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So my low weight was 165 but I looked terrible. My goal was 185 which I maintained for about 4 years. I have been creeping up and down the last two years. Now I'm at 204 and I don't even know what to do. I am tracking my food intake and walking. 

I know part of it is Covid, staying home, working from home. 

I think I am having hypoglycemia a lot too. It pisses me off because I could go so long without eating for all these years without getting hypoglycemic. I did read that during perimenopause your blood sugar is more unsteady. 

I'm afraid that doing the pouch test or doing some thing very low carb is going to have my blood sugar going even lower. 

 

Where do I start? 

 

I am going to get my hormones checked next month and try to get on bioidenticals but I need to have more of a plan in terms of eating. 

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I'd be starting by getting a blood glucose monitor and checking if you are actually hypoglycemic or not. I do get severely hypoglycemic at times, but often get very similar symptoms,  and on testing my blood glucose find it is completely normal. The pouch reset diet is definitely not a good move if you are hypoglycemic. A hypoglycemia diagnosis will generally come with advice to eat 6 times a day with 2-3 hours between small meals that consist of both protien and complex carbohydrates. That certainly hasn't proven to be the way forward for me, but people experience hypoglycemia for many different reasons. If you are genuinely becoming hypoglycemic (I'm not doubting your symptoms by the way, I just would rather you had an actual diagnosis instead of a suspicion),  then you need to find out why it is happening before trying to treat it. It's pretty much always to do with insulin levels and effectiveness,  and too dangerous a symptom to leave undiagnosed and untreated.

Edited by Aussie Bear
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I think you are right. 

The problem with pouch reset is when we come home from surgery, we don't have to do much, are on pain killers. I didn't even want to eat anything for a few weeks. 

Now I work full time and I'm in  school full time. That doesn't give enough nutrition for a brain to be functional during that time. I also have a teen daughter and a dog and I live alone. 

Im not sure how to basically starve myself while living a normal life. The first few days I wouldn't have enough energy to walk my dog much less work and think and not feel completely sick. 

Maybe I should look at a revision. I don't know what the requirements are but I feel like my sleeve has stretched a lot. 

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6 hours ago, lightenupwoman said:

 

Maybe I should look at a revision. I don't know what the requirements are but I feel like my sleeve has stretched a lot. 

A revision is unlikely to yield a good result. Sleeve to bypass is pretty ineffective in the long run. Search Dr Matthew Weiner "revision" in YouTube as he has an excellent video regarding revisions. Claims that longterm results from sleeve to bypass is only around 15-25lbs, and just not worth it. 

 

I really do suggest you get yourself a blood glucose monitor and do a blood sugar diary for a few days. Find out if hypoglycemia is an issue first. Sleeves do stretch, but not as much as people think they do. Regain is expected with sleeves at 2-3 years, and with bypass between 3-5 years. I suspect the biggest issue though is we tend to become complacent with diet after a period of maintenance.  We tend to become comfortable with the new slimmer version of ourselves, and maybe even forgetful of what led us to surgery in the first place. We allow pre-surgery eating/drinking habits to slip back in over time, and these result in a slow but steady regain. I was actually watching a YouTube video yesterday (it came up in my recommendations)  of a woman that had VSG 4 years ago. She lost 100lb to get to goal by the 12 month mark, then very slowly started to regain over the following 3 years. She said it was just 14lbs the first year, 15 or so the next year and about the same in her 4th year. In all she'd regained about 50lbs over those three years. It was just a slow and insidious regain. Curious, I pulled out my calculator... that regain, going by calories in vs calories out, equated to about 150 calories per day excess. That is so easy to do. Once we have been at an obesity level where we've needed WLS, I don't believe we ever get a break from needing to keep a pretty close watch over our diets. While we do get that relatively long "honeymoon period" to help set up our required new healthier lifestyle, once that's over we're pretty much back where we started, but at a much lower weight thankfully. Unfortunately,  revisional WLS doesn't come with an extended honeymoon period, just a short 3-4 months while moving through the healing process with the restricted diet phases.

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Well I don't think I have the time/energy/money for a revision any way. I'm going to have to get back to basics, log my food and my exercise. 

I think I'll track blood sugar too. I'm working with a wellness coach so I hope having that accountability will help me. 

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Well this is odd. I was 204 last week with clothes on first thing in the morning. I have been walking at least a mile every other day. I started tracking my food last week and over the weekend I reviewed the VSG rules and decided to get back to low carb, low fat and only eating 4 oz at a meal. 

For some reason I am 196 this morning. It has to be water weight. My pants do feel looser. I took my waist and hip measurements and put them in my fitness pal too. I wish they went back more than a year on that, I haven't measured in over a year. I would like to know what my lowest measurements were. Oh well. 

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On 11/13/2020 at 4:19 PM, Aussie Bear said:

A revision is unlikely to yield a good result. Sleeve to bypass is pretty ineffective in the long run. Search Dr Matthew Weiner "revision" in YouTube as he has an excellent video regarding revisions. Claims that longterm results from sleeve to bypass is only around 15-25lbs, and just not worth it. 

 

I really do suggest you get yourself a blood glucose monitor and do a blood sugar diary for a few days. Find out if hypoglycemia is an issue first. Sleeves do stretch, but not as much as people think they do. Regain is expected with sleeves at 2-3 years, and with bypass between 3-5 years. I suspect the biggest issue though is we tend to become complacent with diet after a period of maintenance.  We tend to become comfortable with the new slimmer version of ourselves, and maybe even forgetful of what led us to surgery in the first place. We allow pre-surgery eating/drinking habits to slip back in over time, and these result in a slow but steady regain. I was actually watching a YouTube video yesterday (it came up in my recommendations)  of a woman that had VSG 4 years ago. She lost 100lb to get to goal by the 12 month mark, then very slowly started to regain over the following 3 years. She said it was just 14lbs the first year, 15 or so the next year and about the same in her 4th year. In all she'd regained about 50lbs over those three years. It was just a slow and insidious regain. Curious, I pulled out my calculator... that regain, going by calories in vs calories out, equated to about 150 calories per day excess. That is so easy to do. Once we have been at an obesity level where we've needed WLS, I don't believe we ever get a break from needing to keep a pretty close watch over our diets. While we do get that relatively long "honeymoon period" to help set up our required new healthier lifestyle, once that's over we're pretty much back where we started, but at a much lower weight thankfully. Unfortunately,  revisional WLS doesn't come with an extended honeymoon period, just a short 3-4 months while moving through the healing process with the restricted diet phases.

This is all very interesting !!  Thank you for the information.  150 calories a day really makes you think.  I am a daily weigher for the most part and that helps me stay in the zone I like.

So you are saying the revision surgeries  have a 4 month honeymoon and is the regain the same after revision to bypass being 3-5 years.

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On 11/16/2020 at 11:16 AM, lightenupwoman said:

Well this is odd. I was 204 last week with clothes on first thing in the morning. I have been walking at least a mile every other day. I started tracking my food last week and over the weekend I reviewed the VSG rules and decided to get back to low carb, low fat and only eating 4 oz at a meal. 

For some reason I am 196 this morning. It has to be water weight. My pants do feel looser. I took my waist and hip measurements and put them in my fitness pal too. I wish they went back more than a year on that, I haven't measured in over a year. I would like to know what my lowest measurements were. Oh well. 

That is great !!  Congrats.   How is it going this week ?

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6 hours ago, tracyringo said:

This is all very interesting !!  Thank you for the information.  150 calories a day really makes you think.  I am a daily weigher for the most part and that helps me stay in the zone I like.

So you are saying the revision surgeries  have a 4 month honeymoon and is the regain the same after revision to bypass being 3-5 years.

It really made me think to see the calories for that 50lb over 3 years was so low. It's pretty easy to overeat by 150 calories a day, and for those that don't regularly check in with their scales, it can and does add up eventually. 

The regain timing is for standard WLS...not to do with revisions. I've read many an article (as well as been told by a few bariatric surgeons)  that the real danger time for regain is 2-3 years for VSG and 3-5 years for bypass, and that the majority of patients will have at least a 10% regain. Of course there will be some that don't, while there'll be others that regain far more. I always though the takeaway from those stats was that if you managed to get yourself past these time periods, then you had a good enough control through lifestyle choices to hopefully maintain forever. I look at the moderators here, @Res Ipsa @cinwa  @Cheesehead and it would definitely seem that way. They don't ever seem to discus struggling with regain, or having to "reset" like other members not so far out from surgery seem to struggle with. If they do, I'd certainly like to hear about it.

...and yes, revisions are well known to surgeons to have far shorter adjustment "honeymoon periods". That doesn't mean those who have revisions will stop losing weight, it just means the surgery alone won't be doing most of the work like it can for the first year or so after a first WLS. As we all know, weightloss isn't easy...ever. It is less of a struggle straight after surgery for many reasons, but many of those reasons (especially the hormonal stuff) don't apply after revisional surgeries. 

Edited by Aussie Bear
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I don’t struggle with regain.  But I think much of that is because I struggle to eat.  Nothing sounds or tastes good.  The thought of doing a reset is a no go.  I’m afraid it would awaken the hunger demon..

my food today was a protein bar and banana for breakfast.  Lunch half an egg and slice of low carb bread (egg sounded good but still make me gag) and 1 cup of homemade chicken chili for supper (hubby is away for work and I’m trying to finish it; otherwise with him gone I’d have had a protein shake or bar.  I used to love to cook).   
im bypass but I find if I eat something high in carbs my blood sugar drops drastically, so I stay away from the carbs..a good indication of low blood sugar for me is I start sweating (I don’t sweat normally)

I do weigh every morning; first thing with my birthday suit on so I can’t use the excuse my clothes weigh more today.  

Go back to basics.  In a revision they are going to tell you protein first, no drinking with meals, weigh your food..

I aim for 10,000 steps a day.  I walk a lot at work and if I don’t get them in at work, when I get home, I jump out of the car and walk til I have them in; before I can get in the house and get comfy..

I can easily drop 2 pounds a day if I don’t watch it.  So keep up what you’re doing!  

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Quote:  "im bypass but I find if I eat something high in carbs my blood sugar drops drastically, so I stay away from the carbs..a good indication of low blood sugar for me is I start sweating (I don’t sweat normally)"

 

I did not realize this was a side effect of eating carbs.  I had a few potato and carrot bites in some beef stew last week, then went for my normal evening walk.  It was cool enough that I would normally be freezing, but was sweating and became very dizzy/disoriented.  Had to have my wife come pick me up.  Very odd feeling and not one I get very often.  Maybe it was the carbs?  I am usually nearly carb free....

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37 minutes ago, Second_Chance_Graham said:

Quote:  "im bypass but I find if I eat something high in carbs my blood sugar drops drastically, so I stay away from the carbs..a good indication of low blood sugar for me is I start sweating (I don’t sweat normally)"

 

I did not realize this was a side effect of eating carbs.  I had a few potato and carrot bites in some beef stew last week, then went for my normal evening walk.  It was cool enough that I would normally be freezing, but was sweating and became very dizzy/disoriented.  Had to have my wife come pick me up.  Very odd feeling and not one I get very often.  Maybe it was the carbs?  I am usually nearly carb free....

Graham - do a forum search on "hypoglycemia".  It'll bring up some good reading.  Been there myself and it's pretty scary when it happens.

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I don't struggle with regain because I know how wonderful it is to be at my personal goal weight and no food (not even chocolate :o) is worth regain.  I still enjoy food - but I limit unhealthy foods and lead an active lifestyle.  For me, I lived most of my life as an overweight person and my gastric bypass gave me a second chance at being at a normal weight and living much longer.  Failure is not an option.  

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9 hours ago, Second_Chance_Graham said:

Quote:  "im bypass but I find if I eat something high in carbs my blood sugar drops drastically, so I stay away from the carbs..a good indication of low blood sugar for me is I start sweating (I don’t sweat normally)"

 

I did not realize this was a side effect of eating carbs.  I had a few potato and carrot bites in some beef stew last week, then went for my normal evening walk.  It was cool enough that I would normally be freezing, but was sweating and became very dizzy/disoriented.  Had to have my wife come pick me up.  Very odd feeling and not one I get very often.  Maybe it was the carbs?  I am usually nearly carb free....

This can definitely be a side effect of carbohydrates,  especially the higher GI simple carbs (think white here...eg sugar, flour, white bread, rice, potatoes, pasta etc). I have a very severe form of reactive hypoglycemia since my bypass,  and WILL have a hypoglycemic episode within 2-3 hours after consuming a glycemic load above about 10. No amount of protien and/or fat consumed with the carbs will stop it,  although that is definitely the suggestion for those that aren't quite as affected by carbs as I am. I've never been diabetic, but have been trialled on many diabetic medications since my bypass in an attempt to keep my blood sugar levels more stable. Generally for me the first sign that my blood sugar is dropping is having a blurring of my central vision (higher blood sugar actually causes a fluid change in the lens of the eye), second is a feeling that my body is heating up, by the time I start to actually sweat my blood sugar is already below 1.9 (<33 in US measurement). If you are concerned, get yourself a blood glucose meter.  They are pretty cheap these says, and just measure your blood sugars both before, and again about 1 hour after eating a carb heavy meal. This will give you a pretty good idea how much sugar is actually entering your blood stream. Measure again about an hour after a raised blood glucose reading to see what your insulin response is like. If your blood sugar has dropped too low, it's a pretty good indication that your pancreas is pumping out far too much insulin in response to the carbohydrate you've consumed. Knowing your response to various carbohydrates helps immensely in determining your tolerance and keeping yourself safe from the potentially life threatening consequences of hypoglycemia. 

Edited by Aussie Bear
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