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9 Month Post Op Fears and Worries



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Hello Everyone!

It has been a while since I posted on here, but I wanted to get some input and reassurance/knowledge from others who have potentially dealt with this. I had GS surgery done on 9/5/23 and things were ROUGH at the beginning. It did not help that my surgeon is out of state an their office was not the best with returning calls and in a sense "caring" about my progress/recovery. It is a longer story for another time, as this post is about something more current but somewhat related. Since my surgery I have no gone to my follow up appointments being that 1. I decided to not work with them after the complications and lack of any kind of support/communication from my surgeons office until right before my 3 month appointment, 2. They are out of state and I had not found a primary care physician in my new state, and 3. Probably because I am stubborn as hell, LOL!

On the 5th I will be 9 months post op, and after I somewhat got my food/liquid intake figured out I was able to get things moving. Being a food addict I have a love/hate relationship with food and emotional connections to them. I am not the type of food addict that if its there I am going to eat it. Once I am full I do not crave or even want to think about food. So, with the lack of hunger from the surgery I was feeling like I was unstoppable. I was eating when i thought i was hungry/knew it had been several hours. Looking back i think it was the common fear of it all that probably set me up wrong, but we live and we learn. I was afraid of eating too much and afraid to see the number go up as well. I would basically only eat at Breakfast and dinner and maybe a snack somewhere in between. I thought i was doing well honestly an thought it was normal. Well here we are nearly 9 months later and I was maybe eating 5 ounces a meal and it was like a single taco or 1.5 sausage patties and some eggs. again, thought it was totally normal. Then i spoke to a friend who did the surgery and she informed me of what she was able to eat by the time I am at and i realized i am eating way way way less than what she listed. So, I have been trying to increase my portions/time in between meals. I have a food scale and weigh out majority of my ingredients and now am calorie obsessed. I am doing it to hopefully eat enough and make sure I am getting enough in me to help with my dizziness and hair loss/brittle nails issues. Since doing so though now I have MAJOR fear that i am eating too much and i am doing it wrong. I am terrified i stretched my stomach and something is not right because i am not gaining weight. I am up 4 pounds and in my terrible mind it feels like I've gained 40 pounds. I was consistently walking everyday until mid-December, but stopped due to pain in my hips (another long story), but have started walking again consistently as of last month. I am also trying to find a new doctor/surgeon here in Tuscaloosa or Birmingham to have a consistent source of information/support. But until then I am in mind panic mode. Has anyone felt this way or dealt with stretching? My family is convinced it has not stretched, but I being the crazy one worried about it feels like i have. I am open to private messages if thats a thing and willing to answer any questions as well!

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Stretching in the sense that you mean it is exceedingly rare and only happens if someone consistently binge eats over a relatively long period of time. What does happen naturally is increased capacity. This is true for sleeve and bypass both. After 6 months or so, your stomach regains some of its elasticity and can accommodate a bit more at one sitting. This is fine and healthy.

Everyone is different, and everyone's capacity at a given point post-op is different. I don't know what you were told for goals, but my program says 60-80g Protein per day and 64oz minimum of Water. They want my protein to be around 40% of my calories, and I generally aim for 800-1000 calories per day, but that was not strictly set and will change over time. 1200 seems to be a common goal for the later stages of weight loss, with the amount going up once you are in maintenance.

5oz per meal is reasonable, but you need to be eating Breakfast, lunch, and dinner. Plus possibly a snack. My program says aim for 20-25g protein per meal, and supplement with a protein snack or shake as needed until you can get the full amount from food comfortably. By 9 months, you should be fine getting it all from food. Your brittle nails and Hair loss suggest you are not getting enough protein and may not be getting enough other nutrients.

You should continue to aim for around 4 oz of lean meat or fish, (or a serving of Greek yogurt or cottage cheese, for example) per meal. 4oz cooked skinless chicken breast has 25g protein. Your second priority at every meal should be nonstarchy veg. If you still have room, you can have a little bit of carb (rice, potato, sweet potato, bread, etc.). A serving of fruit makes a nice dessert. An easy way to eyeball it is to take a salad plate (not dinner plate), and put a piece of meat the size and thickness of your palm on one side, and fill about 2/3 of the other side with nonstarchy veg and the remaining 1/3 with carb. Go light on the sauces and butter.

If in doubt, check Amazon for bariatric cookbooks. There are several by bariatric experts, including surgeons and registered dietitians. Kristin Willard's Bariatric Meal Prep is a personal favorite, with portion sizes for different stages, and a full color photo for every recipe.

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I came on here to say essentially everything @NickelChip said, but she beat me to it. Just screenshot her post and you'll be good lol But I will echo that it would be exceedingly rare for you to stretch your stomach out, and with how little you were eating, there's no way that happened.

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First, don't panic! And don't compare your progress to others, if you can help it. :)

I agree with everything Nickel said -- including the book rec. Kristin Willard's Bariatric Meal Prep is a great resource, and I also really like "The High-Protein Bariatric Cookbook" by Stacey Gulbin and "Fresh Start Bariatric Cookbook" by Sarah Kent. I think a good Bariatric book might help cover some of the information you've been missing from your 'care-team'.

Is it possible that you've been focusing extra/too much on calories and not enough on what makes up those calories?

My team told me that calories can be important (especially later on) but the first several months it was definitely more about making sure you're getting enough nutrients. 60-80 g Protein per day minimum -- my team told me for me personally, she'd actually recommend 70-90g -- and definitely 3 meals a day (+ 1-2 protein-geared snacks). If you have to make them smaller at first since you're used to eating two meals, that should be ok. Maybe while you get back into a regular routine, make one of your meals a Protein Shake or Protein Bar?
It was suggested to me that both my day (and each meal) should be 50-60% protein, and the rest of my plate should be mostly non-starchy veg -- with any starchy veg or complex carb coming in at 10-15% (20% max).

The types of carbohydrates can be really important too. A whole grain/whole wheat item or a starchy but nutritious veg is going to put you in a much better place than a processed corn taco or white tortilla.

Are you taking any supplements?

Also, maybe check out local nutritionists and see if any of them have experience with bariatric patients.

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Great advice from everyone and I would second finding yourself a nutritionalist/dietician sooner rather than later. And maybe a therapist who has experience with bariatric surgery & disordered eating.

Do you track your food? I’m not a tracker (didn’t have to) but I do random checks on portions sizes, nutrient content & Protein to ensure I’m on the right path or haven’t got complacent. It might be idea to start tracking if you don’t even for a few weeks just to see where you may be missing some key nutrients, to ensure a balanced intake, etc. can’t hurt anyway.

Check out some the you tube videos by Drs Matthew Weiner and/or John Pilcher. Dr Weiner has some great books too which may be helpful. These may offer some support while you’re trying to find a new surgeon & doctor.

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Like the others said before me, I think it is highly unlikely that you have stretched your stomach. Weight will fluctuate (annoying I know) as your body copes with the changes. Please try not to stress yourself out unnecessarily.

I think try to find a resource of a dietician, maybe even one online if that is quicker than a local one.

Did your care team, at the time, give you any reading material for post-op foods etc? I didn't get much advice for long-term from my team so I spent a lot of time online and found some good online reading material at 'Bariatric Meal Prep', 'My Bariatric Dietitian' and a few other sites/blogs.

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