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1. No surgeon in my area and 2. real life after sleeve surgery....



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Hello everyone,

Today my doctor's office called to tell me that other than the Adult Bariatric Centres in the major cities in my province, there are no self-pay options. The bariatric centres are the long wait programs, dieting, psyche, etc. And about a 3 year wait.

So - I'm back to the surgeon I originally was researching (a member on here told me about him and had her surgery by him recently). Dr. Michel Gagner in Montreal. For those that have read my other posts, he's a long way away from home, so added cost of flights for me and my husband, and several nights in hotel. But that isn't the real concern - it's the after-care that is, and to be frank, the before care. Due to distance it would be a phone consult with the surgeon at $250. then a one month wait after that for surgery so there's time to get required medical tests, books flights and hotel, etc. I really don't know how much education prior they provide, but I'm hoping that there will be at least something online.

When I told my doctor about the surgeon in Montreal she said "why would you go so far? Why not here in Alberta? And what about the after-care? Who's responsibility would you be if something goes wrong?" I'm sure there are many Albertans not willing to wait so long for surgery and they are going out of province or country for that matter. I'm also sure that should anything go seriously wrong, I just have to turn up at the hospital and I'll be looked after there. I think she is more concerned about dietician, counselling, etc. that I would need. Plus, I don't think she likes the idea of having to go so far for an elective surgery. I'll have to make an appointment to see her again since this is not the outcome I was hoping for - even she thought there would be somebody here that can do the surgery.

My other question - it's been weighing on me - I've done a lot of research in the past two months or so, but the one question or unknown that I'm wrestling with is that I don't really understand what life will truly be like after the surgery. The things that I'm most in the dark about are:

1) How many calories do you (or should you) be topping out at once you've lost the excess weight?

2) I've read a lot about the fact that your calories should come from Protein for the most part. But what about vegetables and fruit? what about a balanced diet, with nutrients and Vitamins from lots of different foods? How does one thrive on a diet rich in protein but deficient in veg and fruit and some carbs?

3) I can't quite find the answer to how much food is consumed in a sitting - i.e. if I make a roast beef dinner for my family, (typical beef, yorkshire pudding, potatoes, veg) how much can somebody actually eat in a meal?

I know these questions are all about food, but this surgery is really all about food too. I'm trying to envision my life after the surgery and I can't because I can't understand these parts of it. I can envision how it'll feel to be lighter and able to do all the active things I always loved. I can see myself feeling better, etc. I cannot figure out the food part and how you get enough nutrition to be able to do all the active things I'd like to do.

The other one is drinking fluids - if it's really hot out, or you've worked out and are very thirsty and just want to drink down Water fast - can you do that?

And drinking and eating. Can you never drink liquid with meals anymore? What about eating dryer foods sometimes? Still can't wash it down with water?

Thanks for your input - it's really the last piece in the puzzle for me that I need to settle before I make the big decision!

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1). For the first week I couldn't eat more than 450 calories a day, then during the next week, about 500. Right now my goal is 650-800: 800 simply is too much. I average around 650-700. In a month my nut wants me at 700-800 per day. It changes with each significant percentage of weight lost (10%, 25%, 50% etc). I think the maintainance is 1200-1500 but my surgeon says this will very much depend on how active I am.

2) The Protein shakes I drink are Vitamin rich. I love veggies and fruit but seldom have room for them. My nut says I will take Vitamins for the rest of my life. I take a multi, B1, B12. Biotin.

3) My surgeon says one day I will be able to eat 4 oz at a time. I can't yet. 4 oz would make me very sick.

Sent from my iPhone using the BariatricPal App

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Hello everyone,

Today my doctor's office called to tell me that other than the Adult Bariatric Centres in the major cities in my province, there are no self-pay options. The bariatric centres are the long wait programs, dieting, psyche, etc. And about a 3 year wait.

So - I'm back to the surgeon I originally was researching (a member on here told me about him and had her surgery by him recently). Dr. Michel Gagner in Montreal. For those that have read my other posts, he's a long way away from home, so added cost of flights for me and my husband, and several nights in hotel. But that isn't the real concern - it's the after-care that is, and to be frank, the before care. Due to distance it would be a phone consult with the surgeon at $250. then a one month wait after that for surgery so there's time to get required medical tests, books flights and hotel, etc. I really don't know how much education prior they provide, but I'm hoping that there will be at least something online.

When I told my doctor about the surgeon in Montreal she said "why would you go so far? Why not here in Alberta? And what about the after-care? Who's responsibility would you be if something goes wrong?" I'm sure there are many Albertans not willing to wait so long for surgery and they are going out of province or country for that matter. I'm also sure that should anything go seriously wrong, I just have to turn up at the hospital and I'll be looked after there. I think she is more concerned about dietician, counselling, etc. that I would need. Plus, I don't think she likes the idea of having to go so far for an elective surgery. I'll have to make an appointment to see her again since this is not the outcome I was hoping for - even she thought there would be somebody here that can do the surgery.

My other question - it's been weighing on me - I've done a lot of research in the past two months or so, but the one question or unknown that I'm wrestling with is that I don't really understand what life will truly be like after the surgery. The things that I'm most in the dark about are:

1) How many calories do you (or should you) be topping out at once you've lost the excess weight?

2) I've read a lot about the fact that your calories should come from Protein for the most part. But what about vegetables and fruit? what about a balanced diet, with nutrients and Vitamins from lots of different foods? How does one thrive on a diet rich in Protein but deficient in veg and fruit and some carbs?

3) I can't quite find the answer to how much food is consumed in a sitting - i.e. if I make a roast beef dinner for my family, (typical beef, yorkshire pudding, potatoes, veg) how much can somebody actually eat in a meal?

I know these questions are all about food, but this surgery is really all about food too. I'm trying to envision my life after the surgery and I can't because I can't understand these parts of it. I can envision how it'll feel to be lighter and able to do all the active things I always loved. I can see myself feeling better, etc. I cannot figure out the food part and how you get enough nutrition to be able to do all the active things I'd like to do.

The other one is drinking fluids - if it's really hot out, or you've worked out and are very thirsty and just want to drink down Water fast - can you do that?

And drinking and eating. Can you never drink liquid with meals anymore? What about eating dryer foods sometimes? Still can't wash it down with Water?

Thanks for your input - it's really the last piece in the puzzle for me that I need to settle before I make the big decision!

1. Everyone is different. I've seen some maintain on 1000 calories and some on 1800 calories. It's important as you get further out from surgery that you INCREASE calories in order to achieve a set point so you aren't having to maintain on 800 calories the rest of your life. I personally maintain on 1200. Anymore than that and I gain.

2. Protein is most important early out because you're healing, losing weight and losing muscle, and you have such little space in your tummy, that's really all you have room for. As you advance stages and can naturally eat more as the months how by, you CAN incorporate fruits and veggies into your diet. But protein always should be first, and then if you have room the others. Protein also helps stave off hunger and keeps you satisfied longer, which can be key if you're prone to snacking.

3. The amount of food you can eat in one sitting is totally depending on how far out you are from surgery. In the early weeks, you can sometimes only eat literally 4 bites. As things heal and loosen up, it goes to 4 ounces. At 2 years out, I can eat 3-4 Oz of chicken (dense) 4-5 Oz of beef with a bite or 3 of veggies. I can eat much more seafood (not as dense). As the years go by, you will naturally be able to eat more and more. It's normal and inevitable.

I drink right up until I eat, never but a tiny sip with food, and even after 2 years still wait 30 minutes after I eat to drink. You get used to it. I can drink 16 Oz of room temperature Fluid in a matter of minutes now, instead of an hour like early out :)

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1). For the first week I couldn't eat more than 450 calories a day, then during the next week, about 500. Right now my goal is 650-800: 800 simply is too much. I average around 650-700. In a month my nut wants me at 700-800 per day. It changes with each significant percentage of weight lost (10%, 25%, 50% etc). I think the maintainance is 1200-1500 but my surgeon says this will very much depend on how active I am.

2) The Protein shakes I drink are Vitamin rich. I love veggies and fruit but seldom have room for them. My nut says I will take Vitamins for the rest of my life. I take a multi, B1, B12. Biotin.

3) My surgeon says one day I will be able to eat 4 oz at a time. I can't yet. 4 oz would make me very sick.

Sent from my iPhone using the BariatricPal App

Thanks! 4 oz is 1/2 cup of food. Not a lot! I guess I was imagining you'd eventually get to a point where you are eating what we all SHOULD have been eating in a meal in the first place - but I didn't imagine it to be quite so little. The one good thing I see about it is that food will become so much less important! Right now entertainment is around food and wine when I go out with my husband - I will miss that as we do enjoy it. But even he is all for the surgery if I want to do it - I told him when we go out to eat, he'll be eating his meal and most of mine - maybe that's why he likes the idea of the surgery! lol So really, I guess that really won't change - after I'm healed and on solids we can go out for our anniversary or whatever, I'll just be eating less :-)

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Hello everyone,

Today my doctor's office called to tell me that other than the Adult Bariatric Centres in the major cities in my province, there are no self-pay options. The bariatric centres are the long wait programs, dieting, psyche, etc. And about a 3 year wait.

So - I'm back to the surgeon I originally was researching (a member on here told me about him and had her surgery by him recently). Dr. Michel Gagner in Montreal. For those that have read my other posts, he's a long way away from home, so added cost of flights for me and my husband, and several nights in hotel. But that isn't the real concern - it's the after-care that is, and to be frank, the before care. Due to distance it would be a phone consult with the surgeon at $250. then a one month wait after that for surgery so there's time to get required medical tests, books flights and hotel, etc. I really don't know how much education prior they provide, but I'm hoping that there will be at least something online.

When I told my doctor about the surgeon in Montreal she said "why would you go so far? Why not here in Alberta? And what about the after-care? Who's responsibility would you be if something goes wrong?" I'm sure there are many Albertans not willing to wait so long for surgery and they are going out of province or country for that matter. I'm also sure that should anything go seriously wrong, I just have to turn up at the hospital and I'll be looked after there. I think she is more concerned about dietician, counselling, etc. that I would need. Plus, I don't think she likes the idea of having to go so far for an elective surgery. I'll have to make an appointment to see her again since this is not the outcome I was hoping for - even she thought there would be somebody here that can do the surgery.

My other question - it's been weighing on me - I've done a lot of research in the past two months or so, but the one question or unknown that I'm wrestling with is that I don't really understand what life will truly be like after the surgery. The things that I'm most in the dark about are:

1) How many calories do you (or should you) be topping out at once you've lost the excess weight?

2) I've read a lot about the fact that your calories should come from Protein for the most part. But what about vegetables and fruit? what about a balanced diet, with nutrients and Vitamins from lots of different foods? How does one thrive on a diet rich in Protein but deficient in veg and fruit and some carbs?

3) I can't quite find the answer to how much food is consumed in a sitting - i.e. if I make a roast beef dinner for my family, (typical beef, yorkshire pudding, potatoes, veg) how much can somebody actually eat in a meal?

I know these questions are all about food, but this surgery is really all about food too. I'm trying to envision my life after the surgery and I can't because I can't understand these parts of it. I can envision how it'll feel to be lighter and able to do all the active things I always loved. I can see myself feeling better, etc. I cannot figure out the food part and how you get enough nutrition to be able to do all the active things I'd like to do.

The other one is drinking fluids - if it's really hot out, or you've worked out and are very thirsty and just want to drink down Water fast - can you do that?

And drinking and eating. Can you never drink liquid with meals anymore? What about eating dryer foods sometimes? Still can't wash it down with Water?

Thanks for your input - it's really the last piece in the puzzle for me that I need to settle before I make the big decision!

1. Everyone is different. I've seen some maintain on 1000 calories and some on 1800 calories. It's important as you get further out from surgery that you INCREASE calories in order to achieve a set point so you aren't having to maintain on 800 calories the rest of your life. I personally maintain on 1200. Anymore than that and I gain.

2. Protein is most important early out because you're healing, losing weight and losing muscle, and you have such little space in your tummy, that's really all you have room for. As you advance stages and can naturally eat more as the months how by, you CAN incorporate fruits and veggies into your diet. But protein always should be first, and then if you have room the others. Protein also helps stave off hunger and keeps you satisfied longer, which can be key if you're prone to snacking.

3. The amount of food you can eat in one sitting is totally depending on how far out you are from surgery. In the early weeks, you can sometimes only eat literally 4 bites. As things heal and loosen up, it goes to 4 ounces. At 2 years out, I can eat 3-4 Oz of chicken (dense) 4-5 Oz of beef with a bite or 3 of veggies. I can eat much more seafood (not as dense). As the years go by, you will naturally be able to eat more and more. It's normal and inevitable.

I drink right up until I eat, never but a tiny sip with food, and even after 2 years still wait 30 minutes after I eat to drink. You get used to it. I can drink 16 Oz of room temperature Fluid in a matter of minutes now, instead of an hour like early out :)

So helpful :-) I'm feeling more and more confident - especially after reading all the great replies. Taking that last big step and booking the surgery - so hard!

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As for eating out- I share with my husband. He's not overweight but it does help

him to have appropriate portions. Restaurant sizes are stupid big.

Sent from my iPhone using the BariatricPal App

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Calories really vary. I am still losing eat 1400 to 1600 calories a day. With my activity level, that still puts me at a deficit. Like @@Babbs said, it is really important to raise your calories as you are losing and can eat more so you don't ruin your metabolism and have to eat 800 or 1000 calories a day forever.

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Calories really vary. I am still losing eat 1400 to 1600 calories a day. With my activity level, that still puts me at a deficit. Like @@Babbs said, it is really important to raise your calories as you are losing and can eat more so you don't ruin your metabolism and have to eat 800 or 1000 calories a day forever.

Ha! and counter to all my years 'joining' Weight watchers. As you lose weight, your points are lowered. But I see the importance of being very diligent with your calories - this is why a nutritionist is important after this surgery I would think

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@@TracyBar

Well we start very different than Weight Watchers, we start at 500-600 calories if lucky and have to work our way up. A lot of people hit 1000 calories and never up their calories, then they are stuck there forever because that is what their body adjusts to. When they naturally regain, they have nothing to cut.

WW starts people at the BMRish (not exactly sure how WW and points works) and keeps subtracting.

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@@TracyBar

2) I've read a lot about the fact that your calories should come from Protein for the most part. But what about vegetables and fruit? what about a balanced diet, with nutrients and Vitamins from lots of different foods? How does one thrive on a diet rich in Protein but deficient in veg and fruit and some carbs?

I'm two years out. Salads/vegetables combined with my protein helps to keep me satisfied. I feel the sensation of full better. Also Fiber and nutrients.

You will learn so mush about how to fuel your body correctly.All of the old ways that didn't serve us well will change over to eating healthy. You have a better understanding of a new relationship with food.

food is still amazing.Eating becomes normal.

Attached are recipes of what food will look like.

http://insidekarenskitchen.com/bariatric-friendly-recipes/

My instructions were after 75% of weight loss to add plant based or whole wheat carbs. Here is an example of a bariatric plate.

bariatricplate.jpg

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@@TracyBar

2) I've read a lot about the fact that your calories should come from Protein for the most part. But what about vegetables and fruit? what about a balanced diet, with nutrients and Vitamins from lots of different foods? How does one thrive on a diet rich in Protein but deficient in veg and fruit and some carbs?

I'm two years out. Salads/vegetables combined with my protein helps to keep me satisfied. I feel the sensation of full better. Also Fiber and nutrients.

You will learn so mush about how to fuel your body correctly.All of the old ways that didn't serve us well will change over to eating healthy. You have a better understanding of a new relationship with food.

food is still amazing.Eating becomes normal.

Attached are recipes of what food will look like.

http://insidekarenskitchen.com/bariatric-friendly-recipes/

My instructions were after 75% of weight loss to add plant based or whole wheat carbs. Here is an example of a bariatric plate.

bariatricplate.jpg

Thank you ! the recipes look really great....

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