5+ Weeks Out = High Level of Dissatisfaction with Sleeve

 

Here’s the long and short of it: I am hungry all. the. time. and I can eat a LOT. Yes, I take a PPI and increased it to 2x/day after seeing my surgeon this week.

Yes, I follow the sleeve guidelines: protein first, 60+ ounces of water a day, at least 30 minutes on either side of eating. Typically I eat 80-100+ grams of protein a day, 20-40 grams of carbs. Here is a typical day for me but I might even have more than this—another protein shake, a tall Starbucks 1% latte and/or a half-cup Greek yogurt with half an apple or something like that. I could easily eat every two hours, so when the hunger pangs start, I just try to ignore them by getting involved in something.

Breakfast	Calories	Carbs	Fat	Protein
Generic Coffee - Coffee With Milk 1 % , 4 oz	8	4	0	1
Jones Dairy Farm - All Natural Uncured Canadian Bacon - Double Cherrywood Smoked (97% Fat Free), 1 slices	20	0	0	4
Eggs - Fried (whole egg), 1 large	92	0	7	6
No Name - Shredded Cheese - Cheddar Monterey Jack, 0.13 cup (30 g)	55	0	5	4
Add Food  Quick Tools	175	4	12	15
Lunch
Carrots - Baby, raw, 6 large	32	7	0	1
Hass---(Corrected for Total Net Carbs - Avocado (California), 0.25 medium	63	1	6	1
Krakus - Polish Dill Pickles, 1 Pickle (28g)	5	1	0	0
Radishes - Raw, 3 large (1" to 1-1/4" dia)	4	1	0	0
Reese - Green Olives Stuffed With Blue Cheese, 2 olives	15	1	1	0
Kirkland Select Tail-on Cooked Shrimp 20-25 - Cooked Shrimp, 2 oz	47	0	0	17
Krinos - Oil Cured Olives, 3 olives	35	2	3	0
Add Food  Quick Tools	201	13	10	19
Dinner
Generic - Oven Roasted Brussels Sprouts W/ Olive Oil, 0.13 cup	10	1	1	1
Hass---(Corrected for Total Net Carbs - Avocado (California), 0.25 medium	63	1	6	1
Radishes - Raw, 3 large (1" to 1-1/4" dia)	4	1	0	0
Royal Fiord - Smoked Roasted Salmon (Costco), 2 oz	100	1	6	11
Carrots - Baby, raw, 3 large	16	4	0	0
Generic - Cucumbers (5 Slices), 7 slices	13	1	0	0
Sabra - Roasted Pine Nut Hummus, 1 tbsp	40	2	4	1
Add Food  Quick Tools	246	11	17	14
Snacks
Premier Nutrition - Ready to Drink Chocolate Protein Shake, 1 Shake	160	5	3	30
Add Food  Quick Tools	160	5	3	30
Totals	782	33	42	78
Your Daily Goal	1,769	242	58	66
Remaining	987	209	16	-12
	Calories	Carbs	Fat	Protein

 

No, it’s not head hunger. Five years prior to my most recent weight gain caused by Cushing’s Disease,  I lost 100 pounds (and maintained it) following a much more stringent (in terms of foods allowed) food plan than the one I’m on now, so I can differentiate between physiological and psychological hunger.

I’ve lost 33 pounds, most from the pre-op/immediate post-op diet. I walk my dogs for an hour every day and in the next week or so, I’ll add weight-training and more cardio 4x/week.

I didn’t do a whole lot of research prior to having the sleeve and while I did question my surgeon about bougie size (40 for me) I’m thinking now that while smaller bougie sizes may cause more difficulty immediately post-surgery (I’ve had nothing but smooth sailing) but are more effective in the long run in terms of feelings of satiety and restriction. Honestly, I was feeling so demoralized by the weight that in retrospect, I would not have debated sleeve size with him or gone elsewhere, so water under the bridge, but I do feel stupid and like I didn’t get a “good deal”.

I realize now that I have to accept that this is just going to be more difficult for me since I was apparently left with all my ghrelin and that while I do have a feeling of satiety after a meal that lasts about an hour, I'm going to have to be really careful about not grazing all day. Luckily, I am unaccustomed to this since that was not permitted on my previous food plan.

Really, I didn’t come on here to ***** and moan, but more to look for advice from vets, especially those who may have had the same experience I have. Is there anything that I’m not doing that I could be doing to maximize my experience?

Advice - stick to measuring/weighing your food, follow Frisco's advice and under eat your sleeve - just b ecause you "can" doesnt mean you "should - when it comes to eating. 

I am on the max dose of a PPI, and I still get "hungry" when I have acid issues. I know it's acid because eating doesnt make it go away (or it comes back 20 minutes later when I know it's impossible to be hungry again). Sometimes my stomach just doesnt feel quite right, sometimes it burns. The symptoms are all over the place, but just because you are on a PPI doesnt mean it cant be acid related hunger. 

The key to success is following a plan and making lifestyle changes. Focus on protein, protein, protein - get rid of the carbs, get moving, get your fluids and your vites. 

DITTO!!  JUST BECAUSE YOU CAN EAT A COW DOES IT MEAN YOU SHOULD!!!    UNDEREAT YOUR SLEEVE...

 

measure your plan's amount & stick to it...  if still hungry, wait 30 minutes and drink water til you float

I am sorry for the situation you find yourself in, my friend.  Boo and double boo.

I, like you, never lost my hunger.  Period, the end.  Thru trial and error what I have found is dense protein (meat) PERIOD is what keeps me full for longest.

Add an apple in there, add some veggies (fiber value matters not with said veggies), pickles, make it a little soupy, then I have about an hour.  Dense meat keeps me full longest, up to 3ish hours. 

I can manipulate things to stay full longer by making sure I wait AT LEAST the 30 minutes before and an hour after eating.  Otherwise, it seems to shuusht things thru my belly faster.

I never had blood sugar issues before surgery or after surgery (symptoms or labs) but out of curiosity one day I checked them (a podcast interested me) and I find my blood sugars still bounce way up with some foods that folks might not think would matter, even non caloric sweeteners and maltodextrin or dextrose in VITAMINS bounce it around - so knowing that when blood sugars are bouncing around, the body usually responds with hunger, then I can test and keep bouncing to a minimum.

I season things with spices, ghee, coconut oil.   Enough for taste, but not enough to make soupy.  I have to drink protein shakes or my serum protein levels fall.  Some folks say that shakes help them stay full/satisfied longer, this is not true for me.  Also, protein ISOLATE (which is the optimum choice) DOUBLES my blood sugar, so protein mixes are what I consume, so it also helped knowing that.

Hopefully some of the big throbbing brains around here can  be helpful to you, but for me - the only things I have to add are

Blood sugars manipulate my hunger.

Anything IN ADDITION to dense protein - I get hungry faster than just dense protein alone.  I hope things will change for you.

Also right now, your "full" might be off because of the nerves that were cut in our stomach.  Its possible you might feel full differently later. 

OH!  Also, for me, hormones make me want to eat my arm off, and make my belly feel like a pit that needs filling and cant be filled, I just get to remind myself that its not forever.  It just FEELS like it in the middle of it.  :S

***** away. I don't have Cushings but I know of its notorious reputation for causing hunger. I really feel for you and hope you get the help you need to make the sleeve work for you. Take care

The type of protein matters to me. Lean dense meats go a long way. To me almost everything else is a slider. Lots of veges do not satisfy me. I also find that the ratio is important. 75-25 or 80-20, protein to carbs it I dont want to be hungry all day. Fell off the wagon in Feb, gained 10 # this year. Had to go back to liquid proteins (unjury) to get a hold of my self.

 

Fay

I'm only 4 weeks out, but what strikes me is that, with the exception of breakfast, your meals are protein light for the number of calories.  Lunch was 201 calories but on 47 of those calories were from your protein.  At dinner, 100 calories of your 245 were from protein.  And since you had a protein deficit, you needed a shake at the end of the day-- which is not unusual,but since it's liquid, it doesn't stave on hunger for me!

You'll hear more from other vets, but I'd suggest eating a larger serving of protein first, of course chewing slowly and all that.  Are you avoiding liquids before, during and after meals?  Lots of liquids help your food digest more quickly.

How long does it take you to eat your protein?  My plan recommends taking very small bites and chewing a lot! There is a specific note in my plan book -- If you are feeling hungry between meals, increase your protein and fiber, and eat 1-2 high protein snacks.   I didn't see any fiber numbers, but I don't think any of your non-protein foods have much fiber.

My sleeve is on the larger end, and I do have hunger -- but it is not that all consuming hunger from before. I could eat a lot of soft items, like purees, so once I went to soft meats, I was very careful to eat slowly and just stop at 2-3 oz of meats like chicken and turkey.  I'm just now moving into denser meats.  But lighter meats, light fish, I would definitely be looking at the 3 oz end of the world!

My suggestion -- increase your protein, and look for more higher fiber veggies to go with it.

Best of luck.  PS -- you can adjust your daily totals in MFP by going in a creating custom nutrition goals, and also then you can customize the distribution of nutrients.  I get annoyed with MFP's little messages about undereating my calories and if I keep eating at this level, I should be xx weight in a month!

 

Like Brandilynn, when I add fruits or veggies to protein, I maybe feel full for an hour - maybe. Also, I've found that I have to wait AT LEAST 1 hour after eating to starting drinking again, or the food goes right through me. But, if I wait that hour (sometimes even a little longer), I feel satisfied for a few hours. I never feel hunger, but at over a year out, I am starting to feel like it's time to eat something - It's hard to explain.

I keep my veggies for snacks and I always try to add a protein with them.

I drink 100-110 oz of water a way (you are still early on, so the 60+ oz you are getting is very good. This just might be something you work up to.)

I count TOTAL carbs - never net carbs. IMO, net carbs are too subjective and don't give a realistic account of what I am actually taking in.

I always ask myself if just because I want to eat, is it time to it? Could I have a glass of water first?

 

I'm sorry that you are frustrated. I had buyers remorse for a long, long time. Early on I swore to anyone who would listen that I would NEVER say "I LOVE MY SLEEVE!!!!!" That is still true for me. IMO, it was a necessary evil. But, at some point your have to decide if you are going to allow your frustration at taking this path in life to run your emotions. You may never be happy with this decision, that I can understand. But, you don't have to let it take away your joy, either.

What's done is done. It sounds like to me that you are making the most of it. The sleeve is only a tool. You have to work on the brain **** to truly start working toward "healthy."

Good luck.

 

I dont' know anything about Cushings, but I will say a few things. 

Firstly, you have had significant weight loss.  33 lbs in five weeks is not bad at all.  It slowed down for me after the first two weeks, and I have to remind myself, that kind of fast loss will not continue forever. 

As far as feeling hungry, I have to say that I often have a feeling of being "unsatisfied", more than hunger it is a feeling that something is missing, like I haven't quite gotten to the thing I am craving, but I dont' know what that is.  I do feel full longer after dense proteins.  Since you are managing pretty well with raw veggies, etc, I would suggest backing off of the veggies and focusing more on protein.  I don't find that the protein shakes have ever really filled me up, even prior to surgery, so I have never had that experience like others. 

I was told by my physician that it may take up to six months for the body to catch up with what has happened and really feel "normal" again about food(ie. full when I should be, hungry when I should be ect).  I wish you luck. 

Please read this about bougie size.  Carmelita is good about explaining things and backing it up with research.  http://m.obesityhelp.com/member/carmelita/blog/2011/03/31/-2/

As far as the hunger some say it takes a while for that to go away.  Some it never does.  It's an individual thing.  As for the acid that may naturally reduce with time.  Mine has to a great extent and I only take the PPI every so often.