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About herealways

  • Rank
    Advanced Member

Profile Information

  • Gender
  • Location
    Boston, MA


  • Surgeon
    Ali Tavakkoli
  • Hospital
    Brigham & Women's
  • Height (ft-in)
  • Start Weight
  • Current Weight
  • Goal Weight
  • Body Mass Index (BMI)
  • Surgery Date
  • Surgery Type
    Vertical Sleeve

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  1. Hello Dr. Gupta,I had VSG in August 2014. I started at 290, down to 175 at my lowest. I'm 5'11" and my doctor set my long term goal between 175-185. I've been working with a trainer for about a year and we've upped my calorie intake a bit since I wasn't gaining muscle mass. I've gained about 10 pounds in the last 3 months - some fat I'm sure (body fat percentage went up about a percent and a half) but I think some muscle.I'm unhappy with a few areas on my body. I have some excess skin around the stomach area and love handles. I have what feels like a relatively solid pooch below my below my belly button as well that I can't tell if is skin or fat. Finally I'm also unhappy with how saggy my chest is - when I flex my pec muscles they are much higher than my nipple line. Overall I just feel saggy and droopy in my chest and stomach. Curious whether plastic surgery timing is right given the small weight gain I've had over the last few months and what procedures you would recommend. I have a consultation with a plastic surgeon in a few weeks but wanted to get your expert opinion as well. I've included some recent pictures to hopefully help weigh in. Thanks so much! Mike
  2. Hey all! Quite a long time since I've been on this forum, despite the amazing support it was for me pre and immediately post surgery. I'm down approximately 100 pounds from when I had surgery in August 2014, representing essentially 100% of my excess body weight. I've been working with a trainer 3x week and trying to add muscle mass. He had me up my calorie intake because I wasn't building much mass, and in the last 3 months I've put on 10 pounds. I'm freaking out a bit - I don't see obvious indications that the weight I've gained is either lean muscle or fat, my sense is that it is a mix (my body fat percentage has gone up a percent). So I'm returning back to basics after having strayed a bit during the honeymoon phase, which I'm realizing is now ending. Adding back in protein shakes in lieu of meals, cutting out carbs that had crept into my diet, etc. My questions are twofold: 1.) Any of the guys out there have any experience/tips/thoughts on adjusting nutrition to building muscle? My nutritionist hasn't really been able to give me good guidance on how many calories and the correct macronutrient proportions to shoot for. 2.) I'm considering having a panniculectomy, perhaps a tummy tuck and perhaps liposuction. Does anyone have any thoughts on whether this is the right time to do that, or if I should wait longer after surgery? I've been relatively lucky that I haven't had major excess skin but there is definitely some that I'd like to address. I'm concerned about scarring in particular. Thanks everyone! New pics of me attached :-)
  3. Dani, It's probably worth following up with the bariatric doctor to find out why you were turned down. There may be some component of your medical history that puts you at risk for the procedure, or you may not meet their qualifications (but could meet the qualifications of another doctor.) Self-pay seems like a drastic step from a single doctor turning you down for the procedure, especially since you don't yet know the reasons why.
  4. So I supplement the Carnation with a half scoop of Unjury unflavored protein powder (and a small squirt of sugar free Hershey's syrup). The Carnation and Hershey's have mostly been for flavor to be able to get the shake down - though during the pre-op diet I liked that the Carnation at least had some nutrients in it as well. What I might do is rebalance the Carnation and Unjury - instead of a full packet of Carnation and half a scoop of Unjury, maybe I'll flip to half a packet of Carnation and a full scoop of Unjury. With that much protein I think I can go with almond milk and not miss the loss of the protein from the milk. If not, I'll flip over to soy milk (which I know from past experience I like). Thanks so much! :-) Best, Mike
  5. I wholeheartedly agree - it wasn't until I put everything into MyFitnessPal that I saw how high the carbs were from the banana. Definitely dropping that off the list (even though approved on my program). My shakes have a surprisingly high amount of carbs as well - mostly from the milk, but also from the Sugar Free Carnation Breakfast. Not quite sure what to do about that, if anything...
  6. We are indeed kindred spirits Dees - I have a masters in accounting as well. :-)
  7. THIS IS WHAT I NEEDED!!!! Big virtual hugs Dees. Something more than just "follow the program, we don't know why, but just do it". Flipping back primarily to liquids for my second week in the program. Good work. Mike
  8. Must be the lawyer in me :-) I definitely did come to the forum with this question to gain the benefit of advice from everyone. I'm mindful of the fact that I'm not entirely off program here - (a) I'm advancing my current program by approximately one week and ( I'm actually following other programs that other surgeons have in place for their patients. What had me particularly curious was how well it was going - I had expected to hit snags at some point and was surprised when there didn't seem to be any. But you're not wrong - I don't want to establish bad habits early on and lose the benefit of the tool. I'll continue to give this all some thought, including the great advice in this string and on the forum generally. I may be questioning at times, I may have thoughts that run counter to "follow the program blindly", but I am indeed listening. Best, Mike
  9. I appreciate it Dees a great deal - you guys are terrific! I talked with my NUT. With the salmon from last night I had started dipping my toes into Stage 3B from my program (the more advanced soft food stage). She advised going back to Stage 2 (liquids only). I think I'm going to compromise and stick with Stage 3A (the earlier soft food stage) and just keep checking in with my body to see how things are going. I did some research and found other VSG programs that are on the schedule that I'm adopting (soft foods as tolerated after day 3) - so I am indeed sticking to a plan, just not my surgeon's particular one. I find the inconsistencies among the programs curious and frustrating to navigate, particularly when my NUT can't articulate a reasoning behind it other than "these are our guidelines". But you're right - I was pushing things a bit too fast so I will ease up. Thanks for the advice everyone, much appreciated! Mike
  10. Ah, Jolls - I was hoping you'd weigh in - thank you! So here is my $1,000,000 question. I definitely have sensation in my new sleeve (when I eat too fast, take too big a bite, etc., I can feel a tight pressure in my chest that doesn't go away until a small burp comes up). So if I'm not feeling any unpleasant sensations when I'm eating, does that mean that everything is OK? That has somewhat been my guidepost for the past few days - if it feels good going down (and it's protein), then I've been thinking I'm OK. I've had no instances of throwing up (nowhere close), no instances of chest tightness, no unpleasant sensations whatsoever....I have definitely felt the restriction with slightly more solid foods (after about an ounce of salmon today I realized despite it tasting amazing that I was done)...but other than that, nothing. Am I risking - what? Popping a staple? Wouldn't there be a precursor of pain or pressure or tightness or nausea or something? Thank you!
  11. A fair point, but along the way here I'm trying to balance what seems to be working well for my body versus the rigid program instructions - especially since there is a such a great degree of inconsistency amongst them (look at our two programs, for example - very different in the two weeks post-op). But I do struggle with what you're pointing out here - do I have the willpower to follow the program and is the lack of following the program a lack of discipline and willpower in general? Unless I'm over-rationalizing, I think my goal is to develop livable strategies for an overall lifestyle change. After all, the rigidity of the program goes away in relatively short order (I hit the final "lifetime" stage of my program in something like two months) and if all I've done along the way is do what I've been told then what happens when I'm no longer being told what to do? So far my basic guiding principles have been - soft foods, protein focused with minimal carbs, and hit the fluid and protein goals for the day. I've avoided things like oatmeal and cream of wheat, even though they are approved, because I could get protein in better ways and I didn't want to take in all the carbs. I've e-mailed my nutritionist this evening on this point to get her thoughts. I appreciate yours as well health journey! :-) Best, Mike
  12. Most insurance (United included) wants a statement from your physician regarding a 5 year weight history. They don't explicitly state that they want you to be at or above a 40 BMI, but they do consider the stablity of your weight and the duration of time that you have been above a qualifying weight. My suggestion would be to push your surgeon's office to submit a prequalification request sooner rather than later, so that you don't go through 6 months of appointments only to find out that you haven't been at a high enough weight long enough for your insurance to approve you.
  13. My surgeon offered a no-cost pre-operative weight loss program (they referred to it as POWL). It met multiple times per month, but my insurance only required one visit per month. (Actually, sidebar, by a quirk of my employer's flavor of United I wasn't required to do POWL at all, I just had to provide a 6 month pre-notification of the surgery. It was an odd quirk of what my employer opted for and didn't opt for when setting up our insurance.) Bottom line, I would check with your surgeon's office to see if they have resources available to you like some sort of group class. I'm doing extremely well so far. No pain, hitting protein and fluid goals and walking. Down to 255 from 290 when I started. Don't hesitate to reach out if you need additional support - this forum has a LOT of experience collectively as well as great advice and support.
  14. Hi all, Sleeved last Tuesday, so just crossed my one week anniversary. First day was a little rough in the hospital (fortunately I had morphine for that) and had a little bit of nausea, otherwise very few issues. Was discharged on Thursday and haven't had to take any pain medication, prescription or otherwise, since the day after surgery. I did the full liquids stage for a few days, and then started having trouble getting the protein shakes down...besides the strained soups, I needed something non-sweet. I tried 1/8 of a cup of ricotta (which I salted and peppered) and it went down and settled great. Later in the day I tried a wedge of Laughing Cow light swiss cheese, and that too went down great. Since then I've been experimenting with more and more food options to see what would go down and settle nicely (scrambled egg whites - when that went well the next day an egg white omelette, etc.) So far the only thing that didn't go down well was mashed potatoes (bummer since that was one of my favorite foods pre-op, but perhaps it's a good thing I'm not liking them...) I've been cautious to stick to foods that are approved for the next stage of the diet (which is supposed to start in a week) and not go any further, and I've yet to have a problem. Today I got in 73 grams of protein with just one protein shake (22 grams), the rest from actual food. I had a total of 875 calories, 80 grams of carbs (mostly from the protein shake, but also from a mashed banana) and 30 grams of fat in total. I'll talk to my nutritionist next week, but I just wanted to check in on experiences other folks had immediately post-op. I'm steadily losing weight, down 35 pounds in total and about 15 of that post-op. If I'm not in any pain, food is going down and settling well and I'm hitting both my fluid and protein goals while still losing weight then everything is going along better than planned, right? Thanks for your thoughts! Mike