5 weeks post with questions

Hi all!

I have a couple of questions for you vets out there. :)

I'm 5 weeks post op and my experience doesn't seem to be matching what I'm seeing as the norm for post op. For example, I haven't ever had difficulty eating or drinking. Post op day 1 I was drinking more than 8 hours of water an hour without difficulty. No problems with shakes, or mushies, or solid food. It's a little disconcerting.

Also, I keep hearing about a mythical honeymoon period where one isn't hungry. I'm *hungry*. I do feel what I think is appropriate restriction when I eat (for example, a half cup of cottage cheese is satisfying) but the satiety doesn't last. I get hungry about 90 minutes later.

I'm down 20 pounds, but currently stalled for the last week, bouncing up and down the same pound. It's frustrating.

Any idea what is going on? Is this normal?

Last question: ultimately, how much should I anticipate losing in a week/month? Maybe my expectations are unrealistic?

Stuff that you might ask:

1) yes, I journal - my calories range from 600 (on a rare great day) to 1100 (on an equally rare bad day) and average about 900 if I'm logging correctly

2) I'm getting all my protein and liquid in.

3) I'm a band revision patient. I had fantastic success with my band, but had to revise following a slip.

Any suggestions or advice would be greatly appreciated.

Thanks,

Didi

Every experience is individual. Some tolerate liquids and foods better/fatster than others. Some have hunger return, some don't. I wouldn't be concerned. How much weight you lose will depend largely on compliance, and what your starting weight was. Band revisions do seem to lose slower for some reason.

im do oncerned about your reaching 1100 calories at 5 weeks out. Even is rare- it means your eating too much, of likely the wrong thing, to soon. How much protein and how much liquid are you getting? Be specific. What was yesterday's menu?

Please do not try and test what your pouch can hold. Measure what you are supppsed to eat at this stage( usually 2oz)- eat it and move on. If you feel hungry 20 minutes later, wait 10 more minutes and drink something. Also, acid mimics hunger- did you doc suggest a ppi? Know the difference between hunger and a cravings. Cravings make you want specific things, hunger can be quelled by any food.

Hi, thanks for your input.

Here is yesterday's menu - about 900 calories. This isn't an unusual day for me.

Totals	909	73	32	81	1,104	6
Your Daily Goal	600	45	20	60	2,300	45
Remaining	-309	-28	-12	-21	1,196	39
	Calories kcal	Carbs g	Fat g	Protein g	Sodium mg	Sugar g

I get >60 ounces of water per day. I' m definitely not trying to test my pouch. I was compliant with the band and am doing my best to be compliant with the RNY rules - but I am pretty hungry all the time. My team said don't worry about the calories, but just focus on the protein (but I think that instruction is leading to me consuming too much.)

Many thanks for any insight.

Didi

Breakfast	Calories kcal	Carbs g	Fat g	Protein g	Sodium mg	Sugar g
Wawa - Decaf Coffee With 2% Milk, 24 oz	10	1	0	0	20	1
Chobani - Original Plain Whole Milk Yogurt, 0.35 cup	67	3	3	7	30	2
Hood - Cottage Cheese, 2 oz	57	2	2	7	217	2
Add Food Quick Tools	134	6	5	14	267	5
Lunch
enriched roasted broad bean crisps - bean crisps, 1 oz	100	15	3	7	130	1
Generic - Salmon - Fresh Sashimi, 3 oz. (85g)	177	0	11	17	50	0
Squid - Squid, 100 g	92	3	1	16	44	0
Add Food Quick Tools	369	18	15	40	224	1
Dinner
Smith's - 85% Ground Beef, 1 oz.	60	0	4	5	19	0
Potato - Mashed Potato, 0.15 cup cooked	26	6	0	1	95	0
Vegetables, mixed, frozen, unprepared, 0.1 package (10 oz)	20	4	0	1	13	0
Add Food Quick Tools	106	10	4	7	127	0
Snacks
chicken corn chowder - Homemade, 2 laddles	300	39	8	20	486	0
Add Food Quick Tools

I think advice to not worry about calories when your already on solid foods is awful. If you were on Liquids or puréed, maybe, but not solids.

My thoughts- drop the veggies, mashed potatoes, corn chowder and bean crisps. Too many carbs vs. protein they have.

Did you have reflux with you band?

Thank you for your input. I wasn't thrilled with the non-response about how many calories I should be getting in either, TBH. I'm shooting for 600, trying never to exceed 900. I'm 5 feet tall and weigh 179 right now.

I'll reduce the carbs as low as possible. My go-to diet pre-op was ketogenic, so maybe I should just unpack those old strategies again.

I had no problems with my band for 14 years. Lost 80 pounds, maintained a weight of 130 for a decade, no reflux... the thing was damned near magic. I loved it, but when it slipped, the team advised me that statistically, it was better to revise than replace.

This is a very different experience than my band. I'm super happy I did it, but it's a different thing altogether. I have a lot to learn.

Thanks for chiming in. I really appreciate hearing from you all who've been down this road already.

Didi

My surgeon's mantra always was "Protein first, then veggies and then IF you have any room, fruit then carbs(the starchy ones). Most people pretty much for the first year don't have room for fruit and carbs. Did I ever have a carb the first year? Yes, but they were few and far between. Not regular.

Most people eat low carb, high protein and don't worry about the fat. Not exactly keto. When I could I worked my way up to 100g of protein a day and stayed there for most of weight loss. Stayed for the most part under 1000 calories a day then as well.

I did get hungry in the beginning, sometimes that is acid. Do they have you on any acid medicine?

For reference, I am not a vet yet, only 4 years out. I met my goal of a "normal" BMI (between 20.5 and 22) at about 20 months out -- going from 347 to 135 to 145 in maintenance. I have not suffered re-gain as of yet. Here's my answers to your questions -- YMMV.

1. I never had difficulty drinking, eating soft foods, and most solids. I was able to drink (although, not gulp/chug) fluids from day 1.
2. The honeymoon period is the time you have the most restriction and malabsorption. It does not mean that you aren't hungry. I was always hungry, albeit, a lot of it was head hunger rather than physical hunger. You can tell the difference because usually with head hunger you will want specific foods. With real hunger, not so much. Learning to tell the difference is really difficult.
3. Twenty pounds in the first 5 weeks is above average in loss. It slows down each month after that. You seem to have started as a relative light-weight, so your monthly loss may look smaller than other posters. You cannot compare your loss to that of a heavy-weight's loss.
4. A stall is completely normal in weeks 3 to 5. Most people lose in a stair-step fashion.
5. Yes, it sounds pretty darn normal.
6. I can only guess on what you should expect to lose, I am 5'5" and weighed 347 to start, thus my loss was larger at first -- but a pound to two a week would be typical in the first 6 months after surgery.
7. Judging by your menu, you are eating more calories/larger portions than I was at 5 weeks out, and far more carbs. I still NEVER go over 900 calories or more than 45 carbs in maintenance. You are eating closer to what I do to maintain 135 to 145 pounds at 5'5". Again, everyone is different.
8. I would highly recommend dropping the unnecessary carbs: potatoes, bean chips, corn, etc -- and instead concentrate solid dense protein until you reach goal. That is the best way, imho, to reach goal and maximize your surgical results during your honeymoon period.

Hey Didi, Welcome! Your story sounds similar to mine, so I thought I would chime in...

I am also a light-weight, band-revision patient. I am 4'11" and my weight at the time of revision was 160. I was actually maintaining at 140 - 145 with the band until the very end when I was really, really, really sick and could no longer keep anything down that was remotely related to protein. It was all carbs just to stay alive at the end there. Ugh.

Anyway, here is the deal. If you were like me, the band told you are full when it literally hurt to eat. Pain in your esophagus and burning in your chest, most likely? The RNY has a very different stop signal that is harder to put your finger on or describe. At the beginning, when my nerves were severed I didn't really feel any stop signals at all, which was so weird, coming from the discomfort of eating with the band. After about 5 or 6 months, I started to feel "real" restriction. It's hard to explain the sensation, but you'll know it when you experience it.

As for weight loss, you will find that revision patients and light weight patients are the two categories that often lose slowest. And you get to wear both crowns! Yay? But all is not lost! You will get there, but you just won't have the same 20lbs in a month that others here can have. It's hard to read those stories, but you are losing at a rate that is appropriate for your body. The only unfortunate thing is that you are probably going to have to stay even more calorie restricted than the average WLS patient from the start, to keep a small body, losing. As Kat mentioned above, your menu points to calories and carbs being higher than I would recommend. You'll probably still lose slowly on that menu, but if you want to kick start things, lose all the carbs and prioritize protein.

I know you said you are hungry. Two things about that... First, are you on a PPI? Acid mimics hunger and sometimes if you can control the acid you can reduce those hunger pains. I am almost sure that after living with the band, acid was part of your life, so that might be the place to start. The second advice is not to stick to 3 meals. Turn it into 6 or 8 really small ones. Eat more often if you need to, but turn that cottage cheese into 2 meals and eat more often. I was doing 6 - 8 meals for the first year, and even now at 2.5 years, I still plan for 5 - 6.

I looked back on my menus from that time period and I was at 500 - 600 calories and 80g protein. I wasn't too focused on carb or fat counts back then because to eat 600 calories and get in 80g of protein, there was literally no space for crackers or fruit so I couldn't mess up too badly, lol.

Anyway, despite feeling like things are slow, it sounds like you are doing great! You are losing well and it sounds like you have some really great habits--tracking food, and getting in protein and fluids! This is a great community. I hope you will stick around and join us--having a daily touch point has been immeasurable valuable to my success.

Hi JuniperBerry,

Thank you so much for your response. I really identified with what you wrote. I think you have great insight on being a post-band patient.

>Anyway, here is the deal. If you were like me, the band told you are full when it literally hurt to eat. Pain in your esophagus and burning in your chest, most likely? The RNY has a very different stop signal that is harder to put your finger on or describe. At the beginning, when my nerves were severed I didn't really feel any stop signals at all, which was so weird, coming from the discomfort of eating with the band. After about 5 or 6 months, I started to feel "real" restriction. It's hard to explain the sensation, but you'll know it when you experience it.

Yes, that's it. Band patients don't ever feel full, but we get immediate and strong signals when the pouch is full. Maybe that is what I am interpreting as lack of satiety? That's super insightful. I'll think on that. Thank you.

>As for weight loss, you will find that revision patients and light weight patients are the two categories that often lose slowest. And you get to wear both crowns! Yay?

Um, woo hoo. ;) Darn it.

I am on a PPI (assuming that's proton pump inhibitor). I'm not experiencing any reflux. I will try to separate my meals into smaller/more frequent as you and others are recommending.

Thanks so much.

Hi,

I am lapband to sleeve to RNY. The restriction is very different with RNY. I had lots of restriction with the band. Also with the sleeve until it got larger over time (9 years) . I am a 3x revision so weight loss is somewhat slower. Part of it is me because as I am getting further out, I do get hungrier and unless I measure I am eating more than 750 a day. MOre like 900 now which for many is a maintenance weight. So far in 7 and a half months I am down 58 pounds. Not bad.. look at my stats over the last months to get an idea.

The first five weeks I was eating no more than 650 per day and almost all protein sources.