Ketones??

I am spilling ketones in my urine. I know with Atkins that is what you want to do. With VSG should I be burning ketones or should I up my carbs?

I'm not a diabetic and I drink about 100 ozs of fluid a day.

You're fine, just in ketosis.  Keep pushing the fluids.

If you are burning fat, which is what we are supposed to be doing here, you will be dropping some ketones in your urine and that will show up in your labs, so that is quite normal and has nothing to do with the VSG or any specific procedure but rather from the diet used. Some like to take things to extremes a la Atkins so that this becomes symptomatic with bad breath and body odors (what is often referred to as "being in ketosis" and is implied to be essential to burning fat by those marketing low carb or "ketogenic" products) but such extremes are unnecessary. One can happily burn fat and lose weight at well above Atkins levels - I typically ran at two to three times the nominal Atkins 40g limits with a healthy, varied diet and was free of the classic ketosis and low carb side effects such as lethargy, brain fade and hypoglycemia yet still lost as fast as one would want to lose.

In short, if you aren't experiencing any of these normal side effects of a diet overly low in carbs, then you should be fine; concentrate on getting in your required protein with as high quality of foods that you can get in consistent with your post op progression, keep your calories in line at levels appropriate for a fairly high caloric deficit and let the rest take care of themselves - our diets are inherently low carb and low fat by any sane standards without taking things to extremes.

I was sooooo hoping that this approach would work for me. But these last 20 lbs are just stuck on me. I am truly scared that they will refuse to leave. I can cut off a bit with plastics but not 20 lbs... Don't know how to budge them coz doing what I was doing and consistency doesn't seem to be working so well anymore,

Thanks!