Lots of questions

Hi - 

My name is Brenda and I am attending a VGS information session this Friday.  I keep waffling back and forth from being 100% gung-ho, to being terrified of having this surgery.  I have read about PPI on several posts - can someone please tell me what this is (some kind of protein powder or something)?  Also - what is head hunger?  Is is true that you never really feel full/satisfied after the surgery - just uncomfortable and tight?  Do you ever get to the point of eating a normal amount of calories, or is your metabolism slowed down so much that you have to stay at 1200 to 1500 calories for life?  Is there a problem getting enough fiber in your diet (for instance - the recommended 5 to 9 servings of fruits and vegetables per day)?

Thanks in advance for any answers to my long list of questions.

- Brenda

Hi Brenda- I am only 6 weeks post op but I can try to help. I would suggest using the search feature in the top right. It can be really helpful. 

PPI- Proton Pump Inhibitor- This is an acid reducer such as prevacid or the like. Some VSG patients take it to reduce the stomach acid. Stomach acid can mimic hunger, so even if you aren't hungry having too much stomach acid can make you feel hungry so the PPI helps that.

Head Hunger- It is truly that, when you are not really hungry...it is just in your head. You need to understand the emotion tie you have to food and why you over eat. For me, I use it as comfort, for anything and everything. Happy, sad, bored, whatever. There are many times pre-op I found myself in the kitchen looking for something to eat knowing well that I wasn't hungry.

Like I said above, I am only 6 weeks post op. At this post, I don't have any sensation. I don't feel "full" yet. I eat based on a schedule because I wouldn't know when I was full and I don't feel hungry which is why I use the schedule.

As I have read from this bored the normal caloric range for weight loss is 600-800. I believe the folks who are in the maintenance phase have up'd their calorie intake to 1200 or so but I can not speak for them.

I can't give any input on the fiber question. I use myfitnesspal to track my foods and that does track fiber as well but I haven't paid much attention to it. Probably something I should ask my Dr. though.

Good luck to you!

Sounds like you're asking a lot of great questions :)  I too was terrified of the surgery; I could have had it with my husband 18 months before I did, and just wasn't ready.  On one hand, I wish I had done it sooner, but then again I am glad I waited until I was ready... this is not something to rush into.  Definitely go ahead and go to the info session, but don't rush in your decision.

Now, to answer a few of your questions...

PPI- protein pump inhibitor... think antacids.  The way it was explained to me is that we need these because our bodies still produce about the same amount of acid as they did before surgery, but our smaller tummies don't need as much, so we are more prone to heartburn and acid that can mimmick hunger, especially immediately post op.  I took mine for the first few months, but am doing just fine now without it.

Head hunger just means that we think we are hungry but we are really not.  It's something many people battle with regardless of whether or not they've had surgery... it's just we sleevers tend to ponder it more, IMO, because eating too much can make us sick, whereas people with a regular stomach just consume too many calories and go on if they give in to it.

I feel satisfied after most meals... but I have gotten to where I prefer to not feel full because it can be a bit uncomfortable.  Everyone is a little different on this one.

I'm at the end of my losing phase, so I can't really comment on this... but my husband, who was sleeved two years ago, maintains his weight with no problem eating 1500-2000 calories a day and exercising three times a week.  Even when I try to eat more than 800 calories a day, I seldom go over 1200 naturally.  The foods that keep me satisfied the longest just happen to be lower calorie anyway, so I really don't need more than that right now.  My metabolism hasn't seemed to have suffered, but I do work out pretty regularly, so maybe that has something to do with it.

Early out, I had to take fiber supplements (powder mixed into my drinks).  Now that I am further out and can eat more, I don't really have a problem getting my fiber in.

Thank you both so much for the helpful answers!  I am really looking forward to the meeting Friday and will let you know how it goes.

 I have read about PPI on several posts - can someone please tell me what this is (some kind of protein powder or something)?  I took a PPI (Prilosec) immediately following surgery for 6 weeks.  After that, I just take it as needed (about one treatment every 6 months, MUCH less than pre-op).  I don't take it every day, all of the time, like some people.

 Also - what is head hunger?  Some people don't ever get real physical hunger after surgery.  They just get cravings and impulses for food (head hunger).  Unfortunately, I have real hunger AND head hunger after surgery.  If I go more than 3 hours between eating protein, I get real, stomach growling, hunger.  I feel my best if I have a small, high protein meal every 3 hours or so.

Is is true that you never really feel full/satisfied after the surgery - just uncomfortable and tight? That is how I felt after eating, when I was first postop.  Now that I am almost 2 years post-op, I get satisfied after meals.  If I eat too much (like more than 3 ounces of protein) I feel "full"... I try to avoid getting to the point of "full".

 Do you ever get to the point of eating a normal amount of calories, or is your metabolism slowed down so much that you have to stay at 1200 to 1500 calories for life? If I work out, I can maintain at 1200-1500 a day.  However, if I don't track my food and exercise, I found that I eat too much and gain weight :(  Right now, I'm trying to lose some weight that I gained over the summer, so I am eating approx 800-1200 calories a day and working out.  The amount of calories I'm eating right now depends upon how much I've worked out that day.

Is there a problem getting enough fiber in your diet (for instance - the recommended 5 to 9 servings of fruits and vegetables per day)? YES!  There is no way that I can get the recommended daily amount of grains, fruits, and veggies, and still get all of my protein in!  Therefore, I have been taking gummy fiber pills since about 6 months out.  I take gummy fiber 2-3 times a day.  Note, I had to start out by taking it once a day, and worked my way up to 3 times a day.  If I don't take my gummy fiber, I don't go #2 regularly.

Hi Brenda, and welcome to the club.

The PPI and head hunger points have been well answered and I nothing to add on those points. On the feeling full/satisfied, etc. point, it seems that it takes a while for the body to adjust to what has happened to it, so some mixed messages get sent and interpreted by the brain, but that usually works out over a few months time. Also different types of foods are recognized and handled differently by the stomach (soft and sloppy things go right on through, as do some other harder but chewed things that need minimal processing by the stomach, while firmer and more fibrous foods dwell in the stomach longer for processing. This is going on in our normal sized stomachs as well but we don't notice the difference because there is so much room in there, but it makes a big difference when your stomach only holds 2-3 oz. So, early on when you're mostly on soft and mushy foods, there isn't much to trigger any full feelings since not much is staying in the stomach, but that changes as you get to firmer foods, proteins in particular, and nerves heal up and the messages from the stomach start making more sense to the brain.

On eating normal calories, that is a relative thing. Part of the idea of the sleeve (and WLS in general) is that we aren't eating what was normal for us before (the normal that got us into trouble!) I have not seen much evidence that the sleeve, or the very low calorie diets that some use with it, does much damage to our metabolism - the major metabolic damage where people must maintain very low calories forever seems to be a function of personal history, yo-yo dieting in particular gets much of the blame. (When I was talking with the psych for the pre-op eval he was telling me of some of his non-WLS weight loss patients who are maintaining on 600 calories - any more and they gain, so there are a number of factors that can influence this, but the surgery doesn't seem to be one of them.) The maintenance calories that you will need at whatever healthy goal weight that you achieve will be pretty much the same whether you get there with WLS or without, but the WLS will give you a couple more tools to use to maintain that weight once you get there. I'm consuming around 2000 calories per day, and that has been working well for the past year (2000 used to be considered normal for a man before the days of super-sizing, so 1600-ish would not be abnormal for a woman, depending upon height, build and activity levels (though some of our marathoners are burning a lot more!)

Yes, you can get enough fiber and have a healthy, balanced diet once you get through all of this. I'm averaging 7-8 veg/fruit servings per day (my target is 10 but I only occasionally get there so far,) so between that and a smattering of whole grains I haven't needed fiber supplements for well over a year (and things are flowing through normally and regularly.) Be aware that these recommendations for so many servings of this or that is prefaced on a nominal 2000 calorie diet, so if you wind up with more or less than that in maintenance, those recommended levels adjust proportionately. Many here use very carbophobic diets, even in maintenance, so fiber and regularity issues are not uncommon, but those are personal issues not related to the sleeve - you can use whatever dietary regimen makes sense for you without regard to what's in fashion at the moment.

Good luck you your journey - the gung-ho usually far outstrips the terrified once you get into this!

vacationlover and califsleever - thank you for the detailed responses!  I have had a lot of problems after having my gallbladder removed and my gastroenterologist is very interested in me getting a lot of fiber in my diet.  Colon polyps also run in my family so I was worred about living on protein powder for the next 40 years  :)  The more research I do, the more I think this procedure could really be a Godsend for me.  I