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Disclaimer: Keep in mind that I am a sleeve patient, 1+ year out, and not a doctor / nutritionist. Please follow the advice of your own medical professional care team.

I have found it helpful to capture what I enjoy eating at various stages of this process. Below is a typical day for me at this stage, and a recipe for my current favorite shake.

breakfast:
Strawberry-oatmeal smoothie (on cardio days) or
Kashi high protein cereal, high protein milk, & frozen blueberries or
Poached egg on toast

lunch:
Leftovers (I always have leftovers in my fridge which is so weird to me) or
Thawed cooked shrimp w/cocktail sauce or
Homemade tuna salad with crackers or toast.

Snacks:
crackers with reduced fat-cheese or
string cheese or
fruit - typically clementine orange or
post-workout shake (strength training days) or
yogurt or
peanut butter crackers (danger!)

dinner:
3-4 oz of the protein portion of whatever the family is having (first) + veggies/complex carbs as I am able
2 sugar-free popsicles

My favorite shake so far: Strawberries & Creme Oatmeal Smoothie

This shake is amazing. The oatmeal not only tastes surprisingly good but keeps you full and helps you stay regular. Frozen strawberres are key for texture. Don't do it with fresh.

In a blender, combine:
1 scoop Vanilla protein powder
1 cup frozen strawberries (2 handfuls, about 7-8) (frozen peaches are also divine in this)
1/2 c old fashioned oats, uncooked (not instant/quick-cook). I pre-measure these into snack baggies for speed.
4oz orange juice + 4oz cold water

Letting it sit for a few minutes after blending will soften the oats if you find it too chewy. I find the oats also help stabilize the shake so it "keeps" longer and doesn't separate, which is good since it can take a while to get this down.

Wow - it's been a year since my last post!

So I am now down  just shy of 120lbs.  from my initial consult weight, and about 5 lbs from my surgeon's goal for me. My weight has been stable for about 2 months now, so I am probably not likely to lose a lot more unless I really put some effort in. However, if I never lost another pound I would be happy at my current weight.

The best part is not being self-conscious about my size anymore. 

The most surprising thing is that I am discovering that I actually like clothes that aren't loose.

The biggest drawback is having to wear so many layers to keep warm! Seriously I am cold a lot!

I gained a ton of endurance, but lost a lot of strength - shame on me for not working out - so that is my goal this year.

The productive belching I mentioned in my last post hasn't happened in about 6 months, and only then because I ate something stupid.

I can try most anything but a lot of bad foods I just have no desire for. 

Me and my sleeve are getting along much bettter now.

So I am about 2.5 months post-op VSG now and doing well. The most common negative side-effect I have experienced is what my Dr. refers to as productive belching (PB).  I'd like to talk about that a little bit today.

For any pre-ops or recent post-ops, you may have heard this mentioned in your pre-op reading materials. In my classes they mentioned it briefly and provided some preventative tips. However these tips take a lot of getting used to, so in the meantime it is almost inevitable that you will run into this at some point.

So what is Productive Belching?

It is definitely not a normal "belch", but not really like true vomiting either.

Here is my experience - It only happens when I am eating or shortly after - it isn't an all the time thing. Most of the time I get a few minutes warning in the form of lots of thin clear mucus-like fluid in my mouth, and a tightening of my throat that indicates it does not want to swallow. You will want to find a way to discretely spit out this mucus - do not swallow it, it will only make it worse. Do not drink water, it accelerates the problem and makes it more messy when it happens. When the mucus starts, I usually do not feel any other discomfort - it is an early warning sign.

When this happens, I  get up and walk, preferably towards a restroom. About 20% of the time it will pass by walking but usu sally it is inevitable that it will progress to PB for me.  I start feeling an overwhelming need to burp.

When it happens, it is a burp or short series of burps with a small wad of food, coated in that clear slime, instead of gas. It is not nearly as uncomfortable as vomiting. For me there is no acidic stomach liquid, no full-body retching, no broken blood vessels, no headache, no projectiles. The discomfort quickly dissipates, although I will be done eating for a half-hour at least.

So what triggers this?

For me the big culprit is too big a first bite, usually taken on the way to the table, multi-tasking while I eat, or snacking while standing. All of these are habits I am working on breaking, but it isn't easy.

Sometimes it's just the food or the way it is prepared. Once you PB on something a few times - you really lose an appetite for it.

When I go out-to-eat - I am particularly vigilant since I do NOT want to have to suddenly excuse myself. I go VERY slowly, particularly with the first bites. I nibble, pull-apart, mash, taste, etc. Essentially "playing" with my food, and taking very tiny bites.

I do not drink during meals but sometimes about a capful of liquid if I feel tightness (without the slime). If I get the slime - no liquids since it makes it faster and worse.

I probably PB about 4-5x week, and would like to get this down to 1-2x. I don't think I will ever get rid of it since I like a lot of variety in my diet, and with variety comes risk (and reward).

All considered, I am still glad I had the surgery. Being 67 lbs healthier is fantastic. However my commitment to this community is to be honest about my experiences and not sugar-coat it in the bliss of weight loss. As always questions/comments are welcome!

My 2 month surgiversary is rapidly approaching and it has been about a month since my last update, so here goes:

Physically:
Wow! I am down almost 62 lbs since my initial consult, and about 30 since surgery just 2 months ago.  I am still far from skinny, but there are some definite changes to my shape, and I am back in some sizes I haven't seen in a long while.

With the exception of this week I have been healthy and energetic the last 4-5 weeks. A stomach bug earlier this week was a real doozy, and I think I may have gotten dangerously dehydrated. I really should have forced more liquids that day but was feeling really awful and didn't realize how far behind I was on liquids until I was until I very nearly blacked out. Please - if you get sick - do not stop hydrating! It was very scary.

I have been off my exercise schedule for two weeks. I've had a lot going on - which shouldn't be an excuse - it's just a reflection that I still need to work on my priorities. I am an imperfect person.

I have been doing good with my protein and supplementation (except for early this week), although I do have a hard time remembering to get in my calcium supplements during the day. They don't taste bad, but do have an unpleasant aftertaste about 30 minutes afterward, so I have to kind of plan them before meals.

Mentally - here are a collection of thoughts and observations I have had over the last month or so:

It is really weird not being hungry - mostly I get the desire to taste things, but once I swallow, the urge for more goes away quickly.

I still have issues remembering to sit down and concentrate on thoroughly chewing the first bite. After the discomfort it causes, I remember quickly what I SHOULD have done.

I have been getting cravings for more carb type foods. Most of them don't sit too well, so I ignore it for the most part, or try to incorporate something similar that I can tolerate - crackers instead of bread for example. Seems to be working OK for now, but I still wouldn't trust myself with ice cream anytime soon.

Discovering I can eat thin-crust pizza (slowly) again was both exciting and a bit scary considering it's status as a trigger  food pre-op. As long as it is in the house, I will continue to eat a slice for a meal. So at least I am getting 3-4 meals, instead of 4 slices (or more) at one meal. Luckily one of my favorite pre-op binges, peanut butter, doesn't seem to have as much effect on me as it used to. I tolerate it fine, but have little problem with walking away after a taste, and crave it far less.

I am too impatient with my weight loss. "I want my Oompa Loompa NOW!" If anyone has noticed who didn't know about my surgery - they haven't said anything. I know this is ridiculous, but sometimes I feel like "How could it be that I was so fat, that when I lose 60 lbs people not even notice? How much more will it take?"

I get disgusted with portion sizes when I eat out. Sometimes just the sight of a huge plate of food can turn my stomach. I try to split a plate or make a special order whenever practical, but am constantly surprised at the portion sizes that before were totally acceptable to me.  Resealable storage containers of all sizes are constantly in use as we try to re-learn how to purchase and cook re-scaled meals for the family.

I am thankful for the opportunities this surgery has provided, and for my progress so far. I am not to the point where I can say "I love my sleeve!" yet -  we are still getting used to each other through this awkward arranged relationship. There is no doubt in my mind that it is necessary and helpful - but the same thing can be said about wearing eyeglasses - it just takes some getting used to.

I fired my scale yesterday.

That stupid thing is all over the map. It is one of those digital WW scales, that I have had for about 5 years. I have it on a hard level surface, fresh batteries, and can step on multiple times and the range of measurements I get are +/- 3 lbs. within a 5-minute period. I am pretty sure it does the memory retention trick to give false repeatability as well, so I was having to spoof it between readings to get a fresh reading. Taking about 5 readings (That's 9 times I turn the scale on, due to the spoofing) and averaging. I weigh daily, and this is quite a hassle. So it's gone.

I really wanted a physician beam scale, but the budget and decorating committee nixed the request. My new scale is a Tanita, and I am pretty impressed. It was dead accurate with a number of objects of known weight, and correctly incremented my weight by .5 lb when I stepped on with 8oz of water. I believe it takes a longer average before displaying the weight, which I like since it always takes me a second to find a good balance when stepping on those tiny platforms.

So this morning, after 2 weeks of 281-284 readings I am finally under 280.  I'm not calling the plateau broken yet, but it is progress.

This week I have been shaking things up a bit. I have started tracking my food on MyFitnessPal . It has a really great food database with user-submitted items as well. The interface is super-easy, and looks to have some nice Apps for those with smartphones. I was using livestrong/daily plate before, but there were too many ads for me. I put in a call to my NUT to verify my goals but haven't heard back yet. I am trying to get my excercise back on track.

My insurance company, Aetna, has assigned telephone-support nurse, behavioral counselor, and healthy lifestyle coach at no additional charge. That was kind of cool - I know they are just trying to protect their investment, but I am taking all the support I can get right now.

No more taste and spit this week. Soft foods have opened up a whole new world for me, and I am able to find something legal for just about any taste craving. However, the soft foods have been much more difficult to eat comfortably, and I have had to learn the lesson of chew,chew,chew, the hard way twice this week. On the plus side they are MUCH more satisfying.

Seriously - it took me almost an hour to eat 1/2 cup of refried beans, and I was stuffed. I could have eaten 2 mexican dinners in that time before surgery. it is hard to resist the urge to drink during meals. It really helps when the bite was just a little too big.

Feeling a bit more positive this week, as I am starting to take control of my habits, and getting more variety.

I keep hoping that one day I can come on here and write about how wonderful things are since my surgery. I'm just not there yet, and I really want to be honest about what I am going through so that when the good days come I can recall when it wasn't that way.

This sure isn't the "easy way out". I had no misconceptions about that before hand, and it has been discussed extensively on this site so I won't get into it.

So physically-
I have been on a plateau for the last week - hovering within a 3 pound range, loosely correlated with my bowel cycles. I am down about 10lbs since surgery (not counting the extra fluid weight from the surgery itself).  I have had no vomiting, and my bowel cycles are becoming more regular but much less frequent. My incisions are healing great (no more staples yea!) and my appetite has returned to a degree.

I am using appetite loosely here, because I still am having trouble differentiating head hunger from real hunger. Most times I just want to taste something, but not eat it. There is still a general low-level ache in my stomach that keeps me from being hungry like I was before surgery, and quick stomach discomfort if I don't adhere to my safe list. Hiccuping and sneezing still suck. Doesn't happen often, but it does hurt. Other than that I am pain free, and certainly able to work and do houselhold stuff. Unfortunately surgery can't cure lazy yet.

I do enjoy walking a lot more now. I usually take my 5yo daughter, and we have the best conversation. Yesterday she wore large butterfly wings and cowboy boots.I am sure the neighbors get a kick out of it. She talked me into taking a 2-mile trail in some nearby woods, that I probably wouldn't have done without her. So now getting to "walk my daughter" has become a real highlight of my day.

Mentallly, I am still struggling a lot. It seems like this is the worst time mentally for a plateau. I am here trying to adjust and stick with an entirely new way of eating, and my body is really giving me no positive feedback, other than my healing incisions and increased appetite. I keep hoping each day that I will wake up and bust through to the 270's. But it remains elusive. I am learning from the forums that this is fairly common within the first month after surgery. I found this terrific article that explains why we hit plateaus shortly after WLS: http://www.dsfacts.com/weight-loss-stall-or-plateau.html . But even with all the rational explanation and shared experience here, it is disheartening to be working so hard and getting so little.

I have started chewing and spitting out things when I absolutely can't stop myself from trying something off-list. Hopefully this will go away once some of the restrictions are liffted and I am able to get more variety. But I have to be honest and say I am doing it about once a day. It feels like an eating disorder, so I am acknowledging it, owning up to it, and will seek help if it doesn't go away.

However I will end with this positive thought. If I hadn't had this surgery, I would have quit my diet this week. I would be back to eating pizza and fast food. But I can't, I haven't, and i won't. So a big thank you to my tiny tummy, and to all of you. This too, shall pass.

Here are the things I am actually enjoying eating at this phase -  I may continue to add to this list as I progress over the next two weeks - Please add your suggestions below in the comments for the liquid phase, and I may give it a try!

Stuff I love:
Sugar-Free Popsicles
Diluted Crystal Light - Orange Sunrise is my fav, and mixes well with vanilla  protein, too.
Drinkable Yogurt (DanActive) - 3g protein
1c Tomato Basil soup w/ a little soy milk 3-5g protein
1c Egg Drop Soup - 8g protein
Fav Protein Shake  - 33g protein 1 sv Muscle Milk Vanilla Whey, 2 ice cubes,  4-8 oz Soy Milk, 1/2 t Banana extract, 1 T Peanut Butter
Braum's skim milk - still is not a frequent item because of some lingering discomfort, but at 16 grams protein per great tasting cup - sometimes it is worth the pain!

Not favorites, but still help me with protein variety:
Gatorade 3 "Recovery" 14g Protein/ watch out RNY - 16g carbs. mostly sugar
1c Split Pea soup, blended and strained (the pea hulls are yucky). 9g protein

Stuff I tried that isn't sitting well yet:
Ice water
Skim Milk - I hope I can drink this again, good protein/taste, just doesn't sit well.
Isopure
New Whey bullets

This time last week I was sleeping peacefully while my surgeon hacked away at my insides. If you read my previous post, my recovery was far from the easy painless recovery I had hoped for, but I have made big improvements since then. For those of you who have been through hopefully you can relate. For those waiting for your turn, their maybe some things below that you can benefit from.

I have been completely off completely off pain meds for about 3 days now, and am now back to work for 2 days (desk job).

As far as lingering pain, gas/internal discomfort/noisy bowel is like a constant low-level pain (1-2). If it hurts, then I stretch or walk or drink . Usually moving helps it move, too.

Be gentle with yourself regarding nutrition /water goals. My priority was 1) water & medicine,  2) vitamins, and  3) protein. It took me about 4 days before I could meet all my Dr. goals, and was a day of celebration.

Flavors  taste like 10x stronger right now. I can split those little crystal light individual bottle packets into 2-3 bottles and be totally fine. I really like Vitamin Water - it is the perfect sweetness for me, but is a bit pricey so I only grab it if I am out and forgot or run out of liquids. Because of the taste changes, plain water still tastes a little funny to me.  Don't buy a lot of any particular protein supplement before surgery, as tastes change, but don't throw it away if you did as you may re-acclimate to it.

I have a problem with really cold water, so I use a lot less ice for now. However, sugar-free Popsicles are still awesome.
We went to Boston Market last night. I had them drain the chicken noodle soup with a ladle so I got all broth. Yes it was probably more fatty and salty than I should have regularly but It was fan-frigging-tastic compared to the artificial protein and stuff I have had over the last 3 weeks. I would stay away from the tortilla soup - still to spicy for this tender tummy.

I am having a problem with milk. I get some cramping and quite a bit of gas within 15-30 minutes of drinking it. I was not lactose-intolerant before, so I really hope this goes away once I reestablish my gut bacteria next week with yogurt. I am on soy milk (similar protein, OK taste in shakes)  or almond milk (better taste, less protein)  this week. Milk is a "protein drink" I actually enjoy, so really hope I can get things back in order.

I had gag reflex several times during the hospital, but nothing really productive except some mucus. I have had no nausea except while riding in the car, unless I bring a drink. If I ride in a car without my drink I get this nasty foam in my throat. It is really bizarre, and I have read about these "foamies" here before, so at least I know it is normal, but feels far from it.

My incision sites are doing great. Had most of my staples removed yesterday. Mostly painless - just little pinches with a mild burning sensation/itchiness afterward. Sleeping with a shirt on seems to help with the irritation at night - which is when I notice them most.

My family would probably say that I have been grumpy and short-tempered this week. I wouldn't argue with them (about that).  However my outlook is MUCH more positive than it was 3 days ago. I may big improvements between days 3-5 and while the healing is slowing, I would say I am about 85% healed.

Doc has me on a Nexium suspension. If you have this, I suggest mixing it a little thinner (20-25 ml) letting it set 2-3 minutes then stir. Down it like a shot. DO NOT CHEW, add more liquid to the cup and repeat twice. I have had no problems with heartburn, but I understand this is mostly to allow my stomach lining to heal.

Doc put me back on blood pressure med yesterday, which I have to crush and is the absolute worst thing I have to do right now. There is no hiding that nastiness. I may talk to my PCP to see if their is an alternate form/med.

Oh almost forgot - I am down almost 10 lbs since surgery (+7 that I gained during surgery from all the fluids they pumped me with). It's kinda funny that I really don't even care about the weight loss right now. I am focused on getting what my body needs to live, and the weight is taking care of itself for now. Pretty damn cool.

WTG

Had my surgery Thursday AM. Came home Friday evening. I may not write much now, and it may not all make sense, but wanted to capture some of my feelings before I forget.

From my perspective, the surgery itself was fairly uneventful. I showed up, answered a bunch of questions, the anesthesiologist showed up, mixed me the daily special, and away we went.

I was in quite a bit of pain when I woke up - they said they didn't want to give me anymore pain meds because they wanted me to breathe more. I stayed in what I would consider a 3-6 pain range during my entire stay. THe stuff that really knocked me out helped the most with the pain but limited my ability to all the other stuff I was supposed to be doing like walking and breathing exercises. The day without liquids was rough, but at least I didn't have to worry that my body was getting enough because they had me on IV. Too much sugar in my  IV apparently, because they woundup giving me insulin shots (I am not diabetic, so this was a pretty big surprise to me). I made it through the day gargling water frequently and using glycerine swabs. Sleeping, and hall walking, it is a blur to me even now. I do recall feeling nausea every time that I sat up, a nasty taste in my mouth, and  short moments of clarity where I could get up and walk. Mostly I slept. I loved the pneumatic massage stockings. I want a set for home.

Swallowing the iodine solution for the leak check the next day was quite an unusual experience - it tsted nasty, and since it was the first thing I was allowed to swallow it was a whole new experience. The restriction was incrediblsaid it's tooe. Like trying to swallow while someone is holding your throat and punching you in the gut. The table had a motorized recline as well. It was a wild ride. I somehow made it through without hurling.

Everything they brought me tasted nasty, with the exception of some vegetable broth which I managed to get down a whopping 3oz over an hour. Everything else was about 1oz/hour at most. With goals of 40oz protein and 480z fluids - it was clear I wouldn't meet that. They were bringing another tray as soon as pushed away the previous.

The surgeon showed up on Fri (the day after surgery), threw open the blinds and said "it's too gloomy in here. go outside and walk. A man your age - we should have you out running." I hope he doesn't read this. I really wanted to punch him.

The hospital wanted to continue giving me insulin injections even though my blood sugar had dropped in the normal range and I was off IV fluids. I declined the injection. I tried to get some answere from the nurses about whethere the amount of restriction I was experiencing was normal or safe. I had troule getting a straight answer,  and decided I would be better off continuing my recovery at home. My surgeon, who in my opinion, seemed impatient to discharge me quickly agreed. We left at 6pm, roughly 36 hours after surgery.

I have had zero problems with my six incision sites. They were small, closed cleanly, and appear to be healing well. Only minor localized pain.

My intestines hurt quite a bit. and are noisy all night.  I feel like I have had the biggest Thanksgiving meal of my life, while having the worst stomach flu, and being asked to drink nasty liquid medicine around the clock. I have taken some gas-x but it hasn't helped much.

Everything tasted like medicine to me. even water. I think I got in about 20oz yesterday.

Had a popsicle today that was pretty good, but no nutritional value of course. That's realy all I can think of right now. I have got to find a protein I can tolerate - I found them all tolerable before surgery, but smells and tastes are so intensified and anything not natural tastes foreign to me.

Hoping things will get better soon. Oh and I gained a temporary 7 lbs during surgery from all the fluids and swelling - another small suprise.

I apologize for all the typos I am sure are above - I'm just not up to proofing right now, and wanted to give an honest account of my experience before I forget. I remain positive that things will get better, they just suck right now.

So I have been doing this mostly liquid pre-op diet for a week now. The good news is that I have lost around 15# over the last week. The bad news is that I feel pretty crummy right now.

Doc has me on about a 600-cal mostly liquid diet (2 shakes + a Lean Cuisine), starting tomorrow I will be on shakes only (low / no calorie liquids allowed). I have never made so much Jello, Broth, and Crystal Light in my life. I know I will have to do this after surgery, but at least then I will have a tool to help with the hunger.

Physically, I am struggling right now. Not to be gross, but bowel irregularity is a big issue right now and my gut won't shut up - it is constantly complaining. I am glad I work form home and not somewhere where my coworkers would have to witness my noisy gut and very frequent bathroom trips. I have managed to walk the neighborhood twice this week, and run along with my budding bike-riders, but overall energy is low low low.

Mentally, I am doing better than I expected. Not having as many specific food cravings as I thought (other than a craving for food in general). Not nearly as anxious about the surgery as I expected - it's more impatience than anxiety. So far I am sleeping well, possibly due to low energy. Mental clarity is an issue right now. I am having trouble staying focused and feel like I am in a mental fog most of the day. I suspect this is diet-related.

I have picked up all my post-op supplies except the required acid blocker and some protein supplements I want to try, and my hospital packing list is ready. The kids are looking forward to visiting the grandparents for a few days. I have to go in for some pre-op blood work next week, and then I should be set!