs less than 10g sugar I have a few concerns... I have already been going well over those amounts at just over a month post-op. I've typically getting around 800-900 calories per day. It seems like a real struggle to get to the upper range of protein daily while sticking to the allowed amounts and without using any shakes or protein supplements. Even then, 80g seems low for a protein goal. I have never been a big meat eater (I was vegetarian through most of my teens and 20s), and I absolutely cannot stand any fish or seafood. I do eat a lot of dairy, eggs, and beans, but it seems like that's not going to do it. The standard daily fiber goal I've always heard is 25g per day. I've been getting about 12-15g per day right now, but knowing that I'm overeating and already having too many carbs means even that's not sustainable. I've struggled with post-op constipation... I have gotten to a much better place recently, but if I need to cut back to 4-5g of fiber per day to be within my other limits, I'm afraid of going backwards. That I'm limited to 1/2 cup of food per meal for the rest of my life came as a shock to me, as a revision patient. I knew that my pouch would be smaller than my sleeve, and like with my original surgery, the amount I'd be able to eat at one time would be very small initially. But with my sleeve (which was done by a different surgeon in a different program), there was definitely not the expectation that the amount I could/should eat at 1 month post-op would be the same as what I could/should be eating at 6 months or 1 year out. My bypass surgeon also told me that she left my pouch a little larger than normal so that I wouldn't lose too much additional weight, so my pouch is already larger than a regular bypass patient's. Do these amounts seem in line with other people's experiences? Or am I way off-base?

I was on clear liquids 3 days, then full liquids for the first 2 weeks post op! While I craved substantial food at 6 days, my stomach wasn’t anywhere near ready for pureed food. Started pureed on day 15 post op and will be on it until 4 weeks post op. Next stage is soft food (weeks 4-6). At 6 weeks post op, I can slowly transition to solids

Just hit 3 weeks post-op today. I’m also on 2oz purée food to be SLOWLY eaten over 30 minutes. At this stage, protein shakes no longer count towards water goal of 48-64oz. I have also still been hungry and felt like I needed more substance. Met with my surgeon yesterday and he said the hunger hormones are still adjusting in my body, and it may take a few more weeks to feel less hungry. Also, I know some of the hunger is mental. Some things that have helped me are to actually take 30 minutes to eat the 2oz- which is quite difficult for me to slow down that much. I also stick to 16oz of water slowly sipped until around 8am. Protein shake slowly sipped 10am-12pm (I started adding a serving of collagen peptides to my morning protein shake (my program says collagen peptides are not a complete source of nutrition, so should not be taken as a full meal)- this has put me at more calories and protein earlier in the day. Lunch around 2pm, dinner around 5:30/6pm, another protein shake or 1oz purée a little later if needed. Goal is 60-75 grams of protein

Hello Irene, Welcome in here and congratulations on your surgery date. You will find a March 2024 group on here that you can join. Don't read anything on the net. Scare stories are not needed. This surgery is very safe. This forum is a safe place. Stick to your teams advice, There is not a single person on here who has the same regime as you, pre or post op. Don't buy loads of things you think you may need. Our tastes buds change after surgery because of Ketosis. Just buy a few of a selection of protein shakes. You may want to buy pain meds if you are not in the UK. You will not need much at the hospital. Go in clothes that you can go home in. Take a Chapstick and some Biotin. Some people take a phone charger with a long lead. You might want to use a recliner chair for sleeping, if you have one. I didn't and had to sleep upright in bed for a while and a recliner would have been easier. I had a bed wedge and lots of pillows. If you have a pre op diet they are tough for the first 4 or 5 days but its worth it in the end. You will have a weight loss stall at 2-3 weeks. You have not done anything wrong. You may get over emotional and / or get the regrets at this time. Our hormones are in the fat cells and releasing them in such a hurry makes our hormones go on a wild ride.

Try to work through the liquid diet and stay on it as recommended. Getting in 3 Protein shakes a day is pretty good, you're getting your protein in. I'm 3 weeks out from my surgery. Don't rush the soft foods, from my own experience you won't be able to eat much at all. It seemed like I could get in all the liquid I needed. Once I started soft food, I can barely get 1 measuring cup of food in. So you will need to drink one or two protein shakes a day to get in the protein you need with the food you can eat once you get to soft food phase. You won't be able to eat enough protein to get he recommended amount set by the dietician or whoever is directing you the recommended amount protein you need. I too lost weight before my surgery 70 lbs. Since my surgery I've only lost 7 lbs. Which is expected because of healing and getting the body back used to taking in soft foods again. You're doing really good, keep it up. Remember, when you do get to eat soft foods, take it slow. I've vomited only a couple times from getting to full. It's definitely different when you can only take a few bites and feel full. Wish you the best!

You will only get help and kindness here but we are not surgeons or dieticians. We can only help so much. We always recommend a visit with your team if possible. If you are not eating well and not getting enough liquids in then your body is holding every little calorie it can because you are in starvation mode. You will not loose weight, your body is in charge of this. If you can not get water down and you could a while back then you have a narrowing/ swelling in your new tummy and it needs a little easy tweak to stretch it back out. Its called a stricture. If this is something you have had from the beginning then you are forcing too much food and or drink in at once. Small sips of drinks, they can be hot, cold or frozen see which might work . Once you have mastered drinking, then pare down the foods to really soft, protein based ones again. Chew well and add sauces, it helps. Soft eggs, protein yogurt, soft cheese etc. Only eat a small amount, say 1 - 2 ounces and see if you can keep the foamies at bay. Foamies happen when your stomach rejects the food or drink it does not want that day. It may have been ok the day before but.... today, oh no you are not putting any more of that in me ... I haven't exercised as such, I was too decrepit too start with and I lack motivation now so I walk a few miles a week. Exercise doesn't really count for much weight loss unless its marathon running or such.

This is so awful, I am beyond sorry that you have had to go through this. I know most of us can completely empathise with how hard the waiting game is at the best of times, let alone with the added stress of the NHS and how badly run it seems to be with WLS! I had initially considered just staying on the NHS waiting list (I am currently on the Tier 3 Weight Management programme), but after hearing awful experiences like yours, and from reading about waiting times, I decided to look into going private with Spire. I think it may be worth just getting a second opinion in regards to what you were told before by a private surgeon! My surgeon, Simon Monkhouse, was amazing in the initial consultation. I have PCOS too, and an underactive thyroid, and he recommended a bypass and was transparent about it all. You can get a free consultation with him quite quickly, maybe this would be an option for you! simonmonkhouse.com I have everything crossed for you that you will get the surgery soon, and everything will work out. I'd definitely pursue putting in a complaint, too. Sending love and hugs x

So I am six months past surgery. My initial operation was August 21, 2023. I was 328 on the day of, and 376 at my highest before surgery. I lost 20 pounds by 2 weeks after the surgery, and have not lost weight since. I had weighed 305 since then. I noticed my weight creeping up on the scale now, and I'm at 309 again. I will say, however, I have gone from wearing a 4x to wearing a 1x in shirt sizes, though have only gone down two sizes in pants 28 to 24. I am struggling with drinking water. I feel starving. I've noticed myself wanting to eat every few hours. Then when I eat I vomit, or feel nauseous and spend a good amount of time nearly throwing up. Whenever I drink water I get that pre-vomit spit thing that happens and my mouth just makes spit for like 30 minutes and I feel awful. I think lack of physical activity has kept me held back in terms of the stagnant weight, I spend most of my days in bed or sitting in a chair at a desk. Is there anything that has helped anyone, any slight tricks to fix me? I don't want to hide and say I'm doing all the things right I'm doing great anymore, I know I'm not doing the best and I am looking to find support in getting there.

The purée/mush foods may be too heavy in your poor tummy & digestive system. Stick to the liquids for a couple of weeks. 2 weeks liquids, 2 weeks purée, 2 weeks soft, 2 weeks solid food is the most common post surgical eating plan but plans differ so check with your team. You’ve had a pretty major surgery & there are lots of staples & sutures holding your digestive system together. Nausea is quite common so ask for an anti nausea prescription or buy an over the counter version. We heal differently but generally it takes a good 8 weeks to fully heal so tread slowly & carefully. I wonder if you have an UTI from the catheter? It’s not unusual to have no other symptoms except a change in peeing habits. Best to see your doctor & have a urine test to be sure. And grab some cranberry tablets too.

It really is amazing to see how all the different doctors approach the pre diet, surgery, out patient vs hospital stay, post diet length of phases, what you can eat, what you can't in each phase. Of course we probably all think / hope that our own doc is doing it right. I'm trying hard to follow my doctor's course, even though when I read where some of you are, it gets difficult. Had first puree tonight (cheated by starting 12hrs early.. Oh well!) It was really good but really surprising how different your stomach reacts to it. I was definitely full after a few teaspoons as compared to eating pudding. I have a nutribullet, so you really end up making many servings so there's enough volume to puree. The mental part of the recovery has been awful. Hoping that being on the puree for the next two weeks will start to bring up the mood. FYI.. My insurance doesn't cover a nutritionist/dietician. Some of my doctor's dietician appts are considered part of the procedure and thus discounted cost. I paid almost nothing for the procedure itself, but not the dietician part. I looked online and found Health Loft. Many insurances cover them, including mine. They advertise as services for eating disorders, but they also have specialists for bariatric. It's virtual. Now I can use a dietician and get some counseling for many more visits as I try to change my life. Even though I've known for decades how I should be eating, I need all the help I can get.

There's a reason when I describe my eating plan it is "3 meals of 3-4oz protein, 1oz veggies, or when I am full, whichever comes first." Typically, I probably complete 1 meal of 5 or 6, and a couple bites in 1 meal of 5 or 6, then the others are somewhere between. This is very normal for me, even all these years later. Good luck, Tek

Hi! I was wondering if anyone who is 5+ years since surgery is still experiencing any issues? I find that when I eat certain foods, much like when I was about a year or so out, that I have a feeling of being too full and can’t keep the food down. It isnt all the time. And it isnt really if I eat too much or too fast. I still eat pretty small meals at any given time and typically just eat 6 or so very small meals. An example would be if I eat pasta, maybe 1/3 to 1/2 a cup may feel unbearable and too full and can’t keep the pasta down. It could be something random like a handful of jelly belly jelly beans. I would say it happens maybe 1 a week? Just curious if anyone else has this issue. I have done well at keeping the weight off since the surgery and have hovered around 130-140 for the past 2 years. I am fairly active 50’s, 5’5 female. Thanks!!

Hi there! I just had my surgery last Monday on February 19th! I am on day 8, and honestly, im starting to feel almost back to normal! Struggling with the fact that I can't eat anything other than soup and pudding despite being so so hungry. Everything has been going down really good. I have had no issues getting in protein. I have 3 premier protein shakes a day, which equals to 90g of protein. I just wish I could eat soft foods like mashed potato and eggs. But my nurse practitioner wants me to stay on the liquid diet for another 3 weeks. YEAH RIGHT, hahah im going to be introducing some foods next week I think. I can't wait any longer. I am so hungry! I hope you have a speedy recovery from surgery! If you need any advice or have any questions, I am always here for you! Heaviest Weight: 376 - April 2023 Weight on day of surgery: 291 - February 2024 Total lbs lost before surgery: 85 lbs Current weight (1 week after surgery): 280 Total lbs lost since April: 96 lbs Im so close to meeting my 100 lbs down goal!!

Hi there! I just had my surgery last Monday on February 19th! I am on day 8, and honestly, im starting to feel almost back to normal! Struggling with the fact that I can't eat anything other than soup and pudding despite being so so hungry. Everything has been going down really good. I have had no issues getting in protein. I have 3 premier protein shakes a day, which equals to 90g of protein. I just wish I could eat soft foods like mashed potato and eggs. But my nurse practitioner wants me to stay on the liquid diet for another 3 weeks. YEAH RIGHT, hahah im going to be introducing some foods next week I think. I can't wait any longer. I am so hungry! I hope you have a speedy recovery from surgery! If you need any advice or have any questions, I am always here for you!

Thank you, I completely agree. Common practice usually would be to call the patient on the waitlist at the top (I have been told you are able to refuse a date to be offered another just one time, in the event you have a situation you can't miss in your personal life, for example), and offer the date with 2-4 weeks notice of surgery to begin the liver reduction diet. I agree though, it doesn't take a genius to work out that this way of contacting people is simply ridiculous. What if one is driving again, or it's an inappropriate time to answer a call? I have since found the complaints email for the health service trust, and have sent one off to explain the situation. I would be shocked if this was their policy, honestly, but I'll wait and see I suppose.

I spoke with the nurse last night and tomorrow I get to begin the soft proteins phase, which will be one week post-op. I'm going to the grocery store tonight. I will have to start separating food and liquids, waiting 30 minutes after drinking to eat and then 30-60 minutes after eating to drink. This is going to be a challenge because it takes me forever to drink anything. Part of the problem is I am developing an aversion to my protein shakes and anything sweet or artificially flavored. I think it's time to start making use of my unflavored protein and Greek yogurt to make my own shakes because the commercial stuff is just tasting terrible. Soft proteins include cottage cheese, string cheese, ricotta, flaky white fish, ground poultry, refried beans, tuna salad, eggs, yogurt, and tofu. My eating schedule when I begin soft proteins will be: Breakfast soft protein 16-20oz fluid plus a protein shake between breakfast and lunch Lunch soft protein 16-20 oz fluid plus a protein shake between lunch and dinner Dinner soft protein 16-20 oz fluid plus a protein shake after dinner/before bed

Whoa, be careful with the salt, It will dehydrate you more. If I could suggest something, get some cranberry juice and get as much down you as possible. Its great for bladder issues. Lots of us are not allowed food for a few weeks and I know that until I got onto real solid food and anti nausea tablets that I suffered terribly.

Hooray it's done. Took about 1.5 hours. As mentioned, my surgeon didn't require a pre-op diet other than the day before. Maybe he should have, because I was supposed to have my gall bladder out too... And he couldn't get to it cause my liver was too fat 🤣🤣 Other than that, was up and walking about 3 hours after. Only pain is from over drinking my water a couple times, no pain really. Everything just feels weird. Looking forward to getting out of here today! Can't believe it's only one overnight... But I am glad cause I'd get so bored. Happy to answer question.

Excited and nervous pretty much sums up my mental state from last July when I started the surgical program to last week when I finally got the surgery!

Excited and nervous pretty much sums up my mental state from last July when I started the surgical program to last week when I finally got the surgery!

Hey!! You are a little over 2 weeks post op. Burping and feeling bloated are quite normal. As the internal swelling goes down these will ease (unless you chug water, then you'll feel bloated for sure! LOL). It isn't unusual to feel like things are creeping up your esophagus, right now everything is very swollen in there and that leads to a pressurized feeling. It can feel like water and food take forever to go down, or that they go down a bit and then start trying to crawl back up, before going down again. I had all these issues. I also had this thing where every time I drank something I could feel the fluid displacing air in my digestive tract, causing burping and then this trickling, gurgling feeling AND sound as the fluid tracked down into my stomach. It sounded like liquid going down a drain you just unclogged. It was weird as hell. LOL It lasted for the first month until the swelling went down enough inside to make more space. Fluids for another week are not going to hurt you. When you say fluids do you mean strict liquids only like milk and water? Or are you including shakes, pudding, yogurt, and so on? I was on strict fluids only for 2 weeks, no yogurt or puddings and I wasn't even able to stomach a real protein shake for the first month. I was not able to get any protein down the first two weeks without intense stomach spasms. The surgeon said that was not unusual at all. After the first two weeks we were supposed to introduce thin purees for the third week, and he told me I could have really soft fish and soft eggs. I hated purees. Yogurt sat too heavy. I still couldn't do jello. Sugar free pudding was a no too. I could do protein water, milk, a little bit of soft pureed egg, and weirdly enough, a little soft fish chewed well. At the 4th week we were told to progress to soft solids, but it took me another week before I was able to consistently. I had to be very gradual about my food progression. My team said that was perfectly fine, everyone's pace is a little different, just be sure to keep them posted on your progress as you go and follow their advice, but without forcing yourself to eat things your tummy doesn't feel ready for. You sound like you are right on schedule. ❤️

I love this! I know my partner loves me regardless of the weight I am as long as I am healthy. (one of the convos we had that if anyone on of us became unhealthily overweight we would have a conversation about that- I wasn't there) He does have to navigate how this is going to go and how he will feel towards me. The parts that he loved are getting small, so I have these self destructive thoughts. Its a me thing and I know that, because my guy always compliments me and tells me how much he loves my saggy boobies LOL or my handful of a butt now. he's encouragement. I don't want to put so much emphasis on looks but man its tough when that's the only thing that is changing! Then I had an HR rep come up to me and tell me I am withering away and I look great. Like omg I wanna cry. I feel like I was this huge person walking around and more ppl want to talk to me. My partner is more handsy. Idk I didn't expect this. Its a lot ( I am rambling I know). I went through a lot of therapy when I left my abusive ex and I consider myself a very strong woman but my god the last week or so I have been feeling a type of way!