Realistic Goals and Personal Responsibility

[southernlady]

Southern Lady, I have long thought that I was the only DSer with reactive hypoglycemia. I have also learned that a combo of carbs and protein are best, I wore a 24-hr glucose monitors and it showed my lowest lows were at 2 am. I take one half of a peanut butter and jelly on whole whet to bed and usually et 2-3 bites at 2 am, but don't usually finish it. I eat every 2-3 hours doing the day, heavy protein, but always with some carbs. The best advice I got was to always mix protein with a little carbs and never eat carbs without protein,. Like you, I find fat with carbs are best. It has worked. I am at ideal, and maybe a bit below, ideal weight, This discussion reveals how individual we all are. I had diabetes pre-op and have a very strong family history of diabetes, and I believe my DS is not like none else's. there is no one size fits all in any area of medicine, and DS is no different.

No, you aren't the only one. I KNEW I had RH long before my DS. Tested for it with a GTT in 1990, and wasn't diagnosed diabetic til Dec 15th, 1997. But that and NSAIDS were the two KEY factors in deciding for my DS. I could have easily had the RNY but something told me making a pouch out of your stomach was just wrong. And when I started reading all the clinical info about RNY making RH worse, I knew it wasn't for me.

 

[robs477]

Scott, I agree 100%. You SHOULD have a few complex carbs with every protein you ingest. That is what any professional trainer has always told me and I trained with the best of the best, Lee Labrada. So this has been well known even back in the 80’s - 90’s and before.

@newwomanin2015 ……… OK, lets try to figure this out. I really FEEL for you and there are a LOT of BRILLIANT people here, so…lets nail this!

First of all, you sound a LOT like me, pre-DS, so, I know. I could NOT eat carbs hardly at all and was on a forever low carb diet at under 800 calories a day for 30+ yrs. IF I went over that, I would literally gain a pound or two per day. My metabolism was FUBAR’ed more than anyone else I’ve ever known.

I had my DS last Feb 10, 7 months, 3 days ago. You can go back over countless posts that I have written describing the instant metabolic change that happened and that I could feel the very next day after my surgery. My metabolism somehow, someway was “re-booted” and reset and it had NOTHING to do with WL, this happened immediately so it was 100% Bio-chemical related, some way, somehow. As BRILLIANT as everyone is here, there is not ANYONE, including our esteemed Diana or ANY DR or Scientist that can explain exactly what that mechanism is, which IMHO is the exact same or similar Bio-chemical related mechanism that puts diabetes in remission. My personal opinion is, is that there are a host of hormonal and other Neuro/Bio-chemicals that become “re-enabled” again to allow better cellular absorption, i.e., the opposite of what diabetes is which is insulin resistivity, (non cellular absorption) of all those Bio-chemicals. In essence, my cells were absorbing, reacting and COMMUNICATING with each other again in harmony, this I can tell you 100000% for sure.

So…back to you. That similar metabolic change may have not happened with you and that must really suck, BUT, there are many here that were/are in a similar situation and have still fared well with the DS. @Munchkin is one of them, she was/is a “Super Absorber” (highly trained and adapted efficient absorber of nutrients due to our being in the perennial starvation mode for years).

I have had stalls also, I could feel EVERY single GD one of them. My body slows down on peeing, urine turns yellow, you hold water, ALL so that your body can do this “Conversion” where it actually is turning on to be in the fat burning mode and not fat storing mode.

Yes, IT CAN BE VERY DISCOURAGING, BUT, your DS can NOT fail you, it just can’t, its pure math and science, you have a shortened pipe, period. When I had my first stall at 26 days, 3+ weeks, it lasted for almost 3 weeks. I have them regularly and can see/feel it and ALWAYS lose 3-4 lbs right after I come out of it and it happens 1-3 times per month.

@hilary1617 and @SHales SAVED ME, and told me that I was probably NOT EATING ENOUGH, both Carbs and protein. They BOTH recommended having a high carb day once a week or so and actually to start eating MORE CARBS….(SEE ORIGINAL POST BELOW)…EVERY single time I did, I would bust through my stall..so, IT FLIPPIN WORKED!!!! BUT was THE hardest thing for me to do the first time or two because you feel like your actually sabotaging your WL and you have conditioned yourself for SO many years to NOT eat carbs.

http://bariatricfacts.org/threads/how-does-one-fail-break-their-surgery.2709/

Anyway, sorry for the book, but, I just wanted to help and could really relate. Here are a couple other really relevant posts regarding the same subject I posted

http://bariatricfacts.org/threads/end-of-my-5th-week-update-some-crazy-stuff.2672/

Also here is Diana’s original post regarding the science behind “The Inevitable Stall”
Search The Inevitable Stall
By Diana C. (our own @DianaCox )

http://bariatricfacts.org/threads/the-three-week-stall.743/

 

[southernlady]

@robs477 Part of @newwomanin2015's issue is she is a type 1 diabetic. That can NOT be fixed with the DS. The part that can be is to properly use the insulin she has to add to her body ALL the damned time to stay alive.

 

[robs477]

@robs477 Part of @newwomanin2015's issue is she is a type 1 diabetic. That can NOT be fixed with the DS. The part that can be is to properly use the insulin she has to add to her body ALL the damned time to stay alive.

Thxs Liz, yes, I definitely missed that part, so my advice is way more limited, no doubt.I guess my whole point is though to try something different, it throws your body off balance and inhibits its your bodies Bio-memory patterns from getting "stuck" in one mode. With the diabetes, that pretty much minimizes the carb loading idea though.

 

[southernlady]

Thxs Liz, yes, I definitely missed that part, so my advice is way more limited, no doubt.I guess my whole point is though to try something different, it throws your body off balance and inhibits its your bodies Bio-memory patterns from getting "stuck" in one mode. With the diabetes, that pretty much minimizes the carb loading idea though.

While adding SOME carbs can be done, it has to be done exceedingly carefully as to not throw her into a high followed by an extreme low. The types of carbs is very critical.

 

[newwomanin2015]

Thanks for digging this up. This is a great post.

I wish people in the first few years from surgery would better understand there are no guarantees. I read a post somewhere else from someone who is less than 6 months out who said he had the DS so he could eat whatever he wanted. That is so not true - well, not if you want to maintain your loss. The DS helps give us a normal metabolism, but even people with a normal metabolism don't have a free ticket to eat whatever they want. The honeymoon phase ends and regain is quite real.

But I also think people can look at redefining "normal". "Normal" bodies come in different shapes and sizes. Look at people who were never obese. Not everyone is a size 4. There are size 8's, 12's, and 16's, etc out there - but all normal by any standard. The DS does the same for us. It's common that we'll see someone a year or two out, as the rapid weight loss phase is ending, and they'll be lamenting the extra 20, 30, 40 pounds they still have to lose. That's quite normal for most people, and we need to remember that 75-80% EWL is the average. Most people will lose in that range, and for everyone who makes it to a normal BMI there is someone who doesn't even achieve that 75-80% loss.

But even though most people will not lose 100% excess weight, I dont think I have ever seen anyone remain morbidly obese. I encourage people who judge and measure by the scale and BMI to redefine what they consider success. Before my DS, I wrote down all the reasons I wanted it. The reasons were things like normal blood pressure, fitting into airline and theater seats, shopping in the Misses section, and being able to walk up flights of stairs without turning red and panting. I reached ALL those goals by the time I lost to at least 60-70 pounds OVER what I am right now. Everything else was just the icing on the cake. Or the butter on the veggies...to make it more DS appropriate

I agree with redefining the new normal. For me , would be very happy to be within 200 or so pounds. However, do fear being one of those unlucky ones who stops losing after 6 months. As someone with a BMI over 50, I unfortunately need to lose more than most to achieve a longer healthier life. I really want to be here for our daughter's big moments and to feel more energetic as well as fitting in theater and plane seats, etc. I don't putting in the work to get there, either. Just worry that body won't respond as it should.

 

[newwomanin2015]

Thanks...that's a really good post.

I have a personal goal...but to me, it's more pie in the sky kind of a dream goal which I don't consider to be realistic.
I know with my metabolic challenges I may never reach that goal...so I'm just along for the ride and what will be what will be. I know that whatever that is I will have done my best to maximize my chances (with the exception of exercise which maybe one day I'll be able to do some sort of exercise, who knows) and I'll accept wherever I end up.

I track everything I eat, and think for being 7 weeks out from my conversion to DS with partial re-sleeve that I'm doing pretty good nutrition wise...except for getting enough fats. I average 80-100g of protein, and under 30g of total carbs per day. But I'm only averaging maybe 50-60g of fats. I'm working on upping that. I don't worry about calories but mfp tracks that so I've been averaging about 850 calories per day.

Since the day of surgery I've lost 17 lbs which I think is pretty darn good for being such a lightweight to start. 195 day of surgery and 178 today.

Have just started tracking my nutrients, thanks to all for recommending the myfitnesspal app! Am having a little trouble getting enough protein without going over in fat. Am trying not to worry about it as it has just been 3 months and really do not like chicken as I used to before DS. These days, I seem to crave fat and look for the fattier parts of meat with steak, country style ribs, etc. Chicken tastes too dry to me now. Also, am not sure how accurate fat is as it is a measurement of raw bacon, etc.and does not account for the fat left behind in the pan. All days am averaging less than 30 grams of carbs, 72 to 117 grams of protein, and 121 to 155 grams of fat. The fat is high, but, haven't had any adverse effects from getting more than 120 grams, though, do worry that might be why weight loss has stalled. If so,I might have to force myself to eat chicken more to get the protein without the fat, ugghhhhh! Or, give up on the yummy crust less quiches that are wonderful for breakfast. Boo to that, too. Am not counting calories, but,most days am around 1750, which pleases the app, while it is very concerned over my fat intake!

 

[star0210]

Have just started tracking my nutrients, thanks to all for recommending the myfitnesspal app! Am having a little trouble getting enough protein without going over in fat. Am trying not to worry about it as it has just been 3 months and really do not like chicken as I used to before DS. These days, I seem to crave fat and look for the fattier parts of meat with steak, country style ribs, etc. Chicken tastes too dry to me now. Also, am not sure how accurate fat is as it is a measurement of raw bacon, etc.and does not account for the fat left behind in the pan. All days am averaging less than 30 grams of carbs, 72 to 117 grams of protein, and 121 to 155 grams of fat. The fat is high, but, haven't had any adverse effects from getting more than 120 grams, though, do worry that might be why weight loss has stalled. If so,I might have to force myself to eat chicken more to get the protein without the fat, ugghhhhh! Or, give up on the yummy crust less quiches that are wonderful for breakfast. Boo to that, too. Am not counting calories, but,most days am around 1750, which pleases the app, while it is very concerned over my fat intake!

Your numbers look way better than mine. When I wrote that post I was 7 weeks out. I'm now 9 months out from my revision. While the loss is very slow...my % of excess weight loss is great. I was 196 the day of surgery (typo on my previous post said 195 lol) and today I'm at 151. Since Beginning of May I've only lost about 10 lbs. But in all its 73% of my excess weight.
I aim for 100g protein, 100g fat, and I stay under 30g carbs.
I threw it all out the window when we went on vacation and lots of fruity alcoholic drinks. Got home and the scale was up about 8 lbs. went back to eating on plan and it came back off.
I'd like to get down to 135 which puts me JUST at a normal BMI....but pie in the sky dream goal would be 125. I'm only 5'2" on my tippy toes.
I have no idea if my body will let me make that goal of 135 but I'm just steadily plugging along.

 

[newwomanin2015]

@newwomanin2015
I do advocate Dr. Bernstein BUT I never followed his advice to a T. But then I also have documented Reactive Hypoglycemia mixed into my diabetes. I STILL have RH. But one thing some of us have found is to NOT cut carbs to the bone. I lost all my excess staying between 70-100 carbs (total) not below 30. I maintain staying between 100-150. Most of my carbs are dairy or veggie. (tried looking for the thread but carbs are a very common subject around here). I did discover that an all protein/fat second breakfast sends me into RH whereas adding a slice of heavily buttered toast to that keeps me fine for many hours. All it takes is that ONE slice of bread (and thanks to jaw surgeries, I don't eat the crust any longer) to keep my blood sugars up enough to last much longer.

I have never heard of reactive hypoglycemia, but, will have to look into it. I like the idea of shocking the body with changing how much you eat every once in a while so that it does not think you're starving...think this is referred to as cycling by some. Though, the idea of eating breads and other carbs of that type scares me a little because it took so long to finally have near normal blood sugars. Also, and it might be different after the DS, am not sure since I haven't tried it yet, but, it gave me peace from all of the cravings and hunger when I gave up all that stuff. For years, it seemed like I always was thinking about food and feeling hungry and after about two weeks of not having those foods, it just went away after a lifetime of obsessing over food constantly. It really felt like such a gift. Has anyone else experienced this? Did it change after surgery where having a slice of toast no longer caused the cravings?

 

[newwomanin2015]

Southern Lady, I have long thought that I was the only DSer with reactive hypoglycemia. I have also learned that a combo of carbs and protein are best, I wore a 24-hr glucose monitors and it showed my lowest lows were at 2 am. I take one half of a peanut butter and jelly on whole whet to bed and usually et 2-3 bites at 2 am, but don't usually finish it. I eat every 2-3 hours doing the day, heavy protein, but always with some carbs. The best advice I got was to always mix protein with a little carbs and never eat carbs without protein,. Like you, I find fat with carbs are best. It has worked. I am at ideal, and maybe a bit below, ideal weight, This discussion reveals how individual we all are. I had diabetes pre-op and have a very strong family history of diabetes, and I believe my DS is not like none else's. there is no one size fits all in any area of medicine, and DS is no different.

Definitely agree about the diabetes, no two are alike, though, doctors often seem to think that it is a one size fits all solution. It makes sense that the DS would be the same. Hopefully, I haven't broken this body's metabolism to where it won't lose at all. Still no loss and am hoping it will budge soon. It's been a little over a month and feel like it's wasting my honeymoon period.

 

[newwomanin2015]

No, you aren't the only one. I KNEW I had RH long before my DS. Tested for it with a GTT in 1990, and wasn't diagnosed diabetic til Dec 15th, 1997. But that and NSAIDS were the two KEY factors in deciding for my DS. I could have easily had the RNY but something told me making a pouch out of your stomach was just wrong. And when I started reading all the clinical info about RNY making RH worse, I knew it wasn't for me.

You know, my mom, who had the RNY, had low blood sugars for the first time after her surgery. She had not been diabetic before the surgery and her doctor put her on Metformin to help control the lows, which seemed odd to me at the time. He said it helped with keeping the sugars level.

 

[newwomanin2015]

You know, my mom, who had the RNY, had low blood sugars for the first time after her surgery. She had not been diabetic before the surgery and her doctor put her on Metformin to help control the lows, which seemed odd to me at the time. He said it helped with keeping the sugars level.

Now, I wonder if it was the same thing as what you have!

 

[southernlady]

Now, I wonder if it was the same thing as what you have!

I suspect it is.

RH is very common with RNY'ers. I think I have a thread around here somewhere with all the links I found during my research. (No, I didn't but I do now http://bariatricfacts.org/threads/reactive-hypoglycemia-and-wls.3411/) I DID notice that RH is commonly called late dumping by bariatric surgeons but reactive hypoglycemia by ENDO'S!!!!

 

[newwomanin2015]

I suspect it is.

RH is very common with RNY'ers. I think I have a thread around here somewhere with all the links I found during my research. (No, I didn't but I do now http://bariatricfacts.org/threads/reactive-hypoglycemia-and-wls.3411/) I DID notice that RH is commonly called late dumping by bariatric surgeons but reactive hypoglycemia by ENDO'S!!!!

Thanks for the great information! I'm going to pass this on to my mom!

 

[newwomanin2015]

Aside from reactive hypoglycemia which I'd a different animal.... I was told that our body/metabolism needs a certain amount of carbs to allow us to maximize protein absorption and fuel our furnace. It was a GI who actually started me on Creon who told me that. He said a lack of carbs can exacerbate protein malabsorption....

I still go back to our common sense moderation and think there has to be some merit to that thought process but I have no science to back it up.. Just my personal belief

I do eat carbs, but, am very particular as to which ones. Eating only those in eggs, cheese, and green vegetables really has helped with keeping blood sugars as close to normal as possible and also helps me not feel hungry all the time.Well, at least before the surgery it did, not sure how I would react to breads, fruits etc. now. Have heard that carbs can cause some intestinal issues after DS.