Rob_VSG

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    62
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About Rob_VSG

  • Rank
    Advanced Member
  • Birthday 11/11/1960

Profile Information

  • Gender
    Male
  • Location
    Dallas, TX
  • Age
    57

Information

  • Surgeon
    Dr. McCarty
  • Hospital
    Pine Creek Medical Center
  • Height (ft-in)
    5-10
  • Start Weight
    332
  • Current Weight
    190
  • Goal Weight
    230
  • Body Mass Index (BMI)
    27.5
  • Surgery Date
    3/8/2018
  • Surgery Type
    Vertical Sleeve

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  1. I am still trying to lose. The surgeon set that goal based on some math but I have my own expectations. My BMI is currently hovering near 27 (as tracked by my fancy digital scale) and I would like to get to a BMI of 25 or below which hasn't happened since about 2nd grade. I'm not sure what the rules are on these forums so I left my surgeon's goal number on my profile despite my personal goal being much different. I am very comfortable where I am now and fasting 16hrs and eating for 8 feels normal to me now and requires less thinking about food than trying to get in 3+ meals a day. Weight loss is slow but steady and I will see my surgeon February 20th for the 12 month follow up and see what he has to say. My gut feeling is I should break below a BMI of 25 somewhere around 170-180 or maybe sooner if I actually make the effort to build some muscle.
  2. I'd like to congratulate you on your long term success. It seems you are experiencing a feeling of control that is so important for permanent success too! Best of luck on your future plastics. Hopefully someone will chime in. Rob
  3. Good points. I barely lost some weight in November and December, however I consider that, just not gaining weight in that time period is a victory because the majority of the general population gains weight in the holiday period. Despite very slow weight loss, I made it through Halloween, my birthday, Thanksgiving, Christmas and New Years without gaining any weight.
  4. Pre-op my HbA1c was around 6.2 and I was told I was pre-diabetic. Three months post OP my HbA1c was 5.5 and considered in the "normal" reference range. My surgeon didn't check my HbA1c at my 6 month follow up. My 12 month follow up is coming up in February, I'll make sure he checks it then. Doctors here don't typically measure Insulin level either. I have home meters to monitor Glucose and Ketone levels. My fasting glucose seems to sit on the high end, typically 90-105 mg/dl (or 5-5.8 mmol/L) and my blood ketones usually range from 0.5-2 mmol/L. I would suspect that if you have good ketone levels (a better energy source than glucose) then fairly low glucose levels wouldn't be too much of a worry, but, without checking insulin at the same time it feels like we only have half of the picture. If you are concerned about hypoglycemia you might want to use a home meter if you are not are not currently doing so. My understanding is that a FBG above 50 mg/dl or 2.78 mmol/L is adequate to keep you out of a hypoglycemic state. Cheers!
  5. I am happy to share on this subject. Let me qualify first that I am just sharing my experiences and how it has been working for me and this may or may not be right for other individuals. Also, I'm an engineer and not a doctor. Since VSG, generally, does not cause nutrient malabsorption I wasn't too concerned about proper nutrition as my post-op recovery was pretty easy as far as the amounts of food I was able to consume was fairly substantial and I keep up with my vitamin supplements. I did focus on protein and drinking lots of water like the doctor told me. Aussie Bear is spot on! I too did much research, even before my surgery date, however in my case I didn't manage to come across the concerns about trying IF in the first 6 months post-op but have since found similar information that Aussie Bear discussed. I just saw a Dr. V video on youtube about why its best to focus on nutrition and getting your head straight during the honeymoon period post-op. In my case, my thought was trying IF while in the honeymoon period was a good idea because it would give me the confidence I would need to be able to implement it when my weight loss slows in the future. In my case, this worked out fine, but then I'm 58 years old, live alone and don't have many psychological challenges around food other than I really like to eat tasty food!. I even tried 3 24hr fasts in the first 6 months and when I went in for my 6 month surgery follow up, my nutritionist was aghast when I told her and she admonished me and warned that would slow my metabolism. After that the doctor measured my Resting Metabolic Rate and it was HIGHER than pre-op! Also my blood work looked great. After 8 months post-op, my weight loss did slow considerably so I slowly started extending my over night fast into the morning by skipping breakfast and found 12 hours eating and 12 hours fasting really easy to do. At 11 months post-op now my target is 8 hours eating and 16 hours fasting. Some days I hit that target some days I only get 12-14 hours fasting and others I can go as long as 18 hours fasted. This gives me plenty of flexibility to attend work lunches if needed. I should add, I too am following close to what would be considered "ketogenic diet" macros however I'm not super strict so I would call it keto-ish or keto-esque, and like Aussie Bear, approached my diet from the "low glycemic" point of view. So if I eat fruit, it is low on the glycemic index like organic wild blueberries or cherries. If I eat red meat it's usually grass fed beef, or poultry will be free range chicken, fish will be wild caught salmon and vegetables typically organically grown. Refined carbs or sugars are close to zero. Using Keto+IF has seriously reduced my head hunger and I feel very in control and satisfied. The reduced eating time window means less time planning and preparing healthy meals as well as less time thinking about food. My plan is to reach my goal of being a "normal" BMI then just fine tune my eating vs. fasting times to switch to maintenance. During this honeymoon period I have worked hard to find healthy alternatives to satisfy my every craving and over time my tastes and cravings have actually changed towards those healthy alternatives so I rarely feel like I am denying myself food that I want. Denial is rarely a long term strategy for success. I feel much better using IF and I don't believe the human body is well suited for long periods of eating and short periods of fasting. See Dr. Jason Fung's videos on Insulin and fasting, they are very informative. Being diagnosed years back as pre-type 2 diabetic, which means becoming insulin resistant, I am very focused on controlling insulin. Editing this post with an additional addendum: My weight loss post op has been done almost entirely on just diet and NO intense exercising. I can usually get in a 20 or 30 minute walk 3 or 4 times a week but other than that my lifestyle is rather sedentary. I am doing it that way because of my personality and I know if I force myself to exercise as part of losing weight that most likely at some point in the future I will likely lose interest in that activity so my full focus is on proper nutrition and eating strategy and turning that into my "new normal". Some folks on these forums are different though and have physical activities they truly enjoy and are able to enjoy even more after losing weight and that is really awesome. I still expect that at some point in the future I will find a physical activity I enjoy that keeps me motivated, but until then, I'm on track with my current approach.
  6. Hey, your date is coming up soon. I had lots of anticipation and a little bit of nervous. Everything still went way better than I anticipated, I suspect it will for you too! Most of us look back and try to remember why it was we were nervous. Best of luck and happy holidays, I'm confident you will be happy with your decision. Rob
  7. I would like to add some info to this thread. Prior to my VSG surgery I was researching keto diets, then when I looked at my surgeons post-op diet plan, it appeared it would cause ketosis and I asked him to confirm this and he said "yes" even know he didn't seem a proponent of the keto diet (but I'm stubborn). So as an experiment I purchased a blood glucose/ketone meter off of Amazon to track data after the surgery. Two days post-op my body was starting to make ketones (yep no carbs, just bone broth and water). My thought was if the post-op diet would put me into ketosis, I would see if I can keep that going from the very beginning. The worst part of starting a ketogenic diet is carb withdrawal (keto flu), and that would happen post-op so I decided I only want to experience that once. By day 5 or 6 post-op my body was making so many ketones it went off the ketone meter scale and just read "High", so that was scary, but wasn't a problem because my glucose was plenty low. During that keto flu phase, it seemed my body was making ketones but my organs (including my brain) had not started using them for fuel right away, as if they were waiting around for some carbs. After a couple weeks I felt as if I was becoming "Keto-adapted" which means I was able to use the ketones as a source of fuel for energy. At 4 weeks post-op I had mental clarity and function that exceeded what it was prior to the surgery (hint: ketone fuel crosses the blood/brain barrier more easily than glucose) and that motivated me to keep it up. Since I track blood ketones, I don't worry about being strict, if I sneak in a few carbs here and there I just check my ketone level the next day as long it is in range (for me like 0.8-2.8) I don't sweat it. Plus occasionally moving in and out of ketosis from time to time isn't really a problem as long as one doesn't go on a multi-day carbohydrate binge. The weight I'm dropping is substantial and my blood tests are good, so my surgeon doesn't ask me what I'm eating. My regular doctor has taken me off the blood pressure meds (my last prescription) and all of the auto-immune issues I had are about gone (yes ketones are anti-inflammatory). I am in month 9 post-op and am now trying a daily 8 hour eating window and 16 hour fasting window. Being keto-adapted seems to train the body to smoothly transition to metabolizing stored fat when fasting so no noticeable loss of energy when I fast. I tend to feel an increase in energy near the end of the fast at which point I'm eating food to calm down. My 2 cents worth. Rob
  8. This strategy works well for me too, I don't think of it as not eating, just delaying the activity. Also, I found this video from Dr. V the weight loss surgeon helped me rethink how I view hunger: Rob
  9. You will crave tomorrow what you eat today. Especially carbs! Keep up the good fight. Rob
  10. That's awesome! You can try it out, baby steps. I'm at the point where I worry less about getting enough food in and more worried about snacking myself into weight gain. Since I have become keto-adapted, it feels like my liver just switches to oxidizing fatty acids (from stored energy) when I fast, and it happens without any energy dip. I actually have excessive energy at the end of each fasting period. Again, that's just me, I know everyone is different and I'm just sharing my individual experience. My job is a desk job so I'm fairly sedentary.
  11. @Jen581791 Sticking to the 8/16 was a little challenging at first. I started out 12/12 and worked up to it, so my "feeding window" is usually 2PM to 10PM. In the morning I add some exogenous ketone salts to my coffee and my energy is fine well into the afternoon, I just have to push past some head hunger around noon then it subsides by 1pm. Usually I break my fast by making a smoothie around 2-4PM then start eating food after that. I have on a few occasions pushed the fast to 23 or 24 hours without feeling weak or tired but at that point I just had a strong urge to chew on something so I would give in to that need. I'm not super strict, so if my eating window increases a couple hours one day, that is still 14 hours fasting. I feel better when I give my digestive system some "time off" to do whatever it does when it isn't busy digesting food. I figure it is probably easier for me to try and build new eating habits while I'm still in the post surgery "honeymoon" period and the longer I can keep it up, the more normal it will feel and improve my chances when the honeymoon is over.
  12. Well, 15 months out and you are still making progress. You hang in there @tracyringo !! I'm a little over 8 months out and I already have snack urges. The tools I have been using.... I still maintain nutritional ketosis as my primary objective, not for everybody, but it's working for me. In addition to that I work very hard to maintain a 8/16 schedule where I can eat for up to 8 hours of the day, and the other 16 hours, I don't eat and that has been working well for me because I can still feel restriction from the sleeve so I'm limited on how much I can take in during an 8 hour period. Since I am resolute about maintaining ketosis, I don't keep any snacks or food around with refined carbohydrates (or sugars) so that means even if I decide to snack I will stay in Ketosis and that combined with limited eating time window really helps keep total calorie intake (which I'm not really keeping track of) down. I've had challenges with depression in the past, I totally know how that feels. Depression will tend to push me to food for comfort and it's hard habit to break. Since changing my diet, I am no longer using anti-depressants and my doctor has taken me off of my blood pressure medication so now I have zero prescriptions to fill. At this point I'm hoping my attitude change is permanent, but only time will tell, so it's one day at time for me. I hope your plastics go well! Keep on trucking! Rob Addendum: One thing I've noticed, if I eat from the time I wake up to the time I go to bed, I can eat MUCH more and feel less restriction. The 8/16 plan gives me 16hrs of fasting and increases the restriction I feel when I start eating again. There is probably a good medical explanation or maybe it's just in my head.
  13. On the caffeine question, I'd say if you mean coffee or tea, should be ok, but if you are drinking caffeinated drinks with artificial sweeteners I think that could potentially cause you to hold onto weight. A low carb/keto diet will require more than the usual amount of water also, and maybe some extra salt. I've stayed in Ketosis since my surgery in March and have been experimenting with time restricted feeding, intermittent fasting and find that helps me push past a plateau. Might not work for everyone but just thought I'd share. Restricting the number of hours during the day you consume food (feeding window) gives you a longer period of time where you are not consuming food at which point your Insulin will drop and that is the hormone that tells your body to story energy (fat). Basically, the longer period of time your insulin is low, the more fat your body will burn. The other way to help keep insulin low is to stick to lower glycemic foods as they tend to spike your insulin less when consumed. My weight loss at the beginning was steep and linear, now it has slowed and is more of a stair step where I will stick at a weight for longer than a week, then at some point 2 pounds will come off.
  14. That's awesome. It seems you are getting a handle on the situation. Good job! Rob
  15. I've been using a Kirkland brand B-12 sublingual that is 5000mcg in one small pill I dissolve under my tongue. Been happy with it. Any sublingual that is Methycobalamin form should work well. My blood work came back as B12 too high, but that doesn't worry me.