u/SierraSugar

As the title says I am 3 months post op as of 3 days ago. There have been a few ups and downs, mostly ups. So, I thought I would share my progress thus far. A long read but hopefully helpful and encouraging to those considering this path.

At 4'7" my surgery day weight was 214lbs, morbidly obese for my height. I have been morbidly obese for most of my adult life. Exercize and calories in/calories out did not work for me. At my 3 month post op appt I weighed in at 161.2lbs. Just over 50lbs gone on 90 days! I am half way to my goal weight of between 100-120lbs.

**Positives:**

•Obviously the weight loss.

•I am now just "obese" instead of morbidly obease.

•My blood pressure is normal and my doctor discontinued my blood pressure medication.

•I no longer need to take Metformin.

•I have been bone on bone, in a knee brace, in severe pain in my right knee after a fall and meniscectomy for almost 2 years. Now? No knee pain, no knee brace, no cane, no pain meds!

•So far, all my labs have been within normal range.

•My skin is clear! No constant break outs.

•I can now fit into clothes that have been shoved to the back of my closet for years. Even my smallest (size 16) shorts need a belt to stay up, and I haven't been able to even pull them up over my hips in years.

•My belly is no longer smooshed against the steering wheel when I drive. In fact, there is about the thickness of my hand and a half between my belly and the steering wheel.

•The past few days I have actually WANTED to be outside in the sunshine instead of hiding in my house avoiding the heat.

•I reach my protein goals every day between 1 full and 1 half-size protein shake and the rest real food. I have found a chocolate whey protein isolate powder I enjoy and it's like drinking chocolate milk. I've never been a morning breakfast person, just coffee since I was a kid. So the protein drink in the morning works for me long term. And most nights an hour or so after dinner I'll have a small glass of "chocolate milk" as dessert.

All good and exciting things!

**For the struggles:**

•*About a week after my Modified Duodenal Switch surgery I started having HORRIBLE Bile Reflux.* I was put on multiple medications and nothing worked. A followup EGD showed a pool of bile in my stomach, and signifiant irritation to my stomach lining, esophagus, and nasal track. So, about 10 weeks post MDS I had to go back in for a Biliary Diversion surgery.

The relief was instant! I now only take the pretty standard (by my clinic anyway) GERD medication once a day for a year. No more waking up gasping for air, sour bile in my throat or coming out of my nose. I am sleeping through the night and finally able to wear my CPAP. (I've had sleep apnea since I was a young child, not at all overweight, and a gymnist. So, unfortunately, the apnea won't be resolved with weightloss).

•*I did have to go back in a liquid only diet for a week after the Biliary Diversion.* That sucked after being on soft-cooked proteins and non-starchy vegetables for over a month. Thankfully, at my 1 week post op Biliary Diversion, it was also my 3-month MDS post op and I was cleared to resume my previous level as well as slowly introduce Textures. This includes nuts, peanut butter, crispy chicken skin, jerky, protein chips, protein bars, and raw non-starchy veggies. I am MOST excited to get peanut butter and crispy chicken skin/protein chips back!

•*About a month after my MDS I started having really bad pain in my left ankle and heel*. So bad, it made it difficult to walk on my treadmill, and some days almost impossible to walk at all. A visit to my ortho showed I have a large, double barbed dorsal bone spur at the back of heel under my Achilles tendon. The weightloss removed the fat that was protecting the tendon from irritation from the spur.

Corrective surgery would involve disconnecting the tendon to access and remove the spur, reconnecting the tendon, and then being both non-weight bearing and in an immobilization boot for a while. OR attempting physical therapy to increase flexibility, increase ankle strength, and reduce inflammation through ultrasound and dry needling modalities. I opted for PT. So far, it is working. I still have painful days, but I have not had any days where I cannot walk at all. I am hopeful I might be able to completely avoid surgery, at least for a while.

•*I struggled with the bariatric vitamins.* The multi-adek pill made so sick to my stomach. I had to try a few different chewable brands before finding a combination that works for me. Thankfully, I'm finally able to tolerate the pills, but plan to keep chewables on hand for those days where I just can't swallow another pill or my stomach feels overly sloshy from water.

•*After MDS, I have struggled with reaching fluid goals.* I used to love plain cold water, and now I don't. Most flavor additives taste horrible. I also lost my taste for coffee, which as a Cuban is practically sacreligious! Lately, I've found that homemade lemonade using water, true lemon, pink salt, and a stevia/monkfruit/allulose blend is easy for me to drink. And now that I also have caffeine back, I'm excited to try the Crystal Light Wild Strawberry as it was always my favorite. I've finally been drinking between 58-62 ounces total fluid a day, so I'm getting closer to those goals.

**Biggest takeaway and advice for those considering bariatric surgery or are struggling in the early days post op:**

•*Stay in contact with your surgeon and weightloss team/clinic.* This is what they are there for. They want you to succeed and they want you to be health doing it. If you have to call every week or every day, do it! Be vocal and an advocate for your well-being.

•*Don't push yourself too hard or be hard on yourself if you aren't reaching your protein, fluid, or exercize goals right out of the gate.* Your body just went through MAJOR surgery and you have a whole new anatomy and digestive process. Your new stomach, intestines, and connections are dealing with a ton of swelling, inflammation, and trying to heal. You will reach those goals eventually. Your weightloss team does not expect you to reach them day 1, week 1, or even month 1. As long as you are trying and having some slow progress you are good.

•*If protein drinks/powders make you feel yucky, try finding one that is 100% whey protein isolate.* Our new digestive system struggles with whey protein concentrate. Premier is a popular brand, but it is whey concentrate. Most Adkins drinks are concentrate. The Adkins Strong are Isolate. Dymatize has 100% whey protein isolate. Their Coco Puffs taste like chocolate milk and their Fruity Pebbles tastes like the milk after a bowl of Fruit Loops or Fruity Pebbles. There are other brands out there, you just have to read the ingredients. Also note, that concentrate does not make everyone feel yucky. Some people tolerate it fine, others do not.

•*Be kind to yourself.* Everyone loses weight at a different pace. Age, overall health, and total weight needed to be lost all make a difference. Some will lose fast, others slow. Some will drop a bunch at first then slow down to snails speed. We all will have plateaus and stalls where it seems like weeks go by and the scale doesn't budge. When that happens, forget the scale. Hide it away for a month. Instead focus on how your clothes fit, moving more, increasing water and protein, and look for non-scale victories (like my stomach not touching the steering wheel or reduced pain levels).

If you are also doing weight training along with or instead of cardio, remember *muscle is more dense than fat*. The scale may be stalled because you've lost fat but put on muscle. The numbers on a scale do not tell the whole story. Don't let yourself get caught up in the numbers that you don't see the bigger picture.

•*If standard exercize is difficult for any reason, look for alternative ways to move your body.* Do line dancing in your livingroom to the music you love. Do chair yoga or chair dancing. Look into pilates or calisthenics. Do yoga in your bed before going to sleep or after waking up. Do leg lifts and stetches at the counter while waiting for that pot of water to boil or coffee to brew. Remember, all movement counts and helps, even regular house cleaning!

***•Lastly, take your vitamins***.

Find a combination that both works for you and is approved by your weight loss team. Don't risk your health for the sake of not swallowing a few pills or "saving" a few bucks. Because in the long run, the cost to your health without vitamin supplementation will be so much more costly.

By all accounts from those who had these surgeries years ago before more was known, by the time deficiencies show up in your blood work it is too late. It is infinitely harder and more costly to recover and correct health conditions due to mal-nutrition than it is take a few vitamins every day.

We decided on the surgery route to not just lose weight, but to improve our overall health and quality of life. Do not sabotage yourself by skipping out on vitamins.

As the title says I am 3 months post op as of 3 days ago. There have been a few ups and downs, mostly ups. So, I thought I would share my progress thus far. A long read but hopefully helpful and encouraging to those considering this path.

At 4'7" my surgery day weight was 214lbs, morbidly obese for my height. I have been morbidly obese for most of my adult life. Exercize and calories in/calories out did not work for me. At my 3 month post op appt I weighed in at 161.2lbs. Just over 50lbs gone on 90 days! I am half way to my goal weight of between 100-120lbs.

Positives:

•Obviously the weight loss.

•I am now just "obese" instead of morbidly obease.

•My blood pressure is normal and my doctor discontinued my blood pressure medication.

•I no longer need to take Metformin.

•I have been bone on bone, in a knee brace, in severe pain in my right knee after a fall and meniscectomy for almost 2 years. Now? No knee pain, no knee brace, no cane, no pain meds!

•So far, all my labs have been within normal range.

•My skin is clear! No constant break outs.

•I can now fit into clothes that have been shoved to the back of my closet for years. Even my smallest (size 16) shorts need a belt to stay up, and I haven't been able to even pull them up over my hips in years.

•My belly is no longer smooshed against the steering wheel when I drive. In fact, there is about the thickness of my hand and a half between my belly and the steering wheel.

•The past few days I have actually WANTED to be outside in the sunshine instead of hiding in my house avoiding the heat.

•I reach my protein goals every day between 1 full and 1 half-size protein shake and the rest real food. I have found a chocolate whey protein isolate powder I enjoy and it's like drinking chocolate milk. I've never been a morning breakfast person, just coffee since I was a kid. So the protein drink in the morning works for me long term. And most nights an hour or so after dinner I'll have a small glass of "chocolate milk" as dessert.

All good and exciting things!

For the struggles:

•About a week after my Modified Duodenal Switch surgery I started having HORRIBLE Bile Reflux. I was put on multiple medications and nothing worked. A followup EGD showed a pool of bile in my stomach, and signifiant irritation to my stomach lining, esophagus, and nasal track. So, about 10 weeks post MDS I had to go back in for a Biliary Diversion surgery.

The relief was instant! I now only take the pretty standard (by my clinic anyway) GERD medication once a day for a year. No more waking up gasping for air, sour bile in my throat or coming out of my nose. I am sleeping through the night and finally able to wear my CPAP. (I've had sleep apnea since I was a young child, not at all overweight, and a gymnist. So, unfortunately, the apnea won't be resolved with weightloss).

•I did have to go back in a liquid only diet for a week after the Biliary Diversion. That sucked after being on soft-cooked proteins and non-starchy vegetables for over a month. Thankfully, at my 1 week post op Biliary Diversion, it was also my 3-month MDS post op and I was cleared to resume my previous level as well as slowly introduce Textures. This includes nuts, peanut butter, crispy chicken skin, jerky, protein chips, protein bars, and raw non-starchy veggies. I am MOST excited to get peanut butter and crispy chicken skin/protein chips back!

•About a month after my MDS I started having really bad pain in my left ankle and heel. So bad, it made it difficult to walk on my treadmill, and some days almost impossible to walk at all. A visit to my ortho showed I have a large, double barbed dorsal bone spur at the back of heel under my Achilles tendon. The weightloss removed the fat that was protecting the tendon from irritation from the spur.

Corrective surgery would involve disconnecting the tendon to access and remove the spur, reconnecting the tendon, and then being both non-weight bearing and in an immobilization boot for a while. OR attempting physical therapy to increase flexibility, increase ankle strength, and reduce inflammation through ultrasound and dry needling modalities. I opted for PT. So far, it is working. I still have painful days, but I have not had any days where I cannot walk at all. I am hopeful I might be able to completely avoid surgery, at least for a while.

•I struggled with the bariatric vitamins. The multi-adek pill made so sick to my stomach. I had to try a few different chewable brands before finding a combination that works for me. Thankfully, I'm finally able to tolerate the pills, but plan to keep chewables on hand for those days where I just can't swallow another pill or my stomach feels overly sloshy from water.

•After MDS, I have struggled with reaching fluid goals. I used to love plain cold water, and now I don't. Most flavor additives taste horrible. I also lost my taste for coffee, which as a Cuban is practically sacreligious! Lately, I've found that homemade lemonade using water, true lemon, pink salt, and a stevia/monkfruit/allulose blend is easy for me to drink. And now that I also have caffeine back, I'm excited to try the Crystal Light Wild Strawberry as it was always my favorite. I've finally been drinking between 58-62 ounces total fluid a day, so I'm getting closer to those goals.

Biggest takeaway and advice for those considering bariatric surgery or are struggling in the early days post op:

•Stay in contact with your surgeon and weightloss team/clinic. This is what they are there for. They want you to succeed and they want you to be health doing it. If you have to call every week or every day, do it! Be vocal and an advocate for your well-being.

•Don't push yourself too hard or be hard on yourself if you aren't reaching your protein, fluid, or exercize goals right out of the gate. Your body just went through MAJOR surgery and you have a whole new anatomy and digestive process. Your new stomach, intestines, and connections are dealing with a ton of swelling, inflammation, and trying to heal. You will reach those goals eventually. Your weightloss team does not expect you to reach them day 1, week 1, or even month 1. As long as you are trying and having some slow progress you are good.

•If protein drinks/powders make you feel yucky, try finding one that is 100% whey protein isolate. Our new digestive system struggles with whey protein concentrate. Premier is a popular brand, but it is whey concentrate. Most Adkins drinks are concentrate. The Adkins Strong are Isolate. Dymatize has 100% whey protein isolate. Their Coco Puffs taste like chocolate milk and their Fruity Pebbles tastes like the milk after a bowl of Fruit Loops or Fruity Pebbles. There are other brands out there, you just have to read the ingredients. Also note, that concentrate does not make everyone feel yucky. Some people tolerate it fine, others do not.

•Be kind to yourself. Everyone loses weight at a different pace. Age, overall health, and total weight needed to be lost all make a difference. Some will lose fast, others slow. Some will drop a bunch at first then slow down to snails speed. We all will have plateaus and stalls where it seems like weeks go by and the scale doesn't budge. When that happens, forget the scale. Hide it away for a month. Instead focus on how your clothes fit, moving more, increasing water and protein, and look for non-scale victories (like my stomach not touching the steering wheel or reduced pain levels).

If you are also doing weight training along with or instead of cardio, remember muscle is more dense than fat. The scale may be stalled because you've lost fat but put on muscle. The numbers on a scale do not tell the whole story. Don't let yourself get caught up in the numbers that you don't see the bigger picture.

•If standard exercize is difficult for any reason, look for alternative ways to move your body. Do line dancing in your livingroom to the music you love. Do chair yoga or chair dancing. Look into pilates or calisthenics. Do yoga in your bed before going to sleep or after waking up. Do leg lifts and stetches at the counter while waiting for that pot of water to boil or coffee to brew. Remember, all movement counts and helps, even regular house cleaning!

•Lastly, take your vitamins.

Find a combination that both works for you and is approved by your weight loss team. Don't risk your health for the sake of not swallowing a few pills or "saving" a few bucks. Because in the long run, the cost to your health without vitamin supplementation will be so much more costly.

By all accounts from those who had these surgeries years ago before more was known, by the time deficiencies show up in your blood work it is too late. It is infinitely harder and more costly to recover and correct health conditions due to mal-nutrition than it is take a few vitamins every day.

We decided on the surgery route to not just lose weight, but to improve our overall health and quality of life. Do not sabotage yourself by skipping out on vitamins.