Gastric Sleeve - Weight gain

Question
I am 2 months post-op and after losing 30 lbs in the first 6 weeks, I have gained back 10 lbs. over the last 2 weeks.  I have suffered a tragedy during this same 2 week period, the loss of my grandfather.  I have also found out that I can handle carbonated drink without complication and have consumed a soda per day... lately.  Have I stretched my sleeve, or can I get back on track?  Please help!  
Thanks

Answer
Hi Roshaun:

I'm so sorry to hear about your grandfather.  First off, don't worry, you're weight loss is not over.  It's pretty normal for weight loss to slow down once people start on purees and then go on to solid foods.  Part of the reason is that during that time, your stomach is healing, inflammation is going down and you can actually eat more because your stomach is not so inflamed by the surgery.  

I've been hearing stories about carbonation stretching your pouch/sleeve/etc. for over 15 years now, but you know what?  I've never seen one study in a peer-reviewed journal that showed that carbonation could have any permanent effect on stomach/pouch size.  None.  The stomach is a pretty strong/flexible thing.  The portion of your stomach that remains following a sleeve gastrectomy is even stronger.  Liquids, including carbonated ones, pass through the stomach relatively quickly.  I just can't see that affecting one's sleeve on a permanent basis.  Your sleeve will get larger over time, but it will never stretch to the size of a "normal" stomach.  You can make it larger through constantly overeating, that's true.  But did you permanently damage or stretch it over the past two weeks?? Highly unlikely.  Some people find that going back on liquids for 5 days to one week makes their sleeve or pouch feel tighter.  If you feel able to do that, give it a try.

You still have months of great weight loss ahead of you.  I'm sure your surgeon provided you with a nutrition guide to follow.  In general, if you stick to *real* food--protein first, following by non-starchy veggies, fruits, and then carbs.  You'll do fine. Plan five to six small meals per day.  Set the times and when you first feel full (which can be a learning process with a sleeve), you're done eating until your next time. Try and go back to water as your drink.  Save soda, even diet, for special occasions.  With the holidays coming up, yes, you can eat your favorites, but you need to stop when you're full...and not keep going back as soon as you feel you have space.  If you eat healthfully throughout the day and then have one Thanksgiving, Christmas, Eid, etc. meal which you eat within your sleeve's limits... you'll be fine. You're still at risk for dehydration, so you really do need to consume adequate fluids.  Track your protein.  If you're not getting at least 60 grams per day, consider adding a protein shake.  Make sure you're taking your supplements--Vitamin B12 (sublingual--under the tongue), Calcium (preferably Calcium Citrate due to your reduced stomach size and acid), Vitamin D, Iron, and a multi.  If you haven't started exercising, start.  It's going to be easier now that you're down 20 pounds then it was pre-surgery.  Walking is easy.  If it's too cold where you are, try some of Leslie Sansone's walking DVDs or check out "ShapelyGirl" (debramazda.com)  If you don't like those, try something else until you find movement that you like.  

Be gentle with yourself.  You just lost a beloved family member.  Your sleeve is still fine.  You can still reach your goals.  Don't worry!

Karla

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