2 months until gastric sleeve - advice please

[Ckannte]

Hi all
Has anyone had a gastric sleeve on the NHS?
I'm on the list and have so far met with anaesthetist, surgeon and had bloods and stuff
With the psychology and dietician and workshops what gets covered in these?
Do they explain what to expect after surgery?
What to do with the different food phases?
Just want to be prepared as to what happens with them.
I am absolutely terrified of the surgery but I feel it's my last hope.

Why on Earth are the NHS still recommending and carrying out unnecessary surgery like gastric sleeves when weight loss drugs are both available and much cheaper?

Have you researched weight loss medications? Have you tried them?

Of course I have tried them! And they made me violently ill.

Ah ok. Sorry. That’s such a shame. Which did you try?

My advice is don't do it

I've tried mounjaro which made me ill. Then moved onto wegovy and that did absolutely nothing for me. Made my way up to the top doses.
Why would you say don't do it?

I had a gastric sleeve and don’t regret it for a second. I didn’t do it on the NHS. Cut down on caffeine beforehand as you can’t have it at first and the withdrawal from that meant I had a lot of headaches. The first few weeks are tough with the food, but it’s just a few weeks and doable. Be aware that you cannot eat and drink at the same time, but you soon get into a routine. I have lost 8 stone and eat fairly normal sized meals now, but I cannot overeat. I’ve gone off red mean mainly and prefer fish to anything else.

I had a gastric sleeve 3 years ago and it was life changing.
immediately after the operation I had to stick to 2 weeks liquids, followed by 2 weeks on purées (probably the worst stage) then 2 weeks on soft foods. After that the amount I could eat slowly increased. Now I can eat most of a main course and if there is a gap a small dessert as well.
I lost 8 stone in a year. I’ve put on about half a stone since ( which is normal) and am fairly stable now.
Loosing weight helped with lots of medical issues and I feel much healthier now.
i’m still still technically obese but a size 16 instead of size 26/28.
covid was still around when I had my op so the psychological assessment was done over the phone. I think they are just making sure that you don’t have an addictive personality - some people transfer their food addiction to alcohol after the op.
the dieticians were helpful preparing me what to expect afterwards and also explaining the liver reducing diet view the op.
Good luck!

Thank you! That's really helpful to know and glad to hear it was a positive experience xx

Thank you!!! I don't really drink caffeine so that's one less thing to think about lol

I had this 2.5 years ago, after not succeeding with the injections, they did work for me but I had an aversion to actually injecting and just avoided them so they became pointless. The tablet form make me violently ill

So, next step surgery. Private. GP referred me for this on the NHS and told me to save my money. No thanks, I knew I wouldnt even see that surgery until some years later. In the meantime its changed my life, extended my life and I dont regret it for a second. I took a loan out and have since paid it back

You need to be aware of the following

• Do the LRD prior to the surgery. In reality my advice would be to cut right down on calorie intake right now. I booked my surgery in for about 5 months after the consultation because I was having another surgery for something else, needed recovery time from that and then it was xmas, blah blah blah. So booked a long way off. In that time I prepped like a military operation, started taking supplements, low carb, collagen and very low calorie, around 1k to 1200 per day. I got a lot of weight off and this put me in good stead for the op, surgeon was very pleased
• Make sure you understand and research the food stages and prepare for this. First 2 weeks is liquid, thin liquids. You'll find there are things you can get down you and things you cant. There is no rhyme or reason to it, just go with what you can. You'll have blood thinning injections to take, you might need pain killers straight after the op (I didnt), tons of wind, feeling of stuckness in your throat/upper stomach, I still get this from time to time but it lasted for months at a high level and other people also find this. Start your proper supplements, follow the regime carefully and dont deviate or believe people who say 'you dont need all that' - you do.
• Next stage is puree, your body will tell you if it cant cope with this. I couldnt eat yoghurt (still struggle) whereas other people in my group were packing that away, I couldnt do eggs for about 6 months so nice soft scrambled egg that I was looking forward to, I couldnt do it. Sometimes I managed hot drinks sometimes not, that seemed to turn off and on like a switch. Your calories will be very very low, around 400-600 a day. Make sure you are sticking to your supplements and trying to get in as much liquid as you can. You might need to go back to liquid some days, other days not.
• Next stage is mushy or soft foods. If you get stuck or feel uncomfortable you go back a stage, the vague timelines given for these stages depend on you, they're not cast in stone.
• Longer term, you need to take your supplements for life, you may need PPIs for life (this is surgeon dependent), stay away from carbs, eat very small mouthfulls at a time, chew until its virtualy liquid before swallowing, take time between mouthfuls. I can tell you from experience as time goes on and you're tempted to use full size cutlery and eat at the same pace as people around you, you'll pay for it, its not comfortable and puts you off your food in the end. Eat very small portions, its not comfortable if you try to push it, you'll pay later in the day!
• Make sure you have enough fibre, eat regularly, 6 very small meals a day. Focus on low carb. I dont eat bread, pasta, potatoes but I can manage rice. My bariatric nurses told me about making sure that you consider drinks as a snack, such as a latte or something milky, this is all you need sometimes. I also use pots of olives, or some nuts, or chunks of cheese or dates, or apricots, depending on what my other meals are for the day, I try to spread the protein out through the day so I wouldnt have chicken at lunch and dinner for example, or I wouldnt have a snack of nuts and then have nuts in a meal later. I dont double up so that I have a range of variety.
• DO NOT WEIGH YOURSELF FOR THE FIRST 4 WEEKS - you will ignore this piece of advice but this is vital. You'll get fixated, the weight will come off, you cant stop it, but it will be in fits and starts and wont make sense. Ignore the scales. Put them away.
• Once you become lighter, you'll be much more active, be aware of how much pressure this is putting on your joints! I have discovered that I have arthritis, medics have told me that even without knowing it, you move around much much more and so dont realise how much more active you are and your body isnt used to it!
• DONT BUY ANY NEW CLOTHES - you'l also ignore this piece of advice too, but you'll waste money, believe me I have lived this!!
• Around 12 weeks after surgery you will start losing your hair. It will come out in clumps all over the pillows, all in the plug hole, in handfuls when washing your hair. Do not panic. Around a year after surgery it will resolve itself slowly. Just be patient, get a cut which disguises, accept it and wait for it to fix itself. No amount of biotin and supplements stops or supports it, its a reaction to the surgery itself and the cut in calories.
• Invest in teaspoons this is what you'll be eating off
• We now go to bars/bistros rather than restaurants, this means I can have my liquid (tea, coffee, wine, whatever) without being pestered to order, then I can wait a while, then order our food. I can usually eat around half a starters worth of food. Thats it
• You dont mix liquids with food, its uncomfortable. So I drink, then eat. I cannot eat, then drink. I need a long gap after eating before I can next drink. You'll need to juggle this with your supplements because for example I have to have my vitamain tablet after something quite substantial, like my porridge in the morning. If I miss it, I cant take it easily the rest of the day because I only eat veg/salad and protein, its not substantial enough to prevent me feeling ill. They make me really sicky.
• Supplements all have their own rules, dont mix calcium with iron, dont take all your calcium at once, needs spreading through the day, cant take calcium or iron with the PPI, also needs a gap, so you have to plan these carefully. Its part of my routine now.
• Your hunger will come back, you will have normal hunger around a year after the op, the hormones start taking effect again. However for me, it has enabled me to learn why I get cravings. For me it is being cold and tired. So I have to think now 'am I hungry or not', if cold, put a jumper on/hot water bottle, if tired, have a coffee or know that you need an early night. When I am actually hungry a few mouthfuls is all I need, but humans will naturally eat faster and with bigger mouthfuls when hungry so you have to pay attention to what you are doing.
• My bariatric nurses told me that 1kg of weight = 1g of protein a day, dont listen to this narrative of 140g a day type of thing, its not necessary. Just focus on less carbs though.
• Remember that you cant take anti inflammatory medication afterwards. But then since losing weight Ive barely had the aches and pains I used to have.

All this sounds a total ball ache Im sure, but to totally misquote Kate Moss , nothing is as tasty as losing the weight, or as inconvenient as being morbidly obese. It is life changing.

Ive probably forgotten a load of stuff.

Also I had 6 weeks off work which makes me sound like a baby but it wasnt really 'recovery' as such, it was that I was knackered and I have a really full on fast paced busy, urgent job, I wouldnt have had the energy to manage it in those initial weeks.

Many people go back to work the first week and they're fine.

Also the above is what works for me, there are many people who say they can drink alcohol, eat bread and other carbs easily, they dont worry about mixing liquid and solids, they dont use their supplements, they dont need to take PPIs

Thats fine for them. The above is 'standard' advice and expectations and what I have found for me personally. I also think its fool hardy to try to replicate eating habits we had before surgery, those were the habits that made us morbidly obese. For me I was a volume eater and I love my own cooking, I still love my own cooking but now have miniscule amounts of it, it hasnt dampened my enthusiasm for food, Im a foodie, we still eat all over the world and try new things, I just eat small amounts of it.

I dont really drink now though, and thats a bit of a shame with a meal but there we are.

This is amazing guidance thank you so much.
Part of me still doesn't feel like it will actually happen and I think that's the denial for me of am I really going to do this.
My husband is scared for me and hesitant. I have fibro and rheumatoid arthritis and I said to him if they offered me an operation that meant I'd be cured of all joint pain wouldn't I be jumping at it? So we are trying to think of it like that in that whilst it's scary and risky it should help me in so many areas and reduce my risk of diabetes and all the other awful diseases.

I cant believe I did it. I cannot believe I took control and fixed me

Most of us overweight people for decades (in my case) have a saboteur in our brain, 'you'll never succeed, you'll always be a failure, you'll never lose weight, this isnt for you this is for other people, successful people who thrive and take care of themselves, this isnt you'

Thats why you're hesitant and feel it wont happen

It will happen, you'll succeed and your life will be changed.

I agree all of the above. It seems overwhelming but once you’re ’living it’ it becomes second nature. Also, yes, I did lose hair, but it grew back. And don’t bother buying mid-sized clothes, Vinted is your friend! I’m a size 8-10 now and 5’6. At my biggest, I 5ought I was a size 20, but I was more like a 22 really.

I had the surgery and was back at work the week after; however, I caught covid days into being back at work and was ill with it, so was off for another week. Don’t think you will lose a lot of weight immediately. I was losing a few pounds each week for the first couple of months. After that, it was a steady 1-3lbs every week. It took me a just under a year and a half to lose 6 and a half stone then another year to lose a stone and a half.