DLCoggin

Diabetes gone, sleep apnea gone, back and knee pain gone, cholesterol normal, hypertension gone, 130 lbs gone. Pretty much sums it up! Except...loving the new me!!

At twelve days out your pouch is still very much in the healing stage. Your stomach (and now your pouch) has stretch sensors in it which send a full signal to the brain. Following the surgery, those nerves are temporarily ineffective as the healing process takes place. It's not that the pouch isn't full (or even more than full). It's that the process of signaling the brain that you're full is not functioning. Very common and it will pass probably within two to three weeks. In the meantime, consider The Prime Directive - lifestyle changes. Are lifestyle changes based on what you "can" or "cannot" do? Or are they based on what you "choose" to do or "choose" not to do? If you accept the premise that lifestyle changes are based on "choice" as opposed to some kind of physical necessity, everything falls into place. Forget about testing your pouch to see what you can or can't do. Make the choice to stay focused on following the protocol your doctor gave you as closely to the letter as you possibly can. Make the choice to stay positive. Make the choice to stay patient. And make the choice to maintain a food log. Do those things and you're gonna love the new you!!

Knowing someone who has had complications as the result of the surgery brings the possibility too close to home and your concern is certainly understandable. But it is not a statistically viable basis for making your decision. With roughly 200,000 bariatric surgeries performed annually in the U.S. alone, if you personally knew 2,000 folks who suffered serious complications, that would be 1% of the surgery population. Minor complications (usually defined as not requiring hospitalization) for bariatric surgery is approximately 15%. Major complications are about 5% and dropping steadily as refinements in the surgical procedure are developed. On the flip side of the coin, the success rate of RnY specifically is approximately 85% at the five year post-op mark. All surgeries have risks and RnY is no exception. There are no guarantees. No absolutes. The risk factor associated with RnY is often compared to the risk associated with having your gall bladder removed. The decision is a very personal one. RnY has a history of research and clinical studies spanning more than 30 years. It is the single most studied bariatric surgery there is - by a very wide margin. The bottom line is that from a statistical standpoint, the odds of having a successful surgery are overwhelmingly in your favor. You're gonna love the new you!

Today, Oct 20th, marks my second anniversary of this surgery we call RnY. In a very real sense it feels like the second birthday of the new and improved me. I can't help but reflect back on all of the changes that the last two years have seen. And at the same time, thinking in terms of new goals and challenges for the coming year. The first year following my surgery was an exciting time indeed. I was laser focused on one thing - achieving my optimum weight. I decided even before my surgery that rather than set a specific goal weight, I would allow my body to tell me when it was where it wanted to be. Just over a year later, that message came at 155 lbs. My weight stabilized. I felt great. And in my one year follow-up visit with my surgeon, she recommended that I not lose any more. It was time to shift my thinking, and my actions, away from losing and toward maintaining the new, 130 lb lighter, me. I had reached my destination. When I looked back at that first year, it occurred to me that is was much like what walking a tightrope would be. Maintaining an average calorie intake of just under 1300 calories a day was something of a delicate balancing act. There were days when I was over my goal. And those days had to be followed by "corrections" - days when I was under my goal. It was all about balance. And in the back of my mind the nagging, and always present fear that one misstep could result in all being lost. The more rational, confident part of me did not think that would happen. Still, I knew the surgery could be defeated. What if... So in that same follow-up appointment, my surgeon recommended that I increase my calories to approximately 1800 a day. To be sure, the number had some appeal. But I was concerned that it might be too high. What if? So I opted for a gradual increase to a more conservative 1600 calorie goal. My decision was undoubtedly due in part to a concern that kept going through my mind. It seemed that everywhere I looked, I read that many (if not most) bariatric surgery patients gain 10-20 lbs somewhere between 12 to 18 months post-op. A weight gain that is often described as "bounce back". That was out of the question. I was determined to not let that happen. So my goal for this past year became ensuring that I held my weight at, or very close to, the 155 lb mark. As the days and weeks went by my confidence grew. I decided it was time to really get to know my new body. I was tired of the balancing act. I wanted to enjoy a nice dinner at a nice restaurant with my wife, our family or friends. Or Celebrate a holiday or birthday enjoying the food that is inevitably part of festivities. I needed to test my limits. And I needed to know whether or not I had what it takes to do those things and still control my weight. Thanks to the amazing power of my food log, I got my answer. And it was in pursuit of that Quest that I discovered something quite remarkable. First there was the occasional 1800 calorie day. Not surprisingly, the following morning weigh-in usually reflected a gain of a pound or so. So my calorie goal became 1400-1500 for the next day or two. And sure enough, my weight would drop back down. Not just once or twice, but a number of times over the weeks and months that followed. Then came the occasional 2000 calorie day. Not often, but every now and then. Weight went up. Calories were reduced for a day or two. Weight came back down. At some point along the way I had a revelation. Controlling your weight is not about walking a tightrope - it's about riding a teeter totter. Up...and down. Up...and down. Gently. Relaxed. No fear. One misstep is not catastrophic. Wow. Since hitting the 155 lb mark almost a year ago, my weight has never been more than 156, or less than 151. This morning, this second anniversary of the new me, 152.2. No bounce back. Wow. So my goal for the coming year? More of the same. I have read in many places, including this forum, that maintaining your weight becomes more difficult after the two year mark. But I will be facing that new challenge coming not from a place of fear, but of vigilance. My food log will guide me. And it will tell the story. So next year, same time, same place - the next chapter in this amazing, life-changing journey.

And thank you all for the kind words! You guys have a great weekend!!

First of all, you are having a challenge right now and you've reached out to the community for a helping hand. That's a great first step and if you haven't already, congratulate yourself on taking that first step. It says to me that you're still as committed as ever and just need an idea or two on how best to get back in the zone. Secondly, perhaps it's important to remind yourself that you are not the first to hit this particular bump in the road and you certainly won't be the last. The fact that you're struggling a little at the moment does not in any way diminish the amazing progress you've already accomplished (congratulations!) nor does it mean even better things are not well within your reach. Many have experienced the same challenge and gone on to realize all of their goals and more. It is not uncommon to hear folks say "I can eat this and this and this and have no problem." Back to The Prime Directive - lifestyle changes. Are lifestyle changes about what you "can" or "can't" do? Or are they about what you "choose" to do or "choose" not to do? If you accept the premise that they are about choice, then I would submit to you that the single most powerful tool (in the universe - lol) for helping us make better eating choices is - a food log. Food logs allow you to set a daily calorie goal. Every minute of every day you have instant access to exactly where you are at calorie wise relative to your goal. Why is that so important? Because it allows you to make informed eating "choices". Every meal. Every snack. Every drink. Every calorie. Every day. Or to put it another way, food logs make you accountable - to you. Food logs do amazing things for your confidence. I like thinking of my log as a compass - always pointing me in the direction that I want to go. Sometimes I get a little off course. That's just fine. I don't panic, I don't stress and I don't worry. Why? Because I always know that a minor course correction will get me right back on track. I gain a pound or two, make the correction, and my weight goes right back to where I want it to be. You don't have to do that very many times before your confidence goes right through the roof. You "know" you're in control. You "know" you can manage your weight instead of your weight managing you. And you prove it to yourself - again, and again, and again. The secret to food logs is what I like to call the "Law of Averages". Although you have a daily calorie goal, it is ridiculous to expect to hit that goal every single day for the rest of your life. And who would want to? Unrealistic, not sustainable, and absolutely not necessary. But change that daily calorie goal into a weekly calorie AVERAGE and it almost magically changes everything. Life is supposed to be fun! Life is full of special occasions and many of those occasions involve food. So you enjoy and savor one of those special occasions and you see that your calories go up for that day. No problem! You simply make a minor, 100 to 200 calorie adjustment for a day or two and you're right back on course, right back on track, with your AVERAGE. It's simple. It's painless. And it is so, so effective. Commit to logging your food for 90 days and you'll never go back. My Fitness Pal highly recommended but there are any number of options that do pretty much the same thing. Regardless of the one you choose, you're gonna love the new you!

The key to the success of any bariatric surgery is the all important Prime Directive - lifestyle changes. You have made the commitment to the lifestyle changes that work best for you. Good for you! You're gonna love the new you!!

Terry I was (and am again) drinking one glass of wine before dinner - more days than not. But just to be clear, I did not drink wine (or anything alcoholic) until one year post-op. I was diagnosed with the ulcer at about 13 months post-op. So, did the wine have anything to do with it? I really don't know. The doctors were aware that I was drinking wine and they didn't know either. Some doctors advise their patients not to have alcohol for a period of six months following the surgery. So one year would appear to be on the conservative side. The anastomosis (which is where the ulcer was) should have been completely healed after that period of time. I was slightly anemic and a stool test picked up a little blood. There was never any pain or any other symptoms, just the anemia. Following the endoscopy and the diagnosis, my surgeon increased my Prevacid from one capsule (30mg) to two a day. That was it. No other treatment. A second endoscopy about three to four months later showed that the ulcer was completely healed. I went back to my glass of wine and blood work was spot on at my 18 month check-up. Sunday will be my two year anniversary and I have an appointment with my surgeon on Tuesday. Lab work is already done so I'll know the results on Tuesday. Ulcers are one of the more common complications following bypass and are usually the result of bacterial infection (H. pylori) as opposed to food (or drink) related causes. But that doesn't mean that alcohol is not an irritant and was not/could not be a contributing factor. It appears to be a difficult question to answer except in extreme cases such as alcoholism or family history of ulcers.

"Your body has a different schedule than your brain." Very well put Music - as always!

This is hands down the BEST explanation I have ever seen for the "30/30" rule - no drinking 30 minutes before or after eating. There are very good reasons for that rule and this short video explains it all!!

I am not a vegetarian or vegan but I have friends and family that are and I have great respect for the motivation and commitment of those who make that choice. That said, I believe that it is important to recognize the value of whey Protein (including whey isolate) for those whose goal it is to get the most protein possible with the fewest possible calories. Whey isolate is the result of a high tech nano filtering process which removes virtually all of the lactose and fat from the whey. The resulting product is about 95% pure protein. The tradeoff for the increased purity of the protein (and reduction of calories) is the loss of the immune system boost provided by those healthy fats that are filtered out. That does not mean that whey isolate is unhealthy. It is simply a product produced to provide a very specific benefit - very high protein content while limiting calories. For those who are lactose intolerant, whey isolate is often an excellent choice since it is usually well tolerated. Whey isolate is also highly digestible. All the protein in the world is useless if your body cannot metabolize it. Whey, milk, soy and egg Proteins all have the highest digestibility score possible - 1.00 (based on the PDCAAS scoring system adopted by the Institute of Medicine, World Health Organization and the Federal food and Drug Administration). Protein is a nutrient. Protein, along with fat and carbs, are the three "macronutrients" required by the body in relatively large amounts. So whey isolate is certainly nutritious - but targeted. Garden of Life certainly seems to be an excellent product which is about 75% protein (17g of protein and 90 calories per serving) and appears to be a good choice for those seeking a vegan or vegetarian alternative. But there are other healthy and nutritious options for RNY patients who have not made the vegan or vegetarian choice.

Crazy? No. Obsessing? Perhaps a little. Your journey can be an emotional roller coaster ride. Full of self-doubt, frustration, second guessing, fear, even depression. But it does not have to be that way. There is no schedule for stalls. No "too early" or "too late" or "too many" or "too few" or "too long" or "too short" or, or, or... You've probably heard it already and you'll hear it again - everyone is different. There are simply too many variables. So you need a plan. I'm sure others will weigh in with what has worked for them. Here's what worked, and continues to work, for me: * Stay positive. * Stay patient. * Stay focused on following the protocol as closely to the letter as you possibly can. * Maintain a food log. There will be lots of variables. Sometimes you're going to lose weight quickly. Sometimes slowly. And sometimes not at all. But no matter what your weight is doing, your plan is ALWAYS the same. When you lose fast - follow your plan. When you lose slow - follow your plan. When you're not losing at all - follow your plan. Trust the process. With more than 30 years of research and clinical studies behind it, there is no doubt that RNY works. Follow your plan and the weight will take care of itself. Regardless of what you do, your body is going to find its own way in its own time. So you have a choice. Panic, stress, frustration and worry every time something changes. Or focus, commitment, confidence and absolute belief that your plan will take you where you want to go. Your goal is physical change. Your challenge is mental discipline. Follow your plan and you're gonna love the new you!!

Most stories from bypass patients that drink will be similar. After surgery the alcohol moves much more quickly (and pretty much all at once) into the small intestine. That's why it hits you harder and more quickly than it did before. It also moves out of the shortened intestine faster than it did before which is why you sober up more quickly. My surgeon said no alcohol for a year and I followed it to the letter and still wound up with an ulcer at the anastomosis. It healed fairly quickly but I'd be cautious about pushing the time line. I very much enjoy a glass of wine before dinner (pre-op and post-op) but you want to be sure that the surgery is completely healed before alcohol. Pre-op or post-op, alcohol is still an irritant.

I use MFP as well (highly recommended). Fast, easy to use and probably the largest food database of any of the apps.

OK, you know that everyone is different. You know that stalls are almost certainly going to occur. And you know that you are going to follow your surgeon's protocol to a T. Sounds to me like you are ready!! Best advice for helping everyone who goes through a stall? Forget about some kind of "stall schedule" - too many variables. Forget about trying to anticipate how long a stall will/could/should last - too many variables. Forget about comparing your weight loss to someone else's weight loss - too many variables. All of these things are a waste of energy that can be much more beneficial elsewhere. Sometimes you'll lose quickly. Sometimes more slowly. And sometimes not at all. It's all perfectly normal and all part of the process. But the process is so much easier if you remember that regardless of what your weight is doing, your focus, your plan, your routine - are always the same. Stay positive. Stay patient. Stay focused on following the protocol as closely to the letter as you possibly can. Maintain a food log. And then do your best to relax and let your body find its own way in its own time. Trust the process and the weight will take care of itself. You're gonna love the new you!!

There are all kinds of ideas on the forum about things you can do to try to break a stall. Personally, I think your best plan is to just keep following the protocol as closely as you possibly can and let the stall take care of itself. Stalls - long, short or somewhere in between - are all part of the process. Though frustrating, they are perfectly normal and most folks will experience more than one before all is said and done. Your food log is one of the most powerful tools that you can possibly have for managing your weight. The longer you use it, the more you'll learn. I've been logging for two years and am still learning new things. Unless you're really exceptionally active, or less than three months out, you should be fine on 1000 calories a day as long as you're getting ALL of your doctor's recommended Protein in. You're gonna love the new you!!

White rice and I don't get along. Tried it twice and wound up dumping both times. No problems with brown rice. No dumping problems with bread but I seldom eat it simply because it just sort of sits in the pouch in a big lump. Not painful, just uncomfortably full. And as others have said, there are so many other great options. Long term, the list of things you will not be able to eat will likely be very short. It's a common, but mistaken belief that bypass patients have a long list of foods that they have to give up for life. That is simply not the case. What is true is that the list of foods that you CHOOSE to give up will likely be considerably longer than the list of foods that you HAVE to give up. Which is another way of saying you're gonna love the new you!!

Soy is an excellent source of protein with the same digestibility score (PDCAAS) as whey, milk and egg proteins. And since it's a vegetable protein, soy is ideal for vegetarians or vegans. Some concerns have been raised regarding hormonal effects of soy protein but clinical studies have been unable to identify any conclusive cause and effect link. The majority of doctors recommend whey as their first choice but milk, egg and soy are all good alternatives.

Amazon has a ton of food scales. This is the one that we bought and it's been great. http://www.amazon.com/EatSmart-Precision-Digital-Kitchen-Silver/dp/B001N07KUE/ref=sr_1_1?ie=UTF8&qid=1381367125&sr=8-1&keywords=food+scales

We bought this one from Amazon. Works great. http://www.amazon.com/BalanceFrom-Accuracy-Bathroom-Backlight-Technology/dp/B00A8SLH8I/ref=sr_1_1?ie=UTF8&qid=1381333949&sr=8-1&keywords=scales

There are two ways that you can determine a calorie goal. One is OK, the other is the one that I believe is the best. The first is to just use a BMR (Basal Metabolic Rate) calculator. There is one on My Fitness Pal but you can probably Google one easily. You enter your weight, height, age and gender and it calculates a calorie count. Note that BMR is the minimum number of calories that you would burn if you did nothing but rest for 24 hours. In other words, it's the number of calories your body needs to simply maintain normal functions like respiration, heart rate, etc. You would need to add some calories to that number depending on your activity level. The better way to really zero in on your specific calorie number is use a food log. I use My Fitness Pal (highly recommended) but there are many apps that do essentially the same thing. You configure your profile in the app with all of the stuff above plus your goal weight, how much you want to lose per week (or gain or just maintain) and the app will calculate a calorie goal. Log your food for a week and see what happens with your weight. For example if your goal is to lose one pound a week, if at the end of the week you've lost a pound, that calorie count is your number. If you didn't lose anything, then make a moderate adjustment, say 100 calories, and see what happens after another week. If you gained a little, adjust down 150-200 calories and see what happens. You get the idea. In a short period of time you can identify the specific calorie goal that works best for you. This is by far the best method I know of for anyone to determine what their specific calorie goal should be. Doctors will usually make recommendations but even they are simply making an educated guess. There are simply too many variables in terms of activity levels, carbs, fats, Proteins, etc. for them to be any more specific. With a little trial and error, you'll know what will work best specifically for you and your lifestyle. Food logs are extremely powerful and unfortunately under utilized tools for managing your weight, regardless of where you're at in your journey. Commit to logging for ninety days and you'll never stop. I've been doing it for almost two years and I'd be lost without it!

I have never printed any of them but MFP has a number of reports on their website and I'm sure you could either print them directly or possibly copy and paste into Word and print them that way. Some are considerably more detailed than what you see on the phone app. If you try it I'd love to hear how it works!

Wow, 247 lbs in a year. That is truly amazing and a testament to your commitment. Congratulations and well done!!

I third maintaining a food log. My Fitness Pal is excellent and my personal choice but Sparkpeople is highly recommended by many forum members. Commit to logging everything you eat for 90 days and you'll never stop. You will be amazed at the amount of information your log gives you. Logging gives you control and it's all about control, not denial. You'll discover how relatively easy it is to make adjustments in your diet to ensure that you're getting enough Protein and a healthy number of calories. And you can make minor adjustments in your calorie intake until you find the perfect number that works best for you. Your confidence will soar. Carbs are king when it comes to energy. On a normal, solid food diet, about 60% of your energy needs come from carbs. But when you're on a low carb diet, protein becomes your best friend. Your body will metabolize protein for energy in place of carbs. Most doctors will recommend 80g to 100g a day for men. Since you are very active, you probably would benefit from aiming for the high end. Get all of your doctor's recommended protein and maintain a food log - you're gonna love the new you!!

The ONLY Protein shot out there that I would recommend is Yes Whey. Every other protein shot that I have seen is made with collagen protein. Protein is rated according to digestibility with a maximum score of 1.00. Collagen protein has a digestibility score of 0.08. All the protein in the world is useless if your body cannot digest it. Yes Whey is 100% whey isolate which has a digestibility score of 1.00. I only very recently discovered this protein shot after seeing a post by another member. You can see the nutrition label at http://www.luckyvitamin.com/p-435130-protica-nutritional-research-yes-whey-rtd-liquid-protein-shot-orange-29-oz . Check the nutrition label on any protein "shot" or "bullet" that you are considering. If the primary ingredient is listed as collagen (or any derivative of it like "collagenic"), it's pretty much useless regardless of how many grams of protein it may have. One word of caution - I personally have not tried Yes Whey but a couple of forum members have and it is not considered tasty, to say the least. Whey isolate is made by a high-tech nano filtering process that removes virtually all of the lactose and fat. Good for those who are lactose intolerant but at a hefty cost in terms of taste. The up side is that you can get a lot of highly digestible protein (25g) for a very small (2.9 oz) volume.