I just had a lovely visit with my doc about this. And let me tell you, I love all of my numbers, except for one. My vitamin D is so low that as a health care professional, I was very concerned. Yes, I realize I live in the darkest city of the continental U.S., and yes this has been a very rough winter; I just wasn't expecting my level to be that low. Usually, I would tell you to check your magnesium, potassium, and sodium levels; after my doc appointment though, I have to admit that this very long and dark winter has taken it's toll on many of us. So don't discount vitamin D! Also, early on in my keto days, I made the mistake of not eating enough calories, even though I had the macros down perfect. That can make you feel as tired and sick as too low of electrolytes can. It's funny, how even knowing this, I still fell into the trap of not eating enough. I recommend getting a Complete Metabolic Panel with magnesium level, Vitamin D 25 Hydroxy level, and just to make sure your thyroid is okay, check your TSH. These would be normal tests that any doc would order when a patient complains of being physically tired. And for giggles, have a lipid panel done now to see where you stand on your cholesterol, so that later on down the road, you can check it again for progress. My doc and his PA had to pick up their jaws when they saw my awesome lipid panel. They couldn't believe I had such good numbers from a lchf diet/lifestyle.

Another suggestion, is to really evaluate your caloric needs. I have a wonderful history of weight loss, but had gained a few pounds from a back injury. So in my attempt to lose the weight from my injury, I cut my calories. But I recently had to increase my calories because I too stalled. It was a reality check. All of my education and experience has taught me that restricting calories too much, leads to weight loss stall, and yet I still fell into that trap. We are programmed to think that very low is good. It is not. Taking in too little, especially while on keto, can mimic symptoms of hypothyroidism. You will feel cold, lose hair, feel tired, etc. And I don't understand why we feel 1200 is a magical number to start off at. Again, we have been bombarded with unrealistic and unsafe expectations, and even health care professionals fall victim to it.

It sounds like your initial weight loss was from the extra "water" that you got rid of when you started keto. I'm sure you've read about this. So maybe upping your calories, is what your body wants in order for you to lose weight, and not just to 1500, but maybe 1600 with no exercise, and 1800 with exercise.

Think about it, research it, and let us know what you do to feel better and break your stall :-)

Can you meet with a physical therapist prior to your surgery? And remember you are having surgery on your leg, not on your arms, or back, or abdomen. I say this because so many patients experience unnecessary muscle loss all over their body after surgery for one preventable reason: they are afraid to move ANY body part!

Educate yourself before your surgery by talking to a physical therapist and planning for your rehabilitation now before it becomes an issue. Get acquainted with some of the exercises you can expect to do, and what realistic outcomes are. You will be surprised! In the Surgical ICU where I work, early mobilization is a vital component to recovery, and a factor that prevents readmission. I just wish that more surgeons and insurance companies required visits with physical therapists prior to elective procedures.

Don't punt, and best of luck :-)