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I consider myself an expert when it comes to autoimmune rheumatic diseases. First- let's talk your prednisone: See an endocrinologist. Pronto. I was taking 60 mg of pred a day for years. There was no weaning off, because any time I got down to 20-25mg, I literally could not function. In any capacity. Enter the endocrinologist. Because the prednisone does just as much (if not more!) damage than good, my adrenal function was gone, I had prednisone induced glaucoma as well as prednisone induced diabetes. I needed off the meds ASAP. She prescribed me ORAL hydrocortisone. It mimics- and tricks- your body into believing it is prednisone, and is MUCH easier to wean off of than the prednisone. It took a total of 2.5 months vs over a year or longer if it were the prednisone. Do this. Again, ASAP. Ask for it. Second- methotrexate, either by pill or injection: pills made me sick, puking, typical chemo side effects. The shots did not, and they actually work much more effectively than the pills, so if given a choice, it is a once a week teeny tiny needle. Side effects- don't bother paying attention to them. The benefits far outweigh any possible adverse effects. You will need regular blood work to monitor your liver enzymes. Again, I have been on a very high dosage, so mine were often screwy. Third: I can't imagine any surgeon doing WLS or ANY elective surgery while you are on either of these meds. I had to "wash out" before I could have my surgery, meaning get all traces of the meds out of my blood system and stored reserves. Both drugs make you more susceptible to infection and the prednisone especially makes healing hard. And keeps weight on. Again- seeing an endocrinologist will get you off the pred by using oral hydrocortisone pills. Usually PMR goes away after a year or so. I wonder if you don't have true rheumatoid arthritis? The tests- a sed rate and C-reactive Protein screen are used for PMR as well as other autoimmune arthritis diagnosis. Just a thought. So- don't worry about side effects of the methotrexate and get off the pred!!! Sent from my iPhone using the BariatricPal App

It's 4 hours long so be prepared for that lol however it went by quickly for me because I was so interested. I was reactivating and have gone through orientation before so I knew most of what they were saying but I was still intrigued. You will get weighed and then a surgeon will speak and show video of the surgery, as well as Dr. Z (psych), and Liz the case manager who is also taking over for the dietician while she's on maternity leave

I was reactivating into the program so the process for me was a tiny bit different. I got my referral July 13. I had a health education class July 27 that covered general details about bariatric surgery and the program. After that you need to talk to doc again and say you're interested they then refer you into the program. August 4 was my orientation (4 hours long!!!!!) This where they weigh you and only this weight and their scale will be the one that matters. Since I'm reactivating I had to take 4 bariatric lifestyle class (extremely helpful). They are every Wednesday. On my 4th class day I called to schedule my psych eval, I was SO lucky I called when I did because it was either the next day September 8 or all the way until October 4, I took the 9/8 because I would be on a trip for the next available appt. Dr. Z (psych) cleared me and scheduled me for my surgeon appt w/ Dr. Mostaedi October 11 (where I'll get my goal weight) I've already lost 23lbs so that must be why Dr. Z cleared me quickly. I have to wait till December for surgery because of school but I would have to wait anyway because I was a vaper. If you are a smoker you will have to be 3 months nicotine free before surgery. If I wasn't a vaper and didn't have school I would probably be having this surgery in October.

Thank you everyone,yes I will keep you updated. My body is in constant overdrive and I have been on bp meds for years. I am hoping to get off of them but I guess not until I get my thyroid levels stabilized. I used to wake up with extreme night sweats but it has been better, but I'm always hot. I'm concerned about going hypo if I get on meds or gaining weight back and they have run all kinds on tests on me. They did a mri to check my pituitary gland, checked me for nodules, checked me for graves (though graves unfortunately does run in my family) and so far it's all been negative. Don't know what's causing the extra low tsh.

@@MissB1982 Glad you are seeing your Endo. I have Graves Disease (Hyper thyroid). It is genetic, but I was diagnosed with it pre Sleeve, as part of the tests pre op. I've walked around with it for decades ..... This put my surgery back for 9 months to get my thyroid stabilised. I tried anti-thyroid drugs but this was taking too long, so I was on Beta Blockers and had RAI done last year (radioactive iodine) to destroy my thyroid. 4 months later I went hypo, and was put on Thyroxine (Synthroid) 100mcg. After my sleeve early March 2016 I started noticing that I wasn't sleeping well again, and my bad headaches came back. In May my Thyroxine dose was reduced. I was OK for a while, but with continuous weight loss, the Hyper thyroid symptoms came back: bad insomnia, awful headaches, high blood pressure and racing pulse, sweats. My TSH was back to less than 0.01 again! I saw my Endo last week, and she reduced my Thyroxine to 50 mcg (half dose). She told me to have a week off Thyroxine, to stop it completely, and re-start it at 50 mcg this coming Friday. I also had to go back on Beta Blockers to lower down heart rate and blood pressure. She confirmed that with weight-loss, this affects the med dose. It is very weight sensitive. So far I am starting to sleep better, and my vitals have improved, rare headaches now and still bit hot at times. @@MissB1982 I hope you get your answers from your Endo. You sound quite Hyper thyroid to me. It can put a strain on the heart, and the whole condition is very unpleasant. There are anti-thyroid meds, such as Carbimazole, plus Beta Blockers to slower the heart rate, and there is RAI: Radioactive Iodine Tx. Good luck, and let us know how you went.

I'm hypo had half of mines removed due to goiter I take pills for it daily was just sleeved on 6th of September Sent from my iPhone using the BariatricPal App

Apologizing in advance for the length of this post but here goes my 'deleting my online profile' story: So...I met a guy on Zoosk in the spring of 2015. No attraction on my part, and every time we went out, I said to myself that I would end it. Problem was...I really enjoyed spending time with him. Eventually we did become a couple and I hid my profile rather than delete it. Glad I did because after nine months of dating, he blindsided me and dumped me. We were not in love and I'm fairly certain in time, the relationship would have limped along till one of us made the move to end it. But because I wasn't prepared, it hit me like a ton of bricks and brought up all kinds of rejection issues for me and well.....you ladies know how this part goes...what did I do wrong?, why was I not good enough?, yada yada yada. What I did know when the relationship was over, was that I wanted to be with someone so crying hysterically, I resubscribed back onto Zoosk and JDate, which I had also shut down but not deleted my profile from. To my complete surprise, I met a man on JDate in June and we have been having a great time together. This relationship is nothing like with the other guy. This new one and I have so much in common and we enjoy talking about all kinds of things and doing so many of the same things. I wrote on another thread that he might be the lid to my pot and so far, it's going gangbusters. I know he deleted his profile from both Match and JDate a few weeks ago and knew that I had not. It wasn't that I was dating anyone else...I just wasn't ready to shut it down again. Last night I went onto Zoosk because I was getting email notifications from them and on a whim, went onto the site. Just for the heck of it, I looked up former boyfriend's profile...which he had not reactivated when I first went back onto Zoosk..and sure enough, he popped up this time. I looked at his profile..his new profile by the way...and the updated pictures on it. And that's when I knew...time to shut down my profile. It's not that I don't hope he finds someone...I'm not that petty. I just know more than ever now, that he's my past, and it's time to focus on my future..and with this new man in particular. Now...if I could just figure out how I managed to send old boyfriend a friggin' friend request on FB, it would be great. I swear I have no idea how I did that, but I did. I can't unfriend him now...not after sending that request...even by accident. Oh..and why he accepted that request is beyond me. But if I'm lucky, he'll see the pictures of me and the new guy, and delete me from his feed...

@@WLSResources/ClothingExch Because after radioactive treatment my thyroid got destroyed and stopped functioning. I had RAI early August 2015, and by December 2015 I was Hypo thyroid, at TSH 17.3 (when I was Hyper, TSH was less than 0.01) Hence my now life-time thyroid hormone replacement. At surgery, my TSH was 1-1.5, few weeks later it went to 0.6 and I started feeling unwell again. Since the past 3 months, TSH has been less than 0.01 again, due to continuing weight loss. So I am back to Hyper thyroid symptoms, not all of them, but few troublesome ones. Hence dosage adjustments, but they take weeks to work. I nursed before, so I know a fair bit about different meds, and so I tried my anti-thyroid drugs again, and they certainly helped me, at least to sleep! Anyway, hopefully my Thyroxine will be lowered again. The Thyroxine/Synthroid is very weight sensitive, and I feel I now should be on 75 mcg. I'll find out on Thursday when I see my Endo again. Without the thyroid hormone replacement, we can't survive. So, either Hyper of Hypo thyroid can be life threatening. At least with Hypo, you only take 1 tablet a day. When I was very Hyper, I was taking up to 18 tablets a day! Carbimazole (anti-thyroid) plus Beta Blockers for my heart. It was just too much, so I decided to go with the radioactive Tx, then 1 tablet a day. One day, when my weight stabilises, so will my Thyroxine dose. And I finally should feel well/normal again. If not for my thyroid issues, my WLS recovery would have been easy and smooth ......

It's funny... I've always wished I was hyper rather than hypo.. That way, the weight would just fall off... make it a great day Hope you get stable soon, krakow! make it a great day

I've been hypo for about 14 years, but then had thyroid cancer 8 years ago. My thyroid was removed. Been clear now for 6 years, thank god...Thanks for asking... make it a great day

Hi @@judy vsg, few of us here with thyroid issues. Welcome to the club I have Graves disease, pain in the butt! However I am hoping for some stability in my thyroid once I reach goal weight. Have only been hypo for 1 month, 4 months after radioactive iodine treatment. Can't wait for my Thyroxine levels to be lowered and stay stable. How are you doing? Hope you are well.

I was never diagnosed with reactive hypoglycemia, but when I was pregnant, my blood sugar would drop to the high 40's (normal fasting is 70-100). I managed it by eating several small meals - every 3 or 4 hours - making sure I had good amounts of Protein in each. Which also cleared up my all-day morning sickness. Outside of pregnancy, I've had a few times where I got clammy and shaky and knew what it was and got some sugar on board quick. You can get glucose meters and supplies without a prescription, but a prescription is required for insurance to cover the cost. But it's important to be working with your doc and team regardless. I'm not far along enough to see if it's better or worse after the sleeve, but I'm on the lookout for it. This is a great topic, thanks for posting it!!

I feel like shit I barley eat anything , I feel very weak and now I'm having trouble with very low sugars I don't no if I should of had this surgery I'm having dibetic hypos on a daily basis I'm just lost for words really no support out here where I live I feel all alone I'm off to the hospital for a suspected blood clot to can things get any worse ???????? Sent from my SM-N910F using the BariatricPal App

I should probably clarify what i mean by long term, 12 months is relatively safe, beyond that being at extremely low calories can cause the following: Fatigue Anemia Cardiovascular issues Gallbladder issues Increased cortisol Ferility issues Psychological Vitamin deficiency Loss of muscle mass Malnutrition Reactive hypoglycemia I know some of these are resolved with weight loss, but they can also be brought on by having extremely low calories for years.

Day 16 and I ain't got a clue I really think my doctors have failed me with information being dibetic to everyday hypos and they expect me to inject my self with insulin which I refuse I dunno if I should of had surgery now I'm clueless the nhs is a big con system ???? Sent from my SM-N910F using the BariatricPal App

I am not a doctor nor do I have medical experience. So take what I say with a grain of salt. I am 3 years post-op RNY gastric bypass surgery. It seems like you have multiple conditions, so let me talk about these individually. General The three most important elements after RNY gastric bypass surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. Weight loss is achieved after surgery through volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as Protein shakes. It looks like you have lost the weight are in the Maintenance phase. So generally your meal volume allotment is now large enough that if you concentrated on eating high protein meals, you might not need to add protein supplements (protein shakes, protein bars). I found it difficult to transition to solid foods (such as steak and chicken) after surgery so I primarily relied on softer foods such as chili and Soups. I fortified these with extra protein. I have included the recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf But if you are having difficulty keeping food down, then you may have to go back to protein supplements just to ensure you get the proper amount of protein in daily. Ulcers Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present. So the general advice from above if I am interpreting it properly is to eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed. Also avoid NSAIDs (such as Aspirin, Ibuprofen, Diclofenac, Naproxen, Meloxicam, Celecoxib, Indomethacin, Ketorolac, Ketoprofen, Nimesulide, Piroxicam, Etoricoxib, Mefenamic acid, Carprofen, Aspirin/paracetamol/caffeine, Etodolac, Loxoprofen, Nabumetone, Flurbiprofen, Salicylic acid, Aceclofenac, Sulindac, Phenylbutazone, Dexketoprofen, Lornoxicam, Tenoxicam, Diflunisal, Diclofenac/Misoprostol, Flunixin, Benzydamine, Valdecoxib, Oxaprozin, Nepafenac, Etofenamate, Ethenzamide, Naproxen sodium, Dexibuprofen, Diclofenac sodium, Bromfenac, Diclofenac potassium, Fenoprofen, Tolfenamic acid, Tolmetin, Tiaprofenic acid, Lumiracoxib, Phenazone, Salsalate, Felbinac, Hydrocodone/ibuprofen, Fenbufen] and but use proton pump inhibitors [Omeprazole, Pantoprazole, Esomeprazole, Lansoprazole, Rabeprazole, Dexlansoprazole, Rabeprazole sodium, Pantoprazole sodium, Esomeprazole magnesium, Omeprazole magnesium, Naproxen/Esomeprazole, Esomeprazole sodium, Omeprazole/Bicarbonate ion] and/or sucralfate [Carafate] antacid. After RNY gastric bypass surgery, my surgeon put me on Omeprazole [Prilosec] for a year to lessen the affects of surgery on my stomach. Passing Out The fact that you have passed out a few times might be due to a condition called Reactive Hypoglycemia. This is a low blood sugar condition that affects some RNY patients. Here is a link that describes the condition. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass

Here is a link to an article on reactive hypoglycemia post–gastric bypass. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass The three most important things after surgery are fluids, Vitamins and Protein. Since you said that "when I drink Protein I throw instantly", have you tried MILK. 32 ounces of 1% milk fortified with 1 cup of powdered milk will give you 56 grams of protein. You cannot drink this all at once but spreading this out throughout the day will help you meet your daily protein requirement.

The three most important elements after weight loss surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. You are at least 10 weeks post-op. If you can't keep Water down, you may have a stricture. If you are unable to meet your daily protein, fluid and vitamin requirements, you need to seek medical attention and resolve the issue. Your problems may be caused by dehydration. They may be caused by a lack of Vitamins and minerals. It may be caused by reactive hypoglycemia. The fact that you were dizzy and took soda (sugar) rested and then felt better does point towards reactive hypoglycemia but you may have a whole slew of problems to deal with.

@@cuddletime Yep, I have reactive hyperglycemia. It is manageable. Consult your surgery team.

I've read some posts about folks dealing with reactive hypoglycemia at about 1 year + out. Im a little over a year out and now struggling with it. Ive read several links explaining what it exactly is. What I'm asking with this post is what are some of your personal remedy foods and emergency Snacks? I could use some ideas. Protein pairing seems to be key.

I agree. Start as if you had surgery yesterday with the liquid diet and follow the 5 day pouch reset. That will help get a lot of the sugar toxins out of your system and it will jump start you. Then, focus on the rules: 1. No drinking anything 30 minutes before and 30 minutes after you eat. 2. Limit your beverage calories. Try to stay on Water or sugar free non carbonated beverages. Stay away from alcohol. If you can, even limit caffeine as it really does cause you to feel hunger. 3. Mindful eating, remove distractions so you can pay attention to your pouch. Your tool is still there, you just need to retrain it. 4. Eat your meals slowly chewing well in between eat bite. Put the fork down in between but do not go over 30 minutes for your meal as your pouch begins emptying at that point. 5. Drink a minimum of 64oz of water or SF non carbonated liquids. 6. Ensure you get a minimum of 1 gram of Protein for every inch you are tall. Even a little more is better. Make sure that you get that protein mostly from dense Proteins like fish, seafood, beef, chicken and pork. These foods will keep your pouch fuller longer and provide you with much needed protein grams. 7. If you have not done this recently, you should have a full Bariatric blood panel drawn to ensure you are not lacking any nutritional elements that could cause you problems. 8. Are you still taking lifelong Vitamins like B12, Calcium Citrate or any other vitamins your Bariatric Doctor put you on? If not, you will want that nutritional panel to inform those decisions. 9. No grazing.....this is where most people start to have weight gain. Eat your 3 meals a day and try to avoid snacking. If you are one of those people like me who has reactive hypoglycemia, then have 5 smaller meals. 10. Avoid sugar, potatoes, Pasta, rice and bread. Same thing with any prepackaged processed foods. Get rid of the junk and stick to good quality proteins and veggies and fruits. Once you hit goal again, then you can introduce some whole grains back into your diet slowly until you get to a good maintenance schedule. 11. Try to get some exercise even if it is just walking daily. These are the things that I will do if I ever start to regain my weight. It really is getting back to the basics.

I too was 5 lbs heavier post op the day i got home from the hospital. I was so depreessed, being hypothyroid as well. I felt so defeated . i knew I lost weight on 2 week pre op. To then gain weight on sf jello and popsicles. I called the drs office in tears of course. I am 5 days post op now and am scared to get on the scale again. However, I can see weight loss in my body. Still# pts hypo scale

The three most important elements after RNY gastric bypass surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. Weight loss is achieved after surgery through volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as Protein shakes. Back to the point of Dizziness. It might be due to several factors. For example if you were taking medication prior to surgery, they may need to be adjusted. This can especially be true for medication to control blood sugar and blood pressure. Also there is a condition called reactive hypoglycemia that some individuals encounter after weight loss surgery. Dizziness or lightheadedness is also caused by dehydration. In order to get a handle on the cause, you might want to evaluate when it occurs. For example, do you experience this first thing in the morning when you get out of bed or when you get up after sitting down. Or do you experience this a few hours after a meal? Do you experience this all the time?

Thyroid Storm can act like that. So anyone on thyroid meds have to be mindful that their body is changing quickly and adjustments need to be made to medication or they might be taking too much. As a result you could throw yourself into a storm. Please keep that in mind. Your going from hypo-to-hyper! If you take thyroid meds make sure you tell the ER. Sent from my iPhone using the BariatricPal App

It may be that you just got sick - either a virus or food poisoning. If it's a virus, you'll just have to wait it out and see if you feel better in a few days, but you also might want to change out the food/broth/whatever you're eating for a different batch (not from whatever you are currently eating/drinking - go to a different store and buy a different brand of everything) and seeing if you still get the same symptoms. If it's not food poisoning it might be a sensitivity to a specific brand of something you're eating before you get sick. It sort of sounds like some of the symptoms of reactive hyperglycemia: https://en.wikipedia.org/wiki/Reactive_hypoglycemia I'd also caution you to not lay down within 30 minutes of eating or drinking anyway as it can cause you to get reflux in the early days. It wouldn't likely be what is making you sick tho. It honestly sounds more like you caught a flu bug or something like that more than anything related to your surgery.