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I have a wonderful recipe for crab cakes. I don't know how it stacks up nutritionally but it doesn't use a lot of breadcrumbs for filler so it is better than most. I 'fry' them on a pancake griddle with just a little oil so it's not a diet-buster. I'm happy to share it. I made these when my husband and I had a food truck. Big seller! Cajun-Style Crab Cakes 6 Slices white bread 1 tsp garlic, minced 2 eggs 1lb crab meat ¼ c heavy cream 4 green onions 1 tbsp fresh lemon juice 5 slices bacon, cooked & crumbled ½ tsp dry mustard 1 tsp Cajun spice mix Salt, to taste Tear up bread slices and grind in a blender or food processor. Add eggs, cream and lemon juice to form a heavy batter, then remove to a bowl and add all the remaining ingredients. Fry in oil or on oiled grill. Serve with Creole Honey-Mustard Sauce. Creole Honey-Mustard Sauce 1 tbsp vegetable oil 6 tbsp mayonnaise 1 tbsp green peppercorns, crushed 6 tbsp sour cream 1 tsp freshly ground black pepper 1 tbsp honey 1 shallot, minced ½ c dry white wine 2 tbsp Dijon mustard In a small, non-reactive saucepan over medium heat, heat the oil and sauté the peppercorns, pepper, and shallots for about 3 minutes or until the shallots are translucent. Add the white wine and simmer until the wine has almost completely evaporated. Let cool. Add the remaining ingredients and check the seasoning. Oh, the sauce is DIVINE!! Enjoy.

Has anybody tried adding Fiber to their food/shakes? I am 5 weeks post op, approved for all foods, but dont really have room for high fiber foods after getting the Protein in. I would prefer a premptive approach rather than a reactive one as I am worried about treatments "kicking in" during inopertune times like meetings, driving etc. HW 385 SW 359 CW 335 (50lbs down!) Sleeved 10/5/16

I got that way when I was about three years out. I had a complete workup - nothing. Everything normal. Then I noticed once that I got a bad case of it about an hour after I ate a piece of cake at a retirement party. I asked my PCP if it could be RH (reactive hypoglycemia). She said it was definitely possible - it could be that my blood sugar was normal the day/time they tested it, so that wouldn't have jumped out at them. She said I could get a glucose monitor to verify - OR just try to eat something every 3-4 hours. Either a protein or, if a carb, then pair it with a protein. That seems to have done the trick - at least for me. The dehydration theory could also be what's up, though. (btw - during the workup they also checked my inner ear and checked me for orthostatic hypotension. They also did a urinalysis - not sure what they were looking for there - and did a complete blood panel.

Being even an older bandster than ReneBean (!)...I whole heartedly support your decision to do this as a preventative measure to the health problems facing you in the future. Being proactive beats being reactive! Personally I did not have any serious weight issues until my 30's...but how I wish I could have done this then, and had back the years I spent inactive and privately ashamed of how I had let myself go...but I am doing it now, and loving it! I am back to actually wanting to DO things. Exercise is something I enjoy, as opposed to avoid. It sounds like you are doing all the proper research, and have a good handle on the work you will be required to do with the band! If you have any questions we will be happy to help. You have come across a site, full of helpful people, with lots of band knowledge---welcome! Kat

style="margin:0;padding:0;background-color:#d8dde8;color:#5a5a5a;font:normal 13px helvetica, arial, sans-serif;position:relative;"> Hey BariatricPal Members! Merry Christmas, and Happy Hanukah to our Jewish friends! Season’s Greetings for those of you who are not celebrating a holiday now – it’s still a festive time when everyone can enjoy the uplifting spirit around town. As we near the end of a long season of tempting food, you may need a little help getting back on track or staying on track. Here are our offerings. Weight Loss on Christmas? A Personal Challenge Breaking the Slump: Make a Healthy Choice Now! The Holidays, Your Family, and Weight Loss Surgery Hopefully this newsletter can help you keep your weight loss goals in mind and give you a little push to inch closer to hitting them. After reading the newsletter and spending some quality time with your loved ones, don’t forget to head on over to the BariatricPal Forums so you can share your tips and ideas with all of the BariatricPal members! Merry Christmas! Sincerely, Alex Brecher Founder, BariatricPal Weight Loss on Christmas? A Personal Challenge The weight loss surgery journey itself is a bumpy road, and recent weeks may have been even tougher as the holiday spirit has taken over. High-calorie, fatty, sugary foods have been everywhere, and gift shopping, family obligations, and holiday parties may have been eating into the time you might otherwise have spent exercising or planning healthy meals. So, what do you say to a challenge to lose weight this Christmas? The idea may sound crazy, but it is actually possible if you try hard. Here are our suggestions for a weight loss Christmas Day. Christmas dinner the WLS Way The totals for a full-blown Christmas dinner can be somewhere between staggering and horrifying. You yourself may have indulged in a few such dinners in the past. Between the ham or turkey, stuffing, mashed potatoes, casseroles, and Desserts, plus some alcohol and a bit of nibbling on appetizers and nuts, you can have 5,000 or more calories on this single day. Yuck – that’s 1.5 pounds of fat! Here is a more reasonable Christmas Day scenario to consider. Breakfast: Festive Protein pancakes with 1 cup sliced strawberries (150 calories) Meet ‘n’ Greet Appetizers 1 cup fresh cut vegetables with yogurt-based dip (100 calories) Red, white, and green Christmas skewers with cherries, peeled apples or pears, and green grapes. (100 calories) chocolate Coated Protein Puffs Soy Snacks (150 calories) Christmas Dinner 3 ounces of ham or skinless turkey or duck breast with mustard (150 calories) Green bean frittata – a high-protein, low-calorie substitute for green bean casserole (100 calories) Green salad with Light Dressing ½ cup pureed sweet potatoes sprinkled lightly with crushed pecans and sugar (or honey or low-calorie sugar substitute) (200 calories) 1 medium baked apple with cinnamon, served with light or sugar-free whipped topping (150 calories) Later Snacks Protein Cocoa or Mocha (100 calories) 1/2 ounce mixed nuts (100 calories) (Don’t forget to use coupon code BPNEWSLETTER10 for a 10% discount of your first order!) Savor Your Treat Don’t forget to leave room for a treat. That’s right, even WLS patients deserve a treat. Just make sure: It’s one that you really, really want. You can tolerate it (some treats are too sugary or fatty for your post-op digestive system, and even a small serving can make you feel sick). You take only a small amount and count the calories. In the sample Christmas Day menu shown above, there is room for another 200 to 400 calories from your treat while still staying under 1,500 to 1,800 for the day. Those calories can get you any two of the following: A half-cup of mashed potatoes with gravy. A half-cup of bread or rice-based stuffing. A 1-inch sliver of pecan, pumpkin, or another kind of pie. A small square of fudge. A small dinner roll with a pat of butter. A half-cup of eggnog. Get Moving, for So Many Reasons It’s a busy day, but surely you can find a few minutes to get in a short walk or workout. There are so many reasons to get moving in the morning or during the day. Burn calories and boost metabolism. Keep yourself motivated as you notice how good it feels to get moving rather than eat. Take time away from the food because when you are walking, you are not eating. Bond with your children, nieces, or nephews; with your out of town relatives; or with your significant other. Breaking the Slump: Make a Healthy Choice Now! One bad day of eating does not make a habit, but a six-week period does. A skipped workout or two doesn’t get you out of shape, but a month of inactivity makes you sluggish. A single bad weigh-in is no cause for alarm, but a few weeks of climbing numbers is reason to take heed. The time between Thanksgiving and Christmas can put you in a weight loss slump. Over time, your can get weaker and those poor decisions can get easier. While a bite of a cookie might have made you feel guilty in early November, the whole cookie and a second one may be par for the course now. Snap out of it! It is time to get out your slump. If the thought of reversing all those bad habits at once is too much, take heart. You can put yourself on the right path with a single decision. One good decision can increase your confidence and lead to more good decisions. You could: Make your own 200-calorie Breakfast sandwich with Protein Pancakes, a fat-free slice of cheese, and egg whites instead of hitting the drive-through for a 500-calorie breakfast biscuit. Schedule a short walk with a neighbor – no backing out! Log your food for a day, no matter how bad you know the numbers will be. Step on the scale if you’ve been avoiding it. How will you break your slump? The Holidays, Your Family, and Weight Loss Surgery As hard as the food and lifestyle around the holidays may be for you as a weight loss surgery patient, your family can make things even harder. You can prevent them from knocking you off your game by being prepared for what to expect and how to handle it. Problem: Pressure to Go Off Your Diet Saying no is just one of those things you have to learn how to do in life. Refusing your relatives’ offer of freshly baked Christmas bread or Christmas Cookies made “just for you” is difficult. They may feel that you are rejecting them. Practicing ahead of time can help. A simple, “No, thanks” can do wonders, and it leaves no room for argument. You could elaborate with variations such as “No, thanks, I’m not hungry,” “No, thanks, my doctor says I can’t eat that anymore,” or, “Not right now, thanks. It’s already great to get to see you!” Problem: Unwanted Comments on Your Weight or Weight Loss If you got your WLS in the past year, you may have dropped several pounds since relatives from out of town saw you. They may be overly reactive to your weight loss. Or, they could have the opposite reaction and say something discouraging about how they expected you to lose more weight by now. Whatever they say, do not let them throw you off your game. Problem: Lack of Acceptance of Your WLS They are not living your life, and they do not know exactly what you have gone through. A lack of understanding about what WLS is and how a WLS lives can inspire negative comments. You can choose to ignore them, or try to explain your WLS to them. You can also try to include them in your routine, such as inviting them on a walk or asking for their help in your kitchen while they’re in town. You can grow closer and develop a better understanding. Again, Happy Holidays! Enjoy this special time with family and friends, and make it a safe and healthy time for yourself and your loved ones. Thanks for spending some time with the newsletter, and we look forward to seeing you on the forums! · Unsubscribe from all BariatricPal E-Mail.

Chelly, how do you manage your reactive hypoglycemia?

Well the week before last I went to my PNP and got lab work done and my TSH was 96.5 (Normal 1-5ish)! She said she is not sure how I am even moving around right now. What really sucks is my level was actually right on about 6-7 months ago on 274mcg of levothyroxine but my old PNP made a mistake and told me that I was Hypo again, but really my TSH number was low. So I decided to switch from levothyroxine to Armor Thyroid (60mg twice a day) and kept forgetting to take it regularly. Anyway True Results re-drew my thyroid levels yesterday and were supposed to call me back today to let me know what they were. They didn't and now they are closed until Monday morning and I am left worrying if I will even have surgery on Thursday. The real kicker is I started my preop diet today...as if this isn't hard enough! Anyone else had experience with True Results and high TSH levels? My patient advocate said she would still try to get it approved because the Dr. normally doesn't care as long as it's not something that will affect your actual surgery.

I got one of every class to 80 (and got many of them epic/raid gear), then got bored and quit. Now I'm addicted to LotRO, but I'm also finding that my newfound energy due to weight loss is pulling me outside a lot more! I used to play mostly PVE on Baelgun. Look up Drhfuhruhurr (80 Warlock) sometime. When Cataclysm comes out, I may reactivate my accounts long enough to bring my 80 Pally (my favorite) to 85...

What's an OM egg? Leatha, I think I'm getting to the same point you are. I've noticed recently that I can eat faster than I've been able to for a long time, and before I know it I've eaten too much and have definite discomfort. The feelings that used to stop me from eating too fast are much less evident now. Naturally my thoughts stray first toward wanting a tighter fill, but I worry that my esophagus isn't as reactive as it used to be and that's the problem, not the restriction level. My doctor says he expects to see more and more examples of reduced esophageal sensitivity as time goes on, and I don't want to be one of them. It's SO HARD to break those habits!! Even 21 months out and I still have a tendency to eat too darned fast!!!

Banded 11/24/2009. Weight loss only 22lbs. Just now (today) have good restriction after 6 fills. I take 75 mcg of Synthroid for Hypo. I believe the restriction has been what held up my weight loss; not the Hypo.

There is no universal carb limit prescribed by surgeons after WLS that I know of. My surgeon / NUT / bariatric PA never mentioned any carb limits at all. Just Protein limits. Therefore, I never, ever focused on low-carb during all my weight losing phases. Also, I read early on posts by the very small percentage of folks who developed post-bariatric reactive hypoglycemia. It seemed to me (just a theory here, no serious research about it done that I can find) that these posts were all made by people who'd gone significantly low-carb for most of their weight-losing phases. So I decided I didn't need to lose weight super-fast anyway and would just eat plenty of healthy, unprocessed carbs. And I did. Coincidentally, I wound up matching my protein and carb levels. Early on, my Proteins / carbs were around 60, with daily cals around 800. Then in Month Five I ramped up to 1000 cals, and proteins and carbs went up to 80. Then in Month Seven I ramped up to 1200 calories, and my proteins and carbs went up to around 100. I reached my weight goal (150 pounds) 8.3 months post-op. I've lost another 6 pounds since then (in the last 3+ months), but I think I'm now stabilized. By now, my daily maintenance calories range from 1300 - 2000, and my weekly averages are over 1600 cals. I think my final maintenance calorie budget will be 1700-1750. Honestly, looking back, I think I lucked out by not going super low-carb or super low-cal during my weight losing days. I have online friends who ate a lot less during the weight-losing phases, and some of them (not all) are struggling to maintain their goal weights at 1200 cals/day. And who knows what I'll deal with in the coming years as I work to maintain this weight. So that's been my experience. Take from it what you will. And realize that our bodies don't all respond the same to food. If we were all alike, this whole weight loss / weight maintenance business would be a helluva lot less mysterious.

I'm a Type2 and had a lapband back in 2009, starting at 153.5 kilos. I lost 20 kgs. However I had a lot of problems (sprung a leak in the tubing in the beginning and it never really worked for me) so I'm having a revision to mini gastric bypass. The thing with my diabetes is I get hypos if I eat high carbs (sugar) and then nothing else for ages. So eg. a croissant for breakfast and then by 1pm I'm having a hypo. My theory is that the body overshoots the insulin for the croissant so I have too much floating around that has nothing to do but send my blood sugar crashing. When I go keto, eg keep carbs to between 20 and 50 grams a day, I simply don't get hypos. So you may find the problem for you is too many high sugary carbs and surgery and limiting your carbs will really help re: hypos. My doc says they perform this surgery specifically to send diabetes into to remission, so it's definitely something to consider. Many blessings Sent from my SM-G930F using BariatricPal mobile app

I'm hypo and actually had to have my meds increased since my levels TSH levels were rising instead of falling. It is now under control - but I didn't noticed any particular problems due to the fluctuation. Doc monitored it every 3 months and now every 6 to make sure it is in range.

Reactivate, do you go to Kaiser? There are groups in Sacramento I think. Send me a PM if you'd like more info.

Sorry you are going through this. I was hyper thyroid and went to hypo thyroid so they changed my meds but only by a 25mcg and I make them check it every month to see if I'm on track don't wait. However, I think it is why I have stalled in my weight loss no loss or gain for 3months

Do anyone in the morning after waking up experience low blood sugar? I wake up fine, then try to have something to eat, then a few minutes later I feel warm, sweating, feel like passing out. I read something about reactive hypoglycaemia, and before I had the sleeve I had low blood sugar moments. Now I been sleeved for almost 3 months now and its happened 3 times to me since. What do you do, anyone experience it?

I was diagnosed with Hypothyroidism about ten years ago. My levothyroxine has been decreased since surgery also. I can't say I've been a slow loser but. I am a very happy loser either way you look at it. My stats: HW 289lbs SW 251lbs CW 183lbs Highest BMI 43 Current BMI 28 I am 5'8" and feeling healthier that I have in many, many years. I try to exercise daily, Walking for 5+ miles is my new freedom. I am now 9 months post-op. My weight-loss has slowed considerably in the last 2 months but I expected that as I get closer to my goal of 160lbs. The main thing is......I am still losing. My Dr's goal for me was to lose 70% of my excess weight. I've met and exceeded that goal by 17lbs. My personal goal is to hit 160lbs. That will put me just under 25 for a BMI. Woohoo! Only 23 more lbs to go! Good Luck to all of my fellow Hypo's.

I actually have experienced a kind of dumping syndrome both within the week after surgery and now. When I went on to full liquids (milk/soy base Protein shakes), it caused me to shake a bit, sweat, and run for the toilet. My body held nothing and I had to slow down my Protein Shake intake from 8 oz in 30 mins to 2 hrs to help me retain it. This is using low sugar, low fat, bariatric Protein shakes. Now, I have a strong sensitivity to carbs. If I have a meal w/ 20 g total carbs (including fiber), my heart starts to race. I had 1/2 slice of pizza from a small pie, this triggers the same effect. I'm netting around 25-40 g carb per day, which is extremely low. My doctor says its likely reactive hypoglycemia, when my body produces too much insulin in response to a relatively high blood sugar load. Some patients experience thing after surgery, but you'll want to consult with your doctor to rule out anything else.

I ended up with emergency surgery. Leak reappeared and spleen abscess reactivated. My surgery was 5.5 hours. The stomach leak was fixed. Spleen fused to liver and pancreas so my spleen was removed along with a small piece of liver and pancreas. Due to the way sleeve was done they were able to just snip off a leakey piece of stomach. So far i am doing good.

It definitely sounds like reactive hypoglycemia, but with your meds and medical issues you need to see your doctor. An English muffin and peanut butter has too many carbs in it. To many simple carbs and your blood sugar shoots up then crashes. The crash is going to make you feel horrible. You'll struggle to keep your eyes open, your hands get really shaky and you may start sweating. You feel like you need to eat more carbs, but resist and eat some protein like cheese, nuts, or lunch meat. The best way to manage it is to have 5-6 small meals a day and avoid simple carbs. No bread, Pasta, rice, sugar, or peanut butter with sugar in it.

Yes, we do get into it here sometimes. There are posts and comments that cause our hackles to rise. We are from different states, countries, cultures and have different values systems, experiences and opinions. We respond to different approaches in different ways. Some of us need a "kick in the pants" or "tough love" and respond well to that, others are more responsive to a gentle hand and softer words. There is no one size fits all in these forums, which is what makes it stronger for the differences. One thing is obvious to me at least, and that is we all share a common experience and passion. We are planning to, or have been through vsg surgery and we are at times scared, excited, thankful, ashamed, proud, angry, apathetic, and countless other feelings. This is an emotional process. It is mentally stressful. It is academic in our search for information. It is very physical. For some it is even spiritual. We do not have to agree on everything. We are here to share our thoughts, opinions, experiences and questions. Since it is a public forum, it is also open to anything from anyone at anytime. That may be more challenging for some than others when they read a response that they interpret as offensive. Some react strongly, others are not as emotionally invested in what others have to say. There is no right or wrong way to feel about this. We do all need to remember that we are working through a framework of a shared experience, though we may process our thinking about it in different ways. Definition of Reactive Thinking Reactive thinking is crisis-based thinking, coming up with solutions after problems develop. Reactive thinking responds to the situation. A reactive thinker often spends too much of his time fighting fires. A reactive thinker is easily blindsided by circumstances. A crisis-driven reactive thinker may be more prone to feeling stress. Definition of Proactive Thinking Proactive thinking, on the other hand, involves foresight. To be proactive means to think ahead, in anticipation of future changes or problems. It means covering your bases to include all possible scenarios. A proactive thinker will have several contingencies in mind. A proactive thinker sees the likelihood of crises before they happen. Ref: http://www.ehow.com/...e-thinking.html

Hey everyone! *waves* THE SHORT STORY I've been hypothyroid for fifteen years. Is bariatric surgery effective and worth the risk for hypothyroid patients? THE LONG STORY So, I'm considering WLS. I can't believe I'm actually thinking about it. My husband had WLS about three years ago and is doing fine. He's regained some weight but is still far ahead of where he was. My son had WLS around the same time. He did not do well. He had extreme absorption issues and had to have a feeding port installed just weeks after his surgery. We lost him in November 2015. The official cause of death was cancer, but we wonder if the malnutrition contributed to his developing cancer. For me, my thyroid died somewhere around 2002. I was on the Atkins program, had lost about 70 pounds, and was on my way to single digit clothing size! Then, bam - one week I gained four pounds. The next week six. And then eight. All while still working out daily and eating the Atkins way. DNA? Age? Splenda? Who knows the cause, but my thyroid was done ... completely. The weight gain, it turns out, wasn't the worst part of hypo for me. It was the depression. My doctor put me on synthetic thyroid that didn't help at all. Finally, in 2009 I found Nature-Throid and a doctor who would prescribe it. Nature-Throid eased the depression, but my weight slowly and steadily continued to climb. In 2015, my hair began falling out. My skin had always been dry. Now it peels off in sheets. And I put on an additional fifty pounds within months. I chalked a lot of those symptoms to stress. The last few years have just been awful. In January 2015, my husband had emergency surgery to place a stent in his heart and I blew out my knee. Mid 2015, I had to shop for a nursing home for my mom. If you've ever done that, you know there aren't any good nursing homes. Mom died on Christmas Day 2015 ... six weeks after losing my son. August 2016, my brother was diagnosed with inoperable brain cancer. Next, I made a super poor career decision and lost my job in December 2016. My brother died January 30, 2017. Yet, I'm still standing ... just barely. Because both knees are now bone on bone. My blood pressure is fine. I'm not diabetic. No heart disease. Except for that damn thyroid, my blood work is all healthy. But I'm at an all-time high of 311 lbs. It hurts to move. It hurts to stand. I carry a lot of the weight in my hips and thighs which even makes it hurt to sit. I hurt and I don't want to hurt anymore. If you've read this far, thank you for letting me rant. I'd love to hear from other hypothyroid patients. What has been your experience with WLS? Pros? Cons?

@ - Not good. When you are waking up exhausted and taking two anti-depressants, well "Huston we have a problem." (Check out crazymeds.org - best site for really monitoring the effect of these drugs). There is an art and a science of medicine. The science is "appendix burst, take it out"). The art is how to do it without creating more problems. The meds you are on are really on the art side. You have to work with the docs and tell them how it is working. You have to know how long does it take before this stuff should have an effect. For instance...I take Welbutrin. It takes a month before I should expect any changes. I marked on my calendar. You need to write this down so you have real info to give to your doc. This is a partnership. Please take it that seriously. If I seem to be over reactive, well I am with this stuff. It's not like eating a piece of pizza, it can be really bad.

I'm 3 mos post op and lost 33 lbs including preop diet! So yeah jump for joy. I'm a slow loser & have hypo thyroid but I'm have way to goal. Woohoo!

Sounds like symptoms of reactive hypoglycemia. Might want to do some research on it.