Six-week Post-Op Appointment

Firstly, I adore my surgeon. He is really great - before and after surgery. He will spend crazy amounts of time taking all my questions and listening to my musings and concerns. What a guy! I have read about terrible surgeons - one post in particular even really shook me up this week. I am really grateful for my surgeon.

Tomorrow, I am six weeks post-op. He is very pleased with my weight loss. Officially, in his office, I have lost 26.5 pounds - our numbers vary a bit because of my naked state on my own scale, his registering of a lower "high" weight than I do (because he does not know the true extent of how much weight I gained when I quit smoking in October), etc. But we agree, categorically, that I have lost a lot of weight. By his scale, I have lost 22.5 pounds since the morning of the surgery. We'll use his scale, just for this post, just to be nice. :)

His number is only relevant here because it has been a month since I've seen him, and per his scale, I have lost 14 pounds in that month. This, he says, is spot on. He expects 5-15 pounds per month the first six to nine months. This made me feel good. Well, it also made me feel bad. He said, based on past history with the sleeve, I will lose about 85 pounds, or a third of my body weight (gulp) from the surgery. The rest, he says, is completely on me. Want to lose more? Work more.

He is impressed with my near-daily half hour walk at lunchtime. He is less impressed with my seeming inability to get the kids to the YMCA in the evening. He also remarked that I really have no business knowing that ice cream gives me diarrhea. Errr. Well, he said it nicely and with warm concern, anyway.

Now, others reading this explanation from my surgeon may say, "Well, duh, Julie." But every time my doctor has explained it to me, it turns a light bulb on in my head, so I will share it here. The reason you lose more weight immediately following surgery is because you are able to create a massive calorie deficit. As an obese person, your body burns more energy just to exist. You just had surgery and cannot eat a damn thing, thus, no calories coming in. As you lose weight, your body gets smaller and needs less energy to survive. Conversely, you are able to take in more calories than you did immediately following surgery. The once massive calorie deficit shrinks and shrinks as time goes by, thus slowing down weight loss.

Cheating the system:
1. Continue taking in fewer calories, even as time progresses.
2. Burn more calories as your body shrinks.

See? Duh. But I still like to hear it. For some reason, it just makes me feel more empowered with this whole process.

He also said that as you lose weight, the levels of female hormones (e.g. progesterone) increase. Women lose weight and skin softens, facial hair goes away, etc. This is interesting - I don't have facial hair, but yes, I have seen many morbidly obese women with facial hair. He said in my case, it could also make my cycle go bonkers, even if I don't normally have periods since I have a Mirena IUD. But he wants me to check with my GYN, because he doesn't like three periods in six weeks (ME NEITHER!) nor the bloaty feeling I have now. He thinks it will settle down. It betta. He also thinks Cheetos will cause water retention. Hrm.

No more soft foods, he said. Sigh. Soft foods make my tummy happy. He said I am to get off the soups, the chilis, etc. Basically, anything that my tummy likes, I should cut out of my diet immediately. The key to maximizing weight loss, he said, is making my stomach work for it. Dense protein forces small, slow bites, and fills my tummy up. This keeps you from eating too much. Chili, while sleeve-friendly, is not my friend. He likes my breakfast of one turkey sausage link. He likes my dinner of one meatball. Sigh.

He is also impressed that I can eat veggies, including lettuce. I can't eat much, but what I have eaten has not seemed to bother me. Rice, too. He said things that do bother me: eggs, cheese, cottage cheese; and things that don't "bother" me terribly but are still uncomfortable, such as nuts, will get better with time.

Dense protein, some veggies, three meals a day and an occasional snack, if it's protein or veggie or occasional fruit. Yipes. Grains and such are good, too, but my main goal is to be making my stomach work on digesting food.

Oh, and he released me to drinking before meals. I have been adhering to the "no liquid half-hour before or after eating." He said I can drink before a meal, but not for a half an hour after eating.

That was pretty much the transcript of the appointment. Body has healed nicely. I am still allowed to be tired. Come back in three months. In the next week or two, the hematologist will re-check my iron and Vitamin D levels. On 3/21, I go back to the sleep doctor for a CPAP check. Along those lines, I am going to start using the damn CPAP tonight. I haven't used it since a couple nights after surgery. Hateful thing. But this will give him a month of data to look at, hopefully to prove I don't need it anymore.